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Documents show Army's disservice to broken soldiers

By Carl Prine

PITTSBURGH TRIBUNE-REVIEW

Sunday, February 6, 2011

20-year servicewoman, disabled by war, faces ruin

By Carl Prine



Medical units pay price of lowered recruiting standards, reports say

By Carl Prine



Program for departing service members plagued by inconsistencies, indifference

By Carl Prine



Army's mental health programs swamped, understaffed

By Carl Prine


Monday, February 7, 2011

Transition staff for military wounded poorly trained, stigmatized, fatigued

By Carl Prine



Lieutenant colonel finds success treating 'soldier as a person'

By Carl Prine


Tuesday, February 8, 2011

(412) 320-7826 Carl Prine

Documents show Army's disservice to broken soldiers

By Carl Prine



WASHINGTON The Army's special medical units should be healing more than 9,300 soldiers entrusted to their care.

But a nine-month probe by the Tribune-Review found America's sick and injured soldiers must struggle to mend inside 38 Warrior Transition units the Army has turned into dumping grounds for criminals, malingerers and dope addicts.

Originally designed to treat the wounded from twin wars in Iraq and Afghanistan, after nearly a decade of battle these barracks snag soldiers in red tape. Despite an epidemic of post-traumatic stress disorder, depression, brain injuries and substance abuse linked to repeated combat deployments, soldiers sometimes spend years desperately seeking psychological care.

Overlooked, over-medicated and overseen by a stressed staff, the hardest hit often are in the Army National Guard and Reserves.

Picked by President Obama's administration in early 2009 to alleviate suffering in the units, former Deputy Undersecretary of Defense Noel Koch said his tenure ended abruptly in April when he and his investigators at the Pentagon's Office of Wounded Warrior Care and Transition Policy were in the midst of a nationwide investigation similar to the Trib probe.

After compiling reams of audits, reports and interviews with commanders, hospital personnel and patients nationwide and in Europe documenting these problems, Koch said he was given the choice of resigning or being fired by his boss, Under Secretary of Defense for Personnel and Readiness Clifford L. Stanley.

Koch says he quit.

"They're trying to fight two wars at the same time, and everything is breaking down," said Koch, a Vietnam veteran and high-ranking official in President Ronald Reagan's administration. "The Secretary of Defense, Robert Gates, is a good man. He has a Pentagon to run and two wars to fight, so he pushed this down to the services to handle. But they need help."

In his 11 months on the job, Koch said he tried to meet with Gates but was rebuffed. He said Stanley, a former Marine Corps. general, also declined weekly briefings until that fateful staff meeting in early 2010.

After delivering his report, Koch said Stanley uttered a single word, "Wow," and then gave him a cryptic warning: "He did not address me by name, but he did look directly at me and said the following: 'It is important to be careful what is put in written reports. These can affect people's careers.' "

Gates, Stanley and other Pentagon leaders declined to comment.

When the Trib filed a request to view these reports under the Freedom of Information Act, Stanley's department heavily redacted the released versions, citing secrecy and security needs typically reserved for classified military plans.

Concerned that the Pentagon was covering up shoddy treatment of soldiers, insiders then passed unredacted files to the Trib. They soon were joined by Army employees nationwide who exposed problems at their bases.

In a written response, the Army's former commander of the Warrior Transition program said he couldn't "understand Mr. Koch's perseverating" on the program.

"Unfortunately, I'm not sure Mr. Koch has ever fully understood the consequences of 10 years of warfare and the challenges of deploying brigades with a year or less at home station between deployments," wrote Maj. Gen. Gary Cheek in October.

Most of the Army's top medical commanders refused to speak to the Trib for months. On the eve of publishing these articles, the Army's Inspector General released a report echoing the findings both of Koch's investigators and the Trib.

More Walter Reeds

The Office of Wounded Warrior Care and Transition Policy doesn't direct day-to-day operations of the Army's special medical units. Instead, the Pentagon agency identifies problems plaguing them and tries to find policy solutions.

Although ongoing challenges bedevil the Air Force, Marine Corps and Navy, inspectors found the most chronic problems dog the Army, America's largest service and the one that's doing the most fighting overseas.

The top concern: The Army seems unable to trim the ranks of patients filling the Warrior Transition units a never-ending flood of broken soldiers that too often buried the special medical units, demoralizing patients and military staffers, according to the files.

These problems aren't new. In early 2007, stories by The Washington Post and other news outlets alleged shoddy treatment of the wounded at the Army's Walter Reed hospital in Washington. Reeling from the scandal, the Army invoked a new mantra "No more Walter Reeds." The "medical holds" housing most of the sick and injured were scrapped and merged with special segregated units for the wounded that had been carved out of the system in 2004, according to Koch and Army studies.

An Army order to send all ailing soldiers to the new Warrior Transition units un-leashed a flood of 10,000 patients who previously hadn't been identified as "nondeployable," a wave that overwhelmed the medical barracks and from which they're still recovering, according to the Pentagon reports and unit commanders.

At Kentucky's Fort Campbell, home of the 101st Airborne Division, the 67 soldiers in the "medhold" in 2007 soon were joined by nearly 400 patients, according to Army Col. Mike Heimall, a commander who has drawn praise for compassionate care there and at Fort Riley in Kansas.

The Army brass issued "Frago 3" in 2008 to dam the flood of broken soldiers by erecting barriers to entering the new Warrior Transition units. Individualized medical diagnoses called "profiles" limiting their military duties for more than six months are now required. The underlying conditions must be "complex" and require extensive clinical case management by trained nurses, who are supposed to oversee the care of about 25 soldiers each, according to the Pentagon reports and Army files.

The Army credits Frago 3 with finally halving the number of Warrior Transition patients since the unexpected deluge. But it never fully blocked the tide of ailing personnel, according to internal reports. Despite dwindling combat in Iraq, the nationwide Warrior Transition population stays at more than 9,000 soldiers. An equal number who might qualify for the special program are in their original units, according to Army leaders.

"There are a lot of things wrong with the (units). We have our concerns with the growth of them and how we manage them because they're kind of taking on a life of themselves. I think it's going to require a more direct supervisory approach," said Thomas R. Lamont, a retired Illinois National Guard colonel who serves as the Army's assistant secretary for Manpower and Reserve Affairs.

