Mystery in Hot Springs: Veterans are baffled and furious as VA prepares to abandon a medical center that serves three states

By Ken Olsen

(Copyright 2014, All Rights Reserved)

John Renstrom used to get all his medical care at a VA hospital near his home in the southern Black Hills of South Dakota. Now he drives 120 miles round-trip for everything from PTSD treatment to a 15-minute medication checkup. And soon, he and thousands of other veterans will have to travel even farther for medical care if VA closes the Hot Springs, S.D., medical center that has served three states and two of the nation’s most impoverished Indian reservations for more than a century.

“Hot Springs VA was the best preventive care a man could receive,” says Renstrom, a Vietnam War veteran. “Now they are going to take that away from me.”

“What are we going to do with young men coming home from the wars now?” adds Richard Galeano, another Vietnam veteran and a former Hot Springs VA employee.

Cutting services in Hot Springs runs contrary to efforts to expand veterans’ care in response to the scandals at VA hospitals in Phoenix and other cities where former servicemembers wait months to have urgent medical needs addressed. “The veterans we serve will be put into longer waiting lines at the VA medical center where they will be referred,” says Patrick Russell, an Army veteran and medical technologist at the Hot Springs VA.

There are also concerns that VA manipulated patient data, overstated maintenance costs and mismanaged medical staff to make closure of the Hot Springs medical center inevitable, Sen. John Thune, R-S.D., said in a letter submitted to the U.S. House Veterans’ Affairs Committee during an August hearing in Hot Springs.

Given these discrepancies and the resignations of the two most prominent supporters of  closing Hot Springs – VA Secretary Eric Shinseki and Health Undersecretary Robert Petzel – VA should drop its Hot Springs “reconfiguration” plan, Thune added. “I believe VA should rescind its proposal and focus all of its energies on addressing the recent scandals and the pressing issue of veteran wait times.”


Sign in Hot Springs neighborhood low resHot Springs VA is the town’s largest employer and an important source of jobs for veterans. It started as a sanitarium in 1907. A hospital was added in 1926, and the sanitarium eventually became a domiciliary renowned for PTSD and substance-abuse treatment. Some 87 percent of Hot Springs domiciliary patients remain clean and sober after completing the program here. Hot Springs is also widely praised by veterans for its medical care.

The campus included a 250-bed hospital when Renstrom started working there in 1989. It was one-stop shopping for veterans from western South Dakota, northern Nebraska, eastern Wyoming, and the Pine Ridge and Rosebud reservations.

“Veterans could see their doctors, get their X-rays and get their prescriptions filled,” he says. “Everybody went the extra mile to make sure people didn’t have to come back.”

Hot Springs VA has a reputation for being especially welcoming to Native American veterans and became home to the first sweat lodge built at a VA hospital.

“It is one place I can come and feel like I’m treated the same as my non-Indian counterparts,” says Bryan Brewer, president of the Oglala Sioux Tribe, headquartered on nearby Pine Ridge.


Hot Springs’ fortunes changed in 1995 when Petzel became director of the VA region that includes western South Dakota. The Fort Meade VA hospital in Sturgis and the Hot Springs medical center merged into a single administrative unit called the Black Hills Health Care System. VA cut maintenance funds for the Hot Springs campus and transferred several medical services to Fort Meade. Hot Springs lost its intensive care unit, emergency room, all surgeries, cardiac rehabilitation and preventive services such as colonoscopies. The sleep lab and pacemaker clinics are gone. The hospital no longer even has the ability to ventilate patients with acute breathing problems, Russell says.

As consequences of these cutbacks accumulated, Petzel was promoted to VA undersecretary for health in 2010, but resigned last May after a litany of patient-care scandals came to light.

Edwin Thompson -- Hot Springs, SD low res

Ed Thompson

Meanwhile, VA has been slow to fill Hot Springs job vacancies and forced some medical staff to practice at both Fort Meade and Hot Springs, effectively adding a 200-mile round-trip commute to their job descriptions, says Ed Thompson, District 2 commander for the South Dakota American Legion. Moreover, VA has passed over qualified job candidates in favor of medical staff deemed less likely to stay in Hot Springs, according to Thune.

It’s been excruciating for veterans and Hot Springs VA staff alike. “This systematic dismantling has caused undue hardship on the veterans and lowered the morale of employees who have been bearing the brunt of a greater workload,” says Russell, who is also president of American Federation of Government Employees Local 1539.

Veterans and hospital employees started questioning whether VA secretly planned to close Hot Springs more than three years ago. After months of stonewalling, VA announced in December 2011 that it planned to “realign” the mission of the Hot Springs medical center and domiciliary – widely believed to be a euphemism for closing the campus. When asked to defend the proposal, “VA was unable to produce a cost-benefit analysis to justify the reconfiguration, leaving doubt as to how VA decided on its plan and raising suspicion that the change was directed by a political agenda,” Thune said.

The region was devastated.

Rev in Hot Springs cover low res“Veterans expressed anger, and confusion over what they felt was betrayal by a country they had once served,” says author Mary Ellen Goulet, who compiled a book of interviews with area veterans called Reveille in Hot Springs that makes the case for keeping the medical center. “Many feared for the future of the younger veterans who may not have the help of this VA when they return from the service.”


Can the Hot Springs VA – and the town it supports – be saved?

Closing the medical center runs counter to the 2004 Capital Asset Realignment for Enhanced Services (CARES) Commission recommendation that VA continue to operate a hospital, domiciliary and outpatient services here. It is also mystifying given that South Dakota is constructing a $41 million, 100-bed state veterans home in Hot Springs that relies on the local VA hospital to care for its residents. In fact, VA contributed $25.4 million to the project, which replaces a veterans home that dates to the 1880s.

But VA says the Hot Springs medical center loses money and that the domiciliary requires expensive renovations to make it compliant with the Americans with Disabilities Act. Maintenance costs on the old buildings are high, and it’s difficult to recruit medical staff to a small town in rural South Dakota. Veterans believe the latter problem is a consequence of VA failing to fill vacancies. “I’ve had nine different primary care doctors since 2009 and all of them said they would have stayed if they were offered permanent jobs,” Renstrom says.

Steven DiStasio, director of the Fort Meade and Hot Springs hospitals, is clear about his preferences: he wants to move. “I need a new building,” DiStasio says. “I would like to have it in Rapid City.”

DiStasio acknowledges that such a move will devastate the Hot Springs economy. Some of that could be offset if a private company repurposed the property, he says. When pressed to offer an example, he suggests that the Hot Springs VA is well suited to become a rental storage facility. “This building is never going to blow down, fall down, never going to get flooded,” he says of the regal sandstone block building that is on the National Historic Register.

“What are they going to store in that? Fly ash from North Dakota?” Renstrom replies.

More to the point, who will be left to store anything in a former medical center if VA pulls out of Hot Springs, population 3,800, and takes 370 federal jobs with it?


Sonnys sign Hot Springs SD low resVA also argues that a declining number of patients will use the Hot Springs medical center over the next 20 years. But the agency’s own projections show almost no change in the veteran population in the Hot Springs service area. The evidence suggests that VA is driving patients away by cutting staff and eliminating medical services, Thune says.

VA is also excluding veterans from the nearby reservations when it calculates future demand for Hot Springs’ services, says Thompson, a member of the Oglala tribe. There are nearly 3,600 veterans at Pine Ridge alone, many of whom may not be aware they are eligible for VA care, and another 2,000 at the Cheyenne River and Rosebud reservations. VA dismisses those numbers, saying they can’t be verified.

The agency eventually produced a cost-benefit analysis of Hot Springs that has also been questioned. VA says it would have to spend 
$1.5 million to acquire land if it were to build a new domiciliary here, despite the fact that it owns ample acreage in Hot Springs, Thune says. VA also estimates it will have to spend $1.9 million to repair a maintenance building that essentially serves as a garage. And the agency lists $112,000 in expenses for a laundry building even though the agency closed the Hot Springs laundry services years ago, Thune says.

The agency’s budget also calls for spending 
$10 million a year to lease domiciliary space in Rapid City – an expense easily avoided if the facility stays in Hot Springs, says Navy veteran Bob Nelson Sr., who worked at the Hot Springs VA for nearly four decades.

VA did not respond to questions about these discrepancies.


VA portrays the closure of Hot Springs as an opportunity for veterans to receive care close to home even though the closest VA hospital will be Fort Meade, another 100 miles north. Instead of forcing veterans to drive even farther for care, VA will pay for veterans to see private providers or, in the case of tribal members, the Indian Health Service, DiStasio says.

VA has little to back up that plan. More than two years after it announced its plan to close Hot Springs, Fall River Health Services – the only other hospital in town – told The American Legion’s System Worth Saving Task Force that it never received a formal proposal from VA. DiStasio confirmed that during a national commander’s visit to Hot Springs in May, saying it was premature to negotiate specifics.

