In practically every substance abuse therapeutic environment in the world, a system has been established as overwhelmingly dominant for its success in treating individuals with Substance-Abuse Disorders and co-occurring mental health disorders (such as Bi-Polar, PTSD or Schizophrenia).

It works quite simply. If you are willing to ask for help, then you enter an Inpatient (that is, residing on the campus of the facility) treatment program where you will reside, from anywhere, typically, between 28 to 90 days. Following successful completion, it is recommended you attend an outpatient program associated with the inpatient program, where the individual may be enrolled for up to a year. Following successful completion of the outpatient program, “Aftercare” programs are usually offered, that can give the patient a continuous connection to their treatment program, sometimes available indefinitely.

The data shows that when an individual asks for help/intervention, it is the best case scenario for introduction into a program that will intervene in the individual’s life for a brief period. This is commonly known in treatment as separation from “People, Places and Things.” It’s a key component to evidence-based treatment for the past 20+ years. Get the individual out of a negative environment, replace it with a therapeutic community, and surround the individual with winning strategies and like-minded people.

The VA seems to think it has a better way.

At the Miami VA (and many other VHA hospitals across the nation), its 5th floor Substance-Abuse Treatment Program, SARRTP (Substance Abuse Residential Rehabilitation Treatment Program) operates in the reverse. You are required to attend its outpatient program, OSAC (Outpatient Substance Abuse Clinic), typically for 30 days or more, before you can be considered to be “eligible” for the inpatient program.

Social Worker and Intake Coordinator for the SARRTP Program at the Miami VA, Iramis Viera, told me that “…their [Miami VHA] studies have shown more success in their treatment program when an individual attends the OSAC program prior to admission to SARRTP.” She further clarified that SAARTP is a “residential program” not an “inpatient program,” like the acute episode psychological ward in the Miami VA, commonly known by its location in the hospital, 4Ab, is.

Here is the Merriam-Webster Dictionary definition of inpatient:

Obviously, this is EXACTLY what the SAARTP program is, who’s program length is anywhere between 63 to 90 days, according to the SARRTP Program Handbook for 2015/2016, where you are required to live in the 5D ward at the Miami VA Hospital to undergo treatment.

LET’S CUT THE BS.

Reclassifying the SARRTP program as “residential” instead of “inpatient” is the VHA’s first step to fudge the numbers to look better than they really are.

Their second method is their REAL intake process, as I highlighted above.

TO BE ACCEPTED INTO THE PROGRAM, YOU HAVE TO ALREADY HAVE CLOSE TO OR MORE THAN 30 DAYS OF ABSTINENCE FROM YOUR DRUG OF CHOICE.

Basically, you have to EARN your way into the program. You see, the less people who successfully complete the initial phase of the program, THE LESS CASH TO CONTINUE TO SUPPORT THE PROGRAM. Bonuses shrink or disappear. And, I’m sure, staff would have to be reduced.

OF COURSE SOMEONE WITH A MONTH OR MORE OF SOBRIETY WILL FARE BETTER THAN SOMEONE WITH A WEEK OR TWO! Statistically, it makes perfect sense! So why even worry about ACTUALLY treating the Veterans in immediate need, when having money to POTENTIALLY do it is MUCH MORE IMPORTANT?

Good job, yet again VHA. You require a COMPLETE overhaul in this arena too.

BUT LET’S BE FRANK. THIS SPECIFIC DRUG-TREATMENT PROGRAM AT THE MIAMI VA IS ALREADY RIDDLED WITH CORRUPTION, AND HAD ITS HANDS IN THE DEATH OF ONE OF IT’S RESIDENTS IN THE NOT TOO DISTANT PAST.

