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October 13, 2016

North Dallas Chamber of Commerce

10707 Preston Rd.
Dallas, TX 75230

Dear Dallas Chamber of Commerce,

We at Tenet Healthcare are partnering with Operation Delta Dog to increase awareness of the
lives of veterans that are suffering from Post-Traumatic Stress Disorder (PTSD) in Dallas, Texas.
We want to assist in the lives of veterans who have risked their own lives behind enemy lines so
that the people of this great country can sleep a little safer at night. The veterans that serve this
great country are the shield that protects each and every one of us, but even a shield can come
back home chipped and dented after battle. The many veterans that have served throughout the
countless battles of U.S. History need the aid and support from the people of this country and
some veterans need the support more than others.

Introduction

During the Vietnam War there was a military investigation that discovered many veterans had
developed symptoms of PTSD (Glover, 2014). Statistically speaking, over 30% of the veterans
were dealing with PTSD during the war and over 84% showed symptoms of PTSD years later
(Glover, 2014). For the veterans that have been in recent battles from the Afghanistan and Iraq
wars (over two million veterans), roughly 11-20% have already shown symptoms of PTSD
(Glover, 2014). The data that has been recently collected does show that the percentage on the
number of veterans dealing with PTSD has decreased, but the story has yet to completely unfold.
For many veterans, symptoms can and will develop years later, and because of this, the victory
over PTSD has yet to be attained.

We believe that by partnering with Operation Delta Dog, we can help veterans here in Dallas,
Texas by providing service dogs to ease the pain caused by traumatic events. To help with the
issue at hand, outside assistance will be required to provide us the assets needed to pay for the
administration costs, that will then allow us to put together a well-organized staff, which will
lead to a credible evaluation to whom will be given a service dog. The proposal that we have put
together and hope you consider might just save the life of a veteran.

Background and Purpose

Dallas Chamber of Commerce Oct. 13, 2016 2

Post-traumatic stress disorder is a very real problem, manifesting itself in anyone from children
to grown adults. It is described as a disorder that causes the individual to act sporadically both
physically and mentally. The symptoms of this disorder include: flashbacks to the traumatic
event, terrifying dreams, difficulty falling asleep, constant feeling of being on edge, negative
outlook on one's self, avoiding certain things that are a reminder of the trauma and irate
outbursts. PTSD, can be caused by anything from a sudden death to a devastating natural
disaster, but the most well known trigger is frontline war experiences. About 24.4 million people
in the United States suffer from PTSD (National Institute of Mental Health, n.d.). While there is
no exact figure on just how many of those people served in the Armed Forces, it is estimated that
30 percent of soldiers develop this disorder (PTSD United, n.d.). Doing anything in our power to
increase the quality of life for those who have sacrificed their comforts and put their lives on the
line in order to protect us should be a priority, especially those who are suffering from such a
challenging disorder. Negligence of veterans in the country is a travesty seeing as how many of
them return home from service to a life of poverty, poor healthcare, and overall low quality of
life. It is estimated that roughly 1.5 million veterans are living an impoverished life (National
Veterans Foundation, n.d.). Living in such conditions can cause disorders such a PTSD to
intensify, but an even more severe effect is suicide. It has been found that veterans accounted for
about 18% of all suicides in the United States among adults (U.S. Department, July 2016). In
fact, people suffering from severe cases of Post-Traumatic Stress Disorder are likely to have
suicidal thoughts and are likely to act upon them. The problem we as healthcare providers are
facing now is: how do we improve the quality of life for these veterans? Is there something we
can do or provide that can treat or even heal veterans suffering from PTSD? The answer is yes;
there is something we can do and the time to act is now.

