Military Personnel: DOD Needs to Address Long-term Reserve Force 
Availability and Related Mobilization and Demobilization Issues  
(15-SEP-04, GAO-04-1031).					 
                                                                 
Over 335,000 reserve members have been involuntarily called to	 
active duty since September 11, 2001, and the Department of	 
Defense (DOD) expects future reserve usage to remain high. This  
report is the second in response to a request for GAO to review  
DOD's mobilization and demobilization process. This review	 
specifically examined the extent to which (1) DOD's		 
implementation of a key mobilization authority and personnel	 
polices affect reserve force availability, (2) the Army was able 
to execute its mobilization and demobilization plans efficiently,
and (3) DOD can manage the health of its mobilized reserve	 
forces. 							 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-04-1031					        
    ACCNO:   A12468						        
  TITLE:     Military Personnel: DOD Needs to Address Long-term       
Reserve Force Availability and Related Mobilization and 	 
Demobilization Issues						 
     DATE:   09/15/2004 
  SUBJECT:   Defense operations 				 
	     Military bases					 
	     Military operations				 
	     Military personnel 				 
	     Military policies					 
	     Military reserve personnel 			 
	     Mobilization					 
	     National defense operations			 
	     Personnel management				 
	     Strategic mobility forces				 
	     Strategic planning 				 
	     Military capabilities				 
	     Global War on Terrorism				 

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GAO-04-1031

                 United States Government Accountability Office

 GAO	Report to the Subcommittee on Personnel, Committee on Armed Services, U.S.
                                     Senate

September 2004

MILITARY PERSONNEL

     DOD Needs to Address Long-term Reserve Force Availability and Related
                     Mobilization and Demobilization Issues

                                       a

GAO-04-1031

Highlights of GAO-04-1031, a report to the Subcommittee on Personnel,
Committee on Armed Services, U.S. Senate

Over 335,000 reserve members have been involuntarily called to active duty
since September 11, 2001, and the Department of Defense (DOD) expects
future reserve usage to remain high. This report is the second in response
to a request for GAO to review DOD's mobilization and demobilization
process. This review specifically examined the extent to which (1) DOD's
implementation of a key mobilization authority and personnel polices
affect reserve force availability, (2) the Army was able to execute its
mobilization and demobilization plans efficiently, and (3) DOD can manage
the health of its mobilized reserve forces.

GAO recommends that DOD develop a strategic framework with personnel
policies linked to human capital goals, update planning assumptions,
determine the most efficient mobilization support options, update health
guidance, set a timeline for submitting health assessments electronically,
and improve medical oversight. Of eight recommendations, DOD agreed with
five and partially agreed with three. DOD cited four documents that it
says, along with associated personnel policies, constitute its strategic
framework. GAO notes that DOD's policies were issued prior to these
framework documents. DOD said oversight of Marine Corps health data would
be difficult. GAO believes this oversight is needed to determine the
medical readiness of reservists.

www.gao.gov/cgi-bin/getrpt?GAO-04-1031.

To view the full product, including the scope and methodology, click on
the link above. For more information, contact Derek B. Stewart at (202)
512-5559 or [email protected].

September 2004

MILITARY PERSONNEL

DOD Needs to Address Long-term Reserve Force Availability and Related
Mobilization and Demobilization Issues

DOD's implementation of a key mobilization authority to involuntarily call
up reserve component members and personnel policies greatly affects the
numbers of reserve members available to fill requirements. Involuntary
mobilizations are currently limited to a cumulative total of 24 months
under DOD's implementation of the partial mobilization authority. Faced
with some critical shortages, DOD changed a number of its personnel
policies to increase force availability. However, these changes addressed
immediate needs and did not take place within a strategic framework that
linked human capital goals with DOD's organizational goals to fight the
Global War on Terrorism. DOD was also considering a change in its
implementation of the partial mobilization authority that would have
expanded its pool of available personnel. This policy revision would have
authorized mobilizations of up to 24 consecutive months without limiting
the number of times personnel could be mobilized, and thus provide an
essentially unlimited flow of forces. In commenting on a draft of this
report, DOD stated that it would retain its current cumulative approach,
but DOD did not elaborate in its comments on how it expected to address
its increased personnel requirements.

The Army was not able to efficiently execute its mobilization and
demobilization plans, because the plans contained outdated assumptions
concerning the availability of facilities and support personnel. For
example, plans assumed that active forces would be deployed abroad, thus
vacating facilities when reserves were mobilizing and demobilizing but
reserve forces were used earlier and active forces had often not vacated
the facilities. As a result, some units were diverted away from their
planned mobilization sites, and disparities in housing accommodations
existed between active and reserve forces. Efficiency was also lost when
short notice hampered coordination efforts among planners, support
personnel, and mobilizing or demobilizing reserve forces. To address
shortages in housing and other facilities, the Army has embarked on
several construction and renovation projects without updating its planning
assumptions regarding the availability of facilities. As a result, the
Army risks spending money inefficiently on projects that may not be
located where the need is greatest. Further, the Army has not taken a
coordinated approach evaluating all the support costs associated with
mobilization and demobilization at alternative sites in order to determine
the most efficient options for the Global War on Terrorism.

DOD's ability to effectively manage the health status of its reserve
forces is limited because its centralized database has missing and
incomplete health records and it has not maintained full visibility over
reserve component members with medical problems. For example, the Marine
Corps did not send pre-deployment health assessments to DOD's database as
required, due to unclear guidance and a lack of compliance monitoring. The
Air Force has visibility of involuntarily mobilized members with health
problems, but lacks visibility of members with health problems who are on
voluntary orders. As a result, some personnel had medical problems that
had not been resolved for up to 18 months, but the full extent of this
situation is unknown.

Contents

Letter~

Results in Brief
Background
Availability of Reserves Is Greatly Influenced by Mobilization

Authorities and Personnel Policies
The Army Was Not Able to Efficiently Execute Its Mobilization and

Demobilization Plans
Ability to Effectively Manage Health of Servicemembers Is Limited
Conclusions
Recommendations for Executive Action
Agency Comments and Our Evaluation

                                       1

                                      3 8

16

26 37 50 52 53

Appendix I Scope and Methodology

Appendix II National Guard and Reserve End Strength Figures

Appendix III Service Mobilization and Demobilization Installations 62

Appendix IVEURDifferences between Demobilization and Periodic Physicals
for Reserve Component Members

Appendix V Pre- and Post-Deployment Health Assessment Forms 69

Appendix VI Service Stop-Loss Policies since September 11, 2001 75

Appendix VIIEURReserve Component Recruiting Results, Fiscal Year
~1993-2004 79

Appendix VIIIEURService Medical and Physical Evaluation Board Processes 82

Appendix IX Comments from the Department of Defense

Appendix X GAO Contact and Staff Acknowledgments

Related GAO Products

Tables

Table 1: Authorities Used to Mobilize Reservists after September 11, 2001

Table 2: Mobilization and Pre-Deployment Assessment Numbers

Table 3: Service Decisions Concerning Reserve Component Member
Deployability

Table 4: Pre-Deployment Overall Health Status and Medical Referrals

Table 5: Post-Deployment Overall Health Status and Medical Referrals

Table 6: Comparison of Self-Reported Composite Health from Preand
Post-Deployment Health Assessments

Table 7: Changes in Reserve Category End Strengths

Table 8: Fiscal Year 2003 End Strengths for Each of DOD's Six Reserve
Components

Table 9: Physical Requirements

Table 10: Reserve Component Recruiting Figures

                                     10 38

                                       40

                                       43

                                       44

                                     45 61

61 68 80

Figures

Figure 1: Average Days of Duty Performed by DOD's Reserve Component
Forces, Fiscal Years 1989-2003 13 Figure 2: Steps of DOD's Disabilities
Evaluation System 82

Abbreviations

AMSA Army Medical Surveillance Activity

DOD Department of Defense
GAO Government Accountability Office
IMA Installation Management Agency

IRR Individual Ready Reserve
MEB Medical Evaluation Board
OASD/RA Office of the Assistant Secretary of Defense

(Reserve Affairs) OSD Office of the Secretary of Defense PEB Physical
Evaluation Board TPFDD Time-Phased Force and Deployment Data

This is a work of the U.S. government and is not subject to copyright
protection in the United States. It may be reproduced and distributed in
its entirety without further permission from GAO. However, because this
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copyright holder may be necessary if you wish to reproduce this material
separately.

United States Government Accountability Office Washington, DC 20548

September 15, 2004

The Honorable Saxby Chambliss
Chairman
The Honorable E. Benjamin Nelson
Ranking Minority Member
Subcommittee on Personnel
Committee on Armed Services
United States Senate

The Department of Defense (DOD) currently cannot meet its global
commitments without sizeable participation from among its 1.2 million
National Guard and Reserve members. Since September 11, 2001, more
than 335,000 of DOD's reserve component1 members have been
involuntarily called to active duty-almost 234,000 from the Army, almost
56,000 from the Air Force, over 24,000 from the Marine Corps and over
21,000 from the Navy. Furthermore, thousands of reserve component
members have volunteered for extended periods of active duty service,
according to DOD officials. During this period, the Army has had more
reserve component members mobilized than all the other services
combined. Much of the Army's reserve component force has been
organized, trained, and resourced as a strategic reserve that would
receive
personnel, training, and equipment as a later-deploying reserve force
rather than an operational force designed for continued overseas
deployments.

Reserve component members have been deployed around the world; some
helping to maintain peace and security at home while others serve on the
front lines in Iraq, Afghanistan, and the Balkans. According to DOD
figures, over 195,000 of the mobilized reserve component members had
been demobilized as of April 7, 2004. Since the pace of reserve operations
is expected to remain high due to the Global War on Terrorism stretching

1DOD's reserve components include the collective forces of the Army
National Guard and the Air National Guard, as well as the forces from the
Army Reserve, the Naval Reserve, the Marine Corps Reserve, and the Air
Force Reserve. The Coast Guard Reserve also assists DOD in meeting its
commitments. However, we did not cover the Coast Guard Reserve during this
review because it accounts for about 1 percent of the total reserve force
and comes under the day-to-day control of the Department of Homeland
Security rather than DOD.

indefinitely into the future, it is critical that the services mobilize
and demobilize their reserve forces as efficiently as possible.2
Furthermore, DOD has recognized that the treatment of these servicemembers
is one of the keys to the retention of a quality force. In addition, the
health and treatment of Guard and Reserve members when mobilized have been
the subject of recent media reports and congressional hearings. Health
data are important to determine reservists' deployability and to identify
health trends for servicemembers, which could assist in the early
identification of the causes of potential post-deployment health problems.

This is the second and final report responding to your Subcommittee's
request that we review a wide range of issues related to mobilizations and
demobilizations. Our first report, issued in August 2003, focused on
reserve mobilization issues, including the mobilization approval process,
visibility over the process, and DOD's limited use of the Individual Ready
Reserve. 3 As agreed with your offices, this review specifically examined
the extent to which (1) DOD's implementation of a key mobilization
authority to involuntarily call up reserve component members and DOD's
personnel polices affect reserve component force availability, (2) the
Army was able to efficiently execute its mobilization and demobilization
plans, and (3) DOD can effectively manage the health status of its
mobilized reserve component members.

In addressing our objectives, we reviewed policies from the services and
the Office of the Secretary of Defense (OSD) in light of the various
mobilization authorities that are available to DOD and planned deployment
rotations. We also visited sites where the services conduct mobilization
and demobilization processing and interviewed responsible officials at
those sites. Although we visited sites for all the services, we focused
our review primarily on the Army's mobilization and demobilization
processes, since more personnel from the Army have been and are expected
to be mobilized than from all the other services combined. We analyzed
personnel and facility data obtained during the

2 Mobilization is the process of assembling and organizing personnel and
equipment, activating or federalizing units and members of the National
Guard and Reserves for active duty, and bringing the armed forces to a
state of readiness for war or other national emergency. Demobilization is
the process necessary to release from active duty units and members of the
National Guard and Reserve components who were ordered to active duty
under various legislative authorities.

3 GAO, Military Personnel: DOD Actions Needed to Improve the Efficiency of
Mobilizations for Reserve Forces, GAO-03-921 (Washington, D.C.: Aug. 21,
2003).

site visits and held meetings with military and civilian officials from
OSD, the Joint Chiefs of Staff, the service headquarters, reserve
component headquarters, and support agencies. In addition, we examined the
collection and processing of pre-and post-deployment health assessment
information, and spoke to officials responsible for collecting and
reviewing health assessment information at the mobilization and
demobilization sites we visited. We also interviewed the officer in charge
of the organization responsible for maintaining DOD's centralized health
assessment database, and obtained and analyzed information from the
database containing the health assessments of over 290,000 reserve
component members who were mobilized or demobilized from November 2001
through March 2004. We also interviewed reserve component members with
medical problems at the mobilization and demobilization sites we visited,
and interviewed hospital commanders and their staffs, case managers and
medical liaison officers, and officials from the service Surgeons General
offices. Finally, we tracked and analyzed trends in service data
concerning the numbers of personnel with medical problems, their
locations, and the elapsed time since they had been diagnosed with their
medical problems. Based on our review of databases we used, we determined
that the DOD-provided data were reliable for the purposes of this report.
We conducted our review from November 2003 through July 2004 in accordance
with generally accepted government auditing standards. A more thorough
description of our scope and methodology is provided in appendix I.

                                Results in Brief

DOD's implementation of a key mobilization authority and the department's
personnel policies greatly affect the numbers of National Guard and
Reserve personnel available to fill the increased requirements for the
Global War on Terrorism.

o  	The manner in which DOD implements its mobilization authorities
affects the number of reserve component members available. The partial
mobilization authority limits involuntary mobilizations to not more than 1
million reserve component members at any one time, for not more than 24
consecutive months during a time of national emergency. Under DOD's
current implementation of the authority, reserve component members can be
involuntarily mobilized more than once, but involuntary mobilizations are
limited to a cumulative total of 24 months. If DOD's implementation of the
partial mobilization authority restricts the cumulative time that reserve
component forces can be mobilized, then it is possible that DOD will run
out of forces. Faced with critical shortages of some reserve component
personnel,

DOD considered a change in its implementation of the partial mobilization
authority that would have expanded its pool of available personnel. Under
such a revised implementation, DOD could have mobilized its reserve
component forces for less than 24 consecutive months; sent them home for
an unspecified period; and then remobilized them, repeating this cycle
indefinitely and providing an essentially unlimited flow of forces.

o  	DOD's personnel policies also affect the availability of reserve
component members. Many of DOD's policies that affect mobilized reserve
component personnel were implemented in a piecemeal manner and were
focused on the short-term requirements of the services and the needs of
reserve component members rather than on long-term requirements and
predictability. For example, DOD has sometimes implemented stop-loss
policies, which are short-term measures that increase the availability of
reserve component forces by retaining both active and reserve component
members on active duty beyond the end of their obligated service. Overall,
the policies reflect DOD's past use of the reserve component as a
later-deploying reserve force rather than a force designed for continued
overseas deployments. However, DOD's policies were not developed within
the context of an overall strategic framework, which would set human
capital goals concerning the availability of reserve forces and show how
the policies work in conjunction with each other to meet the department's
longterm requirements for the Global War on Terrorism. Consequently, the
policies underwent numerous changes as DOD strove to increase the
availability of the reserve components to meet current requirements. These
policy changes created uncertainties for reserve component members
concerning the likelihood of their mobilization, the length of their
service commitments, the length of their overseas rotations, and the types
of missions that they would be asked to perform. It remains to be seen how
these uncertainties will affect recruiting, retention, and the long-term
viability of the reserve components. There are already indications that
some portions of the force are being stressed. For example, the Army
National Guard failed to meet its recruiting goal during 14 of 20 months
from October 2002 through May 2004, and ended fiscal year 2003
approximately 7,800 soldiers below its recruiting goal.

o  	Furthermore, it is unclear how DOD plans to meet its longer-term
requirements for the Global War on Terrorism. In commenting on a draft of
this report, DOD stated that it would retain its current implementation
approach to the partial mobilization authority- limiting mobilizations to
a cumulative total of 24 months. Policies that

limit involuntary mobilizations based on cumulative service make it
difficult for mobilization planners, who must keep track of prior
mobilizations in order to determine which forces are available to meet
future requirements. In June 2004, DOD had more than 150,000 reserve
component members mobilized, and it projects that over the next 3 to 5
years, it will continuously have 100,000 to about 150,000 reserve
component members mobilized. It also noted that about 30,000 reserve
members had already been mobilized for 24 months. The availability of the
reserve force will continue to play an important role in the success of
DOD's missions. However, DOD's comments that said it would retain its
current implementation approach to the partial mobilization authority did
not elaborate on how it would address the increased requirements under
this approach.

The Army was not able to efficiently execute its mobilization and
demobilization plans because the plans contained outdated assumptions
concerning the availability of facilities and support personnel.
Specifically, the plans assumed (1) that active forces would deploy away
from the mobilization and demobilization sites before the reserve forces
arrived and (2) that specialized reserve component support units would
remain available to support ongoing mobilizations and demobilizations.
However, installation officials were not always able to prepare adequate
facilities for the arrival of mobilizing and demobilizing reserve
component forces because active forces had not deployed away from the
mobilization and demobilization sites as plans had assumed. As a result,
some reserve component units were diverted away from their planned
mobilization sites, and disparities in housing accommodations arose
between active and reserve component forces at the same installations. To
address housing and other facilities shortages at mobilization and
demobilization sites, the Army has embarked on a number of facility
construction and renovation projects without updating its planning
assumptions regarding the availability of facilities. In addition,
installation officials faced uncertainties concerning the availability of
specialized reserve component support units that provide much of the
medical, training, logistics, and processing support during mobilization
and demobilization. Faced with the prospect of mobilizing support
personnel for more than 24 months, the Army began a series of initiatives
to replace many of these specialized reserve component support personnel
with civilians or contractors. These initiatives coupled with the facility
construction and renovation projects are projected to run into the
hundreds of millions of dollars. However, the Army did not take a
coordinated approach to evaluate all the support costs associated with
mobilization and demobilization at alternative sites- including both
facility (construction, renovation, and maintenance) and

support personnel (reserve component, civilian, contractor or a
combination) costs-and determine the most efficient options.

