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.