With the introduction of canine companions major advancements are being made in the path
towards treating this disorder. The effect a dog can have on a persons psyche is undeniable.
Speaking from a normal everyday perspective, having a dog around showing affection and
providing loyal companionship makes all the difference, and the same can apply in the case of a
person suffering from PTSD. Now from a normal civilians point-of-view, a dog, as mentioned
before, could mean just having a companion or an extension of the family, but for a war veteran
it can mean that and much more. Immediate benefits of having a service dog range from an
increase of positive emotions to encouraging one to go outside to not only cater to the dogs needs
but also to provide a change of scenery and increase physical activity. Also, dogs take orders
similar to what veterans experienced on the front lines which can bring a sense of familiarity and
normality. Having a renewed feeling of being cared for can help lead someone riddled with
PTSD down the path towards combating and overcoming it, but it is not as simple as it seems.
The premise of service dogs having a positive effect on people is great, but it is also expensive.
Perspectively, the cost to train one dog for about a year's time will run you anywhere from
$10,000 to $20,000; some even ballooning up to $60,000 (Paws and Stripes, n.d.). Unfortunately,
Veteran Affairs does not fund service dog programs at this time. While we can hope that one-day
service dogs will be readily available for those in need, the more practical solution is to start
slowly implementing them throughout the veteran community, starting right here in the Dallas-
Fort Worth area. Below is data regarding veteran population in the Texas and based on the
numbers, there is definitely a large enough number to warrant attention from us at Tenet Health.
Dallas Chamber of Commerce Oct. 13, 2016 3

Table 1.

Veteran Population in the State of Texas

(U.S. Department of Veteran Affairs, State Summary)

We at Tenet Healthcare operate daily with one thing in mind, to help people live happier,
healthier lives (Tenet Healthcare, n.d.). With over 470 outpatient centers and 79 hospitals we
take pride in providing patients with the most efficient and effective services. With recent
findings, and based on our own research, we are now ready to tread new waters and impact the
veteran community right here at home, but we will not be tackling this problem by ourselves.
Together with the organization known as Operation Delta Dog, we will begin to pursue our new
goal.

Operation Delta Dog is an organization like no other. Not only are they equally focused on
solving the PTSD epidemic, but they also have found a solution to the problem of overpopulated
animal shelters. Instead of seeking out purebred puppies or any other expensive alternative to
finding canines, they use dogs already in the shelter that would be otherwise put down. Over a
year's time the volunteers at Delta Dog teach the adopted dog basic training as well as pairing
them with veterans who are the best candidates for that specific dog. Having already racked up
several success stories from this program, Delta Dog has proven to be trustworthy and reliable,
along with being a first class organization who truly does care about the community like we do.
But due to the fact that Delta Dog is stationed in Massachusetts, our role is pivotal in making this
project come to fruition. As intermediaries we can now help bring the same service and similar
results to the Dallas area where there is a large veteran community.
Dallas Chamber of Commerce Oct. 13, 2016 4

The one problem that continuously rears its head is the cost of carrying this project out. For a
training period of a year it will cost Delta Dog approximately $10,000 to carry out this process,
which includes: the actual canine training, veterinary supplies, fundraising, and other various
operational costs (Operation Delta Dog, n.d.). Though at first glance it may seem like a steep
price to pay, the result of the project is what makes it all worthwhile. With the distribution of
these trained dogs we can start seeing a slow but steady decline in the amount of PTSD related
incidents, whether it is suicide or depression. Once we finally get these veterans the care they
need, we hope other organizations in the metroplex will be encouraged to follow our lead and
make a similar impact. Along with the obvious benefits the veterans will receive, several dogs
will be saved from being euthanized with shelters becoming more and more overcrowded by the
day.

Post-Traumatic Stress Disorder may not be a highly publicized problem but it does have a
profound hold on our communities. With the partnership between Tenet Healthcare, Operation
Delta Dog and the Dallas Chamber of Commerce we can hopefully shed some light on this
epidemic and start trailblazing the path towards a larger focus on the mental health of our war
heroes and providing them with the help they so desperately need.

Proposal
But when it comes to service dogs, the [United States Department of Veterans Affairs] does not
necessarily endorse their use, and the reasoning for this lies within the legal framework guiding
veteran rehabilitation via service animals (Weinmeyer, 2015, p. 548). Because the United States
Department of Veterans Affairs does not endorse using service dogs for mental disabilities, our
company has decided to step up and help support veterans with PTSD. While military veterans
already have veteran benefits, there could always be more done to help support those in need.
Because Tenet Health is based in Dallas, we believe that we are the most qualified to help Dallas
veterans. Service dogs have increasingly become more popular among veterans as they are able
to assist veterans through physical and emotional means. This includes helping suffering veterans
from PTSD with rehabilitation along with day-to-day activities. To help us with this proposal,
Tenet Health will partner with Operation Delta Dog to help provide and connect veterans with
trained service dogs.
Schedule
The estimated time to complete the proposal is around seven months. We believe that by
purchasing readily available service dogs from Operation Delta Dog, we can also cut back on the
estimated amount of time it would take to complete the proposal. Operation Delta Dog estimates
that fully training a service dog would take about a year. If we were to wait for service dogs to be
fully trained, then the estimated time it would take to complete the proposal would increase to
eighteen months. Purchasing readily available service dogs will reduce the amount of time to
seven months to complete the proposal, helping pair veterans with service dogs at a much
quicker rate. We also believe that service dogs should go to those veterans that are in most need,
so we will have a selection process for applicants that would take up to seven months to
complete. Refer to table 2 to see the estimated proposal time.
Dallas Chamber of Commerce Oct. 13, 2016 5

