1. ARMY STRONG “Apart from the war itself, we have no higher priority!” Warrior Care and Transition Update “A total transformation of the way we care for Soldiers and their Families” “Apart from the war itself, this department and I have no higher priority.”

2. ARMY STRONG “Apart from the war itself, we have no higher priority!” 22 So What Transformed? …a snapshot:

3. ARMY STRONG “Apart from the war itself, we have no higher priority!” 3 The Wounded Soldier has a Mission: To Heal. This is his sole purpose. Everything the Soldiers does must support healing: –Appointments, Rehab, Therapy, Medications are his job! –Nothing is more important than his mission to heal. –The Warrior Transition Unit sets the conditions for him to heal. The Mission is Essential All Units must have a Mission Statement. A Mission Statement provides Focus, Purpose and Essential Tasks, which must be accomplished in order for the unit to be successful. The Mission of the WTU is to support healing. …a unit & Soldier without a mission is like a boat without a rudder! Essential Tasks provide metrics that can be measured. Only then can you assess unit performance – see yourself. We measure this performance Monthly, Quarterly, and Semi- Annually.

4. ARMY STRONG “Apart from the war itself, we have no higher priority!” 4 WCTO Mission Statement The Warrior Care and Transition Office (WCTO) provides HQDA level integration, monitoring and synchronization of strategy and policy for warrior care initiatives and related programs dedicated to the support, care and healing of wounded, ill and injured Soldiers, their Families and caregivers.

5. ARMY STRONG “Apart from the war itself, we have no higher priority!” 5 Director’s Office G-1 WTOACSIM WTO Dir, WCTO / ASG-WCAT ACSIM OTSG WTO DAS DA Staff G-3/5/7OTSGG-1 Synchronizes Supervision Coordination ARNG AdvisorUSAR Advisor Congr Affairs Coord Warrior Care and Transition Office (WCTO) Detailed view of the Dir’s Office showing WTOs & advisors 9/0/1/5=15* *Includes WTOs, Advisors et al OFF/ WO / ENL / CIV = TOTAL TOTAL 16/0/1/18=35 Plans and Policy 2/0/0/6=8 Integration & Operations 2/0/0/5=/7 Information Engagement 3/0/0/2/=5 VA Advisor Senior Enlisted Advisor

6. ARMY STRONG “Apart from the war itself, we have no higher priority!” 6 WTU 1:10 PCMNCM TRIAD COMPANY CMD GRP 1:40 1:20 SQD LDR 1:200 BN CMD GRP PLT SGT CO CDR 1 / CO 1SG 1 / CO CO XO 1 / CO COMPANY SPECIALTY STAFF 1:200 SR NCM 1:100 1:200 TNG SP HR SP 1:60 SUP TECH BN CDR 1 / BN BN XO 1 / BN CSM S1 1 / BN FRSA 1 / BN S3 SR FIN MGR S4 1 / BN BN SPECIALTY STAFF MED NCO 1 / BN S3 1 / BN OPS SGT 1 / BN CHAP 1:4501:600 CHAP ASST OT 1 / BN SUP SP = military position = civilian position (2 – 4 per PLT) (2 – 5 per CO) (max of 10 per CO) (2 – 6 per BN) WTB PCM ASST 1:200 FIN TECH 1:200 1:500 TNS CRD MSA SP 1:100 (1:50) SOC WKROT ASST 1:200 MEB PHYS A/OPS SGT 1:500 SR MED OFF 1/BN = military/civilian position SMSA = SUP, MED SPT ASST Warrior Transition Battalion

7. ARMY STRONG “Apart from the war itself, we have no higher priority!” 7 Barracks Soldier and Family Assistance Center WTU Complex Facility Functional elements X a X b X c 1+1 made accessible1+1 modernized to a, 1 soldier apt. Siting Criteria: 1.All functions within easy walking distance of each other. 2.Site in proximity of Medical Treatment Facility. USO atmosphere WTU Unit Admin & Services (clinical services) Optimized suite: Fully accessible and capable of supporting non-medical attendant. Don LaRocque / (703) 602-5486 /donald.larocquer@hqda.army.mil Strickland Suite Warrior Transition Unit Complex FY 2009 Requirement: $981 Million

8. ARMY STRONG “Apart from the war itself, we have no higher priority!” 8 Warrior Transition Unit Complexes Military Construction (MILCON) Requirements OSD Cut Line DA Cut Line Figures in $ millions (000,000) FY08 $ are not counted in the cumulative total OSD Supported DA Requested Remaining Requirement

