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S. HRG. 109–328

SEATTLE FIELD HEARING: COMING HOME FROM

COMBAT—ARE VETERANS GETTING THE HELP

THEY NEED?

HEARING

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS

UNITED STATES SENATE

ONE HUNDRED NINTH CONGRESS

FIRST SESSION

August 3, 2005

Printed for the use of the Committee on Veterans’ Affairs

(

Available via the World Wide Web: http://www.access.gpo.gov/congress/senate 

(II)

COMMITTEE ON VETERANS’ AFFAIRS

LARRY E. CRAIG, Idaho, Chairman 

ARLEN SPECTER, Pennsylvania 

KAY BAILEY HUTCHISON, Texas 

LINDSEY O. GRAHAM, South Carolina 

RICHARD BURR, North Carolina 

JOHN ENSIGN, Nevada 

JOHN THUNE, South Dakota 

JOHNNY ISAKSON, Georgia 

DANIEL K. AKAKA, Hawaii, Ranking Member 

JOHN D. ROCKEFELLER IV, West Virginia 

JAMES M. JEFFORDS, (I), Vermont 

PATTY MURRAY, Washington 

BARACK OBAMA, Illinois 

KEN SALAZAR, Colorado

LUPE WISSEL, Majority Staff Director 

D. NOELANI KALIPI, Minority Staff Director 

(III)

C O N T E N T S 

AUGUST 3, 2005

SENATORS 

Page

Murray, Hon. Patty, U.S. Senator from Washington ........................................... 1

WITNESSES 

Lowenberg, Major General Timothy, Adjutant General, Washington State 

Military Department ............................................................................................ 4

Prepared statement .......................................................................................... 5

Lewis, Dennis, Assistant Deputy Under Secretary, Health Operations and 

Management; Acting Network Director, Veterans Integrated Service Network 20 (VISN 20) ............................................................................................... 7

Prepared statement .......................................................................................... 8

Arnold, Kristine A., Director, Seattle Veterans Affairs Regional Office, Veterans Benefits Administration, Department of Veterans Affairs ..................... 10 

Prepared statement .......................................................................................... 12

King, John, Director, Washington State Department of Veterans Affairs ......... 15

Prepared statement of John Lee, Deputy Director, Washington State 

Department of Veterans Affairs .................................................................. 16 

Hall, Specialist Blaine Miles, Washington Army National Guard ...................... 24

Prepared statement .......................................................................................... 25

Romanelli, Staff Sergeant Kevin (Ret.), U.S. Army .............................................. 26

Prepared statement .......................................................................................... 26

Hampton, Crystal, Veteran, U.S. Army ................................................................. 28

Prepared statement .......................................................................................... 29

Kauder, Sergeant Robert, Washington Army National Guard ............................ 30

Prepared statement .......................................................................................... 31

Hunt, Stephen, M.D., Director, Deployment Clinic, Puget Sound Health Care 

System, Department of Veterans Affairs ........................................................... 42

Prepared statement .......................................................................................... 43

Boxmeyer, Ron, M.S., Team Leader, Seattle Veterans Center, Readjustment 

Counseling Services, Department of Veterans Affairs ...................................... 45

Prepared statement .......................................................................................... 46

Holt, Linda, Tribal Council Member, Suquamish Tribe ....................................... 47

Prepared statement .......................................................................................... 49

Forbes, Colonel Mary, J–1 and Human Resources Director, Washington Army 

National Guard .................................................................................................... 51

Prepared statement .......................................................................................... 52

(1)

SEATTLE FIELD HEARING: COMING HOME 

FROM COMBAT—ARE VETERANS GETTING 

THE HELP THEY NEED? 

WEDNESDAY, AUGUST 3, 2005

U.S. SENATE, 

COMMITTEE ON VETERANS’ AFFAIRS, 

Washington, DC. 

The Committee met, pursuant to notice, at 10:07 a.m., at the 

Army National Guard Armory, 1601 West Armory Way, Seattle, 

Washington, Hon. Patty Murray, presiding. 

Present: Senator Murray. 

OPENING STATEMENT OF HON. PATTY MURRAY,

U.S. SENATOR FROM WASHINGTON 

Senator MURRAY. Good morning. I call this hearing of the Senate 

Veterans’ Affairs Committee to order. I want to welcome all of you 

and thank you very much for coming today. By being here today, 

you are sending a very strong message that we care about everyone 

who serves our Nation. Every day, in ways large and small, Washington State military personnel are making all of us proud. They 

are facing challenges overseas and their families are making sacrifices here at home. They are doing what our country asked. Now, 

as they come home, we must do what our country has promised; 

heal their wounds, meet their needs and ease their return to family, to work, and to our communities. 

I called this hearing today to explore one question. Are today’s 

veterans getting the help they need as they come home from combat? To answer that question, we will hear testimony today from 

military leaders, service providers and our veterans themselves. In 

the audience today, we have many people who have answered our 

call to their country’s service in times of war and peace. We have 

an obligation to you and I am honored to serve on the Senate Veterans’ Affairs Committee so I can be a voice for you and the 

670,000 veterans throughout our State. 

I grew up understanding sacrifice that veterans make. During 

World War II, my dad was one of the first GIs to land in Okinawa. 

He was injured, sent to Hawaii and then immediately sent back to 

Okinawa. Like many in our audience today, he was awarded the 

Purple Heart. 

When I was in college at Washington State University, I asked 

to do my internship at the VA hospital here in Seattle. I moved 

from home to Seattle for the semester, rented a room and I spent 

my days on the psychiatric ward working with veterans who had 

2

just come home from Vietnam. Today, I am the first woman to 

serve on the Senate Veterans’ Affairs Committee, and as you know, 

I do not hesitate to speak out when our veterans need help. 

I am holding this hearing here in Washington State because 

sometimes I cannot get straight answers from Washington, DC. In 

Washington, DC, they will tell you everything is fine. For months 

the Administration and the VA were telling me they had all the 

money they needed. They said, ‘‘Don’t worry about it, Patty.’’ But 

I did worry, because every time I came home and talked with veterans here, I heard a much different story. I heard about the VA’s 

hiring freeze. I heard about veterans waiting for months just to get 

an appointment, and I heard about veterans who had to drive for 

hours to see a doctor because the clinics they had been promised 

were not yet built. 

So, in March, I proposed increasing veterans spending by 3 percent. It is a small amount, but it would have lifted the hiring 

freeze, reduced delays and allowed the VA to open those clinics 

here in Washington State and throughout the country. 

It is hard to believe, but my proposal was defeated not just once, 

but three times. In Washington, DC, people were telling me everything was fine. Well, 6 weeks ago, we learned the truth. Things 

were not fine. The VA in Washington, DC, admitted that it was at 

least $1 billion, and that’s billion with a B, short of what it needed 

to care for veterans this year. That means many of our veterans 

face delays or do not get the care they deserve. That is wrong. 

I went back to the Senate floor and I offered my amendment 

again. This time, Members finally saw the light and last week the 

full Senate approved an additional $1.5 billion for veterans’ health 

care for this year. 

I am pleased that we got the money in the end, but it should not 

have taken that long. Every day that was wasted over politics was 

a day our veterans were not treated right. That whole episode 

showed me that if I ask people in Washington, DC, they will tell 

me everything is fine. If I ask people here in Washington State, I 

learn the truth. That’s the only way we can make sure we are taking care of the people who are taking care of us. 

Today, I want to hear about the challenges veterans and their 

families face as they return home. For 2 years now, I’ve been meeting with military personnel at every stage. In January of 2004, I 

met with members of the 81st Brigade right before they shipped 

out to Iraq. This March, I traveled to Iraq and Kuwait to meet with 

members of our armed services from Washington State. I saw their 

courage in the face of difficult and dangerous missions. Since then 

I have met with Guard members who have returned home to Everett, Spokane and Port Orchard. This past Monday, I met with family members at Camp Murray. Yesterday, I sat down with returning vets in the Tri-Cities, and tomorrow, Thursday, I’ll be meeting 

with more veterans in Longview. 

I am holding these meetings so I can build a record of what we 

need to do so when people in Washington, DC, tell me everything 

is fine I can show them what is really going on and push them to 

do the right thing. 

This hearing today will be an important part of the record I am 

assembling. For this hearing to be legitimate, we have to follow the 

3

same procedures that are used at hearings in Washington, DC. 

That means that testimony is limited to the invited witnesses. 

There are strict time limits, which these timers I have in front of 

me will indicate, and we have a court reporter here to create a formal record of the proceedings. Unfortunately, that means that we 

are not allowed to take questions or comments from the audience. 

But I want to make sure that anyone here has the opportunity to 

share their view. We do have comment forms available for you to 

fill out. We also have a sign up sheet so you can get updates from 

me as I continue working back in the Senate. 

In addition, I want you to know that I have created a place in 

my Web site where veterans throughout our State can share their 

stories with me. The address for that is murray.senate.gov. If you 

go to that Web site you can see a section where you or anyone you 

know can share their story with me. 

Now, let me explain how today’s hearing is going to work. We are 

going to hear from the panels of witnesses. The first panel will include officials from the Washington State Guard, the Federal VA 

and the State Department of Veterans Affairs. They will give us a 

bird’s-eye view of what’s happening throughout the State and will 

set the stage for our discussion. 

On the second panel, we are going to hear directly from our veterans. I especially want to thank each of you for having the courage to come here today and talk in public about some very personal 

challenges. Again, I want everyone to know there are more 

chances. We will not have time to raise questions today, but I want 

everyone to know that if you have a concern that you didn’t hear 

mentioned today, I want you to write it down and give it to my 

staff. 

Our third panel includes people who work directly with veterans 

who returned from Iraq and Afghanistan. They have received a 

wide range of issues veterans are facing and can give us a firsthand view from the ground level. When I call the first panel, each 

witness will have up to 3 minutes to present their testimony and 

then I will ask them questions. Of course, I want all of our panelists to know that your full written statements will be included in 

the official record. When we are done with each of our witnesses 

on the first panel, I’ll call the second panel and then I’ll go on to 

the third panel. 

Now, before we turn to our first panel, I want you to know that 

hearings like this can truly make a difference. Two summers ago, 

as many of you know, the VA tried to close down three of our hospitals here in Washington State. I worked with veterans throughout our State to make sure that the VA understood we needed 

these hospitals to stay open. Within a day, we were able to persuade the VA secretary to keep our hospital open. Months later, we 

persuaded the commission to save our second hospital. That left 

one of our hospitals in jeopardy, the Wainwright Medical Center in 

Walla Walla. I knew that the Senate needed to hear from the people in the local community who would have a harder time getting 

health care if their hospital was closed. 

So, in April of last year, I held a veterans’ hearing in Walla 

Walla just like the one we are holding today. We built a record of 

the need at that hearing and then I used that record back in WashVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00007 Fmt 6633 Sfmt 6633 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
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ington, DC, to help protect that hospital. With the support of the 

veterans in Walla Walla and throughout our State we won. I know 

that a hearing like this can make a real difference in giving the 

people in Washington, DC, a dose of reality about what our local 

veterans are facing. 

The witnesses here today will help us build an accurate record, 

and I, again, want to thank all of them and all of you who are here 

today. 

Now, I want to add one thing. I know we have many veterans 

who are here in the audience today. If you are here and you do 

need help from the VA, we have representatives here onsite today 

who can help you file a claim if you need us to do that. You can 

meet with officials from the VA regional office, from Tri-Care and 

from the VA hospital. And if you need help with an existing claim, 

members of my staff are here and they may be able to help you 

file a claim with the VA. 

Now, I just want to remind everybody if you ask for assistance, 

because of Federal privacy rules, we do need a signed letter giving 

us permission to investigate your case before we can do anything 

to help. If you are here and need assistance with a case be sure 

to stop and talk with my staff before you leave. 

Senator MURRAY. With that, I would like to introduce our first 

panel who is here with us today, Major General Timothy 

Lowenberg, Adjutant General of the Washington State Military Department; Max Lewis, Veterans Integrated Service Network 20 and 

VISN 20 within the Veterans Health Administration; Christine Arnold, regional director of the VA’s Benefits Administration; and 

John King who is filling in for John Lee with the Washington State 

Department of Veterans Affairs. Thank you very much. 

General, we will start with you. 

STATEMENT OF MAJOR GENERAL TIMOTHY LOWENBERG,

ADJUTANT GENERAL, WASHINGTON STATE MILITARY

DEPARTMENT 

General LOWENBERG. Thank you. I would first like to recognize 

in the audience today, the State’s most distinguished veterans’ advocate. The first Gentleman, Mike Gregoire, and I would like to 

thank Governor Gregoire and you, too, Senator Murray for supporting your National Guard as we have repeatedly mobilized and 

deployed our communities’ sons and daughters, mothers and fathers, and in some cases grandfathers and grandmothers to operations throughout the world, from Iraq to Afghanistan, to countries 

throughout Africa, to Cuba, to South America, to the jungles of the 

Philippines and to South Korea where we have personnel serving 

today. 

We have mobilized and deployed more than 4 times the number 

of Guardsmen in the last 3 years than were activated for the Korean war and the Vietnam conflict combined. And this represents 

a significant transformation not only for the Guard, but for all the 

forces from the strategic reserve to an operational reserve, and we 

are generating a recurring cycle of force presentations never before 

experienced in modern history. 

In answering our country’s call, we have adopted many thoughtful and creative ways of taking care of our soldiers and the chalVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00008 Fmt 6633 Sfmt 6633 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
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lenges our new operations tempo is putting on our families. In 

many respects, I think we have initiated some national ‘‘best practices’’ in the State of Washington. But by leaning forward aggressively we are both in a better position to appreciate the scope of 

unmet needs as well as recognizing the amount of work and systems changes that still need to be made to sustain a combat-ready 

force and combat-ready National Guard families. 

Our major focus, of course, has been on ensuring that our returning veterans are cycled back into family life. But we believe strongly that the collective commitment and support we put together to 

address that need through a coalition of national and state veterans organizations, private non-profit volunteer organizations, 

public service agencies, and employment service agencies is really 

a long-term solution. Long-term solutions are needed to sustain the 

needs of veterans as they go through a lifecycle of change in components and Reserve to active service, veteran’s status, active combat 

service, and it is a recurring cycle not experienced in recent history. 

These and other solutions are within our capacity to conceive and 

develop and execute, but many of the other solutions can only be 

created by refinements to Federal policy and compensation authorized by decisive Congressional action. I would just like to briefly 

mention three of those in my formal statement. 

First, the transition assistance program. The Transition Assistance Program is really designed for a Cold War era force. Although 

it arguably met the needs at that time, we now need a revised 

model that focuses on a wide range of training, readjustment counseling and workshops that are presented both before the end of active service and then continued for up to 1 year after active service. 

In light of the remaining time, Senator, I will submit my formal 

remarks for the record. 

[The prepared statement of General Lowenberg follows:]

PREPARED STATEMENT OF MAJOR GENERAL TIMOTHY LOWENBERG, ADJUTANT

GENERAL, WASHINGTON STATE MILITARY DEPARTMENT

Good morning. For the record, I am Major General Tim Lowenberg, Adjutant General of the State of Washington. I would like to preface my remarks by thanking 

Senator Murray for her tireless support of our Guard members and their families 

before, during and following their activation for Federal military service. Thank you, 

Senator, for standing with and supporting your National Guard as we have repeatedly mobilized and deployed our communities’ sons and daughters, fathers and 

mothers (and in some cases grandfathers and grandmothers) at home and abroad 

in support of Operation Noble Eagle, Operation Enduring Freedom and Operation 

Iraqi Freedom. From Afghanistan to Iraq to countries throughout the Horn of Africa; from Cuba to South America, to the jungles of the Philippines and to South 

Korea—in the past 3 years, we have mobilized and deployed more than 4 times the 

number of Washington National Guard soldiers and airmen as were activated for 

the Korean War and the Vietnam Conflict combined. 

The attacks of September 11, 2001 and the ensuing Global War on Terrorism have 

triggered a paradigm shift for our military—one that has transformed our Nation’s 

Guard and Reserve forces from a strategic reserve to a fully combat ready and combat-tasked operational reserve. 

In answering our country’s call, the Washington National Guard has greatly expanded our traditional roles and missions and we have responded in creative and 

thoughtful ways to the new soldier-care and airmen-care issues and to the unprecedented stresses our operations tempo is putting on our families. In many respects, 

I believe we have initiated national best practices in our State. By leaning forward 

so aggressively, however, we’re both in a position to better appreciate the scope of 

unmet needs and to recognize the amount of work and systems corrections that still 

6

need to be made to sustain a combat ready force and combat-ready National Guard 

families. 

Our major focus has been on ensuring our returning servicemembers—America’s 

new generation of combat veterans—can quickly and smoothly integrate back into 

their family lives, employment and civilian career tracks and community activities. 

We have formed an impressive, formal coalition of Federal and State veterans agencies, social service and employment agencies, and veterans and other non-profit 

service organizations to support these new American heroes. And we believe strongly that the collective commitment and support of these coalition members is one of 

the most important long term solutions for reintegrating servicemembers and addressing their individual and family needs—now and throughout the remainder of 

their service careers. 

These and other solutions are within our capacity to conceive, develop and execute, but many other solutions can only be created by refinements in Federal policy 

and, in some cases, by decisive Congressional action. I would like to call the Committee’s attention to three (3) such problem areas. All three revolve around the fact 

that programs, laws, policies and regulations formulated in the Cold War often no 

longer support an operational reserve force or the tempo of deployments we have 

maintained since 9/11/01. 

First, we need to review the overall Transition Assistance Program (TAP). Second, 

we need to find more innovative and effective means of communicating with our veterans community. And, third, we need to make fundamental adjustments in the 

legal constructs and administrative programs that support our servicemembers before, during and after their deployments for Federal military service. 

The Transition Assistance Program (TAP) is a nationally coordinated effort designed to assist military men and women in transitioning to civilian life. It focuses 

on employment and job training. (Public Law Pub. L. 101–510, sections 1142, 1143, 

Title X, U.S.C.; DOD Directive 1332.35 and DOD Instruction 1332.36; Sec of Def 

Policy Memorandum 30 April 2002; DOD/DVA and DOL MOU; AR 600–8–101). 

Although it arguably met the needs of a strategic reserve force in which the bulk 

of the load was carried by the active duty services, we now need a revised and updated Transition Assistance (TAP) model that is specifically tailored for the needs 

of today’s National Guardsmen and reservists as they transition from extended service in overseas combat and stabilization missions. The revised model should include 

interpersonal and life-skills training, readjustment counseling, and VA briefings and 

workshops that are presented before the member’s active duty tour ends, as well 

as training sessions and workshops that continue for up to 1 year after the veteran’s 

release from active duty. A broad cross-section of civilians (e.g., dependents and 

family representatives), Veterans Administration officials and military professionals 

should be charged with reviewing and updating today’s ‘‘dated’’ reintegration programs. 

Second, we need to find innovative ways of educating our veterans about the 

many Federal and State benefits to which they are entitled, as well as the growing 

number of services provided by private, non-profit public service organizations. 

States, for example, should be encouraged to form veterans outreach committees 

that recruit and capitalize upon the creative talents of the private-sector marketing 

and advertising industry. Private sector companies are, by and large, eager to assist 

military servicemembers. They simply need encouragement and some positive direction in channeling their energies and expertise. Such assistance can obviously be 

outsourced and contracted, but that option bleeds money from already underresourced veterans services. We’re in the early stages of shaping such an initiative 

in our State. I look forward to briefing you in the not-too-distant future on our success. 

Finally, many of our Cold War era laws and regulations are simply no longer sufficient to meet the needs of today’s operational Guard and Reserve forces. Many of 

these statutes, separate and unequal pay and benefits regulations, and other brightline distinctions between career active duty personnel and career National Guard 

and Reserve personnel no longer fit today’s high operations tempo, combat ready reserve forces. Changes in these arcane and outdated systems would go a long way 

toward recruiting and retaining the 21st Century Guard and Reserve force and substantially enhance the reintegration of these veterans and their families following 

each recurring period of Federal military service. I refer, of course, to the separate 

and unequal systems of pay, our members’ severely restricted access to medical and 

dental care and other vestiges of the Cold War era. 

With each cycle of domestic base realignments and closures, active duty forces are 

also becoming confined to a shrinking number of CONUS operating sites, while 

Guardsmen and Reserve soldiers, airmen, sailors, Marines and Coast Guardsmen 

remain scattered throughout the depth and breadth of America, thereby further isoVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00010 Fmt 6633 Sfmt 6621 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
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lating Guardsmen and reservists from active duty service centers, Tri-Care providers and other sources of traditional support for veterans. 

As we rush headlong into the 21st Century—as we answer the call of destiny in 

responding to the scourge of transnational terrorism—time is not our ally. We must 

do everything necessary to support and sustain a combat ready, operational Guard 

and reserve force now. We must therefore make these adjustments now. Our veterans and their families require and deserve nothing less. 

Thank you for your kind attention and for your personal commitment and dedication to America’s veterans. On their behalf, I thank you for your sacrifice and service and for your bold statement of support in conducting this field hearing. I would 

be happy to answer any questions you may have.

Senator MURRAY. Thank you very much. 

Mr. Lewis. 

STATEMENT OF DENNIS LEWIS, ASSISTANT DEPUTY UNDER 

SECRETARY, HEALTH OPERATIONS AND MANAGEMENT; 

ACTING NETWORK DIRECTOR, VETERANS INTEGRATED 

SERVICE NETWORK 20 (VISN 20) 

Mr. LEWIS. Thank you very much. I would like to first start off 

by recognizing you for providing this forum, and for all of your support in Washington, and everything you do for veterans in Washington State and veterans in the Nation. Thank you. I also, on behalf of our 8,000 employees, would like to thank all of the veterans 

in the audience for your sacrifices and service to your country. 

Thank you very much. 

The core of VA’s mission is a solid commitment to the service of 

those men and women who so faithfully serve our country. VISN 

20 is honored to provide veterans, including those recently returning from active duty, reservists and National Guard troops with 

services designed to specifically address the health care needs of 

their military deployment. 

As you know, Washington State has contributed a large number 

of troops to service, not only in Iraq and Afghanistan, but around 

the world. Today, of those nearly 3,300 vets who have returned to 

Washington State—300 of those not within Washington State—

about 65 percent of that number or about 2,100 have been treated 

at Washington State facilities. 

Ensuring that veterans get the care that they need is an ongoing 

endeavor and it is a constantly evolving process that we go 

through, each generation is required to go through. There are new 

types of care, and there is a different expectation on what to expect, and there is no difference here in the Northwest. 

The Puget Sound Health Care System, for example, and I am 

going to tell you a little bit about some of the things that were done 

just recently to address the needs particularly of the veterans that 

are returning. At the Puget Sound Health Care System, the Deployment Health Clinic is the only one of its kind in the country. 

