By Fred W. Baker III
American Forces Press Service
The warrior in transition units now serve as the Army-wide model. In the past, there were 300 cadre taking care of wounded warriors in companies spread out across the Army. Now there are 2,500 cadre caring for 12,000 wounded warriors in 35 transition units and nine community-based health care groups across the United States. The Army plans to build 21 transition complexes that will place the staff, barracks, hospitals and support services in one central location. The first will be built on Fort Riley, Kan., where construction is slated to begin next year.
The 12,000 soldiers in the transition units now represent a cross section of illnesses and injuries, and all are not necessarily combat related. Of those 12,000, only 1,500 are Purple Heart recipients. The move to include all wounded, ill and injured was made, officials said, so they can offer the same level of health care to all soldiers.
"I suppose we could consider a special program for only our [combat] wounded soldiers. But then when I have a soldier who has three combat tours and he's injured in a motorcycle accident, he's not eligible," Cheek said. "Do we not have an obligation to take care of him?"
Wounded Warrior Program Adds Oversight
For some seriously injured soldiers, the Army also has added another layer of advocacy and oversight.
The Army's Wounded Warrior program, or AW2, includes in its fold soldiers who have a single disability rating of 30 percent or a combined disability rating of 50 percent. If a soldier is injured and is anticipated to receive either of those disability ratings, he is entered into the program even before the rating is awarded.
Nastelle Graves with the Warrior Transition Brigade talks to wounded soldiers at a weekly formation at Walter Reed Army Medical Center. The Army has overhauled its wounded warrior program and the brigade at WRAMC now serves as the model across the service.
DoD photo by Fred W. Baker III Hi-Res
More than 3,000 soldiers and veterans are now in the AW2 program and of those, about 900 have a 30 percent disability rating. Army officials expect the program to grow as they work to incorporate those with the combined 50 percent rating.
The AW2 program began in 2004 as The Disabled Soldier Support System, but later changed its name because soldiers didn't view themselves as disabled, officials said. All soldiers in the program have been injured since Sept. 11, 2001. The program encompasses soldiers injured in combat, as well as in training and off-duty accidents.
The soldiers and families are assigned an AW2 advocate that oversees their care, even as they are still being cared for at the transition units by the "triad of care."
"I'll be frank. A number of leaders have asked 'Isn't that redundant?'" said Col. Jim Rice, the AW2 program director. "I'll admit to some redundancy. What makes us unique is that advocate will be with that soldier and family when the [transition] leadership is no longer responsible for them."
An Advocate for Life
Over time, the role of the AW2 advocate increases as the nurse case manager's role decreases, so that by the time the medical board makes a determination, "the person working with them most is the one that is going to be with them for the rest of their life," Rice said.
In fact, the advocate will continue to work with the soldier and family as long as needed, even if the soldier transitions back to active duty, Rice said. So far, 70 soldiers have returned to duty, he said. Most have been medically retired and have returned to their communities where they receive care at Veterans Affairs facilities.
There are about 80 advocates stationed around the United States, Rice said. Some advocates are stationed at major military treatment facilities, others at VA rehabilitation centers, and still others are in remote locations, working out of their homes. All advocates are civilians, either contractors or civil servants, and many are retired military. Some have medical backgrounds, but not all, Rice said. They manage about 40 cases each, but the Army's goal is to get that down to about 30 each, he said.
The advocates typically are generalists and their powers lie in knowing whom to call when there is a problem. They become community-based experts and they have access to senior leaders inside the Capitol Beltway that soldiers and families don't have.
Even as the soldier begins his treatment in the military hospital, it is the advocates who give him a picture of the options for the future. Using an elaborate software program, the advocates input factors like rank, age, number of family members, finances and education and create financial predictions for their future based on the data.
The advocates are required to contact their soldiers and families monthly. While they are in the transition unit, contact could be more often, Rice said. There is no requirement for increased interactions, but the advocates make the judgment based on need, he said.
Many soldiers and families have successfully transitioned to active duty and back to their communities and case management is no longer needed, Rice said. For those who do still need it, contact is made every month, at least for now, he said.
"There is no real graduation from the AW2," Rice said. "The last thing we want to do is leave someone out there who needs some support."
Senior Army officials agree that there is more work to be done in the programs, mostly in the way of fine-tuning the massive overhaul. When surveyed this year, nearly 80 percent of the 12,000 soldiers in the warrior transition units said they were satisfied with the Army's efforts, Cheek said.
"I think the difference for families from February 2007 to now is night and day," Cheek said. "We have simplified things. We have given them single points of contact. We take care of them from day one and work with them through the entire process."
While soldiers recognize the Army's investment, they also will give honest assessments of the program, Cheek said. "It's not all milk and honey from them," he said. "Soldiers are going to tell the things they like and don't like."
For Rice and his AW2 program, success is measured as all or nothing.
"I can't be satisfied until we go out with a survey to all 3,000 and every one of them says … 'I'm getting everything I need,'" Rice said.
