RAAUZYUW RUENAAA0457 2041748-UUUU--RUCRNAD
ZNR UUUUU ZUI RUEWMCF6036 2041743 
R 231747Z JUL 07 PSN 550713K21 
FM CNO WASHINGTON DC 
TO NAVADMIN 
ZEN/NAVADMIN @ AL NAVADMIN(UC) 
INFO ZEN/CNO CNO 
BT 
UNCLAS 
SUBJ: COMBAT AND OPERATIONAL STRESS CONTROL AND WARRIOR TRANSITION 
PROGRAM IMPLEMENTATION 
FM CNO WASHINGTON DC//N1// 
TO NAVADMIN 
INFO CNO WASHINGTON DC//N1// 
UNCLAS //N5000// 
NAVADMIN 182/07 
MSGID/GENADMIN/CNO WASHINGTON DC/N1/JUL// 
SUBJ/COMBAT AND OPERATIONAL STRESS CONTROL AND WARRIOR TRANSITION 
PROGRAM IMPLEMENTATION// 
REF/A/DOC/DODDIR 6490.5/23FEB1999// 
REF/B/ASDHA MEMO/10MAR2005// 
REF/C/MSG/CNO WASHINGTON DC/101294ZJUL06// 
REF/D/DOC/DODINST 6490.3/11AUG2006// 
NARR/REF A DIRECTS THE ESTABLISHMENT OF COMBAT AND OPERATIONAL STRESS 
CONTROL PROGRAMS IN DOD.  REF B ESTABLISHED THE REQUIREMENT FOR PRE- 
DEPLOYMENT AND POST-DEPLOYMENT HEALTH SCREENINGS, AND THE 
REQUIREMENTS 
FOR POST-DEPLOYMENT SCREENINGS AFTER 90 TO 120 DAYS. REF C MANDATES 
THE USE OF ELECTRONIC SUBMISSION OF THE DEPLOYMENT HEALTH ASSESSMENT 
FORMS.  REF D IMPLEMENTS POLICIES AND PRESCRIBES PROCEDURES FOR 
DEPLOYMENT HEALTH ACTIVITIES.// 
RMKS/1.  THIS NAVADMIN ANNOUNCES IMPLEMENTATION OF THE COMBAT AND 
OPERATIONAL STRESS CONTROL (COSC) AND WARRIOR TRANSITION PROGRAM 
(WTP).  THE COSC PROGRAM IS CRITICAL TO THE CONTINUED HEALTH AND 
READINESS OF OUR SAILORS AND ULTIMATELY, TO NAVY S ENDURING SUPPORT 
OF THE GLOBAL WAR ON TERROR.  THIS MESSAGE PROVIDES AN OVERVIEW OF 
THE NAVY'S COSC PROGRAM FOR EXPEDITIONARY AND INDIVIDUAL AUGMENTEE 
(IA) SAILORS AND THEIR COMMANDS AS WELL AS THE COMMANDING OFFICER S 
RESPONSIBILITY TO ENSURE THESE PROCESSES ARE FOLLOWED. 
2.  THE COSC CONTINUUM SPANS THREE PHASES:  PRE-DEPLOYMENT, 
DEPLOYMENT AND POST-DEPLOYMENT.  EACH PHASE CARRIES SPECIFIC FUNCTIONS, 
RESPONSIBILITIES, REQUIRED ASSESSMENTS AND REQUIRED REASSESSMENTS. 
