LifeLines SFTT’s Initiative for Warriors with PTS 260 Riversville Road Greenwich, CT 06831 p. 203-629-0433 info@sftt.org www.sftt.org Table of Contents EXECUTIVE SUMMARY ......................................................................................................................... 3 SUMMARY OF FINANCIAL OBJECTIVES............................................................................................................................ 3 SHORT TERM OBJECTIVES (2013 - 2014) ......................................................................................................................... 4 KEYS TO SUCCESS ................................................................................................................................................................ 4 SFTT’S LIFELINES INITIATIVE ........................................................................................................... 5 SFTT BUSINESS OVERVIEW............................................................................................................................................... 5 GENESIS OF SFTT’S LIFELINES INITIATIVE .................................................................................................................. 5 LIFELINES: INVESTIGATION, INFORMATION AND INTERVENTION ........................................................................ 6 INVESTIGATE: IDENTIFY REPLICABLE AND SUCCESSFUL PROGRAMS ...................................................................... 6 INFORM: A CLEARING HOUSE AND “GO-TO” PTS RESOURCE ................................................................................ 7 INTERVENE: GET OUR VETS THE TREATMENT THEY MERIT ................................................................................... 8 MANAGEMENT TEAM: LEVERAGING EXPERTISE ........................................................................................................ 9 LIFELINES IMPLEMENTATION PLAN ............................................................................................ 11 BIG PICTURE – OVERVIEW OF THE PTS BATTLEFIELD.............................................................................................11 Prescription Drugs Don't Appear To Be the Solution ............................................................................................12 Sharing is Caring: Mentoring Works ..........................................................................................................................12 Treat the Vet, Not the Symptoms...............................................................................................................................13 INITIAL STEPS: BUILDING THE DATABASE..................................................................................................................13 INITIAL PROJECTS: DELIVERABLES 2013 - 2014 .........................................................................................................14 REPURPOSE THE SFTT MISSION TO BEST SUPPORT VETERANS WITH PTS ............................................................14 Background ........................................................................................................................................................................14 Next Steps .........................................................................................................................................................................15 FORMALIZE A RELATIONSHIP WITH VETERAN TREATMENT COURTS ...................................................................15 Background ........................................................................................................................................................................15 Next Steps .........................................................................................................................................................................16 DR. PAUL HARCH’S HYPERBARIC OXYGEN THERAPY ...............................................................................................17 Background ........................................................................................................................................................................17 Next Steps .........................................................................................................................................................................17 NURTURE NEW TREATMENT MODALITIES AND SUPPORT COMMUNITY PROGRAMS.........................................18 Background ........................................................................................................................................................................18 Next Steps .........................................................................................................................................................................19 MANAGEMENT: FOCUSED FOR SUCCESS.....................................................................................................................19 FINANCIAL PLAN OVERVIEW ........................................................................................................... 20 OVERVIEW ..........................................................................................................................................................................20 FIVE-YEAR SFTT ANNUAL OPERATING PLAN ...........................................................................................................21 Key Planning Assumptions .................................................................................................................................................21 Staffing Assumptions .........................................................................................................................................................21 Other Operating Expenses .................................................................................................................................................22 Sources of Funding .............................................................................................................................................................23 FIVE-YEAR SFTT PROJECTED ENDOWMENT FUND..................................................................................................24 Endowment Fund Assumptions .........................................................................................................................................24 Endowment Fund Co-Investing Investment Assumptions ....................................................................................................24 APPENDIX A – SFTT’S BOARD ............................................................................................................ 26 Eilhys England, Chair .......................................................................................................................................................26 Roger Charles, Vice Chair / Secretary ...............................................................................................................................26 MAG GEN John Batiste US Army (Ret), President .......................................................................................................27 Bob Evans, Treasurer ........................................................................................................................................................27 APPENDIX B – THE MEDICAL TASK FORCE .................................................................................. 29 APPENDIX C - THE ENDOWMENT FUND ...................................................................................... 32 APPENDIX D – DEFINITION OF TERMS ......................................................................................... 34 APPENDIX E – SFTT OPERATING PLAN ......................................................................................... 37 APPENDIX F – ENDOWMENT FUND PROJECTIONS ................................................................... 38 Executive Summary Stand for the Troops (SFTT) is a 501(c)(3) Educational Foundation established by the late Col. David H. Hackworth and his wife, Eilhys England, to insure that our frontline troops have the best available leadership, training and equipment and to protect and advocate for them as needed. With at least 1 in 5 Veterans from wars in Iraq and Afghanistan suffering from PTSD and suicides by active duty personnel and Veterans growing at an alarming rate, SFTT has responded with its LifeLines Initiative dedicated to providing effective and replicable treatment to high-risk Veterans to help them reclaim their lives. The Initiative is based on three actionable pillars: Investigation: Leaders of SFTT’s PTS Initiative and the Medical Task Force evaluate existing treatment modalities and promising new ones. We also identify private or community-based programs that provide replicable and successful treatment outcomes. Information: SFTT will use its outstanding reputation for integrity and truth-telling to fulfill the crying need for an integrated “Go-To” Resource and clearinghouse for relevant treatment alternatives. Intervention: SFTT is already intervening in high-risk situations to help troubled Vets and will continue to do so; we’ll also promote promising new treatment methodologies, provide financial support and otherwise nurture community-based treatment programs that offer the best promise to help Veterans recover their lives. Through its lean organization infrastructure and broad network of military and civilian volunteer experts, SFTT will leverage its expertise and unique networking capabilities to promote viable medical treatments and support community-based organizations that offer structured, comprehensive and confidential treatment programs to Veterans. As a non-partisan, apolitical foundation with an esteemed track record of investigative journalism, SFTT and its volunteer Medical Task Force are ideally positioned to provide frank and independent assessment of effective PTSD and TBI treatment programs. In effect, SFTT provides a credible third-party validation that will more clearly explain the healing opportunities that lead to better outcomes. Summary of Financial Objectives SFTT has long relied on small local fund raising events and other relatively small donations to sustain its investigative reporting. Given the complexities and logistics of dealing with the ongoing personal and social tragedies of Veterans who deal with brain-related trauma, SFTT believes the time has arrived to provide key management with the necessary stable funding to fulfill the LifeLines Initiative objectives shown above. To do so, we are recommending that SFTT’s Endowment Fund (“EF”) be increased from its current level of $300,000 to $15,000,000 by the end of 2017. A percentage not to exceed 10% of funds raised for the EF will be allocated to SFTT to cover ongoing expenses until the EF is properly capitalized. Income generated by the EF will be used to help fund promising treatment modalities identified by SFTT and Initiative Leaders. Currently, SFTT expects to leverage contributions to projects by encouraging co-investment. Found below is a chart which summarizes potential annual aggregate investments under different EF projected annual earnings (6% to 12% p.a.) and leveraged investments ($1 from EF in $3 and $7 in third-party contributions). LIFELINES – AUGUST 2013 3 Leveraged SFTT Annual Investments Projected Annual Investment ($15 million Endowment Fund) $15,000,000 6% $10,000,000 8% $5,000,000 10% $0 $1 to $3 6% $1 to $5 10% 12% $1 to $7 $1 SFTT to $"X" 3rd Party Investment Short Term Objectives (2013 - 2014) With the Initiative and core SFTT Management team now in place, SFTT’s most immediate objective is to identify and hire a Funding Manager (“FM”) who will be responsible for soliciting corporate and charitable contributions for SFTT’s EF. The FM will also supervise and direct SFTT’s other fund-raising activities. This will allow SFTT’s management team to concentrate on several important projects apart from our “Go To” information resource already in progress: Formalize a relationship with the Veteran Treatment Courts to identify local treatment alternatives for Vets and develop an efficient pipeline to get immediate treatment for high-risk Veterans; Use our Medical Task Force and Special Advisor, Dr. Yuval Neria of Columbia University, to identify and sponsor promising new treatments like the Harch Hyperbaric Oxygen Treatment, and Dr. Neria’s own Columbia University/NIH PTS Modification Study, a promising autologous stem cell therapy and a collaborative review between neuro-scientists at Columbia and those studying Transcendental Meditation for the David Lynch Foundation; Obtain “official” recognition and funding for Dr. Paul Harch’s Hyperbaric Oxygen Treatment and help Vets gain access to this promising treatment methodology; Promote underutilized VA-funded resources such as Veteran Centers, Supportive Service Center Programs, Veterans Crisis Line as well as other community- and private-based initiatives such as the Veterans Farm in Florida, an organic farming program run by Vets for Vets. Keys to Success In the end, it’s about the willingness of people to roll up their sleeves and help our brave warriors reclaim their lives. SFTT