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The Republicans who take control of the House on Wednesday say they'll try to ban earmarks. But for every bridge to nowhere, there is an earmark that is filling a need. Fort Drum in Upstate New York is the only army base in the country without its own hospital. Soldiers and their families rely on civilian doctors and clinics.

David Sommerstein of North Country Public Radio recently visited the organization that helps find that care, an organization created by an earmark.

DAVID SOMMERSTEIN: Denise Young looks out her office window and grins. It overlooks Watertown's Public Square, the hub of Fort Drum's host city. And there's a fresh foot of snow.

Ms. DENISE YOUNG (Executive Director, Fort Drum Regional Health Planning Organization): As you can see right now, it's all lit up for Christmas and it's beautiful. We really feel like we're at the heart of the action that's happening in the Fort Drum region just by being here.

SOMMERSTEIN: Young directs the Fort Drum Regional Health Planning Organization. It's been all action at Fort Drum this decade. Thousands more soldiers, tons of new construction, all to support constant rotations in and out of Iraq and Afghanistan. Young says because there's no hospital on post, the community health care system had to step up.

Ms. YOUNG: When a soldier gets deployed, he deserves to know that his family here in our community is going to be taken care of. They are serving us, and we need to serve them.

SOMMERSTEIN: So five years ago, an earmark from then-congressman, now secretary of the Army, Republican John McHugh, created Young's organization to become the glue between the military and civilian health care worlds. It connects soldiers with private practice physicians.

Stephanie Burke's family moved to Fort Drum last spring. At military hospitals on other bases, she says her medical records were lost. She says assigned doctors didn't know her children's names or histories. At Fort Drum, she says it's better.

Ms. STEPHANIE BURKE: My husband - first things when he got processed, I remember he called me on his cell phone. And he's like: Wait, you get civilian doctors. You're going to go off-post and you get to choose who you want to go to. And so we are very excited about that.

SOMMERSTEIN: The Health Planning Organization's also working on a military-wide problem; a shortage of mental health clinics to deal with PTSD and the effects of multiple deployments on families. It's helped triple the number of mental health providers in the region. And still, that's barely keeping up.

Retired soldier Jim Sheets is studying to be a social worker in a program brought here by the Health Planning Organization. He says half the students want to become mental health counselors.

Mr. JIM SHEETS: You're going to have 20 people who's right back in this area providing services.

SOMMERSTEIN: The Health Planning Organization also has grants to digitize medical records, recruit doctors and run fiber optic cable between the region's five hospitals. Director Denise Young says a $400,000-a-year earmark has leveraged $100 million in projects.

Ms. YOUNG: The earmark is the catalyst to bring all of these resources to bear in this region to improve the health care system.

SOMMERSTEIN: Thirty miles away, Dr. Steve Lyndaker rushes though the halls of Louis County general Hospital.

Dr. STEVEN LYNDAKER (Lewis County General Hospital): It's my gofer day where I go for this, I go for that.

SOMMERSTEIN: You can argue that all these changes around Fort Drum would have happened without the earmark. Lyndaker disagrees. He says someone needed to bring big institutions like hospitals and the Army together.

Dr. LYNDAKER: We wouldn't be talking about this quite honestly if Denise Young didn't write a grant proposal.

SOMMERSTEIN: Across the country, rural areas suffer from a shortage of doctors, especially specialists. Democrat Bill Owens will be the one defending the Fort Drum Regional Health Planning Organization's earmark in the next Congress. He says the group has helped this region try to buck that trend.

Representative BILL OWENS (Democrat, New York): When you do this, you improve the health care for both the military community and the civilian community,

SOMMERSTEIN: Director Denise Young says her organization transcends politics. It takes care of the people who fight for our country, and she says she's absolutely confident it will survive the battle over earmarks.

For NPR News, I'm David Sommerstein in northern New York.

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