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Hon. Shelley Moore Capito

Hon. Shelley Moore Capito, a Representative in Congress from the State of West Virginia


Good day, Chairman Michaud and Ranking Member Miller and the members of the Subcommittee.  I want to first take this opportunity to thank you sincerely for holding this hearing on this Veteran’s TBI pilot program bill.  In doing so you are demonstrating to our brave men and women in the Armed Services your commitment and concern for their well being.  You are also demonstrating to the American people, and your constituents that you are sincere about upholding the promise made to these young men and women by their country.

As the subcommittee is already aware Traumatic Brain Injury has become one of the signature injuries of the Middle Eastern theatre of the War on Terror.  TBI is a multi faceted injury with a wide ranges of severity and a wide spectrum of symptoms.  Many sufferers require in home care and extensive treatment and rehabilitation.

Symptoms of mild cases of TBI include persistent headaches, ringing in the ears, sleep disturbances, and chronic dizziness.  In the more severe cases symptoms of TBI include loss of consciousness, personality changes, seizures, slurred speech, debilitating weakness or numbness in the extremities, loss of coordination, increased confusion, restlessness, and/or agitation.  Many returning veterans also suffer from PTSD which commonly accompanies TBI.  These symptoms can compound duress, and will also complicate recovery. 

You may recall the story of a Sergeant David Emme, of the U.S. Army. Sergeant Emme’s convey came under an IED attack.  Emme suffered a textbook case of TBI.  Although he was conscious on and off for 10 days after the attack he could not recall what happened until he woke up at Walter Reed after having been transferred from Iraq.  What Emme suffered could be likened to the recovery of a stroke victim.  He had to relearn names, and redevelop cognitive abilities like talking.  Emme noted being horribly confused and disoriented during the first few days of his recovery in which he confused nurses and doctors for CIA agents. 

According to the Defense and Veterans Brain Injury center, in just 2003 TBI comprised up to 20% of all surviving casualties.  I will remind you 2003 saw the fewest U.S. military deaths in Iraq (486 deaths) and saw little over half the deaths of the next most violent year (822 deaths in 2006).  We can only conclude that this percentage has increased with the prominence of IED attacks as the preferred method of attack of insurgents.

As of January 5th, according to the Department of Defense, 28,870 members of the Armed Services have been wounded in Iraq.  20% of that number is 5774, therefore at an absolute minimum almost 6000 returning veterans suffer from some form of TBI.

Currently the VA only has four treatment centers that specialize in treatment for battle related TBI: Richmond, VA, Tampa, FL, Minneapolis, MN, and Palo Alto, CA.  In June of 2006 the National Rural Health Association gave testimony on the need for intensive treatment for geographically isolated veterans suffering from TBI.  The testimony also emphasized the importance of Community Based Outreach Centers and local care facilities in providing the intensive treatment needed to overcome TBI.

What my bill proposes is a five year pilot program run by the Secretary of the VA with the Office of Rural Health.  The program will be run in five state selected by the secretary.  For the VA hospitals in these five states case managers will be assigned to any recovering TBI sufferer receiving treatment at a VA facility.  In carrying out the pilot program, the Secretary is directed to provide training at Department of Veterans Affairs medical facilities located in the selected States for the case managers who are assigned to individuals diagnosed with TBI.

The Secretary will also coordinate with non-Department medical facilities located in the selected states to provide the appropriate training necessary to manage the rehabilitation and treatment of TBI sufferers.  Also the secretary must determine an appropriate ratio of TBI patients to each case manager to ensure the patients receive proper and efficient treatment.

For a state in which no Department of Veterans Affairs medical facility is easily accessible, the secretary can enter into a contract with a private health care provider located in that area for which the provider will be reimbursed. The secretary is responsible for reporting to those providers the most recent and up to date information on the TBI patients they are treating.

Finally, The Secretary of Veterans Affairs shall submit to Congress an annual report on the pilot program.

In summation I would like to express my gratitude to the committee for allowing my testimony today, and for the opportunity for H.R. 3458 to be considered before the U.S. Congress.  Again, I would like to acknowledge the committee’s observation of the valiance and the sacrifices of the armed services.  I am convinced by your actions that at heart you do have the best interests of veterans.