A future deal between VA and Fall River may not do much to alleviate waiting times for veterans. Renstrom attempted to line up a private physician after learning he had heart problems. He was told it would take a minimum of 60 days for him to get an initial appointment, and 90 days before he could see a cardiologist.

“What the hell good does it do to tell me to go see a private-sector doctor when there aren’t any around here?” he asks.

Native American veterans adamantly oppose VA’s proposal to contract with the Indian Health Service for their care, Thompson and other tribal representatives say. Tribal veterans don’t always trust Indian Health Service hospitals, which are poorly funded, often understaffed and poorly supplied with sufficient medications.

There are also concerns about VA’s track record for reimbursing non-agency hospitals and clinics for contract care. That includes “long-standing compensation issues between VA and Indian Health Service,” Thune noted.

In fact, VA’s fee-for-service proposal could jeopardize health care throughout the region. Because VA reimbursement rates are so low, “rural hospitals run the risk of losing money on every veteran they treat,” Nelson says. “Add to that the slowness of the VA to pay their bills, and these hospitals are placed at greater financial risk.”

Veterans here also prefer VA care. “These local hospitals don’t know what the veterans’ issues are,” says Virgil Hagel of Gordon, Neb., a Korean War veteran and past department commander for the Nebraska American Legion who uses the Hot Springs VA. “Veterans were promised health care. We shouldn’t have to be up there fighting for it.”


A citizens group called Save the VA formed soon after VA announced its plans to close the Hot Springs facilities, and drafted several proposals for keeping the campus viable. They include creating a national PTSD treatment center and a work-therapy program that would operate in conjunction with private businesses. VA abruptly stopped negotiating with the group in September 2012 and moved forward with plans to close Hot Springs.

The Legion’s System Worth Saving Task Force has recommended that VA upgrade the Hot Springs medical center and keep as much care there as possible, especially considering the needs of residents of the local veterans home. And if new buildings are required, VA should consider putting them in Hot Springs instead of another community such as Rapid City.

Anything less will devastate the region, 
Renstrom and other veterans say.

“I’m 65,” he says. “I own a home here. If they pull out, I’ve got nothing. Me and thousands of other veterans.”

This story originally appeared in the December 2014 issue of The American Legion Magazine.



1889 A state veterans home is constructed in Hot 
Springs, S.D.

1902 President Theodore Roosevelt signs legislation authorizing the Battle Mountain Sanitarium in Hot Springs, which later becomes a VA domiciliary renowned for its PTSD and substance abuse treatment programs.

1907 The sanitarium welcomes Civil War veterans as its first patients.

1926 A veterans hospital is added to what will become the Hot Springs VA Medical Center campus.

1996 VA combines the Hot Springs VA and the Fort Meade VA in Sturgis, S.D., into one administrative unit named the Black Hills Health Care System. Maintenance budget cuts begin at Hot Springs. The transfer of medical services from Hot Springs to Fort Meade begins.

LATE SUMMER 2011 Veterans and current and former Hot Springs VA employees begin questioning VA about rumored plans to close Hot Springs.

DEC. 11, 2011 VA announces plans to “realign” its Hot Springs medical center campus, widely believed to be a euphemism for closing it.

OCT. 13, 2013 South Dakota breaks ground on a $41 million project to replace older buildings at the state veterans home in Hot Springs. VA provides $25.4 million for the new facilities.

AUG. 14, 2014 Sen. John Thune, R-S.D., sends a letter to the U.S. House Veterans’ Affairs Committee with questions about whether VA manipulated data and cut programs to force the closure of Hot Springs. He also calls on VA to abandon its plans to shutter Hot Springs.


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Betrayed: In West Los Angeles, VA is leasing property to private businesses as mentally disabled veterans languish in the streets

By Ken Olsen

(Copyright 2014, All Rights Reserved)

Of all of the egregious cases involving homeless veterans in Los Angeles, one stands out for attorney Mark Rosenbaum.

VA police arrested a homeless Vietnam War veteran they caught taking food from a trash bin on the West Los Angeles VA campus. Although clearly mentally disabled – the veteran had suffered a head injury after falling out of a helicopter – VA cops didn’t extend a helping hand. Instead, they gave him a citation for stealing government property. He paid the $1,000 fine by collecting aluminum cans.

At a time when veterans are dying in the nation’s  streets in greater numbers than they died at war in Iraq or Afghanistan, VA is not only turning its back on mentally disabled veterans in Los Angeles but actively punishing them, homeless advocates say. It’s especially appalling considering that the West Los Angeles VA campus was built on land given to the federal government for the express purpose of housing disabled veterans.

Not only did VA stop allowing veterans to live there, it turned more than 100 acres of the property into a leasing enterprise for everything from a dog park to charter bus storage, a private school’s athletic center and a hotel chain’s laundry – not to mention the UCLA baseball stadium. And VA is fighting a federal judge’s order prohibiting such deals.

“They have treated these veterans as a nuisance to be ignored,” says Rosenbaum, who is part of a coalition suing to force VA to honor its legal obligation to house veterans at the West Los Angeles VA. “You are better off being a piece of (Marriott’s) laundry.”

VA’s antipathy toward chronically homeless veterans in West Los Angeles is especially striking given the Obama administration’s vow to end homelessness among former servicemembers by 2015. That seems impossible as long as VA denies permanent supportive housing for mentally disabled veterans in the homeless-veteran capital of the United States.

“This really isn’t a Los Angeles story, it’s a national story,” says UCLA law professor emeritus Gary Blasi, who has worked on homeless issues for 40 years. “One in every eight homeless veterans in the country lives in Los Angeles County. And Los Angeles is farthest behind any VA jurisdiction in doing what needs to be done.”

Healing acres

The problem comes down to real estate. The West Los Angeles VA is adjacent to the exclusive Brentwood and Westwood communities. “Serving the needs of veterans became subservient to the interest of homeowners and real-estate people on this side of town,” Blasi says.

No one imagined this conflict when a U.S. senator and a Los Angeles businessman donated 387 acres to the federal government in 1888 with the stipulation that the land be used to “permanently maintain a national home for disabled volunteer soldiers.” The Pacific Branch of the National Veterans Home opened later that year with about 1,000 veterans in temporary quarters. The federal government added a hospital and permanent housing. A post office, churches, theaters and a 10,000-volume library followed. Veterans tended gardens, put on plays and rode the trolley to Santa Monica beaches. By 1922, West Los Angeles was home to about 4,000 veterans. “People had lives,” Rosenbaum says, “and they healed.”

The Pacific Veterans Home eventually became part of VA, but the agency quietly stopped accepting new residents in the late 1960s or early 1970s as a swell of Vietnam War veterans appeared and upscale neighborhoods grew up around the West Los Angeles VA. The war’s unpopularity provided political cover for wealthy Westside interests to lean on the VA. “There was hostility misdirected to Vietnam veterans coming back,” Blasi says. “It certainly made it easier for people developing property around the West Los Angeles campus to apply pressure to decrease the number of veterans living there.”

Sensing opportunity when the government-downsizing Congress came to power in the mid-1990s, private developers wanted to purchase the West Los Angeles VA and build another Century City shopping center, a behemoth Los Angeles complex with nearly 900,000 square feet of retail space. West-side political forces killed that deal as well. “The only thing Brentwood people hate more than homeless people,” Blasi says, “is traffic.”

VA has since leased ground to private companies. Details are sketchy, and VA has never fully disclosed the terms of the leases or how it spends the proceeds. “There has been no public accounting of any of that revenue,” says Melissa Tyner, who runs a legal clinic for homeless female veterans for the Inner City Law Center. And VA has stymied efforts to get those details, even in court.

Indeed, VA referred all questions for this story to the Justice Department, citing ongoing litigation. And the Justice Department also declined to comment.

Skid Row

Without access to housing at the West Los Angeles VA, mentally disabled veterans have been effectively pushed to the streets. Thousands subsist on Skid Row, 50 square blocks of downtown Los Angeles where the city has tried to contain its homeless population for 40 years. It is the greatest concentration of poverty west of the Mississippi, says Adam Murray, executive director of the Inner City Law Center.

About 1,000 people sleep under a crazy quilt of tarps, blankets, cardboard and tents on Skid Row sidewalks. Some 4,000 live in shelters or other short-term housing, and another 6,000 live in single-room occupancy hotels that date back to the arrival of the Union Pacific Railroad more than a century ago, Murray says.

The police presence is intense and citations for petty infractions such as jaywalking are common, Tyner adds. Skid Row residents face the same sort of hefty fines and fees as the Vietnam veteran who was caught digging through the VA’s trash.

The closure of West Los Angeles VA housing also meant that scores of mentally disabled veterans don’t have meaningful access to VA health care, mental health counseling and other services.

