Defense Health Care:

Army Needs to Assess the Health Status of All Early-Deploying Reservists

GAO-03-437: Published: Apr 15, 2003. Publicly Released: Apr 15, 2003.

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During the 1990-1991 Persian Gulf War, health problems prevented the deployment of a significant number of Army reservists. To help correct this problem the Congress passed legislation that required reservists to undergo periodic physical and dental examinations. The National Defense Authorization Act for 2002 directed GAO to review the value and advisability of providing examinations. GAO also examined whether the Army is collecting and maintaining information on reservist health. GAO obtained expert opinion on the value of periodic examinations and visited seven Army reserve units to obtain information on the number of examinations that have been conducted.

Medical experts recommend periodic physical and dental examinations as an effective means of assessing health. Periodic physical and dental examinations for early-deploying reservists provide a means for the Army to determine their health status. Army early-deploying reservists need to be healthy to meet the specific demands of their occupations; examinations and other health screenings can be used to identify those who cannot perform their assigned duties. Without adequate examinations, the Army may train, support, and mobilize reservists who are unfit for duty. The Army has not consistently carried out the statutory requirements for monitoring the health and dental status of Army early-deploying reservists. At the early-deploying units GAO visited, approximately 66 percent of the medical records were available for review. For example, we found that about 68 percent of the required 2-year physical examinations for those over age 40 had not been performed and that none of the annual medical certificates required of reservists were completed by reservists and reviewed by the units. The Army's automated health care information system does not contain comprehensive physical and dental information on early-deploying reservists. According to Army officials, in 2003 the Army plans to expand its system to maintain accurate and complete medical and dental information to monitor the health status of early-deploying reservists.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: According to the Department of Defense's Inspector General and the GAO Open Recommendation Tracking System, the Army has taken action to implement this recommendation. Using O&M Army funds, the Army Reserve initiated contractual arrangements so the statutory requirements for physical examinations for reserve personnel will be met. The Federal Strategic Health Alliance (FEDS HEAL) is a VA-HHS-DOD partnership that links the resources of the Veterans Health Administration and the HHS Division of Federal Occupational Health to provide immunizations, physical examinations, dental screening and other services to members of the Reserve Components. The fielding of MEDPROS, a component of the Medical Occupational Database System (MODS) provides a web-based system that documents and monitors medical and dental readiness. As funding increases for these programs, the medical and dental readiness of the Army reserve components will improve.

    Recommendation: To help ensure that early-deploying reservists are healthy to carry out their duties, the Secretary of Defense should direct the Secretary of the Army to comply with existing statutory requirements to ensure that the 5-year physical examinations for early-deploying reservists under 40 and the biennial physical examinations for early-deploying reservists over 40 are current and complete.

    Agency Affected: Department of Defense

  2. Status: Closed - Implemented

    Comments: According to the Department of Defense Inspector General and the GAO Open Recommendation Tracking System, the Army Reserve has developed the Annual Health Certification Questionnaire. Beta testing was completed on March 3, 2004. Field testing has begun and full implementation will follow.

    Recommendation: To help ensure that early-deploying reservists are healthy to carry out their duties, the Secretary of Defense should direct the Secretary of the Army to comply with existing statutory requirements to ensure that all early-deploying reservists complete their annual medical certificate of health status and that the appropriate Army personnel review the certificate

    Agency Affected: Department of Defense

  3. Status: Closed - Implemented

    Comments: According to the Department of Defense's Inspector General and the GAO Open Recommendation Tracking System, dental assessments are currently being accomplished through the FEDS HEAL program with both private and public agencies and resources. The Army has significantly increased its emphasis and efforts to use automated tracking of all medical and dental readiness through MEDPROS. Increased marketing and education about the availability of the reserve dental plan to reservists should improve its utilization and therefore increase dental readiness.

    Recommendation: To help ensure that early-deploying reservists are healthy to carry out their duties, the Secretary of Defense should direct the Secretary of the Army to comply with existing statutory requirements to ensure that the required dental examinations and treatments for all early-deploying reservists are complete.

    Agency Affected: Department of Defense

 

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