Agenda for 13 Sep 06 Safety Council

1
Agenda for 13 Sep 06 Safety Council

• (0830-0835) Introduction USAREUR, G1
• (0835-0840) Opening Remarks USAREUR, CG
• (0840-0900) 4 May 2006 NTV Accident 18th MP BDE
• Lessons learned and countermeasures
• (0900-0920) 29 May 2006 Vicenza Fatality 173rd AB
  BCT
• Lessons learned and countermeasures
• (0920-0950) PTSD Alcohol/Drug Use ERMC / IMA
  EURO ASAP
• Issues and available resources
• (0950-1010) Combat Readiness Center Update CRC
• Army Safety Update
• Accident Prevention Initiatives
  Countermeasures
• (1010-1015) Winter Own the Edge Campaign USAREUR,
  Safety Division
• 1-2QFY07 Risk Assessment
  Countermeasures
• (1015-1025) Around the Horn USAREUR, G1
• (1025-1030) Closing Remarks USAREUR, CG

2
529TH MP CO (K9) TMP TRAFFIC ACCIDENT04 MAY
06KINDSBACH (KAISERSLAUTERN), GE
529th Military Police Company

3
3
AGENDA

• Personal Data / Background
• Sequence of Events
• Accident Synopsis
• Accident Sketch / Photos
• Causative / Contributing Factors
• Assessment of Unit Safety Program
• After Accident Actions
• Road Ahead
• Questions

4
Personal Data / Background
Sex Male Age 24 Rank SPC MOS 31B1O Time
in Unit lt 3 months Duty Location Pulaski
Barracks, Kaiserslautern

• Background
• Was not identified as a At Risk Soldier
• Attended USAREUR Drivers License Class AUG 02
• Completed TMP Drivers Class MAR 06
• Experienced and mature operator with 9 years of
  experience
• One prior moving violation in the past 9 years
  (speeding, June 2005, Georgia Highway Patrol 11
  mph over the posted)

5
Sequence of Events
3 4 May 2006

• N 17 (1400 1430) Blood drawn by clinic for
  follow-on nutritional counseling Soldier
  informed that more blood will be drawn the next
  day
• N 14 (1700-1730) Soldier had last meal for
  the day
• N 13 (1800 1805) Started fasting IAW
  medical guidance (12 hours prior to)
• N 13 (1805 2230) Watched TV and a DVD
• N 08 (2230 0610) Sleeping
• N 01 (0610 0635) Conducted personal
  hygiene
• N .5 (0635 0650) Drove to the kennels
• N .25 (0650 0700) PMCSd TMP
• N Hour (0700 0706) Enroute to LRMC for
  nutritional appointment

6

Accident Synopsis
Date 4 May 06 Time 0706 Location L-395
Kindsbach, Germany (Off Post) Environmental
Conditions Clear, Dry, 60 F Narrative
Soldier was traveling westbound on L-395 in the
Kindsbach suburb of Kaiserslautern when he lost
control of a TMP vehicle (Soldier stated he
didnt remember the incident) and crossed the
center line into oncoming traffic. Local
National observed Soldier cross the center line
and attempted to swerve to avoid a collision, but
was unsuccessful. The impact of the head-on
collision resulted in both vehicles sustaining
heavy damage. SRS system in Soldiers vehicle
deployed, but the Local National vehicle was not
equipped with any type of airbag
system. Extent/Type of Injuries Soldier
Whiplash, broken bones in left hand and index
finger, knee injury Local National Internal
Injuries, broken bones in arms, legs, ribs and
jaw Accident Reports Local German Police and MP
Reports Completed AGAR Completed
7
Accident Sketch
L-395, adj to Stkm 2,8 between Einsiedlerhof and
Kindsbach
VEH 1
VEH 1
VEH 1
VEH 2
VEH 2
VEH 2
N
W
E
S
8
Accident Photos
Local National vehicle final resting spot
9
9
Accident Photos
Final resting spot of Soldiers vehicle
10
10
Accident Photos
Eastbound view of road L-395
11
11
Accident Photos
Point of Impact
Local National direction of travel
Eastbound view of L-395
12
12
Accident Photos
Soldier
Local National
13
13
Accident Photos
14
14
Accident Photos
15
15
Causative / Contributing Factors