“The class of individuals we represent are mentally impaired homeless veterans with serious needs whose very life is being threatened by this lack of service,” says Ron Olson, a prominent Los Angeles attorney who became involved with the case in part because of his admiration for his uncle, who fought from Iwo Jima to the Philippines then struggled to reintegrate when he returned from World War II. “Too many are self-medicating themselves to more serious illness and even death.”

And their numbers will increase given the injuries prevalent among Iraq and Afghanistan veterans. “The number of people coming back and becoming chronically homeless increased 640 percent from 2006 to 2012,” Blasi says. “There’s no reason to think it won’t continue to rise quite dramatically, and at a higher rate than expected, because of the rate of traumatic brain injuries and PTSD that VA and the military are finding among these vets.”

Send in the vouchers

VA has increased the number of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) vouchers that veterans can use to rent apartments. That helps former servicemembers who are capable of finding their own housing and don’t have pressing health-care needs. But because of their injuries, it’s extremely difficult for mentally disabled veterans to negotiate the bureaucratic hurdles to get connected to VA benefits, much less apply for a HUD-VASH voucher or find permanent housing.

“Imagine living on the street, trying on a daily basis to have your basic needs met, dealing with mental health issues and trying to get services from very entrenched and backward bureaucracies,” Tyner says. “It’s impossible.”

HUD-VASH vouchers also isolate homeless Los Angeles veterans from the VA services they desperately need, Tyner says. That’s because the vouchers don’t cover the high price of an apartment near the West Los Angeles VA, where there’s a huge hospital, a polytrauma center, a domiciliary, mental health counseling, dental care and other services that were easily accessible when veterans were allowed to live on the campus. Instead, voucher-dependent veterans have to live miles from the campus and deal with the city’s complex bus system if they want to get to the West Los Angeles VA. Based on her experience working with veterans with significant mental disabilities, having to take even one bus greatly diminishes the chances a mentally disabled individual will connect to care, Tyner says.

“You might as well give them a ticket to the moon,” Rosenbaum adds.

VA does lease a few buildings on the West Los Angeles campus to nonprofit groups that provide transitional housing. The capacity is limited and veterans have to be clean and sober to qualify – which excludes the veterans most in need of help.

Proven solution

The most effective solution is to “put them in permanent supportive housing without conditions and then support their recovery,” Blasi says. People who work for VA have done much of the research that validates this approach, known as Housing First. “It has been ignored by the people in Los Angeles,” he adds.

A significant number of Los Angeles social service agencies and supportive-housing developers have embraced Housing First as a result of collaboration between United Way of Greater Los Angeles and the Los Angeles Chamber of Commerce. It’s far less expensive than leaving people to fend for themselves on the street, says Mike Alvidrez, executive director of the Skid Row Housing Trust. A 2009 Los Angeles Economic Roundtable study called “Where We Sleep” compared the cost of homelessness, from emergency-room visits to law enforcement interactions, with the price of providing housing and support services. The average homeless person costs the county nearly $3,000 a month and the sickest upwards of $100,000 a year, Alvidrez says. By contrast, it costs about $600 a month to provide these individuals supportive housing.

“It’s absurd, when we’re paying hundreds of thousands (of dollars) a year to keep people on the streets,” Alvidrez says. “It’s the worst outcome with the highest price tag.”

In short, “without housing, we’re not going to have an impact,” Tyner says.

That’s one of the reasons Bobby Shriver and other homeless advocates began pushing VA to again provide permanent housing for disabled veterans at VA’s largest campus. There’s plenty of space in its more than 100 empty buildings. “Ten years have gone by, two wars have been fought, and VA has not moved on that,” says Shriver, a former Santa Monica mayor and city councilman who is now running for the Los Angeles County Commission seat with zoning jurisdiction over West Los Angeles.

A coalition including the ACLU, Blasi, the law firms of Arnold & Porter and Munger, Tolles & Olson, the Inner City Law Center and Harvard law professor Laurence Tribe filed their lawsuit on behalf of thousands of homeless veterans in June 2011. Last fall, a federal judge in California ruled that VA’s leases with the private schools and private businesses were illegal. Enterprise Rent-a-Car and Marriott have moved out. But the judge also rejected the plaintiff’s argument that VA is required to provide housing to mentally disabled veterans. Both sides appealed.

The coalition representing homeless veterans contends that VA is compelled to provide permanent supportive housing under the terms of the original deed as well as laws mandating services for disabled individuals. VA contends that it has the prerogative to lease parts of the West Los Angeles campus, given that it owns the property. UCLA joined VA in its appeal, arguing that the judge’s decision to void the leases leaves the university’s baseball program “homeless.”

Meanwhile, Sen. Dianne Feinstein and Rep. Henry Waxman persuaded Congress to pass legislation prohibiting sale or commercialization of the West Los Angeles VA property – a measure VA seems to ignore. They also pushed through legislation authorizing the renovation of two buildings for therapeutic housing. Only one of the renovations is funded.

There are other catches. “It is so far removed from the concept of permanent supportive housing that it won’t work with our clients,” Blasi said. “It’s restricted to therapeutic housing which is, by definition, temporary. And it comes with the assumption that you have to be clean and sober before you get a bed. If it’s not amended, it will fail.”

The solution is obvious to those who demand change. Rather than serving up halfhearted measures or tying up the case in court, VA should provide veterans the care they earned. The buildings are already in place at the West Los Angeles VA. Making them available for permanent supportive housing is a simple executive decision.

“(President) Barack Obama can make that housing happen with one phone call,” Bobby Shriver says. “You know that ad that says one phone call could save you 15 percent? Here, one phone call could save 2,000 lives.”

This story originally appeared in the September 2014 issue of The American Legion Magazine.


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Last Rites : As demand at national veterans cemeteries soars, VA scrambles to add burial space – and one community takes matters into its own hands

By Ken Olsen

(Copyright 2014, All Rights Reserved)

Kristie Roberts’ family was disheartened to learn that she didn’t qualify for burial in the national veterans cemetery near their home in upstate New York. It was Roberts’ wish when she first enlisted in the National Guard in 2002, and her last request when she died in August 2012.

Kristie Roberts

Kristie Roberts

“She left a note when she committed suicide that said her wish was to be cremated and buried in the cemetery where her grandfather was buried,” says Roberts’ mother, Cindy. But interment at Gerald B.H. Solomon Saratoga National Cemetery or any other VA burial ground wasn’t possible, her family learned, because Roberts’ deployment orders said she’d been on training missions instead of active duty.

That was unacceptable. “Both my husband and I felt like there wasn’t anything else we could do for her,” Cindy says. “We had to fight until there were no options left.”

Tens of thousands of other veterans’ families share the Roberts’ determination to bury their loved ones in these revered national burial grounds. “A national cemetery is maintained at a very high level,” says Ami Neiberger-Miller of Tragedy Assistance Program for Survivors (TAPS).“It honors service and sacrifice in a way that is very beautiful for families.”

This sentiment, an aging veterans population and increasing awareness of burial benefits have VA scrambling to add cemetery space at the fastest pace since the Civil War. Demand has tripled in the past 20 years and isn’t expected to peak until 2017. VA also wants to increase the number of veterans who choose national cemeteries.

Nearly 4 million veterans from every conflict since the Revolutionary War are interred in 131 national veterans cemeteries run by VA in the United States and Puerto Rico (the Army administers Arlington National Cemetery). The agency has opened 19 new cemeteries since 1997 and is in the process of adding five more. It also offers a few burial sites in national cemeteries that are officially full when remains are removed and reinterred elsewhere. (That’s the case at the National Memorial Cemetery of the Pacific in Honolulu, for example, where the remains of previously unknown Korean War veterans have recently been identified and moved.)

VA is expanding existing national cemeteries, funding veterans burial sections in community cemeteries, and providing grants to states and tribes to build their own veterans cemeteries. Overall, some 90 percent of veterans should have “reasonable access to a burial option within a 75-mile radius of their home” as of this fiscal year, the agency says.

That still leaves millions of veterans and families without convenient access to national cemeteries. Eleven states with a total of 1.8 million veterans don’t have one. Six of those states – Nevada, Idaho, Utah, Montana, Wyoming and North Dakota – are hundreds of miles from the nearest national cemetery.

“Think of the families who don’t get to go see their loved ones,” says Rep. Dina Titus, D-Nev. Titus, the ranking member of the House Disability Assistance and Memorial Affairs Subcommittee. She is on a mission to change that. “A national cemetery has a higher standard and better management and oversight,” Titus says. “You shouldn’t be denied that privilege just because you happen to live west of the Mississippi.” VA has plans for an additional 18 national burial facilities over the next 10 years, she adds. Surely one or two of the national cemeteries could be in one of these six Western states.


Under VA’s strict population criteria, at least 80,000 veterans must live within a 75-mile radius of a potential national cemetery site. By Titus’ calculations, 170,000 veterans alone live in the Las Vegas area, which is part of her southern Nevada district. But VA says that not enough live within the required radius to justify a site.

