United States Anny Inspector General Agency Warrior Care And Transition .
United States Anny Inspector General Agency . Inspection of the Warrior Care and Transition Program Table of Contents . COVER l-ETTER 1. EXECUTIVE SUMMARY 2. Summary of Observations and Recommendations TAB AD POLICIES AND PROCEDURES TAB B - SUPPORT SYSTEMS FOR SOLDIERS AND FAMILY MEMBERS TAB C -MANAGEMENT OF "MEDICAlLY NOT READY "SOLDIERS TAB D - OTHER MATTERS TAB E POSITIVE NOTES co TAB F - METHODOLOGY APPENDIX 1 Directive APPENDIX 2 - Stakeholder Briefing APPENDIX 3 Acronym List )z-r- . . FOR OFFIelAL USE 8NLY. lNe lIoeument "MaIne Iftfonnetloft which 18 E'ltempt &em Manltateiy DlIlOIGIMII'liI Hl'lder'DIe FFaedem ef '"farm." /1st. IIssemlllatl8'" '8p!'1i')hiltlled . . .pI . . elf"y'telteed tIy JIlt . .
UlJited States Army. Inspector General Agency Inspection. of the Warrior Care and Transition Program Table of Contents COVER LETTER 1. EXECUTIVE SUMMARY 2. Summary of Observations and Recommendations TAB A· POLICIES AND PRPCEDURES Observation 1.1: No single synchronized source document outlining governing policies. A·1 guidance. 'and regulatory requirements Observation 1.2: Warrior Transition Unit (WTU) fosters a focused environment of healing and transitioning. however WT personal motivations may drive transition decisions A·17 Observation 1.3: A mixture of combat wounded, injured and ill Soldiers In the WTU has created perceptions leading to leadership, medical management, public relations and small unit cohes.i?n challenges A·20 Observation 1.4: Challenges exist to Implement rapidly issued/changIng policy without A-23 the-requisite resources Observation 1.5: Subordinate commanders and some healthcare providers consider Fragmentary Order (FRAGO) 3 WTU entrance criteria to be vague and inconsistently . applied Observation 1.6: Medical Command's (MEDCOM) accountability processes for Soldiers evacuated out of theater result in Immediate acceptance into the WTU without meeting FRAGO 3 screening criteria Observation 1.7: Most WTU cadre are concerned with inconsistencies in determining , the Medical Retention Decision Point (MRDP) A-25 \ A-27 A-29 Observation 1.8: Selection ofWTU cadre shifted from "best qualified- to "good and . first available" A·31 Observation 1.9: The current WTU classroom-centrlc and theory-based instruction does n equately prepare ths'cadre to perform their duties A-33 . . , . .l. . . . '" RJR OFFiew. lfSE ONLY. This documellt contains Infomnllton which hi Exempt from Mandatory Disclosure under the Fl"iIItdom CIf IlIfcnml!illon Act. Bi8IIamln&1ion Ie proIdbltiad Me. wUlDFlzed bJAR 20 1.
Observation 1.10: Most MUs visited are not meeting the intent and implementation of the Comprehensive Transition Plan (CTP) A-35 Observation 1.11: Most Warrior Transition Units have not implemented the Transition Review Board (TRB) 14:-37 Observation 1.12: Army-wide specialty care shortages exist.in Behavioral Health, Occupational Therapy, and Physical Therapy and contribute to delays in Soldiers treatment and healing 14:-39 Observation 1.13: Army is failing to properly document Line of Duty (LOD) for Reserve Component (RC) Soldiers - critical to the follow-on care and transition for the RC Soldier A-.41 Observation 1.14: Perception that Warriors in Transition are not held to same standards of dlscip6ne as required in other Army units A.043 TAB B - SUPPORT SYSTEMS FOR SOLDIERS AND FAMILY MEMBERS Observation 2.1: Soldier and Family Assistance Centers (SFAC) are underutilized, however they provide WTs with a level of personal ce ahd an environment . conducive to their medical and transitional needs. Most SFACs encounter near-term resource challenges (facilities, funding, and staffing) B-45 Observation 2.2: Providing services for Component (COMPO) 213 WTs and Families is challenging due to the dispersion of state resources 8-47 Observation 2.3: Communities outside the gate are beginning to selectively support onlV combat-wounded WTs with incentives resulting in non-standardized practices across installations 8-48 TAB C . MANAGEMENT OF "MEDICALLY NOT READY "SOLDIERS Observation 3.1: The Army does not use common terms of reference to accurately determine statUs of "medically not readY', -medically non-deployable", and -not . available" Soldiers C-49 Observation 3.2: Army medical fitness determination processes have not kept pace with Army Force Generation (ARFORGEN) requirements C-52 FOR OfFIeIAL USE ONLY. 11M doeumerd eontaiM infonnatJon which Is Eumpt lronl MCII'IdaIoIy Disclosure under the Freedom Df Informllltlon Act; BI8.lnatl,," Is pnmIbIted except . authorized by AR it-1. .
