Transcripts For CSPAN Hearing On Service Dogs And Veterans With PTSD 20160417

President ial race continues tuesday night for the new york state primary. Join us at 9 00 for viewer reaction and speeches, taking you on the road to the white house on cspan, cspan radio, in cspan. Org. Monday on of the communicators, george ford, chief economist of the Phoenix Center for Public Policy studies and mark cooper, Research Director for the Consumer Federation of america, debate the secs proposal allowing consumers to buy their own settop boxes instead of renting them from cable providers, a move to open up competition in the settop box market. They are joined by lydia bay ude. We think we need competition in the settop box market, and we want competition, competition, competition. Someplace who has worked; some places it hasnt. This is one where it really hasnt. We the lower prices and more choices with vigorous competition. The first question is is there a market for settop boxes . The answer really, in terms of what has been over the cable network, is no, because they are a component of the network. That is the most efficient way to design and deliver Cable Television service, and it is the cheapest way to do it that the market has developed. Communicators, monday night at 8 00 p. M. Eastern on cspan2. A house subcommittee is looking at the benefits of providing service dogs to veterans suffering from postTraumatic Stress and other Mental Health issues. We heard from a panel of witnesses from the Veterans Affairs department and the head of the nonprofit that provides Trained Service canines. This is an hour, 20 minutes. Subcommittee on National Security will come to order. The chairs authorized to declare recess l. A. Times. Veteran suicides continue to be a national epidemic. They are estimated to have a rate 50 higher than those who did not serve. The major driver of suicide rates the incidence of postTraumatic Stress among veterans. Acquainted department of Veterans Affairs, between 11 and 20 of those who served in Operation Iraqi freedom and or enduring freedom suffered from ptsd. Other estimates range at 529 . Veterans may be troubled by intrusive thoughts, and experienced hyper awareness and nightmares. They may find they are no longer able to trust and love those closest to them; some may even feel that life is no longer worth living. Unfortunately, many veterans have met significant problems in receiving the health care they deserve. The issues regarding the inadequate treatment of veterans by the v. A. Has been widely reported these include. Utilizing thed full range of effective treatments for veterans suffering from postTraumatic Stress is something that the v. A. Must do without delay. In treatment that complements existing therapies is the connection of veterans with ptsd with service dogs. These are not covered dogs or therapy dogs, as you suppose they might be. Service dogs perform valuable services for veterans, calling them during a panic attack, turning on lights in the dark home, flicking them from nightmares. Currently, the v. A. Provides a service dollars witto veterans with physical disabilities, but the v. A. Does face challenges implementing the guides in Service Dog Programs that they only started assisting mobility in 2008, six years after being authorized to do so. The v. A. Personnel told us the actual demand for service dogs is unknown. Attended thousands of veterans of ing due to the use this sixyear delay represents as running bureaucratic failure. The v. A. Contends there is insufficient evidence that it helps those with pts but ample scientific findings and ongoing says that may be wrong. Service dogs are not intended to nor do they care if yes but they do provide safe tools for veterans to live Productive Lives and could provide couple months for existing treatment. The urgency of the veteran suicide rate explores this option. Authorized aress threeyear study on the efficacy of curing pts with service dogs. Intead of being completed 2013 it is not expected to be completed until 2019. The study has undergone multiple challenges. The first phase of the study, referred to as phase one, began in 2011, and had to be restarted twice. The v. A. Attributed problems to vendors that provided through the service dogs. Of the 27 veterans enrolled in phase one, only 12 completed the study. The convocations could have been prevented had the v. A. Properly screened. Organizations like one in my district joy experience complications, because they are experienced. The department of defense already has its own working dog standards. The v. A. Began phase two of its study with Lessons Learned from phase one. It included incorporating veterinary standards, and moving the study from one site in florida to three sites. Yet, the v. A. Is only meeting cap of its recruiting coal of having 12 goal of having 12 seconds per study. With the v. A. Struggling to pair service stocks, other organizations are attempting to fill the void. The committee has spoken with various organizations like you relatively claimed to have hundreds of dogs prepared to be paired. Contrary to the v. A. s assertion that theres not enough research to know if dogs help, but there there is ample anecdotal and Scientific Evidence that they can help veterans with pts. Today we will hear from one veteran who attributes his service. To lowering the effects of ptsd. Veterans cannot wait until 2018 to introduce the lowcost and high reward treatment options. The problem of veterans or site is to urgent. For this, i have introduced a bill for 2017. This legislation would create a program for veterans with the most severe levels of pts to be referred to an accredited service dog organization. The v. A. Would reimburse the organization to find the service dog, and all expenses would be offset. Those who risk their lives for this country deserve the best care upon their return, and time is up the essence. I would like to think the witnesses today. We have veterans testifying, and many joining us in the audience. I want to thank them for their service. With that, i will recognize mr. Lynch for his opening statements. Rep. Lynch thank you. I would like to thank todays panel of witnesses for helping the committee with its work, and again, think all the veterans and active military. It is the mission of the department of v. A. To serve in honor more than 21 million men and women who are americas veterans to care for those who have formed the battle born the battle. With the formal and of the combat mission in iraq in 2010 and in afghanistan in 2014, the return of veterans from service, the fundamental to the of the v. A. To provide care to veterans and their families remains as critical as effort. Oversight of the v. A. Is essential to make sure the agency carries out its mission. As recently evidence imposed 9 11 veterans returning, effective treatment of postTraumatic Stress is one urgent area that the v. A. And Congress Must continue to strengthen. According to the National Center for postTraumatic Stress, 27 of our veterans who served in 2700 veterans who served have postTraumatic Stress every year. It is normally the result of multiple towards the duty and recent combat exposure. Veterans with ptsd are particularly foldable to the risk of suicide, which continues to affect veterans other devastating rate. Last month, it was estimated that every day, approximately 22 veterans take their lives. That is tragic. Similarly, the department of defense reported that suicide rates for active Duty Service Members remain high for the seven. The seventh year in a row. We are clearly failing to meet our obligations racked up and returning servicemembers. The impact of postTraumatic Stress in our community is a complex issue. I was proud to join the chairman on the bipartisan on the omnibus