So instead of constructing a national cemetery in Nevada, VA is buying a section of burial plots for veterans in a local cemetery in Elko, Nev., 430 miles to the north. The agency also notes that all the states without national cemeteries, including Nevada, have at least one state veterans cemetery.

But a state cemetery doesn’t address the needs of many veterans and families, says Janet Snyder of Las Vegas, legislative chair of the National Society of Military Widows, and a member of American Legion Auxiliary Unit 149 and other veterans organizations.

“A state cemetery is kind of second-class,” says Snyder, who placed a memorial marker for her late husband, Tom, at the Southern Nevada Veterans Memorial Cemetery in Boulder City because she felt like she didn’t have any other option. “I would have preferred a national cemetery. It seems much more prestigious and more of an honor for our military heroes.”

Although it’s a nice facility, there have been problems at the state cemetery over the years, Titus adds. “There was an example where they didn’t follow the rules, and the crews were taking the old gravestones and building patios out of them,” she says. “And one veteran who was interviewed for a little TV spot on this topic said, ‘We fought for this nation, not this state. We deserve to be in a national veterans cemetery.’ I think that says it all.”

It’s also a major undertaking for Snyder and other widows to visit Boulder City, though it’s only an hour away. Like Snyder, many of them don’t drive.

“We’ve got World War II widows whose husbands are buried at Boulder City,” says Snyder, 73, whose husband served in Vietnam during his 20-year Army career. “Last time one of them got carsick. She said, ‘I’m not sure I can do this again.’”

“If it was here in the Las Vegas area,” she adds, “I could ride my bicycle or take a bus.”

The hassles extend beyond getting to the cemetery for birthdays, the anniversary of a loved one’s death and Memorial Day. When friends and family visit Snyder, they also want to go out and place flowers or a flag at her husband’s marker. “It takes a lot out of the precious time they are here,” she says.


Some states have given up on landing new national cemeteries and plan to tap VA’s grant program to build their own facilities. Last summer, New Mexico Gov. Susana Martinez announced plans to establish up to four veterans cemeteries to serve her state’s rural reaches, hundreds of miles from the national cemeteries in Santa Fe and Fort Bayard, N.M., or Fort Bliss, Texas.

The governor has asked communities to apply to host one of the new cemeteries. Under her plan, the state will recoup a large portion of the costs from VA.

Carlsbad has decided to build a veterans cemetery to national standards even if it’s not selected. The southeastern New Mexico community has been trying to get a veterans cemetery for 20 years, says Adon Rodriguez, who is spearheading the Carlsbad Veterans Cemetery project. Since the latest effort was announced three years ago, “I’ve had 10 families call me and say, ‘If we had a veterans cemetery, I would move my loved one home’” from the national cemetery in Santa Fe, he says. These aging families can no longer travel to see their loved ones’ graves.

The city has donated 4½ undeveloped acres in an existing cemetery called Sunset Gardens, and there’s the promise of additional land in the future if needed. “We have a beautiful location a quarter mile from the Pecos River, real quiet, farm fields all around it,” Rodriguez says.

The Carlsbad Veterans Cemetery project is attracting cash donations from citizens and companies, as well as pledges of free labor and material from local contractors. The Eddy County Commission has offered to pave the parking lot and driveways. A consultant is helping ensure that the cemetery is constructed to VA’s national standards. With any luck, Rodriguez says, VA will one day adopt the Carlsbad cemetery.

“We’re shooting real hard, hoping we’ll be a national cemetery,” says Rodriguez, who served six years in the National Guard in the 1950s. “If we finish this cemetery, maybe I can qualify to be buried with my fellow veterans.”

Kristie Roberts' headstone low resFor the Roberts family, Kristie’s burial in the Saratoga national cemetery was about more than laying her to rest with her fellow veterans and honoring her service as a paramedic. She took her re-enlistment oath at her grandfather’s grave in 2010, noting how proud he was to see her in uniform just before he died on Christmas eight years earlier.

“She first enlisted at 17. She had always been patriotic, a volunteer from the get-go,” Cindy Roberts says. Both Kristie and her grandfather, Robert, an Army veteran, were members of American Legion Post 374 in Lake George, N.Y. “She was a granddaughter to make her grandpa proud.”

Bob Roberts, Kristie's father, shovels a path to his daughter's headstone.

Bob Roberts, Kristie’s father, shovels a path to his daughter’s headstone.

Kristie’s parents started contacting public officials for help soon after she died. “I felt like it was one brick wall after another,” Cindy says. They eventually connected with TAPS, which helped them apply for a burial waiver, which can only be granted by the VA secretary. U.S. Rep. Bill Owens, D-N.Y., also worked on their behalf. Thirteen months later, they received permission to place Kristie’s ashes next to her grandfather, a kindness made possible in part because her grandmother relinquished her burial plot.

“I was pleased,” Cindy says. “She would have gone anywhere in the world they sent her without question. We should not have had to fight that hard to finally get permission for Kristie to be laid to rest in the national cemetery. No veteran’s family should.”

This story originally appeared in the May 2014 issue of The American Legion Magazine.

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‘We are not giving up on him’ — A Colorado community and The American Legion rally around the family of an Army veteran lost in last year’s historic floods

By Ken Olsen

(Copyright 2014, All Rights Reserved)

Gerry Boland

Gerry Boland

Before Gerry Boland went missing, he made his way to Lyons Elementary School to make sure the lights were on for people taking refuge from the floods ravaging Colorado’s Front Range last September. Then the 80-year-old retired teacher and coach braved the storm to find his wife, Cheron. He had lost sight of her after they attempted to leave Lyons in separate vehicles.

At the same time, Cheron was searching for him. She was rescued moments before the rising water engulfed her car, but Gerry vanished. A week later, his body was found a few hundred yards from the ruins of the couple’s home. “What the two of them did was so heroic,” daughter Amy Hoh says. “They went back to look for each other without thinking, ‘Will I be safe?’”

That’s the couple’s legacy: stay focused on helping someone else, to the very end.

“Mr. Boland didn’t simply pass on,” says Adam Mack, who grew up a mile from the Bolands and was one of Gerry’s sixth-grade students. “For the last 50 years, he’s been passing down his leadership skills, his sense of direction, his humor.”

The week it took to find him, marked by false sightings and futile searches, was wrenching for the family, friends and community who loved him. “Everyone mobilized,” says Holli Stetson, Gerry’s oldest daughter. “Everyone said, ‘We’ve got to find Mr. Boland.’”

It’s easy to understand why he was regarded as the sort of self-reliant individual who would find a way to ride out the deluge that dumped more than 12 inches of rain in the first two days of the storm alone. Gifted with an optimistic, can-do attitude, he was known for his love of the outdoors and leading the local Boy Scout troop on 50-mile canoe trips. “At that time, there were a couple hundred people missing,” Mack says. “I really thought he had found his way to the home of a neighbor who had no power and no phone.”

Born in Kansas, Gerry Boland was 8 when his parents divorced. His mother supported them by cooking in a café and bringing home leftovers. “He would reflect on having French onion soup for breakfast,” Stetson says. To extend the life of his shoes, he’d use discarded cardboard boxes to make insoles.

Gerry served in the Army in the early 1950s. The armistice was signed four days before he was scheduled to go to Korea, Stetson says. Using the GI Bill, he enrolled in what is now the University of Northern Colorado in the fall of 1955. Seated alphabetically, he found himself next to Cheron Cruise in all their freshman classes.

“He was very handsome,” Cheron says. “I was impressed.” The couple got to know each other over coffee at the student union. Meanwhile, Gerry started singing with the college’s show choir, the Choral Aires, which followed Bob Hope’s troop-entertainment tour through Korea and Japan in the late 1950s.

Gerry and Cheron married in August 1959 and moved to Lyons, where Gerry got a job teaching high school science and Cheron was hired to teach fourth grade. They soon purchased the house near the North St. Vrain River where they raised Holli, Amy and son Brent.

Five years into his teaching career, Gerry took over Lyons’ sixth-grade class but continued to coach high school basketball and football. Both daughters had him as their teacher, calling him “Mr. Dad.”

“He told me I had to work twice as hard because I was the teacher’s kid,” Stetson says.

Stetson especially appreciated her father’s rapport with students after she became a high school teacher and volleyball coach in nearby Longmont. “They knew he cared about them. As a teacher and a coach, I know kids need that. Not everyone gets that at home.”

Gerry’s stewardship went beyond the classroom. He started an outdoor education program called Eco-Week for his students near Rocky Mountain National Park. He was involved with several service organizations, including American Legion Post 32 in Longmont.

Busy as they were, Gerry and Cheron never missed their children’s sporting events. Gerry sat down with them after games to talk about their performances. That included asking his son how many assists he’d made during a basketball game instead of how many points he scored. “I considered that a disappointment,” Brent says. “Now I realize he wasn’t teaching basketball. He was teaching life. It’s not about you. It’s about the people around you.”