Weeding out

By mid-2010, the reports estimated 10,000 soldiers had sought Temporary Disability Retirement for catastrophic ailments a rising trend that was going to make the population "the most ever." The reason the Army is reeling instead of healing is because of the Army's own policies, according to Koch's fact-finders. The Pentagon files indicate that commanders circumvent Frago 3's regulations and hurt the health of all Warrior Transition patients by dumping on the medical units soldiers they don't want to take overseas everyone from cancer cases and GIs hurt in accidents to trouble makers, dope addicts, potential suicides and malingerers.

While often presented to America as special wards for the wounded, only 11 percent of the soldiers in the medical units have Purple Hearts or fell ill in a war zone, according to the Pentagon files. They're outnumbered by the estimated 16 percent of the patient population that never deployed to combat and never will, but this tally varies by base.

A February 2010 report estimated that one-third of the 450 soldiers assigned to the Warrior Transition barracks at Washington state's Joint Base Lewis-McChord had never seen combat. They were "high risk soldiers who are not ready to deploy and may display high risk tendencies" such as drug addiction, suicide and criminal conduct, the report said.

Georgia's Fort Benning medical barracks also were "burdened with soldiers placed in there by commanders as an expedient means by which to rid their units of their 'undesirables' " an ongoing problem investigators concluded was occurring nationwide and that "deflected or defeated" other patients trying to heal.

The reports allege commanders nationwide knowingly turn the special units into convenient pre-deployment "dumping grounds." And the Pentagon team wasn't the only one uncovering the problem: The Department of Veterans Affairs in 2009 discovered brigades doing the same thing at Georgia's Fort Stewart, home of the Army's Third Infantry Division.

'Triad of Care'

Koch's investigators feared that packing too many soldiers into the Warrior Transition units would destroy what the Army calls its "Triad of Care" a "cadre" of staffers who oversee patients in the barracks; nurse case managers who coordinate treatment; and primary care providers, who usually are nurse practitioners and physicians assistants.

The post-Walter Reed reforms in 2007 raised the cadre by quickly drawing often involuntarily hundreds of staffers from all the Army's branches, even combat units. These soldiers often lacked experience in medicine, especially caring for soldiers showing signs of substance abuse, brain injury, suicidal thoughts and other problems increasingly prevalent in the service, according to the Pentagon reports and medical commanders interviewed by the Trib.

Koch and his investigators say they are worried that high caseloads from the 2007 flood, along with ongoing "surges" of soldiers shed as units near deployment dates, continue to overwhelm nurses, primary caregivers and an overworked and undertrained cadre nationwide.

Fort Benning returns about half of its Warrior Transition soldiers to active duty. Nationwide, however, less than one in three patients remains in uniform. The rest re-enter civilian life too often unhealed after about a year, according to the Pentagon files.

The reports starkly lay out the crux of the problem: The Pentagon is letting the Army turn the Warrior Transition barracks into "dumping grounds" that are "set up to handle everybody," a policy that creates an "exponential misbalance" between veterans who should be there and personnel that commanders don't want on combat deployments. Army policies make it too "difficult to determine a reasonable line of demarcation when it comes to providing care, and what level of care," the reports contend.

To Koch, the growth of the Army's Warrior Transition system and the shape it continues to take "actually made 29 Walter Reeds" plus nine off-site units designed for National Guard and Army Reserve troops.

"What bothered me is that they just wanted to keep the profile as low as possible. They didn't want to focus on it at all," Koch said. "There were a lot of bureaucrats at the Pentagon who were just trying to make the services deal with it, to make the services, especially the Army, take the fall on this. That's the bottom line. They weren't interested in fixing it, but in handling it as a PR issue." Medical commanders told the Trib, however, that the distinction between a combat injury and a garrison malady is becoming increasingly blurred after nearly 10 years of war, especially because of rising mental illness diagnoses. More than one out of five patients in the special units suffers from post-traumatic stress disorder (PTSD) caused by combat or sexual trauma, according to the reports. At Fort Riley, home to the First Infantry Division, two out of every three soldiers in the Warrior Transition barracks have been diagnosed with mental issues such as PTSD or substance abuse ailments often after the soldiers underwent repeated combat deployments.

"OK, let's say I have a soldier who has done three tours. He comes home and his wife leaves him. He begins to have financial difficulties. The stress retriggers PTSD symptoms. Now, you tell me: Which came first, the chicken or the egg?" said Lt. Col. Andrew Price, the commander of the Fort Riley unit.

'A huge step ahead'

When a Trib reporter directly asked Army Surgeon General Lt. Gen. Eric B. Schoomaker about the problems the Pentagon team uncovered, the three-star general tasked with overseeing the Warrior Transition units walked away. Neither he nor his staff has answered written questions they requested from the Trib in October.

Schoomaker's four-star boss outgoing Chief of Staff of the Army George Casey told the Trib he's glad the Pentagon went out "inspecting and finding things that we can do better" so his commanders could start "moving it to another level." He nevertheless disputes the charge that Warrior Transition units are "dumping grounds" worse than the wards they replaced.

"Believe me, the WTUs are a huge step ahead of the medical hold detachments," said Casey, who believes that the end of war in Iraq and Afghanistan eventually will allow the Army a chance to "reset" and heal.

Troops nationwide interviewed by the Trib, however, said patients who need more time to mend or who want second diagnoses to ensure adequate retirement benefits often are tagged in Casey's Army as "malingerers" or ungrateful "garrison wreckage."

Koch heard their complaints, too.

"I think the time has come for Congress to look harder into what has been going on with our wounded warriors. We've deserted them before," Koch said. "We did this during Vietnam. We don't need to repeat that history."

Read more: Documents show Army's disservice to broken soldiers - Pittsburgh Tribune-Review http://www.pittsburghlive.com/x/pittsburghtrib/news/s_721598.html#ixzz1DYjqIeQ9

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20-year servicewoman, disabled by war, faces ruin

By Carl Prine



PORTLAND, Ore. Aggravating a combat training injury, Sgt. 1st Class Diana Clark's back and neck gave out in Iraq in 2006. The soldier's heavy armor slowly tore apart discs and muscles, just as the images of Mosul's dead swaddled in linen wore down her mind.

But she didn't return from war until an automobile accident sent her husband into a fatal coma. With his income now gone and her injuries barring a return to her civilian boilermaker job, Clark is stuck with a house she can't afford to fix or sell in a collapsed market.

"Over three months, my life turned upside down and I couldn't turn it right side up," said Clark, 55, who also worked at a strip mine when she wasn't doing duty in the Navy, Army Reserves and National Guard.

Her kitchen's electrical wiring is shot, so she heats dinner noodles in the flickering light of a piano lamp. During the day, the "weekend warrior" with nearly two decades of military service counts spare parts in an armory tool room.

