For Immediate Release
Office of the Press Secretary
October 16, 2007

Fact Sheet: Ensuring Our Wounded Warriors Get the Best Possible Care
Administration Moves Forward To Implement Recommendations Of The President's Commission On Care For America's Returning Wounded Warriors

White House News

      In Focus: Veterans
      President Bush Meets with Senator Bob Dole and Secretary Donna Shalala on the Commission on Care for Wounded Warriors

Today, President Bush discussed legislation Congress should pass and actions the Administration is taking to implement recommendations of the President's Commission on Care for America's Returning Wounded Warriors. In March, President Bush signed an Executive Order creating this bipartisan commission to conduct a comprehensive review of the services America is providing our returning wounded warriors. The Commission released its findings on July 25, 2007, and the President immediately instructed the Secretaries of Defense and Veterans Affairs to implement its recommendations.

• The Administration is working with Congress and taking action to implement the Commission's six recommendations to improve care for America's returning wounded warriors. Today, the President discussed progress on these goals in a meeting with Commission co-chairs Bob Dole and Donna Shalala, Defense Secretary Robert Gates, acting Veterans Affairs Secretary Gordon Mansfield, and wounded service members and their families:
  1. Modernizing and improving the disability and compensation systems.
  2. Aggressively preventing and treating post-traumatic stress disorder and traumatic brain injury.
  3. Significantly strengthening support for families.
  4. Immediately creating comprehensive recovery plans to provide the right care and support at the right time in the right place.
  5. Rapidly transferring patient information between the Departments of Defense (DoD) and Veterans Affairs (VA).
  6. Strongly supporting Walter Reed by recruiting and retaining first-rate professionals through 2011.

Congress Should Pass The Legislation Necessary To Ensure The Commission's Recommendations Are Fully Implemented

To the extent that the Administration can move forward without legislative action, we are working to implement the Commission's recommendations; however, some reforms require Congressional action:

Modernizing And Improving The Disability And Compensation Systems

Commission Recommendations

1. Change DoD Disability Entitlement for those deemed unfit for duty for combat-related reasons by providing an annuity based solely on rank and service, rather than percent disability.
2. Expand TRICARE Coverage to those unfit for duty for combat-related reasons, not just those who are at least 30 percent disabled or who have 20 years of service, as in the current system.
3. Restructure VA disability entitlement such that, for new entrants retired from service for fitness, VA benefits would include transition payments to cover living expenses equal to either three months of base pay (if no rehabilitation is needed) or family living expenses for longer-term rehab patients. The new VA disability benefits would also include "earnings-loss payments" and "quality-of-life payments."
4. Reassess all disability rating schedules to ensure they reflect modern medicine and modern concepts of the impact of disability. VA would reassess disability status every three years and adjust compensation accordingly.
5. Increase vocational rehabilitation benefits such that VA would pay a bonus equal to 10 percent of transition pay after year one, 5 percent after year two, and 10 percent after year three of training completion.

Legislation

• DoD disability payments should be replaced by DoD annuity payment for all eligible service members separated or retired after the implementation date of this provision. Those separated or retired since the beginning of the Operation Enduring Freedom/Operation Iraqi Freedom will be able to choose between the existing system and the new system.
• TRICARE benefits should be extended for those seriously injured in combat or combat-related activities.
• The VA disability system should be strengthened and improved to provide for an immediate transition payment, loss of earnings, and quality of life payment.
• Individuals and their conditions will be reassessed every three years.
• The disability rating schedule should be updated to reflect modern concepts of medicine and disability.
• The disability system restructure will take effect upon conclusion of the seven-month disability compensation study, legislation implementing VA disability payment rates, and regulations updating VA's disability rating schedules.

Administrative Actions

• Beginning in November 2007, DoD and VA will pilot a replacement to the cumbersome previous system of two entirely separate disability determinations by each Department with a single, comprehensive medical exam to be administered by DoD.
• Rulemaking is underway to update the VA Schedule for Rating Disabilities to include Traumatic Brain Injury (TBI) and severe burns.

Aggressively Preventing And Treating Post-Traumatic Stress Disorder And Traumatic Brain Injury

Commission Recommendations

1. Expand VA health coverage to ensure that all veterans of Operation Enduring Freedom and Operation Iraqi Freedom with post-traumatic stress disorder (PTSD) receive care related to this condition.
2. Address DoD shortage of mental health clinicians.
3. Conduct awareness training and provide clinical guidelines for PTSD and traumatic brain injury (TBI).

