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Department of Defense Documents
Army Expanding Community-Based Health Care
1 February 2005
Department of Defense U.S. Army Releases
FORT McPHERSON, Ga. (Army News Service, Feb. 1, 2005) -- The Army is expanding its program to provide medical care close to home for injured reserve-component Soldiers on active duty.
The Community-Based Health Care Organization currently has programs in Florida, Arkansas, Wisconsin, Massachusetts, and California, covering 23 states. In 2005, the Army plans to open six additional locations to bring CBHCO access to Soldiers in all 50 states and Puerto Rico.
CBHCOs are scheduled open in Alabama and Virginia this month, and one is scheduled to open in Utah in March. In addition, Alaska, Hawaii and Puerto Rico are authorized to run CBHCO-like operations from local garrisons and medical treatment facilities starting in February.
The CBHCO began as a means to relieve overcrowding at active Army installations due to a larger number of RC Soldiers needing medical care as a result of Operation Iraqi Freedom mobilization. Many activated RC Soldiers arrived at their mobilization stations needing medical care, said Col. Barbara Scherb, chief nurse and senior officer in charge for medical holdover operations at U.S. Army Forces Command. Most of the Soldiers entering the CBHCO program now are receiving treatment for injuries sustained following deployment, she said.
In April 2004, the Army opened the first of five CBHCOs to allow RC Soldiers who could be treated by medical professionals in their communities to return home. The CBHCOs can expand to treat up to 500 Soldiers if necessary. About1,200 Soldiers are currently assigned to the five CBHCOs, Scherb said.
Allowing Soldiers to return to their communities assists them in making the transition from the deployment environment back to the home environment.
"When they come back, one of the things we have discovered to be very important is to get the Soldiers reconnected with their family and friends and their home support system," Scherb said. "When active-component Soldiers come back from deployments, they return to the [mobilization] stations and they have family and friends at the [mobilization] stations...When RC Soldiers return to the [mobilization] stations, in most cases their family and friends are some place else. If we hold them at the [mobilization] station, that reunion and transition back to their family life is delayed. So by sending them out to the CBHCOs, they can begin the transition back to family life, the reunification with their family and friends while they're getting their medical care."
Only those Soldiers whose conditions can be well treated by civilian doctors in their communities can participate in the CBHCO program, Scherb said.
"Unless they can't find care, they just have no way to get to and from appointments on a daily basis, or if someone is undergoing some sort of UCMJ action, or they have a military-unique illness like Leishmaniaisis--there aren't a lot of civilian physicians who are experienced in caring for Leishmaniaisis--those Soldiers we would try to keep in the military direct-care system at the installations where they can get the most current treatment," Scherb said. Soldiers might also stay on a military installation if moving to the CBHCO would delay treatment or evaluation boards, Scherb said.
Currently, eligible RC Soldiers in need of ongoing medical treatment enter the CBHCO as soon as possible. Once they are settled at home, a care manager from the CBHCO helps them locate appropriate medical personnel, makes medical appointments, and ensures that the Soldiers receive all the care they need.
Each CBHCO is staffed by 31 Soldiers, most of whom are activated Army National Guard Soldiers from National Guard medical detachments; the personnel running the CBHCOs include a commander, a first sergeant, a physician, nurse case managers, a patient administration officer (who also serves as a physical evaluation board liaison officer), patient administration specialists, and other administrative personnel. This staffing allows the CBHCO to function like a micro-installation, Scherb said; the staff is able to handle most if not all of the Soldiers' personnel issues as well as managing the medical care.
Another service performed by the CBHCO is placing Soldiers who are able to work in a suitable work environment. While receiving medical care, the Soldiers also support the Army mission in offices near their homes. National Guard armories and Army recruiting stations are some of the places where Soldiers are working when they are not going to medical or therapy appointments.
The work aspect of the CBHCOs has proved to be "very therapeutic" for Soldier's mental health while they convalesce, Scherb said.
"We've now come to realize that having a job is important to the mental health of these Soldiers. Having to get up in the morning, be someplace, contribute to the Army, gives them the sense that they can work," Scherb said. "Some of these Soldiers will have physical limitations for life. It also helps them when they return to Reserve status, or they're separated and they're looking for a civilian job, they can tell their employer yes, I can work."
(Editor's note: Jamie Danesi writes for FORSCOM News Service.)