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S. HRG. 110–801 

FIELD HEARING: VA AND DOD COOPERATION 

TO PROVIDE HEALTH CARE TO OUR WOUNDED 

SOLDIERS RETURNING FROM IRAQ AND 

AFGHANISTAN 

HEARING 

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED TENTH CONGRESS 

FIRST SESSION 

AUGUST 28, 2007 

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 

DANIEL K. AKAKA, Hawaii, Chairman 

JOHN D. ROCKEFELLER IV, West Virginia 

PATTY MURRAY, Washington 

BARACK OBAMA, Illinois 

BERNARD SANDERS, (I) Vermont 

SHERROD BROWN, Ohio 

JIM WEBB, Virginia 

JON TESTER, Montana 

RICHARD BURR, North Carolina, Ranking 

Member 

ARLEN SPECTER, Pennsylvania 

LARRY E. CRAIG, Idaho 

KAY BAILEY HUTCHISON, Texas 

JOHN ENSIGN, Nevada 

LINDSEY O. GRAHAM, South Carolina 

JOHNNY ISAKSON, Georgia 

WILLIAM E. BREW, Staff Director 

LUPE WISSEL, Republican Staff Director 

(III) 

C O N T E N T S 

AUGUST 28, 2007 

SENATORS 

Page 

Isakson, Hon. Johnny, U.S. Senator from Georgia ............................................... 1 

Opening statement ........................................................................................... 3 

WITNESSES 

Broun, Paul C., M.D., U.S. Representative from Georgia .................................... 1 

Morrissey, Thomas M., Sergeant First Class, U.S. Army .................................... 4 

Prepared statement .......................................................................................... 6 

Capps, Jason, Specialist, U.S. Army ...................................................................... 8 

Prepared statement .......................................................................................... 10 

Ott, Laurie, Director, CSRA Wounded Warrior Care Project, Augusta VA 

Medical Center and the Active Duty Rehab Unit ............................................. 15 

Hollins, Dennis, M.D., Medical Director, Active Duty Rehab Unit, Augusta 

VA Medical Center ............................................................................................... 16 

Prepared statement .......................................................................................... 17 

Schoomaker, Eric B., Major General, M.D., Commander, North Atlantic Regional Medical Command and Walter Reed Army Medical Center ................. 18 

Prepared statement .......................................................................................... 21 

Bradshaw, Donald M., Brigadier General, Commander, Southeast Regional 

Medical Command ................................................................................................ 24 

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

Biro, Lawrence A., Network Director, VA Southeast Network ............................ 31 

Prepared statement .......................................................................................... 33 

Kilpatrick, Michael E., M.D., Deputy Director, Force Health Protection and 

Readiness Programs, Department of Defense .................................................... 34 

APPENDIX 

Copenhaver, Deke, Mayor, Augusta, Georgia; letter ............................................ 39 

Rahn, Daniel W., President, Medical College of Georgia; prepared statement .. 40 

(1) 

FIELD HEARING: VA AND DOD COOPERATION 

TO PROVIDE HEALTH CARE TO OUR 

WOUNDED SOLDIERS RETURNING FROM 

IRAQ AND AFGHANISTAN 

TUESDAY, AUGUST 28, 2007 

U.S. SENATE, 

COMMITTEE ON VETERANS’ AFFAIRS, 

Washington, DC. 

The Committee met, pursuant to notice, at 10 a.m., in the Conference Room of the Active Duty Rehab Unit at the Augusta VA 

Medical Center, Augusta, Georgia. Hon. Johnny Isakson, Member 

of the Committee, presiding. 

WELCOME STATEMENT OF HON. JOHNNY ISAKSON, 

U.S. SENATOR FROM GEORGIA 

Senator ISAKSON. I’d like to welcome everybody and to call this 

meeting to order of the Veterans’ Affairs Committee of the U.S. 

Senate. I would like to thank everybody who is here today for this 

very important hearing on the great work that’s being done here 

at the Augusta VA and Eisenhower Medical Center. 

Before I do anything, though, I want to introduce the recently 

newly-elected Congressman from this district, Dr. Paul Broun, to 

welcome everybody to his district. Paul. 

STATEMENT OF CONGRESSMAN PAUL C. BROUN, M.D., 

U.S. REPRESENTATIVE FROM GEORGIA 

Dr. BROUN. Senator Isakson and distinguished Members of the 

Committee, thank you for holding today’s hearings here in Augusta. Senator Isakson, as you’re well aware, Augusta has a tremendous story to tell regarding the treatment our men and women 

who have suffered injuries in service to our country. You have been 

a leader in working on this issue and I greatly appreciate your efforts. Men and women who serve our country in uniform come from 

all over America, but as my friend Laurie Ott of the Wounded Warriors project points out: approximately 70 percent of those returning from Operation Iraqi Freedom and Operation Enduring Freedom come from the southeastern United States. Regrettably, some 

of these men and women return from their service with severe injuries. As a medical doctor I know patients recover more quickly 

when they’re surrounded by family and those they love. So what 

can we do to treat more of our Nation’s wounded warriors closer 

to home, especially at a time when our Nation’s resources are 

stretched thin. Today’s hearing will focus on a possible answer. As 

2 

the Committee will learn, the Veterans Administration and Department of Defense have entered into a unique partnership in Augusta 

which allows them to share resources to treat soldiers. It is a successful program that can serve as a model for the Nation and it is 

my hope that other communities around the country will be able 

to learn from our local example. 

The program features collaboration between two assets of different Federal agencies: the Department of Defense Dwight D. Eisenhower Army Medical Center at Fort Gordon; and Augusta’s Uptown VA. Each of these important medical centers deserves further 

description. The Army Medical Center is second only to Walter 

Reed, which is scheduled to close—second in the number of evacuees treated from Iraq and Afghanistan. From January 2005 to 

March 2007 the President’s Commission on Wounded Warrior Care 

found that the soldiers treated near home have better care and better outcomes, so I’m happy to welcome you. I’m happy to serve as 

the Congressman of the 10th Congressional District and I’m excited 

about this project. I’m excited that Senator Isakson has brought 

this hearing here to the VA hospital, because I think we have a 

wonderful opportunity to show the Nation how well we can treat 

our wounded warriors and how two different departments—and 

maybe with the Medical College of Georgia, with its burn center— 

that we can even grow our facilities and grow our efforts to treat 

our brave men and women in the military. So, thank you, Senator 

Isakson, for your work. I thank you for the opportunity to be here 

and welcome you to Augusta and the VA hospital. Thank you. 

Senator ISAKSON. Thank you very much, Congressman Broun. 

Congratulations on your election. [Applause.] 

I want to introduce some very special people but I want it to be 

known, first and foremost, that the very special people that are 

here today are all our men and women in the U.S. Armed Services. 

We have a lot of folks here today and I want to tell you, on behalf 

of not just myself, but the people of the State of Georgia and the 

people of the United States of America, God bless you for your 

service and your sacrifice. [Applause.] 

And running a close second is the first lady of Augusta, Georgia, 

Gloria Norwood. Where is Gloria? Stand up Gloria. [Applause.] 

Don’t sit down. I’m going to brag just a second. This lady is the 

beautiful wife of the late Charlie Norwood, Congressman for seven 

terms from this district. I called him Dr. Feelgood. He was never 

short for an opinion and he was never in doubt, and he did more 

for health care in the U.S. Congress while he was there than any 

other member of the Congress. He became a great friend of mine. 

Every time I was having a bad day I tried to find Charlie and I 

always ended up with a smile, mainly because he married so far 

over his head. Gloria, we’re glad to have you here. [Applause.] 

I want to introduce Tom Cook. Where is Tom? Tom, would you 

stand. Tom is the assistant to Pete Wheeler who is the Commissioner of Veterans Affairs for the State of Georgia and has been for 

58 years. He is the longest-serving commissioner in the history of 

the United States of America in any State. I called him because I 

wanted him here today so I could brag about him to his face. I’ve 

been in government a long time, but I’m just a baby compared to 

Pete. But Pete said he had to be in Reno, I think, today because 

3 

the President had him come out there for the American Legion, so 

we will give him an excuse to go see the President. But thank you, 

Tom, for being here, very much. 

Mr. COOK. Thank you, sir. 

Senator ISAKSON. Thanks for what you all do. [Applause.] 

This district was represented for 16 years in Congress by a truly 

great Georgian and a great friend of mine, Congressman Doug Barnard. Doug, would you stand up. 

Mr. BARNARD. Thank you. 

Senator ISAKSON. Doug got my attention, I guess, over a year ago 

to make sure I understood what you all were doing in Augusta and 

what was being done specifically at this center. And he’s the reason 

I got to meet General Schoomaker, got to find out what was going 

on as a model and example to all the Veteran’s and DOD officers 

around the county. And, Doug, I want to thank you for the leadership you’ve demonstrated in this community in so many ways, but 

in particular, in taking care of our wounded warriors and finding 

a new and a better way to have seamless transition from DOD to 

VA. Congratulations to you. 

From the Committee Chairman, Danny Akaka—his staff member 

representing him is Ted Pusey. Where is Ted? Ted, stand up right 

back there. And John Towers from Senator Craig’s staff is right 

back there. Thank you for all the work that you did in making 

today possible. 

From the Augusta area there are two distinguished members of 

the Georgia House of Representatives, Representative Barbara 

Sims—where are you, Barbara? Stand up; you’re too pretty to sit 

down. And the Majority Whip of the Georgia House of Representatives, Barry Fleming. Where is Barry? Welcome and thank you all 

for coming. [Applause.] 

I am delighted to be here personally for this hearing. I am going 

to give an opening statement and then we’re going to turn it over 

to the real heroes who will be testifying in three panels. The way 

we’re going to do those three panels is we’ll have each one make 

their testimony, and I would ask the panelists to try and keep it 

within 5 minutes. But the first two guys are exempt. The generals, 

I’m going to hold them tight. These two guys sitting at the table 

up here, I’m going to give them a liberal license. If the red light 

goes off, wherever it is—where’s the red light? Back there. If you 

see the red light you two don’t have to pay any attention to it, but 

the generals are going to have to pay close attention. 

OPENING STATEMENT OF HON. JOHNNY ISAKSON, 

U.S. SENATOR FROM GEORGIA 

We’re going to have three panels to discuss what’s happened here 

at the Uptown Augusta Medical Center and the seamless handoff 

between the Department of Defense and the Department of Veterans Affair. 

This medical center operates an active duty rehab unit which is 

the Nation’s only medical rehabilitation unit within the VA system 

for active duty military personnel. It is my sincere hope, General 

Schoomaker, in years to come the word ‘‘only’’ will be deleted from 

that statement and what’s been done here can be replicated in 

other areas of the United States for our soldiers. 

4 

The Augusta VA Medical Center was awarded the Olin Teague 

award by Secretary Nicholson in 2005 for successful partnership 

with the military and VA in regards to the active duty rehab unit. 

Major General Schoomaker, who is a witness today and is doing a 

wonderful job at Walter Reed Hospital in Washington, DC, was instrumental in the creation of the active duty rehab unit when he 

was commander of the Eisenhower Medical Center at Fort Gordon. 

As I cited earlier, Pete Wheeler, who cannot be here today, was 

also instrumental in being a catalyst for what happened here to actually take place and become a reality. The active duty unit has revealed how the collaboration and coordination of this idea—a seamless transfer—can benefit wounded veterans who come back from 

Operations Iraqi Freedom and Enduring Freedom. 

As of August 2007, 1,037 active duty personnel have been treated 

at this facility: more than 490 of them as inpatients; and 26 percent have returned to active duty in the U.S. Armed Forces. Since 

August 24, 2004, on average on any given day 25 to 30 active duty 

personnel will be here at this center in rehab and 24 of the 30 beds 

are filled with active duty personnel today. So, it is a pleasure for 

me to be here today and illuminate what has been done here in Augusta. 

I’d like to introduce our first panel. We have Sergeant First Class 

Thomas Morrissey and Specialist Jason Capps. I want to tell you 

just a little bit about them. Sergeant First Class Morrissey has 

served the U.S. military for 30 years, the last 13 of them in the 

Illinois National Guard. In 2006, on his third combat tour in Afghanistan, he received eight direct hits from an AK–47 in all four 

extremities and his upper chest area. Specialist Jason Capps, who 

is also here to testify today, from 1990 to 1993 served in the Marines in the intelligence field, and was deployed overseas during 

Desert Storm. In September 2006 he joined the Army as a combat 

medic. In May 2007 Specialist Capps was again deployed to Iraq 

with the Third ID—deployed out of Georgia I might add. Specialist 

Capps was injured on June 10, 2007, when an Iraqi suicide bomber 

drove a civilian vehicle packed with explosives and detonated it 

under the bridge where his staff was on guard. I want to tell both 

of you gentleman before I introduce you, thank you for your service 

to your country and God bless you for all you’ve done for all of us 

in this State and this Nation. [Applause.] 

Sergeant Morrissey. 

STATEMENT OF THOMAS M. MORRISSEY, 

SERGEANT FIRST CLASS, U.S. ARMY 

Sergeant MORRISSEY. Good morning, Chairman Isakson and distinguished guests. As the Senator said, I’ve served over 30 years 

in the military and he’s told you a little bit about my story. I’m 

able to speak to you here today because of the superior leadership, 

training, equipment and medical care that I received from the U.S. 

military. It starts with my team commander who insisted on extensive medical training and rehearsals ad nauseam before each of my 

deployments. This insured that at the time I was shot I reacted 

without thinking in those critical moments right after the event 

happened. Medical personnel from an American forward operating 

base had responded to my call for assistance. I was in the air on 

5 

a medical evacuation flight within 45 minutes after the shooting 

and into my first surgery within 2 hours. I awoke in the recovery 

room the next day and my first thought was of my family. They 

had been contacted shortly after I was shot and I was able to speak 

to them by phone. I owe my battalion commander many thanks for 

personally keeping my family advised of my status. The next day 

I left Afghanistan and headed for Germany where I remained for 

5 days and two additional surgeries. Nine days after receiving my 

wounds I arrived at Eisenhower and I was reunited with my family 

in the ER where we were all briefed on what we could expect. The 

next morning I began the process of having both my arms rebuilt, 

literally. My right humerus had been shattered from one of the 

shots and they had to use a cadaver bone to implant and rebuild 

it. My left forearm, both bones—my ulna and radius—were fractured so there were many pins, bolts and plates that were put in 

there. The nerves in both arms were damaged or traumatized, 

luckily not severed, and so my arms were virtually useless for 

about 2 to 3 months. Both of my legs had extensive soft tissue 

damage, but no fractured bones. 

Every morning a procession of doctors would start their rotation 

through my room at 0600 hours. I was completely dependent on the 

nursing staff for all activities of my daily life. This humbles a person even more than the initial realization that the simple things 

we take for granted I could no longer do. This went on for many 

months. My wife who is a social worker in a civilian hospital, was 

amazed at the support and care that I was receiving. 

It took 21⁄2 months of surgeries and general rehabilitation before 

I was ambulatory and able to exit my bed. During that time secondary complications added to the difficulty of my physical and occupational therapies. At the end of August 2006 I moved to the 

Veterans Affairs active duty rehabilitation unit to further my 

progress. Prior to leaving Eisenhower I met the head doctor and 

physician’s assistant from the VA rehab unit. They briefed me on 

the facility, staff and the uniqueness of the unit I was about to become a part of. I quickly realized the unit was staffed at all levels 

by capable professionals filled with compassion for all injured soldiers. My inpatient status at the VA lasted 10 months. During that 

time I reported back to Eisenhower for regular doctor reviews and 

follow-up surgeries, but my day-to-day needs were very effectively 

taken care of by the VA. 

I moved back to Fort Gordon in July 2007 and continued my rehabilitation here at the VA as an outpatient. To date, I have received 16 surgeries and have at least two more planned. I’m able 

to perform all basic ADLs, but I still have my limitations. Every 

day is a new challenge and a new opportunity. 

No process or program is perfect and improvements can always 

be made. Some part of my personal success is the fact that I’m a 

senior NCO and I know my way around the military structure. The 

areas I believe which need to be refined and better integrated for 

the benefit of all injured soldiers are as follows. 

Case management: it appears to me that most injured soldiers 

are in their late teens or early 20’s and they have not been in the 

military very long. Even though some may be seasoned early by 

their experiences, they really don’t know how to get around a buVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00009 Fmt 6633 Sfmt 6633 H:\DOCS\082807.TXT SVETS PsN: PAULIN
6 

reaucracy. Their families are under emotional stress. The individual is both physically and emotionally traumatized. The issue is 

continuity. In my own case I’ve dealt with seven different case 

managers in the past year, both civilian and military. 

