Category Archives: VA

Housewarming for Al

Housewarming! 

For Al !!

Al Jordan, our homeless veteran friend moved into veteran’s transitional housing on April 1, 2008.  He is still excited.   Pat Shankle of Georgia Home Staging with the help of husband Scott and friends staged his new apartment.  That means she selected the furnishings from the warehouse of MUST Ministries, added other stuff such as pictures, decorations, pillows, kitchen and dining room stuff and then professionally decorated the entire apartment – living room, bedroom, kitchen and dining room.   Pat does this for a living, normally staging houses for sale in order to make them more attractive, leading to quicker sale.   She also staged a home for our last Habitat homeowner, Joi.  Pat has said she is negotiating with MUST to stage a number of additional apartments as part of her homeless ministry.  Admire her work in the following pictures.

Als Apartment entry

Entry to Al’s new apartment.

Some of Als friends from our church gave him a housewarming dinner last night (April 3).   It was a great event for Al and his new housemate, Danny.  

Danny, Pat, Al

Danny McDaniel, Pat Shankle, Al Jordan

The food was catered by our Wednesday night dinner food experts.  It was GREAT eating.

Shrimp!  Chicken was also avialable

Shrimp!  Bacon and green beans.  Chicken was also available.  Desert consisted of ice cream with hot fudge.

Here are a few pictures of Als apartment taken while he gave us the grand tour:

Als Bedroom

Als Bedroom

Car tag

Prized car tag in window! for when he can afford a car.  Link to Macland Presbyterian

Bedroom

Another view of Al’s bedroom. 

Kitchen

Kitchen.  The fridge is opposite the stove.  Yes that is a coffee grinder in the far left corner and bags of Starbucks (gifts) on the shelf.

Dining room

Dining nook and lighting

Now to the gifts and people.  Al’s guests came with gifts ranging from DVD players to $50 gift cards and more than a few misty moments as Al opened them and read the cards.   Here are a few photos:

Ladies and Al

As ususal, all the ladies sat on one side of the room and the gents on the other.  And yes, Al is working with a hankie at the moment.

Cross

Admiring the Cross

Al with Pastor Ray Jones III

Our Pastor, Ray Jones III with Al. 

Towels

More gifts, in this case towels and other bathroom supplies

Scott Shankle

Pat’s husband Scott.

Jeff Staka

Jeff Straka.   You may remember him from our meeting with the Police Chief in an earlier blog.

I think we were all as pleased as Jeff appears to be in this photo with the outcome of our first venture into the homeless world.    Al and Danny seemed pleased too.   Although there are not many pictures of Danny here, he was not left out of the festivities and joined in our meal and prayers as well as shared in the joy of the moment for Al.

Danny and Al seem to be very comfortable house mates and will get along well together.  Danny, also a veteran in the program, has a car and has offered to drive Al to our Wednesday night dinner and to Church.  Looks like we have made a new friend there as well.  Danny’s is a different story where he once was married to the daughter of one of the biggest landowners in this area and now struggling to climb out of homelessness.

We also met a bear of a man, Jon who came in to check the refrigerator.  He is also a veteran, lives on the property and maintains/repairs anything that needs fixing.  This is a 20 unit complex entirely devoted to transitional housing for homeless veterans.   With two men to a unit, 40 veterans are served.  Jon said he is enrolled in the STEP program.   Nether Danny nor Al are enrolled in treatment programs, though they are required to find and keep jobs and eventually work their way out of the housing.

Part of the challange is this:  The entire complex is surrounded by woods habitated by other homeless men, somewhat envious of their neighbors.   The area is a high crime area including drugs.   Part of Jon’s job is to keep the area clear of anyone not residents of the complex.   It seems to be working.  I found the complex clean and nicely kept. 

I was well pleased with the housing situation.   This complex is funded by HUD and run by MUST ministries with grants from HUD.   Something just feels right about this situation.

Slide Show

Here is a slideshow with includes all of the pictures taken by me at the dinner, 47 in all.  Enjoy

Oldtimer

Good News – Ask the right question!

Ask the right question. 

 Al was frustrated.  We were frustrated, even his case manager at MUST was frustrated.  The new transitional housing program was due to start April 1 but to get in, Al needed to prove his eligibility and he needed his DD-14.  The deadline was just a few days away.   It was already March 26.   He had his application in for months.  He had his request for his DD-14 copy in for months.  Nothing was happening.  His case manager had even faxed in a copy of the application papers.   No response.   It looked pretty bleak as nothing was happening at the VA.

No DD-14 on the way and no good reason why.  I don’t know the details other than this:  Al said he had been conferencing with his case manager on Wednesday and they were both lamenting that nothing seemed to be working.  Then Al happened to mention that he has a birthday coming up in a few months and he “needed to get his VA drivers license renewed”.   Just a simple off-the-wall comment to pass the time.

The case manager said something like:  “WHAT did you just say?!!!… You have a VA drivers license?… Let me see it!”  “This is all you need for proof… you are in!”.

It turns out that no one had asked the right question.  

You don’t get a veterans driver’s license without a DD-14  and it requires a certificate of eligibility from the VA to get the licence.  The existence of the driver’s license was all that has been needed all along.  Now Al is going into transitional housing on April 1.  It was an alert case manager that finally saved the day.  It would have been easy to not notice the remark.  None of us trying to help him knew.  No one at the VA asked whether he had a veterans driver’s license.   Al didn’t know it would suffice.   Only the alert case manager caught the significance.   Thank you Michael Laird of MUST ministries.  

Al once had his separation papers and has since lost them.  That happens to homeless veterans a lot.    He qualified for his veteran’s drivers license some time ago and has maintained it current.    

So much trouble and so much delay for lack of the right question.  So if any of you veterans are having trouble getting a copy of your separation papers and you have a veterans drivers license, pull it out!   You may have a shortcut!

We have something special planned for Al, but don’t go hinting, as it is a surprise.

Oldtimer

PS:  This is what the GA DMV says:

Veterans

Veterans receive a free license until they reach the age of 65. Then they must renew their licenses every five years and are required to pass a vision test each renewal period.

You’ll need to provide a copy of your separation papers, showing your honorable discharge, to your county’s Department of Veterans Service to receive your certificate of eligibility. Present this certificate to your local driver’s license office to receive your free license.”

  

Good News, Good News!

Good News Today

There was particularly good news to report today.    Our homeless friends Al J. and Steve W. have both been assigned a place to live, but we are not talking just a shelter here!  They are excited, I mean really excited.  So is the group at our church that has been working with them so very long.

 

 

 

 

 

 

 

 

 

 

 

 

Al, surprised by the flash.

Al is a homeless veteran.  He had been living in the woods for quite some time.  When our small group first met him he was resistant to the idea of moving out of the woods.   He was heavily bearded with wild long hair and looked pretty ragged.   “I like it here,” he said.    Of course, it was not true.  Later he admitted that he was resigned to living in the woods and never expected to get out.   “I like it here” was just a way of coping.

That was before several families in our Church began to develop real relationships with the homeless they were feeding breakfast to on Sunday mornings.    By relationships, I mean friendships, and true bonds.   This extended beyond just providing food and supplies, beyond inviting them to Church, Sunday School and Wednesday night dinners.   It included true friendships and love for fellow man. 

When Al complained that “I smell,” and said he was uncomfortable in church looking like a tramp, Scott and Pat took him to their home where he showered and put on newly cleaned clothes.   Scott then took him to his son’s hair salon where he was treated like royalty and given a full shampoo, shave and haircut to the astonishment of other customers.    How do you want your hair today, Sir?  Does that look ok, Sir?   

