Report Says Fixes Slow To Come at Walter Reed

Washington Post Staff Writer
Thursday, September 27, 2007; Page A01

More than half a year after disclosures of systemic problems at Walter Reed Army Medical Center and other military hospitals, the Pentagon's promised fixes are threatened by staff shortages and uncertainty about how best to improve long-term care for wounded troops, according to a congressional report issued yesterday.

Army units developed to shepherd recovering soldiers lack enough nurses and social workers, and proposals to streamline the military's disability evaluation system and to provide "recovery coordinators" are behind schedule, according to the Government Accountability Office report.

Members of a congressional oversight committee, discussing the report at a hearing yesterday, said the effort to reform the medical bureaucracy has itself become mired in bureaucracy.

"After so many promises but so little progress, we need to see more concrete results," said Rep. Thomas M. Davis III (Va.), the ranking Republican on the panel. His staff hears "appalling stories" every week from soldiers dealing with the disability process, he said, adding that "they're trapped in a system they don't understand and that doesn't understand them."

"The pace of change is frustratingly slow," said Rep. Henry A. Waxman (D-Calif.), chairman of the oversight committee. "Still the horror stories continue."

Members of the House oversight subcommittee on national security laid the blame on the Defense Department, the Army and the Department of Veterans Affairs for what Rep. John F. Tierney (D-Mass.) termed an "utter lack of urgency."

The preliminary GAO report said the Army has taken steps to streamline its disability evaluation process, which determines whether soldiers are fit for duty and, if not, what disability payments they should receive. Nonetheless, the report noted, "Many challenges remain, and critical questions remain unanswered."

For example, the Army has established "warrior transition units" at 32 installations around the country, with recovering soldiers assigned to a team of physicians, case managers and squad leaders. Whereas the unit at Walter Reed is almost fully staffed, more than half the units had less than 50 percent of workers in place by mid-September, the GAO found.

Maj. Gen. Eric B. Schoomaker, the Walter Reed commander, told the subcommittee that the units have 65 percent of their manpower and should be fully staffed by January.

In July, a presidential commission led by former senator Robert J. Dole and former health and human services secretary Donna E. Shalala recommended that "recovery coordinators" be assigned to shepherd each seriously wounded service member through medical care. A high-level oversight committee established by the Pentagon and the VA agreed to begin implementing the recommendation by mid-October.

But the oversight committee has not determined how many recovery coordinators will be needed or how to decide which injured soldiers need them, the GAO found.

Moreover, the Dole-Shalala commission recommended that the recovery coordinators come from outside the Defense Department or the VA, suggesting instead the Public Health Service.

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