Financial entitlements: there has been a rush to establish an upgrade in various entitlements for injured soldiers. Some are specific 

to veterans who have served in theater and others are applicable 

to all soldiers regardless of where injured. The problem is no one 

individual appears to be responsible for advising the soldier of the 

entitlements or where to find them. A simple checklist and official 

briefing on all potential entitlements may be a simple answer, but 

the responsibility to manage the ongoing change needs to be assigned somewhere. 

Family visitation: when I first arrived at Eisenhower I was told 

that while I was in the hospital two to three family members would 

be covered on official Army orders. The orders were intended to 

cover their lodging and per diem while I was in the hospital. However, once I moved to the VA this entitlement stopped. There appears to be some inconsistency in the policy, because I did find in 

casual conversation that people who complained actually received 

more support to have their families with them. While this was really no concern to me, I’m concerned for the young soldiers who may 

be the sole income producers for their families and don’t have other 

opportunities. Family participation in the recovery of the soldier is 

critical. 

The health care I received from the U.S. Army and the Veterans 

Affairs has been exceptional. My family and I have been treated 

with respect and compassion always. I’m amazed at the capabilities 

I’ve recovered in such a short time. I will be forever grateful. In 

my opinion, this unique partnership should be expanded anywhere 

complementary facilities exist. This is to ensure the largest number 

of injured soldiers return to their maximum potential. Thank you. 

PREPARED STATEMENT OF SERGEANT FIRST CLASS THOMAS M. MORRISSEY, 

ILLINOIS NATIONAL GUARD SOLDIER

Good morning Chairman Isakson and Members of the Committee: My name is 

Sergeant First Class Thomas M. Morrissey. Thank you for extending me the invitation to speak before you today. I’ve served in uniform for over 30 years. For the last 

13 years, I’ve been a member of the Illinois National Guard and I’m proud to be 

a citizen/soldier in service to his country during a time of national need. 

In June 2006, I was on my 3rd combat tour in Afghanistan when I was caught 

in an enemy ambush. As a result, I received 8 direct hits from an AK–47 in all 4 

extremities and my upper pectoral area. I’m able to speak to you today because of 

the superior leadership, training, equipment and medical care provided to me by the 

U.S. Army. It starts with my team commander who insisted on extensive medical 

training and rehearsals during our pre-deployment train-up. It was due to his leadership and emphasis on training that I reacted without having to think in the seconds after being shot. 

Medical personnel from an American forward operating base (FOB) quickly responded to my call for assistance. I was in the air on a medical evacuation flight 

45 minutes after the ambush and into my first surgery within 2 hours. I awoke in 

the recovery room the next day and my first thought was about my family. They 

had been contacted shortly after I was injured and were at home when I called to 

speak to them. I owe my Battalion Commander many thanks for personally keeping 

them advised on my status. The next day I left Afghanistan for Germany where I 

remained for 5 days and 2 additional surgeries. 

Nine days after receiving my wounds, I arrived at Eisenhower Army Medical Center (EAMC), Fort Gordon, GA. I was reunited with my family in the emergency 

room where the medical staff gave us a joint briefing on what to expect. The next 

7 

morning I began the process of having both my arms rebuilt. My right humerus 

bone had been shattered and a cadaver bone was implanted as part of the repair. 

In my left forearm, both my ulna and radius bones were fractured. The nerves in 

both arms were traumatized so I could not use the arms to do anything. Both of 

my legs had extensive soft tissue damage, but no fractured bones. 

Every morning, a procession of doctors would start their rotation through my 

room at 0600 hours. I was completely dependent on the nursing staff to assist me 

in all activities of daily life (ADL). This humbles a person even more than the initial 

realization that one cannot do the simple things we all take for granted. This went 

on for months. My wife, who is a social worker in a civilian hospital, was amazed 

at the attention and support I was receiving. 

It took 21⁄2 months of surgeries and general rehabilitation before I was ambulatory and could exit my bed. During that time, secondary complications added to the 

difficulty of my physical and occupational therapies. Lymphodema, heterotrophic 

ossification, muscle atrophy, a gangrenous gall bladder, multiple infections caused 

by the hospital environment and even tinnitus made it difficult to establish a regular, effective rehabilitation regimen. 

At the end of August 2006, I moved to the Veterans Affairs (VA) Active Duty Rehabilitation Unit to further my progress. Prior to leaving EAMC, I met the head 

doctor and physician’s assistant from the VA rehab unit. They briefed me on the 

facility, staff and the uniqueness of the unit I was about to become a part of. I 

quickly realized the unit is staffed at all levels by professionals filled with compassion for all injured soldiers. 

My inpatient status at the VA lasted 10 months. During that time, I reported 

back to EAMC for regular doctor reviews and follow-on surgeries, but my day-today needs were very efficiently served at the VA. I moved back to Ft. Gordon in 

July 2007 and continue my rehabilitation as an outpatient at the VA. To date I’ve 

received 16 surgeries and have at least 2 more planned. I’m able to perform all basic 

ADLs, but I still have my limitations. Everyday is a new challenge and an opportunity. 

No process or program is perfect and improvements can always be made. Some 

part of my personal success is the fact I’m a senior NCO who knows how to make 

his way around the structure of the military. The areas I believe which need to be 

refined and better integrated for the benefit of all soldiers are as follows: 

1) Case Management—It appears most injured soldiers are in their late teens or 

early twenties and have not been in the military very long. Some may be seasoned 

early by their exposure to a war zone, but most do not yet know how to deal effectively with a bureaucracy. This is especially true when they and their families are 

under physical and emotional stress. The case manager is expected to help the people assigned to them with the everyday management of their health care program. 

The issue is continuity. In my own case I’ve dealt with 7 different case managers 

in the past year, both civilian and military. Based on their individual training, experience and personality their effectiveness in helping or hurting a soldier varies. 

2) Financial Entitlements—There has been a rush to establish and upgrade various entitlements for injured soldiers. Some are specific to veterans injured in theater and others are applicable to all soldiers regardless of how and where injured. 

The problem is no one individual appears to be responsible for advising the soldier 

of the entitlements, or where/how to get them A simple checklist and official briefing 

on all the potential entitlements maybe the simple answer, but the responsibility 

to deal with the on-going changes needs to be assigned somewhere. 

3) Family Visitation—When I first arrived at EAMC, I was told that while I was 

in the hospital two family members would remain on official Army orders. The orders were intended to cover reimbursement on lodging and per diem when the family members were visiting me in Augusta, GA. Once I moved to the VA, I was told 

the family orders were no longer valid. This seems to be an inconsistent policy. In 

casual conversation with other soldiers I found those who complained received extended compensation for their family members. My concern is not for myself, but 

the junior enlisted who maybe the sole income producing member of a family. Family participation in the recovery of the soldier is critical and should be supported. 

The health care I’ve received from the U.S. Army and the Veterans Affairs has 

been exceptional. My family has been treated with respect and compassion always. 

I’m amazed at the capabilities I’ve recovered due to the joint effort of my doctors, 

therapists and nurses. I will be forever grateful. In my opinion, this unique partnership should be expanded anywhere complementary facilities exist to insure the largest number of injured soldiers recover their maximum potential. 

Senator ISAKSON. Thank you, Sergeant. [Applause.] 

8 

Specialist Capps. 

STATEMENT OF JASON CAPPS, SPECIALIST, U.S. ARMY 

Specialist CAPPS. Good morning, Senator Isakson and Members 

of the Committee. My name is Specialist Jason Capps. As the 

Chairman said, I was in the U.S. Marine Corps in the intelligence 

field and was deployed during Desert Storm. I rejoined the service 

back in September 2006 as a member of the U.S. Army as a combat 

medic. Never did I question whether or not I made the right decision to join the Army because I believe in the war efforts we have 

in Iraq. In May I was again deployed in Iraq with the 3rd Infantry 

Division, 269 Armor. My unit had already been deployed, so I had 

to play a little catch up and met with them at FOB Kalsu. I was 

thrilled that I’d been put with some of the best soldiers the Army 

had to offer. 

We had three general duties that we performed. The majority 

of the time we were the QRF unit that was deployed if a convoy 

took a hit from an IED, or if another U.N. convoy needed our assistance. We also performed other daily missions as well. For 3 

days of each week we rotated guard on two different posts: Checkpoint 20 and 21. 

It was on Checkpoint 20 where I received life-changing injuries. 

On June 10, an Iraqi suicide bomber drove a civilian vehicle packed 

with explosives equivalent to a 4,000-pound bomb under our bridge 

and detonated the device. The bridge, along with our squad, fell to 

the ground. Fortunately, our troops that were on the other side of 

the bridge were not injured. Out of the ten soldiers that were on 

our side of the bridge, three soldiers were killed and six of the remaining soldiers were injured, including myself. Luckily for us, one 

of our lieutenants was on Checkpoint 21 and was outside at the 

time of the explosion. He saw the explosion, radioed our location 

and got no response, and at that time he called the QRF unit back 

on FOB Kalsu. He jumped into a vehicle and came to our aid within minutes; and also luckily for us, there was a U.S. convoy coming 

through at that time who stopped and rendered aid to us. 

The U.N. personnel along with our lieutenants secured the areas 

and radio command our nine-line Medevac. Within 20 minutes I 

was on a Black Hawk helicopter headed for Baghdad. As a result 

of the blast I received two spinal fractures, six pelvic fractures and 

multiple facial lacerations, which basically confined me to a gurney 

for the next week while in transition back to the U.S. 

The medical personnel I came in contact with from Baghdad to 

Landstuhl, Germany, were very compassionate and professional in 

all treatment needs. They also made sure that I stayed in contact 

with my wife and family at all times. I called my wife immediately 

to inform her in case she had happened to be seeing anything on 

the news. I didn’t want it to be alarming to her. My wife relayed 

the information to my brother and sister as soon as I got off the 

phone with her at 0300 Monday morning. My mother was reading 

an article that morning in the paper about a bridge collapse and 

thought I might have been in the area and was concerned. My 

brother informed her that I was in the blast and that I was stable. 

My doctors and nurses made sure that I made contact with my 

9 

mother and family at all times for their peace of mind. I will never 

forget their attention to detail. 

I was originally sent back to Martin Army Hospital at Fort 

Benning. After consulting with the physicians we determined that 

the active duty rehab facility would be the best place for me to 

rehab. My wife, Darla, actually works at a VA hospital in Oklahoma in the prosthetics department. I was asked if I would like to 

do my rehab in my hometown. I telephoned my wife and her immediate response was no. Her reasoning was this: the rehab I would 

receive in Oklahoma would be based on an older generation and 

not the aggressive rehab that I needed. Our decision was made to 

do the rehab in Augusta because of the information we received of 

the top notch care and resources that were available. Our decision 

was correct. 

I never expected the care and compassion that I received from 

day one at the active duty department. My daily life now comprises 

physical and mental rehab. My in-house doctor and therapists are 

always asking me how I’m doing. My problems are dealt with immediately instead of later. I feel if I’m going through something 

they are sincerely concerned with my issue. 

I have mentioned mental rehab. Our recreational therapist, Dave 

James, works to no end to make sure that we have recreational 

events every week. He does this with the help of the community 

and other nonprofit organizations such as the Reynolds Plantation 

that wanted to help in our rehabilitation. He sacrifices his own 

time that he could be spending with his family for the soldiers of 

this unit. There are no words that can express my gratitude to him. 

The nursing staff is led by Jeff Beard and it’s one of the most 

caring groups of people I’ve ever come in contact with. Without 

these professionals this unit would not be a success story. If it were 

up to me there would be a unit like this in every region of the 

country. I believe that I would still be in a wheelchair at this 

time—at least for another 2 or 3 months—if it wasn’t for these people. To the employees of the active duty rehab unit I say thank 

you. 

We now have a platoon sergeant and a squad leader who acts as 

our liaison between the VA and the Army to make our lives less 

stressful and help us with our individual concerns. This will, in 

turn, take a partial load off Master Sergeant Stewart who has been 

working so diligently to take care of our needs. They can now work 

together to achieve the goals that are set in front of us. 

We do have a few issues that need to be addressed to try to 

maximize our mission. There are a number of entitlements that 

most soldiers do not know about. We could use specialists in that 

area who can explain them thoroughly to each soldier that comes 

to the unit. Soldiers, including myself, are having a hard time receiving our personal belongings from theater locations. We are 

being told that our belongings are in transit but cannot be traced. 

Third, it would be more efficient for us to be able to receive treatment from the doctors who specialize in each individual’s needs 

here at the VA Medical Center instead of being transported to the 

Eisenhower Medical Center for each appointment. We are having 

a tough time even being seen on base because of the number of soldiers that are walking through their doors on a daily basis. There 

10 

are other small things that are troublesome but everyone from doctors to military are trying to eradicate the situation. 

From the time I was transferred here there have been a number 

of groups and organizations that have come to my aid. Operation 

Homefront, Operation First Response and the Reynolds Plantation 

are only a few of the organizations that have helped me since I’ve 

been back. Airplane tickets for my family, rental cars, clothing are 

only a few of the things that have helped—they have helped me 

with. 

Two weeks ago I was invited to attend a trip to Washington, DC, 

to view different sights, the Pentagon, the Capitol Building, Arlington Cemetery and all the different war memorials. The part that 

hurt me the most was going to Arlington Cemetery and seeing the 

graves of the soldiers—excuse me. It made me sad knowing that 

many more soldiers would be buried there before it’s over. Hopefully, none of these soldiers perished because of a lack of care. As 

for me, my government has done its very best to make sure that 

I have a full recovery. Every soldier deserves the right to heal with 

the very best resources we have to offer. Thank you. [Applause.] 

PREPARED STATEMENT OF SPECIALIST JASON CAPPS, U.S. ARMY

Good morning Chairman Isakson and Members of the Committee. My name is 

Specialist Jason Capps. I appreciate the opportunity to share my story with you 

today. From 1990 to 1993, I served as a United States Marine in the Intelligence 

field and was deployed overseas during Desert Storm. In September 2006, I joined 

the U.S. Army as a Combat Medic to again serve my country in its time of need. 

Never did I question whether or not I made the right decision to join the Army because I believed in what we are doing for Iraq. 

In May 2007, I was again deployed to Iraq with the 3rd infantry Division, 2–69 

Armor. My unit had already been deployed in March so I had to catch up to them 

at FOB (Forward Operating Base) Kalsu. I was thrilled that I had been put with 

some of the best soldiers the Army has to offer. We had three (3) general duties 

we performed. For the majority of the time, we were the QRF unit (Quick Reaction 

Force) that was deployed if a convoy took a hit from an IED or any other United 

Nations Force that needed our assistance. We also preformed other daily missions 

as well. For three (3) days of each week, we rotated guard on two (2) different 

bridges (checkpoint 20 and 21). It was on checkpoint 20 where I received life changing injuries. 

On June 10, an Iraqi suicide bomber drove a civilian vehicle packed with explosives, equivalent of a 4,000 lb. bomb, under our bridge and detonated the device. 

The bridge along with our squad fell to the ground. Fortunately, our troops that 

were on the other side of the bridge escaped without any injuries. Out of the ten 

soldiers that were on our side of the bridge, three soldiers were killed and six of 

the remaining were injured, including me. Luckily for us, one of our lieutenants was 

on checkpoint 21 (approximately one mile away) and witnessed the explosion and 

immediately radioed our location and received no response. At this time, he radioed 

the Quick Reaction Force on FOB Kalsu and jumped into a vehicle and came to our 

aid within minutes. We were also blessed to have a U.N. convoy at our site within 

minutes. Our lieutenant along with the U.N. personnel secured the scene and 

radioed to command the 9-line medevac report. Within 20 minutes, I was on a Black 

Hawk helicopter heading for Baghdad. 

As a result of the blast, I received two (2) spinal fractures, six (6) pelvic fractures 

and multiple facial lacerations which basically confined me to a hospital gurney for 

the next week while I was being transferred back to the United States. The medical 

personnel I came into contact with from Baghdad and Landstuhl, Germany were 

very compassionate and professional in all of my treatment needs. They also made 

sure that I stayed in contact with my wife and family everyday to reassure them 

of my health and well-being. As soon as I arrived in Baghdad, they insisted that 

I call my wife immediately to inform her in case she happened to see something 

in the news and become alarmed. My wife relayed the information to my brother 

and sister as soon I got off the phone with her at 0300 Monday morning. My mother 

was reading an article in the morning paper about the bridge blast and thought I 

11 

might have been in that area and was concerned. My brother informed her that 

I was in the blast, but I was stable. By the doctors and nurses making sure that 

I made contact gave my mother and family peace of mind. I will never forget their 

attention to detail. 

