"The commanding general of U.S. Army Medical Command, Lt. Gen. Kevin Kiley, will be acting temporarily as Walter Reed commander until a general officer is selected for this important leadership position," the statement said. http://www.cnn.com/2007/US/03/01/walter.reed/index.html Oh, just great. How terribly typical. The guy who's been tabbed to take over at Walter Reed was the commander there from 2002 to 2004, and is part of the on-going problem, not a solution, even if a temporary one. Gen. Kiley knew about vets' outpatient scandal Veterans groups told the Army surgeon general about the shockingly bad mental health treatment at Walter Reed two months before the latest expose, but there's no evidence he followed up. Feb. 27, 2007 | Though he has since dodged the question in a television interview, the officer in charge of medical care for the U.S. Army was told more than two months ago that the Army's outpatient medical care program was dysfunctional, yet he apparently took no action in response. The Army's outpatient services include the substandard treatment at Walter Reed Army Medical Center that has been the subject of a number of recent articles in the Washington Post and a series of stories in Salon in 2005. At a meeting last Dec. 20, a group of veterans advocates informed Lt. Gen. Kevin Kiley, former commander of Walter Reed Army Medical Center and now the Army surgeon general, that soldiers returning from Iraq were routinely struggling for outpatient treatment and getting tangled in the military's byzantine disability compensation system -- and that their families were suffering along with them. "We are here to tell you that our soldiers and our veterans, and some of their families, are falling through the cracks," Steve Robinson, director of veterans affairs at Veterans for America, told Kiley at a meeting of the Department of Defense Health Board Task Force on Mental Health. Kiley co-chairs the panel, which was created by Congress to probe military mental-healthcare capabilities. "Hundreds and potentially thousands of soldiers are facing barriers to mental healthcare," said Robinson, "and are facing improper discharges" because of the Army's complex discharge and compensation system. Robinson also warned Kiley, who ran Walter Reed from 2002 through 2004 and still has responsibility for it as Army surgeon general, that the scandalous situation threatened to become a media firestorm. "If we identify something," said Robinson, "we would much rather bring it to the chain of command than see it reported in [CBS'] '60 Minutes.'" Kiley called the veterans' remarks "very important testimony," and allowed speakers to go beyond their allotted time limits, but there's no evidence that he has followed up. Since the Post stories broke, Kiley has mostly insisted that the outpatient problems are confined to poor building maintenance, and has denied any evidence of poor healthcare treatment. Kiley's office did not respond to an e-mail asking him to discuss what steps he may have taken to address the shortfalls described to him last December. Robinson, from Veterans for America and a retired Army Ranger, said Kiley should have acted after that briefing. "I took this as an opportunity to testify before Kiley and put on the record that we knew what was going on and we wanted him to do something about it," Robinson said in a telephone interview. "It was that the system was broke." http://www.salon.com/news/feature/2007/02/27/kiley/ D&D. The Cutting Edge of Societal Devolution.
As far as I can tell, taken in conjunction with Oski2005's article from yesterday I have a hard time seeing this replacement as anything more than a political move. The Army may be trying to fix the problems, I don't know. But it seems that they are also doing their best concurrently to placate the media and ensure that other problems don't become public. To me, that seems to show dedication to fixing issues, but rather a dedication to PR.
From what little I gathered from CNN a while ago, Kiley is never going to take that office again, temporarily or otherwise. Gates woke up, fired the Army Secretary, and is going to appoint a permanent replacement to head Walter Reed shortly. Thank goodness. D&D. The Top of the Lowest Order of Mankind. We be sittin' on TOP, people!
