1. WARRIOR TRANSITION PROGRAM Update to the SFAC Action Planning Conference 29 July 2008 Unclassified Mr David Burns Warrior Transition Office Office of the Surgeon General Army Medical Command

2. WARRIOR TRANSITION PROGRAM Slide 2 FRAGO 3 Implementation Major Actions Directed By FRAGO 3 to Army Senior Commanders: –Cadre ratios at 100% fill based on WTU population not TDA –Common understanding of WTU entry/exit criteria to ensure consistent execution across the force Soldier in MEB is not automatic entry into WTU Status of WTs on “transition” leave / impact on resources –Awareness and support to key CSA focus areas: Streamlining MEB/PEB processing Timelines of orders/assignment process for WT Soldiers/cadre Improving availability of mental health care

3. WARRIOR TRANSITION PROGRAM Slide 3 Assessment of WTU Cadre Fill

4. WARRIOR TRANSITION PROGRAM Slide 4 MEDCOM Assessment AMAP implementation remains top priority. AMAP implementation remains top priority. Implementing FRAGO 3 has decreased staffing pressures in WTUs. Implementing FRAGO 3 has decreased staffing pressures in WTUs. Commands filled to requirements generated from WT census; WT census includes 6% in transitional leave status. Commands filled to requirements generated from WT census; WT census includes 6% in transitional leave status. Revised WTU entry and exit criteria will reduce WT census over time. Revised WTU entry and exit criteria will reduce WT census over time. Re-balancing focus to Comprehensive Care and Transition Management. Re-balancing focus to Comprehensive Care and Transition Management.

5. WARRIOR TRANSITION PROGRAM Slide 5 MEDCOM Strategy Streamline MEB/PEB process Streamline MEB/PEB process –With PDA, reduced the paperwork for PDES from over 30 separate documents to 19. –Automate MEB process with JAN 09 target date –Improved quality control over process; decreased error rate from 15% to 11% last quarter –Improved staffing and training of MEB physicians, PCMs and PEBLOs Intensely manage WT entry and exit processes ICW Triad of Leadership and MACOMs Intensely manage WT entry and exit processes ICW Triad of Leadership and MACOMs Streamline WT orders process ICW supporting commands and G-1 Streamline WT orders process ICW supporting commands and G-1 Continue improvement of WT access to care Continue improvement of WT access to care Improve civilian hiring practices Improve civilian hiring practices Begin to assign and hire to WTU October 08 staffing ratios Begin to assign and hire to WTU October 08 staffing ratios

6. WARRIOR TRANSITION PROGRAM Slide 6 MEDCOM Issues Shortage of providers presents challenges in balancing the system. Shortage of providers presents challenges in balancing the system. Movement of healthcare providers into WTUs may impact access to care for other beneficiaries. Movement of healthcare providers into WTUs may impact access to care for other beneficiaries. Marked reduction in WT population will result in returning staff to MTFs in a few months. Marked reduction in WT population will result in returning staff to MTFs in a few months. Support to non-WTU MEB population. Support to non-WTU MEB population. Force structure will lag behind changes in WT population. Force structure will lag behind changes in WT population.

7. WARRIOR TRANSITION PROGRAM Slide 7 Mental Health Implement comprehensive mental health strategy Implement comprehensive mental health strategy Increase psychiatric health providers Increase psychiatric health providers –192 additional contract clinicians. –127 additional uniformed psychiatric healthcare providers authorized (25 psychiatrists, 15 psychiatric nurses, 87 psychiatric technicians). –Increase inpatient psychiatric capability. –Increased psychiatric health purchased care by 79% for AD and 6% for ADFM (OCT-APR 2007/2008 comparison). –Increased retention and recruiting program for military psychiatric health providers.

8. WARRIOR TRANSITION PROGRAM Slide 8 Latest News New Director WTO –COL Rick Agosta replaces COL Becky Baker –COL Baker will continue to serve in the WTO Senior Leader testimony on Warriors in Transition to House Armed Services Committee went well MG Formica, G3/5/7, approves new WTU cadre ratios –Squad leaders 1:10 –Nurse Case Managers 1:20 all MTFs (MEDCENS and Hospitals) –Issues remain with Retention NCOs and drivers Planning Warrior in Transition (AMAP) Conference –Mid September –All Army Commands and major activities will participate –Focus on Administration, Orders, MEB/PEB, Transition and other leader issues

9. WARRIOR TRANSITION PROGRAM Slide 9 BACK – UP SLIDES

10. WARRIOR TRANSITION PROGRAM Slide 10 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

11. WARRIOR TRANSITION PROGRAM Slide 11 Warrior Transition Unit

12. June 10, 2016View "Header and Footer" 12 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.  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 POPULATION Method for Entry into WTU

13. WARRIOR TRANSITION PROGRAM Slide 13 RESPONSIVE WSFH 4/day PROACTIVE MEDCOM MEDICAL ASSISTANCE GROUP Established March 2007 SME’s at MEDCOM Follow-up Contact Soldier < 24 Hrs Resolution “On Track” < 72 Hrs Resolution Report to WSFH < 72Hrs Use OMBUDSMAN to insure “Up-close & Personal” Help MEDCOM WT OMBUDSMAN PROGRAM Established April 2007 48 OMBUDSMAN at 29 Sites Report to MEDCOM NOT Local Command Anonymity & Confidentiality Proactive – Resolve issues before they become WSFH Calls, Congressionals etc. Work in concert with Patient Advocate OMBUDSMA N PROGRAM 30% MEDICAL CARE 20% ADMINISTRATIVE 15% MEB/PEB Request for Specialty Care Care Complaint Request for 2 nd opinion MED Record Problems Finance/Pay Problems Line of Duty Issue Problem with Orders TSGLI/CIP Uniform/Equipment REFRAD/Reclassify Process too slow Process not understood Dissatisfied with % Soldier Desires MEB Need Assistance with Appeal From Apr 07 – Jul 08 = 7041 Cases Assisting Soldiers/Family Members Most Frequent Categories