Clark has been in the Army's Warrior Transition program for 3 1/2 years, first at Joint Base Lewis-McChord south of Seattle, then at her Oregon home, part of a special initiative for Reservists and National Guard troops called the "Community Based Warrior Transition Unit."

That has meant taking orders from both a hospital two hours north by car and a "cadre" office more than 500 miles south in Sacramento, Calif. She thinks that's led to a lack of compassion and deaf ears turned to her calls for help.

"Rarely do you ever see any of them. They're voices on a phone, words in an e-mail," Clark said. "If you're physically broken, that doesn't mean that you're morally broken. They talk to you like you're deficient, like you're defective. But I'm not defective! I'm just hurting."

Citing health privacy concerns, Joint Base Lewis-McChord officials declined to comment about Clark's case.

Warrior inaction

A military historical archivist by training, Clark says she's "barely treading water" financially, and after her discharge she will drown. Although she draws active duty pay about $48,000 annually she says that's a third less than her civilian income. Her military pay will be cut another third when she leaves the service and must subsist on retirement income.

Clark says almost all of what's left then will be gobbled by mortgage payments, residential taxes and utilities, leaving her with no way to find the $50,000 that workmen say she needs to bring the house up to code for sale. After four surgeries, she says she can't muster the physical endurance to fix the house herself.

A federal Housing Assistance Program mortgage buy-out program meant for broken soldiers like her could stave off bankruptcy, foreclosure or homelessness, Clark says, but Army officers have balked at approving her application.

She's been asking for help since March 31, according to Army documents obtained by the Tribune-Review. The paperwork shows that she wasn't just trying to save her home, but also to get pain relief and physical therapy she needed to heal.

Commanders took no action until the Trib contacted them Dec. 13, the records indicate. A conference call the following day between Clark and officials in Sacramento and Lewis-McChord finally delivered the medical care she needed but no help with the house.

Files show commanders balked at setting a precedent by declaring that she's injured enough to qualify for the housing program at least until after Veterans Affairs can complete her benefits package. They don't know if they can move her to a cheaper town if she ends up in bankruptcy or foreclosure.

Clark says the Social Security Administration determined she's permanently disabled by her war injuries, but the other agencies aren't obligated to listen.

"Failing to help me now is pushing me into a choiceless choice. Unless someone in Washington, D.C., helps, I lose my house," Clark said. "The new commander here is really trying to help. He cares. He really cares, but I'm facing ruin."

Turnover issues

Overseen by former Deputy Undersecretary of Defense Noel Koch, investigators at the Pentagon's Office of Wounded Warrior Care and Transition Policy wrote in early 2010 that Guardsmen and Reservists like Clark too often risked "falling through the cracks" nationwide, according to files provided to the Trib.

At Georgia's Fort Stewart, the investigators wrote that "extremely limited" services were provided for demobilizing Reservist and National Guard units.

The Army couldn't even count how many Reservists had been processed through the hospital at Georgia's Fort Benning, the reports state. The papers stated that the base lacked enough primary case managers to treat patients, and that soldiers often received incomplete medical records and had to spend "their own money to come in for medical appointments."

Jay Ebbeson, a spokesman for Joint Base Lewis-McChord's Madigan Hospital, said in a written statement that Clark's installation was acting on recommendations from a similar Army investigation into the treatment of Oregon National Guardsmen.

Redeploying soldiers now receive thorough medical reviews, and Western Regional Medical Commander Army Maj. Gen. Philip Volpe is making other changes, Ebbeson said.

In the Pentagon files, investigators estimated that 500 National Guard and Reserve soldiers administered through Madigan Hospital had no nurse case managers. Nurse case managers are key to the Wounded Transition program because they ensure continuously good medical and psychological care for patients.

Ebbeson said that the soldiers didn't have ailments so complex that they merited entry into the program. He said they were afforded all the care they needed and that Madigan recently added six special case managers to help them. He said the Warrior Transition unit has "a good history of keeping nurse case managers" and the Sacramento office had a senior case manager with 12 nurses under her, a number that's consistent with Army standards.

The Pentagon files, however, report that Madigan's nurse case managers and Veterans Affairs liaisons complained of "high turnover" and a "lack of consistency amongst medical providers." Similar problems were found at other bases nationwide.

On Tuesday, Clark said that she was going to receive her eighth nurse case manager since entering the program in 2007.

"I called it the 'Madigan merry-go-round.' You would go around and around, and you never got any better," she said.

Read more: 20-year servicewoman, disabled by war, faces ruin - Pittsburgh Tribune-Review http://www.pittsburghlive.com/x/pittsburghtrib/news/s_721599.html#ixzz1DYzpfF7p

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Medical units pay price of lowered recruiting standards, reports say

By Carl Prine



WASHINGTON Special Army medical units designed to heal wounded heroes today brim with criminals, drug addicts, malingerers and mentally and physically broken soldiers who brought their ailments to boot camp, according to internal Pentagon reports obtained by the Tribune-Review.

Compiled in 2009 and 2010 by the Pentagons Office of Wounded Warrior Care and Transition Policy in Alexandria, Va., the reports allege that the Army's 38 Warrior Transition units are clogged with soldiers who wouldn't have entered service had the Army not lowered recruiting standards during the wars in Iraq and Afghanistan.

The reports allege that slumping morale of combat soldiers in the special medical units had become "exponential," partly due to malingering malcontents and "barracks lawyers" who "game the system" by "camping for years" there to the point they eventually outnumber those hurt overseas.

"A lot of them are people who never should have been recruited in the first place," said former Deputy Undersecretary of Defense Noel Koch, who sent investigators out to canvass Warrior Transition units nationwide and in Europe. "There seems to be some willful blindness by some in the military, for careerism or whatever other reason, for not making the connection."

The White House's choice to fix the Department of Defense's special medical units, Koch said he was forced to resign last April after he brought these and other findings to Pentagon officials.

Officials declined to comment.

Koch's concerns cut to the heart of a debate about the all-volunteer force that has sustained the Army throughout the wars in Afghanistan and Iraq. To meet manpower goals, Koch suspects the Pentagon began cutting corners in 2004, when the insurgency in Iraq exploded and the Army was hit with a chronic recruiting slump.

Back then, the Army lowered recruiting standards and granted increasingly higher numbers of "moral" and medical waivers to enlistees who admitted drug abuse, criminality or health problems conditions that formerly disqualified them from service.

In 2004, about 12 percent of recruits entering the Army were granted these special medical and legal waivers. By 2008, however, the number of waivers had more than doubled to nearly 26 percent, according to Army records.

