At the recent 2009 Defense Forum sponsored by MOAA and USNI, Adm. Mike Mullen addressed an audience of governmental, for-profit and non-profit organizations caring for or providing some measure of support for injured servicemembers and their families. Also in the audience were medical professionals, academics and researchers that are studying how best to care for and support our injured troops. But, suffice it to say that, despite the dedication of everyone in the room, no one has figured out the right formula and glaring gaps still exist. Despite the fact that military medicine can provide world class battlefield care, hospital care and rehab care, it is still clear that outpatient care – especially the bureaucracy behind it – often fails our servicemembers, veterans and their families at their greatest time of need.

“How do we create a system across America that sustains their needs throughout their lives?” Admiral Mullen asked the audience somewhat rhetorically. He didn’t have an answer and he expressed his frustration at the slow pace inside the government to fix the acute problems and innovate the entire system so that a combination of DoD and the VA can do just that – take care of the needs of these servicemembers from the time they raise their hand to enlist until the death of their last dependent.

DoD and the VA cannot do it alone. Despite the fact that less than 1% of the U.S. population serves in the military today, this microcosm of our society needs the entire U.S. populace more than ever. The private sector – corporations, non-profit organizations and local and state government – needs to step up and raise their hand to augment the care and services currently provided by DoD and the VA to our wounded servicemembers, those who suffer from “unseen injuries” from their service in OEF and OIF. There are many organizations that have cropped up since 9-11 to “support the troops,” but most are very small, managed by volunteers and focused on tangible donations, i.e., care packages, quilts, homes, meals, transportation, etc. More highly efficient, well funded and professionally led organizations in the civilian sector are needed that can provide rapidly accessible and convenient services to the injured and their families. There are a few who are in the vanguard of this movement.

Admiral Mullen recognized the efforts of USA Together, a non-profit that matches servicemembers with vetted organizations that can provide services – financial or in-kind. It quickly and simply connects military people who have an identified need with individuals or organizations who have services or goods to donate. It puts the needy and the service provider together with no third-party intervention or referrals.

Another good one is Give An Hour, a non profit founded in 2005 that has created a national network of mental health professionals who are providing free services to U.S. troops, veterans and their families – in the communities in which they live and work.

Another one is the state of Virginia, which is putting together a structure that includes a community service board with representation from all civilian organizations that can augment the VA. This is being initially funded with $1.7 million out of the state budget.

Another one is in the state of Illinois, where then-Director of the Illinois Department of Veterans Affairs Tammy Duckworth fostered the establishment of 768 community-based outpatient clinics to allow access to care in remote areas of the state. She also awarded non-profits that were working directly with Illinois veterans with state grants of up to $100,000.

The military needs more of these. Admiral Mullen made it clear that he wants to see more collaboration between DoD, the VA and community-based organizations. This sounds like a call for public-private partnerships, a business model that has proven effective for DoD. They already partner with the private sector to build military housing and the Marine Corps museum in Quantico was built by a robust public-private partnership. But many DoD lawyers want all “non-federal entities” to be treated exactly the same to avoid an appearance of endorsement. However, this prohibits the kind of partnerships that create smart and measurable results. It was refreshing to hear the leader at the top of food chain recommending that DoD should find “the gold standard and join them – not compete – and spread the best practices.”




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  • CINCLAX

    “But many DoD lawyers want all “non-federal entities” to be treated exactly the same to avoid an appearance of endorsement.”

    I really don’t see anything the matter with this requirement, especially as massive NGO fraud–and other improprieties– have reared their ugly heads in recent months. Any time public and private money is handed out in large amounts, a certain number of fraudsters and crooks always come out of the woodwork, looking for an easy payoff.

    Of course the difficulties suffered by wounded veterans evoke legitimate concerns from all of us, so any vetting or investigation of an NGO can easily be seen as something of an affront. However this shouldn’t be an excuse to turn a blind eye to possible fraud, embezzlement or political manipulations.

