GAO continues criticism of Pentagon center for PTSD, TBI
By T. CHRISTIAN MILLER AND JOAQUIN SAPIEN | Propublica, NPR | Published: July 12, 2011
If you want more explanation about the military’s troubles in treating troops with traumatic brain injuries and post-traumatic stress, read no further than two recent but largely unnoticed reports from the Government Accountability Office.
It turns out the Pentagon’s solution to the problems is an organization plagued by weak leadership, uncertain priorities and a money trail so tangled that even the GAO’s investigators couldn’t sort it out. The GAO findings on the Pentagon’s Defense Centers of Excellence (DCOE) echo our own series on the military’s difficulty in handling the so-called invisible wounds of war.
“We have an organization that exists, but we have considerable concern about what it is that it’s actually accomplishing,” said Denise Fantone, a GAO director who supervised research on one of the reports. She added: “I can’t say with any certainty that I know what DCOE does, and I think that’s a concern.”
First, some background. After the 2007 scandal over poor care delivered to soldiers at the Walter Reed Army Medical Center, Congress ordered the Pentagon to do a better job treating soldiers suffering from post-traumatic stress disorder and traumatic brain injury. The Pentagon’s answer was to create DCOE. The new organization was supposed to be a clearinghouse to foster cutting-edge research in treatments.
DCOE was rushed into existence in late 2007. Since then, it has churned through three leaders, including one let go after alleged sexual harassment of subordinates. It takes more than five months to hire each employee because of the federal government’s glacial process. As a result, private contractors make up much of the center’s staff.
“DCOE’s development has been challenged by a mission that lacks clarity and by time-consuming hiring processes,” according to the first report in the GAO series, focusing on “management weakness” at DCOE.
Just as concerning, the GAO says that it can’t quite figure out how much money DCOE has received or where it has all gone. DCOE has never submitted a budget document that fully conformed to typical federal standards, according to a GAO report released last month. In one year, the center simply turned in a spreadsheet without detailed explanations.
The Defense Department says that DCOE got $168 million beginning in fiscal year 2010—but the GAO isn’t buying that number: “Because of unresolved concerns with the reliability of funding and obligations data provided by DOD (Department of Defense), we cannot confirm the accuracy of figures related to DCOE.” The GAO report reproduces this disclaimer no fewer than five times.
DCOE concurred with the bulk of the GAO’s findings and promised to fix its accounting errors and prevent them from happening again.
In its defense, DCOE has never had an easy job. It was created on the fly and tasked to deal with some of the most complicated mental-health issues in the military’s history. In addition, it has faced stiff bureaucratic resistance, with some Pentagon officials questioning its usefulness..
The Pentagon said that DCOE was conducting a “comprehensive review” to improve its operations.
“There is still substantial work to be done,” said Cynthia O. Smith, a Pentagon spokeswoman. “We must ensure we are properly allocating resources and establishing priorities to take care of our service members.”
One telling GAO footnote suggests the extent of the obstacles the organization has faced. In Pentagon war games, the enemy is generally represented by the color red. When Congress ordered up its improvements in 2007, the Pentagon created a special committee to push through reforms that led to DCOE’s creation.
The special committee decided to call itself the “Red Cell.” Why? “The daunting task facing this team would likely make them the enemy of everyone else in the bureaucracy they sought to change,” the GAO says.