In 2009, the Army drastically slashed the number of "moral" waivers, but still sent 18,000 recruits about one out of every four enlistees to boot camp with pre-existing medical problems, according to a recent report by the Army's Division of Preventive Medicine.

More than half of all recruits requesting waivers for hypertension, alcohol and cocaine abuse, personality disorders, head injuries, seizures, valvular heart disease, glaucoma and most other ailments successfully entered the Army. Overall, about 65 percent of all recruits seeking medical waivers between 2004 and 2010 were granted entry into the Army; 8,200 of these soldiers later were treated for neurotic or personality disorders, psychosis or substance addiction, according to the study.

Koch says he is convinced many of those soldiers who came in on special waivers to meet manpower goals ended up in the Army's Warrior Transition units. But that problem was compounded by soldiers going to boot camp with conditions that never were detected by Army medical screeners and recruiters.

In late 2009, Koch's team learned that nearly a third of those receiving medical discharges at Georgia's Fort Benning were recruits who couldn't make it out of boot camp.

Many recruits had "stopped taking medication to meet recruiting standards" and a "significant number" of the patients in the Army's Warrior Transition units were freighted with "pre-existing behavioral health or chronic health issues ... not reported during recruitment process," according to the internal reports.

When the Trib brought these findings to Lt. Gen. Thomas P. Bostick, the three-star general who oversaw Army recruiting between late 2005 and 2009, he said he was unaware of reports linking recruits with pre-existing conditions to the bloated medical barracks.

While Bostick defended his recruiters by saying federal privacy laws gagged them from grilling enlistees about potentially disqualifying mental health problems, he nevertheless insisted that recruiters "have the ability and the background and the experience to determine what's going on."

While it's easy for the Pentagon to count soldiers with pre-existing conditions getting discharged for the maladies years later, analysts have difficulty estimating the number of "malingerers" faking or exaggerating their conditions to shirk duty or gain Army and Department of Veterans Affairs benefits.

The Army takes malingering seriously. Feigning ailments or self-inflicting wounds to avoid duty or garner benefits are felonies that could trigger prison sentences of up to 10 years under the military's Uniform Code of Military Justice.

At Fort Riley in Kansas, home to the First Infantry Division, cadre squad leaders at the base's Warrior Transition unit estimated three malingerers to every one legitimately sick or injured soldier, according to the internal reports. At Fort Benning, however, staffers put the number closer to 10 percent.

Anne Champney, a former civilian ombudsman hired by the Army's Medical Command to safeguard the rights of patients at Joint Base Lewis-McChord south of Seattle, said "very, very few" malingerers were found there over the past two years, maybe "only a couple of soldiers."

Read more: Medical units pay price of lowered recruiting standards, reports say - Pittsburgh Tribune-Review http://www.pittsburghlive.com/x/pittsburghtrib/news/s_721600.html#ixzz1DZ0YX0iV

Program for departing service members plagued by inconsistencies, indifference

By Carl Prine



WASHINGTON Launched during a time of peace to aid departing service members, the Transition Assistance Program is failing war veterans and their families, according to Pentagon reports obtained by the Tribune-Review.

Called "TAP," it began in 1989 as a federal pilot program run by the Department of Defense, Labor Department and the Department of Veterans Affairs. For most of the 140,000 troops who annually must take the course, it's three days of classes on topics ranging from the new GI Bill for college to special initiatives that help wounded personnel and their families.

Crisscrossing the U.S. and Europe, investigators from the Pentagons Office of Wounded Warrior Care and Transition Policy in Alexandria, Va., determined that TAP was plagued with "significant gaps in consistency of services" and "low" spousal participation, according to the files. The reports added that there was "little evidence" financial aid, relocation assistance or post-military education applications "are emphasized or provided" by TAP coordinators.

Reports state that TAP staffers often failed to help military spouses find off-base jobs and were "not well versed" in recovery care programs; TAP support for injured personnel and their families was "not readily apparent."

"It's an issue of selling it. We had a hard time getting people to understand the issues and what's available to them," said Noel Koch, the former Deputy Undersecretary of Defense who ordered the investigations before he resigned in April.

"Military commanders fought us on letting guys even go to the TAP briefings. It was a slog. We identified the problems and tried to find ways to overcome them. We weren't satisfied with the status quo."

Koch claims he was forced out after bringing problems about TAP and other programs to Pentagon officials, who declined to comment on the allegations.

The reports allege:

Instructors at Italy's Naval Air Station Signorella in late 2009 lacked the training and "established level of competency" to conduct counseling for personnel leaving the service.

Sailors at Florida's Naval Station Mayport slept through classes in late 2009 because they were forced to stand overnight watch, a problem of "mission win; Sailors lose." At naval bases in southern Europe, sailors were forced to pay their own way to attend briefings.

Military discharge counseling so bad at Naval Hospital Jacksonville in Florida that the "risks of violations of federal statute high."

A program at Camp Lejeune in North Carolina that exceeded classroom capacity for Marines, offered limited child care to spouses attending workshops and discharged reservists who weren't receiving the courses that they needed.

Questions about the program's ability to "maintain enduring connection with National Guard or Reserve Community questionable; extent of proactive engagement could not be determined."

Another key problem investigators identified was the services' inability to attract personnel and their spouses to TAP and Veterans Affairs briefings. U.S Army Garrison Vicenza Italy, for example, provided a mere 31 soldiers with federal employment and resume writing classes out of nearly 2,800 personnel stationed there, according to the reports.

Koch told the Trib the services often failed to tell today's generation of GIs about the program in the electronic media they use. He said David DuBois, a top aide at the Warrior Transition policy office, was working on reforms, but the Pentagon inexplicably removed him from that job in a bureaucratic reshuffle.

Pentagon officials declined to comment.

The Pentagon reports disclosed "unmanageable caseloads" for Veterans Affairs counselors at Air Force bases nationwide and widespread confusion triggered by the 2008 enactment of the GI Bill, especially for the VA in Europe.

When military personnel called the VAs toll-free numbers to get help, they found them "unpopular and unresponsive," according to the Pentagon reports.

VA leaders told the Trib that most of the GI Bill problems had been solved and they were revamping the hotlines.

In a written statement, Department of Labor spokesman Jesse Lawder agreed with Koch's assessment of TAP, saying that the "program is not providing those who have served and sacrificed for their country with the best tools the marketplace has to offer to enable them to realize their professional goals."

