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thedrifter
02-22-07, 09:02 AM
Leaders take blame for wounded care woes

Health officials ‘surprised;’ lawmakers seeking solutions
By William H. McMichael - Staff writer
Posted : Thursday Feb 22, 2007 5:45:30 EST

The Army’s vice chief of staff said Wednesday that a “breakdown in leadership” is responsible for the widespread administrative problems faced by some wounded war veterans at Walter Reed Army Medical Center in Washington.

Meanwhile, the military’s top civilian health official said that while he was “surprised” to learn of the problems, he and other leaders are aggressively seeking solutions.

The problems at Walter Reed “are serious matters,” said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, during a Wednesday press conference at the Pentagon. “They deserve immediate attention, and they’re getting immediate attention.”

Gen. Richard A. Cody, the Army's No. 2 leader, said “appropriate action is being taken to hold the leadership at every level accountable, as well as to ensure that they understand the standard, and we put the right people in charge, the right level of rank, the right level of responsibility. We want to immediately correct it, but also to ensure that this doesn’t happen again.”

The Pentagon, clearly stung by recent media accounts of the problems at Walter Reed, announced late Tuesday the formation of an independent review group that will examine outpatient care and administrative processes at both Walter Reed and the National Naval Medical Center in Bethesda, Md.

The effort will run parallel to and be complemented by probes also announced Tuesday by the secretaries of the Army and Navy. Those efforts “have begun,” the Pentagon said.

No administrative problems have been reported at the Bethesda complex, and a second Pentagon official said operations there were being reviewed as a cautionary move since it is fairly close to Walter Reed, also provides treatment for wounded vets of the wars in Iraq and Afghanistan and was mentioned anecdotally in the media reports. Nor has any criticism of the actual medical treatment at either facility has been raised.

But recent stories in The Washington Post and the Military Times newspapers and web sites reported that dozens of recovering vets were living in substandard conditions in an overflow facility outside the main Walter Reed campus, and that they and others faced miles of red tape while dealing with issues such as pay and benefits, lost records, medical evaluations and a lack of first-line supervisors.

The Post stories focused in part on “Building 18,” a 54-room Army-owned facility across the street from the main Walter Reed campus where nearly 70 recovering service members are being housed. The stories described some rooms in various states of disrepair, along with a rodent and cockroach infestation — a situation Cody said he should have been briefed on much earlier.

“I am disappointed that I had to learn about the conditions of that building through media reports, despite frequent visits to Walter Reed facilities, informal and formal discussions with patients and their families and the medical staff,” Cody said. “Clearly, we've had a breakdown in leadership, and the bureaucratic, medical and professional processes bogged down a speedy solution to these problems.”

Cody wouldn't identify where the breakdown in leadership took place. “I'll take responsibility and I'll make sure that it's fixed,” he said. “I can assure you that the appropriate vigor and leadership is being applied to this issue. And we will correct any problems immediately.”

Cody said no one has been relieved of command or fired over the problems. “We will do the right thing across the board as we continue to assess where the leadership failure and breakdowns were,” he said, adding that the problems were not due to a lack of resources.

He said he would personally oversee the upgrading of Building 18 and added that the building's name would soon be changed to something that better reflects the building's mission. “Referring to a place where our soldiers stay as Building 18 is not appropriate,” he said.

Tell us your ideas for renaming Building 18 here.

“We will do what's right for our soldiers and our families,” Cody added. “I will not be satisfied until we have a family assistance center at Walter Reed where it's one stop, it has an ‘easy button’, and families and the soldiers all can take care of their financial issues, their scheduling issues, their follow-up care issues. ... Right now, we're close to that, but it does not meet my standard or the leadership standard.”

Winkenwerder said “caring for and supporting the whole person” is just as important as the medical care a service member receives.

Members of the Pentagon’s independent review group have yet to be named, but it is expected to include “people from outside, perhaps some retirees,” Pentagon spokesman Bryan Whitman said Tuesday. He said Defense Secretary Robert Gates wants results within 45 days of the group's formation.

The group will have “unrestricted access to all facilities and personnel and will be provided appropriate assistance and administrative support,” according to the Pentagon. The group will also have a “special advisor” who can provide advice and expertise in the areas of social work, rehabilitation, psychological counseling and family support issues.

