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Task Force True North Cost Model

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Research Questions

  1. How have the other services, and U.S. Special Operations Command, implemented embedded health care?
  2. How can the Air Force identify units and populations that are at high, medium, and low risk for decreased resilience and increased negative outcomes?
  3. What support personnel packages could be embedded in units that are at high, medium, and low risk for decreased resilience and increased negative outcomes?
  4. What are the advantages and disadvantages of alternative approaches for expanding the TFTN program?

The Air Force seeks to maximize airman fitness and minimize threats to individual and unit readiness, such as domestic and sexual violence and suicide. The purpose of the Air Force's Task Force True North (TFTN) is to provide effective prevention and treatment programs to airmen in need by embedding health care providers directly into units.

In this report, the authors identify potential courses of action (COAs) for expanding the TFTN program, including estimating each approach's associated manpower requirements, recruiting requirements, total costs, and implementation timelines. In developing these COAs, the authors analyzed embedded behavioral and physical health programs in the Army, Navy, Marine Corps, and U.S. Special Operations Command; developed a framework for analyzing mental, physical, and social squadron risk levels; developed personnel packages for low-, medium-, and high-risk squadrons; and estimated the costs of implementing these personnel packages under different timelines. In addition to detailing these COAs, the authors provide recommendations on best practices for the Air Force to follow as it expands the TFTN program.

Key Findings

Other military embedded health care programs offer lessons for the Air Force

  • Program design must follow directly from program goals, rather than the inverse.
  • All embedded providers need to be able to build trust and buy-in with both unit commanders and service members.
  • Even if programs are not centralized or standardized across all units, data collection should be.

The four potential COAs each have trade-offs

  • The baseline COA is the Air Force's existing plan to expand the TFTN program over a four-year timeline. COA 1 extends the timeline to five years and makes some changes based on the RAND team's risk characterizations. COA 2 extends the timeline to ten years and makes most of the same changes as COA 1. COA 3 uses the five-year timeline of COA 1 but also reduces the number of embedded physical health care providers.
  • The least expensive option at year 10 is COA 3, as it is the only one under which personnel are reduced. COA 2 is less expensive than the baseline COA and COA 1 at year 5 because implementation is much slower over a ten-year period.
  • There are risks associated with each of the COAs. The COAs with the shorter timelines risk not being able to meet those aggressive timelines for various reasons. The ten-year timeline may seem less risky, but such a long timeline could also prevent the expansion from being fully implemented because of changing priorities, budget challenges, or other reasons.

Recommendations

  • Ensure top leadership support and commitment.
  • Clarify program goals to enable success.
  • Plan up front to facilitate data collection and evaluation.
  • Consider issues of chain of command and organizational structure.
  • Be prepared to respond to changing needs.
  • Monitor progress of implementation over time.

Research conducted by

The research reported here was commissioned by Brig Gen Michael E. Martin, Director of Air Force Resilience (AF/A1Z), and conducted within the Manpower, Personnel, and Training Program of RAND Project AIR FORCE.

This report is part of the RAND research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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