Wednesday, February 6, 2013

Department of Defense Rejects GAO Recommendation Regarding "Sexual Assault Victimization" in the Military

    On January 23, news broke that outgoing Defense Secretary Leon Panetta had issued a directive that the military's ban on women in combat would be lifted.  The New York Times reported that his decision was in response to unanimous agreement among the Joint Chiefs of Staff as expressed in a letter to Panetta:
Mr. Panetta’s decision came after he received a Jan. 9 letter from Gen. Martin E. Dempsey, the chairman of the Joint Chiefs of Staff, who stated in strong terms that the armed service chiefs all agreed that “the time has come to rescind the direct combat exclusion rule for women and to eliminate all unnecessary gender-based barriers to service.”
     The Times article said it was unclear why the Joint Chiefs decided to act now after years of discussion, although there is speculation that recent threats of legal action may have played a role.  However, a Government Accountability Office report issued on January 29 raises some questions about the timing of such a monumental change in policy.

    I first reported the GAO report in a January 31 blog post at The Weekly Standard where I addressed the fiscal impact of allowing women in combat positions.  However, the broader focus of the report is spelled out in its title: "DOD Has Taken Steps to Meet the Health Needs of Deployed Servicewomen, but Actions Are Needed to Enhance Care for Sexual Assault Victims." An explanation of the special focus on sexual assault victims appears early in the report [emphasis added]:
The roles for women in the military have been expanding and evolving, particularly since the Persian Gulf War more than 2 decades ago. Formerly, servicewomen served primarily in supportive roles in overseas U.S. military operations. Today, servicewomen are integral to combat support and counterinsurgency operations, and they serve in many roles they previously did not hold. In late 2011, for example, women began serving aboard Navy submarines. In early 2012, the Department of Defense (DOD) announced that changes to its assignment policies would result in more than 14,000 additional positions being opened to women, including positions in select direct ground combat units. Further, while sexual assault victimization is not unique to women, the presence of women in new roles suggests that continued vigilance with respect to this issue is needed. Given the expanding and evolving role of women in the military, the health and wellness of servicewomen plays an important role in overall military readiness. 
    According to the National Defense Authorization Act for 2012, this report was originally due by December 31, 2012.  As mentioned above, the report was released on January 29, but given that the paragraph above does not mention the lifting of the women in combat ban, the GAO report was apparently finalized prior to Panetta's announcement. This policy change, much more far reaching that even the change opening "14,000 additional positions" in early 2012, exponentially increases the need for "continued vigilance" regarding "sexual assault victimization" that the GAO calls for.  Therefore, the timing of the announcement lifting the ban and the DOD's reaction to the GAO report recommendations is curious.

    The GAO made two recommendations at the conclusion of its inquiry regarding "sexual assault victimization":
To enhance the medical and mental health care for servicewomen who are victims of sexual assault, GAO recommends that DOD (1) develop department-level guidance on the provision of care to victims of sexual assault; and (2) take steps to improve first responders' compliance with the department's requirements for annual refresher training. DOD did not concur with the first recommendation, but cited steps it is taking that appear consistent with the recommendation. DOD concurred with the second recommendation.
     In this short summary of the DOD's reaction to the draft report, which the DOD reviewed before the GAO prepared and issued the final version on January 29, the GAO notes that the DOD "did not concur with the first recommendation, but cited steps it is taking that appear consistent with the recommendation." This summary sounds sanguine about the steps the DOD is taking to conform to the GAO's first recommendation, but it fails to convey the lengths to which the DOD appears to have gone to avoid concurring and to avoid fully cooperating with the GAO staff conducting the review.  Here is the full paragraph from the body of the report discussing the DOD's recommendations.  It is quite lengthy, but I have taken the liberty of highlighting all the references to the DOD's reticence to fully engage the GAO:
In written comments on a draft of this report, DOD stated in its cover letter that, overall, the department did not concur with the report's findings and conclusions. However, DOD's cover letter did not provide an explanation for this comment. In an enclosure to its letter, DOD stated that it did not concur with our first recommendation that the Assistant Secretary of Defense for Health Affairs develop and implement department-level guidance on the provision of medical and mental health care to victims of sexual assault that would specify health care providers' responsibilities to respond to and care for sexual assault victims, whether in the United States or in deployed environments. DOD's justification of its assessment, however, did not make clear why the department did not concur. Instead, DOD provided examples of steps it has been taking that may help to address the findings in this report. Specifically, DOD stated that, while the second version of DOD Instruction 6495.02, entitled "Sexual Assault Prevention and Response (SAPR) Program Procedures" has been in coordination for nearly 2 years and is not yet published, the revised instruction will be comprehensive and will contain two medical enclosures. According to DOD, the first medical enclosure will address health care provider procedures and direct the Surgeons General of the military services to carry out responsibilities related to the
coordination, evaluation, and implementation of care, while the second medical enclosure will address health care providers' responsibilities related to Sexual Assault Forensic Examination kits. During the course of this review, we met with DOD officials who had knowledge of and were involved in the instruction's revision, but these officials did not discuss or share their draft revisions with us when we presented our findings to them. We cannot verify, therefore, whether the enclosures referenced in DOD's comments will address our recommendation. However, we plan to review the instruction when DOD finalizes it to determine whether it meets the intent of our recommendation. Finally, DOD stated that the department meets its oversight responsibilities with regard to sexual assault response through training in graduate medical education and through monitoring and oversight of the process that governs credentialing and privileging of providers.  However, it is not clear why this statement is applicable to our recommendation. We did not address these points in the finding that led to this recommendation, and our recommendation is focused on the need for additional guidance. 
    The DOD's lack of transparency and full cooperation with the GAO has certainly compromised the effectiveness of this report at the precise time when a huge policy change regarding women is emerging. Not only, as the GAO indicates above, will this require further follow up by the GAO, but it has prevented Congress from having complete information on an important aspect of the issue at a time when Congress must decide whether or not to act.  As the GAO report said:
Given the expanding and evolving role of women in the military, the health and wellness of servicewomen plays an important role in overall military readiness. 
    Implementing this policy change, unless Congress intervenes, will be the first order of business for Chuck Hagel or whoever ends up being confirmed as the next Secretary of Defense. And given the importance of the military readiness of the United States, the Department of Defense owes the GAO, Congress and the American people full disclosure when it comes to how it plans to handle one of the most significant changes to the armed forces in our lifetime.

Note: A version of this article first appeared on February 6, 2013 at The Weekly Standard.

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