rrs T Observation 3.3: Army medical capabilities do not support the needs of the Medlcany Not Ready (MNR)/Me9ically .Non-Deployable(MND) in units C-S5 Observation 3.4: C;:urrent medical priorities do not assist commanders In maintaining a fit fighting force that Is medically ready to deploy. e-57 Observation 3.5: Leaders are concerned abOut Soldiers that Permanent Change of Station (PCS) with known or unknown medical issues, particularly behavioral health Issues (Traumatic Brain Injury (TBJ}and Post-Traumatic Stress Disorder(PTSD» e-g Observation 3.6: Soldiers in the Medical Evaluation Board (MEB)lPhysical Evaluation Board(PEB) process that are not assigned to a WTU are disadvantaged from a lack of information, lower priority In access to care, and length of M'ea I PEB process C-59 Observation 3.7: Individual Ready Reserve (IRR) Soldiers are often not identified as non-deployable until they reach a mobilization pla onn, approximately 42 days or more after recalled to active duty . C·SU TAB 0 ·'OTHER MATTERS Other Matter 1: Leaders. health care professionals. and Soldiers stated that MEBIPEB 0·1 inefficiencies affect the Army's ability to mee the needs of Soldiers and the Army in a timely manner other Matter 2: Umited and/or no interoperability between DoD Armed Forces Health 0·3 Longitudinal TeChnology Application (AHLTA), Department of Veterans Affairs (VA) Veterans Health Information Systems and Technology Architecture (VISTA). TRICARE network, and civilian provider information systems Other Matter 3: COMPO 213 are not longer a strategic reserve; current Army resources D-4 appear to be insufficient to medically sustain RC in an operational environment Other Matter 4: The majority of medical management staff have some level of concern 0·6 for personal safety in managing increasing numbers of Soldiers with behavioral health .issues Other MaHer 5: Most healthcare providers interviewed(Primary care Managers (PCM). D·7 Nurse case Managers (NCM) estimate 25-3S% of WTs are dependent on or addicted to dl'llgs . rr r mrs r 7FII T reR erFlCIAL WE ONL . Tld8 cIoeliliNid eontahas lilfOiliiatlon.wtllcfi Is !lip! " .11 Mandatot) DlscIusu,. IIlide. III. F.eedom of blfo.n.atfOiI Act Dissemination i9 prohibited .- tld Q8 autbol'f2ed by AR 28-1.
TAB E . POSITIVE NOTES . Positive Note 1: Some units Implemented pain and prescription management programs to assist in the reduction of medication dependency. E·1 Positive Note 2: Fort Bragg's Focused Transition Review (FTR) is a multidiscip6nary platform that combines features of the Comprehensive Transition Plan (CTP) with the Transition Review Board (TRB) . E·1 Positive Note 3: Eisenhower Army Medical Center's In-patient substance addictionE-1 program provides for more effective Command and Control (e2) and Medical Management (M2) of Soldiers with addiction diagnoses Positive Note 4: 4th Infantry Division (IO) "Building The Soldier Athlete" fitness program motivates Medically Non·Deployable (MND) Soldiers; focuses on abilities instead of disabilities E·1 Positive Note 5: Evans Army Community Hospital, Fort Carson established robust Mobile Behavior Health Team (MBHT) as a single point of contact to improve mission readiness E.1 TAB F . METHODOLOGY APPENDIX 1- Directive APPENDIX·2 Stakeholder Briefing APPENDIX 3 Acronym List 7'1-' mE : . .- -. 7 'Q" FOR ornetAL USE ONLY. This do em eeftt:8IM fnIonna'llon Which . Exempt from Malldatol, DfscIosule IJlld8i ttl. Fteedum of Infoi Illation Id; .,.mluatloii Ie prohlbrted except . . aalhOitz:ed by Aft 2001. .
