“Celebrating 25 Years as the Voice of the Army Family” HQDA 2009 Army Family Action Plan Conference January 2009 Alexandria, Virginia

“Celebrating 25 Years as the Voice of the Army Family” Mobilization, Deployment and Family Readiness Strengths 1.Military One Source 2.Family Morale, Welfare and Recreation Programs and Army Family Programs 3.Reintegration Program (Assists Soldiers and Families readjust post-deployment) 4.Leadership Awareness of the Importance of Family Support 5.Rest and Recuperation Leave

“Celebrating 25 Years as the Voice of the Army Family” 1. Length of Dwell Time between Deployments 2. Keeping Remote Families Informed and Connected with the Unit 3. Inconsistent Command Support for Family Readiness Groups 4. Increase in Domestic and Substance Abuse 5. Simultaneous Dual Military Deployment of Family Members (Increases the difficulty of care of Family members during deployment) Mobilization, Deployment and Family Readiness Challenges

“Celebrating 25 Years as the Voice of the Army Family” Critical 6 Active AFAP Issues 1. Issue 497: Distribution of Montgomery GI Bill Benefits to Dependents 2. Issue 578: Paternity Permissive TDY 3. Issue 521: In-State College Tuition 4.Issue 605: Table of Distribution and Allowance Position for Garrison BOSS Program 5. Issue 524: Military Spouse Unemployment Compensation 6. Issue 617: Federal Hiring Process for Wounded Warriors

“Celebrating 25 Years as the Voice of the Army Family” Top 5 Conference Issues 4. Shortages of Medical Providers in Military Treatment Facilities (MTF) 3. Secure Accessible Storage for Soldiers Residing in Barracks 2. Official Photographs for Soldiers 1. Bereavement Permissive TDY 5. Availability of Standardized Respite Care for Wounded Warrior Caregivers

“Celebrating 25 Years as the Voice of the Army Family” Issue Full Briefs

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Benefits and Entitlements

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Bereavement Permissive Temporary Duty (TDY) SCOPE: A military leave category for bereavement does not exist. Multiple permissive TDY categories exist but none authorizes non-chargeable bereavement leave. Soldiers take chargeable leave or a pass in the event of the death of an immediate Family member. Responsibilities associated with the death of a Family member may require more time than accrued leave or a pass. Insufficient time for grieving the loss of a Family member and administering responsibilities impacts the Soldier/Family’s ability to mourn and recover from a traumatic loss. RECOMMENDATION: Establish a permissive TDY category for bereavement.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Service Members Group Life Insurance (SGLI) Cap SCOPE: The SGLI cap of $400,000 is insufficient for many Families. The SGLI cap may be inadequate to secure surviving Families’ financial stability when considering the cost of living and accrued debt at time of death. Consequently, many Soldiers purchase supplemental insurance at significantly higher rates in addition to SGLI. Enabling Soldiers to purchase additional benefits through the SGLI ensures their insurability and offers affordable financial security in the event of death. RECOMMENDATION: Increase SGLI cap incrementally to $1,000,000.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Employment

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Career Coordinators for Army Wounded Warrior (AW2) Soldiers and Their Family Members/Caregivers SCOPE: The AW2 Program lacks sufficient Career Coordinators to assist AW2 Soldiers/Families with transition. A four-coordinator Career Cell serves 3,814 Soldiers, Families, and supports 120 advocates. Last year, AW2 Soldiers increased by 1,315 with a significant increase projected. The career management standard is 1:30; the ratio of coordinators to Soldiers is 1:953. This prevents effective career coordination, employer network development, or long-term management for the complex employment/education issues. RECOMMENDATION: Increase authorizations/funding for coordinators assigned to AW2 Program to reach a 1:30 standard.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Death Gratuity for Beneficiaries of Department of the Army (DA) Civilians Killed in Military Contingency Operations SCOPE: The preferred beneficiary of a DA Civilian killed in a military contingency operation is not always allowed to receive 100% of the gratuity. DA Civilians’ eligible survivors (spouse, children, parents, siblings) receive up to 100%. Other beneficiaries (foster child, fiancée, grandparent, etc.) are only authorized up to 50%; the rest is paid to an eligible survivor or stays with the government. Soldiers’ beneficiaries receive 100%, regardless of their relationship. By differentiating between DA Civilian beneficiaries, the government fails to fully recognize the significance of all survivors’ loss. RECOMMENDATION: Authorize 100% to be paid to any person(s) designated by the DA Civilian regardless of their relationship.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Family Support I

