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VA Support for OIF OEF - United States Department of Labor

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					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              1
                 The Reality of War




The New Generation of Veterans Returning to Hometown America   2
                      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
                                                             3
               Recovery and Health Continuum of Care




    (2004)                                                       VA OIF/OEF
                                                              Program Managers
   VA at MTF


                                  2005




                                    State Coalitions
                                     State Coalitions
                            Transition Assistance Advisors
Battlefield                  Transition Assistance Advisors
                                   Family Programs
                                     Family Programs
                                                                 Outreach
                                                              PEB and PDHRA

Transitioning from DoD to VA to the Community
                                                                                 4
                                  Categories of War Wounded
                         Seamless Transition Process                      Category 2:
                                                                          Category 2:
                                                                     •• Medical Hold/holdover
                                                                         Medical Hold/holdover
                                           Category 1:
                                           Category 1:                  •• Community Based
DoD                                        Severely Injured                Community Based
                                            Severely Injured         Healthcare Organization
                                                                      Healthcare Organization
                                                                             (CBHCO)
                                                                              (CBHCO)
   VA full time VA Social Worker
   VBA Benefits Counselor



11 MTF Liaisons at:
•Brooke AMC, Balboa
•Eisenhower AMC
•Madigan AMC
•Bethesda NNMC, WR
                                                Tampa VAMC
•Ft. Carson, Ft Hood                                                        Category 3:
                                                                             Category 3:
                                     VA
• Camp Pendleton
                                                                         Hidden Wounds at
                                                                         Hidden Wounds at
• Gordon and CFI
                                 Transition                              Post deployment
                                                                          Post deployment
Severely Injured:
         • TBI
         • SCI           VA Liaisons/POC               Veterans
      •Amputee
 •Severe disfigurement
                                                        Tracking
                         •VHA facilities: 157
        •Burns                                         Application
        •PTSD            •VBA ROs: 57
                         • 4 Polytrauma Centers
                         • 2 WRIISC, 207 Vet Centers
                                                                                                 5
          Category 1: Severely Injured

      New Positions at MTF, VAMC and Regional Office

                              •   VA Liaison for Healthcare (10 MTFs)
                                  and adding 7 more
DoD                           •   Veterans Integrated Service
                 VA               Network (VISN) POCs (21)
                              •   VA Medical Center OIF/OEF
                                  Program Manager at 157 VA VTA
                                  facilities
       VTA                    •   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
               “Walk on in”
                                  prevention coordinators

                                                                        6
             New DoD/VA Medical Center Positions


VA Liaison          VA and Community
Healthcare
 at DoD




                                               7
                 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




                                               Reserve/Guard may live at
                                               Home, receive
                                               rehabilitation at VAMC near
Treatment at local VAMC                        home. Case management
Guard/Reserve with case                        from CBHCO
Management from community based health
Care organization (CBHCO)                                                       8
                            Category 2: Warrior Transition Units
                  Community Based Health Care Organizations (CBHCO)
                                                                    CBHCO Detachment and
                                                                    Case Manager Locations



                                                    Rock Island Arsenal, IL                   Concord
                                                                                                MA

   California
                Sacramento
(ID-NV-OR-WA)

                               Riverton UT                                               Virginia Beach, VA

                                              Camp Robinson, AR




         Utah
                                                                                         8 Sites
                                                                                         8 Sites
(AZ-CO-MT-ND-NM-SD-WY)                                    Huntsville, AL

      Arkansas             Wisconsin
(KS-LA-MO-NE-OK-TX)     (IA-IL-IN-MI-MN)                                      Orlando, FL

 Alabama      Florida          Virginia              Massachusetts
(KY-MS-TN)   (GA-SC)    (DC-DE-MD-NC-OH-WV)    (CT-ME-NH-NJ-NY-PA-RI-VT)
                                                                                    PR


                    Active Duty Status with Maximum 300 per site
                    Active Duty Status with Maximum 300 per site
                                                                                                              9
                           Reserve Components: Noble Eagle
                            Reserve Components: Noble Eagle
                          Enduring Freedom and Iraqi Freedom
                           Enduring Freedom and Iraqi Freedom

Mobilized: 88,084                     Demobilized: 534,965                        Total:    623,049
Reserve         ARNG        USAR        ANG      USAFR    USNR        USMCR        USCGR         Total
Components


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



Demobilized     240,529     147,578     35,375   32,418   33,432      36,763       8,870         534,965
To Date:



Total           290,064     175,221     36,320   32,694   38,519      41,060       9,171         623,049
Mobilized
To Date:




                    ++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
11
 VA and NG State Coalition




MOU between VA and NG (May 2005)
 Access to Troops and Families of National Guard

                                                   12
                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
                                                                   13
        VA/NGB
         VA/NGB                                                                                                          NGB/VA
                                                                                                                        NGB/VA
        Liaison
         Liaison
   VA Office of Seamless
                                                NG/VA TAA’s Network                                                      Liaison
                                                                                                                        Liaison
    VA Office of Seamless                                                                                            NG Joint Staff
         Transition
          Transition                                      Services and Benefits                                     NG Joint Staff
  NCA
   NCA VHA
                                                  National
                                                    National
        VHA                          VBA
                                      VBA          VSO VSO                                                              Financial
                                                                                                                        Financial
                                                                                                                        Services
                                                                                                                         Services
                                                                                                                                     ESGR
 VA Services
 VA Services                                                                                                            SFPD
                                                                                                                                     ESGR