DEPARTMENT OF THE ARMY OFFICE OF THE INSPECTOR GENERAL 1700 A1fIIV PENTAGON WASHINGTON DC 2031G-t700 SA IG-ZA SEP 22 2010 MEMORANDUM FOR SECRETARY OF THE ARMY SUBJECT: Results of the Warrior Care and Transition Program Inspection 1. The U.S. Army Inspector General Agency conducted an Inspection of the Warrior Care and Transition Program from 27 January 2010 to 30 June 2010. Three objectives were assessed (further discussed in paragraph 3). 2. Background. In February 2007, the Army established the Army Medical Action Plan (AMAP) now known as the Warrior Care and Transition Program to effectively manage Soldiers receiving outpatient care. A its heart, the Warrior Transition Unit (WTU) Is an organizational and cultural shift In how the Army cares for its wounded. ill, and injured Soldiers. a. There are currently 29 WTUs on Army installations and ninecpmmunity-based warrior transition units (CBWTU). These units are designed to provide support to Soldiers who are expected to require at least six months of rehabilitative care and the need for ·complex medical case management" for active component (COMPO) or -definitive heaHhcare" for reserve component Soldiers. The units have dedicated phYSicians, nurses, behavioral health professionals. and military leaders. These leaders and healthcare professionals are charged with ensuring Soldiers' needs are met, their care is coordinated, and their Families' concerns are addressed. . b. Since June 2007. the WTU returned 12,956 Soldiers to duty with an average stay of seven months. During that same period, 13,504 Oldiers transitloned from the Army with an average WTU stay of over 14 months as cited in a report by Plans, Analysis, and Evaluations (PA&E), Office of The Surgeon General (OTSG) on Warrior Transition Status, dated 14 June 2010. The current combined WTU and CBwru population Is approximately 9,500. . c. There is a misperception that all or most Warriors in Transition(WT) were wounded In combat OTSG Status Report statistics show only 10% were wounded In combat; 37% were evacuated from a combat zone due to disease and non-battle injuries; and 53% had illnesses or injuries not associated with combat (COMPO 1 Soldiers command-referred and COMPO 2 and 3 Soldiers in mobilization and de-mobilization). FOR OFFICIAl: USE ONLY. Oisseminmn is prohibited expect 8S authorized by AA 20 1. . This Document contains information EXEMPT FROM MMlDATORV DISCLOSURE under FOIA; Eemptioo 5 applies.
SAIG-ZA SUBJECT: Results of Warrior Care and Transition Program Inspection 3. Inspection Summary. The inspection team visited 17 installations with WTUs or caWTUs to assess their policies, procedures and support systems. Additionally, the Inspection team assessed brigade and below unit procedures in managing Soldiers considered "medically not ready" (MNR) or "medically not deployable" (MND). Inspectors contacted over 2,100 individuals during the inspection which included senior/unit commanders, healtheare profesSionals, cadre members, WT, and Family members. "rhe inspections determined that. while the WTU leaders and staff are dedicated to supporting ourWTs, there remained issues that must be improved. This report outrrnes 24 observations, 5 other matters and 56 recommendations. a. Inspection Objective #1 (Assess Implementation and oversight of policies and procedures for the US Army Warrior care and Transition Program). (1) The inspection team concluded that wru leaders and Cadre were dedicated and committed to assuring care and transition of Warriors back to duty or into Civilian life as productive veterans. Inspectors interviewed 786 wr and determined that most felt that being aSSigned to a transition unit was the best place for them to recuperate; however, it remains soiety on the Soldier's personal motivations as the driving factor to either return to duty or decide to transition out of the Army. Briefings and orientations provided by transition units help'educate WTs on medical disability entitlements and often influence Sordiers personal motivations. There is a noticeable sense of awareness about these entitlements among the wrs intervieWed. However, the lnspectof' noted that the Warrior Care and Transition. Program lacked a single synchronizing document outlining governing policies, guidance and regulatory requirements. There are numerous orders, messages .and policy memos that guide the program, creating varying interpretations and, in some cases, confusion at the unit level. rhe inspection team specifically assessed the eligibility criteria that was published in FRAGO 3/4 (July 2008/May 2009) and found it vague. The criteria of ·complex medical case management" and -definitive healthcare" are ambiguous and applied inconSistently to Soldiers seeking admission to a transition unit. . (2) The Comprehensive Transition Plan (CTP) is the cornerstone of the WTs roadmap to healing and transitioning back to the force or to veteran status. This guidance was inconsistently applied a·nd misunderstood within the WTUs. The CTP sets Initial expectations for entering WTs and also guides medical providers and unit leaders to plan and assist WTs in the healing process. (3) Lastly. the demand fQr behavior health services has increased as more Soldiers are diagnosed with PostTra\jmatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). Most WTU cadre and WTs s ted specialty care provider shortages contribute to delays in diagnosis and treatment and thereby increasing length of stays. FOR OFFICiAl USE ONLY. Dissemination Is prohibited expect as authorized by AR 20·1. 2 This Document contains information EXEMPT FROM MANDATORV DISCLOSURE IInder FOIAo Exemptien 5 applies.