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Dedicated Special Needs Space within Child, Youth, and School (CYS) Services SCOPE: CYS Services spaces across the Army are often not dedicated to support special needs children and youth. While AR , Child Development Services, authorizes each garrison commander to set aside a percentage of spaces, no Army level uniformity exists. Failure to provide these dedicated spaces for special needs children could negatively impact the Family financially, denies the child opportunities to participate in CYS Services, and denies quality consistent care afforded to Army Families. RECOMMENDATION: Dedicate child and youth spaces within Army CYS Services in order to accommodate special needs children.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Temporary Lodging Expense (TLE) Duration SCOPE: The 10-day limitation on TLE is insufficient to allow Soldiers and Families to familiarize themselves with the local area and secure adequate/affordable housing. TLE duration has not been increased since 1 Apr 94. Under FY94 National Defense Authorization Act, TLE duration was increased from 4 to 10 days. Increasing TLE will provide adequate time to complete military in-processing requirements, obtain affordable housing, enroll Family members in schools/childcare, and support quality of life. RECOMMENDATION: Increase duration of TLE to 20 days.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Family Support II

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Collaborative Community Support of Severely Wounded, Injured, and Ill Soldiers and their Families SCOPE: Many communities are not aware of how to support returning wounded Soldiers. The support network between community resources and Soldiers/Families is inconsistent. This network is essential to the long term recovery and reintegration of these Soldiers/Families. RECOMMENDATIONS: 1.Implement/communicate a support program that connects community resources with Soldiers/Families. 2.Implement a management plan that evaluates the effectiveness of the support program.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Availability of Standardized Respite Care for Wounded Warrior Caregivers SCOPE: Standardized respite care is not available to all Wounded Warrior caregivers. The lack of availability exists due to inconsistencies in areas such as: information, reimbursement, policy, personnel, and location. Caregivers of Wounded Warriors commonly suffer burn-out and compassion fatigue. A Soldier’s ability to sustain activities of daily living is directly associated with the well being of the caregiver. The lack of availability of standardized respite care for these caregivers jeopardizes the caregiver’s stability and negatively affects the recovery of his/her Soldier. RECOMMENDATION: Provide uniform availability of standardized respite care to all caregivers of Wounded Warriors.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Force Support

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Funding for Better Opportunities for Single Soldiers (BOSS) SCOPE: The BOSS program is the only Army program that exclusively supports single Soldiers and single parents, yet there is no consistent funding. Army statistics indicate 47 percent of the active duty population falls into this category, not including National Guard, Reserve, and geographically separated Soldiers. Failure to provide dedicated funding puts the future of BOSS at risk, impacting one of the Army’s largest demographics. RECOMMENDATION: Mandate funding for BOSS in POM

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Official Photographs for All Soldiers SCOPE: Official photographs are not required for all Soldiers. The Army requires an official DA photograph at certain grade levels. There is no official photograph available to the media that provides a professional head and shoulder view of the Soldier with individual achievements. Personal photos have been used in the media to identify Soldiers. Inappropriate or grainy photos do not accurately reflect the professionalism of the Army or the Soldier. Having an official photograph of this type on file would ensure Soldiers are portrayed in a dignified and respectful manner. RECOMMENDATION: Require a professional quality official or semi- official head and shoulder photograph for all Soldiers.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Housing and Facilities

