Defense cites strides in medical care for deployed civilians

U.S. surgeons work in the operating room of a military hospital in Baghdad's Green Zone. U.S. surgeons work in the operating room of a military hospital in Baghdad's Green Zone. Damir Sagolj /Landov
The Defense Department and other agencies have taken strides to improve medical care for civilian federal employees deployed to Iraq and Afghanistan, but there still is room for improvement in implementing existing plans, witnesses told a House Armed Services subcommittee Tuesday.

According to Rep. Vic Snyder, D-Ark., chairman of the panel's Oversight and Investigations Subcommittee, 6,000 civilian Defense employees have been deployed to Iraq and 1,500 to Afghanistan since 2001. Additionally, the State Department has deployed 1,400 employees to Iraq and Afghanistan since 2003. Snyder said he called the hearing to examine whether reports that civilian federal employees were not receiving proper medical care for injuries sustained in theater were isolated incidents or symptomatic of larger problems.

Patricia Bradshaw, the Defense deputy undersecretary for civilian personnel policy, said the Pentagon has gone to great lengths to improve its policies toward deployed civilians. Bradshaw said the deployment health assessments now required of both military personnel and civilian employees are comprehensive and include mental health screening.

She added that the requirements for civilians, updated within the past year, are "consistent with the requirements for deploying military personnel . . . Our policies require that the scope of care provided shall be equivalent to that received by our active duty military personnel."

Brenda Farrell, director of the Defense Capabilities and Management Team at the Government Accountability Office, testified that Defense has established policies aimed at assessing and reducing health risks for deployed civilians, but said the agency needs to continue to work toward full implementation of the policies.

"DoD currently has important policies in place that relate to the deployment of its federal civilians . . . DoD is taking steps in the right direction," Farrell said. "If the department follows through with its efforts, we believe it will strengthen its force health protection and surveillance oversight for the total force."

Bradshaw said cases of civilians receiving insufficient medical care, which occurred during early deployment phases, were a result of implementation, not policy.

"The department's policies . . . are sometimes not known or well understood," Bradshaw said. "The department is taking deliberate steps to communicate these policies more clearly and broadly on a regular and recurring basis."

Snyder and Rep. Todd Akin, R-Mo., the ranking member on the subcommittee, released a joint statement vowing to continue looking into the issues raised at the hearing. The statement said the subcommittee will shortly begin holding informal meetings with injured federal employees and contractors to get an understanding of the care they received in theater and after returning from deployment.

"Our goal is to ensure that the health care system available for these individuals is providing adequate medical treatment and that these important groups are not falling through the cracks," Akin and Snyder said in the statement. "We are asking these civilians to face many of the same dangers as our troops face. They must be taken care of just as thoroughly."

Snyder and Akin also pledged to hold briefings on incentives and benefits offered to federal employees who volunteer to be deployed.

"We must ensure that the best and brightest from these agencies are not being deterred by lack of incentive," the representatives stated.

In addition, they expressed their disappointment that the State Department did not testify at Tuesday's hearing, saying they had great concern about the agency's civilian deployment practices. Snyder said at the hearing that a representative from the agency was expected but the subcommittee was told that pressing commitments prevented the representative from appearing.

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