DOD audit: Lewis-McChord's warrior transition unit lacks training

By ADAM ASHTON | The News Tribune (Tacoma, Wash.) | Published: July 5, 2013

TACOMA, Wash. — Some of the soldiers managing care for ill and wounded troops at Joint Base Lewis-McChord's Warrior Transition Battalion lacked proper training before they began their assignments, according to a recently released Defense Department audit.

That inconsistent training coupled with lengthy delays in the Army's medical retirement process exasperated soldiers at a vulnerable point in military careers, soldiers told the Defense Department Inspector General when a team visited the Lewis-McChord site in summer 2011.

The Warrior Transition Battalion "steals your soul and puts you in a deeper depression," one National Guard soldier told the auditors. "They tell me to plan for the future, but they cannot tell me when I can leave."

Comments in the Inspector General report echo some of the criticism that has been leveled at the Army's 38 so-called warrior transition units since they were created in 2007. A 2010 New York Times story famously labeled them "warehouses of despair" that kept soldiers in limbo between the civilian and military worlds.

Warrior transition units are charged with providing long-term care to ill, injured and wounded soldiers at a challenging period in their lives. Once there, the Army decides whether the soldier can become healthy enough to return to service or should receive a medical retirement and a launch into the civilian sector.

The Lewis-McChord report released May 31 was one of five published Inspector General studies taking a deep look at specific warrior transition sites. It praised the local warrior transition battalion for making innovative uses of social workers on site, connecting Army families with comprehensive resources and for compelling soldiers to think about their goals almost as soon as they arrive in the unit.

"The idea of setting goals as your end-state works well because it is your plan so you have something to strive for," one National Guard soldier told the auditors.

The Inspector General called on the Lewis-McChord unit and the nationwide Warrior Transition Command to:

  • Provide more training to soldiers who volunteer to serve in the medical units.
  • Slow staff turnover.
  • Eliminate barriers that prevent soldiers leaving the Army from taking internships outside the federal government while they await medical retirements.
  • Make better use of self-reporting tools that ill and injured soldiers use to track their progress.

Some of the Warrior Transition Battalion staff told the Inspector General they did not receive enough training to learn how to work with soldiers experiencing post-traumatic stress disorder or the effects of concussive head injuries.

Up to 60 percent of the patients at Lewis-McChord's Warrior Transition Battalion have some sort of diagnosed behavioral health condition, the report says. About 40 percent have PTSD or a past head injury that affects their behavior.

"You are still never prepared for some of the types of issues these soldiers have," a nurse case manager told the Inspector General.

Several of the report's recommendations have already been addressed since the Inspector General team visited Lewis-McChord two years ago, officials said.

For example, current Warrior Transition Battalion Commander Lt. Col. Jeff Mosso requires that all of the soldiers assigned to supervise wounded, injured and ill troops must complete three weeks of special training before taking their full responsibilities.

During the Inspector General visit, some of the unit's military staff attended special training for their assignments only after they started working at the Warrior Transition Battalion. That left them ill-equipped to guide soldiers through complex recoveries, the report said.

"As a result, WTB personnel working with the soldiers were at risk of not having the requisite knowledge and capability to effectively assist the soldiers and their families in their healing and transition process," the report said.

Other changes are speeding up the medical retirement process soldiers experience as they move through the battalion.

The Inspector General report noted that most Warrior Transition Battalion soldiers spent between 327 and 455 days waiting for complete medical evaluations for their retirements. The Pentagon wanted those reports within 100 days of their initiation.

Madigan Army Medical Center this week could not provide a current average wait time for those reports. It noted some of the bottlenecks identified in the Inspector General report have been resolved.

For instance, the hospital no longer uses forensic psychologists in standard medical retirements. Patients and caregivers told the Inspector General that waiting for an appointment with forensic psychologists often took months in 2011.

Those doctors fell out of favor last year when patients and their families complained to lawmakers about confusing changes in their behavioral health diagnoses at Madigan. The Army now uses them in a more limited fashion.

Madigan spokesman Jay Ebbeson said the hospital also expedited the typical wait for the narrative summary that accompanies medical evaluations, cutting the typical time down from a delay of 69 days to three.

"They are making great strides in helping to reduce the overall time the soldier spends in the (medical retirement process)," Madigan Deputy Commander Col. Karen O'Brien said in a written statement.


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