9. ARMY STRONG “Apart from the war itself, we have no higher priority!” 9 WTU Growth Non-deployables from Deploying or Mobilizing RC Units Medevacs from Deployed Units in Theater Injured from Redeploying Units or Demobilizing RC Units Medical Discharge Return to unit (RC) Return to operating force Inflow currently exceeding outflow by 925 WTs per month AC OTHER 23% PEB2% MEB 18% DMOB 19% MOB 4% EVAC DI 15% EVAC NBI 6% EVAC BI 13% Monthly net gain of 647 WTs per month are AC soldiers (70% of total) This large majority of growth attributed to FORSCOM installations, where growth is predominantly AC, identifies the main overall issue behind growth in WTUs WTU

10. ARMY STRONG “Apart from the war itself, we have no higher priority!” 10 Warrior Transition Unit Ft. Drum 502 Ft. Dix 248 Ft. Eustis 188 Ft. Carson 669 Ft. Riley 442 Ft. Leonard Wood 140 Ft. Lewis 791 Ft. Stewart 591 Ft. Benning 351 Ft. Jackson 92 Ft. Knox 323 Ft. Gordon 388 Ft. Campbell 776 Ft. Sam Houston 611 Ft. Polk* 333 Ft. Sill 149 Ft. Hood 1332 Ft. Bliss 299 PR 95 Ft. Richardson* 139 TAMC 257 West Point 62 CA 216 AR 233 AL 102 UT 134 MA 172 WI 217 FL 140 Ft. Irwin & Balboa 150 Ft. Wainwright 85 WRAMC 683 Ft Huachuca 51 Ft. Leavenworth 19 Ft. Belvoir 50 Ft. Lee 62 VA 197 Ft Meade 39 Redstone Arsenal 14 Ft Rucker 22 WTU CO - 17 WTU BDE - 1 CBHCO - 9 WTU BN - 17* Landstuhl 218 Heidelberg* 36 Wuerzburg 210 Current WT Population (assigned or attached to a WTU) is 12,878 Soldiers Ft. Bragg 665 (as of 02 June 08) *BN TDA appr 22 May 08 Edate: 04 Oct 08

11. ARMY STRONG “Apart from the war itself, we have no higher priority!” 11 Number of AC/RC WT Soldiers MONTHLY INCREMENTS 12,878 (29 Month throughput has been approximately 633 WT Soldiers dispositioned per month) Establishment of WTU WARRIOR TRANSITION PROGRAM: Monthly Census (November 2004—May 2008)

12. ARMY STRONG “Apart from the war itself, we have no higher priority!” 12 Length of Stay (LOS) in 30 Day Increments Number of Warrior in Transition 30,883 WT Soldiers: LOS < 360 days 935 WT Soldiers: LOS 720 days—1080 days 5,632 WT Soldiers: LOS 360 days—720 days 64% 1.6% Medically Separated 0.9% Returned to the Force 7% 1 YR 3 YR 2 YR 139 WT Soldiers: LOS > 1081 days 19% 8% 10,534 (28%) 27,175 (72%) <1 year in WTU, ρ =.77 1-2 years in WTU, ρ =.50 2-3 years in WTU, ρ =.34 >3 years in WTU, ρ =.18 <1 year in WTU, ρ =.77 1-2 years in WTU, ρ =.50 2-3 years in WTU, ρ =.34 >3 years in WTU, ρ =.18 Probability of Soldier being Returned to the Force 88% are Corporal to Sergeant First Class 2 Brigades a year Back to the Force! Returning Warriors to the Line... Data source: MODS, October 2001—3 March 2008 POC: Dr. Michael J. Carino, OTSG

13. ARMY STRONG “Apart from the war itself, we have no higher priority!” 13 Warrior Transition Unit Cadre Special Duty Assignment Pay (SDAP) 05 Jun ’08: Revised SDAP policy approved and signed by the Assistant Secretary of the Army (Manpower and Reserve Affairs) –Modifies MILPER Msg 08-027, Subject: Special Duty Assignment Pay (SDAP) for Soldiers Who Are in the Warrior Transition Units (WTU) The monthly rate will be paid at the SD-5 level of $375 per month for Squad Leaders and Platoon Sergeants Requirements: –24 months experience preferred but not required –SL and PSG must complete USAMEDCOM prescribed training and be certified as qualified Army Center for Enhanced Performance (ACEP) triad training, Unit Ministry Team sensitivity training, and Risk Management Training as outlined in FRAGO 24 to MEDCOM OPORD 07-55 As a substitute, Soldiers may attend the AMEDDC&S resident WTU Certification Course. Completion of these additional training requirements will be verified by their WTU Commander. –Must be serving in an authorized position (duty assignment) that is documented and designated for award of SDAP. –Reserve Component Soldiers serving in authorized positions designated for award of SDAP must be on active duty orders in excess of 180 days to receive SDAP

