Friday, July 25, 2008
A.J. Smith (Photo: Kenny Goldberg/KPBS)
It's not easy for people in the armed forces to shift from combat duty back to civilian life. That's particularly true with those who've been injured in the wars in Iraq and Afghanistan. A special team in San Diego's VA medical system helps veterans make the transition. KPBS Health Reporter Kenny Goldberg has the story.
A.J. Smith served in the Army National Guard for 20 years. He fought in Iraq in 2003 and 2004.
Smith hurt his arm during a mortar attack. His right knee was shattered in another incident. He came back with lingering injuries, and post traumatic stress disorder.
Then, just as Smith was getting out of the service in 2005, he was diagnosed with leukemia.
AJ Smith : You know, at first I was kind of depressed because I was a master fitness trainer, I've been in top physical shape all my military career. I was just trying to cope with just being ill, and you know, just takin' different medications and all the treatments.
Luckily for Smith, a team from the VA medical system took him under their wing. They made sure he knew about all of the benefits he was entitled to, and helped coordinate his care.
AJ Smith : Without the VA, I wouldn't have just not made it, I can tell you that for a fact. Without the VA I wouldn't be here today.
Those who served in the Vietnam War were largely ignored when they got out of the service. A few years ago, Congress decided to make sure vets from the Iraq and Afghanistan conflicts got a better deal.
They told the VA to make treating recent vets a priority.
So the VA created special teams at all of its hospitals to manage recent veterans' care.
One of the first team members vets see in San Diego is social worker Jennifer Phelps.
Phelps screens people for a variety of mental health conditions, including post traumatic stress disorder, and depression.
When it's appropriate, she'll make recommendations for care, and even schedule the appointments.
Jennifer Phelps: I see myself as a point of contact. I see myself as a clinician, and someone who can educate regarding mental health issues. And I see myself as someone who can help them navigate the VA Healthcare system, especially since it's new and very large, and hook them up with services so they don't fall through the cracks, essentially.
Phelps also asks questions about other issues that affect vets, including housing, education, and employment.
Michael Kilmer heads up the care management team in San Diego. He says his people try to meet the full range of veterans' needs.
Michael Kilmer : We may not provide the direct service, but the reason we sit down with each individual and ask about the whole gamut of issues, is to try to hopefully successfully link them up with people who might be offering jobs or vocational rehab, or educational benefits and services.
The service is highly tailored to the individual. Kilmer says severely injured vets may need a lot of help, at first.
Kilmer : However, once they get into life and they're groovin' along, you know, they might not need us as much, but we stay there in the background. So right now, for our seriously ill and injured the expectation is that we'll provide care management throughout their life.
That doesn't sit well with some older veterans.
Al Kovac : Veterans from previous wars are being pushed back, while the new guys get front-line privileges. I support these guys getting sweet deals, and the problem is it's coming at the expense of other veterans.
Al Kovac is president of the Cal Diego Paralyzed Veterans Association . Kovac says some vets who've been in the system a long time feel like they're getting the shaft.
Kovac: The waiting times to get into the hospital to be seen by a doctor, the benefits process has been slowed down. It's really been a big disappointment. You know, these guys were heroes of their day, and now they're no longer heroes.
VA officials disagree. They concede new vets are given priority enrollment in the healthcare system. But officials maintain 99 percent of all veterans are seen within 30 days in San Diego.
AJ Smith can't say enough about the program. His leukemia is in remission. He's getting some mental health counseling. Smith says he's getting ready for the next stage in his life.
Smith: You know, nothin' happens overnight, so it takes time. And I'm about 90 percent to where I once was, and so, that's a good thing.
The San Diego team manages care for 263 severely ill or injured vets. More than 11,000 combat veterans have entered the local VA system since 2003.
Kenny Goldberg, KPBS News.