• Soldier received verbal safety briefing prior
  to leaving the kennel.
• Soldier stated he blacked out prior to the
  accident
• All required safety equipment was used
• Alcohol was not a factor
• Heavy traffic on the road way
• No known driving distracters (smoking, eating,
  cell phone)
• Traveling within the posted speed limit

16
Assessment of Unit Safety Program

• Safety Briefings are conducted by the Kennel
  NCOICs for each community every week covering
  topics including vehicle operations, recreational
  activities, and other risk.
• Risk assessments are done covering all normal
  activities covered by routine K9 operations on a
  weekly basis by the USAG kennel master.
• Soldier successfully completed the USAREUR
  Drivers Class.
• Soldier successfully completed the online
  accident avoidance class.
  
• Soldier had a current USAREUR drivers license
  and TMP NTV license.

17
After Accident Actions

• Soldier completed online accident avoidance
  course.
• Soldier completed TMP re-training on 18 August
  2006 in Heidelberg.
• Soldier helped prepare and participated in
  completing Accident Review Board slides.
• Continue to track Local National Civilian, and
  his return to work status.
• Soldier titled with failure to maintain control
  (UR Reg 190-1).
• Command pulled Soldiers license (POV/TMP)
  until medically cleared.
• 23 Aug 06 initial diagnosis is a vasovagal
  syncope (simple fainting) because of fasting and
  recent purposeful weight loss.
• Avoid dehydration.
• If no symptoms recur within 6 months then
  Soldier may resume driving and full duties.

18
Road Ahead

• Continued command emphasis and leader
  involvement at all levels.
• Leaders aggressively involved in reception of
  new Soldiers to assess and identify At Risk
  Soldiers.
• Continue conducting safety briefings, drivers
  training and risk assessments IAW current
  policies.
• Assess nature of medical appointments to
  determine whether or not a driver is required.
• Unit will conduct TMP check ride prior to
  Soldiers driving again.
• Soldier will complete medical screening to
  determine if he is medically cleared to drive a
  TMP/POV.
• Buddy System will be used for Soldiers
  fasting prior to a medical appointment.

19
DAMAGES AND ECOD

VEH 1 2005, Ford Explorer Operator
Soldier Damage Major Disabling Damage to Front
of Vehicle ACOD 18, 673.25 VEH 2 1990,
Nissan Station Wagon Operator Local
National Damage Major Disabling Damage to Entire
Drivers Side ECOD 4,500.00
20

QUESTIONS?
21
U. S. ARMY SOUTHERN EUROPEAN TASK FORCE AND 173RD
AIRBORNE BRIGADE COMBAT TEAM
ACCIDENT AAR PARATROOPER OFF-DUTY FATALITY 29
MAY 2006
22
PERSONAL DATA/BACKGROUND

• A 25 YEAR OLD MALE, SPECIALIST/E4
• MOS 11C1P GUNNER
• TIME IN UNIT 2 YEARS, 4 MONTHS
• MARITAL STATUS SINGLE LIVED IN BARRACKS
• RECENTLY RETURNED (MARCH 06) FROM 1 YEAR
  DEPLOYMENT IN OEF
• NO PREVIOUS DISCIPLINARY ACTIONS

23
PERSONAL DATA/BACKGROUND

• PERFORMED ADMIRABLY IN A COMBAT
• HISTORY OF DRUG AND ALCOHOL ABUSE BEFORE HE
  JOINED THE ARMY
• ABUSED SLEEP MEDICATION UPON REDEPLOYMENT
• SOLDIER SELF REFERS TO ASAP (ARMY SUBSTANCE ABUSE
  PROGRAM) UPON RETURN TO VICENZA