Lawder said that the department was scrutinizing bids to fix the agency's portion of TAP and reforming six major components of the initiative, including providing personal and online support and counseling for veterans after they take the TAP course.

Army's mental health programs swamped, understaffed

By Carl Prine



WASHINGTON -- Thousands of sick and wounded soldiers within the Army's Warrior Transition program aren't receiving psychological care they need and are being discharged into communities ill-prepared to help them.

A nine-month investigation by the Tribune-Review, buttressed by documents passed to the newspaper by soldiers and the Pentagon's Office of Wounded Warrior Care & Transition Policy in Alexandria, Va., reveal an Army reeling from an epidemic of mental and behavioral health problems after nearly a decade of constant combat overseas.

At Joint Base Lewis-McChord in Washington state, officials in April told investigators mental health cases skyrocketed 400 percent in recent years, according to files provided to the Trib.

A late 2009 report from New York's Fort Drum, home to the 10th Mountain Division, found "backed up" mental health clinics on and off base for soldiers suffering from depression and Post-Traumatic Stress Disorder (PTSD). Nationwide, more than one out of every five of the 9,300 Warrior Transition patients suffers from diagnosed PTSD, according to the files.

At Hawaii's Tripler Army Medical Center, officials in an early 2010 report estimated three out of every five Warrior Transition soldiers brought there suffered from "behavioral health issues." The hospital treated them for depression, anxiety and suicidal thoughts, but the files claimed the program "is not designed to be PTSD-specific."

The Pentagon documents reveal a chronic shortage of trained social workers, psychologists and other mental health professionals to diagnose and treat the suffering at bases nationwide. At the 25th Infantry Division's Schofield Barracks in Hawaii, for example, investigators determined there was only one Army mental health officer for every 265 cases. The military standard is one to 50, according to the report.

While Pentagon investigators visited the bases, the Army was coping with a series of tragedies linked to the service's mental health workers. A Nov. 5, 2009, rampage at the Armys Fort Hood in Texas left 13 soldiers dead and 30 wounded. Army psychiatrist Maj. Nidal Hasan is charged with the murders. Nine of the victims were Army therapists.

The massacre followed the May slayings of five soldiers at Baghdad's Camp Liberty by a soldier seeking psychological counseling there.

On Jan. 31, federal prosecutors in Kansas charged an Army-contracted therapist -- who was treating a Fort Riley sergeant grappling with PTSD and marital issues -- with stalking and sexually assaulting the patient before leading police on a high-speed chase after she strayed onto base. The therapist, Rachelle

Santiago, 43, worked at Irwin Army Community Hospital, base officials told the Trib.

Breaking point

None of these incidents comes as a shock to Dr. Stephen M. Stahl, a University of California-San Diego professor of psychiatry who led a team of clinicians teaching Army mental health workers at Fort Hood.

A study he authored in the December 2009 neuroscience journal "CNS Spectrums" pointed to an Army mental health system that's "understaffed, under tremendous pressure, and near the breaking point."

"But it's not something we can't fix," Stahl told the Trib. "It might take two years, but with the proper training and retraining, we can get a group of dedicated professionals who are already there, the nurses, to tackle the Army's mental health challenges."

Stahl's research indicated Fort Hood commanders and nurses had little confidence in Army mental health care. Staffers told him patients were overmedicated, especially with too many opiate-based pills, and that, when mixed with other drugs, often triggered the suicide attempts plaguing Army bases nationwide.

Stahl understood exactly what he was witnessing. He's the author of the most widely read textbook in the field of pharmaceutical and psychiatric research.

Like the Pentagon investigators, Stahl concluded Fort Hood suffered from chronic lack of mental health practitioners. He said only about 400 psychiatrists are in uniform or hired under contract to treat the more than 1.2 million active duty Army Reserve and National Guard soldiers. Although the Army has pledged to fill more than 1,000 vacancies for mental health workers, Stahl said "they're not getting the number of volunteers that they need."

Stahl learned soldiers were leaving base to seek the help of civilian doctors -- who often didn't know the medication already prescribed. He found an Army culture that continued to stigmatize mental illness despite nine years of combat and an active-duty force that has 17 percent of its personnel on anti-depressant medication.

Although Fort Hood's nurses believed PTSD to be a real disorder, Stahl's study concluded most cadre staffers overseeing wounded soldiers in the barracks thought patients were faking it.

Army officials declined to comment.

"No clear answer"

Similar concerns were voiced in reports from the Office of Wounded Warrior Care & Transition Policy. The Pentagon team agreed with commanders that some soldiers in the Warrior Transition units game the system to garner financial rewards by faking PTSD, but uncovered other serious problems nationwide.

Without naming bases, Pentagon reports revealed the Army located three Warrior Transition units near firing ranges. Patients "complained about having flashbacks or negative reactions when training occurs."

A 2009 report on the Warrior Transition unit at North Carolina's Fort Bragg found "no clear answer" for how it helped those diagnosed with Traumatic Brain Injury or related severe mental health problems "other than to say a Personal Digital Assistant (PDA) is provided" to help the memory-impaired get to appointments.

The Army reported problems at Fort Bragg were corrected, but declined further comment.

A 2009 report on New York's Fort Drum revealed combat soldiers often hurt their own mental health:

"Some soldiers have started memorizing answers" on parts of the Military Acute Concussion Evaluation in order "to stay in theatre" and fight, even though they realized they were defeating their chances of getting help later, according to the files.

That concerns Barbara Van Dahlen, a Washington clinical psychologist and founder of the "Give an Hour" nonprofit that so far recruited more than 5,000 mental health providers to donate treatment to America's military veterans.

"Local communities will bear the brunt of caring for these people long-term, not the military," said Van Dahlen.

Researchers estimate more than 400,000 active and former service members might suffer from PTSD, traumatic brain injuries and other illnesses tied to nearly a decade of war. Van Dahlen fears soldiers who aren't getting proper treatment in the Army will be thrust upon local caregivers, often in small communities, and many of them aren't trained specifically to aid combat vets.

That's why she's linking mental health workers to veterans before it gets worse.

"There's a public health crisis that's brewing," she said. "It's an entire generation of combat veterans, and we don't want to lose them."

Read more: Army's mental health programs swamped, understaffed - Pittsburgh Tribune-Review http://www.pittsburghlive.com/x/pittsburghtrib/news/s_721604.html#ixzz1DYjCJZkG

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Transition staff for military wounded poorly trained, stigmatized, fatigued

By Carl Prine



FAYETTEVILLE, N.C. -- On May 28, 2007, a bomb planted by an Iraqi insurgent along Route Canal in the village of Zaganiyah tore into Sgt Ken Katter's truck.

