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Meeting Transcript 1 U.S. DEPARTMENT OF DEFENSE + + + + + TASK FORCE ON THE CARE, MANAGEMENT, AND TRANSITION OF RECOVERING WOUNDED, ILL, AND INJURED MEMBERS OF THE ARMED FORCES + + + + + BUSINESS MEETING + + + + + TUESDAY FEBRUARY 26, 2013 + + + + + The Task Force met in the Washington Room of the DoubleTree by Hilton Hotel Washington DC-Crystal City, 300 Army Navy Drive, Arlington, Virginia, at 8:00 a.m., VADM Matthew L. Nathan, DoD Co-Chair, and Suzanne Crockett-Jones, Non-DoD Co-Chair, presiding. PRESENT VADM MATTHEW L. NATHAN, M.D., USN, DoD Co- Chair SUZANNE CROCKETT-JONES, Non-DoD Co-Chair JUSTIN CONSTANTINE, J.D., Member CSM STEVEN D. DEJONG, ARNG, Member RONALD DRACH, Member TSGT ALEX T. EUDY, USAF & SOCOM, Member CAPT CONSTANCE J. EVANS, USN, Member LTCOL SEAN P.K. KEANE, USMC, Member KAREN T. MALEBRANCHE, RN, MSN, CNS, Member MG RICHARD P. MUSTION, USA, Member STEVEN J. PHILLIPS, M.D., Member DAVID REHBEIN, M.S., Member MG RICHARD A. STONE, M.D., USAR, Member RUSSELL A. TURNER, M.D., Member NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 2 ALSO PRESENT DENISE F. DAILEY, PMP, Executive Director, Designated Federal Officer ANNE E. SOBOTA, Alternate Designated Federal Officer BG DAVID BISHOP, USA LTC EDWARD BRUSHER, USA REGINALD COFFEY COL JEAN JONES, USA LTC JON BAKER, USA MARY COLLEEN TUDDENHAM LTC DANIEL DUDEK, USA NANCY ADAMS MELISSA GLINER COL PRISCILLA BERRY, USA HORACE LARRY COL NICHOLAS DEMARCO, USAF COL TODD POINDEXTER, USAF COL GARY WALKER, USAF CARRA SIMS LTCOL MICHAEL C. WYATT, USAF TIM TOWNES TAMARA NEWTON LTCOL ANTHONY LANUZO, USAF EDMUNDO A. GONZALES NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 3 T-A-B-L-E O-F C-O-N-T-E-N-T-S PAGE Welcome and Sequestration ................. 5 Site Visit Review Captain James A. Lovell Federal Health Care Center .................. 23 Fort Bragg .......................... 44 CBWTU Arkansas ...................... 55 Army WTC Briefing Army Response to RWTF FY '12 Recommendations by BG David Bishop .................. 62 by LTC Edward Brusher ............... 74 by Mr. Reginald Coffey ............. 123 by COL Jean Jones .................. 141 Recommendation 15, Identification of Principal Point of Contact by Col Jean Jones .................. 162 Recommendation 16, Education of Family & Caregivers on Potential Benefit Changes on Separation by LTC Jon Baker .................. 167 Recommendation 17, Education of Family & Caregivers on Potential Loss of TRICARE Extended Care Help Option by LTC Jon Baker ................... 172 Recommendation 18, Unifying Family & Caregiver with Recovering Warrior by Col Jean Jones .................. 176 Recommendation 20, Soldier & Family Assistance Center by Mary Tuddenham .................. 198 NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 4 Recommendation 23, Out-processing of Reserve Component Soldiers with Home Unit by LTC Danny Dudek ................. 201 Recommendation 33, PEBLO Staffing Models by LTC Jon Baker ................... 203 Recommendation 34, Contact of Recovering Warriors by MEB Lawyer by LTC Jon Baker ................... 222 Recommendation 35, Service Members to Begin Relationship with VA & Marketing of VA Services to Soldiers and Leadership by Mrs. Nancy Adams ................ 230 Army Program Survey, Service Satisfaction and Program Changes by Dr. Melissa Gliner .............. 238 Caring for Families & Caregivers by Col Jean Jones .................. 269 PTSD Services by LTC Edward Brusher .............. 275 Vocational Services by Mrs. Nancy Adams ................ 279 Air Force Warrior and Survivor Care Briefing Air Force Response to RWTF FY12 Recommendations .................... 289 Air Force Warrior & Survivor Care Survey Program by Dr. Carra Sims .................. 380 NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 5 1 P-R-O-C-E-E-D-I-N-G-S 2 (8:03 a.m.) 3 CO-CHAIR NATHAN: Okay, well, good 4 morning, everybody. It looks like we have a 5 quorum. For those of you who are new to the 6 meeting or who weren't here last time, I'm Vice 7 Admiral Nathan, Matt Nathan. Pleasure to be 8 here. 9 I've been informed that we're not 10 having a group photo this morning, which is a 11 shame because I spent a lot of time on my hair 12 today and all for naught, so we'll do that 13 tomorrow. 