# Presentation: 426878

## DoD-VA Seamless Transition Programs

## “To care for him who shall have borne the battle and for his widow and for his orphan”
– Abraham Lincoln

***– ******Abraham Lincoln***

**DoD-VA Seamless Transition Programs**

##  153 Hospitals

*** ******21 Veterans Integrated Service Networks (VISNs)***

*** ******153 Hospitals***

*** ******882 Clinics***

*** ******135 Nursing Homes***

*** ******232 Vet Centers***

*** ******46 Domiciliaries***

**DoD-VA Seamless Transition Programs**

## DoD-VA Seamless Transition Programs

**DoD-VA Seamless Transition Programs**

**VA’s Newest Combat Veterans**
**Younger...Families...Parental Involvement**

## 
Influx of a new mix and new types of injuries (e.g. TBI, etc.)
AD Patients were younger than typical VA patient....greater than anticipated interest in RTD and Rehab
Transfer of MTF medical records and nursing notes
Feelings of abandonment by the military for both SM and family
No one available to:
Coordinate the issuance of Invitational Travel Orders/Non-Medical Attendant Orders for family members
Resolve pay problems for SMs & coordinate financial assistance for family members
Initiate applications for TSGLI
Assist SM with Medical Evaluation Board/Physical Evaluation Board processing
Assist SM with convalescent leave & make transportation arrangements
Work with VA Volunteer Services and Vet’s Service Organizations in securing donated funds to cover emergencies and items not covered by the military

***Influx of a new mix and new types of injuries (e.g. TBI, etc.)***
***AD Patients were younger than typical VA patient....greater than anticipated interest in RTD and Rehab***
***Transfer of MTF medical records and nursing notes***
***Feelings of abandonment by the military for both SM and family***
***No one available to:***
***Coordinate the issuance of Invitational Travel Orders/Non-Medical Attendant Orders for family members***
***Resolve pay problems for SMs & coordinate financial assistance for family members***
***Initiate applications for TSGLI***
***Assist SM with Medical Evaluation Board/Physical Evaluation Board processing***
***Assist SM with convalescent leave & make transportation arrangements***
***Work with VA Volunteer Services and Vet’s Service Organizations in securing donated funds to cover emergencies and items not covered by the military***

**DoD-VA Seamless Transition Programs**

**Lessons Learned from OIF / OEF**

## 
Arrange transportation of household goods, JAG support, ID cards, etc.
Need to develop working relationship with Services & American Red Cross
Active family and extended family issues:
Spouse or parents take a leave of absence or quits work to be with AD SM
Military funded travel, lodging and local transportation issues 
Child care issues, at the VAMC or at the HOR 
Parents needs, questions and concerns.  (A mother concerned about the care and  treatment of her son/daughter is a formidable force)
Managing conflict between family members (divorces & separations).
Addressing health care concerns of visiting family members 
Too few Military LNOs, providing coverage for other Services
Working with Reserve & National Guard Units
Visiting dignitaries (Members of Congress; GO or Flag Officers; Senior VA staff; and others)       

***Arrange transportation of household goods, JAG support, ID cards, etc.***
***Need to develop working relationship with Services & American Red Cross***
***Active family and extended family issues:***
***Spouse or parents take a leave of absence or quits work to be with AD SM***
***Military funded travel, lodging and local transportation issues ***
***Child care issues, at the VAMC or at the HOR ***
***Parents needs, questions and concerns.  (A mother concerned about the care and  treatment of her son/daughter is a formidable force)***
***Managing conflict between family members (divorces & separations).***
***Addressing health care concerns of visiting family members ***
***Too few Military LNOs, providing coverage for other Services***
***Working with Reserve & National Guard Units***
***Visiting dignitaries (Members of Congress; GO or Flag Officers; Senior VA staff; and others)****       *