Blood dribbling from his ears and regaining consciousness, the Army cavalry scout dusted himself off and never left the front lines of America's Global War on Terror.

The 5-73rd Cavalry hung a Purple Heart on his chest, and Katter kept patrolling Diyalah Province's deadliest acres, despite mounting seizures, debilitating migraines, wrenching neck and back pain, and nerve tremors that quaked his arm, according to medical records provided to the Tribune-Review.

Once back at North Carolina's Fort Bragg, however, Katter's chain of command accused him of shirking his duty. Shuffled off to a Warrior Transition Battalion in the shadow of the base's Womack Army Medical Center, Katter was bedeviled for nearly three years by "cadre" staffers, soldiers without combat experience who were supposed to care for him.

For a man who honorably served in the Marine Corps and left to become a Michigan police officer before joining the Army after the Sept. 11, 2001, terror attacks, it was hard to understand.

"I didn't expect our own people to treat us like that. At least in Iraq, we knew who the enemies were," said Katter, 43, of Saginaw, Mich.

His cadre stole Christmas presents intended for the wounded, threatened him with criminal charges for lying about his fitness -- allegations later proven unfounded by a Fort Bragg investigation -- and tagged him with a crude nickname they scrawled on a duty board, according to Fort Bragg files, as well as interviews with Katter and nearly a dozen former combat veterans and local volunteers assigned to his Warrior Transition unit.

A highly decorated but permanently disabled soldier diagnosed with the signature wounds of the wars in Iraq and Afghanistan -- traumatic brain injury and post-traumatic stress disorder -- Katter was honorably discharged from the Warrior Transition unit in August.

He was given a 100 percent permanent disability rating by the Veterans Administration, according to his medical files.

Fort Bragg commanders insist that what Katter and other combat vets experienced will never happen again, as a result of ongoing changes from the top to fix the Warrior Transition unit there.

"This organization is truly all about leadership. Period," said Army Lt. Col. Tom Schumacher, 43, who took over the unit Nov. 3. "We have 626 warriors in transition. That's 626 missions we need to lead them through. The only way you can manage that is through leadership, with compassion."

Stigmatized duty

The majority of staffers recruited to care for wounded, injured and sick soldiers at the Army's 29 Warrior Transition units and nine special off-site programs for Reservists are decent, hard-working men and women, according to documents passed to the Trib by the Pentagon's Office of Wounded Warrior Care and Transition Policy in Alexandria, Va.

But the reports contend that they're also set up to fail: Cadre duty is a stigmatized chore that's detrimental to career advancement; the staffers often have been poorly trained and easily overwhelmed by the "high stress" and "complex" work and are "not able to meet the demands of the job." Some suffer from "compassion fatigue" with bad consequences for vulnerable soldiers entrusted to their care.

The Army could fix those problems by cutting back on "collateral duties" assigned to Warrior Transition staffers, who undergo the constant strain of dealing with high-risk soldiers likely to abuse drugs, cause trouble or commit suicide, records state.

At the Army's Schofield Barracks in Hawaii, for example, investigators found cadre routinely assigned collateral duties, such as manning a 24-hour office desk while still being expected to aid wounded soldiers, a practice that "divides their attention between two sets of responsibilities," according to the reports.

The files say that the cadre there "may need to be screened for their own possible PTSD and how to recognize symptoms of compassion fatigue." The reports allege that "cadre and caseworkers are overwhelmed. Caseloads too high." Commanders begged for more cadre to overcome staffing shortages exacerbated by having to drive long hours across Oahu to get patients to their medical appointments, according to the documents.

Military officials declined to tell the Trib if they got the extra help.

It was a theme the Pentagon investigators heard at other bases. The reports show that they were told at Fort Riley in Kansas that the Army's standard staffing ratio of one cadre soldier to every 10 patients should be nearly halved and that burn-out affected nearly the entire cadre after only two years of duty.

Files also show Army Brig. Gen. Jeff Mathis III, then-acting commander of Joint Base Lewis-McChord and "I" Corps in the state of Washington, telling investigators that a "great deal of pressure" affected the cadre there and they lacked a "sufficient replacement plan in place" to guide those following them.

In the report, the base's cadre to patient ratio was one to 14.

"If you look at it from the cadre's perspective, the question becomes, 'When does it end?' You're dealing with some bad people, maybe 20 who don't belong there. And you're trying to help those who are genuinely wounded and want to go back on the line, and you've got collateral duty. You have to be a strong person to put up with that, especially when there's no end in sight," said former Deputy Undersecretary of Defense Noel Koch.

Koch says he was forced to resign from the Pentagon in April after detailing Office of Wounded Warrior Care and Transition Policy investigative findings to his superiors.

Officials declined to comment.

'A nightmare'

Koch's investigators concluded that cadre staff nationwide were violating standing Army orders by scheduling garrison watch duties for recovering wounded. That practice deprived patients of sleep and often retriggered PTSD symptoms, they reported. The files disclosed a "recurring theme" of cadre forcing the wounded to "participate in physical training and meet height and weight standards despite portfolio showing medical conditions" barring the training.

After Iraqi insurgent bullets shredded his legs, cavalry scout Sgt. Dary Finck spent nine months in the Army's Walter Reed hospital in Washington before entering Fort Bragg's Warrior Transition unit. He told the Trib that despite both of his legs getting "shot out, the cadre still ordered me to come and watch everyone else PT."

"They didn't even show up to work all the time. Sometimes, they would take trips that were intended for the wounded warriors. They took their places. It was a nightmare," said Finck, today a pilot, plane mechanic and Christian missionary who lives north of Seattle.

Other veterans complained that Fort Bragg's cadre became convinced that even seriously wounded soldiers in the Warrior Transition Battalions were potential malingerers to be hounded.

"The medical care is the complete opposite of the care given to us by the cadre in the WTB," said Sgt. Andrew Harriman, one of the most decorated medics in the history of the 82nd Airborne Division and until late 2009 a Fort Bragg patient after a "friendly fire" blast from a Chinook helicopter two years earlier.

A recipient of the Silver Star medal for combat heroism in Iraq, Harriman saved Finck's life in Diyalah Province and then watched him, Katter and others in the 5-73 squadron get "terrible treatment in the WTB that took me longer to heal."

"The medical care was top-notch," Harriman said. "No expense seemed to be spared when it came to the treatments at the medical facilities. It was strictly the WTB and the cadre that were the issues."