I was originally sent back to Martin Army hospital at Ft. Benning. After consulting with the physicians, we determined that the active duty rehab facility would 

be the best place for me to rehab. My wife Darla actually works at a VA hospital 

in Oklahoma in the prosthetics department. I was asked if I would like to do my 

rehab in my home town. I telephoned my wife and her response was ‘‘NO.’’ Her reasoning was this. The rehab I would receive in Oklahoma would be based on an older 

generation and not the aggressive rehab that I needed. Our decision was made to 

do my rehab in Augusta because of the information that we received of the top notch 

care and resources that were available. Our decision was correct. I never expected 

the care and compassion that I received from day one at the active duty department. 

My daily life now is comprised of physical and mental rehab. My in-house doctor 

and therapist are always asking me how I’m doing. My problems are dealt with immediately instead of later. I feel that if I’m going through something, there are sincerely concerned with my issue. I had mentioned mental rehab. Our recreational 

therapist, Dave James, works to no end to make sure that we have recreational 

events every week. He does this with the help of the community and other non-profit organizations such as the Reynolds Plantation that want to help in our rehabilitation. He sacrifices his own time that he could be spending with family for the soldiers of our unit. There are no words that could express my gratitude to him. The 

nursing staff is lead by Jeff Beard and is the most caring group of individuals I’ve 

ever witnessed in any hospital environment. I can actually say that we are for the 

most part a big family including doctors, therapists, nurses and patients. Without 

these professionals, this unit would not be a success story. If it were up to me, there 

would be a unit like this in every region of the United States. As of Monday, August 

20, I no longer require the use of a wheelchair. I believe that I would still be in 

a wheelchair for at least other two or three months if I would have gone anywhere 

else. To the employees of the Active Duty Rehab Unit I say ‘‘Thank you.’’ 

We now have a platoon sergeant and squad leader who act as our liaison between 

the VA and the Army to make our lives less stressful and help us with our individual concerns. This will in turn take partial load off Master Sergeant Stewart who 

has been working so diligently to take care of our needs. They can now work together to achieve the goals that are set in front of us. We do have a few issues that 

need to be addressed to try and maximize our mission: 

• There are a number of entitlements that most soldiers do not know about. We 

could use a specialist in that area who can explain them thoroughly to each soldier 

that comes to the unit. 

• Soldiers, including myself, are having a hard time receiving our personal belongings from theater locations. We are being told that our belongings are in transit 

but cannot be traced. 

• It would be more efficient for us to be able to receive treatment from the doctors 

who specialize in each individual’s needs here at the VA Medical Center instead of 

being transported to the Eisenhower Medical center for each appointment. We are 

having a tough time even being seen on base because of the number of soldiers that 

go through their doors on a daily basis. 

There are other small things that are troublesome but everyone from doctors to 

military is trying to eradicate this situation. From the time I was transferred here, 

there have been a number of groups and organizations that have come to my aid. 

Operation Home front, Operation First Response and the Reynolds Plantation are 

only a few of the organizations that have helped me since I’ve been back. Airplane 

tickets for family, rental cars, hotel rooms and clothing are only a few things that 

they have helped me with. 

Two weeks ago, I was invited to attend a trip to Washington, DC, to view different 

sites like the Pentagon, Capitol building, Arlington Cemetery and all of the different 

war memorials. The part that hurt me the most was going to the Arlington Cemetery and seeing the graves of the soldiers that were lost in Iraq. What made me 

sad was imagining how many more soldiers will be buried there before it’s over. 

Hopefully, none of these soldiers perished because of lack of care. As for me, my 

government has done its very best to make sure that I have a full recovery. Every 

soldier deserves that right—to heal with the very best resources we have to offer. 

Senator ISAKSON. Specialist Capps, that is exactly why we are 

here today, to see to it that our soldiers get the very best care possible. And as your testimony has said, what’s being done here at 

12 

the Augusta VA Medical Center is the example of exactly what you 

want for every soldier in the military, if I understood your testimony. 

Specialist CAPPS. Yes, sir. Thank you. 

Senator ISAKSON. I want to take just a minute to ask both of you 

a couple of questions and I want to thank you very much for your 

testimonies. 

Sergeant Morrissey, Specialist Capps repeated your second point 

in terms of recommendations with regard to financial entitlements. 

And in the Committee in Washington—I know our staff would go 

along with this—we have heard this a number of times. What suggestion—understanding that you’re a 30-year veteran and know 

your way around the military—which I appreciate that comment 

because sergeants always do—tell us what you would recommend 

the military do in terms of making those entitlements known on a 

timely basis to these soldiers. 

Sergeant MORRISSEY. The first observation, Senator, is that the 

information needs to be distributed within the hierarchy of the 

military and explained fully before it can leak out and be disseminated down to the soldiers. I found that I had any number of family, friends, military, nurses telling me about every little thing and 

then as I started to push, I knew that the people I was talking to 

weren’t even aware of some of these things. For instance, like the 

combat injury pay. The TSGLI (which I didn’t know about until I 

awoke in the hospital and one of the nurses told me about it), at 

first I couldn’t even believe it was true. But then finding people— 

you know, you go through all the case managers and they are saying, ‘‘it’s, well, you know, that’s not me now. That’s not my responsibility.’’ Well, if you’re supposed to be taking care of my needs, 

what are you supposed to be doing? So, I really think that the information needs to be distributed through the hierarchy and understood immediately; and taught where the responsibility for dissemination of that information lies. The biggest confusion I found was 

people pointing at the other guy. 

Senator ISAKSON. In your testimony you said you had seven case 

managers. Was that within your time here? 

Sergeant MORRISSEY. That is correct. Both the time that I spent 

at Eisenhower, the VA, and then being moved back to Eisenhower, 

I have been through seven different case managers, which for me— 

I’m not saying it was a problem for me. But, I always am concerned 

that if the younger troops who don’t know how to make their way 

encounter that, they may be less willing to push ahead. So, I think 

we need to make it easier for younger troops. 

Senator ISAKSON. I have two questions, subquestions, to that. 

Number 1, are the case managers facility-specific rather than soldier-specific? In other words, case managers at Eisenhower and 

case managers at the Augusta VA don’t cross. 

Sergeant MORRISSEY. Correct. When I was at the hospital in Eisenhower I dealt with them. When I moved over here, I was told 

the case manager here would be my primary contact. But then once 

I moved back, then I was assigned to another person again. So for 

me it was easy to make my own way, but I use the example simply 

because I’m not sure if a younger person, less experienced, would 

be as aggressive in pushing ahead. 

13 

Senator ISAKSON. But those case managers, are they full-time 

case managers? I mean, is that their job? 

Sergeant MORRISSEY. Yes, I believe so. 

Senator ISAKSON. In terms of hierarchy, I take it that what you 

meant by that was, not everybody in the hierarchy knows what everybody else knows with regard to benefits, and it’s kind of a 

patchwork; is that correct? 

Sergeant MORRISSEY. That is correct, sir. 

Senator ISAKSON. Your testimony is very helpful. Thank you. 

Specialist Capps, your testimony was wonderful and part of it hit 

home with me on why it’s so important what Doug and everybody 

down here have done. I just left 2 weeks ago touring the VA hospital in Atlanta on Clairmont Road and there were a lot of veterans 

who were receiving services, and they were veterans of World War 

II, Korea and Vietnam. What struck me, having been to Landstuhl 

and Walter Reed hospitals, is the dramatic change in the types of 

injuries in this war. In Afghanistan and Iraq the weapon of choice 

is an explosive IED or a suicide bomber, and the injuries are traumatic, both from a standpoint of the brain as well as the extremities. For the benefit of those who don’t know that, would you talk 

a little bit about the time—from the time you were hit and the 20 

minutes you were picked up and your process in how you got treatment due to those types of injuries. 

Specialist CAPPS. Well, at the time I was hit I immediately went 

to the ground. I remember the actual explosive blew up directly 

below me. Everything went black. I stayed conscious the whole 

time, though. I remember lifting up and coming back down. The 

reason why I mentioned that our guys were some of the best I’d 

ever seen was their professionalism—no matter what their age. 

They immediately secured the area in which we did have some insurgent activity. It was dealt with very, very quickly. Before I 

knew it, I was on a helicopter. Our lieutenant had secured the 

area. All the personnel who needed to be treated were treated 

quickly by our combat lifesavers. I was the only actual medic out 

there on the scene until the U.N. convoy showed up, which was 

minutes after it happened. Some of those guys jumped in the middle of it. I was amazed to see them work. By the time I got on that 

Black Hawk I had nurses there, doctors already on the Black Hawk 

treating my wounds and making sure that—just like a little cut on 

my nose here. Actually, the tip of my nose was almost cut off. They 

had put it back into place and before I got there, they already knew 

my injuries; and immediately—there were six of us brought in at 

that time—and at that point they jumped in there. Those people 

were so professional in what they did. I had x-rays; talking on the 

cell phone to my wife I had all my lacerations fixed on my face. 

This was in the first—within the first 30 minutes to an hour. That 

was how quick and how responsive they were. And some of the 

other gentlemen who had facial lacerations were being dealt with 

too. The personnel were great there. I hope that answers your 

question a little bit on how the— 

Senator ISAKSON. One of the points I was getting to—you went 

from the battlefield to immediate care within minutes. Did you 

then go to Landstuhl? 

Specialist CAPPS. Yes, sir. 

14 

Senator ISAKSON. How did you—did you go by C–17? 

Specialist CAPPS. Yes, sir. Yes, sir. 

Senator ISAKSON. Which is this phenomenal piece of equipment, 

if you’ve ever seen the Medevac C–17 configuration. I appreciate 

your paying tribute to those people at Landstuhl because they do 

a miraculous job as well. The point I was getting to is because of 

those miraculous jobs—both because of the equipment that our soldiers now have on the torso and the blast glasses and all those protective things, the preponderance of injuries are to the extremities 

and you have a lot more amputations. You have a lot more prostheses and you have a longer type of medical service need. It’s 

not—it’s not just like your nose. You can sew it up and it looks just 

fine and it’s not going to cause you a problem. But there are other 

injuries where—not only while you’re on active duty but as a veteran retired or off-duty you’re going to continue to need those services. That’s why what they’ve done here is so important, because 

it’s a seamless transfer and those injuries are really timeless. Many 

of them will be with you the rest of your life. So, your story was 

very important to illustrate to everybody the nature of the injuries 

that are received in Afghanistan and Iraq and the need for that 

seamless transfer from DOD to VA and the long-term care that our 

veterans deserve and should get. 

Specialist CAPPS. Yes, sir. It was very, very seamless; and it was 

very caring all the way—all the way—even on the transport, sir. 

The medical personnel there were attending to every need of every 

soldier who was wounded. 

Senator ISAKSON. It’s a flying hospital, isn’t it? 

Specialist CAPPS. Yes, sir. 

Senator ISAKSON. And your recommendation, which echoed Sergeant Morrissey’s recommendation on entitlements, you said precisely the same thing he did in a different way. We will take that 

back to the Committee and work with the Department of Defense 

and see what we can do to make that better so that particularly 

the young soldiers who don’t know their way around have a onestop shop where they can go and get the information they need on 

the entitlements that they have earned and deserve. Thank you 

very much for your testimony today. [Applause.] 

As our next panel is coming forward and our two veterans are 

making room for them, I’m going to break with the agenda, which 

since I’m the only person from the Committee here I guess I’ve got 

the authority to do. I want to introduce Laurie Ott. Laurie, could 

you come up here a second. Would you come right over here. 

I’m introducing Laurie because she is, as I told Doug Barnard, 

she’s easy on the eyes. But also, she’s got a great story to tell about 

what has been done here in Augusta and about how this idea started. And just like these two brave, courageous veterans who have 

just testified—talk about a veteran that really was the catalyst to 

make this happen. 

Laurie, would you take a minute or two to just fill us in. 

15 

STATEMENT OF LAURIE OTT, EXECUTIVE DIRECTOR, CSRA 

WOUNDED WARRIOR CARE PROJECT, AUGUSTA’S VA MEDICAL CENTER AND THE ACTIVE DUTY REHAB UNIT 

Ms. OTT. Thank you, Senator. It is a delight and an honor to be 

here with you. Thank you so much for coming to Augusta. We really appreciate your efforts, all that you have been doing and all that 

we hope you do. 

I had the pleasure and honor, really, of interviewing Specialist 

Crystal Davis in early March of this year. She is a 22-year-old 

young woman from Camden, South Carolina. She was in Ramadi, 

Iraq, in November 2005. She’s a track mechanic. She was supposed 

to fix the tracks on tanks and when she arrived in Iraq she realized there weren’t any tanks and she would be doing something 

else. 

She was driving an 18-wheeler truck to go retrieve our exploded 

vehicles from the road and they were also on a convoy to discover 

and find IEDs. She found one. Her vehicle suffered an IED blast 

directly under her vehicle on the driver’s side and she ended up 

losing her leg in that blast. She said she saw it happening; she 

could feel it happening. And she told me when it was happening 

she thought, well, I guess I’m going to lose that leg. 

She ended up being transferred very quickly from Iraq to 

Landstuhl; from Landstuhl to Walter Reed. She was at Walter 

Reed and had dozens of surgeries—more than she could count. She 

said she received excellent medical care at Walter Reed; however, 

when it came time for her physical therapy and occupational therapy, there was a delay. She said she could get one appointment a 

day at Walter Reed, but she said she felt she needed more. And she 

also felt that conditions were very crowded and that she wasn’t 

being pushed. When she would come home to Camden from Walter 

Reed and visit her family, she would notice she would get better 

and then when she returned to Walter Reed she felt she would deteriorate. She ended up being transferred to the active duty rehab 

unit here at the VA and she reported to me that she arrived on 

a walker and within 3 weeks was on her prosthetic full time. 

I thought this was a very dramatic story and I thought it should 

be told, so, we featured her on the news. Additionally, Specialist 

Davis told me something else. She said it was the best thing that 

had ever happened to her, that she felt it had given her a purpose 

in life; and now she wants to go to physical therapy tech school in 

Texas to become a physical therapy technician. She wants to turn 

around and help those like herself. And I hope that one day she 

gets transferred back to Augusta. I hope she ends up working in 

our active duty rehab unit. I think she’s a wonderful example of 

the service the men and women of our military give to our country, 

and we can never thank them enough. She’s a source of inspiration 

for all of us. Thank you for letting me tell her story. 

Senator ISAKSON. Thank you, Laurie. Crystal’s story is a very important testimony to what’s been done here—how much quicker she 

got service and how much better she got in time because it was 

close in proximity and easy to access. Thank you, Laurie. 

I’d now like to introduce our second panel. First is Dr. Dennis 

Hollins. Dr. Hollins is a Ph.D. and he’s the medical director of the 

Augusta VA Medical Center active duty rehabilitation unit at the 

16 

Augusta VA Medical Center. Welcome, Doctor. We’re glad to have 

you. 

Next is the guy I brag about all the time, General Schoomaker, 

who right now is on duty at Walter Reed Army Hospital in Washington, DC, where I spend about 1 day every couple of months 

when there’s a Georgia soldier there, going to see firsthand the 

services that they receive. And I can tell you that they are just phenomenal, General, and I appreciate what you’re doing. I also appreciate your attention to address those problems that we have experienced to see to it that it gets even better. 

And last but not least, Brigadier General Bradshaw. Welcome, 

sir. We’re glad to have you at this hearing today and glad to have 

you at this Vet Center. Your service to your country has been wonderful and outstanding. Your service here at Eisenhower is phenomenal and we’re very appreciative. 

If each of you would take about 5 minutes—we have your written 

testimony, which will be submitted for the record, I might add. 

We’ll start with you, Dr. Hollins, and then we’ll go along and then 

I’ll have a few questions for each of you. 

Dr. HOLLINS. Thank you. Good morning, Senator Isakson. 

Senator ISAKSON. Good morning. 

STATEMENT OF DENNIS HOLLINS, M.D., MEDICAL DIRECTOR, 

ACTIVE DUTY REHAB UNIT, AUGUSTA VA MEDICAL CENTER 

Dr. HOLLINS. Congressman Broun and other distinguished 

guests, on behalf of the staff of the Augusta VA Medical Center I 

would like to welcome you to our fair city and our facility; and to 

thank you for your dedication and service to our Nation’s veterans 

and servicemembers. Thank you also for allowing me to represent 

the U.S. Army Southeast Regional Medical Command and the VA 

Southeast Network (VISN7). 