During the 52 years Gerry and Cheron lived near the river, there was never a flood warning. So Gerry was skeptical when the evacuation order came at 2:30 a.m. last Sept. 12. Cheron persuaded him to move. They headed for Stetson’s house about five miles away, taking separate vehicles with the idea that they would save both their car and pickup if the flood came. When they got to the south end of Lyons, they saw that a bridge was washed out, so they turned back toward town. But there were no streetlights, and they lost track of each other in the darkness and rain.

Cheron pulled over in a restaurant parking lot and waited for Gerry to drive by. Meanwhile, Gerry went to the elementary school, the official shelter and the place he taught for most of his 30-year career. The school still had power, so he turned on the lights, asked people if they had seen Cheron, and left to search for her.

Meanwhile, Cheron waited a few hours, then left to look for her husband. Her car stalled in rising waters as she got to the edge of town, and she called 911. A half-hour later, a wetsuit-clad rescue team used a front-end loader to get to Cheron. They put her in a life jacket and drove her to the elementary school in the muddy loader bucket. “I had a few bruises, but I made it out,” she says. “All the people up on the cliff were cheering.”

A bystander recorded the rescue with a mobile phone, and the footage made the news. Even as they watched it on TV, Cheron’s children didn’t recognize the car or realize that the woman being carried to safety was their mother until Stetson got a call reporting that she was at a shelter.

“Where my mom’s car stalled, there are signs that say, ‘In case of flash flood, climb to safety,’” Hoh says. “That scared me as a little girl. And my dad would say, ‘It’s never going to flash flood.’”

Early on, the family assumed Gerry had made it back home and was stuck there. They didn’t realize the St. Vrain had jumped its banks and plowed right through the house. A FEMA rescue team wasn’t able to get inside the house until late on Sept. 13, to discover that Gerry was not there.

The family’s fraying emotions were pummeled by false reports. They received one call saying that Gerry was on the last evacuation bus out of Lyons. The family searched every shelter in the area. The next day, a resident told them Gerry’s body had been found in his truck, also not true.

Later that weekend, a detective called to say that Gerry’s pickup had been found near a neighbor’s house, but the high, swift water made it unsafe to try to reach the vehicle. One day later, they learned that Gerry wasn’t with his truck. Cheron remained resilient. “Mom said, ‘We are not giving up on him until we hear that final sentence,’” Hoh says.

A week after the evacuation order, Gerry’s body was found a few hundred yards from his house.

More than 1,000 people attended his memorial service a few weeks later, including people who sang with him in the Choral Aires.

Ralph Bozella of The American Legion’s Department of Colorado immediately called the Boland family and offered help. “They were the first of any organizations to reach out,” Hoh says. “And they reached out in a big, big way. My mother was so touched by it.”

The way the community turned out to search for Gerry and comfort his wife and children was his final gift to his family, years in the making. “He made a huge impact on people,” Hoh says. “The love from his community came back to love us when we needed it.”

This story originally appeared in the June 2014 issue of The American Legion Magazine.

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On The Edge: Doctors over prescribe opioid painkillers to young veterans, leading to addictions and accidental overdoses

By Ken Olsen

(Copyright 2014, All Rights Reserved)

By the time Justin Minyard discovered the video of himself stoned, drooling and unable to help his daughter unwrap her Christmas presents, he was taking enough OxyContin, oxycodone and Valium every day to deaden the pain of several terminally ill cancer patients.

“Heroin addicts call it the nod,” the former Special Forces soldier says of his demeanor in that video. “My head went back. My eyes rolled back in my head. I started drooling on myself. My daughter was asking why I wasn’t helping her, why I wasn’t listening to her.”

Seeing that video jolted Minyard out of a two-year opiate stupor. He asked a Fort Bragg pain specialist to help him get off the painkillers his primary care physician had prescribed. “I was extremely disappointed in myself,” he says. “I knew I couldn’t do that to my family again.”

There are thousands of post-9/11 veterans like Minyard – men and women whose bodies were broken by roadside bombs, bullets or jumping out of helicopters and Humvees day after day, deployment after deployment, wearing 80 pounds of body armor and battle gear. Some have traumatic brain injuries. Some have PTSD. Some have deteriorating knees, shoulders or spines. All have pain.

Overwhelmed primary care physicians have responded with ever-increasing doses of prescription opioids. There has been a 270-percent increase in VA prescriptions for four key opiates since 9/11, according to an analysis by the Center for Investigative Reporting. VA patients are twice as likely to die from accidental drug overdoses as civilians, according to a VA study published in the journal Medical Care in 2011. Yet opioid painkillers provide “only modest medical benefits in treating chronic non-cancer pain,” a separate VA study found.

In Minyard’s case, as in so many others, “the treatment regimen was as bad as the disease,” says Dr. Tony Dragovich, an Army pain specialist now in private practice in Virginia who helped get Minyard off opioids.


A series of debilitating injuries led to Minyard’s massive painkiller habit. The first occurred when he and other members of the 3rd Infantry Regiment spent six weeks moving piles of rubble at the Pentagon following the 9/11 attacks. He then volunteered for language school, and by the time he deployed to Afghanistan in 2004 as an interrogator he was already taking aspirin, ibuprofen, Vicodin and muscle relaxants, and was being administered epidurals for his back pain. “I was only 25,” he says. “And if you looked at an MRI, I had the spine of a 60-year-old.”

The injuries mounted. Minyard fell two stories during a combat operation in Afghanistan, on top of the wear and tear that comes from riding in a helicopter – the vibration in a Black Hawk is particularly hard on the spine, Dragovich says  – and running around in full combat gear. He had surgery to replace two discs after he returned from that deployment. By then he was alternating between Percocet and Vicodin and should have stayed home. But because the Army was short of soldiers fluent in Arabic, he volunteered to go to Iraq in 2007.

“Looking back, that was probably one of the worst decisions I made,” Minyard says. “It had a lot of ripple effects beyond my health. I left when my daughter was three weeks old.”

His pre-deployment physical was a quick conversation with a physician sitting behind a desk, who asked if he “needed any meds.” Minyard doesn’t blame the doctor. “Probably half of the people coming to his office every day are trying to get out of deployment,” he says. “And he has to deal with 500 guys who are in line behind me. He probably doesn’t care about Justin and his back problems.”

The op tempo in Iraq was as furious as the strain on Minyard’s body. Before his unit rolled out on missions, he gave himself injections of a super-strength anti-inflammatory called Toradol. Between them, he visited the medical tent for epidurals and additional pain medications. “That was a double-edged sword,” he says. It eased his pain while enabling him to continue harming his back.

Minyard’s pain was severe enough, however, that he went to the doctor while home on R&R. Fort Bragg physicians told him the damage to his spine was so significant that he shouldn’t return to Iraq. For him, that would have meant abandoning his platoon. “I chose my military family over my real family,” he says. “I chose the military over my personal health.”

The accumulated damage caught up to him. Minyard collapsed as he climbed out of a Humvee in August 2008. He was airlifted to Balad, where he sustained a concussion and additional back injuries after a nurse dumped him on the floor during a mortar attack, he says. Once home, surgeons at Duke University installed eight titanium rods to hold his spine in place – a procedure called an “anterior-posterior interbody fusion.”

Before doctors could operate, however, Duke had to bring in an outside team to figure out how to treat Minyard’s post-surgical pain given his high tolerance to opioids. They settled on ketamine in combination with other drugs that allowed Minyard to disengage from reality, he says. It worked. But by that time he was confined to a wheelchair and weighed 280 pounds.

For the next two years, Minyard struggled with PTSD, depression, severe cognitive challenges, the loss of his military career and anger over his injuries. He took ever larger doses of “big league opioids,” as he puts it. “No one said, ‘This is a problem.’ This was offered to me.”

Somewhere in that haze he came close to killing himself.

“To go from a very successful career as a soldier to hiding out in our guest bedroom with the shades closed for weeks at a time, taking pain pills and being ashamed … I considered taking the whole 30-day supply in one shot,” he says. “It would have been incredibly selfish on my part.” Though not unusual. Seven of his friends died in combat. Fifteen have killed themselves since coming back.

Minyard attempted to kick opioids three different times. “It was the most unpleasant, horrible, excruciating time of my life,” he says. In the middle of moving to a different home, he came across an unlabeled video, popped it in the VCR, and watched in horror as his near-comatose self couldn’t even help his daughter unwrap her Christmas presents. He asked his primary care physician at Fort Bragg to refer him to a pain specialist.