SA IG-ZA SUBJECT: Results of Warrior Care and Transition Program Inspection b. Inspection Objective #2'(Assess Warrior Care and Transftion support systems for Soldiers and Family members). The Army Installation Management Command (IMCOM) assumed the mission of establishing and operating Soldier and Family Assistance Centers (SFAC) as part of the Warrior Care and Transition Program. SFACs provide specialized Soldier and Family support services, including. but not fimited to, child care, legal assistance, pastoral care, travel claims. lodging assistance for non-Invitational Travel Orders (ITO) Family members. vehicle registration, and translation services. Although the services provided by the SFAC can be found In Army Community Service (ACS) and Soldier Processing Centers, it is focused to support a smaller population with unique requirements such as providing a higher level of service catering to each individuars time and attention and maintaining access to more tranquil environments. The team determined that the services may be underutilized on some installations.due to the small population that they support. c. Inspection Objective #3 (Assess tools and processes Implemented by Commanders to manage Soldiers who are tlMedically Not Ready (MNR)tl). Tactical unit commanders are challenged by the increasing numbers of assigned Soldiers who are MNR but are not part of a WTU. Leaders face many challenges in managing Soldiers undergoing medical determination throughout the ARFORGEN cycle. There is a Significant amount of medical resources dedicated to treati,ng the WTU population; which represents only 'about . 26% of the MNR population. The rest of the MNR Soldiers compete for the limited amount of medical resource remaining. MNR SoldIers in tactical units undergoing medical determination processes. profiles. and board actions such as MOS/Medical Retention Board (MMRB), Medical Evaluation Board (MEB) and Physical Evaluation Board (PES), can take up to 24 months, nearly a full ARFORGEN cycle, as cfted in GEN(R) Franks Task Force Report rrhe Franks Report) in April 2009. These processes are not synchronized with the ARFORGEN cycle. The Army's medical resources are stretched and encumbered by an'increasing population of Soldiers that cannot deploy. 4. Other Matters. There were matters that did not fatl within the scope of our assessment butwere deemed appropriate for further discussion in this report. The most Significant was the MEB/PEBboard Inefficiencies which affected the Army's abilfty to meet Soldiers' needs. ,A majority of those Int rvlewed stated that the processes are complex, disjointed. confusing, and lengthy. In The Franks Report, WTs stated that the board process is stow, reportedly taking a year or more to initiate, and an additional 1824 months to complete. Less than.1 0% of Soldiers In the MEB/PEB process retuf'l" to duty Which Impacts unit readiness. In practicalfty. Soldiers pending an MEB should be considered a loss to the unit which allows for a trained and ready replacement to be requisitioned . Delays in the board processes cause existing efforts to expire and thereby repeating them which further draws on already limited resources. Measurement of the board timeline is difficult when health care providers can stop, start and terminate board actions. tn some cases, Soldiers identify -new" conditions requiring initial evaluations or assessments. Most of the subjects Interviewed were concerned that medical staffing is FOR OFFICIAL USE ONLY. Dissemination is prohibited expect as authorized 8)' AR 20-1. 3 This Document contains InformatioA EXEMPT FROM MANDATORY DISCLOSURE urlder FOJA. Exemption 5. applies.
