John W. Boerstler, Nathan L. Cook, and Matthew J. Frederick

The United States and United Kingdom have both endured the most casualties in the Global War on Terror, specifically in the Iraq and Afghanistan Wars. As the first and second largest troop contributors to these conflicts, both countries have developed extensive programs to facilitate a successful transition for service members from military to civilian life with varying degrees of success. The purpose of this study is to conduct a comparative analysis between the military transition and resettlement systems in the United States and United Kingdom. This informal overview details the project team’s experience meeting with experts in the UK to draw comparisons between the two systems and identify new and innovative ways to more effectively serve returning veterans in both countries.

Our project team is Houston-based and focused on the delivery of services for our generation – Post 9/11 Iraq and Afghanistan veterans. All three of our project team members are Marshall Fellows, the flagship program of the German Marshall Fund, a Washington, D.C.-based think tank dedicated to improving transatlantic relations. We are all also Iraq War veterans who live and work in the Houston area. We have all held leadership positions in the Lone Star Veterans Association (LSVA), the largest network of Iraq and Afghanistan veterans in Texas. Although our full-time lines of work vary markedly from one another, we are all passionate about making Houston the best place for transitioning military families and Post 9/11 veterans.

The three of us play a leadership role in our region – one of the largest populations of veterans in the United States – and hope to implement learned concepts at the community-level. If the project team is successful in showing how our community can improve our coordination of care for transitioning service members, we are optimistic that similar practices can be adopted by other communities across the country and perhaps even among our Allies. More specifically, Combined Arms is the system that we are developing to unite the community to accelerate the impact of veterans on Houston using the lessons derived from our trips to the UK and Denmark, as well as other communities in the United States. It is our hope that this project will be a meaningful exchange of ideas that may influence more innovative and effective ways to improve the military transition process and collaborate among the veteran-serving organizations.

Great Britain and the United States have enjoyed a valuable and important relationship as leaders in the international community. As a former British colony, the United States shares many similarities with our forbearers, especially in the way our military organizations are designed. However, our cultural, political, and social systems are markedly different, which enabled our project team to develop several important assumptions that keep these fundamental differences in mind in order to conduct an effective comparative analysis.

The United Kingdom of Great Britain and Northern Ireland have a much more expansive social welfare system than that of the United States. The National Health System (NHS) will be referred to several times throughout this report, and it should be noted that the American private health insurance and provider model is significantly different from the government-run universal healthcare delivery system in Britain. Due to different organizational structures and patient populations, it is challenging to objectively compare the NHS with the Veterans Health Administration (VHA), which is the largest government-run healthcare delivery system in the United States with a close second being the Department of Defense’s (DoD) Health Agency. That being said, it is interesting when comparing the NHS to the VHA. According to the Congressional Research Service, only 27% of American military veterans access the services the Veterans Health Administration offers, and 36% of Iraq and Afghanistan or Post 9/11 veterans that this report focuses on, according to the VHA’s recent reports. All other veterans use private health care providers, paid for by either private insurance or other governmental healthcare payers, like Medicare or Tricare.

The definition of the term “veteran” is different in both countries. A veteran in the United Kingdom is technically anyone who served one day in the Armed Forces, according to a new review conducted by Lord Ashcroft, a former member of Parliament who published the Veterans Transition Review to evaluate the British Resettlement system and define eligibility criteria for who a “veteran” is in the UK. A veteran in the United States has many different eligibility criteria based on service term length and how a discharge is characterized. However, to receive education, home loan, disability, or some health care benefits, a veteran is technically anyone who served at least 90 days outside of training and has an honorable discharge, although several caveats do exist in the VA’s interpretation of the term, according to a Congressional Research Service report detailing the differences. Additionally, the US refers to those leaving the military as “transitioning service members” whereas Britain refers to them as “service leavers” – both of which will be referred to throughout this analysis.British veterans are strongly tied to their units or Regiments, both during and after their term of service. This strong sense of community has a significant impact on networking for employment and other peer-to-peer support services that come as a natural byproduct of service during wartime. Due to the geographical size and organizational complexity, this isn’t as practical in the US as it is in the UK.

