Kingston center seeks OK to treat war vets with brain injuries

Soldiers returning from Iraq and Afghanistan with traumatic brain injuries (TBI) might soon be able to receive treatment at a Hudson Valley facility that specializes in such cases, enabling vets from the area to get help closer to home.

U.S. Rep. Maurice Hinchey, D-Hurley, U.S. Sen. Charles Schumer, and three members of the Ulster County Legislature are petitioning the Defense and Veterans Brain Injury Center, a clinical research and medical care center run by the Department of Defense, the Department of Veterans Affairs (VA) and a civilian partner, to include the Northeast Center for Special Care in its network of facilities treating soldiers with TBI.

The Northeast Center for Special Care, a privately owned treatment center, opened in 1999 and is located at the former IBM Corp. complex in Kingston. With 400 employees and 280 beds, the center is unique in that it specializes in the long-term rehabilitative care of people who”™ve suffered brain, head and spinal cord injuries. It is the only facility of its kind in the state and one of the few in the nation offering such comprehensive care, which includes occupational therapy, neuropsychology, counseling, internal medicine, and a dozen other specialties, to a relatively high volume of patients, according to administrator Anthony Marmo.

The center is seeking to have 20 beds allocated for the care of vets returning from Iraq and Afghanistan with TBI. To qualify, it needs to get a contract with TRICARE Management, which functions like an HMO for the VA. Inclusion in this network would enable vets receiving treatment at the center to use their VA benefits to cover the cost. Working closely with Hinchey, Marmo is meeting with key decision makers in Washington.

Currently there are nine TBI-designated facilities in the TRICARE system, of which the closest geographically is the Walter Reed Army Medical Center in Washington, D.C., and a 15-bed private facility in Pennsylvania. Because Walter Reed deals with more acute-care cases and the Pennsylvania facility is designed for TBI residents, Marmo said the Northeast Center would fill an important gap, since it deals with the long-term, intermediate level of care that represents the transition between initial acute-care treatment and placement in a residential setting, such as the Pennsylvania facility.

Between January 2003 and February 2007, the number of TBI soldiers from Iraq and Afghanistan who”™ve been evacuated to Walter Reed is 1,977, or 29 percent of the total injured being transferred to the hospital, according to Chuck Dasey, a spokesperson for the U.S. Army Medical Research and Materiel Command, in Fort Detrich, Md. Only 30 percent of those TBI patients had severe brain injuries, he said. However, he didn”™t know what the total number of TBI-injured soldiers was (not all are sent to Walter Reed).

Statistics released by Schumer paint a much direr picture. His office reported that as of last September, more than 50,500 U.S. soldiers from those areas of conflict suffered wounds. The ratio to casualties was 16 wounded servicemen per fatality ”“ far higher than the 2.6 injuries per fatality in the Vietnam War. That”™s partly a tribute to medical advances, which are saving soldiers who previously would have died, but it also indicates that many soldiers are likely suffering from very severe wounds. Locally, Schumer”™s office estimated there were 1,500 veterans from the current wars in the region, of which 44 percent are in Orange County.

Schumer has been lobbying to restore cuts made by the Bush Administration to the VA system, which has created “a crisis situation.” In a statement, his office noted the 2008 budget allocation of $752 million for health-care services to returning vets falls far short of the allocated demand, according to VA estimates.

The petition by the Northeast Center for Special Treatment to treat brain-injured vets is not without controversy. Critics, such as the Long Term Care Community Coalition, an advocacy group based in New York City, point to code violations cited by both the New York State Department of Health (DOH) and the federal Center for Medicaid & Medicare Services (CMS), both of which do annual inspections.

“The facility has on-going problems, and it”™s beyond despicable that it”™s being considered as a treatment center for Iraq War soldiers,” said Long Term Care”™s executive director, Richard Mollet.

While the center lost its Medicaid funding due to substandard levels of care in the early part of the decade, it has corrected the problems, Marmo said. DOH spokesperson Jeffrey Hammond confirmed the facility is in compliance with DOH standards and has no current violations.

The center did pay a $1,000 fine to the DOH for five violations cited in its inspection in 2006. However, that matches the average number of deficiencies for state nursing homes, according to the CMS (the U.S. average is higher, with eight violations). The problems in part “stem from the issue that we”™re a unique facility,” Marmo said. “We”™re classified as a nursing home, but we don”™t exactly fit the criteria.”

Ulster County Legislator Brian Cahill, one of three legislators who have introduced a resolution in support of the center”™s initiative to allocate 20 beds for the vets, said he had checked out the allegations by Long Term Care Community Coalition and found nothing in the CMS or state DOH records since 2004 that was of concern.

What”™s needed, he said, is a regional approach to the care of TBI vets. By being closer to home, the injured vets would be able to get treatment without having to leave their friends and families. “The status quo is not OK,” he said. “I would like to see veterans get the care they deserve and need. This is one of the best places in the country for treatment of traumatic brain injuries.”