1. Navy Comprehensive Casualty Care Program SAFE HARBOR COMMAND BRIEF
Taking Care of Our Wounded, Ill, and Injured Sailors and Their Families
Navy Comprehensive Casualty Care Program
SAFE HARBOR COMMAND BRIEF
CAPT Key Watkins
Commanding Officer

2. Comprehensive Care Mission Statement Wounded, Ill, and Injured (WII)
The Navy’s comprehensive casualty care program will provide support and assistance to all wounded, ill, and injured Sailors and their family members throughout their recovery and beyond.
Shipmates for Life

3. Concept for Comprehensive Care Wounded, Ill, and Injured (WII)
The Navy has a continuum of capabilities that provide support for all wounded, ill, and injured Sailors and their families – SAFE HARBOR is the Navy’s focal point
Successful, long-established programs: Limited Duty, Light Duty, Medical Hold, and Line of Duty enhanced with SAFE HARBOR case tracking, policy oversight, and individualized case management on an as needed basis
Comprehensive, non-clinical case management system tailored to support each Sailor’s unique challenges and circumstances
Programs assist Sailor reintegration with their family, community, and Command
Ongoing program refinement based on best practices and lessons learned
Navy will continue to enhance non-clinical support for those Sailors most in need (severely wounded, ill, and injured) while also continuing to look after the needs of all wounded, ill, or injured Sailors

4. Covenant Leadership Wounded, Ill, and Injured (WII)
There’s Nothing More Important
All Levels of Leadership Need to be Engaged
Wounded, Ill, and Injured – Still Linked to their Shipmates
Personal Relationships
Sailors Talking to and Taking Care of Sailors
Unit Affiliation
Command Involvement
Families, Peers and Community
Culture
“Shipmate for Life”
Reaching Out to Those In Need
Taking Care of Those Who Care for Our Wounded, Ill, and Injured
A Continuum of Support
Trust and Recognition
They’ve Delivered on their Obligation...We Will do the Same

5. We are the Navy...taking care of our Sailors!
SAFE HARBOR COMMAND Guiding Principle: Numquam Navigare Solus – Never to Sail Alone
Mission Statement:
SAFE HARBOR Command is the Navy’s focal point for the non-medical care of all wounded, ill and injured Sailors and their family members. We provide support and assistance throughout a Sailor’s recovery and beyond.
We are the Navy...taking care of our Sailors!

6. SAFE HARBOR COMMAND Guiding Principle: Numquam Navigare Solus – Never to Sail Alone
Vision:
Our vision is for SAFE HARBOR Command to be recognized as the gold standard of care throughout the Wounded, Ill, and Injured community because of the world class support that we provide to each and every one of our SAFE HARBOR Sailors and their families.
Goals:
Take care of the Sailors and Families who need care.
Craft an enduring organization that is responsive to the changing needs of our customer.
Build quality into everything we do – improve the process at every opportunity.
Share our successes with our Wounded Warrior community partners -learn from theirs.
Create a climate where the core values of honor, courage & commitment are paramount.
Support the professional and personal development of our SAFE HARBOR Staff.
Recognize sustained superior performance.

7. SAFE HARBOR Evolution ...Built on Basic Guiding Principles in Navy Medicine
20 OEF/OIF Wounded Sailors
Military Severely Injured Center (MSIC) requests Navy liaison
SAFE HARBOR (SH) Director appointed from N135
Out Reach Case Manager assigned to SAFE HARBOR
2005 Staff of 3
40 OEF/OIF Wounded Sailors
Additional Navy Liaison assigned to MSIC
SAFE HARBOR Representative assigned to NNMC Bethesda supporting Basic Advocacy
2006 Staff of 4
Combat Casualty Care Working Group (C3WG) established by RDML White – 4 members
8 Case Managers hired for MTFs and VA Polytrauma Centers
SAFE HARBOR Program moved from N13 to N12
SAFE HARBOR Mission expanded to all severely wounded, ill, or Injured (not just OEF/OIF)
CNO appointed RDML White as Special Assistant for Comprehensive Casualty Care
145 Severely Wounded, Ill, or Injured (SWII) Sailors
2007 Staff of 13
Our Navy Safe Harbor program was originally developed in October 2005, to be an organization that focused on advocacy for the Sailors and their families who were seriously injured as a result of OEF/OIF operations. The program is being expanded to cover any “Seriously ill/injured (SI) and Very seriously ill/injured (VSI)” Sailors and their families. The role of the Advocate is expanding to actively engage in providing proactive non-clinical case management support.
C3WG renamed Comprehensive Casualty Care Working Group to reflect expanded mission
CAPT Watkins assigned as CO of SH & CAPT Wright as director of C3WG (5 members)
3 additional staff members on board & SAFE HARBOR Mission expanded to provide tracking and oversight for all wounded, ill, and injured
2008 Staff of 16
174 SWII Sailors
Over 5,000 Wounded, Ill or Injured Sailors
Planned growth to 14 Case Managers at 9 sites and 14 HQ Staff in DC & Millington, TN 7

