	Background

Since the onset of OIF and OEF, over 1 million servicemembers have been  deployed. Servicemembers injured during OIF and OEF are surviving injuries that  would have been fatal in past conflicts. Separation from the military and return to civilian life may entail the  exchange of individually identifiable health information between DOD and  VA. VA Has Established Policies and Outreach Efforts Intended to Smooth the Transition from DOD Health Care

VA has taken several steps to provide OIF and OEF servicemembers with  timely access to health care and information on health care services. Recent VA Policies Designed to Facilitate Transition to VA Health Care

Since 2002, VA has issued a memorandum and four directives addressing  eligibility criteria and the health care needs of recently discharged  servicemembers. An October 2003 directive (1) provided instructions to VA employees for  determining the eligibility of recent combat veterans to be enrolled for VA  health care; (2) required each VA medical facility to designate a clinically  trained combat case manager, usually a social worker or nurse, to  coordinate all of the medical care and services provided to recent combat  veterans by VA and non-VA agencies until the veterans no longer need  care; and (3) required VA medical facilities to designate a point of  contact—administrative staff, social worker, or nurse—to receive and  expedite transfers of servicemembers from MTFs to VA medical facilities  and coordinate with VA’s combat case managers. Also in August 2003, VA created the Taskforce for the Seamless Transition  of Returning Service Members. In  January 2005, VA established the Seamless Transition Office to further  improve coordination within the Veterans Benefits Administration and the  Veterans Health Administration as well as between DOD and VA. To help ensure that VA staff assisting OIF and OEF servicemembers can  be responsive to their health care needs, the agency created an internal  Web site to provide a single source of access to VA policies, procedures,  and directives for wounded, ill, and seriously injured servicemembers and  veterans. VA Outreach Efforts to OIF and OEF Servicemembers

VA has instituted several outreach strategies to provide information about  the health care services available to OIF and OEF servicemembers who  have been discharged. For OIF and OEF servicemembers who may potentially use VA  services, DOD and VA share some types of administrative data, such as  individuals’ names and addresses; however, the sharing of health  information between the two departments remains limited. VA could not report how many of these were OIF and OEF servicemembers. MOU for the sharing of individually identifiable health information. The MOU does not specify particular  types of individually identifiable heath information that will be exchanged  and when the information will be shared. The absence of specific data  sharing procedures continues to hinder VA’s efforts to obtain needed  health information from DOD. In July  2005, DOD transmitted to VA postdeployment health assessment data for  those individuals who have been discharged from the military. According  to VA officials, DOD is expected to transmit these data monthly beginning  in October 2005. However, according to VA  officials, DOD is not providing health assessment information to VA for  Reserve and National Guard members, who comprise 35 percent of the  OIF and OEF forces.
Why GAO Did This Study

Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) servicemembers and those who are discharged from military service may receive health care from the Department of Veterans Affairs (VA). Since the onset of OIF and OEF, the Department of Defense (DOD) has reported that more than 15,000 servicemembers have been wounded in combat. Those who are seriously injured require comprehensive health care services and may be treated at either DOD or VA medical facilities. Because VA is expected to provide health care to many of the injured OIF and OEF servicemembers, concerns have been raised about the ease with which these individuals and their health care information transition from DOD's to VA's health care system. This statement is based on GAO's preliminary work on "seamless transition" and focuses on (1) the policies and outreach efforts that VA has instituted to provide timely access to health care to OIF and OEF servicemembers and (2) the extent to which individually identifiable health information is shared systematically between DOD and VA. Since GAO's work is still in the early stages of review, the statement is limited to information gathered to date.

What GAO Found

Since 2002, VA has developed policies and procedures that direct its medical facilities to provide OIF and OEF servicemembers timely access to care. Most notably, VA assigned VA social workers to selected military treatment facilities in August 2003, directed VA facilities to designate combat case managers in October 2003, and directed the establishment of four VA polytrauma centers for OIF and OEF servicemembers in June 2005. In January 2005, VA established the Seamless Transition Office to further improve coordination within the Veterans Benefits Administration and the Veterans Health Administration as well as between DOD and VA. In addition, VA has increased outreach efforts by providing OIF and OEF servicemembers who have been discharged with personal letters and newsletters, a Web site for health information tailored to OIF and OEF servicemembers, counseling services, and briefings on available VA health care services. GAO is in the beginning stages of reviewing VA's efforts to provide a smooth transition from DOD health care and has not yet evaluated the effectiveness of VA's related policies, procedures, and outreach initiatives. An important issue associated with transitioning servicemembers to VA health care is the sharing of health care information between DOD and VA. The two departments have signed a memorandum of understanding for sharing individually identifiable health information, but the memorandum does not specify the particular types of individually identifiable health information that will be exchanged and when the information will be shared. The absence of specific procedures continues to hinder VA's efforts to obtain needed health information from DOD. Recently, DOD has begun to share certain health assessment information with VA on individuals who have been discharged from the military, and the transmitting of this information to VA on a routine basis is expected to occur in October 2005. However, according to VA officials, DOD is not providing health assessment information to VA for Reserve and National Guard members, who comprise 35 percent of the OIF and OEF forces.