Transcript WARRIOR TRANSITION PROGRAM

WARRIOR TRANSITION PROGRAM
Mr David Burns
Warrior Transition Office
Office of the Surgeon General
Army Medical Command
28 July 2008
Unclassified
WARRIOR TRANSITION PROGRAM
“I am a Warrior in
Transition. My job is to
heal as I transition back
to duty or become a
productive, responsible
citizen in society. This is
not a status but a
mission. I will succeed in
this mission because I
am Warrior. “
Slide 2
WARRIOR TRANSITION PROGRAM
Warrior Transition Background
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June 2003: Mobilized Reserve Component Soldiers
– Injured Soldiers returning and medevaced from Afghanistan (OEF) and Iraq
(OIF) in greater numbers
– Soldiers who reported to MOB stations who were not medically deployable
were kept at MOB stations to either fix and deploy or refer to Physical
Disability Evaluation System (PDES)
– Soldiers demobing were able to stay on Active Duty for treatment of “In Line
of Duty” conditions (medical conditions aggravated or incurred while
mobilized)
– First Nurse Case Managers were mobilized to manage Reserve population
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June 2003- March 2004
– Formal MHO structure, operations, organization and dedicated Command
and Control established on Installations
– Each MHO Soldier assigned to a Nurse Case Manager
– Developed MHO Program operational standards
Slide 3
WARRIOR TRANSITION PROGRAM
Warrior Transition Background
• March - April 2007
– Congress asks Army to evaluate structure, care, systems,
and process for all “Warriors in Transition” regardless of
Compo or GWOT affiliation.
– Development of Warrior Transition Unit
• Staffing Ratios set for PCM, CM, PLT SGT, PEBLO,
BH, etc.
– Same standard set for all Soldiers
– Ombudsman Program established at MTFs
– Significant changes made in the Army Physical Disability
Evaluation System (PDES)
– Greater emphasis placed on training of the Cadre
Slide 4
WARRIOR TRANSITION PROGRAM
Mission Essential Task List
• The WTU will…
– Provide Command and Control
– Provide Administrative Support
– Provide high quality, expert primary care and case
management
– Provide coordination and synchronization of care,
treatment and services through the Triad of care
with the multidisciplinary team: Primary Care
Manager, Case Manager, and Squad Leader
– Promote readiness of Soldier and family to
transition back to the force or civilian life
Slide 5
WARRIOR TRANSITION PROGRAM
WTU
An Army Brigade, Battalion, or Company which provides
command and control, administrative support, primary
care and case management, coordination and
synchronization of care, treatment and services through
the Triad of care: Primary Care Manager, Nurse Case
Manager, and Squad Leader, to promote readiness of
Soldier and family to transition back to the force or
civilian life.
Slide 6
WTU BDE - 1
WTU BN - 14
WTU CO - 20
CBHCO - 9
WARRIOR
PROGRAM
WarriorTRANSITION
Transition
Unit
Landstuhl 230
Heidelberg 44
Current WT Population (assigned or
attached to a WTU) is 12,879 Soldiers
Bavaria 229
Ft. Drum
566
MA
West Point
160
63
WI
Ft. Dix
217
Ft. Lewis
Ft. Riley
259
761
450
Ft. Belvoir
Ft. Carson
774
CA
61
WRAMC
Ft. Leavenworth
653
18
Ft. Lee
VA
220
66
197
UT
137
Ft. Irwin
& Balboa
Ft Huachuca
164
51
Ft. Leonard Wood
Ft Meade
155
58
Ft. Sill
143
Ft. Hood
1332
Ft. Richardson
AR
Ft. Campbell
233
762
Ft. Eustis
192
Ft. Knox
Ft. Bragg
330
718
Ft. Jackson
83
Redstone Arsenal
13
Ft. Gordon
148
433
Ft. Bliss
343
Ft. Stewart
Ft Rucker
Ft. Wainwright
597
19
AL
82
TAMC
Ft. Sam Houston
Ft. Polk
616
331
261
POC: Dr. Michael J. Carino, OTSG, 7 July 2008
105
FL
149
Ft. Benning
PR
347
88
Slide 7
WARRIOR TRANSITION POPULATION
Method for Entry into WTU
Current WT Population (10,866) by EVAC (BI, NBI, Disease) and NON-EVAC
POC: Dr. Michael J. Carino, OTSG 17 March 2008
Evacuation Information verified using TRANSCOM Patient Movement Reports
Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) information verified using the Medical
Evaluation Board Internal Tracking Tool (MEBITT)
MEB/PEB numbers only reflect the number of Soldiers who were referred to the WTU for completion of their
Board Process; Other Categories on the Pie Chart may include additional WT Soldiers in the MEB/PEB process
who Entered the WTU for other reasons.