link Hospital Officials Knew of Neglect Complaints About Walter Reed Were Voiced for Years By Anne Hull and Dana Priest Washington Post Staff Writers Thursday, March 1, 2007; Page A01 Top officials at Walter Reed Army Medical Center, including the Army's surgeon general, have heard complaints about outpatient neglect from family members, veterans groups and members of Congress for more than three years. A procession of Pentagon and Walter Reed officials expressed surprise last week about the living conditions and bureaucratic nightmares faced by wounded soldiers staying at the D.C. medical facility. But as far back as 2003, the commander of Walter Reed, Lt. Gen. Kevin C. Kiley, who is now the Army's top medical officer, was told that soldiers who were wounded in Iraq and Afghanistan were languishing and lost on the grounds, according to interviews. Buy This Photo Behind the gates of the Walter Reed Army Medical Center on Butternut Street, the stately homes of Commander George W. Weightman and top Army medical officer Kevin C. Kiley stand in stark contrast to Building 18, which is just across Georgia Avenue. (Photos By Michael Williamson -- The Washington Post) The Other Walter Reed Painting Over the Problems at Walter Reed's Building 18 Walter Reed Stories Factual But Unfair, Medical Chief Says At Walter Reed, 'We're Going to Fix It' Swift Action Promised at Walter Reed POST EDITORIAL: Rotten Homecoming More Stories Military News Military news top strip Bush Orders Review of Service Members' Care Islamic Group Claims It Kidnapped 18 Iraqi Government Workers Shortages Threaten Guard's Capability Australian Detainee Is Charged Under '06 Law More Stories Who's Blogging? Read what bloggers are saying about this article. Tailrank - Top News for Today AlterNet: Blogs: PEEK Think Progress Full List of Blogs (227 links) » Most Blogged About Articles On washingtonpost.com | On the web Save & Share Article What's This? DiggGoogle del.icio.usYahoo! RedditFacebook Steve Robinson, director of veterans affairs at Veterans for America, said he ran into Kiley in the foyer of the command headquarters at Walter Reed shortly after the Iraq war began and told him that "there are people in the barracks who are drinking themselves to death and people who are sharing drugs and people not getting the care they need." "I met guys who weren't going to appointments because the hospital didn't even know they were there," Robinson said. Kiley told him to speak to a sergeant major, a top enlisted officer. A recent Washington Post series detailed conditions at Walter Reed, including those at Building 18, a dingy former hotel on Georgia Avenue where the wounded were housed among mice, mold, rot and cockroaches. Kiley lives across the street from Building 18. From his quarters, he can see the scrappy building and busy traffic the soldiers must cross to get to the 113-acre post. At a news conference last week, Kiley, who declined several requests for interviews for this article, said that the problems of Building 18 "weren't serious and there weren't a lot of them." He also said they were not "emblematic of a process of Walter Reed that has abandoned soldiers and their families." But according to interviews, Kiley, his successive commanders at Walter Reed and various top noncommissioned officers in charge of soldiers' lives have heard a stream of complaints about outpatient treatment over the past several years. The complaints have surfaced at town hall meetings for staff and soldiers, at commanders' "sensing sessions" in which soldiers or officers are encouraged to speak freely, and in several inspector general's reports detailing building conditions, safety issues and other matters. Retired Maj. Gen. Kenneth L. Farmer Jr., who commanded Walter Reed for two years until last August, said that he was aware of outpatient problems and that there were "ongoing reviews and discussions" about how to fix them when he left. He said he shared many of those issues with Kiley, his immediate commander. Last summer when he turned over command to Maj. Gen. George W. Weightman, Farmer said, "there were a variety of things we identified as opportunities for continued improvement." In 2004, Rep. C.W. Bill Young (R-Fla.) and his wife stopped visiting the wounded at Walter Reed out of frustration. Young said he voiced concerns to commanders over troubling incidents he witnessed but was rebuffed or ignored. "When Bev or I would bring problems to the attention of authorities of Walter Reed, we were made to feel very uncomfortable," said Young, who began visiting the wounded recuperating at other facilities. Beverly Young said she complained to Kiley several times. She once visited a soldier who was lying in urine on his mattress pad in the hospital. When a nurse ignored her, Young said, "I went flying down to Kevin Kiley's office again, and got nowhere. He has skirted this stuff for five years and blamed everyone else." Young said that even after Kiley left Walter Reed to become the Army's surgeon general, "if anything could have been done to correct problems, he could have done it." Soldiers and family members say their complaints have been ignored by commanders at many levels.