is a catalyst to make good things happen. The “right” people and adequate funding to allow SFTT to make a difference are the keys that we hope will bring the prospect of a much brighter future to the many young men and women who volunteered to protect our way of life. LIFELINES – AUGUST 2013 4 SFTT’s LifeLines Initiative SFTT Business Overview Stand For The Troops, a 501(c)(3) non-profit Educational Foundation, was established by the late Col. David H. Hackworth and his wife, Eilhys England, to insure that our frontline troops have the best available leadership, training and equipment and to protect and advocate for them as needed. SFTT is a non-partisan, apolitical foundation committed to provide our brave defenders and all Americans who care deeply about them with a national platform that spotlights critical issues directly affecting their chances of both winning battles, surviving combat and reclaiming their lives. SFTT's mission is to ensure that our country’s warriors receive the best available personal combat gear and protective equipment, including body armor and helmets, and the best care when they return home. In fact, the military has been testing helmet sensors in Afghanistan for well over four years to evaluate the effect of Improvised Explosive Devices ("IED") attacks on our troops while the attacks continue to escalate with little being done to provide our warriors with more adequate head protection. The sorry result is a near epidemic of troops suffering from traumatic brain injury (“TBI”) as well as Post Traumatic Stress Disorder (“PTSD”) from their service in Afghanistan and Iraq. We are in the forefront of the effort to correct this deplorable situation. SFTT believes that we need to destigmatize PTSD if we are to effectively mobilize the necessary resources to deal with this terrible epidemic. PTSD is not simply a “disorder” that can be treated like the common cold. At the request of many of our warriors, we strongly encourage dropping the “D” and will henceforth usually refer to PTSD and any other brain trauma (i.e. “TBI”) as PTS. Genesis of SFTT’s LifeLines Initiative Government sources indicate that 1 in 5 Veterans from our wars in Afghanistan and Iraq suffer from the lingering effects of battle stress and brain-related injury. While most independent assessments place that number far higher, at a minimum well over 200,000 Veterans currently suffer from PTS and, more frighteningly, an average of 22 Vets commit suicide every day. Veteran unemployment rates and those living in poverty are two to three times the national average. While senior military officials acknowledge that PTS is a serious and growing problem, diagnosis and treatment remain disjointed, not to mention that admitting to the disorder on record appears to be a career killer. Meanwhile new stories break daily about Veterans taking their own lives or behaving erratically despite desperate pleas by the families, friends and fellow service members to the chain of command for more easily available, more effective – and more confidential -treatment. Over the last couple of years, SFTT’s management and investigative arm have been looking into how military personnel receive treatment for these debilitating injuries. Sadly, we were stunned by the lack of effective and comprehensive long-term treatment programs available to our Veterans. In fact, the recommended Veterans Administration “treatment” protocols have created a legion of Veterans with chronic drug-abuse problems rather than any sustainable improvement to their condition - a problem that grows worse daily. LIFELINES – AUGUST 2013 5 In addition to our investigative findings, SFTT personally intervened in several high-profile situations where the lives of Veterans and/or their loved ones were at risk. SFTT was instrumental in helping place these Vets in programs that offered a variety of community-based social and treatment alternatives not currently available to most Veterans suffering from similar problems. This valuable learning experience placed SFTT’s management with leading experts in the field of brain-trauma injury and rehabilitation alternatives. This exposure and the generous contributions from military and civilians from all walks of life helped SFTT develop the Lifelines Initiative. LifeLines: Investigation, Information and Intervention As part of Stand For The Troops’ expanded mission, we have mobilized a task force of knowledgeable executives and eminent medical professionals to evaluate existing PTS treatment within the military and general communities to bring forward a comprehensive, targeted, more effective treatment menu for the benefit of our warriors. For too long the military has allowed frontline troops to either resume active duty or return to their civilian lives while suffering from this debilitating condition - all too often resulting in devastating consequences for both our brave warriors, their loved ones and their communities. Cutting-edge research must be adequately vetted and the results shared with others so that practical, replicable, effective and more extensive treatment programs can receive adequate funding to provide more viable and better alternatives for our Vets than those currently available. The Initiative is primarily focused on “Extreme Cases” where troubled warriors are potentially suicidal, and/or otherwise hopelessly lost as to how to fit back into the American way of life we all take for granted. The LifeLines program, described in more detail below, is broken down into three main initiatives: Investigate Inform Intervene Investigate: Identify replicable and successful programs There are hundreds - if not thousands - of treatment modalities to deal with PTS. Some have been officially sanctioned to treat Veterans. Competent authorities are currently vetting others, but the vast majority relies on anecdotal hype rather than solid replicable empirical evidence. Even “officially sanctioned” treatments provided by the Veterans Administration (“VA”) have come under fire because of a tendency to overmedicate. One should not be surprised that agreement on an effective treatment is so difficult to pin down. SFTT’s analysis suggests that treatment programs must be tailored to the individual rather than imposing a “silver bullet” solution. In fact, a Vet’s particular family, social and economic circumstances can be just as important in an effective rehabilitation program as any proposed treatment to deal with the trauma. The identification of promising PTS treatment possibilities and collaboration with VA-funded and other community-based treatment programs appear to be the most practical way forward. Found below are specific Investigative Initiatives: LIFELINES – AUGUST 2013 6 1. Continue SFTT’s investigative reporting on the “Basic Five” (body armor, helmets, boots, rifles, and sidearm weapons) to ensure that our military has the best personal combat equipment available – with less chance of actual physical trauma; 2. Develop an effective and replicable pilot PTS program in consultation with SFTT’s Initiative Leaders, the Medical Task Force (“MTF”), the SFTT Advisory Board, and outside subject matter experts/consultants; 3. Identify and evaluate promising new treatment programs that produce replicable positive outcomes for Veterans with PTS; 4. Focus and rely on our special advisors and the MTF to screen, validate, recommend and endorse overall PTS programs as well as specific treatment modalities for SFTT support; 5. Identify and collaborate with promising PTS VA funded and other community treatment programs to improve services and treatment they provide to Veterans and active service members suffering from PTS; 6. Partner the VA funded and other community-based programs; 7. Poll visitors and members on the SFTT website to stimulate debate. Inform: A Clearing House and “Go-To” PTS Resource SFTT sees itself as a nurturer and incubator of new and existing treatment programs that can be selfsustaining and provide Veterans suffering from PTS a chance to reclaim their lives. In that regard, SFTT uses its website, public and private forums and the media to disseminate relevant information to those seeking immediate help and, equally important, to those seeking to support SFTT-vetted treatment centers and/or treatment modalities. Information shared with Veterans and the public is based on SFTT’s investigative findings (see above) and other information deemed reliable that may be initially obtained in the public domain. While much information exists in the public domain, it is next to impossible to determine what information is reliable and, as important, how high-risk Vets can access these treatment programs. SFTT has already started on a clearinghouse for a variety of synthesized and practical information to help Vets locate the treatment they need and deserve. Found below are specific Information Initiatives: 1. Expand upon the current SFTT website to become the “Go-To” national resource to help high-risk Veterans find immediate assistance: a. Evaluate and list Veteran PTS Suicide Hotlines state-by-state, with precise descriptions of what each offers, and, where possible, the personnel; b. Provide information on State Resource Centers; c. Provide information on Veterans Court networks and services; d. Expand the SFTT website to host a Whitepaper Resource Center, including book reviews, interviews with authors, forums and social media Initiatives; e. Host a “Dear Abby” interactive forum to engage troubled Veterans, family members, loved ones and concerned citizens; f. Serve as an information and education center for model PTS treatment programs, new treatments, Veteran success stories, a “suggestion box” and a newsletter based on LIFELINES – AUGUST 2013 7 contributions of the MTF, the SFTT Advisory Board, SFTT’s staff and volunteers, and other relevant sources; g. Showcase treatment successes on the website, through YouTube, other social media and public forums; 2. Establish SFTT as a highly informed PTS resource to the following constituencies: a. The media; b. National, state, local and community leaders; c. The military; d. The general public. 3. Establish direct and mutually sustaining relationships with compatible third party organizations to promote Vet wellness initiatives. Intervene: Get our Vets the Treatment they Merit The number of Veterans suffering from PTS has already overwhelmed the resources available to support them. On the positive side of the ledger, there are many people and organizations poised to assist them. The issue is to determine the best way(s) to mobilize large (but not unlimited) resources to bring about lifechanging improvement to the greatest number of Veterans suffering from PTS. SFTT’s goal and challenge is to use its experts to help identify and promote promising new treatment methodologies, provide support to community-based treatment programs and nurture and support those programs that offer the best promise to help Veterans recover their lives—never losing sight of this question: How many brave young men and women who wore our country’s uniform were helped by these interventions? Found below are SFTT’s specific Intervention Initiatives: 1. Intervention: a. Intervene in high-risk situations to help troubled Vets obtain immediate help to prevent injuries to themselves and others; b. Identify and place troubled Vets in treatment programs before any event of consequence has occurred, to include substance abuse programs in parallel to PTS treatment programs; c. After arrest, assist defense counsels to intervene with the judicial system, including Veterans’ Courts, public prosecutors and judges--and if necessary, the Military where there has been a questionable Dishonorable Discharge; d. Where warranted and possible, help arrange for treatment as probation (instead of jail); e. Work with legal firms to provide Vets with pro bono legal services and help expand the Veterans’ Court System across America (currently in only 27 states). 2. Care & Treatment: a. Under the SFTT “Farmhaven” effort (see Farmhaven Program under “Specific Initiatives”), collaborate with and improve an existing Florida-based Vet Farm Program to create a bestin-class therapeutic program run by Vets for Vets; set the conditions to replicate regionally; b. Where possible and appropriate, partner with VA-supported community-based programs that practice confidentiality; LIFELINES – AUGUST 2013 8 c. Identify, support and collaborate with “third-party” community-based therapy and rehab programs that meet the standards deemed appropriate by our Initiative Leaders, Special Advisor, Suicide Expert and the MTF; assist programs to offer the most effective therapies. 