Good morning ladies and gentlemen.  I am Carroll Thackston and  I am the Mayor of South Boston, Virginia. I have served over ten years as both Vice-Mayor and Mayor of our Town which numbers 8,500 in population.  I am also a retired Major General, United States Army, having served for over 40 years, the last 4½ years as the Adjutant General of the Virginia National Guard.

I served on active duty for over six years, but spent 35 years in the National Guard. With this background, I have a good understanding of National Guard operations, goals and objectives, and the problems, current and future, facing the National Guard.

My main focus this morning will be about the National Guard and its probable impact on the Department of Veterans’ Affairs. As you are aware, the Total Force Policy has been in effect since post-Vietnam and treats the three components of the Army and Air Force  – the Regular forces, the National Guard and the  Reserves as a single force. Unlike the impact of Vietnam veterans on the VA system, the total integration and increased reliance on the combat and combat support units of the National Guard throughout the 90’s and the War on Terror creates a whole new dynamic for Veterans’ Affairs.

Before I discuss some of my concerns about the Guard and its increasing impact on the VA, I would like to tell you about our local efforts to help the veterans of Halifax County and immediate nearby counties.  For the past three years several of us have worked with a small group of local Halifax veterans, primarily Vietnam veterans, to establish a primary care facility in South Boston to serve local area veterans.   We have met many times and traveled many miles in pursuit of our goal. At this point, we are aggressively seeking designation as a rural locality under the VA’s Enhanced Contract Care Pilot Program. If successful, the Halifax Regional Hospital’s new Primary Care Facility located in South Boston will serve as a pilot project site for contract care within VISN 6. Our group has met numerous times with Congressman Perriello, his staff, and VA representatives. We traveled to Washington and were able to meet with Secretary Shinseki, and most recently  participated in a lengthy teleconference that included Deputy Assistant Undersecretary Vandenberg and numerous VA staffers. In January of this year, Dr. Roger Browne, a member of our group, testified during the  Roundtable Discussion of the Committee on Veterans’ Affairs on “Meeting the Unique Health Care Needs of Rural Veterans.”  Dr. Browne’s credentials as a specialist in internal medicine who has treated Halifax County veterans for over 30 years and his personal experience as Brigade Surgeon for the 198th Light Infantry Brigade in Vietnam in 1968 have provided our group with the leadership and credibility to clearly identify the quality primary health care our veterans need and deserve. At the finish line, we hope to have our new and modern Primary Care Center in South Boston operating as a VA primary care contractor  providing all Halifax County veterans, both old and young, regular forces or Guard and Reserve, with the quality primary medical care that they have earned and are entitled to, both legally and morally.  There were 1,127 veterans in Halifax County enrolled in the VA system at the end of fiscal year 2009.  There are 2,954 civilian veterans in Halifax County according to the most recent census data.  We want all of them participating in the VA health system, and we want a local facility that is convenient for them and their families. And we want to insure that our growing population of veterans that are returning from current tours of active duty are assimilated back into their home communities with the assurance that convenient, quality VA medical care is there for them.

As a former Adjutant General of the Virginia National Guard, I have deep concerns about the coming impacts to the VA system as a result of the extensive use of National Guard combat and combat support units during Operations Iraqi Freedom and Operation Enduring Freedom in Afghanistan. During my tenure as Adjutant General, in spite of actively seeking overseas operations for our ten National Guard Divisions, the Guard was more or less relegated to Homeland Security and domestic crises. That is not the situation the Guard finds itself in post 9-11.

In Virginia, we have 7,838 members currently assigned to the Army National Guard which is 102% of its authorized strength.  Since 9-11, 8,862 Army National Guard personnel and over 700 Air National Guard personnel have been deployed.  Eighty-one (81) Purple Hearts have been awarded to Virginia Guardsmen and ten (10) Guardsmen have been killed in action. There are currently 630  Virginia Army National Guard and    Virginia Air National Guard on active duty.

On the national scene, the total number currently on active duty from the Army National Guard and Army Reserve is 90,144; Navy Reserve, 6,354; Air National Guard and Air Force Reserve, 16,457; Marine Corps Reserve, 4,917; and the Coast Guard Reserve, 787.  This brings the total National Guard and Reserve personnel  currently activated to 118,659, including both units and individual augmentees ( DOD News Release 7-14-10  -  National Guard (in Federal Status) and Reserve Activated as of July 13, 2010)

These figures are current as of July 13th. When you consider the continuing participation in the war efforts since 2001, the total number of National Guard and Reserve members is substantial.

So, in conclusion, when we consider the huge influx of citizen soldier veterans created by the integration of Guard and Reserve forces by the Total Concept Policy and the prosecution of extensive combat operations in the Middle East, there is an enormous workload headed for the Department of Veterans Affairs.

When you consider the demands being put on the Department of Veterans Affairs  by that intense combat environment and multiple tours of duty, combined with the effort to increase VA medical care eligibility for veterans, I believe the VA will be required to expand its network of healthcare facilities to meet those increased demands.  News reports last week indicate that the VA is adopting new rules regarding post-traumatic stress disorder that will, in my opinion, drastically increase the clinical workload for the VA.  Reports cite a 2009 Rand Corporation estimate that “nearly 20 percent of returning veterans, or 300,000, have symptoms of PTSD or major depression”.  It will be interesting to see those estimates updated to reflect the new rules announced last week.

The education our group has received in pursuing a contract primary care facility for Halifax County, has clearly enlightened us on the tremendous strides the VA has made since the mid-1990’s with the establishment of the VISN network and CBOC’s , or Community Based Outreach Clinics.

We are absolutely convinced that the VA will need to rely on the numerous professional, and highly qualified, private-sector medical facilities to meet the coming demand for VA medical health care.  Expanding the CBOC system may be prudent and wise, but the full utilization of contract medical facilities such as the one in South Boston will be essential to meeting those demands – both on-time and on-cost. Our research has shown considerable savings in time and fuel by veterans using more convenient and accessible primary care locations. Only through an aggressive primary care program that is structured to include all qualified veterans, will the VA be able to cultivate a climate of preventive medicine and early detection of serious illnesses. The VA Medical Center will always be the bedrock of VA medical care to take care of the most serious medical problems of our veterans and the VISN/CBOC system is a proven winner in our opinion. Contract primary care using existing private sector facilities is going to be critical to the VA.  We in South Boston and Halifax County are ready to show you the way.

Thank you.  May I answer any questions.