DOD's ability to effectively manage the health status of its reserve
component members is limited because (1) its centralized database has
missing and incomplete health records and (2) it has not maintained full
visibility over reserve component members with medical problems.

o  	First, not all of the required information collected from reserve
component members has reached DOD's central data collection point. For
example, the Marine Corps did not send servicemembers' predeployment
health assessment forms to the centralized database as required.4 Marine
Corps officials told us that Marine Corps guidance did

not require them to submit pre-deployment health assessments to the
centralized database. The Marine Corps also lacks a mechanism for
overseeing the submission of these forms to the database. Some records in
DOD's centralized health assessment database did not include information
that could be used to identify the causes of various medical problems,
often because the forms were not submitted electronically. Even though all
of the reserve components have the capability to submit the forms
electronically-and such electronic submission would expedite the inclusion
of key data for meaningful analysis, increase accuracy of the reported
information, and lessen the burden of sites forwarding paper copies and
the likelihood that information would be lost-DOD has not set a timeline
for the services to electronically submit the health assessment forms to
the centralized database. Despite some missing information in the
database, we determined that over 90 percent of the more than 290,000
mobilized reserve component personnel rated their overall health as good
to excellent. Despite the small percentages of mobilized personnel with
medical problems, there are still thousands of reserve component personnel
on active duty with medical problems, due to the large reserve component
mobilizations.

o  	Second, DOD's ability to effectively manage the health of its reserve
component members is limited because some of the reserve components could
not adequately track personnel with medical issues. The Army previously
lacked central visibility over its reserve

4 DOD policy requires that the services collect pre-and post-deployment
health information from servicemembers, and submit copies of the forms
that are used to collect this information to the Army Medical Surveillance
Activity.

component personnel with medical problems, and this contributed to housing
and pay problems for the reserve component members, lost health care
coverage for their dependents, and allegations that it was taking too long
to get medical treatment. The Army has taken steps to address all of these
problems and now has good visibility over its reserve component personnel
who are on active duty with medical problems. However, the Air Force has
visibility over only some of its personnel on active duty with medical
problems because it lacks a mechanism for tracking reserve component
members with health problems who are on voluntary active duty orders.5 As
a result, some air reserve component members have medical issues that may
not have been resolved over long periods of time. For example, at one of
the sites we visited, several reservists told us that they were currently
on voluntary orders with medical problems, and one reservist who was
currently on voluntary orders told us that his problem had lasted for 18
months and he did not expect resolution of his case anytime soon. The
extent to which such a problem is commonplace is unknown, given the
inability of the Air Force to track such personnel.

We are making eight recommendations in this report. We recommend that DOD
develop a strategic framework that sets human capital goals concerning the
availability of its reserve force to meet the longer-term requirements of
the Global War on Terrorism and that DOD identify personnel policies that
should be linked within the context of the strategic framework. We also
recommend that DOD update the Army's mobilization-and
demobilization-planning assumptions, evaluate all support costs associated
with mobilization and demobilization at alternative Army sites to
determine the most efficient options, update Marine Corps guidance
concerning the submission of health assessments, improve Marine Corps
oversight of the submission of health assessments, set a timeline for the
military departments to electronically submit health assessments, and
develop a mechanism for Air Force tracking of reserve component members on
voluntary active duty orders with health problems.

In commenting on a draft of this report, DOD concurred with five of our
eight recommendations and partially concurred with the other three. DOD
stated that it has a strategic framework for setting human capital goals,

5 Reserve component members often switch to voluntary mobilization orders
after the expiration of involuntary orders, but the Air Force has also
used voluntary mobilizations in lieu of involuntary mobilizations under
the current partial mobilization authority.

which was established through a December 2002 force mix review, a January
2004 rebalancing report, and other planning and budgeting guidance.
However, DOD agreed that it should review and, as appropriate, update its
strategic framework. Although the documents cited by DOD lay some of the
groundwork needed to develop a strategic framework, these documents do not
specifically address how DOD will integrate and align its personnel
policies to maximize its efficient usage of reserve component personnel in
order to meet its overall organizational goals. DOD also stated that its
September 20, 2001, personnel and pay policy and its July 19, 2002,
addendum established personnel policies associated with this strategic
framework and said that the department should review, and as appropriate,
update the policies. However, the policies cited by DOD predate the 2004
report and the December 2002 review, which DOD cited as part of its
strategic framework. The strategic framework should be established prior
to the creation of personnel policies. Regarding our recommendation
concerning Marine Corps oversight of health assessments, DOD stated that
electronic submission might not be practical for every Marine Corps
deployment. However, this recommendation was directed at the oversight of
health assessments regardless of how the assessments are submitted-in
paper or electric form. We continue to believe that the Marine Corps needs
to establish a mechanism for overseeing the submission of its pre- and
post-deployment health assessments.

Mobilization is the process of assembling and organizing personnel and
equipment, activating or federalizing units and members of the National
Guard and Reserves for active duty, and bringing the armed forces to a
state of readiness for war or other national emergency. It is a complex
undertaking that requires constant and precise coordination between a
number of commands and officials. Mobilization usually begins when the
President invokes a mobilization authority and ends with the voluntary or
involuntary mobilization of an individual Reserve or National Guard
member. Demobilization6 is the process necessary to release from active
duty units and members of the National Guard and Reserve components who
were ordered to active duty under various legislative authorities.

Background

6 Some of the services use the term "deactivation" to describe the process
for taking reserve component members off active duty and use the term
"demobilization" to describe the broader processes that also include
restoring equipment to its reserve status. We have used the more common
"demobilization" term throughout this report even though the report is
focused on personnel issues.

Mobilization and demobilization times can vary from a matter of hours to
months depending on a number of factors. For example, many air reserve
component units are required to be available to mobilize within 72 hours
while Army National Guard brigades may require months of training as part
of their mobilizations. Reserve component members' usage of accrued leave
can greatly affect demobilization times. Actual demobilization processing
typically takes a matter of days once the member arrives back in the
United States. However, since members earn 30 days of leave each year,
they could have up to 60 days of leave available to them at the end of a
2-year mobilization.

    Reserve Components and Categories

DOD has six reserve components: the Army Reserve, the Army National Guard,
the Air Force Reserve, the Air National Guard, the Naval Reserve, and the
Marine Corps Reserve. Reserve forces can be divided into three major
categories: the Ready Reserve, the Standby Reserve, and the Retired
Reserve. The Ready Reserve had approximately 1.2 million National Guard
and Reserve members at the end of fiscal year 2003, and its members were
the only reservists who were subject to involuntary mobilization under the
partial mobilization declared by President Bush on September 14, 2001.
Within the Ready Reserve, there are three subcategories: the Selected
Reserve, the Individual Ready Reserve (IRR), and the Inactive National
Guard. Members of all three subcategories are subject to mobilization
under a partial mobilization.

o  	At the end of fiscal year 2003, DOD had 875,072 Selected Reserve
members. The Selected Reserve's members included individual mobilization
augmentees-individuals who train regularly, for pay, with active component
units-as well as members who participate in regular training as members of
National Guard or Reserve units.

o  	At the end of fiscal year 2003, DOD had 274,199 IRR members. During a
partial mobilization, these individuals-who were previously trained during
periods of active duty service-can be mobilized to fill requirements. Each
year, the services transfer thousands of personnel who have completed the
active duty or Selected Reserve portions of their military contracts, but
who have not reached the end of their military service obligations, to the
IRR.7 However, IRR members do not

7 While enlistment contracts can vary, a typical enlistee would incur an
8-year military service obligation, which could consist of a 4-year active
duty obligation followed by a 4year IRR obligation.

participate in any regularly scheduled training, and they are not paid for
their membership in the IRR.8

o  	At the end of fiscal year 2003, the Inactive National Guard had 2,138
Army National Guard members. This subcategory contains individuals who are
temporarily unable to participate in regular training but who wish to
remain attached to their National Guard unit.

Appendix II contains additional information about end strengths within the
various reserve components and different categories.

Mobilization Authorities 	Most reservists who were called to active duty
for other than normal training after September 11, 2001, were mobilized
under one of the three legislative authorities listed in table 1.

Table 1: Authorities Used to Mobilize Reservists after September 11, 2001

                                              Number of Ready Reservists that

can be Title 10 U.S.C. Type of mobilized at section mobilization any one
time Length of mobilizations

                       12304 Involuntary 200,000a  Not more than 270 days for 
                                                                          any 
               (Presidential                              operational mission 
             reserve call-up                      
                  authority)                      

12302 1,000,000

(Partial mobilization authority)

12301 (d) Voluntary Unlimited Unlimited

Source: GAO.

aUnder this authority, DOD can mobilize members of the Selected Reserve
and certain IRR members but it is limited to not more than 200,000 members
at any one time, of whom not more than 30,000 may be members of the IRR.

8 IRR members can request to participate in annual training or other
operations, but most do not. Those who are activated are paid for their
service. Also, there are small groups of IRR members who participate in
unpaid training. The members of this last group are often in the IRR only
for short periods while they are waiting to transfer to paid positions in
the Selected Reserve. IRR members can receive retirement credit if they
meet basic eligibility criteria through voluntary training or
mobilizations.

On September 14, 2001, President Bush declared that a national emergency
existed as a result of the attacks on the World Trade Center in New York
City, New York, and the Pentagon in Washington, D.C., and he invoked 10
U.S.C. S: 12302, which is commonly referred to as the "partial
mobilization authority." On September 20, 2001, DOD issued mobilization
guidance that, among a host of other things, directed the services as a
matter of policy to specify in initial orders to Ready Reserve members
that the period of active duty service under 10 U.S.C. S: 12302 would not
exceed 12 months. However, the guidance allowed the service secretaries to
extend orders for an additional 12 months or remobilize reserve component
members under the partial mobilization authority as long as an individual
member's cumulative service did not exceed 24 months under 10 U.S.C. S:
12302. It further specified that "No member of the Ready Reserve called to
involuntary active duty under 10 U.S.C. 12302 in support of the effective
conduct of operations in response to the World Trade Center and Pentagon
attacks, shall serve on active duty in excess of 24 months under that
authority, including travel time to return the member to the residence
from which he or she left when called to active duty and use of accrued
leave." The guidance also allowed the services to retain members on active
duty after they had served 24 or fewer months under 10 U.S.C. S: 12302
with the member's consent if additional orders were authorized under 10
U.S.C. S: 12301(d).9

    Mobilization and Demobilization Roles and Responsibilities

Combatant commanders are principally responsible for the preparation and
implementation of operation plans that specify the necessary level of
mobilization of reserve component forces. The military services are the
primary executors of mobilization. At the direction of the Secretary of
Defense, the services prepare detailed mobilization plans to support the
operation plans and provide forces and logistical support to the combatant
commanders.

The Assistant Secretary of Defense for Reserve Affairs, who reports to the
Under Secretary of Defense for Personnel and Readiness, is to provide
policy, programs, and guidance for the mobilization and demobilization of
the reserve components. The Chairman of the Joint Chiefs of Staff, after

9 According to DOD, this policy guidance is still in effect and the only
major change to the policy has been to allow the Army to call up reserve
component members for more than 12 months on their initial orders.
However, DOD also noted that there have been multiple other documents
published to augment the policy, provide more information, or implement
legal requirements.

coordination with the Assistant Secretary of Defense for Reserve Affairs,
the secretaries of the military departments, and the commanders of the
Unified Combatant Commands, is to advise the Secretary of Defense on the
need to augment the active forces with members of the reserve components.
The Chairman of the Joint Chiefs of Staff also has responsibility for
recommending the period of service for units and members of the reserve
components ordered to active duty. The service secretaries are to prepare
plans for mobilization and demobilization and to periodically review and
test the plans to ensure the services' capabilities to mobilize reserve
forces and to assimilate them effectively into the active forces.

    Reserve Component Approaches to Mobilization and Demobilization

Within the constraints of the existing mobilization authorities and DOD
guidance, the services have flexibility as to how, where, and when they
conduct mobilization and demobilization processing. Unit readiness also
affects time frames. For example, air reserve component units, which must
be ready to deploy on short notice, generally complete their mobilization
processing much quicker than Army units that have been funded at low
levels under the Army's tiered readiness concept. However, higher-priority
units may take longer to complete demobilization processing because, at
the end of the processing, they must be ready to deploy on short notice
again.

The reserve components differ in their approaches to the mobilization and
demobilization processes. The Army and Navy use centralized approaches,
mobilizing and demobilizing their reserve component forces at a limited
number of locations. The Army utilizes 15 primary sites that it labels
"power projection platforms" and 12 secondary sites called "power support
platforms." The Navy has 15 geographically dispersed Navy Mobilization
Processing Sites but is currently using only 5 of these sites because of
the relatively small numbers of personnel who are mobilizing and
demobilizing.

By contrast, the Air Force uses a decentralized approach, mobilizing and
demobilizing its reserve component members at their home stations-135 for
the Air Force Reserve and 90 for the Air National Guard. The Marine Corps
uses a hybrid approach. It has five Mobilization Processing Centers to
centrally mobilize individual reservists and is currently using three of
these centers. However, the Marine Corps uses a decentralized approach to
mobilize its units. Selected Marine Corps Reserve units do most of their
mobilization processing at their home stations and then report to their
gaining commands, such as the First or Second Marine Expeditionary

Force located at Camp Pendleton and Camp Lejeune, respectively.
Individuals usually demobilize at the same location where they mobilized
and units generally demobilize at Camp Pendleton or Camp Lejeune. See
appendix III for a listing of the services' mobilization and
demobilization sites.

Service Usage of the Figure 1 shows reserve component usage on a per
capita basis since fiscal Reserve Component since year 1989 and
demonstrates the dramatic increase in usage that occurred September 11,
2001 after September 11, 2001. It shows that the ongoing usage-which
includes

support to operations Noble Eagle, Enduring Freedom, and Iraqi
Freedom-exceeds the usage rates during the 1991 Persian Gulf War in both
length and magnitude.10

Figure 1: Average Days of Duty Performed by DOD's Reserve Component
Forces, Fiscal Years 1989-2003

Duty days per capita

140.0

120.0

100.0

80.0

60.0

40.0

20.0

0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
2003

Fiscal year

Source: GAO analysis of OASD/RA data Note: Duty days in figure 1 include
training days as well as support for operational missions.

10 Noble Eagle is the name for the domestic war on terrorism. Enduring
Freedom is the name for the international war on terrorism, including
operations in Afghanistan. Iraqi Freedom is the name for operations in and
around Iraq.

While reserve component usage increased significantly after September 11,
2001, an equally important shift occurred at the end of 2002. Following
the events of September 11, 2001, the Air Force initially used the partial
mobilization authority more than the other services. However, service
usage shifted in 2002, and by the end of that year, the Army had more
reserve component members mobilized than all the other services combined.
Since that time, usage of the Army's reserve component members has
continued to dominate DOD's figures. On June 30, 2004, the Army had about
131,000 reserve component members mobilized while the Air Force had about
12,000, the Marine Corps about 9,000, and the Navy about 3,000.

Under the current partial mobilization authority, DOD increased not only
the numbers of reserve component members that it mobilized, but also the
length of the members' mobilizations. The average mobilization for
Operations Desert Shield and Desert Storm in 1990-91 was 156 days.
However, by December 31, 2003, the average mobilization for operations
Noble Eagle, Enduring Freedom, and Iraqi Freedom was 319 days, or double
the length of mobilizations for Desert Shield and Desert Storm. By March
31, 2004, the average mobilization for the three ongoing operations had
increased to 342 days, and that figure is expected to continue to rise.

    DOD's Management of Reserve Component Health Issues

Section 1074f of Title 10, United States Code required that the Secretary
of Defense establish a system to assess the medical condition of members
of the armed forces (including members of the reserve components) who are
deployed outside of the United States, its territories, or its possessions
as part of a contingency operation or combat operation. It further
required that records be maintained in a centralized location to improve
future access to records and that the Secretary establish a quality
assurance program to evaluate the success of the system in ensuring that
members receive pre-and post-deployment medical examinations11 and that
recordkeeping requirements are met.

DOD policy requires that the services collect pre-and post-deployment
health information from their members and submit copies of the forms that
are used to collect this information to the Army Medical Surveillance

11 Physical examinations are not required but servicemembers may request
physicals as part of their demobilization processing. Appendix IV shows
the differences between required periodic physicals and optional
demobilization physicals.

Activity (AMSA).12 Initially, deployment health assessments were required
for all active and reserve component personnel who were on troop movements
resulting from deployment orders of 30 continuous days or greater to
land-based locations outside the United States that did not have permanent
U.S. military medical treatment facilities. However, on October 25, 2001,
the Assistant Secretary of Defense for Health Affairs updated DOD's policy
and required deployment-related health assessments for all reserve
component personnel called to active duty for 30 days or more. The policy
specifically stated that the assessments were to be done whether or not
the personnel were deploying outside the United States. Both assessments
use a questionnaire designed to help military health care providers in
identifying health problems and providing needed medical care. The
pre-deployment health assessment is generally administered at the service
mobilization site or unit home station before deployment, and the
post-deployment health assessment is completed either in theater before
redeployment to the servicemember's home unit or shortly after
redeployment.

On February 1, 2002, the Chairman of the Joint Chiefs of Staff issued
updated deployment health surveillance procedures. Among other things,
these procedures specified that servicemembers must complete or revalidate
the health assessment within 30 days prior to deployment. The procedures
also stated that the original completed health assessment forms were to be
placed in the servicemember's permanent medical record and a copy
"immediately forwarded to AMSA."

Both the pre-and the post-deployment assessments were originally twopage
forms, but on April 22, 2003, the post-deployment assessment was expanded
to four pages "in response to national interest in the health of deployed
personnel, combined with the timing and scope of current deployments."
Both forms include demographic information about the servicemember,
member-provided information about the member's general health, and
information about referrals that are issued when service medical providers
review the health assessments. The predeployment assessment also includes
a final medical disposition that shows whether the member was deployable
or not, and the postdeployment assessment contains additional information
about the location where the member was deployed and things that the
member might have been exposed to during the deployment. Compared with the
two-page

12 AMSA operates the Defense Medical Surveillance System, which was
established in 1997.

post-deployment form, the four-page form captures more-detailed
information on deployment locations, potentially hazardous exposures, and
medical symptoms the servicemember might have experienced. It also asks a
number of mental health questions. Examples of the forms can be found in
appendix V.

    GAO's Prior Report on DOD's Mobilization Process

  Availability of Reserves Is Greatly Influenced by Mobilization Authorities and
  Personnel Policies

Our August 2003 report found the following:

o  	DOD's process to mobilize reservists after September 11, 2001, had to
be modified and contained numerous inefficiencies.

o  	DOD did not have visibility over the entire mobilization process
primarily because it lacked adequate systems for tracking personnel and
other resources.

o  	The services have used two primary approaches-predictable operating
cycles and formal advance notification-to provide time for units and
personnel to prepare for mobilizations and deployments.

o  	Mobilizations were hampered because one-quarter of the Ready Reserve
was not readily available for mobilization or deployment. Over 70,000
reservists could not be mobilized because they had not completed training
requirements, and the services lacked information needed to fully use the
300,000 previously trained IRR members. 13

We made a number of recommendations in our report to enhance the
efficiency of DOD's reserve component mobilizations. DOD generally
concurred with the recommendations and has mobilization reengineering
efforts under way to make the process more efficient. The Army has also
taken steps to improve the information it maintains on IRR members.

The availability of reserve component forces to meet future requirements
is greatly influenced by DOD's implementation of the partial mobilization
authority and by the department's personnel policies. Furthermore, many of
DOD's policies that affect mobilized reserve component personnel were
implemented in a piecemeal manner, and were focused on the short-term
needs of the services and reserve component members rather than on
long-term requirements and predictability. The availability of reserve
component forces will continue to play an important role in the success of
DOD's missions because requirements that increased significantly after

13 GAO-03-921.

September 11, 2001, are expected to remain high for the foreseeable
future. As a result, there are early indicators that DOD may have trouble
meeting predictable troop deployment and recruiting goals for some reserve
components and occupational specialties.

