- Contact the Committee

Mr. Chairman and distinguished members of the Committee, thank you for the opportunity to come before you today to discuss Invitational Travel Orders and support of family members of wounded and ill Soldiers sent to VA Medical Centers from military treatment facilities. This is an area we recognized was in need of work, and we appreciate the opportunity to share our systemic improvements with you.

An Invitational Travel Order (ITO) is a mechanism used by the Army to cover transportation and sustainment costs for individuals. ITOs have a wide-variety of uses. A Non-Medical Attendant (NMA) order is a particular type of ITO that allows family members of injured Soldiers to travel from home or a military medical treatment facility to another medical treatment facility, including civilian and VA facilities. Even before the start of the Global War On Terror, the use of NMA orders was a fairly common practice. The authority for issuing NMA orders is clearly outlined in the Joint Federal Travel Regulation and Military Medical Treatment facilities are very familiar with the NMA process.

NMA orders are issued when medical authorities determine that a non medical attendant is in the best interest of the patient. They are normally issued when a patient is unable to travel alone due to physical or mental disability. The orders are issued and funded by the military treatment facility responsible for providing medical care. NMA orders authorize reimbursement for travel, lodging, and meals. They are not open-ended, but extensions are possible on a case-by-case basis.

Since the beginning of GWOT, the Army’s Human Resources Command (HRC), Casualty Branch has issued ITOs to bring family members from their homes to the bedside of their injured Soldier while they are hospitalized in a military treatment facility. These ITOs are different from the NMA orders issued at military treatment facilities. In the past, there has been some confusion between ITOs issued by HRC and NMA ITOs issued by military treatment facilities. Once Soldiers were transferred to the VA facilities, HRC no longer had visibility of the Soldiers and family members. When ITOs expired, HRC was unaware of the situation. Once this was identified as a systemic flaw, action was immediately taken to correct the process. Instead of extending existing ITOs by HRC to cover the Soldier’s family member at the VA facility, Army MTFs are now issuing NMA orders authorizing family member travel to VA facilities. This allows the MTF to transfer the Soldier and family member to the appropriate civilian or VA facility for continued care without requiring HRC to amend the existing ITO or issue a new travel order. The MTF has the medical authority required to issue and extend the Attendant order as well as the patient tracking systems necessary to know where patients are located and when they will be transferred.

ITO and NMA orders for family members of Operation Iraqi Freedom and Operation Enduring Freedom casualties are funded using GWOT supplemental dollars. When the Soldier is discharged from a VA facility or medically separated or retired, funding of family member by the Department of Defense stops.

Although this new process has only been in place for two months, we are already seeing improved results. In addition, we have placed senior Army medical department representatives at the four VA Poly-Trauma Centers to provide continuous support to our Soldiers and their families. The seamless transition of Soldiers and their families from military treatment facilities to VA Centers is an integral part of providing care to our Soldiers. NMA ITO orders issued and tracked by MTFs will improve this important transition. Whether Soldiers are receiving medical care at an Army hospital or a VA medical center, the Army is committed to providing world-class, compassionate care to our wounded warriors and their families.

Thank you for the opportunity to appear before the committee.