It is dedicated to caring for the unique health concerns related to 

specific military deployment. Beginning in September 2003, we located VHV social workers at the Madigan Medical Center and 

worked closely with our counterparts, the Department of Defense 

and the VA to help support the successful transition of veterans returning to civilian life. 

The Puget Sound Health Care System has nominated Seattle as 

the Northwest Network’s Tertiary Polytrauma Center, which has 

been approved, and there will be additional resources coming to SeVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00011 Fmt 6633 Sfmt 6601 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
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attle to help support that Center in the future. What this means 

is, Seattle will now assure throughout the network that veterans 

who have suffered loss of limbs or very severe debilitating injuries 

due to their service in the military have access to the same high 

level of care. 

In Eastern Washington, Spokane and Walla Walla have taken 

the lead with other Federal and State veterans agencies and organized Family Days. These are roundtable discussions held with veterans and their families describing in detail what services are 

available from the VA, as well as from the State agencies, and 

helping them understand what those benefits are and what they 

are entitled to. 

At the Portland VA Medical Center and its Vancouver campus, 

we are working with veterans in the southwest part of the State, 

and particularly working with the Washington State National 

Guard, in developing a new Web site that helps explain, again, all 

of the different educational benefits that are available not only to 

OIF/OEF veterans, but to all of our veterans. 

And finally, local VA staff has taken the initiative in addressing 

mental health. In 2004, we sponsored a very large comprehensive 

clinical update for VA as well as other folks outside the VA, behavioral/mental health staff and others, on issue of responding to trauma particularly as it relates to military service. The program provides an opportunity for the more than 330 participants to share 

best practices. It highlighted recent research and data to assist others working with veterans. The program is so successful that we 

are planning to hold another one for November, and it will be in 

Washington State. 

I have given you a very short overview of VISN 20’s commitment 

to our veterans. There is more information in my testimony, and 

I would like to say that on behalf of the Network, I can assure you 

that we are prepared not only to meet the needs of veterans in 

other parts of the world, but to meet the needs of all veterans that 

we serve. Thank you. I will submit my formal comments. 

[The prepared statement of Mr. Lewis follows:]

PREPARED STATEMENT OF DENNIS LEWIS, ASSISTANT DEPUTY UNDER SECRETARY, 

HEALTH OPERATIONS AND MANAGEMENT; ACTING NETWORK DIRECTOR, VETERANS

INTEGRATED SERVICE NETWORK 20 (VISN 20) 

Good Morning Senator Murray and Members of the Committee: Thank you for the 

opportunity to appear today to discuss our preparedness to meet the needs of returning Operation Iraqi Freedom and Operation Enduring Freedom veterans. I am 

Dennis Lewis, the Acting Network Director of the Veterans Integrated Services Network (VISN 20), providing healthcare to Northwest veterans. I am also the Assistant Deputy Under Secretary for Health for Operations and Management; a position 

I have held since July 2002. 

I would like to recognize you, Senator Murray, for providing this forum to focus 

on our returning OIF/OEF veterans and for your continuing leadership and support 

for all veterans in Washington State. 

At the core of VA’s mission is a solid commitment to the service of those men and 

women who so faithfully have served our country. The VA Northwest Health Network is honored to be able to provide veterans, including recently returning active 

duty, reservists and National Guard troops with services designated to specifically 

address the health care needs of their military deployment. 

In addition to Washington State, the VA Northwest Health Network is comprised 

of the States of Alaska and Oregon, most of Idaho, and one county each in Montana 

and California. Our 135 counties cover approximately 23 percent of the United 

States land mass. VISN 20 consists of 6 medical centers, including 2 academic referVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00012 Fmt 6633 Sfmt 6621 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
9

ral sites, 1 independent outpatient clinic, 1 rehabilitation center, 19 communitybased outpatient clinics, and one mobile clinic. Other services include 7 nursing 

home care units, 2 homeless domiciliaries, and 14 Veterans Outreach Centers (Vet 

Centers). VISN 20 has one of the VA’s most robust research programs. Program 

areas of significance to veterans include limb loss prevention and prosthetics; spinal 

cord injury and rehabilitative medicine; mental health; addiction treatment; PostTraumatic Stress Disorder (PTSD); and deployment health programs. 

VISN 20 supports the use of Telemedicine to enhance care to our veterans. Telemedicine involves the use of electronic medical information and communication to 

provide and support health care when distance separates the provider from the patient. Because of our geographic distribution, we use telemedicine throughout the 

Network to increase access to our care, and find it especially useful in providing 

care for veterans in remote areas, veterans in State Veterans Home and those who 

are disabled and elderly. We use telemedicine in radiology, mental health, cardiology, pathology, dermatology, psychiatry, and in-home care teleconsultations for 

spinal cord injury patients and for patients with other chronic conditions. 

In Washington State, veterans receive care at the VA Puget Sound Health Care 

System, the VA Medical Center (VAMC) Spokane, VAMC Walla Walla and the Vancouver campus of the VAMC Portland, in addition to eight community-based outpatient clinics (CBOCs) and five veterans readjustment counseling centers (Vet Centers). During fiscal year 2005, VISN 20’s operating budget has amounted to approximately $1.20B, and the Network employs 7,966 staff. In fiscal year 2004, VISN 20 

served 194,949 veterans, a 6.6 percent increase over fiscal year 2003, making us 

first in growth within the Veterans Health Administration (VHA), more than double 

the national average growth rate. In spite of these increases, the Network costs 

grew at just 0.6 percent in fiscal year 2004. 

As you well know, Washington State has a significant number of troops currently 

serving in Operation Enduring Freedom and Operation Iraqi Freedom. To date, we 

have seen nearly 3,300 (3,281) returning veterans from OIF/OEF within the Network, of whom, nearly 65 percent (2,131) have been treated at our Washington State 

facilities. 

In addressing today’s topic, I would like to profile the Washington State facilities 

who provide care to our returning veterans. I am pleased that Dr. Stephen Hunt 

will be sharing information with you about the VA Puget Sound Health Care System (PSHCS) Deployment Health Clinic that follows the care of veterans (including 

active duty, National Guard and reservists) who are experiencing unique health concerns related to their specific military deployment. This care is provided even if the 

veteran is receiving his/her care outside a VA setting. As a result of Dr. Hunt’s leadership, the PSHCS has become known as a national leader in issues of deployment 

health. 

The VA PSHCS, with campuses in Seattle and at American Lake (Tacoma) is the 

largest VA academic referral medical center in the Northwest. As a primary and tertiary care facility, the VA Puget Sound Health Care System provides a full range 

of patient care services, with state-of-the-art care. 

The PSHCS had approximately 612,377 patient visits in fiscal year 2004, providing care to 59,329 veterans, throughout the State and across the VISN. So far 

this year, they have provided care to 5.7 percent more veterans than last year at 

this time including 1,567 OIF/OEF veterans. 

At our Spokane facility, during fiscal year 2004, there were 204,915 patient visits 

providing care to 21,008 veterans, primarily from Spokane and Kootenai counties. 

So far this year, the VAMC Spokane has provided care to 8.9 percent percent more 

veterans than last year at this time including 368 OIF/OEF veterans. Spokane VA 

operates a mobile primary care clinic that visits nine remote sites (five in WA, three 

in ID and one in MT) providing follow-up care to their patients. 

At the Walla Walla VAMC, 93,643 patient visits occurred in fiscal year 2004. The 

Medical Center provided care to 12,611 veterans, primarily from 15 counties. So far 

this year, the VAMC Walla Walla has provided care to 196 OIF/OEF veterans. In 

addition to the parent facility, the VAMC Walla Walla operates Community-Based 

Outpatient Clinics in Yakima and Richland (Washington) and in Lewiston (Idaho). 

VISN 20 has demonstrated our commitment to the seamless transition of returning combat veterans. In anticipation of returning OIF/OEF veterans, our Medical 

Center employees, throughout the VISN, have been thoroughly trained to ensure 

that they can identify these new combat veterans, and to take appropriate steps to 

ensure that they receive the world class care they have earned. 

Since August 2003, VISN 20 has supported the placement of two VHA social 

workers located at Madigan Army Medical Center working with Veterans Benefits 

Administration (VBA), to ensure a successful transition for returning service personnel. These employees work closely with specifically assigned Points of Contact 

10

(POCs) at each of VISN 20’s facilities and our VISN office; this active out-processing 

program has touched the lives of 2,624 individuals throughout the VISN since 2003 

resulting in over 1,700 referrals. Our intent is to continue this important partnership as a means of encouraging those who are returning home from military commitments to pursue post-deployment support. 

VISN 20 is also prepared to provide specialized care for servicemembers and veterans. The PSHCS Spinal Cord Injury Unit (SCI) has provided care to four veterans 

transferred directly from Walter Reed Army Hospital. In addition, their Rehabilitation Care Service has provided a combination of inpatient and outpatient care to 12 

veterans also directly transferred directly from Walter Reed. 

The PSHCS has been nominated to be the Northwest Network’s Tertiary 

Polytrauma Center. The facility will coordinate the care and services required to 

meet the needs of the amputee population and assure that patients have access to 

the same high level of care across the network. They will be responsible for implementing care that transitions individuals back into their home community. 

VISN 20 is also participating in VHA National initiatives focused on OIF/OEF. 

PSHCS has been approved to develop ‘‘VISN-Wide Outreach, Early Intervention 

Collaborative Care with DoD and State Partners.’’ Spokane VAMC has been funded 

to establish ‘‘PTSD Rural Outreach Services.’’

VISN 20 has taken a collaborative approach in addressing the Mental Health care 

needs for our Nation’s newest veterans. In 2004, we sponsored a comprehensive clinical update for our behavioral/mental health staff and others (Readjustment Counseling Centers, Private Sector Health Care Systems and Agencies, other VISNs and 

Washington State DVA). The program provided an opportunity among the 330 participants for sharing best practices. In addition, it highlighted recent research and 

data to assist clinicians as they provide care to veterans. An OIF/OEF Conference 

is currently planned for November 3–5, 2005. The program will be comprised of 

three 1-day programs focusing on specific audiences (Primary Care, Mental Health 

Clinicians and Veteran/National Guard and Families). 

Additionally, VISN 20 is an active participant in a Memorandum of Understanding, initiated by the Washington State Department of Veterans Affairs, with 

the Washington State Department of Defense, the National Guard and the Reserve 

to inform returning servicemembers and their families of their benefits and deliver 

the services that are needed for our Nation’s newest veterans. Oregon has also recently entered into a similar agreement and one is pending in the State of Idaho. 

Senator Murray, I have provided you an overview of VISN 20 and the services 

we provide to our veterans and patients. However, it is our veterans who tell us 

how we are doing and provide us ongoing feedback. VHA measures patient and veteran satisfaction for both outpatient and inpatient care. I am proud to share with 

you that VISN 20 has tied nationally as number one for overall satisfaction for inpatient care (Spokane is rated number one for all VHA facilities) and we are number 

five overall for outpatient care. We also measure how long our veterans wait to see 

their providers once they arrive for their clinic appointment. Our goal is for them 

to be seen within 20 minutes or less. We are ranked 3rd in the Nation and continually strive to improve. As you can see, our veterans continue to acknowledge we 

are providing timely quality care. 

As we celebrate the VA’s 75th anniversary, all of the dedicated employees in the 

Northwest Network are proud to serve the VHA mission: Honor America’s Veterans 

by Providing Exceptional Healthcare that Improves Their Health and Well-being. I 

believe we have demonstrated and can promise that we are prepared to continue 

meeting the needs of returning veterans. 

Thank you, Senator Murray. This concludes my formal remarks. I welcome any 

questions the Committee Members may have.

Senator MURRAY. Thank you very much. We will move to Kristine Arnold. 

STATEMENT OF KRISTINE A. ARNOLD, DIRECTOR, SEATTLE 

VETERANS AFFAIRS REGIONAL OFFICE, VETERANS

BENEFITS ADMINISTRATION, DEPARTMENT OF VETERANS

AFFAIRS 

Ms. ARNOLD. Thank you very much. I appreciate your giving me 

the opportunity to testify today on the Veterans’ Benefits Administration’s response to the needs of veterans returning from for Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). 

11

I would like to address three topics: the programs that VBA developed to ease the transition of veterans back into civilian life; the 

outreach efforts that VBA and Seattle Regional Office have made 

to the National Guard and Reserves; and the Seattle Regional Office’s specific plans for recently returned Washington National 

Guard and Reserve units. 

Veterans returning from Iraq and Afghanistan, like all other veterans, are eligible for a full array of monetary benefits offered 

through VBA programs to assist them in readjusting to civilian life, 

and through outreach effort, to inform them about the many benefits and services. 

The Seattle VA Regional Office is actively involved in educating 

returning soldiers about VA benefits: helping servicemembers, soon 

to be released from active duty, with the processing of their claims; 

and ensuring their smooth transition back to civilian life. 

The Benefits Delivery At Discharge program, which there are 

140 based throughout the country, has been in place for almost 10 

years. In Washington State, we have Benefits Delivery At Discharge programs at Fort Lewis which also serves McCord, at Bremerton which serves all the Naval installations in the Puget Sound 

area, and Fairchild Air Force Base, as well. 

In most cases, disabled servicemembers under the Benefits Delivery At Discharge program receive their disability benefits within 60 

days of discharge. Returning servicemembers, including members 

of the National Guard and Reserves, may elect to attend Transition 

Assitance Program (TAP) sessions which were discussed by General Lowenberg. At TAP workshops, servicemembers are fully 

briefed on the VA benefits available to them and are encouraged 

to apply. 

The Seamless Transition Initiative is aimed at helping returning 

veterans make a smooth transition back into civilian life. Since 

March 2003, a VBA OEF/OIF Coordinator is assigned to each military treatment facility. Since March 2003, each claim from a seriously disabled OEF/OIF veteran has been case managed for seamless and expeditious processing. 

Gene Finney, Seattle’s nationally recognized OEF/OIF Coordinator, works with case managers at Madigan Army Medical Center 

to assure seamless transition for all servicemembers, particularly 

those identified as being either Very Seriously Injured (VSI) or Seriously Injured (SI). We have identified 21 soldiers in those 2 categories. But in addition, since October 2003, we have seen 915 injured soldiers at Madigan, 826 of which were either National 

Guard or Reserve. We coordinated with transition counselors from 

the local VA Medical Center regarding 547 servicemembers to ensure seamless services; we processed 243 claims for compensation 

and 152 claims for vocational rehabilitation. 

Outreach efforts to the National Guard and Reserve members 

take on critical importance in light of the composition of our forces. 

Return and deactivation of Reserve and Guard units presents significant challenges to the VA because rotation is irregular and 

servicemembers spend short periods of time at a military installation before being released to their Guard or Reserve components. 

For this reason, outreach efforts are focused at the local armories 

or Reserve centers within 2 months of the unit’s return. 

12

Washington State is unique because Fort Lewis is the major mobilization/demobilization point for the National Guard and Reserves for the whole Western United States. So we have unique 

challenges for all of those troops even if they are admitted off to 

Idaho, California, and places far away. Since March 2003, the Seattle regional office has conducted 345 briefings to nearly 22,000 

demobilizing OIF/OEF servicemembers. In fiscal year 2005, alone 

we have conducted 158 briefings to 11,000 demobilizing 

servicemembers. 

The 81st Brigade and its associated National Guard units returned from deployment in Iraq beginning in March 2005. They demobilized through the Soldier Readiness Program at Fort Lewis 

prior to returning home. The Seattle Regional Office OEF/OIF Coordinator provided a Transition Assistance Briefing as part of their 

demobilization activity at Fort Lewis. And again, they received a 

full array of information about all of the benefits and services offered by the VA. 

The OEF/OIF coordinator maintains weekly contact with the 

servicemembers who are assigned to the 654th Army Support Garrison. This unit includes about 400 Guard and Reserve 

servicemembers who are recovering from illnesses or injuries which 

have resulted in an extension of their mobilization. 

In addition, the coordinator maintains weekly contact with the 

servicemembers at Madigan and its associated Medical Hold Unit. 

The purpose of these contacts is to counsel servicemembers on the 

benefits and services available to them. 

On November 5, 2004, the Seattle Regional Office signed a 

Memorandum of Understanding with the Washington State Military Department, the Washington State Department of Veterans 

Affairs, the Washington State Employment Security Department, 

the Veterans Health Administration, the U.S. Department of 

Labor, the Association of Washington Businesses, and the Governor’s Veterans Affairs Advisory Committee. 

On May 26, 2005, the 70th Army Reserve Support Command became an MOU partner and on August 8th, coming up, we will sign 

the same MOU with the Naval Reserve Command. We have 27 

Family Activity Days scheduled through November 6th in support 

of the Washington Army National Guard. We intend to revisit 

these units within a year. 

I thank you, Senator, for the opportunity to speak. 

[The prepared statement of Ms. Arnold follows:]

PREPARED STATEMENT OF KRISTINE A. ARNOLD, DIRECTOR, SEATTLE VETERANS AFFAIRS REGIONAL OFFICE, VETERANS BENEFITS ADMINISTRATION, DEPARTMENT OF

VETERANS AFFAIRS

Senator Murray, I appreciate this opportunity to testify today on the Veterans 

Benefits Administration’s (VBA’s) response to the needs of veterans returning from 

Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). 

My testimony addresses three related topics: the programs that VBA developed 

to ease the transition of OEF/OIF veterans back into civilian life; the outreach efforts of both VBA and the Seattle VA Regional Office to the National Guard and 

Reserves; and the Seattle VA Regional Office’s specific plans for recently returned 

Washington National Guard and Reserve units. 

Veterans returning from Iraq and Afghanistan are eligible for a full array of benefits offered through VBA. These include: 

• Disability Compensation and Related Benefits; 

• Education and Training Benefits; 

13

• Vocational Rehabilitation and Employment; 

• Home Loan Guaranties; 

• Life Insurance; 

• Burial Benefits; and 

• Dependents’ and Survivors’ Benefits. 

In addition to providing this broad range of benefits, VBA is reaching out to OEF/

OIF veterans with programs to assist them in readjusting to civilian life, and with 

information about our many benefits and services. I will briefly discuss some of 

these assistance programs and then talk about our outreach efforts. My focus will 

be on outreach to members of the National Guard and Reserves. 

PROGRAMS TO ASSIST RETURNING OEF/OIF VETERANS

The Seattle VA Regional Office is actively involved in educating returning 

servicemembers about VA benefits, in helping servicemembers, soon to be released 

from active duty, with the processing of claims, and in ensuring a smooth transition 

from military duty back into civilian life. The Benefits Delivery at Discharge Program, the Transition Assistance Program, and the Seamless Transition Initiative all 

exemplify VBA’s active participation in the readjustment process. 

The Benefits Delivery at Discharge Program, or BDD, is in place at 140 military 

installations around the country and overseas. In Washington State, we have BDD 

programs at Ft. Lewis, which also serves McChord Air Force Base, at Bremerton, 

which serves all naval installations in the Puget Sound area, and at Fairchild Air 

Force Base. Under this program, active duty servicemembers who are within 180 

days of separation are encouraged to file disability compensation claims with VA 

staff who are serving at military bases either on a full-time or itinerant basis. 

Servicemembers can complete the necessary physical examinations and have their 

claims evaluated before or closely following their military separation dates. In most 

cases, disabled servicemembers participating in the BDD program begin receiving 

VA disability compensation benefits within 60 days of their separation from active 

duty, which serves to ease the transition from active duty to civilian status. 

Returning servicemembers, including members of the National Guard and Reserves, may elect to attend the formal 3–day workshops provided through the Transition Assistance Program (TAP), a joint effort of VA, the Department of Defense, 

and the Department of Labor. At TAP workshops, servicemembers are fully briefed 

on the VA benefits available to them and encouraged to apply for all benefits to 

which they are entitled. In fiscal year 2004, the Seattle VA Regional Office conducted 37 TAP briefings attended by 1,851 servicemembers. 

The Seamless Transition Initiative is aimed at helping returning veterans make 

a smooth transition back into civilian life. In 2003, VA began placing Veterans Service Representatives at key military treatment facilities (MTFs) where severely 

wounded servicemembers from OEF/OIF are frequently sent. 

Since March 2003, a VBA OEF/OIF coordinator has been assigned to each MTF. 

As of January 2005, over 4,500 hospitalized returning servicemembers were assisted 

through this program at Walter Reed Army Medical Center, Bethesda Naval Hospital, Madigan Army Medical Center, Eisenhower Army Medical Center, and Brooke 

Army Medical Center. Since March 2003, each claim from a seriously injured OEF/

OIF veteran has been case managed for seamless and expeditious processing. 

Gene Finney, Seattle’s OIF/OEF Coordinator, works with Veterans Health Administration (VHA) transition case managers at the Madigan Army Medical Center to 

ensure seamless transition for all servicemembers, particularly those identified as 

being either Very Seriously Injured (VSI) or Seriously Injured (SI). Either Frank 

Pierce, the Assistant Director, or I contact injured servicemembers to thank them 

for their service and review benefits and services available to them. We have identified 21 soldiers as either very seriously injured or seriously injured. Since October 

2003, we have seen 915 injured OIF/OEF soldiers at Madigan, 826 of whom were 

either in the National Guard or Reserve. We coordinated with transition counselors 

from the local VA Medical Centers regarding 547 servicemembers to insure seamless 

services; we processed 243 claims for compensation and 152 claims for vocational 

rehabilitation services. 

OUTREACH TO NATIONAL GUARD AND RESERVES

Outreach to Reserve/Guard members is part of the overall VBA outreach program. 

In peacetime, this outreach is generally accomplished on an ‘‘on call’’ or ‘‘as requested’’ basis. With the activation and deployment of large numbers of Reserve/

Guard members following the September 11, 2001, attack on America, and OEF/

OIF, VBA outreach to this group has been greatly expanded. 

14

Outreach efforts to National Guard and Reserve members take on critical importance in light of the composition of our forces. Return and deactivation of Reserve/

Guard units present significant challenges to VA because rotation is irregular and 

the servicemembers spend extremely short periods of time at military installations 

prior to being released to their Guard or Reserve components. For this reason, outreach efforts are focused at the local armories or reserve centers within 2 months 

of a unit’s deactivation. Washington State is unique because Ft. Lewis is a major 

mobilization/demobilization point for Army National Guard and Army Reserve Units 

for the Western United States. Since March 2003, the Seattle VA Regional Office 

has conducted 345 briefings to 21,480 demobilizing OIF/OEF servicemembers. In fiscal year 2005 alone, we have conducted 158 briefings to 11,000 demobilizing 

servicemembers. 

In addition to these briefings and our other efforts to reach out in person to returning veterans, all separating and retiring servicemembers (including Reserve/

Guard members) receive a ‘‘Welcome Home Package’’ that includes a letter from the 

Secretary of Veterans Affairs, a copy of VA Pamphlet 21–00–1, A Summary of VA 

Benefits, and VA Form 21–0501, Veterans Benefits Timetable, through the Veterans 

Assistance at Discharge System (VADS). Six months later similar information is 

mailed to servicemembers following discharge with a follow-up letter. 