An untold number of other veterans don’t get the sort of help that saved Minyard. A 43-year-old retired Army veteran died four days after back surgery in the fall of 2011. The Arkansas State Crime Lab ruled the cause of death as “mixed drug intoxication” complicated by back surgery. His widow, Kimberly Stowe Green, told the House Veterans’ Affairs Committee, “My husband – Ricky Green – died as a result of VA’s skyrocketing use of prescription painkillers.” Ricky’s medication list included oxycodone, hydrocodone, Valium, Ambien, Zoloft, Gabapentin and Tramadol. This despite her husband’s repeated requests that VA doctors treat the root cause of his medical problems – knee, back and ankle injuries acquired over his 23-year career as a paratrooper and military policeman – and reduce his prescription opiate painkillers, she said.

VA declined to answer questions regarding Green’s case, noting that it does not comment on specific patients. Overall, the agency says it has “worked aggressively to promote the safe and effective use of opioid therapy.” VA clinicians discuss benefits and side effects of medications with patients. Opting for opioids is “a collective decision between the veteran and their health-care team,” VA says. In addition, VA connects patients and families to “pain schools,” support groups and other resources.

VA has also adopted regulations aimed at reducing the risks of prescription painkiller use – a strategy it emphasized during that same congressional hearing. But VA hospitals and clinics are not adopting those changes, Green says. “They were repeatedly violated in my husband’s case – and he had to pay with his life.”

There are several other factors fueling the prescription painkiller epidemic, according to congressional testimony from The American Legion. Veterans can receive overlapping prescriptions from DoD, VA and TRICARE, and Medicaid or Medicare providers. Physicians often have difficulty distinguishing between TBI, PTSD and pain issues. The result is over-reliance on painkiller prescriptions. In addition, there is a significant need for prescription painkiller oversight among VA providers, the Legion says.

Meanwhile, Iraq and Afghanistan veterans who are at the greatest risk of addiction and accidental overdoses are the most likely to receive opioid painkillers from VA, according to a VA study published in 2012. This was particularly true if the veteran also had PTSD.

“People at the greatest risk of addiction and overdose are the people who are going to have the most distress from their pain,” Dragovich says. “If a patient comes to you with a lot of psychological distress and a lot of pain-related distress, most physicians are going to give them opioids.”


High doses of opioids became standard protocol for pain treatment in the late 1990s and early 2000s, Dragovich says. When that protocol is applied to a military base with 1 million primary care visits a year, the result is a lot of opioid prescriptions. Because young soldiers build tolerance to opioids quickly, he adds, doctors escalate the doses quickly.

Severely injured servicemembers also often come out of the hospital receiving high doses of opioids for traumatic battle injuries such as the loss of an arm or leg. Then they are faced with the excruciating work of getting off opioids for good. That’s not an easy sell no matter the patient.

It took Minyard six months from his first meeting with Dragovich to agree to try the doctor’s plan for helping him kick opioids. Dragovich used a drug called Suboxone to ease Minyard’s transition off the painkillers. He also arranged for him to get a spinal-cord stimulator that uses electrical impulses to short-circuit pain messages before they reach the brain. He calls it a pacemaker for pain.

“(It) was like a lightning bolt,” Minyard says.

“I felt like this was going to be the one thing that helps turn me around.” It did. Today he’s out of his wheelchair, has lost 100 pounds and regularly bicycles.

The Army supports the use of spinal-cord stimulation, but there are few specialists to guide soldiers to such alternatives. Fort Bragg had two board-certified, fellowship-trained pain specialists while Dragovich was stationed there. As a result, it may take three or four years of other treatments before injured troops see someone with Dragovich’s expertise.

It’s also difficult to get a referral to a pain specialist in VA, says Minyard. And it’s quite difficult to receive spinal-cord stimulation at VA. “You have to fail at all other treatment plans,” he says. “Is failure an overdose? Or is failure when you are a full-blown addict?”

VA says it has expanded its alternative medicine offerings, and provided spinal cord stimulation to 36 patients from fiscal 2011 to fiscal 2013. Beyond that, its treatment includes “timely access to secondary consultations from pain medicine, behavioral health, physical medicine and rehabilitation,” VA says.

Minyard, who is 90-percent service-connected for his injuries through VA, has charted his own recovery. He took his last opioid painkiller in October 2011. At his Army retirement ceremony in March 2012, he thanked Dragovich for saving his life. He feels so passionately about staying off opioids that he has a medical directive prohibiting the use of narcotics without his consent. And if he’s unable to provide that consent, his wife has to agree to it. He tested that directive when he was struck by a truck while bicycling at Fort Bragg – an unsolved hit-and-run. But he has no second thoughts about opioids.

“I consider myself extremely lucky,” he says. “I was able to push through the maze of providers … and find the doctor who knew the secret. Many soldiers aren’t so lucky, and are left to the crushing reality of lifelong opioid dependency. Or worse.”


Group sees spinal-cord stimulation, other alternatives as better way to treat veterans’ pain.

By Ken Olsen

(Copyright 2014, All Rights Reserved)

When veterans seek help for pain problems, their first treatment option usually involves the most potent and highly addictive opioid medications, Justin Minyard says. Alternative treatments – without any of the destructive side effects – are last on the list.

“That’s insane to me,” says the former soldier, who fought his own painkiller addiction after a series of back injuries during his military career. “Why isn’t the first step an alternative like spinal-cord stimulation? You can take it for a test drive. It’s not addictive. It’s not damaging to your body.”

Spinal-cord stimulation helped Minyard stop using opioids and manage his pain. He started Operation Shifting Gears in 2013 to help combat-injured veterans quickly access alternative treatment, find jobs and deal with other hurdles in the transition to civilian life. The all-volunteer group includes a physician who looks at veterans’ medical challenges holistically. “If you have PTSD, he looks at what’s exacerbating your symptoms,” Minyard says. “He might work with you on diet and exercise or getting enough sleep.”

Helping veterans access nonnarcotic pain treatment, find a job or deal with other problems can be a life-and-death matter, says Minyard, who has lost many colleagues to suicide.

When a veteran turns to Operation Shifting Gears for help, the organization has a plan in place to address that individual’s needs in five days, including working with other nonprofits to help veterans find jobs. Minyard values that sort of collaborative approach over building a large organization. “Because we’re small, we’re able to react very quickly,” he says. “We fill in a lot of gaps where VA provides a lot of bureaucracy.”

Funded solely by donor dollars, Operation Shifting Gears helps veterans with pain issues get spinal-cord stimulation. Once the group identifies a candidate for the therapy, Minyard works with the manufacturer of the stimulator – Boston Scientific – and surgeons near where the veteran lives to get the stimulator implanted at a dramatically reduced rate. When possible, the group helps offset some of the cost.

Operation Shifting Gears has made it possible for about a dozen veterans who were denied spinal-cord stimulation to receive the therapy. Another 30 are on the waiting list.

“You’d be hard-pressed to find someone who’s served in the last 10 years who is not dealing with chronic back pain or knee pain,” Minyard says. “This issue is going to get worse – and it’s going to be with us a long time.”

These stories originally appeared in the April 2014 issue of The American Legion Magazine.

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Veterans and widows are bewildered by VA’s unpredictable — and seemingly unfair — approach to Agent Orange claims

By Ken Olsen

(Copyright 2014, All Rights Reserved)

When Mary Warner’s husband became too sick to care for himself, she took early retirement and a reduced pension to attend to his needs. It was a significant financial risk. The Warners thought they could squeak by, given Philip’s Agent Orange stipend and the promise that Mary could count on VA survivor benefits if something happened to her husband.

They were wrong.

Philip Warner in 1964

Philip Warner in 1964

Soon after Philip died of kidney failure in September 2011, VA decided the Vietnam War Navy veteran shouldn’t have received a decade’s worth of compensation for diesases the agency acknowledges are caused by Agent Orange exposure. In fact, VA now questions whether Philip was in Vietnam at all, despite service records he provided when he filed his first claim in 2001.

“I think it’s unethical for them to come back and say he was erroneously awarded Agent Orange benefits when he’s not here to speak for himself,” Mary says. “Why didn’t they ask these questions when he was living?”

Although VA trumpets its efforts to resolve 230,000 new  Agent Orange claims in recent years, its track record remains contradictory and confusing, particularly for servicemembers who cannot prove they set foot in Vietnam. In 2012, for example, one Blue Water Navy veteran’s leukemia claim was approved while an identical claim from another sailor who served on the same ship at the same time was denied. Widows like Warner find themselves in a fight for survivor benefits after their husbands die of Agent Orange-related causes. Thousands of Brown Water veterans who served on Vietnam’s rivers and inland waterways have been waiting almost four years for VA to review their cases after a U.S. senator discovered their claims had been denied without checking records of where they served.

“Thousands of veterans exposed to the toxin are left behind when it comes to vital treatment and benefits,” American Legion National Commander Dan Dellinger told a joint hearing of the U.S. House and Senate Veterans’ Affairs committees in
September. “Studies indicate that Blue Water Navy veterans may have experienced higher exposure rates to Agent Orange than those who were on the ground, due to water-desalination systems on the ships. This has never been satisfactorily addressed by VA.”