link Hospital Officials Knew of Neglect More than a year ago, Chief Warrant Officer Jayson Kendrick, an outpatient, attended a sensing session, the Army's version of a town hall meeting where concerns are raised in front of the chain of command. Kendrick spoke about the deterioration and crowded conditions of the outpatient administrative building, which had secondhand computers and office furniture shoved into cubicles, creating chaos for family members. An inspector general attending the meeting "chuckled and said, 'What do you want, pool tables and Ping-Pong tables in there?' " Kendrick recalled. Army officials have been at other meetings in which outpatient problems were detailed. Buy This Photo Behind the gates of the Walter Reed Army Medical Center on Butternut Street, the stately homes of Commander George W. Weightman and top Army medical officer Kevin C. Kiley stand in stark contrast to Building 18, which is just across Georgia Avenue. (Photos By Michael Williamson -- The Washington Post) The Other Walter Reed Painting Over the Problems at Walter Reed's Building 18 Walter Reed Stories Factual But Unfair, Medical Chief Says At Walter Reed, 'We're Going to Fix It' Swift Action Promised at Walter Reed POST EDITORIAL: Rotten Homecoming More Stories Military News Military news top strip Bush Orders Review of Service Members' Care Islamic Group Claims It Kidnapped 18 Iraqi Government Workers Shortages Threaten Guard's Capability Australian Detainee Is Charged Under '06 Law More Stories Who's Blogging? Read what bloggers are saying about this article. Tailrank - Top News for Today AlterNet: Blogs: PEEK Think Progress Full List of Blogs (227 links) » Most Blogged About Articles On washingtonpost.com | On the web Save & Share Article What's This? DiggGoogle del.icio.usYahoo! RedditFacebook On Feb. 17, 2005, Kiley sat in a congressional hearing room as Sgt. 1st Class John Allen, injured in Afghanistan in 2002, described what he called a "dysfunctional system" at Walter Reed in which "soldiers go months without pay, nowhere to live, their medical appointments canceled." Allen added: "The result is a massive stress and mental pain causing further harm. It would be very easy to correct the situation if the command element climate supported it. The command staff at Walter Reed needs to show their care." In 2006, Joe Wilson, a clinical social worker in the department of psychiatry, briefed several colonels at Walter Reed about problems and steps that could be taken to improve living conditions at Building 18. Last March, he also shared the findings of a survey his department had conducted. It found that 75 percent of outpatients said their experience at Walter Reed had been "stressful" and that there was a "significant population of unsatisfied, frustrated, disenfranchised patients." Military commanders played down the findings. "These people knew about it," Wilson said. "The bottom line is, people knew about it but the culture of the Army didn't allow it to be addressed." Last October, Joyce Rumsfeld, the wife of then-Defense Secretary Donald H. Rumsfeld, was taken to Walter Reed by a friend concerned about outpatient treatment. She attended a weekly meeting, called Girls Time Out, at which wives, girlfriends and mothers of soldiers exchange stories and offer support. According to three people who attended the gathering, Rumsfeld listened quietly. Some of the women did not know who she was. At the end of the meeting, Rumsfeld asked one of the staff members whether she thought that the soldiers her husband was meeting on his visits had been handpicked to paint a rosy picture of their time there. The answer was yes. When Walter Reed officials found out that Rumsfeld had visited, they told the friend who brought her -- a woman who had volunteered there many times -- that she was no longer welcome on the grounds. Last week, the Army relieved of duty several low-ranking soldiers who managed outpatients. This week, in a move that some soldiers viewed as reprisal for speaking to the media, the wounded troops were told that early-morning room inspections would be held and that further contact with reporters is prohibited. Yesterday, Walter Reed received an unscheduled inspection by a hospital accreditation agency. Members of the Joint Commission, formerly the Joint Commission on Accreditation of Healthcare Organizations, began a two-day visit "for cause" to examine discharge practices that have allowed soldiers to go missing or unaccounted for after they are released from the hospital.