bill that specifically targets health care and suicide prevention. We must develop commonsense alternative solutions that could further assist veterans with pts rehabilitation. As noted in the American Medical Association journal of ethics, initial Academic Studies have revealed that veterans paired with service dogs reveal less symptoms, stronger social relationships, and other increased health benefits. In 2010, Congress Mandated a threeyear study as noted by the chairman. That study was to examine the benefits of using service dogs in the rehabilitation of pts. As a result, as the chairman has noted, the agency now expects to complete the study in november or into 2019. A delay for this amount of time is simply unacceptable. I look forward to examining the progress of this further study with the witnesses. I think the idea of Going Forward with a part of the program, which can be based on the evidence in hand today, is a great way to go at this problem. Im proud to cosponsor two pieces of Bipartisan Legislation to facilitate the use of service dogs to assist our veterans. A colleague on this committee has introduced a bill to commence the Pilot Program right away. Also, jim mcgovern of massachusetts has introduced legislation to assist nonprofit organizations in developing and establishing Service Dog Programs for veterans. Mr. Chairman, i would ask unanimous consent if i could please send that his legislation for the record. And supporting statement as well. Rep. Densantis without objection. Rep. Lynch thank you again for holding this important hearing. Rep. Dsantis thank you for your effort. I will hold the record open for five legislative days for any member submit a statement. We will now recognize the witnesses. Im pleased to welcome michael fallon. Mr. Rory diamond. Mr. Cole lyle, and stephen feldman. If you would please rise in major raise your right hand. Do you solemnly swear that the testimony you give will be the truth. Thank you, please be seated. Please limit your statement to five minutes. Mr. Fallon, you are recognized for five minutes. Dr. Fallon thank you for the opportunity to update congress on the ptsd service dog study. Ive accompanied by dr. Patricia warre andn dr. Chris crowe. The 2010 defense act directed the v. A. To examine the use of service dogs with veterans. The v. A. To sign the study to focus on veterans with ptsd because it is a high priority and it is not established in the literature. For the study, the v. A. Hired its own dog trainers, reducing experiment of bias. The v. A. Also developed its own training standards for dogs. Three study sites are operating and enrolling veterans from different parts of the country. Approximately once a quarter for 12 months, measures are taken. Veteran and moment in the study began in 2014. As of this week, 109 of 220 veterans have been enrolled, and all 30 teams are fully staffed to receive 1215 veterans per month. Data collection will end in late 2018, and will then be analyzed. Results will be published in a peerreviewed journal. Currently, pa does not provide benefits for ptsd or Mental Health jobs because research is not proven them to be effective. The carefully designed study is incredibly important in addressing shortcomings. Ca continues to monitor other scientific literature for quality of evidence and remains strongly committed to completing the Current Study at an estimated cost of 12 million. The v. A. Is committed to the best care for veterans with ptsd. D. O. T. V. A. Evidence recommends the following as treatments. Trauma focused cognitive therapy and cognitive processing therapy. Stress and occupation. Research demonstrating the effectiveness is strong. The next require that all facilities provide pe or cpt. Uptake of evidencebased therapy across the Health Care System is rapid. For veterans who choose other treatment approaches have a range of options. The v. A. Is the leader in the global standard for ptsd treatment. I appreciate the opportunity to be here before you today. I am my colleagues are prepared to answer any questions that you may have. Rep. Desantis thank you. Mr. Dimon, you are now recognized. Mr. Diamond thank you. Im executive director of canines for warriors. We have the founder and also to graduates. I also have with me at tenure and air force veteran with his service dog, molly. Statistically speaking, 22 veterans will commit suicide today. That is why canines for warriors exists. It has grown to an organization with 36 staff and the campus in florida. Most important, we have a track record of helping hundreds of veterans with the symptoms of pts. We are very successful in preventing veteran suicide. Every veteran who comes through our door gets the family treatment. A service canine, equipment, training, instruction, housing, homecooked meals. If house moms who listen, how sad to provide advice how stands provide if ice. We say we always have our veterans backs, and we never charge the veterans. The program is 100 free. We have had people analyze our program, phds. They come back with the same conclusion. The program works. It is effective. The average applicant is on 1015 medications. They will reduce or eliminate those medications after receiving the dog. 85 will provide insight a better. 77 report a reduction of nightmares or night terrors finally being able to get a full night sleep and get back on a lifecycle. As adam says about his service dog, she allows me to be a father and functioning member of society again. As joe says, i just would not be here without lily, she is the light in the darkness. When reread on the v. A. Website that there is not enough research to know if dogs help the symptoms of ptsd, we fundamentally disagree. There is not a void of research in this regard. There is enough research. Canines for warriors is an example of how that can work. Given the Current Crisis of veteran suicide in america, we think it makes sense to air on the side of providing more options for our veterans. What is the harm here check of the very worst thing that can happen is a veteran ends up with a dog. The v. A. Is responding to a reluctance to agree that this can work. Our veterans report to us. We asked them all the time, tell us, how is the v. A. Treating q . How is your ptsd being treated . This is what they tell us. It is shocking to hear over and over. They wait, wait, and wait and finally get an appointment. They wait hour after hour, and get in front of a psychologist or clinical social worker. They have their moment. Lets understand with this moment what this moment is. This is the one lifeline our government is giving them to recover from pts. They report to us that they get and do they get 45 minutes of a discussion of the wonderful panoply of options that we just heard dr. Fallon talk about . No. They report to us they get 10, 15 minutes maybe. The first question is always about, how are your meds . I guarantee you they walk out with another prescription drug. The va has three responses to the pts crisis in america. Drugs, drugs, and more drugs to help you with the drugs we already gave you. That is the response. And we find it unacceptable. The va in our opinion has fumbled the first round of the Pilot Program. In our opinion, we have no confidence that they will sex successfully they will successfully pull off this second round. We see an immediate veteran suicide crisis today. We believe the time is now, not after the va gets their act together, but right now to start saving these lives. We appreciate the chairmans leadership on this issue, and be happy to answer questions. Ron desantis thank you. Mr. Lyle, you are up for five minutes. Cole lyle thank you. Chairman desantis, Ranking Member lynch, distinguished members of the subcommittee i , appreciate the opportunity to testify. Id like to begin by saying that