Enlisted Medical Department Executive Course

Medical Inspector General Briefing

HMCS (SW/AW) Michael W. Smith

Training Objectives

Terminal Objective: Provide an overview of current Medical Inspector General

policies, processes, and practices and how they impact the Navy Medical Department.

Enabling Objectives: Describe the purpose of the BUMED Medical Inspector

General. Explain the Navy Medicine Investigation process. Discuss key aspects of the Military Whistleblower/

Reprisal.

Training Objectives

Enabling Objectives:

Explain the Medical Inspector General investigation and inspection process.

Overview• Purpose• Investigation Program

– Hotline– Frequent Findings

• Inspection Process– Preparation– Inspection– Focus Groups– Findings– Resolution

The Purpose• The Medical Inspector General ensures

oversight of BSO-18 programs and operations ensuring safe health service delivery.

• The Joint Commission (TJC) Liaison during MTF surveys

• Investigate, report and assist on behalf of the Navy Surgeon General

• Independent and impartial

Navy Medicine Hotline Program

• Purpose: To receive and evaluate allegations pertaining to fraud, waste and mismanagement and conduct an inquiry or investigation if appropriate.

• To ensure complaints are efficiently and effectively investigated and reported, close relationship with:Office of the Naval Inspector GeneralDepartment of Defense Inspector GeneralOther Defense agencies' Inspectors General

• Each Regional Medical IG has their own hotline, as well as the majority of echelon 4s.

• BUMED Hotline 1-800-637-6175 or DSN 295-9019

CY13 Navy MedicineHotline Complaint Types

EEO3%

Reprisal6% Abuse of Author-

ity6%

Personal Conduct7%

Personnel Issues - Military & Civil-

ian11%

Entitlements16%

Other51%

Military Whistleblower/Reprisal

• Reprisal - taking or threatening to take an unfavorable personnel action, or withholding or threatening to withhold a favorable personnel action, for making or preparing to make a protected communication.

• Number one Hotline Complaint in the Navy • Navy Medicine has the most Reprisal cases of

any other Echelon II• DoD 7050.6 “Military Whistleblower Protection”

Military Whistleblower/Reprisal

• Most common allegation of unfavorable personnel action is a Fitness Report/Evaluation or being reassigned.

• Majority of inquiries/investigations find that unfavorable personnel action occurred independent of the protected communication.

• Recommendation – communicate often and in writing when counseling on performance. Maintain all Mid-term counseling documentation as mandated by instruction.

Military Whistleblower/ Reprisal

• Protected Communication• Category I – Congress / IG (lawful communication)• Category II – Any office designated to receive complaints (CMEO, Safety

Officer, Chain of Command, etc.) Must reasonably believe that there was a violation of rule or regulation.

• “Unfavorable” Personnel Actions

• Responsible Management Official Knowledge

Ex: Signing Eval

• Was there an independent basis for action?

MEDIG Inspection Process

• Assessment of Echelon 3-5 commands every one to three years

• MEDIG develops schedule– Periodicity– Randomness– Area(s) of Concern: as required

• Strong relationship with The Joint Commission

MEDIG Inspection Timeline

CONUS

OCONUS

NotificationMEDIG

& Joint Commission (JC)

present

MEDIG/JC out brief

Final report released to activity and Regional Commander

Activity submits required ISRs

Program reviews and focus groups

Staff and customers surveyed

MEDIG concludes process or conducts re-inspection

7 business days prior Day 1 Day 3 - 4

NLT 30 days after inspection

Due 60 days after final report

NotificationMEDIG

& JC

present

MEDIG/JC out brief

Final report released to activity and Regional Commander

Activity submits required ISRs

Program reviews and focus groups

Staff and customers surveyed

MEDIG concludes process or conducts re-inspection

30 business days prior Day 1 Day 3 - 4

NLT 30 days after inspection

Due 60 days after final report

Inspection Focus (Aligned with CNO & BUMED Priorities)

