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Shinseki Promises to Modernize VA
Associated Press
JANUARY 15, 2009

WASHINGTON – President-elect Barack Obama's choice to lead the Department of Veterans Affairs said Wednesday that six-month waits to process a disability claim would not be acceptable under his watch.

Retired Gen. Eric K. Shinseki, 66, promised to modernize the nation's second largest agency.

If confirmed, Shinseki would be the first Asian-American to lead the agency. He received a warm welcome from senators at his confirmation hearing before the Senate Veterans Affairs Committee.

Committee Chairman Daniel Akaka, D-Hawaii, said he anticipates Shinseki would be confirmed on Tuesday — the day Obama is sworn in as president. Akaka praised Shinseki's qualifications and empathy for veterans but warned that leading the agency wouldn't be easy.

"The frustrating lack of timeliness, and the challenges of coordinating DOD and VA's systems, are some of the areas that must be addressed quickly," he said.

Shinseki was the Army's first four-star general of Japanese-American descent. As Army chief of staff, he helped lead the Army's transformation to a lighter, more mobile force. He retired in 2003, shortly after clashing with the Bush administration on war policy.

He told the senators he doesn't understand why veterans are currently waiting six months on average to have a claim processed. "We need to do something about this," he said.

Shinseki said another priority would be to ensure that new GI benefits are rolled out in August, as planned.

He promised to work to reopen benefits to many "Priority 8" middle-income veterans who didn't qualify under the Bush administration. Such "Priority 8" veterans, whose income exceeded roughly $30,000 annually, were blocked from enrollment in the VA system in January 2003.

As Army chief of staff, Shinseki testified before Congress prior to the 2003 invasion of Iraq that it might take several hundred thousand U.S. troops to control the country afterward. Then-Defense Secretary Donald Rumsfeld belittled that estimate, and Shinseki retired soon after.

But Shinseki's words proved prophetic four years later, when President George W. Bush announced a surge of additional troops to Iraq.

Like the veterans the agency serves, Shinseki knows well the potential lifetime consequences of combat. He was injured twice in combat, losing part of a foot while serving in Vietnam when he stepped on a land mine.


On the Net:

Veterans Affairs Department: http://www.va.gov/

Senate Committee on Veterans' Affairs: http://veterans.senate.gov/


Rumsfeld Nemesis Shinseki to be Named VA Secretary
Associated Press

WASHINGTON – President-elect Barack Obama has chosen retired Gen. Eric K. Shinseki to be the next Veterans Affairs secretary, turning to a former Army chief of staff once vilified by the Bush administration for questioning its Iraq war strategy.

Obama will announce the selection of Shinseki, the first Army four-star general of Japanese-American ancestry, at a news conference Sunday in Chicago. He will be the first Asian-American to hold the post of Veterans Affairs secretary, adding to the growing diversity of Obama's Cabinet.

"I think that General Shinseki is exactly the right person who is going to be able to make sure that we honor our troops when they come home," Obama said in an interview with NBC's "Meet the Press" to be broadcast Sunday.

NBC released a transcript of the interview after The Associated Press reported that Shinseki was Obama's pick.

Shinseki's tenure as Army chief of staff from 1999 to 2003 was marked by constant tensions with Defense Secretary Donald Rumsfeld, which boiled over in 2003 when Shinseki testified to Congress that it might take several hundred thousand U.S. troops to control Iraq after the invasion.

Rumsfeld and his deputy, Paul Wolfowitz, belittled the estimate as "wildly off the mark" and the army general was ousted within months. But Shinseki's words proved prophetic after President George W. Bush in early 2007 announced a "surge" of additional troops to Iraq after miscalculating the numbers needed to stem sectarian violence.

Obama said he chose Shinseki for the VA post because he "was right" in predicting that the U.S. will need more troops in Iraq than Rumsfeld believed at the time.

"When I reflect on the sacrifices that have been made by our veterans and I think about how so many veterans around the country are struggling even more than those who have not served — higher unemployment rates, higher homeless rates, higher substance abuse rates, medical care that is inadequate — it breaks my heart," Obama told NBC.

Shinseki, 66, is slated to take the helm of the government's second largest agency, which was roundly criticized during the Bush administration for underestimating the amount of funding needed to treat thousands of injured veterans returning from Iraq and Afghanistan.

Thousands of veterans currently endure six-month waits for disability benefits, despite promises by current VA Secretary James Peake and his predecessor, Jim Nicholson, to reduce delays. The department also is scrambling to upgrade government technology systems before new legislation providing for millions of dollars in new GI benefits takes effect next August.

Sen. Daniel Akaka, D-Hawaii, and chairman of the Senate Veterans Affairs Committee, praised Shinseki as a "great choice" who will make an excellent VA secretary.

"I have great respect for General Shinseki's judgment and abilities," Akaka said in a statement. "I am confident that he will use his wisdom and experience to ensure that our veterans receive the respect and care they have earned in defense of our nation. President-elect Obama is selecting a team that reflects our nation's greatest strength, its diversity, and I applaud him."

Veterans groups also cheered the decision.

"General Shinseki has a record of courage and honesty, and is a bold choice to lead the VA into the future," said Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America. "He is a man that has always put patriotism ahead of politics, and is held in high regard by veterans of Iraq and Afghanistan."

Obama's choice of Shinseki, who grew up in Hawaii, is the latest indication that the president-elect is making good on his pledge to have a diverse Cabinet.

In Obama's eight Cabinet announcements so far, white men are the minority with two nominations — Timothy Geithner at Treasury and Robert Gates at Defense. Three are women — Janet Napolitano at Homeland Security, Susan Rice as United Nations ambassador and Hillary Rodham Clinton at State. Eric Holder at the Justice Department is African American, while Bill Richardson at Commerce is Latino.

Shinseki is a recipient of two Purple Hearts for life-threatening injuries in Vietnam.

Upon leaving his post in June 2003, Shinseki in his farewell speech sternly warned against arrogance in leadership.

"You must love those you lead before you can be an effective leader," he said. "You can certainly command without that sense of commitment, but you cannot lead without it. And without leadership, command is a hollow experience, a vacuum often filled with mistrust and arrogance."

Shinseki also left with the warning: "Beware a 12-division strategy for a 10-division army."


VA Quadruples Payment to Vets with Brain Injuries
Associated Press

The government is more than quadrupling monthly payments to some veterans suffering brain injuries, as the number of such war wounds mounts from the roadside bombings of Iraq and Afghanistan.

The new compensation is based on the assessment that even some troops who have the mildest form of traumatic brain injury could end up with chronic headaches, memory loss, anxiety or other symptoms that will hurt their chances of getting a job or job advancement — thus reducing their lifetime earnings by 40 percent.

In a regulation announced Tuesday by the Department of Veterans Affairs, officials changed the way they evaluate the injuries. They now judge a person to be 40 percent disabled in such cases rather than 10 percent. The old lower rating was set by a 1961 regulation.

The rating change means that an unmarried veteran, who now receives $117 monthly in compensation, will receive $512. Extra money also will be calculated for troops with spouses and children.

Mild traumatic brain injury is basically a form of concussion that results from severe shaking of the brain after a blast. It can cause blurred vision, insomnia, irritability and other problems.

The VA change represents the "best judgment of medical experts about what the impact" of such injuries is and how best to evaluate veterans who come to the VA for help, said Tom Pamperin, a deputy director for the department's compensation and pension service.

The change goes into effect in 30 days and those receiving compensation under the old system can have their cases reviewed.

Roughly 1.7 million American troops have served in Iraq and Afghanistan and a RAND Corporation study estimated early this year that up to 320,000 may have suffered a traumatic brain injury. Officials say that the vast majority of the cases are mild — and that most veterans recover from the mild cases in weeks or months. The new, higher disability rating is for the smaller percentage who suffer permanent damage, Pamperin said.

The extra disability compensation is expected to cost nearly $124 million through 2017. That's based on the assumption that the number of troops who get such payments will rise steadily in the coming years to 5,100 for 2017 from about 800 new cases a year now, Pamperin said.

He said the number of troops going to the VA with brain injuries was only about 200 annually before the start of the Iraq war, where insurgent use of roadside explosives and car-bombs has made brain injuries, amputations, burns and post-traumatic stress disorder the vast majority of wounds from the campaign. Insurgents are also increasingly using explosives in Afghanistan.

Officials believe compensation levels are already correct for troops with moderate and severe traumatic brain injury that can involve open head wounds.

Though most troops with the severe cases already can be rated at 100 percent disabled, an increase has been approved for additional care they might need. That is, a single vet who needs assisted care can get $3,145 a month compared to the current $2,527 payment.


Soldiers' Suicide Rate On Pace to Set Record
By Ann Scott Tyson
Washington Post

Suicides among active-duty soldiers this year are on pace to exceed both last year's all-time record and, for the first time since the Vietnam War, the rate among the general U.S. population, Army officials said yesterday.

Ninety-three active-duty soldiers had killed themselves through the end of August, the latest data show. A third of those cases are under investigation by the Armed Forces Medical Examiner's Office. In 2007, 115 soldiers committed suicide.

Failed relationships, legal and financial troubles, and the high stress of wartime operations in Iraq and Afghanistan are the leading factors linked to the suicides, Army officials said.

The officials voiced concern that an array of Army programs aimed at suicide prevention has not checked a years-long rise in the suicide rate. Still, they said, the number of deaths probably would have climbed even more without such efforts.

"What does success look like? Frankly, we do not know," said Col. Eddie Stephens, deputy director for human resources under the Army's personnel division.

The Army's suicide rate has increased from 12.4 per 100,000 in 2003, when the Iraq war started, to 18.1 per 100,000 last year. Suicide attempts by soldiers have also increased since 2003, Stephens said.

This year the death rate is likely to exceed that of a demographically similar segment of the U.S. population -- 19.5 per 100,000, Stephens said. According to service officials, the last time that occurred was in the late 1960s during the Vietnam War, when the United States had a draft Army that suffered from serious discipline problems. In 1973, the nation created an all-volunteer force that has generally enjoyed an above-average level of mental health, a condition contradicted by the recent rise in suicides.

The latest Army prevention efforts include the hiring of hundreds of new mental health providers, the production of an interactive video on the subject, to be released this fall, and the introduction of an intervention program aimed at teaching junior Army leaders not only suicidal symptoms but actions that can prevent suicides.

The ACE program includes handing out laminated cards decorated with the ace of hearts that advise three steps -- "ask," "care" and "escort" -- that spell "ACE": Ask your buddy direct questions such as "Are you thinking of killing yourself?"; care for your buddy by taking away weapons; and escort your buddy to a military chaplain or health provider.

"Take away the weapon if someone is playing Russian roulette with it. . . . Unfortunately, people have not always done that," said Brig. Gen. Rhonda Cornum, the Army's assistant surgeon general for force protection. Army prevention programs to this point have not trained soldiers adequately in what to do after they learn a comrade is in crisis, she added.

Another measure that Cornum said has proven effective is for Army commanders in combat zones to take a more "humanistic" approach and to return soldiers home so they can deal with personal crises and thereby "live another day to keep serving."

Col. Scott McBride, commander of the 1st Brigade of the 101st Airborne Division, said such measures have helped him prevent any suicides among his 4,000 soldiers, who have been deployed in northern Iraq for the past year.

"If they're having a problem at home and we can keep a family together, reduce stress by sending a soldier home so he can take care of that problem, we're doing that," McBride said yesterday by video link from Iraq.


