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Evaluation of Department of Defense Military Medical Treatment Facility Challenges During the Coronavirus Disease-2019 (COVID-19) Pandemic in Fiscal Year 2021
Rec. A.1.a: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to streamline the hiring process to allow Military Medical Treatment Facilities to more quickly fill civilian staffing positions.
Rec. A.1.b: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to determine if salaries for Military Medical Treatment Facility civilian nurses are commensurate with each facility's local market and if military treatment facilities are able to hire nurses at those salaries. For locations where military treatment facility salaries are not commensurate with the local market, take appropriate actions that will reduce the disparity in those markets.
Rec. A.1.c: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to establish a central authority with the knowledge of the Services' requests for individual and large group deployments of medical staff coming out of Military Medical Treatment Facilities and the associated risks to health care delivery.
Rec. A.1.d: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to assess the ability of Military Medical Treatment Facilities to rapidly receive augmentation of medical staff from the Reserve Components.
Rec. A.2.a: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with the Secretaries of the Military Departments establish the manpower requirements for the coronavirus disease-2019 mission within the Military Medical Treatment Facilities for the staff required to support testing, vaccinations, contact tracing, and acute respiratory clinics.
Rec. A.2.b: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with the Secretaries of the Military Departments identify the medical personnel requirements within the Military Medical Treatment Facilities, including clinicians, nurses, and support staff, needed for future long-term pandemic response and biological incidents.
Rec. B: The DoD OIG recommended that the Assistant Secretary of Defense (Health Affairs) develop DoD policy for the maximum consecutive hours to be worked, maximum shifts per week, and coverage of duties when absent, for Military Health System staff (at minimum, active duty military and civilian physicians, nurses, respiratory therapists, and lab technicians) working in Military Medical Treatment Facilities to reduce the physical impacts leading to fatigue and burnout, and develop the appropriate waivers of this policy for Military Health System staff.
Rec. C: The DoD OIG recommended that the Assistant Secretary of Defense (Health Affairs) direct a new or existing working group to develop a plan to implement the recommendations in the Military Health System COVID-19 After Action Report and to develop and monitor milestones for each recommendation.
Evaluation of Access to Department of Defense Information Technology and Communications During the Coronavirus Disease-2019 Pandemic
Rec. 1.a: The DoD OIG recommended that the Assistant Secretary of Defense for Homeland Defense and Global Security revise the "DoD Implementation Plan for Pandemic Influenza" to update the planning assumptions in the DoD Implementation Plan for Pandemic Influenza to include the use of telework for essential and non-essential personnel and to align the DoD Implementation Plan for Pandemic Influenza with the DoD Telework Policy, Enclosure 3, Section 3(i)(2).
Rec. 1.b: The DoD OIG recommended that the Assistant Secretary of Defense for Homeland Defense and Global Security revise the "DoD Implementation Plan for Pandemic Influenza" to require DoD Components to update their Pandemic Plans to include the revised assumptions regarding telework for essential and non-essential personnel and the resources required to support the teleworking workforce.
Rec. 2: The DoD OIG recommended that the Under Secretary of Defense for Policy, in coordination with the Under Secretary of Defense for Personnel and Readiness, establish management oversight procedures to verify that DoD Components have performed the testing, training, and exercise requirements of the DoD Implementation Plan for Pandemic Influenza and the DoD Telework Policy. The oversight procedures should assess the ability of DoD Components to support Government-wide mandated telework, including the results from tests of network and communications systems and telework exercises with personnel.
Evaluation of Department of Defense Medical Treatment Facility Challenges During the Coronavirus Disease-2019 (COVID-19) Pandemic
Rec. 1.a: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in conjunction with the Assistant Secretary of Defense for Health Affairs and Secretaries of the Military Departments, establish a working group within 30 days of this report's publication, to address the personnel, supplies, testing capabilities, information technology, communication, and lines of authority challenges that we identified during the Coronavirus Disease-2019 pandemic that exist between the Services and the Defense Health Agency. The working group should establish milestones to develop guidance for coordinating the staffing of multi-Service military treatment facilities during a pandemic.
Rec. 1.b: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in conjunction with the Assistant Secretary of Defense for Health Affairs and Secretaries of the Military Departments, establish a working group within 30 days of this report's publication, to address the personnel, supplies, testing capabilities, information technology, communication, and lines of authority challenges that we identified during the Coronavirus Disease-2019 pandemic that exist between the Services and the Defense Health Agency. The working group should establish milestones to consolidate Coronavirus Disease-2019 reporting requirements and recipients to reduce duplication and inconsistent requirements.
Rec. 1.c: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in conjunction with the Assistant Secretary of Defense for Health Affairs and Secretaries of the Military Departments, establish a working group within 30 days of this report's publication, to address the personnel, supplies, testing capabilities, information technology, communication, and lines of authority challenges that we identified during the Coronavirus Disease-2019 pandemic that exist between the Services and the Defense Health Agency. The working group should establish milestones to create a pandemic-related informational website and a toll-free number for beneficiaries to find Coronavirus Disease-2019-related information and ensure the website and toll-free number are advertised and maintained.
Rec. 1.d: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in conjunction with the Assistant Secretary of Defense for Health Affairs and Secretaries of the Military Departments, establish a working group within 30 days of this report's publication, to address the personnel, supplies, testing capabilities, information technology, communication, and lines of authority challenges that we identified during the Coronavirus Disease-2019 pandemic that exist between the Services and the Defense Health Agency. The working group should establish milestones to issue clarifying guidance for defining essential personnel for civilian healthcare workers.
Rec. 1.e: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in conjunction with the Assistant Secretary of Defense for Health Affairs and Secretaries of the Military Departments, establish a working group within 30 days of this report's publication, to address the personnel, supplies, testing capabilities, information technology, communication, and lines of authority challenges that we identified during the Coronavirus Disease-2019 pandemic that exist between the Services and the Defense Health Agency. The working group should establish milestones to update contracts to allow for more flexibility regarding the use of contracted personnel during extenuating circumstances, such as a pandemic.