Table 2 .
Estimated Schedule
Description Time

Begin Process February 2017

Apply for Service Dogs February 2017

Begin Application Process March 2017

Narrow Applicants to Interview May 2017

Complete Application Process July 2017

Pair Service Dogs to Veterans August 2017

Plan

Operation Delta Dog calculates that the total cost of training and delivering five service dogs
will be estimated at $75,000, while the estimated time to complete the proposal would be seven
months. To pair veterans with service dogs, Tenet Health will create an application process where
veterans may apply for service dogs online. A team of administrators will then look through these
applications and select a handful of veterans that look promising enough to be given a service
dog. The list of potential veterans will be narrowed down after an interview with a standardized
list of questions. Background checks will be used for all applicants to see if there are any
conflicts of interest. Service dogs will then be given to those veterans that have been approved
and accepted. By combining resources from both Delta Dog and Tenet Health, we can help those
veterans suffering from PTSD by pairing them with service dogs. If all goes according to plan,
the project will begin February of 2017 and end on August of 2017.
Staffing
For this project we have chosen five talented and dedicated staff members to work with us in
building our service dog program from the ground up. We will have an executive director, an
assistant director, a trainer supervisor, a finance manager, a social media marketing associate, a
medical coordinator, a tech support associate and three dog trainers. Over the course of seven
months, our hand-picked staff will work five days a week from 10am to 5pm to prepare the dogs
for our veterans. We also plan on holding events on the weekends for our staff and our dogs. We
have also included a detailed list of our future staff and why they are qualified to work on our
project.

Executive Director
We have chosen Bino Abraham as our executive director of the project. Mr. Abraham received a
BS in business administration from the University of Texas at Dallas. Before working on this
project, Mr. Abraham was overseeing a 20-person team as they established a new location for
Tenet Health in the Houston area.
Dallas Chamber of Commerce Oct. 13, 2016 6

Assistant Director
The Assistant Director position will essentially be the right hand man for our Executive
Director, Bino Abraham. They we will also have a strong role in developing our project and will
act as an assistant to Bino. For this position we have chosen Kevin Nguyen. Mr. Nguyen is also a
University of Texas at Dallas alum, who is currently working as a human resources manager for
Tenet Health.

Trainer Supervisor
The trainer supervisor position is an important part of this project. This person will act as head
trainer for the five service dogs that we will procure. They will also supervise three other
trainers. We have chosen Gilbert Espinoza to lead our training team. Mr. Espinoza is an
extremely experienced trainer with 15 years of experience under his belt. Mr. Espinoza received
a trainer certificate from Bergin University 15 years ago and has since acquired his license to
train service dogs 10 years ago. He has trained or overlooked training of over 50 service dogs
and has been a local name in Dallas for years.

Finance Manager
Jay Patidar has been chosen as our finance manager. Mr. Patidar is a University of Texas at
Dallas alum, and has received his BS degree in accounting. This position will be in charge of
most of our financial decisions and will be working closely with our executive director, Bino
Abraham. Mr. Patidar will create a budget for our training materials and will also be in charge of
payroll for our staff. Mr. Patidar is currently a financial advisor for Tenet Health and will switch
to a full-time finance manager for the duration of the project's startup.

Social Media Marketing Associate

In order for our project to grow here in the Dallas area, we must establish a strong presence
online. That is mainly done today via social media on websites like Twitter and Facebook. We
will be putting one of our own social media marketers, Henry Castro, on the job. Like many of
our future staff, Henry graduated from the University of Texas at Dallas, and has been a Tenet
Health employee for the past two years.