It is my pleasure and honor to share with you how the Department of Veterans Affairs and the Department of Defense work together on the active duty rehabilitation unit at the Augusta VA to 

provide health care to wounded soldiers returning from Iraq and 

Afghanistan. I would like to request my written statement be submitted for the record. 

Senator ISAKSON. Without objection. 

Dr. HOLLINS. The active duty rehabilitation unit at the Augusta 

VA meets the unique intensive medical rehabilitation needs of active duty servicemembers injured in combat or who sustain serious 

non-combat injuries during service. Since the program was created 

3 years ago the active duty unit has provided care to more than 

1,037 servicemembers—more than 491 of whom were treated as inpatients. Approximately 32 percent of all patients were injured in 

combat in Operation Enduring Freedom or Operation Iraqi Freedom, and about 25 percent of our admissions are for brain injuries. 

Roughly 16 percent of our admissions will be considered for medical retirement through the medical board process and, as you 

noted, 26 percent of our inpatients are returned to their units fit 

for duty. 

Even before OEF and OIF began, the military knew providing 

care to wounded servicemembers would demand the highest priority. Then-Brigadier General Eric B. Schoomaker, the comVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00020 Fmt 6633 Sfmt 6601 H:\DOCS\082807.TXT SVETS PsN: PAULIN
17 

manding general of Eisenhower Army Medical Center, approached 

Augusta VA officials in August 2003 to determine if a team of medical specialists capable of providing therapeutic support could treat 

patients at Eisenhower. Augusta VA’s leadership proposed a new 

active duty inpatient unit in the Augusta VA Medical Center and 

this unit would provide clinically managed and medically rehabilitative care to active duty servicemembers. The active duty unit received its first inpatients in February 2004. Leadership obtained 

necessary rehab equipment, assembled a rehabilitation care team 

and oversaw the creation of a 3400-square-foot gym—a therapy 

gymnasium. Representatives from the Southeast Regional Medical 

Command and VISN7 signed a memorandum of understanding defining roles for the support and growth of the program. 

As Committee members know, most combat injuries from OEF/ 

OIF are the result of explosive blasts. Orthopedic injuries, wound 

management and Traumatic Brain Injuries are the most frequently 

seen medical problems at our unit. The active duty unit also contains a very strong PTSD or Post Traumatic Stress Disorder treatment program designed to help patients process their combat experiences. We screen all patients with combat exposure during the 

admissions process for both PTSD and TBIs. 

The active duty unit maintains a warrior ethos for the sailors, 

soldiers, Marines and airmen we treat in a variety of ways, from 

addressing our patients by rank to using military terminology on 

the unit. A dedicated military liaison case manager handles administrative and command and control issues for our patients, which 

helps them and their families feel at home, helping to reduce their 

stress. This project has been a success because VA and DOD staff 

communicate openly and directly. Warrior and transition commanders at Eisenhower attend our weekly team conference meeting here in the VA and once a week the unit’s medical staff attends 

the orthopedic surgery rounds at Eisenhower Army Medical Center. 

This cooperation and integration demonstrates what VA and DOD 

can do for our wounded servicemembers and veterans when we 

work together. The pride this Nation takes in those who serve is 

evident in the tremendous attention and accolades this unit has received. 

This concludes my prepared statement. I’ll be happy to take any 

questions you have. 

[The prepared statement of Dr. Hollins follows:] 

PREPARED STATEMENT OF DENNIS HOLLINS, M.D., MEDICAL DIRECTOR, ACTIVE DUTY

REHABILITATION UNIT, U.S. ARMY SOUTHEAST REGIONAL MEDICAL COMMAND

(SERMC) AND AUGUSTA VA MEDICAL CENTER AND VA SOUTHEAST NETWORK

(VISN 7) 

Good Morning, Senator Isakson. On behalf of the staff of the Augusta VA Medical 

Center, I would like to welcome you to our fair city and our facility, and to thank 

you for your dedication and service to our Nation’s veterans and servicemembers. 

Thank you also for allowing me to represent the U.S. Army Southeast Regional 

Medical Command (SERMC) and VA Southeast Network (VISN 7). It is my pleasure 

and honor to share with you how the Department of Veterans Affairs (VA) and the 

Department of Defense (DOD) work together on the Active Duty Rehabilitation Unit 

at the Augusta VA Medical Center to provide health care to wounded soldiers returning from Iraq and Afghanistan. I would like to request my written statement 

be submitted for the record. 

The Active Duty Rehabilitation Unit (ADRU) at the Augusta VA Medical Center 

meets the unique intensive medical rehabilitation needs of active duty serviceVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00021 Fmt 6633 Sfmt 6621 H:\DOCS\082807.TXT SVETS PsN: PAULIN
18 

members injured in combat or who sustained serious, non-combat injuries during 

service. Since the program was created 3 years ago, the Active Duty Unit has provided care to 1,037 servicemembers, 491 of whom were treated as inpatients. Approximately 32 percent of all patients were injured in combat in Operation Enduring 

Freedom or Operation Iraqi Freedom (OEF/OIF), and about 25 percent of our admissions are for brain injuries. Roughly 16 percent of our admissions will be considered 

for medical retirement. 

Even before OEF and OIF began, the military knew providing care to wounded 

servicemembers would demand the highest priority. Brigadier General Eric B. 

Schoomaker, then Commanding General of Eisenhower Army Medical Center, approached Augusta VA officials in August 2003 to determine if a team of medical specialists capable of providing therapeutic support could treat patients at Eisenhower. 

Augusta VA’s leadership proposed a new, active duty inpatient unit in the Augusta 

VA Medical Center. This unit would provide clinically managed and medically rehabilitative care to active duty servicemembers. 

The Active Duty Unit received its first inpatients in February 2004. Leadership 

obtained necessary rehabilitation equipment, assembled a rehabilitation care team, 

and oversaw the creation of a 3,400 square feet therapy gymnasium. Representatives from the Southeast Regional Medical Command and VISN 7 signed a Memorandum of Understanding defining roles for the support and growth of the program. 

As the Committee members know, most combat injuries from OEF/OIF are the 

result of explosive blasts. Orthopedic injuries, wound management, and Traumatic 

Brain Injuries (TBI) are the most frequent medical problems managed at the Augusta VA Medical Center. The Active Duty Unit also contains a strong Post Traumatic Stress Disorder (PTSD) treatment program, designed to help patients process 

their combat experiences. We screen all patients with combat exposure during the 

admissions process for PTSD and TBI. 

The Active Duty Unit maintains the Warrior Ethos for the Sailors, Soldiers, Marines, and Airmen we treat in a variety of ways, from addressing patients by rank 

to using military terminology. A dedicated military liaison/case manager handles administrative and command and control issues for our patients. This helps our patients and their families feel at home, reducing their stress. 

This project is a success because VA and DOD staff communicate openly and directly. Warrior in Transition commanders at Eisenhower attend our weekly team 

conference meeting here in the Augusta VA Medical Center, and once a week, the 

unit’s medical staff attends the orthopedic surgery rounds at Eisenhower Army 

Medical Center. This cooperation and integration demonstrate what VA and DOD 

can do for our wounded servicemembers and veterans when we work together. The 

pride this Nation takes in those who served is evident in the tremendous attention 

and accolades this unit receives. 

Senator Isakson, this concludes my prepared statement. At this time I would be 

happy to respond to any questions you may have. 

Senator ISAKSON. Thank you, Dr. Hollins. 

General Schoomaker. 

STATEMENT OF ERIC B. SCHOOMAKER, MAJOR GENERAL, 

M.D., COMMANDER, NORTH ATLANTIC REGIONAL MEDICAL 

COMMAND AND WALTER REED ARMY MEDICAL CENTER 

General SCHOOMAKER. Good morning, sir. Greetings to you and 

to Congressman Broun and all the distinguished guests and leaders 

that are here today. Senator Isakson, thank you so much for the 

opportunity to participate in these hearings on these cooperative efforts between the Department of Defense, Department of the Army 

and the Department of Veterans Affairs in providing comprehensive and rehabilitative care to our service men and women. I’m 

Major General Eric Schoomaker. As you pointed out earlier, I currently serve as the commanding general of the North Atlantic Regional Medical Command and Walter Reed Army Medical Center. 

I am Don Bradshaw’s counterpart in the North Atlantic now. 

The relationship between the Augusta VA and the Dwight David 

Eisenhower Medical Center has grown under a joint venture for 

shared services at JVSS since 1993. Under the JVSS we have 

19 

shared open heart surgery and other services such as physical therapy, hyperbaric therapy, gynecologic and obstetric services, just to 

name a few of the collaborative efforts that were here to enhance 

health care services for beneficiaries in the southeast U.S. and, 

really, throughout the services. I think it’s important to note that 

two key conditions were present that have lent to the success of 

this collaborative effort that we see here in Augusta. The first is 

an essential pre-condition for a large cooperative team of health 

care leaders in the VISN7 and the integrated network for the VA 

that’s comparable to our Army regional commands, especially the 

then-VISN director, Ms. Linda Watson and her chief medical officer, Dr. Carter Mecher; leaders in the Augusta VA Medical Center, 

notably the then-director, Mr. Jim Trusley, and his chief of staff 

Dr. Tom Tiernan who’s here in the audience today; and leaders on 

my own Southeast Regional Medical Command staff at the time, 

our chief of staff Colonel, now retired, Sam Franko and our chief 

regional physician, Colonel Dr. Mike Stapleton, who’s now retired 

and has fallen into the position that Carter Mecher had in the VA. 

Working closely with clinicians and administrators at both hospitals, especially Dr. Rose Trenser and now Dr. Dennis Hollins 

here at the Augusta VA Medical Center—you know, sir, I’m a little 

embarrassed that I’m often credited with being the creator of this 

and point out it’s illustrative of that principle that when people like 

you they remember what you do well; when they don’t like you 

they remember everything you didn’t do well. And I guess this is 

just a sign people like me and that as a leader, things were working well, because this team was what really put this together, and 

I think that you know this as well as I do. I’m just privileged simply to be the talking head for that team. 

This unique and very successful partnership is principally about 

a very visionary and industrious team working together with one 

goal in mind. And you heard Dennis describe that providing the 

best care for soldiers, sailors, airmen and Marines at a site that 

was closest to their home. 

The second precondition that led to this success was the complementary plan for organizing services and patient referral on a 

regional basis. On a regional basis. Just as critical as the team I 

outlined above was the notion of overlapping the VA and Army regional health care delivery. In truth, this Augusta VA active duty 

rehab unit was just one of many successful programs that were 

subcomponents of a larger SERMC—that is Southeast Regional 

Medical Command—and VISN7 joint venture for shared services. 

Both the SERMC and the VISN committed to this overarching plan 

and this extends to other army medical and VA facilities in the regions that I believe the VISN director, Mr. Biro, will be talking 

about. Many of the first major active component units in support 

of OEF and OIF were deployed from Army posts within the 

SERMC area of responsibility—and you’ve heard about the 3rd Infantry Division. Quite frankly, early in OIF and OEF the 3rd Infantry Division out of Fort Stewart, Georgia; the 101st Airborne Division out of Fort Campbell, Kentucky; and many of the earliest 

National Guard and Reserve units that were deployed in support 

of the war came out of the southeastern U.S.. And it was apparent 

that we in Army medicine needed a regional response plan for the 

20 

injured soldiers that were discovered either during mobilization 

and training or for returning casualties, and that’s when we turned 

to the Augusta VA Medical Center and the VISN7, and developed 

the active duty rehab unit. We leaned very heavily on their pre-existing expertise in Post Traumatic Stress Disorder, spinal cord injury, blind and deaf treatment, and the like. 

I believe it’s important to point out that these sharing arrangements between the DOD and the VA can aid in the success of the 

Army medical action plan. That’s what the Army calls a larger 

operational and strategic plan which is standardizing many of the 

processes that you heard these two soldiers complain about—standardized approaches to benefit counseling, for example. We are centering much of that in our active duty large hospitals in soldier and 

family assistance centers, SFACs, so that we get our counselors, we 

get our finance people, we get our personnelists, VA benefits counselors, we get our VA health advisors all in one place working off 

of a single plan. It’s very hard to coordinate the many, many diverse programs of—generous programs from charitable contributions to government programs that are intended to provide for the 

needs of these soldiers, sailors, airmen and families and that that, 

again, needs to be done in a standardized process that the Army 

medical action plan is working and very, very instrumental in that. 

I’ll conclude my comments by pointing out how these shared arrangements between the DOD and the VA can aid in the success 

of this Army medical action plan which is being engineered by— 

the architect and engineer for that, the bureaucracy buster as we 

call him in the Army—is my deputy commander of the NARMC, 

Brigadier General Mike Tucker, who you may have met. 

It’s facilitating a seamless transition for these brave warriors— 

soldiers like Sergeant First Class Morrissey and Specialist Capps, 

and their families—who have borne really the heat of the battle. 

A seamless transition, either back to duty, because often lost in 

this is how many of these soldiers, sailors and airmen are returning to duty. The vast majority of them are going back to duty. We 

have retained 20 percent of our amputees in uniform with prosthetic devices. This is an unprecedented accomplishment, just as 

you pointed out the survival of battlefield wounds is unprecedented. 

As a sidebar, I spoke on Saturday evening to the veterans—61st 

annual reunion of the 83rd Infantry Division, mobilized in 1942, 

trained in Camp Atterbury, Indiana. They landed in Normandy 

and saw 270 days of continuous combat from Normandy through 

the hedgerows, through Brittany into Luxembourg, the Hu ̈ rtgen 

Forest. They were trapped at Bastogne; and crossed the Elbe 

river—the only military unit to cross the Elbe—and charged on 

Berlin before being called back. In 270 days, sir, they lost 1,500 

casualties, 2,800 of whom died. I talked to the veterans of that conflict in that division. Many of the soldiers, like the two soldiers you 

saw today, in prior conflicts would not have survived. One solder 

talked about seeing his first loss in combat, a man who had lost 

his arm and his leg simultaneously, and those soldiers could only 

stand by and watch that man bleed to death. Today we’re seeing 

those soldiers back through the evacuation system and are taking 

care of them and many of them, thankfully, are returning to duty 

21 

or to productive civilian lives. And that’s our goal and that’s the 

goal of the Army medical action plan. In this regard the VA has 

been extraordinarily instrumental, providing us with VA counselors 

from a time no later than 30 days before the soldier is discharged 

from the hospital so that that handoff is smooth; and we have a 

warm handshake between the VA and the Army, or the services, 

to make that happen. 

Sir, it’s been a privilege to participate in today’s hearings and I 

look forward to your questions. 

[The prepared statement of MG Schoomaker follows:] 

PREPARED STATEMENT OF MAJOR GENERAL ERIC B. SCHOOMAKER, COMMANDER, 

NORTH ATLANTIC REGIONAL MEDICAL COMMAND AND WALTER REED ARMY MEDICAL CENTER

Senator Isakson, Thank you for the opportunity to participate in this hearing on 

the cooperative efforts between the Department of Defense (DOD), Department of 

the Army (DA), and the Department of Veterans Affairs (VA) to provide the most 

comprehensive care and rehabilitation for our service men and women. I am Major 

General Eric Schoomaker, currently serving as the Commanding General of the 

North Atlantic Regional Medical Command (NARMC) for the Army Medical Department and the Commanding General of the Walter Reed Army Medical Center 

(WRAMC) in Washington, DC. 

I feel especially privileged to be included in these hearings today, having spent 

three very professionally and personally rewarding years as Commanding General 

of my counterpart regional medical command and medical center—the Southeast 

Regional Medical Command (SERMC) and Dwight David Eisenhower Army Medical 

Center (DDEAMC)—here at Ft. Gordon in Augusta, GA—a command currently held 

by my good friend and trusted colleague, Brigadier General Don Bradshaw. It was 

during my years in Augusta, at the outset of the current phase of the Global War 

on Terrorism—Operations Enduring and Iraqi Freedom—that this unique medical 

and rehabilitation unit—The Active Duty Medical Rehabilitation Unit in the Augusta VA Medical Center (Augusta VAMC)—was created. To gain a better understanding of the genesis of this unit, it is necessary to outline the history of the relationship between these two Federal medical facilities. 