Finally, VA has created a new internet Web page especially for veterans returning 

from Afghanistan and Iraq at http://www.seamlesstransition.va.gov/. Information 

specific to National Guard and Reserves is also included on this Web page, along 

with links to Web sites with information about other Federal benefits that may be 

of interest to returning servicemembers. 

SEATTLE VA REGIONAL OFFICE PLANS FOR THE WASHINGTON NATIONAL GUARD

Beginning in March 2005, the 81st Brigade and its associated National Guard 

units returned from deployment to Iraq. They mobilized and demobilized through 

the Soldier Readiness Program (SRP) at Ft. Lewis prior to returning home. The Seattle VA Regional Office OIF/OEF Coordinator provided a Transition Assistance 

Briefing as part of their demobilization activity at Ft. Lewis. During this presentation, the OIF/OEF Coordinator reviewed VA benefits and services available and 

provided each servicemember with a packet of pamphlets and forms to assist the 

servicemember in applying for services. The following activities are already underway: 

1. Coordination with VA Medical Centers: The Seattle Regional Office’s (RO’s) 

OIF/OEF Coordinator maintains regular contact with his counterparts in all of the 

VA Medical Centers (MCs) that support Washington’s veterans. When OIF/OEF veterans go to one of these MCs for care, the coordinators refer them to the Seattle 

RO for benefits. Conversely, the RO refers all veterans who come there to the MCs. 

2. Coordination with Madigan and the 654th Army Support Garrison (ASG): The 

OIF/OEF Coordinator maintains weekly contact with servicemembers assigned to 

the 654th ASG. This unit includes approximately 400 Guard and Reserve 

servicemembers who are recovering from illnesses or injuries, which have resulted 

in an extension of their mobilization. In addition, the coordinator maintains weekly 

contact with servicemembers at Madigan and its associated Medical Hold unit. The 

purpose of these contacts is to counsel servicemembers on VA benefits and services 

and assist them in the application process. 

3. Coordination of Services: On November 5, 2004, the Seattle VA Regional Office 

signed a memorandum of understanding (MOU) with the Washington State Military 

Department, the Washington State Department of Veterans Affairs, the Washington 

State Employment Security Department, the Veterans Health Administration, the 

U.S. Department of Labor, the Association of Washington Businesses, and the Governor’s Veterans Affairs Advisory Committee. On May 26, 2005, the 70th Army Reserve Support command became an MOU partner, and on Monday, August 8th, in 

a signing ceremony at the Bangor Sub Base, the Naval Reserve Command will become an MOU partner. The Seattle Regional Office and the other MOU signatories 

participate in Family Activity Days at their facilities that provide servicemembers 

and their families personalized assistance in understanding and applying for Federal and State benefits and services. We currently have 27 Family Activity Days 

scheduled through November 6th in support of the Washington Army National 

Guard. We intend to revisit these units within 1 year of their return from Iraq or 

Afghanistan. 

Senator Murray, I hope this testimony has given you and the Committee a better 

understanding of the VA benefits, services, and outreach being provided to veterans 

of the OEF/OIF conflicts. I also want to assure you that the Seattle VA Regional 

Office is ready and eager to serve the men and women coming home to Washington 

15

State. This concludes my testimony. I will be pleased to answer any questions you 

might have.

Senator MURRAY. Thank you very much. 

John King. 

STATEMENT OF JOHN KING, DIRECTOR, WASHINGTON STATE 

DEPARTMENT OF VETERANS AFFAIRS 

Mr. KING. Thank you, Senator, for the opportunity to talk with 

you today. We regret that John couldn’t be here today. It is truly 

his leadership that has made Washington State’s collaborative effort to the MOU a national model. Long before the recent homecomings, we were most concerned about how well we would receive 

those returning home. Our country could not afford to make the 

same mistakes it did when our Vietnam veterans returned. There 

isn’t time today to discuss all of the elements needed to ensure that 

our veterans are taken care of. So I will focus on an area that is 

of particular interest to you and one that we think needs to be aggressively addressed at the national level. 

Year after year, we have watched the VA budget negotiation 

process. Each year the scenario is the same. The Administration in 

office proposes a budget. The veterans community responds by 

pointing out what is lacking. And the country’s veterans end up 

with something in the middle. That needs to change. The historical 

budget leaves Washington always playing catch up. 

As you well know, the national veterans population is diminishing as the State of Washington continues to grow. You know, 

Washington is a militarily strong State. Half of those that discharge stay here. They like Washington State for a lot of reasons. 

What is needed is a method to deal with the VA budget in a forward thinking way, with a cost estimate, and it is not hard to do. 

The science is there, but the bureaucratic process and the old ways 

of doing business prevent Washington from ever catching up. And 

that makes it near impossible through VISN 20 and the service 

providers to continue to perform in the most excellent manner they 

do. 

I do know in my 81⁄2 years in this job about the quality of care. 

It is world class care. It is about access. It is about being resourced. 

Our colleagues and peers at the Federal level suffer from unbelievable workloads. It needs to be a level playing field. 

Most recently we heard that the VA described the needs of Operation Enduring Freedom and Operation Iraqi Freedom Veterans as 

being an absolute priority. They were assured that VA would provide health care for 2 years. Unfortunately it isn’t translating on 

the ground. Our veterans in the general veteran population are 

finding their waits are longer, especially for specialty services. Veterans from Enduring Freedom and Iraqi Freedom are being treated 

only for issues directly related to service in these operations. And 

I know the service providers are looking for every way possible to 

make them eligible, but they are dealing with a strained budget. 

This is not how that policy was promoted. 

Another close to home example is the success—you brought it 

up—in adding specific budget language asking the VA to open a 

community-based outpatient clinic in North Central Washington. 

There is a demonstrated need, especially in rural Washington. 

16

With the ongoing budget crisis, the opening of this CBOC has been 

pushed back again at a time when our soldiers are returning to 

rural areas, and community-based care is absolutely essential to 

their getting VA benefits and entitlements. So what are we going 

to do about it? 

Washington State in particular is going to put a lot more effort 

into outreach, making sure that we help eligible veterans get enrolled in the VA health care. As you well know in these tough economic times when unemployment rates are high, more people are 

choosing VA health care in spite of the long lines. They know it is 

quality care, and it is their option of choice and during hard economic times, in many cases, their only option. 

Lines may grow a little longer. What we would like to see is the 

budget process itself changed to be more prospective. 

Now, the latest news is that our current VA system is cutting 

back on mental health fees for service care. This affects veterans 

returning to rural Washington. Cutting PTSD services simply 

doesn’t make sense. We know that we can make issues around veterans as they return home, but the young men and woman returning from extended deployment, 20 percent are exhibiting symptoms 

of PTSD, and another 20 percent would likely benefit from counseling to deal with marital issues, substance abuse and readjustment issues. So while we are busy saying we appreciate your service and sacrifice we are restricting access to the very services that 

they need the most. 

Throughout MOU partnership we will reach out to these returning veterans at 18 family activity days in August and September. 

These family activity days are opportunities for service providers to 

offer information and services not only to the veterans, but also to 

the family members who may see the signs that help is needed before the soldier does or admits. Information and assistance provided, include counseling, health care, mental health, employment 

rights and veterans’ benefits. 

As an example, we held a family activity day in March. Of the 

76 soldiers who attended that event, over 40 filed claims—35 requesting counseling for PTSD. Not only does this tell us that there 

is a great need, it tells us that we could continue taking the services to them. Family activity days are the third direct contact as 

indicated by Director Arnold, yet for over half of those in attendance it was the first time that they asked for help. So it takes a 

while after you have been home and you assimilate and realize 

that life has changed. 

Our goal is to ensure that when they ask for help we can follow 

through by providing access to the benefits and services that they 

are entitled to. And, again, in no way do I want to impugn the 

quality of services out of the health care side or the benefit side. 

I think we have world class services here in the State of Washington, and the leadership will utilize all the resource base that 

they have to be able to provide all we need. Thank you, Senator. 

[The prepared statement of Mr. Lee follows:]

17

PREPARED STATEMENT OF JOHN LEE, DEPUTY DIRECTOR, WASHINGTON STATE

DEPARTMENT OF VETERANS AFFAIRS

Senator Murray, thank you for the opportunity to talk with you today about the 

needs of our military personnel returning from extended deployments. 

Long before the recent homecomings, we began evaluating the needs of returnees 

from Operation Enduring Freedom and Operation Iraqi Freedom, We looked at everything from employment to mental health to VA health care. There was a common 

theme that ran through our discussions: Our country could not afford to make the 

mistakes that were made when soldiers returned from Vietnam. 

We found numerous providers ready and willing to help—all with the very best 

intentions to serve these new veterans, but there was a lack of coordination to ensure soldiers didn’t fall through the cracks and efforts weren’t duplicated unnecessarily. 

WDVA began serving as a benefits and service coordinator through a Memorandum of Understanding. This document was signed by a number of Federal, 

State, local and private partners; and to date, is resulting in our newest veterans, 

and their family members being offered information and assistance not once, or 

twice, but time and again to ensure we’re there when they need us. 

There isn’t time today to discuss all the elements needed to ensure our newest 

veterans are taken care of, so I will focus on an area where I think, you Senator, 

and other Members of the Senate Committee on Veterans’ Affairs can make a difference—the Federal VA Budget. 

Year after year, we watch the VA budget negotiation process. Each year the scenario is the same. The Administration in office proposes a budget, the veterans community responds by pointing out where it is lacking, Congress battles to restore 

what was omitted, and our country’s veterans end up with something in the middle. 

However, regardless of what the amount is, the budget is never focused on the 

prospective needs of veterans. The bulk of the budget is written based on what the 

VA used in the past, rather than what we know will happen in the future. 

A case in point is Washington State. We remain stuck in a pattern of being in 

the highest 1⁄3 for veteran population and in the lowest 1⁄3 for percentage of VA utilization. 

This historical budgeting leaves Washington always playing catch-up. What is 

needed is a method to deal with the VA budget in a forward thinking way based 

on need, not on past performance. 

We’ve seen what happens when the VA is faced with an emergent issue but 

doesn’t have flexibility in its budget to effectively deal with it. 

For example, when VA Health Care was opened to all veterans in the late 1990s, 

the VA’s enrollment numbers skyrocketed, but budgets built on historical data rose 

more slowly. The result was longer waiting lists for primary and specialty health 

care and finally a moratorium on providing care for veterans in Priority Groups 7 

and 8. 

More recently, we heard the VA describe the needs of Operation Enduring Freedom and Operation Iraqi Freedom veterans as being an absolute priority. They were 

assured the VA would provide Health Care for 2 years. This too is a great initiative. 

It’s an initiative that kept the fear of repeating the mistakes of Vietnam from creeping into our thoughts. Unfortunately it isn’t translating on the ground. Other veterans are finding that their waits are longer, specifically for specialty services, and 

veterans of Enduring Freedom and Iraqi Freedom are being treated only for issues 

directly related to service in these Operations. This was not how the new policy direction was promoted. 

This incredibly good idea is faltering because of a lack of prospective budgeting. 

And that is a shame, because we knew from the initial deployments how many military personnel would be returning a year in advance, and how many would be eligible for 2 years of VA Health Care. 

Another close to home example is the success you and your colleagues had in adding specific budget language asking the VA to open a Community-Based Outpatient 

Clinic in North Central Washington. Although there is a demonstrated need and it 

was authorized by Congress and the President, the CBOC still isn’t open. With the 

ongoing budget crisis, it has been pushed back again. At a time when our citizen 

soldiers are returning to rural areas of Washington, community-based care is absolutely essential to getting them connected with VA benefits and entitlements. 

So, how can Washington State, where we have a demonstrated need, an increasing veteran population, and a lower than average utilization rate, continue to wait 

and see what the VA budget will bring each year? 

We are going to get aggressive about ensuring veterans are enrolled in VA health 

care. 

18

Lines may grow for a little while, but playing the budget wait and see game 

hasn’t worked. 

Look at what is happening with these young men and women returning from year 

long deployments—the largest National Guard deployment since WWII. We know 

they will have short-term and long-term care needs. These veterans are returning 

to homes all over our State and are encountering a strained VA system. 

Now the latest news is that our strained VA system is cutting back on mental 

health fee for service care, which will disproportionately affect veterans returning 

to rural Washington. 

Cutting PTSD services simply doesn’t make sense. We know that we can prevent 

many issues by wrapping a support system around veterans. Of the young men and 

women returning home from extended deployments 20 percent are exhibiting symptoms of PTSD, and another 20 percent could likely benefit from counseling to deal 

with marital issues, substance abuse, and readjustment issues. 

So while we’re busy telling veterans we appreciate their service and sacrifice, 

we’re restricting access to the very services we know they need. 

I don’t have all the answers; however, I will tell you that the system being used 

to appropriate money to meet veterans’ health care needs is simply not working. In 

Washington we’re going to aggressively enroll veterans in an attempt to boost our 

baseline and start seeing an increase in funding to care for those who need it. 

Through our MOU partnership, we will reach out to these returnees at 18 Family 

Activity Days in August and September alone. These Family Activity Days are opportunities for service providers to offer information and services not only to the veteran, but also their family members who may see signs that help is needed before 

the soldier does. (Information and assistance provided includes employment counseling and assistance, health care, mental health, employment rights and veterans 

benefits.) 

As an example, we held a Family Activity Day in March. Of the 76 soldiers who 

attended this event, over 40 filed claims for VA Health Care and 35 requested counseling for PTSD. Not only does this tell us the need is great, it tells us that we need 

to continue taking the services to them. Family Activity Days are the third direct 

contact each of these returnees receive, yet for over half of those in attendance, it 

was the first time they asked for help. 

Our goal is to ensure that when they ask for help, we can follow through by providing access to the benefits and services they are entitled to. 

As I said in the beginning, the VA Health Care budget is only one component of 

the issues facing our returnees; however, it is imperative that we fix it.

Senator MURRAY. Thank you very much. Thank you for all of 

your testimony. I really appreciate it. Your testimony will be a part 

of the official Senate record as well. General Lowenberg, let me 

begin with you. 

In your statement today you talked about the transitional assistance program that needed to be adjusted for the current military 

model. You have been with me around the State as we have heard 

from soldiers returning from Iraq and Afghanistan, and I am hearing a lot about medical care that gets lost in that transition, and 

soldiers paying for their own health care because they got lost in 

the system. And they are frustrated. Military pay that gets lost 

someplace. Is that all part of a transitional program that isn’t built 

around a model of Guard and Reserve? 

General LOWENBERG. The problem is widespread. It is not all related to the TAP program. The TAP program, I think, is symptomatic of systems that are predicated on Cold War models where 

the Navy, Marines and Air Force, Army—whatever—to be on activated Federal service, perhaps once in their career, are separated 

perhaps from that active service one time. 

Operationally, there is a continuing cycle of Federal service, 

peacetime training over an extended career. Programs like that 

aren’t focused on preparing them for transition while they are still 

on active service deployed overseas. That would be a beneficial 

change. And then providing a continuum of support for up to a year 

19

after they have deactivated. The program is much more narrowly 

focused than that, but it doesn’t reflect the current operational 

commitment of the American forces worldwide. 

Senator MURRAY. So we need to revise the transition program so 

it works for the fact that we are using it for Guard and Reserve 

soldiers differently than we have in the past? 

General LOWENBERG. What I would suggest is that the VA convene a task force that would include attendance of family members, 

as well as Veterans’ Administration officials and military professionals to take a look at the new dynamic under which we are operating and reassess what the veterans’ needs are. 

Senator MURRAY. Thank you very much. I appreciate that. 

Director Lewis, in your testimony you stated the VISN 20 Pacific 

Northwest network’s growth rate for veterans seeking service. Can 

you tell me what is causing those rates to be so high particularly 

here in the Northwest? 

Mr. LEWIS. I think there are a number of reasons. I think the 

first has to do with economics. The State has mentioned already 

there are a number of employment factors that weigh into this. 

Veterans returning home, they thought that they had health insurance, and they come back and they find that the company they 

worked for has gone bankrupt, or the fact that they do not have 

a job. And that is a problem that we are continually working with 

the State too, you know, some commitment that has been made. 

I think that there are, at least in the case of Washington State, 

more folks moving into the State who are veterans. That plays a 

role in that. I think the reputation for the quality of care that is 

being provided also plays a role in that. There have been a number 

of articles in the last year that have identified VA care as being 

the best in the country if not in the world. That plays a part, too. 

I think the communications that have been ongoing from the veterans service organizations, from the military itself, have played a 

large part in making folks aware of what benefits are available and 

what they are entitled to. 

Senator MURRAY. I heard John King say they were going to do 

more outreach. Are you taking into account the effect of that in the 

increased number of soldiers or veterans who are seeking care? 

Mr. LEWIS. Yes, because we do participate in that outreach as 

well. So that is part of our early warning at this stage. The work 

last year doubled by a factor of, you know, twice what the national 

growth rate was. It slowed down a little bit this year. It is not 

quite twice now. But it is still higher than any of the other networks in the country. 

Senator MURRAY. Are you able to demonstrate that growth to 

Under Secretary Perlin and others at the VA and get increased 

funding for VISN 20 as a result of that? 

Mr. LEWIS. To identify it, we do have a bearer system, and a 

bearer system is basically a historical model which recognizes 

workload as it occurred 2 years in the past. But the short answer 

to your question is Dr. Perlin was just in this network 2 days ago 

and is very well aware of the workload impact in this network. He 

actually visited Walla Walla, has been out there and toured the facility as well, and understands some of the issues that are occurring in Network 20. 

20

Senator MURRAY. And I agree he has been active in that and 

done good, but we are relying on a system that doesn’t take into 

account——

Mr. LEWIS. The system does work, though. Part of that also plays 

into how the managers in these facilities operate and how they operated before the supplemental funding that we just learned about 

recently was coming in. The managers were already working on 

some new models for providing care. 

It is true that we have increased demand in the network, and 

that the wait is long, but they have developed some strategies for 

getting those wait lists down and we will continue to work with our 

counterparts, both VBA and the State, to provide timely care for 

those folks. And so it is always a balancing act. 

Senator MURRAY. I do believe that the system here does an excellent job of providing care, but they can only deal with the resources 

they have been given. I think the fact that we are $1 billion short 

this year alone says there is something wrong with how money in 

interpreted back in Washington, DC, based on calculations and 

what Congress has been told they need versus in reality what is 

happening on the ground. 

Mr. LEWIS. Our headquarters in Washington are aware of network 20’s issues and, in fact, did provide supplemental dollars to 

this network even before the Congressional votes of last month. 

Senator MURRAY. We still have work to do. 

Mr. LEWIS. Yes. 

Senator MURRAY. So, we will work with you on that. 

Let me ask you one more question before I return to Director Arnold. I heard John King talk about the need for care in isolated 

areas, the clinic that we have been working on for North Central 

Washington, and the lack of access for our veterans. Many of these 

are members who have returned home to remote communities. 

What is the VA doing today to increase medical access and care in 

remote parts of Washington State? 

Mr. LEWIS. Well, there are a number of activities that are ongoing. I have been in the—with your permission, I will probably call 

them to give you just a little bit more information than I can provide. But just briefly, we have actually allocated additional dollars 

both to our medical services primarily for mental health and PTSD 

in rural areas. About $400,000 last month went for these programs. 

An additional $450,000 was provided in July for our Telehealth 

home care coordination program in rural areas in Washington 

State and there are a number of other outreach activities that are 

going on. We have also submitted the North Central communitybased clinic for approval in Washington. 

Senator MURRAY. When are we going to see that new clinic in 

North Central Washington? 

Mr. LEWIS. When it is approved and when it is built are probably 

two separate questions, because it will take a while to coordinate 

the space, and award the contract and things like that. I can tell 

you that it is in Washington State being——

Senator MURRAY. We will be following up on that. 

Mr. LEWIS. If I could just ask Joe——

Senator MURRAY. Very quickly. 

Mr. LEWIS. The director in Spokane——

21

Senator MURRAY. Actually what I would like to do is get your 

testimony for the record on that because I want to make sure that 

we have time for a few other questions. 

Mr. Lewis, I did have one other thing. Mr. King pointed out that 

Washington has one of the highest per capita veterans populations, 

but very low VA utilization. One of the concerns I have is, as 

health care itself becomes harder to access for many people, those 

who are veterans are turning to our VA system. Are we able to 

quickly adjust your budget? Should we see a large number of veterans coming to your system that weren’t accessing it before, but 

who qualify for it? 

Mr. LEWIS. I think, again, that is communication, and that is the 

VA communicating with our Congressional representatives and 

making them aware of the needs that we have to adjust the budget. 

Senator MURRAY. Thank you very much. 

Director Arnold, let me turn to you. As Regional Director of the 

Veterans Benefits Administration, can you tell us how well we are 

processing the veterans from Iraq and Afghanistan? Are there any 

delays? 

Ms. ARNOLD. I am very proud to announce, Senator Murray, that 

we are doing an excellent job in the State of Washington. We are 

getting very high marks nationally for this last year. We have veterans waiting about 5 months for a decision on their claim. That 

doesn’t mean there aren’t some veterans who wait longer, but in 

those cases sometimes we talk about more complicated claims that 

take us out of the process in getting the evidence. And specifically 

PTSD claims, as a matter of fact, take us somewhat longer to get 

the evidence. But in general, we have reduced our inventory of 

claims by some 3,000 over the last 12 months. What that means 

to veterans is they are getting answers more quickly. 

Senator MURRAY. I am hearing from a lot of veterans as I travel 

around the State, who have returned from Iraq and Afghanistan 

and gone back to try and rebuild their businesses. A lot of them 

who had small businesses before they left are going under. Do you 

think there is a need for a new benefit for veterans to access small 

business loans through the VA? 

Ms. ARNOLD. I know there was legislation passed like that several years ago and the funds were never appropriated for it. So I 

think still that would be a great idea. 

Senator MURRAY. Are you aware, as I am, that there are a number of veterans who need services like that? 

Ms. ARNOLD. Yes. As a matter of fact, we in our Vocational Rehabilitation program have now put a special on some self-employment. Generally before, Vocational Rehabilitation has been geared 

toward re-education, retraining type efforts to get a disabled veteran back into a career. But in many cases they want a self-employment opportunity. So we are making major efforts toward selfemployment for disabled veterans. 

Senator MURRAY. Thank you very much. 

Mr. King, your Department often ends up being the broker between the Department of Defense and the VA in order to get our 

veterans processed. Can you tell us how well these agencies are 

working together to get veterans the help they need? 