SAIG-ZA SUBJECT: Results of Warrior Care and Transition Program Inspection insufficient to support timely MEBIPEB ·processing. A detailed discussion of this is In the written report. 5. Recommendations. The report contains 56 recommendations for implementation, as well as 24 observations and five other matters which should be considered by appropriate proponents as outlined in the body of the report. Upon your approval, the Director, Army Staffwill"direct execution on your behalf. 6. Follow-up. The deficiencies enclosed in this report will be entered into the USAIGA Corrective Action Oversight System. Designated responsible entities will provide bimonthly status updates. I recommend the Inspector General Agency conduct a follow-up inspection in 12 months upon approval of this report to determine the effectiveness of implementing the recommendations provided. e. WILLIAM H. MCC Major General, usY Acting The Inspector General Encl Reportof Inspection of the Anny Warrior Care and Transition Program ' CF: UNDER SECRETARY OF THE ARMY CHIEF OF STAFF, ARMY VICE CHIEF OF STAFF, ARMY APPROVE.D0 ".11"'\\ DISAPPRO -\ SEEME FOR OFRCIAl USE ONLY. e!sseminatfon is prehibited eKpeGt as authorized by AR 20-1. 4 This Doetlment oontsins information EXEMPT FROM MANDATORY DISCLOSURE under POIA; Exemption 5 applies.
Summary of Observations and Recommendations: OBJECTIVE 1: Assess implementation and oversight of policies and procedures for the United States Army.Warrior care and Transition Program OBSERVAnON 1.1: No synchronized source document outlining governing policies, guidance, and regulatory requirements RECOMMENDATIONS: a. OTSG/MEDCOM: Publish a single, synchronized document to govem the Warrior Care and Transition Program. Warrior Transition Command Is developing a single source manual for Warrior Care and Transition Plan. b. MEDCOM: Publish DA PAM in support of single source document standardizing WTU procedures. ' 'OBSERVATION 1.2: Warrior Transition Units (WTU) foster a focused environment of healing and transitioning, however, some WTs' abuse the system and manipulate it to maximize entitlements. RECOMMENDATION: OTSG/MEDCOM: Revise Warrior Care and Transition Program procedures to incorporate a sequential approach initially focusing on strengthening the incentives for Soldiers retuming to duty ahead of disability-based compensation. OBSERVAnON 1.3: A mixture of combat wounded, injured and ill Soldiers in the Warrior Transition Unit has created perceptions leading to leadership. medical management. pubUc relations and small unit cohes,ion challenges. RECOMMENDATION: OTSGIMEDCOM: Detennine messages and strategies to educate the Army and public on the Warrior care and Transition Program. OBSERVATION 1.4: Challenges exist to implement rapidly Issued/changing policy withoUt the requisite resources. RECOMMENDATION:
OTSG/MEDCOM, ICW ASA(FM&C) and IMCOM: Ensure a cost benefit ana.lysis is conducted and appropriate resources are available for year of execution for WT policy requirements. OBSERVATION 1.5;' Subordinate commanders and some healthcare providers consider FRAGO 3/4 WTU entrance criteria to be vague and inconsistently applied. RECOMMENDATIONS: a. OTSGIMEDCOM: Define acomplex medical care," "extensive and. clinical case management," "definitive healthcare," and standardize screening criteria for entry into the WTU to add.ress medical condition for all COMPOs. OTSG Is currentfystaffing EXORD that establishes a MEB referral formal reporting system and a General Officer requirement to approve treatment plans for WTUICBwrU wrs with a length of stay greater than 12-months without.MEB start date. b. ASA(M&RA)lG1: Consolidate Medical Retention Processing Evaluation (MRP-E), Medical Retention Processing (MRP). Medical Retention Processing 2 (lViRP2) and Active Duty Medical Extension (ADME) into one order similar to COMPO 1. OBSERVATION 1.6: MEDCOM's accountability processes for Soldiers evacuated out of theater result In immediate acceptance into the WTU without meeting FRAGO 3 screening criteria. RECOMMENDATION: OTSGlMEDCOM: Develop a standardized process to evaluate Soldiers evacuated from theater to detennine if they meet WTU entrance criteria. OBSERVATlON 1.7: Most WTU cadres are concerned with Inconsistencies in determining the Medical Retention Decision Point (MRDP). RECOMMENDATIONS: a.OTSGIMEDCOM: Redefine the MRDPto be m re clear. concise and proscriptive; develop a standardized metric for assessing the MRDP; establish reporting requirements for Soldiers being treated for more than one year without reaching the MRDP. ·OTSG is currently staffing EXORD that establishes a MEB referral formal reporting system and a General Officer requirement to approve treatment plans for WTulcewru WTs with a length of stay greater than 12-months without MEB start date.