Prior to 1993, Augusta VAMC and DDEAMC shared resources on a limited basis 

via a traditional VA/DOD sharing agreement. This included laboratory and other 

ancillary services. In October 1993, a decade before the war began, the Augusta 

VAMC and DDEAMC began sharing operations under a Joint Venture for Shared 

Services Agreement (JVSS) approved at the highest levels of both VA and DOD. 

This allowed sharing of services without the restrictions placed by sharing agreement regulations. The bartering of services was central to this agreement. This also 

allowed for the quick establishment of local agreements to meet the urgent needs 

of both facilities. Under this authority, a joint neurosurgery program was established at the Augusta VAMC. As a result, today all neurosurgery services for VA 

and DOD beneficiaries are provided at Augusta VAMC utilizing Department of the 

Army neurosurgeons. 

Under JVSS authority, numerous business agreements were put into place, including open heart surgery which is provided to both VA and DOD beneficiaries at 

DDEAMC utilizing Department of the Army surgeons. Other agreements under the 

JVSS authority included: 

• Sleep Lab Studies 

• Imaging services (including Mammography) 

• Gynecological/Obstetric Services 

• Separation Physical Examinations 

• Speech Pathology Support 

• Laboratory Services 

• Physical & Occupational Therapy 

• Hyperbaric Oxygen Therapy 

• Intensive Care Unit beds when needed 

• Laboratory Space for Animals 

• Echocardiogram Readings 

• Lodging for DDEAMC Inpatient Substance Abuse Programs 

The FY 2003 National Defense Authorization Act required a number of health 

care resource sharing and coordination projects. These included coordinated manVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00025 Fmt 6633 Sfmt 6621 H:\DOCS\082807.TXT SVETS PsN: PAULIN
22 

agement systems in Budget & Financial Management System; Coordinated Personnel Staffing; and Medical Information/IT Systems. Augusta VAMC and 

DDEAMC successfully competed for funding for a project in Coordinated Personnel 

Staffing. The proposal focused on hiring of Registered Nurses for critical care. It was 

subsequently expanded to neurosurgery when both Army neurosurgeons at 

DDEAMC retired from active duty and those positions were not backfilled by the 

Department of the Army. Funds from the demonstration project were approved for 

the use of paying salaries of two neurosurgeons to continue the joint Augusta 

VAMC/DDEAMC neurosurgery program. The demonstration project expires at the 

end of FY 2007. Augusta VAMC and DDEAMC officials are in discussions on how 

the neurosurgery program will continue. 

In 2004, new guidance was given to VA and DOD health care facilities regarding 

the sharing of resources. Bartering of services was no longer allowed, and an agreed 

upon rate of CHAMPUS Maximal Allowable Charges (CMAC) minus 10 percent was 

established for outpatient services provided by one department to the other. In view 

of this a blanket sharing agreement was established between the Veterans Integrated Service Network 7 (VISN 7) and the Southeastern Regional Medical Command (SERMC). This agreement provided guidance to VISN 7 and SERMC facilities 

on billing of outpatient and inpatient services. Inpatient rates of exchange are based 

upon the interagency exchange rate or locally agreed upon rates to insure coverage 

of facility costs. This agreement was subsequently updated in FY 2007. 

So the ground was fertile for a close working relationship between our two facilities at the outset of the GWOT. We in the Army Medical Department, in DDEAMC 

and in SERMC had grown confident in and respectful of what the Augusta VAMC 

and VISN 7 could offer our patients and our VA colleagues had grown more familiar 

with our culture and patient needs. It is important to note that two key conditions 

were present: 

1) An essential precondition was a large cooperative team of health care leaders 

in VISN 7, especially the then-VISN Director, Ms. Linda Watson, and her chief medical officer, Dr. Carter Mecher; leaders at the Augusta VAMC, notably the then-Director, Mr. Jim Trusley, and the Chief of Staff, Dr. Thomas Kiernan; leaders on my 

SERMC staff—our Chief of Staff, Colonel (now retired) Sam Franco and our chief 

regional physician, Colonel (Dr.) Mike Stapleton (now retired and working for the 

VA); and clinicians and administrators at both hospitals, especially Dr. Rose 

Trincher and Dr. Dennis Hollins at the Augusta VAMC. This unique and very successful partnership is principally about a very visionary and industrious team working together with one goal in mind: to provide the best care for Soldiers, Sailors, 

Airmen and Marines at a site closest to their home or home unit. 

2) The second condition which led to this success was a complementary plan of 

organizing services and patient referral on a regional basis. Just as critical as the 

team I outlined above was the notion of overlapping VA and Army regional health 

care delivery. In truth, the Augusta VAMC Active Duty Medical Rehabilitation Unit 

was one very successful sub-component of a larger SERMC and VISN 7 Joint Venture for Shared Services (JVSS) described above. Both the SERMC and the VISN 

are committed to this overarching plan—which extends to other Army medical and 

VA facilities in the region and even extends into such areas as mutual support of 

disaster planning and response. 

When many of the first major Active Component units in support of OEF/OIF 

were deployed out of Army posts within the SERMC area of responsibility—such as 

the 101st Airborne Division from Ft. Campbell, KY; the 3rd Infantry Division from 

Ft. Stewart, GA; and a large number of the first Reserve Component battalions, 

regiments and brigades mobilized out of this region as well, it was apparent that 

we in Army Medicine needed a regional response plan for ill and injured Soldiers 

during the mobilization and training process and for returning casualties and Soldiers and other Service Members who fell ill during deployments and returned to 

their home station in the Southeast. 

In response to this critical need to provide rehabilitation services for military personnel injured in Iraq and Afghanistan, VISN 7 and SERMC developed the Augusta 

VAMC’s Active Duty Medical Rehabilitation Unit. We leaned heavily on the VAMC’s 

expertise in management of spinal cord injury, treatment of Post Traumatic Stress 

Disorder (PTSD), as well as rehabilitation for blind and deaf veterans. The unit, 

staffed by VA personnel, provides all aspects of rehabilitative medicine services, including both Traumatic Brain Injury (TBI) and blast injuries. The first patient was 

admitted to the program on February 4, 2004. The unit was formally opened in May 

2004. Through August 3, 2007, 1,037 active duty personnel have been treated in this 

unique unit. 

23 

Others will speak today about the specifics of what had to be done at SERMC/ 

DDEAMC and VISN 7/Augusta VAMC to establish and maintain this unit and the 

partnership. I will add two perspectives with regard to challenges we experienced: 

1) The first involved the transformation of the cultures of both the VA and of the 

DDEAMC—from clinicians to command and control elements to mutually meet the 

needs of the other. I have been thoroughly impressed and humbled by the efforts 

which our VA colleagues have made to successfully engage a younger population of 

Warriors and new veterans and to build their trust and confidence that ‘‘this is not 

your father’s—or grandfather’s—VA hospital.’’ They treat our wounded warriors as 

we do: highly trained athletes whose new mission is to heal as completely as possible and to rejoin their comrades in uniform or to leave Active Duty and resume 

productive lives as citizens. We in the military health system know that the VA 

health care system is among the top systems of care in the Nation and the world, 

focused on evidence-based medicine and outcomes of care. It has been gratifying to 

see them win the respect of each Wounded Warrior, one Soldier and Family at a 

time. We, in turn, aggressively placed liaisons and made daily contacts with our patients and the Veterans Healthcare Administration (VHA) staff to jointly manage 

these rehabilitating Warriors. 

2) Second, the notion of marrying the Army’s regional medical commands and 

VHA’s regional health care assets has been very successful in this region. However, 

it was not the initial focus of the VA leadership and ran counter to their focus on 

the four VHA Poly-Trauma Units. Frankly, we all questioned this approach, especially since SERMC and DDEAMC as a regional asset for the entire U.S. Army 

Medical Command was the centerpiece of Soldier care, rehabilitation and physical 

disability adjudication. We also experienced first-hand the support and treatment 

which the Augusta VAMC could provide literally in our own back-yard. It is gratifying to see a more dispersed system of regional and community-based care emerging from the experience of the last 4 years. 

Many of the leaders and clinicians mentioned earlier were present when 

DDEAMC-Augusta VAMC Active Duty Medical Rehab program was awarded the 

Olin Teague award by VA Secretary Jim Nicholson in 2005. The pride many of us 

have in this achievement is second only to the pride we feel in seeing our Warriors 

receiving the very best care which Federal and U.S. Medicine can provide through 

this partnership. The unit serves as one important example of what our two systems 

of care can provide in defense of the Nation when we harness the vision, energy, 

intelligence and resources of both in support of the Service Member and his or her 

Family. 

As I conclude my comments, I believe it important to point out how sharing arrangements between the DOD and the VA can aid in the success of the Army Medical Action Plan (AMAP), an Army-wide initiative to facilitate a seamless transition 

for those brave Warriors who have borne the battle and their Families to civilian 

life and ongoing care and assistance through the many programs and services of the 

VA. Key to the development and ultimate success of the AMAP is the establishment 

of close working relationships with the VA early in the healing process. The AMAP 

provides for this by assigning VA Primary Care and Case Managers to every Warrior in Transition no later than 30 days prior to discharge. By co-locating VA Liaisons with Military Treatment Facilities where Warrior Transition Units have been 

established, many of the preliminary interactions between the VA and Warriors in 

Transition can be accomplished prior to discharge. VA appointments can be arranged, Veteran benefits counseling completed, accessibility modifications made to 

Warrior homes and automobiles, disability determinations completed, monthly compensation arranged to begin in a timely manner immediately following discharge, 

and follow-on care and rehabilitation programs developed. 

With the growing number of Warriors requiring care and assistance as a result 

of wounds, injuries, and illness received as the world continues to prosecute the 

Global War on Terror, the DOD Military Health System (MHS) and the Veterans 

Health Administration are challenged to provide the resources and care these heroes 

require. Through sharing resources, care can be provided across the United States 

of America in the most cost effective manner possible. Where the VHA has expertise 

but not the infrastructure to support necessary medical specialties, DOD can provide that infrastructure and conversely, where the DOD MHS has the resources the 

VHA requires, cooperative arrangements allow both to leverage these resources. Existing statutory vehicles such as the DOD/VA Health Care Sharing Incentive Fund 

established in 38 U.S.C. Section 8111 can be leveraged by visionary Congressional, 

DOD and VA leadership to see to it that those so deserving always have the best 

possible medical facilities, medical professionals, equipment, and supplies available 

when and where they are needed. 

24 

Thank you again for the opportunity to appear at this hearing and for your focus 

on our joint DOD/VA health care and rehabilitation initiatives. 

Senator ISAKSON. Thank you, General. 

General Bradshaw. 

STATEMENT OF DONALD M. BRADSHAW, BRIGADIER GENERAL, COMMANDER, SOUTHEAST REGIONAL MEDICAL COMMAND 

General BRADSHAW. Senator Isakson and other distinguished 

guests, thank you for the opportunity to discuss the relationship 

between the Southeast Regional Medical Command, Eisenhower 

Army Medical Center, Veterans Integrated Service Network 7 and 

the Augusta Veterans Affairs Medical Center pertaining to our 

joint mission to provide seamless quality health care to the brave 

men and women of the U.S. Armed Forces. 

As a soldier, commander and family medicine physician I recognize the profound impact a combat environment can have on the 

physical, behavioral, emotional and spiritual well-being of our warriors and their families. As the current commander of Southeast 

Regional Medical Command and Eisenhower Army Medical Center 

I recognize the importance of working cooperatively with our Veterans Affairs partners to ensure these warriors, veterans and their 

families receive the health care they need and deserve to restore 

themselves in body, soul and spirit. 

As you have heard, Eisenhower and the Southeast have a long 

history of working with VISN7 and Augusta Medical Center to optimize the Federal health care resources for the provision of care. 

This collaborative relationship led to the establishment of the active duty rehab unit in 2004 and you’ve heard about that. Embedded in the active duty rehab unit, as Dr. Hollins mentioned, are 

our Eisenhower Army nurse corps case management staff and Eisenhower warrior in transition battalion command and control personnel. This combination of clinical and command elements enables 

the warriors in transition assigned to the active duty rehab unit to 

receive coordinated timely health care and to maintain the sense 

of military esprit de corps. In addition to these military liaisons, we 

have combined multi-disciplinary meetings where my staff comes 

down and meets with his and then his staff comes out and meets 

with my staff, not only on the clinical but screening potential patients, taking care of the emotional, spiritual, as well as the physical. Furthermore, a Department of Veterans Affairs health and 

benefits advisor is embedded in Eisenhower. This individual meets 

with our wounded warriors to ensure they have a basic understanding of their entitlements under the DVA system. 

The remainder of my comments I’d like to focus on the resourcesharing achievements between Southeast Region, the VISN, Eisenhower and the Augusta Medical Center. Currently, our joint leadership meets on a regular basis to monitor the sharing activities, proliferate best practices and seek opportunities to partner and create 

efficiencies for providing health care services to the DVA and DOD 

beneficiaries. Examples of this sharing have already been mentioned and include imaging services, obstetrical and gynecological 

services, the sharing of intensive care unit beds and laboratory 

services. Eisenhower and the Augusta VA Medical Center also coVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00028 Fmt 6633 Sfmt 6601 H:\DOCS\082807.TXT SVETS PsN: PAULIN
25 

operate in a number of joint endeavors to sustain the quality 

health care for our DOD and DVA beneficiaries and to maximize 

the available resources. Three significant ones are the neurosurgical program that was begun in 1995 and smoothly 

transitioned last summer from military positions to civilian positions. Second, the coordinated staffing and recruitment joint demonstration project which began in 2004 to recruit and train nurses 

for both our systems. And last, our cardiovascular—sorry, cardiothoracic resource sharing initiative. 

I want to assure the Committee that the Army medical department’s highest priority is caring for our warriors and their families. 

Thank you for holding this hearing and thank you for this opportunity. 

[The prepared statement of BG Bradshaw follows:] 

PREPARED STATEMENT OF BRIGADIER GENERAL DONALD M. BRADSHAW, COMMANDER, SOUTHEAST REGIONAL MEDICAL COMMAND

Senator Isakson, Senator Graham, and other distinguished Members of the Committee, I thank you for the opportunity to discuss the relationships that exist between the Southeast Regional Medical Command (SERMC), Dwight D. Eisenhower 

Army Medical Center (DDEAMC), the Veterans Integrated Service Network (VISN) 

7, and Augusta Veterans Affairs Medical Center (VAMC) and our joint mission to 

provide seamless, quality health care to the brave men and women of the United 

States Armed Forces. As a Soldier and a Family Medicine physician, I recognize the 

profound impact a combat environment can have on the physical, behavioral, emotional and spiritual well-being of our Warriors In Transition and their Families. As 

the current SERMC and DDEAMC Commander, I also recognize the importance of 

working cooperatively with our VA partners to ensure our Warriors, Veterans, and 

their Families receive the health care they need to restore themselves in body, 

mind, and soul. 

In opening, DDEAMC and the SERMC have a long and strong history of working 

collaboratively with VISN 7 and the Augusta VAMC to optimize the use of Federal 

health care resources for the provision of health care to our Nation’s Warriors and 

Veterans. Our sharing efforts actually started in the early 1980’s, then matured in 

1995 with the joint provision of neurosurgical services to DOD and VA beneficiaries, 

and now includes cardiothoracic surgery, the exchange of intensive care beds, imaging, and hyperbaric services, to name just a few. One of the most noteworthy initiatives occurred in May 2003 when the SERMC Commander and the VISN 7 Director 

established a VA/DOD Tiger Team with the goals of identifying opportunities for resource sharing and standardizing business processes. This was implemented in anticipation of the need for closer collaboration between the DOD and VA in response 

to the impact of the Global War on Terrorism. 

As direct result of this joint effort, the SERMC/VA Southeast Network Active 

Duty Rehabilitation Unit (ADRU) was established at the Augusta VAMC in May 

2004 to ensure the health care needs of severely injured Warriors returning from 

Operations Iraqi and Enduring Freedom (OIF/OEF) are met. The ADRU currently 

consists of 30 inpatient beds and is staffed by numerous VA rehabilitation specialists including physiatrists, psychiatrists, psychologists, physical, occupational and 

recreational therapists, social workers, nursing, and administrative staff. Other appropriate specialties, such as respiratory therapy, are available as needed. The 

ADRU provides all aspects of rehabilitative medicine services for blast, traumatic 

brain (TBI), and spinal cord injuries and also identifies and treats Post Traumatic 

Stress Disorder (PTSD). 