    DOD's Recent Use of Mobilization Authorities

On September 14, 2001, DOD broke with its previous pattern of invoking
successive authorities by invoking a partial mobilization authority
without a prior Presidential Reserve call-up. In addition, DOD was
considering a change in its implementation of the partial mobilization
authority. The manner in which DOD implements the mobilization authorities
currently available can result in either an essentially unlimited supply
of forces or running out of forces available for deployment, at least in
the short term.

While DOD has consistently used two mobilization authorities to gain
involuntary access to its reserve component forces since 1990, the methods
of using the authorities has not remained constant. On August 22, 1990,
the President invoked Title 10 U.S.C. Section 673b, allowing DOD to
mobilize Selected Reserve members for Operation Desert Shield.14 The
provision was then commonly referred to as the Presidential Selected
Reserve Call-up authority and is now called the Presidential Reserve
Callup authority.15 This authority limits involuntary mobilizations to not
more than 200,000 reserve component members at any one time, for not more
than 270 days, for any operational mission. On January 18, 1991, the
President invoked Title 10 U.S.C. Section 673, commonly referred to as the
"partial mobilization authority," thus providing DOD with additional
authority to respond to the continued threat posed by Iraq's invasion of
Kuwait.16 The partial mobilization authority limits involuntary
mobilizations to not more than 1 million reserve component members at any
one time, for not more than 24 consecutive months, during a time of
national emergency. During the years between Operation Desert Shield and
September 11, 2001, DOD invoked a number of separate missionspecific
Presidential Reserve Call-ups for operations in Bosnia, Kosovo, Southwest
Asia, and Haiti. The department did not seek a partial

14 The provision was renumbered 12304 in 1994. Pub. L. No. 103-337,
S:1662(e) (2) (1994).

15 In 1990, the authority permitted the involuntary call-up of only
members of the Selected Reserve. The statute was amended to permit the
call-up of up to 30,000 members of the Individual Ready Reserve and is
consequently now referred to as the Presidential Reserve Call-up
authority. Pub. L. No. 105-85 S: 511 (1997).

16 This provision was renumbered 12302 in 1994. Pub. L. No. 103-337,
S:1662(e) (2) (1994).

mobilization authority for any of these operations, and it continued to
view the partial mobilization authority as the second step in a series of
progressive measures to address escalating requirements during a time of
national emergency.

Unlike the progressive use of mobilization authorities following Iraq's
1990 invasion of Kuwait, after the events of September 11, 2001, the
President invoked the partial mobilization authority without a prior
Presidential Reserve Call-up.17 Since the partial mobilization for the
Global War on Terrorism went into effect in 2001, DOD has used both the
partial mobilization authority and the Presidential Reserve Call-up
authority to involuntarily mobilize reserve component members for
operations in the Balkans.

The manner in which DOD implements the partial mobilization authority
affects the number of reserve component forces available for deployment.
When DOD issued its initial guidance concerning the partial mobilization
authority in 2001, it limited mobilization orders to 12 months but allowed
the service secretaries to extend the orders for an additional 12 months
or remobilize reserve component members, as long as an individual member's
cumulative service under the partial mobilization authority did not exceed
24 months. Under this cumulative implementation approach, it is possible
for DOD to run out of forces during an extended conflict such as the
long-term Global War on Terrorism. During our review, DOD was already
facing some critical personnel shortages. To expand its pool of available
personnel, DOD was considering a policy shift that would have authorized
mobilizations of up to 24 consecutive months under the partial
mobilization authority with no limit on cumulative months. Under the
considered approach, DOD would have been able to mobilize its forces for
less than 24 months; send them home; and then remobilize them, repeating
this cycle indefinitely and providing essentially an unlimited flow of
forces.

17 In commenting on a draft of this report, DOD indicated that under its
analysis of the applicable authorities at the time, DOD was not authorized
to use Presidential Reserve Call-up authority in September 2001. DOD also
noted that 10 U.S.C 12304(b) has since been changed to allow for the
call-up of Reserve members in response to "...a terrorist attack or
threatened terrorist attack...".

    Piecemeal Policies Did Not Address Long-term Requirements or Predictability

Volunteer and Individual Ready Reserve Policies

Many of DOD's policies that affect mobilized reserve component personnel
were implemented in a piecemeal manner and were not linked within the
context of a strategic framework to meet the organizational goals.
Overall, the policies reflected DOD's past use of the reserve components
as a strategic force rather than DOD's current use of the reserve
component as an operational force to respond to the increased requirements
of the Global War on Terrorism. Faced with some critical shortages, the
policies focused on the short-term needs of the services and reserve
component members rather than on long-term requirements and
predictability. This approach was necessary because the department had not
developed a strategic framework that identified DOD's human capital goals
necessary to meet organizational requirements. Without a strategic
framework, OSD and the services made several changes to their personnel
policies to increase the availability of the reserve components for the
longer-term requirements of the Global War on Terrorism, and
predictability declined for reserve component members. Specifically,
reserve component members have faced uncertainties concerning the
likelihood of their mobilizations, the length of their service
commitments, the length of their overseas rotations, and the types of
missions that they would be asked to perform.

The partial mobilization authority allows DOD to involuntarily mobilize
members of the Ready Reserve, including the IRR;18 but after the President
invoked the partial mobilization authority on September 14, 2001, DOD and
service policies encouraged the use of volunteers and generally
discouraged the involuntary mobilization of IRR members. DOD officials
said that they could meet requirements without using the IRR and stated
that they wanted to focus involuntary mobilizations on the paid, rather
than unpaid members, of the reserve components. However, our August 2003
report documented the lack of predictability that resulted from the
volunteer and IRR policies.19 These policies were disruptive to the
integrity of Army units because there was a steady flow of personnel among
units. Personnel were transferred from nonmobilizing units to mobilizing
units that were short of personnel, and when the units that had supplied
the

18 The partial mobilization authority (10 U.S.C. S: 12302) states that "To
achieve fair treatment as between members in the Ready Reserve who are
being considered for recall to duty without their consent, consideration
shall be given to (1) the length and nature of previous service, to assure
such sharing of exposure to hazards as the national security and military
requirements will reasonably allow; (2) family responsibilities; and (3)
employment necessary to maintain the national health, safety, or
interest."

19 GAO-03-921.

personnel were later mobilized, they in turn were short of personnel and
had to draw personnel from still other units. Despite the DOD and Army
reluctance to use the IRR, the Chief of the Army Reserve has advocated
using the IRR to cut down on the disruptive cross-leveling and individual
mobilizations that have been breaking Army units. From September 11, 2001
to May 15, 2004, the Army Reserve mobilized 110,000 of its reservists, but
more than 27,000 of these reservists were cross-leveled and mobilized with
units that they did not normally train with. Furthermore, because the IRR
makes up almost one-quarter of the Ready Reserve, policies that discourage
the use of the IRR will cause members of the Selected Reserve to share
greater exposures to the hazards associated with national security and
military requirements. Moreover, policies that discourage the use of the
IRR could cause DOD's pool of available reserve component personnel to
shrink by more than 200,000 personnel.

Since our August 2003 report, Navy and Air Force officials have stated
that they still have not involuntarily mobilized any members of their
IRRs. In our August 2003 report, we noted that the Air Force's reluctance
to use any of its more than 44,000 IRR members resulted in unfilled
requirements for more than 9,000 personnel to guard Air Force bases.
However, the Army National Guard agreed to provide personnel from its
Selected Reserve units to fill these requirements. Faced with critical
personnel shortages, the Army recently changed its policy and now plans to
make limited use of its IRR. To date, the Marine Corps has made the most
extensive use of its IRR, capitalizing on the willingness of many members
to voluntarily return to active duty.

Stop-Loss Policies	At various times since September 2001, all of the
services have had "stoploss" policies in effect.20 These policies are
short-term measures that increase the availability of reserve component
forces while decreasing predictability for reserve component members who
are prevented from leaving the service at the end of their enlistment
periods. Stop-loss policies are often implemented to retain personnel in
critical or high-use occupational specialties. Appendix VI contains a
summary of the services' stop-loss policies that have been in effect since
September 2001.

The only stop-loss policy in effect when we ended our review was an Army
policy that applied to units rather than individuals in critical
occupations.

20 Stop-loss policies can affect active as well as reserve component
personnel. The focus of our report was those policies affecting the
reserves.

Under that policy, Army reserve component personnel were not permitted to
leave the service from the time their unit was alerted21 until 90 days
after the date when their unit was demobilized. Because many Army units
undergo several months of training after being mobilized but before being
deployed overseas for 12 months, stop-loss periods can reach 2 years or
more.

According to Army officials, a substantial number of reserve component
members have been affected by the changing stop-loss policies. As of June
30, 2004, the Army had over 130,000 reserve component members mobilized
and thousands more alerted or demobilized less than 90 days. Because they
have remaining service obligations, many of these reserve component
members would not have been eligible to leave the Army even if stop-loss
policies had not been in effect. However, from fiscal year 1993 through
fiscal year 2001,22 Army National Guard annual attrition rates exceeded 16
percent and Army Reserve rates exceeded 25 percent. Even a 16 percent
attrition rate means that 20,800 of the mobilized 130,000 reserve
component soldiers would have left their reserve component each year. If
attrition rates exceed 16 percent or the thousands of personnel who are
alerted or who have been demobilized for less than 90 days are included,
the numbers of personnel affected by stop-loss policies would increase
even more.23 When the Army's stop-loss policies are eventually lifted,
thousands of servicemembers could retire or leave the service all at once
and the Army's reserve components could be confronted with a huge increase
in recruiting requirements.

Following DOD's issuance of guidance concerning the length of
mobilizations in September 2001, the services initially limited most
mobilizations to 12 months, and most services maintained their existing
operational rotation policies to provide deployments of a predictable
length that are preceded and followed by standard maintenance and training
periods. However, the Air Force and the Army later increased the length of
their rotations, and the Army increased the length of its mobilizations as
well. These increases in the length of mobilizations and

Mobilization and Rotation Policies

21 The Army goal is to alert units at least 30 days prior to the units'
mobilization date.

22 Army stop-loss policies went into effect early in fiscal year 2002.

23 Officials from the Office of the Assistant Secretary of the Army
(Manpower and Reserve Affairs) estimated that recent stop-loss policies
might have prevented more than 42,000 reserve component soldiers from
leaving the service on the date when they would have been eligible if
stop-loss policies had not been in effect.

rotations increased the availability of reserve component forces but
decreased predictability for individual reserve component members who were
mobilized and deployed under one set of policies but later extended as a
result of the policy changes.

The Air Force's operational concept prior to September 2001, was based on
a rotation policy that made reserve component forces available for 3 out
of every 15 months. After September 2001, the Air Force was not able to
solely rely on its normal rotations and had to involuntarily mobilize
large numbers of reserve component personnel. From September 11, 2001, to
March 31, 2004, the Air National Guard mobilized more than 31,000
personnel, and the Air Force Reserve mobilized more than 24,000 personnel.
Although most Air Force mobilizations were for 12 months or less, more
than 10,000 air reserve component members had their mobilization orders
extended to 24 months. Most of these personnel were in security-related
occupations. Since September 2001, the Air Force has not been able to
return to its normal operating cycle, and in June 2004, the Air Force
Chief of Staff announced that Air Force rotations would be increased to 4
months beginning in September 2004.

Before September 2001, the Army mobilized its reserve component forces for
up to 270 days under the Presidential Reserve Call-up authority, and it
deployed these troops overseas for rotations that lasted about 6 months.
When it began mobilizing forces under the partial mobilization authority
in September 2001, the Army generally mobilized troops for 12 months.
However, troops that were headed for duty in the Balkans continued to be
mobilized under the Presidential Reserve Call-up authority. When worldwide
requirements for both active and reserve component Army troops increased,
the Army changed its Balkan rotation schedules. These schedules had been
published years in advance to allow poorly resourced Guard and Reserve
units time to train and prepare for the deployments. As a result of the
changed schedules, some reserve component units did not have adequate time
to prepare and train for Balkan rotations and then deploy for 6 months and
still remain with the 270-day limit of the Presidential Reserve Call-up
authority. Therefore, the Army mobilized some reserve component units
under the partial mobilization authority so that they could undergo longer
training periods prior to deploying for 6 months under the Presidential
Reserve Call-up authority. The Army's initial deployments to Iraq and
Afghanistan were scheduled for 6 months, just like the overseas rotations
for the Balkans. Eventually, the Army increased the length of its
rotations to Iraq and Afghanistan to 12 months. This increased the
availability of reserve component forces, but it decreased predictability
for members who were mobilized and deployed

                            Cross-Training Policies

during the transition period when the policy changed. Because overseas
rotations were extended to 12 months and mobilization periods must include
mobilization and demobilization processing time, training time, and time
for the reserve component members to take any leave that they earn, the
change in rotation policy required a corresponding increase in the length
of mobilizations.

DOD has a number of training initiatives underway that will increase the
availability of its reserve component forces to meet immediate needs.
Servicemembers are receiving limited training-called "cross-training"-
that enables them to perform missions that are outside their area of
expertise. In the Army, field artillery and air defense artillery units
have been trained to perform some military police duties. Air Force and
Navy personnel received additional training and are providing the Army
with additional transportation assets. DOD also has plans to permanently
convert thousands of positions from low-use career fields to stressed
career fields.

    Early Indications That DOD May Have Trouble Meeting Its Rotation and
    Recruiting Goals Exist

While it remains to be seen how the uncertainty resulting from changing
personnel policies will affect recruiting, retention, and the long-term
viability of the reserve components, there are already indications that
some portions of the force are being stressed. For example, the Army
National Guard failed to meet its recruiting goal during 14 of 20 months
and ended fiscal year 2003 approximately 7,800 soldiers below its
recruiting goal. (Appendix VII contains additional information about
reserve component recruiting results.)

The Secretary of Defense established a force-planning metric to limit
involuntary mobilizations to "reasonable and sustainable rates" and has
set the metric for such mobilizations at 1 year out of every 6. However,
on the basis of current and projected usage, it appears that DOD may face
difficulties achieving its goal within the Army's reserve components in
the near term. Since February 2003, the Army has continuously had between
20 and 29 percent of its Selected Reserve members mobilized. To
illustrate, even if the Army were to maintain the lower 20 percent
mobilization rate for Selected Reserve members, it would need to mobilize

one-fifth of its selected reserve members each year.24 DOD is aware that
certain portions of the force are used much more highly than others, and
it plans to address some of the imbalances by converting thousands of
positions from lower- demand specialties into higher-demand specialties.
However, these conversions will take place over several years and even
when the positions are converted, it may take some time to recruit and
train people for the new positions.

    DOD Plans to Address Increased Personnel Requirements Are Unclear

It is unclear how DOD plans to address its longer-term personnel
requirements for the Global War on Terrorism, given its current
implementation of the partial mobilization authority. Requirements for
reserve component forces increased dramatically after September 11, 2001,
and are expected to remain high for the foreseeable future. In the initial
months following September 11, 2001, the Air Force used the partial
mobilization authority more than the other services, and it reached its
peak with almost 38,000 reserve component members mobilized in April 2002.
However, by July 2002, Army mobilizations surpassed those of the Air
Force, and since December 2002, the Army has had more reserve component
members mobilized than all the other services combined. Although many of
the members who have been called to active duty under the partial
mobilization authority have been demobilized, as of March 31, 2004,
approximately 175,000 of DOD's reserve component members were still
mobilized and serving on active duty. According to OASD/RA data, about 40
percent of DOD's Selected Reserve forces had been mobilized from September
11, 2001, to March 31, 2004.25

By June 30, 2004, the number of mobilized reserve component members had
dropped to about 155,000-consisting of about 131,000 members from the
Army, about 12,000 from the Air Force, about 9,000 from the Marine Corps,
and about 3,000 from the Navy. However, the number of mobilized reserve
component forces is projected to remain high for the foreseeable

24 Given the fiscal year 2003 attrition rates of 17 percent for the Army
National Guard and 21 percent for the Army Reserve, it might be possible
to achieve the one in six metric if attrition is concentrated in the
population that has already been mobilized, and the Army is able to fully
utilize its entire selected reserve population by mobilizing individual
soldiers out of its reserve component units that have already been
mobilized.

25 This percentage does not take into account the more than 270,00 IRR
members who can be mobilized under a partial mobilization authority. DOD
officials said that IRR members make up less than 2 percent of the 343,020
reserve component members who were mobilized from September 11, 2001, to
March 31, 2004.

future. DOD projects that over the next 3 to 5 years, it will continuously
have 100,000 to about 150,000 reserve component members mobilized, and the
Army National Guard and Army Reserve will continue to supply most of these
personnel.

While Army forces may face the greatest levels of involuntary
mobilizations over the next few years, all the reserve components have
career fields that have been highly stressed. For example, the Navy and
Marine Corps have mobilized 60 and 100 percent of their enlisted law
enforcement specialists and 48 and 100 percent of their intelligence
officers, respectively. The Air National Guard and Air Force Reserve
mobilized 64 and 93 percent of their enlisted law enforcement specialists
and 71 and 86 percent of their installation security personnel,
respectively.

o  	As noted earlier, during our review, DOD was considering changing its
implementation of the partial mobilization authority from its current
approach, which limits mobilizations to 24 cumulative months, to an
approach that would have limited mobilizations to 24 consecutive months to
expand its pool of available personnel. However, in commenting on a draft
of this report, DOD stated that it would retain its current cumulative
implementation approach. Policies that limit involuntary mobilizations on
the basis of cumulative service make it difficult for mobilization
planners, who must keep track of prior mobilizations in order to determine
which forces are available to meet future requirements. This can be
particularly difficult now, when many mobilizations involve individuals or
small detachments rather than complete units.

o  	In June 2004, DOD noted that about 30,000 reserve members had already
been mobilized for 24 months. Under DOD's cumulative approach, these
personnel will not be available to meet future requirements. The shrinking
pool of available personnel, along with the lack of a strategic plan to
clarify goals regarding the reserve component force's availability, will
present the department with additional short-and long-term challenges as
it tries to fill requirements for mobilized reserve component forces. In
its comments on a draft of our report, DOD did not elaborate on how it
expected to address its increased personnel requirements.

  The Army Was Not Able to Efficiently Execute Its Mobilization and
  Demobilization Plans

The Army was not able to efficiently execute its mobilization and
demobilization plans, because mobilization and demobilization site
officials faced uncertainties concerning demands for facilities, turnover
among support personnel, and the arrival of reserve component forces. The
efficiency of the mobilization and demobilization process depends on
advanced planning and coordination. However, the Army's planning
assumptions did not accurately portray the availability of installations
and personnel needed to fully accommodate the high number of mobilizations
and demobilizations. Moreover, officials did not always have adequate
notice to prepare for arriving troops. The Army has several initiatives
under way to improve facility and support personnel availability, but it
has not taken a coordinated approach to evaluate all the support costs
associated with mobilization and demobilization at alternative sites in
order to determine the most efficient options under the operating
environment for the Global War on Terrorism.