b. OTSGIMEDCOM: Develop and publish standardized elective procedure/surgery policy. , , c.OTSG/MEDCOM: Develop and pub fish ,policy regarding treatm.ent of additional medical conditions subs quent to admittance Into the Warrior Care and Transition Program (WCTP). OBSERVATION 1.8: Selection of WTU Cadre shifted from "best qualified" to "good. and first available." RECOMMENDATIONS: a. ASA{M&RA)lG1, ICW OTSG/MEDCOM: Add WTU Cadre eligibility requirements to AR 614-200, Enlisted Assignment and Utilization Management; AR 614-100. Officer Assignment POlicies. Details. and Transfers. . b. ASA(M&RA)lG1: Implement a selection process for WTU cadre commensurate with other Special Duty assignments (Recruiter, Drill Sergeant) for all COMPOs. OBSERVATION 1.9: The current Warrior Transition Unit (WTU) classroom-centric and theory-based instruction does not adequately prepare the cadre to perform their duties. RECOMMENDATIONS: a. OTSGIMEDCOM: Implement training for cadre that is scenario-based; deals with behavioral health Issues; side effects of prescription medications and includes sensitivity training. b. OTSGIMEDCOM: Require cadre training prior to assignment to WTU and implement sustainment training. Consider use of computer based training for cadre sustainment training. c. OTSGIMEDCOM: Require WTU Primary Care Managers to attend cadre training within 3Q days of assignment. d. OTSGIMEDCOM: Provide a leader's guide to address Warrior in Transition processes and policies. OBSERVATION 1.10: MostWTUs visited are not meeting the Intent and implementation of the Comprehensive Transition Plan (CTP). RECOMMENDATION:
OTSGIMEDCOM: Provi e policy and guidance to support automated CTP and enforce/re-enforce the Implementation and execution. WTU started implementation of the automated CTP and have over 6000 WTs In the program with plan to have all WTs in the automated program in the next six months. OBSERVATION 1.11: Most Warrior Transition Units (WTU) have not implemented the Transition Review Board (TRB). RECOMMENDATIONS: a. OTSG/MEDCOM: Enforce the implementation of the TRB and consider conducting the TRB for every WT at each 180 day period. b. OTSG/MEDCOM: ICW ASA(M&RA)lG1, establish reporting requirements of TRB resufts. c. OTSGiMEDCOM: .Assess· the feasibility of combining the TRB and the CT? OBSERVATION 1.12: Army-wide specialty care shortages exist in Behavioral Hearth, Occupational Therapy. and Physical Therapy and contribute to delays In Soldiers treatment and healing. RECOMMENDATIONS: a. Army G3/SI7: ICW OTSGIMEDCOM, validate manpower requirements criteria for healthcare services. personnel. b. ASA(M&RA)lG1: lew G3I5f1, and OTSGIMEDCOM review "rOA structure/staffing requirements for the specialty care providers (BH. OT, PT) and develop staffing actions to address shortages. c. ASA {M&RA)lG : ICW G3/S17, and OTSG/MEDCOM, confirm salary competitiveness amongbehavforar specialists. OBSERVATION 1'.13: Army is failing to properly document Line of Duty (LOD) investigations for Reserve Component Soldiers - critical to the follow-on care and transition for the RC Soldier. RECOMMENDATIONS: a. ASA{M&RA)lG1: Publish message to commanders emphasizing required completlon.of LOD for RC Soldiers prior to REFRAD.