24
SEQUENCE OF EVENTS

• 25 MAY-1400 RECEIVED COMPANY SAFETY BRIEF PRIOR
  TO COMMENCEMENT OF HOLIDAY WEEKEND. ABUSE OF
  ALCOHOL COVERED IN DEPTH BY COMPANY 1ST SERGEANT
• 28 MAY-1800 SM AND TWO OTHER PARATROOPERS
  PROCEED TO DOWNTOWN VICENZA
• SM IGNORES ASAP ORDER NOT TO MIX ALCOHOL WITH
  MEDICATION. HE CONSUMES BOTH
• 29 MAY-0430 PARATROOPERS HAVE NO FUNDS TO TAKE
  TAXI BACK TO BASE AND CALL THEIR BN STAFF DUTY
  FOR ASSISTANCE
• 29 MAY-0430 BN STAFF DUTY PICKS UP PARATROOPERS
  IN DOWNTOWN VINCENZA

25
SEQUENCE OF EVENTS

• SM AND ANOTHER PARATROOPER RETURN TO POST IN BN
  VEHICLE.
• UPON ARRIVAL AT GATE ONE, CASERMA EDERLE, MPs
  NOTE
• THAT SM WAS NOT BREATHING
• ATTEMPTS TO REVIVE SM BY MPS AND EMTS, WHO HAD
  BEEN CALLED TO SCENE, WERE UNSUCCESSFUL
• 29 MAY-0555 SM PRONOUNCED DEAD
• LOCAL NATIONAL AUTHORITIES ASSUME RESPONSIBILITY
  FOR DEATH INVESTIGATION WORKING WITH ARMY CID
• CID INVESTIGATION IS ONGOING

26
CAUSATIVE / CONTRIBUTING FACTORS

• HISTORY OF ALCOHOL AND DRUG ABUSE PRIOR TO
  ENTERING ARMY
• EVENT OCCURRED LESS THAN 15 DAYS AFTER
  REINTEGRATION LEAVE
• EXCESSIVE ALCOHOL AND DRUG CONSUMPTION

27
UNIT SAFETY PROGRAM

• SAFETY BRIEFINGS ARE CONDUCTED BY THE UNIT
  LEADERSHIP PRIOR TO EVERY WEEKEND WITH SPECIAL
  EMPHASIS PRIOR TO LONG WEEKENDS COVERING TOPICS
  INCLUDING SAFE VEHICLE OPERATIONS, DRINKING, SAFE
  SEX, AND OTHER RISKS
• RISK ASSESSMENTS ARE DONE COVERING ALL NORMAL
  TRAINING ACTIVITIES COVERED BY COMPANY AND
  BATTALION SAFETY REPRESENTATIVES

28
ACTIONS TAKEN BY COMMAND AFTER ACCIDENT

• FOCUSED UNIT SAFETY BRIEFINGS
• UNDER THE OAK TREE COUNSELING IN ORDER TO
  IDENTIFY HIGH RISK PARATROOPERS
• TRAINING SESSIONS WERE CONDUCTED TO TEACH
  TROOPERS THE SYMPTOMS OF ALCOHOL-INDUCED
  POISONING IN CONJUNCTION WITH ASAP
• IMPLEMENTED A TAXI CARD PROGRAM IN ALL UNITS TO
  PROVIDE A MEANS FOR TROOPERS TO RETURN TO THE
  CASERMA WITHOUT FUNDS.
• CONDUCTED MULTIPLE 100 PERCENT URINANALYSES
  ACROSS UNIT
• CONTINUED EMPHASIS ON PSYCHOLOGY ASSISTANCE TO ID
  HIGH RISK POPULATION
• COMMANDER SET LIMITS ON ALCOHOL IN THE BARRACKS

29
ROAD AHEAD

• CONTINUE COMMAND EMPHASIS AND INVOLVEMENT TO
  IDENTIFY AT RISK TROOPERS
• INCREASE AWARENESS OF THE INHERENT DANGERS OF
  OVER-CONSUMING ALCOHOL
• SUSTAIN THE URINALYSIS PROGRAM
• IMPLEMENT A COMMANDERS POLICY LETTER ON ALCOHOL
  ABUSE, FOCUSING ON MISCONDUCT AND UNACCEPTABLE
  BEHAVIOR
• DEVELOPING FORMAL DIALOGUE BETWEEN INSTALLATION
  ASAP, UNIT PSYCHOLOGIST AND COMMANDERS TO BETTER
  IDENTIFY AT RISK PARATROOPERS
• PROMOTE SELF REFERRAL TO ASAP AND MENTAL HEALTH
  PROVIDER

