Although LHI administers the PDHRA to Reserve  component servicemembers on behalf of DOD, the military services are  responsible for identifying and notifying servicemembers to whom the  PDHRA requirement applies and for submitting questionnaires to DOD’s  central repository. DOD’s Central Repository Did Not Contain PDHRA Questionnaires for a Substantial Percentage of Servicemembers Who Returned from Deployment to Iraq or Afghanistan

On the two occasions we queried DOD’s central repository, we did not find  PDHRA questionnaires for a substantial percentage of the active and  Reserve component servicemembers in our population of interest. On September 4, 2009, we queried DOD’s central repository again to  update our April 2009 data and determine whether any progress had been  made in reporting questionnaires to the central repository. When questionnaires for servicemembers from our  population of interest are not in the central repository, DOD does not have  reasonable assurance that all members of this vulnerable population of  active component, Reserve, and National Guard servicemembers that  deployed to Iraq or Afghanistan were administered the PDHRA  questionnaire, which is intended to help identify deployment-related  health concerns that emerge over time and facilitate the opportunity for  servicemembers to address these concerns. The office’s documentation does not allow DOD to have  reasonable assurance that potential problems that may relate to the  welfare and safety of servicemembers have been addressed and resolved. More  broadly, the RHRP office also uses the four methods to monitor whether  the objective of the PDHRA program—to identify and address  servicemembers’ health concerns that emerge over time following  deployments—is being met for Reserve component servicemembers. The RHRP office receives several periodic  reports that DOD requires from LHI on LHI’s administration of the PDHRA  to Reserve component servicemembers. An RHRP official told us  that the office reviews LHI’s reports to examine data related to the  administration of the PDHRA and identifies potential problems that could  pose risks to servicemembers and the objective of the PDHRA program. Inspections of the administration of PDHRA. Feedback on the administration of the PDHRA from military service  officials. Weekly telephone discussions with LHI staff. DOD Generally Does Not Clearly Document Its Monitoring of the PDHRA Program

When monitoring the administration of the PDHRA to Reserve component  servicemembers, DOD does not maintain clear documentation that is  consistent with good management practices outlined in federal internal  control standards. In our review of the documentation related to 15 potential problems we  selected, we found that the RHRP office’s documentation generally did not  clearly describe the problem, the actions taken to address the problem,  and whether these actions have resolved the problem. In addition, servicemembers are not  eligible to fill out a PDHRA questionnaire until 90 to 180 days after they  have returned from deployment. To determine how DOD monitors the administration of the PDHRA to  Reserve component servicemembers, we reviewed DOD’s policies for  monitoring its contract with Logistics Health, Inc. (LHI), the contractor  that administers the PDHRA to Reserve component servicemembers. Appendix III: Post-Deployment Health Reassessment Questionnaires in DOD’s Central Repository and Services’ Databases

Department of Defense (DOD) policy requires that the military services electronically  submit post-deployment health reassessment (PDHRA) questionnaires to DOD’s  central repository, which DOD uses as a key source of health surveillance  information. On April 15, 2009, we found that for approximately 23 percent of the  roughly 319,000 servicemembers who, according to DOD deployment data, returned  from deployment to Iraq or Afghanistan between January 1, 2007, and May 31, 2008,  we could not identify questionnaires in the central repository (see table 2).
Why GAO Did This Study

The Department of Defense (DOD) implemented the post-deployment health reassessment (PDHRA), which is required to be administered to servicemembers 90 to 180 days after their return from deployment. DOD established the PDHRA program to identify and address servicemembers' health concerns that emerge over time following deployments. This report is the second in response to a Senate Armed Services Committee report directing the Government Accountability Office (GAO) to review DOD's administration of the PDHRA, and to additional congressional requests. In this report, GAO examined (1) the extent to which DOD's central repository contains PDHRA questionnaires for active and Reserve component servicemembers who returned from deployment to Iraq or Afghanistan and (2) how DOD monitors the administration of the PDHRA to Reserve component servicemembers. To conduct this review, GAO performed a quantitative analysis using DOD deployment and PDHRA data, reviewed relevant PDHRA policies, and interviewed DOD officials.

What GAO Found

DOD policy requires that the military services electronically submit PDHRA questionnaires to DOD's central repository. Based on two separate queries to this repository in 2009, GAO did not find PDHRA questionnaires for a substantial percentage of the 319,000 active and Reserve component servicemembers who returned from deployment to Iraq or Afghanistan between January 1, 2007, and May 31, 2008. GAO's first query on April 15, 2009, showed that only 77 percent of this population of interest had questionnaires in the central repository, leaving approximately 74,000 servicemembers without questionnaires in the repository. On September 4, 2009, GAO queried DOD's central repository again to update its April 2009 data and found that DOD's central repository was still missing PDHRA questionnaires for about 72,000 servicemembers, or 23 percent of the servicemembers in GAO's original population of interest. When PDHRA questionnaires are not in DOD's central repository, DOD does not have reasonable assurance that servicemembers to whom the PDHRA requirement applies were given the opportunity to fill out the questionnaire and identify and address health concerns that could emerge over time following deployment. DOD uses four methods to monitor the contractor, Logistics Health, Inc. (LHI), that administers the PDHRA to Reserve component servicemembers. The four monitoring methods are: (1) reviews of periodic reports from LHI; (2) inspections of LHI's administration of the PDHRA; (3) feedback on LHI's administration of the PDHRA from military service officials; and (4) weekly telephone discussions with LHI staff. These methods are used to help ensure that the objective of the PDHRA program is being met for Reserve component servicemembers. Through these methods, DOD identified a number of potential problems that may pose risks to the PDHRA program objective and to the welfare and safety of Reserve component servicemembers. However, GAO found that when monitoring the administration of the PDHRA to Reserve component servicemembers, DOD does not maintain clear documentation that is consistent with federal internal control standards. GAO found that the documentation generated by DOD generally did not clearly describe the potential problems, the actions taken to address the problems, and whether these actions had resolved the problems. Overall, this lack of clear documentation does not allow DOD to have reasonable assurance that potential problems related to the administration of the PDHRA to Reserve component servicemembers have been addressed and resolved.