Why is President Bush Threatening to Veto Legislation Supported by Major Veterans Organizations and Bipartisan Majorities in Congress?

Last month, Congress passed the G.I. Bill for the 21st Century – critical legislation providing a full, four-year college education to the men and women of the U.S. military who have served on active duty since September 11, 2001. The bill helps make our troops and veterans part of a new economic recovery, just like the Greatest Generation did after World War II. But despite bipartisan majorities in the House and Senate and overwhelming support from veterans groups, President Bush has threatened to veto the bill.

Some of the Veterans & Other Organizations Supporting the G.I Bill for 21st Century

American Legion
National Guard Association of the United States
Non-Commissioned Officers Association
Disabled American Veterans
Paralyzed Veterans of America
Iraq and Afghanistan Veterans of America
Student Veterans of America
Military Officers Association of America
Veterans of Foreign Wars
National Association of Black Veterans
Vietnam Veterans of America

Key Republicans Supporting the G.I. Bill for 21st Century

Sen. John Warner (R-Virginia) – 2nd-Ranking Republican and former Chairman, Senate Armed Services Committee; Secretary of the Navy (1972-1974); Navy (1944-1946); Marines (1950-1964)

Sen. Pat Roberts (R-Kansas) – Ranking Member and former Chairman, Senate Intelligence Committee; Marine (1958-1962)

Sen. Chuck Hagel (R-Nebraska) – 2nd-Ranking Republican Member, Senate Foreign Relations Committee; Army (1967-1968)

Rep. Steve Buyer (R-Indiana) – Ranking Member, House Veterans Affairs Committee; Colonel in the Army Reserve; Army Reserve (1980-1984; 1987-present); Army (1984-1987)

Key Republican Senator Calls Pentagon Claims that Bill Would Hurt Retention “Thin and Tenuous”

Republican Former Senate Armed Services Chairman John Warner calls the Pentagon’s opposition “very thin and tenuous…The flip side of that is putting a big piece of cheese out there will induce more qualified people to join just to get this. It should be a tremendous incentive for recruitment.” [Politico, 4/ 30/08]



Over the weekend, VA Secretary James Peake visited Alaska with Sen. Ted Stevens (R-AK). While there, they met with Vietnam veteran John Guinn, who questioned the Secretary about the growing problem of post-traumatic stress disorder (PTSD) amongst veterans.

Peake suggested that some concerns about PTSD are "overblown," adding that many of the brain injuries were "akin to what anyone who played football in their youth might have suffered."

On Saturday, Peake also said that many vets with PTSD may just need "a little counseling" and shouldn't "need the PTSD label their whole lives." Peake's comments are disturbing, especially in light of new numbers released by the Pentagon this week showing that the number of new PTSD cases "jumped by roughly 50 percent in 2007."

Additionally, as Brandon Friedman at VetVoice points out, Peake's comments are undermined by VA psychiatrist Jonathan Shay, who has stressed the seriousness of PSTD: "Combat PTSD is a war injury.

Veterans with combat PTSD are war wounded, carrying the burdens of sacrifice for the rest of us as surely as the amputees, the burned, the blind, and the paralyzed carry them."



The Pentagon, the White House and other conservatives have rallied against Sen. Jim Webb's (D-VA) 21st Century GI Bill, citing a recent CBO report that concluded that Webb's bill would reduce reenlistment rates by 16 percent.

In fact, the report says that the drop in reenlistment rate would be offset by a 16 percent increase in recruitment.

Slate has taken a closer look at the CBO's numbers and has noted that the military would in fact see several times as many new recruits as drop-outs because "the '16 percents'" in the CBO report "aren't necessarily equal." Slate explains: "the CBO estimate concluded that the 16 percent increase in recruitment would add an additional 30,000 recruits annually, while a 16 percent decline in re-enlistment would result in 7,000 fewer re-enlistments annually. In other words, new recruits would greatly outnumber soldiers who decline to re-enlist."


CBS: Veteran Suicide Cover-Up Runs Deep

New information reveals that statistics related to veterans’ suicides was explicitly withheld from the public and from CBS News.

“People within the Veterans Administration who were withholding this information were not at the bottom of the totem pole, this went all the way to the top,” one veterans’ rights attorney told CBS chief investigative correspondent Armen Keteyian.

In one email, Keteyian reports that a VA media adviser wrote, “I don’t want to give CBS any more numbers on veteran suicides or attempts than they already have– It will only lead to more questions.”


Nearly 1 In 5 Troops Has Mental Problems After War Service
Associated Press

Roughly one in every five U.S. troops who have survived the bombs and other dangers of Iraq and Afghanistan now suffers from major depression or post-traumatic stress, an independent study said Thursday. It estimated the toll at 300,000 or more.

As many or more report possible brain injuries from explosions or other head wounds, said the study, the first major survey from outside the government.

Only about half of those with mental health problems have sought treatment. Even fewer of those with head injuries have seen doctors.

Army Surgeon General Eric Schoomaker said the report, from the Rand Corp., was welcome.

"They're helping us to raise the visibility and the attention that's needed by the American public at large," said Schoomaker, a lieutenant general. "They are making this a national debate."

The researchers said 18.5 percent of current and former service members contacted in a recent survey reported symptoms of depression or post-traumatic stress. Based on Pentagon data that more than 1.6 million have deployed to the two wars, the researchers calculated that about 300,000 are suffering mental health problems.

Nineteen percent — or an estimated 320,000 — may have suffered head injuries, the study calculated. Those range from mild concussions to severe, penetrating head wounds.

"There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," said Terri Tanielian, the project's co-leader and a researcher at Rand. "Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation."

The study, the first large-scale, private assessment of its kind, includes a survey of 1,965 service members across the country, from all branches of the armed forces and including those still in the military as well veterans who have completed their service. The Iraq war has been notable for the repeat tours required of many troops, sometimes for longer than a year at a time.

The results of the study appear consistent with mental health reports from within the government, though the Defense Department has not released the number of people it has diagnosed or who are being treated for mental problems.

The Department of Veterans Affairs said this month that its records show about 120,000 who served in the two wars and are no longer in the military have been diagnosed with mental health problems. Of those, about 60,000 are suffering from post-traumatic stress, and depression runs a close second.

Veterans Affairs is responsible for care of service members after they have leave the military. The Defense Department covers active duty and reservist needs.

The lack of numbers from the Pentagon was one motivation for the Rand study, Tanielian said in an interview.

The most prominent and detailed Pentagon study on the military's mental health that is released regularly to the public is the Army's survey of soldiers, taken annually at the battle zones since 2003.


Veterans Affairs Refuses To Provide Voter Registration For Wounded Vets
Filed by John Byrne

At a quiet 1999 ceremony in MaComb County, Michigan, a plainspoken former Texas governor delivered a patriotic speech to commemorate Veterans' Day.

But none of the eight veterans interviewed by The New York Times after the ceremony promised George W. Bush their vote.

A new report Thursday reveals that Secretary of Veterans Affairs James Peake told two Democratic senators his department will not help injured veterans register to vote before the 2008 election.

"VA remains opposed to becoming a voter registration agency pursuant to the National Voter Registration Act, as this designation would divert substantial resources from our primary mission," Peake said in an April 8th letter to Sens. Diane Feinstein (D-CA) and John Kerry (D-MA) acquired by Steven Rosenfeld at Alternet.

Peake refers to a 1993 law that allows government departments to engage in voter registration efforts, Rosenfeld says.

What this means is that many injured veterans still in VA hospitals who can't find means to register outside of their facilities will effectively lose their right to vote. Wounded veterans who have moved must re-register at their "new addresses" or file for absentee ballots in order to participate in the presidential and other elections.

Peake defends the decision by saying that a court recently ruled the VA's limits on "partisan political activities" "does not on its face violate [veterans'] First Amendment' rights," Rosenfeld notes, without articulating how registering veterans is a partisan activity.

Peake added, "VA shares your commitment to assisting veterans in exercising their Constitutional right to vote."

The court ruling he's appears to be referring to is Patrick Griffin v. Secretary of Veterans Affairs, in which a Federal Circuit of Appeals court upheld the VA's rules governing the conduct of those who practice "free speech" -- or protest -- in government graveyards.

Among other things, the VA prohibits "partisan activities, i.e., those involving commentary or actions in support of, or in opposition to, or attempting to influence, any current policy of the Government of the United States, or any private group, association, or enterprise."

Sens. Kerry and Feinstein fired off a letter in reply.

"The Department of Veterans Affairs should provide voter materials to veterans," Feinstein wrote, according to Rosenfeld's report. "I believe the cost of providing these voter materials is minimal. It's a small price to pay for the sacrifice these men and women have made in fighting for our nation's freedom. I am disappointed."

"You'd think that when so many people give speeches about keeping faith with our veterans, the least the government would do is protect their right to vote, after they volunteered to go thousands of miles from home to fight and give that right to others," Kerry said. "And yet we've seen the government itself block veterans from registering to vote in VA facilities, without any legal basis or rational explanation."

Veterans' Affairs other scandals

It isn't the first time the Bush Administration's Department of Veterans' Affairs has been accused of slighting the nations thousands of Iraq vets. In 2005, Salon.com's Mark Benajamin revealed that military naval hospitals were delivering grossly subpar treatment to vets.

Before he hanged himself with his bathrobe sash in the psychiatric ward at Walter Reed Army Medical Center, Spc. Alexis Soto-Ramirez complained to friends about his medical treatment. Soto-Ramirez, 43, had been flown out of Iraq five months before then because of chronic back pain that became excruciating during the war. But doctors were really worried about his mind. They thought he suffered from post-traumatic stress disorder after serving with the 544th Military Police Company, a unit of the Puerto Rico National Guard, the kind of unit that saw dirty, face-to-face combat in Iraq.

A copy of Soto-Ramirez's medical records, reviewed by Salon, show that a doctor who treated him in Puerto Rico upon his return from Iraq believed his mental problems were probably caused by the war and that his future was in the Army's hands. "Clearly, the psychiatric symptoms are combat related," a clinical psychologist at Roosevelt Roads Naval Hospital wrote on Nov. 24, 2003. The entry says, "Outcome will depend on adequacy and appropriateness of treatment." Doctors in Puerto Rico sent Soto-Ramirez to Walter Reed in Washington, D.C., to get the best care the Army had to offer. There, he was put in Ward 54, Walter Reed's "lockdown," or inpatient psychiatric ward, where the most troubled patients are supposed to have constant supervision.

At that time, Walter Reed officials wouldn't discuss Salon's findings: "We are satisfied that there is a very high level of patient satisfaction with their treatment."

The Washington Post's Dana Priest delivered a stunning series on the failures at the hospital in her series, "The Other Walter Reed," for which she and her newspaper won a Pulitzer Prize.

"Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold," Priest wrote. "When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses."

Veterans' advocates are incensed about the VA's decision not to allow registration at military hospitals.

"During a time of war, our Nation has a special and sacred duty to assist our fellow citizens who have defended our Constitution with their lives - our military veterans -- with registering to vote and with voting," Paul Sullivan, Veterans for Common Sense executive director, told Rosenfeld. "We encourage VA to allow non-partisan voter registration drives at VA facilities so that as many veterans as possible can actively participate in our democracy -- we owe our veterans no less for standing between a bullet and our Constitution."