Combined ArmsNext the team met with Ministry of Defence Resettlement Head Colonel Andrew Deans, Struan Macdonald, and Neil Lewis (pictured below with John Boerstler (left), Matt Frederick and Nathan Cook on the far right). In a broad stroke, MoD’s program for resettlement is contracted to the Career Transition Program (CTP) and is comprehensively different than the analogous program(s) of its US counterpart, Department of Defense (DoD) . In short, the MoD is held accountable for a positive outcome for its veterans and the successes/failures are measured, tracked and analyzed by the MoD after service members exit the service. To further highlight the differences, the MoD conducts one resettlement/transition program for all branches of services and the vast preponderance of the work is contracted to a global manpower management firm, Right Management. Comparatively, the DoD is held accountable for conducting an approximately week long transition class (~35 hours) as a condition to end active service and the composition/standards of those classes are different per service. Additionally, the DoD is not held accountable for employment transition outcomes. There isn’t any information available to suggest that data is tracked, analyzed and acted upon in terms of employment of a US veteran post active service.

The latest MoD-CTP Ex-Service Personnel Employment Outcomes report shows that 83-85% (with 95% confidence) of transitioning veterans employed, defined as sixteen weeks of continuous work within 6 months of ending active service. This team is not aware of a similar metric tracked by the DoD and the best source of comparison is to extrapolate the Department of Labor’s regularly published Employment Situation of Veterans in order to back into unemployment statistics for US veterans. This point highlights the philosophical difference between the MoD and DoD. A quote from Lord Ashcroft’s Veterans Transition Review states that “good transition is important for the country. Having invested heavily in the training and development of individuals over months or years, the public can expect the Forces to ensure that those individuals are in a position to be contributors to society not just during their Service career but when they leave.” In short, a subset of the MoD mission is to facilitate a successful transition because if veteran net contribution to society is positive after active service, this can be viewed as a force multiplier for the nation. The flip side is if the transition is a negative net contribution, then society and the veteran is pays a much higher price. The DoD’s mission and purpose is to “…deter war and to protect the security of the nation” which doesn’t include a subordinate mission of ensuring transitional success post active service for American veterans.

The Career Transition Partnership (CTP) is a department within the for-profit entity Right Management, which is the UK division of Manpower, a global staffing, recruiting and human resources consulting firm. CTP is contracted by the MoD to provide career transition services 24 months prior to discharge and 24 months post-discharge for anyone leaving service in the UK. CTP staff are stationed at each military installation to deliver the pre-discharge programs and regionally based to deliver the post-discharge services. The entire operation is tracked through one centralized customer/client relationship management (CRM) tool called “Adapt”, a key technological enabler. Adapt is used to ensure that no service leaver falls through the gaps when making the transition from military to civilian career and allows case managers to track their progress through the resume preparation, interview skills, and networking workshops that are all provided on-post and in a community-based setting. At first glance this program far outshines its reciprocal program in the United States – DoD Transition Assistance Program (TAP) because of the advantages of having community-based staff, a nationwide CRM platform to track transition progress and maintaining the responsibility of a service member’s successful transition 24 months prior to and following discharge.

Certainly no perfect system exists. Like many large public and private systems, the process is entirely dependent on individual commands, personalities, regions/communities capabilities and culture. However, many positive attributes exist within each system. One certainty is that it’s much more cost effective to be proactive in a service member’s transition in order to prevent these issues from impacting their life post-military. Catching them early in the process will undoubtedly prevent future transition troubles and save the government, service member and the communities they return to significant human and financial capital. Programs like CTP that teach service members “how to fish” as a method to empower rather than just “taking them fishing” as a method to entitle and check a box like DoD TAP are vastly different in their outputs and outcomes. Additionally, the top-down, nationwide CRM platform enables the MoD to track data, evaluate trends, analyze failure, and improve the system whereas the DoD does not have that ability to do so.

Another positive attribute that is applied in the MoD program is the insertion of Service Resettlement Advisors (SRA’s) in the process whose sole purpose is to hold MoD, individual service members, individual commands, and the CTP staff more accountable. The role of the SRA is functionally equivalent to a care coordinator who follows the service member throughout the 24 months leading up to discharge where they are positively handed off to one of CTP’s regionally based program managers. The results are that fewer service members ultimately fall through cracks which mean less unemployment benefit payouts and a more successful transition overall. It must be effective because 88% of transitioning service members are accessing the services provided despite CTP being an opt-in, or voluntary program.

