ATTACHMENT 11 - Executive Action Joint Fact Sheet.pdf

JOINT FACT SHEET

DoD and VA Take New Steps to Support the Mental Health Needs of Service Members and Veterans

Today, President Obama will announce 19 new executive actions that the Departments of

Veterans Affairs (VA) and Defense (DoD) are taking to improve the mental health of service members, veterans and their families. Today’s announcement builds on the actions the

Departments have taken in response to the President’s 2012 Executive Order on service members, veterans and their families’ mental health. In response to the Executive Order, VA has increased its mental health staffing, expanded the capacity of the Veterans Crisis Line, and enhanced its partnerships with community mental health providers. DoD is reviewing its mental health outreach programs to prioritize those with the greatest impact; DoD and VA worked to increase suicide prevention awareness and, DoD, VA and the National Institutes of Health jointly developed the National Research Action Plan on military and veteran’s mental health to better coordinate federal research efforts. These efforts and actions represent the latest in DoD and the

VA’s continued commitment to ensure that this Administration is working to fulfill our promises to service members, veterans and their families, and we will continue to look for additional ways to do so in this space, both thorough our work and work with the private sector.

Today’s executive actions include:

Improving Service Members’ Transition from DOD to VA and Civilian Health Care

Providers

Supporting service members with mental health conditions in making the transition to VA care: DoD will ensure that all service members leaving military service who are receiving care for mental health conditions are automatically enrolled in the inTransition program, through which trained mental health professionals assist service members in transitioning to new care teams in VA or the community. Currently, service members must be referred to inTransition by their DoD providers or seek out the program on their own.

Ensuring continuity of mental health medications during the transition from DoD to

VA: VA is revising its drug formulary policy to ensure that service members leaving military service and enrolling in the VA health care system maintain access to mental health medication prescribed by an authorized DoD provider, regardless of whether the medication is currently on the VA formulary, unless the health care provider identifies specific safety or clinical reasons to make a change. Currently, VA providers must seek a waiver to maintain a transitioning service member on a DoD-prescribed mental health medication if it is not on the VA drug formulary. VA and DoD will inform service members, Veterans and prescribers about this new policy.

Coordinating care between DoD and VA: DoD and VA recently signed a

Memorandum of Understanding on integrated complex care coordination, ensuring that

DoD and VA will work together to develop a single joint, comprehensive plan for service members transitioning from DoD to VA with multiple, complex, severe conditions such as traumatic brain injury, psychological trauma, or other cognitive, psychological, or emotional disorders. Each comprehensive plan will address the service member/Veteran’s goals for recovery, rehabilitation, and reintegration, and will be visible to the patient, family, and Care Management Team.

Improving Access and Quality of Mental Health Care at DoD and VA

Integrating peer specialists into primary care: Today, VA is announcing that it will pilot the expansion of peer support beyond traditional mental health sites of care to

Veterans in primary care settings. Peer specialists are Veterans trained to help other

Veterans and will work with primary care teams to help improve the health and well-being of Veterans being treated in primary care settings. VA’s pilot will place 1-to-2 peer specialists in 25 primary care sites. DoD will also initiate a peer support pilot project that will embed peer coordinators at 30 Special Operation Forces locations utilizing the same

Reciprocal Peer Support model as the Vets4Warriors program.

Supporting TRICARE mental health parity: Although, TRICARE is not subject to the

Mental Health Parity and Addiction Equity Act of 2008, DoD is taking action to change its operations to meet the intent of the law. DoD has initiated action to do what it can under its authority to eliminate quantitative limits for mental health care. DoD is continuing to work with Congress to bring its mental health and substance use disorder care coverage up to full parity with medical or surgical conditions.

Enhancing mental health care where service members work: DoD has been moving mental health care to where Soldiers, Sailors, Marines and Airmen work – in operational units. To support this work, over the next 12 months, DoD will: 1) expand to all

Services the Behavioral Health Data Portal, a secure, automated system the Army uses to allow providers, patients and clinical leaders to access vital patient-centered clinical outcomes data for mental health conditions and substance use disorders, even in austere settings such as deployed operational units, 2) aggregate and analyze data on the effectiveness of forward-located care delivery models for improving behavioral health and other key outcomes, and 3) design a study to determine if this approach is equal to or more effective than the traditional way in which patients seek care within a clinic or hospital setting. DoD has also expanded eligibility for non-medical counseling through

Military OneSource, the 24/7 resource for service members and their families, and

Military Family Life Counselors who provide anonymous help while embedded at installations at the unit level, at child development centers and youth centers.

Continuing our commitment to improve treatments for mental health conditions including

PTSD

Harnessing the efforts of researchers from DoD, VA, the National Institutes of

Health and academia: Today, the Administration announced the White House BRAIN conference which will take place this fall. This event will feature numerous panels on

PTSD and TBI, with a goal of further advancing efforts fostered by DoD, VA, and programs such as the INTRUST consortium.