According to a senior defense official, the Pentagon review was initiated by Gates, who “was concerned about what he had read and heard about.”

Gates, who met with Army leadership on the issue Tuesday, has “a very strong desire to see this done in a very expeditious fashion,” the official said.

The media reports of conditions at Walter Reed quickly caught the eye of lawmakers on Capitol Hill, with Democratic Sens. Barack Obama of Illinois, Claire McCaskill of Missouri and John Kerry of Massachusetts calling for legislation to improve the situation there.

“We owe our returning veterans a debt of gratitude, not substandard treatment at an overcrowded medical facility,” Kerry said in a statement. “The administration has consistently talked a big game but shortchanged the needs of veterans.”

The Times story documented waiting periods as long as 15 months for service members wounded in battle, as well as sinking disability payments The Post piece looked at buildings in disrepair, mandatory formations for wounded service members, and confusion about the process.

“Anecdotally, we’d heard some complaints before,” said Kerry spokesman Vincent Morris. “But the feeling was mixed because the care at Walter Reed is the best in the country. There was a groundswell of support for Walter Reed when the president announced plans to close it” as part of the latest round of base realignments and closures that was approved in 2005 and is now in motion.

The media coverage of the problems at Walter Reed, he said, brought the anecdotes into sharp focus.

“There are a lot of vets coming back who need help,” Morris said, adding that “Kerry saw those stories like everybody else.”

The legislation, sponsored by Obama and McCaskill and co-sponsored by Kerry, calls for:

* Simplifying the paperwork process for recovering troops.

* Increasing the number of case workers.

* Increasing case worker training.

* Requiring more frequent Inspector General reviews of the hospital and its care.

* Establishing timelines for facilities repairs.

* Providing psychological counseling.

* Reporting to Congress on the number of recovering soldiers and caseworkers, as well as average waiting time, suicide attempts, accidental deaths and drug overdoses.

Staff writer Kelly Kennedy contributed to this report.

Ellie

thedrifter
02-22-07, 02:42 PM
A Hospital Overdue for Treatment
$6 Million in Hand, D.C. Seeks Right Plan

By Sue Anne Pressley Montes
Washington Post Staff Writer
Thursday, February 22, 2007; DZ01

The stately red-brick building with the carriage house and black iron fence has stood mostly vacant for years. But it is easy to look at the Old Naval Hospital on Capitol Hill and imagine when it was busy and vital, as a hospital for sailors and Marines recovering from wounds received in the Civil War.

Now, the property at 921 Pennsylvania Ave. SE is set for a new lease on life. Last week, the D.C. Office of Property Management began welcoming proposals for the 140-year-old building's "restoration, renovation and reuse." The District has allocated $6 million for the project, and many longtime champions of the historic facility are hoping it will be revived as some sort of neighborhood center.

"It's a real jewel of Capitol Hill that's been covered in all the muck and mire of the years," said Greg Richey, president of the Friends of the Old Naval Hospital, a nonprofit group of Capitol Hill residents. "And it can be a real center for the community if we can ever see it to the point where it is restored."

The 2 1/2 -story building was constructed at the close of the Civil War and opened as the "Naval Hospital, Washington City," on Oct. 1, 1866, with a 50-patient capacity. Its first patient was a 24-year-old black sailor named Benjamin Drummond, who had been shot in the shoulder and both legs during a battle off the Texas coast, according to the group. Hospital records show that his wounds were slow to heal, and Drummond was in great pain during his year-and-a-half stay.

The facility remained a Naval Hospital for 40 years, until 1906, and later served as a Hospital Corps Training School and a temporary home for veterans attending to business in Washington. After the Navy transferred jurisdiction over the building to the D.C. government in 1962, it was used for anti-poverty programs and leased to the private Center for Youth Services. But in recent years, it has been mostly empty, except for occasional use by a Neighborhood Advisory Commission.

The building, with its crumbling but gracious Greek Revival and Second Empire flourishes, was listed on the National Register of Historic Places in 1974. In 2000, the D.C. Council considered the building as a possible site for a mayoral mansion, if one were to be funded.