im not here for myself. Im here strictly for my brothers and sisters still struggling to transition to post military life while also struggling with post Traumatic Stress. And no other options besides drugs and therapy. Im here for those of us in the veteran communities who have been left behind and continue to deal with the pain of suicide as other veterans see no way out. Im here for the veterans who have lost faith in the system, lost hope for themselves, and have lost purpose in their lives. Im here for the men and women that, like myself, have had to go it alone and acquire their service dogs at extraordinary financial burden to them. For these reasons, ive been fighting for the last year to change the existing va policy. I believe that allowing veterans to fight pts without all options available to them is tantamount to sending our military to fight an enemy without a secondary weapon in their arsenal. While in afghanistan for the majority of 2011, my unit served , where i spent time on a royal airbase. My physical injuries as a result of military service are insignificant relative to my fellow veterans. But like many veterans today who show little signs of physical injury, there are many scars beneath the surface. During the last few months of my deployment as our replacements were starting to arrive and take over the operational capabilities of our unit, i felt i wasnt doing enough to help the cause of our war fighters. I started volunteering my time, largely during sleep hours, at a severely understaffed trauma center. It was there, mentally unprepared for the new volunteer role i assumed, that has affected me most in my post deployment transition. Upon returning state side, veterans take a post Deployment Health assessment, which indicated that i needed to seek treatment for post Traumatic Stress. I started to utilize the va system, and eventually i met with a psychologist who confirmed the preliminary results of the health assessment. I was then prescribed sleep aids and antidepressants and told to utilize what is called a veteran center in my local area for counseling. A little less than two years on this path, the symptoms seemed to stagnate or get worse. Upon discharge from the marine corps in early 2014, interpersonal relationships were harder to maintain than necessary, along with not having the support system of my fellow marines and the chain of command. I didnt have a civilian job, was not in school yet, and simultaneously was experiencing a divorce. In the same few months, i would experience what most veterans now are all too familiar with. The loss of military friends to preventable suicide. Many of these veterans had gotten addicted to the slew of pills prescribed to them and lost even a glimmer of hope in their lives. Some of these men and women had children, mothers, fathers, and friends they left behind because the status quo of treatment for post Traumatic Stress failed them. Life as i had known it had been ripped away and one night alone i decided to end it all. , it is only for the timing of a friend, a fellow marine, arriving on my doorstep at that exact moment that i am here right now. Semper fidelis indeed. The next day, i quit medication cold turkey, not wanting to continue down the dark path of opiate addiction. I sought another way and found that a Trained Service dog was an option, but not one provided by the va. Further inquiry to local nonprofits similar to canines for warriors resulted in wait times over a year, with the demand being as high and nonprofitbased budgets what they are. A few months after searching myself, i got kaya, who is at my feet today, who quite literally pounced into my life. I had her obedience trained, then subsequently trained for post Traumatic Stress symptoms by an Assistance Dogs International Accredited trainer. After roughly 10,000 all told, with my familys assistance, of my own money, i got the help i needed. Yet today, many veterans still dont have those resources. I still have my bad days, but with kaya at my side, im largely in a different phase. I call it recovery retired marine general james mattis called it post traumatic growth. The bad days are less frequent than theyve ever been, and they mainly come when i get news of another friend who has committed suicide. Since starting this quest, more and more of the veteran community have come forward to impart upon me the stories of their brothers and sisters who have taken their lives. Just last week, a close friend of mine in texas lost a marine he served with to suicide. A month ago, one of my best friends who i deployed with and the father of my goddaughter admitted to me that he had gotten close and also would have succeeded had another marine not stepped in. They all come to me pleading, in fact begging, to use what voice i have in this chamber and in the halls of congress to give you all this message. Service dogs will save lives, and with the current epidemic of veteran suicide, it is unconscionable to keep the status quo and wait any longer to institute this change we all know is a viable solution to reduce the epidemic of veteran suicide. Thank you very much for the opportunity to testify, and i look forward to answering your questions. Ron desantis thank you. Mr. Feldman, youre up for five minutes. Steven feldman mr. Chairman, Ranking Member lynch, members of the subcommittee, thank you for the opportunity to testify today. Im steve feldman, executive it director of the human Animal Bond Research initiative. We are a Nonprofit Research and Education Foundation that Funds Research on the benefits of companion animals to human health, and specifically were looking at children with autism, were looking at victims of domestic violence, and we are looking at how we can use these animalassisted interventions for veterans with post Traumatic Stress. In addition to funding this research, we also have built and maintained the Worlds Largest Research Library on humananimal interaction, and thats free and online and available and searchable to anyone who is doing research in this area. And we also support common sense Public Policies that should reflect the definitive body of science that show significant positive Health Impacts that companion animals have on human health. The va says it doesnt have enough evidence to support Service Animals for veterans with pts. We respectfully disagree, and thats why we support hr4764. We believe there is significant Scientific Evidence to support the efficacy of service dogs for veterans with pts. We funded the first systematic review of research on the animal assisted intervention for victims of trauma. That was conducted at Purdue University with dr. Fallons alma mater, and it was published less than a year ago. And what it found was preliminary evidence that animals provide unique elements to address pts symptoms. I think it is also really important to note, because mr. Diamond said whats the harm this systematic review of published and Unpublished Research found no negative effects from any of these studies. So no harm was found in any of the research that we looked at. So we think this supports the conclusion that service dogs for trauma survivors including veterans with pts can positively affect depression, anxiety, social outcomes, sleep, and quality of life. Were currently funding a pilot study on the effects of service dogs on Mental Health and wellness in military veterans with pts. Scientists are measuring psychological and psychosocial functioning, including symptoms of ptsd, depression, life and relationship satisfaction, and quality of life in 137 military veterans diagnosed with ptsd who either have a service dog or are waiting to receive one. The ones who are waiting to receive one is our controlled scientific control group. And so the preliminary , unpublished results