Al looked like and felt like a new man.  Transformed, ready at last to come out of the woods, ready to not be homeless any more.    Somehow he has managed to maintain his neat appearnce despite continuous living in the deep woods.   The homeless ministry team followed through and helped Al get his VA papers.  He said he did not even know he was elgible for help through the VA.   The ministry team managed to get him signed up for the new veteran’s transitional housing program at MUST.   The papers, however, were a long time coming.  Far too long.

  

 

 

 

 

 

 

 

 

 

Two pictures of Steve.

 

 

 

Steve turns out to be an energetic worker, jack of all trades, experienced in all sorts of construction work.  I know.  He has worked for several families in our church and for me.  

I found that he is an excellent carpenter and never slows down.   When he runs out of a job, he picks up a broom or rake, or starts the next phase.   He is also very dependable and has an excellent outlook on life.   I found out that he is experienced in renovation of old houses and had once owned a house just two blocks from the one my wife grew up in.  He gave it up to his wife and began a long downward spiral from there to homelessness. 

When we first met Steve, he lived in a tarp in a pine thicket between two buildings.  After the police raids in the area and Dominic froze to death, he applied to MUST Ministries for entry into their resident’s progam and was eventually accepted.   He said he “did not want to end up like Dominic”.   Steve is the one in the video talking about Dominic that I posted a few weeks ago.    He and Al have attended Sunday School, Church services and Wednesday night dinners almost every week.  That is a bible he is carrying in the left picture above.

Members of our church sponsored Steve and Al to a family church retreat over a recent weekend.  Al said it was the “most fun I’ve had since I was a child”.  Steve said it was a “wonderful experience”.

 Well, the good news came from both of them today.  Al has been accepted into a veteran’s transitional housing program and Steve into a supportive housing program.  Both through MUST Ministries.    Both start April 1.    Our homeless ministry team is planning to have a dinner for them in celebration.  It will be quite a celebration and with many thanks to God for His Grace.

It has turned out to be a great day.  God is good!  

 

 

 

 

Marietta Georgia – No compassion for homeless – NONE

The City of Marietta is evicting homeless from within our city limits.  Al, our homeless veteran friend that our church is trying its best to help reports that he and his friends, which are mostly homeless veterans, have been given notice to move “south”, meaning out of Marietta and toward Atlanta.

We have been helping Al and some of his friends in numerous ways.  Pat (see an earlier story on Pat here and her husband Scott and a few others in our church have been serving breakfast Sunday Mornings and later bringing some to our church for bible study and services, often treating them to lunch afterward.  Scott put Al in a hotel during the cold snap and the group has been taking supplies and clothing to them. 

Al has been faithful in attending, and as a result has taken to the idea that he can get out of this.  He no longer looks homeless, is neat, trimmed and dressed in his best clothes.  However, despite the information, forms, trips to the VA, Al still has not received his papers or his VA card.  He is still homeless.  He has said he has now committed to getting off the streets but has no place to go.

Above is one of the homeless camps being evicted by the City of Marietta.  This is an old photo taken from the air, but it also the site of Als current camp.   Believe it or not, this was found by use of the Hit and Visitor Map to the right of this blog.  It has zoom and several modes, including hybrid (satellite and road labeling), airborne, and “bird’s eye”.  I used the hybrid mode in zoom to find the general area, then switched to bird’s eye and quickly found his camp and 2 other camps.   Try it in your area (bird’s eye is not available in all areas, mostly metropolitan areas around large cities like Atlanta).  Look for blue tarps in mostly wooded areas.  Let me know if you find any. 

Now comes the City of Marietta.  They have systematically attacked the homeless camps within their city and have now worked their way to Als camp.  They did give them a little prior notice.  They were told that they are trespassing (wooded right of way of city) have to be packed up and moved out by Monday.  

Guess What?  Its snowing in Georgia.  The ground is covered.  A few will accept winter shelter but the beds are full.   They are totally dependent on MUST ministries a few blocks from their camp for food which MUST serves once a day on weekdays.   Nothing on weekends.

Moving means a miles long treck instead of a block or so walk.   The plan is obvious, make the homeless either seek shelter or get out.  Unfortunatly there are not enough beds to go around.  Not nearly enough.  So the plan is equally obvious – get out of our city

The city should provide facilities for these homeless before making them move.  They don’t.  They depend on MUST Ministries and a few other shelters that they have forced into industrial zones and have for the most part squelched expansion of facilities.  

Our city has decided to take the cheaper route – run them out of our city before they cost us money!  It also has another up side for the city:  Next year the homeless count will show another “remarkable” drop and no one will have to cook the books by redefining the homeless or unfinding any.  

Al works when he can find a job.  He doesn’t drink, doesn’t do drugs, has no noticeable mental problems.  He is a true walking hero with no place to go and our VA is not doing its duty.  Nor the VFW, nor our heartless City of Marietta.   He has fallen through the cracks and it makes me want to cry.

MUST Ministries, a block away from Al, serves Al a noon meal every week day. and  recently announced receiving grant money to set up transitional housing for veterans.   I’m sure they are hearing of the problem, but its been most of a week now since I left a message there for the program manager and sent a email inquiring about the program.  No response to the email and no returned call, and I know the guy, so he must be “out of pocket”.    MUST does do a wonderful job of helping feed and house the homeless and works tirelessly to serve them. 

Another mission, New Hope Missions reports that they are being swamped with homeless in the same desperate condition as Al.  New Hope serves about 125 breakfast and conducts services on Sunday and about half come from the area being evicted.  Some of them have to be out Wednesday.  Al has to be out Monday.

This is how not to minister to the homeless 

City of Marietta GA:  Shame!

Oldtimer

Traumatic Brain Injury – TBI and Spinal Cord Injury SCI

The VA says this about TBI and SCI: 

Due to the ongoing conflicts in Afghanistan and Iraq, Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) accounts for almost 25% of combat casualties.

Improvised explosive devices, blast (high pressure waves), landmines, and explosive fragments account for the majority of combat injuries in Afghanistan and Iraq. Although Kevlar helmets and advances in body armor have saved the lives of many soldiers, they do not protect against blasts and impacts to the head, face and cervical spinal cord.

Blast injuries often result in multiple traumas, including injuries to internal organs, limb loss, sensory loss, and psychological disorders. The term “polytrauma” has been coined to describe the co-occurring injuries.

The information above and below come from here which are part of an introduction and overview prepared by Joel Kupersmith, MD, Chief Research and Development Officer, VA for the purposes of a proposal solicitation.  I thought the overview might be of interest to those with these injuries and their families.

Traumatic Brain Injury:

Kevlar helmets have done much to protect the head but leave the forehead unprotected. The left and right frontal lobes, located behind the forehead control intellectual abilities such as the ability to plan and organize. This area of the brain also controls personality, behavior, and emotional control.

Concussion or mild TBI is the most common form of combat-related injury. Mild TBI can occur even in those not directly hit by the blast, without obvious external injuries, without loss of consciousness and without visible findings from acute Magnetic Resonance Imaging. Problems with memory, lack of concentration, increased anxiety and irritability are common hallmarks of mild TBI. Although evidence suggests that the majority of OIF/OEF soldiers who suffer mild TBI will recover over time, early diagnoses and treatment are critical so that aberrant behaviors due to TBI are not misinterpreted and soldiers are spared the risk of second impact syndrome. Appropriate recognition of TBI will facilitate quick return to pre-injury activity levels, including return to duty status.