    Advanced Planning and Coordination Are Key to Efficient Mobilizations and
    Demobilizations

The efficiency of the mobilization and demobilization processes depends
largely on advanced planning in the form of facility preparation and
coordination between installation planners, support personnel, and
arriving reserve component units or individuals. The Army attempts to take
the necessary planning steps to support efficient servicemember
mobilization and demobilization. For example, installations that are
responsible for mobilizing and demobilizing reserve component forces
attempt to contact units or personnel prior to their arrival, so that both
the reserve component forces and the supporting installations can be
prepared to meet the Army's mobilization and demobilization requirements.
During these contacts, reserve component forces are told what records, and
equipment to bring to the mobilization and demobilization sites and
installation officials obtain information-such as the number of arriving
troops and the anticipated time of their arrival- that is necessary for
them to efficiently prepare for the arrival of the reserve component
forces. With this information, the installations can plan where they will
house, feed, and train the troops; how they will transport the troops
around the installation and to their final destinations; and when

they will send the troops for medical and dental screenings and
administrative processing.26

Army guidance, which states that units are to demobilize at the same
installation where they mobilized, can add to the efficiency of the
demobilization process. Efficiencies can be realized because many of
records created during the mobilization process or copies of the records
are kept at the installation and can be used to do advanced preparation
before the demobilizing unit arrives at the installation. Army officials
told us that since September 11, 2001, most units have demobilized at the
same installation where they mobilized, but there have been some
exceptions. For example, officials from the First U.S. Army told us that
they had mobilized a unit for Operation Iraqi Freedom at Fort Rucker,
Alabama, and were demobilizing the unit at Fort Benning, Georgia. They
also told us that troops who had mobilized at Fort Stewart, Georgia, were
going to be demobilizing at Fort Dix, New Jersey, after a deployment to
Kosovo. To accommodate shifts in demobilization sites, the new sites must,
among other things, obtain reserve component unit medical, dental, and
personnel records and must coordinate the return of individual equipment,
such as helmets, sleeping bags, packs, and canteens that were issued at
the original mobilization site.27 With adequate notice and planning,
alternate demobilization sites can demobilize reserve component units
without any major problems. However, officials at Fort Lewis, Washington,
told us that their support personnel had to reconstruct dental records for
150 soldiers in an engineer unit that had originally mobilized at Fort
Leonard Wood, Missouri. Because the Army's goal is to complete
demobilization processing within 5 days of a unit's arrival at a
demobilization site, the Fort Lewis personnel were not able to wait for
the arrival of the dental records, which had been sent from Fort Leonard
Wood via routine mail rather than overnight delivery.

26 Among other things, this administrative processing involves issuing
identification cards; storing, retrieving, and checking pay and personnel
records; processing travel vouchers; and providing numerous briefings on
the reserve component members' rights and benefits, such as health care.
At one site we visited, 17 different briefings were given to the reserve
component members during mobilization processing and 13 different
briefings during demobilization processing. The briefings cover topics
such as health benefits, pay, and legal and mental health matters. Some
briefings were given during both mobilization and demobilization
processing; other briefings were applicable only one time.

27 Body armor had been among the items that were returned to the sites
where it had been issued, but during our visit to Fort Lewis in March
2004, officials told us that body armor was being managed in theater and
not being returned to the demobilization sites.

    Army Planning Assumptions Were Not Accurate

Assumptions for Availability of Facilities Were Outdated

The Army's planning assumptions did not accurately portray the
availability of installations and personnel needed to fully accommodate
the high number of mobilizations and demobilizations. Specifically,
planning assumptions regarding the availability of facilities for
mobilization and demobilization were outdated, and did not anticipate the
availability of specially designed reserve component support units to
provide much of the medical, training, logistics, and processing support
needed to mobilize and demobilize reserve component units and individuals.

The Army's planning assumptions regarding the availability of facilities
for mobilization and demobilization were outdated. Consequently,
installations sometimes lacked the support infrastructure needed to
accommodate both active and reserve component mobilizing and demobilizing
members in an equitable manner. The Army's mobilization and demobilization
plans assumed that active forces would be deployed abroad, thus vacating
installations when reserve component forces were mobilizing and often
demobilizing. These assumptions are important because they served as a
basis to help the Army determine which installations would have the
necessary support facilities to serve as its primary and secondary
mobilization sites.28 Most of the Army's primary mobilization sites are
installations that serve as home bases for large active Army units. For
example, three of the Army's primary sites that we visited-Fort Lewis,
Washington; Fort Stewart, Georgia; and Fort Hood, Texas-are home to two
active combat brigades, an active combat division, and two active combat
divisions, respectively, along with hosts of other active forces. Fort
Hood alone has about 42,000 active troops assigned to the installation.

Under the Army's plans, reserve component units were assigned mobilization
and demobilization sites so that units could plan in advance for their
mobilizations. Units often developed relationships with the installations
where they expected to mobilize and in many cases the units trained at
these installations. However, because active units had not vacated many of
the Army's major mobilization sites as planned, mobilizing reserve
component forces were moved to sites where they had

28 The Army refers to its primary mobilization and demobilization sites as
"power projection platforms" and its secondary sites as "power support
platforms" and mobilizes most of its reserve component forces at these
installations. However, the Army also uses a number of other installations
to mobilize and demobilize small units or other troops that are slated to
remain at or in the immediate vicinity of these other mobilizing
installations.

Assumptions Did Not Account for Long-term Needs for Reserve Component
Support Personnel under a Partial Mobilization Authority

not trained and where they had not developed any relationships that could
have increased the mobilizations' efficiency. As a result, transportation
distances for personnel and equipment were increased, and extra
coordination was required with the mobilization sites and sometimes even
within units. For example, the 116th Cavalry Brigade from the Idaho Army
National Guard, which had planned to mobilize at Fort Lewis, Washington,
was mobilized at Fort Bliss, Texas, because, among other things, adequate
housing facilities were not available at Fort Lewis. Another Army National
Guard Brigade, which was mobilized at Fort Bragg, North Carolina, faced
increased coordination challenges because one of its battalions was
mobilized at Fort Drum, New York, and another at Fort Stewart, Georgia,
because of a lack of available facilities at Fort Bragg.

At mobilization and demobilization sites where active forces remained on
the installations while reserve component forces were mobilizing or
demobilizing, competing demands sometimes led to housing inequities for
the reserve members. For example, at the installations we visited, single
active component personnel who were permanently assigned to the
installation were generally housed in barracks where two to four people
shared a room,29 but mobilized reserve component personnel were often
housed in open-bay barracks. At some installations, reserve component
personnel were housed in tents, gymnasiums, or older buildings that were
designed for short training periods rather than mobilization periods that
could last several months. The presence of large active duty and reserve
contingents on the same installations at the same time also strained
training and medical facilities.30 Fort Hood officials said that the
scheduling and rescheduling of training ranges presented major challenges
during 2003 when the installation was preparing to deploy both its active
divisions and a large group of reserve component forces at the same time.
To address these facility challenges, the Army has begun a number of
housing and facility construction and renovation projects.

The Army did not anticipate that its reserve component units that support
mobilizations and demobilizations would be needed beyond 24 months under a
partial mobilization authority. When the Army created these units to
provide much of the medical, training, logistics, and processing support
to mobilizing and demobilizing units and individuals, it anticipated that
the need for these units would be commensurate with the mobilization

29 Officers and senior enlisted personnel often had individual rooms. 30
Medical facility issues are addressed in the next section of this report.

authority in place at the time. However, the Army is now facing support
requirements for a long-term Global War on Terrorism, while being limited
to involuntary mobilizations of not more than 24 cumulative months under
the department's implementation of the partial mobilization authority.

The underlying assumptions of the Army's mobilization and demobilization
plans were that (1) only a small portion of these reserve component
support personnel would be required to support the limited mobilizations
associated with a Presidential reserve call-up and (2) all of the reserve
component support personnel would be available for as long as needed to
support the large mobilizations for long periods that are associated with
full or total mobilizations. The Army's plans called for these support
personnel to be among the first reserve component members mobilized and
the last demobilized. Army officials assumed that, under a partial
mobilization authority, these reserve component support forces would be
able to support large mobilizations and demobilizations, or support
mobilizations for long periods, but not large mobilizations for long
periods.

As a result of the large requirements for the Army's reserve component
forces, many pieces of the reserve component support units were mobilized
for 12 months early in the Global War on Terrorism and then later
extended. Some support personnel were mobilized for 24 months under the
partial mobilization authority-which, under DOD's current implementation,
limits involuntary mobilizations to 24 cumulative months-and then sent
home. However, many others agreed to stay on active duty under voluntary
mobilization orders after they had served 24 months under the partial
mobilization authority. For example, from a 27person support detachment
that was mobilized for 12 months at Fort Hood, in October 2001, 13 people
were later extended for a full 2 years, and 6 of these reserve component
personnel accepted voluntary orders at the end of their mobilizations. At
Fort Lewis, two reserve component support detachments-one with 59
personnel and the other with 17-were mobilized in September 2001. Both
detachments served on active duty for 2 full years. In July 2004, more
than 1,100 reserve component support personnel were on voluntary orders or
mobilization extensions.

Even though some reserve component support personnel have voluntarily
extended their orders, the Army is facing a shortage of mobilization and
demobilization support personnel because the Global War on Terrorism is
lasting beyond the time when most reserve component support personnel
would reach their 24-month mobilization points. Consequently, the Army has
begun hiring civilian and contractor replacement personnel to provide

medical, training, logistics, and administrative support at its
mobilization and demobilization sites.

    Installation Planning and Support Officials Sometimes Lacked Adequate Notice
    to Prepare for Arriving Troops

Planners and the installations that mobilize and demobilize reserve
component forces have not always had adequate notice to prepare for
arriving troops. Without advanced notice, officials at these sites are
forced to make last-minute adjustments that may result in the inefficient
use of installation facilities and support personnel. Our prior report
highlighted problems associated with the lack of advance notice in March
2003.31 While officials at the installations we visited noted that the
level of advance notice had improved significantly for mobilizing troops,
they still faced some short-notice mobilizations. According to Army
officials, the Army is currently providing 30 days' notice to all
involuntarily mobilized troops. However, as of May 2004 some units that
are being mobilized under the partial mobilization authority are still
being mobilized with less than 30 days advance notice. According to Army
Reserve officials, each member of these units signs a volunteer waiver
stating that he or she agrees to be mobilized with less than 30 days
advance notice. Therefore, the Army does not violate its policy concerning
advance notice for involuntary mobilizations.

Installation planning officials told us that they typically receive
shorter notice and less definitive information concerning the arrival of
demobilizing troops. Typically, when an installation mobilizes a reserve
component unit, the installation planner records the length of unit
mobilization orders. Depending on the length of unit mobilization orders
and the resulting time available for leave at the end of the orders,
installation planners begin to anticipate the return of the unit up to
several months before the unit's orders expire. The planners said that
they use a variety of formal and informal means to try to ascertain the
specific arrival dates and times for demobilizing troops but that the
arrival dates and times are often uncertain right up until the time the
troops arrive. This is because their different sources of information
sometimes provide conflicting information.

The planners generally begin their search for information about units
returning to their installation using the automated systems within DOD's
Joint Operations Planning and Execution System. A primary source of

31 GAO-03-921.

information is the time-phased force and deployment data (TPFDD).
Installation planning officials told us that the TPFDD is most valuable in
providing them with information on large units with orders that have not
changed and that return as complete units. However, the planners stated
that it is not uncommon for the TPFDD to be incorrect or outdated because
changes are constantly being made to redeployment schedules, particularly
for small units or individuals.

One source of such last-minute changes stems from changes in travel
arrangements. According to DOD officials, when there are empty seats
available on planes departing the theater of operations, small units are
often placed on the planes at the last minute to fill the empty seats.
However, these changes are not always captured in the TPFDD or DOD's other
automated systems. For example, while we were visiting Fort Lewis,
planning officials were trying to determine which unit or units might be
returning to Fort Lewis to go through demobilization processing along with
the 502nd Transportation Company and 114th Chaplain detachment that were
scheduled to arrive on March 1, 2004. Neither the TPFDD nor the other
automated tracking systems that were available to planning officials at
Fort Lewis provided definitive answers. As a result of contacts through
informal channels, at 11:20 a.m. on March 1, 2004, Fort Lewis officials
thought that 21 people from the 854th Quartermaster Unit were going to
arrive at McChord Air Force Base-located adjacent to Fort Lewis, just
south of Tacoma, Washington-40 minutes later. Due to the lack of reliable
information, Fort Lewis officials could not finalize planning
arrangements. For example, because they did not know whether to expect
male or female soldiers, they could not finalize housing plans for the
soldiers. Nor did they know whether the unit was bringing weapons with
them or what types of weapons they might have, and thus transportation
personnel and personnel in the arms room at Fort Lewis were placed on
standby. A check with McChord officials at 11:50 a.m. revealed that there
were no inbound flights. At 3:53 p.m. Fort Lewis officials had
confirmation that the soldiers would be arriving at 9:35 p.m. and that
there were 19 additional personnel from an unknown unit or units on the
plane with the 21 soldiers from the 854th Quartermaster unit. By 4:12 p.m.
on March 1, 2004, the Fort Lewis officials had canceled the scheduled
demobilization processing times for the 854th because information showed
that the unit would not arrive until 7:42 a.m. on the following day, March
2, 2004. Planning officials had to make several other adjustments to
planned schedules before the Quartermaster unit finally arrived. Moreover,
the 502nd Transportation Company and 114th Chaplain detachment, which had
been visible through DOD's formal systems, also arrived later than the
expected March 1 date.

Sometimes, planning officials receive information from informal sources,
such as family members of deployed personnel. During our visit to Fort
Lewis, officials had begun tracking an inbound Army National Guard
military police unit on the basis of information received from an informal
information source. This unit became visible to the planning officials
when the wife of one of the soldiers, who also served as the unit's family
readiness coordinator, notified the officials that her husband and 11
other unit personnel had left Iraq, were in Germany, and were scheduled to
fly to Washington state on a commercial airliner the next day. The
coordinator also provided the Fort Lewis officials with the names and
social security numbers for all 12 returning soldiers. According to Fort
Lewis officials, in the past, 2 out of every 10 units have arrived at the
site without notification. The demobilization planning officials at Fort
Lewis summed up their visibility situation by stating, "Most valuable
information on unit redeployment is not official, rather it is word of
mouth."

Demobilization officials at other installations said that they also had
good visibility over large units that returned as planned but said that it
was difficult to plan for the arrival of small units and individuals.
During our visit to Fort McCoy, Wisconsin, 28 soldiers-a 9-soldier unit,
and a 19soldier unit-arrived at the site unexpectedly. In addition,
officials at Fort Hood said that they were able to track the evacuation of
medical patients from the theater to stabilization hospitals, such as the
Walter Reed Army Medical Center in Washington, D.C., or Brooke Army
Medical Center in Texas, but that they often lost visibility of the
patients during the last leg of their journey back to Fort Hood. They also
said that visibility was sometimes a problem for individual soldiers who
had reached the end of their enlistments or mobilization orders and were
returning as individuals on "freedom flights" because the automated
tracking systems were designed primarily to handle units and not
individuals.

    Army Facility Improvements Were Begun with Outdated Assumptions and Were Not
    Coordinated with Support Personnel Changes

Without updating its planning assumptions regarding the availability of
facilities for mobilization and demobilization, the Army has begun a
number of costly short-and long-term efforts to address facility and
support personnel shortfalls at individual mobilization and demobilization
sites. Furthermore, the Army has not taken a coordinated approach to
evaluate all the support costs associated with mobilization and
demobilization at alternative sites in order to determine the most
efficient options under the operating environment for the Global War on
Terrorism. The use of civilian and contractor personnel to provide
mobilization and demobilization support may not provide cost-effective
alternatives to some reserve component support personnel.

Facility Construction and Renovation Projects Are Not Based on Updated
Planning Assumptions

To address housing and other facilities shortages at mobilization and
demobilization sites, the Army has embarked on a number of facility
construction and renovation projects without updating its planning
assumptions regarding the availability of facilities and personnel. As a
result, the Army risks spending money inefficiently on projects that may
not be located where the need is greatest. Until the Army updates its
planning assumptions, it cannot determine whether the current primary and
secondary mobilization sites are the best sites for future mobilizations
and demobilizations.

The Army has a variety of individual construction and renovation plans
under way. For example, Fort Hood has a $5.1 million project to renovate
its open-bay, cinder block barracks that have been used to house reserve
component soldiers at North Fort Hood. Fort Stewart has a similar project
under way to renovate National Guard barracks to current mobilization
standards. Fort Stewart has also submitted plans to build a new facility
to house its reserve component members with medical problems.

The Army also has developed a plan to construct several new buildings that
would be used to house active and reserve component soldiers who are
undergoing training. In addition, these facilities would be available for
use when reserve component units were mobilizing and demobilizing. This
project has not yet been funded or approved by Army leadership. However
possible sites for these buildings include Fort Lewis, Washington; Fort
Hood, Texas; Fort Bliss, Texas; Fort Carson, Colorado; Fort Polk,
Louisiana; Fort Riley, Kansas; and Fort Stewart, Georgia. The construction
of some of these facilities could begin as early as 2006. However, a
recent GAO review found that DOD's efforts to improve facility conditions
are likely to take longer than expected because of competing funding
pressures. The review also found that without periodic reassessments of
project prioritization, projects that are important to an installation's
ability to accomplish its mission and improve servicemembers' quality of
life could continually be deferred.32

The Army also has plans to make greater use of one of its secondary
mobilization sites. The Army is planning to make greater use of Camp
Shelby, Mississippi, a secondary mobilization site that is owned by the
state of Mississippi. Because this site does not have active troops and
has

32 GAO, Defense Infrastructure: Long-term Challenges in Managing the
Military Construction Program, GAO-04-288 (Washington D.C.: Feb. 24,
2004).

Civilian and Contractor Personnel May Not Provide Cost-Effective
Alternatives to Some Reserve Component Support Personnel

a large housing capacity, the Army plans to use this site to relieve
immediate pressures on its primary mobilization sites. However, Camp
Shelby's facilities are not new, and they are in need of repairs. Housing
units are made of cinder block, have no heating or air conditioning, and
were not designed for year-round accommodations. According to officials
from the U.S. Army Forces Command, Camp Shelby will require $22 million in
federal funding for renovations.

Key officials at the mobilization and demobilization sites we visited
expressed a number of concerns about the availability of civilian or
contractor personnel and the abilities of these personnel to provide
capable, flexible replacements for the reserve component support personnel
at a reasonable cost. In addition, the Army has not fully analyzed the
costs of hiring these civilian and contractor personnel at its existing
mobilization sites compared with the costs and feasibility of hiring
support personnel at an alternative set of mobilization and demobilization
sites.