22

Mr. KING. I am absolutely impressed with how well the system 

is working together. That the commitment from every entity is 

there. The practice is there. It is about resources, Senator. You 

made a very important statement on the front end of your opening 

remarks, and that is we have 670,000 veterans in the State of 

Washington. I don’t think you will find that number anywhere else 

but from those of us that work the problem. That is not the number that the VA budget is on. They use Census 2000 as a latest 

update and modeled after national modeling. That is part of why 

the State of Washington which experiences inordinate growth in 

our community is so out of balance with the rest of the Nation. On 

the east coast they are declining. On the west coast, especially in 

the Pacific Northwest, we are growing at a rate that other States 

don’t experience. 

Senator MURRAY. In your remarks, you mentioned that 20 percent of the returning vets are seeking care for post-traumatic stress 

syndrome. 

Mr. KING. You know, it is the early indicator. I can’t say that it 

is a specific trend. But the early indicators are that of the young 

men and women returning home from extended deployments, 20 

percent presented with PTSD, and another 20 percent could likely 

benefit from counseling to deal with marital issues, substance 

abuse and readjustment issues. And 35 out of 76 applied for help, 

this is a real strong indicator that this was very hard and it does 

have a huge impact. 

Senator MURRAY. The other thing I am hearing is a concern that 

returning Iraq and Afghanistan veterans may displace some of our 

Vietnam and Korean veterans who are trying to access care. Can 

you share with us any knowledge about that? 

Mr. KING. Because we are familiar with the care initiative and 

watching the wait lines problem being aggressively addressed, then 

to find ourselves right back to where we started, and my concern 

is this. Both OEF/OIF are certainly issues presently in front of us, 

but it should not replace the focus on the rest of the veterans community who have served well. 

It is almost as if it obfuscates the issue that we thought was 

being resolved, and now it is back on our heels again. We are back 

to the long waiting lines at or beyond what it was before we started 

the care initiative. So I am not sure I answered your question, but 

the larger veteran population is now further in——

Senator MURRAY. General Lowenberg, let me ask you a few more 

questions. How many Guard members from Washington State have 

now been deployed to Iraq and Afghanistan? 

General LOWENBERG. I don’t know the exact number, but it 

would be in excess of 4,000. 

Senator MURRAY. How many were returned injured? 

General LOWENBERG. In the hundreds. We at one point had several hundred on medical hold at Madigan and there are several 

still, as you know from our meetings with soldiers in Everett and 

other locations, that are still part of that system. 

Senator MURRAY. I am hearing a number of concerns from them 

about the ability to access services because they are still under a 

medical care situation. 

General LOWENBERG. That is correct. 

23

Senator MURRAY. One other issue I heard recently is the tremendous impact it has on families when Guard members serve in Iraq 

or Afghanistan for over a year, up to 14 months some of them. I 

have heard from a number of soldiers on both sides of the issue, 

but the suggestion is to shorten that length of time to 120 days. 

The impact on marriages, the impact on businesses, the impact on 

families has been tremendous. Is there a discussion of changing deployment for the Guard? 

General LOWENBERG. There is a very active discussion. The focus 

is on shortening the ground time for Army Reserves and Guardsmen to something less than 12 months, and something in the 

neighborhood of 9 months is the short-term goal. In combination 

with that, the Army’s deployment process needs to be modernized 

and timelines shortened. Right now, to have boots on the ground 

requires an 18-month commitment on the part of the soldiers, and 

nearly all of that is on the front end getting them ready to deploy. 

So recognizing we have to transition from a strategic reserve to 

an operational reserve national military strategy means, that we 

need to invest the resources in health care, and in training the soldiers and in helping the soldiers so that they are closer to ready 

for deployment as they reach that 5th or 6th year force rotation 

model. If we do that and reduce the down time, then we have a 

more sustainable force, and I think a more ready and sustainable 

family force. 

Predictability is the key, whether it is a 12-month rotation cycle, 

9-month rotation cycle or shorter. If families know that a commitment to public service and military service—what that cycle will 

be—they can adjust their lives to that cycle. 

Senator MURRAY. I think it is an important discussion, because 

I talked to one soldier in the Tri-Cities who was literally gone for 

18 months, gone from his wife and children for 18 months, and 

stayed at home for 2 weeks feeling like a visitor in his own home. 

Now he is really struggling with family relationships. And we have 

heard from many, many families, and I think we need to have a 

serious discussion if this is going to be in the future about how 

Guard and Reserve are deployed because of the tremendous impact 

on families. 

General LOWENBERG. I couldn’t agree more. We had an entire 

Transportation Company from Ephrata that was extended in theater twice. They stayed substantially longer. So a lot depends on 

the military occupational specialty and the mission involved. 

Senator MURRAY. And this will have an impact on veterans because a number of the soldiers returning and the services they require are measurably increasing, is that right? 

General LOWENBERG. It goes back to that earlier, that if that 

transitional assistance was made available while they were in theater reaching—you know including months of their activation, and 

to continue up to a year after they came back, it provides for a 

more stable and sustainable transition for the veteran and their 

family. 

Senator MURRAY. Thank you very much. I am sorry our time is 

up for this panel. But I really appreciate all of your input. 

I would like to invite our second panel. As they are coming forward, I am going to introduce our second panel. Specialist Blaine 

24

Miles Hall of the Washington Army National Guard from Moses 

Lake, Washington; Staff Sergeant Kevin Romanelli who recently 

retired from the Army and lives in East Wenatchee, Washington. 

We have Crystal Hampton. She is an Army veteran from Vancouver, Washington who served in Afghanistan; and First Sergeant 

Robert Kauder from the Washington Army National Guard who 

joins us from Spokane. 

Thank you all for joining us again. As I said in my opening remarks, I particularly appreciate all of you for coming forward, and 

for having the courage to come forward and speak about personal 

matters. I know it is not easy. I really appreciate all of you being 

here today. 

With that, Specialist Hall, we will begin with you. 

STATEMENT OF SPECIALIST BLAINE MILES HALL, 

WASHINGTON ARMY NATIONAL GUARD 

Specialist HALL. I would like to say that I am proud to be in the 

Washington Army National Guard. And I understand the possibility for deployment can occur at any time with no notice, and it 

is our responsibility to be up and ready for that deployment. We 

are told that when we come in. 

I heard a lot of positives up here on the panel, but the problems 

that the soldiers that I have dealt with and myself have dealt with, 

is not in what is available. It is how it is available to us. It is how 

the programs that you have heard in the legislature are actually 

practically applied. 

The SBA, Small Business Association, has a disaster relief program for National Guard Reserve small business owners that are 

being deployed. The program itself is a great program, but the 

process isn’t failsafe. To prevent people from abusing it, the regulation in place is making it almost impossible for soldiers to use it. 

The first step says that you need a copy of your orders to start 

receiving those funds. You don’t receive your orders, and as a business owner you need that money up front to train, hire and go over 

the costs for your business. And a lot of people think that is a benefit. It is a loan. You are also paying that back. So it is not like 

you are getting a hand me down even. You are paying that back 

and you are paying it back with a marginal interest rate at that. 

But to begin the process you need to have orders and they won’t 

start without it. Once you have orders, your boots are on the 

ground, and you are training with your troops and you can’t focus 

on your business anymore. You have to make a decision then 

whether you are closing your business or keeping it open hoping 

that the loan comes through. Soldiers don’t have faith in those Government programs to let their affairs run like that. 

The second thing is you never will know when you are going to 

be deployed, but at least in our instance we were told a couple of 

times the deployment was happening and you are to stand down. 

Deployment is happening. Stand down. If a warning letter comes 

from the Department of the Army saying they are planning to activate, if they could get the funds available right away it will really 

help keep some soldiers—their financial levels and get the program 

started. 

25

For instance, the Soldiers Relief Act again requires that you have 

orders, but once you have those orders you can’t be calling your 

creditors, your agencies, because you are already in Fort Lewis. 

You are training, you are going through what you need to focus 

on—the war at that time. Your time to focus on your family, business and financing is over. The time you have left to focus on your 

business is that 1 month when they tell you are going to be activated. If you don’t have those funds and resources available to you 

at that point, you are just sitting there in the water knowing that 

there are these programs available, but you can’t use them. 

The SBA Disaster Relief Program is not a disaster relief program. It is more of a credit-rating based. It is still a loan process. 

It is still the Government telling you whether your business needs 

better criteria. I think the only criteria for a loan or disaster relief 

should be that you are a soldier and that you have a business that 

is going to be impacted after your deployment. 

When I applied for a loan I didn’t have tax documentation. My 

business has not been open for 2 years, so I couldn’t use the program. I was also told that anyone who opens a business can determine through ESP whether your profit and loss statements—

whether they are working or not. My profit and loss statements 

don’t look profitable in their eyes. My business has only been open 

for 2 years and, of course, it is not making a lot of money. My credit has been overextended in that business and I would lose a lot 

if I closed. 

It just seems to me that these programs are said to worry more 

about abuse than to actually help the deploying soldiers. Can’t they 

remember that we are soldiers? I mean, that you are going to get 

your money. It is the Government. You know, the Soldier Relief Act 

is a great relief Act, but it doesn’t allow for—there is no enforcement of it. If a company doesn’t apply for the Soldiers Relief Act, 

what is there to offer them? There isn’t. But the whole time we are 

sitting in Iraq we are ruining our credit rating. Thank you. 

[The prepared statement of Specialist Hall follows:]

PREPARED STATEMENT OF SPECIALIST BLAINE MILES HALL, WASHINGTON ARMY

NATIONAL GUARD

DEPLOYMENT ISSUES AS THEY PERTAIN TO SMALL BUSINESS

Intro: I would like to start off by saying that I am proud to be in the Washington 

Army National Guard and I understand the possibility for deployment can occur at 

anytime with little notice, and that it is our responsibility to keep our households 

and business’ ready for deployment while we are members of the Washington Army 

National Guard. While I don’t want to focus on the situation that occurred with me 

personally, I would like to focus more on the program problems themselves, below 

you will find a brief outline of my situation, the problems that I have found with 

the programs and the solutions I see available to make the legislature already 

passed a success. 

Personal Story: Opened my business in November of 2002. My business was turning a profit, though minimal till I was forced to close it in October of 2003. In May 

of 2003 we received notice from our command group that we would be deploying to 

Iraq within 90 days and that orders would be sent to us within a week or 2. Upon 

this notice I contacted the SBA Disaster relief program to start applying for a loan. 

I found out that I cannot start the process until I receive orders. Knowing the extensive training I was going to have to give the person I hire to replace me, I spent 

my own funds to find, hire, and train an employee to handle my business while I 

was deployed. Word came down from my commander at the end of June that we 

were no longer being deployed. I had to lay off my employee and continued to struggle with all the money I had spent coming out of my own pocket. In October of 2003 

26

we were again told that we would be deploying to Iraq in November, with no money 

left to hire and train yet another employee and the SBA unwilling to work with me 

until I had orders (they did not arrive in my hand until December 2nd 2003). I was 

forced to close my business and file for bankruptcy. 

The Problem: The Disaster program is a great program that needs to be loosened 

to accommodate the army way of functioning. Soldiers often do not receive their orders until after a deployment starts and this does not allow a business to fund the 

larger costs of deployment that occur at the very onset. The soldiers and Sailors relief act that allows for soldiers to opt out of leases and drop interest rates down to 

6 percent has no enforcement structure to enforce that lending and leasing agencies 

actually agree to comply. The SBA loan process allows for you to apply for the loan 

after you have been activated but will not offer a loan to you if you closed your business during the deployment. The SBA is also Credit Rating based, which means 

your business may be financial profitable but if the SBA determines that you are 

over extended, your business has not been open for 2 years, your type of business 

does not offer the collateral necessary to cover the loan, or have negative credit they 

will decline you for a loan. It seems to me that there is more of a worry that the 

system will be abused than there is a worry to actually help the deploying soldiers. 

Why can we allow these troops to go risk their lives, but cannot in-trust them to 

keep their business alive for when they get back? Does it make sense to set rules 

that hinder much needed aid to soldiers in the fear that one or two might abuse 

the system? 

Suggestion for Solution: Allow soldiers access to the loan process before they are 

ordered to active duty, there should be a warning order, or letter of deployment 

issued by the army that will suffice for the SBA to allow the release of funds while 

the troops are still home side and able to use the money to benefit their business. 

This program should not be based on Credit Ratings or any other means other than 

the needs of the individual business and soldier. Remember that soldiers are government employees and that any abuse of this program can be deducted from their pay 

or taxes. Create a penalty program for any company that does not wish to comply 

with the Soldiers and Sailors relief act, it is incredibly easy for companies to negatively effect your credit report (especially while you are fighting a war over seas and 

unable to check it) but it is impossible to fix the damage once it has been caused, 

and with no Governmental help.

Senator MURRAY. Thank you very much. 

Staff Sergeant Romanelli. 

STATEMENT OF STAFF SERGEANT KEVIN ROMANELLI (RET.),

U.S. ARMY 

Sergeant ROMANELLI. Thank you for allowing me to speak. 

Again, I apologize if some of it is negative. I retired in February 

of 2005 after 26 years in service. I have got a combat star as a reservist in Bosnia, Kosovo, Afghanistan. I was home for 3 months 

and joined up with the unit to go to Iraq. When I got injured here 

at Fort Lewis, I encountered a lot of problems. One of them, the 

medical hold. I met a lot of soldiers from Washington and found out 

that our common problem is it is taking a little longer to get the 

care that we need and it is putting a financial burden on us. 

It is to the point where, I have three little girls, I couldn’t do 

anything for their birthdays. My vehicle was repossessed. I tried to 

call these agencies to get answers, and I couldn’t get them. That 

is what a lot of the soldiers are having a hard time with, Senator. 

And I would like my written statement put on the record, please. 

[The prepared statement of Staff Sergeant Romanelli follows:]

PREPARED STATEMENT OF STAFF SERGEANT KEVIN ROMANELLI (RET.), U.S. ARMY

Good morning, Senator Murray. Thank you for inviting me to speak to you today 

on my behalf, and on behalf of fellow veterans who have faced challenges since their 

return from Afghanistan and Iraq. I will share my experiences with you in the hope 

that you will use that information to improve our transitions into civilian life. 

My name is Kevin Michael Romanelli Staff Sergeant (E–6), United States Army, 

Retired. I served a total of 26 years in the Army and Washington State National 

27

Guard. During that time I served two tours in Kosovo, and one tour in Afghanistan. 

I volunteered to go to Iraq; however, I was found non-deployable because of my medical condition. 

On 3 February 2005 I was placed on the Temporary Disability Retired List 

(TDRL) after the Medical Evaluation Board (MEB) at Madigan Army Medical Center determined that I was 30 percent disabled. 

The Medical Evaluation Board determined that I would only receive disabililty 

ratings for a fraction of my diagnosed medical conditions. I received a 20 percent 

rating for my spinal conditions (upper right extremity pain and weakness impinging 

at C–7 nerve group; herniated disc at C–6 and C–7; and C–6 pinching spinal cord 

at C–5 and C–6), and 10 percent for my neck condition (neck pain and restricted 

motion with insidious onset during AD tour image shows large herniating at C–6–

7), for a combined rating of 30 percent. 

I also have severe migraine headaches, chest wall lipoma, hypertension and 

hyerlipidemia. The Medical Evaluation Board determined that those conditions met 

retention standards, they did not award me a disability rating for them. During the 

time I was going through the Army’s Medical Evaluation Board process I was told 

to wait until that process was complete before I filed my VA claim. If I had been 

able to submit the claim during my MEB process I would have received my VA disability rating when I was transferred to the TRDL list, which would have eliminated the hardships that my family and I have experienced. 

I have a claim pending with the Department of Veterans Affairs. I am seeking 

service connection for 13 separate conditions. I was diagnosed with all these conditions while serving on active duty. They include: PTSD, bilateral degenerative joint 

disease in my knees, hearing loss, tinnitus, and problems with my eyesight—which 

are residuals of an episode of Bells Palsy, herniated discs, limited range of motion 

of my neck, hyerlipidemia, hypertension, migraine headaches, acid reflux and a 

hiatal hernia. My compensation and pension exams were conducted by QTC. They 

referred me to three healthcare providers for tests and examinations. 

I am receiving bills from the places that QTC referred me to telling me that my 

bills are past due. I inform them that the VA is responsible for the bill. QTC sent 

me to doctor in Moses Lake who conducted a separate examination, he conducted 

an upper GI it revealed that I have acid reflux and a hiatal hernia. The doctor did 

not have my medical information when he conducted the exam. QTC sent me a letter informing me not to bring my medical records because the VA would send the 

appropriate medical records to the examining physician before the exam. All they 

sent him was a questionnaire. I brought my own medical records, despite their letter. This gave the doctor something to go by otherwise he would have had nothing. 

QTC also sent me to Wenatchee Valley Medical Center for x-rays. Wenatchee Valley 

had not been notified that I was coming. If I had not brought my referral slip the 

x-rays would not have been taken. I am being billed for $66.75; the bill is due on 

August 6, 2005. QTC also sent me to Chelan-Douglas Behavioral Health Clinic for 

my PTSD examination. (I have combat tours going back to 1999, Bosnia, Kosovo and 

in 2002 Afghanistan at Bagram Airfield.) I arrived there 20 April 02 to 16 October 

02. 

I applied for Social Security disability and my claim was denied. They said that 

my claim was denied because they were unable to get my medical record. They requested information from the VA, from the physician Dr. Quinn where I referred 

by QTC and Valley Medical, no reports were received so my claim was denied. The 

denial that although SSA realizes that I cannot do the jobs I had done previously, 

because of my age, education and past work experience I could do other work. My 

previous work experience is as a firefighter, a Police officer and a heavy equipment 

operator. With all the pain medication I am taking, how could I work in this condition? 

The most difficult thing for me is the hardship that has been imposed on my family. We are living on $300 per month. My car, bed, washer and dryer have been repossessed. When I was on active duty my basic pay and VHA came to $4000 per 

month. Now, I receive 50 percent of my basic pay. My family of five is living on 

$1300 per month. My rent is $1000 per month, so my family is actually living on 

$300 per month. While waiting for my VA and Social Security disability claims to 

be processed I had to seek financial assistance VFW and the American Legion with 

rent and bills. I am constantly contacted by bill collectors who want to know when 

I will be able to pay them. When I contact the VA 800 number to find out how long 

it will take to process my claim, so that I have something to tell the bill collectors, 

I am told that I need to contact them in writing. I need the help now. 

There are many veterans living in the same situation that I am in. I hope that 

something can be done to help them. Another sergeant I know was discharged on 

November 20th. He was wounded in Iraq and is a purple heart recipient. His claim 

28

still is pending. On Friday he was just notified by QTC that his compensation and 

pension examination appointments have been scheduled. 

Other soldiers were not able to endure the challenges and uncertainty they experience when they come home. Three soldiers from my platoon have committed suicide after they were separated. One of them, one individual lost his home, his wife 

left him and his vehicle was repossessed. He did not have anywhere to turn. He was 

trying to get answers and he couldn’t get any. I learned about his death through 

a former platoon member. 

When I came back from Kosovo, I was contacted by a VA rep immediately. He 

wants to know how I was doing and offered support from the VA. Unfortunately, 

I did not have the same experience after I was put on TDRL. I had no contact with 

anyone after the MEB. I attended a general VA briefing; however, no one followed 

up with me. When I out processed they sent me to Ora Robe from AMVETS. She 

helped me filled out the 21–526 on 17 March. I was notified about my first compensation and pension appointment 23 May 2005. I had to wait for payday. Then 

I returned and filed the claim through AMVETS. 

Things began to look up for me after I received a letter from the Governor who 

informed me about the services available to me. I called for help. Tom Riggs called 

me back and he has been helping me ever since. He is working with me on my 

claim, he has resolved my prescription medication issues. A lot of my problems have 

been resolved in the last couple of weeks than in the entire time that I have been 

out there doing it myself. 

Thank you again, for giving me the opportunity to testify.

Senator MURRAY. Thank you, Sergeant. We will put that as part 

of your written statement. I will have a chance to ask you some 

questions in a few minutes. Thank you very much. 

Ms. Hampton. 

STATEMENT OF CRYSTAL HAMPTON, VETERAN, U.S. ARMY 

MS. HAMPTON. Hello, ladies and gentlemen, directors. My name 

is Crystal Hampton. I am 26 years old from Vancouver, Washington. I served 6 years on active duty in the United States Army 

as a CH 26 Delta crew chief. My first duty assignment was at 

Charlie Company 159th in Fort Bragg, North Carolina. Then to 

Bravo second aviation in Korea where I spent 2 years, and 3 

months of it in a hospital in Seoul, after I was hit by an odeshi, 

by an AHAR [phon]. Then I went to K 159 aviation, where I was 

deployed for 7 months to Kandahar, Afghanistan in support of Enduring Freedom. 

I had various assignments while I was there. I was section sergeant in charge of nine soldiers. I was confined to the fuel cell 

mostly because I was the smallest person to fit into the cell. I was 

also the downed aircraft recovery team leader. So I was a very busy 

girl when I was there. 

However, I want to tell you all that I loved my job, and serving 

in the military was the greatest thing that I have ever done. I was 

honorably discharged with a rank of corporal in September 2004. 

Now, when you are about to leave the Army you are sent to ACAP 

classes. Unfortunately, I don’t remember what that stands for, but 

that is what you have. ACAP is where the active duty 

servicemembers are taught how to be a civilian again. You are sent 

to various different classes where you have to learn to write a resume, and you go to job interviews and you get a 30-minute block 

of instruction on the VA. 

I did not know anything about the VA. I learned a little bit about 

the VA loan. Nothing that really helped me. I did not know that 

I could receive benefits. None of that. The only reason I found that 

29

out was because Bob Cruze happened to be at my parents’ shop one 

day. 

Now, thinking about this, I asked my fiance ́ who is on active 

duty in Iraq right now, Staff Sergeant Luke, and he didn’t know 

anything about the VA. And he has been in the service for 13 

years. So he asked his officers and a few other enlisted, and they 

didn’t know about it. However, they are very excited that this opportunity will be accorded to them, but still it doesn’t help them. 

My point is that servicemembers coming back from war, a lot of 

times, are not aware of the benefits they can receive. And if we can 

find a way to inform these future veterans of what they are entitled to, it would be better for them. 

Lucky for me, Bob found me and my personal transition to the 

VA was a very good one. The people are fantastic. Being in the 

military is a physically and emotionally demanding job. Being a petite female with a displaced kneecap from running—some of us 

aren’t meant to run unfortunately—tendinitis in my wrist from 

turning wrenches and from push-ups, and some hearing loss due 

to working on helicopters for many years. 

The VA has done a wonderful job trying to accommodate me and 

my injuries. However, I feel that with more resources they would 

have an easier time processing these things. A few more reasons—

like a veteran Ob-Gyn for females down in Vancouver. That would 

be great. Also they would be able to process paperwork, and processing soldiers like myself would be quicker. 

