In addition to addressing the published recommendations, the SOC  assumed responsibility for addressing the policy development and  reporting requirements contained in the NDAA 2008. Also, the IPO’s scope of responsibility was  broadened to include personnel and benefits data sharing between DOD  and VA.

	DOD and VA Have Completed the Majority of the Requirements to Jointly Develop Policies on Care and Management, Medical and Disability Evaluation, Return to Active Duty, and the Transition from DOD to VA

As of April 2009, DOD and VA have completed 60 of the 76 requirements  we identified for jointly developing policies for recovering  servicemembers on (1) care and management, (2) medical and disability  evaluation, (3) return to active duty, and (4) servicemember transition  from DOD to VA. DOD and VA Have Completed More Than Two-Thirds of the Requirements for the Care and Management of Recovering Servicemembers

We found that more than two-thirds of the requirements for DOD’s and  VA’s joint policy development to improve the care and management of  recovering servicemembers have been completed, while the remaining  requirements are in progress. According to DOD and VA officials, the January 2009 DTM serves as the  interim policy for care, management, and transition until the completion of  DOD’s comprehensive policy instruction, which is estimated to be  completed by August 2009. DOD and VA Have Completed All of the Requirements for Developing Policy on the Medical Evaluation and Disability Evaluation of Recovering Servicemembers

DOD and VA have completed all of the requirements for developing policy  to improve the medical and physical disability evaluation of recovering  servicemembers. According to a DOD official, further  assessment of the feasibility and advisability of consolidation will be  conducted. DOD and VA anticipate issuing a final report on the pilot in  August 2009. A VA official reported that VA plans to  separately issue policy guidance addressing the requirements for  transitioning servicemembers from DOD to VA in the fourth quarter of  2009. DOD and VA Officials Experienced Challenges during Joint Development of Required Policies

DOD and VA officials told us that they experienced numerous challenges  as they worked to jointly develop policies to improve the care,  management, and transition of recovering servicemembers. According to  officials, these challenges contributed to the length of time required to  issue policy guidance, and in some cases the challenges have not yet been  completely resolved. Establishing standard definitions for operational terms. One of the  important tasks facing the SOC was the need to standardize key  terminology relevant to policy issues affecting recovering servicemembers. The need to resolve this challenge assumes  even greater importance in light of DOD’s and VA’s increasing capability to  exchange medical records electronically, which will expand DOD’s ability  to access records of servicemembers who have received medical  treatment from VA.

		Changes to the SOC’s Staff and Scope of Responsibilities Could Pose Future Challenges to Joint Policy Development

The SOC has experienced turnover in leadership, reconfiguration in its  organizational structure at DOD, and changes affecting policy  development responsibilities. In contrast, others are concerned by DOD’s  changes, stating that the new organizations disrupt the unity of command  that once characterized the SOC’s management because personnel within  the SOC organization now report to three different officials within DOD  and VA. However, it is too soon to determine how well DOD’s new  structure will work in conjunction with the SOC. DOD and VA officials we  spoke with told us that the SOC’s work groups continue to carry out their  roles and responsibilities. Finally, according to DOD and VA officials, the scope of responsibilities of  both the SOC and the DOD and VA Joint Executive Council appear to be in  flux and may evolve further still. While the SOC will remain  responsible for policy matters directly related to recovering  servicemembers, a number of policy issues may now be directed to the  Joint Executive Council, including issues that the SOC had previously  addressed. Agency Comments and Our Evaluation

We provided a draft of this report to DOD and VA for comment. VA  provided technical comments, which we incorporated as appropriate. DOD and VA did not provide other comments. Appendix I: Summary of Selected Requirements from the National Defense Authorization Act for Fiscal Year 2008

To summarize the status of the Departments’ of Defense (DOD) and  Veterans Affairs (VA) efforts to jointly develop policies for each of the four  policy areas outlined in sections 1611 through 1614 of the National  Defense Authorization Act for Fiscal Year 2008 (NDAA 2008), we identified  76 requirements in these sections and grouped related requirements into  14 logical categories.
Why GAO Did This Study

The National Defense Authorization Act for Fiscal Year 2008 (NDAA 2008) requires the Departments of Defense (DOD) and Veterans Affairs (VA) to jointly develop and implement comprehensive policies on the care, management, and transition of recovering servicemembers. The Wounded, Ill, and Injured Senior Oversight Committee (SOC)--jointly chaired by DOD and VA leadership--has assumed responsibility for these policies. The NDAA 2008 also requires GAO to report on the progress DOD and VA make in jointly developing and implementing the policies. This report focuses on the joint development of the policies. Implementation of the policies will be addressed in future reports. Specifically, this report provides information on (1) the progress DOD and VA have made in jointly developing the comprehensive policies required by the NDAA 2008 and (2) the challenges DOD and VA are encountering in the joint development of these policies. GAO determined the current status of policy development by assessing the status reported by SOC officials and analyzing supporting documentation. To identify challenges, GAO interviewed the Acting Under Secretary of Defense for Personnel and Readiness, the Executive Director and Chief of Staff of the SOC, the departmental co-leads for most of the SOC work groups, the Acting Director of DOD's Office of Transition Policy and Care Coordination, and other knowledgeable officials.

What GAO Found

DOD and VA have made substantial progress in jointly developing policies required by sections 1611 through 1614 of the NDAA 2008 in the areas of (1) care and management, (2) medical and disability evaluation, (3) return to active duty, and (4) transition of care and services received from DOD to VA. Overall, GAO's analysis showed that as of April 2009, 60 of the 76 policy requirements GAO identified have been completed and the remaining 16 policy requirements are in progress. DOD and VA have completed all of the policy development requirements for medical and physical disability evaluations, including issuing a report on the feasibility and advisability of consolidating the DOD and VA disability evaluation systems, although the pilot for this approach is still ongoing. DOD has also completed establishing standards for returning recovering servicemembers to active duty. More than two-thirds of the policy development requirements have been completed for the remaining two policy areas--care and management and the transition of recovering servicemembers from DOD to VA. Most of these requirements were addressed in a January 2009 DOD memorandum that was developed in consultation with VA. DOD officials reported that more information will be provided in a subsequent policy instruction, which is to be issued in August 2009. VA also plans to issue related policy guidance in the fourth quarter of 2009. DOD and VA officials told GAO that they have experienced numerous challenges as they worked to jointly develop policies to improve the care, management, and transition of recovering servicemembers. According to officials, these challenges contributed to the length of time required to issue policy guidance, and in some cases the challenges have not yet been completely resolved. For example, the SOC must still standardize key terminology relevant to policy issues affecting recovering servicemembers. DOD and VA agreement on key definitions for what constitutes "mental health," for instance, is important for developing policies that define the scope, eligibility, and service levels for recovering servicemembers. Recent changes affecting the SOC may also pose future challenges to policy development. Some officials have expressed concern that DOD's recent changes to staff supporting the SOC have disrupted the unity of command because SOC staff now report to three different officials within DOD and VA. However, it is too soon to determine how well DOD's staffing changes will work. Additionally, according to DOD and VA officials, the SOC's scope of responsibilities appears to be in flux. While the SOC will remain responsible for policy matters for recovering servicemembers, a number of policy issues may now be directed to the DOD and VA Joint Executive Council. Despite this uncertainty, DOD and VA officials told GAO that the SOC's work groups continue to carry out their roles and responsibilities. GAO provided a draft of this report to DOD and VA for comment. VA provided technical comments, which GAO incorporated as appropriate. DOD and VA did not provide other comments.