At Fort Stewart, Georgia, officials said that there is a very small
civilian population in the area from which to draw replacement personnel.
They also noted that the rural nature of the area and lack of cultural
amenities makes it difficult to attract physicians and other highly paid
specialists who support the mobilization and demobilization process.
Officials at Fort Lewis had already replaced many of their medical support
personnel at the time of our visit but acknowledged that even with the
large population of the Seattle-Tacoma area to draw upon, they were still
facing challenges in the hiring of physician assistants and nurse
practitioners. The commander of the hospital at Fort Hood said that the
hospital had issued a contract to try to fill its nurse shortage, but the
only result from the contract was that civilian nurses at the hospital
left the hospital to work for a contractor that paid them more. Thus, the
net result was that the hospital did not fill its shortages, and it kept
the same nurses but paid the contractor more for their services.

Even when civilian or contractor personnel are available to replace
reserve component personnel, the replacements may not be able to provide
the same capability or flexibility as reserve component support personnel.
During our visit to Fort Hood, officials told us that over the past 10
years, the Army had repeatedly looked at the option of using civilian or
contractor medical evacuation teams to replace reserve component support
personnel. However, the option has not been adopted because the civilians
would not be able to fly into live-fire training areas or under blackout
conditions without costly Army flight training. Fort Lewis

officials raised similar concerns about the limited abilities of civilian
helicopter rescue teams during our prior review.33 In addition, officials
at mobilization and demobilization sites said that reserve component
support personnel provided them with great flexibility in dealing with the
unexpected arrival of mobilizing or demobilizing soldiers. Reserve
component personnel are technically available 24 hours per day, 7 days per
week. Therefore, processing could be scheduled for any hour and any day
without regard to overtime considerations. During our visits, we observed
several cases where civilian personnel left their processing sites at the
end of their scheduled workday but reserve component personnel stayed
until all processing was completed.

In addition to the civilian replacements for reserve component medical
support personnel, the Army is looking for replacements for the reserve
component personnel who performed administrative processing, logistic,
training, and other support functions within its garrison support units.
The Army's Installation Management Agency (IMA) is working with the Army
Contracting Agency to develop short-and long-term replacement solutions.
The long-term solution is an "Indefinite Delivery/Indefinite Quantity"
contract that will allow installation commanders to place task orders to
hire or contract workers for particular support functions. According to
contracting officials, this contract will be awarded on or about October
1, 2004. IMA is programmed to receive $238 million for this contract in
fiscal year 2005. By July 2004, IMA had received $56 million and had
allocated $48.4 million to 12 different mobilization sites to cover the
transition period until the long-term contract is in place. This interim
funding can be used to expand existing installation support contracts or
to hire temporary workers. In addition, the Army is also keeping over
1,100 reserve component members on active duty to help cover the
transition period.34

33 GAO-03-921.

34 These personnel had not been mobilized for 24 months under the partial
mobilization authority, or they had agreed to accept voluntary
mobilization orders.

Ability to Effectively DOD's ability to effectively manage the health
status of its reserve

component members is limited because (1) its centralized database has
Manage Health of missing and incomplete health records and (2) it has not
maintained full Servicemembers Is visibility over reserve component
members with medical issues.

  Limited

    DOD's Centralized Database Has Missing and Incomplete Health Records

Required Health Assessments Have Not Reached DOD's Assessment Collection
Point

During our review of health data collected at AMSA, DOD's central data
collection point, we found that the database had missing and incomplete
records. Not all of the required health information collected from reserve
component members had reached AMSA. Furthermore, only some of the health
assessment information that had reached AMSA had been entered into the
centralized database.

DOD policy guidance issued in October 2001 directed the services to submit
pre-and post-deployment health forms to AMSA, 35 but not all of the
required health information collected from reserve component members
during their mobilization and demobilization processing has reached DOD's
central collection activity at AMSA. Table 2 compares the number of
personnel who were mobilized from September 11, 2001, to March 30, 2004
with the number of pre-deployment health assessments submitted to AMSA
from November 1, 2001-the first month when health assessments were
required for all mobilizing and demobilizing reserve component members-to
March 31, 2004. The differences between the mobilization numbers and the
pre-deployment health assessment numbers provide indications that
assessment forms may be missing for members of all six of DOD's reserve
components. However, because the mobilization and health assessment data
cover slightly different time periods and come from different sources, we
could not determine the exact extent of the mismatch. When we investigated
the cause of the large differences between Marine Corps numbers, officials
told us that the Marine Corps' guidance did not require them to submit
pre-deployment health assessments to AMSA.

35 The tracking system was established pursuant to 10 U.S.C. Section
1074f.

 Table 2: Mobilization and Pre-Deployment Assessment Numbers Reserve component

Mobilizations Sept. 11, 2001-Mar. 31, 2004

                 Pre-deployment health assessments Nov. 1, 2001-Mar. 29, 2004

                        Army National Guard     138,345               120,664 
                               Army Reserve      95,515                78,835 
                   Air Force National Guard      31,383                22,225 
                          Air Force Reserve      24,468                 9,980 
                       Marine Corps Reserve      24,468                 2,104 
                               Navy Reserve      21,328                 5,786 
                                      Total     335,507               239,594 

Source: GAO analysis of data from AMSA and OASD/RA.

Note: Pre-deployment health assessments became mandatory for all mobilized
reserve component members on October 25, 2001.

The officials cited guidance, in the form of two Marine Corps
administrative messages that directed responsible officials to submit
postdeployment health assessments to AMSA. However, the administrative
messages neglect to direct the officials to submit pre-deployment health
assessments. Furthermore, no additional administrative messages have
addressed the requirement for pre-deployment assessments. As a result, the
AMSA database contained only 2,104 pre-deployment health assessments but
11,499 post-deployment health assessments for Marine Corps reservists.

Another possible reason why the Marine Corps has not submitted
predeployment health assessments to AMSA is because the Marine Corps lacks
a mechanism for overseeing the submission of these forms. There is no
current Marine Corps requirement for tracking and reporting the submission
of theses forms in the Deployment Health Quality Assurance program. In a
March 12, 2004, memorandum to the Deputy Assistant Secretary of Defense
for Force Health Protection and Readiness, the Marine Corps reported the
number and percentage of post-deployment health assessments that were
completed but did not report any information on pre-deployment
assessments.

Officials at Camp Lejeune told us that they would begin submitting
predeployment health assessments to AMSA after we raised the issue during
a site visit in 2004 and the issuance of subsequent Navy Department
guidance. Officials told us that the Marine Corps Medical Office had
drafted new guidance to address this requirement, but the guidance had

not been issued by the time we drafted our report in July 2004 and we were
not able to determine the cause of the delay or to verify that new
guidance would adequately address the submission of pre-deployment health
assessments.

Navy health assessment submissions to AMSA also appear to be incomplete.
According to Navy procedures, all mobilizing reservists are to complete
their pre-deployment health assessment at their local reserve center
before they report to their Navy Mobilization Processing Sites. In such
cases, the reserve center is required to send the reservists' completed
pre-deployment health assessment forms to AMSA. Therefore, Navy data
collection is only done centrally at the Navy Mobilization Processing
Stations in limited cases when a reservist arrives without a completed
predeployment health assessment. We did not visit any individual Navy
Reserve centers to verify the submission of pre-deployment health
assessments. We did review Navy Quality Assurance program guidance and
found that it does not address the submission of pre-deployment health
assessments. However, the guidance specifies that a 90 percent submission
rate is considered satisfactory for post-deployment health assessments.

In September 2003, we reported similar findings for the active forces.36
Specifically, we found that DOD did not maintain a complete, centralized
database of active servicemember health assessments and immunizations.
Following our 2003 review, DOD established a deployment health quality
assurance program to improve data collection and accuracy. The
department's first annual report documenting issues relating to deployment
health assessments will not be available until February 2005, and it is
too early to determine the extent to which the new quality assurance
program will provide effective oversight to address data submission
problems from each of the services and their reserve components.

While the services are not in complete compliance with the requirement to
submit pre-and post-deployment assessments to AMSA, the number of
assessments in the database has grown significantly. According to AMSA
officials, the database contained about 140,000 assessments at the end of

36 GAO, Defense Health Care: Quality Assurance Process Needed to Improve
Force Health Protection and Surveillance, GAO-03-1041 (Washington, D.C.:
Sept. 19, 2003).

Data from Health Assessments Have Not Been Entered into DOD's Centralized
Database

Some Database Records Missing Key Information

1999, and grew to about 1 million assessments by May 2003, and 1,960,125
by June 2004.

Not all the records in the AMSA database contained complete information,
thus limiting the amount of meaningful analysis that can be conducted.
Health assessment database records sometimes did not include information
that could be used to identify the causes of various medical problems.
Nonetheless, the available data indicate that the overall pre- and
post-deployment health status of mobilized reserve component members was
good.

Records in the health assessment database sometimes did not include key
information or information that could be used to identify the causes of
various medical problems. For example, records were sometimes missing
information on the servicemember's deployability and the specific types of
medical referrals that were given to members with referrals.

Almost 6 percent of the nearly 240,000 pre-deployment health assessments
we reviewed did not have the servicemember's deployability status recorded
in the AMSA database. As shown in table 3, the missing data ranged from
less than 4 percent for the Army National Guard to almost 18 percent for
the Naval Reserve.

  Table 3: Service Decisions Concerning Reserve Component Member Deployability

     Reserve                                                       Percentage 
                                                                   Percentage 
    component   Deployable Nondeployable Answer    Total              missing 
                                  missing                       nondeployable 
       Army                                              
     Reserve        67,747           6,907 4,181 78,835             5.3% 9.3% 
       Army                                              
     National                                            
      Guard        108,237           7,891 4,536 120,664            3.8% 6.8% 
      Naval                                              
     Reserve         4,704              63 1,019   5,786           17.6% 1.3% 
    Air Force                                            
     Reserve         8,243              98 1,639   9,980           16.4% 1.2% 
Marine Corps                                          
     Reserve         1,752                18 334   2,104           15.9% 1.0% 
Air National                                          
      Guard         19,630             140 2,455 22,225            11.0% 0.7% 
      Total        210,313     15,117 14,164     239,594            5.9% 6.7% 
                           Source: GAO analysis          
                               of AMSA data.             
                                                         GAO-04-1031 Military 
                                  Page 40                           Personnel 

For the remaining records with the deployability status recorded, 93
percent of the servicemembers were deployable. Nondeployable rates ranged
from less than 1 percent in the Air National Guard to more than 9 percent
in the Army Reserve. Other data showed that most of the nondeployable
personnel had medical conditions that clearly made them nondeployable, and
which did not require medical referrals. According to medical officials,
some of these personnel, such as those who had suffered multiple heart
attacks, should have been discharged prior to the time that they received
their mobilization orders. Others had temporary conditions, such as broken
bones and pregnancies that did not warrant medical discharges but made
them nondeployable at the time of their assessment.

Detailed referral information could assist the services in determining and
addressing the factors that cause reserve component members to be
nondeployable; however, these data were often missing in AMSA's database.
About 99 percent of the pre-and post-deployment assessments we reviewed
showed whether or not reserve component members had been given a medical
referral, but less than 44 percent of the records with referrals contained
detailed information about the type of referral that was given to the
member (eye, ear, cardiac, mental health, etc.).

One reason for the incomplete health assessment records we found at AMSA
at the time of our data draw in March 2004 is that some of the health
assessments were entered into AMSA's database by hand. According to the
officer in charge of AMSA, records in the database with detailed referral
data had been submitted electronically rather than as paper copies, which
the installations are required to forward to the centralized database.
Generally, electronic data are sent to AMSA after being collected in one
of two different ways: (1) from applications that are available at Army
installations and over the Internet and (2) on stand-alone laptop
computers and hand-held personal digital assistant units, which collect
data in the theater and elsewhere. All electronic data are transmitted to
AMSA and updated immediately upon receipt. Because of workload demands,
when paper forms were received at AMSA, database personnel captured only a
data element indicating if a referral was needed, not the specific type of
referral indicated.37 In addition, when there was a backlog of four page
paper post-deployment health assessments to be

37 After summary data from the forms are entered into the database, AMSA
scans an image of the complete health assessment forms, and additional
data from the form can be entered into the database at a later date.
Individual health assessments in the database can sometimes be linked to
other detailed health records.

entered into the database, data entry personnel were entering only the
first and last pages of the form and not the middle two pages. Because of
this, at various times the data that have been collected from
servicemembers may not be available for analysis. However, as of June
2004, the officer in charge of AMSA said that AMSA had no backlog of paper
forms to be entered into the centralized database and had 15 people
working full-time to process pre- and post-deployment health assessment
forms. Furthermore, he estimated that by the end of July 2004, they would
be caught up with the entries of the middle pages of the post-deployment
health assessments that had been skipped earlier. Still, there is a delay
between receipt of the form and its entry into the database. The AMSA
Chief said the paper forms take approximately 1 week for processing,
scanning, and entering data.

All of the reserve components have the capability to submit the health
assessments electronically, including detailed medical referral
information. Many Army and Air Force servicemember health assessments are
now transmitted electronically, and detailed information is captured into
the database from those forms. The Army has been sending electronic health
assessment data for active and reserve servicemembers to AMSA since July
2003. Although the Army is capable of transmitting all of its forms
electronically, only about 52 percent of its forms submitted from January
1, 2003, to May 3, 2004, had been submitted electronically. The Air Force
began sending electronic data to AMSA in June 2004. The Navy and Marine
Corps have established a working group that is currently evaluating
several options and developing an implementation plan.

DOD established a deployment health task force to make recommendations by
late April 2004 on completing all pre-and postdeployment health
assessments electronically. However, the Deployment Health Task Force is
continuing its work to expedite and monitor progress toward the electronic
capture of deployment health assessment forms. Even though electronic
submission of the health assessment forms from the mobilization and
demobilization sites to AMSA's centralized database would expedite the
inclusion of key data for meaningful analysis, increase accuracy of the
reported information, and lessen the burden of sites forwarding paper
copies and the likelihood of lost information, DOD has not set a timeline
for the services to electronically submit the health assessment forms to
the centralized database.

Available Data Show Reserve Table 4 shows that 98 percent of the reserve
component members Component Members Self-reported that they were in good
to excellent health when they completed Reported Health Is Good their
pre-deployment health assessments. The Army Reserve had the

lowest number-97 percent-of servicemembers considering themselves in good
to excellent health.38

Table 4: Pre-Deployment Overall Health Status and Medical Referrals

                                  Overall health status     
             Reserve component Good or excellent Fair or    Medical referrals 
                               poor                         
          Marine Corps Reserve                       99% 1%                3% 
                 Naval Reserve                       99% 1%                4% 
            Air National Guard                       99% 1%                1% 
             Air Force Reserve                       99% 1%                2% 
           Army National Guard                       98% 2%                5% 
                  Army Reserve                       97% 3%                6% 
                         Total                       98% 2%                5% 

Source: GAO analysis of AMSA data.

Table 4 also shows that the total referral rate that resulted from the
predeployment health assessments was 5 percent but ranged from 1 percent
for the Air National Guard to 6 percent for the Army Reserve.

Table 5 shows that even after deployment, a high percentage of reserve
component members thought they were in good to excellent health. However,
a comparison of table 4 with table 5 shows that numbers had generally
declined from pre-deployment levels. In particular, the percentage of
personnel who rated their health as good to excellent declined from 98
percent to 93 percent. The Army Reserve had the lowest percentage of
servicemembers who considered themselves in good to excellent health
during their post-deployment assessments-89 percent-while the Air National
Guard and Air Force Reserve had the highest percentage of servicemembers
who considered themselves in good to excellent health after deployment-98
percent.

38 The percentages do not necessarily mean that the servicemembers were in
those categories when first mobilized. Because pre-deployment health
assessments have to be completed within 30 days of deployment, thousands
of reserve component members (primarily in the Army) who had long
post-mobilization training periods completed two or more pre-deployment
health assessments. Only the most recent pre-deployment health assessment
is kept in the AMSA database.

Table 5: Post-Deployment Overall Health Status and Medical Referrals

                                  Overall health status     
             Reserve component Good or excellent Fair or    Medical referrals 
                               poor                         
          Marine Corps Reserve                      90% 10%               24% 
                 Naval Reserve                       96% 4%               13% 
            Air National Guard                       98% 2%                8% 
             Air Force Reserve                       98% 2%               10% 
           Army National Guard                       92% 8%               21% 
                  Army Reserve                      89% 11%               30% 
                         Total                       93% 7%               21% 

Source: GAO analysis of AMSA data.

Moreover, the percentage of medical referrals jumped to 21 percent on the
post-deployment health assessments. A comparison of tables 4 and 5 shows
that the referral rate that resulted from post-deployment assessments was
quadruple the 5 percent referral rate from predeployment assessments.
There were also differences between the services, in that reserve
component personnel from the Army and Marine Corps received higher
referral rates, as would be expected for ground forces, than those in the
Air Force and the Navy. The percentages ranged from 8 percent for the Air
National Guard to 30 percent for the Army Reserve.

Table 6 shows that when reserve component members completed their
post-deployment health assessments, almost half of them chose the same
category to characterize their overall health as they had chosen on their
pre-deployment health assessment. The table shows that almost 14 percent
of the personnel who completed both pre-and post-deployment health surveys
believed that their health had improved enough to warrant
recharacterizations of their original assessments.

Table 6: Comparison of Self-Reported Composite Health from Pre- and
Post-Deployment Health Assessments

                   Matching pre-                               
                       and post-                               
                      deployment                               
           Reserve        health                 Health stayed 
                   assessments                        the same         Health 
         component               Health improved                     declined 

                       Marine                                      
                        Corps                                      
                      Reserve      871           9%        39%            52% 
                        Naval                                      
                      Reserve     3,438         12%        52%            36% 
                 Air National                                      
                        Guard     14,118        14%        58%            28% 
                    Air Force                                      
                      Reserve     5,345         14%        57%            29% 
                         Army                                      
                     National                                      
                        Guard     51,514        14%        46%            39% 
                         Army                                      
                      Reserve     39,220        13%        44%            43% 
                        Total    114,506        14%        48%            39% 

Source: GAO analysis of AMSA data.

Note: DOD's health assessments ask servicemembers to categorize their
general health into one of five categories: (1) excellent, (2) very good,
(3) good, (4) fair, or (5) poor.

The table above also shows that 39 percent of the personnel who completed
both the pre-and post-deployment health surveys reported that their health
had declined between the assessments. Reserve component personnel from the
Army and Marine Corps experienced larger declines than those of the Navy
and Air Force.

    DOD Could Not Maintain Visibility over Reserve Component Personnel on Active
    Duty with Medical Issues

Some of the services could not maintain visibility over reserve component
members with medical issues because they could not adequately track those
personnel, which contributed to problems for those personnel. In the Army,
the lack of tracking information for reserve component personnel with
medical issues contributed to problems for those personnel. In the Army,
the lack of visibility over reservists with medical issues resulted in
housing and pay problems for some personnel. The Air Force has also lost
visibility of some reservists with medical issues, which has resulted in
lengthy periods of time without resolution to their medical issues.

Army

Reserve component personnel who have been involuntarily mobilized, along
with members who are voluntarily serving on active duty, may experience
medical problems for a variety of reasons. Some are injured during combat
operations; others become injured or sick during the course of their
training or routine duties; and others have problems that are identified
during medical appointments, physicals, or health assessments and other
medical screenings. Our review focused on reserve component members with
medical problems that were expected to keep them from being returned to
full duty or from being demobilized within 30 days. This group contained
reserve component members with a wide variety of injuries and ailments.
During our visits to mobilization and demobilization sites, we spoke with
reserve component members who had suffered heart attacks or combat wounds,
as well as to members with knee and ankle injuries, diabetes, chronic back
pain, and mental health problems.