Why Does Johnny Come Marching Homeless?
In Wake of Afghanistan and Iraq, a New Generation of Homeless Veterans Emerges
Peter Mohan traces the path from the Iraqi battlefield to this lifeless conference room, where he sits in a kilt and a Camp Kill Yourself T-shirt and calmly describes how he became a sad cliche: a homeless veteran.
There was a happy homecoming, but then an accident — car crash, broken collarbone. And then a move east, close to his wife's new job but away from his best friends.
And then self-destruction: He would gun his motorcycle to 100 mph and try to stand on the seat. He would wait for his wife to leave in the morning, draw the blinds and open up whatever bottle of booze was closest.
He would pull out his gun, a .45-caliber, semiautomatic pistol. He would lovingly clean it, or just look at it and put it away. Sometimes place it in his mouth.
"I don't know what to do anymore," his wife, Anna, told him one day. "You can't be here anymore."
Peter Mohan never did find a steady job after he left Iraq. He lost his wife — a judge granted their divorce this fall — and he lost his friends and he lost his home, and now he is here, in a shelter.
He is 28 years old. "People come back from war different," he offers by way of a summary.
This is not a new story in America: A young veteran back from war whose struggle to rejoin society has failed, at least for the moment, fighting demons and left homeless.
But it is happening to a new generation. As the war in Afghanistan plods on in its seventh year, and the war in Iraq in its fifth, a new cadre of homeless veterans is taking shape.
And with it come the questions: How is it that a nation that became so familiar with the archetypal homeless, combat-addled Vietnam veteran is now watching as more homeless veterans turn up from new wars?
What lessons have we not learned? Who is failing these people? Or is homelessness an unavoidable byproduct of war, of young men and women who devote themselves to serving their country and then see things no man or woman should?
For as long as the United States has sent its young men — and later its young women — off to war, it has watched as a segment of them come home and lose the battle with their own memories, their own scars, and wind up without homes.
The Civil War produced thousands of wandering veterans. Frequently addicted to morphine, they were known as "tramps," searching for jobs and, in many cases, literally still tending their wounds.
More than a decade after the end of World War I, the "Bonus Army" descended on Washington — demanding immediate payment on benefits that had been promised to them, but payable years later — and were routed by the U.S. military.
And, most publicly and perhaps most painfully, there was Vietnam: Tens of thousands of war-weary veterans, infamously rejected or forgotten by many of their own fellow citizens.
Now it is happening again, in small but growing numbers.
For now, about 1,500 veterans from Iraq and Afghanistan have been identified by the Department of Veterans Affairs. About 400 of them have taken part in VA programs designed to target homelessness.
The 1,500 are a small, young segment of an estimated 336,000 veterans in the United States who were homeless at some point in 2006, the most recent year for which statistics are available, according to the National Alliance to End Homelessness.
Still, advocates for homeless veterans use words like "surge" and "onslaught" and even "tsunami" to describe what could happen in the coming years, as both wars continue and thousands of veterans struggle with post-traumatic stress.
People who have studied postwar trauma say there is always a lengthy gap between coming home — the time of parades and backslaps and "The Boys Are Back in Town" on the local FM station — and the moments of utter darkness that leave some of them homeless.
In that time, usually a period of years, some veterans focus on the horrors they saw on the battlefield, or the friends they lost, or why on earth they themselves deserved to come home at all. They self-medicate, develop addictions, spiral down.
How — or perhaps the better question is why — is this happening again?
"I really wish I could answer that question," says Anthony Belcher, an outreach supervisor at New Directions, which conducts monthly sweeps of Skid Row in Los Angeles, identifying homeless veterans and trying to help them get over addictions.
"It's the same question I've been asking myself and everyone around me. I'm like, wait, wait, hold it, we did this before. I don't know how our society can allow this to happen again."
Mental illness, financial troubles and difficulty in finding affordable housing are generally accepted as the three primary causes of homelessness among veterans, and in the case of Iraq and Afghanistan, the first has raised particular concern.
Iraq veterans are less likely to have substance abuse problems but more likely to suffer mental illness, particularly post-traumatic stress, according to the Veterans Administration. And that stress by itself can trigger substance abuse.
Some advocates say there are also some factors particular to the Iraq war, like multiple deployments and the proliferation of improvised explosive devices, that could be pulling an early trigger on stress disorders that can lead to homelessness.
While many Vietnam veterans began showing manifestations of stress disorders roughly 10 years after returning from the front, Iraq and Afghanistan veterans have shown the signs much earlier.
That could also be because stress disorders are much better understood now than they were a generation ago, advocates say.
"There's something about going back, and a third and a fourth time, that really aggravates that level of stress," said Michael Blecker, executive director of Swords to Plowshares," a San Francisco homeless-vet outreach program.
"And being in a situation where you have these IEDs, everywhere's a combat zone. There's no really safe zone there. I think that all is just a stew for post-traumatic stress disorder."
Others point to something more difficult to define, something about American culture that — while celebrating and honoring troops in a very real way upon their homecoming — ultimately forgets them.
This is not necessarily due to deliberate negligence. Perhaps because of the lingering memory of Vietnam, when troops returned from an unpopular war to face open hostility, many Americans have taken care to express support for the troops even as they solidly disapprove of the war in Iraq.
But it remains easy for veterans home from Iraq for several years, and teetering on the edge of losing a job or home, to slip into the shadows. And as their troubles mount, they often feel increasingly alienated from friends and family members.
"War changes people," says John Driscoll, vice president for operations and programs at the National Coalition for Homeless Veterans. "Your trust in people is strained. You've been separated from loved ones and friends. The camaraderie between troops is very extreme, and now you feel vulnerable."
The VA spends about $265 million annually on programs targeting homeless veterans. And as Iraq and Afghanistan veterans face problems, the VA will not simply "wait for 10 years until they show up," Pete Dougherty, the VA's director of homeless programs, said when the new figures were released.
"We're out there now trying to get everybody we can to get those kinds of services today, so we avoid this kind of problem in the future," he said.
These are all problems defined in broad strokes, but they cascade in very real and acute ways in the lives of individual veterans.
Take Mike Lally. He thinks back now to the long stretches in the stifling Iraq heat, nothing to do but play Spades and count flies, and about the day insurgents killed the friendly shop owner who sold his battalion Pringles and candy bars.
He thinks about crouching in the back of a Humvee watching bullets crash into fuel tanks during his first firefight, and about waiting back at base for the vodka his mother sent him, dyed blue and concealed in bottles of Scope mouthwash.
It was a little maddening, he supposes, every piece of it, but Lally is fairly sure that what finally cracked him was the bodies. Unloading the dead from ambulances and loading them onto helicopters. That was his job.
"I guess I loaded at least 20," he says. "Always a couple at a time. And you knew who it was. You always knew who it was."
It was in 2004, when he came back from his second tour in Iraq with the Marine Corps, that his own bumpy ride down began.
He would wake up at night, sweating and screaming, and during the days he imagined people in the shadows — a state the professionals call hypervigilence and Mike Lally calls "being on high alert, all the time."
His father-in-law tossed him a job installing vinyl siding, but the stress overcame him, and Lally began to drink. A little rum in his morning coffee at first, and before he knew it he was drunk on the job, and then had no job at all.
And now Mike Lally, still only 26 years old, is here, booted out of his house by his wife, padding around in an old T-shirt and sweats at a Leeds shelter called Soldier On, trying to get sober and perhaps, on a day he can envision but not yet grasp, get his home and family and life back.
"I was trying to live every day in a fog," he says, reflecting between spits of tobacco juice. "I'd think I was back in there, see people popping out of windows. Any loud noise would set me off. It still does."
Soldier On is staffed entirely by homeless veterans. A handful who fought in Iraq or Afghanistan, usually six or seven at a time, mix with dozens from Vietnam. Its president, Jack Downing, has spent nearly four decades working with addicts, the homeless and the mentally ill.
Next spring, he plans to open a limited-equity cooperative in the western Massachusetts city of Pittsfield. Formerly homeless veterans will live there, with half their rents going into individual deposit accounts.
Downing is convinced that ushering homeless veterans back into homeownership is the best way out of the pattern of homelessness that has repeated itself in an endless loop, war after war.
"It's a disgrace," Downing says. "You have served your country, you get damaged, and you come back and we don't take care of you. And we make you prove that you need our services."
"And how do you prove it?" he continues, voice rising in anger. "You prove it by regularly failing until you end up in a system where you're identified as a person in crisis. That has shocked me."
Even as the nation gains a much better understanding of the types of post-traumatic stress disorders suffered by so many thousands of veterans — even as it learns the lessons of Vietnam and tries to learn the lessons of Iraq — it is probably impossible to foretell a day when young American men and women come home from wars unscarred.
At least as long as there are wars.
But Driscoll, at least, sees an opportunity to do much better.
He notes that the VA now has more than 200 veteran adjustment centers to help ease the transition back into society, and the existence of more than 900 VA-connected community clinics nationwide.
"We're hopeful that five years down the road, you're not going to see the same problems you saw after the Vietnam War," he says. "If we as a nation do the right thing by these guys."

VA's Performance On Benefits Slips Or Is Unchanged
Chris Adams | McClatchy Newspapers

WASHINGTON — The Department of Veterans Affairs fell farther behind this year in its attempts to give veterans timely decisions on their disability claims, new records show.

The latest numbers are in an annual report the VA prepares for Congress detailing a range of short- and long-term goals for its disability, health and other benefit programs. Overall, the agency either has fallen behind or has made no progress in improving its performance in more than half of what it lists as its key goals.

In the benefits measure the VA has said is "most critical to veterans" — the speed of processing disability claims — the agency lost ground for the third year in a row.

Moreover, McClatchy has found that the VA put a positive spin on many of its numbers, and in two instances provided Congress with incorrect or incomplete figures.

The agency said it took an average of 183 days to process a claim in fiscal 2007, longer than in any of the five years tracked in the report. Processing exceeded its 2007 goal of 160 days and its long-term goal of eventually reducing processing time to 125 days.

Congress and veterans closely watch the time it takes the VA to process claims, and the agency has vowed in previous years to pick up the pace. When it was asked about its processing speed last year, for example, the VA told McClatchy that hiring new workers would help it increase production and decrease its backlog of claims in 2007.

In fact, processing time increased by an average of six days, and the backlog of pending claims rose from 377,681 to 391,257, the agency's records show.

The VA said this week that it was aggressively tackling the issue, hiring more than 1,000 workers, boosting overtime and revamping training. The agency also said it was receiving more disability claims than it had at any time in recent history, and that it had received more than it had expected in 2007.

Beyond that, the agency said that meeting or exceeding its goals — what it generally calls "targets" — wasn't always the best measure of success.

"The VA sets goals to measure how we are doing so that we can continuously improve performance," said Bob Henke, the assistant secretary for management. "We use goals to move and improve performance."

But for Sen. Patty Murray, D-Wash., the report is more evidence that the agency hasn't been upfront with Congress about its performance or its needs.

"It is extremely frustrating to hear the song and dance that we are doing better when the reality is we are not," said Murray, a member of the Senate Veterans' Affairs Committee. "I want to say I'm surprised. But I'm not."

The report also shows that:

_ The accuracy rate for disability claims in 2007 remained the same as in 2006, at 88 percent. The VA's long-term goal for accuracy is 98 percent, but the agency has been stuck in the high 80s for the past five years.

_ The agency continues to be tardy in handing in its homework to Congress. Only 40 percent of the reports due to Congress are completed on time. Of the questions Congress asks of the VA — for example, follow-ups to questions asked in oversight hearings — less than 30 percent are answered on time.