3. Advocacy: a. Serve as an advocate for Vets suffering from PTS; destigmatize PTS among Vets and active service members; engage our Initiative Leaders, Special Advisor, Suicide Expert, MTF members and other experts as appropriate; b. Continue our awareness Initiative and hold community-geared fundraisers as well as majormarket music and comedy events, preferably corporate-sponsored, to gain widespread grassroots understanding and support; generate resources to support SFTT sponsored programs; c. Consider a “Stand For The Troops: Across America” Cross-Continental Mini-Caravan and Car Raffle, perhaps driving from the Florida-based Veterans Farm to another Veterans Farm in California; d. Develop and execute an SFTT website-based campaign: 1,000 donate $1000 – and so Stand for the Troops; e. Establish a highly visible Frontline Photo Contest (to dramatize what our warriors have survived) across multi-channels, kicked off with full pages in major men’s magazines such as Esquire, Maxim, Men’s Health - all already committed - and headlined “Esquire Stands for the Troops” etc. Management Team: Leveraging Expertise SFTT has long relied on volunteer contributions and efforts to sustain its investigative reporting and vaunted networking. Through its lean organization infrastructure and broad network of military and civilian volunteer experts, SFTT has already begun to leverage its expertise to promote viable medical treatments and support community-based organizations that offer well structured and comprehensive treatment programs to Veterans. As a non-partisan, apolitical foundation with an established track record of feature-level awardwinning investigative journalism, integrity and overall truth-telling, SFTT and its volunteer Medical Task Force are uniquely positioned to provide frank and independent assessment of effective PTS treatment programs. In effect, SFTT provides a credible third-party validation of well-structured and sustainable treatments that promise better outcomes. Given the complexities and logistics of making a credible dent in dealing with the ongoing personal and social tragedies of Veterans with brain-related trauma, SFTT has assembled an impressive core of acclaimed men and women from the fields of medicine and psychiatry to help bring forward the right current and new treatment modalities. SFTT’s PTS LifeLines Initiative is Chaired by Maj. Gen. John Batiste, US Army Ret. and Co-Chaired by Col. James D. McDonough, Jr., US Army Ret. who is currently the Senior Fellow for Veterans Affairs at the New York State Health Foundation. Special Advisor Dr. Yuval Neria, PhD, a Professor of Clinical Psychology at the College of Physicians and Surgeons at Columbia University and the Director of its PTS initiative, directly supports both our PTS Initiative Chairmen and SFTT overall Chair Eilhys England, who works closely on medical-related activities. LIFELINES – AUGUST 2013 9 SFTT’s Medical Task Force (also referred to as the Medical Advisory Board) is co-chaired by the following individuals: Dr. Henry Grayson, PhD, Co-Chair of SFTT’s Medical Task Force - A psychologist practicing in New York City and Connecticut. He has a PhD from Boston University, a postdoctoral certificate in psychoanalysis and psychotherapy from the Postgraduate Center for Mental Health and a theology degree from Emory University. The author of three books in his field, he and founded the National Institute for Psychotherapies, the Institute for Spirituality, Science and Psychotherapy and the Association for Spirituality and Psychotherapy. Dr. Frank M. Ochberg, M.D., Co-Chair of SFTT’s Medical Task Force – A psychiatry professor at Michigan State University with degrees from Harvard University, Johns Hopkins University, Stanford University and the University of London. Formerly an associate director of the National Institute of Mental Health, more recently he has been involved with numerous organizations dealing with PTS and also with founding Gift From Within, a non-profit foundation, and consulting at Columbine High School in Colorado. In 2003 he received a lifetime achievement award from the International Society for Traumatic Stress Studies. Other eminent scientists and professors include Suicide Expert Dr. Eric D. Caine, MD, Chair, the Department of Psychiatry, University of Rochester; Dr. Robert Cancro, former Chair, NYU Department of Psychiatry, and Addiction Expert; Dr. Stephen Ross, MD, Assistant Professor of Psychiatry, NYU and Bellevue Director of Alcoholism and Drug Abuse; and more than 20 other psychiatrists, clinical physicians, professors, social workers and other volunteer medical professionals who give freely of their time to help our brave warriors become whole. For more information on SFTT’s Medical Task Force, consult Appendix A. SFTT’s minimal-cost infrastructure has been sufficient to support its investigative journalism, but the challenges of brain-related trauma suffered by so many Veterans cannot be effectively addressed by SFTT without a modest investment in a slightly expanded full-time staff to help identify “best practices” and, where possible, help promising community-based treatment programs across the United States improve their capabilities. Most importantly, the personal and social ravages caused by this destructive trauma need to be addressed far more openly and responsibly in our society. With adequate resources, SFTT can provide Veterans, active-duty military personnel and their loved ones current and reliable information on “best practices” within their community and serve as a “Go-To” resource for those in need of help. Over the next couple of years, SFTT proposes to add a Managing Director (“MD”) to coordinate the expanding initiative. Supporting the Board and the MD are the Funding, Information and Public Relations Managers who will evaluate and disseminate mission-critical information to help improve and expand legitimate treatment programs and procedures for our men and women who have served our country so valiantly. SFTT will both maintain its lean organization infrastructure and be better able to leverage its broad network of military and civilian volunteer experts to identify and promote viable medical treatments and support community-based organizations that offer well structured and comprehensive treatment programs to Veterans. Also, a non-partisan, apolitical foundation with an esteemed investigative track record, SFTT’s LIFELINES – AUGUST 2013 10 “Go-To” Resource is uniquely positioned to provide a frank, independent and credible third-party assessment, in an easily accessible format, of what’s worthwhile and available. LifeLines Implementation Plan While Armed Services related PTS may not receive the media attention of a Newtown, CT school tragedy or a sensational televised murder trial, the fact that an average of 22 Veterans commit suicide each day - a staggering 20% of all reported suicides in the United States - is a shocker! SFTT is not arguing that all of these suicides should be attributed to PTS; however, there is an overwhelming body of evidence suggesting that the vast majority probably is combat-related. The resources of the Veterans Administration have been inadequate to deal with the growing number of Veterans suffering from PTS. While approved VA medication plans may sometimes deal with the symptoms, the evidence suggests that prescription drugs have had no lasting benefit to Veterans and may, in fact, produce dangerous, sometimes fatal, side effects. With growing disillusion, Veterans have been seeking help elsewhere. In many cases, internet-search and word-of-mouth alternatives have proved to be equally ineffective and possibly just as dangerous. Big Picture – Overview of the PTS Battlefield While there is no shortage of ideas to help address military-related Post Traumatic Stress problems and there are many caring organizations that do help Veterans and their loved ones cope with problems stemming from PTS, the PTS battlefield is littered with hundreds of scams and organizations which offer little real value. The recent disclosure of the $300 million fraud perpetrated by Allied Veterans of the World simply underscores this problem. SFTT has connected with hundreds of public and private organizations, independent physicians, Veterans and caregivers to determine which treatment alternatives offer promising and lasting positive outcomes. Although we still have not discovered a "silver bullet" to treat PTS 100% effectively, we have identified treatment approaches that seem to work better than others and a host of people genuinely committed to helping our Veterans reclaim their lives. With your support, we hope to discover still more - and validate, nurture and support as many of these promising treatment programs as possible. For quite some time, the Veterans Administration has been contributing financially to selected communitybased outreach programs and services across the United States that run the gamut from group and individual therapy programs, job-training, housing and even financial assistance. These programs have been vetted and partially funded by the VA, but also rely on the generous financial contributions of businesses and individuals within the community and volunteer efforts of concerned Americans who give generously of their time and expertise to work with Veterans. These community organizations are autonomously managed and staffed by non-VA individuals without much of the traditional paperwork and structure of the VA. Most importantly, these organizations operate at arm’slength from the VA, thereby protecting the privacy of Veterans who avail themselves of their services. Col. James D. McDonough, Jr., US Army (Ret.) who is currently the Senior Director of Community Engagement LIFELINES – AUGUST 2013 11 and Innovation at Syracuse University’s Institute for Veterans and Military Families, has identified three VAsponsored programs which tend to provide useful community-based assistance to Veterans: Veteran Centers; Supportive Service Center Programs and the Veteran’s Crisis Line. While these community-based programs appear to offer considerable local and confidential assistance to Veterans without the traditional bureaucracy of the VA, the benefits of these programs are not widely understood and therefore not accessed by the majority of needy Veterans. Prescription Drugs Don't Appear To Be the Solution It is hard to imagine the sense of alienation and the self-worth issues faced by Veterans trained to react in a combat environment trying to acclimate to civilian life. With the unemployment rate among Veterans three times the national average, with over 20 Veterans committing suicide every day - almost one-forth of all suicides in the United States - prescription drugs or self-medicating are hard to resist. The result is rampant substance abuse among returning Veterans, particularly those with PTS. Prescription drugs tend to treat the symptoms of PTS - depression, anxiety attacks, etc. - rather than offer any long-term cure. In fact, there is an overwhelming body of evidence that many Veterans are overmedicated, with appalling consequences. For example, one Veteran drug counselor, with years of experience in the field, suggested that as many as 90% of Veterans with PTS have a substance abuse problem. In his opinion, the problem often stems from a cocktail of OxyContin, which produces serious side effects, coupled with other potent drugs prescribed by the VA. While we assume this protocol is well-intended, it’s close to impossible to predict what will happen when combat trauma, prescription drugs and alcohol intersect. Currently, the only VA-approved non-pharmacology programs to treat Veterans with PTS are Prolonged Exposure Therapy (“PET”) and Cognitive Behavioral Therapy (“CBT”). Both of these “exposure” therapy programs are supported by clinical evidence of about 50% efficacy, but clearly these programs alone are insufficient. Other alternative treatment methodologies used outside of the VA include Transcendental Meditation, equine or dog therapy, music therapy, dream therapy and even medicinal marijuana. Despite both anecdotal and some clinical evidence that these programs have some success in treating some Veterans, the VA has yet to endorse or underwrite any treatment beyond PET and CBT. SFTT believes that research today is better and that the VA is becoming stricter in administering prescription drugs. But it would be naive to expect that Veterans with PTS would stoically deal with their issues when painkillers, prescription drugs, alcohol and illegal drugs remain so readily available. Sharing is Caring: Mentoring Works SFTT has found that treatment programs consisting of a network of Veterans tend to produce better results than outpatient treatment programs. Predictably, having someone to lean on with similar military experiences can aid recovery and help keep aberrant behavior in check. However, while peer pressure does assist in the recovery process, third-party supervision and ongoing treatment are key to a self-sustaining positive result. Simply put, groups of Veterans in supervised treatment programs with a common goal - i.e. full recovery tend to have better long-term outcomes. LIFELINES – AUGUST 2013 12 Treat the Vet, Not the Symptoms In practice, most current treatment programs are focused on treating the symptoms of PTS rather than offering replicable and proven procedures to deal with the Vets as individuals. SFTT believes that while the underlying trauma or brain-injury may have a root cause – and there is no clear agreement even on this – Veterans’ social, financial and educational life-skills can vary significantly, which can have a huge bearing on their ability to reclaim their lives. It follows that treatment programs offering a variety of regularly scheduled treatment alternatives and other life-skill programs (i.e. financial counseling, job-training, high school diplomas or a technical degree equivalent) tailored to the needs of the individual, tend to produce more positive