In addition to mild TBI, soldiers close to the blasts are experiencing severe diffuse and contrecoup injuries. Soldiers with a moderate to severe TBI often show the similar symptoms as mild TBI yet also report: worsening headaches; repeated vomiting or nausea; seizures; inability to awaken from sleep; slurred speech; weakness, numbness and loss of coordination. Unlike mild TBI, these problems and others can persist long-term or result in permanent difficulties with memory, reasoning, emotion and expression making it impossible to return to duty, hold steady employment or regain pre-injury quality of life.

Penetrating focal injuries from mortar rounds or other forms of heavy artillery resulting in severe brain injury are not as prevalent. However, focal destruction of brain tissue is the most life-threatening, intractable type of brain injury causing permanent damage to the affected area and the functions it controls.

Spinal Cord Injury:

Current designs in military protective gear and advanced evacuation procedures have resulted in both a decrease in the percentage of spinal cord injured soldiers and an increase in the number of those that ultimately survive. Blast force and shrapnel injuries are most common. For those that survive, the cervical spinal cord, the unprotected and most mobile portion of the spinal cord, is the most common site of injury.

Soldiers with cervical SCI face short- and long-term consequences of losing motor and sensory function below the level of injury, coupled with a loss of autonomic regulation. Every organ system may be affected by cervical spinal cord injury. Alterations in the gastrointestinal, renal, skin and musculoskeletal organs are common, and respiratory problems are the overwhelming cause of morbidity and mortality. In addition, patients may experience chronic pain at or below the level of injury and, less frequently, above it.

Alterations in respiratory mechanics, and the development of alveolar hypoventilation, pneumonia, aspiration of gastric contents, pulmonary embolism, pulmonary edema, and sleep apnea are a few of the common respiratory complications associated with cervical SCI. Ultimately, dysfunction depends on the level and extent of injury. Lesions above C3 paralyze all respiratory muscles. When SCI involves C3 to C5 lesions, profound respiratory muscle dysfunction occurs leaving the patient unable to generate a cough or clear secretions. Because of this, neuroprotective strategies that rescue even one or two segments may be of significant functional benefit to veterans with SCI.

Let’s pray that this proposal results in research that leads to significant help for our injured veterans.    

Oldtimer

VA Research Factsheet on PTSD

The following is a factsheet from the VA’s Research Advances Series titled Posttraumatic Stress Disorder (PTSD),  published in September, 2007:

Soldier from VA BulletinSoldier from VA Bulletin VA’s Office of Research & Development supports a strong program of research directed to understanding, treating, and preventing Posttraumatic Stress Disorder (PTSD), which is an unrelenting biological reaction to the experience of a traumatic event. In the case of veterans, the trauma may occur from combat duty or other experiences where one’s safety or life is threatened. VA researchers have long been leaders in discovering new advances for treating and understanding PTSD.    The photo came with the article in 2007    I found a larger version here They title it “Prayer”.    I don’t know who the original photographer was.

Examples of VA research advances

Drug already used by millions may be effective in the treatment of PTSD – In an exciting new treatment development, VA researchers found that prazosin, an inexpensive generic drug already used by millions of Americans for high blood pressure and prostate problems, improved sleep and reduced trauma nightmares in a small number of veterans with PTSD.  Plans are under way for a large, multi-site trial to confirm the drug’s effectiveness.

Prolonged-exposure therapy effective in treatment of women veterans with PTSD– VA researchers found that prolonged-exposure therapy – in which therapists helped them recall their trauma memories under safe, controlled conditions-was effective in reducing PTSD symptoms in women veterans who have developed PTSD as the result of sexual trauma in the military, and that such reductions remained stable over time. Women who received prolonged-exposure therapy had greater reductions of PTSD symptoms than women who received only emotional support and counseling focused on current problems. This approach may be tested in, and applied to, other PTSD populations.

First ever clinical trial for the treatment of military service-related chronic PTSD– The largest study of its kind, involving 400 veterans from 20 VA medical centers nationwide, is being conducted to determine if risperidone, a medication already shown to be safe and effective in the treatment of PTSD, is also effective in veterans with chronic PTSD who continue to have symptoms despite receiving standard medications used for this disorder.

Facts About PTSD:

PTSD is a psychiatric disorder that can affect people who have experienced life-threatening events, such as combat, a terrorist attack, or a personal assault. Symptoms include flashbacks, nightmares, depression, and social withdrawal, as well as physical health changes. Treatment often includes anti-anxiety drugs or other medication, as well as exposure therapy, a form of cognitive-behavioral therapy in which patients recall their traumas in a safe setting and gradually learn to adjust their emotional response. VA Research has long been leaders in making new advances for treating and understanding PTSD.

http://www.research.va.gov
Research & Development
Veterans Affairs

Oldtimer’s Comment: There are 17 of these factsheets.  Below is a linked list of them.    You may find something of interest in one or more of them.   For example, PTSD is mentioned in several.

Factsheets

  • Alzheimer’s Disease (193 KB, PDF)
  • Depression (192 KB, PDF)
  • Diabetes (168 KB, PDF)
  • Hearing Loss (194 KB, PDF)
  • Heart Disease and Stroke (223 KB, PDF)
  • Hepatitis C (198 KB, PDF)
  • HIV / AIDS (205 KB, PDF)
  • Iraq / Afghanistan (232 KB, )
  • Low Vision (248 KB, PDF)
  • Mental Health (191 KB, PDF)
  • Obesity (214 KB, PDF)
  • Osteoarthritis (175 KB, PDF)
  • Parkinson’s Disease (179 KB, PDF)
  • Personalized Medicine (208 KB, PDF)
  • Post-Traumatic Stress Disorder (PTSD) (189 KB, PDF)
  • Prosthetics / Amputations (209 KB, PDF)
  • Spinal Cord Injury (205 KB, PDF)
  • Substance Abuse (175 KB, PDF)
  • Womens’ Health (201 KB, PDF)
  • Oldtimer

    VA overrates its success stories

    VA overrates its success stories

    This problem was first brought to light by an article written by Chris Adams that appeared in the Ledger Enquirer in an article printed May 11, 2007.  

    The McClatchy Newspapers study shows that the VA has “habitually exaggerated” its success stories in ways that would assure Congress that the agency is doing a good job of caring for our soldier heroes.   The indented areas below are details taken from the article linked above.  Large portions of the original article are omitted and others paraphrased.  You should take the time to read the original article in its entirety to get all the details.  

    The agency has touted how quickly veterans get in for appointments, but its own inspector general found that scheduling records have been manipulated repeatedly.

    For example, on Oct. 2, 2003, a veteran was referred to an ophthalmology clinic. On May 3, 2004, a scheduler created an appointment, saying the “desired date” was June 21. The appointment was scheduled for June 23, the inspector general said.

    Actual waiting time: 264 days. Reported waiting time: two days. Some schedulers even kept “informal waiting lists” to consult when they were ready to make formal appointments.

    The VA boasted that its customer service ratings are 10 points higher than those of private-sector hospitals, but the survey it cited shows a far smaller gap.

    The article details how that the gap narrows to 3 points (still favorable but not nearly 10 points higher) when adjusted to the same conditions.  

    Regarding the key issue of PTSD treatment, the VA said this about the PTSD treatment teams: “There are over 200 of them,” Dr. Michael Kussman told a congressional subcommittee. He indicated that they were in all of the agency’s roughly 155 hospitals.

    When McClatchy asked for more detail, the VA said that about 40 hospitals didn’t have the specialized units known as “PTSD clinical teams.” Committees in the House of Representatives and the Senate and experts within the VA have encouraged the agency to put those teams into every hospital.  