30
LESSONS LEARNED

• REINTEGRATION SAFETY EMPHASIS MUST CONTINUE WELL
  AFTER THE UNITS NORMAL BATTLE RHYTHM IS
  RE-ESTABLISHED.
• TAXI RIDE PROGRAM WORKS BUT MUST EDUCATE TROOPERS
  ON ITS AVAILABILITY.
• EXTREMELY IMPORTANT TO IDENTIFY HIGH RISK
  SOLDIERS DURING THE REINTEGRATION PROCESS. BEST
  DONE UTILIZING UNDER THE OAK TREE COUNSELING.
• UTILIZE UNIT HEALTH CLIMATE SURVEYS AS ANOTHER
  COMMANDERS TOOL TO IDENTIFY AT RISK TROOPERS.
• IMMEDIATELY IMPLEMENT AN AGGRESSIVE SUBSTANCE
  ABUSE DETERRENT PROGRAM FOLLOWING REDEPLOYMENT
• PSYCHOLOGIST DOWN RANGE TO DEVELOP EARLY
  INTERVENTION AS WELL AS POST DEPLOYMENT
  ASSISTANCE. TRUST ISSUE

31

• QUESTIONS

32
Combat Exposure and High Risk Behavior
LTC Gary Tryniszewski Director, Soldier and
Family Support Services, Europe Regional Medical
Command Dr. Robert C. McCollum IMA-E Alcohol
and Drug Control Officer
33
BLUF

• Commanders can positively impact high risk
  behaviors of Soldiers

34
Agenda

• Combat Stress and
• High Risk Behaviors
• USAMRU-E Post Combat Transition Study
• High Risk Behavior and
• Combat Exposure
• Deployment
• Transition Issue
• Battlemind Training
• Medical Counseling Referrals from Post Deployment
  Health Reassessments (PDHRA)
• Discussion of Findings

• Army Substance Abuse Program (ASAP) High Risk
  Behavior Analysis
• Army Risk Reduction Program
• Risk Reduction Program vs. Unit Risk Inventory
  Data
• Pre vs. Post Deployment High Risk Behavior Rates
• High Risk SoldiersWhat They Look Like
• High Risk SoldiersHow they Act/React
• Prime for Life Program

• THE WAY AHEAD

35
Self-Reported Risky Behavior and Deployment to
Iraq Selected Findings from the US Army
Medical Research Unit-Europes Post-Deployment
Transition Training Study
28 August 2006
36
Background

• At part of a post-combat transition study, BCT
  Soldiers in CONUS were surveyed three times by
  USAMRU-E
• Reintegration
• Surveyed about deployment experiences
• 4 months post-deployment
• Surveyed about alcohol driving
• 10 months post-deployment
• Surveyed about risky behaviors

July/August 2005
December 2005
June/July 2006
Post-Deployment
Deployment
10 Month Follow-up Survey 2,200 Soldiers
Reverse SRP Reintegration Training and
Survey 2,877 Soldiers
4 month Follow-up Training and Survey 2,109
Soldiers
37
Examples of Combat Exposure

• Self-reported combat exposure assessed using 34
  items
• Examples of items and exposure rates listed below
• All items summed to provide total exposure score
  (0-34)

Receiving incoming artillery, rocket or mortar
fire
Knowing someone seriously injured or killed
Being attacked or ambushed
Seeing dead bodies
Shooting or directing fire at the enemy
38
Combat Exposure and Risky Behavior

• As combat exposure scores increase, risky
  behavior increases.
• High combat exposure scores assessed at
  reintegration associated with
• Increased probability of using alcohol more than
  intended four months later
• Increased probability of being pulled over for
  traffic four months later

39
Deployment Experience and Risky Behavior

• History of being deployed is associated with
  subsequent risky behavior
• At 10 months Post-OIF, more Soldiers who deployed
  report risky behavior than did non-deployers.

Significantly different by deployment history.
40
Transition Issues and Risky Behavior

• Soldiers who report engaging in risky behaviors
  also report transition issues related to the
  deployment.