**DoD-VA Seamless Transition Programs**

**Lessons Learned from OIF/OEF**

## DoD-VA Seamless Transition Programs

***8 Federal ***
***Recovery***
***Coordinators***

***14 VHA Staff Assigned***
*** ******to Military ***
***Treatment Facilities***

**DoD-VA Seamless Transition Programs**

**Medical Center OEF/OIF Veteran Support**

## New joint DoD / VA program

As of 7 Jan 08 (with 2 hire actions pending):
Walter Reed Army MC (3)
National Naval MC (3)
Brooke Army MC (2)

FRCs identify severely injured upon arrival from theater, overall responsibility for assuring SM has access to all clinical & non-clinical services

Coordinates with:
VHA LNOs in MTFs
Military LNOs in VAMCs
VHA OEF-OIF Program Managers In VAMCs

***As of 7 Jan 08 (with 2 hire actions pending):***
***Walter Reed Army MC (3)***
***National Naval MC (3)***
***Brooke Army MC (2)***
***FRCs identify severely injured upon arrival from theater, overall responsibility for assuring SM has access to all clinical & non-clinical services***
***Coordinates with:***
***VHA LNOs in MTFs***
***Military LNOs in VAMCs***
***VHA OEF-OIF Program Managers In VAMCs***

**DoD-VA Seamless Transition Programs**

**Federal Recovery Coordinators**

## DoD-VA Seamless Transition Programs

***Walter Reed Army Medical Center, Washington D.C******	******3      1***
***National Naval Medical Center, Bethesda******	******	******1      ***
***Brooke Army Medical Center, San Antonio, TX******	******1***
***Darnall Army Medical Center, Ft. Hood, TX******	******	******1***
***Madigan Army Medical Center, Puget Sound, WA******	******2***
***Eisenhower Army Medical Center, Augusta, GA******	******1***
***Evans Army Community Hospital, Ft. Carson, CO******	******1***
***Naval Medical Center, San Diego, CA******	******	******1***
***Womack Army Medical Center, Ft. Bragg, NC******	******1***
***Naval Hospital, Camp Pendleton, CA******	******	******1***
***Center for the Intrepid, San Antonio, TX******	******	******1***
***Note: VBA also has Benefit Counselors assigned to each of the MTFs***

**DoD-VA Seamless Transition Programs**

**VHA LNOs at MTFs**

_***Minneapolis***_
***2 Army Liaisons***
***2 Marine Liaisons***
***1 AW2 Advocate***
_***Palo Alto***_
***3 Army Liaisons***
***2 Marine Liaisons***
***1 Navy Liaison***
***1 AW2 Advocate***

**DoD-VA Seamless Transition Programs**

**Military LNOs Currently at VA ****Poly-trauma Rehab Centers**

_***Richmond***_
***   ******1 Army Liaison***
***   ******2 Marine Liaisons***
***   ******1 AW2 Advocate***
_***Tampa***_
***   ******3 Army Liaison***
***   ******3 Marine Liaisons***
***   ******1 Navy Liaisons***
***   ******2 AW2 Advocates***

## Serves as the primary VAMC POC for OEF/OIF

Oversee all seamless transition activities @ VAMC

Links with VA LNOs at MTFs regarding transfers

Assigns VA Transition Patient Advocate as ombudsman for each SM before & during transfer

Assigns Case Manager for all severely injured/ill and others as needed upon transfer to the VA

Work closely with VBA to track benefits claims

***Oversee all seamless transition activities @ VAMC***
***Links with VA LNOs at MTFs regarding transfers***
***Assigns VA Transition Patient Advocate as ombudsman for each SM before & during transfer***
***Assigns Case Manager for all severely injured/ill and others as needed upon transfer to the VA***
***Work closely with VBA to track benefits claims***

**DoD-VA Seamless Transition Programs**

**VA Medical Center OEF/OIF ****Program Manager**

## Initiates contact with patients & families before patient leaves MTF

Coordinates healthcare (appointments, primary and specialty care, Long Term Care placements, etc.)