The MoD and DoD training budgets are both substantial but an argument can be made to increase them on the front end to save money on the back end in an effort to achieve a higher average return on investment (ROI). One of America’s post-service employment challenges is lack of civilian credentials for the same type of work post service. “The Armed Forces offer what amounts to Britain’s biggest and best apprenticeship scheme” according to Lord Ashcroft’s report. The MoD is investing in service members by “over training” them and one example that is mandated by law that soldiers must have civilian equivalent credentials in order to operate or work on-base. For example, roles like heavy equipment operators, truck drivers, electricians, plumbers and engineers are all licensed by civilian accreditation agencies, which not only standardizes skilled military labor but also ensures that soldiers have equivalent credentials upon transition from service. This positively impacts the transition process by increasing the probability of soldiers placing directly into a civilian-equivalent career

In contrast, the DoD training command is solely focused on the skills required to complete service in the context of fighting and winning the nation’s war(s). For example, a US Army-trained electrician does not end active service with a civilian equivalent after completing basic and advanced training in the trade and gaining significant work experience in the field over the course of 4, 8, or even 20 years in some cases. Because of this, the electrician (or any applicable trade craft) is forced to use their federal education benefits (GI Bill) to go through repetitive training coursework at a community college that becomes a burden on the soldier, the family, and the taxpayer. If the DoD worked with civilian credentialing organizations to ensure the craft skill was certified to operate in the civilian workforce, he could transition immediately to a civilian career saving taxpayer dollars by not drawing unemployment benefits or enrolling in repetitive training courses.

The GI Bill is the core of America’s transition entitlement and is accessible to the vast majority post active service. The benefit presents an enormous opportunity for unskilled service members, or those whose skills don’t directly translate to civilian careers, are able to earn a trade certification or degree in order to successfully transition into civilian life. Progress has been made in regards to the Post 9/11 GI Bill in terms of availability to veterans in a multitude of different family and economic situations, although it is still not a viable option for many veterans seeking to immediately exit into a career as only 50% of those eligible actually access their federal education benefits, according to the Philanthropy Roundtable.

Combined ArmsThe United Kingdom’s Royal British Legion has created something similar in 16 communities spread across the country called “Pop-In Centers”. The mission behind these community-based transition centers is to offer a “welcoming space for service personnel and veterans to get practical help and advice”. Our team visited the Pop-In Center in Manchester and in Leeds. Information Officers like Graham Connor (pictured right) is very proud to provide such a space in a very centrally-located part of each region, not far from the main train station and close to all of the major retail areas in the bustling university town. The Pop-in Center is a collaborative space that also provides offices for 6 other partnering charities that offer a variety of services such as career transition, financial assistance, and benefits help. The centers are modern and very welcoming which is exactly what is needed when engaging returning Iraq and Afghanistan veterans in a community-based setting. Matt Frederick and CTP Regional Employer Relations Manager Faye Livesey are pictured left in the modern, centrally-located Pop-in Centre in Manchester. Using the decentralized Pop-in Center model as a modern example of what collaboration looks like in the UK, we hope that Combined Arms will also become an easily accessible, central point of transition for returning veterans and their families in Houston. Combined Arms is founded on the collective impact or systems-based approach where major stakeholders in the governmental, non-profit, and private sectors are brought together to solve a community problem.

Establish a centrally-located point of transition by developing a physical co-working and program incubation space for organizations to collaborate and soldiers to receive services;
Integrate resource and referral technology by connecting organizations through one central system in order to ensure tracking, follow-up, and successful transition of soldiers; and
Actively market Houston as the transitioning veteran’s “new unit” so they’re not only aware of what services our community offers but welcomes them home.
This concept is but one approach that can be taken. Others in Northwest England like Liverpool Veterans are another approach to collective impact that can play a significant role in better connecting the community.

