From the U.S. Government Accountability Office, www.gao.gov

Transcript for: Persistent Problems with Care for Wounded Warriors

Description: Audio interview by GAO staff with Randy Williamson,
Director, Health Care

Related GAO Work: GAO-13-5: Recovering Servicemembers and Veterans:
Sustained Leadership Attention and Systematic Oversight Needed to
Resolve Persistent Problems Affecting Care and Benefits

Released: November 2012

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[ Narrator: ] Welcome to GAO's Watchdog Report, your source for news and
information from the U.S. Government Accountability Office. It's
November 2012. Deficiencies exposed at Walter Reed Army Hospital in 2007
prompted a reexamination of the care provided to wounded, ill, and
injured service members and veterans by the Defense and Veterans Affairs
departments. A group led by Randy Williamson, a director in GAO's Health
Care team, recently reviewed the extent to which these persistent
problems have been addressed. GAO's Jeremy Cluchey sat down with Randy
to talk about what they found.

[ Jeremy Cluchey: ] Can you talk about what prompted GAO to look at the
way DOD and Veterans Affairs care for wounded warriors?

[ Randy Williamson: ] Deficiencies at Walter Reed Army Medical Center in
2007 served as a catalyst compelling the Department of Defense and the
Veterans Administration to address a host of problems that wounded, ill,
and injured service members faced as they navigate the recovery care
continuum. That is as they receive acute medical treatment, as they then
transition to rehab services, and then as they are reintegrated into
either to going back to the military active duty or into the civilian
community as a veteran. Subsequently, a number of review groups
identified other problems. The most serious of which included inadequate
care coordination and case management to ensure continuative care and
confusing disability evaluation systems, and thirdly, an inability of
both VA and DOD to electronically share medical records of service
members. The Congress then asked GAO to assess the progress that these
two agencies had made in the last five years to address the problems and
to delineate any challenges that remain.

[ Jeremy Cluchey: ] Your team identified, in the course of this report,
some of the problems that continue to face service members as they
recover. Can you give some examples of what you found?

 [Randy Williamson: ] Sure. Basically, on care coordination in case
management, we found that although DOD and VA have established numerous
programs to address the problems that were identified, oftentimes those
programs are not accessible in all cases to the wounded warriors. There
are basically two main contributing factors to that and a perfect
process for identifying and referring service members who could benefit
from the programs, and also, inconsistencies among the military services
and the eligibility criteria for entering into those programs. And let
me give you a couple of examples. The Wounded Warrior Programs mainly
rely on referrals to identify service members who could benefit from
their services. One of their main sources of the referrals is the
casualty report which outlines service member's injuries and other vital
information. We found that those casualty reports are not always
prepared for every service member and or they’re prepared late in their
recovery process. There are also problems with the disability evaluation
system. It's oftentimes confusing and frustrating to people going
through it. To address those things, both DOD and VA established an
integrated streamline system shortly after the problems at Walter Reed
were revealed. We found that the waiting times after they established
this new process actually went up substantially, as a matter of fact. VA
and DOD attribute that to heavy case loads and not enough staff to
complete the steps necessary for that process.

[ Jeremy Cluchey: ] Given this range of problems facing recovering
service members, what steps is GAO recommending be taken to improve the
situation?

[ Randy Williamson: ] So, our recommendations basically address the
kinds of things I've talked about. For example, we recommended that DOD
address the monitoring issue and basically setup a mechanism to do that.
Also, that they establish consistent eligibility criteria. A final
recommendation is much broader in the sense that we would expect DOD and
VA to really bring a sustained leadership and attention to the issues
and the problems that have been raised that hold some mechanism they've
set up to really achieve that.

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[ Narrator: ] To learn more, visit GAO.gov and be sure to tune in to the
next episode of GAO's Watchdog Report for more from the congressional
Watchdog, the U.S. Government Accountability Office.