_ The average time needed to process pension claims for veterans jumped to 104 days, the longest in five years and well above the long-term goal of 60 days.

It takes two or three years for new workers to become fully proficient in their jobs, the VA said, which has hindered its ability to achieve some goals.

"They are way behind, and they are playing catch-up," said Randy Reese, the national service director for the advocacy group Disabled American Veterans. "So they started to hire new people in 2007 to knock down the backlog. The backlog has a five-year advantage."

In many sections of the report, the VA looks past the missed goals to put the best face on its efforts.

Under "Positive 2007 Outcomes," for example, the VA highlights "accurate claims processing," saying that the "accuracy rate . . . was maintained at 88 percent, helping to ensure that veterans receive the proper level of monetary benefits." Only elsewhere does the report note that 88 percent is well below the agency's long-term goal of 98 percent.

The VA reports that 95 percent or more of outpatient visits are scheduled within 30 days of patients' desired dates, a fact it's touted to Congress repeatedly. The agency's inspector general, however, found this year that only 75 percent of the visits it examined took place within 30 days. The VA said it didn't agree with that finding and was examining the issue further.

The VA also claimed that customer-satisfaction ratings by inpatients at VA hospitals are 10 points higher than ratings from private-sector hospitals. In fact, the number the agency used as a comparison is wrong, and as a result the advantage for VA hospitals is half as big as the VA claims.

The VA told McClatchy on Monday that the mistake was made by a "transposition error and we will be fixing that as soon as possible."

It does appear that the agency is meeting some of its goals, but only because those goals have changed.

Until this year, the VA had a goal to handle appeals for denied claims in 365 days. This year, the average processing time increased to 660 days — but the goal was lengthened to 675 days.


20,000 Vets' Brain Injuries Not Listed In Pentagon Tally
By Gregg Zoroya

At least 20,000 U.S. troops who were not classified as wounded during combat in Iraq and Afghanistan have been found with signs of brain injuries, according to military and veterans records compiled by USA TODAY.

The data, provided by the Army, Navy and Department of Veterans Affairs, show that about five times as many troops sustained brain trauma as the 4,471 officially listed by the Pentagon through Sept. 30. These cases also are not reflected in the Pentagon's official tally of wounded, which stands at 30,327.

HIDDEN WOUNDS: Marine didn't recognize signs of brain injury

The number of brain-injury cases were tabulated from records kept by the VA and four military bases that house units that have served multiple combat tours in Iraq and Afghanistan.

One base released its count of brain injuries at a medical conference. The others provided their records at the request of USA TODAY, in some cases only after a Freedom of Information Act filing was submitted.

USA TODAY ARCHIVES: Brain injuries from war worse than thought

The data came from:

• Landstuhl Army Regional Medical Center in Germany, where troops evacuated from Iraq and Afghanistan for injury, illness or wounds are brought before going home. Since May 2006, more than 2,300 soldiers screened positive for brain injury, hospital spokeswoman Marie Shaw says.

• Fort Hood, Texas, home of the 4th Infantry Division, which returned from a second Iraq combat tour late last year. At least 2,700 soldiers suffered a combat brain injury, Lt. Col. Steve Stover says.

• Fort Carson, Colo., where more than 2,100 soldiers screened were found to have suffered a brain injury, according to remarks by Army Col. Heidi Terrio before a brain injury association seminar.

• Marine Corps Base Camp Pendleton, where 1,737 Marines were found to have suffered a brain injury, according to Navy Cmdr. Martin Holland, a neurosurgeon with the Naval Medical Center San Diego.

• VA hospitals, where Iraq and Afghanistan veterans have been screened for combat brain injuries since April. The VA found about 20% of 61,285 surveyed — or 11,804 veterans — with signs of brain injury, spokeswoman Alison Aikele says. VA doctors say more evaluation is necessary before a true diagnosis of brain injury can be confirmed in all these cases, Aikele says.

Soldiers and Marines whose wounds were discovered after they left Iraq are not added to the official casualty list, says Army Col. Robert Labutta, a neurologist and brain injury consultant for the Pentagon.

"We are working to do a better job of reflecting accurate data in the official casualty table," Labutta says.

Most of the new cases involve mild or moderate brain injuries, commonly from exposure to blasts.

More than 150,000 troops may have suffered head injuries in combat, says Rep. Bill Pascrell, D-N.J., founder of the Congressional Brain Injury Task Force.

"I am wary that the number of brain-injured troops far exceeds the total number reported injured," he says.

About 1.5 million troops have served in Iraq, where traumatic brain injury can occur despite heavy body armor worn by troops.



How America treats it’s Heroes

Thousands of Vietnam veterans will likely head to Washington, DC, this weekend to commemorate the 25th anniversary of the Vietnam Veterans Memorial. Many of these soldiers unfortunately received a "chilly public reception" when they returned home from that highly unpopular war.

But now they are now helping the nation embrace troops returning from Iraq and Afghanistan. Despite low public support for the Iraq war, a Pew Research poll in March found that 77 percent of the American public has a favorable view of the military and "72 percent say the government doesn't give enough support" to returning soldiers.

Indeed, despite the lessons learned from Vietnam, the Bush administration still isn't providing the services necessary to help the nation's veterans return to civilian life.


Seven months after the Washington Post uncovered the deplorable conditions of "neglect" at Walter Reed Army Medical Center, a September Government Accountability Office report found that "wounded warriors are still getting the runaround" from the Pentagon and Department of Veterans Affairs (VA).

Wars take a heavy toll on the health of the nation's soldiers. At least "283 combat veterans who left the military between the start of the war in Afghanistan on Oct. 7, 2001, and the end of 2005 took their own lives," a figure "reminiscent of the increased suicide risk among returning soldiers in the Vietnam era."

Additionally, more than 100,000 combat veterans have "sought help for mental illness since the start of the war in Afghanistan in 2001"; half of those cases were for post-traumatic stress disorder (PTSD). Yet the nation's health care system still isn't up to the task of caring for these veterans.

A recent National Academies study found that PTSD treatments generally "lack rigorous scientific evidence that they are effective," with evidence often "assembled by pharmaceutical companies that make the drugs or by researchers with conflicts of interest in the outcome of the studies." This week, President Bush signed into law the Joshua Omvig Veterans Suicide Prevention Act, which directs the VA to "develop a comprehensive program to reduce the rate of suicide among veterans."


"Members of Congress and other political leaders often say that the men and women who have served in our military since 9/11 are the 'new greatest generation'" writes Sens. Jim Webb (D-VA) and Chuck Hagel (R-NE) in today's New York Times.

"Well, here's a thought from two infantry combat veterans of the Vietnam era's 'wounded generation': if you truly believe that our Iraq and Afghanistan veterans are like those who fought in World War II, let us provide them with the same G.I. Bill that was given to the veterans of that war." Instead of receiving full college tuition and fees, veterans today receive approximately $800 a month for college, which is about "13 percent of the cost of attending Columbia." Yet the administration continues to resist efforts to strengthen the G.I. Bill. In August, a VA official said the idea would be too "cumbersome."


In addition to receiving medical care, veterans struggle to return to jobs, school, and even their homes. A new report released this week finds that veterans make up one in four homeless people in the United States, with 1,500 homeless veterans from the wars in Afghanistan and Iraq.

"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."

On Wednesday, the Bush administration announced "remarkable progress" in caring for the chronic homeless. But the VA has developed just 1,780 supported housing units for veterans; the National Alliance to End Homelessness says that number needs to grow to 25,000.

This week, the House "passed a bill to increase funding for a low-interest loan program that helps veterans in Oregon and four other states, including Texas, buy homes."


When VA Secretary Jim Nicholson stepped down in July, he left behind an agency that left veterans at risk. In May 2006, Nicholson waited two weeks to notify the Justice Department and FBI of the "largest loss of personal data in U.S. government history," and then another full week before notifying the 26.5 million affected veterans.

He also awarded "$3.8 million in bonuses to top executives in fiscal 2006" -- many totaling as much as $33,000 -- despite a $1.3 billion department shortfall. Bush waited four months after Nicholson's announcement before nominating Dr. James Peake as a replacement. Jon Soltz, an Iraq war veteran and chairman of VoteVets.org, notes the challenges for Peake if he becomes secretary: "The most pressing question here is, will Dr. Peake be a leader, or will be he be a follower?

This administration has been nothing but hostile to veterans care and funding for key veterans programs. Will Dr. Peake stand up for Veterans and challenge this President, or will he just go along to get along?"


'National Embarrassment,' Says Cafferty: 1.8 Million Veterans Without Healthcare
Mike Aivaz and Jason Rhyne

CNN's Jack Cafferty says it's a "national embarrassment" that US military veterans are among the 47 million Americans that do not have health insurance.

Cafferty cited new research conducted at Harvard Medical School indicating that 1.8 million veterans were uninsured in 2004, a number that's climbed by 290,000 since 2000 estimates. The same study found an additional 3.8 million people, all members of veteran households, also lacked coverage.

"Turns out most uninsured veterans are in the middle class and thus are ineligible for VA care because of their incomes," said Cafferty. "They're too high. Others can't afford to make the co-payments, and some just simply lack veterans facilities in their communities."

The lead researcher on the study, Dr. David Himmelstein, of Cambridge Health Alliance, said in a press release that the problem was on the rise -- and pointed to universal health care as a possible fix.

"The number of uninsured vets has skyrocketed since 2000, and eligibility has been cut, barring hundreds of thousands of veterans from care,” said Himmelstein. “We need a solution that works for veterans, their families, and all Americans -- single payer national health insurance."

Cafferty said that even one uninsured American veteran was nothing short of a disgrace.

"That, in this humble fellow's opinion, is a national embarrassment," he said. "That we have any veterans in this country unable to get health care because they don't have the money, that's wrong."

At the end of the segment, Cafferty read an email from one North Carolina veteran denied coverage.

"I am a Vietnam era vet and I tried to get VA medical and was told that my income was too high. I then asked to be covered if I took the co-pay and was told that they were not accepting any new candidates," said the ex-military man. "That's about as close to 'get lost, vet' as you can get."

"That's pretty sad stuff," Cafferty concluded.