Cut VA benefits and slash budgets and it's bound to bite you in the azz. ----------- 'It Is Just Not Walter Reed' Soldiers Share Troubling Stories Of Military Health Care Across U.S. http://www.washingtonpost.com/wp-dyn/content/article/2007/03/04/AR2007030401394_pf.html Focus on Veterans’ Chief as Inquiries on Care Begin http://www.nytimes.com/2007/03/05/w...l=1&adxnnlx=1173100671-TLwSBdVjDHeAAKa/INHfug
I understand that my anecdotal experience is not necessarily reflective of anything important, but the program I work for has been in contact with LTG Kiley over the past four months or so. He and a fifteen-person task force schlepped across the country to listen to our program recommendations for improving health care for veterans, and I have to say, he was impressive as hell. Smart questions, cut through BS, totally alert during our boring-ass four plus hour presentation, and displayed a tremendous sensitivity to the needs of returning vets. I presented a half-hour-or-so report to him, we chatted before and after, and he left a very very good impression on all of us. He also made things happen afterwards. He was not at all partisan, he was very contemporary in his understanding of complicated issues, open-minded, a great listener, good humored and very energetic. I've been very surprised by how many senior military officers are like this. It is very humbling. He is, actually, exaclty the kind of guy I would want in charge of a place like Walter Reed- medically sophisticated, personally charismatic and articulate, and thoughtful and unafraid of change. VA health care and DOD processes are extremely complicated, very slow to change, and very sprawling and difficult to manage. Maybe Lt. Gen Kiley has some shady past or some bad resume, but it is tough for me to picture him twiddling his thumbs while soldiers suffer. From our morning together, he was clearly not a Bush hack, clearly not a partisan dolt, clearly not a dull bureaucrat - he was all about the vets. period. I think the thing to remember is, sometimes big public systems cab be very broken, and good people can be at the helm when bad things are happening - not that people should not be held accountable, but inherited mess is difficult, prioritizing fixes is not always easy, and sometimes people's hands are tied by factors beyond their control. We need top be sure we do not demonize everyone within a 10 mile radius when something goes wrong. It's too easy, and it is disincentivizes good people away from tough jobs. I mean, who knows, my interaction with Lt. Gen. Kiley was for one day, and what do I know. But he impressed the bejesus out of me, made things happen in the wake of his visit - I am not that easily starstruck, but dude was a total stud in my experience.
CBFC, I can certainly understand the impact of seeing someone in person (I've been accused of being overly fond of JFK, because I saw him give a big speech at Rice Stadium), so I could be wrong about the guy, but how could he be in charge of Walter Reed for 2 years and not be aware of these conditions? D&D. The Cutting Edge of Societal Devolution.
I dont know - he never said he was not aware of them, I don't think. It's hard for me to defend him on that, I really don't know; I would almost be more surprised if he did NOT know about them than if he had to have people tell him about the shortcomings. My guess is that when people have limited resources or inadequate resources, they are likely to take a fall for unsolves problems.I dont know, i really dont. But I can relate to that "okay, i have four dollars to allocate to 950 worthy causes" thing, and those decisions are really really tough, especially with vets, all of whom are deserving. The point i am trying to make is, these changes come v-e-r-y s-l-o-w-l-y. Maybe Kevin Kiley was not effective at Walter Reed; i really dont know for sure, I have no insight on that. But I do know that the larger problems - resources, bureacracy and supply/demand - are more complicated than demonizing any one woman or man - someone who demonstrated a good deal of integrity and motivation and efficacy to me firsthand. We tend to be very good about blasting people and ridding ourselves of them, but less effective at changing an ineffective system. It requires insight, research, understanding and sometimes unglamorous changes and sometimes expensive ones - all politically inconvenient, and not always as politicizable as decision makers would like them to be. Kevin Kiley is not our problem. Our problem is delivering high quality medical care to an incredibly deserving population, at great expense, and in great quantity, in geographically disparate locations. It is a transcendent issue, beyond politics. Anyone want a crack at it?
