Before I begin, I would like to thank Chairman Michaud, Congressman Teague and the House Veterans Affairs Subcommittee on Health for the opportunity to address you today. The issues being discussed in today’s hearing are critically important to our veterans, to whom I believe deserve the full measure of our efforts to provide for them the rights and services that they deserve.

My name is Dalton Boyd and I am employed by the New Mexico Dept. of Veterans Services.  I have the privilege of serving our veterans as their Veterans Service Officer.  As one who works with our veterans on a daily basis I feel that I have a unique perspective concerning the needs of our veterans.  I see their individual needs daily and draw from the resources available to aid them in addressing their needs.

I would like to begin by addressing VA Healthcare for Veterans in rural areas.  I personally believe that the VA provides world class healthcare but, as with anything else there is always room for improvement. Veterans in rural areas face some unique problems with fragmented healthcare being one of those problems.  We have a very good Community Outreach Based Clinic in my hometown of Hobbs but they provide only basic services with preventative healthcare being their primary focus.  Veterans with special needs must travel hundreds of miles for treatment by specialist or facilities that can meet their needs.  For example: veterans from Hobbs with cardiology or orthopedic conditions have to travel to Albuquerque for treatment, a round trip of 640 miles.  Often these are older WWII veterans in their 80s, in poor health and for whom a trip of 640 miles or more for medical care is very difficult if  not impossible.  I realize that Fee Basis is a very costly undertaking for the VA and I understand the concept that if the VA can treat a veteran they will provide that treatment at a VA facility in part, as a cost cutting measure.  It is my opinion that Fee Basis should be more readily available to veterans in certain circumstances.  For example, an 85 year old WWII veteran with a serious heart condition or a veteran taking chemotherapy should be given consideration for care locally through Fee Basis.

I would also like to address the lack of resources available for Homeless Veterans in rural areas.  A lot of progress has been made in caring for our homeless veterans.  Homeless veterans in metropolitan areas have numerous options and we are all grateful that they have those options. Those options often do not exist in rural areas.  In practical terms, homeless veterans that I see in Hobbs have 2 options:  temporary shelter at a facility within Hobbs or entrance into a substance abuse treatment program with the VA Hospital in Big Springs, Tx..  We do have the New Mexico Veterans Integration Center in Albuquerque, the Mesilla Valley Community of Hope in Las Cruces and the New Mexico State Veterans Home in Truth or Consequences.  Homeless veterans in rural areas often are not able to relocate or do not want to relocate to areas far from what has been their home and comfort zone.  What they often seek is temporary assistance within their community.  I do not know what the solution to this problem is but I do know there is a need for a solution.

I would also like to speak about services for veterans transitioning from the military to civilian life.  New Mexico veterans receive readjustment counseling services from Vet Centers located in Albuquerque, Farmington, Santa Fe and Las Cruces.  Lea county veterans are served by the Midland, Tx Vet Center. The Vet Centers provide readjustment counseling services to combat veterans.  Most of the veterans they serve suffer from PTSD and depressive disorders. The Vet Centers serve veterans from WWII through present day combat veterans.  According to the New Mexico Department of Veterans’ Services 2008 Annual Report there are approximately 179,000 veterans in New Mexico with 39,246 Gulf War, Iraq, Afghanistan era veterans and 52,011 Vietnam era veterans.  The bulk of the Vet Center’s clients are OIF/OEF and Vietnam veterans.

Of course the VA provides mental health care on a number of levels through the COBCs, Hospitals and Tele-health.  The Vet Center counselors are, as I see them, the front line troops in the battle with mental health problems.  They have the mobility, conduct the outreaches and take their expertise directly to the veterans.  Critically important is the fact that the Vet Center also provides services to the family members of veterans.    

An article in Psychiatric Times reports rates of PTSD in returning troops average 15% to 16% and that up to 35% meet the criteria for major depressive disorder.  Clearly these rates represent a large number of veterans in need of mental health care.  As the number of deployed troops is reduced and the troops are brought home, the number of veterans in need of Mental Health Care  services will rapidly increase. We have to be prepared to meet the needs of the growing number of veterans in need of mental healthcare.

I appreciate the opportunity to address you today.  I hope that I have given you a clearer understanding of some of the issues facing veterans in rural areas and the task that the VA's mental health care providers are confronted with.

Thank you.