Embedded within the ADRU are DDEAMC Army Nurse Corps case management 

staff and DDEAMC command and control personnel. This combination of clinical 

and command elements enables Warriors In Transition assigned to the ADRU to receive coordinated, timely health care and to maintain a sense of esprit de corps. 

Both Departments and facilities recognize it is critical to our success that a high 

degree of communication and cooperation exist between the VA and the DOD. Toward that end, in addition to the military liaisons assigned to the program, the 

Warriors in Transition commanders at DDEAMC attend weekly team conferences 

where multi-disciplinary reviews are made of each Warrior’s progress and treatment 

plans and goals are set. Also once a week, the ADRU medical staff attends orthopedic surgery rounds at DDEAMC to report back on progress being made by WarVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00029 Fmt 6633 Sfmt 6621 H:\DOCS\082807.TXT SVETS PsN: PAULIN
26 

riors assigned to the ADRU and to review patients slated for transfer to the program. 

As of August 2007, a total of 1,037 active duty personnel have been treated in 

the ADRU, including 491 inpatients. Patients admitted to the ADRU included Warriors injured in OIF/OEF combat operations, training incidents, and other accidents. 

Twenty-five percent of the Warriors were treated for TBI. Most servicemembers are 

discharged back to an Army MTF, while 25 percent are returned to duty and 16 

percent go on to be medically boarded. If upon discharge from the ADRU, it is determined a Warrior still requires intensive outpatient therapy and is not sufficiently 

recovered to be self-reliant, the Warrior is assigned to the Outpatient Care Unit 

(OCU) at the Augusta VAMC. This program allows the Warrior to be housed at the 

Augusta VAMC ensuring availability for treatment and preventing potential delays 

in care. 

I would like to briefly address our joint efforts to ensure the seamless transition 

of our Wounded Warriors. As these brave men and women return from theater, 

often with grievous injuries, it is paramount they and their loved ones receive the 

best care available. It is also essential that those Warriors no longer able to serve, 

seamlessly transition from active duty to veteran status without a lapse in benefits. 

To facilitate this transition, a VA Health and Benefits Advisor is embedded within 

DDEAMC. This individual meets with our Wounded Warriors to ensure they have 

a basic understanding of their entitlements under the VA system. Both DOD and 

VA have rich benefit programs for the active duty soldier and the veteran but significant disparities exist between these programs and the health benefits covered by 

TRICARE. We must ensure that no Family member is unable to visit and support 

their loved one as a result of the extensive out-of-pocket expenses required by a system established on a reimbursement basis. We must ensure these costs are covered 

up front. A promise of reimbursement is worthless if the Family cannot afford to 

pay these initial expenses. The leadership and staff of the SERMC, VISN 7, 

DDEAMC, and the Augusta VAMC are working to make sure every Warrior and 

Family are taken care of, however, your support in making this policy change would 

make this task considerably less cumbersome and further reduce the frustrations 

of our Warriors and their Families. 

It should be recognized by this Committee that in 2005, VISN 7, the SERMC, and 

the Augusta VAMC were given the Olin Teague Award, the highest VA customer 

service award, in recognition of our unique and innovative operation of the ADRU 

in providing outstanding rehabilitation care to members of all the services. 

In the remainder of my comments I would like to focus on other resource sharing 

achievements between SERMC, VISN 7, DDEAMC, and the Augusta VAMC. Currently DOD and VA leadership meet on a regular basis both at the local and regional levels to monitor sharing activities, proliferate best business practices, and 

seek opportunities to partner and create efficiencies for providing health care services to VA and DOD beneficiaries. In March 2007, a new Master Sharing Agreement 

(MSA) and a new Outpatient Care Unit Agreement were implemented between the 

SERMC and VISN 7. The MSA provides an instrument for sharing health care resources between VISN 7 and SERMC facilities in instances where the need for sharing is either immediate, short-term or of insignificant volume to warrant a separate 

sharing agreement. The MSA also provides a detailed process for referrals, authorizations, reimbursement rates and resolution of issues that may arise between DOD 

and VA facilities. Examples of sharing instituted at SERMC and the Augusta 

VAMC under the agreement include imaging services, OB/GYN services, the sharing 

of intensive care unit beds, echocardiogram reading, and laboratory services. 

DDEAMC and the Augusta VAMC also cooperate in a number of joint endeavors 

designed to sustain the quality of health care for DOD and VA beneficiaries and 

maximize available resources. Let me briefly highlight three of our most significant 

and innovative sharing initiatives. The Coordinated Staffing and Recruitment Joint 

Demonstration Project began in 2004 with the purpose of exploring the use of the 

VA’s hiring authority to recruit and retain critical medical, nursing, and ancillary 

staff to fill key shortages at both medical centers. The concept was to maximize the 

VA’s ability to recruit and pay these critical staff under Title 38 authority, effectively minimizing the impact of deployments and military staffing shortages on the 

patient care provided by both organizations. The program has demonstrated successes in recruiting and retaining critical care nursing staff for the Augusta VAMC 

and DDEAMC and was essential in maintaining the viability of our DDEAMC/ 

Augusta VAMC Neurosurgery program. This program began in 1995 as a result of 

DDEAMC having two military neurosurgeons with a minimum of operating room 

slots available for performing neurosurgery cases. At that time, the Augusta VAMC 

possessed ample OR time but was paying significant dollars to contract for a part 

time neurosurgeon and was still referring many patients to the Atlanta VAMC. By 

27 

locating DDEAMC surgeons and support staff at the Augusta VAMC and utilizing 

their surgical suites, support staff and inpatient wards, access to neurosurgical services was preserved for both DOD and VA beneficiaries. This enabled DOD provider 

readiness to be sustained at a significant reduction in cost to the taxpayer. In the 

fall of 2005, DDEAMC and the Augusta VAMC, in anticipation of losing their two 

military neurosurgeons, submitted a request for the approval of funds to support the 

hiring of two civilian neurosurgeons under the Coordinated Staffing and Recruitment Project. As stated previously, the approval of this proposal preserved neurosurgical services for both the Augusta VAMC and DDEAMC and identified numerous lessons learned in the sharing of joint recruitment and staffing processes. A 

final report is due to Congress later this year. 

The DDEAMC and Augusta VAMC Cardiothoracic Resource Sharing initiative is 

also a premier example of using combined resources to meet the medical needs of 

our beneficiaries. Under this agreement, DDEAMC performs cardiothoracic surgery 

on DOD and VA beneficiaries at DDEAMC. This provides necessary workload for 

DDEAMC’s Graduate Medical Education (GME) programs, sustains the skills of our 

active duty surgeons, and reduces VA costs by minimizing their dependence on the 

private sector. The VA reimburses DDEAMC at DOD/VA discount rates which at 

present make this a win/win for both organizations. I would strongly recommend to 

this committee that the Congress re-look the current DOD/VA guidance on mandated reimbursement rates for inpatient (DRG—10%) and outpatient (TMAC—10%) 

sharing between DOD and VA facilities. This reimbursement methodology no longer 

provides incentives for DOD and VA facilities to enter into sharing initiatives as 

this discount can be achieved through network providers without incurring any 

MTF resources to support the program. 

Health Care is local—and we (SERMC, DDEAMC, VISN and AVAMC) have ongoing collaborative meetings—monthly between AVAMC and DDEAMC, quarterly 

VISN and SERMC but more frequently at the staff level. This opens communication, 

ensures accountability and removes personality of leaders from the process. Request 

you encourage this communication through more flexible and consistent resource 

streams as well as consistency in recruiting and paying staff, advertising and benefits packages. 

I want to assure this Committee that the Army Medical Department’s highest priority is caring for our Warriors and their Families. Thank you for holding this hearing and thank you for your continued support of the Army Medical Department and 

the Warriors that we are honored to serve. 

Senator ISAKSON. Thank you, General, for your testimony. 

Dr. Hollins, we just passed in the Senate the wounded warriors 

legislation. A part of that dealt with the subject you talked about, 

PTSD, and particularly with the referral of PTSD because PTSD is 

kind of one of those things, as I understand it, that can lay 

undiagnosed and then all of a sudden appear some time years 

later. Is that correct? 

Dr. HOLLINS. Yes, it is, Senator. 

Senator ISAKSON. Isn’t it also correct that any number of specialists in the private sector, say an ophthalmologist, actually have the 

capability of detecting that and may be the first people to detect 

it after a soldier is in fact out of the military? 

Dr. HOLLINS. Yes, that is true. 

Senator ISAKSON. And my question is, if a soldier has gone to the 

ophthalmologist after he’s out of the military—he fought in Desert 

Storm and he’s been out a couple years—the ophthalmologist diagnoses that. Is there a referral back to VA for treatment on that, 

or how does that work? 

Dr. HOLLINS. For PTSD treatment? 

Senator ISAKSON. Yes. 

Dr. HOLLINS. Yes. Well, any veteran who comes to the VA could 

be referred to a PTSD program in the VA. This is something that 

the VA has done for many years. 

28 

Senator ISAKSON. And you take those referrals out of the private 

sector if they in fact are already out of the military when it’s diagnosed? 

Dr. HOLLINS. Certainly, yes. 

Senator ISAKSON. General Schoomaker, thank you for your humility. And I still give you a lot of credit, but I do realize what you 

said is true: that there’s a terrific team here in Augusta. And you 

used the word visionary. Do you think what’s happened here requires the visionary leadership at the local level up or is there a 

way we can maybe look to inspire some of that down? Because I 

know there have to be other cities and areas like Augusta where 

you have a major military installation and a major VA facility. Is 

there a way we could do that? 

General SCHOOMAKER. Well, sir, I mean I’m going to be the ultimate compromiser and say it works both ways, I think. As you 

know, health care is a local event. Ironically, Don was the commander at Fort Benning where Specialist Capps was first returned 

to or deployed out of and where it was decided that he should be 

regionally managed by the Augusta VA Medical Center and Eisenhower. 

So, the first thing I would say is that on a local and regional 

basis I think we have to attend to what the demands are on local 

commanders and to include the local units that these soldiers come 

out of to best serve their needs and serve the needs of their families. And that really is best done as close, as we’ve heard, to where 

they live, where their home bases are, where their families have 

settled and where that soldier wants to go back into his or her 

unit. 

At the same time, I think that higher leadership needs to be in 

a position to allocate the resources and direct standardization and 

you’ve already attended to that with some of the questions directed 

to these soldiers. Local communities and even regional—regions 

can’t be in a position of just open entrepreneurship of the program. 

There needs to be some standardization and allocation of resource 

to those places that do it well. And I think this notion that on a 

regional basis both for the VA and in this case the Army medical 

department—for our regional medical commanders to allow us the 

latitude to build these relationships close to where we have our 

large Army medical centers is the best way. And I’ve spoken to my 

counterparts and Don’s counterparts at the Great Plains Regional 

Medical Command in San Antonio and the Western Regional Medical Command centered in Fort Lewis and the Pacific at Tripler 

and my own up at Walter Reed. We all feel the same way, that 

building these relationships one-on-one with the VA close to our 

major hub medical centers and large community hospitals is certainly the way to go. 

Senator ISAKSON. Thank you, General. 

General Bradshaw, you used the term shared services. General 

Schoomaker used the term shared services. Dr. Hollins used the 

term shared services. In the testimony of Sergeant Morrissey, I 

think at one point he referred to being directed back and forth between Eisenhower and VA, depending on the specialty. And I think 

what he was referring to, he had multiple injuries and multiple 

specialties; and with the seamless handoff that you’ve had down 

29 

here you’re utilizing your assets at both facilities depending on 

what has the need. Is that correct? 

General BRADSHAW. Yes, sir. We balance it, obviously focused on 

the patient—the soldier, sailor, airmen, Marines’ needs—but also 

what our capacities are, because that changes day to day. How 

many ORs we have open, exactly what kind of specialists we have. 

I have a great hand surgeon but he deployed for 90 days so that 

we were dependent on other expertise, and we balance that back 

and forth, and that’s the ongoing discussion that we have. That’s 

the benefit of the close relationship and the ongoing interactions, 

routine meetings, and the comfort of our staffs to handle that. And 

it’s not directed at high levels, but they do it on a daily basis. It’s 

part of the reason we’ve put the case manager down here. It’s part 

of the reason the C2 is down here and it’s part of the reason that 

we have the joint meetings. Because patients don’t go just from 

DOD to DVA; they go back and forth repeatedly, sometimes very 

close like this. Sometimes it’s months in an active duty poly—I 

mean, VA polytrauma unit—and then they’ll come back to our facility. So I think the relationship has got to be back and forth, not 

unidirectional; and that’s key. 

Senator ISAKSON. General Schoomaker, one last question. Both 

you and General Bradshaw addressed the concern that Sergeant 

Morrissey raised with regard to entitlements and receiving information. You referred to the medical action plan. I think that’s what 

you referred to where you were working on that. How old is that 

medical action plan? Is that something that’s been recently done? 

General SCHOOMAKER. Yes, sir. The Army medical action plan, 

sir, was launched in early March, not long after the initial Washington Post stories that addressed the problems at Walter Reed. 

I arrived at Walter Reed on March 3. My deputy, Mike Tucker, 

was—I selected him with the help of Vice Chief of Staff of the 

Army, General Cody, who has taken a personal and directive interest in this along with Secretary Geren. And that plan started on 

or about March 19. 

It is now 6 months or so into the plan. It’s been very aggressively 

pursued. The Army as a whole has very aggressively embraced this 

because it involves multiple major commands of the Army, not just 

the Army medical department but the installation management 

command that builds barracks and supports ADA compliance for 

those barracks. It impacts the personnel community because of assignment of cadres to warrior transition units, which is what we 

now call the units that are clustered around. You heard one of the 

soldiers talk about his now having a squad leader and platoon leader. Those are warrior transition unit cadre that are assigned by the 

Army. 

So across the board, sir, this has been a very aggressive plan engaging the Congress at every step, so that they’re aware through 

the House Armed Services and Senate Armed Services and the 

HAC and SAC to ensure that we are complying with their requirements that we fix the problems that we identified at Walter Reed; 

that it spreads across the Army as a whole and into the DOD; and 

it interfaces with our VA colleagues. Does that answer the question? 

30 

Senator ISAKSON. Well, it does. And the reason I asked the question was for you to be able to say that, because I want to commend 

you and the Army and the entire team spreading the credit as it 

is deserved for responding to that need and have done so in a remarkable way. And just as these soldiers—their injuries were a 

while back when that was not in place. I think what you’ve done 

and what’s been done with the medical action plan addresses probably the single most repeated concern that we’ve got, which you’ve 

heard today. And I appreciate very much your timeliness in getting 

that. And I think also some of that came from recommendations 

from the Dole-Shalala Commission Report, if I remember correctly. 

General SCHOOMAKER. Yes, sir. 

Senator ISAKSON. So your responsiveness to that is appreciated 

and I thank you very much. 

General SCHOOMAKER. Sure. 

Senator ISAKSON. I thank all our panelists. 

General SCHOOMAKER. Yes, sir. I wonder if I might make one last 

pitch— 

Senator ISAKSON. Absolutely. 

General SCHOOMAKER [continuing]. To follow on with one of the 

things that both Dr. Hollins and Dr. Bradshaw just discussed. And 

that has to do with this sharing of personnel but also the importance, as you heard Don describe, of maintaining a vibrant direct 

health care system within the military to maintain the readiness 

skills of our physicians, nurses, medics and the like. Now, you 

heard the fact that one of our most talented hand surgeons, Paul 

Cutting, was deployed in the middle of the treatment of one of 

these soldiers who had an upper extremity injury. It’s not by 

chance, sir, that we are having the survival of battlefield wounds 

that you see today. Those surgeons and those critical care nurses 

that are in the air with the Air Force or on the ground in combat 

support hospitals, support surgical teams, sir, they maintain their 

medical readiness skills by working in Eisenhower and Walter 

Reed with folks every day on soldiers and sailors and airmen and 

Marines, their retiree population and their families. If we don’t 

have that, sir, we’re not going to continue to achieve the achievements that we have in combat. 

Senator ISAKSON. Well, since you said that, I’ll close with a comment from one of my constituents. You had a young man, Specialist 

Pearson, who was in Walter Reed about 3 months ago who I went 

to visit. He’s from Cobb County, Georgia, which is my hometown. 

When I go to Walter Reed I usually—I don’t usually, I always— 

give the soldier my home number and ask him to be sure and 

call—in Washington and ask him to be sure and call me if he needs 

anything. And I get the number of his parents and I call his parents just to let them know I went to see him and if they need anything, since I’m in Washington and they’re in Georgia, just to let 

me know. So I called Specialist Pearson’s father that night and got 

him on the phone and said, ‘‘Listen, I went to see your son today. 

