Health Care Improves, GAO Says
Staff Shortages, Other Issues Remain, Officials Tell House Panel

By Steve Vogel
Washington Post Staff Writer
Thursday, February 28, 2008

The Army has significantly improved its support for service members undergoing medical treatment at Walter Reed Army Medical Center and other military hospitals, but it still faces shortages of staff and other gaps, GAO officials told a congressional committee yesterday.

"Challenges remain, but the trend is in the right direction," John Pendleton, acting director of health care for the Governmental Accountability Office, told a House subcommittee on oversight and governmental reform.

Rep. John F. Tierney (D-Mass.), chairman of the subcommittee, credited the Army with improving military health care in the year since a scandal developed over reports in The Washington Post of poor treatment for wounded service members at Walter Reed. But he raised concerns about the continuing shortfalls identified and the progress of efforts to streamline the disability-evaluation process.

"It's equally clear we have a ways to go," Tierney said.

The GAO reported in September that the Army faced serious shortages in staffing new warrior transition units that have been created to help wounded soldiers navigate the medical bureaucracy. Since then, the Army has increased the number of staff in key positions by almost 75 percent, the GAO said, but more than one-third of the units are still short staffed.

Army Lt. Gen. Eric Schoomaker, who took command of Walter Reed after the scandal a year ago and now serves as the Army surgeon general, credited a "total transformation the Army is undergoing in the way we care for soldiers and families" for the improvements.

"A year ago, our wounded believed their complaints were falling on deaf ears," Schoomaker said.

The Pentagon and the Department of Veteran Affairs are testing a pilot program at Walter Reed and elsewhere to simplify the process that determines how much disability pay wounded soldiers should receive. The cumbersome process now in place, involving evaluations by each agency, is at the heart of much of the frustration experienced by soldiers recovering from wounds suffered in Iraq and Afghanistan.

The GAO expressed concern that the Pentagon and VA lack any means of evaluating the timeliness and accuracy of the pilot program. Daniel Bertoni, director of education, workforce and income security for the GAO, said the agencies will only have "limited data" to assess the pilot's effectiveness.

"There's a legitimate concern that we may end up at the end of this pilot program right back at the beginning," said Tierney, who questioned why the Pentagon and VA were testing only one pilot.

Michael L. Dominguez, the principal deputy undersecretary of defense for personnel and readiness, said the Pentagon and VA are confident the pilot program is on the right track. "What we did so far is simple -- take two steps that were redundant" and streamline them into one, he said. "Just pulling that out seems to me relatively unobjectionable," he said.

The mild criticism leveled at yesterday's meeting was notably changed from hearings last year, when members of Congress took turns lambasting the Army.

With votes scheduled in the House, only five of 21 subcommittee members were present for the hearing, and by the time it ended, all but the chairman had left.

Tierney vowed that the subcommittee would continue holding hearings on the progress at Walter Reed. He said that over the past year, a host of congressional, White House, Army, Pentagon, VA and independent commissions have investigated the issue and urged changes.

"If past is prologue, none of the work by these groups will mean anything unless there is the political will and resolve to fundamentally improve the system and to make the difficult choices necessary to actually implement some of the most wide-ranging recommendations," Tierney said.

Dominguez acknowledged that Congress and the GAO should keep monitoring the Pentagon's efforts. "Extra eyes on the problem continue to be needed," he said.

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