Military health-care reform leaves wounded warriors entangled in more red tape

Reforms meant to streamline military health care for severely wounded service members have in many cases worsened the bureaucracy, causing duplication, confusion and turf battles, according to families, congressional overseers and advocates for veterans.

After reports that troops recovering from catastrophic wounds at Walter Reed Army Medical Center and other facilities were getting lost in the military’s system, a high-profile commission recommended in 2007 that every severely wounded service member be assigned a federal recovery coordinator. This “single point of contact” was to cut red tape and shepherd the wounded through recovery and the transition back to military duty or civilian life.

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(John McDonnell/THE WASHINGTON POST) - Retired Army Sgt. Ted Wade, hurt in a bombing in Iraq, has had at least six case managers. He and wife Sarah have pushed for reforms.

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But at least a dozen Defense Department and Department of Veterans Affairs programs have sprung up to coordinate the care.

The proliferation of programs and case managers, intended to better manage health care, “may actually have the opposite effect,” Debra Draper, health-care director for the Government Accountability Office, told a congressional committee last month.

A Rand Corp. study released last week found more than 200 programs sponsored or funded by the Defense Department to help troops with psychological health and traumatic brain injury, leading to significant duplication within and across branches of service.

The bureaucratic problems for the severely wounded can range from additional paperwork to conflicting guidance.

In one situation, five case managers were working on the same life insurance problem for one person, according to a GAO report.

In another, one service member with multiple amputations was advised by his federal coordinator to retire in order to get VA services, but a military coordinator set a goal for him to remain on active duty, greatly confusing the family.

A ‘safety net’

Pentagon officials defend the programs, saying the redundancies ensure that recovering troops get help.

“This is an intentional safety net to make sure these people do not fall through the cracks,” said Philip Burdette, director of wounded-warrior care for the Defense Department.

Burdette said that when he visits hospitals, he often asks troops and their families how many business cards they have collected from program representatives. “Frequently, the number is in the dozens,” he said.

Abbie Holland Schmit, a manager with the Wounded Warrior Project, a nonprofit group that assists injured service members and veterans, said, “I’ve heard people say I need a case manager to manage my case managers — that’s a true statement.”

Retired Army Sgt. Ted Wade advocates for reform of the reform.

Wade lost his right arm and suffered traumatic brain injury in a roadside bombing while serving with the 82nd Airborne in Iraq seven years ago. In 2007, he appeared before the commission with his wife, Sarah, asking that the system be simplified.

“We were drinking from a fire hose,” Sarah Wade recalled.

Now, they say, multiple new programs with overlapping jurisdiction have further confused the situation.

“Things are no more clear to me today than they were back then,” she said. The Wades have at least six case managers. Other families have eight or more.