14. ARMY STRONG “Apart from the war itself, we have no higher priority!” 14 Manpower Analysis Findings and Recommendations BLUF:  WTU populations growing at an uncontrolled rate, particularly at FORSCOM installations  Population growth has a larger impact on TDA size than does cadre to WT ratio Recommendation:  Army review entry and exit strategy for WTUs  Army review number and size of WTUs for enduring WT program  Strengthen ratios for the Triad to reduce workload; realign to enhance unity of effort  Redistribute cadre positions to better reflect compo population

15. ARMY STRONG “Apart from the war itself, we have no higher priority!” 15 Monitoring / Improving Customer Satisfaction Stakeholders Wounded Warriors Family Members American Public Trust Confidence Confidentiality Relationships Convenience/Available Anger/Frustration Lack of Knowledge Misperceptions External Sensors Ombudsmen (24/7) Wounded Soldier&FM Hotline (800)984-8523 wsfsupport@conus.army.mil Senior Leader Visits WTU Satisfaction Survey (Monthly) Town Hall Meetings (Monthly) Staff Assistance Visits (Periodic) Command Climate (Periodic) OSD(HA) Survey (Monthly) GAO (Periodic) DAIG (Periodic) Federal Recovery Coordinator Internal Sensors WTU Leadership (24/7) MTF Leadership (24/7) Ombudsmen (24/7) Chaplain (24/7) Dashboard (Weekly) Unit Status Report (Monthly) VCSA WTU Cdr VTC (Monthly) SecArmy Group (Monthly) Quarterly Status Brief (Qtrly) Semi-Annual Status Brief Army Leadership Means/Sensors Accountable Driver/Motivation Who do I go to? Required/ Recommende d Actions? Fix and Report Back How do I decide who to go to? Based upon: I have/ perceive a problem. Media Congressional Interest New Means/Sensors, and Methods to ensure better flow of feedback to Army Leadership

16. ARMY STRONG “Apart from the war itself, we have no higher priority!” 16 Comprehensive Transition Plan Healing the Total Person Holistic Care Clinical Care Commander, Platoon Sergeant, Squad Leader, MD, Nurse ChaplainEducation Counselor 1.Strengthened- Physically, Mentally, Socially, Spiritually 2.Vocationally Enabled 3.Able to Maintain Relationships 4.Proud of Service New program with AMAP Medical Assessment WTU Leadership & Mentorship Medical Treatment Surgery Occupational Therapy Physical Therapy Pain Management Life Skills Development Physical Fitness Risk Management RTD Soldier Skills Relationship Coaching Pastoral Care Psychosocial Assessment Addiction Therapy Successful Soldier or Successful Veteran Educational Development Behavior Health Treatment Nutrition Counseling Vocational Development End state Comprehensive Transition Plan (Body, Mind, Heart, Spirit) Serious injury or illness

17. Ft. Drum MSC-3 (F) VR&E-1 (P) Ft. Dix MSC-1 (F) VR&E-1 (P) Ft. Eustis MSC-1 (P) Ft. Carson SW-1 (F) MSC-3 (F) VR&E-1 (P) Ft. Riley MSC-1 (F) VR&E-1 (F) Ft. Leonard Wood MSC-4 (F) VR&E-1 (P) Ft. Lewis SW-2 (F) MSC –1(F) VR&E-1 (P) Ft. Stewart VR&E-1 (P) MSC-5 (F) Ft. Benning SW-1 (F) VR&E-1 (P) MSC-5 (F) Ft. Jackson MSC-1 (P) VR&E-1 (P) Ft. Knox MSC-2 (F) VR&E-1 (F) Ft. Gordon SW-1 (F) VR&E-1 (F) MSC-3 (F) Ft. Campbell VR&E-4(P) MSC-3 (F) Ft. Sam Houston SW-3 (F) VR&E-1(P) MSC-2 (F) Ft. Polk MSC-1 Ft. Sill MSC-5 (F) Ft. Hood SW-2 (F) VR&E-1 (F) MSC-3 (F) Ft. Bliss MSC-10 (F) VR&E-1 (F) PR MSC-1 (P) VR&E-1 (P) Ft. Richardson MSC-1 (P) VR&E-1 (P) TAMC, Schofield & Ft.Shafter West Point MSC-1 (P) VR&E-1 (P) CA MSC-1 (P) VR&E-1 (P) AR AL MSC-1 (P) VR&E-1 (P) UT MSC-1 (P) VR&E-1 (P) MA MSC-1 (P) VR&E-1 (P) WI MSC-1 (P) VR&E-1 (P) FL VR&E-1 (P) WTU CO - 17 WTU BDE - 1 CBHCO - 9 WTU BN - 17 Ft. Irwin & Balboa SW-1 (F) MSC-2 (P) VR&E-1 (P) Ft. Wainwright MSC –1 (P) VR&E-1 (P) WRAMC SW-5 (F) MSC-4 (F) VR&E-1 (F) Ft Huachuca MSC-1 (P) VR&E-1 (F) Ft. Leavenworth MSC-1 (P) VR&E-1 (F) Ft. Belvoir MSC-1 (P) VR&E-1 (P) Ft. Lee MSC-1 (P) VA Ft Meade MSC-1 (P) VR&E-1 (P) Redstone Arsenal MSC-1 (P) VR&E-1 (P) Ft Rucker MSC-1 (P) VR&E-1 (P) Landstuhl MSC-1 (F) Heidelberg MSC-1 (F) Wuerzburg MSC-1 (F) Army – VA Integration Ft. Bragg SW-1 (F) MSC-1 (F) VR&E-1 (F) VHA Social Works (SW) VBA Counselors (MSC) AS of 30 Apr 08 VR&E Counselors (VR&E) Part Time (P); Full Time (F) Benefits Delivery at Discharge (BDD) Site