indicate that military veterans with service dogs experience significantly lower overall pts symptoms severity, and that includes better ability to cope with flashbacks and anxiety attacks, reduced frequency of nightmares and less overall sleep disturbance, lower overall anxiety and depression, higher levels of relationship and social reintegration, increased psychological well being and higher levels of Life Satisfaction and resilience. We have to wait for the final results of this study to be published later this year but we wanted to bring you these preliminary outcomes because they are so encouraging and important to the discussion today. I also urge the committee and the va to look broadly at Research Studies that really look at several key measures of Mental Health and well being like depression, anxiety, stress, and social integration. All of which are associated with pts. My written testimony covers these in great detail, and you can find even more studies in our database. Thats why an organization like ours can hopefully be really helpful, because we are looking at the Broad Spectrum of research, not just one nar little narrow slice of it. We are looking at whats happening in a persons brain when they interact with an animal. The level of oxytocin, which is a good hormone, goes up. The level of cortisol, the stress hormones, go down. And so when fingers meet fur theres something really , fantastic thats happening. I think weve heard about some of those specific examples today. You know if you combine those , scientificallydocumented therapeutic effects with the trained actions of a service dog you get a powerful combination. ,the americans with disabilities act recognizes service dogs for ptsd in their regulations. And states are increasingly updating their definition of Service Animals. Just last year, the state of florida passed a law to expand protections of Service Animal statutes to include traumatic brain injury and ptsd. And the inclusion of these protections allows veterans who have a disability that may not be outwardly visible to have access to public accommodations with their service dogs. Sometimes these symptoms manifest themselves in public. So while pets and emotional support animals can provide some of the benefits weve just been discussing, its only a Trained Service dog that has full Public Access that can provide that animal assisted intervention wherever and whenever it is really necessary for a veteran with ptsd. You know, what about the doctors on all this . We did a survey last year which showed that of ,000 doctors, 69 1000 doctors, 69 of them have worked with animals in hospitals, medical centers, or medical practices. 88 of doctors saw improvement in a patients physical condition, and 97 saw an improvement in a patients Mental Health condition as a result of animalassisted intervention. So doctors are likely to be really supportive if we can get this program going. And really willing participants, as we provide service dogs to veterans with pts. So, i just want to conclude by saying there is a growing body of research that demonstrates widespread positive Mental Health impacts from the humananimal bond, and we hope that you and the va will take this broad evidence into consideration when shaping Public Health policy, both in relation to 4764 and beyond. And i hope the members of the subcommittee and the va will rely on us as a resource. Thats what we are here, to be a Scientific Resource for anyone who is interested in this. With pts affecting so many of our veterans, we need to make sure that everyone has access to service dogs. And hr4764 really is a great step in the right direction and thats why we fully support the legislation. So mr. Chairman, Ranking Member lynch, members of the committee, i really want to thank you and your hard working staff. Especially mr. Chairman, thank you for your leadership on this issue. And i am happy to answer any questions that you have. Ron desantis thank you the , chair now recognizes himself for five minutes. Dr. Fallon, so why did the va reject pairing a veteran suffering from pts with service dogs . Michael fallon we dont, mr. Chairman. Va is thrilled that service dogs help veterans. Its just as a large medical organization, we have to rely on evidencebased medicine. Veteran population is very heterogeneous. What helps one veteran is not going to help all. Ron desantis has any of the preliminary results that have been pointed to by the witnesses at purdue or any of those, has that changed any of the thinking within the va . Michael fallon mr. Chairman, i would point out that in the publication that was funded by habry, one main conclusion was more Research Needs to be done. She also documented a number of deficiencies in the literature. She also was quoted in military times article on her work that nonbiased Research Needed to be completed. This was in 2015. Ron desantis so that said, so the vas approach to pts, is it fair to say, it relies heavily on pharmaceuticals . Michael fallon im a veterinarian, mr. Chairman. I couldnt ron desantis but youre not familiar with how these veterans basically youre here as a veterinarian. You dont have as much knowledge on just pts generally . Michael fallon no, mr. Chairman. My role here is to update you on our study. I certainly would not pretend to be an expert in human clinical medicine. Ron desantis ok, well, i think all the indications we received from witnesses, from veterans, are that you get counseling. You get drugs. Thats kind of the two things. Michael fallon thats effectivee people, but there are other people i think cole lyle is one who will say that thats not good. So maybe you cant answer this, but are there dangers associated with providing veterans opioids and other pharmaceuticals to deal with pts . Michael fallon i couldnt comment on that, mr. Chair. Man. Ron desanits well, what would you say to that, mr. Diamond . Rory diamond if you look at the wikipedia entry for some of the opioids, they clearly set down an entire list of side effects, including increased suicide. In our opinion, is dog is not going to cause any harm, yet we see every single month our classes, the warriors are transforming. They come in, and they are a wreck. Theyre overmedicated. They are lost. Theyre frightened just to have left their homes. And we see them over three weeks working with our staff. Working with their service dog as that bond kicks in. That they become different people. And they are able to walk out the front door again. Theyre able to go to the store again. Theyre able to go to a beach in florida again. These are things they could not do without their service dogs. It opens the door, it lowers barriers. They become more like the people they were before they went off to war. Ron desantis mr. Feldman, can you the opioids, is there dangerous side effects with that . Is that accurate to say that thats the case . Steven feldman i think pretty much everyone knows that. But i do want to respond to something that dr. Fallon said. You know were here in , washington, and so there is a lot of people who do regulations. Youre never going to meet a regulator who says we have enough regulations. Youre never going to meet a researcher who says we have enough research. So of course we need to continue to do more research, and thats what we are funding right now. But when you add it all up, we really do think there is enough research to substantiate this program. Ron desantis has there been any research that substantiates dangerous side effects with pairing a veteran with a service dog . Steven feldman no, sir. There is in fact an absence of that evidence. Ron desantis cole lyle, have you had any negative side effects since youve been paired with your service dog . Cole lynch thats a strong negative, mr. Chairman. Ron desantis so, i