Warrior Care Recovery Care Coordinator (RCC) and Recovery Team s Roles and Responsibilities

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Warrior Care Recovery Care Coordinator (RCC) and Recovery Team s Roles and Responsibilities March 2018

Objectives Define Recovery Team List possible members of the Recovery Team Describe the Recovery Team s roles and responsibilities Explain the collaboration process of the Recovery Team 2

What is a Recovery Team? A group of professionals from diverse disciplines who come together to provide comprehensive assessment, consultation and Care Plan development for Service members and their family and caregivers. (Often referred to as a Care Management Team.) 3

Recovery Team Members DoDI 1300.24, Enclosure 3, 4a All Recovery Teams shall include the recovering Service member s (RSM s) commander, RSM, a Recovery Care Coordinator (RCC) or Federal Recovery Coordinator (FRC), a Medical Care Case Manager (MCCM), and a Non-Medical Care Manager (NMCM). They may also include medical professionals such as primary care managers, mental health providers, physical and occupational therapists, and others such as Physical Evaluation Board Liaison Officer (PEBLO), VA Medical Services Coordinators (MSC), chaplain and family support program representatives. Variations in the Field Medical Care Case Managers: Primary Care Physician/Manager, Nurse Case Manager, Behavioral Health Providers Non-Medical Care Managers: RCC, FRC, Advocate, Liaison Commander/Chain of Command: Squad Leader, Platoon Sergeant 4

Recovery Team Roles & Responsibilities Develop and continually evaluate the Care Plan with the recovering Service member Provide "checks and balances" to ensure that the interests and rights of the Service member and family/caregiver are addressed Identify service gaps and breakdowns Evaluate the support system (family/caregiver) of the Service member Collaborate with the recovering Service member and family/caregiver to resolve difficult issues 5

Key Recovery Team Roles Recovery Care Coordinator (RCC) Primarily responsible for the review and assistance of recovering Service member and family care management throughout the Continuum of Care Oversees the development and execution of the Care Plan Non-medical Care Manager (NMCM) Assists the Service member in resolving problems involving financial, administrative, personnel, transitional, and other matters that arise during care, recovery and transition Caregiver and Family Caregivers/family control their own level of involvement in the care and support of recovering Service members Caregivers are designated by the Service member 6

Key Recovery Team Roles, cont. Medical Care Case Manager (MCCM) Assists the recovering Service member throughout the Continuum of Care in the 1) receipt of medical care and 2) review of medical status Federal Recovery Coordinators (FRC) Provides assistance and coordination for the care, management and transition of catastrophically injured Service members on active duty and veteran status 7

Recovery Team Meetings Recovery Teams meet based on policy and recovering Service member s needs and the RCC should attend if possible. What happens in the Recovery Team meeting? review current status (health care, mental health, well-being) gather input from all team members create and implement plans for the future Recovery Teams are as diverse as the communities in which they reside. some teams may work together very well, others may not they vary in their level of formality the role of the RCC may vary on different teams 8

RCC Daily Activities Recovery Rehabilitation Reintegration Collaborate with Recovery Teams to ensure the recovering Service member and family/caregiver have access to all available services Develop, implement and oversee the Care Plan in accordance with governing program guidance Coordinate with key personnel to facilitate effective rehabilitation and reintegration Address and support family/caregiver s needs as they relate to the Care Plan, and assist in coordination of local and state resources Coordinate and monitor non-medical services and identify gaps in non-medical service; assist with coordination or resources needed to develop and improve the outcome for enhanced delivery of nonmedical services 9

Discussion: What Can You Contribute to the Team? 10

What Can You Contribute to the Team? Connect the team to a wealth of resource knowledge Share prior interventions that have proven to be successful/unsuccessful Build a bridge of communication between multiple resources Clarify the role of a resource Build resource networks Discuss relevant concerns expressed to you by the recovering Service member and family/caregiver with their permission 11

What Can You Contribute to the Team? (cont.) Communicate clearly Understand each member s role, how you can work together, and what is expected of you Ensure realistic expectations Follow up do what you say you will Provide flexibility and creative solutions Exhibit an open mind 12

Small Group Activity: Staff Sergeant Jones Recovery Team 13

Case 2: Staff Sergeant Jones Case History: Traumatic Open Brain Injury from motorcycle accident 18 months ago Limited use of his left hand and left foot Speech impediment that makes it difficult for him to communicate Numerous surgeries, including two cranioplasties (Walter Reed Bethesda); spent time in Tampa, VA; and then Quality of Life Institute in Nebraska for 6 months of rehabilitation Inpatient for first year of recovery; not assigned to Marine Corps Wounded Warrior Battalion until two months ago Currently undergoing IDES Background: Not coping well with pain meds, cannot sleep, poor memory Father and stepmother, Sunni, are primary caregivers; SSgt Jones relies heavily on stepmother for support Father works FT and stepmother quit work to care for SSgt Jones Stepmother moved from her home in Padukah, KY to live with SSgt Jones in Camp Lejeune, NC Wants to move his home of record to Padukah, KY 14

Possible Recovery Team Members Command Leadership Medical Care Case Manager Non-Medical Care Manager Recovery Care Coordinator Federal Recovery Care Coordinator Advocate Primary Care Managers Mental Health Providers Chaplain Physical Therapist Orthopedic Therapist Speech Therapist Physical Evaluation Board Liaison Officer (PEBLO) Military Liaisons Family Support Programs Department of Veterans Affairs/Transition and Care Management Services Occupational Therapist Caregiver/Family Member 15

Objectives Review Define Recovery Team List possible members of the Recovery Team Describe the Recovery Team s roles and responsibilities Explain the collaboration process of the Recovery Team 16

Warrior Care Recovery Care Coordinator (RCC) and Recovery Team s Roles and Responsibilities