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Mr. Chairman and members of the House Subcommittee on Health, on behalf of the Iraq and Afghanistan Veterans of America (IAVA), thank you for this opportunity to address the needs of new veterans suffering with Traumatic Brain Injury.

IAVA is the nation’s first and largest organization for Veterans of the wars in Iraq and Afghanistan. IAVA believes that the troops and veterans who were on the front lines are uniquely qualified to speak about and educate the public about the realities of war, its implications on the health of our military, and its impact on the strength of our country.

Traumatic Brain Injury has been called the hallmark injury of the Iraq war. Unfortunately, the military’s red tape and the under-funding of the VA have left hospitals under-equipped to cope with patients with TBI. The story of the Behee family illustrates the compounded burdens faced by a military family as they struggle to overcome both the physical and mental limitations of their wounded veteran and the barriers to care caused by VA underfunding.

On May 25th 2005, 26-year-old Staff Sgt. Jarod Behee was on his second tour in Iraq. While on patrol that Wednesday, an insurgent sniper shot Jarod in the head. Jarod, a California National Guardsman, was critically wounded, suffering from severe brain swelling and damaged blood vessels which would require multiple surgeries. According to his wife, Marissa: “It is a miracle that he is alive.”

After being transferred from Balad to Landstuhl to Walter Reed and then to the Palo Alto VA, he spent months recuperating, slowly becoming more responsive and regaining the ability to breathe and move on his own. For months, his wife Marissa was staying in a hotel near Jarod’s VA facility in Palo Alto, six hours away from their family and their five-year-old daughter, Madison, who stayed with her grandparents.

In September of 2005, Marissa concluded that the VA facility that Jarod was in was “not up to par.” Because of understaffing, Jarod received only about 3 hours of therapy a day. As Marissa reported at the time, “I know Jarod is capable of handling a much more rigorous schedule. He continually tells me that he is bored here. I could fight all day long for them to do more with Jarod, but bottom line, they don't have the means to do more here.” The hospital was eager to transfer him to a sub-acute unit, a nursing facility that would put much less focus on rehabilitation.

In addition, Jarod’s prolonged stay far from his home was limiting his chances to return to a normal life, the family was incurring flight, hotel and food expenses, and Marissa could not work while looking after her husband.

Marissa was left with no option other than to take Jarod to a private rehabilition facility near their family. She found the Casa Colina Rehabilitation Center, only ten minutes from their home. Casa Colina is the number one brain rehabilitation facility in the nation, and like other private facilities, it accepts TRICARE. Any combat-injured soldier could make use of this facility and others like it, and yet troops with TBI are regularly sent to understaffed VA hospitals. As Marissa’s father has said, “Until the VA can provide adequate care for these soldiers, troops with brain injuries should have the option of going to a private facility.”

Thanks a rigorous 10-hour-per-day rehabilitation schedule, Jarod made dramatic improvements at the private clinic. Marissa remembers the first weeks at the new hospital:

His occupational therapist even said that there was definite movement in Jarod’s left arm. She said that it is very weak, but there was movement and something to work with. Wow, that was a huge prayer answered because all I had been hearing for the past three months [at the Palo Alto VA] was that there was nothing there.

At this point in Jarod’s rehab, the military had agreed to cover all medical expenses through TRICARE while Jarod was still in an acute-care hospital setting. The hospital also gave the Behees a house on hospital grounds, so that the family could live close by.

Jarod’s physical health has improved dramatically, and on August 14th 2006, Jarod was discharged from the hospital. He can now walk totally unassisted and has specific jobs around the house, like making the bed, taking out the trash and doing the dishes. He also continues to go to the gym with his brother, Jason, two days a week for a few hours. This summer, sixteen months after Jarod’s injury, the family was able to enjoy typical summer activities – a trip to the beach, and to San Diego’s Sea World.

But the struggle of the Behee family continues. His family is seeking other private options to continue his cognitive therapy. But private care is expensive, and once Jarod is medically retired, TRICARE will not cover his cognitive rehabilitation or speech therapy – which can cost in excess of $1300 a month. Now the Behees are looking for housing outside of the hospital, and waiting on word regarding Jarod’s pension. In the meantime, a combat-injured soldier and a spouse that can’t work because of those injuries will be living below the poverty line.

Traumatic Brain Injury is a tragedy takes its toll on the entire family. The understaffed and overworked VA hospitals are simply not able to give wounded troops the treatment they so badly need to get back to a "normal" life. Jarod and his family have sacrificed so much. They, and the hundreds of military families like them, deserve better.