UNCLASSIFIED

Department of Veterans Affairs
Caring for Those Who Served in Seamless Transition
USDOL-VETS 2007 Competitive Grantees Training Conference August 7-9, 2007

National Guard and Reserves Combat Veterans

Marianne Mathewson-Chapman PhD, ARNP VA Office of Seamless Transition

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The Reality of War

The New Generation of Veterans Returning to Hometown America

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Outline
• Seamless Transition from DoD to VA to community • …………………….Caring for the War Wounded • Categories of War Injuries
Severely Injured (TBI, SCI, Blind, Amputee, PTSD, Burn) Medical Holdover and CBHCO: (Warriors in Transition) Hidden/Lingering Wounds

• Unique Challenges for National Guard and Reserve • Geographical Dispersion, State Coalitions and Role of Transition Assistance Advisors in each state • Outreach Programs • Recommendations to Enhance Employment
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Recovery and Health Continuum of Care

(2004)

VA at MTF 2005

VA OIF/OEF Program Managers

Battlefield

Transitioning from DoD to VA to the Community
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State Coalitions Transition Assistance Advisors Family Programs

Outreach 15 PEB and PDHRA

Categories of War Wounded
Seamless Transition Process DoD

Category 1:
Severely Injured

• Medical Hold/holdover • Community Based Healthcare Organization (CBHCO)

Category 2:

VA full time VA Social Worker VBA Benefits Counselor

11 MTF Liaisons at:
•Brooke AMC, Balboa •Eisenhower AMC •Madigan AMC •Bethesda NNMC, WR •Ft. Carson, Ft Hood • Camp Pendleton • Gordon and CFI

Tampa VAMC

VA Transition
Veterans Tracking Application

Category 3: Hidden Wounds at Post deployment

Severely Injured:
• TBI • SCI •Amputee •Severe disfigurement •Burns •PTSD

VA Liaisons/POC
•VHA facilities: 157 •VBA ROs: 57 • 4 Polytrauma Centers • 2 WRIISC, 207 Vet Centers

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Category 1: Severely Injured
New Positions at MTF, VAMC and Regional Office
• DoD VA • • VA Liaison for Healthcare (10 MTFs) and adding 7 more Veterans Integrated Service Network (VISN) POCs (21) VA Medical Center OIF/OEF VTA Program Manager at 157 VA facilities OEF/OIF Case Managers Transition Patient Advocates (TPA) VBA Regional Offices OEF/OIF Coordinators in each state-57 Readjustment Counseling Services (Vet Centers 206+) for outpatients VA Inpatient mental health/suicide prevention coordinators
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VTA

• • • • •
“Walk on in”

New DoD/VA Medical Center Positions
VA Liaison Healthcare at DoD

VA and Community

V A M e d ic a l C e n te r O E F /O IF P ro g ra m M a n a g e r

O E F /O IF N u r s e a n d S o c ia l W o r k e r C a s e M a n a g e rs

O th e r C a s e M a n a g e rs V IS T , S C I, W o m e n V e te r a n s , p o ly tr a u m a

T r a n s itio n P a tie n t A d v o c a te (s )

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Category 2: WTU/Med Hold/CBHCO
Military Treatment Facility and Warrior in Transition Units (WTU)

Continued Care at Military Treatment Facility. Case management in Warrior Transition Unit (WTU)

Live at Home

MEB/PEB determination

Treatment at local VAMC

Guard/Reserve with case Management from community based health Care organization (CBHCO)

Reserve/Guard may live at Home, receive rehabilitation at VAMC near home. Case management from CBHCO
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Category 2: Warrior Transition Units
Community Based Health Care Organizations Locations Case Manager (CBHCO)
CBHCO Detachment and

Rock Island Arsenal, IL California (ID-NV-OR-WA)

Concord MA

Sacramento Riverton UT
Camp Robinson, AR Virginia Beach, VA

Utah (AZ-CO-MT-ND-NM-SD-WY) Arkansas (KS-LA-MO-NE-OK-TX) Alabama (KY-MS-TN) Florida (GA-SC) Wisconsin (IA-IL-IN-MI-MN) Virginia (DC-DE-MD-NC-OH-WV)

Huntsville, AL Orlando, FL Massachusetts (CT-ME-NH-NJ-NY-PA-RI-VT)

8 Sites

PR

Active Duty Status with Maximum 300 per site
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Reserve Components: Noble Eagle Enduring Freedom and Iraqi Freedom
Mobilized: 88,084 Demobilized: 534,965
USAR ANG USAFR USNR USMCR

Total:
USCGR Total

623,049
Reserve Components Currently Mobilized 49,535 27,643 945 276 5,087 4,297 301 88,084

ARNG

Demobilized To Date:

240,529

147,578

35,375

32,418

33,432

36,763

8,870

534,965

Total Mobilized To Date:

290,064

175,221

36,320

32,694

38,519

41,060

9,171

623,049

++Includes Mobilized and Demobilized more than once

Former Active duty now veterans………….292,289
Mobilized: Involuntary active duty in a Federal Status (10 USC 12302) that authorizes the use of Reserve Forces for up to 24 months
18 July 2007 Services Daily Mobilization Report 10

The Aging Force
Army Medical Department

Reserve Affairs Direct orate

Graying of the Force
Over age 40
–AC –ARNG –USAR –AF acti ve –Air Guard –AFR –Navy AC –NR –479,000 –350,600 –207,000 –42,000 –90,000 –57,000 – – – – – – – – 9% 26% 28% 13% 37% 42% 10% 32%

351,000 106,000 72,300 367,000 87,000

Sol die rs O n Poi nt for the Na t on… Persu asive i n Peace , Invin cibl e in War i