Oh, you haven’t heard? Check out Jim DeFede from Miami’s Local CBS Affiliate’s investigation, where a Miami VA Hospital Police Detective blew the whistle on the corruption: http://miami.cbslocal.com/2014/05/20/miami-va-whistleblower-exposes-drug-dealing-theft-abuse/

Or how about the Miami New Times’ article on the neglect which resulted in the Veteran’s death? http://www.miaminewtimes.com/news/nick-cutters-death-exposes-neglect-scandal-at-miami-va-hospital-6396446

Maybe the Miami Herald? http://www.miamiherald.com/news/local/community/miami-dade/article1962207.html

HOW ABOUT THE VA’S OWN INTERNAL REPORT? http://www.va.gov/oig/pubs/VAOIG-13-03089-104.pdf

Here’s some more links form places like TIME magazine, The Washington Times, etc. You know… small investigatory organizations, who must not know what’s really going on….

• Afghan Vet Dies of Overdose in VA Substance-Abuse Center
• Report finds major problems at Miami VA rehab site

OR HOW ABOUT A LETTER FROM LOCAL CONGRESSIONAL REPRESENTATIVES, ILEANA ROS-LEHTINEN AND MARIE DIAZ-BALART:

SHAME ON YOU MIAMI VHA.

These articles and letters all point to something that is an epidemic in the both the VBA and VHA systems of the Department of Veterans Affairs:

CORRUPTION AND NEGLECT WITHIN ITS LEADERSHIP AND PROGRAMS, FROM TOP TO BOTTOM.

I call for an administrative review of the Substance Abuse Treatment programs under the VA’s purview, beginning with the Miami VHA. I further call on Secretary Robert McDonald to personally initiate this review. Mr. Secretary, I believe you are an honorable man dedicated to fixing a system you publicly acknowledge as broken. You accepted that when you succeeded Gen. Shinseki. I’ve seen some amazing movement in the past few years, the Clay Hunt SAV Act taking the cake.

I implore you, Mr. Secretary, to be swift, and order the removal of such barriers to treatment as a mandatory period of abstinence as a guideline or reference point to any intake interview or review session, with the understanding that acute intervention is acceptable, such as when medically detoxing a patient before a program may be clinically processed and implemented.

An update will be posted within the next few weeks, with more supporting evidence, and any updates with movement within the VA on this issue and call to action.

Inquiries and comments can be directed within Medium, or to: FixTheVAmiami@gmail.com

Written by Brian W. Sims. Sims is service-connected disabled veteran and a Peer Counselor and Advocate for fellow vets. He is also a veteran of the Global War on Terrorism, having served in the United States Army Infantry. He also enjoys baseball, sarcasm, Bill Murray, vanilla dunkaroos and bacon (extra crispy) and recommends you check out the upcoming bad-ass Veteran Made movie, RANGE 15, by the boys at Ranger UP and Art-15 Clothing rltw: https://www.indiegogo.com/projects/range-15-movie#/

There exists a systematic failure when it comes to the care of veterans in this country. Difficulty navigating the VA’s benefits, securing employment, funding their education, securing housing and a lack of “purpose” are listed as the top five needs individual Veterans are challenged with solving today. Sure, we could blame it on the VA or the DoD or other government agencies, and they do shoulder the majority of the problem, but I don’t believe that the blame rests squarely on their shoulders.

I believe the responsibility rests on the shoulders of my fellow veterans.

So many of us are successful in business ventures, we’re having our books published, operating non-profits, attending school, and we’re holding positions in public office. Some might retort with a view (and supporting data) that demonstrates an overall success when it comes to veterans in these sectors. They would be right.

But let’s take a step back for a minute. There are over 40,000 veteran based/focused nonprofits operating in the United States. Each has a common goal in mind: to improve the quality of life for veterans, and each has a unique approach in doing so. What I’m about to propose is not a new idea, but it is our unique approach that we believe will bridge the gap of services provided by the government and the private sector.