Finally, I feel that college grants for vets returning home or for 

the spouses of stable vets would be a considerable help. It occurred 

to me now that I am out, that I do not know how to do anything 

but work on helicopters. I remember all of it like it was yesterday. 

Granted that it is a good paying job in the civilian world, I still 

don’t want it and I can’t physically do that for the rest of my life. 

If I have no skills, I am sure that there are other soldiers who are 

in the same boat as I am. And the spouses of the disabled veterans 

who have become the primary breadwinners of their family, if they 

had training or more college education to get a better paying job 

or find a job that would be available to them, the stress that would 

be lifted off their shoulders would be amazing. 

In closing, I feel the Veterans’ Administration has done a world 

of good for those who know about it. With a few more resources, 

what they could do would be unbelievable. Thank you all for your 

time. 

[The prepared statement of Ms. Hampton follows:]

PREPARED STATEMENT OF CRYSTAL HAMPTON, VETERAN, U.S. ARMY

Hello Ladies and Gentlemen. 

My Name is Crystal Hamtpon. I am 26 years old and from Vancouver, WA. I 

served 6 years in the U.S. Army as a CH47D or‘‘ Chinook’’ Helicopter Crew Chief. 

My First Duty assignment was at C159th Avn at Ft. Bragg, NC. Then to Bco 2/

52 Avn in Camp Humphrey, Korea, where I spent 2 Years and 3 days in a military 

hospital after being ran over by and odeshi. Then to K159th Avn at Hunter Army 

Airfield in Savannah, GA where I was then deployed to Kandahar, Afghanistan in 

support of Operation Enduring Freedom 3. Home of foot long camel spiders. While 

in the desert I had various duty assignments including Section Sergeant in charge 

of 9 soldiers. Phase Team Leader (a phase is a period of 200 hrs at the end of which 

the helicopter is give a maintenance overhaul. This usually takes 20 days and costs 

approximately $5 million). I was also the Confined Space and Fuel Cell Repair team 

leader and Downed Aircraft Recovery Team Leader. I was a busy girl. However, I 

30

want to tell you I did love my job and serving in the Army was the best thing I 

have ever done. I reached the rank of Corporal and was honorably discharged in 

September of 2004. 

When you are about to leave the Army you are sent to ACAP classes, (sorry I 

don’t remember what that stands for). Acap is where they teach you to be a civilian 

again. They teach you things like how to write a resume and job interview skills, 

and finally about your VA benefits. I received a 30 min block of instruction about 

the VA which mostly covered the VA Loan. I did NOT learn anything. I did not 

know I was entitled to anything. I would not have known of the benefits if it had 

not been for Bob Cruze coming through my parent’s oil change shop. So basically 

it’s by random chance I have benefits. 

Now thinking about this. I asked my fiance ́ SSG David Luke, Who is in Iraq at 

this time. David didn’t know anything about VA and he’s been in for 13 years. So 

he asked some of his officers and a few enlisted, and they didn’t know. They were 

excited and relieved to hear that they were entitled to some benefits. My point is 

that the men and women coming back from war and serving our country are not 

aware of the VA, and what it does. We need to find a way to inform these future 

veterans, of what they are entitled to. Lucky for me Bob found me and made my 

personal transition to the VA Medical system as easy as possible. 

Being in the military is a physically and emotionally demanding job. Being a petite female in a predominately man’s job definitely took its toll on me. I have a displaced kneecap from the running. Some of us were not meant to run. I have 

tendonitis in my wrists from turning wrenches and from push-ups and some hearing 

loss from working on the helicopters for 6 years. The VA has done a wonderful job 

trying to accommodate me and care for my afflictions considering the number of veterans they serve and the amount of resources they have. I feel with more resources 

(like better O/GYN and women’s services for example) they could do their job better 

and more efficiently. They also would be able to process paperwork with more ease. 

So the claims for former soldiers like myself would go a little quicker. 

Finally I think that career training or college grants for the Vets returning home 

and for spouses of disabled veterans would be of considerable help. It occurs to me 

now that I’m out, I don’t know how to do anything but work on helicopters. 

Granted that it is a good job in the civilian world, but I don’t want it, and physically, I can’t do that for the rest of my life. And if I have no skills, I’m sure there 

are many other Veterans like me. Also the spouses of disabled vets who have now 

become the primary breadwinners, if they were given the opportunity to go to school 

or get a better job with a little training so they could make more money to support 

their family, they would be less stressed. In closing the Veterans Administration 

does a world of good for those who know about it. With more resources the things 

they could do would be unbelievable. Thank you all for your time.

Senator MURRAY. Thank you very much. 

First Sergeant Robert Kauder. 

STATEMENT OF SERGEANT ROBERT KAUDER,

WASHINGTON ARMY NATIONAL GUARD 

Sergeant KAUDER. Good morning, Senator Murray, distinguished 

members of the audience. First of all, since this is for the record 

I do need to point out I appreciate the promotion, but actually I 

am just a sergeant. 

Senator MURRAY. I can’t do that for you? 

Sergeant KAUDER. Having returned recently from a tour in Iraq, 

one thing that has struck me is on every squad patrol I would meet 

with my squad and squad leader before we go outside the wire. We 

would get together in a circle and we would talk, and I would let 

them know two things. That no matter what happens once we roll 

outside the gate that everyone would come home dead or alive, and 

no one would get left behind. 

The reason why I am here today, as I was in May when we met 

for the first time in Spokane, is I am concerned now that I am no 

longer in a position to provide for their care and training that my 

soldiers are getting left behind. Soldiers have been coming home 

with a variety of feelings, but two of the primary feelings that they 

31

have are guilt and shame. When I say, ‘‘guilt,’’ what I am referring 

to is survivor’s guilt. 

My platoon sustained several casualties. One of the men in my 

squad was killed in action in a firefight on July 9, 2004. It goes 

without saying that several battle casualties and non-battle casualties are forcing some soldiers to rotate home, and be put on med 

hold and be put through surgeries. For the soldiers who didn’t get 

wounded but stayed behind, there is the traditional guilt that any 

soldier can attest to. Why was it that person and not myself? 

The other thing they are experiencing is shame. Shame over having this emotional trauma, post-traumatic stress disorder. Where a 

soldier who has been shot or has experienced some sort of physical 

trauma can be treated with surgery, someone who witnesses that 

or is experiencing survivor’s guilt, there’s no Band-Aid. There is no 

surgery. There is no miracle pill that can cause them to stop feeling this way. 

In my experience, there are two types of soldiers. They are either 

going to face their fears, face the problems that they are having, 

the sleepless nights, the anger, the frustration that they are experiencing or they are not. And they are going to turn inward. This is 

the dilemma that we are going to face when dealing with the VA, 

the soldiers that seek treatment are going to get it. The soldiers 

that are not seeking treatment are going to turn to alcohol, turn 

to illicit drugs, and their relationships are going to fail. This is 

similar to what we saw in Vietnam. 

What we need to do is have them think out of the box. Get away 

from what I call the bottom mentality. We need to get away from 

the facilities and out into the field. We need to have more outreach 

programs to address issues, particularly in North Central Washington. Reach out to those people, get to the armories and address 

these situations, and address these concerns the soldiers have before it gets too big and we get into a situation like we were faced 

with Vietnam veterans who became disenfranchised. We have the 

resources. We need to use those resources to the best of our abilities to reach out to veterans. Thank you. 

[The prepared statement of Sergeant Kauder follows:]

PREPARED STATEMENT OF SERGEANT ROBERT KAUDER, WASHINGTON ARMY

NATIONAL GUARD

My name is Rob Kauder and I present this testimony today not as a National 

Guardsman but as a veteran with nearly two decades of service to his country. My 

comments and concerns presented here reflect my experiences in the process of demobilization and reintegration, attempting to leave the Guard as a soldier on stoploss and the challenges soldiers face with processing claims through the Department 

of Veterans Affairs. The opinions expressed in this testimony are mine alone and 

should not be construed as an official position made by a National Guardsman. 

I am currently a news producer for a television station in Spokane, Washington, 

but for the better part of the last 18 years I have also served in the Armed Forces 

in varying capacities. Following graduation from high school in 1987 I enlisted in 

the United States Marine Corps, where I served on active duty for 6 years. During 

my enlistment I participated in Operations Desert Shield, Desert Storm, the United 

Nations Mission to Somalia (UNOSOM) and two counter-narcotics missions along 

the US-Mexican border with Joint Task Force-Six. 

After my honorable discharge from the Marines I went to college in Ellensburg 

and joined the Marine Reserves and served 3 years. In 1998 I joined the Army National Guard and have served in Charlie Company, 1st Battalion, 161st Infantry for 

the better part of the last 7 years. During the last year-and-a-half I have served 

32

on active duty with my Guard unit as part of the general mobilization of the Washington Army National Guard’s 81st Brigade in November of 2003. 

During the last year I served as an infantry squad leader and participated in fullspectrum stability and support operations in and around the Green Zone in Baghdad, Iraq with my unit, which was attached to the 1st Cavalry Division out of Fort 

Hood, TX. I returned from the theater of operations on March 1st, 2005 to begin 

my reintegration back to civilian life. 

I wish I could come to you today and tell you the reintegration of myself and fellow members of my unit has gone smoothly; the reality is that a number of men 

in my platoon are struggling to come to grips with their adjustment from the combat 

zone to the homefront. Several men have left long-term relationships or are going 

through divorces; others have not adjusted emotionally to a world where they don’t 

have to be on a near-constant state of alert, ready for attack from any quarter at 

any moment. At least one soldier, offered a lucrative tax-free contract, has gone 

back to Iraq with a private security firm; several others, struggling to cope with life 

back home are considering volunteering to go back to Iraq as well. 

On the surface, the demobilization process went fairly quickly and smoothly upon 

our return from Southwest Asia to Fort Lewis. After our aircraft touched down at 

McChord Air Force Base, we were given a flurry of briefings before being allowed 

to leave with our loved ones for 3 days of rest and recuperation before beginning 

the demobilization. 

For the majority of the men the demobilization process took approximately 5 days. 

During outprocessing soldiers are given a variety of briefings including discussions 

about a myriad of support networks and programs available through the Department of Veteran’s Affairs, but to be honest the briefings were nothing but a hazy 

blur. I paid attention to nothing more than checking each box on the outprocessing 

sheet and checking my watch to see how much time was left before we would be 

done and out of the Army. 

It wasn’t that the information wasn’t important to myself or any of the other men; 

it was just that the overriding concern among those in attendance was to be done 

with the whole process, be done with the seemingly never-ending red tape, be done 

with the active duty military and be back home in the civilian world. 

I would sum up the demobilization phase with a comment made by one of our 

instructors at Fort Irwin prior to our deployment to Iraq. He said once that war 

is controlled chaos and Americans thrive at war because we practice controlled 

chaos on a daily basis. Following his reasoning then soldiers must also thrive on 

outprocessing as well. 

After outprocessing, the soldiers of Charlie Company were told to return back to 

their respective platoon armories in Wenatchee, Spokane and Moses Lake. For some 

reason, there was an assumption that each soldier had their personal vehicles to 

drive to their home armories from Fort Lewis so no Government transport had been 

arranged. As a result soldiers had to arrange for their own transportation for themselves and their equipment from the demobilizationsite to their respective armories. 

Upon our platoon’s return to the National Guard Armory in Moses Lake we were 

told that 5th Army had mandated that we were to stay at the armory for 2 days; 

there was however, no plan from what I could ascertain as to what exactly we were 

supposed to do during this period other than have friends, family and community 

members come to the armory for an open house. From the perspective of the enlisted man, we had finished our demobilization and had been told we were to spend 

two more days at our home armories with no tangible agenda other than to spend 

2 days at our armories. 

At every other phase of our deployment while under Federal orders we had been 

provided food and lodging; for some reason when we returned to Moses Lake there 

was no contingency for providing either for the soldiers, which proved inconvenient 

for those men who did not live in the immediate vicinity particularly when we were 

told that since we were under Federal orders we were not allowed to stay in the 

armory. 

As I am writing this I realize that this week marks the 1-year anniversary of my 

original end-of-active-service (EAS) date; like numerous other soldiers, I was placed 

on stop-loss prior to our deployment. As I look at today’s date I also realize that 

it has been almost 5 months since I returned from the combat zone and yet to this 

day, technically, I am still in the Washington Army National Guard, even though 

I had been under the assumption that all stop-loss personnel would be released from 

their National Guard service 90 days after their release from Federal service. I was 

released from active duty in the first week of March and finished terminal leave 

the first week in April, which would mean that the 90-day period would have expired the first week in July. 

Here’s where the situation gets confusing. 

33

I talked to a soldier at the armory in Moses Lake and was told that I was mistaken; all soldiers including those that were on stop-loss were required to attend 

the next regularly scheduled drill weekend near the end of August which, for reference, would be almost 6 months following our release from active duty (REFRAD). 

It was made clear to me that any soldier that did not show up for this important 

drill weekend—which would include an award ceremony and a picnic—would be designated AWOL. 

I took the matter up with the battalion S1 (Administration) office at Geiger Field 

near Spokane and it was explained to me by the non-commissioned officer on duty 

that the 90-day period for stop-loss personnel was incorrect; all soldiers had been 

extended—according to their orders for Federal duty—through 2031, and stop-lossed 

soldiers awaiting release from Guard service would be released when the paperwork 

was completed. No date was given as to when that would take place. 

So then I talked with my former platoon sergeant and he explained in detail that 

any soldier that was on stop-loss had to be released at the end of the 90-day period 

as long as they turned in all of their military equipment and the paperwork was 

finished. After talking with him I spoke with another soldier who I served with 

overseas who confirmed that according to my records my end of active service (EAS) 

date had been July 10th. 

My concerns about this situation are several. Over the last 5 months, the National 

Guard Bureau has seen fit to send multiple mailings to my home filled with messages highlighting different programs to help with reintegration for soldiers and 

their families, messages of congratulations from various officials, and yet in the 4 

months since I finished terminal leave there has not been one letter explaining the 

final procedure for stop-loss personnel outprocessing out of the National Guard. 

I have taken the initiative and inquired about the procedure I have been given 

several contradictory stories as to what the procedure is for stop-loss personnel leaving the Guard and when I would be released from stop-loss. It was only through 

contacting someone outside my chain-of-command that I was able to ascertain my 

EAS date; nobody within my chain-of-command was able to give me a straight answer as to when I would be released from service. In summary, I would say that 

I have fulfilled my active duty obligation and received an honorable discharge for 

that service and now I am curious as to when exactly I will no longer be contractually obligated to the National Guard. 

After returning home and beginning my readjustment back to civilian life I found 

myself experiencing varying degrees of anger, frustration and stress. I’ve had difficulty sleeping and have experienced bouts of insomnia, night sweats, tossing and 

turning in my sleep, shouting while sleeping and on occasion woken up to the sound 

of incoming mortars that weren’t there. I’ve had a hard time relaxing and have 

found myself going on-alert in an instant, my internal fight-or-flight mechanism 

triggered by the sound of a passing helicopter, a back-firing car or even the smell 

of diesel fuel. 

I realize that no man is an island, and took action to contact the VA and begin 

receiving treatment for what has been diagnosed as post-traumatic stress disorder. 

While I took that step to get help, many of my brothers-in-arms have not. Living 

in backwater communities across eastern Washington, access to VA medical care 

isn’t as easy for some soldiers as it is for those of us that live within close proximity 

of the handful of VA clinics across the State. 

The other thing to keep in mind when it comes to the VA is the feelings of the 

individual soldier, which can be summarized in two words: shame and guilt. Many 

soldiers I have served with are suffering in silence, unwilling to admit they are having a hard time coping with life back in the States. To admit they cannot cope on 

their own would be an admission of weakness to some of them. They would rather 

turn to alcohol or turn inwards and away from friends and family, reaching out only 

to their fellow soldiers who have ‘‘been there and done that’’ as they would be the 

only ones who could fully grasp the nature of their hidden pain. 

Some soldiers I have observed also live with a lingering sense of survivor’s guilt; 

our infantry company suffered several casualties, including two soldiers killed and 

a half dozen or so wounded and injured. While the numbers of killed and wounded 

among our ranks are a pittance compared to, say, an infantry company on D-Day 

in Normandy, the relatively light numbers of wounded and dead doesn’t lessen the 

emotional trauma these men feel. 

Unfortunately, I cannot offer any realistic solution as to what the VA can do to 

help these soldiers. They have to want to reach out for help, to take that first step 

like I did, in order to get back on the path to sound mental and emotional health. 

The VA right now does not have, in my opinion, an adequate outreach program 

to meet the needs of all of the veterans in eastern Washington returning home from 

Iraq and Afghanistan. The major facilities that are available—one in Walla Walla 

34

and the other in Spokane—are hundreds of miles away from where some soldiers 

live, making it difficult for them to schedule regular appointments to receive treatment. For example, while there are outreach clinics in Richland and Yakima, there 

is no VA support to population centers such as Moses Lake or Wenatchee. This 

means soldiers living in those areas have to travel to Seattle, Yakima, Richland or 

Spokane to receive treatment. 

The problem with this is the VA, like the military, requires extensive inprocessing 

in order to get enrolled. It took me three visits over a period of a month to get enrolled in the VA and another two visits before I met with a clinician that could prescribe medications to help curb the effects of PTSD. Five hospital visits over a 6-

week period before I could receive medication isn’t really problematic for me since 

I live 10 miles from the VA Medical Center in Spokane. 

For a soldier in Wenatchee, however, that becomes a 21⁄2-hour drive one-way for 

a 30-minute appointment. When you take into account that round trip time, multiplied over time with the number of appointments a veteran needs in order to enroll 

and begin receiving treatment you’ll find that it can be extremely prohibitive for soldiers living in north central Washington to receive adequate medical treatment. 

In the years since PTSD was first confirmed as an ailment suffered by veterans—

and traced back to battle fatigue (World War II) and shell shock (World War I)—

there have been numerous advances in treatment and medications to support veterans returning from combat. While the VA provides a wealth of resources, there 

are many other opportunities that veterans can take advantage of to help them reintegrate back into mainstream society they may not be aware of. 

For example, soldiers of Native American descent could have opportunities to participate in spiritual cleansing in tribal sweat lodges; two soldiers in my platoon were 

Native Americans and did this upon their return home from Iraq. Through my work 

as a TV news producer I’ve also become familiar with the owners of Hidden Creek 

Ranch, a North Idaho camp run by John Muir (a direct descendent of the famous 

naturalist) and his wife Iris. They have been running special week-long programs 

through their non-profit foundation to support relatives of victims of 9–11 since 

2001; recent attempts to reach out to the military to help support family members 

of Iraq casualties in a similar fashion have been rebuffed by the military. 

I use these two examples to highlight the fact that there are other opportunities 

that exist outside the VA to support veterans and their families, and would say that 

looking into programs like these and others that exist outside the DoD and the VA 

and informing soldiers of their existence can only help them in their search for resources to help them reintegrate back into society. 

Many soldiers that I served with have come home frustrated and disillusioned; 

while a handful, lured by the opportunity of tax-free bonuses, have re-enlisted in 

the National Guard, many that I served with have taken off their packs, so to 

speak, and are done. Several soldiers, myself included, have decided to end their careers with the Guard while others who have time left in their service contracts plan 

to get out at the soonest opportunity. 

The average enlisted man feels shortchanged and harbors resentment toward the 

military for what has been done and what has been left undone. Many I have spoken with look at the camaraderie between the enlisted men as their only source of 

pride when it comes to our tour in Iraq; there is little if any esprit de corps for the 

National Guard or the Army in general. They’ve received the various blanket-awarded trinkets, hardy handshakes and thanks from a number of various, anonymous 

staff officers within the Guard and yet still feel cheated. 

In general the average enlisted man probably isn’t as well-educated as the average officer, but that doesn’t mean that these soldiers don’t understand the world 

they operated in. They lament about how at times the Army in general seems more 

concerned with force-protection or polishing its image than accomplishing the mission or troop welfare. 

These soldiers survived a season in hell fighting unseen enemies and coping with 

life encamped in a foreign capital as part of an occupying army. Despite the hardships of life in the combat zone, these men were adequately equipped due in no 

small part to the billions of dollars spent to keep our armed forces battle-ready in 

Iraq. But now they’ve come home and don’t have the same level of support they did 

when they were in-country. 

Unfortunately for these soldiers, the war hasn’t ended yet, and the Federal Government has an obligation to each of these men and women to give them the same 

amount of care through the VA as they did through the Army. 

Therefore it is our obligation as a Nation, in order to prevent another generation 

of returning war veterans from growing disillusioned with our country, to reach out 

not with parades, trinkets and handshakes but with quality medical care and adeVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00038 Fmt 6633 Sfmt 6621 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
35

quate funding for the VA to respond to the requests for treatment from the thousands of war veterans returning from Iraq and Afghanistan. 

Respectfully Submitted, Rob Kauder.

Senator MURRAY. Thank you very much. I appreciate all of your 

testimony and I have questions that I would like to engage you on. 

I want to start with Specialist Hall. 

In your written testimony you talked about your business that 

you had that you lost subsequently because of the lack of services, 

and it is very compelling and I appreciate that. Another issue that 

I have heard a lot about are pay issues from Guard and Reserve 

members, especially about the Department of Defense’s inability to 

pay some soldiers while they are deployed. 

Is this something you have experienced or anybody that you 

know has experienced? 

Specialist HALL. When we first started deployment, we had two 

soldiers in my squad who did not receive pay for 3 months. 

Senator MURRAY. Who did not? 

Specialist HALL. For 3 months. I don’t know exactly what the 

program is called, but you go to this office. You present the paperwork. They will give you funds to get through until your pay is directed. We found out that we were unable to use that program because we are National Guard. Allotment programs and other things 

like that we are not allowed to use because we are National Guard. 

What we found out is that, yes, the Army does pay you, but that 

late payment for your house or that foreclosure notice, all those 

things that affect you for 7 years, still affect you. 

I think as a National Guard, we have the benefit of being State 

employees as well as being, you know, soldiers. I would like to see 

a program where there was a relief fund for active soldiers so we 

could do it like active duty do. And say that private so and so 

hadn’t been paid. Give him the amount of money. Because the Government doesn’t have to worry about whether that car gets repossessed, or whether that house gets foreclosed or whether the kids 

have food to eat. Like I said, soldiers always get paid, but there 

is never a timing factor that the Government cares about. 

Senator MURRAY. So you saw a number of soldiers who were 

really stressed about families left behind who were trying to make 

house payments and get food for kids? 

Specialist HALL. It also affects the mission itself. We had arguments in our barracks when we were getting ready to deploy when 

people didn’t stress about the situation and other soldiers that are 

trying to get them to work are all stressed about it. The only thing 

you should focus on is your job. When you think about your family, 

it should be positive and not worrying about them. 

Senator MURRAY. You have a business? 

Specialist HALL. Yes, ma’am. 