18. ARMY STRONG “Apart from the war itself, we have no higher priority!” 18 EAMC and VAMC Collaboration Active Duty Residential Rehab Program (Pilot) PTSD, Depression, Anxiety 1 of 4 returned to duty Inpatient surgical collaboration Cardio-Thoracic and Neuro Surgery POC: Laurie Ott, Executive Director, CSRA Wounded Warrior Care Project

19. ARMY STRONG “Apart from the war itself, we have no higher priority!” 19 Partnering with the VA – Providing “Total Warrior Care” Active Duty Rehab Unit Amputees Spinal cord injuries Poly-Trauma / TBI Mental Health component built-in Joint VA/DoD staffing Results: –558 inpatients –189 outpatients –156 RTD (28%) Seamless Transition Center OEF/OIF outreach Initial counseling and assessment Community-based resource center Soldier, Veteran and Family resource center

20. ARMY STRONG “Apart from the war itself, we have no higher priority!” 20 Transitioning for Success An Interagency Approach The Warrior Care and Transition Office Transition Team Charter: –Integrate, synchronize, market, and develop policy for benefits, services, opportunities and information that focus on assistance services for wounded, ill, and injured Soldiers, their Families, and surviving Family members to enable retention or as a productive member of a community Leverage existing capabilities from: –Veterans Affairs, Department of Labor, Equal Employment Opportunity disability programs, Army Career & Alumni Program, Army Community Service, Solider & Family Assistance Centers

21. ARMY STRONG “Apart from the war itself, we have no higher priority!” 21 Military and Veteran Support Organizations and Initiatives Sentinels of Freedom: –Provide life-changing opportunities for men and women of the U.S. Armed Forces who have suffered severe injuries and need the support of grateful communities to realize their dreams Merchant Marine Academy Initiative: –U.S. Merchant Marine Academy at Kings Point staff assignments opened to Navy, Marine Corps, Army Soldiers and veterans recovering from injuries Entrepreneurship Bootcamp for Veterans with Disabilities (EBV) –Offers cutting edge, experiential training in entrepreneurship and small business management to soldiers, sailors, airmen, and marines disabled as a result of their service supporting OEF and OIF

22. ARMY STRONG “Apart from the war itself, we have no higher priority!” 22 What’s Next Right-size the population Comprehensive Transition Plan Build an enduring program that is: –Enduring, affordable, expandable, collapsible and responsive to the Army and the needs of the Warriors in Transition Seamless partnership with the VA, Veteran Support Organizations (VSO) & Military Support Organizations (MSO) Take care of the Soldier: Veteran – productive member of the community Back to the Army

23. ARMY STRONG “Apart from the war itself, we have no higher priority!” 23 Warrior Care and Transition Office Contact Information Director: BG Gary Cheek Chief of Staff: COL Jimmie Keenan Deputy Chief of Staff: COL Lisa Hines Chief Operations, Plans, Policy: LTC Michael K. Mixen VA Advisor: Frank Bryceland Office Contact info: Warrior Care and Transition Office Zachary Taylor Building 2530 Crystal Drive, Suite 3E30 Arlington, VA 22202-3926 –Main: (703) 602-8511 DSN 332 –WarriorCareTransitionOffice@conus.army.milWarriorCareTransitionOffice@conus.army.mil –WCTO Strategic Communications: WarriorCareCommunications@conus.army.mil WarriorCareCommunications@conus.army.mil

24. ARMY STRONG “Apart from the war itself, we have no higher priority!” 24 This is what we do... I will Never Quit! I will Never Leave a Fallen Comrade! A Special Operations Force Soldier lost his leg to enemy machine gun fire in Sep 05’. After 5 months at Walter Reed, he was returned to duty. He is currently deployed.

25. ARMY STRONG “Apart from the war itself, we have no higher priority!” QUESTIONS