It looks like he’s doing good.’’ He had some very serious injuries 

and had been in the hospital 10 days at Reed from coming from 

Landstuhl. I said, ‘‘He looks like he’s doing good but I just wanted 

to let you know if there’s anything I can do for you, just let me 

know.’’ He said, well, there is something you can do for me. He 

31 

said, please tell everybody that my wife and I have been up there 

the last 10 days and our son has never received better care than 

he’s received at Walter Reed. So that’s a testimony from a father 

of a wounded warrior in Cobb County who I happened to shake 

hands with about 3 months ago at Walter Reed. That’s the best testimony of all of what you do. Thank you. [Applause.] 

While we’re waiting on our last panel to come forward—for the 

record, for the staff—I want to, by unanimous consent, enter into 

the record the testimony of Dr. Rahn, President of the Medical College of Georgia. He could not be here today. And Mayor 

Copenhaver from Augusta, who, in his testimony, said Augusta 

used to be known for one week out of the year when the Masters 

was played, but now it’s known for two things: the Masters; and 

for this great facility here that the VA and DOD have made together. So, I wanted you all to hear that. That’s from the mayor’s 

words himself. 

Our final two panelists, welcome to both of you for being here. 

Mr. Lawrence Biro—is that correct, Biro? 

Mr. BIRO. Yes, sir. 

Senator ISAKSON. Network Director of the VA Southeast Network. And you are the VISN7 that everybody kept referring to in 

the previous testimony? 

Mr. BIRO. That’s right. 

Senator ISAKSON. And Dr. Michael Kilpatrick, Deputy Director of 

Force Health Protection and Readiness Programs, U.S. Department 

of Defense. Welcome to both of you. Mr. Biro, you’ll be first. 

STATEMENT OF LAWRENCE A. BIRO, NETWORK DIRECTOR, 

VA SOUTHEAST NETWORK 

Mr. BIRO. OK. Good morning, Senator Isakson and Congressman 

Broun and distinguished guests. Thank you for this opportunity to 

participate in this hearing on cooperative efforts between the Department of Defense and the Department of Veterans Affairs. 

I’ve submitted my written testimony and ask that it be included 

in the official record. 

Senator ISAKSON. Without objection. 

Mr. BIRO. Network 7 consists of the States of Georgia, South 

Carolina, and Alabama through its eight medical centers and 27 

community-based outpatient clinics. The network serves a veteran 

population of over 1.5 million in this area, of which 300,000 are 

users of our health care system. Previous testimony has clearly 

presented the cooperative efforts between Augusta VA and the Eisenhower Army Medical Center. The active duty rehabilitation unit 

is our largest endeavor here in Augusta. These cooperative efforts 

in Augusta are the largest efforts within our network and account 

for approximately 75 percent of the cooperative arrangements in 

the network in terms of services purchased by the Department of 

Defense. 

In that these projects have been fully discussed in previous testimony, I will not discuss them again. Instead I’ll elaborate and outline some other cooperative arrangements we have in VISN7. Second, I’d like to just briefly talk about our efforts we have underway 

to ensure that there is seamless transition for active duty—from 

active duty to veteran status for our newest veterans. Our other coVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00035 Fmt 6633 Sfmt 6601 H:\DOCS\082807.TXT SVETS PsN: PAULIN
32 

operative arrangements—the authority for these cooperative arrangements are 38 U.S.C. 8111 and we have several just up the 

road in Charleston, South Carolina. We’re in the process of building a clinic in cooperation with the U.S. Navy, the Naval Weapons 

Station at Goose Creek. It’s a $41 million project. We will be sharing staff there and obviously physical facilities and there will also 

be equipment sharing. 

There is the—it’s been mentioned a couple of times—the joint incentive fund. This is a fund set up between the Department of Defense and the Department of Veterans Affairs to fund projects, and 

our Network has done very well. We’ve just been funded in 

Charleston for an MRI that will go into that clinic at Goose Creek. 

So that is one project. Just up the road is Columbia, South Carolina, where again there has been a longstanding relationship between Fort Jackson and the Dorn VA. Mr. Heckert, the director, is 

here today and he’d be glad to tell you more. We’ve just, again, 

been funded through that joint incentive fund to expand mental 

health services in a cooperative arrangement with the Moncrief 

Army Community Hospital and the Shaw Air Force Base clinic. 

And these will be the provision of mental health services, nonstandard hours, at Fort Jackson. 

In southeast Alabama, again, another joint incentive fund project 

where we are working with and will be locating our communitybased outpatient clinic at Fort Rucker to expand our outpatient 

services and to complement the Army efforts there. We have additional arrangements at the Maxwell Air Force Base in Montgomery, Alabama, and several other military facilities. It’s our policy to be constantly seeking cooperative arrangements with the 

military that will improve the quality and access for both active 

duty military and their families and veterans. 

Second, I just wanted to briefly talk to you on our seamless transition efforts. It’s been mentioned that seamless transition requires 

flawless handoffs between the military and the Department of Veterans Affairs and I can assure you that every day we work on this 

in VISN7. To date 19,000 warriors from OEF/OIF and the global 

war on terror have enrolled in our Network; 16,000 are using our 

services. 

To these veterans and all the veterans in Network 7 we make 

three promises. The first is that the care that they receive in our 

network will be second to none and that’s non-negotiable. It will be 

the best care and stand up to any comparison any place, any time. 

It’s already been proven over and over again that the VA does provide the best care. It’s been written up in the Washington Post to 

Newsweek, Business Week and through other research. So we make 

that promise. The care that you get from VISN7 will be second to 

none and it’s non-negotiable. 

Second, that we will maintain and expand services. We’ve discussed this morning the services that are to be provided and we 

will provide them and we will continue to provide them to veterans 

here in this network. At least as long as I’m here, we’ll never hear 

from me that we cannot provide what we need to provide. And we 

will continue to expand services where we need to. 

And third—and the most important—is that every veteran in 

this network who receives care from us will be personally satisfied 

33 

on the care that they receive, based on the outcome. And I do mean 

personally satisfied. 

Senator, you might want to ask me, well, how can you say that? 

You just said you’ve got 1.5 million veterans and 300,000 users. 

Let’s just say I said it and I will stand behind it: that each and 

every veteran will be personally satisfied. 

As you visited Atlanta a couple of weeks ago we informed you of 

a couple of things that we’re doing and I just wanted to mention 

here to we’re reaching out to all those 19,000 OEF/OIF veterans. 

We have a plan and we’re recontacting everybody and there’s some 

interesting stories. I have to tell you one. 

The Dublin people were calling and with this modern technology 

that we’ve been talking about, they reached a veteran that had 

been redeployed. He called us back from Iraq and said, you know, 

if you’re looking for me, I’m over here in Iraq. You know, I’ll remember you when I get back. 

We found a veteran in Wilmington, Delaware, which is one of my 

former networks—my former network, and we helped reconnect 

that veteran to the Wilmington VA. So, first we’re reaching out to 

find all those 19,000 veterans and make sure that we’re doing what 

we need to do. 

The second thing that I mentioned to you just recently was that 

Secretary Nicholson had put transitional patient advocates out. 

We’ve hired nine of them. Our philosophy is to get them out in the 

field and they are out. They all have cars and they’re going out and 

finding veterans—helping with the case management of the seriously injured and seriously ill. But they’re also going out to make 

contact with other veterans in the most nontraditional ways that 

we can find. So we’re working on that. 

So, our mantra always in this network is to help one veteran at 

a time and if we can help one veteran at a time, we can show that 

we’ve made a difference. We certainly are concerned—we’ve talked 

about numbers—but we’re concerned with the one. 

So just in summary, the Southeast Veteran—Southeast Network 

has many cooperative efforts underway with the Department of Defense and we’ll continue to look for additional opportunities. And 

again, we will continue to work with the Department of Defense to 

ensure that there’s a seamless transition from active duty to veteran status. Again, thank you for the opportunity to speak to you. 

[The prepared statement of Mr. Biro follows:] 

PREPARED STATEMENT OF LAWRENCE A. BIRO, DIRECTOR, VA SOUTHEAST NETWORK

(VISN 7), VETERANS HEALTH ADMINISTRATION, DEPARTMENT OF VETERANS AFFAIRS

Mr. Chairman, and Members of the Committee: Thank you for allowing me to appear before you today to discuss the Active Duty Rehabilitation Unit at the Augusta 

VA Medical Center (VAMC), operated by the Augusta VA Medical Center in partnership with the U.S. Army Southeast Regional Medical Command (SERMC). Veterans Integrated Service Network (VISN) 7 serves the broad tri-state region of Georgia, Alabama and South Carolina, home to 1.5 million veterans. 

In October 2005, Secretary Nicholson presented the Augusta VAMC with the Olin 

‘‘Tiger’’ Teague Award, the highest award recognized in VA. Secretary James Nicholson remarked that ‘‘doctors, nurses, rehabilitation specialists and support staff, 

came together at the Augusta VAMC in what can only be described as a blessed 

partnership of caring, healing, and compassionate health care professionals.’’ 

I could not agree more, and it is a privilege to testify today on their behalf. 

The Augusta VAMC and the Eisenhower Army Medical Center (AMC) have a long 

history of partnering to provide exemplary care to veterans and servicemembers. In 

34 

October 1993, the Augusta VAMC and Eisenhower AMC began sharing operations 

under a Joint Venture for Shared Services (JVSS) agreement approved at the highest levels of VA and DOD. This agreement allowed the facilities to share services 

with few restrictions. The joint venture also streamlined the process for establishing 

local agreements to meet the urgent needs of both facilities. VA and DOD created 

a joint neurosurgery program, and since that time, all neurosurgery services for veterans and servicemembers are provided at Augusta VAMC with the help of Department of the Army neurosurgeons. 

Over the past 15 years, VA and DOD have relied on the JVSS for a number of 

other business sharing and medical care agreements, including open heart surgery, 

imaging services (including mammography), gynecological/obstetric services, separation physical examinations, expansion of laboratory services, physical and occupational therapy, intensive care unit (ICU) beds, echocardiogram readings, and lodging 

for Eisenhower inpatient substance abuse programs, among others. 

The 2003 National Defense Authorization Act (NDAA) expanded VA/DOD health 

care resource sharing and coordination projects by including coordinated management operations in budget and financial management systems, coordinated personnel staffing, and interlinked medical information technology systems. 

Pursuant to this Act, the Augusta VAMC and Eisenhower AMC received funding 

for a national demonstration project in coordinated personnel staffing. The project 

focused on hiring registered nurses (RNs) for critical care and was later expanded 

to include neurosurgery. VA and DOD used approved funds from this project to hire 

two new neurosurgeons to continue the joint program. This project is due to expire 

at the end of Fiscal Year 2007, and Augusta VAMC and Eisenhower AMC officials 

are discussing how best to continue the neurosurgery program. 

In 2004, VA and DOD agreed to adopt a rate 10 percent below the CHAMPUS 

Maximum Allowance Charge for outpatient services provided by one Department to 

the other, in accordance with the 2003 NDAA. VISN 7 and the SERMC established 

a blanket sharing agreement, which provided guidance to VA and DOD facilities on 

outpatient and inpatient care billing practices. Inpatient rates of exchange were 

based upon the interagency exchange rate or locally agreed upon rates to ensure 

coverage of facility costs. VA and DOD updated this agreement in FY 2007. 

While all of these accomplishments are certainly noteworthy, our cooperation on 

treating the critical health care needs of military service personnel injured in Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) is truly our ‘‘crown jewel.’’ 

In 2003, VISN 7 and SERMC partnered to create the Augusta VAMC Active Duty 

Rehabilitation Unit, which provides rehabilitative care, including both Traumatic 

Brain Injury (TBI) and blast injuries, to Soldiers, Sailors, Airmen and Marines. 

The Active Duty Rehabilitation Unit represents the best of VA and DOD medical 

care, and represents the fulfillment of our promise to veterans and servicemembers. 

Mr. Chairman, this concludes my prepared remarks. I would like to request my 

written statement be submitted for the record, and I would be happy to answer any 

questions you may have. 

Senator ISAKSON. Thank you very much. 

Dr. Kilpatrick. 

STATEMENT OF MICHAEL E. KILPATRICK, M.D., DEPUTY DIRECTOR, FORCE HEALTH PROTECTION AND READINESS 

PROGRAMS, DEPARTMENT OF DEFENSE 

Dr. KILPATRICK. Senator Isakson and distinguished guests, thank 

you for the opportunity to speak to you on behalf of the Assistant 

Secretary of Defense for Health Affairs regarding DOD and VA cooperation in providing health care for returning servicemembers 

and new veterans. 

It is fitting we are here in this active duty rehabilitation unit 

where soldiers, sailors, airmen and Marines and their families are 

receiving the quality care and support they need and deserve. The 

collaboration between VA and DOD that made this unit possible is 

just one example of the way our health care system can positively 

influence the lives of servicemembers and their families. The men 

and women being treated here and at DOD and VA facilities across 

this Nation have paid a substantial price protecting our way of life 

35 

and we owe them nothing less than our best. As we continue to improve our two medical communities’ cooperation and processes we 

must keep—always keep our focus on the patient and the family. 

Today I’d like to highlight some of the significant programs that 

DOD and VA put in place to provide world-class medical care. We 

have recently had many independent and internal groups evaluate 

DOD and VA’s abilities to support and care for ill and injured 

servicemembers and veterans, culminating in nearly 400 recommendations. As those recommendations were being developed, 

the Secretary of Defense and the Secretary of Veterans Affairs 

chartered a senior oversight committee to systematically address 

treatment processes. That committee is collecting all recommendations, evaluating executability, breaking down the recommendations into actionable parts and associating those actionable parts 

with timelines and milestones, and establishing priorities to apply 

resources against them. 

The global war on terrorism poses a challenge to both departments as the severity and complexity of wounds and the requirements for long-term rehabilitative care for our combat veterans increase demands on our systems. But with the last several years the 

DOD and VA have made significant strides in coordinating and developing common health care and support services along the entire 

continuum of care. Forty-eight DOD and VA joint incentive fund 

projects are now underway or completed, covering such diverse 

areas of medical care as mental health counseling; web-based training for pharmacy technicians; cardiothoracic surgery; neurosurgery; 

and increased physical therapy services for both DOD and VA 

beneficiaries. 

Resource sharing is also helping us improve effectiveness and efficiency. Joint staffing is occurring at a number of Federal health 

facilities such as here at Eisenhower and at the Center for the Intrepid, a state-of-the-art facility in San Antonio, Texas. An Army 

liaison and VA polytrauma rehabilitation center collaboration program, often called Boots on the Ground, is designed to ensure the 

severely injured servicemembers who are transferred directly from 

military treatment facilities to one of the four VA polytrauma centers are met by a familiar face in a uniform. The VA has personnel 

at our medical facilities. There are VA social workers and counselors assigned to ten military treatment facilities, including here 

at Eisenhower. These social workers ensure the seamless transition 

of health care, including a comprehensive plan for treatment. As of 

June 29, 2007, the VA social worker liaisons had processed nearly 

8,000 new patient transfers to the Veterans Health Administration, 

including 436 inpatient transfers. 

Our greatest mission is to honor our servicemembers by providing the best quality care and ensuring a compassionate, fair and 

timely disability adjudication process to enable them to return to 

the fullest, most productive and complete quality-of-life possible. 

The satisfaction with medical care a servicemember has after becoming ill or injured in the combat theater will be the major success of cooperation between the Department of Defense and the Department of Veterans Affairs in providing facilities, treatment, rehabilitation and support for servicemembers and their families. 

36 

I thank you again for the opportunity to share the cooperative efforts of the Department of Defense and the Department of Veterans 

Affairs. We look forward to continuing to work with your Committee as we make progress on these very important issues. Thank 

you. 

Senator ISAKSON. Thank you very much. 

Mr. Biro, I want to first of all acknowledge we are in the eastern 

central part of the State, but thank you and the department for the 

most recent announcement on the Rome clinic. The VA is continuing to expand their services in Georgia and with the Committee I’ve just reauthorized the $20.6 million, I think, for the hospital—redo of the hospital at Clairmont Road in Decatur, which I 

think illustrates our commitment to follow through on a request 

that you have made. 

You mentioned Charleston, Columbia, and Fort Jackson, South 

Carolina; the Alabama clinics at Fort Rucker and Maxwell Air 

Force Base. Were those all for DOD/VA collaborations? 