8. Program Breakdown Continuum of Wounded, Ill, and Injured (WII)
Navy
Marine Corps
Program (# of participants) Final Entry/Exit Authority
Population Served
Severely Wounded, Ill, and Injured
Reserve personnel on orders greater than 30 days, requiring medical evaluation/treatment to resolve condition incurred while on active duty
Reserve personnel on orders less than 30 days, requiring medical evaluation/treatment to resolve condition incurred while on inactive duty
Active personnel wounded/ill/injured expected to remain on a restricted status for more than 90 days
Active Duty personnel ill/injured on restricted duty in 30 day increments for up to 90 days
Severely WII Enrollees (174) Entry –N1 (SAFE HARBOR CO)/ Exit - “SAFE HARBOR for Life”
Medical Hold Status (220) DCNO (MPTE) /SAFE HARBOR Tracking & Oversight- Entry/Exit - N1
Wounded Warrior Regiment
Approximately 9,000 Wounded, Ill, and Injured
SAFE HARBOR
Line of Duty Status (780) DCNO (MPTE) /SAFE HARBOR Tracking & Oversight- Entry/Exit - N1
Limited Duty Status (4,642) /SAFE HARBOR Tracking & Oversight Entry/Exit-Convening Authority at MTF and PERS 8 (if >12 Months)
Light Duty (Tracked by Parent Command) Entry and Exit – Medical Provider in Collaboration with Chain of Command
Parent Command
(May go to WWR)
The Navy’s continuum of care covers
the full spectrum of Navy Wounded, Ill, and Injured

9. SAFE HARBOR Reported Population Continuum of Wounded, Ill, and Injured (WII)
Daily Snapshot
(Data Update 06 Mar 2008)
~ 5800
Limited Duty Status
4,642
Severely Wounded, Ill, and Injured Program ~250 annually
Medical Hold
Status
220
Line of Duty Status
780
Traumatic Brain Injury, Amputees, severe Burns, Debilitating Illness
Minor Orthopedic Conditions
Minor
Condition Acuity Continuum
Severe
Recovery time ranges from months to years -
Case Management Support can range from hours to a lifetime

10. Navy Oversight and Tracking Continuum of Wounded, Ill, and Injured (WII)
PROGRAM
(Management)
POPULATION SERVED
DECISION AUTHORITY AND CASE MANAGEMENT
TRACKING
SAFE HARBOR
Severely Wounded, Ill, and Injured Program (N12/SAFE HARBOR)
Severely Wounded, Ill, and Injured
Final Entry Authority: N12 SAFE HARBOR CO
Final Exit Authority: None - “SAFE HARBOR for Life”
Non-clinical Case Manager assigned to individual; clinical case manager assigned
Non-clinical case management tracked in Military Severely Injured Tracking System (MSITS) Database; clinical case management in DoD’s Armed Forces Health Longitudinal Tracking Application (AHLTA)*
MEDHOLD
(SAFE HARBOR, PERS-95 & NOSCs)
Reserve personnel on orders greater than 30 days, requiring medical evaluation/treatment to resolve condition incurred while on active duty
Final Entry Authority: DCNO (MPTE) N1
Final Exit Authority: DCNO (MPTE) N1
Non-clinical and clinical case manager with caseload at Navy Mobilization Processing Sites; case worker with caseload at PERS-95; SAFE HARBOR tracking & oversight, Individual Case Management (as required basis)
Non-clinical case management tracked in Microsoft Access Database; Clinical case management in DoD’s Armed Forces Health Longitudinal Tracking Application (AHLTA)*
LINE OF DUTY
Reserve personnel on orders less than 30 days, requiring medical evaluation/treatment to resolve condition incurred while on inactive duty
Medical Department Representative at Navy Operational Support Center (NOSC) tracks case locally; case worker with caseload at PERS-95; SAFE HARBOR tracking & oversight, Individual Case Management (as required basis)
Medical Readiness Reporting System (MRRS) Line of Duty (LOD) module supports non-clinical case-management; clinical case management tracked in a separate LOD record (paper) at NOSC
LIMITED DUTY
(SAFE HARBOR, PERS-82 & Parent Commands)
Active personnel wounded/ill/injured expected to remain on a restricted status for more than 90 days
Final Entry and Exit Authority: Convening Authority at MTF and BUPERS (PERS 8) if longer than 12 months
Command Limited Duty (LIMDU) Coordinator; staffed through MedBoard office at Military Treatment Facility; based on clinical acuity, clinical case manager assigned; SAFE HARBOR tracking & oversight, Individual Case Management (as required basis)
Medical Board Online TRICARE Tracking (MEDBOLTT) System; Weekly SECNAV report; Clinical Case management in AHLTA
LIGHT DUTY
(Parent Commands)
Active Duty personnel ill/injured on restricted duty in 30 day increments for up to 90 days (length of Light Duty based on condition)
Final Entry and Exit Authority: Medical Provider in Collaboration with Chain of Command
Member provides light duty chit to Command; Binnacle list shipboard; Primary Care Manager provides medical oversight
No electronic tracking – operational assets tracked by Operational Medical Department and Command
* Armed Force Health Longitudinal Tracking Application (AHLTA): DoD electronic medical record for clinical documentation
* Medical Readiness Reporting System (MRRS): Navy and Marine Corps (AC and RC) electronic tracking system for Individual
Medical Readiness data