Legislation

• All Operation Enduring Freedom and Operation Iraqi Freedom veterans should be allowed to receive PTSD care from the VA without first showing service connection.

Administrative Actions

• Secretaries of the military departments have begun using existing authorities such as incentive pay and bonuses to recruit and retain sufficient experts in mental health fields.
• DoD and HHS are working on an MOU to provide additional mental health professionals to meet short term needs.
• By November 30, 2007, DoD and VA will establish a National Center of Excellence to conduct training and research, deliver care, and disseminate clinical best practices with regard to TBI, PTSD, and other mental health conditions.
• DoD has expanded mental health and TBI training programs for deploying service members.
• VA is working to screen all patients for PTSD as part of their initial treatment.

Significantly Strengthening Support For Families

Commission Recommendations

1. Expand TRICARE respite care and aide and personal attendant benefits to service members seriously injured in combat.
2. Provide training and counseling to family members to support them as caregivers. DoD and VA should standardize and assure universal access to family services early in the treatment process. This package should include education about the service member's injuries and expected progress, caregiver training and counseling, and psychological services.
3. Amend the Family Medical Leave Act (FMLA) to allow up to six months of unpaid leave for family members of combat-injured service members, and allow combinations of unpaid and paid leave, when available.

Legislation

• TRICARE respite care and aide and personal attendant benefits should be provided to service members seriously wounded in combat under Extended Care Health Option (ECHO).
• Many family members of service members with combat-related serious injuries should be eligible to receive 26 weeks of unpaid leave within the first 24 months following the injury or diagnosis of the injury.

Administrative Actions

• DoD and VA have implemented family caregiver training.
• DoD and VA are developing a package of employment options and health care options for caregivers of seriously injured service members.

The Administration Is Acting Now To Implement Recommendations That Do Not Require Legislative Action

Immediately Creating Comprehensive Recovery Plans To Provide The Right Care And Support At The Right Time In The Right Place

Commission Recommendations

1. Those seriously injured in combat will receive an individual Recovery Plan that leads them back to duty or public life seamlessly guiding and supporting them through medical, rehabilitation, and disability programs.
2. A Recovery Coordinator will be assigned to service members seriously injured in combat to serve as their ultimate resource in the recovery process. The Public Health Service (PHS) Commissioned Corps will help develop this cadre of well-trained and highly skilled advocates.

Administrative Actions

• On September 19, 2007, DoD, VA, and the Department of Health and Human Services (HHS) signed a joint Memorandum of Understanding (MOU) for the creation of a joint Recovery Coordinator Program for service members seriously injured in combat or combat-related activity.
• By December 1, 2007, DoD and VA will develop the Recovery "Life" Plan to be used by the Federal Recovery Coordinators for seriously injured service members with combat-related injuries.
• VA will take the lead on creating the organizational structure for the Federal Recovery Coordinators. The PHS Commissioned Corps will serve as consultants for program development and care management.

Rapidly Transferring Patient Information Between The Departments Of Defense And Veterans Affairs

Commission Recommendations

1. DoD and VA must continue the work under way towards a fully interoperable IT system that will meet long-term administrative and clinical needs.
2. DoD and VA must, within the next 12 months, have all patient information viewable by any clinician, health professional, or administrator who needs it within either department.
3. DoD and VA must develop a plan for a user-friendly health and benefits portal for service members, veterans, and family members.

Administration Actions

• No later than October 31, 2008, DoD and VA will make available and viewable all essential health and administrative data.
• By March 31, 2008, DoD and VA will have the ability to share all essential health images.
• DoD and VA are creating a single Web portal to provide for the care and support needs of veterans and their families.

Strongly Supporting Walter Reed By Recruiting And Retaining First-Rate Professionals Through Closure In 2011

Commission Recommendations

1. DoD must ensure that Walter Reed (WRAMC) has the resources it needs in outpatient and inpatient care.
2. DoD must implement tailored incentive packages to encourage civilian personnel to continue working at Walter Reed, and enable recruitment of new professionals as needed.

Administrative Actions

• The Secretary of the Army will ensure that WRAMC has a sufficient budget to fund recruitment and retention bonuses.
• The Secretary of the Army is pursuing additional recruitment authorities to hire and assign health care practitioners and support personnel.
• DoD sent a request to the Office of Personnel Management to authorize DoD's use of retention bonuses to retain high-quality personnel.
• DoD is creating a "guaranteed placement program" to ensure that critical employees at Walter Reed will have placement at the new National Military Medical Center if they stay in place until WRAMC closure.

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