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Defense Health: Management Weaknesses at Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Require Attention

GAO-11-219 Published: Feb 28, 2011. Publicly Released: Feb 28, 2011.
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Highlights

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCOE) was established to lead DOD's effort to develop excellence in DOD prevention, outreach, and care for those with psychological health and traumatic brain injury conditions. GAO was asked to report on (1) challenges DCOE has faced in its development; (2) the extent to which DCOE's strategic plan aligns with key practices used by leading public-sector organizations; and (3) the extent to which internal controls provide reasonable assurance that DCOE information on financial obligations is reliable for management decision making. GAO reviewed documentation and interviewed DCOE officials about DCOE development challenges, evaluated DCOE's strategic plan against practices used by leading public-sector organizations, assessed the design of internal controls for recording obligations, and tested fiscal year 2009 DCOE obligations to supporting documentation to determine if the obligations were properly classified.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense To address weaknesses in DCOE's strategic plan, the Secretary of Defense, through the Director of TMA, should direct the DCOE director to revisit and revise as necessary the organization's goals for completing statutorily required responsibilities.
Closed – Not Implemented
In February 2016, DCOE was organizationally realigned under the Defense Health Agency (DHA), moving from under the U.S. Army Medical Research and Materiel Command. In 2017, DHA completed the consolidation of DCOE and its centers and retired the DCOE brand. DHCC officially changed its name to the Psychological Health Center of Excellence to better align with its current mission to improve the lives of service members, veterans, and their families by advancing excellence in psychological health care, readiness, and prevention of psychological health disorders. With the reorganization, realignment, and mission change of the organization, formally known as DCOE, this recommendation is no longer applicable.
Department of Defense To address weaknesses in DCOE's strategic plan, the Secretary of Defense, through the Director of TMA, should direct the DCOE director to require the directorates to align their day-to-day activities to support DCOE's mission and goals.
Closed – Not Implemented
In February 2016, DCOE was organizationally realigned under the Defense Health Agency (DHA), moving from under the U.S. Army Medical Research and Materiel Command. In 2017, DHA completed the consolidation of DCOE and its centers and retired the DCOE brand. DHCC officially changed its name to the Psychological Health Center of Excellence to better align with its current mission to improve the lives of service members, veterans, and their families by advancing excellence in psychological health care, readiness, and prevention of psychological health disorders. With the reorganization, realignment, and mission change of the organization, formally known as DCOE, this recommendation is no longer applicable.
Department of Defense To address weaknesses in DCOE's strategic plan, the Secretary of Defense, through the Director of TMA, should direct the DCOE director to improve the performance measures in the plan to enable DCOE to determine if achievement of each measure fully supports attainment of its associated goal.
Closed – Not Implemented
In February 2016, DCOE was organizationally realigned under the Defense Health Agency (DHA), moving from under the U.S. Army Medical Research and Materiel Command. In 2017, DHA completed the consolidation of DCOE and its centers and retired the DCOE brand. DHCC officially changed its name to the Psychological Health Center of Excellence to better align with its current mission to improve the lives of our nation's service members, veterans, and their families by advancing excellence in psychological health care, readiness, and prevention of psychological health disorders. With the reorganization, realignment, and mission change of the organization, formally known as DCOE, this recommendation is no longer applicable.
Department of Defense To ensure that DCOE obligations are properly classified and recorded in accordance with OMB guidance, the Secretary of Defense, through the Office of the Assistant Secretary of Defense (Health Affairs) (ASD(HA)), should direct TMA to develop written procedures with detailed steps to be performed for ensuring proper classification and recording of obligations in TMA's financial management systems.
Closed – Not Implemented
In February 2016, DCOE was organizationally realigned under the Defense Health Agency (DHA), moving from under the U.S. Army Medical Research and Materiel Command. In 2017, DHA completed the consolidation of DCOE and its centers and retired the DCOE brand. DCOE officially changed its name to the Psychological Health Center of Excellence to better align with its current mission. At the time this recommendation was made, DCOE was a separate entity not organizationally aligned under the Tricare Management Activity (TMA). With the reorganization and realignment of the organization, formally known as DCOE, under the organization (DHA) that provides its funding, this recommendation is no longer applicable.
Department of Defense To ensure that DCOE obligations are properly classified and recorded in accordance with OMB guidance, the Secretary of Defense, through the ASD(HA), should direct TMA to assign responsibility for updating and maintaining procedural guidance and systems codes to assure consistency with annual OMB guidance.
Closed – Not Implemented
In February 2016, DCOE was organizationally realigned under the Defense Health Agency (DHA), moving from under the U.S. Army Medical Research and Materiel Command. In 2017, DHA completed the consolidation of DCOE and its centers and retired the DCOE brand. DCOE officially changed its name to the Psychological Health Center of Excellence to better align with its current mission. At the time this recommendation was made, DCOE was a separate entity not organizationally aligned under, but received funding from, the Tricare Management Activity (TMA). With the reorganization and realignment of the organization, formally known as DCOE, under the organization (DHA) that provides its funding, this recommendation is no longer applicable.

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Agency missionsDecision makingFinancial managementHiring policiesInternal controlsMilitary health servicesPerformance measuresStrategic planningBudget obligationsPolicies and proceduresProgram goals or objectives