Friday, April 20, 2007

Walter Reed Review Group Publishes Findings

Courtesy of Military Officers Association of America

The Independent Review Group (IRG), appointed by the Secretary of Defense to investigate conditions at Walter Reed and Bethesda medical centers, has published its final report on their web site, offering extensive recommendations to overhaul care delivery and disability retirement systems for wounded servicemembers.

The bipartisan IRG was co-chaired by Reagan-era Army Secretary John Marsh and Clinton-era Army and VA Secretary Togo West and included seven other distinguished military and civic leaders. Its report minces no words, describing significant shortcomings in care delivery, leadership, policy and oversight.

While it found first-class care from the time of the injury through the time of inpatient hospitalization, the system broke down when the wounded members transitioned to outpatient status. The group emphasized what co-chairman West described at a hearing last Saturday as "the horrors of the disability review process," in which seriously impaired members are given lowball disability ratings and separated from service rather than being medically retired with health and other benefits. The report also highlighted problems with:

Qualification and training of case managers

  • Inadequate consideration, training and care for members with traumatic brain injuries (TBI), burns, amputations and PTSD
  • Inadequate - and declining - mental/behavioral health staffing
  • Accessibility of advanced follow-on care for amputees outside military facilities
  • Lack of electronic interface between military and VA systems
  • A "perfect storm" of BRAC, outsourcing and funding shortfalls that has crippled services at Walter Reed, while a planned transition to Bethesda faces roadblocks
  • Unique challenges for Guard/Reserve members in a system that categorizes them differently than active duty members and raises potential for differential treatment
    Assistance to family members
  • Inadequate housing and maintenance of facilities for outpatients and family members
  • Serious leadership failures to fix these shortcomings and more

The IRG report's recommendations include:

  • Assigning each wounded member a single primary physician and case manager
  • Establishing a center of excellence for TBI and PTSD research and training
  • Creative recruiting and compensation plans to address military staffing shortages
  • A complete overhaul of the disability evaluation system to ensure fairness and consistency
  • Acceleration of transition from Walter Reed to Bethesda and Ft. Belvoir

Testifying on April 14 before the President's Commission on Care for America's Returning Wounded Warriors - a separate 9-member commission appointed by the President to review similar issues - co-chairman West spoke eloquently on what current treatment of wounded warriors says about the country.

"Who are we as a nation?" he asked, observing that, on this score, "We won't like the answer."

"How long will we take to act?" he asked, observing that there have been four similar reports in the last 10 years that had identified and recommended fixes for the same problems the IRG found, and yet the problems haven't been fixed.

MOAA shares that extreme frustration. There are plenty of people pointing out problems with coordinating between service programs, transferring facilities from Walter Reed to Bethesda/Ft. Belvoir, coordinating between DoD and VA programs, between the Administration and Congress, between the House and Senate, and between congressional committees. There's no end of people pointing at somebody else as the primary source of the problem.

It's long past time, on the issue of taking care of the Nation's war-wounded, for leaders in all services, departments, branches, and chambers to get past the rhetoric and finger-pointing and do what it takes to work together and get these problems fixed -- now.

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