    A.  PRE-DEPLOYMENT - THE FIRST PHASE OF THE COSC PROCESS BEGINS 
BEFORE DEPLOYMENT THROUGH THE EXECUTION OF A PRE-DEPLOYMENT HEALTH 
ASSESSMENT (DD 2795) PER REFS B, C, AND D.  FOR IA SAILORS, THIS 
PROCESS IS COMPLETED AS PART OF A SUITABILITY-FOR-DEPLOYMENT 
SCREENING AND MUST BE REPORTED TO NAVY PERSONNEL COMMAND (NPC) NO LATER THAN 
TWO WEEKS AFTER ORDERS ARE RECEIVED.  THE UP-TO-DATE STANDARD 
SCREENING IS THE EXPEDITIONARY COMBAT READINESS CENTER (ECRC) IA CHECKLIST 
LOCATED ON NAVY KNOWLEDGE ONLINE (WWW.NKO.NAVY.MIL., CLICK ON 
INDIVIDUAL AUGMENTEE) 
    B.  DEPLOYMENT - ONGOING PREVENTION, SUPPORT, AND TREATMENT FOR 
STRESS AND STRESS RELATED INJURIES (IF NEEDED) WILL BE PROVIDED 
THROUGHOUT THE DEPLOYMENT PHASE.  IN-THEATER MENTAL HEALTH 
PROFESSIONALS SHOULD BE CONSULTED AS SOON AS POSSIBLE IF CONSERVATIVE 
MANAGEMENT OF COMBAT STRESS AND EXPECTATION OF RETURN TO DUTY IS 
IMPROBABLE OR FAILS.  TO PROVIDE POST-DEPLOYMENT COSC TOOLS, HELP 
IDENTIFY COMMON REDEPLOYMENT PROBLEMS AND REHEARSE RETURN AND REUNION 
SCRIPT, THE SECOND PHASE OF THE COSC PROGRAM OCCURS BETWEEN 
COMPLETION OF THE COMBAT ZONE ASSIGNMENT AND PRIOR TO RETURNING TO CONUS.  ALL 
SAILORS SHOULD BE AFFORDED A THREE TO FIVE DAY DECOMPRESSION PERIOD 
FOR COSC.  WHERE OPERATIONALLY FEASIBLE, COSC PHASE II SHOULD BE DONE 
IMMEDIATELY BEFORE DEPARTING THEATER.  FOR NAVY IA SAILORS, THE 
EXPEDITIONARY COMBAT READINESS CENTER  ESTABLISHED THE WARRIOR 
TRANSITION PROGRAM (WTP) TO ASSIST SAILORS TRANSITIONING FROM THEIR 
TOURS IN A COMBAT ENVIRONMENT.  LOCATED IN KUWAIT, WTP IS THE LAST 
IN-THEATER STOP DURING REDEPLOYMENT TO CONUS AND FULFILLS COMBAT 
STRESS MITIGATION AND REQUIRED DECOMPRESSION TIME DURING A SAILOR S 
TRANSITION FROM THE HIGH STRESS, COMBAT ENVIRONMENT.  IN ADDITION, WTP CONDUCTS 
SMALL GROUP DISCUSSIONS FACILITATED BY ACCREDITED PROFESSIONALS AND 
FOCUSES ON VARIOUS TOPICS INCLUDING, BUT NOT LIMITED TO:  COMBAT AND 
OPERATIONAL STRESS BRIEFINGS, WEAPONS AND GEAR RETURN, FLEET AND 
FAMILY SUPPORT CENTER BRIEFINGS, CUSTOMS PROCESSING, AND FOLLOW-ON TRAVEL 
COORDINATION.  WTP ENSURES THAT EVERY RETURNING IA SAILOR BENEFITS 
FROM THIS CRITICAL PROGRAM. 
    C.  POST-DEPLOYMENT - THE THIRD PHASE OF THE COSC PROGRAM TAKES 
PLACE AFTER A SAILOR RETURNS FROM DEPLOYMENT WHEN SAILORS MAY 
EXPERIENCE DIFFICULTIES ADJUSTING TO HOME STATION.  SINCE SYMPTOMS OF COMBAT AND 
OPERATIONAL STRESS MAY NOT APPEAR UNTIL AFFECTED SAILORS RETURN HOME, 
THEIR COMMANDING OFFICERS ARE RESPONSIBLE FOR ENSURING THAT THE POST- 
DEPLOYMENT HEALTH REASSESSMENTS (PDHRA-DD 2900) ARE COMPLETED BETWEEN 
90-180 DAYS AFTER RETURN AND ANY NEEDED FOLLOW-UP CARE IS OBTAINED 
(REFS B-D PROVIDE ADDITIONAL DETAILS).  ALL COMMANDING OFFICERS MUST 
ENSURE THAT SAILORS WHO RETURNED FROM DEPLOYMENT TO EITHER IRAQ OR 
AFGHANISTAN AFTER 19 MARCH 2004 HAVE COMPLETED THEIR REQUIRED PDHRAS. 
3.  THE PRE-DEPLOYMENT, DEPLOYMENT, AND POST-DEPLOYMENT COMBAT AND 
OPERATIONAL STRESS PROCESSES OUTLINED IN THIS NAVADMIN ARE MINIMUM 
REQUIREMENTS EXPECTED FOR SAILORS AND THEIR COMMANDING OFFICERS. 
COMMANDING OFFICERS ARE RESPONSIBLE FOR ENSURING THAT APPROPRIATE 
COSC PROCESSES AND PROCEDURES ARE IMPLEMENTED IN THEIR COMMANDS. 
4.  POINT OF CONTACTS: 
- CAPT J.K. MCDOWELL, CNO (N1/TFIA), AT (703) 614-6879/DSN 224, 
OR E-MAIL AT john.k.mcdowell@navy.mil. 
- MR. RANDALL OSER, N1 CASUALTY CARE WORKING GROUP, AT (703) 
614-4147/ 
DSN 224, OR E-MAIL AT RANDALL.OSER@NAVY.MIL. 
5.  RELEASED BY VADM J. C. HARVEY, JR., N1.// 
BT 
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