11. Guiding Principle: Numquam Navigare Solus – Never to Sail Alone
Safe Harbor Severely Wounded, Ill, and Injured Program
Guiding Principle: Numquam Navigare Solus – Never to Sail Alone
The SAFE HARBOR Severely Wounded, Ill, and Injured Program will provide superior quality, life-long non-clinical case management to the Sailors and their family members that are most in need. The SAFE HARBOR team of caring professionals will develop and administer individually tailored support plans to ensure long-term, sustained engagement in providing for the health and welfare of our Sailors and their families.

12. Targeting a Key Navy Population Severely Wounded, Ill, and Injured (SWII)
Severely Wounded, Ill, and Injured Program
In 2005, Navy established the SAFE HARBOR program to support severely injured Sailors from OEF/OIF
In FY 2008,
Mission expanded to provide non-clinical case management to all “Severely Wounded, Ill, and Injured” Sailors and their families in addition to tracking & oversight of Navy’s non-severely WII programs
Program enhanced with Command and Control element
Severely Wounded, Ill, and Injured population projected at 250 Sailors and their families annually (increase from current 175 total SAFE HARBOR SWII Cases)
Frequency of contacts based on needs but a minimum of once per month
Sailors enrolled for “Life”
Clearly identified interfaces with Federal Recovery Coordinators, USMC Wounded Warrior Regiment, and Other Organizations
Emphasis on FY10-15 funding
Participant to Case Manager ratio: 24:1 (Current); 18:1 (Planned)
Case Managers assigned to all Major Hospitals and Fleet Concentration Areas
Participants have 24/7 access to Case Managers via Toll Free Number and Website
Navy responded by expanding its Program to include all Severely Wounded, Ill, and Injured Sailors 12

13. Strategic Reach Wounded, Ill, and Injured (WII)
SAFE HARBOR AND A NATIONAL NETWORK OF NAVY OPERATIONAL SUPPORT CENTERS
BREMERTON (1)
GREAT LAKES / MINNEAPOLIS (1)
PALO ALTO (1)
BETHESDA / WRAMC (2)
WASHINGTON DC (12)
AT-LARGE EAST (1)
PORTSMOUTH/RICHMOND (1)
SAN DIEGO (2)
AT-LARGE WEST (1)
MILLINGTON TN (2)
JACKSONVILLE (1)
BAMC (2)
TAMPA (1)
VA POLY TRAUMA CENTER
MILITARY TREATMENT FACILITY
SAFE HARBOR HEADQUARTERS STAFF
NAVY OPERATONAL SUPPORT CENTER

14. Oversight and Coordination Wounded, Ill, and Injured (WII)
VCNO
CNO
N12
BUPERS
N1/CNP
Special Assistant for Comprehensive Casualty Care
Dual Hat
Program Sponsorship / Management & Execution
Comprehensive Casualty Care Working Group
Wounded Warrior Regiment, BUMED, CNIC, SOCOM, Army/Air Force Wounded Warrior Programs
NAVY SAFE HARBOR COMMAND
Full Tracking & Case Management
Internal Coordination
External Coordination
Case Tracking, Program Policy Oversight, Individual Case Management (as required basis)
MED HOLD, LIMITED DUTY, LINE OF DUTY PROGRAMS
SEVERELY WOUNDED, ILL & INJURED
Direct Lines of Action/Reporting with Senior Oversight facilitate Comprehensive Casualty Care