If You Don't Give A Damn About Our Children, Then How About Our Veterans?
Overlooked Provisions in Insurance Bill Have Significant Impact on Military Families
NEW YORK – Iraq and Afghanistan Veterans of America (IAVA), the nation's first and largest nonpartisan organization for veterans of the wars in Iraq and Afghanistan, today urged Congress to override the President’s veto of the State Children’s Health Insurance Program (SCHIP) reauthorization. SCHIP includes two little-known provisions which help the families of critically wounded troops. The provisions provide one year of employment discrimination protection to family members caring for severely injured troops, and extends permitted work leave for those family members from three months to six months.
Congress passed SCHIP earlier this month, but President Bush vetoed the legislation for reasons unrelated to these military families’ amendments. This Thursday, the House will vote on whether to override the President’s veto.
“Any member of Congress who supports the troops should vote to override the President’s veto. If SCHIP fails, so does this protection for families of our most grievously wounded troops. These service members and their families carry the heaviest burdens of this war and they need all the help they can get,” said Paul Rieckhoff, IAVA Executive Director. “Thanks to improved battlefield medicine, thousands of troops are surviving catastrophic injuries, but they face long and painful recoveries at home. The last thing these wounded heroes should have to worry about is whether the loved one at their bedside is going to lose his or her job.”
One in five severely wounded troops say a family member or friend has been forced to give up a job to care for them. This is true of Annette McLeod, who is featured in the national TV ad campaign IAVA is running this week to demand that Congress and the President improve care for veterans. Mrs. McLeod’s husband, Specialist Wendall McLeod, sustained multiple, life-threatening injuries while serving in Iraq. “When my husband returned home grievously wounded, it ripped my life apart,” said Mrs. McLeod. “I lived in South Carolina, but Wendell was being treated in Washington, DC. After just three months, the human resources department at the factory where I had worked for 20 years said I had exhausted my time off. Being forced to give up my job made a heart-wrenching and difficult time even harder.”
“Already this month, 70 service members have been injured in Iraq and Afghanistan. A number of them will require long-term care at hospitals which are far from their hometowns. The emotional and financial toll this takes on their loved ones is enormous,” said Rieckhoff.
“The time to protect these families is now. This is not a partisan issue; it’s simply a matter of treating the families of wounded troops fairly. We urge lawmakers to vote the right way on this issue.”
Two elements of SCHIP impact the families of wounded troops. The first provision, known as the ‘‘Support for Injured Servicemembers Act,” would allow up to six months of leave for family members who serve as primary caregivers of combat-wounded service members. Currently, the Family Medical Leave Act (FMLA) provides only up to three months of coverage.
The second portion, ‘‘Military Family Job Protection Act,’’ prohibits employment discrimination against these family members by protecting their employment, promotion, and benefits for up to one year. The provisions can be found under Subtitle C, sections 621 and 622.

Iraq and Afghanistan Veterans of America (IAVA) is the nation’s first and largest group for veterans of the wars in Iraq and Afghanistan. A non-profit and nonpartisan organization, IAVA represents more than 62,000 veteran members and civilian supporters in all 50 states.
To arrange an interview with Paul Rieckhoff, Annette McLeod or any other IAVA member veterans, please contact Michael Houston at (212)-982-9699, or email michael[at]iava.org. For more information or to view the ad, please visit www.iava.org.

Wounded Vets Also Suffer Financial Woes
Associated Press

He was one of America's first defenders on Sept. 11, 2001, a Marine who pulled burned bodies from the ruins of the Pentagon. He saw more horrors in Kuwait and Iraq.

Today, he can't keep a job, pay his bills, or chase thoughts of suicide from his tortured brain. In a few weeks, he may lose his house, too.

Gamal Awad, the American son of a Sudanese immigrant, exemplifies an emerging group of war veterans: the economic casualties.

More than in past wars, many wounded troops are coming home alive from the Middle East. That's a triumph for military medicine. But they often return hobbled by prolonged physical and mental injuries from homemade bombs and the unremitting anxiety of fighting a hidden enemy along blurred battle lines. Treatment, recovery and retraining often can't be assured quickly or cheaply.

These troops are just starting to seek help in large numbers, more than 185,000 so far. But the cost of their benefits is already testing resources set aside by government and threatening the future of these wounded veterans for decades to come, say economists and veterans' groups.

"The wounded and their families no longer trust that the government will take care of them the way they thought they'd be taken care of," says veterans advocate Mary Ellen Salzano.

How does a war veteran expect to be treated? "As a hero," she says.

Full Story


VA studies: PTSD care inconsistent

Posted on Sunday, September 16, 2007

WASHINGTON — The Department of Veterans Affairs, which touts its special programs to treat post-traumatic stress disorder in returning soldiers, spends little on those programs in some parts of the country, and some of its efforts fail to meet some of the VA's own goals, according to internal reports obtained by McClatchy Newspapers.

In fiscal year 2006, the reports show, some of the VA's specialized PTSD units spent a fraction of what the average unit did. Five medical centers — in California, Iowa, Louisiana, Tennessee and Wisconsin — spent about $100,000 on their PTSD clinical teams, less than

Veterans and mental health

one-fifth the national average.

The documents also show that while the VA's treatment for PTSD is generally effective, nearly a third of the agency's inpatient and other intensive PTSD units failed to meet at least one of the quality goals monitored by a VA health-research organization. The VA medical center in Lexington, Ky., failed to meet four of six quality goals, according to the internal reports.

A top VA mental-health official dismissed the reports' significance, saying veterans receive adequate care, either in specialized PTSD units or from general mental-health providers. In addition, he said, some of the spending differences aren't as extreme as the documents indicate, and the department is working to increase its resources for mental health treatment.

As the VA prepares for a surge of Iraq and Afghanistan veterans experiencing PTSD, it's come under fire for staffing and funding shortfalls in its mental health units and for the wide differences in how much it spends on such treatment at its medical centers.

The agency maintains that it delivers consistently high-quality treatment. "The best measurement of success, and what really counts, is how well we are doing in improving our patients' health," the agency's top medical official, Michael Kussman, said in a statement to McClatchy Newspapers earlier this year. "When we make comparisons among our facilities, our results are uniformly positive."

The spending and quality numbers are in two reports that a VA mental health-research office produces each year. The reports used to be readily available to the public, but the VA removed them from its Web site in the past year. McClatchy obtained the most recent reports, for fiscal year 2006, under provisions of the Freedom of Information Act.

One of the reports indicates that the number of veterans using the VA's specialized outpatient PTSD services is growing much faster than the number of medical appointments the VA is providing. The report shows that the number of veterans treated grew more than 4 percent from 2005 to 2006, while the number of appointments the VA provided grew just 1 percent, meaning that the average number of visits each veteran got dropped.

The report also says that the data "suggest considerable variability" across the VA in the delivery of some PTSD services.

"It is the task of thoughtful planning, performance assessment and clinical care to assure that, as VA passes through a period of major change during the years to come, the treatment provided to veterans with PTSD is equitably distributed, accessible, effective and efficient," the report concludes.

Paul Sullivan, a former VA official who works for the advocacy group Veterans for Common Sense, said the numbers indicated that the VA wasn't prepared to treat the number of soldiers who were coming home with PTSD.

"If the ominous trend continues or if all our Iraq soldiers return home quickly, VA's crisis may deteriorate into a full-blown catastrophe," he said.

The VA already is contending with the influx of troops from Iraq and Afghanistan as well as Vietnam-era and other veterans battling the ailment.

The agency provides mental health treatment at inpatient hospital wards and outpatient clinics. Care also is divided between general treatment and specialized programs for conditions such as PTSD.

The specialized programs are staffed by experts who concentrate on PTSD, and they've "long been recognized as an essential feature in treatment of military-related PTSD," one of the reports concludes.

"The availability of specialized PTSD programs is an important indicator of the quality of health care provided by VA," it says.

The most prevalent type of specialized program is an outpatient unit called a PTSD clinical team, and members of Congress and VA experts have pushed the agency to establish such a team at every VA medical center.

The VA has 153 medical centers, and one of the reports lists 103 centers with the special PTSD clinical units as of the end of fiscal 2006. The VA has added such units rapidly in the past year, and by the end of this year about 120 centers will have them, according to a May statement by the department.

Spending varies widely among the units, however, from more than $2,000 per treated veteran in centers in The Bronx, N.Y., and Boise, Idaho, to about $300 per treated veteran in Augusta, Ga., and about $200 in Palo Alto, Calif., one of the reports says.

Ira Katz, a top VA mental-health official, said different medical centers used different accounting systems but that the VA was working to make its PTSD care more uniform across the country.

"We want to increase the expectation of what kind of care every veteran can expect, no matter where they are," Katz said.

VA leaders are to meet this fall to help standardize the agency's PTSD program offerings. Over time, Katz said, spending on the programs will increase and the range among different centers will narrow.

Gauging the effectiveness of PTSD treatment is an inexact science, but one of the reports attempts to do so.

For treatment in hospital inpatient and other similar units, VA researchers track veterans' PTSD symptoms as well as their abuse of drugs or alcohol, propensity for violence and work habits.

They then adjust the results to account for the differences in the veterans being treated at each VA center, such as the severity of the veteran's mental illness.

Overall, the results show, treatment is effective: PTSD symptoms are reduced, for example. But some programs were better than others.

Only about 40 of the 153 VA medical centers had the specialized inpatient units, and not all of them had enough data to analyze. But 11 of the 36 that did, including the Lexington center, failed to meet at least one of the treatment goals the report tracked.

The VA researchers also came up with what they said was an overall measure of quality similar to a "cumulative grade-point average."

Lexington got the lowest marks; the VA center in Coatesville, Pa., was first. Katz said the Lexington medical center already had started to receive funding to support 20 new mental-health workers in an attempt to boost its outreach, education and treatment.

In a series of e-mails, however, he dismissed the reports' significance, saying they were produced by an internal VA research unit that's outside the agency's "formal quality improvement process."

Although the unit has been refining and publishing financial figures for several years, Katz said, the financial figures for individual PTSD programs aren't "meaningful" because of the VA centers' differing accounting procedures.

As for the services being provided, Katz said that veterans who weren't being cared for by the VA's specialized programs received "comparable care" from the system's general mental-health units. Finally, he said, the differences in outcomes among the units are minor.

"VA is always looking for ways to improve the care it provides," he said. "The apparent differences in spending and outcomes are possible signals, not scandals."

2007 McClatchy Newspapers

VA May Win Boost In Funding For Mental Conditions Caused By War
Chris Adams | McClatchy Newspapers

WASHINGTON — Congressional appropriators are pushing a huge increase in spending for the Department of Veterans Affairs, despite some resistance from the White House.

Prompted by concerns that the VA can't adequately care for soldiers coming home from Iraq and Afghanistan, as well as older veterans already in the system, Congress is instructing the VA to push more money toward treatment of mental health and traumatic brain injuries.

A report by McClatchy Newspapers on inadequate treatment of mental ailments among veterans was specifically mentioned by Congress.

In recent days, appropriations bills for VA spending have moved through the House of Representatives and await a full-Senate vote. While there are slight differences between the bills, they call for a total of about $43 billion in health care and other discretionary VA funds — an increase of more than $6.5 billion, or about 18 percent, over the amount enacted for fiscal 2007, and substantially more than the president's proposal.

The White House last week said the congressional efforts involve an "excessive level of spending" and that the president's proposal of about $39 billion gives the VA "ample resources."

If Congress insists on increasing the VA budget, the White House said in a statement, it must cut other parts of the overall budget, ensuring that total spending remains under a certain level. If it doesn't, the president said he would veto other unspecified spending bills to bring the overall package in line.

But with broad support in both houses, Joseph A. Violante of the Disabled American Veterans said the VA budget appears safe. "Now we have to hold them accountable," he said.

The bills increase the president's request for mental health treatment, for building maintenance and for hiring workers to speed the processing of disability claims.

The House bill includes an extra $604 million for new initiatives in treating mental health, post-traumatic stress disorder and traumatic brain injury. It includes an extra $508 million for maintaining and renovating buildings.

The spending increases were spurred in part by complaints from veterans' groups and media coverage of poor or inconsistent treatment of America's veterans.

On Feb. 11, McClatchy Newspapers revealed how the VA's mental health spending was insufficient, leaving wide disparities in services and access. House and Senate Veterans' Committee members cited McClatchy's report as they urged Congress to boost mental health spending.

A week later, stories in The Washington Post prompted a major scandal as they detailed substandard care and poor maintenance at Walter Reed Army Medical Center. Although Walter Reed is a Department of Defense facility and not run by the VA, Congress is giving extra money to the VA to avoid similar problems in its medical centers.



