Between 2001 and 2011, 2.2 million service members were deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) (Sayer, 2011). In the era of the all-volunteer force, the pace and demands of these conflicts have led to longer and more frequent deployments and historically high levels of participation by reserve forces (Hosek, Kavanagh and Miller, 2006; Chu, Speakes, and Gardner, 2007). Improvised explosive devices have been used extensively against U.S. forces during these conflicts and have been one of the leading causes of death. Injuries among those who survive an improvised explosive device blast often include...

This chapter provides an overview of the program structure, staffing, and administrative lines of authority. CCP’s decentralized nature has advantages but also creates challenges, as RCCs both report to CCP headquarters and reside in a local facility. In this chapter, we outline the implications of these program characteristics, highlighting innovative practices and lessons learned.

As noted above, DVBIC is the operational component of DCoE that provides such services as population-level TBI screening, health care provider training, and direct support to service members and veterans affected by TBIs. DVBIC headquarters are located in Washington, D.C., and there are 17 care and...

Given CCP’s decentralized administrative structure, most RCCs must be able to work independently and, in some ways, run their own “offices.” Administrators at CCP headquarters note that they explicitly hire for this trait and also expect and encourage independent functioning. Perhaps in part due to this requirement, the program hires a cadre of highly skilled and educated care coordinators. Other case management programs may rely on bachelors-level staff, but CCP recruits licensed clinicians. Thus, the RCCs themselves are one of the unique and innovative components of the program.

Each RCC is a licensed nurse or has a masters-level education in...

This chapter provides detail on the eligibility criteria for CCP services and the population served. It also describes the referral process and how individuals become engaged with the program. These criteria, target populations, and referral sources were developed at the height of the OEF/OIF, with an eye toward ensuring that those most likely to benefit from program services were identified and engaged. However, given the changing landscape of U.S. military involvement overseas and the impending drawdown of troops, the previously defined criteria and approaches to identifying eligible populations are beginning to introduce a variety of challenges that may threaten program...

Outreach to both referral organizations and to individuals who may benefit from the program is considered both an essential feature of the program and a critical factor in its sustainability. Nevertheless, our findings suggest that current outreach and referral strategies may not be reaching certain populations for whom DVBIC CCP services may be beneficial. In fact, outreach was almost uniformly mentioned by RCCs as the one area in which the program could be improved. This includes both direct outreach to potential clients to inform them of the CCP and outreach to DoD, VA, and community-based services to further expand and...

The DVBIC CCP addresses a well-documented gap in health care provision for service members with TBI by providing a unique and crucial bridge across systems of care and geographic regions. Our assessment of the program identified a number of innovative practices, summarized at the conclusion of each chapter. Perhaps the most notable strength of the program, as identified by the RCCs, is their focus on identifying and serving individuals who may otherwise fall through the cracks. Unlike other care coordinators or case managers, who are limited in both scope and geographic reach, RCCs are individually and at times collectively able...