The military builds their team in a simple way. Train an individual in a specific skill set. Take the appropriate amount of individuals trained in the specific skill sets necessary to complete a given task, and the result is a task force with the knowledge, skills and experience necessary to complete the mission in an accurate, timely manner. It is this same approach I believe we need to apply to the issues facing Veteran reintegration and services today.

I won’t fluff this anymore and I’ll break it down very simply, because this is a simple concept.

One: Construct a database of services available for veterans, their dependents and caretakers, and the service providers that support them, that is user friendly, easily accessible, fully populated with data, and designed with both the needs of Veterans and Veteran Service Providers in mind. One that reaches not just nationally, but GLOBALLY, for US vets abroad, and coalition and non-coalition veterans as well. Google, I’m looking to YOU for help with this. You have the access to data, algortihms and genius to adjust where needed. On top of that, the world is already familiar with your simple, functional interfaces, so minor adjustments to create a new output format is all we really need, combined with a ranking system to verify the legitimacy of an organization and its contributions.

Two: pair that technology with a physical location where our veteran focused organizations can operate as a “rally point.” This will organically strengthen veteran communities and provide personalized care and direct access to providers themselves, simplifying case management. These “rally points” will provide low cost or rent free desks to the providers. In addition, they will have a fitness component added to them in the form of free access to an onsite functional fitness gym and a social area where Vets can play pool, some video games, do homework or use a computer to apply for jobs, the possibilities are endless. All locations will be tailored to the needs of the community they are located within. We can construct new ones, rent spaces or square footage, or “charter” existing organizations. The locations need to be veteran staffed, empowering those veterans with a sense of ownership, thus organically strengthening the impact and reach of the initiative.

And that’s it.

To sum it up: “Think and act local, on a united, national scale.”

Some of you might say, “Well, there’s organizations already doing that.” And you would be absolutely correct. But these organizations are not united on a national scale. Some are supported by the VA. Some by local governments. Some are privatized corporations, and some are non-profits. The point is, no one is speaking the same language, and there is a systematic failure when it comes to providing access to services down to the individual veteran’s level because everyone is trying to grab money from the same cookie jar from every level, local up to the national scale and the private donors in between.

Just as we united under the same flag, the glorious stars and stripes we hold in such high regard, to solve this issue, the same approach needs to be made. We, as veteran service organizations and individual veterans, need to re-focus on the issue at hand:

THE ONLY THING THAT MATTERS IS THE INDIVIDUAL VETERAN.

That’s how we reduce the horrifying statistic of 22 veterans a day taking their own life. That’s how we get medical services and much needed education, housing and employment opportunities quickly and effectively to the individual veteran.

We need to pause, focus on what we as individual service organizations or providers do BEST, do that thing BETTER, and gather at a Rally Point to effectively provide that information to the individual veteran in a continuous fashion. That’s the only thing I’m proposing this initiative will do as an organization, be the best at gathering and deploying veteran resources, or in other words, logistics.

lo·gis·tics ləˈjistiks noun

1. the detailed coordination of a complex operation involving many people, facilities, or supplies.

The civilian sector is struggling to understand the issues we face, and how best to solve them. We don’t need them to. We already know how. We are leaders. WE ARE A TEAM. It’s time to show the world what 22 million United States Military Veterans can do together. We have a unique view of this world, and a unique skill set to offer in a most unique time in history. Together, we can achieve what no one else could.

In closing, I ask you to partner with us in this initiative, which we have named The Phoenix Project. Phoenixes burst into flame when it is time for them to die and are reborn from the ashes. So we too, as veterans, have figuratively died when we left the military, trading our military lives for one in the civilian sector. It is our DUTY to rise from those ashes and blaze a new path, where we can positively aid this world more than any one group ever could. Please join us in this growing movement, this band of brothers and sisters, where NOTHING SHALL EVER TEAR US ASUNDER.

Perpetually Yours,

Brian W. Sims, PRS-V(FL)

twitter: @BrianSims305 facebook: https://www.facebook.com/tppmiami/