mean, i think we all agree that veteran suicides are a major problem. We need to do everything we can to prevent them. And i think it makes sense that the va should explore all possible ways that this can be dealt with. And i understand that there may not people can say, well, there needs to be more literature. But we have enough evidence there that i think it is something that is long overdue. Let me ask you this, mr. Feldman. How is the vas opposition to providing service dog harm veterans with pts . Steven feldman i will speak as a citizen on this one. I just dont think the words veteran and waiting list sort of belong in the same sentence. And while canines for warriors and other organizations like it are doing their best to put as many paws on the ground as they possibly can, the only way we are really going to get this done is if we have the va providing that kind of support. Ron desantis mr. Diamond, whats your judgment about the v. A. s posture . How has that affected veterans . Rory diamond its caused lives. There are thousands ever veterans suicide that would have been prevented had they had the access to a service dog. Ron desantis cole lyle, i know you have been involved in advocacy on this issue. Youve gone through the halls of congress and spoken with people. Whats been the reception from members of congress on both sides of the aisle so far . Cole lynch mr. Chairman, the response has been overwhelmingly supportive. We have bipartisan support on hr4764. This is not a partisan issue. Everybody knows that we need to take care of our veterans. Of course, we have different ideas about how to go about that. But i personally, walking the halls of congress and speaking with democrats, republicans, conservatives, liberals, everybody agrees that this is a good idea, and that we should do it. Ron desanits youve done a very good job. I mean, as this bill progresses and we have success, some of these guys on k street may be coming after you because of your success in working congress. Mr. Diamond, i think canines for warriors has done a great job. It is a part of the district that im privileged to represent and i know you guys have , expanded, and youre there to help. But i mean, you can only do so much. I mean, i wish you guys could just have unlimited numbers. But so you guys are part of it, but i think we need to have a broader awareness here. But i appreciate all the witnesses for their testimony and i thank you guys for coming , and i now recognize the , Ranking Member, mr. Lynch. Stephen lynch thank you, mr. Chairman. Just for the record, we had some hearings over in the senate on veterans and opioid addiction. And this was a 2015 hearing. And in response to questions around opioid disorder by senator joe donnelly of indiana, va indicated that about 68,000 veterans today had or in 2015 had opioid use disorders. , figure represents about 13 of the total population of veterans currently taking opioids according to the va. So thats a lot of veterans. 68,000 have opioid use disorders, and thats 13 of the veterans on opioids. Thats a huge, huge problem. A couple of the witnesses have mentioned the costs. We just had an opportunity to go to iraq last week, anbar province. They had a couple of dogs there trained. But those are trained for bomb detection. But i asked, i asked the dod, i said, what does it cost for us to train a dog, in that context . And they said, 55,000 each. But thats dod. You know im not surprised the , private sector is doing it for a heck of a lot less. And thats probably apples and oranges. They get trained for something completely different. But mr. Lyle, first of all, thank you for your Courageous Service to our country and to helping veterans still. Is that that 10,000 that you mentioned, is that what it cost you to cole lyle yes, sir. Thats what it cost me to acquire kaya, to pay for her training and all initial Veterinary Care for her. I would note that 10,000 Stephen Lynch is that acquisition as well . Cole lyle yes. I would note that 10,000 is quite frankly cheap, or , Stephen Lynch well, the life of the dog and benefit that it conveys, youre right. Absolutely. Cole lyle the 10,000, i would pay it ten more times if i had to do it over again. Stephen lynch dont let the dod hear you. [laughter] cole lyle i mean, but it has paid dividends in how im able to overcome specific symptoms associated with military experience. And i would recommend it highly to anybody who feels as though opioids and traditional therapies just arent working. Stephen lynch thank you. Mr. Diamond and mr. Feldman, mr. Diamond first. You 17,000 square feet. , im not sure you mentioned your facility down in florida. Obviously there are efficiencies of scale because you are training so many dogs. How many dogs do you probably train at a time . Rory diamond right now, we have capacity for about 30 dogs on our campus. In a couple of months, well have capacity for about 60. Stephen lynch okay. What do you see in terms of the costs of you more professionally doing it 30 times at a whack . What do you see your costs on average . Rory diamond were finally seeing economies of scale. Two years ago, we were in the 40,000s. This past year we were at 32,000. This year 27,000. We expect next year for the entire threeweek program and the lifetime Wraparound Services to be 22,000, 23,000. Weve probably hit economies of scale. I would echo mr. Lyles comments. We think that it is a savings to the government with the reduction in use of prescription use, reduction of use of va service generally speaking, better quality of life, a better human being you get at the end of it is a huge cost savings for the country. Stephen lynch whats the life span, the average life span of one of the dogs . Rory diamond its between 8 and 12 years. Stephen lynch 10 years, yeah. Mr. Lyle, you had Something Else . Cole lyle congressman lynch, i would note that eight to 10 years kaya started helping me within weeks. It does not take eight to 12 years for these dogs to really assist veterans. Stephen lynch oh, no, no. I mean theyre training throughout that 10 years. So that is a service thats being rendered. You divide the cost of training and acquisition over the ten years. Mr. Feldman, anything else you would like to add . You talked about cost. The pilot study looked at 137 veterans which we announced the funding for last year and which will be completed next next month and published next year , and that whole study cost up to 350,000, and were getting results in a twoyear period. Yes, we have to do more research, but it does not have to take that long and cost that much. Stephen lynch yeah, you see the number of veterans that were treating with opioids, and theres just no happy ending they are with the addiction rate we have. We have to try something different. My time has expired. Thank you for your indulgence, mr. Chairman. Ron desantis thank you, gentlemen. We welcome mr. Russell for five minutes. Steve russell thank you, mr. Chairman, and thank you each for being here today. I notice that you served in the military, and when you did, that the veterinary capacity, as i understand. Is that correct . Michael fallon yes, sir. Steve russell did you develop a bond with the animals in your care . Michael fallon absolutely, yes. Steve russell would you say that now as a doctor of veteran veterinary medicine that you , have a bond with the animals in your care . Michael fallon absolutely. Steve russell do you see danger in repairing service dogs with veterans . Michael fallon well, as i have seen problems with dogs that are not properly trained. We had the two children bitten, and it did not help those veterans. There are some things to take into consideration. If the dog becomes sick, ends up ends upllness with a chronic illness and there , are huge bills associated, and the veteran