15. SAFE HARBOR Staff Severely Wounded, Ill, and Injured (WII)
TSGLI / MPT&E Support
YC-2/Millington
Admin Officer
YC-2/DC
Admin Support Military Personnel
E-6/DC
Family Support / NGO Coordinator
YA-2/DC
IT/Data Mgmt Support
Public Affairs Officer
ADDU N1 PAO/DC
VA Liaison
Detailee/DC
Commanding Officer
O-6/DC
Executive Officer
Senior Enlisted Advisor
E-9/DC
Senior Medical Officer
Ops Officer
O-5/DC
Pgm/Financial Analyst
Strategic Support Officer
YC-3/DC
OIC Navy Reserve
Surge Unit (10 Pers)
NNMC Case Manager
Military-Mob
NMCSD
Case Manager
YA-2
GLAKES/MLPS VA
NH Jacksonville Case Manager
NMPC/Richmond VA Case Manager
BAMC Case Manager
NH Bremerton Case Manager
At-Large (DC HQ) Case Manager East
Palo Alto VA Case Manager
At-Large (NMCSD) Case Manager West
Tampa VA Case Manager
Admin Support Correspondence
Additional Duty as CO/XO Administrative Assistant
MPT&E Officer
YA-2/Millington
DOL Liaison
Additional Duty for Case Manager Training and Oversight
Chaplain
O-4/ADDU DC
MED HOLD,
LIMDU,
LOD Programs
DCNP/CNPC

16. Snapshot of Typical Case Management Services Provided
Sample of Some of the Services Provided
Providers
Pay & Personnel
Navy Service Members are provided
these services by many
existing programs depending on
specific situations and needs.
In most cases, Service Members will
not require services beyond medical
care coordination and pay/personnel
support. However, in the event of
case complications or specific needs,
tailored non-medical case
management support will be made
available to the member and the
family.
Invitational Travel Orders
Warrior Support
Housing & Lodging
Child & Youth Programs
Recreation & Leisure
Transportation Needs
Legal & Guardianship Issues
Education and Training Benefits
Commissary & Exchange Access
Respite Care
TBI/PTSD Services

17. Program Assessments Wounded, Ill, and Injured (WII)
Hearing the “Voice of the Customer”
Regular bedside and family visits
Assessment team visits to MTFs, VA Centers, and Navy Mobilization Processing Sites
Severely/Non-Severely Wounded, Ill, and Injured participant feedback
SAFE HARBOR Advocate Survey Report (Dec 07)
Semi-Annual survey of all actively managed cases (Planned/Will be coordinated across DoN)
Formal DoN Quality of Life survey under development (late FY08 planned rollout)
Ensure long term, sustained engagement in providing for
the health and welfare of our Sailors and their families

18. Initiatives Examples Improved Organizations Enhanced Case Tracking
Line of Duty, Medical Hold, and Limited Duty functions and processes aligned at NPC with SAFE HARBOR as the Navy’s focal point to improve effectiveness and program management including: Case Tracking, Program Policy Oversight, and Individual Case Management (on an as required basis)
SAFE HARBOR aligned under VCNO & N12 (Special Assistant to CNO for Comprehensive Casualty Care) to enhance command and control
Enhanced Case Tracking
Appointed Senior Medical Officer in PERS to track and review cases for disposition
Line of Duty Tracked in Medical Readiness Report System (MRRS) and Limited Duty Tracked in Medical Board Liaison Tracking Tool (MEDBOLTT) to enhance visibility of status; SAFE HARBOR cases tracked in Military Severely Injured Tracking System (MSITS) Database
Refined Processes
Medical Hold and Line of Duty processes codified in SECNAVINST D
Implemented new criteria and strict timelines for Light Duty and Limited Duty periods

19. Navy Way Ahead Wounded, Ill, and Injured (WII)
Coordinate and assess multidisciplinary support for all Wounded, Ill, and Injured Sailors and their families …ensure long-term engagement
Partner with Reserve Component, Navy Operational Support Centers to extend Strategic Reach and improve overall assistance to our Sailors and their family members
Craft an enduring organization that is responsive to the changing needs of our customer
Continue to improve understanding and address future requirements
Collect data and refine support processes as best practices and lessons learned are identified
Continue on-going coordination, integration, and collaboration efforts with USMC Wounded Warrior Regiment (e.g., Call Center) and other organizations
Ensure long term, sustained engagement in providing for
the health and welfare of our Sailors and their families

20. We are Sailors caring for Sailors
QUESTIONS?
We are Sailors caring for Sailors
Contact us:
CommandSupport/SafeHarbor
CAPT Key Watkins, USN
Command Officer, Safe Harbor Command