sustainable outcomes. Most importantly, SFTT has seen clear evidence that improved long-term outcomes are best achieved in closely supervised situations where at-risk Vets live and work together in treatment centers or a related controlled environment for an extended period of time. Veterans suffering from PTS need effective and replicable long-term solutions to allow them to reclaim their lives. In addition to the trauma and its debilitating consequences, too often Veterans have been thrust back into an apparently benign social milieu for which they are ill prepared, especially since many are still trying to unlearn the split-second combat reactions now inappropriate to their present environment. While the battlefield hardships and constant threats on the lives of these men and women may be left behind when they’re redeployed Stateside or mustered out, their reactions to perceived threats and traumas are still real. Moreover, the military provides a 24/7 structure to active-duty military personnel that is impossible to replicate in civilian life. Dealing with the changed circumstances of the home front is for many returning Vets no less disturbing and overwhelming than combat. Any consequent erratic behavior can affect their relationship with their family and loved ones, their ability to hold a job and their struggle to reclaim their lives. Initial Steps: Building the Database SFTT’s most immediate goal is to develop and maintain a meaningful and current database of communitybased PTS treatment facilities in the United States and, where possible, to conduct a due-diligence of those facilities based on SFTT-developed treatment standards so as to hopefully screen out charlatans who profit from the misery and suffering of others. As indicated previously, there are a number of active VA-supported community initiatives that are currently under-utilized by Veterans because of various misconceptions. To rectify that and offer more easily accessible information about other treatment choices, SFTT is developing a much needed comprehensive “Go-To” Resource for Veterans, their spouses and loved ones. Over time, the database will allow researchers to determine “best practices” and maintain and evolve a replicable menu of best treatments with best outcomes that can be adapted to specific needs as well as serving an increasing number of suffering Veterans without sacrificing overall quality of care. Developing alternative treatment programs and expanding the services currently available at existing treatment facilities is vital, but discretely tracking the success-failure data to determine which treatments and programs are most successful and then freely sharing this information is equally so. LIFELINES – AUGUST 2013 13 Initial Projects: Deliverables 2013 - 2014 Based on its initial fieldwork, SFTT has already identified several important initiatives that appear consistent with our LifeLines Initiative. In some cases SFTT has already worked with these organizations leading toward more formal, ongoing liaisons once the capabilities and needs of each organization are properly assessed. In no particular order of importance (most projects will be developed simultaneously), the initial deliverables over the next 18 or so months are listed below: Rework the SFTT website, investigative reporting and public relations initiatives to accommodate the PTS Initiative, including the “Go-To” Resource; Formalize a relationship with the Veteran Treatment Courts to help identify appropriate treatment centers for Vets and to develop an efficient pipeline to identify and assist high-risk Veterans get immediate treatment; Obtain “official” recognition and funding for Dr. Paul Harch’s Hyperbaric Oxygen Treatment and help Vets gain access to this promising treatment; Seed Special Advisor Dr. Yuval Neria as he leads a team of researchers from Columbia University and the NIH testing a new neuroscience-informed computer-based Attention-Bias Modification Treatment (“ABMT”) designed to substantially ameliorate PTS symptoms; Evaluate Transcendental Meditation; Evaluate a promising state-of-the-art Autologous Stem Cell therapy; Help the Veterans Farm in Florida, under our Farmhaven Program, with housing, a John Deere “Gator” and other needs, then use as a model to replicate similar community-based programs with appropriate partners in other communities across the United States, focusing initially on the States of Connecticut and California. Repurpose the SFTT mission to best support Veterans with PTS Background There are hundreds of well-meaning organizations across the United States that provide community-based services to Veterans. But Veterans are generally not aware of the many “independent” services available to them within their own community. In fact, many Veterans lack the confidence, motivation or resources to seek treatment and/or support from these local organizations. Currently, the VA has three community-based initiatives that seem to offer Veterans with PTS a less intrusive alternative to conventional VA treatment programs. Many Veterans shun the VA itself because of the bureaucracy and the likelihood that any treatment or procedure will become a part of their military record and possibly affect their benefits. There are over 300 Vet Centers across the United States that effectively provide community-based services to Veterans who have served in combat. While these programs have been vetted and received grants from the VA, they operate relatively autonomously through street-front retail centers across the United States. At these Vet Centers, combat Veterans can receive a variety of services and support without much of the customary bureaucratic red tape. LIFELINES – AUGUST 2013 14 Similarly, the VA recently launched the Supportive Services for Veterans Family Programs (“SSVF”) that “awards grants to private non-profit organizations and consumer cooperatives who can provide supportive services to very low-income Veteran families living in or transitioning to permanent housing.” SSVF grants have been awarded to well over 100 community-based programs that have been vetted by the VA. To insure that VA grants effectively address the housing needs of Veteran families in financial difficulties, the VA will evaluate these community service-providers regularly. The Veteran’s Crisis Line (formerly referred to as a suicide hotline) is one of the more successful programs supported by the VA, but administered by third parties. “The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat or text.” This vital first-line defense is often the difference between a veteran obtaining immediate attention and far more disturbing outcomes, including suicide. Well over 50% of the individuals who respond to troubled Veterans are volunteers with considerable experience in dealing with crisis situations. Many volunteers who staff call centers are ex-military who can empathize with a Veteran. Information exchanged between Veterans and staff and volunteers at the Veteran’s Crisis Line is considered confidential. Next Steps The VA has already taken a number of positive steps to provide grants and assistance to community-based organizations to support troubled Veterans and Veterans with financial problems. They have done so promising confidentiality, and SFTT is encouraged that many of these programs are providing a welcome safety net within communities across the United States for Veterans with health and/or financial difficulties. Lamentably, most Veterans are unaware of these “local” services and have great difficulty finding trustworthy resources. In response, SFTT plans to highlight on our website where to go for help. Below are specific plans: Develop SFTT to become the “Go-To” Resource Center for Veterans seeking immediate and long term assistance; Actively support and nurture new treatment modalities (e.g., Harch Hyperbaric) and where appropriate, other alternative treatment programs such as Farmhaven which can be deployed regionally; Consolidate available VA-supported programs (e.g., Veteran Centers and SSVF programs) and other privately run community programs into an easily accessible database for Veterans; Reposition the SFTT website to provide Veterans with a comfortable and easily navigable way to identify and access other support resources within their community; Partner with responsible national and community employment providers to develop a reliable and up-todate job resource database for Veterans seeking employment; Develop a monitored forum for Veterans to comment on existing treatment programs and to suggest other essential services that might prove beneficial; Through SFTT’s Special Advisor and Medical Task Force, provide informed commentary on new and emerging treatment alternatives for PTS. Formalize a Relationship with Veteran Treatment Courts Background In a far-reaching report summarized by Howard Altman of the Tampa Tribune, Major Evan R. Seamone, a member of the Army's Judge Advocate General's Corps, argues that "courts-martial function as problemLIFELINES – AUGUST 2013 15 generating courts when they result in punitive discharges that preclude mentally ill offenders from obtaining Veterans Affairs treatment. Such practices create a class of individuals whose untreated conditions endanger public safety and the veteran as they grow worse over time." Major Seamone's 212 page report for the Military Law Journal may be accessed by clicking on this hyperlink: The Military Court system and PTSD. His observations are clearly on target when it comes to dealing with Veterans suffering from PTS and, as observed earlier, the astoundingly large proportion of Vets who suffer both from PTS and a substance abuse problem. Although substance abuse can all too easily become an opiate for those already suffering from combat-related trauma, the V.A. and our military courts tend to address PTS and substance abuse as separate issues, depriving large numbers of Veterans from the comprehensive treatment they desperately need and deserve. But since mid-1990, the US judicial system has recognized the need to deal with drug-related criminal activity and has established some 2,600 Drug Treatment Courts in the United States. Drug Treatment Courts are specialized community courts designed to help stop the abuse of drugs, alcohol, and related criminal activity. Non-violent offenders who have been charged with simple possession of drugs are given the option of receiving treatment instead of a jail sentence. These Courts have proven to be remarkably successful at reducing the level of recidivism in our prison system. Capitalizing on the legislation, legal infrastructure and documented success of the Drug Treatment Courts, approximately 120 Veteran Courts have been established in 35 states to deal with Veterans who have committed a crime while suffering from substance abuse. Rather than jail time, Veterans are given the opportunity to enter a two-year closely monitored rehabilitation program where they must be drug-free, obtain the equivalent of a high school diploma and have a paying job. In many cases, these troubled Veterans have the support of other Vets (often from the Vietnam era) who mentor their military colleagues and serve as a sounding board through this rehabilitation process. Judge John Schwartz in Rochester, NY, one of the early pioneers in the Vet Court system, placed it very clearly in its proper context: "We offer hope to these troubled Veterans who have served our country so valiantly. It's simply common sense." SFTT has been working closely with several members of the Vet Court system for close to two years. In fact, Vets referred by the Vet Court system have been placed through SFTT in independently run PTS treatment programs and a group living facility. Judge David Jordan of the Lansing, Michigan Vet Court has just retired and agreed to volunteer for SFTT as the Chair of our Vet Court Liaison. Next Steps SFTT has found the mentoring process afforded by the Vet Court system to be a positive influence to provide Vets with a second chance and one that can come without a record. Clearly, substance abuse is not the only issue troubling these Vets, and SFTT believes that early intervention at the Vet Court level offers some reasonable chance that problems will not escalate past the point where a Vet does bodily harm to him or herself or to others. The Vet Court system can serve as a conduit to help identify and screen high-risk candidates for possible inclusion in PTS treatment programs as deemed appropriate. Planned steps are as follows: LIFELINES – AUGUST 2013 16 Establish relationships with Veteran Courts and Justice for Vets to offer periodic training where appropriate by members of the Medical Task Force; As SFTT builds its database of “vetted” treatment facilities, develop a timely and effective communication channel through the Vet Courts to help get viable monitored treatment options preand post-sentencing that can serve as productive alternatives to prison or probation. Eventually develop a nationwide database to monitor recidivism. Dr. Paul Harch’s Hyperbaric Oxygen Therapy Background Well over a year ago, Eilhys England met with Dr. Paul Harch, a pioneer and leading expert on Hyperbaric Oxygen Therapy or HBOT. According to Dr. Harch’s website, “HBOT uses 100% oxygen in a pressurized chamber to treat wounds in the body of any duration