Mr. BIRO. Yes, they are. 

Senator ISAKSON. Are they similar to what’s been done here in 

Augusta? 

Mr. BIRO. This here in Augusta is unique. It’s inpatient. There— that’s why there’s 75 percent of the effort here. But over $7–$8 million that’s virtually all inpatient. The other efforts are outpatient 

facilities. 

Senator ISAKSON. The point you made about 19,000 veterans of 

Operations Iraqi Freedom and Enduring Freedom are both in this 

region. And that region is just Georgia, South Carolina and Alabama. Is that right? 

Mr. BIRO. Right. And that’s the number that are enrolled. 

Senator ISAKSON. That’s the number that are enrolled. 16,000 

are being treated? 

Mr. BIRO. Treated, yes. 

Senator ISAKSON. You made a comment about VA health care 

and I want everybody to recognize your comment wasn’t just home 

team bragging because Time magazine referred to VA health care 

as the gold standard, particularly the use of information technology 

in medicine, which is being done at the VA. So I commend you on 

what you are doing. 

Dr. Kilpatrick, you’re employed by the Department of Defense? 

Dr. KILPATRICK. That’s correct. 

Senator ISAKSON. And Mr. Biro is employed by the Veterans Administration; is that correct? Well, you all are— 

Mr. BIRO. That’s correct. 

Senator ISAKSON [continuing]. A pretty good example of seamless 

coordination testifying together, I’ll certainly testify to that. 

And the secretary—the previous Secretary of the Armed Services 

went through transformation—or the military was going through 

transformation. In fact, we were going through it when we ended 

up being attacked on September 11, 2001, and have been going 

through it while we’ve had our folks deployed around the world. 

Are the many things that you mentioned for efforts for joint sharing services. Is that a part of transformation? 

Dr. KILPATRICK. I definitely think it is because we are looking at 

what are today’s needs. We have to get the sense of looking at that 

37 

at the ground level. How do you meet those needs in the most efficient, effective manner. Being good stewards of taxpayer dollars, 

looking to make sure that the quality of care is not anywhere 

fenced because of dollars to make sure that people get the care 

they need when they need it. And I think that—you heard from 

earlier panels—that care is a local issue. The best solutions are at 

a local level but it has to be standardized centrally and it has to 

be certainly funded and supported from a central area. And I think 

that’s what the ongoing transformation is today, particularly as 

DOD and VA are working closer together than they ever have in 

the past. Having said that, there’s still opportunity for continued 

coordination and cooperation. 

Senator ISAKSON. On that point you referred in your testimony 

to disability adjudication. That is, of course, of tremendous importance on issues like concurrent procedure. What the military ends 

up deciding as the adjudication of a disability has a tremendous 

impact on that veteran’s life in the future. How fast or how—fast 

is not the right word. How timely is that adjudication taking place? 

Dr. KILPATRICK. Well, I think right now today that adjudication 

is taking too long. I think we’ve heard that from servicemembers. 

We’ve heard that from veterans. The whole claims process within 

the VA is a very time-consuming issue. I think that people are 

looking at re-engineering, if you will, or transforming that process 

at the VA and DOD levels. At the very top level they’re looking at 

how to start with a clean sheet of paper. What is in the best interest of the individual to make that determination. 

General Schoomaker said many of our severely injured men and 

women in uniform want to stay in uniform and we’ve made a commitment that if they’re able to get back and perform in a job skill 

set that’s required by the Department of Defense, they will be allowed to stay in uniform. And so we don’t want to rush prematurely to say you have a severe injury and you’re no longer part 

of the Department of Defense. So timing, I think, is a critical issue 

on that. But I think for people to know and understand what their 

options are, because it is an all-volunteer force and I think that if 

they are continuing to want to volunteer to stay, they need to know 

what the options are if they don’t. I think that’s what we heard 

from the two soldiers earlier; that they didn’t know and they 

couldn’t find somebody who knew. That’s a process that we need 

to make simpler and we need to streamline and we need to make 

it logical and seamless. 

Senator ISAKSON. And am I not correct that one of the difficulties 

in that assessment, again, are injuries, particularly relevant to 

what’s going on in Iraq, in terms of Traumatic Brain Injury or 

mental affects? PTSD, I guess, too, in its entirety. You could actually adjudicate a disability that’s physical and years later have another disability that’s mental crop up; is that not correct? 

Dr. KILPATRICK. That’s absolutely correct. And if you adjudicate 

something today and somebody recovers later on, do we start to reverse issues? And I think those are some of the real problems in 

trying to get it right and not necessarily get it fast. So there has 

to be the right amount of time taken. 

I think that as it occurred before, trying to associate illnesses 20- 

30-50 years from now to military service is always going to be difVerDate Nov 24 2008 17:34 Jun 22, 2009 Jkt 000000 PO 00000 Frm 00041 Fmt 6633 Sfmt 6601 H:\DOCS\082807.TXT SVETS PsN: PAULIN
38 

ficult. Medical science is not always able to help somebody. Why 

you have that cancer or why you have diabetes, and to say that 

there’s a point source or a point exposure that caused that, medical 

science is not able to do that for servicemembers. And I think that’s 

one of the concerns of so many men and women in uniform—will 

the VA be there for that problem that I have later on in life that 

I believe is due to my military service. And that’s a hard issue in 

that for the disability problem. It becomes very difficult. 

Senator ISAKSON. Those are the tough calls, but those are tough 

calls in workers’ compensation in the private sector, too, what actually is the cause of the problem. But I want to thank you for your 

attention and I appreciate you mentioning that. Although that 

wasn’t necessarily a subject of this hearing, it’s one of the things 

I hear the most about out there from the constituents that I serve. 

Thanks to both of you for your testimony. Before you get up I 

want to close the hearing, so you all just stay put and then we can 

all get up together. 

I want to thank any number of people. I want to first of all thank 

this facility for all their accommodation. They’ve been fantastic. I 

want to thank Congressman Doug Barnard for his friendship and 

for his advocacy on behalf of Augusta-Richmond County and in particular our wounded warriors. He’s done a fantastic job and it’s 

greatly appreciated. 

For those of you in the military—General Schoomaker, I think 

you’d like to know what kind of a community you’re in. This is a 

little brochure that is supplied by the American Pride Through 

Education Incorporated Act. This is a group of local citizens that 

take the month of November to teach our kids about pride in America and about our Armed Services and about the great legacy that 

our country has. Jane Alexander’s here today and she has supplied 

me with a sample of each one of those for you all when you leave. 

But thanks very much to the VA. Thanks to DOD. Thanks to the 

people of Augusta and our distinguished elected officials that are 

here. And as I began, I’d like to, again, say thanks to the most important people of all here today and that’s the men and women who 

serve or have served the United States of America in harm’s way. 

This is a great country that has been blessed by God, and because 

of all of you we’re allowed to assemble freely today in peace. God 

bless you. 

[Applause.] 

[Hearing concludes at 11:30 a.m.] 

(39) 

A P P E N D I X 

OFFICE OF THE MAYOR, 

Augusta, GA, August 23, 2007. 

Hon. JOHNNY ISAKSON, 

U.S. Senator from Georgia, 

Committee on Veterans’ Affairs, 

U.S. Senate, Washington, DC. 

SENATOR ISAKSON and other distinguished Members of the Committee: Welcome 

to the city of Augusta. While our community is well-known one week a year for the 

world’s most prestigious golf tournament, year-round we are committed and dedicated to serving our Nation’s men and women in uniform. 

Augusta is home to a well-kept secret, though by your presence here today, I suspect it will be a secret no more. Since 2005, Augusta’s Uptown VA Medical Center 

has been home to the Nation’s only Active Duty Rehabilitation Unit within a VA 

facility. This collaboration between the Department of Defense and the VA is not 

only unique because it is the only one of its kind. It is also unique because it alone 

is poised to take on more missions to better serve America’s wounded warriors. 

To date, more than 421 wounded warriors have been treated at the ADRU, with 

26 percent of them returning to Active Duty. The ADRU is not just a place where 

wounded troops come for healing. It is also a place where they come to be returned 

to their full capacities as productive members of our society. The facility was constructed with 60 beds for in-patient care, and 30 of those beds are currently staffed 

and funded. Our community stands at the ready to see the other 30 beds fully funded so that we might extend the gold standard of care to more wounded warriors who 

so richly deserve the best. 

Should Tiger Woods get hurt and require rehabilitation, he’d find no finer medical 

care than is offered here at the Uptown VA ADRU. The success stories are numerous, but one recent example is worth citing. 

Specialist Crystal Davis lost her leg in an IED blast in Ramadi Iraq in 2005. She 

was sent to Walter Reed AMC, and underwent dozens of surgeries. After her surgeries, she underwent physical therapy there. She noticed something when she came 

home for visits to her family in Camden, South Carolina. She noticed she would get 

better. When she went back to Walter Reed for care, she was disappointed to only 

receive one PT appointment a day. She reported there were delays for her getting 

the care she needed to learn to walk on her prosthetic. She was transferred to Augusta and the ADRU, and within 3 weeks was off her walker and on her prosthetic 

full time. She credits the ADRU, the level of care she received as an in-patient here, 

and being close to family as major factors in her recovery. 

Spc. Davis is not the only success story from the ADRU, but her example shows 

how much better our wounded warriors heal when they are close to home. Also of 

importance is the fact that 70% of the returning troops from OEF and OIF are from 

the southeastern United States. We owe it to our wounded warriors to help them 

heal as close to home as we can get them. We respectfully submit Augusta, Georgia, 

is centrally located to help them do just that. 

Augusta is also home to Fort Gordon and the Dwight D. Eisenhower Army Medical Center, the Army’s southeast medical command. The DDEAMC is the number 

two recipient of evacuees from the war, second only to Walter Reed. Medical College 

of Georgia residents currently do psychiatric rounds at both Eisenhower and the VA. 

With the existing collaborative efforts between the Medical College of Georgia and 

both Eisenhower and the VA medical facilities, Augusta stands uniquely qualified 

and equipped with the resources necessary to provide the physical, emotional, and 

mental needs of wounded warriors. 

In addition, Augusta has 4 major medical facilities (University, MCG, Doctors 

Hospital and Trinity Hospital) within 11 miles of Eisenhower and both VA facilities. 

40 

Walton Rehabilitation Hospital also specializes in returning TBI (traumatic brain 

injured) patients to as normal a life as possible. Walton Rehabilitation Hospital is 

also the recipient of numerous HUD grants providing low-cost housing for those who 

are becoming independent after brain injuries, something now known as the ‘‘signature injury’’ in the conflicts in Iraq and Afghanistan. 

Also, as you may know, Augusta was recently named the number one affordable 

housing market in the Nation. The low cost of housing, the Fisher House on Fort 

Gordon (housing for seven families), and the strong employment market in Augusta 

all combine to offer wounded warriors and their families not just a place to heal, 

but a place to live and thrive while they heal. 

Augusta, Georgia stands at the ready to answer the Nation’s call to better serve 

the wounded warrior. We are currently collaborating in a community-wide effort 

known as the Wounded Warrior Care Project, lead by The Honorable Doug Barnard 

and others to expand Augusta’s capacities to care for the wounded warrior, while 

mindful of the importance of transportation, housing, and vocational training, in addition to the physical and emotional aspects of healing wounded warriors. 

Sincerely, 

DEKE COPENHAVER, 

Mayor. 

PREPARED STATEMENT OF WOUNDED WARRIORS AND THE MEDICAL COLLEGE OF

GEORGIA PRESIDENT DANIEL W. RAHN’S COMMENTS ON HOW THE STATE’S HEALTH

SCIENCES UNIVERSITY CAN ENHANCE CARE FOR THE NATION’S ARMED FORCES

The Medical College of Georgia is one of more than 100 academic health centers 

nationwide. Academic health centers stand at the forefront of patient care, biomedical research, and health professions education and are thus uniquely equipped 

to serve as leaders of change—both identifying and implementing solutions to the 

Nation’s most vexing health care challenges. 

In its recently approved Public Policy Agenda, the Association for Academic 

Health Centers noted that ‘‘perhaps more than ever before, academic health centers 

collectively must take center stage and be promoted with ideas that energize and 

convince all stakeholders to pursue an agenda that merges academic health center 

goals with those of the Nation.’’ Care for our Nation’s wounded warriors provides 

one such opportunity. 

While the United States Department of Defense and Department of Veterans Affairs bear primary responsibility for the care of active duty military personnel and 

veterans, the complexity and volume of care needed, particularly during wartime, 

necessitates leveraging all available resources, including the health care services 

available in the civilian health care sector. 

The environment for health care policy in this country is deeply rooted in the national history of the United States and our core values of entrepreneurialism, rugged individualism, and self-reliance. Innovation, productivity through competition, 

individual opportunity these are all national strengths borne out of our history. We 

must work together to ensure that the weaknesses that may be associated with 

those strengths—such as partisanship, decentralization, diffused, segmented, and 

diluted authority—don’t stand in the way of creating a true system of care for the 

men and women injured while serving our country. 

MCG currently has strong affiliations with Eisenhower Army Medical Center and 

the Veterans Affair Medical Center located in Augusta. These could be further leveraged to improve support to our Nation’s wounded warriors. For example, the MCGVAMC Psychology Consortium is one of only 20 federally funded psychology programs in the Nation. The MCG-VAMC has an enduring track record of producing 

psychologists who pursue careers that are directed toward integrated approaches to 

health care. Expansion of this training program and utilization of these graduates 

could help to ensure high quality and highly integrated care throughout patients’ 

journeys to recovery. Additionally, MCG’s departments of neurology, neurosurgery, 

and psychiatry and health behavior bring significant clinical resources to the table— 

expertise and infrastructure that could be accessed to fill gaps in the existing system of care for America’s wounded warriors, particularly as it related to posttraumatic stress and Traumatic Brain Injuries. 

The July 2007 Report of the President’s Commission on Care for America’s Returning Wounded Warriors contains six recommendations that ‘‘will produce a patient-centered system that fosters high-quality care, increases access to needed care 

and programs, promotes efficiency, supports families, and facilitates the work of the 

thousands of dedicated individuals who provide a gamut of health care and disability programs to injured servicemembers and veterans.’’ The perspective I share 

41 

in this document with the U.S. Senate Committee on Veterans’ Affairs is viewed 

through the lens of patient- and family-centered care—an area for which the Medical College of Georgia and the MCG Health System have been lauded nationally. 

We know very well the power of involving families in the treatment and recovery 

of patients and would be honored to assist in a regional and cross-sector approach 

to care for wounded warriors returning to their homes in Georgia and across the 

southeast. 

MCG also strongly supports the commission’s recommendation regarding the development of comprehensive patient- and family-centered recovery plans. As noted 

in the commission’s report, recovery plans should smoothly and seamlessly guide 

and support servicemembers through medical care, rehabilitation, and disability 

programs. Recovery coordinators would drive the implementation of these plans. 

Educational preparation, recruitment, and retention of appropriately qualified individuals to serve as coordinators will be critical to the successful implementation of 

this recommendation. 

MCG’s various health professions schools would be honored to take a leadership 

role in the educational preparation of recovery coordinators. For example, MCG recently launched a new graduate nursing program for the education and training of 

Clinical Nurse Leaders. The 10th such program developed in the Nation, MCG’s 

CNL program prepares nurses to be clinical leaders who can thrive in the current 

health care system while improving patient outcomes and reducing costs. We are 

committed to preparing leaders who facilitate and assure individualized, evidencebased, and highly effective care to patients and families. I encourage this committee 

to consider the role these highly trained clinical leaders could play in ensuring continuity of care through the implementation and long-term oversight of recovery 

plans for wounded warriors. 

My intent in this testimony is not to provide a laundry list of MCG educational, 

clinical, and research strengths—for they are many—but to emphasize the importance of innovative thinking, cross-sector collaboration, and bold approaches to care. 

MCG does indeed possess significant strength and resources that could be leveraged 

as the Federal Government works to implement the recommendations outlined in 

the commission’s final report. We would very much like to be included in a consortium that inventories regional resources and works to connect them to effect better 

health outcomes for wounded warriors and better support for their families. 

Thank you for the opportunity to provide input into your deliberations. I applaud 

the good work of the President’s commission. The recommendations put forth in the 

final report, if appropriately operationalized, will significantly enhance the quality 

of care provided to America’s wounded warriors. Please know that the Medical College of Georgia is prepared to stand shoulder to shoulder with our Federal partners 

to serve those injured in the line of duty, support their recovery, and simplify the 

complex systems through which they access their care. 

Æ