• Defining "Risky Behavior"
• Pulled over for traffic violation
• Had traffic accident
• Drank more than meant to
• Late for work or missed work because of
  drinking
• Drove after drinking
• Rode with someone who drove after drinking

Significantly different by agreement with
statement.
41
Planning Considerations

• Options found to reduce negative effects of
  combat experience on well-being in USAMRU-E
  transition research
• Battlemind training at re-integration and 3 to 6
  months post (as part of PDHRA program)
• System of training developed by the Walter Reed
  Army Institute of Research
• PowerPoint training available at Army G1 website
  www.armyg1.army.mil/hr/dcs.asp and
  www.battlemind.org
• Battlemind AAR (platoon-level structured review
  of deployment experiences) at re-integration
• If short on resources, target high combat
  exposure units

42
Points of Contact for Research Findings
LTC Paul Bliese Commander, US Army Medical
Research Unit-Europe Walter Reed Army Institute
of Research DSN 371-2626 Commercial
011-49-6221-172626 E-mail paul.bliese_at_us.army.mil
Dr. Amy Adler US Army Medical Research
Unit-Europe Walter Reed Army Institute of
Research DSN 371-2626 Commercial
011-49-6221-172626 E-mail amy.adler_at_us.army.mil


WRAIR Study Team LTC Carl Castro and Dr. Amy
Adler (co-principal investigators), LTC Paul
Bliese, Dr. Kathleen Wright, LTC Anthony Cox,
MAJ Dennis McGurk, MAJ Jeffrey Thomas, CPT Oscar
Cabrera, Dr. Lyndon Riviere, SGT Deena Carr, SGT
Nadia Kendall-Diaz, SPC Matthew Baker, SPC Megan
Legenos, SPC Nickolas Hamilton, SPC Kyle Schaul,
SPC Steven Terry, Ms. Wanda Cook, Ms. Angela
Salvi, Ms. Julie Clark, Ms. Rachel Prayner, Ms.
Allison Whitt, Mr. Lloyd Shanklin, Ms.
Christina Terra.
43
Medical Counseling Referrals from PDHRA (DD2900)
by Selected Regional Medical Commands
Abstracted from MEDPROS Post Deployment Health
Reassessment Aggregate Reports From 04/01/06
through 08/15/06

• Tier I (Post after 10 Mar 2005, Combat Flag
  Y)

44
Possible Explanations for Low PDHRA ASAP Referrals

• Soldier referred to another behavioral/mental
  health agency with combat operational stress,
  depression, or anxiety as primary diagnosis
• Providers did not recognize alcohol abuse as an
  emerging problem
• Reluctance on part of provider/soldier to refer
  to ASAP because seen as punitive

45
Army Substance Abuse Program (ASAP) High Risk
Behavioral Analysis
by Dr. Robert S. McCollum IMA-EURO Alcohol Drug
Control Officer
Our Mission Manage Army installations to
support readiness and mission execution provide
equitable services and facilities, optimize
resources, sustain the environment and enhance
the well-being of the military community
Leading Change for Installation
Excellence
46
Army Risk Reduction Program (RRP)

• Army Risk Reduction Program (RRP)
• Developed for Fort Campbell following high risk
  incidents in
• 1994
• Promotes a prevention-focused approach
• Coordinates actions between installation agencies
  and the chain of command of battalions with high
  risk profiles

47

Unit Risk Inventory (URI) URI-Reintegration
(URI-R) Information

• Army approved survey
• Designed for company-level
• administration
• Identifies unit-specific rates of
• high-risk behavior
• Provides commanders with
• behaviors to target with training
• Takes 30 min to complete is free
• Administered anonymously to
• 90 of unit to obtain reliable
• results

48

The Complete Risk Picture

RRP Shot Group
Risk-Related Reports by Installations
Risk-Related Behaviors Reported by Soldiers on
Surveys
URI-R
URI
49
URI RRP Rates Comparison
50
Pre-Deployment vs. Post Deployment Risk Behavior
ttempts
DATA COLLECTED 2002 to 2005
51
SoldiersWho They Are
Have relatives with alcohol problems 50 Use
illegal drugs 4 Smoke
cigarettes 36 Describe self as a
loner 21 Recently ended a
relationship 28 Abused by parents 24 Had
suicidal thoughts within the last year 10 Have
previously attempted suicide 6 Had
financial problems within the last year 34
Summarized from 71,000 Unit Risk Inventories
52
How They Actor React
Problem drinkers 32 Drive under
drug/alcohol influence 18 Have multiple sexual
partners 36 Been detained by police due to
drinking 5 Committed illegal act while
drinking 9 Abused spouse/girlfriend/boyfrien
d 8 Abused a child 8 Committed crime
against a person 4 Committed crime against
property 4
Summarized from 71,000 Unit Risk Inventories
53
Intervention Programs