in any location.” In effect, pure oxygen is delivered at pressures up to 3 times the normal atmosphere over a period of about an hour. From a layman’s perspective, the ingested oxygen (up to 10 times the normal oxygen level) serves as a drug to stimulate red blood cells to regenerate neglected or afflicted cells in the body. Depending on the severity of the ailment, up to 40 sessions in the Hyperbaric Chamber are required. Dr. Harch has written extensively about The Oxygen Revolution and has received many awards and citations in medical journals for his research. In fact, the Journal of Neurotrauma reported the following on Dr. Harch’s “ground-breaking” study on Vets with TBI and PTS (excerpts): “On November 22, 2011 the long-awaited preliminary results of the LSU Pilot Trial of hyperbaric oxygen therapy in chronic blast-induced mild-moderate traumatic brain injury (TBI/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD) were published online. And, the results are stunning . . . The study . . . significantly improved the Veterans, their disabling symptoms and quality of life.” Indeed, so compelling were Dr. Harch’s treatment outcomes for Vets with brain trauma that SFTT requested that he treat Maj. Ben Richards, a West Point graduate and scholar who had been prominently featured in the New York Times article entitled “War Wounds” by Nicholas D. Kristoff. Dr. Harch agreed to treat Maj. Richards and at SFTT President John Batiste’s request, Ben’s fellow West Pointers rallied around and made generous contributions to support his housing and family while he was undergoing therapy. SFTT has reported regularly on Maj. Richards’ recovery process, but it is stunning to see the benefits of Hyperbaric Oxygen Therapy in an article published by SFTT that contains a short but very interesting video news clip from WWLTV in Louisiana. Next Steps To date Dr. Harch’s brain function-enhancing Hyperbaric Oxygen Therapy regimen remains unavailable through the VA. Present and future SFTT intervention here includes: Expediting a meeting between SFTT Special Advisor, Dr. Yuval Neria, Columbia University neurologists and Dr. Harch to achieve and then utilize Columbia’s more fully informed support for the Hyperbaric regimen; LIFELINES – AUGUST 2013 17 Using the media to create wider awareness for this treatment therapy with the general public, Vets, the VA, the DoD, members of government and other key influentials; Working with Dr. Harch and non-government third parties to expand treatment coverage for Vets; Co-funding treatment for high-risk Vets with other organizations we identify. Nurture New Treatment Modalities and Support Community Programs Background One of SFTT’s primary goals is to nurture, promote and support promising new treatment modalities like the Harch Hyperbaric Oxygen Therapy and to seed studies of treatments like Special Advisor Dr. Neria’s new computer-based Attention-Bias Modification Treatment Protocol designed to quickly ameliorate PTS symptoms in eight 10-15 minute sessions over a four week period. In addition, SFTT is working with Dr. Steven Victor, Chairman and CEO of IntelliCell BioSciences on possibly treating TBI with Adipose-derived Stem Cells (“ASC’s”). Intravenous administration of ASC’s seems to demonstrate a decrease in inflammation and chronic brain degeneration and promote long-term functional recovery. Dr. Victor and other scientists see great promise in using such therapy to help regenerate brain cells of Veterans suffering from PTS and TBI. As promising new treatment modalities emerge, SFTT will assess their effectiveness, implementation time frame and relevance to SFTT’s overall PTS initiative. Where appropriate, an Initiative Leader from SFTT will be assigned to work with the developer to mobilize the necessary resources to fast-track the treatment within the necessary approval channels. While nurturing promising new treatment modalities, SFTT will focus much of its capabilities on developing and partnering with others to help deploy replicable treatment programs to communities and private and/or charitable initiatives across the United States. SFTT will leverage its human and financial resources to identify, promote and support community and private programs that provide measurable benefits to Veterans. These programs channel different resources, treatment options and approaches to help Veterans with PTS transition back to civilian life, but all selected programs are goal-oriented with the objective of helping these deserving young men and women reclaim their lives to become productive members of their community. For instance, the Veterans Farm program in Jacksonville, FL is an initiative of former Sgt. Adam Burke, an OIF/OEF combat veteran and Purple Heart recipient, who was recently (2012) awarded the prestigious Presidential Citizens Medal by President Obama. Responding to what he believed were serious shortfalls in the VA healthcare system and the Veterans Affairs Voc-Rehab program (supported by an IG audit), Mr. Burke created the Veterans Farm program “to unite disabled Veterans and to help them overcome disabilities such as PTS and TBI, as well as other disabilities that prevent them from employment. This can be accomplished through ‘Horticulture Therapy’. Through this program, Veterans also have a chance to earn while they learn.” Similarly, SFTT will feature, promote and support the successful Veterans Outreach Center (“VOC”) in Rochester, NY - which the co-chair of our PTS initiative, James McDonough, built - as a model program that can be used to enhance similar programs across the United States with lessons learned. LIFELINES – AUGUST 2013 18 Next Steps Given the large and growing personal, family and community suffering and their attendant social costs, it is not surprising that many concerned citizens and organizations have mobilized to support our brave Veterans. Unfortunately, there are still no clear and effective “gold standard” guidelines on how to actually treat PTS with more than 50% effectiveness and, equally importantly, provide caregivers with a proven and replicable roadmap to help Veterans on the path to wellness. SFTT plans to use the PTS Initiative to: Assign Initiative Leaders to fast-track promising new treatment modalities within the approved government and/or medical verification process; Together with the Medical Task Force and other third-party consultants, develop and update effective treatment guidelines and recommended infrastructure requirements and promote networking to assist community-based programs to develop and sustain themselves; Work with the Veterans Farm program in Jacksonville and third parties to secure nearby “permanent” housing for Veterans registered in the Horticulture Therapy program; Partner with the VOC in Rochester and similar successful VA-supported programs to build a model of excellence which can be adapted to the needs of Veterans in other communities across the United States; Identify other promising community-based programs across the United States that need nurturing and financial support to provide better and sustainable treatment outcomes to Veterans. While SFTT does not have sufficient financial resources at present to directly fund promising privately managed community-based programs, our endorsement and access to decision makers and funding resources attract seed funds that make a difference. And we expect our ability to finance worthy partners who “Stand for the Troops” to expand as rapidly as we project because our plan is so cogent and the cause so worthy. Management: Focused for Success SFTT, a 501(c)(3) non-profit Educational Foundation was established by the late Col. David H. Hackworth and his wife Eilhys England and primarily supported by them until Col. Hackworth’s death in 2005. Since then SFTT has relied on small fundraisers, contributions and drawing down from a small Endowment Fund as needed. This Spartan philosophy has been sufficient to fund SFTT’s investigative reporting on the Basic Five (Body Armor, Combat Boots, Helmets, Weapons and Sidearms), but SFTT’s volunteers and consultants are no longer adequate to successfully implement SFTT’s expanding LifeLines PTS Initiative as described above. While SFTT’s leadership will continue to benefit from Chairperson Eilhys England’s marketing and networking capabilities, President John Batiste’s wisdom and outreach and our other eminent volunteers’ crucial input, day-to-day implementation will eventually be transferred to a Managing Director, hopefully a distinguished military Veteran, who will manage and mobilize third-party resources to help address the needs of our Veterans. Already, SFTT President John Batiste, (Maj Gen US Army Ret) is working closely with Eilhys England on SFTT’s transition into our expanding role in the PTS arena. Gen. Batiste will be as instrumental in recruiting the right ex-military Managing Director for this key function as he was with PTS Initiatives Co-Chair James McDonough (Col., US Army, Ret.). LIFELINES – AUGUST 2013 19 Supporting the MD will be a small cadre of three to four individuals (full- and part-time) who will be focused on funding the Endowment Fund, overseeing SFTT’s day-to-day financial needs and - most importantly developing the database on treatment programs across the United States and conducting regular due diligence of those that seek or receive funding from the increased Endowment. Subject to possible confidentiality agreements, SFTT is committed to transparency and plans to share all information freely with Veterans, the general public and any public or private institution seeking information to support SFTT or their own activities to help care for Veterans. All this is in line with what SFTT has always done - focus the best resources to tackle a specific problem. `In many cases, we can do this by channeling highly qualified volunteers committed to giving their time and expertise to help our Veterans. SFTT’s goal is to continue to expand our volunteer base and use our volunteer assets wisely so that their limited time is not wasted or dispersed. SFTT is dedicated to bringing forward promising new treatment modalities most cost-effectively, and to supporting third-party organizations that provide the best available care and treatment at the lowest cost. By vetting caregivers and then supplying a public database to encourage “best practices,” SFTT can cut through the mire to identify, nurture and support “above the rest” community-based treatment centers across the country rather than attempting to independently develop our own. Financial Plan Overview Overview SFTT’s business strategy is lean and mean, focused on raising capital to leverage its expertise and maximize the volunteer efforts of competent authorities to promote viable medical treatments and support communitybased organizations that offer well-structured and comprehensive treatment programs to Veterans. The financial plan, described in summary form below, reflects that strategy. Like many organizations, SFTT has been idea-rich and cash poor. Nevertheless, SFTT has built a formidable name for itself within military and public circles for its investigative research and its efforts, as the late Col. Hackworth would say, “to make sure American grunts get the right stuff!” Now that so many of our brave heroes are returning home after repeated deployments to the battlefields of Iraq and Afghanistan, “the right stuff” is no longer only the best combat equipment and protective gear, it is also something less tangible but no less life-affecting: proper and effective treatment for Veterans with PTS and TBI. SFTT’s financial plan will support this transition SFTT smartly, effectively and efficiently. SFTT’s financial plan has two interrelated components: the Annual Operating Plan and the SFTT Endowment Fund. The Annual Operating Plan (“AOP”) consists of the planned expenses over a 5-year time frame required to implement the LifeLines PTS Initiative (“LL”) described above and the projected growth of the Endowment Fund (“EF”) that will partially fund SFTT’s AOP and, as an imperative, provide grants to support new treatment procedures and community-based programs. Initially, SFTT’s primary focus is to attract funding to support the necessary staff required to implement the LifeLines Initiative and continue SFTT’s investigative reporting. Found below is a narrative and supporting financial summary of each key financial component: LIFELINES – AUGUST 2013 20 Five-Year SFTT Annual Operating Plan Key Planning Assumptions The goal of SFTT is to serve the front line troops - both Veterans and active-duty warriors - as efficiently as possible and mobilize volunteers and dedicated third-party consultants. SFTT will identify and support emerging new treatments for PTS and support effective community based programs. Where appropriate, SFTT will “incubate” alternative treatment programs vetted by the Medical Task Force and Initiative Leaders to help them through what is often a long and complicated gestation period. SFTT will continue to operate under a “less is more” philosophy, but will add more permanent staffing as needed to achieve the objectives described. SFTT will add no new premises or fixed assets over the plan period, but will hire four new permanent staff members phased in over the next two years to help develop a stable funding base for the