The services have used different policies and procedures to accommodate
involuntarily mobilized reserve component personnel who have long-term
medical problems. In some cases, the services have left the members on
their original mobilization orders and then extended those orders as
necessary. In other cases, the services have switched the members to
voluntary orders or offered the members the option to leave active duty
and have their medical conditions cared for through the Department of
Veterans Affairs.39

The dramatic increase in the use of the reserve components has led to a
dramatic increase in the numbers of reserve component members on active
duty with medical problems. For example, our analysis of data from the
more than 239,500 pre-deployment health assessments collected in the AMSA
database from November 2001 through March 2004 showed that over 15,100
members, or almost 7 percent, were not deployable; almost 14,800 of these
members came from the Army's reserve components.40 Prior to a change in
Army policy in October 2003, personnel who were mobilized and found to be
non-deployable were kept on active duty until (1) their medical problems
had been resolved and they were returned to full duty or (2) they had been
referred to a medical board process and

39 DOD officials told us that very few members choose this option because
they lose their active duty pay and some other benefits when they leave
active duty.

40 Over 14,100 records, or almost 6 percent, were missing information
concerning the servicemembers' deployability status.

discharged from the Army. (See appendix VIII for additional information on
the services' medical evaluation boards.)

As a result of its October 2003 policy change, the Army was able to
demobilize personnel who were found to be nondeployable within the first
25 days of their mobilizations. This policy change helped to reduce the
inflow of reserve component personnel on active duty with medical problems
who were identified during the pre-deployment health-screening process.
However, the reserve component members who were already on active duty
with medical problems that had been identified during the predeployment
health-screening process were not demobilized when the policy changed. In
addition, significant numbers of reserve component personnel continued to
experience medical problems as a result of injuries or illnesses that
occurred (1) after the members had been mobilized for 25 days and (2) as a
result of problems that were identified during their postdeployment heath
assessments. As a result, on July 14, 2004, the Army still had over 4,000
reserve component personnel on active duty with medical problems.41
Although Army officials said that the primary responsibility that these
soldiers had was to go to their medical treatment so they could get well,
many of the soldiers did not require daily medical treatment. As a result,
these soldiers often do other work ranging from temporary details to
maintain base facilities to longer-term jobs such as working at
mobilization processing sites or working as mechanics in installation
motor pools.

Initially, issues associated with the care of Army personnel with medical
problems were usually dealt with at the Army installation where the
servicemember was mobilized or demobilized and at nearby medical treatment
facilities. As the numbers of reserve component personnel with medical
problems increased, the Army found that it had difficulty maintaining
visibility of such personnel, resulting in some housing, pay, and other
problems for the personnel.

For example, at Fort Stewart, Georgia, reserve component soldiers with
medical problems were being housed in open-bay, cinder block barracks that
did not have heating or air conditioning. In addition, shower and bathroom
facilities were in separate, nearby buildings. These facilities

41 The 4,000-plus personnel were in units that Army identifies as "medical
hold" or "medical holdover," respectively, depending on whether the
members are actually attached to a medical treatment facility or attached
to an installation and are just receiving care at the medical treatment
facility.

normally housed National Guard personnel during their 2-week annual
training periods. Following media attention to these conditions, the Under
Secretary of Defense for Personnel and Readiness issued a memorandum that
established housing standards for personnel with medical problems in
October 2003. During our visit to Fort Stewart, in November 2003 we found
that the soldiers with medical problems were being housed in accordance
with the updated standards, which required climate-controlled quarters
that included integrated bathroom facilities. The Army also created a
servicewide medical-status tracking system during the summer of 2003. This
system generates regular weekly reports on the numbers of reserve
component members on active duty with medical problems, their locations,
and the length of time that they have been receiving medical care.

Following up on allegations in 2003 that medical treatment was taking too
long, and that soldiers were missing their scheduled medical appointments,
investigators at Fort Stewart also found that case managers42 were needed
to track the care of the soldiers with medical problems and that a command
structure was needed to manage the other needs and duties of these
personnel. At the time of our visit, Fort Stewart had 15 case managers in
place, and a new command and control structure had been set up to manage
the soldiers with medical problems. However, officials told us that they
still faced challenges with the management and care of these soldiers
because the group was so large. On November 19, 2003, there were 661
reserve component members with medical problems at Fort Stewart; as of
July 14, 2004, there were 349 members.

The lack of visibility and tracking also caused problems for members with
medical problems at Fort Lewis, Washington. Army procedures called for
reserve component members on involuntary mobilization orders to be
switched over to voluntary active duty medical extension orders after a
long-term medical problem had been identified. The administrative process
for issuing these active duty medical extensions was cumbersome, and
mechanisms were not in place to effectively track requests for these
extensions, which had to be submitted from the units with servicemembers
experiencing medical problems to a central office in the Pentagon. When we
visited Fort Lewis in March 2004, we found that medical extension orders
had expired for 19 of 84 personnel in the medical

42 The Army has been using nurses or administrative personnel who report
to nurses to serve as case managers.

Air Force

hold unit. When a servicemember's orders expire, the member's pay stops
and the member's dependents lose their health care coverage. 43 After our
visit to Fort Lewis, the Army changed its policy concerning active duty
medical extensions. On March 6, 2004, the Assistant Secretary of the Army
for Manpower and Reserve Affairs issued a policy that provides
installations with the ability to issue voluntary orders for up to 180
days for reserve component members with medical problems without going
through the cumbersome active duty medical extension process. While the
authority to issue these voluntary orders has been delegated to the
installation level, the Army is still maintaining visibility over its
reserve component personnel with medical problems because these personnel
are assigned to units that must report their personnel numbers on a weekly
basis.

In the Air Force, a lack of central visibility of some reserve component
personnel with medical problems who are serving on active duty has
resulted in delayed resolution to their medical problems. The Air Force
does have central visibility over reserve component personnel with medical
problems who remain on their original mobilization orders or receive
extensions to those orders.44 However, the Air Force also allows personnel
with medical problems to switch over to voluntary orders.45 These orders
are issued by the Air Force's major commands. The Air Force can track the
number of orders issued and the number of days covered by these orders,
but it does not have a mechanism in place to track the numbers of
personnel who have medical problems and are serving under these orders. As
with many of the reserve component personnel in the Army's medical hold
and holdover units, many of the air reserve component personnel with
medical problems are still able to perform significant amounts of work
while undergoing their medical treatment or medical discharge processing.

While the reservists experiencing medical problems who we interviewed did
not identify any difficulties with their housing or their orders, they did
identify problems with the amount of time it was taking to resolve their
medical issues, much like the problems identified at Fort Stewart prior to

43 A number of GAO reports on pay problems are included in the list of
related GAO products at the end of this report.

44 On June 11, 2004, there were 219 personnel in these categories.

45 The Air Force refers to these as military personnel appropriation (MPA)
day orders.

Conclusions

the deployment of case managers to that location. At one of the sites we
visited, an Air Force reservist told us that he had been in a medical
status on voluntary orders for 18 months and did not expect resolution of
his case anytime soon. The extent to which such a problem is commonplace
is unknown, given the inability of the Air Force to track such personnel.

As the Global War on Terrorism is entering its fourth year, DOD officials
have made it clear that they do not expect the war to end anytime soon.
Furthermore, indications exist that certain components and occupational
specialties are being stressed and the long-term impact of this stress on
recruiting and retention is unknown. Moreover, although DOD has a number
of rebalancing efforts under way, these efforts will take years to
implement. Because this war is expected to last a long time and requires
far greater reserve component personnel resources than any of the smaller
operations of the previous two decades, DOD can no longer afford policies
that are developed piecemeal to maximize short-term benefits and must have
an integrated set of policies that address both the long-term requirements
for reserve component forces and individual reserve component members'
needs for predictability.

For example, service rotation polices are directly tied to other personnel
policies such as policies concerning the use of the IRR, and the extent of
cross training. Policies to fully utilize the IRR would increase the pool
of available servicemembers and would thus decrease the length of time
each member would need to be deployed based on a static requirement.
Policies that encourage the use of cross-training for lesser-utilized
units could also increase the pool of available servicemembers and
decrease the length of rotations. Until DOD addresses its personnel
policies within the context of an overall strategic framework, it will not
have clear visibility over the forces that are available to meet future
requirements. In addition, it will be unable to provide reserve component
members with clear expectations of their military obligations and the
increased predictability, which DOD has recognized as a key factor in
retaining reserve component members who are seeking to successfully
balance their military commitments with family and civilian employment
obligations.

The Army's mobilization and demobilization plans contained outdated
assumptions about the location of active duty forces during reserve
mobilizations and demobilizations. As a result, facilities were not always
available to equitably support active and reserve component forces that
were collocated on bases that serve as mobilization and demobilization
sites. Until the Army updates the assumptions in its mobilization and

demobilization plans and therefore recognizes that active and reserve
component forces are likely to need simultaneous support at Army
installations within the United States, it may not be able to adequately
address the support needs of both its active and reserve component forces.
The Army has a number of uncoordinated efforts under way to correct the
facility infrastructure shortage that has developed. However, these
projects are being conducted without considering the long-term
requirements and associated costs. In addition, when the Army created
medical, training, logistics, and administrative support units that relied
heavily on reserve component members, it did not anticipate that it would
have to support long-term mobilization requirements for a Global War on
Terrorism under a partial mobilization authority. As a result, the reserve
component force cannot continue to support mobilizations as DOD currently
implements the partial mobilization authority and the Army is now planning
to rely on civilians and contractors. However, the Army has not determined
the costs and availability of these civilian and contractor personnel.
Until the Army makes these determinations, it cannot plan to conduct
future mobilizations and demobilizations in the most efficient manner.

DOD's ability to effectively manage the health status of reserve component
members has been hampered by a lack of complete information and the
inability to track servicemembers with health issues. For example, the
AMSA database does not contain a large number of health assessment records
for the Marine Corps and lacks complete information from some of the
health assessment records that were submitted to the database in a
nonelectronic format. Consequently, the deployability status and related
health problems of some reserve component members were not discoverable.
Until the Marine Corps addresses its data submission problems with updated
guidance and a mechanism to oversee the submission of health assessments
to the centralized database and until DOD establishes a timeline for the
military departments to submit health assessments electronically, DOD and
the services will continue to face difficulties in determining and
addressing the factors that cause reserve component members to be
nondeployable. Moreover, until the Air Force develops a mechanism to track
its reserve component members who are on voluntary active duty orders with
health problems, it cannot determine whether these personnel are having
their health problems addressed in a timely manner. Furthermore, the
treatment of the nation's reserve component members who have served their
country and experienced medical problems while on active duty is an
important issue for DOD to address. Until DOD gains visibility over the
status of all of its reserve component personnel on active duty with
medical problems, it cannot

  Recommendations for Executive Action

effectively oversee their situations and deploy, demobilize, or discharge
them.

We recommend that the Secretary of Defense direct the Under Secretary of
Defense for Personnel and Readiness, in concert with the service
secretaries and Joint Staff, to take the following two actions:

o  	develop a strategic framework that sets human capital goals concerning
the availability of its reserve component forces to meet the longer-term
requirements of the Global War on Terrorism under various mobilization
authorities and

o  	identify personnel policies that should be linked within the context
of the strategic framework.

We recommend that the Secretary of Defense direct the Secretary of the
Army to take, within the context of establishing DOD's strategic framework
for force availability, the following two actions:

o  	update mobilization and demobilization planning assumptions to reflect
the new operating environment for the Global War on Terrorism-long-term
requirements for mobilization and demobilization support facilities and
personnel and the likelihood that active forces will continue to rotate
through U.S. bases while reserve component forces are mobilizing and
demobilizing and

o  	develop a coordinated approach to evaluate all the support costs
associated with mobilization and demobilization at alternative sites-
including both facility (construction, renovation, and maintenance) and
support personnel (reserve component, civilian, contractor, or a
combination) costs-to determine the most efficient options; and then
update the list of primary and secondary mobilization and demobilization
sites as necessary.

We also recommend that the Secretary of Defense take the following four
actions:

o  	direct the Commandant of the Marine Corps to issue updated
mobilization guidance that specifically lists the requirement to submit
pre-deployment health assessments to AMSA,

o  	direct the Commandant of the Marine Corps to establish a mechanism for
overseeing submission of pre-and post-deployment assessments to the
centralized database,

o  	direct the Under Secretary of Defense for Personnel and Readiness, in
concert with the service secretaries, to set a timeline for the military

  Agency Comments
  and Our Evaluation

       departments to electronically submit pre-and post-deployment heath

assessments,  o  direct the Secretary of the Air Force to develop a
mechanism for tracking reserve component members who are on voluntary
active duty orders with medical problems.

In written comments on a draft of this report, DOD generally concurred
with our recommendations. The Department specifically concurred with our
recommendations to (1) update Army mobilization and demobilization
planning assumptions to reflect the new operating environment for the
Global War on Terrorism; (2) develop a coordinated approach to evaluate
all the support costs associated with Army mobilizations and
demobilizations at alternative sites-including both facility and support
personnel costs-to determine the most efficient options, and then update
the list of primary and secondary mobilization and demobilization sites as
necessary; (3) issue updated Marine Corps mobilization guidance that
specifically lists the requirement to submit pre-deployment health
assessments to AMSA; (4) set a timeline for the military departments to
electronically submit pre-and post-deployment heath assessments; and (5)
develop a mechanism for tracking Air Force reserve component members who
are on voluntary active duty orders with medical problems.

DOD partially concurred with our other three recommendations. In partially
concurring with our recommendation concerning the development of a
strategic framework, DOD stated that it has a strategic framework for
setting human capital goals, which was established through its December
2002 comprehensive review of active and reserve force mix, its January
2004 force rebalancing report, and other planning and budgeting guidance.
However, DOD agreed that it should review and, as appropriate, update its
strategic framework. Although the documents cited by DOD lay some of the
groundwork needed to develop a strategic framework, these documents do not
specifically address how DOD will integrate and align its personnel
policies, such as its stop-loss and IRR policies, to maximize its
efficient usage of reserve component personnel to meet its overall
organizational goals.

In partially concurring with our recommendation to identify personnel
policies that should be linked within the context of a strategic
framework, DOD stated that its September 20, 2001, personnel and pay
policy and its July 19, 2002, addendum established personnel policies
associated with its strategic framework. DOD also stated that the
department should review, and as appropriate, update these policies. We
agree that the Office of the

Secretary of Defense has issued personnel policies and various guidance
and reports concerning its reserve components. However, the policies cited
by DOD pre-date the 2002 comprehensive review and 2004 force rebalancing
report that were cited as part of the department's strategic framework.
The strategic framework should be established prior to the creation of
personnel policies. We continue to believe that DOD's policies were
implemented in a piecemeal manner and focused on short-term needs. For
example, our report details service changes to policies concerning the use
of the IRR, mobilization lengths, deployment lengths, and service
obligations.

In partially concurring with our recommendation concerning oversight of
the Marine Corps' pre-and post-deployment health assessments, DOD stated
that system improvements are ongoing and that electronic submission of
pre-and post-deployment health assessments is possible and highly
desirable but may not be practical for every Marine Corps deployment.
However, our recommendation was directed at oversight of health
assessments regardless of how the assessments are submitted-in paper or
electronic form. We continue to believe that the Marine Corps needs to
establish a mechanism for overseeing the submission of its preand
post-deployment health assessments. The other services have established
such mechanisms as part of their quality assurance programs.

Finally, in commenting on a draft of this report, DOD stated that after
reviewing its implementation of the partial mobilization authority, it
decided to retain its "24-cumulative month" policy. DOD noted that it had
identified significant problems with changing to a 24-consecutive-month
approach but did not elaborate on those problems. The final decision
concerning the implementation of the partial mobilization authority was
not made until after our review ended, and the decision was counter to the
decision expected by senior personnel we met with during the course of our
review. As noted in our report, with a 24-cumulative-month interpretation
of the partial mobilization authority, DOD risks running out of forces
available for deployment, at least in the short term. Regardless of DOD's
interpretation of the partial mobilization authority, the department needs
to have a strategic framework to maximize the availability of its reserve
component forces. For example, usage of the more than 250,000 IRR members
can affect rotation policies because the use of these reservists would
increase the size of the pool from which to draw mobilized reservists.
Therefore, without a strategic framework setting human capital goals, how
DOD will continue to meet its large requirements for the Global War on
Terrorism remains to be seen. We

have modified our report to recognize the decision that DOD made regarding
its implementation of the partial mobilization authority.

DOD's comments on our recommendations are included in this report in
appendix IX. DOD also provided other relevant comments on portions of the
draft report and technical comments, which we incorporated as appropriate.

We are sending copies of this report to the Secretary of Defense; the
Secretaries of the Army, the Navy, and the Air Force; the Commandant of
the Marine Corps; the Chairman of the Joint Chiefs of Staff; and the
Director, Office of Management and Budget. We will also make copies
available to others upon request. In addition, the report will be
available at
no charge on the GAO Web site at http:www.gao.gov.

If you or your staff have any questions concerning this report, please
contact me at (202) 512-5559 or [email protected] or Brenda S. Farrell,
Assistant Director, at (202) 512-3604 or [email protected]. Others making
significant contributions to this report are included in appendix X.

Derek B. Stewart
Director, Defense Capabilities and Management

                       Appendix I: Scope and Methodology

To determine how the Department of Defense's (DOD) implementation of the
partial mobilization authority and its personnel polices affect reserve
component force availability, we reviewed and analyzed the mobilization
authorities that are available under current law, along with personnel
policies from the services and Office of the Secretary of Defense. We also
collected and analyzed data on DOD's historical usage of the reserve
components and its usage of these forces since September 11, 2001. We
analyzed usage trends since the 1991 Persian Gulf War and compared usage
rates across services, reserve components, and occupational specialties.
We also reviewed DOD documents that addressed the projected future use of
reserve component forces and plans to mitigate the high usage of forces
within certain occupational specialties. We analyzed the structure of the
reserve component forces and evaluated the effects of utilizing or
excluding members of the Individual Ready Reserve from involuntary
call-ups. We discussed the implementation of mobilization authorities and
the effects of various personnel policies with responsible officials from
the

o  Joint Chiefs of Staff, Washington, D.C.;

o  Assistant Secretary of Defense for Reserve Affairs, Washington, D.C.;

o  	Assistant Secretary of the Army for Manpower and Reserve Affairs,
Washington, D.C.;

o  U.S. Army Forces Command, Fort McPherson, Georgia;

o  Air Force Reserve Command, Robins Air Force Base, Georgia;

o  	Commandant, Marine Corps (Manpower, Plans, and Policy), Quantico
Marine Corps Base, Virginia; and

o  U.S. Army Reserve Command, Fort McPherson, Georgia.

During our visits to mobilization and demobilization sites, we also
interviewed reserve component members concerning the length of their
mobilizations, deployments, and service commitments.