    Dr. Jonathan Perlin, then the top VA health official, said in a radio interview that RAND “compared VA care to 12 other health-care organizations, some of the best in the country,” and found VA superior. Studies such as RAND’s showed the agency’s care to be “the best that you can get in the country,” he said.

    Kussman wrote in a statement to McClatchy earlier this year that RAND “recently” reported that veterans “receive better health care than any other patients in America.”

    The VA’s public affairs department wrote in a magazine that the study “was conducted by the RAND Corporation, an independent think tank,” as well as researchers from two universities.

    Those are pretty lofty statements, but as it turns out, the RAND study was neither fully independent nor all that recent. A VA grant helped pay for it. Two of its main authors had received VA career-development awards, and four of its nine listed authors were affiliated with the agency, according to the study’s documentation.

    It was published in 2004 but used data from 1997 to 1999, when the system treated far fewer patients than it does now.  In additon, the “12 other health care organization” were not organizations at all but 12 health care regions under many mixed organizational entities.

    Once again, we see some deliberate misleading statements from the VA, often directly to Congress.  Yet they seem to get away with it.  

    Oldtimer

    PTSD Payments Vary State to State

    PTSD Payments Vary State to State

    I’m indebted to the blog at Healing Combat Trauma for alerting me to this information in which they refererence an article published in Military.com with the above title.   You should read the information at Healing Combat Trauma as it is told better there than I can do it.   Below is a summary of information.

    It seems that the McClatchy Newspapers chain did extensive research through the freedom of information act and discovered that there is wide variation in the way disability ratings are given depending on where the veteran lives.   A veteran returning from Iraq that lives in Ohio or Montana for example, is typically given a much lower disability rating on average than one that returns to New Mexico.

    The study involved some 3 million disability claims records.  Consider these quotes from the Military.com article:

    “The VA workers who decide PTSD cases determine whether a veteran’s ability to function at work is limited a little, a lot or somewhere in between. They examine the frequency of panic attacks and the level of memory loss. The process is subjective, and veterans are placed on a scale that gives them scores – or “ratings” – of zero, 10, 30, 50, 70 or 100.

    “McClatchy’s analysis found that some regional offices are far more likely to give veterans scores of 50 or 70 while others are far more likely to stick with scores of 10 or 30.

    “Consider the New Mexico and Montana offices, where there are big differences up and down the scale.

    “In Montana, more than three-quarters of veterans have ratings of zero, 10 or 30. In New Mexico, a majority of the veterans have ratings of 50 or 70.

    “On top of that, 6 percent of New Mexico veterans had the highest rating possible – 100, worth $2,527 a month – compared with just 1 percent of Montana veterans.”

    The initial ratings pretty much stick with a veteran for the rest of their life, and the disparity in how the disability is rated may make a difference of hundreds of thousands over the remaining lifetime of the veteran.   Apparently some offices make a point of being generous in their ratings and some apparently are downright stingy, not giving a proper rating. 

    “Of recent vets processed in Roanoke, Va., 27 percent have high ratings for post-traumatic stress disorder. In Albuquerque, N.M., the number is 56 percent.”

    You need to read the Healing Combat Trauma article for some excellent commentary and also the military.com article for some extra details.   The research suggests that something is wrong with the VA’s rating system when one city rates twice as many of their veterans higher than in another city.   The VA does not treat our heroes fairly if they happen to live in the wrong part of our great country.

    Oldtimer

    Surge Seen in Number of Homeless Veterans

    Surge Seen in Number of Homeless Veterans

     Oldtimer’s Comment:  I’ve seen a number of these types of articles.   Although the estimates vary depending on the subject area from 400 to about 1500, the word on the street is that the returning soldiers from Iraq and Afghanistan are showing up in shelters much faster than in previous wars.  The problem stems from higher rates of PTSD and TBI (traumatic brain injury) which still take too long to diagnose, and which are resulting from the combined effect of IED’s and higher survival rates.    The VA has long under diagnosed these problems and only recently, after much heat, begun to actively pursue it. 

    Photo by Jeff Swensen for The New York Times
    Frederick Johnson, a veteran of the Iraq war, lives in temporary housing provided by the V.A. after spending a year on the streets.

    By ERIK ECKHOLM

    WASHINGTON, Nov. 7 – More than 400 veterans of the Iraq and Afghanistan wars have turned up homeless, and the Veterans Affairs Department and aid groups say they are bracing for a new surge in homeless veterans in the years ahead.

     

    Photo by Brendan Smialowski for The New York Times
    Joe Williams lives in a homeless shelter in Washington.

    Experts who work with veterans say it often takes several years after leaving military service for veterans’ accumulating problems to push them into the streets. But some aid workers say the Iraq and Afghanistan veterans appear to be turning up sooner than the Vietnam veterans did.

    “We’re beginning to see, across the country, the first trickle of this generation of warriors in homeless shelters,” said Phil Landis, chairman of Veterans Village of San Diego, a residence and counseling center. “But we anticipate that it’s going to be a tsunami.”

    With more women serving in combat zones, the current wars are already resulting in a higher share of homeless women as well. They have an added risk factor: roughly 40 percent of the hundreds of homeless female veterans of recent wars have said they were sexually assaulted by American soldiers while in the military, officials said.

    “Sexual abuse is a risk factor for homelessness,” Pete Dougherty, the V.A.’s director of homeless programs, said.

    Special traits of the current wars may contribute to homelessness, including high rates of post-traumatic stress disorder, or PTSD, and traumatic brain injury, which can cause unstable behavior and substance abuse, and the long and repeated tours of duty, which can make the reintegration into families and work all the harder.

    Frederick Johnson, 37, an Army reservist, slept in abandoned houses shortly after returning to Chester, Pa., from a year in Iraq, where he experienced daily mortar attacks and saw mangled bodies of soldiers and children. He started using crack cocaine and drinking, burning through $6,000 in savings.

    “I cut myself off from my family and went from being a pleasant guy to wanting to rip your head off if you looked at me wrong,” Mr. Johnson said.

    (…)  Read more about Fredrick at the link above

    Poverty and high housing costs also contribute. The National Alliance to End Homelessness in Washington will release a report on Thursday saying that among one million veterans who served after the Sept. 11 attacks, 72,000 are paying more than half their incomes for rent, leaving them highly vulnerable.

    Mr. Dougherty of the V.A. said outreach officers, who visit shelters, soup kitchens and parks, had located about 1,500 returnees from Iraq or Afghanistan who seemed at high risk, though many had jobs. More than 400 have entered agency-supported residential programs around the country. No one knows how many others have not made contact with aid agencies.

    More than 11 percent of the newly homeless veterans are women, Mr. Dougherty said, compared with 4 percent enrolled in such programs over all.

    Veterans have long accounted for a high share of the nation’s homeless. Although they make up 11 percent of the adult population, they make up 26 percent of the homeless on any given day, the National Alliance report calculated.

    Oldtimer’s comment:   My studies show that homeless male veterans make up 43% of the homeless male population, far in excess of what would be expected.

    According to the V.A., some 196,000 veterans of all ages were homeless on any given night in 2006. That represents a decline from about 250,000 a decade back, Mr. Dougherty said, as housing and medical programs grew and older veterans died.

    Oldtimer’s comment:  Oops!  That is a deliberately misleading statement.   A GAO report states that the drop from 250,000 a decade ago was due to a major change in how homeless veterans are counted.   While it is true that our older veterans are dieing off, many more veterans are joining the ranks of the homeless and make up for it.  There has been no real decline, and actually there has been a steady increase in the percentage of homeless veterans vs the overall population of veterans.