Healing the healers

With his entire career spent in Army medicine, Fort Bragg Warrior Transition commander Schumacher says he's building on a tradition of healing to ensure that Harriman's complaints are never echoed by the soldiers under his care.

"This is a special mission unit," said Schumacher, a physician's assistant by training. "This isn't a job for everyone. I expect that the maturity level for the cadre remains high. Those who can't do that can either leave or increase their game."

Fort Bragg's leadership is backing his reforms. They're spending $90 million to build a barracks, and they've committed the base to recruiting more and better cadre volunteers. Fort Bragg's ratio of one cadre staffer to every seven patients is far below the Army average, and almost all have now attended a two-week training course in San Antonio mandated last year by the Pentagon, according to Schumacher.

Company commanders brief him on appointments soldiers miss. Last year, Fort Bragg's Warrior Transition patients averaged 180 missed medical appointments every month, often because their memory had been affected by head trauma tied to roadside bombs in Iraq and Afghanistan. But by late December that had been slashed by more than 90 percent, Schumacher said.

He's also tackling the cadre's "compassion fatigue."

"We need to take some of the negativity out of that," Schumacher said. "We recognize that good (noncommissioned officers) burn out. Sometimes, that can be corrected by letting them take some time off. But sometimes as leaders we need to take them out of the unit because that's the best thing we can do for them, too."

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Military wives take charge to ensure quality care for injured husbands

By Carl Prine



WASHINGTON -- Colleen Kenny Saffron of Castle Shannon married her artilleryman nearly two decades before an improvised explosive device detonated on his truck near Al Rasheed, Iraq. The May 5, 2004, blast killed two buddies next to him and carved off parts of his jaw, which doctors can't replace.

The muscles in Staff Sgt. Terry Saffron's arm unrolled like bark on a tree -- surgeons pared four inches of bone from it -- and he can't always remember where he is when he's left alone in the soup aisle of a grocery. The Veterans Administration rated the former Ambridge man 100 percent permanently disabled. He retired honorably from the Army in October.

Colleen, 39, who is legally deaf, quit doing freelance design work to care for him and raise their three children. During the six years when Terry, 39, was in the Army medical system -- the last year in Fort Hood's Warrior Transition unit -- she says she received no educational loans, extra financial help or special training about how to tend to her brain-injured husband as they edged toward his retirement.

"Everything I learned, I learned online. All the student loans I got, I got on my own to help the family when he transitioned. I received little help from Army. Individuals within the Army were wonderful, but as a system, a process, I got very little help," she said.

Figuring spouses of wounded soldiers also were having a tough time, she started the nonprofit Operation Life Transformed in 2007. It's now part of the Inova Health System's "Military to Medicine" outreach that trains spouses for health care vocations.

After her husband left the Army, however, Saffron has struggled to pay the mortgage and fix the dilapidated car that ferried them to numerous medical appointments.

"I've been to the White House twice, but I can't get a new car," she said. "Less than 1 percent of Americans will serve in these wars. Less than 1 percent of those who serve will be seriously wounded or injured. We're a small part of a big country, and you're telling me that we can't do something more?"

Fort Hood's Volunteer of the Year in 2008, Saffron said "the burden of these wars hasn't fallen on the Army or the Veterans Administration. It's really fallen on spouses and the family of the soldiers. You're putting us in a tough situation. You want us to work and support the family -- and we want to work -- but how can I work and leave my brain-injured husband to get to a doctor's appointment on his own?

"There's so much that we haven't figured out. This isn't a blame game. There are no bad guys, just problems for us to solve."

For better or worse

Since 2001, more than 300,000 military personnel have been diagnosed with brain injuries or Post Traumatic Stress Disorder or evacuated from Iraq and Afghanistan with wounds or nonhostile fire injuries, according to reports by the Department of Defense and Congressional Research Service.

About 70 percent of those ailments are tied to the Army, the largest of the services and the one that's done the most fighting overseas. And today's all-volunteer Army is married.

There's nothing unique about the Army's commissioned officers being hitched -- most of them have been married in every war since Korea; what's new is that three out of five of those in the enlisted ranks have wed, according to Army studies.

Compare that to the draft Army that fought in Korea in 1952 -- only about a third of the enlisted had a spouse at home.

With this new reality in mind, bipartisan Congressional efforts since 2007 have increased military pay, cut taxes for service members and their families, opened government jobs to spouses, lowered medical insurance costs for families of active-duty personnel and provided special training, counseling and respite aid for the spouses of soldiers with acute disabilities.

But some experts who study modern military families wonder if the help has gone far enough.

"The Army and the VA alike have failed to provide adequate support to soldiers and their families as they transition from active duty to civilian life," said Nancy Berglass, a senior fellow of the Center for a New American Security think-tank in Washington.

Her November study, "America's Duty: The Imperative of a New Approach to Warrior and Veteran Care," grapples with the full complexity of the problems.

It urges Congress, the Pentagon and Veterans Administration to help each other more often; work jointly to develop a "National Homecoming Plan" to ease the transition of military personnel and their families back into civilian life; and bring nonprofits inside bases to help -- reforms Berglass says have been blocked by government bureaucracies.

The VA told the Tribune-Review that they're working hard to begin new family-friendly initiatives, especially medical programs that cut red tape, speed discharges and quickly disperse benefits.

The Army declined to comment. It's difficult to gauge how widespread these problems are for Army families, especially those dealing with the Warrior Transition program.

The Army's "Warrior Transition Unit Program Satisfaction Survey" annually polls a small number of departing personnel, and officials use it to claim widespread support for the units. But a 2009 Government Accountability Office study faulted response rates "too low for the Army to reliably report satisfaction" of service members and their families.

The Army wouldn't tell the Trib if they had changed the survey methods.

Breaking the chain

Patti Gallion Katter, 36, says her family had a bad experience. Her husband, Ken, 43, returned from Iraq with extensive brain injuries, nerve damage and a long list of other ailments. He was honorably discharged in August with a 100 percent permanent disability from the VA.

When Patti isn't home schooling her three children, running an Army-Navy surplus store in Saginaw, Mich., and the nonprofit Christian Military Wives helpline, she's the primary caregiver to her husband. But she doesn't want wives like her to be seen as victims.

In fact, she wants all spouses to toughen up and take charge of their loved one's care, like she did when her husband was in Fort Bragg's special Warrior Transition program for 2 1/2 years.

Patti says she helped the Army find paperwork doctors lost twice and constantly toiled to get treatment for his head trauma and nerve damage. She had generals on speed-dial and ended up prodding the Pentagon to buy a bed designed to alleviate her husband's excruciating back pain.

