Sergeant Joe [whose name has been changed by request to protect his privacy] regards himself as one of the lucky ones. After being severely injured in Iraq in 2004, he had to have both his legs and an arm amputated. He was brought to Walter Reed Army Medical Center for medical recovery.
During that time, his mother contacted their congressman, who in turn called the Military Severely Injured Center (MSIC). From that point on, Sergeant Joe and his wife were assigned a care manager through the MSIC who will stay in contact until Sergeant Joe decides they no longer need this individual to check on him, answer questions, offer moral support and makes certain their every need is met.
“We are there to provide support,” said Navy Commander David Julian, a Department of Defense (DOD) liaison assigned to MSIC.
Meanwhile, Sergeant Joe was outfitted with prosthesis, learned to walk again, and thanks to his community, which welcomed this hero home, he received a HUD house, landscaping, furniture, job training and sack loads of groceries.
Care Giving Support
It’s a unfortunate fact: War results in severely injured service men and women. But these dedicated individuals do not have to face the consequences of their injuries alone. In fact, organizations and communities across America are ready and anxious to welcome these heroes home and provide for them in any way they can. It’s a grateful nation’s way of saying “thanks.”
To insure that all severely injured men and women coming out of Iraq and Afghanistan receive a seamless transition back to the military or into the civilian community, the DOD began the MSIC initiative in 2004 and opened the center on Feb. 1, 2005. Based in Arlington, Va., MSIC operates as a 24/7 call center. Staffed with highly qualified and trained professionals known as caregiver managers, MSIC supports and augments existing service programs.
Each branch of the military has its own severely injured program, said Karyn George, service delivery manager for MSIC.
The Army has the Army Wounded Warrior Program, the Navy has the Navy Safe Harbor, the Marine’s have Marine for Life Injured Support Program, and the Air Force has Palace+HART (Helping+Airmen+Recover+Together).
But the DOD saw a need to reach across all service branches to fill in any gaps in the delivery and continuity of care from the time the service member is injured to when he or she either remains on active duty or transitions back to the civilian community. Currently, the center has close to 2,000 such cases in its database.
MSIC employs 31 counselor-advocates who work across the country as the eyes and ears of the MSIC.
“They are actually positioned at the major military treatment facilities and the four Veterans Administration trauma centers,” George said. “We have at least one at each facility. In some locations we may have up to four counselor advocates.”
All counselor advocates have master’s degrees in counseling and receive extensive MSIC training at the Arlington center where they also learn about all military outreach resources. Their training lasts five weeks. They are then partnered with a MSIC care manager in Arlington.
“The goal is for the military service member to receive continuity of care from the MSIC so that even as they leave that military treatment facility where we have that counselor advocate, the care manager will remain a constant,” George said. “We never close cases. Our cases remain open as long as that service member needs us.”
Jena Moore, one of the center’s care managers, has about 140 service members under her care. The average caseload per caregiver is around 100. Moore has worked at MSIC since August 2005.
“I work with all different kinds of injuries from amputations to traumatic brain injuries to loss of vision,” she pointed out.
Care managers such as Moore are trained to do specific assessments of the service member, his or her family, and, in some cases, multiple family members. The number of care managers at MSIC varies.
“We are constantly evaluating how many we need,” George said. “Our mission is to make sure that a care manager has all the time needed to talk on the phone if a service member wants to talk about all the issues and concerns that he may have.”
Part of the job entails detailing with which services the military members may already be connected, as well as finding out when they were injured, what kind of medical treatment they are currently receiving and what medical treatment they can expect in the future.
“We also need to know whether they are active duty or have been medically discharged, as well as obtain information about their families, if they are currently employed, if they are still on active duty and are hoping to be employed when they get out, what kind of training they have or want to have, what medication they are on, whether or not they want to go back to school, and what their financial situation is,” Moore said. “It can be overwhelming to a service member at times. We might start out and finish up later.”
One service member with whom she recently started working was injured in Operation Iraqi Freedom in March 2006.
“He received a brain and back injury. He is now paraplegic,” she said. “I have never been in contact directly with this service member. All contact has been through his spouse. He is in intensive care.”
Sometimes it’s best for counselors to work with the spouse or family members rather than the service member, depending on their injury.
“I started working with the family early on. Right after the injury, the family was at a military treatment facility on a military installation,” Moore said. “They wanted the service member transferred to a VA facility to receive care for his brain injury. During the process, there was some disconnect because he was being moved to another facility. The wife was very overwhelmed with a lot of information.”
Moore assisted by making phone calls to make sure the wife was connected with veterans organizations such as Disabled American Veterans and that insurance reimbursements were being properly handled.
“We wanted to make sure she felt comfortable since she was away from their two children while tending to her husband,” Moore noted.
Cooperative Environment
According to Moore, MSIC especially works well because all caregivers at the center and consultants in the field support each other in this work.
“The relationship between care manager and counselor advocates is amazing,” she said. “My background is in family therapy. Someone else’s background might be in relocation. No one expects everyone to be an expert.”
Each MSIC professional has their own unique skill sets and all have also gone through extensive training to work with the severely injured service members and each another.
In addition, the DOD has provided a liaison from each branch of the military at the center to help the caregivers if they are not certain how to handle something.
“The program is designed so that we have a team approach,” George said.
But the cooperative effort is even more extensive and includes other government agencies such as the Departments of Labor, Transportation, Veterans Affairs and National Security Administration.
“We have points of contact in each of those agencies that are physically at the MSIC so that a care manager like Jena can speak with them to make sure that any services such as employment are available to that military service member,” George pointed out.
The Department of Labor can assist in facilitating job training for a service member’s spouse. The Transportation Security Administration (TSA) can help a severely injured service member circumvent airport security.
For example, severely injured service members with implants have been known to set off alarms upon going through security. As a result, they have received aggressive pat downs that are painful. In another case, a service member had to remove dressings that covered a wound. Since then, TSA has stepped in and worked with MSIC so that airport security is less stressful.
MSIC also engages communities. One successful DOD program in which MSIC works is Heroes to Hometown, which is designed to welcome home severely injured service members by creating a positive transition. Ways in which the community can be involved include organizing a welcome home celebration, helping to secure temporary and/or permanent housing, assisting in adapting a home or vehicle to the injury, finding jobs and educational opportunities, and creating a carpool for hospital visits.
A community can also provide childcare, financial support, entertainment options, counseling, spiritual support and family support.
“It’s a wonderful program,” George said. “Communities have done everything from coming in and refurnishing a house to making sure it is handicap-accessible, making providing landscaping for a year, to providing jobs or for a family member. The military has a long history of taking care of their own. But the American people also want to be there to support these men and women.”
It’s all about offering quality of life to those who serve the United States. After all, the goal is to guarantee all are supported in this caring nation.
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