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news/2008/09/military_postdeployment_care_090408w

Report: DoD cannot ensure troops get checkups


By Kelly Kennedy - Staff writer
Posted : Friday Sep 5, 2008 11:39:55 EDT

Law requires that service members returning from Iraq and Afghanistan go through a post-deployment health re-assessment three to six months after deployment to make sure symptoms for post-traumatic stress disorder and traumatic brain injury, as well as other health concerns that weren’t caught immediately upon return, can be treated.

But the Governmental Accountability Office released a report on Thursday stating that the Defense Department does not have a way to guarantee all war veterans actually complete that process.

The reports they use do not allow the Defense Department “to calculate a completion rate” because they don’t provide the number of service members who should have deployed and, hence, been assessed, GAO said in its report. The office also concluded that the department conducts too few site visits to have a big enough sample to validate the number of service members being assessed.

The Defense Department also had not, as of June 2008, implemented recommendations from GAO’s June 2007 report intended to fix the same problems. Defense Department officials agreed at that time that they needed to require the services to give complete reports, but did not follow through.

“As a result, DoD’s quality-assurance program cannot provide decision makers with reasonable assurance that service members complete” the assessment, the report states.

And, “as of June 2008, DoD’s quality assurance program was staffed with one full-time equivalent position,” which meant that person could not make enough site visits to check for compliance.

Health professionals are supposed to assess each service member immediately after he or she returns home, as well as three to six months afterward. The second assessment is required because symptoms for PTSD often don’t show up for months — or even years — after a deployment, and because service members have been known to ignore symptoms so they can go home, rather than hang out in a medical facility after getting back from a combat zone.

To make sure that assessment happens, each service is supposed to report the number of service members who deployed and returned, along with the number and kinds of assessments performed — pre-deployment, post-deployment or post-deployment reassessment.

“We found that data included in the quarterly reports for 2007 and the first quarter of 2008 remain inconsistent and incomplete,” the report states. “Because DoD does not provide specific standards for collecting and reporting this required information, there are inconsistencies within a service and among the services in what information is included in each quarterly report.”

For example, the Army, in the first quarter of 2007, used samples of 30 to 50 service members who should have completed the assessment at eight bases or posts. During the second quarter, the Army used 91 service members at one installation. For the third quarter, they submitted nothing because of “time constraints, competing events and personnel changes,” and in the fourth quarter, the Army didn’t include information about the post-deployment reassessments and used 143 people at one installation.

At the same time, the Air Force didn’t include the reassessments in any of its quarterly reports, and in its 2008 report, it included everyone who had deployed since 2004.

“The DoD quality assurance program manager told us that she was aware of the inconsistencies on the military services’ quarterly reports and said she does not have the authority to enforce the two reporting requirements for the military services’ quarterly reports,” GAO stated in its report.

Defense Department officials told GAO researchers that they were improving reporting methods, but did not say how or when they anticipated the changes would be made.

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