Senator MURRAY. You described in your testimony how you lost 

that business. Can you just relay it to me again? 

Specialist HALL. I opened up a small used book store in Gig Harbor. It wasn’t anything drastic. I had a 5-year plan and it was 

going well toward that. But you mentioned earlier that the VA had 

signed a program for Small Business Administration that never 

was put into effect. On my level, I see that that bill has been 

signed and that program is there. As a Guardsman, I would not 

36

have—I am a Guardsman first—but knowing that disaster relief 

program is there or the Soldiers and Sailors’ Relief Act is there—

you go into business so that you can do this, this, this. I had time, 

the first time that I was being activated, to hire someone, train 

them, get them ready, and then when we were told to stand down 

I had to send that person to the unemployment line because I can’t 

afford to keep them. The second time, when they say you are being 

activated I didn’t have the money in my pocket anymore. The programs aren’t useful. 

Senator MURRAY. So you subsequently lost your business, is that 

correct? 

Specialist HALL. Yes, ma’am. 

Senator MURRAY. So I am hearing you say that you would very 

much support a program similar to the AD loans, the small business loans, that are directed to National Guard members? 

Specialist HALL. But those programs have to be set up without 

all the crud that goes along with it. 

Senator MURRAY. Crud is not an official word just so you know. 

Specialist HALL. Without all the—you have to meet these criteria. If you are a soldier you are a soldier. And if you are a business owner you are a business owner. Nobody should tell you if 

your business is well enough to keep it alive. And SBA is there to 

help you. 

Senator MURRAY. Thank you very much. I appreciate that. 

Staff Sergeant Romanelli, in your testimony you were quite eloquent about the number of medical conditions that you faced and 

the gap faced in medical care from having to provide for your own 

care now that you served your country for, I believe you said—how 

many years? 

Sergeant ROMANELLI. Twenty-six years. 

Senator MURRAY. There was a Government Accountability Office 

report that outlined many of the problems that you talked about 

in your written testimony. It focuses directly on Guard members 

who need medical expenses in order to keep accessing military hospitals, and they just aren’t processed in time. That report cites an 

inability by the Department of Defense to process Guardsmen and 

women that leave. Many that fall through the cracks just like you 

have. 

Can you describe for us what happened to you after 26 years of 

service, the medical conditions that you experienced and what your 

battle with medical care has been? 

Sergeant ROMANELLI. Basically, the injuries that I sustained is 

a pinched nerve in my neck and also in my spinal cord. So, at 

times, my body gets real numb. I am on a lot of pain medication. 

That is about the only way I can survive. I wound up spending almost 2 years at Fort Lewis in a medical hold going through this 

process. A lot of the problems that we were having there is you go 

to the facilities, and the first thing they hit you with is, are you 

Army or are you National Guard? The issue is brought up through 

the chain of command to the General. 

And General, I personally want to thank you for helping us with 

that problem. I live in East Wenatchee, because like the other distinguished guests, I like Washington. I am from Nevada. I love this 

place up here. This is nice. But my biggest concern is trying to get 

37

the care that I need. Through going through the med board and 

then trying to transition in with the VA, if there is a way we can 

make them both go at the same time a lot of the problems would 

not be happening. 

Some of my fellow soldiers call me, and I have been saddened to 

find out that one of my fellow soldiers got out November 20th and 

he is now just starting his appointments through QTC, which is a 

company that the VA uses to verify all our claims. It has taken me 

a while to get through that system and I finally did it. 

Senator MURRAY. You are there now? 

Sergeant ROMANELLI. I am there. 

Senator MURRAY. It has taken you a long time. And I am hearing 

this from a lot of Guardsmen and women who come back. That 

medical extension prevented them from getting the medical care 

they need. And there are people who tell me this problem has been 

solved, but clearly in your testimony——

Sergeant ROMANELLI. It still has a little ways to go, Senator, before it would be solved. 

Senator MURRAY. When did you first feel like things were going 

in the wrong direction? 

Sergeant ROMANELLI. Beginning of April. 

Senator MURRAY. Of this year? 

Sergeant ROMANELLI. Yes, ma’am, this year. 

Senator MURRAY. What options do you have right now to resolve 

the situation? 

Sergeant ROMANELLI. I, basically through a letter that I received, 

was put in touch with a gentleman by the name of Tom Riggs. Tom 

has been working with me constantly on the phone talking to me 

and he has gotten things moving a lot quicker. We have got some 

other issues to address that have come up, perhaps we can meet 

with you, and hopefully we can get them resolved with the help of 

our distinguished guests that are here today. 

Senator MURRAY. When were you first separated? 

Sergeant ROMANELLI. February 25, 2005. 

Senator MURRAY. And it has taken you this long to get anywhere 

getting medical services? 

Sergeant ROMANELLI. Yes, ma’am. 

Senator MURRAY. What do you think should have happened? 

What can we do better so that people don’t fall through the cracks? 

Sergeant ROMANELLI. Basically, what they did in any case, Senator, when I got my medical they said go through med board process first, then you will deal with the VA. If there is a way you can 

go through med board and VA process at the same time, that way 

you transition out of one right into the other, that would work 

great. 

Senator MURRAY. And that does not happen today? 

Sergeant ROMANELLI. No. 

Senator MURRAY. I have another question for you. If you feel 

comfortable answering I would appreciate it. In your written testimony you mentioned three veterans from your platoon have committed suicide. That is really disturbing. If you feel comfortable, I 

would appreciate it if you could elaborate on those stories so I can 

have a clear understanding of how we can prevent that from happening to others. 

38

Sergeant ROMANELLI. I will try, Senator. It is hard, because we 

spent almost a year-and-a-half together. They were going through 

the med board process. They got med boarded out, and with our 

percent from you get a little bit to live on. Like in my case I went 

from $4,000 a month to $1,300 a month. My rent is $1,000. I am 

running a family of 5 on $300. 

My friend wound up in the same situation. That caused a lot of 

stress at home. His wife wound up leaving him. They repossessed 

his vehicle. They foreclosed on his house. And we didn’t keep the 

tight knit that we had before and he wound up killing himself. And 

it is sad. 

I have got two other soldiers that wound up doing the same thing 

because they are not getting the financial help that they need when 

they need it, and getting the answers that we need, we weren’t getting. And that is what happened to them, Senator. 

Senator MURRAY. Thank you very much. I really appreciate your 

sharing that with us. 

Sergeant ROMANELLI. I thank you, ma’am. 

Senator MURRAY. Crystal Hampton, in your testimony you mentioned that while you were on active duty you had no idea that VA 

benefits were available. And I hear that from many, many soldiers. 

I hear they come home, they are separated and they want to come 

home, and all that is basically put in the back seat of your car until 

you remember that it is there. 

What can we do better so that Guard and Reserve members 

when they come home know what services are available? 

Ms. HAMPTON. Well, ma’am, I had to make the decision I 

would—as far as the active duty goes, I am not sure about the National Guard Reserve, but we have quarterly classes that we have 

to take. They are mandatory. You sign the block, put your name 

there and it goes in your company’s files, and it goes up higher 

until it is observed that your entire company is 100 percent. Things 

like EO, equal opportunity, or SDOSH [phon]. I think it is a political organization. Things like that. If the VA had a quarterly block 

that all soldiers had to go to, had to attend, then I think the word 

would be out there. You can only ignore a class so many times before you finally start either—randomly gets in there or it is going 

to be learned, you know. 

And we had started training on my unit every Thursday. You 

had sergeants training two times a month. It was learning things 

that your squad leader felt you needed to know about. If your 

squad leader felt you had to know about VA that squad was going 

to know about VA. Do you know what I am saying? 

Senator MURRAY. Yes. 

Ms. HAMPTON. So those are two areas that the word could be gotten out a little bit. I think during my ACAP briefs I was given a 

little bit more than 30 minutes and actually explained how important this was to me instead of you get a VA loan and if you have 

certain disabilities you might get benefits, OK. 

Well, at the time I didn’t really hear because I was getting out 

of the Army and I was going home. Great. If the person who described that to me actually sat down for longer than 30 minutes 

and said, you know, all of you guys, look, if you pay attention to 

this and pay attention to me you are going to get benefits and you 

39

will not have the stress of trying to pay for health care that you 

can’t afford or any of that. Because none of us realize that once I 

get out I can’t just go to the doctor anymore. I can’t just go to the 

dentist. It never occurs to you until you are there. So those are 

some of the suggestions that I have. 

Senator MURRAY. Thank you very much. 

Sergeant Kauder, I have listened carefully to your fellow panelists here talk about that financial gap that hits soldiers when they 

are brought home and sent back to their communities. You talked 

a lot about rural communities and lack of access, and whether you 

lose your business, or your finances are just in terrible shape, or 

whether it is over medical care or just trying to get a job. Crystal 

talked about lack of employment services, and what is she going to 

do now and those kinds of things. That is even more critical in 

rural communities and for those who live close to them. 

Can you talk a little bit more about the pressure it puts on soldiers when they come home, go back to their communities and they 

have this big gap in services where they just don’t have the finances that allow them to get back on their feet, is what you were 

saying? 

Sergeant KAUDER. I think the primary problem that soldiers, at 

least from my unit, are facing is like you were saying, the gap in 

coverage. I can’t really speak about the financial problems soldiers 

are having as much as the problems getting connected with the VA 

services. I was with the 81st Battalion, 161st infantry which is 

headquartered out of Spokane—had some geographically diverse 

armies. We are located in Spokane, Wenatchee and Moses Lake. 

Just looking at the two armies, for example, I was based out of 

Moses Lake and our second platoon is in Wenatchee. Those two locations have no service available. There is no VA or medical center 

or outreach center that we are aware of. And I say that because 

we did attend the briefings and check the appropriate boxes during 

the demobilization process. 

I will say I have received numerous flyers in the mail both from 

the National Guard as well as from the VA talking about the benefits that are available. But the problem is that for soldiers who are 

living in remote locations like Omak, Okanogan, Wenatchee. They 

are faced with a 2- to 21⁄2-hour drive to the nearest clinic in order 

to receive support. 

My experience in processing into the VA system is when I had 

to go to a physical. I had to go through a battery of tests. Altogether, to make a long story short, it was six appointments. Now, 

I live 10 miles away from the VA Medical Center in Spokane. That 

happened over a 2-month period in order to get processed in. Now, 

imagine a soldier in Wenatchee of which there are approximately 

40 that I am aware of from my unit. Someone that needs to process 

a claim or get enrolled in the VA and get treated for whatever ails 

them, that is a day. That is 1 day for one appointment for 1⁄2-hour 

or 45-minute appointment. And that has proven problematic to 

those soldiers who live in those remote locations because it is difficult getting back on your feet as these other panelists have discussed. You have got reintegration, reunion with family members, 

trying to get back on your feet, and then add to that several times 

40

out of the month you are completely out of the loop trying to get 

services in a city several hundred miles away. 

Senator MURRAY. Thank you. I wanted to ask you because in 

your written testimony you talked about the impact of stop-loss orders. I just wanted to clarify from your statement no one has ever 

explained to you how and when the stop-loss will be lifted? 

Sergeant KAUDER. No. We returned from the theater of operations on March 1st. So 5 months ago, Monday. Since I came back 

we went through the demobilization process which takes 5 days at 

Fort Lewis. We were then placed on terminal leave, all the leave 

that we accrued during our tour. So that was approximately 30 

days. Stop-loss, at least according to my platoon sergeant and several others that are well versed in these matters, ends 90 days 

after your active duty ends or what they call RFAD, release from 

active duty. That would have been April 9. Now, that would—extending out 90 days would be July 10. 

Since April 9, I have received numerous mails, discussing information about VA benefits and about family support days that the 

VA organize. I have received messages from Brigadier General 

Tony expressing his personal thanks for my service and all of the 

things that the Army is doing in transitioning into the 21st century, mostly about re-enlisting. 

To make a long story short, again, I have received a lot of mails. 

Not one message talks about stop-loss. I have had to take the initiative to find out what was going on through my chain of command and then finally outside of my chain of command to get a 

straight answer. 

Senator MURRAY. Do you know the answer to your question now? 

Sergeant KAUDER. At this time I have got four or five different 

answers. 

Senator MURRAY. Essentially because you don’t know when that 

stop-loss is going to be lifted? 

Sergeant KAUDER. The problem is there are two situations here. 

Stop-loss for me, the end of my service date was technically July 

10. But in addition to being stop-loss, because my original service 

date was last July, I have also been involuntarily extended. That 

has not ended yet. As a matter of fact, anybody that was placed 

on stop-loss and was involuntarily extended, the orders—and this 

was just kind of my understanding based on briefing that I received during the mobilization phase, was that we were being involuntarily extended until 2031. But that was just explained to us 

in our official documentation that is just to cover our bases. 

Technically, I am still on active duty even though I have served 

and received an honorable discharge for my active service. But I 

am still obligated to serve in the National Guard until such a time 

as they officially cut my orders and release me from National 

Guard service. 

Senator MURRAY. What kind of impact do you think that has on 

servicemembers to know that the National Guard intends to keep 

them as long as 2031? 

Sergeant KAUDER. I can only speak for myself. I can’t speculate 

as to what other soldiers feel. But as I heard some chuckling in the 

audience, when I heard that I was going to be involuntarily extended through 2031 I had to laugh myself. For me I have got alVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00044 Fmt 6633 Sfmt 6601 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
41

most two decades of service, but I have decided not to finish and 

close, and force retirement and put in 2 years of service for my own 

personal reasons. My understanding was that I would do my time. 

I would serve and I did. And I served honorably and received a discharge from the active duty Army for my service. 

It has now been close to 6 months since I finished, and as of July 

10th I should have been—at least my understanding—released 

from service. That has not happened yet. And like I said, I received 

at least five different indications as to why I am being kept on involuntary extension. I would like to know why. I would like an official policy statement. I would have liked some proactivism on the 

part of the National Guard telling me here are the boxes you need 

to check as far as turning in gear and supplies, getting counsel as 

far as your decision not to stay in the National Guard. But none 

of those things happened. 

I think the National Guard, in my personal opinion as a veteran, 

needs to be a little bit more proactive in supporting soldiers not 

only who are staying in, but also soldiers who are opting to get out. 

Senator MURRAY. Let me ask you one other question. I know 

time is running out here. You have had quite a lot of contact with 

the soldiers in your platoon since you returned. Can you tell me 

anecdotally how prevalent you think post-traumatic stress syndrome is among our soldiers returning from Iraq and Afghanistan? 

Sergeant KAUDER. I think it is fairly prevalent. I had numerous 

opportunities to be at a dedication for the new VFW hall down in 

Tri-Cities which was dedicated to Jeremiah Slunk, a soldier who 

was killed. We also got together on July 9, the 1 year anniversary 

of his death in a firefight south of Baghdad. On both occasions we 

had 20 or 25 fellow Guardsmen that we served overseas with. 

I have seen signs of soldiers going through relationship problems, 

at least one divorce, several broke-up relationships with long-term 

girl friends. One soldier is—I hate to say it, but he is on assault 

charges and possibly faces some jail time. It is prevalent, but like 

I said in my written testimony, many soldiers aren’t facing it. They 

are not dealing with it. 

Senator MURRAY. OK. Thank you very much. I really appreciate 

all of your written testimony and verbal testimony today. And 

thank you very much, again. 

We now have our third panel who is going to join us, and I would 

like to welcome them up to the table. I will introduce them as they 

are coming forward. We have Dr. Steven Hunt who is the director 

of the VA’s deployment clinic within the Puget Sound Health Care 

System; Dr. Ronald Boxmeyer who is the team leader at the Seattle vet center; Linda Holt who is a tribal council member in the 

Suquamish Tribe; and Colonel Mary Forbes who is human resources director at the Washington Army National Guard. Thank 

you all for coming today and participating in this Senate hearing. 

Dr. Hunt, we are going to be hearing from you first.

42

STATEMENT OF STEPHEN HUNT, M.D., DIRECTOR, DEPLOYMENT CLINIC, PUGET SOUND HEALTH CARE SYSTEM,

DEPARTMENT OF VETERANS AFFAIRS 

Dr. HUNT. Good morning, Senator Murray. I am a physician and 

director of the Deployment Health Clinic at the Puget Sound 

Health Care Center. VA Puget Sound is the largest VA medical 

center in Washington State. It serves as the main referral center 

for tertiary care. In my clinic I have evaluated and continue to follow medically over 200 combat veterans who returned from service 

in Iraq and Afghanistan and I see returning veterans every day. 

I would like to thank the Senate Veterans’ Affairs Committee for 

providing this opportunity to share information on work that is 

being done to meet the needs of combat veterans returning from 

Afghanistan and Iraq. I would like to thank all the veterans 

present and particularly the four of you who just testified. For me 

it really brought this room back to what this is all about today, the 

struggles and needs of returning veterans like the ones who are 

here today. 

We have learned about the impacts of war on military personnel. 

We know that combat may cause physical injuries and wounds. We 

have learned that war causes psychological traumas. It can cause 

emotional wounds. We have learned that war may involve toxic environmental exposure. This can cause health effects. We have 

learned the complex and challenging environment of the war may 

result in a multitude of unexplained symptoms and other health 

changes. 

We know now that if you are involved in combat it may affect 

your body, mind, and spirit. We understand it affects not only the 

veterans, but also the veteran’s spouse, the veteran’s children, the 

veteran’s extended family, and the veteran’s community. 

We have learned a great deal about how to treat wounds. We are 

better able to treat wounds on the battle field. Better able to evacuate the wounded. We are better able to rehabilitate people with 

head injuries, spinal injuries and amputations. We are better able 

to treat PTSD, depression, panic attacks and anxiety disorders that 

may result from combat. We have better rehabilitation programs 

and social services. 

We know what we need to know about the impacts of war on individuals. Now we must do what needs to be done to meet the 

needs of these veterans returning from Iraq and Afghanistan. 

There are three necessary components for the care of returning 

combat veterans. The care must be accessible. They must know 

about it. The care must be integrated care: mental health and 

physical health care. The care must be comprehensive and the care 

must be ongoing. 

To meet the needs of returning combat veterans VA Puget Sound 

and VISN 20 deployed the Deployment Health Clinic, a multi-disciplinary clinic dedicated to the care of veterans with health concerns related to a specific deployment. In this case, veterans returning from combat. Essentially the deployment health clinic provides post combat evaluations and follow-up treatment. 

In the Deployment Health Clinic, veterans receive a comprehensive evaluation including post combat assessment, which takes into 

account all of their combat theater experiences, a physical examVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00046 Fmt 6633 Sfmt 6601 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
43

ination, a mental health evaluation, benefits counseling, and assistance with compensation and pension claims. They can then continue to receive their primary medical care and mental health follow-up through the clinic where we will help them to coordinate 

care. Individual treatment, group treatment, marital counseling, 

and subspecialty referral are all available. Female providers and liaison with the Women’s Clinic are available for female combat veterans. The purpose of the clinic is to address and support veterans 

in all aspects of life that have been affected by their combat experience. 

It is not just a matter of do you or do you not have physical 

wounds? Do you or do you not have PTSD? There is a very complex 

impact that this experience can have on individuals. It is essential 

to provide comprehensive support in an accessible and integrated 

way. We want to provide that support in an ongoing way. Not just 

an initial examination, and a pat on the back and thanks, but ongoing care for the first 2 years after returning at a minimum. We 

want to provide that support to the veterans and their families so 

that they can readjust, recover and be optimally functioning in all 

areas of individual and family life as soon as possible and for the 

long term. 

To date, 250 new returning military veterans have been seen in 

the Deployment Health Clinic. They have received both a physical 

and mental health assessment as part of their post combat evaluation. Many of them are receiving ongoing care. They have also received support on benefits issues. Approximately 400 individuals 

have contacted the clinic to receive other types of assistance and 

referrals. 

We have heard testimony on other services available at VA. I 

would highlight the PTSD services which we are offering to returning veterans. We have a multitude of PTSD services, and joining 

me today is Dr. Miles McFall who is the head of our PTSD program. 

I want to conclude by thanking the veterans and their families 

present today for their service, and thanking Senator Murray, the 

Senate staff and those of you in attendance today for your interest 

and support of our returning combat veterans. It is our national responsibility to collectively embrace and to ultimately succeed in 

this mission. That concludes my testimony and I will submit that. 

[The prepared statement of Dr. Hunt follows:]

PREPARED STATEMENT OF STEPHEN HUNT, M.D., DIRECTOR, DEPLOYMENT CLINIC, 

PUGET SOUND HEALTH CARE SYSTEM, DEPARTMENT OF VETERANS AFFAIRS

Good Morning, Senator Murray, my name is Dr. Stephen Hunt. I am a physician 

and director of the Deployment Health Clinic at the VA Puget Sound Health Care 

System. VA Puget Sound is the largest of the VA medical centers in Washington 

State and serves as the main referral center for tertiary care. This integrated delivery system is the result of thorough financial planning, clinical program integration, 

expanded access and coordination of care among the five VA facilities located in the 

States of Alaska, Idaho and Washington. 

VA Puget Sound Health Care System had approximately 612,377 patient visits in 

fiscal year 2004, providing care to 59,329 veterans, throughout the State and across 

the VISN. So far this year, we have provided care to 5.7 percent more veterans than 

last year at this time including 1,567 OIF/OEF veterans. 

In my clinic I have evaluated and continue to follow medically over 200 combat 

veterans who have returned from service in Iraq and Afghanistan. I see new returning veterans daily in my clinic. 

44

I would like to thank the Senate Veterans’ Affairs Committee for providing this 

opportunity to share with you this information on work that is being done to meet 

the needs of combat veterans returning from Iraq and Afghanistan, and would like 

to thank you all for attending. I would particularly like to thank any veterans 

present for their service and their continued input into this most important issue—

providing care for those who have served. 

Through the experiences and struggles of returning combat veterans over the 

years, we have learned about the impacts of war on military service personnel. We 

have learned that war often involves combat that may cause physical wounds and 

injuries. We have learned that war may frequently involve psychological traumas 

that may cause emotional disturbances. We have learned that war may involve toxic 

environmental exposures that may cause acute and chronic health effects. We have 

learned that the complex and challenging environment of war may result in medically unexplained symptoms. 

We now know that being involved in combat may affect a person’s body, mind and 

spirit. We understand that these effects impact not only the veteran, but also the 

veteran’s spouse, the veteran’s children, the veteran’s extended family and the veteran’s community. 

We have learned a great deal about how to treat the wounds of war. We are better 

able to treat wounds on the battlefield, better able to evacuate the wounded, better 

able to treat and rehabilitate individuals with spinal cord injuries, head injuries, 

and amputations; we are better able to treat post-traumatic stress disorder (PTSD), 

depression, panic attacks and anxiety disorders. We have better rehabilitation programs and social services. 

We know what we need to know about the impacts of war on military personnel. 

