Army's veteran care problems widespread

The Army said Wednesday it was hiring case managers and boosting oversight at military facilities after a new internal review concluded poor outpatient care extended beyond Walter Reed Army Medical Center.

Gen. Richard Cody, the Army's vice chief of staff, said officials were finalizing a report on problems after a team of Army inspectors visited 11 bases in seven states last month to study outpatient treatment, building conditions and the information provided to patients.

The investigation found staffing shortages, excessive paperwork and poor training that created too much bureaucracy and long waits for injured soldiers, particularly at Fort Stewart in Georgia and Fort Hood and Fort Bliss in Texas.

Army officials also were taking a special look at problems at Fort Lewis in Washington state.

Calling the delays unacceptable, Cody and Gen. Michael S. Tucker, a deputy commanding general at Walter Reed, said the Army was working hard to hire the personnel needed by June so injured soldiers could get the treatment they deserve.

"What's happening here at Walter Reed is a microcosm of things we need to address with our Army," Cody said in a briefing with reporters at Walter Reed. "We are now moving to fix it across the Army."

The Army's comments come as a slew of task forces and congressional committees are investigating ways to improve care following disclosures in February of shoddy outpatient treatment at Walter Reed, the Army's premier center for treating injured soldiers returning from Iraq and Afghanistan.

On Tuesday, President Bush ordered the Pentagon and the Veterans Affairs Department, which share responsibility for providing medical care to soldiers and veterans, to work more closely together and increase screenings for brain injury after a presidential task force concluded that gaps existed.

Cody said the internal Army review found many of the delays came as injured soldiers awaited determinations on whether their disability made them unfit to serve, and if so, what level of benefit payments they should get. Patients and doctors also reported shortages in nurses and behavioral specialists.

"They shouldn't have to come back here and fight a bureaucracy. That's what we're attacking," Cody said. "It's 40 years in the making. We have to change a bureaucracy and turbocharge it."

At Walter Reed, patients in the dilapidated Building 18 have already been moved to other parts of the facilities, with rooms equipped with telephones, plasma screen TVs and Internet access. On Wednesday, Walter Reed also activated a new "warrior transition brigade," a group of primarily combat veterans who help guide injured soldiers from inpatient to outpatient treatment.

The new brigades, which will be installed at other medical facilities around the nation, will reduce the case-manager-to-patient ratio from 1:50 to 1:17, the Army said.

Other changes that may require new legislation may take longer, officials said. They include improving cooperation with the VA, and reforming a disability ratings system that critics say is unwieldy and unfair.

The facilities reviewed by Army inspectors last month were:

_Dwight D. Eisenhower Army Medical Center, Fort Gordon, Ga.;

_Winn Army Community Hospital, Fort Stewart, Ga.;

_Tripler Army Medical Center, Honolulu, Hawaii;

_Blanchfield Army Community Hospital at Fort Campbell, Ky.

_Ireland Army Community Hospital at Fort Knox, Ky.;

_Guthrie Ambulatory Health Care Clinic, Fort Drum, N.Y.;

_Womack Army Medical Center, Fort Bragg, N.C.;

_Darnall Army Community Hospital, Fort Hood, Texas;

_Brooke Army Medical Center, Fort Sam Houston, Texas;

_William Beaumont Army Medical Center, Fort Bliss, Texas; and

_Madigan Army Medical Center, Fort Lewis, Wash.

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