Posted on: Monday, March 26, 2007
Wounded Warrior Act 1st step to rectify care of troops
By Tom Philpott
War-wounded service members and their families will have a stronger team of advisers and advocates to guide them through care, recovery and disability evaluation under a package of initiatives unanimously approved last week by the House Armed Services Committee.
The Wounded Warrior Assistance Act (HR 1538) is the first and unusually swift legislative action taken by lawmakers to address a host of problems encountered by outpatients at Walter Reed Army Medical Center in Washington, D.C., and perhaps in other military and VA facilities.
Committee Chairman Ike Skelton, D-Mo., called it a "first step" in response to "the inadequate living conditions and the administrative snafus" experienced at Walter Reed. The full House is expected to vote on the package soon even as an independent task force and various government investigations continue to study what went wrong at Walter Reed.
Reps. Vic Snyder, D-Ark., and John McHugh, R-N.Y., chairman and ranking member of the armed services subcommittee on military personnel, said they worked with their staff and the veterans affairs committee on details of the package. But the aggressive schedule set by House leadership left no time even for its personnel subcommittee to mark up the bill.
Mike Higgins, a personnel issues expert on the committee staff, explained its details to lawmakers before their vote. He said the bill would be providing "the people, the training, the oversight mechanisms" needed to ensure wounded service members and families no longer face the frustrations reported at Walter Reed.
Higgins added, "We are also hopeful that it will restore confidence in the disability (rating) system and members are going to truly believe that the system is not going to let them down."
Among other things, the bill would require:
Assignment of a case manager for all outpatients to oversee their medical and dental care with a quality guideline that no case manager would be responsible for more than 17 patients. Higgins said many war wounded have complained that no one has been identified for them to talk to learn their options for care and rehabilitation.
Creation of a new position of "service member advocate" to assist outpatients and their families with issues involving their welfare and quality of life, whether family members have moved near the hospital or still reside at home. No advocate would be assigned more than 30 cases at a time.
Twice-yearly surveys of wounded warrior outpatients on quality and timeliness of care, adequacy of living conditions, adequacy of case management, and fairness and timeliness of the disability evaluation process. Higgins said the survey would inform hospital commanders, their staffs and their superiors on how well outpatients are being handled.
A toll free hot line for outpatients and their families to report on deficiencies in medical-related support facilities including housing. Staff would have 96 hours to substantiate and rectify the problem to include relocating to adequate quarters.
That medical facilities notify members of Congress when a service member has been evacuated from a theater of operation for care, if the injured member consents to such notification. Presumably this would allow lawmakers to keep track of injured constituents.
Assignment of an independent medical advocate for service members going before medical evaluation boards. Higgins said many members do not feel they get the right kind of access to physicians who decide their futures and disability ratings.
Establishment of a caseload ratio of 20 to 1, as well as standardized training, for physical evaluation board liaison officers. These individuals help members through the disability evaluation system but training is "sadly lacking," Higgins said. This change, he said, is important for "making sure people feel they are getting fairness and equity out of the disability evaluation system." Standardized training on the disability system also would be established for supervisors, commanders, healthcare professionals and others having an active role in the system.
That medical conditions to be deemed "stable and permanent" before a service member can be removed from the Temporary Disability Retirement List.
A 5,000-member pilot program to improve transition of wounded service members from the military to the Department of Veterans Affairs. A transition plan for separating or retiring members would be prepared.
The committee approved various amendments to the bill before passage. The only episode of political partisanship occurred when Rep. Jeff Miller, R-Fla., proposed an amendment to require that no wounded warrior be housed or hospitalized within 50 miles of a "foreign national detainee."
Miller's purpose was to block any move by Democrats to close the prison at Guantannamo Bay, Cuba, and move detainees to stateside military bases. Skelton argued the amendment was inappropriate for a bill to help wounded members. It was rejected 33-to-27 on a straight party line vote.
