When Col. Dallas Homas took charge of Madigan Army Medical Center in 2011, the military-treatment center had been singled out as a poor performer.
The problems included a $300 million deficit, patients who had difficulty accessing care and a sense of complacency among longtime staff that some called “barons,” according to an investigative report released Friday under the federal Freedom of Information Act.
“My guidance in a nutshell was to get Madigan back on the right track, to ensure access to care was where it was supposed to be, and that we were more prudent in how we were delivering health care …,” Homas told an Army investigator in a March 2012 interview.
In his first year on the job, Homas helped to turn Madigan around even as a new controversy erupted over forensic psychiatrists reversing the post-traumatic-stress disorder diagnoses of soldiers.
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The report credits Homas with creating a “positive command climate,” and found that he did not take any inappropriate actions to influence the diagnoses.
The report findings were approved in April 2012, at a time when the controversy over the screenings had resulted in Homas’ suspension. In August of that year, Homas was reinstated as the base commander.
Madigan is at Joint Base Lewis-McChord, south of Tacoma, and has been a major treatment center for retirees and military personnel, including thousands of soldiers who served in the post-9/11 wars.
A still-unreleased Army investigation of the reversal of PTSD diagnoses resulted in the Army Medical Command dropping the use of Madigan forensic psychiatrists to screen patients under consideration for medical retirement.
The Army conducted a separate investigation of Homas that was released Friday in response to Freedom of Information Act requests from The Seattle Times and other media.
In addition to clearing Homas, the report did not find any fault with the forensic psychiatrists involved in the screening of PTSD patients.
But complaints about the forensic screenings were taken seriously by the Army Medical Command, which opted to offer revaluations to hundreds of patients who had been screened at Madigan in recent years.
After a 2008 change in the law, soldiers diagnosed with PTSD and deemed unfit for service typically could qualify for a medical retirement with pensions and other benefits. Some soldiers who had undergone lengthy treatment for PTSD were angry about having their diagnoses reversed by forensic psychiatrists and about sometimes being labeled as possible malingers.
Within the Army bureaucracy, the soldiers found advocates in two Western Washington-based ombudsmen. (Their names were deleted from the report.)
The ombudsmen were concerned the diagnoses were being improperly changed after the forensic teams administered a series of tests. They thought some of the screening might be influenced by efforts to save taxpayer money, and they noted a forensic psychiatrist had said during a lecture that a PTSD diagnosis could cost taxpayers $1.5 million over the lifetime of that soldier.
Homas told an Army investigator he became aware of the PTSD diagnoses controversy in the late summer or early fall of 2011. He said there were reports that several soldiers angered by their PTSD reversals had made death threats against the psychiatrists or psychologists involved in the screening process.
On Sept. 25, 2011, Homas met with one ombudsman. He described her to investigators as “very vocal, tearful and frustrated, obviously passionate about the soldiers she was working with.”
At the meeting, Homas said he thought the forensic diagnoses were comprehensive and accurate, according to his statement to the investigator.
The ombudsman was disappointed with Homas opting not to look into the soldiers’ complaints.
In the report released Tuesday, the Army investigator discounted the ombudsmens’ concerns about financial issues influencing the forensic team. The report said forensic psychiatrists used established medical standards to make their diagnoses.
Yet the Army ended the use of forensic teams for screening.
“What we found is that the forensic methods are not the right ones for the United States Army disability evaluation system,” Gen. Lloyd Austin, then the Army’s vice chief of staff, said last August.
Hal Bernton: 206-464-2581 or email@example.com