  • Grandpa Bluewater

    “When a naval officer with money meets a contractor with experience in government contracts, the contractor gets the money and the officer gets experience.” An old saw, but a sharp one that cuts both ways.

    Unfortunately the contractor is there to make a buck, and the government guy is there to get a task performed.

    If the Fed who thinks he’s in a partnership doesn’t see to it that the contract requires the contractor to actually and specifically do what the government exec expects, eventually at the working level it won’t get done.

    Furthermore, Mr Fed will only get what he inspects while he’s inspecting, not what his expectations, hopes, and dreams of what his “partner” will do. If he’s trusting his partner, rather than frequently and thoroughly inspecting the work process and facility conditions, things are going to hell in a hand basket, quickly.

    Which is why off the naval hospital grounds contractor run or staffed/”partnership” “family clinics” become known as “the Bataan Death March at (fill in the blank)” due to the wait times. And 40 years on, 100% disabled Vietnam vets still languish outside the system because the “partner” only responds to the right forms properly filled out, and the vet, by the nature of his disability, can’t do that without help which the “partner’s” employees have no motivation to provide.

    It’s not in the contract, you see.

    Non-profit status are not a guarantee of beneficence. And no, Virginia, the State of Virginia is not a model of caring customer service to the veteran. Particularly if the vet has a Maine or Michigan accent. Been there, lived that.

    As every businessman knows, “possible fraud, embezzlement or political manipulations” are always with us. They are the reason for internal controls. So when a “partner” acts affronted by “possible fraud, embezzlement or political manipulations”, look harder. It’s no longer possible, it’s probable.

    Just tell “em “It’s not personal. It’s just business.” They’ll understand.

    Now about the VA. On second thought, skip it. Vets all know. Just ask one.

    Partners? Nope. Hired help. Be polite. Be professional. Smile big.
    Have an airtight contract and an escape clause. Trust no one, just act like you might, if they are good.

    Looks like somebody is peddling sunshine by the fathom again.

  • Bill

    Grandpa B,
    With all due respect Sir, that’s all pretty cynical. You saying we should just give up and accept things the way they are?
    Alot of the people at that conference are hoping for a better future.

  • CINCLAX

    So….just how are those “community-based” NGOs doing? I just spent two hours pouring over this watchdog website:

    http://www.vawatchdog.org/

    And is seems the answer is something like “not so good.”

  • RickWilmes

    The private sector and individuals are stepping up. America has recognized that it is a waste of our resources to bring ‘democracy’ to those countries that don’t want it. Maybe our military leaders don’t want to hear it, but needlessly sending our troops out on a daily basis in vehicles to get blown up by IEDs is unacceptable and the voters in America have made that known at the polls.

    Concerning getting healthcare for our wounded Vets, is just one symptom of a wider problem concerning healthcare/health insurance and the American people are also speaking up and acting on this issue. Look at the rallies being held against the President’s healthcare plans and the Tea Parties.

    So I have to disagree with the premise of this post, the private sector is acting but not necessarily to the tune or in the direction our government or it’s military leaders think that action should be directed.

  • Grandpa Bluewater

    Bill:

    It’s just cautions, notes and warnings from old Gramps. You will notice that I thoughtfully included a proven, if sometimes, alas, partial, remedy for the unfortunate and disappointingly regularly observed shortcomings described.

    When you buy that pretty new car, what happens if you don’t change the oil, replace the filter, rotate the tires, keep the fluids topped up, replace belts and hoses and the like? Nobody told you the brakes wear out and you have to maintain them or the car will crash and maybe kill your wife and kids. If it happens shame on you.

    All I’m saying is inspect, measure, adjust and maintain. Believe what the penny says when you stick it in the tire tread, not the sales brochure with the cute little Michelin Man (TM Reg.)logo.

    Human beings aren’t angels. Human nature isn’t nice. Businessmen know this and behave accordingly. So business has nothing to do with trust. It’s all about contracts. I’m not mad at the contractors. It’s not personal, I often like them. It’s just business.

    So no, don’t despair. Don’t expect. Don’t believe. Check.

    Check every thing. And use the checklist.

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