Retention Panel: CF Health Services &CF Health … Panel: CF Health Services &CF Health Services & the Primary Reserve Col Kristiana Stevens Di HS R /HS R Ad i Your health - Our mission

Retention Panel:CF Health Services &CF Health Services & the Primary Reserve

Col Kristiana StevensDi HS R /HS R Ad i

Your health - Our mission

Dir HS Res/HS Res Advisor24 Apr 10

Your health Our mission

Votre santé - Notre mission

SCOPE

• Overview of Res Injuries/Fatalities from TF Afghanistan• PRes Health Benefits: Ombudsman Report 2008

QR & O 34.07i di l hPeriodic Health Assessments

ImmunizationsM di l R dMedical RecordsAnnuitant Breaks

S G l’ I t i G id• Surgeon General’s Interim Guidance• New Veteran’s Charter - VAC



PRes/Reg F Deployment Comparison Afghanistan Mission

4686750000

35000

40000

45000

25000

30000

604710000

15000

20000

0

5000

Total 6047 46867Sum of Res F P Sum of Reg F



PRes/Reg F Deployment Comparison Afghanistan Since ROTO 1 Kandahar & RC South

ROTO PRES REG F1 366 24212 351 22543 439 28164 425 32054 425 32055 662 30406 651 31747 598 42548 669 35659 696 287310 338 249511 5 27



PRes/Reg F Injuries & Deaths – (eff 15 Apr 10)Afghanistan – Since ROTO 1 Kandahar & RC South

1508

1500

1750

INJURIES DEATHS

1250

750

1000

186

250

500

15121

0

250

T t l 1508 186 121 15

Reg F Injuries Res F Injuries Reg F Deaths Res F Deaths



Total 1508 186 121 15

PRes Injuries – (eff 15 Apr 10)Afghanistan – Since ROTO 1 Kandahar & RC South

31

35

2524

27

24

21

25

30

21

151415

20

10

111

0

5

14 15 21 24 27 24 25 31 1 1 1

Roto 1 Roto 2 Roto 3 Roto 4 Roto 5 Roto 6 Roto 7 Roto 8 Roto 4 & 7

Roto 4 & 8

Roto 6 & 8



Total 14 15 21 24 27 24 25 31 1 1 1

Reserve Injuries by Mechanism of Injury

109

120

FF–Friendly Fire

100

FF Friendly FireFrag–Fragmentation InjuryGSW– Gun Shot Wound

49

60

80 WoundIED-Improvised Explosive DeviceMVA-Motor Vehicle Accident

20

40

AccidentND-Negligent DischargeTIC-Troops in ContactOther-Non Battle

21

11

27

3

0

Total 3 7 2 49 11 1 2 109

FF A-10 Frag GSW IED MVA ND TIC Other

Other Non Battle Injury/Disease



Reserve Injuries by Occupational Group

9190

100

70

80

40

50

60

30

16

22

20

30

40

69 10

0

10

All others Med Tech Sigs Cbt Engr Artillery Armd - Crewman

Infantry



Totals 30 6 9 10 16 22 91

Reserve Injuries by Force Generator

62

60

70

4750

60

35

30

40

21810

20

11

2142

0Air

ForceArmy CLS

Army LFAA

Army LFCA

Army LFWA

Army SQFT

CF H Svcs Gp

Misc Navy NDHQUnidentified



Total 8 1 21 35 62 47 4 2 1 2 1

Disposition of Res Injuries (eff 15 Apr 10)

122120

140

100

60

80

20

30

20

40

75

0

20

T t l 30 122 5 20 7

TCAT FitMed Rel (3A/3B)

No Med-admin yet PCAT (restr)



Total 30 122 5 20 7

Res Fatalities by Type

BI – Battle Injury12

14

NBI-Non Battle Injury

10

12

6

8

3

2

4

0

2

Total 12 3BI NBI



Res Fatalities by Force Generator

9

8

7

8

4

5

6

2

3

2

3

4

11

0

1

Army LFAA Army LFCA Army LFWA Army SQFT CF H Svcs Gp



Total 3 2 8 1 1

Health Benefit Framework - Reserves

• Provision of health care to Reservists• Consistency in Standardsy• Benefits for injured Reservists• Reserve Administration – Health Records



Challenges/Action

Challenges:• QR and O Ch 34 does not have flexibility to support required changes• QR and O 34.07 revision process: final auth for QR and O 34.07 rests with

