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DoD forces changes in warrior care at JBLM

Report: Workers lacked training, patients need better access at JBLM

Jul. 21, 2013 - 06:00AM   |  
Mount Rainier reflects the sunset in the distance about 45 miles away from Madigan Army Medical Center at Joint Base Lewis-McChord, Wash.
Mount Rainier reflects the sunset in the distance about 45 miles away from Madigan Army Medical Center at Joint Base Lewis-McChord, Wash. (U.S. Army Corps of Engineers)
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Joint Base Lewis-McChord, Wash., is the headquarters for Western Regional Medical Command, which covers:
■ 20 states
■ 9 medical treatment facilities
■ 10 Warrior Transition Units, which serve more than over 2,000 soldiers and two community-based WTUs.

Facilities serving wounded warriors at Joint Base Lewis-McChord, Wash., faced 'significant challenges,' according to a Defense Department report.

Facilities serving wounded warriors at Joint Base Lewis-McChord, Wash., faced 'significant challenges,' according to a Defense Department report.

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Facilities serving wounded warriors at Joint Base Lewis-McChord, Wash., faced “significant challenges,” according to a Defense Department report, which found cadre at the wounded warrior unit there lacked consistent training, and soldiers had trouble getting access to specialty care at the post’s hospital.

The Warrior Transition Battalion, “Phoenix Battalion,” faced staff training and turnover problems, according to a newly released DoD Inspector General’s report.

The 104-page report was completed May 31 and publicized by the agency. The report examined care at the Warrior Transition Battalion and Madigan Army Medical Center as part of a broader mission to determine whether service members wounded during deployments in Iraq and Afghanistan were cared for and managed effectively and efficiently.

Much time has passed between the DoDIG’s two-week visit to JBLM in 2011 and the report’s publication, and Army Medical Command and other agencies have since been able to respond to many of the issues raised by the DoDIG. The JBLM WTB described in the report has been replaced by a new Warrior Transition Battalion Complex.

At JBLM, the DoDIG found that personnel involved in the management of WTB troops did not consistently receive training before they began work in the WTB cadre. The cadre who had received the training believed they needed more training to address the diverse range of soldiers’ medical and management needs, according to the report.

One reason some newly assigned WTB cadre had not received training was the slow administrative processing time to approve Guard and Reserve positions, according to the report.

Army Medical Command, in a response included by the DoDIG, said it is awaiting approval for a plan to increase the number of instructors in the WTB leadership and cadre training program.

The WTB was also hindered by Army policy changes that resulted in staff turnover. The policies directed that reserve-component soldiers who volunteer for WTB leadership positions to shift from temporary to permanent change-of-station status, cutting one of their financial incentives to take the jobs.

“Without proper planning and oversight of future WTB staffing, there is the potential for gaps in WTB leadership positions that could have a negative impact on the care, management and transition of Soldiers,” the report concluded.

In response, MEDCOM said tightened budgets mean funding for reserve-component soldiers to fill these jobs will remain an issue. WTC has requested that Army headquarters “consider an alternate sourcing solution.”

The report presented a mixed view of Comprehensive Transition Plans. It lauded the process for providing interdisciplinary teams of medical and non-medical professionals to help troops create customized, in-depth recovery and transition goals. But it found some soldiers “were not truthful or accurate with the information they provided to the CTP.”

“The feedback by some squad leaders was ineffective and untimely; and operation of the automated CTP on the Army Knowledge Online website was cumbersome, unreliable and time consuming,” the report states.

The Army’s Warrior Transition Command has since updated its policy related to the CTP for soldiers assigned to wounded warrior units and formalized a review process to help the soldiers progress through the units, according to the report. The CTP has since migrated from AKO to a platform called the Army Warrior Care and Transition System.

At the hospital, soldiers exceeded the 100-day standard for time in the Medical Evaluation Board phase of the disability evaluation system. Soldiers also had difficulty obtaining timely appointments for some specialty medical care needs.

While the Army’s standard is seven days to get an initial specialty care appointment, it usually took soldiers a month to get a forensic psychiatry appointment, then another three to four months for evalution to be completed, according to the report.

Since then, Madigan has increased its initial specialty consults to meet its access-to-care standard 83 percent of the time, short of its goal of 90 percent.

The report praised initiatives at the WTB and Madigan that it found to be “noteworthy practices for supporting the comprehensive care, healing and transition of soldiers.”

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