can be depressed, and we have seen that. Steve russell how would you compare that with opioids abuse and veterans and harming those around them. Getting in a more depressed estate, which would you say is more of a danger . Michael fallon i could not comment on that, sir. Again, i am a veterinarian. All of those things are terrible things. Steve russell do you personally believe veterans would be harmed by their care and association with service dogs . Michael fallon i do not know the answer on that. Steve russell but, you have a lot of experience on this. You are a doctor of veterinary medicine, you have handled animals a lot in your life. Done a lot of extensive research. Since you came as an expert testifying before congress, i am just curious your personal opinion. Do you believe that the veterans would be harmed by their care and association . Michael fallon i am reluctant, because it could affect the the bias the study. Steve russell well, i think thats telling, and i appreciate you being loyal to the veterans administration. But i think we have a greater responsibility to be loyal to combat veterans and those who have suffered a great deal. I have handled the flesh and blood in battle, in iraq. As a conference as an infantry man i have dealt with a , lot of the issues that were discussing here today. , i havereer in politics even assisted and helped Place Service dogs with veterans and seen dramatic results. Whether that is a placebo effect or whether it is reality, i can tell you that the results are remarkable. But here is what i also know. Opioids abuse is a tragic indictment on the veterans administration. I would also tell you that many veteran suicides are miss misdiagnosed. Its not unlikely for a sollier to drink a beer, but now prescribed on oxycontin or percocet. He diminishes himself to a very low state. He does not breathe anymore and then the family finds him in the morning and its like jeez, russell did not have any indication that he had problems. In fact, he was talking about going fishing, and now he is dead. They chunk him up as a suicide. Here we have an opportunity to to do a great deal of good very low risk, and if the price of that is two dog bites, i think that we can do that. I also think that the expense of a dog is far cheaper than years and years of opioid addiction. We are legalizing heroine in the country, and we are using veterans as the number one Scientific Lab of open wheel it of opioid abuse. It really angers me. I have been prescribed percocet and oxycontin. Floated around for several days. I can tell you this, i would quit cold turkey on it. I would have a clear head than deal with drug addiction and depression. I dont think we are being intellectually honest here today. Whether dr. Crow would like to give his professional opinion. If you cannot speak to the medical side or yourself, give me one good reason why we should not implement this, given the absence of all further study. Ron desantis stand and just raise your right hand. Do you swear to tell the truth, the the whole truth, and nothing but the truth, so help you god . Ok. The witness answered in the formative the affirmative. If you could do your microphone, and thank you for being here. Ok. Thank you very much for the question. First of all, we are mistakenly confusing a couple of issues. Opioids are not used to treat ptsd. A lot of folks with opioid addiction may have chronic pain, and they may have started opioids to treat the pain. Opioids are not used by the va to treat ptsd. We monitor prescribing practices and send in experts the those where theres a mispractice going on in an attempt to correct it. As you know we have the kits being put in the hands of every veteran who has been prescribed opioids. This is also very personal issue for me. My sister died of unintended opioid overdose. I take this very seriously. But it is not part of the ptds discussion. I appreciate that, and thank you for your insight. Ron desantis can you state your full name for the record so we have it. Ris crowe dr. Chris crowe ron desantis and your title . Chris crowe senior medical liaison for the veterans administration. Steve russell i appreciate your patience was being put on the spot. I understand you did come here today. This is a real issue, i dont believe anybody sitting out here doesnt have concerns to do the right things. But would you also, in your professional opinion, acknowledge that those that deal more than likely with ptsd issues are also liable to the suffering from some sort of pain due to their service . These two are associated together, would you agree with that . Chris crowe not necessarily. Many people who have been deployed, many opportunities for injury and deployment, they come back with muscle and skeletal pain. There are folks who have been exposed to trauma and may develop postTraumatic Stress over it. But opioids are never used to treat ptsd. Steve russell i will take you at your word for that. I will also absolutely put it to you that people suffering from ptsd are often thrown on a great deal of medications. They have a basket load of issues, and being good sailors or marines, they take their medications and follow the doctors orders. I have exceeded my time, but i would like to say that these programs, there is far more evidence that they work than they dont. There is an awful lot of evidence that were not doing a very good job with our treatment , and we have a lot of veteran suicides, i believe personally, from observation. I come as a veteran, not a doctor. What i would tell you is that were not meeting those types of issues, and were trying to drug our veterans, send them off to some clinic rather than get them engaged in something produthpro productive. I yield back my time. Ron desantis the time expires and the chair recognizes that gentleman from georgia for five minutes. And then we will have dr. Fallon come back and resume his spot on the witness stand. Jody hice thank you very much mr. Chairman. , dr. Fallon, do you have any idea how theyre recruiting qualified veterans for the study . Michael fallon the veteran participants . Jody hice yes. Michael fallon yes, sir. Theyre recruited through the medical centers through flyers and presentations to the Mental Health presentations. Jody hice is there currently a waiting list of qualified veterans who would like to participate . Michael fallon there is a waiting list at one of the sites , the portland, oregon site because we have had particular problems in recruiting qualified dog trainers for that site. However, we now have one trainer thats working now. Jody hice how large is the waiting list . Michael fallon i cannot say. I would say that its probably in the range of 20 people perhaps. Jody hice and this is at one facility . Michael fallon yes, one. Sayingce so, are you that the personnel at v8 medical centers are aware of this study and are actively engaged in in informing veterans and the potential of having a service dog . Michael fallon yes, i would say that. It is a very popular topic of interest with our veterans. Jody hice does the va currently have any way the the gauge the demand for the service dogs . Michael fallon we do not, sir. We do not have a method of gauging demand for the service dogs. Jody hice is that under consideration . Michael fallon that would be outside of my curve, i cannot say. Jody hice mr. Diamond, let me come to you. How are qualified veterans referred to your organization . Rory diamond we have never advertised for a veteran to come to our organization. They come to us from word of mouth. When the veteran applies to us, we have a 22page application , we do background checks, interviews, and we do a process that by the time they come to our campus a year after they apply, we know about them and are ready to bring them into the program. Jody