ROBINS AIR FORCE BASE, Ga. — When Col. John Buterbaugh took the helm as the command surgeon at Air Force Reserve Command in late summer 2018, he wanted to make some bold changes to improve processes for the 70,000 Reserve Citizen Airmen serving around the world.

In an Aug. 28 letter, Buterbaugh outlined four initiatives to increase medical readiness across the command, including eliminating the medical case backlog, removing the mental health requirement differences between active duty and Reservists, providing more full-time medical staff to local units and increasing decision-making ability on medical cases at the wing and squadron levels.

“The current Reserve medical system is out of step with the needs of the mission and the Airmen,” Buterbaugh wrote in the letter. “This has led to the long backlog of cases, task saturation on the (unit training assembly), and decreased quality of medical administrative care of the members. Ultimately, this has negatively affected medical readiness and has decreased the ability of the AF Reserve to take the fight to the enemy.”

Of the four initiatives, aligning mental health requirements with active duty has seen the most progress and affects the highest number of Reservists, according to Buterbaugh. The standards are now the same and some of the mental health issues requiring a waiver or were disqualifying people from the Reserve have been eliminated. As major of a policy change as this was, leadership was able to move quickly to get it approved at the Air Force level.

“This didn’t just affect the Reserve, it affected the Guard as well,” he said. “Once they had signed off on the way it was written, it was voted on by the Air Force Medical Corporate Board.”

The policy change was then added to and published in the Medical Standards Directory. With the new policy in place, Citizen Airmen who currently have waivers for certain mental health issues can now go through a process at their local medical units to have the waivers removed.

The goals of the policy changes are to increase the number of Reservists who are medically ready to deploy, retain more healthy members in the Reserve by eliminating unnecessary barriers and make it easier to recruit people from active duty into the Reserve.

“This is a huge win for the Air Force Reserve and the Guard too,” he said. “People transferring into the Reserve and the Guard were affected by this.”

One of test sites for moving the participation wavier process to the local level is the 315th Airlift Wing at Joint Base Charleston, South Carolina. There, Master Sgt. Hope Lapoczka, Aerospace Medicine manager, is working with her team to implement these changes.

“By having a participation waiver granted it gives the members’ squadron and leadership an opportunity to ensure their wellbeing while they are going through a sometimes difficult process,” Lapoczka said, “especially when someone is going through a mental health related waiver. To some members, the Reserve is their family and their only support system, when you take that away it can have a heavy effect on that member’s wellbeing. Overall, it will increase our ability to complete the mission effectively across the wing and keep a close eye on our fellow Airmen.”

She said the policy changes have had secondary positive effects on the Reservists as well.

“In the past we have had participation waivers denied for members whose full case processing took sometimes over two years,” she said. “This has caused the member to have two bad years towards retirement. Also, it helps relieve financial burdens from not having the monthly Reserve income that they were used to and for some members this is their primary source of income. Some members are on orders so often that they don’t maintain a full time civilian job and rely heavily on military orders. If that type of member is denied a participation waiver for a disqualifying condition, it becomes a sudden loss of income.”

At Travis Air Force Base, California, another test site, Col. Henry Schwartz, 349th Aerospace Medicine Squadron chief, said the ability to process participation waivers has added to the amount of work he and his staff have to do, but it is a positive change.

“It transiently increased our workload as we dig through our backlog,” Schwartz said. “However, the satisfaction of being able to get a valued Reservist back in the fight quickly is huge. The process has resulted in improved moral among the entire staff here at the unit.”

These changes, along with hiring more full-time medical staff to eliminate the medical case backlog, are in motion to enable Reserve Citizen Airmen to serve and succeed.