To determine how efficiently the Army executed its mobilization and
demobilization plans, we interviewed senior and key mobilization officials
involved with the mobilization and demobilization processes to document
their roles and responsibilities and collect data about the processes. We
visited selected sites where the Army conducts mobilization and
demobilization processing. At those sites, we observed mobilization and
demobilization processing and interviewed responsible Army officials as
well as soldiers being processed for mobilization and demobilization at
those sites. We collected and analyzed cost data for facility renovation
and construction projects. We also collected and analyzed available cost
information on the contracts to replace reserve component members with

Appendix I: Scope and Methodology

civilian and contractor personnel. Finally, we documented problems that
the installations had tracking the arrival of mobilizing and demobilizing
troops though their automated systems. We visited five mobilization and
demobilization sites. These sites included four installations that
supported both active and reserve component troops and one site that
supported only reserve component troops. Four of the sites were among the
largest in terms of the numbers of reserve component members mobilized and
demobilized. One was among the smallest. Specifically we visited the
following sites:

o  Fort Stewart, Georgia;

o  Fort Hood, Texas;

o  Fort McCoy, Wisconsin;

o  Fort Lewis, Washington; and

o  Fort McPherson, Georgia.

We also interviewed Army officials from the following locations:

o  U.S. Army Forces Command, Fort McPherson, Georgia;

o  First U.S. Army, Fort Gillem, Georgia;

o  Fifth U.S. Army, Fort Sam Houston, Texas;

o  Army Installation Management Activity, Arlington, Virginia; and

o  Army Contracting Agency, Fort McPherson, Georgia.

As requested, we also visited sites where the other services conducted
mobilization and demobilization processing, but we did not report on the
efficiency of the other services' processes because the numbers of reserve
component members who were mobilizing and demobilizing through these sites
were insufficient for us to draw any conclusions about the services'
processes. Specifically, we interviewed responsible officials and observed
ongoing mobilizations and demobilizations at the following sites:

o  Quantico Marine Corps Base, Virginia;

o  Camp Lejeune Marine Corps Base, North Carolina;

o  Dobbins Air Reserve Base, Georgia;

o  Dover Air Force Base, Delaware; and

o  Navy Mobilization Processing Site Norfolk, Virginia.

At some of the demobilization locations, we observed reservists receiving
medical, legal, and family support briefings, and interviewed some
individuals who had been demobilized, including some on medical
extensions. We also walked through and compared facilities used to house
active and reserve component personnel, specifically focusing on the

Appendix I: Scope and Methodology

facilities used to house personnel with medical problems. We interviewed
appropriate officials about facility capacities, and gathered and analyzed
information about facility renovations and new construction projects. We
obtained and reviewed additional documentation such as mobilization
orders, activation checklists, and demobilization processing checklists.
We also collected and analyzed reserve component mobilization data,
flowcharts, reports, plans, directives, manuals, instructions, and
administrative guidance. We reviewed relevant GAO reports and contacted
other audit and research organizations regarding their work in the area.
We reviewed congressional testimony by Navy officials in which they
described steps planned by the Navy to improve its demobilization process,
and we followed up on the status of those planned steps with officials at
the Navy Mobilization Processing Site Norfolk, Virginia.

To examine the extent to which DOD can effectively manage the health
status of its mobilized reserve component members, we collected and
analyzed data from a variety of sources throughout DOD. We tracked weekly
data from the Office of the Assistant Secretary of Defense for Reserve
Affairs (OASD/RA), which showed the numbers of Army, Navy, Air Force, and
Marine Corps personnel on medical extensions, and the numbers of Army
personnel in medical statuses. We also collected, tracked, and analyzed
data from the Army's Office of the Surgeon General. These data showed the
numbers of reserve component personnel in medical statuses by installation
and by time spent in a medical status. We also reviewed the Army's
projected medical status numbers, the Army's plans to mitigate future
problems, and reports on the lessons that were learned from the
medical-related problems that occurred at Fort Stewart during 2003. We
also obtained and analyzed information from the Office of the Deputy
Assistant Secretary of Defense for Force Health Protection and Readiness,
Deployment Health Support Directorate. We collected and reviewed the
services' medical instructions, memoranda, and policies. In addition, we
interviewed personnel responsible for the processing, reviewing, and
collection of the deployment health assessments at the mobilization and
demobilization sites visited. We compared information about the services'
medical and physical evaluation board processes. We discussed these
medical issues with responsible officials from

o  	Office of the Assistant Secretary of Defense for Reserve Affairs,
Washington, D.C.;

o  	U.S. Army Medical Department, Army Medical Command, Washington, D.C.;

o  U.S. Army Forces Command, Fort McPherson, Georgia;

o  First U.S. Army, Fort Gillem, Georgia;

Appendix I: Scope and Methodology

o  Fifth U.S. Army, Fort Sam Houston, Texas;

o  U.S. Army Medical Command, Fort Sam Houston, Texas;

o  Walter Reed Army Medical Center, Washington, D.C.;

o  Winn Army Community Hospital, Fort Stewart, Georgia;

o  Darnall Army Community Hospital, Fort Hood, Texas;

o  Madigan Army Medical Center, Fort Lewis, Washington;

o  Fort McCoy, Wisconsin;

o  Quantico Marine Corps Base, Virginia;

o  Camp Lejeune Marine Corps Base, North Carolina;

o  Navy Mobilization Processing Site, Norfolk, Virginia;

o  	Headquarters, United States Air Force Military Policy Division,
Washington, D.C.;

o  Air National Guard, Washington, D.C.;

o  Air Force Medical Operations Agency, Washington, D.C.; and

o  Dobbins Air Reserve Base, Georgia.

We also interviewed reserve component members who were in medical status
at the mobilization and demobilization sites visited. We interviewed
hospital commanders and their staff, case managers, medical liaison
officers, and officials from the services' Surgeons General Offices.

We interviewed the Chief of the Army Medical Surveillance Activity (AMSA).
We discussed the information in the consolidated health assessment
database and obtained selected data from all the reserve component member
pre-and post-deployment health assessments that were completed from
October 25, 2001-when assessments became mandatory for all mobilized
reserve component members through March 2004. The data we obtained
contained health assessment records for 290,641 reserve component members.
For 122,603 members, we obtained only pre-deployment health assessments,
for 51,047 members we obtained only post-deployment health assessments,
and for 116,991 members we obtained both pre-and post-deployment health
assessments. We analyzed the data that we obtained to determine referral,
deployability, and exposure rates. We also analyzed data on the
self-reported general health of the reserve component members and compared
the data from predeployment assessments with the data from post-deployment
assessments. We also analyzed the month-by-month flow of forms to the AMSA
to see if the services had been submitting the forms as required. We
compared elapsed times between pre- and post-deployment assessments. We
conducted cross tabulations of the data to identify relationships between
various variables such as the overall health status, deployability, and
referral variables. All of our analyses compared data across the reserve
components to look for differences or trends.

Appendix I: Scope and Methodology

We assessed the reliability of reserve component mobilization,
demobilization, and general usage data supplied by OASD/RA by (1)
reviewing existing information about the data and the systems that
produced them and (2) interviewing agency officials knowledgeable about
the data. We also compared the data with data supplied to us by the
services. Our assessment of the AMSA data was even more rigorous and
included the electronic testing of relevant data elements, and discussions
with knowledgeable officials about not only the procedures for collecting
the data but also the procedures for coding the data. As a result of our
assessments, we determined that the data were sufficiently reliable for
the purposes of this report.

We conducted our review from November 2003 through July 2004 in accordance
with generally accepted government auditing standards.

Appendix II: National Guard and Reserve End Strength Figures

Tables 7 and 8 show information about the Ready Reserve and its
subcategories. Table 7 shows that the strength of the Ready Reserve has
declined steadily from fiscal year 1993 to fiscal year 2003, but the
strength of the Selected Reserve remained fairly steady from fiscal year
1998 to fiscal year 2003 after declining by more than 170,000 personnel
from fiscal year 1993 to fiscal year 1998. The Selected Reserve is the
portion of the Ready Reserve that participates in regular training. Table
8 shows the relative sizes of the reserve components at the end of fiscal
year 2003. The Army's reserve components are larger than those of the
other services and are expected to remain so for the foreseeable future.

  Table 7: Changes in Reserve Category End Strengths Fiscal year Category 1993
               1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Ready
Reserve 1,840,650 1,779,436 1,633,497 1,522,451 1,437,722 1,340,557
1,276,190 1,238,715 1,211,264 1,186,388 1,154,140

 Selected                                                                                    
 Reserve   1,057,676 998,330 945,852 920,371 902,216 881,491 870,917 865,242 867,422 874,326 875,072 
Individual                                                                                   
  Ready                                                                                      
 Reserve     776,080 774,336 681,203 596,788 530,777 454,352 398,525 370,858 336,610 305,922 274,199 
 Inactive                                                                                    
 National                                                                                    
  Guard        6,894   6,770   6,442   5,292   4,729   4,714   4,590   4,212   4,049   3,142   2,138 

Source: Defense Manpower Data Center data.

Table 8: Fiscal Year 2003 End Strengths for Each of DOD's Six Reserve Components

                     Army                                          Department 
                 National    Army   Naval Marine    Air        Air of Defense 
                                          Corps   National   Force 
                  Guard   Reserve Reserve Reserve    Guard Reserve      Total 
Ready Reserve 353,227  329,295 152,855  98,868  108,137 111,758  1,154,140 
     Selected    351,089  211,890  88,156  41,046  108,137  74,754    875,072 
      Reserve                                                      
    Individual            117,405  61,968  57,822           37,004    274,199 
Ready Reserve                                                   
     Inactive                                                                 
     National                                                      
       Guard        2,138                                               2,138

                   Source: Defense Manpower Data Center data.

Appendix III: Service Mobilization and Demobilization Installations

  Army

    Power Projection Platforms

Fort Carson, Colorado.
Fort Benning, Georgia.
Fort Stewart, Georgia.
Fort Riley, Kansas.
Fort Campbell, Kentucky.
Fort Polk, Louisiana.
Fort Bragg, North Carolina.
Fort Dix, New Jersey.
Fort Drum, New York.
Fort Sill, Oklahoma.
Fort Bliss, Texas.
Fort Hood, Texas.
Fort Eustis, Virginia.
Fort Lewis, Washington.
Fort McCoy, Wisconsin.

                            Power Support Platforms

Fort Rucker, Alabama.
Fort Huachuca, Arizona.
Camp Roberts, California.
Gowen Field, Idaho.
Camp Atterbury, Indiana.
Fort Knox, Kentucky.
Aberdeen Proving Ground, Maryland.
Camp Shelby, Mississippi.
Fort Leonard Wood, Missouri.
Fort Buchanan, Puerto Rico.
Fort Jackson, South Carolina.
Fort Lee, Virginia.

  Navy

Navy Mobilization Processing Site New London, Connecticut.
Navy Mobilization Processing Site Seattle, Washington.
Navy Mobilization Processing Site Gulfport, Mississippi.
Navy Mobilization Processing Site Jacksonville, Florida.
Navy Mobilization Processing Site Norfolk, Virginia.
Navy Mobilization Processing Site Pensacola, Florida.
Navy Mobilization Processing Site Port Hueneme, California.
Navy Mobilization Processing Site Washington, D.C.
Navy Mobilization Processing Site Memphis, Tennessee.
Navy Mobilization Processing Site London, United Kingdom.
Navy Mobilization Processing Site Pearl Harbor, Hawaii.

      Appendix III: Service Mobilization and Demobilization Installations

  Marine Corps

Navy Mobilization Processing Site San Diego, California.
Navy Mobilization Processing Site Great Lakes, Illinois.
Navy Mobilization Processing Site Camp Lejeune, North Carolina.
Navy Mobilization Processing Site Camp Pendleton, California.

Camp Pendleton, California (Used to mobilize and demobilize units and
individuals for worldwide usage).

Camp Lejeune, North Carolina (Used to mobilize and demobilize units and
individuals for worldwide usage).

Marine Corps Base Quantico, Virginia (Primarily used to mobilize and
demobilize individual reservists for duty in the Washington, D.C. Metro
area).

Marine Corps Air Station Miramar, California. 1

Marine Corps Air Station Cherry Point, North Carolina.

  Air Force

    United States Air Force Reserve Sites

Maxwell Air Force Base, Alabama.
Little Rock Air Force Base, Arkansas.
Davis-Monthan Air Force Base, Arizona.
Luke Air Force Base, Arizona.
Beale Air Force Base, California.
March Air Reserve Base, California.
Travis Air Force Base, California.
Vandenberg Air Force Base, California.
Peterson Air Force Base, Colorado.
Schriever Air Force Base, Colorado.
Dover Air Force Base, Delaware.
Eglin Air Force Base, Florida.
Homestead Air Reserve Base, Florida.
MacDill Air Force Base, Florida.

1 Marine Corps Air Station Miramar, California, and Marine Corps Air
Station Cherry Point, North Carolina, were both used as mobilization sites
after September 11, 2001, but they were not being used when we visited
Camp Lejeune and Quantico in the spring of 2004.

Appendix III: Service Mobilization and Demobilization Installations

Patrick Air Force Base, Florida.
Dobbins Air Reserve Base, Georgia.
Robins Air Force Base, Georgia.
Andersen Air Force Base, Guam.
Scott Air Force Base, Illinois.
Grissom Air Reserve Base, Indiana.
McConnell Air Force Base, Kansas.
Barksdale Air Force Base, Louisiana.
New Orleans Air Reserve Station, Louisiana.
Hanscom Air Force Base, Massachusetts.
Westover Air Reserve Base, Massachusetts.
Andrews Air Force Base, Maryland.
Selfridge Air National Guard Base, Michigan.
Minneapolis-Saint Paul International Airport Air Reserve Station,
Minnesota.
Whiteman Air Force Base, Missouri.
Columbus Air Force Base, Mississippi.
Keesler Air Force Base, Mississippi.
Pope Air Force Base, North Carolina.
Seymour Johnson Air Force Base, North Carolina.
Offutt Air Force Base, Nebraska.
McGuire Air Force Base, New Jersey.
Kirtland Air Force Base, New Mexico.
Fort Hamilton, New York.
Niagara Falls International Airport Air Reserve Station, New York.
Wright Patterson Air Force Base, Ohio.
Youngstown Air Reserve Station, Ohio.
Tinker Air Force Base, Oklahoma.
Portland International Airport, Oregon.
Pittsburgh International Airport Air Reserve Station, Pennsylvania.
Willow Grove Air Reserve Station, Pennsylvania.
Charleston Air Force Base, South Carolina.
Shaw Air Force Base, South Carolina.
Brooks Air Force Base, Texas.
Fort Worth Naval Air Station Joint Reserve Base, Texas.
Lackland Air Force Base, Texas.
Laughlin Air Force Base, Texas.
Randolph Air Force Base, Texas.
Hill Air Force Base, Utah.
Langley Air Force Base, Virginia.
Norfolk Naval Air Station, Virginia.
Fairchild Air Force Base, Washington.

Appendix III: Service Mobilization and Demobilization Installations

McChord Air Force Base, Washington. General Mitchell Air Reserve Base,
Wisconsin.

                            Air National Guard Sites

Eielson Air Force Base, Alaska.
Kulis Air National Guard Base, Alaska.
Birmingham International Airport, Alabama.
Montgomery Regional Airport, Alabama.
Fort Smith Regional Airport, Arkansas.
Little Rock Air Force Base, Arkansas.
Phoenix Sky Harbor International Airport, Arizona.
Tucson International Airport, Arizona.
Channel Islands Air National Guard Station, California.
Fresno Air Terminal, California.
March Air Reserve Base, California.
Moffett Federal Airfield, California.
Buckley Air Force Base, Colorado.
Bradley Air National Guard Base, Connecticut.
New Castle County Airport, Delaware.
Jacksonville International Airport, Florida.
Robins Air Force Base, Georgia.
Savannah International Airport, Georgia.
Andersen Air Force Base, Guam.
Hickam Air Force Base, Hawaii.
Des Moines International Airport, Iowa.
Sioux City Airport, Iowa.
Gowen Field, Idaho.
Greater Peoria Airport, Illinois.
Scott Air Force Base, Illinois.
Springfield Capital Airport, Illinois.
Fort Wayne International Airport, Indiana.
Terre Haute International Airport, Indiana.
Forbes Field, Kansas.
McConnel Air Force Base, Kansas.
Standiford Field, Kentucky.
New Orleans Naval Air Station, Louisiana.
Barnes Air National Guard Base, Massachusetts.
Otis Air National Guard Base, Massachusetts.
Andrews Air Force Base, Maryland.
Martin State Airport, Maryland.
Bangor International Airport, Maine.
Selfridge Air National Guard Base, Michigan.
W.K. Kellog Airport, Michigan.

Appendix III: Service Mobilization and Demobilization Installations

Duluth Air National Guard International Airport, Minnesota.
Minneapolis-Saint Paul International Airport, Minnesota.
Lambert-Saint Louis International Airport, Missouri.
Rosecrans Memorial Airport, Missouri.
Jackson International Airport, Mississippi.
Key Field, Mississippi.
Great Falls International Airport, Montana.
Charlotte-Douglas International Airport, North Carolina.
Hector International Airport, North Dakota.
Lincoln Municipal Airport, Nebraska.
Pease Air National Guard Base, New Hampshire.
Atlantic City Municipal Airport, New Jersey.
McGuire Air Force Base, New Jersey.
Kirtland Air Force Base, New Mexico.
Reno Cannon International Airport, Nevada.
F.S. Gabreski Airport, New York.
Hancock Field, New York.
Niagara Falls International Airport, New York.
Stewart Air National Guard Base, New York.
Stratton Air National Guard Base, New York.
Mansfield Lahm Airport, Ohio.
Rickenbacker Air National Guard Base, Ohio.
Springfield-Beckley Municipal Airport, Ohio.
Toledo Express Airport, Ohio.
Tulsa International Airport, Oklahoma.
Will Rogers Air National Guard Base, Oklahoma.
Klamath Falls International Airport, Oregon.
Portland International Airport, Oregon.
Harrisburg International Airport, Pennsylvania.
Pittsburgh International Airport, Pennsylvania.
Willow Grove Air Reserve Station, Pennsylvania.
Luis Munoz Marin International Airport, Puerto Rico.
Quonset State Airport, Rhode Island.
McEntire Air National Guard Station, South Carolina.
Joe Foss Field, South Dakota.
McGhee Tyson Air National Guard Base, Tennessee.
Memphis International Airport, Tennessee.
Nashville International Airport, Tennessee.
Ellington Field, Texas.
Fort Worth Naval Air Station Joint Reserve Base, Texas.
Kelly Air Force Base, Texas.
Salt Lake City International Airport, Utah.
Richmond International Airport, Virginia.
Burlington International Airport, Vermont.

Appendix III: Service Mobilization and Demobilization Installations

Camp Murray, Washington.
Fairchild Air Force Base, Washington.
General B. Mitchell Air National Guard Base, Wisconsin.
Truax Field, Wisconsin.
Eastern West Virginia Regional Airport, West Virginia.
Yeager Air National Guard Airport, West Virginia.
Cheyenne Air National Guard, Wyoming.

