VA Losing Care Coordinators

Army Times

June 27, 2008 – The Department of Veterans Affairs has trouble keeping medical care coordinators for severely injured combat veterans, with four of the first eight people having to be replaced.

Two of the original Federal Recovery Coordinators hired late last year quit, and two have died, VA officials confirmed Thursday.

“Of the original eight, two have tragically died and two left the program for personal reasons,” said VA spokeswoman Josephine Schuda.

VA officials and congressional aides, speaking on the condition of not being identified, said they knew that the jobs were going to be stressful — dealing with seriously ill or wounded combat veterans who have especially complex needs can be demanding — but no one anticipated such high turnover.

“There is something called compassion fatigue that affects caregivers and families, and I can see that being magnified for someone who feels responsible not just for one severely injured person but several,” said a senior VA official. “We do know how someone might deal with this job, but we do know it is not for everyone.”

Military and veterans officials testifying in March before the Senate Veterans’ Affairs Committee said the central tenet of the coordinator program was to manage clinical treatment and administrative matters for the injured veteran and their family, helping them maneuver through the systems and prevent anything from falling through the cracks.

Since the four losses, the VA has hired five more people, giving them a total of nine recovery coordinators. And it plans to hire more, Schuda said. There are two each at Walter Reed Army Medical Center in Washington, D.C; National Naval Medical Center in Bethesda, Md.; and at Brooke Army Medical Center in San Antonio. The Balboa Navy Medical Center in San Diego and the VA medical centers in Houston and Providence, R.I., have one coordinator each, Schuda said.

VA expects to add coordinators at Walter Reed, Balboa and Brooke, Schuda said.

In deciding where and when they should be added, Schuda said defense and veterans officials have “begun tracking workload, geographic distribution and complexity of the conditions and situations of the severely injured service members and veterans served by the program.” She gave no timetable for when the hiring might be done.

Secretary of Veterans Affairs James Peake said in May that having coordinators was a key recommendation of presidential commission that studied federal treatment of combat-wounded service members. The first coordinators were placed at the hospitals considered most likely to receive severely wounded combat veterans.

The panel, called the President’s Commission on Care for America’s Returning Wounded Warriors, was looking for a way to eliminate red tape for people who needed care that might involve the military, veterans and private-sector facilities.

In addition to the federal recovery coordinators, case managers also have been assigned to help combat veterans. Case managers generally work on day-to-day issues, while coordinators are responsible for helping design a longer-term recovery plan.

VA officials said patients aided by the federal recovery coordinators include those with spinal cord injuries, amputations, traumatic brain injuries, debilitating burns and severe mental health issues. Some combat veterans have more than one serious medical issue.

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