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VA and NG State Coalition

MOU between VA and NG (May 2005)
Access to Troops and Families of National Guard
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Why High Risks for Guard/Reserve
• • • • • • • • • • • • • Guard/Reserve Units are dispersed to remote areas Limited family support programs in community First deployment and multiple deployments Leave civilian jobs for 1 ½ years and frequent mobilizations Post-Deployment readjustment issues and the stigma of mental health Demobilization station is not near hometown/community Hometown is not near NG/Reserve armory or VA (rural) Service related disabilities: delay in tx or claims Returning Home: High divorce rate, jobless, Homeless and delay seeking medical/mental health Lack understanding family/employer of challenges Limited knowledge of VA healthcare/benefits Display high risk behaviors and alcohol/drug abuse
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VA/NGB Liaison
VA Office of Seamless Transition

NG/VA TAA’s Network
Services and Benefits
VBA
National VSO

NGB/VA Liaison
NG Joint Staff

NCA

VHA

Financial Services ESGR SFPD Family Readiness Volunteers Child and Youth Svce

VA Services
Women Benefits Insurance VRE C&P

VISN
VAMC
Women Health VISN Mental Health

Education

VBA RO
Loan G

POC VISN/RO

Governor’s Office
State Mental Health and Substance Abuse Svce

NG Chaplains WFPC

State Directors Of VA
State VSO Training

Adjutant
General

FACs

TPAs

Army Community Svce

National Guard Services
Legal Services

206 Vet Center DOL

OIF/OEF PMs County Service Officer

Case Managers

Support Family National Guard STATE JOINT FORCE HEADQUARTERS Programs Information Services VA/NG Transition Assistance Advisor
TRICARE AW2: Marine4Life Safe Harbor Palace HART

Fed, State, Local Civilian & Private Orgs. Medical Community

Community Services

Community Mental Health Svce

DoD Services
Military One Source

Military Medical Community Medical Hold (CBHCO)

OSD MSIC

Returning to the State: All Service Members and Family and the Safety Net

MTFs
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Support for Members/Families the State Level 57
State Veterans Affairs Directors

Transition Assistance Advisors (TAA) Counseling

Health Care

Family Programs

Education Monitor Homeless Employment
Coordination With Family Programs

Rehabilitation

Disability Benefits
Coordination With CBHCO
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Outreach Toolkits for VA Education and Awareness Campaign to Veterans, Families and VA Staff
http://www.va.gov

Brochures:
– – – – – Summary of Guard/Reserve VA Benefits VA Benefits Wallet Cards VHA summary of Healthcare OIF/OEF Newsletter on healthcare Vet Center and Women’s Health Program

“Walk on in”

• •
http://www.va.gov http://www.va.gov
Officeof Se m s Tra it n am s Trans io ns a le 2 6

MOU with National Guard and Initiatives with other Reserves Training tools:
– – Veterans Health Initiatives(VHI series) My HealtheVet, Webpage, Displays, videos

2 years if free VA healthcare for service related illness/injury
g Trainin s rogram P

Brochures

Too l Offi kit c Sea e of m Tra less nsi tion
EB W GE PA

• •

Training conferences:
– – VA/Transition Assistance Advisors (Feb 2007) Evolving Paradigms National Conference (2007)

Letter from Secretary VA, USH,USB to:
– – – Service Member Adjutants General RO/VISN and VAMC Directors

o Vide casts road B

I VH

90 days For Dental treatment

• Education/Awareness Campaign Plan and Communication/Distribution Plan for Outreach to Guard/Reserve and family • New Technology: Webcasts, Podcasts, Multi-Media Technology for electronic toolkits

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Recommendations

• Education and Awareness of Service Members, Family Members, clinicians, federal and state employers • Longitudinal Study on employment challenges • Closer links of Employment Specialists with ESGR Coordinators at VAMC with OIF/OEF Program Managers • Participating with the state coalitions and MOU • Employment Coordinators participate in PDHRA events, family programs, job fairs, reunions, and unit events • Support legislation for home station reintegration • Closer ties with VA VRE programs • Robust Reintegration Programs at home station
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Caring for Guard/Reserve Through ……………….Seamless Transition

QUESTIONS ?
VA Office of Seamless Transition 202-273-7822
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2007 Task Force, GAO and Commission Reports to the President
• Togo West’s Commission on Care of War Wounded at Walter Reed VA Secretary Nicholson’s: Returning GWOT Heroes: 25 Recommendations • Bob Dole Commission Final Report GAO reports
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Resources
• Basic VA Benefits Questions:
www.va.gov or 1-877-222-VETS (8387)

• • • • • • •

VA Office Seamless Transition- (202-273-7822) DoD VA Program Coordination Office (703-681-0039) Military Severely Injured Center (1-888-774-1361)
severelyinjured@militaryonesource.com

Army Wounded Warrior Program (1-800-833-6622) www.armyds3.org Marine for Life (1-866-645-8762) injuredsupport@M4L.usmc.mil Air Force Palace HART (1-888-774-1361)
severelyinjured@militaryonesource.com

Navy Safe Harbor (1-888-774-1361)

severelyinjured@militaryonesource.com Military One Source ( 1-800-342-9647) (24/7) www.militaryonesource.com
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VA OIF/OEF Healthcare Utilization Summary

• • • •

SW Asia Veterans Who Separated From Active duty: 631, 174 OEF/OIF veterans and are eligible for VA care since FY 2002-2006 Totals Use VHA Component 292,289): (101, 259) Former Active duty 147,020): (41,090) Reserves 191,865) (62,739) National Guard 631,174 205, 097
32% or 205,097 evaluated by VA from 2002-2006 represents 4% of 5.3 million veterans in any one year

Total Female Veterans: …. 65,231 % Combat Women Veterans enrolled in VHA care…......36.2% (3rd quarter 2006)
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