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Secure Accessible Storage for Soldiers in Barracks SCOPE: A significant number of Soldiers residing in barracks lack sufficient secure accessible storage for their Organizational Clothing and Individual Equipment (OCIE) and personal items. The quantity and size of required issue items have increased dramatically due to deployments. Despite the fact that newly constructed billets include accessible storage cages/areas, the vast majority of existing barracks still lack this essential capability. Lack of sufficient secure accessible storage outside the Soldiers’ authorized living space negatively affects their quality of life by forcing them to live in overcrowded conditions. RECOMMENDATION: Provide secure accessible storage space for Soldiers’ OCIE in a location separate from living space.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Homeowners Assistance Program (HAP) Expansion SCOPE: HAP does not address the needs of Service Member homeowners with permanent change of station (PCS) orders, non- covered BRAC organizations, Wounded Warriors, nor Surviving spouses. Large numbers of homeowners have upside down mortgages due to declining real estate markets. These homeowners will not qualify for other congressionally approved programs because they cannot remain in their homes. Service member homeowners required to PCS, non-covered BRAC organizations, Wounded Warriors, and Surviving spouses are susceptible to catastrophic financial loss. RECOMMENDATION: Expand HAP to provide financial support for service member homeowners required to PCS, non-covered BRAC organizations, Wounded Warriors, and Surviving spouses.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Medical and Dental I

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Medical Nutrition Therapy (MNT) Benefits for All TRICARE Beneficiaries SCOPE: MNT is not a TRICARE benefit. MNT is the assessment and appropriate use of nutrition therapy for a patient, and is provided at Military Treatment Facilities (MTFs) with dietitians on staff. MNT is not always available due to deployments, duty station, and appointment availability. Research shows MNT plays a vital role in wellness and disease management and can potentially save the Army up to $6.2M. Providing MNT benefits will reduce out-of-pocket expenses for beneficiaries and reduce overall healthcare costs for TRICARE. RECOMMENDATION: Establish MNT as a TRICARE benefit for all beneficiaries.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: 24/7 Out-of-Area TRICARE Prime Urgent Care Authorization and Referrals SCOPE: TRICARE Prime beneficiaries are unable to obtain 24/7 out-of-area authorizations and referral assistance for urgent healthcare services. Beneficiaries are required to obtain authorizations from their enrollment sites in order to receive urgent care when traveling outside of their area. TRICARE beneficiaries do not have a streamline one call/one resolution process when urgent care needs are required. Out-of-area referral/authorization process is confusing, untimely, does not help beneficiaries find needed care, and imposes an unnecessary demand while traveling. RECOMMENDATION: Establish a 24/7 centralized toll-free process for TRICARE beneficiaries to request and acquire out-of-area urgent care authorization and referral assistance.

“Celebrating 25 Years as the Voice of the Army Family” Work Group: Medical and Dental II

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Comprehensive Strategy for Over Medication Prevention and Alternative Treatment Options for All Military Healthcare System (MHS) Beneficiaries SCOPE: No comprehensive strategy exists for over medication prevention and alternative treatment options for MHS beneficiaries. Patients, Families, and providers are not adequately educated about over medication and alternative treatment options. The lack of alternative treatment options and/or rehabilitative resources for all beneficiaries contributes to over medication and adversely impacts the function and quality of life. RECOMMENDATION: Authorize and implement a comprehensive strategy to optimize function and manage pain, including but not limited to alternative therapy and patient/provider education, for all MHS beneficiaries.

“Celebrating 25 Years as the Voice of the Army Family” TITLE: Shortages of Medical Providers in Military Treatment Facilities (MTFs) SCOPE: Demand for healthcare exceeds provider availability in MTFs. The Army’s projected growth increases this demand. Statutes limit salaries, incentives, and contracts exacerbating recruiting and retention of medical providers. The lack of providers affects timeliness of medical services, impacts Soldier medical readiness, and the health of Family members and retirees. RECOMMENDATIONS: 1.Expedite staffing of military, civilian, and contracted medical providers to support prioritized needs as identified by the MTF Commander. 2.Implement new strategies for recruiting and retaining medical providers for MTFs.

“Celebrating 25 Years as the Voice of the Army Family” Thank you to our Army Family Action Plan Sponsors

“Celebrating 25 Years as the Voice of the Army Family” “AFAP... Celebrating 25 Years as the Voice of the Army Family”