Last Thursday, the House passed a comprehensive $646 billion defense spending bill by an overwhelming vote of 397-27. The bill authorizes "more than $100 billion in military procurement. That includes money to buy new protective vehicles and body armor for troops, and an additional $142 billion for the wars in Iraq and Afghanistan."

But the White House is threatening to veto the bill because it objects to, among other things, a recommended 3.5 percent military pay raise for 2008, with further increases in 2009 through 2012.

The increases are "intended to reduce the gap between military and civilian pay that stands at about 3.9 percent today." Even after the proposed increases, the gap will still remain at 1.4 percent.

In a statement of administration policy released Wednesday, White House budget officials said the administration "strongly opposes" the pay raise provision because, according to them, extra pay increases are "unnecessary."

The White House is also objecting to a $40 monthly allowance for military survivors, additional benefits for surviving family members of civilian employees, and price controls for prescription drugs under Tricare, the military's health care plan for military personnel and their dependents. Bush's veto threat is holding captive all the funding contained in the bill.


"This is a strong bill that addresses our military's critical readiness needs, supports our troops in the field and at home and protects the American people," said Rep. Ike Skelton (D-MO), the chairman of the House Armed Services Committee.

Veterans groups and members of Congress are rightly outraged at the administration's callous veto threat. "The president just vetoed legislation so he would be able to send more troops into the middle of the Iraqi...civil war -- without end, mind you -- but is against increasing benefits to the spouses of those lost, or a pay increase for those who are serving," wrote Jon Soltz, the co-founder of VoteVets.org.

"If there's a more fitting definition of 'outrage,' I'd love to see it." Rep. Rahm Emanuel (D-IL) said, "The President is a lot of talk when it comes to supporting the troops and their families. ... But actions matter and when it comes to the treatment of our troops and their families, our resources must match our rhetoric."


In April, Defense Secretary Robert Gates announced that he was "extending the tours of duty for active duty Army troops in Iraq and Afghanistan from 12 to 15 months." To no surprise, many soldiers reacted to the forced extensions with "anger," "frustration," and a "collective groan." 

The White House is now facing increased pressure "to ease the strain on the lives of military families suffering as a result of the extended tours of duty in Iraq and Afghanistan and frequent redeployment."

Estrangement from family back home is one of the more significant problems for soldiers facing extended tours. The divorce rate of active-duty soldiers has risen sharply with increased deployments. In 2004, 7,152 enlisted personnel's marriages ended in divorce, up 28 percent from 2003 and 53 percent from 2000; the rate is still increasing.

A recent Pentagon report also found that the more soldiers are deployed, the more likely they are to "suffer mental health problems such as combat trauma, anxiety and depression," contributing to increased problems at home.

A provision in the defense bill passed by the House last Thursday, aimed at helping soldiers struggling with divorce at home, preventing them from "permanently losing custody of their children because of the absence." But with Bush's veto threat, that legal relief is now in jeopardy.


The Army began the Iraq war with an estimated $56 billion equipment shortage. Since then, soldiers and their families have been complaining that troops on the ground have not been provided with the protective gear and equipment they need.

In 2004, then-Secretary of Defense Donald Rumsfeld was famously confronted at a townhall discussion by an active-duty soldier in Kuwait, who asked him, "Why do we soldiers have to dig through local landfills for pieces of scrap metal and compromised ballistic glass to up armor our vehicles?"

As recently as February, U.S. Army units in Iraq and Afghanistan lacked more than 4,000 of "the latest Humvee armor kit, known as the FRAG Kit 5," which is specifically "designed to reduce U.S. troop deaths from roadside bombs...that are now inflicting 70 percent of the American casualties" in Iraq.

Shortages in body armor for troops have also been a constant problem, forcing many families to buy the armor on their own, "despite assurances from the military that the gear will be in hand before they're in harm's way."

A Defense Department audit released in January found that many soldiers have been sent to Iraq "without enough guns, ammunition, and other necessary supplies to 'effectively complete their missions' and have had to cancel and postpone some assignments while waiting for the proper gear."

Even the Army's so-called "ready brigade" has found that with the wars in Iraq and Afghanistan sapping resources, they are no longer quite so ready. For decades, a brigade of the 82nd Airborne Division has been ready to respond to a crisis anywhere in 18 to 72 hours, but now, its soldiers are not fully trained and much of it's equipment, including the cargo aircraft that is supposed to carry it to emergency, is disbursed elsewhere.


The Bush administration's military priorities were clear the moment former Secretary of Defense Donald Rumsfeld took control of the Pentagon. Barely six months into their Department of Defense tenure, Rumsfeld and his aides sought "deep personnel cuts to the Army, Navy and Air Force in order to pay for new high-tech weaponry and missile defenses."

The belief in technology over manpower has resulted in policies that ignore the real human concerns of those who wear the uniform. In Aug. 2003, just six months after the invasion of Iraq, the Pentagon sought to deny the 157,000 troops serving in Iraq and Afghanistan a promised pay increase of "$75 a month in 'imminent danger pay' and $150 a month in 'family separation allowances.'" 

The Defense Department at the time defended cutting the added benefits, "saying its budget can't sustain the higher payments amid a host of other priorities." The proposed cuts angered military families and veterans' groups and even received an editorial attack in the Army Times.

The editorial noted that "Bush's tax cuts have left little elbow room" in the federal budget "and the squeeze is on across the board." Though Congress ultimately approved of the pay increase the Bush administration backpedaled in its opposition.



On April 11, Defense Secretary Robert Gates announced that tours of duty for the Army would be extended from 12 months to 15 months, effective immediately.

In exchange for the extensions, soldiers would receive at least a year home between deployments. This rest time was intended to "provide some long-term predictability for the soldiers and their families...particularly guaranteeing that they will be at home for a full 12 months," Gates added.

But Gates has not kept his promise. Last Thursday, Stars and Stripes reported, "Members of the 1st Armored Division's 1st Battalion, 6th Infantry, Company A, learned Tuesday that they are scheduled to head back to Iraq in November, just nine months after the 150-soldier company left the combat zone in February after a 13-month deployment."

A recent Pentagon report concluded that soldiers on extended and repeated deployments "were more likely to suffer acute stress, and that mental health problems correlated with higher rates of battlefield misconduct."

When asked about this nine-month deployment, Gates simply replied, "I'll be very interested in finding out more about that."

Pentagon spokesman Bryan Whitman's response was that "there are some people, just by the nature of transferring units and things like that may not end up with the full 12 months." According to Whitman, the 12-month rest period between deployments "is a goal," not a guarantee.


Flawed System May Hurt Disabled Soldiers
Associated Press

The way the government rates service members' disabilities is inconsistent, and the Army might be shortchanging injured soldiers, the chairman of a special commission said Thursday.

Testifying before a Senate panel, retired Lt. Gen. James Terry Scott, chairman of the Veterans' Disability Benefits Commission, detailed problems in the Pentagon and Veterans Affairs ratings systems. Critics contend the ratings are easily manipulated to limit disability payments and create undue confusion in a claims system already strained to the limit.

"It is apparent that service members are not well served," Scott said in testimony prepared for delivery to an unusual joint hearing of the Senate Armed Services and Veterans Affairs committees called to examine gaps in the system.

In a preliminary review of Pentagon and VA data, the commission found the Army was much more likely than the other active forces to assign a disability rating of less than 30 percent, the typical cutoff to determine whether a person can get lifetime retirement payments and health care.

VA ratings tended to be higher, due to a separate system the department used that gave consideration to whether injured veterans were afflicted with multiple disabilities — not just a predominant one.

While the differing standards account for some inconsistencies, "it is also apparent that DOD has strong incentive to assign ratings less than 30 percent so that only separation pay is required," Scott said in testimony. His commission was formed in 2004 to study ways to improve the benefits system and is scheduled to issue a report later this year.

Scott also faulted the failure of the Pentagon and VA to work more effectively to create a shared electronic system for health records. He said his commission had repeatedly gotten vague, misleading or outright inaccurate explanations from the departments.

The Senate hearing is the latest to examine troop care after disclosures in February of shoddy conditions and outpatient treatment at Walter Reed Army Medical Center, one of the premier facilities for treating injured service members from Iraq and Afghanistan.

Among the complaints are the difficulties troops and veterans have in navigating the health care system, including long waits, lost paperwork and subjective ratings as they move from military hospitals to the VA's vast network of 1,400 clinics and treatment facilities.

The Army has acknowledged that it must improve its disability ratings system, and the Pentagon and VA have pledged to work together, most recently touting plans to share inpatient records in one system.

"A full solution is still several years away," Deputy Defense Secretary Gordon England said in prepared testimony, while offering assurances that he and VA Secretary Jim Nicholson do confer "when issues need to be addressed at our level."

Since the Walter Reed controversy, three high-level Pentagon officials have been forced to step down, including former Army Secretary Francis Harvey and Maj. Gen. George W. Weightman and Lt. Gen. Kevin Kiley, the two previous commanders at Walter Reed.

An independent review group appointed by Defense Secretary Robert Gates this week said that money woes and Pentagon neglect were to blame for many of the problems, concluding that "leadership at Walter Reed should have been aware of poor living conditions and administrative hurdles" but chose to ignore them.

But on Thursday, acting Army Secretary Pete Geren expressed confidence in the new leadership at Walter Reed. He said numerous steps have been taken to improve conditions, such as adding more case managers, setting up phone hot lines and reducing paperwork.

"We are under no illusions that the work ahead will be easy or quick — or cheap; we have a lot to do to get this right," Geren said. "Mending the seams and fixing the myriad issues we have recently uncovered will take energy, patience, determination and above all, political will."


Pentagon Probing Care of Retired Vets
Associated Press

WASHINGTON (AP) Responding to more allegations of poor health care for veterans, the Pentagon said Thursday it is investigating conditions at a historic retirement home in the capital.

The Defense Department sent a medical team on an inspection visit Wednesday after Defense Secretary Robert Gates received a letter from the Government Accountability Office reporting allegations of a rising death rate and rooms spattered with blood, urine and feces at the Armed Forces Retirement Home in Northwest Washington.

"We are going to take every complaint and we are going to address it," said Maj. Stewart T. Upton, a Pentagon spokesman.

The GAO letter comes a month after revelations of poor living conditions and bureaucratic delays at Walter Reed Army Medical Center, a scandal that has forced the resignations of three high-level Army officials.

That controversy also has prompted a review of the vast network of clinics and hospitals run by the Veterans Affairs - found in a separate probe this week to be beset by maintenance problems such as mold, leaking roofs and even a colony of bats.

The retirement home, formerly known as the Soldiers' and Airmen's Home, was opened in 1851 for wounded and disabled war veterans and is home to more than 1,000 retirees.


Appropriators Vote to Keep Walter Reed Open
House Committee's Action Could Reverse Base Closing Scheduled for 2011
By Steve Vogel
Washington Post Staff Writer

The House Appropriations Committee unanimously approved a measure yesterday that bars the closure of Walter Reed Army Medical Center, an action supporters say will reverse plans to shut the hospital in 2011.

The provision, attached to a bill with additional funding for the wars in Iraq and Afghanistan, blocks the use of any federal money to close Walter Reed.

Keeping open a base that has been chosen for closure by the Defense Department's Base Realignment and Closure Commission would be unprecedented. The system creating an independent commission to make such decisions was adopted by Congress to prevent political interference with base closures. But recent disclosures of serious problems with the long-term care of wounded soldiers at Walter Reed have sparked calls in Congress and elsewhere to reverse the decision. Senior Army officials also suggested that the decision be reconsidered.