    The most troubling face of homelessness has been the chronic cases, those who live in the streets or shelters for more than year. Some 44,000 to 64,000 veterans fit that category, according to the National Alliance study.

    On Wednesday, the Bush administration announced what it described as “remarkable progress” for the chronic homeless. Alphonso R. Jackson, the secretary of housing and urban development, said a new policy of bringing the long-term homeless directly into housing, backed by supporting services, had put more than 20,000, or about 12 percent, into permanent or transitional homes.

    Oldtimer’s comment:  I’m not sure where these numbers come from.  It appears the HUD secretary is talking about all chronic homeless, not just veterans.   20,000 is 12% of 166,000, which is about right for the chronic homeless for the entire homeless population. To get a feel for progress among veterans, see the following two paragraphs.

    Veterans have been among the beneficiaries, but Mary Cunningham, director of the research institute of the National Alliance and chief author of their report, said the share of supported housing marked for veterans was low.

    A collaborative program of the Department of Housing and Urban Development and the V.A. has developed 1,780 such units. The National Alliance said the number needed to grow by 25,000.

    Mr. Dougherty described the large and growing efforts the V.A. was making to prevent homelessness including offering two years of free medical care and identifying psychological and substance abuse problems early.

    Oldtimer’s Comment:  ‘Bout Time!

    (…)

    PTSD vets soon coming like tsunami

    There is a scary article in the San Francisco Chronicle.  The article predicts a flood of new stressed out veterans as they return form Iraq and Afghanistan, many of whom are on the fast track to PTSD, depression, and other mental health disorders compared to previous wars.   I’ve reprinted a little of it below, but you can find the rest at this link where it is reproduced in SGate.com.   

    A flood of stressed vets is expected

    C.W. Nevius

    Sunday, December 9, 2007

    (…) omitted illustrative story about a vet (Tim Chapman) contemplating suicide, find it at the link. 

    First a few facts. Bobby Rosenthal, regional manager for homeless programs at the Department of Veterans Affairs, estimates that one third of the more than 6,000 homeless people – about 2,100 – in San Francisco are veterans.

    And no wonder the number is so high. California leads the nation in homeless veterans by a mile, according to the National Coalition for Homeless Veterans. The 2006 numbers showed 49,724 homeless vets in California. The next nearest state was New York with 21,147.

    Now here’s the scary part. Compared with what’s coming, that’s nothing.

    Roughly 750,000 troops served in the wars in Iraq and Afghanistan, often with multiple tours of duty. Many are only now returning home. But unlike Vietnam veterans, who didn’t begin to demonstrate post-war trauma until five or 10 years after they left the war, this group seems to be on a fast track.

    “Everything is speeded up,” said Michael Blecker, executive director of San Francisco’s Swords to Ploughshares program. “What we’re seeing in San Francisco is guys in their 20s with the kind of stress and trauma that makes it impossible to go on with their lives.”

    It’s been called a health care tsunami. Because not only are the Iraq vets prone to post-traumatic stress disorder (something Chapman has battled) but with improved battlefield health care, far more are surviving traumatic injury. On one hand, that’s good news, but it also means many more vets who are severely disabled, having lost arms and legs. Both factors increase the chances that the returning troops will join the sad ranks of homeless veterans.

    Cities all over the country are bracing themselves, although some, like San Francisco, are bound to be hit harder. Mayor Gavin Newsom says that at a recent conference of mayors, the group passed a resolution asking the VA “to tell us what you are going to do.”   “It’s great lip service,” Newsom said, “but show me the money.”

    If history holds, the mayors shouldn’t hold their breath. If anything, benefits for veterans have been restricted. To take one example, many of us think of the World War II G.I. Bill as a shining example of a reward for service, paying for college for vets. But Blecker, of Swords for Ploughshares, says the current version “is in no way, shape, or form near enough” to pay for a degree.

    As Newsom says, “Yeah, support the troops – as long as they are young, healthy and a great photo op.”

    For San Francisco, the potential impact could be huge. An influx of traumatized, battle-scarred veterans presents a scary future. Consider the case of Scott Kehler, a veteran of the first Gulf War, who needed years to work through his demons. He recalls passing burned bodies and the constant fear that an explosion would suddenly erupt in the street.

    “It was the things I didn’t want to see at night when I closed my eyes,” Kehler said. “I didn’t know what PTSD was. I only knew my dreams, my shame, my guilt, was all coming together.”

    (…) omitted a few details, go to link to get the rest.

    Kehler, who is mentoring Chapman, is testimony to the effectiveness of the Ploughshares slogan – “veterans helping veterans.”

    “Especially now that we’ve got our veterans coming home from Iraq,” said Ploughshares counselor Tyrone Boyd, “we’re going to need people that have been in combat so they know what they are talking about.”

    The challenges are unique. Wanda Heffernon, a program and clinical counselor for Ploughshares, said they had a new inductee who slept in the closet. It was the only place he felt safe.

    It’s the sudden transition that gets them.  “One day they are fighting in a war,” said Kehler. “The next day they are sitting at their mother’s kitchen table.”

    Is it any wonder they end up on the street? Kehler battled alcohol abuse, but Chapman is part of the new breed, who turn to methamphetamine. Married when he returned, he lost his wife and all contact with his parents. Eventually he ended up sleeping in an alley.Now drug-free, living at Treasure Island housing, holding down a full-time job, and reconnected with his mother, he is testimony to the idea that peer counseling seems to work. Ploughshares has earned support from Sens. Dianne Feinstein and Barbara Boxer and House Speaker Nancy Pelosi.

    Imagine the impact it would have on the San Francisco homeless problem if one third of those on street were able to get help and housing.

    But what the vets don’t have is funding.

    “Why isn’t the federal government doing something about this? Why isn’t the Veterans Administration doing something?” Blecker asks. “The irresponsibility of our leaders, not to address this, makes me want to tear my hair out.”

    The VA’s Rosenthal – who gets high marks from local leaders – says the problem is not being ignored.

    “It’s a whole new set of challenges,” she said. “The VA is looking at it. Let’s hope we’ve learned our lesson from Vietnam.”

    We can only hope.

    “You know what scares me?” asks Boyd. “I haven’t heard a plan (from the federal government) about what they are going to do when the troops come home. What’s the plan?”

    Well?

    C.W. Nevius’ column appears Tuesday, Thursday, and Sunday. His blog C.W. Nevius.blog can be found at SFGate.com. E-mail him at cwnevius@sfchronicle.com.

    Oldtimer’s comment:  This story illustrates what I’ve said all along.  PTSD and TBI are leading causes of homelessness among veterans.  It is a rapidly growing problem, approaching flash flood conditions for our heroes returning from Iraq and Afghanistan.   A tsunamis of real people, not just numbers, real people with real names.  Somebody’s sons and daughters, husbands and wives, fathers and mothers, brothers and sisters.  Real people, all in serious trouble, heroes in despair  … we should be crying.  We should be helping, we should be calling on congress, questioning our candidates. 

    Where is your voice, America?

    Oldtimer  

    Vital Mission: Ending Homelessness Among Veterans

    New Report –

    Vital Mission:

    Ending Homelessness

    Among Veterans

    Homeless Veteran

    Photo by  |Shrued (creative commons licensed)  Find it Here

    This 36 page report released by the National Alliance to End Homelessness details the following highlights:

    In 2006, approximately 195,827 veterans were homeless on a given night-an increase of 0.8 percent from 194,254 in 2005. More veterans experience homeless over the course of the year.  They  estimate that 336,627 were homeless in 2006.