organization. Staffing Assumptions The staffing model and underlying planning assumptions in terms of both timing and salary levels are based on realistic scenarios. The growth in the Endowment Funds and actual returns generated by Fund Manager(s) will determine staffing levels and our ability to financially support third-party programs. SFTT anticipates that key managers will be involved in all facets of implementing SFTT’s mission. SFTT has identified four new mission-critical staffing roles: the Managing Director, the Funding Manager, the Information Manager and the Public Relations Manager. Found below is a brief description of their responsibilities and estimated annual compensation in parenthesis: Managing Director ($80,000 p.a.): The Managing Director (“MD”) is responsible for executing the approved business plan formulated in consultation with SFTT’s Board and coordinating all its aspects. This will include mobilizing and supporting SFTT board members and the Medical Task Force to increase public awareness of PTS and the problems faced by Veterans. Most importantly, the MD will actively support, coordinate and promote promising new PTS treatments and community-based programs and liaison with appropriate decision-makers and funding organizations. Funding Manager ($60,000 p.a.): The Funding Manager (“FM”) is responsible for implementing SFTT’s long-term funding planning as determined by SFTT’s Board and the overall management of day-to-day finances of SFTT. The FM will also be responsible for fund-raising to meet Endowment Fund (“EF”) targets and SFTT’s direct funding programs. Where appropriate, and based on recommendations of the Information Manager (see below), and with MD and Board approval, the FM will assist third-parties with fund-raising activities to support their independent initiatives. Information Manager ($60,000): The Information Manager (“IM”) is responsible for compiling a national database of treatment modalities and programs with the objective of providing a meaningful database to identify and track promising treatment outcomes. The objective is to provide an independent assessment of third-party programs. In this capacity, the Information IM will conduct a regular due diligence analysis of new and existing programs supported by SFTT and, where appropriate, submit recommendations for matching grants from SFTT’s EF and collaborating parties. LIFELINES – AUGUST 2013 21 Public Relations Manager ($60,000): The Public Relations Manager (“PRM”) is responsible for executing SFTT’s public relations plan to increase public awareness of SFTT and our PTS Initiative and support SFTT’s ongoing funding initiatives. At the direction of the MD, the PRM will generate a wide range of news releases, publicity placements, outreach alliances and special events to target SFTT’s message with the general public, key decision makers and especially Veterans in need of help. The key new hires identified above will provide the necessary impetus to implement SFTT’s LL Initiative on the shoulders of SFTT’s existing core staffing and independent consulting team. A part-time and then fulltime assistant will be added in Year 3 of the Plan to assist the Information Manager in managing and disseminating the SFTT database to interested third-parties. Found below is a spreadsheet summary of projected staffing expenses: Staffing Expenses 2013 Est. 2014 2015 2016 2017 2018 $0 $60,000 $80,000 $80,000 $80,000 $30,000 $60,000 $60,000 $60,000 $60,000 - Information Manager $0 $30,000 $60,000 $60,000 $60,000 - PR Manager $0 $30,000 $60,000 $60,000 $60,000 - Managing Director - Funding Manger - SFTT Editor $26,000 $26,000 $26,000 $26,000 $26,000 $26,000 - Web Communications $24,000 $24,000 $24,000 $24,000 $24,000 $24,000 - Admin + Part Time $19,635 $18,800 $18,800 $28,800 $58,000 $58,000 $5,611 $9,760 $33,760 $45,760 $51,600 $51,600 - Payroll Taxes Subtotal Staff $75,246 $108,560 $282,560 $384,560 $419,600 $419,600 Other Operating Expenses SFTT’s Other Operating Expenses are primarily a function of overall staffing costs. One fundamental change in the overall composition of SFTT’s other operating expenses is the fact that the organization will use results-oriented third-party consultants for fundraising in coordination with the new Managing Director and Funding Manager. Over the next year or so, these functions will gradually be taken over by the new staff hires who will assume overall responsibility for these activities. Other Expenses 2014 Est 2014 2015 2016 2017 2018 $29,019 $30,000 $30,000 $30,000 $30,000 $30,000 - Promotional Expenses $4,238 $5,000 $10,000 $15,000 $20,000 $25,000 -Accounting/Professional $2,537 $5,000 $5,000 $5,000 $5,000 $5,000 - Web Hosting Expenses $2,610 $2,500 $2,500 $2,500 $2,500 $2,500 - Phone/Supplies $3,307 $4,000 $10,411 $14,169 $15,461 $15,461 - T/E $2,193 $5,000 $13,014 $17,712 $19,326 $19,326 - Miscellaneous $1,593 $5,000 $13,014 $17,712 $19,326 $19,326 $45,497 $56,500 $83,939 $102,093 $111,612 $116,612 - Outside Consultants Subtotal Other LIFELINES – AUGUST 2013 22 Sources of Funding SFTT has long relied on contributions of individual donors, fundraising events and some recurring “sponsorships” from members and supporters of SFTT. Direct contributions to SFTT and fundraising events will continue to be a welcome source of revenue to support our ongoing operating expenses. Nevertheless, new personnel will place considerable pressure on SFTT’s chronic need for resources that while not great considering the importance of the overall mission - are an unrelenting distraction and source of concern to SFTT’s management. For this reason, the Board is determined to focus a great deal of energy to develop a stable and dependable source of funding for SFTT’s Operating Budget. SFTT’s operating and funding strategy is similar to that of a Limited Partnership that consists of the Managing Partner: SFTT; and the Limited Partners: the Endowment Fund, which is funded by donations from individuals, estates, charitable foundations, firms and events of significant scope. The Limited Partners (i.e. the Endowment Fund) charge the Managing Partner (i.e. SFTT) to invest the income generated by the Fund in community-based programs, incubator funding for promising treatment modalities and the dissemination of reliable and timely information to Vets and the public at large. In effect, SFTT is the Operating Partner responsible for appropriately investing the income of its Limited Partner’s investments in the Endowment Fund in projects that support the SFTT LifeLines Initiative. To reach that goal of financial self-sufficiency, we expect that earnings from the EF projected capital base of $15 million will be sufficient by the end of 2018 to fund a large percentage of SFTT’s operating expenses and still generate a cash surplus to partner with other charitable organizations to fund promising PTS treatment programs. Raising funds for the EF is critical to the success of supporting the SFTT mission. Given the importance of developing a stable long-term financial platform, SFTT will allocate 10% of all funds raised for the EF to SFTT’s Operating Budget until the EF is properly capitalized at the Plan level of $15 million. Once the EF is properly capitalized, SFTT may receive periodic allocations - if needed - to fund discretionary expenses in an amount not to exceed 25% of the average of the previous two-year EF earnings generated by Fund Managers. SFTT will continue to host direct fundraising events that also serve to raise public awareness of the ravages of PTS and encourage current and new donors to support SFTT’s annual drive. Nevertheless, the largest projected funding resource is projected to be the 10% allocation to SFTT’s Operating Budget for raising funds for the Endowment Fund. Found below is a financial synopsis of the projected funding plan and the resulting Deficit/Surplus for each of the Plan periods: Funding Projections 2013 Est 2014 2015 2016 2017 2018 Direct Contributions ($- $35,000 $50,000 $75,000 $ 75,000 $ 75,000 Fund-Raising Events ($- $25,000 $50,000 $75,000 $100,000 $125,000 EF Contribution ($- $113,500 $200,000 $300,000 $350,000 $500,000 Subtotal SFTT Funding $120,743 $173,500 $300,000 $450,000 $525,000 $700,000 Total Operating Expenses $120,743 $165,060 $366,499 $486,653 $531,212 $536,212 $0 $8,440 ($ 66,499) ($ 36,653) $ 6,212 $163,788 (Deficit) / Surplus LIFELINES – AUGUST 2013 23 Given SFTT’s loyal base of donors and more public mission, we believe that the projected funding deficits can be met with direct contributions or temporary advances from the Endowment Fund. Five-Year SFTT Projected Endowment Fund As currently structured, SFTT is ill-staffed to implement the LifeLines Initiative described above. An unwarranted amount of energy is spent raising funds to support SFTT’s modest expense base. SFTT’s limited financial resources and staff should best be directed toward identifying useful programs to help treat Veterans with PTS. Now that the Medical Task Force and other experts are in place and projects have been identified to serve the mission, the Board has determined that “resolving SFTT’s chronic funding difficulties” must be the number one priority as SFTT moves forward to implement the LL Initiative initiatives. After reflection and numerous recommendations from competent third parties, the Board recommends hiring a professional fund-raiser (i.e. the Funding Manager) with the objective of building an Endowment Fund of no less than $15 million by the end of 2018. 10% of funds raised by the Endowment Fund will be allocated to SFTT’s Operating Budget until the funding target of $15 million is achieved. As appropriate, the EF will sponsor and/or partner with other donors and charitable organizations to bring forward promising opportunities for treating PTS. Endowment Fund Assumptions From its projected level of $365 thousand at the end of 2013, SFTT’s objective is to grow the Endowment Fund to $15 million by the end of 2018. For this business plan, we are assuming a gradual build-up in the Endowment Fund as SFTT’s mission becomes more widely known, but are hopeful that our planning assumptions will prove far too conservative. Independent fund manager(s) will manage SFTT’s Endowment Fund (“EF”). SFTT’s Board, based on recommendations by Eilhys England, John Batiste and the Financial Manager, will appoint qualified fund managers to manage the Endowment Fund. For years, Endowment Funds earned returns in excess of 10% p.a.; however, this is no longer the case. SFTT’s EF is expected to generate 5.5% in earnings on an annual basis. We believe that this is a very conservative planning assumption, but certainly in line with current market trends. Found below is a summary analysis of the projected growth of the EF and projected annual earnings based on the average EF balance in the plan year. Endowment Fund YE Balance ($000) Annual Return (5.5% p.a.) 2013 Est 2014 2015 2016 2017 2018 $365 $1,500 $3,500 $6,500 $10,000 $15,000 - $51,288 $137,500 $275,000 $453,750 $687,500 Endowment Fund Co-Investing Investment Assumptions SFTT’s goal is to identify and nurture promising PTS and TBI treatments. Based on our survey of existing PTS treatment programs and Foundations seeking charitable contributions, we have identified very few programs that provide replicable and positive outcomes. In fact, many charitable foundations seem perplexed on how best to allocate their contributions to help desperate Veterans. LIFELINES – AUGUST 2013 24 SFTT plans to leverage its EF investment earnings by co-investing in projects with third parties (perhaps the same parties who have invested in the Endowment Fund). Found below is a summary of possible investments based on leveraging EF investments with third parties from $1 to $3 to $1 to $7. Endowment Fund 2013 Plan 2014 2015 2016 2017 2018 EF Earnings N.A. $51,288 $137,500 $275,000 $453,750 $687,500 Match $1 to $ 3 N.A. $153,863 $412,500 $825,000 $1,361,250 $2,062,500 Match $1 to $ 5 N.A. $256,438 $687,500 $1,375,000 $2,268,750 $3,437,500 Match $1 to $ 7 N.A. $359,013 $962,500 $1,925,000 $3,176,250 $4,812,500 Clearly, SFTT’s ability to allocate more to promising treatments will be determined by projected earnings of the Endowment Fund. For instance, the chart below suggests that SFTT will be able to co-sponsor over $12 million in projects by 2018 if EF earnings are 12% and we achieve matching third-party investments at the rate of $1 in SFTT funds for $7 in third-party investments. Leveraged SFTT Annual Investments Projected Annual Investment ($15 million Endowment Fund) $14,000,000 $12,000,000 $10,000,000 6% $8,000,000 8% $6,000,000 10% $4,000,000 10% $2,000,000 12% $0 $1 to $3 6% $1 to $5 $1 to $7 $1 SFTT to $"X" 3rd Party Investment The size of the Endowment Fund and projected returns clearly play a very important role in determining what level of investment can be projected on an annual basis - and, ultimately, how many Veterans we can rescue. LIFELINES – AUGUST 2013 25 Appendix A – SFTT’s Board Eilhys England, Chair Eilhys England Hackworth was wife, partner, co-author, and muse of Soldiers For The Truth (“SFTT”) founder, the late Colonel David H. Hackworth—America’s most valor-decorated soldier—from the late 1980s until his death. Since the passing of this great American hero in May 2005, Ms. England Hackworth has kept her deathbed promise to her husband to