NASHVILLE, Tenn. - Faced with tighter budgets after the Iraq War but still in charge of treating tens of thousands of injured troops, the military is getting a hand from a private foundation that is building medical centers specializing in the signature physical and psychological injuries of Iraq and Afghanistan.
The Pentagon has a partnership with the Intrepid Fallen Heroes Fund, which is raising $100 million to build clinics on military bases. The clinics will form a network aimed at treating and researching traumatic brain injury and post-traumatic stress disorder, two areas the military has focused on since roadside bombs became a common weapon in Iraq and Afghanistan.
Army officials say the foundation, which grew out of the philanthropic efforts of the late New York real estate businessman Zachary Fisher, has been highly effective because it can sidestep government bureaucracy on construction projects and provide a financial boost for medical advances that are desperately needed for injured soldiers, Marines, airmen and sailors.
Since 9/11, the charity has built the nation's top specialized hospitals for troops injured in Iraq and Afghanistan: a brain injury center of excellence in Bethesda, Md., and an amputee and burn rehabilitation center in San Antonio, Texas.
"We have felt that buildings often are catalysts for better care and attention," said Marty Edelman, a trustee of the Intrepid Fallen Heroes Fund and a New York-based real estate attorney.
Staff Sgt. Spencer Milo, 27, went to the National Intrepid Center for Excellence in Bethesda to treat persistent symptoms from a concussion he suffered during a suicide bomber blast in southern Afghanistan last year.
"The second you walk into these buildings, you instantly feel calm," he said. "You're in a small group and you really get very, very specific treatment. The first time you get there you sit in a room with every single doctor and you tell them what's going on, so you don't need to repeat yourself. Everyone is consistently on the same page."
At the Intrepid Center, there were no rushed appointments or bouncing from one doctor to the next, Milo said. He also benefited from alternative treatments and therapies that aren't available at other military hospitals, like art therapy, and he was given a service dog to help him in his recovery.
Now the fund is widening its scope beyond the two hospitals with a plan to build between seven and 10 clinics at the nation's largest military installations, with a hub-and-spoke model to channel the latest patient data up to research hubs and push down treatment models to the doctors and therapists.
Clinic groundbreakings have already happened at Fort Belvoir in Virginia and Camp Lejeune in North Carolina and additional clinics will be built at Fort Campbell in Kentucky, Fort Hood and Fort Bliss in Texas, Fort Carson in Colorado, Fort Bragg in North Carolina, and Joint Base Lewis McChord in Washington.
The charity raises the money to build the facilities and once completed, turns over control to the military branches, which are then responsible for staffing and operating the clinics.
"We don't pretend to be doctors," Edelman said. "So we build the best facilities that money can buy and we engage the entire American community to support us."
The foundation has a history of stepping into the gap when the government has been slow to react or respond to the military's neediest families. At the beginning of the wars in Iraq and Afghanistan, the fund provided grants to the families of U.S. service members who were killed until federal legislation substantially increased survivor benefits.
Edelman said the charity doesn't focus on complaints that the military hasn't done enough to adequately treat the signature wounds from Iraq and Afghanistan.
"I can understand people saying, `How come the government hasn't already done it?'" he said. "... Sometimes it's hard for it to move quickly, but we can. We don't think about as they haven't, we just think about it as we can.
"We are going to help them do it in the time frame and the level of excellence that the American private sector can do," he said.
Col. Nikki Butler, director of the rehabilitation and reintegration division for the office of the Army surgeon general, said the Army is not dependent on the Intrepid Fund but does appreciate the help.
The Army has already been treating soldiers with traumatic brain injury and PTSD at these installations, she said, but the centers will enhance that care with a multidiscipline approach that includes some new types of providers, like acupuncturists to treat chronic pain.
She said the facilities will be very helpful for some of the Army posts that have outgrown existing space, and each new clinic will have staff members tailored to best suit the population at the local installation.
"You want to be able to treat them holistically, in that patient care setting, rather than sending them all over the place," Butler said. "It may require different types of providers, but I think what you get is efficiency and eventually get less demand on the system and better use of the patient's time and the provider's time."
Butler said partnerships with the NFL and public giving campaigns like this one are helping to shed light on concussion care and behavioral health issues.
"Brain injuries are not easy to see and people don't like to talk about the psychological pieces of it. When you have strong partnerships with other big entities, then I think it's much easier to bring it to light in the public venue," she said. "The public is much more aware than they ever were even five, 10 years ago."
Even as the military shrinks in size and overseas obligations, there will continue to be a long-term need to treat these soldiers, Butler said, noting more than 80 percent of all TBI injuries don't occur in a war zone.
The charitable giving comes at a key time for the defense department, which is facing the possibility of severe funding cuts if Congress can't agree on a budget.
Dr. Bret Logan, director of the TBI center at Fort Campbell, Ky., where one of the new clinics will be built later this year, acknowledged that it's a tight financial year for the government, but the military is prioritizing care for the neediest troops.
"What's important is that you don't become a black hole where people are just dumping money into," he said.
Logan said there's always been a constant stream of individuals and groups who want to help these soldiers, but the Intrepid Fund has found a way to streamline public giving.
"It falls to guys like Fisher and the Intrepid Heroes Fund to get the organization together to find these people," he said. "I think everyone is looking for a way, even now, to help. It's a personal thing for people. The easier you make it for people to help, the more they are likely to do so."
Milo, the Army staff sergeant who was treated in Bethesda, said it's refreshing to see a charity step up to help soldiers who are still fighting and dying overseas.
"A lot of times you come back and people want to turn a cold shoulder to you and pretend like it doesn't happen," he said. "It's nice there are people out there like the foundation and others that do care and want to help us when we come back."