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More than three years after its inception, the Pentagon’s premier entity for addressing the invisible injuries of war continues to be plagued by a lack of direction and mismanagement, according to a report released this week.

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, known as DCOE, was established in November 2007 to lead the Defense Department’s efforts to prevent or help troops deal with post-traumatic stress disorder and TBI, among other maladies. Such injuries have become the calling cards of the Iraq and Afghanistan wars.

But according to a report issued Monday by the Government Accountability Office that comes after a year-long audit, DCOE “has been challenged by a mission that lacks clarity.”

“Officials contend that DCOE’s unfocused mission has been exacerbated by unfocused leadership,” the report states, noting that three people led the entity in 2010 alone.

The center’s first director, Brig. Gen. Loree Sutton, resigned her post in June amid criticism that she wasn’t doing enough to improve the military’s efforts to diagnose and treat TBI an PTSD. She abruptly left just as DCOE opened the National Intrepid Center of Excellence at Bethesda, a facility intended to be the premier diagnosis, treatment and research center for servicemembers dealing with brain injuries and mental health issues.

Rep. Susan Davis, a Democrat from California, has been a vocal critic of DCOE. Last spring at a House Armed Services subcommittee, a few months before Sutton resigned, Davis said that the center had largely failed.

“The Defense Center of Excellence, while having achieved some notable small-scale successes, has not inspired great confidence or enthusiasm thus far. ... The center has also made some serious management missteps that call into question its ability to properly administer such a large and important function,” she said.

Davis is referenced in the GAO report, but she couldn’t be reached for comment.

Sutton was replaced by Col. Robert Saum, who was reassigned in September after being accused of sexual harassment. The new director is Navy Capt. Paul Hammer, who headed up the Navy and Marine Corps’ TBI and PTSD program.

DCOE representatives did not respond for comment by deadline.

“According to one official, it seemed like DCOE moved forward in every direction simultaneously rather than focusing on certain clearly defined responsibilities,” the report states.

This lack of focus is manifested in DCOE’s strategic plan, according to the GAO. The strategic plan does not sync the organization’s daily activities with its overall mission and goals, and its performance measures do not help DCOE tell whether it has reached its goals.

“Gaps in DCOE’s strategic planning efforts could hinder its ongoing development, as well as DOD’s overall effort to develop excellence in (psychological health) and TBI care for injured and recovering servicemembers,” the report states. “One official told us that there was an initial lack of clarity about DCOE’s mission both internally and externally, and that the military services still grapple with understanding DCOE’s mission.”

Slow administrative processes have hindered the hiring of DCOE personnel and resulted in a heavy reliance on contractors, according to the report. While DCOE has taken steps to shorten the hiring process, it was still taking an average of 119 days to bring new personnel on board as of July.

“The lack of clarity in DCOE’s mission and slowness in hiring staff have been challenges in the entity’s development,” the report states.

The organization also hasn’t adequately delineated between its legally mandated responsibilities and other initiatives, compounding the lack of focus, according to the GAO.

DCOE is overseen by the Tricare Management Activity. The GAO reported that Tricare misclassified $102.7 million of DCOE’s nearly $112 million fiscal 2009 obligations. The report recommends that TMA develop and implement written procedures for proper classification and recording of obligations according to the nature of the goods and services.

In its response, the Pentagon concurred with all five GAO recommendations. But the report states that the Defense Department’s stated actions for two of the recommendations do not fully address the problems.

The Pentagon’s plans for aligning DCOE’s day-to-day operations to better support its mission and goals -- as well as developing written policies and procedures for classifying and recording financial obligations -- “do not fully address the intent of our recommended actions,” the report states.

“Without effective, written policies and procedures, DCOE likely will continue to have unreliable data for management decision making,” the report states.


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