b. ASA(M&RA)/G1: ICW ARNG, OCAR and TJAG, ensure education and training tools for LOD administrators are available to units prior to and during deployment. c. ASA(M&RA)/G1: Determine feasibility of presumptive LOD for RC Soldiers on Title 10 active duty orders in 'support of Contingency Operations. d. OTSGIMEDCOM: Adopt LOD module in MODS as the Anny's dedicated line of duty tracking system. OBSERVAnON 1.14: Perception that Warnors In Transition are not held to same standards of discipline as required of other Soldiers. RECOMMENDATIONS: a. OTSGIMEDCOM: ICW TJAG. Emphasize the importance of maintaining good order and discipline and ensure WTs are herd to the Army standards of discipline. b.OTSGIMEDCOM: Implement cadre training that Is scenario-based; deals with behavioral health issues and includes side effects of commonly prescribed prescription medications. . OBJECnVE 2: Assess Warrior Care and Transition support systems for Soldiers and Family members OBSERVATION 2.1: Soldier and Family Assistance Centers (SFAC) are underutilized; however they provide Warnors in Transition (WTs) with a level of personal service and an environment conducive to their medical and transitional needs. Most SFACs encounternear-tenn resource challenges (facilities. funding. and staffing). RECOMMENDATIONS: a. IMCOM: Conduct cost-benefltana/ysls to detennlne if SFAC services can be made available to all Soldiers in the MEB process. " , b. IMCOM ICW OTSGlMEDCOM and ASA(FM&C): Ensure resources are provided for year of execution policy requirements (zero sum game). OBSERVATION 2.2: Providing services for COMPO 213 Warriors in Transition (WT) and. Families is challenging due to the dispersion of state resources. RECOMMENDATION:
OTSG/MEDCOM and ASA {M&RA)/G1, ICW IMCOM, ARNG, OCAR, and Army PAD: Establish a steering committee to detennlne most effective methods to deliver Information and servloo to COMPO 213 WTs and Families. OBSERVATION 2.3: Communities outside the gate are beginning·to selectively support only combat-wounded WTs with incentives resulting in non-standardized practices across installations. RECOMMENDATIONS: a. OTSG/MEDCOM: Determine messages and strategies to educate the Army and public on the Warrior Care and Transition Program. . b. OTSG/MEDCOM: Establish policy standardizing acceptance of community Incentives. OBJECTIVE 3: Assess tools and processes implement d by Commanders to manage Soldiers who are "Medically Not Ready" OBSERVATION 3.1: The Army does not use common.terms of reference to aCcurately determine status of "medically not ready, "medically non-deployable and "not available" Soldiers. II RECOMMENDATION: OTSG/MEDCO . ASA(M&RA)/G1, G3/517. ICW FORSCOM: Standardize termin ?logy for Soldier medical readiness status (e.g. for standardization data from deployment checklist could be included in MEDPROS). OBSERVATION 3.2: Anny medical fitness determination processes have not kept pace-with ARFORGEN requirements. RECOMMENDATIONS: a. OTSGlMEDCOM, ASA{M&RA}/G1. 00/517 and FORSCOM: Examine medical support needs of the ARFORGEN cycle to determine processes that can best support the needs of the Army. The Integrated Disability Evaluation System, currently in pilot program phase, may reduce the amount of time. needed to determine fitness· for duty and retention or separation from the Anny. b. ASA{M&RA)/G1: Code Soldiers in MES process as a 'oss" allowing for replacement requisition.,
OBSERVATION 3 3: Army medical capabilities do not support the needs of the Medical Not eady (MNR)lMedical Non-Deployable (MND) in units. RECOMMENDATIONS: a. OTSGlMEDCOM, ASA(M&RA)lG 1, and OCAR: Conduct feasibility assessment to determine requirements and implementation strategies for a temporary increase in medical assets to mitigate current limitations. b. OTSGIMEDCOM: Establish Installation Medical Management Center (IMMC) pilot site for a next deplOying RC brigade to assist in managing MNRlMND Soldiers. The Integrated Disability !Evaluation System, currently in pilot program phase, may enhance visibility of the system for·the Soldier,the Army, and the Veterans Administration. OBSERVATION 3.4: Current medical. priorities do not assist commanders in maintaining a fit fighting force that is medically ready to deploy. RECOMMEN
SUBJECT: Results of the Warrior Care and Transition Program Inspection 1. The U.S. Army Inspector General Agency conducted an Inspection of the Warrior Care and Transition Program from 27 January 2010 to 30 June 2010. Three objectives were assessed (further discussed in paragraph 3). 2. Background.
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