"This is a done deal," Rep. James P. Moran Jr. (D-Va.), a committee member, said after the hearing. "Walter Reed will stay open."

"I can say without fear of contradiction it's not going to close," said Del. Eleanor Holmes Norton (D-D.C.).

Walter Reed was selected to be closed by the BRAC panel in 2005. The recommendation, which Congress approved and President Bush signed into law, calls for the Army hospital to be consolidated with the National Naval Medical Center in Bethesda, where a $2 billion expansion is planned.

Yesterday's amendment came with bipartisan muscle, including the support of Rep. John P. Murtha (D-Pa.), chairman of the Appropriations military subcommittee, and Rep. C.W. Bill Young (R-Fla.), the panel's ranking Republican. A spokesman for Murtha, Matt Mazonkey, said that the prospects for approval by Congress are good but that some members may be loath to open the BRAC process for other reversals.

Jeremiah Gertler, a senior analyst for the 1995 BRAC commission, said last week that Congress would have to invalidate the existing regulation and create a new law.

But Moran said the committee's action yesterday will be sufficient. "What they're saying is BRAC is sacrosanct, and a lot of us don't believe that's the case," Moran said. "If this unravels BRAC, too bad."

The language specifies that "none of the funds in this or any other Act may be used to close Walter Reed Army Medical Center."

It is a tiny part of a $124 billion emergency war spending bill that would set timetables for the withdrawal of combat forces from Iraq.

That bill goes to the House floor next week. Bush has vowed to veto any war spending bill that sets timelines for troop withdrawals or conditions for the use of combat forces, as the House bill does.

Still, the overwhelming support shown for the Walter Reed measure should buoy supporters. If the provision does not survive in the spending bill, it will almost certainly be revisited in a separate war policy bill that will come before Congress later this year and in a defense spending bill for 2008.

Staff writer Jonathan Weisman contributed to this report.



Members of Congress were aware of the abhorrent conditions that soldiers at Walter Reed faced several years before the issue erupted in the Washington Post last month.

In a subcommittee hearing, Rep. Bill Young (R-FL), who was chairman of the House Appropriations Defense Subcommittee at the time, said he and his wife frequently visited veterans residing in poor conditions at the hospital and even "got in Gen. Kiley's face on a regular basis," but Young refused to use his influence as a congressman to bring attention to the problem out of fear of undermining war efforts.

"We did not go public with these concerns, because we did not want to undermine the confidence of the patients and their families and give the Army a black eye," said Young.

Young added that he falsely believed the many instances of patient neglect he witnessed were "basically isolated cases, soldier by soldier" and not evidence of a more systemic problem. Young instead continued to blame Kiley, maintaining, "Appropriations alone cannot solve all problems."

Rep. Thomas M. Davis, III (R-VA), former chairman of the House Government Reform Committee, said he and his committee staff learned about the problems of wounded soldiers' health care in 2004 and directed the Government Accountability Office to "conduct several studies" on the matter. But Davis did not pressure committees or House leaders for better funding or new legislation to address the problems he witnessed.

Rep. John Murtha (D-PA) did attempt to raise awareness about the issue by seeking appropriations to address the problems he saw during visits to veterans hospitals, lambasting the Bush administration and Pentagon for discouraging patients and government officials from talking to legislators.

Starting this past Friday, the House Armed Services Committee and Veterans Affairs Committee will hold hearings on Walter Reed.


Veterans Face Consecutive Budget Cuts
Associated Press

The Bush administration plans to cut funding for veterans' health care two years from now — even as badly wounded troops returning from Iraq could overwhelm the system.

Bush is using the cuts, critics say, to help fulfill his pledge to balance the budget by 2012.

After an increase sought for next year, the Bush budget would turn current trends on their head. Even though the cost of providing medical care to veterans has been growing rapidly — by more than 10 percent in many years — White House budget documents assume consecutive cutbacks in 2009 and 2010 and a freeze thereafter.

The proposed cuts are unrealistic in light of recent VA budget trends — its medical care budget has risen every year for two decades and 83 percent in the six years since Bush took office — sowing suspicion that the White House is simply making them up to make its long-term deficit figures look better.

"Either the administration is willingly proposing massive cuts in VA health care," said Rep. Chet Edwards (news, bio, voting record) of Texas, chairman of the panel overseeing the VA's budget. "Or its promise of a balanced budget by 2012 is based on completely unrealistic assumptions."

Edwards said that a more realistic estimate of veterans costs is $16 billion higher than the Bush estimate for 2012.

In fact, even the White House doesn't seem serious about the numbers. It says the long-term budget numbers don't represent actual administration policies. Similar cuts assumed in earlier budgets have been reversed.

The veterans cuts, said White House budget office spokesman Sean Kevelighan, "don't reflect any policy decisions. We'll revisit them when we do the (future) budgets."

The number of veterans coming into the VA health care system has been rising by about 5 percent a year as the number of people returning from Iraq with illnesses or injuries keep rising. Iraq and Afghanistan war veterans represent almost 5 percent of the VA's patient caseload, and many are returning from battle with grievous injuries requiring costly care, such as traumatic brain injuries.

All told, the VA expects to treat about 5.8 million patients next year, including 263,000 veterans from Iraq and Afghanistan.

The White House budget office, however, assumes that the veterans' medical services budget — up 83 percent since Bush took office and winning a big increase in Bush's proposed 2008 budget — can absorb a 2 percent cut the following year and remain essentially frozen for three years in a row after that.

"It's implausible," Sen. Patty Murray (news, bio, voting record), D-Wash., said of the budget projections.

The White House made virtually identical assumptions last year — a big increase in the first year of the budget and cuts for every year thereafter to veterans medical care. Now, the White House estimate for 2008 is more than $4 billion higher than Bush figured last year.

And the VA has been known to get short-term estimates wrong as well. Two years ago, Congress had to pass an emergency $1.5 billion infusion for veterans health programs for 2005 and added $2.7 billion to Bush's request for 2006. The VA underestimated the number of veterans, including those from Iraq and Afghanistan, who were seeking care, as well as the cost of treatment and long-term care.

The budget for hospital and medical care for veterans is funded for the current year at $35.6 billion, and would rise to $39.6 billion in 2008 under Bush's budget. That's about 9 percent. But the budget faces a cut to $38.8 billion in 2009 and would hover around that level through 2012.

The cuts come even as the number of veterans from the Iraq and Afghanistan wars is expected to increase 26 percent next year.

In Bush's proposal to balance the budget by 2012, he's assuming that spending on domestic agency operating budgets will increase by about 1 percent each year.


Many U.S. troops short on crucial gear
Associated Press Writer

Hundreds of U.S. troops in Iraq and Afghanistan have experienced shortages of key protective equipment including armored vehicles, roadside-bomb countermeasures and communications gear, a Pentagon survey released Tuesday shows.

The Defense Department Inspector General's Office polled roughly 1,100 service members and found they weren't always adequately equipped for their missions. The troops were interviewed in Iraq and Afghanistan last May and June.

Those surveyed reported shortcoming with vehicles outfitted with armor; "crew-served weapons," which are weapons it takes more than one person to handle, such as artillery or a large machine gun; electronic countermeasure devices, such as equipment designed to foil roadside bombs by interfering with cell-phone signals that may be used to detonate them; and communications equipment.

The survey found that those not getting needed gear include troops performing untraditional missions such as training, reconstruction, detainee operations and explosive ordnance disposal.

In some cases, they went ahead with the work anyway, used informal means to get what they needed or canceled or put off operations while waiting for equipment, the report summary said.

The report found the U.S. Central Command and the Army's internal equipment controls inadequate and recommends improvements.

Only a summary of the findings were made public; much of the report is classified.



A new report by the Government Accountability Office found the "Department of Veterans Affairs did not spend all of the extra $300 million it budgeted to increase mental health services and failed to keep track of how some of the money was used."

"VA tracking of spending for plan initiatives was inadequate," the report concluded.

"VA launched a plan in 2004 to improve its mental health services for veterans with post-traumatic stress disorder and substance-abuse problems. To fill gaps in services, the department added $100 million for mental health initiatives in 2005 and $200 million in 2006.

That money was to be distributed to its regional networks of hospitals, medical centers and clinics for new services.

But VA fell short of the spending, by $12 million in 2005 and about $42 million in fiscal 2006." "In addition, VA cannot determine to what extent about $112 million was spent on mental health services improvements or new services in 2006."

The report also found service gaps "in treating veterans with serious mental illness, female veterans, and veterans returning from combat in Iraq and Afghanistan."

"There are thousands of men and women who come home from war and are told they need to wait months for a counseling appointment at the VA," said Paul Rieckhoff, Executive Director of Iraq and Afghanistan Veterans of America. "That is unacceptable."



VoteVets.org, a political advocacy group formed and funded by veterans, released the first-ever poll of Iraq and Afghanistan veterans yesterday.

Respondents, most of whom were conservatives, delivered a damaging assessment of the current state of the military.

"Forty-two percent of the troops surveyed said their equipment was below the military standard of being 90 percent operational.

Nearly two-thirds said the Army and Marines were overextended, and a quarter said their families faced hard times financially because of their deployments."

Jon Soltz, an Iraq war veteran and chairman of VoteVets, said, "The results of this poll should be a wake up call to every American.

We are shortchanging our troops, in combat and at home." He added, "I am proud of my service in Iraq, but my job was made more difficult by the real life-or-death challenges I faced when it came to equipment and supplies that were inadequate or not fully operational."

See the full results here.



Last year, "commanders in Iraq began asking the Pentagon for a new system to counter" what is quickly becoming the weapon of choice for insurgents in Iraq and Afghanistan: rocket-propelled grenades, or RPGs. Instead of employing an already well-established defense system, the Pentagon chose to award the contract to "one of its favored defense contractors," Raytheon.

Indeed, the "Trophy" system, designed by an Israeli company, is "designed to fit on top of tanks and other armored vehicles like the Stryker now in use in Iraq" and protect against RPGs using radar and interceptor missiles.

When the Pentagon's Office of Force Transformation (OFT) tested the Trophy system in March, they "found it at least 98 percent effective against RPGs in near-battlefield conditions."

Despite the OFT's initial plan to buy several system, the Army rejected the idea. Instead, the $70 million contract was granted to Raytheon, a company which, "at almost every turn...was given a significant competitive advantage over other defense contractors," according to an NBC News investigation.

For example, of the 21-person team chosen by the army to evaluate competing systems, nine were from Raytheon.

Unlike the Trophy system, which is nearing use in Israel, the Raytheon system must be developed from scratch and "will not be fielded before 2011 at the earliest."

Asks one senior Pentagon official, "what are our troops in the field supposed to do for the next five or six years?”

The Pentagon, and Donald Rumsfeld, are willing to let more American soldiers die over the next five years,


Money for Brain Injury Treatment for Troops Slashed
Outraged Veterans Say Congress 'Out of Touch'


WASHINGTON,  The head of biggest combat veterans groups lambasted congressional action that cut in half federal funding for the research and treatment of brain injuries caused by explosions, which one neurology expert has called the signature injury of the war in Iraq.

The proposed funding cut "clearly indicates that the Congress is out of touch with the realities and consequences of war," Jim Mueller, the outgoing commander in chief of the Veterans of Foreign Wars and a Vietnam War veteran, said in a written statement. "You either take care of the troops or you do not."