Liverpool Veterans acts as the hub for military programs in the greater Merseyside area and focuses its efforts on serving those who need direction to different programs that are embedded in the community. The team met with Bob Blanchard, Founder of Liverpool Veterans, and learned more about their mission to triage the service member by conducting a critical assessment of their needs before making a positive referral to a social service partner in the community. Founded only 6 years ago, they serve all veterans in the area, and not just those who served in the most recent conflicts. Liverpool City Council initially turned down the idea of a need for such an organization, but relented when it was revealed they had many more veterans in the region than they’d believed (estimated over 32,000). Working through Liverpool’s city-wide leadership board made of representatives from all the service charities, local governments, and the NHS – the region now has a coordinated strategy for addressing and adapting to veterans’ needs. The regional strategy has three main areas of focus:

Information, Advice, and Housing;
Education, Employment, and Training; and
Physical and Mental Wellbeing.
Members of the senior board chair sub-groups that oversee these three focus areas and meet once a quarter for planning and accountability.
Liverpool Veterans serve a critical role as the overall accountability mechanism for veteran services in the region, whether those services are provided by governmental or service charity entities. They continuously follow-up on casework and referrals, both with the veterans and the service providers, to constantly improve service and outcomes.
Among their standout programs, a little outside the box thinking lead Liverpool Veterans to begin training programs for the Merseyside/Liverpool police around veterans awareness. With a three phase focus coupled with a 12 week, veteran-only, NHS-funded substance abuse treatment program, they believe the model is having a meaningful impact on the number of veterans caught in a perpetual criminal justice loop.

Phase 1: Veterans going into criminal justice system;
Phase 2: Veterans coming out of prison; and
Phase 3: Reducing veterans’ recidivism.

From the many interviews our project team conducted with British military transition experts, several additional action items were identified that we can recommend for changes at the policy and community levels in the US military transition systems.

Find a champion for military transition in the United States like Lord Ashcroft was for British forces–someone who has political and cultural influence to produce a report on the state of the system, make recommendations on how to improve it, and have the report be taken seriously. Goals will be to evaluate services landscape, measure effectiveness, identify gaps and failures, and make recommendations to improve the process over time.

Review existing DoD Transition Assistance Program contract outcomes, data measured, failures, and opportunities. The cost of the current DoD TAP contract was $85 million in 2014, according to a recent US Government Accountability Office report. Several questions arose when reviewing this information:
Can taxpayer dollars be saved by switching the contract to the Manpower-Right Management-CTP Model?
How much can be saved by adding levels of accountability and reduce veteran unemployment and increase economic impact?
If the 24 month Model (before and after) were implemented, what would be the cost and potential ROI versus the existing costs of the DoD TAP contract?
Can the DoD TAP contract be changed?
Can the services provided by DoD TAP be contracted to community hubs for 24 months post-service?
How much is saved by Veterans Health Administration (VHA) in healthcare delivery costs if the number of employed veterans with access to health insurance is multiplied by average cost of VHA care per working age patient, aged 18-50?
The most effective part of the MoD’s CTP is the fact that service leavers start their transition 24 months prior to discharge and have access to community-based services for 24 months following discharge and accountability is mandated through contractual obligations. Because consistent communication exists between transition professionals at the installations and in the community via one central CRM platform, service leavers are more effectively served based on the data shown in Lord Ashcroft’s report.

Develop stronger accountability systems similar to UK Service Resettlement Advisor (SRA) role who act as case managers making sure the MoD, unit chains of command, service member and contractor are held accountable for transition successes and failures. Develop a nationwide Client Relationship Management (CRM) platform connecting DoD TAP to community-based hubs. Several examples currently exist and can be easily replicated by one central contractor. Community-based hubs need access to DoD brands once connected in order to legitimize services to employers and standardize program delivery across installations and communities. Several examples of community-based hubs are:

Combined Arms in Houston, Texas
Syracuse University’s Institute for Veterans and Military Families (IVMF) AmericaServes model in New York, North Carolina, Pittsburgh, and several communities in South Carolina
America’s Warrior Partnership
University of Southern California (USC) Los Angeles Veterans Collaborative
Using the decentralized Royal British Legion Pop-in Center model as a modern example of what collaboration looks like in the UK, we hope that Combined Arms will also become an easily accessible, central point of transition for returning veterans and their families in Houston. Combined Arms is founded on the collective impact or systems-based approach where major stakeholders in the governmental, non-profit, and private sectors are brought together to solve a community problem.
How much would this cost the taxpayer above and beyond what’s already budgeted for DoD TAP?
How quickly could this be implemented?
How much could this potentially save the taxpayer?