Now we must do what needs to be done to meet the needs of the individuals returning from Iraq and Afghanistan. There are three necessary components to meeting 

the needs of returning combat veterans: the care must be integrated, the care must 

be comprehensive and high quality, and the care must be ongoing. 

INTEGRATED CARE

The Department of Veterans Affairs (VA) and the Department of Defense (DoD) 

have developed an increasingly effective partnership to meet the needs of our newest veterans by assisting them with a smooth transition from active duty to civilian 

life. 

It is our joint goal to ensure that every serviceman and woman returning from 

combat receives prompt consideration and world-class service. Together, the VA and 

DoD are finding ways to move records more efficiently between the two agencies; 

ways to share critical medical information electronically; ways to protect the health 

of troops stationed in areas where environmental hazards pose a threat; ways to 

process benefits claims quickly and efficiently; and, in all ways possible, to hold 

open the doors to an uncomplicated passage from soldier to citizen. 

BENEFITS AND SERVICES

Veterans, including Reserve and National Guard members, who served in a theater of combat operations are eligible for hospital care, medical services, and nursing home care for injuries or illnesses that may be related to combat service for a 

period up to 2 years beginning on the date of discharge or release from service. 

This 2-year eligibility for medical care is available even if there is insufficient 

medical evidence to conclude that the veteran’s illness is the result of combat service. At the end of the 2-year period, these veterans can continue to receive free 

health care for injuries and illnesses officially connected to military service. 

In addition to health care, VA offers a spectrum of programs for veterans, including disability compensation, vocational rehabilitation, prosthetic services, life insurance, pension, education benefits, specially adapted housing and automobile grants, 

and survivor and burial benefits. VA programs for veterans with a service-connected 

injury or illness apply equally to those who served in the regular active duty forces 

and to National Guard members or reservists returning from Federal activation. 

VA Puget Sound Health Care System and VISN 20 were leaders in establishing 

a seamless transition program based at Madigan Army Medical Center (MAMC), 

where two VA social workers are working full time/side-by-side with MAMC personnel as discharge planners, to ensure a smooth transition to VA services at locations nearest to the veteran’s residence after discharge. Through this coordination, 

the veterans are known at the local VA facilities that process their benefits claims, 

and continuity of their medical care, including medications and therapy, is ensured. 

45

VA PUGET SOUND HEALTH CARE SYSTEM DEPLOYMENT HEALTH CLINIC

Unique to VA Puget Sound and VISN 20 is the Deployment Health Clinic. The 

Deployment Health Clinic is dedicated to the care of veterans who are experiencing 

health concerns related to a specific deployment. 

When veterans come to the Deployment Health Clinic, they receive a comprehensive evaluation including post-combat assessment, physical examination, mental 

health evaluation, benefits counseling, and assistance with compensation and pension claims issues. They will then continue to receive their primary medical care as 

well as their mental health follow-up from the Deployment Health Clinic staff. Individual treatment, group treatment, marital counseling and sub-specialty referral are 

all available. Female providers and liaison with the Women’s Clinic are available 

to meet the unique needs of returning female combat veterans. 

The purpose of the DH Clinic is to: 

1. Address and support veterans in all aspects of life which have been affected 

by their combat experience. 

2. Provide support in an accessible and integrated way. 

3. Provide support in an ongoing way for as long as it is needed. 

4. Provide the support necessary for the veteran and his/her family to readjust, 

recover, and be optimally functioning in all realms as soon as possible after return 

from combat and for the long term. 

To date, 250 newly returning soldiers have been seen in the Deployment Health 

Clinic and have received both a physical and mental health assessment as part of 

their post-deployment health evaluation. Approximately 400 individuals have contacted the clinic to date and have received referrals or assistance in other ways. 

INTEGRATED CARE, QUALITY CARE, ONGOING CARE

The integration of services between the DoD, the VBA, the VHA, Readjustment 

Counseling Centers (Vet Centers), Veterans’ Service organizations and community 

resources is occurring in ways far beyond what has been seen following prior combat 

deployments. The quality of care within the VA and satisfaction ratings of veterans 

relative to their VA care are high. We have programs, personnel and systems in 

place to provide the care which is needed and deserved by combat veterans returning from Iraq and Afghanistan. We will continue our efforts to provide that care; 

when our efforts are less than optimal, we depend upon the feedback of veterans 

and their families to help us to improve our work. 

I conclude by thanking those veterans and their families who are present today 

for their service, and by thanking Senator Murray and the Senate staff and those 

of you in attendance today for your interest and support in the needs of our returning combat veterans. It is our national responsibility to collectively embrace and to 

ultimately succeed in this mission.

Senator MURRAY. Thank you. 

Dr. Ron Boxmeyer. 

STATEMENT OF RON BOXMEYER, M.S., TEAM LEADER,

SEATTLE VETERANS CENTER, READJUSTMENT COUNSELING 

SERVICES, DEPARTMENT OF VETERANS AFFAIRS 

Mr. BOXMEYER. Thank you, Senator Murray. I want to say I am 

not a doctor. 

Senator MURRAY. I am promoting today. 

Mr. BOXMEYER. Vet centers have been the VA’s first line of treatment for combat vets returning from combat for every war since 

Vietnam. For 26 years, vet centers have provided services to address the psychological and social readjustment needs of combat 

veterans and have worked toward preventing the possible development of more chronic and delayed forms of war-related trauma. 

The Seattle Vet Center staff consists of two psychologists, two social workers, one team leader and an office manager. Since the war 

on terrorism, we have seen 309 Iraq veterans. The Seattle vet center’s current case load consists of 328 active cases, of which 120 are 

global war of terrorism veterans or 36 percent of our active case 

46

load. A total of 109 new Iraq veterans have been seen at the vet 

center this fiscal year. 

The Department of Veterans Affairs, as you are aware, has approved an additional 100 positions nationwide to provide services 

to OEF/OIF veterans. We filled one of these positions with Michael 

Colson who is a retired Navy commander and psychologist. He has 

served multiple tours in Iraq and Afghanistan in the Marines, 

Saudi Arabia, Turkey and the Persian Gulf. He has provided briefings to over 5,000 returning veterans. After these briefings, Dr. 

Colson meets with the veterans when they indicate they want to 

be met with and talks to them about readjustment issues. These 

individuals are followed up by him for readjustment counseling 

needs or referred to other vet center counselors or communitybased providers in the area. 

He has been able to establish onsite office space at Fort Lewis, 

Naval Station Everett and Naval Station Whidbey Island. By having office space available at these facilities, he is able to assist with 

readjustment issues in a local setting. He is also actively involved 

in providing services for returning servicemembers at Madigan 

Army Hospital. 

The Seattle Vet Center, along with Puget Sound Health Care 

System, the VA regional office and the Washington State Department of Veterans Affairs have collaborated together to provide a 

DVD that we are providing to OIF/OEF veterans in regard to readjustment needs and dealing with services provided. Hopefully, 

when they get this they will better understand what needs they 

have and what services are available. 

Treatment modalities at the Vet Center include group counseling, psychometric evaluation, sexual trauma counseling, grief 

counseling, EMDR and benefits assistance. When specific Vet Center assistance is not indicated, referrals will be made to appropriate community agencies. As the Seattle Vet Center is the entry 

point for many veterans into the VA system, each veteran is in 

turn referred to the Seattle VA Medical Center Deployment Clinic 

for physical and psychological assessment. 

The Seattle Vet Center also operates a fee contract program, 

with contract counselors available on the Kitsap Peninsula, 

Sequim, and north of Seattle in Everett. The contract program allows the Vet Center to provide services in communities where veterans live. We currently have approximately 80 clients in the contract program, of which 20 are OEF/OIF veterans. 

That concludes my formal statement. 

[The prepared statement of Mr. Boxmeyer follows:]

PREPARED STATEMENT OF RON BOXMEYER, M.S., TEAM LEADER, SEATTLE VETERANS

CENTER, READJUSTMENT COUNSELING SERVICES, DEPARTMENT OF VETERANS AFFAIRS

Vet Centers have been the VA’s first line of contact for troops returning from combat for every war since Viet Nam. For 26 years, Vet Center counselors have provided services for the psychological and social readjustment needs of combat veterans and have worked toward preventing the possible development of more chronic 

and delayed forms of war-related trauma. 

The Seattle Vet Center staff consists of two psychologists, two social workers, one 

team leader/counselor and an office manager. Our current caseload is 315 veterans 

of which 81 are Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) 

veterans. The Under Secretary for Health has approved the hiring of an additional 

100 positions nationwide to provide outreach services to returning OIF/OEF vetVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00050 Fmt 6633 Sfmt 6621 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
47

erans. The Seattle Vet Center filled one of these positions last January when we 

were fortunate enough to hire Dr. Michael Colson, a retired Navy Commander and 

psychologist. 

Dr. Colson has served multiple tours with marines and sailors, including operational tours in Afghanistan, Iraq, Bahrain, Oman, Saudi Arabia, Turkey, and other 

areas in the Persian Gulf. He has provided on-base briefings to over 5,000 returnees 

from Iraq/Afghanistan. Following his educational briefings, Dr. Colson provides individual sessions with veterans who indicate they may be experiencing readjustment 

problems. These individuals are, in turn, referred for follow-up visits with other Vet 

Center Counselors or community-based providers in their area. He has also been 

able to establish onsite office space at Ft. Lewis, the Everett Naval Station and the 

NAS Whidbey Island Naval Air Station. By having office space available at these 

facilities, he is able to assist returnees and deal with readjustment issues in a community setting. He is also actively involved in providing services to returning 

servicemembers on medical hold at Madigan Army Hospital. Today Dr. Colson is at 

the Ft. Lewis Army Base providing briefings to approximately 500 veterans. 

The Seattle Vet Center, along with the Puget Sound Health Care System, VA Regional Office, and the Washington State Department of Veterans Affairs have collaborated in the development of a DVD that we are providing to returning OIF/OEF 

veterans regarding readjustment counseling services available in Washington State. 

The DVD discusses readjustment issues and has assisted many returning OIF/OEF 

veterans better understand their military-related readjustment needs. 

Treatment modalities at the Seattle Vet Center include individual and group readjustment counseling, psychometric evaluation, grief counseling, sexual trauma 

counseling, and benefits assistance. When specific Vet Center services are not indicated, referrals are made to appropriate community agencies. 

As the Seattle Vet Center is the entry point for many veterans into the VA system, each veteran is, in turn, referred to the Seattle VA Medical Center’s Deployment Clinic for a comprehensive physical and needs assessment. 

The Seattle Vet Center also operates a Fee Contract Program, with contract counselors available on the Kitsap Peninsula in Sequim and north of Seattle in Everett. 

The contract program allows the Vet Center to provide services in communities in 

which the veteran lives. We currently have 74 individuals on the contract program 

of which 18 are OIF/OEF veterans.

Senator MURRAY. Thank you very much. 

Ms. Holt? 

STATEMENT OF LINDA HOLT, TRIBAL COUNCIL MEMBER, 

SUQUAMISH TRIBE 

Ms. HOLT. Good morning, Senator Murray and Members of the 

Committee on Veterans’ Affairs. I would like to acknowledge the 

veterans in the room and offer them my personal thanks for their 

service. 

I am Linda Holt. I am an enrolled Suquamish Tribal member of 

the Suquamish Tribe just on the other side of the water here. I also 

serve as a council tribal member for the tribe. I work currently for 

the tribe as their health director and, therefore, oversee all of the 

social service programs that the tribe has and work closely with a 

great deal of veterans. 

I bring you greetings from the Suquamish Tribe, and I want to 

thank Senator Murray and the Committee on Veterans’ Affairs for 

holding this field hearing, and recognizing the mutual trust responsibility that exists between the Federal and tribal governments to 

recognize and protect our veterans rights to quality health care on 

their return home from serving their country. 

First, I would like to acknowledge my inspiration for my involvement and continued commitment to veterans issues. My brother, 

Frank Cordero, a Marine Corps veteran of the Vietnam War, 

served two terms. I have seen firsthand the difficulty he had and 

still has in accessing care and benefits. Frank was supposed to be 

48

here today to provide testimony on behalf of all the Native American veterans that he serves, but his daughter, my niece, is undergoing emergency heart surgery and it is important for him to be 

with her today. So those of you who know Frank,I would ask for 

your prayers here. 

Vietnam vets have waited 30-plus years to apply for post-traumatic stress disorder benefits because they didn’t know it existed 

when they left Vietnam. It took the VA that amount of time to recognize PTSD as a disability. As the previous veterans who testified 

indicated, it was something that they felt shame for. I know my 

brother Frank waited 30 years to apply for it, because he didn’t feel 

he was entitled to it because he was a survivor and had left too 

many friends back in the country. 

In regard to Vietnam, Agent Orange also is just now currently 

arising, and recognizing the Vietnam veterans that are developing 

diabetes in record numbers as a result of Agent Orange. Native 

Americans have served in the Armed Forces even before they were 

citizens of this country. In return, Native Americans have the least 

access to veterans services and benefits. 

The first woman casualty in the Iraq war was Opi Warrior who 

left two children for her parents to raise. It is a proven fact that 

the majority of veterans returning from war are faced with varying 

degrees of post-traumatic stress disorder. 

When Native American veterans return to their rural reservation 

communities, there are few or no services available to meet their 

needs. The Veterans’ Administration and the branches of the 

armed services have not done enough to identify PTSD and to educate not only the veterans, but the entire veteran family. When 

faced with the repercussions of PTSD and their inability to understand what is happening to them, they often self-medicate with alcohol, drugs or a combination of both. This often leads to the possibility of suicide, domestic violence, divorce and sometimes homicide. When children are involved, the effect of PTSD on the family 

is often devastating. 

There needs to be a holistic approach for the whole family so that 

everyone has access to the same knowledge on issues they need to 

address that arise from the absence and return of their loved ones. 

Before a veteran is discharged, the whole family should go through 

counseling on how to recognize and address the issues of PTSD. 

The VA needs to recognize that the families are veterans. 

Outreach programs never seem to reach the tribal level. A trip 

to the VA hospital is an all day endurance for our veterans. This 

is very difficult for World War II veterans and is equally difficult 

for veterans who live in any rural setting. The lack of health facilities available to veterans where they live is a huge issue, limiting 

the available facilities access to the care they need. The problems 

are compounding when existing facilities are on a priority service 

system due to inadequate funding. A Vet living in self-imposed isolation only to find himself denied access to services because of priority levels will eventually cost the system even more money. 

I would like to address an MOU that was signed by the VA and 

the Indian Health services to provide care in Indian Health Service 

facilities for American Indian veterans. This has not been implemented and it is, again, the outreach problem that Indian country 

49

doesn’t know about it. They don’t know how to requisition VA. It 

is the same issue that our fellow veterans were saying, is they 

don’t know how. When these veterans come home, they don’t know 

how to implement and Indian country doesn’t know how to implement. 

In closing, I would like to stress that this country promised quality health care to veterans and promised to meet their needs. It is 

time for Congress to fulfill that obligation. We need to always remember that if it weren’t for our veterans’ continued willingness to 

serve when called upon and to willingly lay down their lives, we 

would not enjoy our ability to share our views in this manner with 

our Government. 

Again, I would like to thank Senator Murray for her continued 

efforts to help veterans from all walks of life and ethnicities. Native Americans in Washington State are estimated at 10,000 and 

this doesn’t include their families. We continue to offer our support 

to you, Senator, and we will continue to keep you where you are 

and fight the battle that you are fighting. We look to you as a warrior for our cause and thank you. My hands are up to you for your 

support for our veterans. 

[The prepared statement of Ms. Holt follows:]

PREPARED STATEMENT OF LINDA HOLT, TRIBAL COUNCIL MEMBER, SUQUAMISH TRIBE

Good morning, Senator Murray and Members of the Committee on Veterans’ Affairs. 

My name is Linda Holt; I am an enrolled Suquamish Tribal member and currently a Tribal Council Member. I am also currently employed by the Suquamish 

Tribe as their Human Services Director; as such I oversee all of the tribes, social 

service programs. Suquamish is in the process of establishing a Veteran program 

to help meet the ongoing needs of our Native American veterans. 

I bring you greetings from the Suquamish Tribe and want to thank Senator Murray and the Committee on Veterans’ Affairs for holding this field hearing, and recognizing the mutual trust responsibility that exists between the Federal and Tribal 

governments to recognize and protect our veteran’s rights to quality health care on 

their return home from service to their country. 

First, I would like to acknowledge my inspiration for my involvement and continued commitment to veterans’ issues. My brother Frank Cordero is a Marine Corp 

veteran of the Vietnam War. Frank was supposed to be here with you today to provide testimony on behalf of the all the Native American veterans’ he serves, but his 

daughter is undergoing heart surgery today, and it is important for him to be with 

her at this time. I would ask for all of your prayers on her behalf for a speedy recovery. I have followed Frank’s integration back into his family and tribal culture since 

his return from Vietnam, and I have seen firsthand the difficulty he had and still 

has in accessing care and benefits. 

It is a well established fact that Native Americans have served in the Armed 

Forces of the United States, more per capita than any other ethnic group, in every 

conflict the U.S. has ever engaged in from the Revolutionary War to present. Despite the fact that our ancestors did so even though they were not even citizens of 

this country. What is not well established is the fact that Native Americans are the 

one minority group that has the least access to use of veterans’ services they are 

entitled to. 

Native American Iraq and Afghan Veterans of this State returning from overseas 

face the same inherent well documented problems faced by their Great grandfathers 

of World War II, grandfathers of Korea and fathers of Vietnam. Many return to the 

rural reservation community where there are little or no services available to meet 

their needs, neither from the county, State, nor Federal governments. It is a proven 

fact that the majority of veterans returning from war are faced with varying degrees 

of Post-Traumatic Stress Disorder (PTSD). This has been true since the first wars 

fought by our United States veterans. The Veterans Administration and the 

branches of our Armed Services have done very little for our warriors returning 

home to identify PTSD and educate not only the veteran, but the entire family that 

he is returning to. 

50

Usually the wife and children have learned how to survive and function as a family without Dads’ presence. When the veteran returns home he or she is faced with 

how to integrate themselves back into the family dynamics. When faced with the 

repercussions of PTSD and their inability to understand what is happening to them, 

they often tend to self-medicate themselves with alcohol, drugs, or a combination of 

both. This often leads to the possibility of suicide, domestic violence, sometimes to 

the murder of their spouse. 

The children of the family have not only had to deal with the parent being gone 

for long periods of time, but also become faced with the person their returning parent has become. This can be emotionally devastating for these children as they 

struggle to accept the absence of and fear for the safe return of their parent, and 

then are faced with the very real problems brought about by the PTSD the veteran 

returns with. 

There needs to be a better way to integrate these veterans back into their families 

and mainstream society. There should be a holistic approach for the whole family 

so that everyone is receiving the knowledge they need to address the issues that 

arise from the absence and return of their loved one. Before a veteran is discharged 

the whole family should go through counseling on how to address the issues of 

PTSD and the impact it could have on their family. This should be followed up by 

the Veterans’ Administration in the treatment of the PTSD, not only of the veteran, 

but of the entire family. 

The question arises as to what is not working within the VA system to help our 

returning veterans with their reintegration back into their family settings as well 

as mainstream society. The lack of congressionally funded outreach programs, county, State and Federal, designed to assist veterans’ in their reintegration. These programs never reach down to the rural reservation communities, nor consider the 

unique circumstances of minorities or the rural nature and isolation of reservation 

communities. This is not only true of Native American veterans but also for all veterans who return to rural settings. Often a trip to the VA hospital is an all day 

endurance for our veterans. This is very difficult for our elderly World War II vets, 

and most times they just refuse to go because they cannot endure the trip. The lack 

of health facilities for our veterans to utilize in the area they live is a very large 

problem. Now we have just faced the closure of the VA hospital in Walla Walla, this 

was a key facility to Native American Veterans in Oregon, Eastern Washington and 

Alaska. With the growing number of veterans returning from Iraq and Afghanistan 

we need to increase the numbers of medical facilities available to veterans for treatment, not reduce them. As I stated it is increasingly difficult for veterans to access 

the care they need with the limited number of facilities available, but they also are 

faced with being turned away for treatment because many of the existing facilities 

are on a priority service only system due to lack of funding. 

Also as previously stated there is a general lack of knowledge among veterans and 

community organizations on what benefits the veteran is entitled to. VA needs to 

develop an outreach program, once again not only for the veteran, but for the veterans’ family and community organizations that are trying to help them. 

This leads me to what is working in Indian Country to assist our Native American 

Veterans. A grassroots network of veterans, including my brother Frank Cordero 

recognized the need to help our veterans obtain the services they needed. This core 

group of Tribal Veterans Representatives came together to develop a system to help. 

For the last 15 years the one bright light for Native Veterans within the State of 

Washington and several other States across the Nation has been the Tribal Veterans Representative (TVR) program. First started here, this program utilizes a Native American of the community of each of the 24 different Tribal communities to 

assist, provide support and aid to any and all veterans residing within their tribal 

community. Where very little services were provided before, the TVR’s have been 

instrumental in assisting not only recent returning veterans, but veterans and eligible dependent family members from other eras as well. Native American Veterans 

through the TVR program have been able to access claims for compensation, pension 

benefits, housing, employment, education, insurance and most importantly the outreach to them within their communities. 

In closing I would like to stress that this country made a promise to these veterans that are returning from a war this country committed them to, in return they 

were promised that this country would take care of them on their return and provide them with quality health care and to meet their needs. It is time for Congress 

to recognize their responsibility to these veterans that have offered their lives for 

the many freedoms we enjoy, and sometimes take for granted, in this country. We 

need to always remember that if it wasn’t for our veterans continued willingness 

to serve when called upon, and to lay down their lives, we would not enjoy the freedom to share our views in this manner with our Government.

51

Again I would like to offer my heartfelt gratitude to Senator Murray for her continued effort to help our veterans from all walks of life and nationality. Native 

Americans in Washington State estimated at 10,000 and their families continue to 

offer our support to keep you there. I also would like to give my personal thanks 

and the thanks of the Suquamish Tribe to the Senate Committee on Veterans’ Affairs for their continued support of veteran’s issues.

Senator MURRAY. Thank you. 

Ms. Forbes. 

STATEMENT OF COLONEL MARY FORBES, J–1 AND HUMAN

RESOURCES DIRECTOR, WASHINGTON ARMY NATIONAL 

GUARD 

Colonel FORBES. Senator Murray, distinguished guests, I am 

truly humbled to be here today and to have this honor, too. My 

name is Colonel Forbes and I have been on active duty for 22 

years. My main objective for the last year has been to work with 

the Army and the Air National Guard on reintegration programs 

to reintegrate the families and to help them prepare to get back 

into civilian life. 

We have worked really hard to develop a model to transition soldiers from combat to civilian life. The model had to be reasonable 

to unit commanders and be able to fit into the commander’s time 

constrained drill time on weekends. Once a Guardsman returns to 

a traditional role, he or she is only available on a weekend or 2 

days a month. 

