Testimony to the United States Senate
Veteran's Affairs Committee
"VA Outreach to Members of the Guard and Reserve"
Colonel Bradley A. Livingston
Director of the Joint Staff, Joint Force Headquarters
Montana National Guard
Mr. Chairman and Members of the Committee:
Thank you for the opportunity to provide testimony on the Montana National Guard's efforts to strengthen our post deployment and reintegration processes.
"My testimony today reflects my personal views and does not necessarily reflect the views of the Air Force, the Department of Defense, or the Administration."
I am Col Brad Livingston, the Director of the Joint Staff for the Montana National Guard. In March 2007, the Montana National Guard lost an Army Soldier to a suicide linked to Post Traumatic Stress Disorder (PTSD). That action prompted Montana's Governor Brian Schweitzer and Adjutant General Randy Mosley to form a Post-Deployment Health Reassessment Program (PDHRA) Task Force to evaluate the post deployment processes used by the Montana National Guard.
We asked the PDHRA Task Force, comprised of ten community subject-matter representatives from a variety of areas, for example: mental health experts, Veterans Administration employees, local ministers, and state government officials to evaluate our current processes and to recommend actions for program improvements.
Although the PDHRA Task Force report confirmed the Montana National Guard was following and, in many cases, exceeding established Department of Defense and National Guard Bureau program guidelines, the Task Force made 14 recommendations in an effort to help improve our program.
The recommendations are as follows:
1. Evaluate medical status before discharge
2. Allow Guardsmen to request honorable discharge
3. Thoroughly review all Guard PDHRA personnel files for completeness
4. Expand the PDHRA Process
5. Mandate Enrollment in the VA Healthcare System
6. Guardsmen receive awards and medals within 90 days of return
7. Send badge information to DoD within 90 days
8. Include mental health focus in training
9. Increase awareness of available resources
10. Create Crisis Response Team (CRT)
11. Allow drill attendance upon return home
12. Increase informal support systems - Vet2Vet
13. Enhance Family Readiness Program
14. Form partnerships with State Veteran's Groups
PDHRA Campaign Plan Summary of Accomplishments
Modified Discharge Process
Montana modified the discharge process to incorporate an additional series of reviews prior to approval of a discharge. In addition to the current command assessment, reviews were added for medical, legal, and senior leadership. This serves the purpose of confirming that a discharge request for an OIF/OEF/ONE member is not related to a PTSD or other combat issue.
Developed Crisis Response Teams
In response to the recommendation, we created two Crisis Response Teams, with one team located in Helena, Montana and the other in Great Falls, Montana. The purpose of the Crisis Response Team is to evaluate, analyze, and advise unit representatives, Guardsmen, and/or their families on situations that involve National Guard members affected by Post Traumatic Stress Disorder (PTSD), Mild Traumatic Brain Injury (mTBI), or other traumatic life events.
Mandated Enrollment into VA System
All returning Soldiers and Airmen now complete the VA Form 1010 EZ to enroll for VA benefits. This expedites follow-on care through the VA in the event it becomes necessary.
Modified PDHRA Process
The current PDHRA process, conducted within 90-180 days after redeployment, has been extended to two years. Redeploying Soldiers and Airmen receive a behavioral health review through either a Post Deployment Health Reassessment or a Periodic Health Assessment, conducted every six months for two years.
Suicide Prevention and PTSD/mTBI Training
Increased training on suicide prevention, PTSD, and mTBI was conducted All units have received suicide training and this is now an annual requirement. Trained Montana counselors conducted PTSD/mTBI Outreach Training in all units. We distributed focused resource/benefit information (to include a copy of the book, Down Range to Iraq and Back) and conducted outreach to increase awareness of the National Guard Transition Assistance Advisor (TAA). We continue our efforts through website modifications, ongoing unit training, and partnerships with community organizations.
Reaffirmed Drill Attendance Policy
The Adjutant General published a policy letter to reaffirm a Soldier's (ARNG only) ability to drill immediately upon redeployment for the first 90 days previously identified as a "no drill" period).
Hired a PDHRA Program Manager
A full-time PDHRA Program Manager was hired. This position manages the PDHRA process and our ongoing efforts in implementing the actions of the PDHRA Campaign Plan.
Redesigned MTNG Website - Yellow Ribbon
The Montana National Guard website, located at www.montanaguard.com, is updated to include information on the Beyond the Yellow Ribbon program. The website consolidates related information to help minimize confusion when benefits are needed. As we move forward, we will develop a separate PDHRA website to continue enhancing this effort.
Implemented Periodic Health Assessment
Montana implemented The Periodic Health Assessment (PHA) in June 2007. This new program replaced the former Annual Medical Certificate and the 5-year physical program with an annual medical review. The new review is required every year. It includes a self-assessment complimented by a medical examination and face-to-face meeting with a physician or physician's assistant.