DoD should implement “career pathways” upon entry into the military with consistent emphasis on and utilization of throughout service members’ careers, regardless of career length. The creation of these pathways can also mandate that soldiers must have civilian equivalent credentials in order to operate or work on base. For example, roles like heavy equipment operators, truck drivers, electricians, plumbers and engineers can all be licensed by civilian accreditation agencies to ensure that soldiers have equivalent credentials upon transition from service and also standardize to meet external code. This would also save taxpayer dollars to prevent soldiers from using their hard-earned federal education (GI Bill) benefits for training programs they’ve already completed in the military. Several questions can be posed to ensure the implementation of such a policy makes economic sense:

How much would the Veterans Benefits Administration (taxpayer) save in reducing amount of repetitive training programs and hours spent by veterans using their GI Bill benefits?
How much time and potential frustration can be saved by the number of veterans this can impact?
Support more studies like the Veterans Civic Health Index by Got Your 6 Campaign that reflect the spirit of the UK’s Prosperity Agenda for veterans in order to advance the studies of key metrics.
Interoperability between DoD and VA electronic medical records must be made a reality, and not just a priority that both agencies continually fail to achieve.
De-stigmatize mental health conditions and treatment, both in the military and civilian cultures. The focus has always been to de-stigmatize the military culture, but without also removing the same prejudices from America’s civil culture, veterans and service members who do seek/receive treatment in the DoD and VA systems will fare no better upon transitioning away from the military and into successful, fulfilling civilian lives.
The British have developed many effective programs that our national and local systems can learn from and even implement. However, we have to acknowledge the differences that exist between the two societies and apply only those lessons that fit within the existing culture and infrastructure. More research is needed to uncover new innovative ways we can learn from one another, so this project will not stop with this report. Both systems have room for improvement but its important to step outside of one’s own comfort zone and see how our strongest ally approaches similar problems confronting those who transition out of the military. The allure of “reinventing the wheel” is almost a regular occurrence within the DoD, VA, Academia and community-based NGO’s but if we can effectively collaborate as a coalition of service providers focused on local impact and individualized services, we will be able to effectively prevent more veteran unemployment, substance abuse, family challenges, homelessness, criminal behavior, and suicide.

We all have a stake in the successful transition of military veterans into our communities. We are now taking ownership at the community level.

Join us.

German Marshall Fund | McKesson Foundation | NextOp
Sue Freeth, Combat Stress CEO
John Leach, Team Rubicon UK CEO
Adrian Peters, Career Transition Partnership Head of Employment
Colonel Andrew Deans, Ministry of Defence Head of Resettlement
Struan Macdonald, Ministry of Defence Resettlement Office
Neil Lewis, Ministry of Defence Resettlement Office
Peter Smith, Help for Heroes Head of Recovery Operations
Faye Livesey, Career Transition Partnership in Manchester
Graham Connor, Royal British Legion Pop-in Center Manchester Information Officer
Steve Hollis, Liverpool Football Club Foundation Veterans Program Manager
Bob Blanchard, Liverpool Veterans Director
Emily Gee, FACT Liverpool Veterans Program
Jay Bell, FACT Liverpool Veterans Program
Mitch Besser, AgeWell Global CEO
Richard Swarbrick, National Health Service-England
Dave Rutter, Department of Health
Dr. Neil Greenberg, King’s College of London Military Research

John Leach, Team Rubicon UK
Ken Harbaugh, Team Rubicon Global
Dr. Ali Hawks, King’s College of London
Dr. Allie Bennington, Help for Heroes
Dr. Drew Helmer, Veterans Health Administration
Filip Medic, German Marshall Fund
Michael Cohen, German Marshall Fund

John Boerstler, Executive Director
John is Executive Director of NextOp a 501(c)(3) non-profit organization founded in Houston, Texas. John was named to his current position in March, 2015.