From the beginning of this process we had John Lee, the deputy 

director of WDVA, the Washington Department of Veterans Affairs, 

and he advocated the idea of after active duty customer service. Readjustment counselors and VA doctors also agreed to this idea of 

after active duty follow-up, because of the fact that often it takes 

months for the soldier or servicemember to realize that there is a 

need. 

The MOU team or memorandum of understanding team created 

this initiative we call family activity day. But we purposely decided 

it wouldn’t be another briefing, but an opportunity for veterans organizations to provide one-on-one customer service. The 4-hour 

Family Activity Day starts with a 20-minute introduction which is 

meant to inspire our soldiers and servicemembers and their family 

members to use the entitlements and benefits they earned. Then 

it is followed by 31⁄2 hours of customer service where they can get 

one-on-one private time to really address their needs. That really, 

truly is private. 

General Lowenberg helped this process by making Family Activity Day an order. This month we will have 11 and we have followed 

through with having 22 in the next 5 months. 

I see two significant challenges in the next several years. First, 

it was talked about several times already today—it’s the challenge 

of continuously communicating with our veterans. Second, is ensuring that servicemembers have the right resources at the right time 

given that many of their issues may not surface or materialize for 

many years to come. 

Getting the word out that there is a vast array of agencies that 

want to help veterans will continue to be difficult. Servicemembers 

may be unaware of the many services that are available to them 

because information may be fragmented, uncoordinated, and changVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00055 Fmt 6633 Sfmt 6601 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
52

ing, or it just may be that they are given the information, as we 

have heard, at a time when they are coming off active duty and 

their mind is somewhere else. 

I strongly believe we need a positive education focused media 

plan to encourage our servicemembers and veterans on the many 

benefits and services available. I believe we need a media plan that 

educates the public using multiple formats, using radio, TV, print, 

Internet and hands-on workshops. Our Family Activity Days is one 

proven successful model to communicate and inform our soldiers. 

Our Family Assistance Center program could provide a healthy 

means to communicate over long term to, inform, educate and reinforce the benefits we have. 

I recommend a partnership that could be formed at the national 

level. We could leverage State, Federal and private organizations 

to develop such a media campaign for radio and TV. The goal 

would be to synchronize the efforts, avoid duplication, plug gaps in 

coverage and be sure we reach every veteran regardless of their location. We need to mutually support a Federal, State and private 

communication campaign over the next 50 years. And I say, ‘‘50 

years,’’ because these vets will be with us for that long and even 

longer. The public campaign would also reassure our veterans, the 

public and the elected officials, the long-term commitment from our 

Government and our private business leaders. 

The second thing I mentioned, is ensuring that our 

servicemembers have access to the right resource at the right time 

given that many of the issues arise over a period of years. 

To accomplish this, I think we need a coordinated system that 

provides services to our members over an extended period of time. 

A working example of that is our family assistance centers of which 

we have eight across the State and we talked about that yesterday. 

We need dedicated resources and funding to ensure our decentralized family assistance centers continue to operate for 2 to 6 years. 

Another system I could mention is the assistant or TAP, which 

is ongoing and is a long-term process. It is not a briefing, but it 

is a customer service piece that must be added to TAP. We can be 

very proud of our procedures here in Washington State to assist 

our servicemembers in their transition from combat to civilian life. 

I encourage everyone here to continue our collaborative efforts and 

future improvements for business practice of taking care of our 

great servicemembers and their families who have given us so 

much. Thank you. 

[The prepared statement of Colonel Forbes follows:]

PREPARED STATEMENT OF COLONEL MARY FORBES, J–1 AND HUMAN RESOURCES

DIRECTOR, WASHINGTON ARMY NATIONAL GUARD

My name is Col. Mary J. Forbes. I am a member of the Washington National 

Guard and I have served over 22 years of active duty. Currently, I am assigned as 

the Joint Personnel Officer, J–1, for the Washington National Guard. I am responsible for the oversight of the Human Resource Office, Family Support Programs, 

Equal Employment and Equal Opportunity Programs, Employer Support to Guard 

and Reserve (ESGR) and Labor Relations. 

Since being assigned in June of 2004, my number one focus has been the reintegration of Washington Guard soldiers and airmen from active duty back to their 

traditional reserve role and the very important job of reconnecting loved ones and 

families. 

We have worked very hard to develop a model to transition soldiers from combat 

to civilian life. The package or model also had to be reasonable to unit commanders 

53

and fit into the commander’s time-constrained weekend training assembly period. 

Once a guardsman returns to the traditional reserve role, he or she is only available 

1 weekend per month. 

Initially we partnered with the Washington Department of Veterans Affairs 

(WDVA). With the assistance and encouragement of WDVA, I participated in a series of veteran affairs meetings in which members of our team incrementally 

brainstormed and then built a model, which we codified in a groundbreaking memorandum of understanding (MOU). 

From the beginning of this process, John Lee, Deputy Director of the WDVA, advocated the idea of ‘‘after’’ active duty customer-service. Readjustment counselors 

and VA Doctors on the committee emphasized that servicemembers often experience 

a need for interdiction services at the 3–6 month mark after active duty. The MOU 

team created an initiative we call ‘‘Family Activity Day.’’ Members purposely decided this would not be another ‘‘briefing’’ but an opportunity for veteran organizations to provide one-on-one customer service. The 4-hour Family Activity Day starts 

with a 20-minute introduction which is meant to inspire servicemembers to use 

their earned VA entitlements and benefits. The following 31⁄2 hours allows the 

servicemember to personally meet with counselors, specialist, and professionals from 

a variety of veteran organizations. 

Washington State’s Adjutant General, Major General Tim Lowenberg, issued the 

following order: I want each Commander to conduct a Family Activity Day within 

3 to 6 months after returning from Operation Enduring Freedom, Operation Iraqi 

Freedom, and Noble Eagle as part of their normal training assembly schedule. The 

Family Activity Day provides servicemembers and their families personalized customer service in understanding, requesting or filing for Veteran’s benefits and entitlements. 

General Lowenberg’s order ensured that each commander would conduct these 

events in a similar manner for all units across the State. To date, we have conducted 4 Family Activity Days and have 22 more scheduled over the next 5 months, 

by which time we will have provided customer service to more than 3,000 

servicemembers. We have already received very positive feedback from 

servicemembers and their family members. Many have expressed great appreciation 

for the opportunity to participate. 

We have been successful thus far in leveraging local, State, and Federal agencies 

as well as private businesses to assist our servicemembers at the 6- to 9-month postactive duty time period. In collaboration with the Washington DVA, the Guard is 

currently planning the program and training that we will focus on the next 18–24 

months. 

I see two significant challenges in the next several years. First, is the challenge 

of continuous communication with veterans. The second is ensuring that 

servicemembers have access to the right resource at the right time given that many 

of their issues may not surface or materialize for many years to come. 

Getting the word out that there is a vast array of agencies that want to help the 

servicemember will continue to be difficult. Servicemembers may be unaware of 

many of the services that are available because information is fragmented, uncoordinated and changing. At the national and State level, I strongly believe we need a 

positive educationally focused media plan to inspire, reinforce, and encourage 

servicemembers of the many benefits and services available. I believe we need a 

media plan that educates the public, using multiple formats such as radio, TV, 

print, internet and hands-on workshops. Our Family Activity Days have proven successful, but are only one method for communicating to and informing our members. 

I recommend a partnership be formed at the national level which leverages State, 

Federal, and private organizations to develop and execute a media campaign for TV, 

radio and other media forms. The goal would be to synchronize efforts, avoid duplication, plug gaps in coverage, and be sure we reach every servicemember regardless 

of location. We need a mutually supporting Federal, State, and private communication campaign over the next 50 years to continue to communicate with our veterans. 

I say 50 years because those heroic servicemembers who are severely disabled will 

need to hear reinforcing VA messages for their entire life. The public campaign 

would reassure the servicemember, the public and elected officials of the long-term 

commitment from our Government and private business leaders. 

Second is ensuring our servicemembers have the access to the right resource at 

the right time given that many of their issues may arise over a period of years. 

To accomplish this, I believe we need a coordinated system that provides services 

to our servicemembers and their families over an extended time period. An example 

of a working system is our Family Assistance Centers. The Washington National 

Guard needs the resources and dedicated funding for our decentralized Family AsVerDate 0ct 09 2002 08:30 Dec 08, 2006 Jkt 000000 PO 00000 Frm 00057 Fmt 6633 Sfmt 6621 H:\RD41451\DOCS\24581.TXT SENVETS PsN: ROWENA
54

sistance Centers throughout the State to ensure this continuous support for the next 

2 to 6 years and beyond. 

We can be very proud of our collaborative efforts to assist our servicemembers in 

their transition to civilian life. I encourage everyone here to continue to collaborate 

and partner on future improvements to our business practices of taking care of the 

great servicemembers and their families who have given so much to our country.

Senator MURRAY. Thank you very much. 

Dr. Hunt, I want to start with you. We heard a lot from the last 

panel about the prevalence of post-traumatic stress syndrome in 

our soldiers returning from Afghanistan and Iraq. 

Can you outline for us why we are seeing such a high prevalence 

of veterans with PTSD? 

Dr. HUNT. Actually the numbers that have been reported vary. 

A recent study rates the prevalence as low as 5 percent, but the 

study in the New England Journal found rates around 17 percent. 

Other reports have found rates up to 30 percent. Some of the most 

reliable information we have from Vietnam veterans suggested that 

30 percent will have lifetime occurrence of diagnosable PTSD. And 

at any given time, 15 percent will have a diagnosable PTSD. And 

it is probably the most reliable figure that is available at this point. 

I think one of the reasons that we see different figures is that these 

symptoms can present themselves at different times along the way. 

People may not have symptoms early on. They may have symptoms 

a year down the road or 2 years down the road. 

We have a program for ex-POWs at our center and sometimes 

these veterans will have PTSD symptoms arise years down the 

road. One reason we are seeing high rates is because the combat 

traumas involved in the current conflicts are widespread and almost everybody is exposed to risks on nearly a daily basis in many 

areas of Iraq and Afghanistan. 

Senator MURRAY. I would ask if you could provide verbal testimony for the record? I am hearing that it is a 24/7 war. There are 

soldiers in Iraq who don’t have any relief, and that is one of the 

reasons servicemembers have——

Dr. HUNT. We see many veterans from the 81st Brigade that 

have had significant combat. So I think it would be reasonable to 

say that for many deployed troops there is a widespread risk often 

on a daily basis, certainly for particular parts of Iraq. 

Senator MURRAY. We have heard some pretty disturbing testimony from some of our previous panelists about what veterans 

have been through. You are seeing a lot of those as they come 

through your Deployment Health Clinic, and I want to know if you 

have any insights on how the situations like Sergeant Romanelli 

described are happening? 

Dr. HUNT. In terms of gaps in care, for example? 

Senator MURRAY. Correct. 

Dr. HUNT. There is no doubt that there is a problem of gaps in 

care particularly for those people that are Reservists that are being 

demobilized. We do have pre-separation programs for people who 

are leaving the military to try to get them into care before they 

separate from the military. For Guard and Reservists who are 

being deactivated, they are eligible for VA care for 2 years for any 

conditions they have. But they may live in an area where they 

can’t come to the VA. 

55

We do have services available through the Washington State Department of Veterans Affairs, and at the Vet Centers. So we can 

get mental health treatment for people wherever they might be living in the State, even in the more remote areas, through contract 

providers. 

Senator MURRAY. Is part of the problem that we are seeing the 

high numbers of Guard and Reserve that don’t necessarily live 

around the base, and come home and reintegrate in a community 

many miles away from the base, or into a community that is not 

aware of military needs that we are seeing these gaps? 

Dr. HUNT. That is a problem. We are trying to reach people while 

they are still in, when we are having Family Days and outreach 

events, trying to reach the National Guard units and Reserve 

units, but we really need to get the word out. Also getting people 

plugged into benefits early on and getting the claims process started for these conditions. Once they are service connected for these 

conditions, then they are eligible for contract care even in the remote areas. So we are trying to assist veterans in getting the 

claims process started early on. Even with this, there may be a 3- 

to 5-month gap in accessible care. 

Senator MURRAY. Which is a lot. 

Dr. HUNT. This is a problem some veterans are experiencing. 

Senator MURRAY. Thank you. Thank you. 

Mr. Boxmeyer, we have heard from a number of our panelists 

about the problems with employment coming home, and the skills 

they used in Iraq such as fixing helicopters does not translate into 

jobs here. This poses problems for small business owners. Can you 

talk a little bit about employment, what you have seen and what 

gaps there are for soldiers? 

Mr. BOXMEYER. There is a gap when there are no jobs available. 

I don’t specialize in employment. We refer people to jobs through 

work sourcing. But commenting on the question you asked before 

about the number of PTSD clients, we are seeing a very high percentage of people coming back with full diagnosed PTSD. For example, in dealing with one member of a unit myself, obviously they 

see a lot of trauma in Iraq, because out of a 12-person unit, 8 have 

been diagnosed with PTSD. That is out of a 12-person unit. 

I think it is also important to realize that in many cases Vietnam 

veterans didn’t realize they had issues until years after the war. 

Veterans coming home now—like Dr. Hunt said—it might be 17 

percent with PTSD, it might be 20 percent with PTSD, but in 10 

years I predict it is going to get a lot higher. 

And the thing we have to remember is that you don’t really cure 

PTSD. You teach people how to live with it, adjust to it, and how 

to function. But every time our country engages in a war, our country has to accept responsibility to bear the casually rate. Thank 

God people like you are speaking up. I just wish there were more 

of you. 

Senator MURRAY. Thank you. 

Ms. Holt, you testified about post-traumatic stress disorder in 

people who live in rural communities. That is a big category. One 

of the things that you mentioned was treating the whole family. I 

have heard a lot from people whom I have talked to say that it is 

not the soldier themselves that recognizes the problem. It is their 

56

spouse. So having them understand what the symptoms are is absolutely critical. 

What have you seen out there that worked or doesn’t work and 

how can we——

Ms. HOLT. Again, Senator, referring to our Native American veterans, I think it is doubly hard for them, because I know when my 

brother Frank applied for veterans benefits, he was initially denied 

because they said he didn’t seek psychiatric care when he came 

home. He was able to appeal that decision and brought one of our 

native healers to testify at that hearing stating that Native American warriors don’t seek traditional western medicine. They seek 

their traditional tribal cultural medicine. The tribal veterans organization and the tribal veterans have done that amongst themselves. 

Kent Chaparrel in Yakima has been very beneficial depending a 

lot on funding. But I think that access to care—Suquamish doesn’t 

have a health clinic like a lot of tribes do. So we are, like I said, 

transporting our veterans to Seattle to receive care. There aren’t 

really any psychiatrists—I believe there is one in Kitsap County 

that offers treatment for post-traumatic stress disorder. 

I saw this with my brother Frank when he came home from Vietnam, and watched him go through the process. The hypervigilance 

my sister-in-law mentioned, the nightmares that he had, and that 

she could not touch him if he was asleep. She had to stand at the 

end of the bed and yell at him to wake him up, because she got 

knocked down a couple of times before she learned that. And so the 

hypervigilance that they have, you know, the sounds of a helicopter 

going over, if he were here right now and heard that, you would 

see that he would be so tensed. The indicators that the family 

would see are alcoholism, drug abuse, anger, domestic violence and 

verbal abuse that spouses take from their spouses. 

I think that it is detrimental that the family themselves aren’t 

being treated as a holistic group when their men come home, because they are the ones that are facing this and they are the ones 

that deal with it silently. 

Senator MURRAY. Dr. Hunt, I want to go back to you because in 

the previous panel we heard about the shame word associated with 

post-traumatic stress syndrome and the concern that, I think, especially for men admitting that post-traumatic stress syndrome is 

there or employment issues. How do we deal with that as policymakers, as a society to make sure that we can get that? 

Dr. HUNT. Because it is so important that people get treatment, 

what we have done on the treatment side is to try to make treatment seem less threatening. To try to destigmatize these post combat symptoms and to really emphasize that these are symptoms 

that many people have, rather than saying, well, ‘‘you have got 

PTSD.’’ Many of these symptoms are common and normal for people who come back from combat. So trying to destigmatize the 

symptoms and the treatment is a very important part of getting 

people into treatment. 

There are real reasons sometimes that people are reluctant to be 

labeled as having PTSD, either because it may impact a security 

clearance, or working in law enforcement or may result in a military career being curtailed. That is a real problem. We have to sort 

57

of balance the need for a treatment for these conditions with the 

very real and potentially problematic social stigmas and personal 

consequence of being ‘‘labeled.’’

What we try to do is deemphasize the labeling of people as having PTSD or not having PTSD and emphasize the issues as post 

combat symptoms, many of which we can treat very specifically. 

We have a new medication, prazosin, that looks like it works for 

treating nightmares, for example, and we have medications that 

might help for difficult sleep problems. Counseling individuals and 

treating the individual in a more holistic way, as Linda was advocating is an important approach. There continue to be stigmas associated with being treated for depression or PTSD. That may be 

a problem, unfortunately, until the public is educated about these 

conditions. 

Senator MURRAY. Colonel Forbes, I am going to jump to you. We 

are in over time, but I wanted to ask you a question about an issue 

I have not heard much about here today. I have heard it everywhere I go in this State and that is that word Tri-Care. Is that a 

problem you are hearing from the soldiers you are dealing with in 

terms of their access to Tri-Care, not getting to go see doctors, ending up paying health care out of their own pockets because the system is so difficult to access? Can you share a little bit——

Colonel FORBES. Yes, ma’am. Yes, there are a lot of questions 

and some of the questions are information based on educational. It 

is just because National Guard Reservists don’t have Tri-Care until 

they are on active duty some of it is a learning curve, and getting 

used to learning the system and learning what not to do or learning to do things ahead of time and preparing themselves. 

And you know, just anecdotally, there are a lot of customers 

right now. There appears to be a lot of customers, and every agency 

whether they are getting service at a medical treatment facility or 

a Tri-Care person off base, everyone is trying to handle the workload. It appears to me that it has just been hard to handle the 

workload at this time with all of the cases that are there. 

Senator MURRAY. So people have gone through——

Colonel FORBES. Because there was not enough staff. There was 

not enough funding available for the number of staff and doctors 

needed. All those things taken into consideration to take care of a 

large group of folks and their families. I don’t really have documentation to back that up, ma’am, but it appears to me that a lot 

of the issues, first of all, go around understanding the system and 

then, you know, how to access it from remote locations that they 

can get their funding concerns, but they have to do it in a certain 

order. 

And then an educational piece also is knowing that you have to 

get the referral. We heard that yesterday. You have to call and get 

a control number to get authorization to see a physician, and that 

is an educational piece. 

Senator MURRAY. Are we doing a better job on deployment of 

educating soldiers about how Tri-Care works in their families? 

Colonel FORBES. Yes, ma’am. What we are doing is we are continually changing and improving our workshops, our seminars. We 

are doing predeployment, more robust predeployment, reintegration 

training, and covering and recovering the areas that we know have 

58

been traditionally difficult to get across to folks. But you know, as 

I mentioned earlier, it is a constant struggle to educate and get 

folks out, because you can’t just give a person a briefing once and 

think they are going to understand a complicated, cumbersome bureaucratic Government’s laws or rules. And so we are trying a new 

model now. 

Senator MURRAY. It was previously referred to as crud. 

Colonel FORBES. I will try to be more eloquent. But what we find 

now is we need to think about those workshops and coming back 

to the topic. I think that the transition program, starting it well 

before they come home and proceeding maybe up to a year after 

they get home so that it can be that reaffirming, reinforcing—here 

are the benefits that you have. 

And if I can just mention this situation. It is not so much for 

folks that are on active duty. It is while they are on medical hold. 

They must be educated and trained, not just once in a briefing, but 

multiple times and then that customer service piece brought in. 

And I have had the pleasure in the last week of talking to the commander at Fort Lewis who handles that, and they are very eager 

to adopt our model and idea. 

The Department of Labor has just hired a person who will be 

seated—an Employment Security Department person that will be 

seated right there with that medical hold company. And we talked 

yesterday because we were excited at Washington Department of 

VA, and all of us together trying to figure out how we can bring 

what we are doing here to them before they get off, and know what 

they are going to have, you know, when their active duty pay stops 

and they have to go into the VA system. So I know that people 

have already recognized these gaps and folks are doing things, Department of Labor, active duty, to try to fill this gap. 

Senator MURRAY. Thank you very much. I want to thank everyone here for helping the Senate Veterans’ Affairs Committee get a 

better handle on the needs of our veterans as they come back from 

Iraq and Afghanistan. All the statements and testimony will help 

our Committee enact policies for our veterans. But these statements and testimony today really make clear that we have a lot 

more that we need to learn and a lot more work that needs to be 

done. I think the testimony on needs for our rural veterans, education, employment, medical concerns, many other issues that were 

raised will help me to do a better job to bring the needs of Washington State veterans back to the other Washington. I look forward 

to working with all of our witnesses who came today, as well as 

many others in Washington State and across the country to continue to shed light on the needs that exist out there. 

I certainly want all of you to know that I will continue to check 

in with you or others in the future to make sure we are doing the 

right thing. I want to encourage everyone here to sign up for our 

veterans update. You go to my Web site, again, 

www.murray.senate.gov. We continue a dialogue on the issues affecting veterans and want to encourage people to be able to use 

that. And as I mentioned earlier, I just successfully fought to get 

the VA funding that it needs for the next several months and the 

VA what it needs for now. We are in the process of making sure 

today that we are now meeting needs for the negligent fiscal year 

59

and this testimony will be very helpful for me as we try to make 

sure we do that right. 

But I will let you know that any funding isn’t going to reach the 

VA for quite some time. So I will keep my eye on these issues and 

want to hear from all of you as we continue in the coming months. 

I want you to make sure that I, along with the entire VA Committee continue to look into these issues to make sure that our veterans have the services they need when they return home from 

combat. I want to again thank everyone for participating in today’s 

hearing, as well as all of you who attended. There are far too many 

people to thank who helped me today. 

I especially want to thank Major Phillip Osterley of the Washington State National Guard——

I am sure he is around here somewhere. There he is—who has 

been really helpful to me, and any Guard members who have 

helped with all aspects of today’s hearing. 

Major, you and your staff really went out of your way to help put 

this together, and I want you to know how much I appreciate the 

work you did, as well as my own staff members who are here who 

put in a tremendous amount of time. 

Finally, I wanted to remind everyone who is here that we have 

a number of service folks who are here from the VA, Tri-Care and 

other services that are here to help. You are welcome to stay and 

talk with any of them if you need additional information. Again, 

thank you to all of you who participated. This hearing is adjourned. 

Thank you very, very much. 

[Whereupon, at 11:10 a.m., the Committee was adjourned.]

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