    Veterans make up a disproportionate share of homeless people. They represent roughly 26 percent of homeless people, but only 11 percent of the civilian population 18 years and older.  (Please see Oldtimer’s comment on these numbers below before you repeat them.) This is true despite the fact that veterans are better educated, more likely to be employed, and have a lower poverty rate than the general population.

    A number of states, including Louisiana and California, had high rates of homeless veterans. In addition, the District of Columbia had a high rate of homelessness among veterans with approximately 7.5 percent of veterans experiencing homelessness.

    They estimate that in 2005 approximately 44,000 to 64,000 veterans were chronically homeless (i.e., homeless for long periods or repeatedly and with a disability).

    Oldtimer’s comment on the numbers:  My own studies show that  the real numbers are more like 43% of the male homeless are veterans. Here is an interesting footnote to the numbers reported above:

    This estimate was calculated with 2005 veterans data from the CHALENG data set and 2005 tabulations of Continuum of Care (CoC) point-in-time counts.The CoC counts do not differentiate between adults and children, so in the number provided here-percent of homeless people who are veterans-the denominator includes some people under 18. If children were taken out of the 744,313 total, veterans would make up a larger percentage of the homeless population. This suggests that 26 percent is a conservative estimate. Either way, this estimate falls within the bounds of past research.Rosenheck (1994) reviewed research studies and found that between 29 and 49 percent of homeless men are veterans. HUD’s recent Annual Homelessness Assessment report (2007) puts the percentage of homeless veterans at 18 percent; however, 35 percent of the cases in this data source were missing, making the estimate highly unreliable.

    The Rosenheck estimate  range includes the 43% that I had independently found.  The basis data for my findings are here.

    The National Alliance to End Homelessness has an interactive map that show veteran homelessness by state.  Click on the map to activate it, then your cursor will bring up data for each state as you hover over it.

    It is interesting to note that Washington DC has the highest percentage of veterans that are homeless, more than double the rate of any other state at a whopping 7.51%.  Other high percentage states are Louisiana, California, Oregon, Nevada, Connecticut and  North Dakota in that order.   The highest number of homeless veterans are in California with more than 49,000 homeless, followed by New York, Florida and Texas in that order.

    The following comes directly from the report:

    Lack of affordable housing is the primary driver of homelessness. The 23.4 million U.S. veterans generally do not have trouble affording housing costs; veterans have high rates of home ownership and appear generally well housed. However, there is a subset of veterans who have severe housing cost burden.

    ■ We estimate that nearly half a million (467,877) veterans were severely rent burdened and were paying more than 50 percent of their income for rent.


    ■ More than half (55 percent) of veterans with severe housing cost burden fell below the poverty level and 43 percent were receiving foods stamps.

    4■ Rhode Island, California, Nevada, and Hawaii were the states with the highest percentage of veterans with severe housing cost burden. The District of Columbia had the highest rate, with 6.4 percent of veterans paying more than 50 percent of their income toward rent.

    ■ Female veterans, those with a disability, and unmarried or separated veterans were more likely to experience severe housing cost burden. There are also differences by period of service, with those serving during the Korean War and WWII more likely to have severe housing cost burden.

    ■ We estimate that approximately 89,553 to 467,877 veterans were at risk of homelessness.  At risk is defined as being below the poverty level and paying more than 50 percent of household income on rent. It also includes households with a member who has a disability, a person living alone, and those who are not in the labor force.

    However, the report body shows a laundry list of causes:

    Lack of Income: Veterans who experience homelessness, like most homeless people, typically have very low incomes, and research suggests that extreme poverty predisposes veterans to homelessness. For this reason, veterans who joined the service after 1973 through the all-volunteer force are more likely to come from poverty and have lower rates of educational attainment.  (…) The unemployment rate for veterans aged 20 to 24 is 15 percent,

    Physical Health and Disability: One out of 10 veterans is disabled and many suffer from physical disabilities, oftentimes caused by injuries in combat. (…)  The number of disabled veterans is increasing with more than 20,000 veterans suffering from wounds in Iraq and Afghanistan.

    Mental Health and Disability: Mental health issues are also prevalent among veterans. The VA reports that 45 percent of homeless veterans suffer from mental illness, including many who report high rates of post-traumatic stress disorder (PTSD).  (…)

    Substance Abuse: According to the Department of Veterans Affairs,  approximately 70 percent of homeless veterans suffer from substance abuse problems (…)

    Weak Social Networks: (…) Veterans have low marriage rates and high divorce rates and, currently, one in five veterans is living alone.  (…) Social networks are particularly important forthose who have a crisis or need temporary help. Without this assistance, they are at high risk for homelessness.

    Lack of Services to Meet Current Need: The VA has over 19,000 transitional housing beds for homeless veterans (10,000 through partnerships with local community agencies) with 460 FTEE in homeless program staffing.  (Oldtimer’s comment:  19,000 beds to serve over 300,000 veterans that are homeless during at least part of the year of which 44,000 to 64,000 are chronically homeless and 195,000 are homeless on any one night!)

    I hope you can sleep well tonight after reading these statistics and findings. I know that I won’t.  I also know the homeless heroes sleeping in the bushes, alleys, behind dumpsters, in doorways, and in the woods or on mountain sides are not going to sleep as well as they could if we could only get our government to respect and support our troops when they come home.

    Our Heroes

    are out there tonight

    and it is so very cold!

    Oldtimer

    Barack Obama: Veterans/Poverty Headlines and Video

    Barack and Veterans Issues

    Ok, I’m not trying to influence any votes here, nor run off any readers.  It’s just that I’m impressed with what I’ve heard said by Senator Obama regarding homelessness and veterans and what the press and veterans advocates have said.  I don’t know if you have seen them.   He does have the advantage of being a member of the Senate Veterans’ Affairs Committe.   I acknowledge that there are other important issues than veterans and homelessness to consider in a campaign, but that is what we are about here, so that is my focus.

    I do have an couple of links to the Clinton side.  There is an equal-time segment at the bottom that will give you a look see between the top two Democratic candidates on veterans issues.   I may come back with more of this and feature a Republican or two later.  We will see how this plays out with my readers first.  Are you interested in politics?

    BarackObamadotcom  (Video) Dinner with Barack Obama:  Four grassroots donors talk to Barack Obama about veterans and poverty during dinner.

    I’ve mentioned Obama and Veterans in a previous post where he discusses his plan to improve veterans care and help get the homeless veterans off the streets as reported by a wire service.

    Here are a few more headlines and links on this subject:

    SEN. OBAMA: VETERANS ADMINISTRATION DENIED HEALTH CARE SERVICES TO NEARLY 9,000 ILLINOIS VETERANS IN 2005

    Sen. Barack Obama (D-IL) today announced that the Department of Veterans Affairs (VA) denied health care to 8,944 Illinois veterans last year as part of a Bush Administration cost-cutting policy begun in 2003. Nationally, more than 260,000 veterans were denied access to VA hospitals, clinics and medications in Fiscal
    Year 2005

    Clinton v. Obama, Veterans Version

    The tit-for-tat between Sens. Hillary Rodham Clinton and Barack Obama has expanded to new territory:   veterans benefits.

    This week, the “Commission on Care of America’s Wounded Warriors” issued recommendations for improving treatment for veterans who return injured from the front. Clinton and Obama responded the way members of Congress often do to government reports – with legislative language.  