Previous Experience
John Boerstler was born in Houston, Texas, into a family with a strong history of military service. In 1999, John enlisted in the United States Marine Corps, where he earned the rank of Sergeant. During his time serving our country, John’s overseas assignments took him to Iraq, Kuwait, Syria, Jordan, Djibouti, and Kenya. As a non-commissioned officer, John served a combat tour in support of Operation Iraqi Freedom from 2004-2005 where he was injured. John received an honorable discharge from the United States Marine Corps in 2007 and went on to complete his bachelor’s degree at Texas A&M University and a Master in Public Administration degree from the University of Houston.
In 2009 John helped found the Lone Star Veterans Association (LSVA) in order to help make Houston and Texas the best place for Post 9/11 veterans and their families. LSVA has become the largest network of Post 9/11 veterans in the State of Texas and provides free, innovative services to this generation of service members and families. In 2011 John was a recipient of the prestigious Marshall Memorial Fellowship where he was tapped to represent the United States in eight different European countries through a month-long fellowship. Today, John has become a strong advocate for veterans, after working for a United States Congressman, two Mayors of Houston, the Wounded Warrior Project, Veteran Energy and now as the leader for NextOp. John is continuing his career in public service by serving on the Board of Directors for Combined Arms, the Lone Star Veterans Association, the Texas Veterans Commission Advisory Committee and Family Services of Greater Houston.

Matthew Frederick, Williams Pipeline
Matt is the Manager of Construction for Williams Pipeline in Houston, Texas. Matt began his career at Williams in June 2013.

Previous Experience
Matt earned his degree and commission from the United States Naval Academy. He was commissioned in the United States Marine Corps in 2006 and graduated from Infantry Officer School in 2007. He was assigned to operational units based out of Camp Pendleton, CA and completed 2 deployments. His last duty station was Inspector-Instructor for an Anti-terrorism unit located in Lafayette, LA. Matt deployed with Regimental Combat Team 5 and served as Heliborn Unit Commander, Mobile Assault Unit Commander and as Company Executive over the course of a 13-month deployment. Upon returning, Matt was assigned to 1st Light Armored Reconnaissance Battalion and served as Platoon Commander, Company Executive Officer and Company Commander. While assigned to 1st LAR, he deployed with Battalion Landing Team 1/4. His military decorations include Navy and Marine Commendation Medals, Navy and Marine Achievement Medals, and numerous other medals and honors.
Matt completed his graduate studies while serving out his last few years on active duty and received his Master’s of Business Administration from Louisiana State University. Matt also serves as the Vice Chairman of Combined Arms as well as Vice Chairman of the Lone Star Veterans Association and Vice President of Honor Capital.

Nathan Cook, McKesson Specialty Health
Nathan is the Senior Manager of Government and Community Relations for McKesson Specialty Health—The US Oncology Network, in The Woodlands, Texas. Nathan has been with The US Oncology Network team since June, 2010.

Previous Experience
Before joining The US Oncology Network, Nathan served as District Director for Rep. Pete Olson (R-TX), where he oversaw district operations and outreach strategies. Prior to that, he served as the Deputy Regional Director for US Senator John Cornyn (R-TX) in the Southeast Texas region for four years.

Nathan served eight years in the US Army (Reserve), from 1997-2005, and attained the rank of Staff Sergeant while serving a one year deployment in support of Operation Iraqi Freedom, stationed at Camp Anaconda in Balad, Iraq (‘04-‘05). Nathan currently serves as Vice President on the Board of Directors for the Voter Awareness Council, a 501(c)3 dedicated to encouraging and equipping citizens in the Montgomery County (Texas) area to vote. He held a Board of Directors position with The Woodlands Area Economic Development Partnership, and still serves as a member of Senator Ted Cruz’s Service Academy Nominations Board. He is also active in advocacy and non-profit work on military/veterans issues, and is a Co-Founder and former Chairman of the Board of Directors for the Lone Star Veterans Association (501(c)3) in Houston, Texas. He has also served on the 2015 & 2016 Executive Leadership Committees for the Leukemia & Lymphoma Society’s Montgomery County Light the Night Walk. He was honored to be selected as a 2012 Marshall Memorial Fellow by the German Marshall Fund. Nathan earned a B.S. in political science from Texas A&M University. He and his wife, Mariana, live in Magnolia, TX.