Technology Support
Kristian Parguian will serve as our primary source of technical support. Mr. Parguian graduated
from the University of Texas at Dallas with a degree in Information Technology Systems. He has
since been employed by Tenet Health in a similar role and has several years of experience doing
so.

Medical Coordinator
Since our program will span a year, having the proper candidate for our medical coordinator will
be key to the programs success. The candidate will be responsible for ensuring our dogs in
training are in the best possible health and have all their medical needs addressed. Our dogs will
need to be up-to-date on their shots and will evaluated at least once a month to check on their
health as the program moves forward. The medical coordinator will work side by side with our
trainer supervisor, Gilbert Espinoza, and his team to create the best possible training environment
for our dogs. For this position we have chosen Cindy Ford. Mrs. Ford is currently a registered
Dallas Chamber of Commerce Oct. 13, 2016 7

veterinary technician (RVT) with eight years of experience on her resume. Mrs. Ford graduated
from Texas A&M with a doctorate in veterinary medicine. Prior to working on our project, she
was working at her own veterinary clinic in Garland, Texas.

Trainers
Along with Gilbert Espinoza, our trainers will be the heart and soul of our service dog project.
We have chosen three trainers based on their extensive experience training dogs of all ages, from
puppies to full grown dogs. The trainers will be working with the dogs between four to five times
a week and at various times of the day to get the dogs accustomed to their future owners.
Trainers will be working with Gilbert to create an appropriate agenda.

Erin Sanders received her certification from the Association of Professional Dog Trainers and
has been working as a personal dog trainer for seven years. Ms. Sanders works with owners and
their dogs in the DFW area, at the owners location. She specializes in rehabilitating grown dogs
with various issues, including aggressiveness and fear of humans or other dogs.

Lara Fisher received her training certification from the certification council for professional dog
trainers and has been employed at Operation Delta Dog for six years and is also a private trainer.

Michael Hurns is the last trainer rounding out our training team. Mr. Hurns attended Bergin
University and has been working for Operation Delta Dog for the past three years.

Budget

As stated previously, it has been decided that the best path to take in preparing and providing
service dogs for veterans suffering from Post-Traumatic Stress Disorder (PTSD), is to team up
with an outside organization which specializes in training dogs for this specific disorder. Again,
the organization which we felt could provide the most adequate and professional training to
prepare service dogs to deal with PTSD patients is, Operation Delta Dog.

In teaming up with Operation Delta Dog, the cost to train a single dog is $10, 000. And as we,
Tenet Healthcare, would like to provided five such dogs to our veterans suffering from PTSD,
the total cost of training the dogs would be $50,000. The total cost of this proposed project,
including miscellaneous costs such as transportation of each dog from the training facility to the
patient (as Operation Delta Dog is based in Massachusetts), is going to be $75,000.

The training program costs consist of training, veterinarian, supplies, fundraising, and
operational expenses (Operation, n.d.). A detailed breakdown as to how the costs will be
apportioned shows that training for each dog will cost $6,700, a total of $33,500 for the five
dogs. Training costs consists of the wages paid to the dog trainers and the fees paid to obtain the
dogs from shelters and [other] rescue organizations (Operation, n.d.).
Moving onto the veterinarian costs, the cost per each dog for veterinary expenses will be $500,
for a total of $2,500 for the five dogs. The veterinary costs include veterinarian fees and
medication costs which Operation Delta Dog will pay for the dogs while they are in this training
program (Operation, n.d.).
Dallas Chamber of Commerce Oct. 13, 2016 8

In addition to training and veterinarian costs, within the $10,000 training program fee, supply
costs for the dog are also included. This expense consists of costs of dog food and treats,
leashes, collars, beds, harnesses, vests, and patches (Operation, n.d.). The supply cost per dog is
going to be $500, for a total of $2,500 for five dogs.

Included in the training costs are costs which Operation Delta Dog uses to raise awareness of its
amazing training program (Operation, n.d.). This fundraising cost we are expected to pay as a
part of our partnership is going to be $1,500 per dog, for a total of $7,500 for all the five dogs.

The last expense which is included in the $10,000 fee is the operations expense; this is the
expense which Operation Delta Dog uses to pay the operational bills they incur while operating
this training program. The operations expense includes insurance, maintenance, accounting and
governmental fees which the organization has to pay to stay in operation (Operation, n.d.). The
cost per dog with regards to the operation portion is going to be $800, and $4,000 total for all of
the dogs.