14 Before we get into the battle rhythm 15 here and sort of kick things off, I just thought 16 I'd make a few comments and, Suzanne, welcome 17 your comments as well, on what can't be ignored 18 these days, the 500-pound gorilla in the room, 19 which is sequestration and, you know, how we look 20 at that in the services right now. 21 After copious amounts of testimony 22 on our service chiefs, the surgeons general, NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 6 1 both to staffers and to Congress on the effects 2 and what has been first and foremost on many 3 Congressional members and Pentagon leaders, not 4 all but many, is effect on wounded warrior care 5 and recovering warrior care. 6 I won't speak for the other 7 services. I think I have pretty good 8 situational awareness of where they are, having 9 talked at great length with my counterparts. 10 But the bottom line is each service 11 has a fairly robust representation of civilian 12 personnel who work for it in the medical 13 departments, the Army probably having the 14 highest percentage and then the Air Force and the 15 Navy. So there is an impact. 16 The question that we're always asked 17 is do you think that this is going to have a 18 direct effect on wounded warrior care, both 19 medical care and non-medical care? 20 And the answer, in theory, is it 21 should not. We have been told that wounded 22 warrior programs will continue to be funded. NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 7 1 There is no hiring freeze on requirements 2 specifically ordained for wounded warrior care. 3 That said, what I've told Congress, 4 and Rich and others please chime in on this from 5 the other services, but what I've told Congress, 6 I don't have two doors in my big hospitals, one 7 door that says wounded warrior care and the other 8 door that says all others. 9 Eventually the wounded warrior 10 recovering care, rehabilitative care, be it 11 emotional, physical, is interlaced with the care 12 I provide in all my components. They share 13 cardiologists, rheumatologists, orthopedists, 14 dermatologists, psychiatrists. 15 And so, outside of those 16 practitioners and support personnel who are 17 completely demarcated just for wounded warrior 18 care, e.g., a family medicine physician or a 19 sports medicine physician or an orthopedic PA 20 who is put into a wounded warrior clinic and does 21 nothing but see recovering warriors, the 22 majority of our care sees everybody and so there NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 8 1 has to be an effect at some point if this goes 2 for any degree of time. 3 What we'll do, of course, is we'll 4 shift resources to the active duty and the 5 recovering warrior care. We'll take all 6 remaining resources that we have and we'll shift 7 in that direction. That'll just simply erode 8 care to some of the non-warrior, non-active duty 9 beneficiaries. 10 It'll probably push care out to the 11 network, to the private sector. Again, most 12 likely not warrior care, most likely not active 13 duty care, but it would eventually push some care 14 out to the network. 15 You can do that for a short period 16 of time and there's no problem at all. If you 17 do that for a prolonged period of time in the 18 services, you end up losing some of your patient 19 base, you end up losing some of the diversity of 20 the kind of care and pathology that you see that 21 keeps your skills current, and so that's the 22 concern. NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 9 1 So I just thought I would share with 2 the Committee what we in our service are telling 3 them, which is we see no dramatic short-term 4 impact or threat to wounded warrior recovering 5 care. 6 In the long run if we were to have 7 a prolonged sequestration, maintain a prolonged 8 continuing resolution with the toll on civilian 9 availability, with the toll on purchasing 10 materials, eventually something has to give and 11 it's pretty hard to just make it give strictly 12 in the non-wounded warrior care arenas where we 13 get the care. 14 So I think this is something we need 15 to keep an eye on if sequestration does occur. 16 And I was coming into the radio today in the car 17 and on one channel it's going to occur; on 18 another channel it's not.
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