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GAO REPORT: OVERSIGHT OF DoD'S POST-DEPLOYMENT
HEALTH REASSESSMENT RATES IS LIMITED -- DoD's
quality
assurance program cannot provide decision makers
with
reasonable assurance that servicemembers complete
PDHRA.

What this report basically says is that DoD has
no idea if returning troops are getting their required health
reassessment. What a shame!
For more about PDHRA, use the VA Watchdog search
engine... click here...
http://www.yourvabenefits.org/sessearch.php?q=pdhra&op=and
Full GAO report
here...
http://www.gao.gov/new.items/d081025r.pdf
Report summary here...
http://www.gao.gov/docsearch/abstract.php?rptno=GAO-08-1025R
Summary below:
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Defense Health Care: Oversight of Military
Services' Post-Deployment Health Reassessment Completion Rates Is Limited
GAO-08-1025R
Military servicemembers engaged in combat tours in Afghanistan and Iraq
are at risk of developing combat-related mental health conditions,
including post-traumatic stress disorder (PTSD). In many cases, signs of
potential mental health conditions do not surface until months after
servicemembers return from deployment. In 2004, Army researchers published
a series of articles that indicated a significant increase in the number
of servicemembers reporting mental health concerns 90 to 120 days after
returning from deployment, compared with mental health concerns reported
before or soon after deployment. These findings led the Department of
Defense (DOD) in March 2005 to develop requirements and policies for the
post-deployment health reassessment (PDHRA) as part of its continuum of
deployment health assessments for servicemembers. PDHRA is a screening
tool for military servicemembers; it is designed to identify and address
their health concerns--including mental health concerns--90 to 180 days
after return from deployment. Servicemembers answer a set of questions
about their physical and mental health conditions and concerns, and health
care providers review the answers and refer servicemembers for further
evaluation and treatment if necessary. A November 2007 study showed that a
larger number of servicemembers indicated mental health concerns on their
PDHRAs than on assessments
earlier
in their deployment cycles. Although DOD established PDHRA requirements
and policies, it gave the military services discretion to implement them
to meet their unique needs as long as the services adhere to the
requirements and policies. DOD oversees the military services' compliance
with PDHRA requirements through its deployment health assessment quality
assurance program and is required to report on the quality assurance
program annually to the Armed Services Committees of the House of
Representatives and Senate. In June 2007, we reported that DOD's oversight
of its deployment health assessments does not provide DOD or Congress with
the information needed to evaluate DOD and the military services'
compliance with deployment health assessment requirements. That report is
part of a body of work in which we identified weaknesses in DOD's quality
assurance program. The Senate Committee on Armed Services directed us to
review DOD's oversight of PDHRA, and the House Committee on Armed Services
and 11 senators also expressed interest in this work. In this report, we
focus on how DOD ensures that servicemembers complete the PDHRA.
Specifically, we discuss how well DOD's quality assurance program oversees
the military services' compliance with the requirement that they ensure
that servicemembers complete the PDHRA.
DOD's quality assurance program has limitations and does not allow the
department to accurately assess whether the military services ensure that
servicemembers complete the PDHRA. DOD's quality assurance program relies
on quarterly reports from each military service, monthly reports from
AFHSC, and site visits to military installations to oversee the military
services' compliance with deployment health assessment requirements,
including completion of PDHRA. Each of these sources of information has
limitations. The military services' quarterly reports and the monthly
reports from AFHSC do not provide the information DOD needs to accurately
assess the military services' PDHRA completion rates, which would allow
DOD to determine if the military services have ensured that servicemembers
completed the PDHRA. These reports do not allow DOD to calculate a
completion rate because they do not provide essential information, such as
the total number of servicemembers who returned from deployment and should
have completed the PDHRA in that quarter or month. Furthermore, DOD cannot
use information collected from site visits to validate the services'
quarterly reports because the small number of site visits constitutes an
insufficient sample for validation purposes. In our 2007 report, we
recommended that DOD make enhancements to its quality assurance program,
which would allow the department to better evaluate compliance with
deployment health requirements. Although DOD concurred with the
recommendation included in the 2007 report, as of June 2008, the
department had not implemented the recommendation. As a result, DOD's
quality assurance program cannot provide decision makers with reasonable
assurance that servicemembers complete PDHRA. Overall, DOD concurred with
our report's findings and conclusions; however, DOD identified several
items in the report that it addressed in written comments. DOD suggested
that the function of oversight is beyond the scope of the quality
assurance program. Additionally, DOD commented that the department is
taking steps that it believes will resolve some of the issues we note in
this report. However, DOD did not provide us with relevant details or
evidence pertaining to these efforts. We believe that oversight is an
essential function of the quality assurance program and that the program
currently does not receive the information necessary to perform this
function.
-------------------------
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