Frustration with VA’s treatment of Vietnam War Navy veterans continues to grow. Groups including Blue Water Sailors of the Vietnam War are pushing for federal legislation restoring benefits to all Vietnam War veterans suffering from Agent Orange-inflicted illnesses. H.R. 543 would reverse a 2002 rule change by the Bush administration that excluded veterans who couldn’t prove they had “boots on the ground” in Vietnam. Prior to that, all Vietnam War veterans who contracted certain diseases had qualified for benefits under the Agent Orange Act of 1991.

Two other veterans advocacy groups filed suit in August to force VA to provide Agent Orange benefits to Navy veterans who served off the coast of Vietnam during the war and are now suffering the consequences.

Mike Hodge is one of those sailors. He served with the gunnery crew on USS Diamond Head, which delivered ammunition to other ships along the Vietnam coast from March to December 1967. Hodge developed Type 2 diabetes in the 1970s, despite being in his 30s and having no family history of the illness. That was followed by neuropathy, ischemic heart disease, blood clots in his lungs, a stroke and an abdominal aortic aneurysm. He’s been unable to work since 2008.

“I felt like my body was giving out,” says Hodge, who lives with his wife, Sharon, in an apartment in Sarasota, Florida.

Hodge has filed four Agent Orange claims since 2001. All were denied. “This is so absurd it’s ridiculous,” Hodge says. “Here I am stuck at home. I have to put my wife to work to pay the bills.” Sharon works as a nursing assistant six days a week – including a 16-hour shift on Mondays – to help support the couple.

“It’s hard, really hard,” says Sharon, who has spent countless hours working on her husband’s claim. That includes unsuccessful attempts to reach members of Florida’s congressional delegation for help. “If you were in the Blue Water Navy, nobody wants to talk to you.”

Hodge, meanwhile, says the dozen-year claims ordeal makes him bitter. “I did my duty,” Hodge says. “Now they are telling us our service wasn’t worth a s**t.”

VA, however, hasn’t treated all Diamond Head crewmembers equally. Bob Webb was granted Agent Orange benefits for chronic lymphocytic leukemia in August 2012 after pursuing his claim for more than two years. He succeeded only after thorough research and persistence, he says. That included hand-carrying information to his local VA office in Wichita, Kan., more than two dozen times. “They hope you give up,” says Webb, who was a gunner’s mate on Diamond Head in 1967. “You have to stay on it.”

In the last packet of supporting material Webb delivered to VA, he included a note that said, “I didn’t ask to get chronic lymphocytic leukemia. I hope you find in my favor.” He and his wife cried when they received notice that VA had approved his claim.

But the chronic lymphocytic leukemia claim of another sailor who served with Webb on Diamond Head during that same Vietnam tour was denied. Steve Voloshin was diagnosed with the cancer in 2004. He filed his Agent Orange claim with the VA office in Denver in 2011. That included a letter from his oncologist stating that his leukemia was likely caused by Agent Orange exposure – to no avail.

“VA said each case is different,” says Voloshin, who lives in Loveland, Colorado. “But we were on the same ship at the same time and we have the same diagnosis.”
Voloshin is appealing his case and searching for additional evidence to back his claim, including deck logs that will show Diamond Head serving in Vietnam’s territorial waters. “I’m glad they granted Bob’s claim,” Voloshin says. “But I feel slighted.”

Veterans advocates say such disparities are common. “The whole claims system is a
mishmash, with each VA regional office doing whatever it wants to do,” says Bill Miltenberger, founder of Blue Water Sailors of the Vietnam War. But there’s a larger problem as well: “(VA) ignores common sense, science, facts and maritime law when denying the majority of those Agent Orange claims.”

VA said it could not answer questions for this article because its funding had been interrupted by the government shutdown last fall.

Meanwhile, Agent Orange claim disparities play out in other ways. VA rejected Pat Rankin’s initial claims after doctors found a tumor at the back of his mouth more than two years ago. Agent Orange benefits are granted to Vietnam War veterans with cancers of the lower respiratory system – the larynx, trachea, lungs and bronchus – but not the upper respiratory system, says Rankin, who served on USS Lloyd Thomas. So he gathered information from the nation’s top medical schools to demonstrate what should have been obvious: Agent Orange-contaminated air passed through a person’s nose and mouth on its way to the lungs and other areas VA considers the respiratory system.

“How can they say this isn’t a respiratory cancer? The tumor was in a sinus cavity in my mouth,” says Rankin, who lives in Moorhead, Minnesota. In addition, Lloyd Thomas has been added to VA’s official list of Brown Water ships – vessels that entered rivers and inland waterways in Vietnam and were contaminated with the drift from Agent Orange spraying.

After appealing his case with the help of American Legion service officers, Rankin now has a 30 percent Agent Orange disability. But his claims for heart disease, high blood pressure and other issues are still pending.

Thousands of other Brown Water veterans aren’t getting any answers. In September 2010, then-Sen. Daniel Akaka asked VA to review nearly 17,000 Brown Water cases after learning it had rejected the claims without reviewing the veterans’ service records. In April 2011, VA said it had examined 6,700 cases. In the ensuing two and a half years, VA has repeatedly been unable to provide the status of the remaining 10,000 claims.

This offers little hope of a timely resolution for a widow like Mary Warner, who is on a tight budget while she works with a Legion service officer in Grand Rapids, Michigan, to appeal the denial of her survivor benefits. Her husband served on USS Constellation during the Vietnam War. He was diagnosed with Type 2 diabetes in 1984 even though he was not overweight, regularly exercised and did not have a family history of diabetes. “It’s not the typical diabetic scenario,” Warner says.

Philip was granted a 50 percent disability rating in late 2002 for diabetes and neuritis. That was upgraded to a 100 percent rating in 2007 after he developed kidney disease. “I’m so thankful he had VA benefits because our medical bills would have been astronomical without them,” Warner says.

But Philip was diagnosed with oral cancer in 2009 and died of kidney failure two years later, Warner says. When she contacted VA, she was told she wouldn’t receive survivor benefits, currently worth about $1,200 a month. Among other things, VA claims her husband’s death wasn’t connected to Agent Orange exposure.

Warner is left worrying about her financial future, given that she left her job as a postal clerk when she was 58. “I wouldn’t have retired early to take care of Philip if I had known,” she says. She was already looking at a reduced pension because she was hired by the U.S. Postal Service after it trimmed its retirement benefits. And at 63, she says it won’t be easy to find another job.

“I wonder,” Warner says, “how many other veterans and families are left behind.”


A version of this story originally appeared in the January 2014 issue of The American Legion MagazineFor more about U.S. veterans and Agent Orange exposure see these other Veterans Voices stories: Rare Victory: Vietnam Navy veterans struggle to prove, and keep, Agent Orange benefits Brown Water Bungle: Paperwork error excluded hundreds of Vietnam Navy veterans from receiving Agent Orange Benefits;  Sailors Adrift: The Lingering Tragedy of Agent Orange  and Still Adrift as well as Toxic Legacy: A Brief History of Agent Orange Exposure in Vietnam,  and Brown Water Update: VA Partially Addresses Bungle that kept Vietnam Navy Veterans from Receiving Benefits


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Quiet Crisis: In the shadow of a record number of military suicides, spouses and children are also taking their own lives

By Ken Olsen

(Copyright 2013, All Rights Reserved)

Her husband suffered a skull-shattering bullet wound in Iraq. She lost her job. Her car was repossessed. A psychiatrist misdiagnosed her then threatened to commit her if she didn’t take medication that made her feel crazy.

These are some of the reasons Torrey Shannon tried to kill herself. Twice.

“It piles on and piles on and you wake up one day and say, ‘I can’t take it anymore,’” Shannon says.

Shannon is part of a quiet crisis sweeping military families. In the shadow of a marked increase in military suicides, spouses and children are also taking their own lives. The crisis is rooted in the strain of 12 years of war, an overwhelmed mental health care system, financial woes, relationship problems and a code of silence dictated by the stigma associated with seeking help. It’s a problem military families expect to get worse as the wars wind down and they no longer have the distraction of the next deployment to postpone dealing with difficult issues.

“The trend is increasing and I would say in the last two years it has close to doubled,” says Brannan Vines, founder of Family of a Vet, whose network receives dozens of messages a week from spouses who are contemplating suicide. “At some point, we’re going to get past the tipping point.”

Military family suicide is a significant public health problem, adds psychologist Craig Bryan, associate director of the National Center for Veterans Studies at the University of Utah. He treated military families in a primary care clinic during his Air Force tenure. “If you don’t pay attention to suicide and suicide risk in family members,” he says, “you are not going to be able to address suicide in the military and society as a whole.”

But the civilian sector is going to have to step up and help.

“We can’t expect DoD and VA to do all of this — they simply don’t have the resources, and in many respects, the cultural competency,” says Kristina Kaufmann, executive director of Code of Support Foundation, which works to bridge the military-civilian divide. “This is not DoD’s Army. This is America’s military.”

