FORT KNOX, Ky. — In the complicated world of military and veterans' benefits, in which returning warriors face a bewildering array of complicated and sometimes conflicting directions, Wally Kotarski is a middleman.
One morning last week, with a fresh coating of snow covering the U.S. Army base in Fort Knox, Kotarski met with a soldier recently back from Iraq. The soldier had such a debilitating case of post-traumatic stress disorder that his squad leader was ushering him around.
Kotarski explained the range of services and benefits that the soldier could — and should — receive once he's discharged from the Army. He tracked down the address of a Vet Center, operated by the Department of Veterans Affairs, in the soldier's neighborhood in Brooklyn. When the soldier goes home, one of Kotarski's colleagues will make sure that somebody in New York gets the veteran to the center.
Kotarski, who served in the Army for 20 years, works for the Kentucky Department of Veterans Affairs, participating in a new program that's designed to ensure that soldiers don't fall through the cracks.
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As troops stream home from Iraq and Afghanistan, and as the VA and military systems restructure their benefits and services, states increasingly are stepping in to help service members navigate the process and get on with their lives five years after the U.S.-led invasion of Iraq.
Citizen soldiers from various states' National Guard and Army Reserve units make up a substantial portion of Iraq forces, and soldiers are doing repeat deployments. Many come back with deep psychological problems on top of their physical wounds.
States, as well as nonprofit organizations such as the American Legion, have long played a role in helping veterans. Since the wars in Iraq and Afghanistan started, however, some states have boosted their efforts, worried that the federal government is overwhelmed or otherwise unable to tend to returning soldiers quickly enough.
"We don't think that the VA is going to come through for our veterans in a timely fashion, and these are problems we see now," said Linda Schwartz, who heads the state veterans department in Connecticut. "If the VA catches up with us, good. If not, we have to take care of our people."
Around the country, state veterans departments spend more than $4 billion a year on benefits and services, according to Leslie Beavers, the head of Kentucky's program and a former president of a national association of state VA directors.
Each state has its own programs. Some run nursing homes for older vets and provide cemetery space in case there are no nearby federal VA cemeteries. Many provide assistance to veterans in applying for federal VA disability benefits.
In recent years, state programs have increased those efforts, both in money spent and in hands-on services. In Kentucky, Beavers said his state program had grown to $44 million a year, up from $17 million in 1998.
In Washington state, director John Lee said his two-year budget had jumped to $111 million, from $70 million at the start of the Iraq war. In Massachusetts, the budget has nearly doubled in the past five years, to a proposed $50 million for the next fiscal year.
The combined spending by state programs is dwarfed by the federal VA budget, which also is expanding rapidly and is proposed to top $90 billion next fiscal year for health-care and disability benefits, among other functions.
The state efforts, however, are driven by the belief that some veterans still slip through the cracks, and the fact that navigating the federal VA is daunting for the average person.
"We have a great VA system, but it's also time-consuming and incredibly complicated," Lee said. "We need somebody to be an advocate for the veteran."
In his state, the legislature made $2 million available to provide fast financial assistance to veterans or their families for small items, including emergency car or home repairs. In Massachusetts, a new program called SAVE is reaching out to and working with veterans who might be at risk of suicide.
Connecticut also is stepping in to treat recent veterans with mental illnesses such as post-traumatic stress disorder, and to treat their families, too. The state trained 225 mental health workers and established a hot line for veterans or their families to call. The hot line sends callers to mental health workers in their areas; in some cases, the state pays for any resulting therapy.
"The VA can't be all things to all people," said Schwartz, of Connecticut's veterans department. "We have one military unit with 500 members in 169 towns. The program can actually be responsive to them."
One of the main functions for state officials is outreach, and making sure that returning soldiers don't slip away without getting the help they need.
In Kentucky, as in other states, Kotarski works out of an Army base, establishing relationships with soldiers who are undergoing medical treatment, often in advance of an impending discharge.
The soldier he saw last week with post-traumatic stress disorder was far away from his family. Kotarski told him about a range of VA and other services available. Later that day, still on base, Kotarski ran into the soldier at lunch. Kotarski had to repeat much of the information he'd given the soldier just hours before.
"Short-term memory loss," Kotarski explained. "It happens with PTSD. These are people who are on six or eight medications. They don't sleep at night."
For each soldier, Kotarski or his colleagues fill out a two-page questionnaire that notes where the veteran plans to go upon discharge. The Kentucky veterans department will forward that information to the veteran's home state, where other state workers will pick up the trail.
The state-to-state tracking was new last year, and is gradually getting established in every state.
As for the veteran with PTSD, Pamela Cypert, who runs the Kentucky tracking program, said they'd make sure he didn't slip away.
"I'll make sure somebody in New York gets him to the Vet Center," she said. "Even if they have to drive him there themselves."