    (…)  explains different positions

    Obama, McCaskill sponsor bill on care for veterans

    Sens. Barack Obama (D-Ill.) and Claire McCaskill (D-Mo.) are sponsoring legislation to improve the lives of recovering veterans at Walter Reed, while Sen. John Kerry (D-Mass.), a cosponsor of the Obama-McCaskill legislation, said that he would explore ways to direct new funds to Walter Reed and make immediate improvements to its veteran housing.

    Barack Obama Honors Sacrifice of America’s Veterans

    Barack Obama has a record of helping the heroes who defend our nation today and the veterans who fought in years past. As a grandson of a World War II veteran who went to college on the G.I. Bill and a member of the Senate Committee on Veterans Affairs, Obama has successfully reached out to Republicans and Democrats to pass laws to combat homelessness among veterans, improve care for troops recovering from injuries, ease the transition of new veterans into society, and make the disability benefits process more equitable.

    Veterans Issues  From Obama’s website

    Homeless Veterans

    Every year, 400,000 veterans across the country, including an estimated 38,000 in Chicago, spend some time living on the streets. Senator Obama has been a leader in fighting homelessness among veterans. He authored the Sheltering All Veterans Everywhere Act (SAVE Act) to strengthen and expand federal homeless veteran programs that serve over 100,000 homeless veterans annually. During the debate on the Fiscal Year 2007 budget, Senator Obama passed an amendment to increase funding for homeless veterans programs by $40 million. These funds would benefit programs that provide food, clothing, mental health and substance abuse counseling, and employment and housing assistance to homeless veterans.

    Working with Senators Akaka and Craig, Senator Obama passed legislation in December 2006 to provide comprehensive services and affordable housing options to veterans through the Department of Veterans Affairs, Department of Housing and Urban Development and nonprofit organizations. This legislation was signed into law and is modeled on parts of the SAVE Act and the Homes for Heroes Act, a measure that Senator Obama had previously authored.

    Benefits Disparities

    The Bush Administration’s approach to handling veterans’ health care ignores the reality of increasing demands on the VA, and the additional burden placed on veterans. The Administration has established a means test for VA health care eligibility, and it has banned hundreds of thousands of veterans – some who make as little as $30,000 a year – from enrolling in the system. These changes affect both older and younger veterans, and Senator Obama has opposed them, fighting instead for greater funding for veterans’ health care.

    Greater Funding for Veterans Health Care

    In January 2007, Senator Obama reintroduced the Lane Evans Veterans Health and Benefits Improvement Act to improve the VA’s planning process to avoid budget shortfalls in the future. The bill requires the VA and the Department of Defense to work together and share data so that we know precisely how many troops will be returning home and entering the VA system.

    Food for Recovering Soldiers

    Senator Obama introduced an amendment that became law providing food services to wounded veterans receiving physical therapy or rehabilitation services at military hospitals. Previously, service members receiving physical therapy or rehabilitation services in a medical hospital for more than 90 days were required to pay for their meals.

    Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI)
     

    Senator Obama fought a VA proposal that would have required a reexamination of all Post Traumatic Stress Disorder (PTSD) cases in which full benefits were granted. He and Senator Durbin passed an amendment that became law preventing the VA from conducting a review of cases, without first providing Congress with a complete report regarding the implementation of such review. In November 2005, the VA announced that it was abandoning its planned review.

    Senator Obama passed an amendment to ensure that all service members returning from Iraq are properly screened for Traumatic Brain Injury (TBI). TBI is being called the signature injury of the Iraq war. The blast from improvised explosive devices can jar the brain, causing bruising or permanent damage. Concussions can have huge health effects including slowed thinking, headaches, memory loss, sleep disturbance, attention and concentration deficits, and irritability.

    Easing the Transition to the VA

    Senator Obama passed an amendment that became law requiring the Department of Defense (DOD) to report to Congress on the delayed development of an electronic medical records system compatible with the VA’s electronic medical records system. DOD’s delay in developing such a system has created obstacles for service members transitioning into the VA health care system.

    Part of the Lane Evans Veterans Health and Benefits Improvement Act, which Senator Obama reintroduced in January 2007, would help veterans transition from the DOD health system to the VA system by extending the window in which new veterans can get mental health care from two years to five years. The Lane Evans bill also would improve transition services for members of the National Guard and Reserves.

    For Equal Time’s sake:

    Compare Senator Obama’s site with Senator Clinton’s site, both on Veterans Issues.

    Oldtimer

    Wounded warriors battle with VA – Story and Videos

    Wounded Warriors Battle With VA

    I watched a horrifying story on CNN last night.  I missed it on regular programming, checked the programming guide and waited for the midnight repeat.   The CNN title of the story was:

    Broken Government: Waging War on the VA

    It repeats tonight, Sunday night (Nov 18) at 8 Eastern, so if you get a chance, please check your schedule.   It is a powerful indictment of the VA’s handling of disability claims.  It is the story of 3 wounded veterans trying to get justice and only able to do it by virtually going to war again to fight for their rights.

    One of the wounded warriors and a really heartbreaking story was Ty Ziegel, 25 years old who had been severely injured by a suicide bomber, “sent back to the states to die”, but lived.  Despite losing nearly half of his skull and a large portion of his brain, penetrating shrapnel and bone fragments in his brain, with both ears, nose and lips burned off and impossible to replace,  loss of an eye and resulting enormous disfiguration, the VA listed him as having “10% head trauma”.  10% head trauma.  In addition the damage to the left lobe of his brain,  loss of an eye and jaw fracture as haveing 0% trauma.  0% for loss of 1/4 of his brain, loss of an eye? He also lost one arm at the elbow, and two fingers and a thumb from his other hand, plus numerous other injuries for which the bulk of his small disability payment was granted.    Far below the poverty line disability for a man disfigured and totally disabled.

    Ty Ziegel before and after

    Ty Ziegel, before and after.   CNN News photo

    (Click on the picture or here to see the video).  These videos are short promo clips about 2 minutes long and I don’t know how long they will keep them up on their site.  Go to  CNN and see the real thing.  Click here for part 2

    Another veteran, Garrett Anderson received a roadside bomb injury that sent shrapanel into his head and body, and he lost an arm while driving a truck in a convoy.  The VA initially rejected his claim, saying that it was “not service connected”.   He was also suffering from what he thought was PTSD.  In Garrett’s case the letter stating that there were “shrapnel wounds all over his body, not service connected” had the signature cut out of the letter with a knife.  Apparently the signer was not proud of his decision and knew it was wrong.  

    Garrett Anderson

    Garrett Anderson.  Click on the picture or here for the video clip.

    In Ziegel’s case, within 48 hours of taping an interview with CNN, the VA changed his disability to 100%.  In Anderson’s case, his wife took a sneak peak at his case file while a nurse was out of he room and she discovered they had  him listed in their files a suffering from Traumatic Brain Injury (TBI), but had failed to tell him or give him any disability credit for it.   He went to Sen. Dick Durbin of Illinois who turned up the pressure on the VA and subsequently has been awarded disability for TBI.

    The third story was about Tammy Duckworth who lost both legs and had severe injuries to one arm and her body.   She later ran for Congress with the hope of improving things for disabled veterans.  She lost but has been appointed by the Governor of Illinois to be the Director of the IL Department of Veterans’ Affairs.

    Click here for the CNN news promo clip for her story.  Go to the link with Tammy’s name above and click on “veteran’s issues” to get a flavor of what she has learned about the Va while she was in their care and her run for Congress.

    Our wounded warriors, our heroes, should not have to fight for our country, then fight for their life and still have to fight for their benefits!