Sometimes we shouldn't base our impression of someone on some polished presentations. Some people are just very good in window dressing. In fact you can read news stories about Walter Reed painting and fixing Building 18 after the news broke. There are also some news stories saying Kevin Kiley ignored many complaints from the patients and their families. I think we should give more cred to the people who are living under his supervision as oppose to your one day encounter. On the other hand, let's assume his ineffectiveness is due to very poor funding of the Bush Admin. In this case, he should first complain. If that failed, he should find another job and then resign if he found that he couldn't do his job without betraying his own conscience. If he kept doing his job (and even got promoted), then he should take the fall even if the fault is on the higher up. That's just the way the world operates.
GRRRRRR. You're missing the point of my post, and actually making the point for me. I am not trying to say Kevin Kiley should not be held accountable. I said one million times that my anecdotal experience is my anecdotal experience. I am not judging him one way or the other, i am trying to give some insight into how it is more complicated that "good guy vs. bad guy." (by the way Kiley did not give the "polished presentation" - he was listening). Whatever - its not important to this debate. What I am trying to say is, demonizing Kiley or whoever else it e-a-s-y. But it is just not that simple. Look, there is going to be a massive influx of veterans needing expensive high quality care, and the system is not currently equipped to handle it. You can fire high-ranking people and demonize them until the world turns flat, but saying "if only there was not an evil a-hole in that position this problem would be solved" is a cop-out. Its harder than that. Kevin Kiley is not Michael Brown, is what I am trying to say, and this problem is a more nuanced, more chronic problem than Katrina, and is going to need a very focused debate. Spinning veteran health through the paradigm of partisan politics is going to water down and extend the debate, and delay the solutions our vets need and deserve. I repeat: Do you want to help us figure out how to deliver high quality medical care to an incredibly deserving population, at great expense, and in great quantity, in geographically disparate locations? Can anyone do it without bashing the administration? Can anyone do it without bashing "the liberals"?
Can you tell us what are the systematic problems in the VA system? I am not an expert in this. I only heard that VA money was cut. So obviously we should start from improving funding. But then how can you do this when you have tax cut and an expensive war going on?
Yeah, it is going to be a supply and demand problem first of all, but also treating problems early, so they do not blossom into public health nightmares longterm (PTSD, traumatic brain injury-related problems, untreated physical health problems, readjustment-related issues - family, vocational, etc - destigmatizing embarassing conditions, communcation between DOD and VA (complicated confidentiality / screening issues...), outreach to those not getting care, etc. etc. etc.). The Vietnam generation got hammered when they returned, making the same mistakes would be awful with these men and women. But its a puzzle that the political debate has missed, i think. Again, I am no expert, i just know what i dont know, and this is going to be along term issue, longer than the war, that both sides of the aisle are going to need to get over from a political perspective.
Or award contracts to former Halliburton Manager's company and cut staff at the hospital. That always save money and improve services.
I just want to reiterate here that Walter Reed is not part of the VA system. People in Walter Reed are still under the authority of the Army/DoD. They are still soldiers, not 'ex-soldiers' even though many undoubtedly will never be able to return as active duty soldiers. The VA system is and has been screwed to hell since forever and that is a total shame, but it is a seperate issue.
That's a myth. From Krugman today in the NYT: "By the early years of this decade the Veterans Health Administration was, by many measures, providing the highest-quality health care in America. (It probably still is: Walter Reed is a military facility, not run by the V.H.A.) " You're right, Walter Reed is not VA, but its not a separate issue - the idea of soldiers getting inadequate care after deployment is a VA problem as much as DOD. The VA - single payer system – has great medical records systems, and has been a magnet for great doctors and researchers for a while now. Not all of them are great, but a lot are very good, and some are really great.
Dothan, AL: Dothan Clinic, Dothan Mental Health Center Montgomery, Al: Central Alabama Veterans Health Care SystemWest Campus Houston, Michael E. DeBakey VA Medical Center Panama City Beach, FL: VA Gulf Coast Health Care System - PanamaOutpatient Clinic Washington DC: Community Clinic-Southeast, Washington DC VA Medical Center Minot, ND: Minot VA Clinic And that's just the states.