Coordination of civilian referrals as appropriate

***Coordinates healthcare (appointments, primary and specialty care, Long Term Care placements, etc.)***
***Coordination of civilian referrals as appropriate***

**DoD-VA Seamless Transition Programs**

**VA Case Managers**

## Approximately 100 new VA staff distributed to the VISNs in 2007

Ensures non-medical issues coordinated, such as:
Invitational Travel Orders for family members
Resolve pay problems for SMs and coordinate financial assistance for family members
Initiate applications for TSGLI
Assist SM with MEB / PEB processing
Assist SM with convalescent leave and make transportation arrangements

***Ensures non-medical issues coordinated, such as:***
***Invitational Travel Orders for family members***
***Resolve pay problems for SMs and coordinate financial assistance for family members***
***Initiate applications for TSGLI***
***Assist SM with MEB / PEB processing***
***Assist SM with convalescent leave and make transportation arrangements***

**DoD-VA Seamless Transition Programs**

**Transition Patient Advocate (TPA)**

## VA Central Office
Tucson, Arizona 
Phoenix, Arizona 
Birmingham, Alabama 
Little Rock, Arkansas
Palo Alto, California 
West LA, California  
Livermore, California  
Denver, Colorado
Washington, DC    
Tampa, Florida   
Orlando, Florida 
Miami, Florida  
Augusta, Georgia
Honolulu, Hawaii
Chicago, Illinois 
Danville, Illinois 
Des Moines, Iowa 
Indianapolis, Indiana
Lexington, Kentucky                
Minneapolis, Minnesota
Boston, Massachusetts 
St. Louis, Missouri 

*Some Sites are in the process of being filled

***Tucson, Arizona ***
***Phoenix, Arizona ***
***Birmingham, Alabama ***
***Little Rock, Arkansas***
***Palo Alto, California ***
***West LA, California  ***
***Livermore, California  ***
***Denver, Colorado***
***Washington, DC    ***
***Tampa, Florida   ***
***Orlando, Florida ***
***Miami, Florida  ***
***Augusta, Georgia***
***Honolulu, Hawaii***
***Chicago, Illinois ***
***Danville, Illinois ***
***Des Moines, Iowa ***
***Indianapolis, Indiana***
***Lexington, Kentucky                ***
***Minneapolis, Minnesota***
***Boston, Massachusetts ***
***St. Louis, Missouri ***
****Some Sites are in the process of being filled***

**DoD-VA Seamless Transition Programs**

**Army Wounded Warrior (AW2) ****Advocates based at VHA Sites***

***       ******Baltimore, Maryland***
***       ******Bronx, New York ***
***       ******Syracuse, New York ***
***       ******Bronx, New York***
***       ******Fayetteville, North Carolina ***
***       ******Manchester, New Hampshire***
***       ******St. Louis, Missouri ***
***       ******Detroit, Michigan ***
***       ******Kansas City, Missouri***
***       ******Cleveland, Ohio ***
***       ******Columbus, Ohio ***
***       ******Oklahoma City, Oklahoma ***
***       ******Portland, Oregon***
***       ******Pittsburgh, Pennsylvania ***
***       ******Philadelphia, Pennsylvania ***
***       ******San Juan, Puerto Rico***
***       ******Houston, Texas ***
***       ******San Antonio, Texas ***
***       ******Dallas, Texas ***
***       ******El Paso, Texas***
***       ******Nashville, Tennessee***
***      ******Richmond, Virginia***
***      ******Seattle, Washington ***
***      ******Milwaukee, Wisconsin***

## 
VA Central Office
Little Rock, Arkansas
San Diego, California
North Chicago, Illinois
Lexington, Kentucky
Santa Fe, New Mexico
Brooklyn, New York
Columbus, Ohio 
Pittsburgh, Pennsylvania
Nashville, Tennessee

***VA Central Office***
***Little Rock, Arkansas***
***San Diego, California***
***North Chicago, Illinois***
***Lexington, Kentucky***
***Santa Fe, New Mexico***
***Brooklyn, New York***
***Columbus, Ohio ***
***Pittsburgh, Pennsylvania***
***Nashville, Tennessee***

**DoD-VA Seamless Transition Programs**

**USMC Wounded Warrior Regiment****Liaisons Based  at VHA Sites**