1. Enlisted Medical Department Executive Course Medical Inspector General Briefing HMCS (SW/AW) Michael W. Smith

2. 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.

3. Training Objectives Enabling Objectives:  Explain the Medical Inspector General investigation and inspection process.

4. Overview Purpose Investigation Program –Hotline –Frequent Findings Inspection Process –Preparation –Inspection –Focus Groups –Findings –Resolution

5. 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

6. 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 General  Department of Defense Inspector General  Other 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

7. CY13 Navy Medicine Hotline Complaint Types

8. 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”

9. 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.

10. 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?

11. 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

12. MEDIG Inspection Timeline CONUS OCONUS Notification MEDIG & 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 1Day 3 - 4 NLT 30 days after inspection Due 60 days after final report Notification MEDIG & 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 1Day 3 - 4 NLT 30 days after inspection Due 60 days after final report

13. 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

14. Programs Inspected Deployment 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

15. 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

16. 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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18. Top Programs with RFIs (FY13)

19. 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

20. Program Management Successful Program Management Program Understanding –Guiding instructions –Shared responsibilities Program Organization –SOP –Command instructions – Appointment letters

21. Program Inspection Success Utilize MEDIG Self-Assessments Utilize Program Subject-Matter Experts –Command –Region –BUMED –MEDIG Command Support –Department –Director –ESC/BOB

22. Additional Information BUMEDINST 5040.2C MEDIG Website (Navy Medicine Online) –http://www.med.navy.milhttp://www.med.navy.mil “BUMED/Headquarters” tab Click on BUMED MEDIG Self-Assessment Tool tab Select Program

23. Questions