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Hon. Michael H. Michaud, Chairman, and a Representative in Congress from the State of Maine

The Subcommittee on Health will come to order. I would like to thank everyone for coming today.

I would like to welcome the Ranking Member, Congressman Jeff Miller of Florida.

We have a lot of hard work to do in the 110th Congress to ensure that veterans receive the best health care available in a timely fashion.

We must ensure that health care and services that meet the needs of our returning servicemembers are available, and accessible, while never forgetting the health care needs of our veterans from previous conflicts.

The wounded from the wars in Afghanistan and Iraq are returning with multiple injuries due to the use of Improvised Explosive Devices, or IEDs. This often results in servicemembers and veterans needing polytrauma care, and has caused an increase in veterans with traumatic brain injury, or TBI.

Today, this Subcommittee hearing will provide us the opportunity to explore, in more detail, the VA’s Polytrauma System of Care, the interaction between the VA and the Department of Defense, and the barriers that exist – barriers that prevent not only a smooth transfer phase between the agencies, but also impede the continuing care of our veterans. Our focus is on the TBI patient.

We hope that we come away this afternoon with an idea of what these barriers may be, and the steps that we can take, working together with VA and DOD, to eliminate them and help fix the system where it needs to be fixed.

In 2005 VA designated Polytrauma Centers at four sites around the country to facilitate the coordination of care and specialized services these grievously wounded service members would need.

The polytrauma centers have grown to number 21, one in each veterans integrated services network.

With that growth come problems with records transfers, patient referrals, logistical and coordination of care issues.

There is a real need for the VA and DOD to work together, but we are faced with two distinct agencies with two distinct missions.
This has resulted in coordination and treatment issues that have proven to be very difficult to address over the last two years.

As many of you know, TBI is considered by many to be the signature injury of the war. Among veterans and service members from OEF/OIF treated at Walter Reed for injuries of any type, approximately 65 percent have TBI as a primary or co-morbid diagnosis.

Survivors of TBI experience physical, cognitive, emotional, and community integration issues. Because of their injury, their capacity and initiative to seek appropriate care on their own is diminished. Milder cases of TBI may often produce symptoms that mirror PTSD.

Frequently, family members are the caregivers for these wounded servicemembers and veterans, as well as their advocates. Their inability to sort through the many issues that come with a TBI and transitioning from one agency to another, as well as knowing where to turn to seek care, can often be frustrating.