    Oldtimer

     

    GAO Testimony – DOD and VA

    Transition Field Unit staffingGAO Testimony – DOD and VA

    This is a troubling situation.  We have our kids off at war and they become severely injured, physically and mentally.   Our country has pulled out all stops to provide the best possible care for them and still we have problems.  Due to the protective gear and terrific and speedy medical care, thankfully more and more are surviving.  This shift in the severity and long term recovery needs requires major adjustments in our programs for treatment and rehabitation, for our benefits and compensation programs.  The cause and effect has driven the case loads and delays out of sight at the expense of our wounded heroes.

    The good news is that that there is a scramble going on to correct these problems as soon as possible. There are people in high places capable of fixing the problem that have a heart for our heroes and are working very hard to fix the problems.  There are people in our VA and in militray trauma centers that are just as frustrated as we are.  There is a continuum of care mentality for our soldiers starting at the battlefield and continuing through our VA system. There are programs under development to reduce the time required to make determinations before our heroes get the treatment and benefits they need.

    The bad news is there are still more than 150,000 cases more than 6 months old among the pending 600,000 cases in the VBA system, and we have no idea how old these cases really are.  The GAO found that new programs designed to correct the problems are not yet fully off the ground and there are severe staffing problems in key places, both on the active duty side and the veteran side of the picture. It appears to me that some of it is due to needing to move physicians from one program to staff another, leaving both under staffed. 

    (Download Here)

    What the GAO found

    Warrior Transition Unit

    Challenges have emerged for staffing the Warrior Transition Unit in which servicemembers are assigned to three key staff – a physician care manager, a nurse care manager, and a squad leader. For example, as of mid-September 2007, over half the U.S. Warrior Transition Units had significant shortfalls in one or more of these critical positions. In addition the number of recovery coordinators and how many servicemembers each would serve have yet to be determined.

    Transition Field Unit staffing

    This table shows that in actuality we have only 35% perminent staffing for these teams.  More than 450 of the existing staff (19%) have been borrowed from elsewhere, likely reducing the staff, already short, in othere facilities.   The table below shows where those with less than 50% staffing are located. 

     Staffing problem locations

    PTSD and TBI 

    Three independent review groups examining the deficiencies found at Walter Reed identified a range of complex problems associated with DOD and VA’s screening, diagnosis, and treatment of TBI (Traumatic Brain Injury) and PTSD, signature injuries of recent conflicts. Both conditions are sometimes referred to as “invisible injuries” because outwardly the individual’s appearance is just as it was before the injury or onset of symptoms. In terms of mild TBI, there may be no observable head injury and symptoms may overlap with those associated with PTSD. With respect to PTSD, there is no objective diagnostic test and its symptoms can sometimes be associated with other psychological conditions (e.g., depression).

    TBI and PTSD chart
     
    This table outlines what is being implimented (or planned) for handling TBI and PTSD better.   However, according to Army officials and the Independent Review Group report, obtaining qualified health professionals, such as clinical psychologists, is a challenge, which is due to competition with private sector salaries and difficulty recruiting for certain geographical locations. 

    Data Sharing

    In addition, the Dole-Shalala Commission noted that while VA is considered a leader in PTSD research and treatment, knowledge generated through research and clinical experience is not systematically disseminated to all DOD and VA providers of care.

    Data Sharing

    This table shows the efforts being taken to improve the data sharing between organizations. 

    Disability Evaluations

    As GAO and others have previously reported, providing timely and consistent disability decisions is a challenge for both DOD and VA. To address identified concerns, the Army has taken steps to streamline its disability evaluation process and reduce bottlenecks.   To address identified concerns, the Army has taken steps to streamline its disability evaluation process and reduce bottlenecks. The Army has also developed and conducted the first certification training for evaluation board liaisons who help servicemembers navigate the system. To address more systemic concerns, the Senior Oversight Committee is planning to pilot a joint disability evaluation system. Pilot options may incorporate variations of three key elements:

    (1) a single, comprehensive medical examination;

    (2) a single disability rating done by VA; and

    (3) a DOD-level evaluation board for adjudicating servicemembers’ fitness for duty.

    DOD and VA officials hoped to begin the pilot in August 2007, but postponed implementation in order to further review options and address open questions, including those related to proposed legislation.

    Fixing these long-standing and complex problems as expeditiously as possible is critical to ensuring high-quality care for returning servicemembers, and success will ultimately depend on sustained attention, systematic oversight by DOD and VA, and sufficient resources.

    You are invited to download and read the entire report here:  GAO Report (pdf – 32 pages)

    Oldtimer

    REFORM NEEDED: Brain-injured vets getting lost in the VA

    REFORM NEEDED:

    Brain-injured vets getting lost in the VA

    I found this in the Opinion Section of the Atlanta Journal Constitution.  It dovetails with an article I was already writing and  nicelly illustrates the enormous problem of finding enough doctors and specialists to adequately care for our heroes that need treatment NOW.  I’ve decided to post it now and follow up with just released GAO testimony relating to the problem which will appear in my next post.  “Stay tuned.”  

    Oldtimer

    By Kevin Ferris
    Philadelphia Inquirer

    Published on: 11/12/07

    Allen McQuarrie is looking for a few good doctors.  He wants them to volunteer their time and talents to their local Veterans Administration hospital.  Nothing against the quality of the folks already working there. The problem is. there simply aren’t enough doctors and specialists to go around for diagnosis and treatment — or to guide vets through the bureaucratic maze.

    Worse, one of the current conflict’s signature wounds — brain injuries — makes it difficult for some vets to juggle the appointments, record-keeping and other demands the VA puts on them.

    “We’re doing a wonderful job of getting the wounded off the battlefield and into a hospital in Germany and then back here,” McQuarrie says. “But continuing care once they’re out of the military is what needs systemic change.”

    McQuarrie learned of the system’s shortcomings because of his son Doug, a 21-year veteran of the Navy SEALs who has back and brain injuries sustained in combat and training.

    Doug McQuarrie has shuttled from the VA to civilian doctors, while trying to hold down a job and support his family in Virginia. The civilians say he needs immediate care, but the VA can’t see him for months — although he can call daily, hoping for a cancellation.

    Allen McQuarrie has tried to help from his home in Doylestown, Pa., calling the VA but also seeking assistance from senators and representatives. In the process, he’s learned that Doug’s case isn’t unique — and that the VA desperately needs help.

    Despairing and angry, he wrote to Sen. Bob Casey (D-Pa.): “It may be better for our men and women to come home dead than to suffer such painful and ultimately mortal deterioration.”

    In the same letter, he asked for emergency legislation to encourage civilian doctors to “adopt” vets and provide the immediate neurological care many need. He suggested tax incentives and improved military insurance to help offset the volunteers’ costs.

    McQuarrie’s hopes for a more responsive, faster-acting VA are shared by others including Congress’ Veterans Disability Benefits Commission.

    One commission member, retired Marine Corps Maj. Gen. James E. Livingston, a Medal of Honor recipient, emphasizes three required changes.

    Have a single review for disabilities. Now there are two.

    Streamline the record-keeping process as vets move from care by the Defense Department to the VA.

    Adopt the technology that will improve efficiency and speed up treatment.

    And don’t worry about the costs.

    (there is more to this story in the AJC – click on the link above and read the rest)

    Now you have a flavor of the problem:  Not enough doctors to go around, too much paperwork, not enough technology – as viewed from the patient/family side of the problem.   Stay tuned for the recent GAO Testimony on the problem, coming up in my next post.

    Oldtimer