continue his mission by taking up the responsibilities as Chair of SFTT. So committed is England Hackworth to her late husband and his vision, she shuttered her successful public relations and marketing agency in order to more fully support Hackworth on the issue of accountability and reform in the United States military, fighting with him to ensure that America’s front line troops get the best possible leadership, training, and equipment, and the best chance possible of making it home alive, in one piece. “It’s a difficult issue and this wasn’t exactly an easy job when Hack and I were together, so you can imagine what it’s like now,” attests England Hackworth. “You could cry a river. It is so much easier to raise money for arts endowments and disease prevention than to convince the American public that their government is hanging their soldiers out to dry instead of giving them the right stuff.” “We have recently decided to expand our mission to call attention to the need to protect our troops from traumatic brain injury (‘TBI’) and post traumatic stress (‘PTS’) and the urgent need for proper medical care for those that have been afflicted with such injuries. We need to insure that our troops have the best headgear possible to protect them from these devastaing injuries and insure that they receive immediate and disciplined medical treatment following any head injury.” Roger Charles, Vice Chair / Secretary A career Marine Corps officer from 1967 to 1990, Roger Charles has enjoyed a second career as an awardwinning investigative journalist. He was a member in 2004 of the 60 Minutes II production team that earned a Peabody Award for the segment “Abuse at Abu Ghraib.” Among his other journalistic achievements: Charles was awarded a Medal for Excellence in Investigative Reporting by journalism’s Investigative Reporters and Editors (I.R.E.) association for his 1992 Newsweek cover story, “Sea of Lies,” and was an Emmy finalist for best investigative piece for the Nightlight Special “The USS Vincennes: Public War, Secret War” in 1992. For television, Charles has served as a consulting investigative reporter and contributor to segment development for 20/20 (a special project on the Oklahoma City bombing), ABC World News Tonight, Nightline, Frontline, Prime Time Live, BBC News, and CNN, among others. LIFELINES – AUGUST 2013 26 Charles has served as an advisor on numerous stories for various print and electronic media outlets including: The New York Times, The Washington Post, The Boston Globe, Newsweek, U.S. News & World Report, and The New Yorker. He has been published in Newsweek, Insight, The Washington Times, The Baltimore Sun, The Chicago Tribune, Soldier of Fortune, Proceedings of the U.S. Naval Institute, and the Marine Corps Gazette, where he served as editorial board member from 1987-1989. In 1996, Charles broke the story of the fraudulent use of combat insignia by Admiral Jeremy Michael Boorda, Chief of Naval Operations. “I saw while I was on active duty that many of the national media that cover security and defense issues are truly ill-informed about basic things they need to perform their job properly,” says Charles of his shift to a civilian role as an investigative journalist specializing in a range of national security issues. “This just destroys any kind of credibility this reporting has for any military audience.” In 1998, Soldiers For The Truth Foundation, a non-profit, non-partisan, apolitical, educational foundation whose purpose is meaningful reform of the U.S. defense establishment, was formed, with Charles serving as the editor-in-chief of its newsletter, Voice of the Grunt. Charles remained active on the non-profit’s Board of Trustees until December 2004, when an ailing Hackworth asked him to assume the foundation presidency and Charles now fills the role of Vice Chair, “The foundation was created around three issues: leadership, training, and equipment,” says Charles. “Think of a stool with three legs. Remove any one of those legs and the stool falls apart.” MAG GEN John Batiste US Army (Ret), President A commissioned infantry officer from West Point John Batiste served the US Army for over 31 years. A twotime combat veteran his combat and peace enforcement experience includes deployments to Saudi Arabia and Iraq during Operation Desert Shield, Operation Desert Storm and Bosnia-Herzegovina from 1995 to 1996 and, years later, Kuwait. While working for the Deputy Secretary of Defense, he was involved in the early planning stages of the Afghanistan war and Iraq war. He was promoted to major general in 2002 and was deployed to Iraq from February 2004 to March 2005. After retiring from the Army as a major general in November, 2005, Batiste entered into the private sector. He is president and CEO of Klein Steel, in Rochester, New York. As of June 2011, he is a member of the board of advisors of the Johns Hopkins University Carey Business School, a board and executive committee member of the Metals Service Center Institute, a board member of the Rochester-based Veterans Outreach Center, the president of the Rochester Regional Veterans Business Council, and chair of the Warrior Salute Advisory Board (a non-profit focused on treating veterans with PTS). Bob Evans, Treasurer Bob served with the 229th Aviation Battalion (First Cavalry Division) in the Republic of Vietnam as a helicopter pilot. He received a commission and extended in Vietnam as the battalion aviation safety officer. LIFELINES – AUGUST 2013 27 He served as division artillery aviation officer, artillery battery executive officer and troop commander at Fort Hood, Texas before separating from the service in 1971. He spent 25 years in the civilian nuclear power industry in Arkansas, Georgia and at the Nuclear Energy Institute in Washington, D.C. In the nuclear industry, he began as a training manager, with responsibilities continuing in the areas of operations, maintenance and support services, and industry and government relations. Bob is presently a National market manager for the 3M Company in Washington, D.C., working with legislators and government agencies in the areas of homeland security, disaster relief, incident response, and energy conservation. LIFELINES – AUGUST 2013 28 Appendix B – The Medical Task Force SFTT’s Medical Task Force (also referred to as the Medical Advisory Board) is co-chaired by the following individuals: Dr. Henry Grayson, PhD, Co-Chair of SFTT’s Medical Task Force - A psychologist practicing in New York City and Connecticut. He has a PhD from Boston University, a postdoctoral certificate in psychoanalysis and psychotherapy from the Postgraduate Center for Mental Health and a theology degree from Emory University. The author of three books in his field, he and founded the National Institute for Psychotherapies, the Institute for Spirituality, Science and Psychotherapy and the Association for Spirituality and Psychotherapy. Dr. Frank M. Ochberg, M.D., Co-Chair of SFTT’s Medical Task Force – A psychiatry professor at Michigan State University with degrees from Harvard University, Johns Hopkins University, Stanford University and the University of London. Formerly an associate director of the National Institute of Mental Health, more recently he has been involved with numerous organizations dealing with PTS and also with founding Gift From Within, a non-profit foundation, and consulting at Columbine High School in Colorado. In 2003 he received a lifetime achievement award from the International Society for Traumatic Stress Studies. Other eminent scientists and professors include Suicide Expert Dr. Eric D. Caine, MD, Chair, the Department of Psychiatry, University of Rochester; Dr. Robert Cancro, former Chair, NYU Department of Psychiatry, and Addiction Expert; Dr. Stephen Ross, MD, Assistant Professor of Psychiatry, NYU and Bellevue Director of Alcoholism and Drug Abuse; and more than 20 other psychiatrists, clinical physicians, professors, social workers and other volunteer medical professionals who give freely of their time to help our brave warriors become whole. Volunteer members of the Medical Task Force include: Dr. Grant Brenner, M.D. – Dr. Brenner graduate of the New Jersey Medical School and as assistant clinical professor at the Albert Einstein College of Medicine Beth Israel Medical Center. He is a member of Physicians for Human Rights and the International Society for the Study of Trauma and Dissociation. Dr. Brenner is the director of trauma services at the William Alanson White Institute, a board member at the Disaster Psychiatry Outreach, and the author of Creating Spiritual and Psychological Resilience-Integrating Care in Disaster Relief Work. Dr. Eric D. Caine, M.D. - A Psychiatry professor at the University of Rochester Medical Center School of Medicine and Dentistry. He is a graduate of Cornell University and Harvard Medical School, and a chair of the department of Psychiatry at the University of Rochester Medical Center School of Medicine and Dentistry. In 2001 he received the American Academy of Child & Adolescent Psychiatry’s Leadership in Training Award for Chair of the Year. Dr. Robert Cancro, M.D. – Dr. Cancro is a professor and chairman of psychiatry at the New York University Medical Center. He is a graduate of SUNY Downstate Medical Center, has served as the director or the Nathan LIFELINES – AUGUST 2013 29 Kline Research Institute, a long time consultant of the U.S. Secret Service, and the recipient of numerous awards in the field of mental health including the New York State Office of Mental Health Award and the Irving Blumberg Human Rights Award. Lorraine Cancro, MSW - A psychotherapist with a Masters from the New York University Silver School of Social Work. She is the executive director of the Global Stress Initiative, a senior consultant at The Barn Yard Group, and formerly the director of business development and military health editor at EP Magazine. Jaine L. Darwin, Psy.D., ABPP - A graduate of Massachusetts School of Professional Psychology is a psychologist-psychoanalyst specializing in trauma and PTSD, relationship issues and depression. Dr. Darwin has run a volunteer organization SOFAR that provided services to family members of military service members and veterans who have served in Iraq and Afghanistan. Kathalynn Davis, MSW - A psychotherapist with Masters from Columbia University, a certified Sedona Method Coach, Life Coach certified at New York University and Practitioner for International Institute for Spiritual Living. Dr. Stephen V. Eliot, Ph.D., - Dr. Eliot is a psychoanalyst with a private practice in Westport CT. Dr. Mark Erlich, M.D. - is a graduate of the City College of New York and the Albert Einstein School of Medicine. He is the founder and director of Profiles & Contours, a clinical assistant professor at New York Medical College and Downstate Medical Center College of Medicine, and a clinical instructor at Mount Sinai School of Medicine. He is also the president of the New York Facial Plastic Surgery Society. Dr. Mitchell Flaum, Ph. D. – Dr. Flaum is a clinical Psychologist with private practice in New York City. Dr. Joseph Ganz, Ph.D., - A psychotherapist and a graduate of the Stress Reduction Program from the University of Massachusetts Medical School. He is also trained in couples and family psychotherapy and is the co-founder, co-director and faculty member of The Metropolitan Center for Object Relations-New Jersey. Dr. Stephen Gullo, Ph.D., - Dr. Gallo received his doctorate in psychology from Columbia University, and for more than a decade, he was a professor and researcher at Columbia University Medical Center. He is the former chair of the National Obesity and Weight Control Education Program of the American Institute for Life Threatening Illness at Columbia Presbyterian Medical Center. His first book, Thin Tastes Better, was a national best seller as was his second book, The Thin Commandments. He has been interviewed by Oprah Winfrey, Larry King, and Barbara Walters and has also made numerous appearances on Today, Good Morning America, and Hard Copy. Dr. Gullo is currently president of the Center for Health and Weight Sciences’ Center for Healthful Living in New York City. Dr. David Haidak, MD a graduate of Albany Medical College is Board Certified Hematology, Internal Medicine and Oncology. Dr. Haidak is in private practice in Maryland. Joan S. Kuehl, L.C.S.W. - Is a social worker with private practice in New York City. LIFELINES – AUGUST 2013 30 Dr. Judy Kuriansky, Ph.D., - A graduate of New York University, an adjunct faculty member at the Teacher’s College Columbia University and at Columbia Medical School. She has provided “psychological first aid” after bombings in Israel, SARS in China, the tsunami in Asia, and after 9/11 in the US. She is a representative to the United Nations for the International Association of Applied Psychology and the International Council of Psychologists. Dr. Lefkovits is Associate Clinical Professor of Dermatology at the Mount Sinai School of Medicine and is Co-Director of the Mount Sinai Dermatological Cosmetic Surgery Program. He is also on the Medical Editorial Advisory Board of “Healthy Aging”, a member of the national educational faculty for Botox® and is member of the Medical Advisory Council of The Skin Cancer Foundation. A past president of the Dermatology Society of Greater New York, he