MNDAction:

• New Governance framework to cover entitlement/provision of health services to pPRes

• Modify QR and O 34.07• Interim guidance CF H Svcs 16 Jul 09



Challenges/Action

Challenges:• Provide Periodic Health Assessment (PHA) for Primary Reserve Force• Provide Periodic Health Assessment (PHA) for Primary Reserve Force• Not yet a funded activity

Action:Action:• Apply Reg Force Standard to the Primary Reserve• Includes core immunizations/vaccines • Includes PHA data entry into CFHIS



Primary Reserve PHA status (as of Nov 09)

N l R 860 t t di / 4185 d• Naval Res 860 outstanding/ 4185 records• Army Res 6574 outstanding/ 22816 records• Air Res 407 outstanding/1900 records

H S 452 di / 1637 d• H Svcs 452 outstanding/ 1637 records• Others* 514 outstanding/ 2554 records

A 9000 t t di tl l ti t f th i d thiApprox 9000 outstanding currently, plus estimate of those coming due this year (5,200) = 14,200

Current Reg Force medical throughput approx 20,000/yr

*Combined Organizations like CEFCOM, RMC etc



Challenges/Actions

Challenges:• Immunizations

Action:• Publish immunization/vaccination standards for all personnel• Publish immunization/vaccination standards for all personnel

involved in DOMOPs• Create mechanism to provide vaccines to Primary Reserves



Challenges/Action

Challenge:• Inconsistent storage, transport and tracking of paper files

A tiAction: • Health records to travel with reservists during re-enrollment

and component transfers.• Reserve Health records to be safeguarded to same extent as

Reg Force. These should resolve with the advent of CFHIS’ electronic health record (18-24 months)



Challenges/Action

Challenge:• Health Care to Reservists on Annuitant Break

Action:Action:• Issues being addressed by DLaw Mil Pers and Surg Gen • VCDS and DLaw Mil Pers tracking



Interim Guidance Guiding Principles (issued Jul 09)

•Develop a culture of looking after our uniformed force

•Always meet the emergent and urgent health care needs

•Chronic care for members on contract <180 days – bestChronic care for members on contract 180 days best served by their civilian care providers

•Level of care based on clinical need

•Need to better educate the Reserve Force on entitlements

•Must partner with civilian health care system to support the Reservist throughout their career.



Interim Guidance - Specific Care Direction

•All Res members that present to a clinic will at a minimum be•All Res members that present to a clinic will, at a minimum, be evaluated

•Class A ServiceClass A Service

•All duty or training related injuries will be treated until it can be safely transferred to primary care physician. Any necessary spectrum of care p y p y y y pbenefits above provincial benefits will be covered by DND.

•Member will be informed and advised to seek civilian primary care for all chronic or non-duty/training related care




•Class B Service

• > 180 days = same benefits as Regular Force

• < 180 days but part of “rolling” contracts which equal service > 180 days = y p g q ysame benefits as Regular Force

• < 180 days with duty/training related injury will be treated until it can be safely transferred to primary care Any necessary spectrum of care benefits abovetransferred to primary care. Any necessary spectrum of care benefits above provincial benefits will be covered by DND

• < 180 days with chronic or non-duty/training issues will be treated by CF and advised to follow-up with civilian primary care provider. Entitlements (ie glasses, hearing aids, orthotics, CPAP machines) will not be provided as they typically apply to chronic or pre-existing conditions.




Cl C S iClass C Service

= same benefits as Regular Forceg



VAC Service & Benefits

New Veterans Charter – implemented April 2006

Provides support in 3 main areas:

1 Helping Res mbrs get well in collaboration with CF1. Helping Res mbrs get well, in collaboration with CF2. Provide disability benefits as recognition for injuries related

to service in the Reserves3 H l th R i t d hi /h f il l th i t iti3. Help the Reservist and his/her family plan their transition

from military to civilian life

• Details at: www.vac-acc.gc.ca



Health Services Group

• Leveraging Health Services Reserve F experience where iblpossible

• Initiatives to support Reservists on-going• Surgeon General willing to lean forward cooperation key• Surgeon General willing to lean forward – cooperation key

to success



QUESTIONS?QUESTIONS?



Documents

Retention Panel: CF Health Services &CF Health … Panel: CF Health Services &CF Health Services & the Primary Reserve Col Kristiana Stevens Di HS R /HS R Ad i Your health - Our mission