hice so you do not do any advertising, its all word of mouth . Rory diamond absolutely. If we advertised, we would get inundated. Were pushing a two year wait list now. Jody hice okay. Thats my point and where i am going. So the va does not seem to have a whole lot of information here, of course, its not their program, but youre actively involved in providing service dogs to veterans, and you have a twoyear waiting list. How many do you have any wage way of gauging what the need is . Rory diamond i wish we had a good measure, and since i am under oath, i am not going to venture a guess. But i do know this for sure, that the number of veterans that are referred to us from the va from the treating physicians says that i do not have anything to help you is increasing. Jody hice sure, thank you. Mr. Lyle, let me ask you, and thank you for your service. Both are powerful, and we deeply in a heart felt way say thank you for what you have done for our country. How did you find out that the service dogs were an option for pts . Cole lyle so, i actually had a personal friend of mine who had a service dog that he also had to acquire on his own and train. I am not sure which organization , well, received his dog where he got his dog trained. But i knew that that was something that was an option that veterans could utilize. And then when i went out to organizations, specifically i went to organizations in texas because thats where i am currently living. I got pretty much the same result the wait times were at , least a year. I did not feel as though i had that time to wait. Jody hice okay. So your introduction came through a personal friend . Cole lyle thats correct. Jody hice mr. Diamond, i will come back to you, and my time is almost up. Twofold question. That veterans struggle with affording service dogs as a general rule, and how does your organization enable them to pair up . Rory diamond two pieces to that. First is that some of our veterans have reported back to us that they would rather make personal sacrifices than to not have to forego having to make a service dog. Theyre on fixed incomes and do have a difficulty in paying for it. Most of the veterans we get could not pay to get a service dog on their own. We have made a lot of corporateps with our supporters. For example, bare health has put together veterinarians to give it Free Health Care for the dogs and pet stores to get free dog food. We do everything that we can on the back end to make it free or almost free for the veteran. The overwhelming message is that they would forgo their own personal comfort to make sure that they get a service dog. Jody hice very good. Thank you, mr. Chairman. Ron desantis i thank the gentleman. Mr. Lyle, what was your experience with the drugs and how did you get prescribed to by the va . Cole lyle well, when i took the post deployment assessment. It was preliminary, i am not sure the timeline but theres a , time line that the va is required to give that once you return state side. I then went to a va facility in forth worth and tried to use their system. I eventually met with a psychologist at the va hospital in forth worth and prescribed the sleep aids and antidepressants. Ron desantis and why did they do that . Was because of your symptoms . Cole lyle correct. When i returned, i was suffering from recurring nightmares and have acute anxiety attacks. I also just had difficulty with close interpersonal relationships. As i had mentioned previously, one of the side affects that goes large largely unnoticed is as a result of postTraumatic Stress, theres a high divorce rate among military members. That also had affected me. It was not the direct case of the divorce, but it definitely did not help in any way shape or , form. It was affecting my personal relationships. The nightmares specifically. Kaya will recognize when i having a nightmare and can jump up in bed and lick me to wake me up. A dog can give you a sense of purpose that a pill cannot do. In the sense that there were , many days that i did not want to get out of bed. I did not have any thing to do. I did not have a job at the time. I wasnt currently enrolled in school. I did not have any reason to. But a service dog needs to be taken outside. They need to be fed. They give you a reason to get up and to be productive on a day the day basis and give you that small sense of purpose again that you can grow on. Again, i reiterate thats , something that the pills did not do for me. Ron desantis we had testimony before this was not something the v. A. Is doing, providing drugs and medical kits. Is that something you agree with . Could you repeat the question . Ron desantis it is not something that drugs or pts, not the been the v. A. Does. Cole lyle well, my issues with postTraumatic Stress were recurring nightmares. I got a sleep aid as a result of those nightmares, so i would disagree with that. , mr. Diamond,and the bill that we have if youre down to 22,000, youre confident that you will be able to continue to reduce the cost of each dog . Rory diamond yeah, i would hate for our donors to hear that, but we have a scale that efficiencies are in the low 20s for the next year. Ron desantis good. Mr. Felman, what is the recommendation for making the case. Youre familiar with the research. What more in congress do we need to be finding and presenting or do you think that theres enough facts and existence to justify moving forward . Michael feldman well, we will continue to do the research and we will share the Public Research that we give you a preview of today. A Pilot Program, as you have written into this bill, is a way to go. You have built in valuation, a report as a part of legislation. The chance to continue studying but also to help a lot of folks. That is why we support it. Ron desantis well, look. At the end of the day, there has been a lot of anecdotal evidence and stuff coming out of the literature. Here is the thing. I can understand why thats a cautionary cautionary tale if there was somehow a negative side effects. But there is not. The worst case is that we have made veterans happy with service dogs as companions. That is like the worst case scenario. Obviously if theres a positive affect, you are actually giving veterans a sense of purpose, and i believe, saving lives. I will tell you since we have been involved in this issue i , have had multiple veterans come up to me and tell me that they would probably have committed suicide but for being paired with a service dog. It is not often people look you in the eye and tell you they probably would have done that. It really registers to hear that. Mr. Lyle . Cole lyle mr. Chairman, i would also note that just being a veteran any veteran will , probably tell you that they have any veteran of iraq or afghanistan, will to you they have a friend or a friend of a friend who has committed suicide and has been affected by this suicide epidemic. I will notehe v. A. Back in 2013 that indicated the 22 veteran a day average committing suicide. That was based on 21 states. So the number tragically is higher than 22 a day. That was just a sideote. But i will also say that since i have been doing this and because i have been talking to members of congress, friend of mine, specifically in texas because , the cost barriers are so high to getting your own service dog, and many veterans join the army to get a family, they do not have that Financial Support anymore. They do not have the Family Support to endeavor and then they get told that theres a wait time over a year and theyre told that had they do not have that time, and they go out and get a dog. I will note, as i believe it was mr. Russell, congressman madell said that he has personal connections the dogs he has been around. I would argue that if you dont think or believe that a dog can be therapeutic, a