Redesigned Individual Mobilization Process
Soldiers and Airmen who volunteer to mobilize as individual augmentees now receive the same redeployment information as units who redeploy. A comprehensive checklist ensures all necessary stations are completed before a Soldier or Airman is released.
Honorable Discharge Policy Request
We published a policy memorandum to allow Guardsmen to request an honorable discharge based on deployment-related PTSD or mTBI difficulties.
Expanded Family Resource Centers
Through additional funding resources, the Montana National Guard Family Program was able to hire two contracted part-time Family Assistant Coordinators, located in Billings and Kalispell, Montana.
Increased Family Communications
The Family Program has expanded its efforts to provide information and additional focus on PTSD/mTBI signs and symptoms, along with providing resource information for families. The family program is also developing a consolidated resource guide to further enhance information access and availability.
State Veteran's Affairs - MT Mental Health Association
The State Department of Veteran's Affairs partnered with the Montana Mental Health Association to air a variety of statewide Public Service Announcement radio spots from 9 Jan 2008 through 19 March 2008.
Received Additional PDHRA Cycle from OSD
Montana Senators Max Baucus and Jon Tester met with Dr. Chu, Undersecretary of Defense for Personnel and Readiness, DoD, and secured an additional PDHRA cycle for Montana. This allows us to expand our current review out to the two-year mark.
Invitational Travel Authorizations for Family Members
National Guard Bureau extended funding to the Montana National Guard to place family members on invitational orders to attend Deployment Cycle Support (DCS) events. This helps us in involving all families in the redeployment training.
TRIWEST Healthcare Pilot Program
The Montana National Guard formed a pilot program with TRIWEST Healthcare Alliance to place a behavioral healthcare specialist at both the Joint Force Headquarters in Helena and at the 120th Fighter Wing Headquarters in Great Falls. This program incorporates a face-to-face with a behavioral health specialist into the annual Periodic Health Assessment program. The pilot began in June 2008 and will continue through December 2008. At that time, we will evaluate the effectiveness, along with options for future participation.
Joint Family Support Assistance Program (JFSAP)
National Guard Bureau selected Montana to participate in the Joint Family Support Assistance Program. This program extends three new positions to our Family Programs to assist with family and youth outreach. These positions include a Child and Youth Specialist and two Military Family Benefits Specialists. Program contractors have already begun the recruitment process.
Community Partnership Program - Picking up the Pieces DVD
The Montana National Guard Public Affairs Office developed a comprehensive marketing plan for our outreach efforts. A large part of the plan included the development of a PTSD Outreach Video and brochures that have been used as educational tools to help the MTNG build stronger community partnerships with Medical (behavioral health care providers), Ministerial (area churches), Veteran Services Organizations (American Legion, VFW, and DAV), State (DPHHS), Federal (OSD, NGB), and Employers located throughout the state. Montana sent a direct mailing that included a copy of the DVD and informational brochures, along with a letter of partnership request, to all behavioral health care providers, ministerial groups, and Veteran Services Organizations in early May 2008. Additionally, we conducted community presentations of our Picking up the Pieces DVD, along with a short presentation on Post Traumatic Stress Disorder (PTSD), in 20 communities that host a National Guard Armory. Our goal was to provide education on the Guard's progress in addressing PTSD, elevate public awareness, and involve Montana communities with our efforts to address the issues of PTSD within the Montana National Guard and other service components. This was a community event conducted during the weeks of 19 May and 26 May 2008. Nearly 400 Montana residents attended one of these meetings.
Radio Public Service Announcements
Montana Veteran's Affairs Division and the Montana Mental Health Association teamed up to produce and air 30 second awareness radio spots across Montana in the months of January, February, and March 2008. These spots focused on PTSD and the VA resources available to assist those in need.
Television Public Service Announcements
The Montana Veteran's Affairs Division and Montana Mental Health Association produced 30-second television public service announcements to again highlight and raise awareness of PTSD. The spots use footage from the recently completed Picking up the Pieces DVD, produced by the MTNG Public Affairs Office.
Published National Guard Resource Guide
The Montana National Guard developed a Resource Guide that consolidates many of the most commonly used resources to treat PTSD and mTBI into one convenient booklet. We mailed the booklet to all members of the Montana National Guard and their families in July 2008.
The Montana National Guard continues to move forward in its implementation of the Task Force recommendations and our new Deployment Cycle Support, Beyond the Yellow Ribbon program. We appreciate the assistance received from our Congressional TEAM, the Governor, National Guard Bureau, Department of Defense, and our many community partners who have contributed their assistance and support in our efforts.
On behalf of Governor Schweitzer, MG Mosley, and the more than 3.700 men and women of the Montana National Guard, thank you for your continued support and commitment to our Montana veterans and their families.
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