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DoD Recovering Warrior Task Force Recovering Warrior Task Force Co-Chairs VADM Matthew L. Nathan, MD, USN Mrs. Suzanne Crockett-Jones Recovering Warrior Task Force Members CSM Steven D. DeJong, ARNG Mr. Ronald Drach TSgt Alex J. Eudy, USAF & SOCOM LtCol Sean P. K. Keane, USMCR COL Karen T. Malebranche (Ret.), RN, MSN, CNS MG Richard P. Mustion, USA LTC Steven J. Philips (Ret.), MD David K. Rehbein, MS CAPT Robert A. Sanders, LPD, JAGC, USN MG Richard A. Stone (Ret.), MD LtCol Theodore L. Wong, USMC Report contributors included the following RWTF staff: COL Denise Dailey (Ret.), Executive Director, Designated Federal Officer (DFO) Insight Policy Research: ICF International: Rachel Gaddes, MPH John Kunz, MA Bryan Johnson, JD, MBA Suzanne Lederer, PhD Amber Bakeman, MA Matthew D. McDonough, MA Crosby Hipes, MA Karen Egan, PhD Ashley Schaad, MA Karen Wessels, MA Operations team: John Booton; Stephen Lu; David McKelvin; Heather Moore; Joseph Nagorka; John Oti; and Tiffany Reese; LaKia Thomas —Wagner Resources Prepared by Insight Policy Research Subcontractor - ICF International Cover photo captions (clockwise from top left) BETHESDA, Md. (April 19, 2011) Explosive Ordnance Disposal Technician 1st Class Todd E. Hammond shows his Purple Heart medal to his two- year-old daughter as his wife looks on. Hammond was presented the medal for wounds received in action while serving in Afghanistan. (U.S. Navy photo by Zona T. Lewis/Released) Specialists Craig Smith (left) and Filipe Hill block a Navy competitor from the ball during wheelchair-basketball preliminaries at the 2010 Warrior Games in Colorado Springs, CO. Jeffrey Adams and Canine Companions for Independence (CCI) Service Dog Sharif Woman in wheelchair on phone: shutterstock_11238490 Wounded young American in hospital bed: istockphoto_12550949 Website: http://rwtf.defense.gov/ Table of Contents PAGE Executive Summary _______________________________________ 1 Chapter 1 Introduction __________________________________ 5 Overview of Recovering Warrior Task Force’s Work ............................................................... 5 Looking to the Future ............................................................................................................. 7 Conclusion ............................................................................................................................ 10 Chapter 2 Recommendations and Findings _________________ 11 Integrated Disability Evaluation System ............................................................................... 11 1: Design new approach to replace current DES ....................................................................................................... 11 Supporting an Enduring RW Mission ..................................................................................... 18 2: Publish DoDI for addressing needs of RW family members and other caregivers ................................................ 18 3: Establish uniformed representative from each Service at WCP ............................................................................ 24 4: Increase WCP effectiveness through realignment and leadership re-grade ......................................................... 25 5: Secure enduring resources to maintain RW programs .......................................................................................... 26 6: Establish interagency policy on DoD and VA WII programs .................................................................................. 28 Facilitating RW Recovery and Transition ............................................................................... 30 7: Optimize family contribution to RW recovery ....................................................................................................... 30 8: Facilitate transfer of Service member from DoD to VA ......................................................................................... 33 9: Take affirmative steps to ensure employment programs are meeting expectations ........................................... 35 Facilitating Access to Health Care ......................................................................................... 40 10: Require health insurance as condition of employment in RC ............................................................................. 40 Best Practices ....................................................................................................................... 41 Status of FY2013, FY2012, and FY2011 Recommendations ................................................... 48 Notes __________________________________________________ 54 Annexes Annex 1 – Member Biographies ............................................................................................................................... 1-1 Annex 2 – Acronym Listing ....................................................................................................................................... 2-1 FY2014 EXECUTIVE SUMMARY i Appendices Appendix A – Legislation .......................................................................................................................................... A-1 Appendix B – Charter ................................................................................................................................................ B-1 Appendix C – Reference Handbook ......................................................................................................................... C-1 Appendix D – Methodology ..................................................................................................................................... D-1 Appendix E – Business Meetings and Presentations/Panels .................................................................................... E-1 Appendix F – Site Visits ............................................................................................................................................. F-1 Appendix G – Information Sources by Topic ........................................................................................................... G-1 Appendix H-1 – Recovering Warrior Focus Group Protocol .................................................................................... H-1 Appendix H-2 – Family Member Focus Group Protocol .......................................................................................... H-9 Appendix H-3 – Recovering Warrior Mini-Survey .................................................................................................. H-17 Appendix H-4 – Family Member Mini-Survey ........................................................................................................ H-23 Appendix I-1 – Recovering Warrior Mini-Survey Results ........................................................................................... I-1 Appendix I-2 – Family Member Mini-Survey Results ............................................................................................... I-13 Appendix J – Data Call Results – Population and Staffing of Programs .....................................................................J-1 Appendix K – Recommendations for Congressionally Mandated Topics ................................................................. K-1 Appendix L – Recommendations for Congressionally Mandated Topics FY2011—FY2014...................................... L-1 ii DoD Recovering Warrior Task Force Executive Summary SUMMARY This is the fourth and final Annual Report of the Department of Defense (DoD) Recovering Warrior Task Force (RWTF), which was established at Congress’ behest to examine the effectiveness of military Recovering Warrior (henceforth Recovering Warriors, or RWs) policies and programs and to recommend improvements.1 Congress specified more than a dozen RW matters that RWTF was to study each year; although these matters focused primarily on RW needs and resources prior to signing a Certificate of Release or Discharge from Active Duty form (known as the DD2142), Congress also charged RWTF to address RWs’ transition to the Department of Veterans Affairs (VA) and civilian status. Drawing upon a comprehensive research plan encompassing a wide variety of data sources and collection methods (see Appendix D, Methodology), RWTF produced a total of 77 recommendations in its first three years of effort. These recommendations can be found in RWTF’s Fiscal Year (FY) 2011, FY2012, and FY2013 Annual Reports, which are available at http://rwtf.defense.gov/. The present FY2014 Annual Report makes 10 recommendations, for a total of 87 RWTF recommendations over four years of operation. Two factors differentiate the tenor and content of this RWTF Annual Report from the three that preceded it: the anticipated sunset of RWTF and the shifting geopolitical landscape. RWTF, a time- limited Federal Advisory Committee (FAC), will sunset November 20, 2014. RWTF is thus mindful that this volume represents a final opportunity to potentially influence the future effectiveness and course of RW care. Secondly, RWTF recognizes that the drawing down of U.S. military operations in Southwest/Central Asia after more than a decade of war poses both risk and opportunity for the enduring RW mission. The decline in combat injuries may jeopardize continued attention and resources for RW matters. At the same time, peacetime affords RW proponents the opportunity— or in RWTF’s view, the obligation—to regroup, strategize, formalize, and marshal support for the way forward in RW care