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View "Header and Footer"
July 17, 2015
Non Evac WT population may also be GWOT related, i.e. due to GWOT Mobilization, GWOT Demobilization, and
AC medical conditions that are GWOT related but the Soldier wasn’t evacuated Out of Theater.
WARRIOR TRANSITION PROGRAM
Staffing Ratios for Warrior Transition Units
• 1 Company for every 200 WT
• 1 Co Cdr and 1SG for every Company
• 1 XO for each company of at least 150 WT
• 1 PSG for every 36 WT
• 1 Squad Leader for every 12 WT
• 1 Nurse Case Manager for every 18 WT (MEDCEN)
• 1 Nurse Case Manager for every 36 WT (MEDDAC)
• 1 Human Resource Sergeant for every 200 WT
• 1 Social Worker (family therapist qualified) for every 100 WT
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(1 to 50 at WRAMC and BAMC)
3 Human Resource Specialists for every 200 WT
1 Finance Sergeant for every 200 WT
Slide 9
WARRIOR TRANSITION PROGRAM
Staffing Ratios for Warrior Transition Units (cont.)
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1 Supply Sergeant for every 200 WT
1 Supply Specialist for every 200 WT
1 Patient Administration Sergeant/Specialist for every 200 WT
MEB Physician for every 200 Soldiers in MEB/PEB process
1 Primary Care Manager for every 200 WT
1 Training Specialist for every 200 WT
1 Occupational Therapist for every WT Brigade or Battalion
1 Occupational Therapy Technician/ Recreation Specialist for
every 200 WT
1 PEBLO for every 30 Soldiers in MEB/PEB process
Ombudsmen (Contract) are “earned” as follows:
o >35 WTs – 200 WTs = 1 Ombudsman
o 201 WTs – 400 WTs = 2 Ombudsmen
o 401 WTs – 600 WTs = 3 Ombudsmen
Slide 10
WARRIOR TRANSITION PROGRAM
Benefits of CBHCO
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Soldier returns to family, friends and community – helps the healing
process
Reintegration support while healing
Continuity of civilian medical providers helps make medical transition
seamless once Soldier is back on Reserve status
Reduces stress and financial hardship of Soldier and family
Unofficial Trial of duty while at CBHCO
Opportunity for establishing link with VA during healing process
Reserve Soldiers taking care of Reserve Soldiers
Congressional and public grass roots support
Social Worker assigned to each CBHCO to improve behavioral health
capability
Slide 11
Community Based Health Care
Organizations
HQ Locations
Alaska
Wisconsin
Washington
Montana
Oregon
Idaho
Wyoming
Hawaii
Utah
Arizona
Minnesota
Maine
VT
NH
South
Dakota
New York
Pennsylvania
Iowa
Illinois
Indiana
Colorado
New
Mexico
Massachusetts
Rhode Island
Michigan
Nebraska
Nevada
California
North
Dakota
Kansas
Ohio
West
Virginia
Kentucky
Missouri
Oklahoma ArkansasTennessee
Texas
MS
Connecticut
NJ
Delaware
North
Carolina
SC
Maryland
Virginia
Georgia
Florida
Alabama
CBHCO Locations
Puerto Rico
WARRIOR TRANSITION PROGRAM
Triad
• The Triad: PCM, Case Manager, and PLT SGT/SQD LDR
collects Soldier data and information; analyzes data and
information to produce a plan of care, treatment, and service
specific to each Soldier’s needs.
• Primary Care Manager (Physician)
– Provides primary oversight and continuity of health care and
ensures the level of care provided is of the highest quality.
The relationship developed between patients and their PCM
is the basis for successful prevention-oriented, coordinated
health care. Patients reap benefits from consistent health
care and improved overall health.
Slide 13
WARRIOR TRANSITION PROGRAM
Triad cont’d
• Case Manager:
Licensed healthcare professionals
(registered nurses) that assess, plan, implement, coordinate,
monitor, and evaluate options and services to meet Soldier’s
health needs. Responsible for implementation of the
Comprehensive Transition Plan (CTP)
• Squad Leader: NCO responsible for all that the squad does
or fails to do. He is a tactical leader and, as such, leads by
example. The squad leader works as part of the Triad
providing for the care of the Warrior and his or her Family.