"It's tragically underutilized right now," said Lars Etzkorn, director of the Office of Property Management. "We encourage the submission of creative self-sustaining uses."

Proposals will be accepted until March 12. Etzkorn said the ideal tenant would be a group "sympathetic to the historic integrity" of the building.

This is the agency's second request for proposals for the building's future. In 2004, the Office of Property Management approved a plan that would have put a yoga institute on the site. But then-Mayor Anthony Williams, who wanted a broader community use of the building, opposed the selection.

As the latest debate gets underway, Richey says the Friends of the Old Naval Hospital "are not advocating for or against any particular use." He said the group, which formed in 1999, is just concerned about "this beautiful building right in the midst of our community, going to waste."

Located two blocks from Eastern Market and a 15-minute walk from the Supreme Court and the U.S. Capitol, the Old Naval Hospital is in the center of a thriving neighborhood. (Abraham Lincoln, who commissioned the hospital, is said to have insisted that the facility be within walking distance of Navy Yard and the Marine Barracks.) Etzkorn said the structure has had very little updating over the years, but an engineering assessment found the building to be sound. Most of the walls, doors and staircases are original.

"When you walk in, you know that you're in a Civil War structure," he said.

As a first step toward restoration, the Office of Property Management recently began refurbishing the original iron fence that surrounds the property. In the February edition of the Capitol Hill Restoration Society News, a plea was put out to the "good neighbors" who "have rescued pieces of the ONH fence that were at risk of destruction" to make arrangements to return them.

Richey said the developments are encouraging to a group that has worked so long to champion the building. But he is a bit concerned about the tight deadline for proposals.

"We've gone through years like this -- there's no reason not to extend it a couple of months to give people more time," he said. "We're not in a rush. We want it done right."

Ellie

thedrifter
02-24-07, 07:28 AM
Gates vows to improve outpatient care at Walter Reed
Facility reportedly full of pests, mold

By Ken Fireman, Bloomberg News | February 24, 2007

WASHINGTON -- Defense Secretary Robert M. Gates condemned as "unacceptable" the outpatient care problems encountered by hundreds of wounded U S troops at Walter Reed Army Medical Center and promised to correct them quickly.

Gates announced the creation of an independent panel to investigate conditions at the facility in Washington and vowed to hold those found responsible for the problems accountable.

"This is about our family," Gates said yesterday at a news conference at the medical facility. "And it appears to us that some of our family may not have been treated the way they should have been."

The Washington Post, in a series of articles earlier this week, reported that dozens of recuperating soldiers and Marines are put in dirty, mold-ridden, pest-infested housing. They and others have also faced daunting bureaucratic obstacles to obtaining needed follow-up care, the newspaper reported.

Gates praised the Post for reporting the problems and said he has seen nothing to indicate that its articles were "in any substantial way wrong."

He said the problems were with outpatient care and didn't extend to the medical care given wounded personnel in the main facility, which Gates called "world class."

The secretary said that he met with President Bush earlier yesterday to discuss the issue and that Bush "is understandably concerned."

In vowing to hold accountable those found responsible for the problems, Gates said "some people who are most directly involved" have already been relieved of their duties.

Pentagon spokesman Bryan Whitman said Gates was referring to "individuals who were in a direct supervisory role."

Whitman and White House spokesman Tony Fratto said there was no connection between the Walter Reed problems and the departure of Dr. William Winkenwerder Jr. as assistant defense secretary for health affairs. Whitman said Winkenwerder told his superiors last year that he wanted to leave government service.

The White House said Winkenwerder will be replaced by Dr. S. Ward Casscells , a professor at University of Texas Health Science Center in Houston.

The review panel will investigate conditions at Walter Reed and the National Naval Medical Center in Bethesda, Md., Gates said. Two former Army secretaries, Togo West and Jack Marsh, will lead the inquiry.

The Senate Armed Services Committee plans to hold a hearing March 6 on conditions at Walter Reed, according to one member of the panel, Senator John W. Warner, a Virginia Republican.

Warner, a former Navy secretary and committee chairman, attended Gates's news conference and praised the secretary's handling of the issue.

Ellie