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VA Support for OIF OEF

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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
Battlefield                  Transition Assistance Advisors
                                    Family Programs
                                                                 Outreach
                                                              PEB and PDHRA

Transitioning from DoD to VA to the Community
                                                                                 4
                                  Categories of War Wounded
                         Seamless Transition Process                      Category 2:
                                                                     • Medical Hold/holdover
                                            Category 1:                • Community Based
DoD                                         Severely Injured
                                                                     Healthcare Organization
                                                                            (CBHCO)
   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
                                                Tampa VAMC
• Camp Pendleton                         VA                                 Category 3:
• Gordon and CFI                                                         Hidden Wounds at
                                                                          Post deployment
Severely Injured:
         • TBI
         • SCI           VA Liaisons/POC                Veterans
      •Amputee                                          Tracking
 •Severe disfigurement   •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


                     VA Medical Center
                         OEF/OIF
                     Program Manager


  OEF/OIF Nurse     Other Case Managers     Transition
and Social Worker    VIST, SCI, Women        Patient
 Case Managers      Veterans, polytrauma   Advocate(s)



                                                         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
                                                              Huntsville, AL
                                                                                                8 Sites
(AZ-CO-MT-ND-NM-SD-WY)
      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
                                                                                                                  9
                           Reserve Components: Noble Eagle
                          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
           Liaison
   VA Office of Seamless
                                                    NG/VA TAA’s Network                                                        NGB/VA
                                                                                                                               Liaison
         Transition                                                 Services and Benefits                                    NG Joint Staff

  NCA                                                    National
                   VHA                  VBA               VSO
                                                                                                                              Financial
                                                                                                                              Services
                                                                                                                                          ESGR
 VA Services                                                                                                                  SFPD
               Women
               Benefits    Insurance     VRE
                                                                           Governor’s                                Family Readiness
                                                                                                                                             Child and
                                                                                                                                            Youth Svce


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

                 Returning to the State: All Service Members and Family                                                   One
                                                                                                                         Source           MTFs
                                    and the Safety Net
                                                                                                                                                         14
                                      Support for Members/Families
                                              the State Level
                                                            57
                                              Transition Assistance
State Veterans Affairs Directors




                                   Counseling     Advisors (TAA)                 Health Care




                                                                                               Family Programs
                                    Education                                Rehabilitation


                                      Monitor
                                     Homeless                              Disability
                                    Employment                             Benefits
                                                  Coordination
                                                      With        Coordination
                                                Family Programs   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                                                    –   VA/Transition Assistance Advisors (Feb 2007)
for service                                                      –   Evolving Paradigms National Conference (2007)
related illness/injury                                    •     Letter from Secretary VA, USH,USB to:
                                                                 –   Service Member
                                                                 –   Adjutants General
                 Brochures                                       –   RO/VISN and VAMC Directors


                                                              • Education/Awareness Campaign
                                                               Plan and Communication/Distribution Plan
                                                               for Outreach to Guard/Reserve and family

                                       90 days                • New Technology: Webcasts,
                                       For
                                       Dental treatment
                                                              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
               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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