– Maintains accountability of his soldiers and equipment.
– Ensures the WT keeps all scheduled medical
appointments.
– Inspects the condition of Soldiers' billeting, clothing, and
equipment.
Slide 14
WARRIOR TRANSITION PROGRAM
WTU ASSIGNMENT/ATTACHMENT CRITERIA
• Each Army MTF will maintain a warrior transition unit (WTU). Units will
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vary in size from small detachments to brigades, depending on patient
population.
A Warrior in Transition is any Soldier who requires significant medical
intervention in order to heal and return to duty or to make a successful
transition to veteran status.
Assignment or attachment to a WTU will not be performed solely to
facilitate the early requisitioning of replacement personnel or for purely
compassionate reasons.
Service members that do not meet the criteria of AR 40-400 will not be
attached or assigned to a WTU.
All Service members who present to the MTF for medical evaluation or
treatment from off-installation locations and who will be present more
than 24 hours will be required to report to the WTU for accountability and
control purposes.
For those Soldiers who are on medical TDY orders, the orders will
specify that the Soldier is under the command and control of the WTU
while at the MTF. All Service members in a TDRL status will report to the
WTU upon arrival at the MTF.
Slide 15
WARRIOR TRANSITION PROGRAM
WTU Assignment Criteria for Active Component
• Requires a temporary profile of more than 6 months duration.
• Treatment plan requires the Soldier to spend most of his/her time
receiving and/or traveling to and from medical treatment.
• Requires an MEB and therefore requires a permanent profile with duty
limitations that preclude the Soldier from contributing to the parent unit’s
mission.
• Profile limitations preclude deployment (AR 40-501, chapter 5) within the
next 60 days and the unit is scheduled to deploy within 60 days.
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Unit has no rear detachment.
– Rear detachment capabilities are insufficient to accommodate the
Soldier’s physical limitations.
– Limitations prevent the Soldier from contributing to the rear
detachment’s mission.
Slide 16
WARRIOR TRANSITION PROGRAM
WTU Assignment Criteria for Reserve Component
• Soldier was mobilized on 10 USC 12302 orders in support of named
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operations and diverted from his/her normal mobilization mission or
demobilization processing in order to receive medical treatment.
Soldier is in need of medical evaluation, treatment, and disposition
including definitive health care for an illness, injury, or disease incurred in
the line of duty and/or for aggravation of a pre-existing medical condition
incurred in the line of duty.
The MTF commander must determine if a Soldier is not expected to RTD
within 60 days from the time of injury or illness or if the Soldier could
RTD within 60 days, but will have fewer than 120 days beyond the
expected RTD date left on 10 USC 12302 partial mobilization order. In
such a case, the Soldier will be converted from partial mobilization orders
to medical retention processing (MRP) 12301(h) orders, subject to the
Soldier’s consent in accordance with current personnel policy guidance
(PPG).
Slide 17
WARRIOR TRANSITION PROGRAM
Data Systems in Support of WTU
• Warrior Transition Web Reporting
– Web-based data system used to track and monitor WT Soldiers
– Data input by CM (clinical info) and Admin Support Staff
Demographics, general diagnostic categories, MEB/PEB Status
Location of Assignment; WTU or CBHCO Case Manager
• Armed Forces Health Longitudinal Technology Application
(AHLTA).
– Military Electronic Medical Record
• Joint Patient Tracking Application (JPTA)
– Web-based patient tracking and management tool that collects,
manages, analyzes and reports data on patients arriving at medical
treatment facilities (MTFs) from forward deployed locations
Slide 19
WARRIOR TRANSITION PROGRAM
MANAGEMENT OF WOUNDED AND ILL
FEDERAL RECOVERY COORDINATOR Oversight/Compliance
Evacuation
and
Notification
Clinical
Management
Treatment
Rehab
Medical Evaluation Board
MEB
COAD / COAR
Evaluation
Transition
Physical Evaluation Board
PEB
Separate / Retire
Maintenance
and
Support
WTU Medical/Case Managers
VA Case Management
Veterans Health Admin (VHA)
Benefits
Management
Seamless
Transition
AW2 SFMS Life-time Tracking…
SFAC Benefits & Services
Veterans Benefits Admin (VBA)
PEBLO
Administration
WTU Command & Control
VA Out Reach Program
Slide 20