Vice President Cheney, addressing the group's national convention in Reno, Nev., Monday pledged to "enhance the respect shown by our government to veterans ... not just in words but in resources."

The Bush administration has requested $7 million in funding for the Defense and Veterans Brain Injury Center as it has done for the last several years, but in the past, Congress has given the center another $7 million, for a total of $14 million. This year, though, Congress has not added the additional funding.

The House passed its version of the spending bill in June and the Senate is to take up the bill when lawmakers return from their August recess.

A spokesman for the Senate Appropriations Committee said the reduction in funding from previous years was the result of spending restraints.

The center, actually a network of facilities around the country, is a collaboration between the Pentagon and the Veterans Affairs Department. Founded in 1992, it operates at seven military and VA medical centers around the nation, and runs a civilian clinic in Charlottesville, Va.

In addition to treating combat veterans, the centers also treat other government employees, including State Department officials who have suffered traumatic brain injuries in the line of their official duties. The program also researches ways to better diagnose brain injuries.

Traumatic brain injuries result from a violent blow to the head -- what's known as a closed-head injury -- or from a bullet or shrapnel that penetrates the brain.

George Zitnay, a Charlottesville brain injury expert who is a co-founder of the Defense and Veterans Brain Injury Center, told ABC News earlier this year that traumatic brain injury is the "signature injury of the war on terrorism."

That's because of the proliferation of roadside bombs in Iraq and improved body armor that shields troops from lethal wounds but can do nothing about the violent jolts to even helmeted heads that can damage the brain as it bounces off the inside of the skull.

As a result, more troops are surviving injuries suffered in Iraq than in previous wars, but more troops are surviving with permanent injuries. According to Pentagon data reported in the New England Journal of Medicine, only about 10 percent of wounds in Iraq are lethal -- less than half the rate in the first Persian Gulf War, Vietnam and Korea each, and a full one-third of the rate in World War II.

By one estimate, as many as 10 percent of all troops in Iraq and up to 20 percent of front-line infantry suffer concussions during combat tours.

Traumatic brain injury can have a wide range of effects. Depending on the part of the brain that's damaged, victims can have difficulty understanding or formulating speech, counting or doing simple math, or undergo personality changes.

"It is absolutely inexcusable that lawmakers would slash funding during a time of war for a research center that is earning its keep by addressing the exact types of injuries our troops are suffering," said Jim Mueller of the Veterans of Foreign Wars. "This research center is an investment in the future potential of traumatically disabled soldiers. It is not an expense."



Following the advice of the taxpayer-funded Institute for Defense Analyses (IDA), the Air Force recently approved an $11 billion contract for the controversial F-22 fighter jet, arguably the Pentagon’s most useless weapon system

One of the most expensive fighter programs ever undertaken, the F-22 has been plagued by cost overruns and technical difficulties, including a cockpit door that got stuck and defective landing gear that led to crashing a plane on its nose.

More importantly, the jet is unnecessary, conceived in 1985 to fight a Soviet fighter jet that was never built.

Ignoring bipartisan opposition and criticism from the Government Accountability Office and the Congressional Research Service, which both concluded that the plane was "unqualified" for an extended contract, the Pentagon based its support for the F-22 system on an endorsement from the "independent" IDA.

But as the Washington Post reported last week, IDA President Dennis Blair is a "member of the board of a subcontractor for the F-22 Raptor fighter program, EDO Corp."

Although Blair admits he was "at the top of the process" of drafting the report urging the Pentagon to approve the contract, he refused to recuse himself.

Senate Armed Services Charmain John Warner (R-VA) called the news "extremely, extremely disturbing," and asked the Pentagon to "clean up" this "sad" situation.



The Bush administration has reneged on its offer of free credit-monitoring to help the 26.5 million veterans and service-members whose personal data was stolen from a Department of Veterans Affairs employee's laptop.

Citing the FBI's "high degree of confidence" that nothing sensitive was accessed, Deputy VA Secretary Gordon Mansfield said that legislation proposed after the burglary, which would require mandatory warnings to victims in the event of a data breach, is now "no longer necessary."

Leaders of veterans groups reacted angrily that the administration will not err "on the side of safety or on the side of veterans," especially since, according to Jim Mueller of the Veterans of Foreign Wars, "Computer industry experts are telling us the exact opposite of what the FBI has reported."

The VA inspector general's office found that the department had "poorly protected" the sensitive information and responded to the theft with "indifference and little sense of urgency or responsibility" at nearly every step.

Senate Veterans Affairs Committee chairman Larry Craig (R-Idaho) said the report is “a stinging indictment of a security system that was lax to nonexistent.”


Bush Backs War Lords in Somalia, who were responsible for the downing of two Black Hawk Helicopters, and the Deaths of 18 Army Rangers in 1993:

"After months of fierce fighting," the New York Times reports, Islamic militias last week declared "that they had taken control of Somalia's capital, Mogadishu, defeating the warlords widely believed to be backed by the United States and raising questions about whether the country would head down an extremist path."

With the warlords on the run, "it appeared that Washington had backed the losing side, presenting the administration with a major setback at a time of continued sectarian violence in Iraq and the resurgence of the Taliban in Afghanistan."

Last month, the Washington Post reported the Bush administration was "secretly supporting secular warlords" in Somalia, some of whom had reportedly "fought against the United States in 1993 during street battles that culminated in an attack that downed two U.S. Black Hawk helicopters and left 18 Army Rangers dead." (The International Crisis Group estimates the U.S. made payments between $100,000 and $150,000 per month to these warlords.)

"Many in Mogadishu said the common belief that the United States was taking sides only strengthened the Islamists, who accused the warlords of being puppets of Washington."


Memorial Day: Duty to veterans


On this Memorial Day, the tally of U.S. soldiers killed in Afghanistan and Iraq is nearing 2,500 and, as always, having U.S. troops in harm's way adds a special poignancy to what is to many of us no more than a three-day weekend.

Dying at a much faster rate, of course, are World War II veterans -- at a rate of more than 1,000 a day, old age proving a more relentless enemy than those they faced on the battlefield.

Few who survive combat do so completely unscarred. For some, the emotional wounds are deep and enduring.

Nearly 1.3 million U.S. military men and women have returned from duty in Afghanistan and Iraq, and like veterans of previous wars, they may face mental health issues as a result.

Are we prepared to help them deal with this cost of having done their duty?

Sen. Patty Murray, D-Wash., is concerned that the military is not sufficiently prepared. The senator points to alarming comments by the VA's undersecretary for health policy coordination, Dr. Frances Murphy. Quoted in Psychiatric News, Murphy said that some VA clinics do not provide mental health or substance abuse care or, if they do, "waiting lists render that care virtually inaccessible."

Murray says Murphy's remarks seem to conflict with VA Secretary Jim Nicholson's assurances that the agency has enough funding to care for veterans.

It's a timely reminder of the debt the nation owes its veterans.



Thirteen military associations are rallying support to block the Bush administration's efforts to the instill new fee increases for Tricare, the health system for military retirees under the age of 65. 

The Military Retirees’ Healthcare Protection Act, HR 4949, would prevent increases in enrollment fees and pharmacy co-pays that could affect three million military retirees and their families unless and until Congress approved changes that would then have to be signed into law.

The bill was introduced in Congress last Tuesday and has already gained 64 co-sponsors in the House. The bill's chief sponsor, Rep. Chet Edwards (D-TX), wondered how people would react if the bill he introduced had "created a tax — $1,000 for retired officers and $490 for retired enlisted people — and had that money go to cover the cost of the war?

That wouldn't be well received, would it? But that is, essentially, what the Bush administration is asking — for retirees to be charged to cover military expenses." 

The Military Officers Association of America has come up with a list of 16 options for reducing military health care costs without increasing fees.



The National Journal reports that two classified intelligence briefs delivered directly to President Bush prior to the Iraq war "cast doubt on key public assertions made by the president, Vice President Cheney, and other administration officials as justifications for invading Iraq."

The first report, delivered to Bush in October 2002, stated that the Energy Department and the State Department's Bureau of Intelligence and Research believed that Iraq's aluminum tubes were "intended for conventional weapons," a view contradicting Bush's statement that the aluminum tubes were being used to enrich nuclear weapons.

A second report informed Bush that "U.S. intelligence agencies unanimously agreed that it was unlikely that Saddam would try to attack the United States -- except if 'ongoing military operations risked the imminent demise of his regime.'"

This report contradicts claims by administration officials at the time that Iraq was a "grave and gathering threat."



President Bush has argued previously that he made a "miscalculation of what the conditions would be" in postwar Iraq.

In fact, as numerous leaked reports have shown, Bush had been presented a great deal of intelligence warning of the postwar chaos, and he simply ignored them.

Most recently, Stuart W. Bowen Jr., the special inspector general for Iraq reconstruction, said, "There was insufficient systematic planning for human capital management in Iraq before and during the U.S.-directed stabilization and reconstruction operations."

Similarly, Knight-Ridder reported last week that a National Intelligence Estimate completed in October 2003 warned that the "insurgency in Iraq had deep local roots, was likely to worsen and could lead to civil war."

When a report by the National Intelligence Council warning about the prospects of a civil war in Iraq was made public in mid-2004, Bush dismissed the analysis as "just guessing." 

A review by former intelligence officers concluded in late 2005 that the Bush administration "apparently paid little or no attention" to prewar assessments by the Central Intelligence Agency that warned of major cultural and political obstacles to stability in postwar Iraq.

The incompetence appears to have stemmed from a "flawed and rushed war-planning process."

President Bush and Defense Secretary Donald Rumsfeld have proposed fee hikes to the Pentagon’s health care system,
TRICARE, that could deny health benefits to as many as 600,000 veterans.
Under Bush's proposal, military retirees would be forced to pay higher prescription drug co-payments and annual enrollment fees. The plan would triple health care costs for retirees.
The Military Officers Association of America says the administration is playing a “shell game” by steering military retirees away from TRICARE and instead toward health plans offered by their current employers.
Rep. John McHugh (R-NY), military personnel subcommittee chairman, said, "I guess we could talk about the morality of that, if that’s the way to contain costs [by] persuading people not to use health care. But I’m going to put that aside."


"Struggling to boost its ranks in wartime," the U.S. Army has "sharply increased the number of recruits who would normally be barred" because of medical problems, alcohol or illegal drug addiction, or a history of criminal misconduct.

In the latest 12-month recruiting period, the Army granted waivers to just over 11,000 Army recruits, some 15 percent of the total, "raising concerns that the Army is lowering its standards to make recruiting goals."

The largest proportion of waivers went to recruits with past medical problems, but there was a "significant increase in the number of recruits with what the Army terms 'serious criminal misconduct' in their background.

That category includes aggravated assault, robbery, vehicular manslaughter, receiving stolen property and making terrorist threats." Despite the increased number of waivers, the Army still failed to meet its recruiting target.


The New York Daily News reports on an internal Veterans Health Administration (VHA) study showing 120,000 U.S. soldiers -- "more than one of every four who served in Iraq and Afghanistan" -- have already sought VHA treatment.

More than 30 percent were afflicted with some type of mental disorder, "mostly posttraumatic stress and depression."

To better accommodate the returning vets, Sen. Chris Dodd (D-CT) proposed an amendment last week to increase veterans' health care spending, and pay for it with a rollback of some of President Bush's capital gains tax cuts.

Despite the American Legion's support for the amendment, the Senate chose tax cuts for the wealthy over support for our troops.


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