service dog specifically can treat certain symptoms related to postTraumatic Stress, that he probably have never owned or been around a dog. Ron desantis i appreciate that. Do you want to go real quick . If youre going to go, i will just recognize you. I will recognize the gentlemen from massachusetts. Stephen lynch thank you, mr. Chairman. The way that this is structured under the chairmans bill the , key relationship will be the the a and the contractor. If it is mr. Diamond or any other group. The 2016 va report said that there was a problem with the va not getting out to the contractor location where the training was going on or to the home of the veteran with the dog , and that broke down. Are we able to cure that in the further studies . In existing studies . Further studies . Yes, absolutely. The problem was that we were relying on the service dog and organization and trainers to interact and that was us not getting timely information about problems that have developed with the dogs and thats why we know hired our own dog trainers. Stephen lynch okay. Thank you. Ron desantis the chair now recognizes the gentleman from texas mr. Hurd. , the votes have started, but we have 13 minutes, so mr. Hurd, and if theres other questions, we may have time for other members. Will hurd thank you, chairman. I would like to thank the gentlemen from florida for having this panel, and i would like to thank mr. Lyle for being here. A ms from my, modern, texas my alma mater, texas a m university. It is where of the most active search and rescue teams you have , a Student Organization called aggie guide dogs and part of the taxes that network which includes operation canine. I want to thank you. As a former officer in the cia, i had the honor of serving alongside members of the military. Im familiar with the sacrifices that you and your family make. I know that this is a life changing experience, and has inspired you to give back to the community. I appreciate you for doing this. My first questions are to mr. Fallon. Has the va reached out to others conducting similar studies . Michael fallon after the difficulties we had with the pilot study will hurd the pilot study from 2006 . Michael fallon the one started in 2011. It was suspended in 2012. We realized we had to change the study protocol. We actually visited major organizations like canine companions. Will hurd my question is actually lets start before that. Why did the va decide to rein vent the wheel rather than relying on some other organizations that have a history in doing this kind of thing . Michael fallon well, for the pilot, sir we relied upon the , organizations themselves and all of which professed to be experienced and produce the high quality dogs. Unfortunately, that did not turn out to be true. Will hurd i dont know where to go. Theres so many questions. Why not reach out to dod and the learn from some of the experiences they have . Worldclass trainers and activities using dogs for , all kinds of services. Michael fallon admittedly, we were not familiar enough with the service Dog Community when we embarked on a pilot study. Will hurd say that again. Michael fallon we were not adequately familiar with the service Dog Community and the pitfalls in that community. No question about that. Will hurd so how much money did the va spend in phase one for the veterinary standards and i , have been told, are no longer in use . Michael fallon i am not sure of the exact figure. Its above 1 million in the pilot study. Will hurd above 1 million or above 10 million . Above 1allon million. That was for entire phase one and phase two. Will hurd could that money have been saved and could they have adopted dods and veterinary standards . Michael fallon no, sir. It was not just the veterinary standards but the training and follow up by the organizations and dog trainers and all of those things ended up to be a major problem. Will hurd now, youre the chief veterinary medical officer, correct . Michael fallon yes, sir. Will hurd what proposals have you suggested to incorporate this into the va . Michael fallon into the study, sir, or the va . Will hurd va, so that more veterans can get this type of of care. Michael fallon well, we have been directed by congress to do this study. That has been my focus. Will hurd whats the best next action . Michael fallon to complete the study successfully. Will hurd and whats the next best action there . The best step to make sure this is completed . Michael fallon we are doing it now. Will hurd when is it going to be done . Lateel fallon we expect 2018. And then a paper published from there. Will hurd mr. Lyle, i have less than a minute, but if you can go if you sotle bit need. Hopefully the chairman indulges my prerogative. Anything that has not been discussed during this hearing today that you think is important to get out there. Cole lyle thank you, congressman hurd. I think its important to understand and to reinterate reiterate what i said, that a service dog not only will combat specific symptoms like kaya does for me and waking up from nightmares etc. Etc. But theres , an affect that they give to you of providing a sense of purpose. When the veterans get out, they lose the military community, they lose their chain of command. They get their mission, their purpose ripped away from from them quickly. Nonprofits have done work in try ing to assist veterans transitioning but theyre still , struggling. I think the main reason is that they lose the sense of purpose. They lose their mission. They do not have anything driving them anymore. I think a service dog also provides that. I will just further note very quickly that i have spent the last year doing this and trying to raise the issue, talking to members of congress, it has been received very well. Its taken me a year to do this funding and all of this myself. We do not have until late 2018 to have this study completed and then try to have a program initiated at that point. 22 veterans a day are committing suicide. Anybody that is ok with that number, i would not say anybody at the v. A. Is ok with that. But we have something we know works. We have evidence now. With 22 veterans committing suicide, i return to what i said earlier, it is unconscionable that we do not explore alternative methods of treatment. Will hurd thank you for your service. Mr. Chairman, i yield back. Ron desantis the gentlemans time is expired. I want to thank you and the witnesses for taking the time to appear before us today. There is no further business. We stand adjourn adjourned. [captions Copyright National cable satellite corp. 2016] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] [background chatter] announcer donald trump is in buffalo, new york on monday. He is holding a campaign rally. Cspan 2 has live coverage at 7 00 eastern. Our live coverage of the president ial race continues tuesday night for the new york state primary. Join us at 9 00 eastern for election results, speeches, and viewer reaction. Taking you on the road to the white house on cspan, cspan radio, and cspan. Org. Madam secretary. We proudly give 72 of our delegate votes to the next president of the united states. [applause] announcer q as next. We have the author of the book the profiteers. That is followed by the question time with Prime Minister david cameron. He is asked about the data breach with the panama papers. Campaign appearance by bernie reporter this week on q a sally denton the profiteers as she talks about her book the which takes a look at the largest engineering and Construction Companies in the world. Sally denton, author of the profiteers. In your notes section you write this, i was denied access to caspar weinbergers papers. Sally denton i was really shocked about that and it turns out it is not really shocking at all, that a lot of public