has lectured at many national and international meetings on Botox®. He is known for his pioneer work with skin cancer detection and treatment as well as for his work with Restylane®, Juvederm®, and laser surgery. Dr. Lefkovits is in private practice in New York City. Dr. Robert Rawdin, D.D.S. - Dr. Rawdin is a graduate of the Northwestern University School of Dentistry and New York University. He is a diplomat of the American Board of Prosthodontics and currently serves as president-elect and program chair of the Northeastern Gnathological Society. He is also a clinical assistant professor at the New York University College of Dentistry. Dr. Jeffrey Rosenthal MD is board certified in Plastic Surgery. A graduate of The University of Guadalajara, San Antonio and has 31 years of experience and practices in Plastic Surgery and Plastic and Reconstructive Surgery. Dr. Rosenthal is in private practice in Fairfield CT. Dr. Stephen Ross, M.D. – Dr. Ross is A graduate of the University of Pennsylvania and the UCLA School of Medicine. He is the director of the division of alcoholism and drug abuse at Bellevue Hospital, director of the NYU Addiction Psychiatry Fellowship, and director of the Bellevue Opioid Overdose Prevention Program. Dr. John Setaro, M.D. - A graduate of Boston University, and a resident and fellow at Yale-New Haven Hospital, as well as an associate professor of medicine at the Yale University School of Medicine. LIFELINES – AUGUST 2013 31 Appendix C - The Endowment Fund SFTT’s operating and funding strategy is similar to that of a Limited Partnership that consists of the Managing Partner: SFTT; and the Limited Partners: the Endowment Fund (“EF”), which is funded by donations from individuals, estates, charitable foundations, firms and events of significant scope. The Limited Partners (i.e., the EF) charge the Managing Partner (i.e., SFTT), to invest the income generated by the Fund in community-based programs, incubator funding for promising treatment modalities and the dissemination of reliable and timely information to Vets and the public at large. In effect, SFTT is the Operating Partner responsible for appropriately investing the income of its Limited Partner’s investments in the EF in projects that support the SFTT LifeLines Initiative. To safeguard the interests of the charitable benefactors to the EF, the finances of SFTT and the EF will be effectively administered as two separate organizations. Below is a brief summary of the key guidelines governing the operating relationship between SFTT and the EF and how EF funds will be disbursed to worthwhile programs administered by third parties: 1. The Endowment Fund (“EF”) will be administered by a Trustee(s) on behalf of charitable contributors according to prescribed operating and investments guidelines (some of which are discussed below); 2. SFTT (as Operating Partner) will disseminate an Annual Report to all Charitable Partners providing (among other things) a description of Fund distributions, a status report on programs funded by SFTT and an analysis of the investment performance of the EF; 3. SFTT will receive 10% of all charitable contributions raised by the EF until the Fund’s principal balance goal of $15 million is reached; 4. After the EF’s funding goal is reached, the EF may allocate up to 25% of the average of the two previous years investment income to support SFTT’s annual operating expenses; 5. Investment Income (i.e. interest, dividends and realized capital appreciation) will be segregated and designated as “Funds Available for Investment;” 6. Funds Available for Investment will be channeled toward treatment modalities and/or community based programs deemed worthy by SFTT; 7. Where possible, the EF will leverage its “investment” in projects promoted by Initiative Leaders by seeking matching contributions from other organizations; 8. Where appropriate, the EF will seek options or other forms of deferred compensation, if the EF is providing seed money to new technologies; 9. SFTT has as a goal to maintain a cash reserve equivalent to two years’ operating expenses. Cash reserves in excess of that amount will be contributed directly the EF’s “Funds Available for Investment.” LIFELINES – AUGUST 2013 32 These are just the highlights of the guidelines currently under consideration to provide charitable partners with the assurances that their contributions will be channeled into worthwhile projects that support the needs of our brave warriors. LIFELINES – AUGUST 2013 33 Appendix D – Definition of Terms Found below in alphabetical order is the definition of recurring terms and acronyms frequently used in the SFTT “LifeLines” Business Plan. Adipose-derived Stem Cells (“ASC’s”): Intravenous administration of ASC’s seems to demonstrate a decrease in inflammation and chronic brain degeneration and promote long-term functional recovery. Dr. Victor and other scientists see great promise in using such therapy to help regenerate brain cells of Veterans suffering from PTS and TBI. Attention-Bias Modification Treatment Protocol: A new computer-based designed to quickly ameliorate PTS symptoms in eight 10-15 minute sessions over a four week period. Developed by SFTT Special Advisor Dr. Yudal Neria. Basic Five: The “Basic Five” refers to SFTT’s current investigative reporting into the efficacy, safety and reliability of Body Armor, Combat Boots, Helmets, Weapons and Sidearms supplied to US combat troops. Charitable Partners: Charitable institutions and corporate and individual contributors who fund the LifeLines Endowment Fund and may co-invest with the EF is specific programs identified by SFTT considered of benefit to Veterans with PTS. EF: An acronym for the LifeLines Endowment Fund which is a charitable trust be administered by a Trustee(s) on behalf of charitable contributors to support and co-fund SFTT program initiatives with other charitable institutions. The EF is funded by donations from individuals, estates, charitable foundations, firms and events of significant scope. EF Co-Investing: SFTT plans to leverage its EF investment earnings by co-investing in projects with third parties (perhaps the same parties who have invested in the LifeLines Endowment Fund). The objective is to leverage SFTT’s expertise by attracting third-party funding to priority investments. FM: An acronym given to SFTT’s Funding Manager Funding Manager: The Funding Manager (“FM”) is responsible for implementing SFTT’s long-term funding planning as determined by SFTT’s Board and the overall management of day-to-day finances of SFTT. Hyperbaric Oxygen Therapy: A promising technology now being utilized by Dr. Paul Harch to successfully treat patients with serious brain disorders. IM: An acronym given to SFTT’s Information Manager LIFELINES – AUGUST 2013 34 Information Manager: The Information Manager (“IM”) is responsible for compiling a national database of treatment modalities and programs with the objective of providing a meaningful database to identify and track promising treatment outcomes. Initiative Leaders: Individuals - often volunteers – assigned to give guidance and counsel to support PTS initiatives developed by third parties. SFTT’s goal is to help promising new treatments raise funding and to support local community initiatives with access to both medical, financial and public relations resources. LL: An acronym that refers to LifeLines or, more appropriately the LifeLines Initiative. LifeLines: A three-prong initiative by SFTT dedicated to providing effective and replicable treatment to high-risk Veterans suffering from Post Traumatic Stress (“PTS”) to help them reclaim their lives. Also referred to as the LifeLines Initiative or LL. LifeLines Endowment Fund: A charitable trust be administered by a Trustee(s) on behalf of charitable contributors to support and co-fund SFTT program initiatives with other charitable institutions. The LifeLines Endowment Fund or “EF” is funded by donations from individuals, estates, charitable foundations, firms and events of significant scope. MD: An acronym given to SFTT’s Managing Director. Managing Director: The Managing Director (“MD”) is responsible for executing the approved business plan formulated in consultation with SFTT’s Board and coordinating all its aspects. Medical Task Force: SFTT’s Medical Task Force or Advisory Board consists of leading experts in the medical profession who volunteer their expertise to PTS: The acronym for Post Traumatic Stress which SFTT and leading physicians believe more accurately reflects the medical condition of Veterans and others who suffer from cognitive and brain-related impairment caused by combat. PTSD: The acronym for Post Traumatic Stress Disorder. Also, please see PTS. PRM: An acronym for the Public Relations Manager. Public Relations Manager: The Public Relations Manager (“PRM”) is responsible for executing SFTT’s public relations plan to increase public awareness of SFTT and our PTS Initiative and support SFTT’s ongoing funding initiatives. SFTT: An acronym for “Stand For The Troops” which is a 501(c)(3) Educational Foundation established by the late Col. David H. Hackworth and his wife, Eilhys England. LIFELINES – AUGUST 2013 35 Stand For The Troops: A 501(c)(3) Educational Foundation established by the late Col. David H. Hackworth and his wife, Eilhys England generally referred to by the acronym of SFTT. Supportive Services for Veterans Family Programs (“SSVF”): Is a VA sponsored program that “awards grants to private non-profit organizations and consumer cooperatives who can provide supportive services to very low-income Veteran families living in or transitioning to permanent housing.” Veteran’s Crisis Line: (formerly referred to as a suicide hotline) is one of the more successful programs supported by the VA, but administered by third parties. “The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat or text.” Veterans Farm: An initiative of former Sgt. Adam Burke, an OIF/OEF combat veteran and Purple Heart recipient to unite disabled Veterans and to help them overcome disabilities such through “Horticulture Therapy”. Veterans Outreach Center: Veterans Centers exist in many towns and cities across the United States. The Veterans Outreach Center in Rochester, NY (“VOC”) was built James McDonough (co-chair of our PTS initiative), which STT believes can serve as a model program to enhance similar programs across the United States. Veteran Treatment Courts: Capitalizing on the legislation, legal infrastructure and documented success of the Drug Treatment Courts, approximately 120 Veteran Courts have been established in 35 states to deal with Veterans who have committed a crime while suffering from substance abuse. Effectively, Veterans can opt for supervised treatment rather than a jail sentence. LIFELINES – AUGUST 2013 36 Appendix E – SFTT Operating Plan SFTT Operating Plan Revenue Sources - Direct Contributions - Fund Raising Events - EF Contribution - Misc Total Revenue Sources 2013 Est. 2014 $35,000 $25,000 $113,500 2015 $50,000 $50,000 $200,000 2016 $75,000 $75,000 $300,000 2017 $75,000 $100,000 $350,000 2018 $75,000 $125,000 $500,000 $120,743 $173,500 $300,000 $450,000 $525,000 $700,000 Staffing Expenses - Managing Director - Funding Manager - Information Manager - PR Manager - SFTT Editor - Web Communications - Admin + Part Time - Payroll Taxes Subtotal Staff 2013 Est. 2014 $0 $30,000 $26,000 $24,000 $19,635 $5,611 $75,246 $26,000 $24,000 $18,800 $9,760 $108,560 2015 $60,000 $60,000 $30,000 $30,000 $26,000 $24,000 $18,800 $33,760 $282,560 2016 $80,000 $60,000 $60,000 $60,000 $26,000 $24,000 $28,800 $45,760 $384,560 2017 $80,000 $60,000 $60,000 $60,000 $26,000 $24,000 $58,000 $51,600 $419,600 2018 $80,000 $60,000 $60,000 $60,000 $26,000 $24,000 $58,000 $51,600 $419,600 Other Operating Expenses - Outside Consultants - Promotional Expenses - Accounting & Professional - Web Hosting Expenses - Phone/Supplies - T/E - Misc Subtotal Other Expenses 2012 Act $29,019 $4,238 $2,537 $2,610 $3,307 $2,193 $1,593 $45,497 2013 $30,000 $5,000 $5,000 $2,500 $4,000 $5,000 $5,000 $56,500 2014 $30,000 $10,000 $5,000 $2,500 $10,411 $13,014 $13,014 $83,939 2015 $30,000 $15,000 $5,000 $2,500 $14,169 $17,712 $17,712 $102,093 2016 $30,000 $20,000 $5,000 $2,500 $15,461 $19,326 $19,326 $111,612 2017 $30,000 $25,000 $5,000 $2,500 $15,461 $19,326 $19,326 $116,612 Total Operating Expenses $120,743 $165,060 $366,499 $486,653 $531,212 $536,212 -8,440 66,499 36,653 6,212 -163,788 Shortfall LIFELINES – AUGUST 2013 37 Appendix F – Endowment Fund Projections Endowment Fund Projection 31-Dec-2013 $365,000 YE Balance Net Change Expected Return Share to General Fund Net Available for Funding Project Support Matching 1 to 3 Matching 1 to 5 Matching 1 to 7 31-Dec-2014 $1,500,000 31-Dec-2015 $3,500,000 31-Dec-2016 $6,500,000 31-Dec-2017 $10,000,000 31-Dec-2018 $15,000,000 $1,135,000 $2,000,000 $3,000,000 $3,500,000 $5,000,000 $51,288 $137,500 $275,000 $453,750 $687,500 $0 $0 $0 $0 $0 $51,288 $137,500 $275,000 $453,750 $687,500 $153,863 $256,438 $359,013 $412,500 $687,500 $962,500 $825,000 $1,375,000 $1,925,000 $1,361,250 $2,268,750 $3,176,250 $2,062,500 $3,437,500 $4,812,500 $74,600 $93,250 $111,900 $200,000 $250,000 $300,000 $400,000 $500,000 $600,000 $660,000 $825,000 $990,000 $1,000,000 $1,250,000 $1,500,000 Contribution to Operating Fund Returns 8% 10% 12% LIFELINES – AUGUST 2013 38