Appendix IV: Differences between Demobilization and Periodic Physicals for
Reserve Component Members

                         Table 9: Physical Requirements

Demobilization physical Periodic physical

                      requirements Requirements Frequency

Army Screenings for all soldiers; Examination includes

referrals and treatment are  o  height, weight, blood pressure,
pulse,based on screening. temperature, vision, and hearing;

Limited physical examination at  o  clinical evaluation of head, face,
scalp, nose,

the request of the soldier; sinuses, mouth, throat, ears, eyes, heart,
lungs,

includes vascular system, abdomen, extremities, feet,

o  	height, weight, blood spine, skin, neurologic exam, breast pressure,
pulse, and exam/testicular exam, neck, and anus;

temperature;  o  lab work includes urinalysis, HIV, and

o  "hands on" clinical evaluation cholesterol testing;

of head, face, scalp, nose, Age 40 and over exam includes prostate
exam,sinuses, mouth, throat, ears, rectal exam with stool, urine-specific
tests (gravity eyes, heart, lungs, vascular and microscopic), test for
intraocular pressure, and system, abdomen, fasting blood sugar and fasting
lipid profile.

extremities, feet, spine, skin,

neurologic exam, and

breast/testicular exam; and

o  	focused laboratory work based on specific problems or physical
findings.

Air Force 	All reservists get an Same as the Army. assessment by a medical
technician and are referred to a provider if needed.

All members returning from austere locations see medical providers
regardless of their physical condition.

Navy/Marine Screenings for all sailors and General examination
requirements similar to the

Corps	Marines; physical examinations Army. and specialty referrals are
given as indicated on a patientdirected, symptom-driven basis.

Physical examinations conducted if the periodic examination expired during
the mobilization period.

Annual health screenings.

Physical every 5 years beginning at age 30 and annually at age 60.

Requirements and frequency vary on the basis of occupational specialty.

Annual health assessment.

Requirements and frequency vary on the basis of occupational specialty.

Annual health certification.

Full physical every 5 years through age 50, every 2 years through age 60,
and annually after age 60.

Requirements and frequency vary on the basis of occupational specialty.

           Source: GAO analysis of DOD instructions and regulations.

                     Page 69 GAO-04-1031 Military Personnel

                     Page 70 GAO-04-1031 Military Personnel

                     Page 71 GAO-04-1031 Military Personnel

                     Page 72 GAO-04-1031 Military Personnel

                     Page 73 GAO-04-1031 Military Personnel

                     Page 74 GAO-04-1031 Military Personnel

Appendix VI: Service Stop-Loss Policies since September 11, 2001

On September 14, 2001, the Secretary of Defense delegated his stop-loss
authority to the service secretaries. This authority allows the services
to retain both active and reserve component members on active duty beyond
the end of their obligated service. Reserve component members who are
affected by the order generally cannot retire or leave the service until
authorized by competent authority. Each of the services has exercised its
stop-loss authority on different occasions and for different military
occupational specialties.

Army 	The Army issued a stop-loss message on December 4, 2001, imposing
stoploss on several active component skill-based specialties. As the needs
of the Army changed, the number of occupational specialties expanded and
then contracted, and included the reserve components as well as the Army's
active forces. The Army ended its specialty-based stop-loss on November
13, 2003. The Army's current stop-loss policy, which affects active and
reserve component forces, is unit-based rather than occupational specialty
driven. Significant stop-loss policy changes that affected the Army's
reserve component forces are listed below.

o  	January 2002. The stop-loss policy already in effect for the active
component is expanded to include soldiers in the Ready Reserve. Soldiers
with 23 different occupational specialties, including special forces,
civil affairs, psychological operations, certain aviation categories,
mortuary affairs, and maintenance are affected.

o  	February 2002. The Army expands its stop-loss policy for the active
and reserve components, adding 38 occupational specialties to the
stop-loss program. The new categories include military police, military
intelligence specialties and technicians, comptrollers, foreign area
officers (Eurasia, Middle East/North Africa), contract and industrial
management, additional aviator specialties, criminal investigators, and
linguists.

o  	June 2002. The Army expands and retracts its stop-loss policy for the
active and reserve components. New occupational specialties affected
include information operations, strategic intelligence, various field
artillery and air defense specialties, explosive ordnance disposal, and
unmanned aerial vehicle operators. Soldiers in the foreign area officer
(Eurasia) and select intelligence specialties were released from the
stop-loss policy.

Appendix VI: Service Stop-Loss Policies since September 11, 2001

o  	November 2002. Army ends skill-based stop-loss policy for the Ready
Reserve and Guard forces. The new stop-loss policy is unit based,
beginning when the unit is alerted until 90 days after the end of the
unit's mobilization.

o  	February 2003. Army expands stop-loss to include active component
units identified for deployment in support of Operation Iraqi Freedom.

o  	November 2003. Army again issues unit stop-loss for active forces, and
cancels occupational specialty stop losses that had been issued since
February 2003. (There were several stop-loss changes issued between
February 2003 and November 2003 but these changes were focused on active
forces.) The unit stop-loss policies for reserve component forces have
remained continuously in effect since they were instituted in 2002.

  Navy

The Navy exercised its stop-loss authority on September 28, 2001, by
imposing stop-loss on several occupational specialties. Unlike the Army,
the Navy's initial stop-loss policy affected both active and reserve
component forces. The Navy's significant stop-loss policy changes are
listed below.

o  	September 2001. The Navy issues a stop-loss policy for a variety of
officer and enlisted occupational specialties, and subspecialties to
include personnel in special operations/special warfare, security, law
enforcement, cryptology, and explosive ordnance disposal as well as
selected physicians, nurses, and linguists.

o  	March 2002. The Navy modifies its existing stop-loss policy, adding
new specialties and removing others. After the changes, selected linguists
and personnel in security, law enforcement, and cryptology were subject to
the stop-loss restriction.

o  August 2002. The Navy ends its stop-loss policy.

Air Force	The Air Force exercises its stop-loss authority on September 22,
2001, by imposing a servicewide stop-loss on all Air Force personnel.
Unlike the Army, the Air Force's initial policy affected active, reserve,
and Air National Guard members. The Air Force's significant stop-loss
policy changes are listed below.

o  	September 2001. The Air Force implements a servicewide, stop-loss
policy.

        Appendix VI: Service Stop-Loss Policies since September 11, 2001

o  	January 2002. The Air Force releases 64 occupational specialties from
the general stop-loss. Specialties that still fall under the limitations
of the stop-loss policy include selected pilots, navigators, intelligence
specialists, weather specialists, security personnel, engineers,
communications specialists, selected health care providers, lawyers,
chaplains, aircrew operators, aircrew protection personnel, command and
control specialists, fuel handlers, logisticians and supply specialists,
selected maintenance providers, and investigators.

o  	June 2002. The Air Force exempts additional occupational specialties
from the general stop-loss. Specialties that remain under the limitations
of the stop-loss policy include selected pilots, navigators, security
personnel, aircrew operators, command and control specialists,
intelligence specialists, aircrew protection, and fuel handlers.

o  	March 2003. The Air Force announces that effective May 2, 2003,
stoploss will be expanded to cover a total of 99 occupational specialties.
Specialties that are affected by the stop-loss policy include selected
pilots, navigators, command and control specialists, intelligence
specialists, security personnel, engineers, selected health care
providers, investigators, aircrew operators, aircrew protection personnel,
communications specialists, logisticians and supply specialists, and fuel
handlers.

o  	May 2003. The Air Force modifies its stop-loss policy, releasing about
half of the previously selected occupational specialties. The list of
specialties still affected by the stop-loss includes selected pilots,
navigators, intelligence specialists, security forces, special
investigators, aircrew operators, fuel handlers, and maintenance
personnel.

o  June 2003. The Air Force ends its stop-loss policy.

                                  Marine Corps

The Marine Corps exercised its stop-loss authority for selective active
and reserve Marines in January 2002. Specific policies varied as to their
applicability to active and reserve forces; however, expansion of
stop-loss policy eventually covered all Marines. The Marine Corps'
significant stoploss policy changes are listed below.

o  	January 2002. The Marine Corps implements a specific stop-loss
authority for Marines with C-130 specialties to assist in Operation
Enduring Freedom. This stop-loss authority includes Marines in the reserve
component.

Appendix VI: Service Stop-Loss Policies since September 11, 2001

o  	January 2003. The Marine Corps implements a general stop-loss policy
for all Marines, regardless of component. Marine Corps reservists cannot
be extended beyond the completion of 24 cumulative months of activated
service. Furthermore, the first general officer in a Marine's chain of
command can exempt Marines from the stop-loss policy.

o  May 2003. The Marine Corps lifts its stop-loss policy.

Appendix VII: Reserve Component Recruiting Results, Fiscal Year 1993-2004

The services use recruiting and retention strategies together to achieve
their programmed end strengths. If retention is better than expected in a
particular year, then the reserve components may achieve their desired end
strengths without achieving their recruiting goals. While the services can
effectively meet their yearly programmed end strengths through a wide
range of recruiting and retention combinations, long-term overreliance on
either recruiting or retention can eventually cause negative impacts for a
service or service component.

A service or component that repeatedly misses its recruiting goals will
need to retain a higher-than-planned percentage of its personnel each
year. This will eventually lead to a force that is out of balance. Either
too many people will be promoted and the component will end up with too
many senior personnel and not enough junior personnel or promotion rates
will decline. Decreased promotion rates tend to lead to increased
attrition rates, which would lead to end strength problems if a component
were already having problems meeting its recruiting goals.

Appendix VI showed that the services have employed a variety of stop-loss
policies since September 11, 2001. Because these policies artificially
inflate retention rates, recruiting figures rather than retention or end
strength figures may be the best indicator of whether or not the
components will face difficulties meeting their future programmed end
strengths. Table 10 shows historical recruiting results. It shows that all
the reserve components met their recruiting goals in fiscal year 2002. But
it shows that the Army National Guard fell far short of its goal in fiscal
year 2003 and was falling far short of its fiscal year 2004 monthly goals
through May of 2004. This dramatic drop in recruiting results occurred as
the Army was significantly increasing its involuntary mobilizations of
Army National Guard combat forces. The improving job market in the United
States may make it even more difficult for the Army National Guard to
achieve its recruiting objectives over the next few years.

Appendix VII: Reserve Component Recruiting Results, Fiscal Year 1993-2004

                 Table 10: Reserve Component Recruiting Figures

Fiscal Army National Army Naval Marine Corps Air National Air Force year
Guard Reserve Reserve Reserve Guard Reserve DOD total Goal Accessions

     1993    68,177    50,600    19,537   10,140   10,454   10,592    169,500 
     1994    69,710    46,500    13,144   11,122   10,325   10,434    161,235 
     1995    60,649    47,732    13,660   11,748   8,496    12,578    154,863 
     1996    61,793    50,179    16,850   10,388   11,000   7,090     157,300 
     1997    59,262    47,935    16,950   10,063   9,996    9,702     153,908 
     1998    56,638    47,940    15,329   10,174   8,004    10,874    148,959 
     1999    56,958    52,084    20,455   9,464    8,520    11,791    159,272 
     2000    54,034    48,461    18,410   9,341    10,080   9,624     149,950 
     2001    60,252    34,910    15,250   8,945    11,808   8,051     139,216 
     2002    60,504    38,857    15,000   9,835    9,570    6,080     139,846 
     2003    62,000    40,900    12,000   8,173    5,712    7,512     136,297 
     2004    56,002    34,782    10,500   7,960    8,842    7,997     126,083 
    2004a    36,575    20,862    6,622    5,268    5,702    5,816      80,845 

                     Page 80 GAO-04-1031 Military Personnel
1993 67,360 50,255 18,367 10,216 9,163 10,908 166,269 1994 61,248 47,412 13,006 11,236 9,177 11,464 153,543 1995 56,711 48,098 13,701 12,043 8,351 9,757 148,661 1996 60,444 46,187 16,820 12,566 9,958 7,566 153,541 1997 63,495 47,153 17,106 10,744 9,986 8,383 156,867 1998 55,401 44,212 14,986 10,213 8,744 8,877 142,433 1999 57,090 41,784 15,715 9,565 8,398 7,518 140,070 2000 61,260 48,596 14,911 9,465 10,730 7,740 152,702 2001 61,956 35,622 15,344 9,117 10,258 8,826 141,123 2002 63,251 41,385 15,355 10,090 10,122 6,926 147,129 2003 54,202 41,851 12,772 8,222 8,471 7,557 133,075 2004a 32,052 21,569 7,140 5,505 5,284 5,304 76,854    Goal            1993 98.8% 99.3% 94.0% 100.7% 87.7% 103.0% 98.1% 1994 87.9% 102.0% 99.0% 101.0% 88.9% 109.9% 95.2% 1995 93.5% 100.8% 100.3% 102.5% 98.3% 77.6% 96.0% 1996 97.8% 92.0% 99.8% 121.0% 90.5% 106.7% 97.6% 1997 107.1% 98.4% 100.9% 106.8% 99.9% 86.4% 101.9% 1998 97.8% 92.2% 97.8% 100.4% 109.2% 81.6% 95.6%                                                  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           achievement                                                                                                                                                                                                                                                                                                                  1999 100.2% 80.2% 76.8% 101.1% 98.6% 63.8% 87.9%

Appendix VII: Reserve Component Recruiting Results, Fiscal Year 1993-2004

Fiscal    Army      Army     Naval Marine         Air       Air    
           National                   Corps       National    Force   
    year        Guard Reserve Reserve    Reserve       Guard Reserve      DOD 
                                                                        total 
    2000       113.4% 100.3%    81.0%     101.3%   106.4%       80.4%  101.8% 
               102.8% 102.0%   100.6%     101.9%       86.9%  109.6%   101.4% 
               104.5% 106.5%   102.4%     102.6%   105.8%     113.9%   105.2% 
                87.4% 102.3%   106.4%     100.6%   148.3%     100.6%    97.6% 
2004a        87.6% 103.4%   107.8%     104.5%       92.7%    91.2%   95.1% 

Source: Defense Manpower Data Center.

aSignifies fiscal year 2004 data through May.

Appendix VIII: Service Medical and Physical Evaluation Board Processes

  Disabilities Evaluation System

DOD's Physical Disabilities Evaluation System consists of four main
elements:

1. medical evaluation by Medical Evaluation Boards (MEBs),

2. 	physical disability evaluation by Physical Evaluation Boards (PEBs) to
include appellate review,

3. servicemember counseling, and

4. final disposition by appropriate personnel authorities.

Figure 2 shows the steps of the disabilities evaluation system, which will
eventually lead to one of two outcomes. Servicemembers will either be
returned to duty or they will be discharged from their military service.
Members who are discharged sometimes, but not always, receive disability
compensation.

            Figure 2: Steps of DOD's Disabilities Evaluation System

Source: GAO analysis of DOD regulations and instructions.

Reserve component personnel who have been involuntarily mobilized, along
with members who are voluntarily serving on active duty, may end up with
medical problems for a variety or reasons. Some are injured during combat
operations; others become injured or sick during the course of their
training or routine duties; and others have problems that are identified
during medical appointments, physicals, or medical screenings.
Servicemembers on active duty or in the Ready Reserve are eligible for
referral into the Disability Evaluation System when they are

Appendix VIII: Service Medical and Physical Evaluation Board Processes

unable to reasonably perform the military duties of their office, grade,
rank, or rating as a result of a diagnosed medical condition.

Servicemembers who have been diagnosed with medical conditions that may
render them unfit for military service enter into medical treatment
programs.

The initial stage of the process, when medical professionals are
diagnosising servicemembers' problems, determining courses of treatment,
and evaluating the effectiveness of the ongoing treatments is often the
most time-consuming portion of the medical process. According to service
officials, this initial phase is intentionally long to give servicemembers
a good chance to get well and return to full duty. If, however, the
servicemembers have not returned to full duty within 1 year of their
diagnoses or if prior to a year they reach a point where they have
achieved the maximum recovery expected, and additional treatment is not
expected to materially affect their condition, their medical status and
duty limitations will be documented and referred to a MEB.

The MEB documents full clinical information on all medical conditions and
states whether each condition is cause for referral into the Disability
Evaluation System. The duty-related impairment MEB package should include
a medical history; records from physical examinations; records of medical
tests and their results; and documentation of medical and surgical
consultations, diagnoses, treatments and prognoses. If the servicemember
meets retention standards, the disability processing ends with the MEB. If
the MEB concludes that the servicemembers do not meet retention standards,
the members' cases are referred to the PEB to determine fitness for duty
and possible entitlement to benefits.

The first step in the PEB process is referral of the cases to informal
PEBs that review documents from the MEB and other administrative documents
without the presence of the servicemember. The informal PEB then issues
its initial findings and recommendations. If servicemembers are found to
be fit for duty, the disability processing ends with the informal PEB. If
servicemembers are found to be unfit for duty, they may request to
personally appear before the PEB during formal PEB hearings.
Servicemembers who do not agree with the decisions of the Formal PEB have
an additional opportunity to appeal the decisions.

When a physician initiates an MEB, the processing time should normally not
exceed 30 days from the date the MEB report is initiated to the date it is
received by the PEB. For cases where reserve component members are

Appendix VIII: Service Medical and Physical Evaluation Board Processes

referred for solely a fitness determination on a non-duty-related
condition, processing time for conducting an MEB or physical examination
should not exceed 90 days. And when the PEB receives the MEB or physical
examination report, the processing time to the date of the final
disposition of the reviewing authority should normally be no more than 40
days.

All servicemembers who enter the Disability Evaluation System receive
counseling. Counselors inform the servicemembers of the sequence and
nature of the steps in the process, statutory and regulatory rights, the
effects of findings and recommendations, and the servicemember's recourse
in the case of an unfavorable finding.

It is not within the mission of the military departments to retain members
on active duty or in the Ready Reserve to provide prolonged, definitive
medical care when it is unlikely the member will return to full military
duty. Servicemembers should be referred into the Disability Evaluation
System as soon as the probability that they will be unable to return to
full duty is ascertained and optimal medical treatment benefits have been
reached.

Appendix IX: Comments from the Department of Defense

Appendix IX: Comments from the Department of Defense

Note: Page numbers in the draft report may differ from those in this
report.

Appendix IX: Comments from the Department of Defense

Appendix IX: Comments from the Department of Defense

Appendix IX: Comments from the Department of Defense

Appendix X: GAO Contact and Staff Acknowledgments

GAO Contact Brenda S. Farrell (202) 512-3604

Acknowledgments 	In addition to the individual named above Kenneth F.
Daniell, Michael J. Ferren, Christopher R. Forys, Jim Melton, Kenneth E.
Patton, Gary W. Phillips, Jennifer R. Popovic, Sharon L. Reid, Irene A.
Robertson, Nicole Volchko, and Robert K. Wild also made significant
contributions to the report.

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Reserve Forces: DOD Actions Needed to Better Manage Relations between
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Reserve Forces: DOD Policies Do Not Ensure That Personnel Meet Medical and
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Defense Health Care: Physical Exams and Dental Care Following the Persian
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