Within our budget, miscellaneous expenses are also included. Not only will we need to pay
$10,000 per dog, but we also expect transportation costs to get the dogs from where they will be
trained (in Massachusetts) to our five veterans suffering from PTSD. The miscellaneous cost per
dog is expected to be $3,000, and totaling to $15,000 for all the five dogs.

Table 3 shows the costs per dog, as well as the total costs for all five dogs with regards to all the
expenses required to train and deliver the dogs to our veterans.

Table 3.
Service Dog Expenses
Cost Per Dog Total Costs

Training $6,700.00 $33,500.00

Veterinarian $500.00 $2,500.00

Supplies $500.00 $2,500.00

Fundraising $1,500.00 $7,500.00

Operations $800.00 $4,000.00

Miscellaneous $3,000.00 $15,000.00

Total $13,000 $75,000.00

Conclusion

We strongly urge the Dallas Chamber of Commerce to consider Tenet Healths proposal to fund
this project so that we can reach out to the veterans of the Dallas community suffering from
PTSD. The plan that we have set, the staff that we have put together, and the budget that we are
considering will enable us to expand on the efforts which other organizations, such as Operation
Dallas Chamber of Commerce Oct. 13, 2016 9

Delta Dog, are putting in to help veterans with PTSD. We believe that the lives of our soldiers
are just as important as the lives that they are protecting by serving this great country and we
want to start the trend here in our own backyards. We, Tenet Health, partnering with Operation
Delta Dog, request the Dallas Chamber of Commerce approve and contribute to this cause.

Sincerely,

Bino Abraham
Henry Castro
Kevin Nguyen
Kristian Parguian
Jay Patidar
Dallas Chamber of Commerce Oct. 13, 2016 10

References

Glover, L. (2014, May 20). Post-Traumatic Stress Disorder (PTSD) Statistics for Veterans -
NerdWallet. Retrieved September 30, 2016, from
https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Katel, P. (2011). Military Suicides. Is the military doing enough to help soldiers cope?
Retrieved September 29th, 2016 from
http://library.cqpress.com/cqresearcher/document.php?
id=cqresrre2011092300&type=hitlist&num=4

National Institute of Mental Health. Post-Traumatic Stress Disorder.(n.d.). Retrieved

September 30th, 2016 from https://www.nimh.nih.gov/health/topics/post-traumatic-
stress-disorder-ptsd/index.shtml

Operation Delta Dog. Distribution of Expenses. (n.d.). Retrieved October 03, 2016, from
http://www.operationdeltadog.org/how-donations-are-used

Paws and Stripes. Who We Are. (n.d.). Retrieved October 10th, 2016 from
http://www.pawsandstripes.org/who-we-are

PTSD United. PTSD Statistics. (n.d.). Retrieved September 29th, 2016 from
http://www.ptsdunited.org/ptsd-statistics-2/

Tenet Health. (n.d.). Retrieved September 22nd, 2016 from

https://www.tenethealth.com/about/our-story

The National Veterans Foundation. The Ugly Face of Veteran Poverty in the United
States .(n.d.). Retreieved from http://nvf.org/veteran-poverty-united-states/

U.S. Department of Veteran Affairs. Dogs and PTSD. (n.d.). Retrieved from
http://www.ptsd.va.gov/public/treatment/cope/dogs_and_ptsd.asp

U.S. Department of Veteran Affairs. Facts about Veteran Affairs. (2016, July). Retrieved
October 11th, 2016 from
http://www.va.gov/opa/publications/factsheets/Suicide_Prevention_FactSheet_New_VA
_Stats_070616_1400.pdf

U.S. Department of Veteran Affairs. State Summary; Texas. (2015, September 30). Retrieved
from http://www.va.gov/vetdata/docs/SpecialReports/State_Summaries_Texas.pdf
Dallas Chamber of Commerce Oct. 13, 2016 11

Weinmeyer, R. (2015, June) Service dogs for veterans with posttraumatic stress disorder.
American Medical Association Journal of Ethics. Retrieved October 3rd, 2016 from
https://utdallas.illiad.oclc.org/illiad/pdf/275822.pdf