Advancing cutting edge PTSD research: As part of the BRAIN Initiative, the Defense

Advanced Research Projects Agency (DARPA) is announcing a new $78.9 million five year research program to develop new, minimally-invasive neurotechnologies that will increase the ability of the body and brain to induce healing . The technology may help in the management of many diseases, including PTSD.

Early detection of suicidality and PTSD: The Department of Defense and the National

Institutes of Health are launching a longitudinal project focused on the early detection of suicidality, PTSD, and long term effects of TBI, and other related issues in service members and Veterans. This research will guide the development of novel prevention and treatment efforts in support of the women and men who have served our country. The overall goal of this initiative is to rapidly translate findings and develop effective interventions.

New investments in suicide prevention: The Department of Veterans Affairs is conducting a national clinical trial on strategies to help prevent future suicidal related activities among Veterans who have survived a recent attempt. The $34.4 million study will involve over 1,800 Veterans at 29 VA hospitals nationwide.

Raising Awareness About Mental Health and Encouraging Individuals to Seek Help

Promoting Vet Centers as a counseling resource for combat Veterans and their families: First Lady Michelle Obama and Dr. Jill Biden’s Joining Forces initiative is partnering with VA to raise awareness about Vet Centers, and encourage Veterans and their families to seek help at these facilities. There are currently 300 Vet Centers, located across the United States, which provide counseling services to combat Veterans and their families, regardless of eligibility status for VA health care.

Training DoD and VA employees to recognize the signs and symptoms of mental health conditions and help connect people in need to help: Just like people can learn first aid for physical health conditions, they can learn the basic signs of mental health problems and how to help someone to get help when needed. Currently, VA provides suicide prevention training during orientation for all Veterans Health Administration employees. VA also provided this training to Veterans Benefits Administration employees in FY 2013. Today, the VA is announcing that it will expand this suicide prevention training in two ways. First, Veterans Health Administration clinicians will be required to renew online suicide risk management training every three years. This refresher training will help further cement suicide prevention principles into the work of

VA clinicians. Second, all other staff members who interact with Veterans will participate in the Department of Veteran Affairs “Operation SAVE” suicide prevention training every two years. DoD will also expand existing mental health training for all service members and improve chaplain training to recognize and refer service members in need to mental health care.

Expanding mental health awareness campaigns: DoD and VA awareness campaigns to reduce stigma surrounding mental health care and encourage people experiencing mental health problems to get help include VA’s Make the Connection campaign and

DoD public service announcements such as “Welcome Home” and “In Your Hands”. In addition, DoD policy and instructions emphasize to commanders the importance of treating mental fitness in the same proactive manner as physical fitness. DoD and VA will expand existing mental health awareness campaigns that have proven benefits for the military and Veteran populations, and will regularly report on metrics for these efforts through the Cross Agency Priority Goal and Interagency Task Force on Military and

Veteran Mental Health.

Providing mental health awareness training more broadly: For example, in partnership with the Department of Veterans Affairs, the Treasury Department will begin a new initiative to include mental health awareness training for volunteer tax preparers who will be in place at over 200 facilities in the next three years as part of an existing initiative.

Improving Patient Safety and Suicide Prevention

Expanding access to opiate overdose reversal kits: DoD is making a new commitment to ensure that opiate overdose reversal kits and training are available to every first responder on military bases or other areas under DoD’s control.

Providing new opportunities for service members, Veterans, and their families to give back unwanted medications: Today, DoD and VA are announcing new programs to make it easier for service members, Veterans, and their families to safely dispose of unwanted prescriptions in their facilities, reducing the opportunities for abuse.

Supporting suicide prevention: Over the next 12 months, DoD will implement a policy to facilitate requests for at-risk service members or at-risk military family members to voluntarily secure their firearms. Additionally, VA will provide coaching and support regarding safety plans for suicide prevention, with a focus on increasing safety in the home, and work with Veterans Service Organizations and others to encourage friends or community groups to help improve firearm safety for Veterans in distress.

Strengthening Community Resources for Service Members, Veterans, and Their Families

Expanding cultural competency training: While any individual can experience a mental health condition, service members, Veterans, and their families may experience additional stressors unique to military service. Community providers may be able to better serve these individuals through understanding military culture and the experiences of service members and their families. DoD and VA will disseminate their new military cultural competency course to 3,000 community mental health providers during FY 2015.

Supporting construction of medical facilities in communities with large veteran populations: The Treasury Department and the Department of Veterans Affairs are working together to identify communities in need of veteran mental health facilities and develop targeted outreach to community development entities (CDEs) in those markets, including community development financial institutions (CDFIs), to take advantage of

Treasury programs that support these efforts.