• Deployment Readiness• Effective Force Health Protection• People• Quality of Care• Patient and Family Centered Care• Performance Based Budget• Research and Development• Financial Resources Management• Materials Management• Safety and Occupational Health

Programs InspectedDeployment Readiness

Independent Duty Corpsman (IDC) Program Deployment Health Assessments Hospital Corpsman Skills Basic (HMSB)/Tactical Combat Casualty Care (TCCC) Program Deployment Support (Health Services Augmentation Program/CIAC/ITEMPO Reporting) Periodic Health Assessment for Individual Medical Readiness (PHA/IMR) Operational Forces Medical Liaison Support

(OFMLS)

People

Good Order and Discipline Program Navy Performance Reports Diversity Program Command Urinalysis Program Command Managed Equal Opportunity (CMEO) Navy Family Ombudsman Program Civilian Personnel Management Education and Training Program Navy Retention and Career Development Program Off-Duty Employment Program Physical Readiness Program Awards and Recognition Program Civilian Drug Free Work Place (CDFWP) Program Command Indoctrination Program Command Sponsorship Program Alcohol and Drug Prevention Program Health Promotion – Wellness/ShipShape Program Comprehensive Tobacco Control for Navy Medicine Brig Medical Program Oversight (as required) BEQ Management Oversight (as required) Suicide Prevention (Operational Stress Control and Pastoral Care)

Quality of Care

Forms and Reports Management Program Navy Records Management (non-medical) Primary Care Program (Medical Home port) Access to Care Referral Management Health Information Management Medical Evaluation Boards Information Security Management Program

Patient and Family Centered Care Sexual Assault Prevention and Response (SAPR) Customer Relations Case Management Personnel Reliability Program

Programs Inspected

Research and Development

Research Integrity Program Biosurety

Financial Management

Comptroller Organization Financial Reporting Support Agreements Civilian Time and Attendance Budget Formulation and Execution Accounting DTS and Government Travel Card Program Managers Internal Control Program Manpower Management Ethics DON Hotline Program (includes Anti-Fraud Program)

Materials Management

Purchase Card Program Material Management Operations Maintenance Management Contract Acquisition and Purchasing Management Equipment Management Contracting Officer’s Representative

Safety and Occupational Health   Industrial Hygiene survey schedule Industrial Hygiene exposure monitoring Occupational Health Support Motorcycle Safety Workers Compensation Hearing Compensation Hazardous Drug Program Centralized technical management of IH, OM, and Audiology services Environment of Care Safety Occupational Health Management

Evaluations (SOHME) Review Enterprise Safety Application System (ESAMS) Mishap Review and Investigation Federal Employee Compensation Act (FECA) Environmental Programs Defense Occupational and Environmental Health Readiness System - IH implementation

 

Effective Force Health Protection

Emergency Management Plan Anti-terrorism / Force Protection Limited Duty Program (LIMDU) Dental Practice Management

Focus Groups

• Civilian (non-supervisor) staff• Department Head• Provider• CPO• E-6 and below• Civilian (supervisor) staff **as required**

• Other: as required dependent on command demographics

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Top Programs with Common RFIs Among Regions(FY12)

Inspection Programs

Requ

irem

ents

for

Impr

ovem

ent

Top Programs with RFIs (FY13)

MEDINSGEN Inspection Findings

• Provided at Out-brief

• Official Report in 30 days– Requirements for Improvement

• Implementation Status Report (ISR)• Required within 60 days

– Supplemental– Opportunities for Improvement

Program Management

• Successful Program Management• Program Understanding

– Guiding instructions– Shared responsibilities

• Program Organization– SOP– Command instructions– Appointment letters

Program Inspection Success

• Utilize MEDIG Self-Assessments• Utilize Program Subject-Matter Experts

– Command– Region– BUMED– MEDIG

• Command Support– Department– Director– ESC/BOB

Additional Information

• BUMEDINST 5040.2C• MEDIG Website (Navy Medicine Online)

– http://www.med.navy.mil• “BUMED/Headquarters” tab • Click on BUMED MEDIG• Self-Assessment Tool tab• Select Program

Questions