                                                                    Governor’s
                                                                                                                        SFPD
              Women
              Benefits     Insurance
                            Insurance
                                      VRE
                                      VRE
                                                                     Governor’s                                  Family Readiness
                                                                                                                                   Child and
                                                                                                                                    Child and
                                                                                                                                   Youth Svce
                                                                                                                  Family Readiness Youth Svce

   VISN
     VISN
                     Education
                        Education C&P
                                            POC
                                                                      Office
                                                                        Office
                                                                                                                    Volunteers
                                                                                                                      Volunteers
                                                                                                                                        NG
                                                                                                                                         NG
                     VBA RO
                      VBA RO                   POC
                                          VISN/RO
                                                                                                                                     Chaplains
                                                                                                                                      Chaplains
                                             VISN/RO                                                               WFPC
                                                                          State Mental                             WFPC
                            Loan G              State Directors               State Mental                                       National
                            Loan G                 State Directors        Health and and                                        National
                                                                              Health                                    FACs
     VAMC
       VAMC                                          Of VA VA
                                                        Of                Substance          Adjutant
                                                                                              Adjutant                  FACs     Guard
                                                                                                                                Guard
                                                                              Substance
                         TPAs
                                                                          Abuse Svce
                                                                              Abuse Svce      General
                                                                                               General                           Services
                                                                                                                          Army Services
          VISN           TPAs          State VSO                                                                           Army
Women
  WomenMental
             VISN                         State VSO                                                                     Community
                                                                                                                         Community
Health      Mental                                                                                                        Svce           Legal
  Health Health                                                                                                            Svce           Legal
            Health       OIF/OEF                               Training                                                                 Services
                          OIF/OEF                                                                                                       Services
  206
                           PMs
                            PMs                                   National Guard   Support
                                                                       National Guard       Family
                                                                                               Family
    206                                                                                    Programs
  Vet
    Vet
                                     County
                                      County            STATE JOINT FORCE HEADQUARTERS Programs
                                                            STATE JOINT FORCE HEADQUARTERS
              Case Managers          Service
 Center        Case Managers          Service
                                                       Information
   Center                            Officer
                                      Officer                                                    Services
                                                                                           Advisor
                                                              VA/NG Transition Assistance Advisor
                                                             VA/NG Transition Assistance                                       Military Medical
                                                                                                                                 Military Medical
        DOL                                                                                                   TRICARE            Community
      DOL                                                                                                     TRICARE               Community
                                                                                                                                Medical Hold
         Fed, State, Local     Civilian                                                                                            Medical Hold
                                                                                                AW2:                              (CBHCO)
             Fed, State, Local      Civilian
          & Private Orgs. Medical Community Community                                             AW2:
                                                                                              Marine4Life
                                                                                                                 DoD
                                                                                                                DoD                  (CBHCO)
              & Private Orgs. Medical Community Community                                       Marine4Life
                                                Mental                                       Safe Harbor
                                                                                               Safe Harbor
                                                                                                               Services
                                                                                                              Services              OSD
                                                                                                                                     OSD
                                                    Mental                                   Palace HART
              Community Services
                Community Services            Health Svce
                                                 Health Svce
                                                                                               Palace HART
                                                                                                                 Military
                                                                                                                                    MSIC
                                                                                                                                    MSIC
                                                                                                                  Military
                                                                                                                  One
                                                                                                                   One
                Returning to the State: All Service Members and Family                                           Source
                                                                                                                  Source            MTFs
                                   and the Safety Net
                                                                                                                                                    14
                                       Support for Members/Families
                                              the State Level
                                                               57
                                                Transition Assistance
State Veterans Affairs Directors




                                   Counseling
                                     Counseling    Advisors (TAA)                  Health Care
                                                                                    Health Care




                                                                                                    Family Programs
                                    Education
                                      Education                                   Rehabilitation
                                                                                   Rehabilitation


                                      Monitor
                                        Monitor
                                     Homeless                                   Disability
                                                                                 Disability
                                       Homeless
                                    Employment                                  Benefits
                                                                                  Benefits
                                      Employment
                                                    Coordination
                                                       Coordination
                                                        With           Coordination
                                                                        Coordination
                                                           With
                                                  Family Programs
                                                     Family Programs
                                                                       With CBHCO
                                                                        With CBHCO

                                                                                                                      15
                                           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”                                                            •     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                                                          •     Training conferences:
VA healthcare                                 Too                               –   VA/Transition Assistance Advisors (Feb 2007)
                                                  l
for service                                  Offi kit                           –   Evolving Paradigms National Conference (2007)
                                                 c
related illness/injury                      Sea e of                     •     Letter from Secretary VA, USH,USB to:
                                                m
                            Trainin
                                    g      Tra less                             –   Service Member
                            Progra
                                    ms        nsit
                                                   ion                          –   Adjutants General
                Brochures                                                       –   RO/VISN and VAMC Directors
                                     o
                                 Vide casts
                                       d          I
                                  Broa          VH
                                          EB
                                         W GE                                • Education/Awareness Campaign
                                          PA
                                                                              Plan and Communication/Distribution
                                                                             Plan
                                                                              for Outreach to Guard/Reserve and family
                                                      90 days
                                                      For
                                                      Dental treatment
                                                                             • New Technology: Webcasts,
                                                                             Podcasts, Multi-Media Technology for
                                                                             electronic toolkits
                                                                                                                                    16
                  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

                                                          17
Caring for Guard/Reserve Through
……………….Seamless Transition




           QUESTIONS ?
     VA Office of Seamless Transition
     VA Office of Seamless Transition
              202-273-7822
               202-273-7822
                                        18
                             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


                                                19
                         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
                                                                                20
            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)

                                                              21

				
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