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Horoho’s testimony shows scope of Army PTSD investigations at Madigan

Post by Adam Ashton / The News Tribune on March 9, 2012 at 4:25 pm with 1 Comment »
March 9, 2012 4:25 pm

Army Surgeon General Lt. Gen. Patricia Horoho this week told lawmakers in a House Appropriations subcommittee that the Army is investigating the ombudsman program that drew attention to a Madigan Army Medical Center forensic psychiatry unit that sometimes adjusted behavioral health diagnoses in such a way that soldiers did not receive full disability benefits for post-traumatic stress.

These are the other known investigations into the Madigan team:

* An Army Medical Command inquiry into the Madigan forensic unit that is checking cases that were screened by Madigan forensic psychiatrists since 2007. Horoho said the Army identified about 1,600 cases that passed through Madigan forensics. Close to 300  oldiers are being invited to have new screenings that could result in different behavioral health diagnoses. So far, six soldiers whose PTSD diagnoses were changed by Madigan forensics have had their original diagnoses reinstated.

* An Army Medical Command investigation into the command climate at Madigan. That investigation explains why Madigan commander Col. Dallas Homas is on administrative leave. Horoho this week told lawmakers his suspension was a normal action for an investigation.

* A Western Region Medical Command quality assurance investigation into Madigan.

* An Army Inspector General investigation into PTSD diagnoses across the service, looking at diagnostic variances at different institutions.

There could be others.

Horoho said the Army Auditing Agency is looking at the ombudsman. The ombudsman at Madigan played a key role in forwarding notes to Horoho’s office from fall meetings where Madigan forensic psychiatrists appeared to encourage their colleagues to be good stewards of taxpayer dollars in doing their work. One psychiatrist noted that a PTSD diagnosis could cost the government $1.5 million over a soldier’s lifetime.

The subtext: Some retired officers and people in uniform speaking on condition of anonymity have been reporting the ombudsman went too far in these cases. They seem to believe the ombudsman has been in contact at least with Sen. Patty Murray, D- Wash., in providing information about Madigan. That breaks typical Army form because the ombudsman is supposed to work within military channels through Army Medical Command.

Rep. Norm Dicks, D-Belfair, at this week’s hearing asked Horoho if the diagnoses were being changed for political reasons. Horoho in2008 as Madigan commander once endorsed the forensic psychiatry unit that is now under her scrutiny.

She replied that she’s seeking a fair result for the entire Army. She stressed that Madigan is the only Army hospital to regularly use forensic psychiatry in medical retirements. The Army has forensic psychiatrists on staff at other hospitals, but it has not said where they work or how their roles are different from the Madigan unit.

“What we’re looking at is wanting to, one, make sure that our service members received the best care possible. And we’re also looking at variants and across our processes. Forensic psychiatry is not a good capability, it’s not a bad capability, it’s a capability,” Horoho replied.

Rep. Jerry Lewis, R-Calif., appeared concerned that Homas was not getting a fair shake in the investigations. Retired Army Brig. Gen. Michael Walter spoke up for Homas in a conversation with the congressman.

“Dr. Walter served and traveled with Dr. Homas in Afghanistan and knows him to be an outstanding soldier, physician and leader whose highest priority is taking care of soldiers,” Lewis said.

Here’s Horoho’s response:

“Regarding Col. Homas, sir, he — there’s a couple of things when we started the investigation. We had the chief of the forensics was actually administratively suspended pending the investigation. The Warrior Transition surgeon was also administratively suspended pending the investigation. And then Col. Homas was administratively suspended pending the investigation. And those are normal procedures when an investigation is ongoing.”

Leave a comment Comments → 1
  1. inuniformmc says:

    A key takeaway from this. LTG (then MG) Horoho took this program on the road and tried to sell it to the bigger Army? Who did she brief it to (rumor says to the Vice Chief of Staff of the Army, GEN Chiarelli), and why? She must have thought this program to be the best thing since sliced bread, as she certainly knew as an MG she would automatically be considered eligible for promotion to LTG (and TSG)…and she was most certainly on a fast-track promotion cycle.

    Horoho needs to take accountability. This was her baby. She vetted it, she funded it, she advertised it as a new ‘best practice’. But how on earth can she now claim that she knows nothing about it, and that the program represents an “unacceptable variance (her words)” in open and public testimony before Congressman Dicks just a couple of weeks ago? Is her memory really that short? Is she covering for somebody? Or….is she simply concealing the truth in order to protect her own hide (insert body part of choice here)? Her actions are eerily reminiscent of the Walter Reed scenario where junior hospital Commanders, clearly not responsible for the mold growing in a commercial hotel room, were relieved on the spot only to be later reinstated when it was demonstrated that responsibility belonged to an entirely different leadership and Command structure. “Fire First; Ask Questions Later”. Then LTG Kiley was formally relieved for concealing and downplaying and manipulating answers to the press…AND TO CONGRESS (my guess amongst other foibles).

    I continue to believe that LTG Horoho has many questions to answer…and that in no way should she — or any of her subordinate staff [read: Deputy Surgeon General or any of the OTSG senior staff] be allowed to be the investigating or reviewing officers. Cross Horoho = Career Over. The AMEDD has seen that time and time again….and here we go, again. And the Army has seen time and time again that the Army Medical Department cannot and is not capable of investigating itself.

    The Army is best served by leaders who take responsibility for their own actions and decisions. Not those who find scape-goats. LTG Horoho should be removed from office, immediately. At a minimum, “pending completion of investigation”. If that’s the standard here…COL Homas relieved, pending completion…the same standard should by all rights apply to her as well.

    The SecDef, Leon Panetta….maybe…just maybe…may be smelling a rat in how the AMEDD is handling this. I truly hope so. But I don’t think so — I think he is most interested in “variance” between services.

    Thank you for reading.

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