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Summit Seeks to Improve Nonmedical Care

By Chad B. Holmes
Office of Wounded Warrior Care and Transition Policy

WASHINGTON, March 28, 2011 – A summit to improve the coordination of nonmedical care for wounded warriors and their families will draw leaders and experts from several federal agencies, the services and the private sector to Leesburg, Va., tomorrow through 31.

The Wounded Warrior Care Coordination Summit is hosted by the Defense Department’s wounded warrior care and transition policy office, and will feature as a keynote speaker Holly Petraeus, who heads the Office of Service Member Affairs at the Consumer Financial Protection Bureau.

“This summit builds on significant improvements in nonmedical care coordination over the past few years,” said Robert Carrington, director for the Recovery Coordination Program in the wounded warrior care and transition policy office. “There is plenty of room to grow.”

While medical case management is a well-established field, Carrington explained, coordinating all of the nonmedical aspects of recovery, rehabilitation and reintegration on behalf of wounded, injured or ill service members and their families is an emerging field.

“We have learned a significant amount over these last few years,” he said.

Working groups at the summit will develop recommendations to improve care coordination in four key areas: collaboration between Defense Department and Veterans Affairs Department recovery care coordination programs, wounded warrior and family education and employment, wounded warrior family resilience, and standardizing best practices in recovery care coordination.

“Working group leaders and facilitators have been collaborating with key members of their groups for several weeks in advance of the summit to identify key challenges and opportunities so they can maximize productivity during the summit,” said John R. Campbell, deputy assistant secretary of defense for wounded warrior care and transition policy. “Each working group will report out to the larger group with actionable recommendations at the end of the summit. We’ll incorporate these into a final report, working with the directors of the military service wounded warrior programs, the Defense Department Recovery Coordination Program, and Veterans Affairs Federal Recovery Coordination Program.”

Campbell will present the report to the Wounded, Ill and Injured Senior Oversight Committee, co-chaired by the deputy secretaries of defense and veterans affairs.

The Defense Department Recovery Coordination Program helps seriously wounded, ill or injured service members and their families understand and make use of the large number of unfamiliar programs and benefits that become available to assist them. It assigns recovery care coordinators to act on behalf of the service member and family to coordinate the efforts of the many nonmedical specialists supporting them, ensuring they are not overwhelmed, and maximizing their benefit.

The recovery care coordinator works with service members and their families to develop a comprehensive recovery plan that empowers and guides them to succeed in their reintegration to military duty or civilian life. It identifies their needs, outlines specific actions, connects them with the resources they require based on their unique circumstances, and aligns the efforts of the recovery team, which includes the primary physician and medical case manager.

Developed jointly by the departments of Defense and Veterans Affairs, the Federal Recovery Coordination Program, administered by the Veterans Affairs Department, provides clinical and nonclinical care coordination services for the most severely wounded, ill, and injured service members, veterans and their families.

A joint Defense Department and Veterans Affairs committee will use the summit as one of several planned events to gather input and ideas from experts and those who coordinate nonmedical care for wounded warriors on a daily basis. More immediate recommendations by this working group will be incorporated in the summit final report, officials said.

“For our nation's wounded warriors and their loved ones, navigating the complex care and benefits systems of the departments of Defense and Veterans Affairs, while simultaneously working to recover from serious injury or illness can sometimes be unnecessarily challenging,” said Dr. Karen S. Guice, executive director of the Federal Recovery Coordination Program in the Veterans Affairs Department, who leads the working group. “It is our collective responsibility to continue to improve our systems of care to provide the very best support possible for these brave men and women.”

The education and employment working group will develop plans for service members to proactively prepare for their post-injury or post-illness career while in recovery and rehabilitation, and while awaiting a determinations of fitness for continued military service or a disability rating. The working group also will also examine ways to expand the use of the GI Bill, military tuition assistance programs, and vocational rehabilitation counseling by wounded warriors to better prepare for the next stage of their lives.

“In January, the unemployment rate for veterans of our current wars reached 15.2 percent, while the national unemployment rate fell to 9 percent,” said Koby J. Langley, special advisor to Campbell for strategic planning and leader of the education and employment working group. “For disabled veterans, the unemployment rate is even higher. These men and women left civilian life and volunteered to go into harm’s way on our behalf. We have to give them all possible assistance to re-enter civilian life and thrive at least as successfully as their counterparts who didn’t step forward to serve their nation.”

Because the spouses of service members often sacrifice career opportunities through frequent moves, and spouses of wounded warriors sometimes very suddenly become the primary bread-winner, the summit also will explore ways to ensure these family members have the education and employment opportunities they require to be successful.

This dovetails with family resilience, the focus of a third working group, led by Mary Campise of the Family Advocacy Program in the office of the assistant secretary of defense for military community and family policy.

“Families and communities provide the context within which wounded warriors ultimately heal,” Campise said. “By bringing together a talented and committed group of diverse, family-focused individuals who have years of experience working with military families, we hope to identify and seize opportunities to integrate and embed effective and meaningful family support across the continuum of care.”

Campise said many innovative best practices already exist, and her group plans to identify them and give them visibility so others can build on what already is working well.

“We've also learned that families of the wounded, ill, and injured can be immensely creative in building their own networks of mutual support,” she added. “We want to figure out how to facilitate, and eliminate roadblocks to, what families and communities do naturally.”

A fourth working group will look for ways to standardize recovery care coordination best practices among all military and Veterans Affairs practitioners. The team will identify ways to better assess compliance with legislative and policy requirements and review entrance, exit and handoff criteria between the services and Veterans Affairs.

“A lack of common definitions and practices has prevented some of our efforts from reaching their full potential,” said Carrington, who leads the best practices working group. “We don’t individually have to come up with all the best answers but as a group and looking at what other smart, innovative people are doing we can ensure our programs reflect the excellence that our wounded warriors deserve.

“We just need to ask the right questions and look for best practices across the various programs with input from our wounded warriors and their families,” he added.

 

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Office of Wounded Warrior Care and Transition Policy


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The opinions expressed in the following comments do not necessarily reflect those of the U.S. Department of Defense.

4/22/2011 11:47:19 AM
To support recovery consider offering more non-pharmaceutical options to promote health, clarity of thought, motivation, focus and follow through; and decrease dependency/abuse of medications and short-term/long-term negative health side effects. Include a pain/depression/anxiety medication contract to put the patient on board with their healing process and medication titration expectation that aligns with their recovery expectation - have a goal and intent. Options should include: nutritional coaching, yoga for stress manangement and sleep, acupressure/acupuncture for pain, anxiety, depression, trauma, and also individualized health plans & goals that the service members create and follow up with their provider. Always Serving, Angela McConnell, Maj USAFR, ret (Wounded Warrior Mentor) www.IntegrativeHealthVA.com
- Angela McConnell, Major ret, N. Virginia

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