Kaufmann has been raising the issues of military spouse suicides for years. She has lost three military spouse friends to suicide and knows of many others who have taken their own lives. They include Kaufmann’s first mentor – “a real practical, strong, get-it-done kind of person who was very involved in her church” – as well a neighbor who was four months pregnant. Both killed themselves the summer of 2009.

But Kaufmann is most troubled by the suicide of a fellow commander’s wife. Faye lived around the corner from Kaufmann and her husband at Fort Bragg. “She looked like the picture of a perfect Army wife – always put together, two great kids,” Kaufman says. Faye locked herself and her children in the garage and started the car during her husband’s deployment in 2006.

“To this day, it haunts me that I didn’t take that opportunity as a commander’s spouse to speak to our battalion about deployment, depression, stress, suicide and asking for help,” Kaufmann says. “But I had no idea how to have that conversation. I couldn’t have done it effectively at that point.”

Part of the problem is the stigma attached to seeking mental health care. That stigma is just as bad if not worse for spouses than it is for servicemembers, Kaufmann says. That’s not a military issue. It’s a societal problem. “The conversation I was too afraid to have in 2006 is a conversation our entire country needs to have,” she says.

Even when military families seek help, it’s often either hard to find or inadequate because the military and veteran’s mental health care systems are understaffed and overwhelmed. Jamie Johnston found no support after her husband, a pilot, was killed in a training accident in the mid-1990s. Her husband’s squadron walked her through life insurance documents and other paperwork then cut her loose. The sole military counselor she connected with was transferred three weeks after her husband’s death. In addition, she had a miscarriage just before her husband’s plane when down.

Johnson was forced to sell their house, find a new place to live and deal with the disappearance of her social circle.  “I had friends tell me, ‘You’re too depressing to be around,” Johnston says. About a month after her husband’s death, she tried to overdose on sleeping pills. “He was my rock and my rock disappeared,” she says. “I just wanted to be able to see him and I needed to die to do that.”

Johnston’s brother discovered her suicide note and she was hospitalized. She found help through the Tragedy Assistance Program for Survivors – which tracked her down and offered its support – then spent years rebuilding. “I was completely broken,” says Johnston, who requested that her real name not be published because she has since remarried and had children.

Shannon sought treatment while her husband, Dan, was hospitalized at Walter Reed Army Medical Center. He was shot in the head in Ramadi in November 2004 and arrived when Walter Reed was at its worst. Dan became part of the front-page story in The Washington Post that revealed despicable conditions at the Army medical center. Meanwhile, Shannon’s family was worried that Dan’s PTS diagnosis meant he was a danger to their children and initiated multiple frivolous Child Protective Services’ investigations, she says.

That pressure, along with financial issues and other family problems, prompted Shannon to seek help. She was assigned to a psychiatrist named Major. Nidal Hasan, who now is on trial for shooting fellow servicemembers at Fort Hood. Hasan misdiagnosed her with bipolar disorder. “I was prescribed a cocktail of medications,” Shannon says. “I went crazy.” Shannon says she told Hasan the drugs made her feel worse. He threatened to have her committed if she stopped taking the medications.

Shannon tried to overdose in November 2006 and April 2007. “In my skewed thinking, I thought I was doing my children a favor,” she says. After getting out of the hospital following her second suicide attempt, Shannon stopped taking the drugs. While medications are helpful for some, “Since I’ve been medication-free, I’ve been fine,” she says.

Military children also are falling through the cracks in the mental health system, sometimes with tragic consequences.

Twelve-year-old Daniel Radenz killed himself just days after convincing doctors at Darnall Army Medical Center in Texas that he didn’t need to be hospitalized despite a litany of warnings including drawing graphic suicide pictures and writing on the walls of a school bathroom with his own blood.

The youngest of three boys, Daniel was a good student with perfect attendance and lots of neighborhood friends, says his mother, Tricia Radenz. A “funny little prankster,” Daniel was close to his father. He postponed his ninth birthday celebration until his father returned from his first deployment.

Soon after Daniel’s father deployed the second time, however, he started having nightmares. He became withdrawn and didn’t want to go to school. “He was just telling me he was so sad and worried about his dad and he didn’t know if his dad was coming home,” Tricia says. She found Daniel an appointment with a civilian counselor – the first opening was about 10 days later – then rushed Daniel to Darnall after his teacher called and told her he needed immediate help. He was seen by both a psychologist and psychiatrist, started on a low dose of medication and set up with a counselor.

Daniel’s mood never improved except when his father came home on R&R in March 2009. “After his dad left, he plummeted,” Tricia says. “He started having hallucinations at school, and writing in blood on the walls of the school.” Meanwhile, it was very difficult to reach his doctor.

Throughout the school year, Tricia had cut back on her hours as an emergency room nurse at a civilian hospital so she was available to help her son whenever he needed her. She and Daniel’s teachers corresponded by email throughout the day. Daniel’s former football coaches took him fishing. “Everybody was trying so hard to help him,” Tricia says. “Nothing was working.” Tricia finally told her husband what was happening. The Army sent him home from Iraq immediately.

While Daniel was happy to see his father, Tricia also believes he felt guilty. “I think he may have wondered, ‘Is dad in trouble because he came home early because I was having problems?’”

After Daniel drew detailed pictures of people shooting themselves in the head, his parents took him to Darnall. “We were very uneasy,” Tricia says. “We thought he needed hospitalization with the pictures and the things happening at school.”

Daniel convinced doctors he was OK and they sent him home. He hung himself within a week. Today, Tricia wishes she wouldn’t have let Daniel out of her sight for even a second. “I thought he went into the kitchen to get a sandwich with his dad. His dad thought he was outside with me. He was out of sight five or 10 minutes. That’s all it took.”

Tricia also wishes she had asked Daniel if he was contemplating suicide. “I think of all of the times I could have opened up the dialogue and prevented it,” she says. “I was afraid of putting the idea in his head. I know now that you don’t put the idea of suicide in someone’s head anymore than you cause a brain tumor.”

Darnall told Daniel’s family it has made changes in the way it treats patients as a result of Daniel’s death, but refused to provide details. “Pointing fingers at this point is counter productive,” Tricia says. “We have to find out where he fell through the cracks and have it not happen again.”

One of those cracks is the strain on the mental health system. “I know (Darnall) is overwhelmed. I know they couldn’t see him as much as they needed to given his situation,” Tricia says. “There were probably a hundred Daniels.”

She also believes parents need more education about the medication their children are given. Tricia read the pharmaceutical company’s warnings about anti-depressant increasing the risk of suicide. Still, “I had no idea of the seriousness of it,” she says. “And his doctor told me he had a lot of success with children taking this medication.”

Tricia now speaks about suicide prevention at places like Fort Hood and Fort Benning. She corresponds with children who need a listening ear on Facebook. She worries about the other children who are in despair.

“You have an increase in suicides when hopelessness exceeds the resources,” Tricia says, “and that’s where we were.”

Andrew Patrin’s family was there was well. Andrew went to an Army primary care clinic in search of help soon after returning to San Antonio to attend college. He felt medications he was given three months earlier were making him more depressed and wanted to be referred to a mental health specialist or inpatient treatment, says his father, George Patrin, then an Army pediatrician commanding a clinic in California. Instead, the physician changed Andrew’s medications and told him to come back in two to three weeks if he wasn’t better. Mental health appointments, he was told, only were available to active duty patients.

After that appointment, Andrew told his best friend he had answered yes to every question about being depressed and suicidal on a survey he was given during that clinic visit and still couldn’t get help. Ten days later, Andrew sent each of his family members a goodbye email from a motel room, turned off his computer and phone and shot himself. “I’m really sorry Dad,” Andrew wrote. “I’m giving up. I’m stuck at 5 percent all the time because of these stupid human limitations.”

Since Andrew died, George retired and he and his wife Pam started the Serendipity Alliance to work on ending suicide and improving health care. They realize, after speaking with hundreds of other grieving families over the past four years, that the same steps that would have saved Andrew will save servicemembers who are completing suicide, George says. That includes referring patients like Andrew to a mental health specialist that same day they ask for help and following up with in a few days to see if patients have improved. It means listening to family members when they say a patient is struggling and including them in a treatment plan when there is a risk of depression or suicide. It means screening for mental health issues every time patients visit a clinic.

Bryan, of the National Center for Veterans Studies, also advocates training mental health professionals in the military and civilian communities to provide the most effective care to servicemembers and their families.

The consequences of not taking these steps are evident in the suicides rates and homelessness of veterans and families who didn’t receive the care they needed 40 years ago. “We have a model of what not to do here – the Vietnam generation,” says Kaufmann of Code of Support. “Are we really going to do that again?”

This story originally appeared in the September 2013 issue of The American Legion Magazine

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