Inspector Common Highlights Staffing Shortages in Navy Well being System

A Nov. 29 report from the Inspector Common of the US Division of Protection highlighted considerations about entry to care and staffing shortages within the Navy Well being System and made suggestions for tactics to start to handle the problems.

After assembly with the 4 Service IGs, the DoD IG determined to publish a administration advisory detailing ongoing considerations. The advisory consists of data offered by the Service IGs, Service Audit Businesses, and the Protection Well being Company (DHA) IG to the DoD Workplace of Inspector Common (OIG), and consists of findings from the DoD OIG based mostly on its revealed work and acquired by way of hotline complaints. The DoD OIG didn’t independently confirm the knowledge offered by the Providers.

The Navy Well being System (MHS) offers well being care to 9.6 million beneficiaries,
together with energetic obligation service members and their households, navy retirees and their
dependents, and in some cases DoD civilians and contractors. The MHS consists of a direct care system, the place beneficiaries get hold of care at navy therapy amenities (MTFs), and a bought care system, the place beneficiaries get hold of care from non-public sector suppliers administered by TRICARE community contracts.

The DoD OIG has recognized points with the power of beneficiaries to obtain entry to
well timed healthcare in prior revealed experiences associated to psychological well being and care offered through the COVID-19 pandemic.

Throughout visits to the INDOPACOM Space of Duty in Could and June 2023, the DoD IG was repeatedly knowledgeable by senior navy and civilian officers of challenges with accessing healthcare, together with challenges with entry to psychological healthcare.

The DoD OIG has acquired no less than seven hotline complaints during the last 12 months from MHS beneficiaries and MHS suppliers highlighting considerations with the power to entry care at MTFs, potential to entry care within the TRICARE community, and staffing shortages on the MTFs.

The Service IGs additionally offered correspondence, documentation, and knowledge
papers to the DoD OIG in April and Could 2023 expressing considerations with the power of
beneficiaries to entry healthcare companies throughout the MHS. The Service IGs particularly highlighted considerations with the power of presidency civilian and contractor staff to entry healthcare companies abroad, and entry to care at smaller MTFs, in addition to staffing shortages. 

The Naval IG carried out focus teams in 2023 and persistently discovered medical care to be among the many prime causes that service members are dissatisfied. The Naval IG offered focus group feedback from Service members expressing dissatisfaction with their entry to care and wait occasions for varied well being companies, together with routine major care and psychological healthcare. Additional analysis by the Naval IG recognized explicit challenges with beneficiary entry to care in places which might be both small, distant, or just lately downsized from a hospital to a clinic. For instance, the Navy recognized access-to-care challenges in Pearl Harbor, Hawaii; Lemoore, California; Oak Harbor, Washington; and Pensacola, Florida, typically resulting from a scarcity of MTF and native community suppliers. In keeping with the Naval IG, small MTFs typically solely serve active-duty service members and ship all different beneficiaries, comparable to relations and retirees, to the TRICARE supplier community.

Nonetheless, the Service IGs offered knowledge displaying that some TRICARE networks usually are not
sturdy or sufficient to satisfy this want and beneficiaries could have problem acquiring community care. For instance, Naval Well being Clinic Pearl Harbor in Hawaii offers restricted specialty care and is presently solely enrolling energetic obligation Service members. Beneficiaries should use a community in Hawaii that solely has one stage 1 trauma heart (in comparison with San Diego which has three) and exceeds the 28-day DoD entry to care requirements for some specialties, comparable to gastroenterology (49 days common wait time for an appointment), psychiatry (52 days common wait time for an appointment), and urology (67 days common wait time for an appointment).

Information offered by the Service IGs point out that entry to psychological well being companies continues to be a specific drawback. For instance, at Naval Hospital Pensacola and surrounding clinics, the Naval IG offered knowledge displaying that many Substance Abuse Rehabilitation Program (SARP) counselor positions are presently empty, and Naval Hospital Pensacola has to persistently rotate these counselors throughout places. 

The Air Power IG offered data from a number of MTFs describing psychological well being supplier shortages and considerations concerning the potential of beneficiaries to entry psychological well being care. For instance, officers from Ellsworth Air Power Base Medical Clinic said that entry to care has been affected by a scarcity of three civilian psychological well being suppliers. The officers stated that with out these

The DoD IG recommends that the Director of the Protection Well being Company determine all
specialties, by location, the place the managed care assist contractor supplier community
isn’t assembly DoD entry to care requirements and, in coordination with the managed care assist contractors, develop and implement a plan to deliver these supplier networks into compliance with the DoD entry to care necessities.

It additionally recommends that the Director of the Protection Well being Company, in coordination with
the Service Surgeons Common:
• Conduct a survey of TRICARE beneficiaries, civilians, and contractors
stationed abroad about their entry to healthcare companies.
• Conduct a survey of suppliers and clinic directors at abroad
Navy Therapy Amenities about entry to well being companies at their location.

The DoD IG report stated that “regardless of being offered a chance to answer the report and an extension of the unique due date, the Director of the Protection Well being Company didn’t reply to the suggestions within the report. Subsequently, the suggestions are unresolved. We request that the Protection Well being Company Director present feedback inside 30 days of issuance of the ultimate report.”