TRO South/Humana Military Health System
Below are three Good News stories from TRO-South for the treatment of RSM. These stories are a result of the informal network established by the TRO and the voluntary Warrior Navigation Assistance Program set up by Humana Military, the South Region MCSC.
While these stories show an effective collaboration between multiple government and civilian agencies, these successes are more a result of networking than the recently established Recovery Plan. We believe such efforts will only be enhanced when we are allowed to interact with the Federal Recovery Coordinators in our region.
Coordination with MTFs and VA
Behavioral Health (Depression)–Intervention
Situation: A recently medically retired combat veteran from Oklahoma City was out of his medication and was having much difficulty accessing the VA and TRICARE services to obtain medication.
Response: Air Force Wounded Warrior offices contacted TRO-South, which was able to break the roadblock in communication with the MTF, and within 24 hours, he was seen by a provider and obtained his medication. The Veterans Benefits of America was contacted and was able to expedite his disability claim.
Coordination Between Regions
Situation: The South Region MCSC received a telephone call from ADSM. ADSM stated that he has been in a lot of pain and has been taking medications for his pain. Subsequently, he admitted himself for rehabilitation and stopped taking some of his medications in an attempt to wean himself off of his prescribed medications. He was very frustrated with TRICARE, because his prescribed medication was not covered on an outpatient basis. He also expressed frustration with the military because he did not get paid for his monthly Basic Housing Allowance, which resulted in him incurring out of pocket expenses. He felt as though the military had “dropped” him. He also shared that he has been depressed to the point of wishing he was dead, and that he has had suicidal thoughts in the past.
Response: Humana called 911 while they stayed on the phone with ADSM until the emergency medical services and the local authorities arrived. The MTF to which this ADSM is assigned was contacted, and a military case manager was briefed. The case manager gave approval for necessary referrals to civilian specialists and made contact with the member. He was referred to a resource regarding not being paid for his basic housing allowance. The MCSC contacted Express Scripts and the prescription issue was resolved in the member’s favor. A follow-up phone call was made to the member, who indicated he had been seen by a psychiatrist, but the Service member started to get upset again, and the MCSC facilitated an immediate call with his MTF Case Manager.
Situation: TRO-South was contacted by Navy Medicine to assist ADSM who had been in a North Region MTF for two years with a spinal fracture. The family requested that the member be moved closer to home to continue treatment.
Response: TRO-South contacted a Center of Excellence in spinal rehabilitation in the member’s hometown and coordinated a Medical Director-to-member’s physician conference. The South region MSCS was brought on to coordinated care between the South, North, and MTF Case Managers. The care was approved and transfer coordinated between different regions, MTF, and Rehab Center. Member’s family was involved in the care plan once the rehabilitation center accepted the member to ensure smooth transition. Once TRO-South was notified, the AD member was at home with his family in two weeks, while receiving top notch outpatient care.