• Prime For Life
• Prime for Life is a risk reduction program
• The first goal of the program is to help each
  participant in the program reduce risk for any
  type of alcohol or drug problem.
• The second goal focuses on self-assessment to
  help people understand and accept the need to
  make changes to protect the things most valuable
  in their lives.

54
Results From Program

• Prime for Life program piloted in USAREUR since
  Oct 2005
• More than 800 Soldiers completed program
• Program evaluation conducted pre and post
  participation found
• Program changed how Soldiers think about
  substance use/abuse
• 10 changed their view of heavy drinking
• 27 acknowledged if they didnt change their
  drinking habits they would become alcoholic
• 20 decided they should drink less
• 19 acknowledged that the amount they thought
  they were able to drink before was excessive
• 6 month follow-up survey found that positive
  changes in attitude toward alcohol were sustained
  

55
Things to Discuss to Reduce High Risk Behaviors

• Allow for limited self-referral to ASAP without
  requiring command involvement
• Use ASAP resources preemptively rather than
  reactively
• Ensure PDHRA providers well trained
• Conduct Battlemind I and II training
• Obtain buy-in that ASAP involvement is not career
  ending
• Expand Prime for Life program to all soldiers
• Improve installation Risk Reduction Program
  reporting
• Improve PMO blotter and journal entry reporting
  to ASAP

56
Points of Contact

• LTC Gary Tryniszewski
• Director, Soldier and Family Support
  Services, Europe Regional Medical Command
• DSN 371-3304/3305
• COM 06221-17-3304/3305
• Email gary.tryniszewski_at_us.army.mil
• Dr. Robert C. McCollum
• IMA-E Alcohol and Drug Control Officer
• DSN 370-7588
• COM 06221-57-7588
• Email robert.s.mccollum_at_us.army.mil

57
Spinning Own the Edge
58
58
59
59
60
60
61
61
62
62
63
63
64
64
65
65
66
66
67
67
68
68
69
69
70
70
71
ARAP Comments
COL USAR This was a very enlightening program.
I am totally impressed with the depth and insight
gained from this survey. Frankly I did not know
that this survey provided this much information
and excellent areas for improvement. LTC AV
Korea This is a lot more than I thought I would
receive an eye opener. It seems our OPTEMPO has
greatly affected the Soldiers. LTC MP Thanks,
this is a lot of information. I have been waiting
for this and we will take the time to digest and
then disseminate the information to the
companies. BN CMD, AV RGT This is the best
assessment program I have seen yet in my
career. BN CMD Individual comments were the
most useful part of the survey.  There were some
very practical and executable suggestions as to
how to improve safety.
71
72
72
73
2006 Winter
Campaign

Mr. Mike Wilson
74
WHATS DRIVING THIS CAMPAIGN?
Fatality rate is FLAT Off Duty Vehicles 1
killer 2 wheel fatalities 4 wheel
fatalities Motorcycle population much smaller
than 4 wheel

• Not a standard winter season safety program
• concentrate on understanding climate
• strengthen attack on the culture and motivation

• Under The Oak Tree continues with more emphasis,
  adds NCOs
• Unit Safety Certification becomes a metric
• Embrace Own the Edge concepts in Composite Risk
  Management
• Army Readiness Assessment Program is
  reemphasized
• participation becomes a metric
• ASMIS-2 POV web-based assessment tool mandatory
• Under the Oak Tree enabler
• Admin mission driver assessment

75
Around the Horn

• United States Army in Europe
• Command Safety Council
• Our Goal No Loss of Life

76
Next Meeting20 March 20071300-1500

• United States Army in Europe
• Command Safety Council
• Our Goal No Loss of Life