"I'm not in the military. I don't have to abide by the chain of command. I can go up to the commanding officer and tell him what's wrong," she said. "The soldiers can't do that. They will get in trouble if they go straight to a general, but spouses should go around the chain of command if they're not getting help. That's what wives, especially the younger wives, need to learn so that they can help their husbands."

Patti recalled how "the commander kept telling me, 'You'll never be able to change the Army.' Well, I thought that I might not be able to change the whole Army, but I'm going to try to do everything in my power to do that."

Like Berglass of the Center for a New American Security, Patti recommends an "Adopt-a-Soldier" initiative that links charities, local families and churches near bases to Warrior Transition patients, advocating for their health care and easing their transition to civilian life.

She also calls on the Army to better include families in the healing process and to take seriously complaints about Warrior Transition staffers -- called "cadre" -- who are alleged to lack compassion for patients.

"For our family, one soldier was wounded -- but a family of five will never be the same," Patti said. "Just being nice to us helps."

Lieutenant colonel finds success treating 'soldier as a person'

By Carl Prine


Tuesday, February 8, 2011

FORT RILEY, KAN. -- It's 6:27 a.m. on a crisp Nov. 19, and the first soldiers in Company A, Warrior Transition Battalion have limped into the cavernous airplane hangar Fort Riley has turned into a gym.

Some stumble on crutches. Others lean against buddies as they shuffle into their morning formation. Squad leaders scoot across the floor like waterbugs in green shorts and their ubiquitous Army yellow reflective belts, waiting for a mountain of a man who will call them to "Attention!"

He's Lt. Col. Andy Price, 48, a Hoosier transplant the Army has put in charge of more than 300 sick, injured and wounded soldiers drawn from a First Infantry Division that has been fighting hard in Iraq and Afghanistan.

"No one wanted the job, and I was too dumb to say 'no,' " said Price, who served in Desert Storm in 1991 and Afghanistan in 2006.

Price is poised to begin his third year running the transition battalion. He has a desk in his office, but no seat. He stands, sometimes for 17 hours in a day, then teaches country dancing to the wounded. He sprinkles his conversations with Francis of Assisi, the tragedies of Sophocles, subparagraphs of Army regulations and the colorful slang of a former military policeman.

He worked his way through nursing school driving big rigs, part of a career most active-duty peers might consider unusual. He served twice in the regular Army, the second tour as a commissioned officer, and spent the rest of his adult years in the Army National Guard or as a civilian trauma nurse.

Price has a colonel who volunteered to serve under him -- Col. Jason Showman, the chief dental officer of the Kansas National Guard -- and another full bird above him, Army Col. Mike Heimall, who applauds the reforms Price has instituted.

"You start by selecting the right leaders," Heimall said. "You have to give them freedom of movement and then pull the risk up to my level when they take chances that might pay off."

When asked to name the commander who most impressed inspectors canvassing the Army's 38 special medical units, former Deputy Undersecretary of Defense Noel Koch quickly said: "Andy. He gets it."

Getting it

To Koch, "getting it" means balancing compassion with a cool efficiency, fixing problems and cutting red tape, acting with a generous dollop of common sense and a stern resolve to preserve unit discipline in a patient population increasingly hooked on drugs and prone to mental illness.

Price's report to Pentagon inspectors was ruthlessly lacerating in its honesty, given without spin but tinged with the hope that his post and the Army would do better. He told investigators that his warriors lacked enough psychiatric care; that the Army should nearly double the staff of "cadre" soldiers in the barracks helping patients heal; and that compassion "burnout" should cap cadre tours at two years or less -- a year or two shorter than most want to hang on.

"They're literally preventing suicides on a routine basis. That weighs on their minds," Price said.

For failing to live up to his standards of compassion, accountability or competence, three commissioned officers and twice as many senior enlisted leaders have been fired by Price since he arrived at Fort Riley two years ago, following a stint helping to fix the Army's Walter Reed hospital in Washington.

"We need to look at one soldier at a time," Price said. "We need to create a system that treats a soldier as a person. I think we've been working hard on that here."

Price is trying to hook his soldiers up with a local trucking firm, arguing that battle-blasted Army drivers used to navigating roads pocked with mines should have no trouble getting commercial driver's licenses or keeping a job on America's highways.

Although his unit crest reads, "Make it so," he tells his wounded patients, "Make yourself employable." More than 80 percent of his troops will re-enter civilian life within less than a year after getting wounded, and he wants them to succeed.

"It's what 'right' looks like," he said.

Lessons learned

Koch is more worried that the Army and the Department of Defense aren't taking lessons learned by better units like Price's and replicating those successes throughout the medical system. For example, Fort Drum's Wounded Warrior Support Center in New York was marked by Koch's investigators as one of the best innovations in military medicine since 2007 because it "bridges the gap" for soldiers who aren't eligible for the Warrior Transition program yet suffer from multiple ailments.

But it needed more staffing and a permanent source of funding. The Army declined to tell the Trib if it would get it or if Drum's advances would be replicated elsewhere.

At Fort Riley, Price has become concerned about what disabled soldiers call the "hand off" -- that gap in time between when the Army care ends and the Department of Veterans Affairs takes over.

"In the future, in theory, if we get a call from a warrior and we say, 'Hey, how is it going?' If he says, 'I'm sleeping in a box under a bridge,' we can say, 'Well, what pay phone are you using? We're going to have the Outreach Center call you to help you,' " Price said.

More than 60,000 veterans nationwide who served in combat zones were homeless at some point last year, and another 500,000 combat vets teeter on the edge of dispossession, according to the nonprofit National Coalition for Homeless Veterans.

Experience has taught Price that a generation of soldiers rocked by head trauma, mental illness and other injuries drawn from repeated combat deployments might be susceptible to bad choices and worse luck during the "hand off" and beyond.

Price based his idea on the successful "Marine for Life" program run by the Marine Corps -- a service that prides itself on never leaving a Marine behind, even when they're civilians.

But Pentagon officials -- who declined comment -- so far have shrugged off his proposal.

"They asked, 'Why do we need another call center? We already have 300 call centers.' But it's not just another hot line," Price said. "It's an outreach center that has worked elsewhere, and it might work better for us, too."

Read more: Lieutenant colonel finds success treating 'soldier as a person' - Pittsburgh Tribune-Review http://www.pittsburghlive.com/x/pittsburghtrib/news/s_721735.html#ixzz1DZ2K2xRO