GAO-12-571R Military Personnel

United States Government Accountability Office

Washington, DC 20548

March 30, 2012

The Honorable Louise M. Slaughter

Ranking Member

Committee on Rules

House of Representatives

Subject: Military Personnel: Prior GAO Work on DOD’s Actions to Prevent and 

Respond to Sexual Assault in the Military

Dear Ms. Slaughter:

Sexual assault is a crime that has a far-reaching negative impact on individuals, 

families, and communities. It also has additional implications for the military services 

because it undermines their core values, degrades mission readiness and esprit de 

corps, subverts strategic goodwill, and raises financial costs. Since 2004, following a 

series of high-profile sexual assault cases, Congress has taken steps to address this 

crime in the military, including passing legislation that directed the Secretary of 

Defense to develop a comprehensive policy for the Department of Defense (DOD) 

on the prevention of, and response to, sexual assaults involving members of the 

Armed Forces.1 Among other things, the legislation required DOD to establish a 

standardized departmentwide definition of sexual assault and procedures for 

confidentially reporting sexual assault incidents.

DOD established the Sexual Assault Prevention and Response (SAPR) program in 

2005 to promote prevention, encourage increased reporting of the crime, and

improve response capabilities for victims. DOD has formally defined sexual assault 

as “intentional sexual contact, characterized by use of force, threats, intimidation, 

abuse of authority, or when the victim does not or cannot consent. Sexual assault 

includes rape, forcible sodomy (oral or anal sex), and other unwanted sexual contact 

that is aggravated, abusive, or wrongful (to include unwanted and inappropriate 

sexual contact), or attempts to commit these acts.”2

 

1

Pub. L. No. 108-375, § 577, 118 Stat. 1811, 1926-28 (2004). 

DOD and the military services 

rely largely on Commanders and Sexual Assault Response Coordinators to 

implement SAPR programs at military installations, including the coordinating and 

reporting of sexual assault incidents. Other responders include victim advocates, 

military lawyers (known as judge advocates), medical and mental health providers, 

criminal investigative personnel, law enforcement personnel, and chaplains.

2

Department of Defense Directive 6495.01, Sexual Assault Prevention and Response (SAPR) 

Program (Oct. 6, 2005). DOD released revisions to its Directive in January 2012.
2 GAO-12-571R Military Personnel

In the Office of the Secretary of Defense (OSD), the Under Secretary of Defense for 

Personnel and Readiness has the responsibility for developing the overall policy and 

guidance for the department’s SAPR program.3 Within the Office of the Under 

Secretary of Defense for Personnel and Readiness, OSD’s Sexual Assault 

Prevention and Response Office serves as the department’s single point of 

responsibility for sexual assault policy matters and is responsible for, among other 

things, providing guidance and technical support; developing programs, policies, and 

training standards for the prevention, reporting, response, and program 

accountability of sexual assaults involving servicemembers; and preparing the 

department’s annual report to Congress on sexual assault in the military. 

Additionally, the DOD Office of the Inspector General is charged with overseeing 

criminal investigations of sexual assault conducted by the DOD components and 

developing policy for DOD criminal investigative organizations. Finally, in addition to 

overall DOD policy, each military service provides sexual assault-specific guidance, 

as well as standard operating and reporting procedures for responding to alleged 

sexual assault incidents.

While DOD strives to promote a culture free of sexual assault, these assaults still 

occur. Those assaulted may seek treatment at military treatment facilities (MTFs), 

where health care providers serve a critical role in addressing the physical and 

mental trauma experienced by a victim. Since 2008, we have issued four reports to 

help inform congressional deliberations on issues related to sexual assault in the 

military.4 Additionally, we testified three times before the Subcommittee on National 

Security and Foreign Affairs, House Committee on Oversight and Government 

Reform, on our findings. You asked us for information about treatment for victims at 

MTFs.

In response to your request, we are providing information related to this topic based 

on our prior work. This includes information on how cases of sexual assault are 

reported, documented, and investigated; how servicemembers are trained on sexual 

assault prevention and response; and the availability of health care for sexual 

assault victims. We briefed your staff on the information contained in this 

correspondence on December 9, 2011. As discussed with your staff at that time, we 

agreed to issue this report, which formally transmits the updated briefing slides. (See 

encl. I.)

To provide this information, we reviewed DOD’s policy and guidance on the 

prevention of and response to sexual assault for information on the medical care 

 

3

This responsibility does not include responsibility for legal processes provided under the Uniform 

Code of Military Justice and Manual for Courts-Martial that are assigned to the judge advocates 

general of the military services and criminal investigative policy matters that are assigned to the DOD 

Office of the Inspector General. 

4

See GAO, Military Personnel: The DOD and Coast Guard Academies Have Taken Steps to Address 

Incidents of Sexual Harassment and Assault, but Greater Federal Oversight Is Needed, GAO-08-296

(Washington, D.C.: Jan. 17, 2008); Military Personnel: DOD’s and the Coast Guard’s Sexual Assault 

Prevention and Response Programs Face Implementation and Oversight Challenges, GAO-08-924

(Washington, D.C.: Aug. 29, 2008); Military Personnel: Additional Actions Are Needed to Strengthen 

DOD’s and the Coast Guard’s Sexual Assault Prevention and Response Programs, GAO-10-215

(Washington, D.C.: Feb. 3, 2010); and Military Justice: Oversight and Better Collaboration Needed for 

Sexual Assault Investigations and Adjudications, GAO-11-579 (Washington, D.C.: June 22, 2011).
3 GAO-12-571R Military Personnel

provided to victims5 as well as DOD’s annual report on sexual assault in the military 

for fiscal year 2010 (the most recent year available at the time we did our work).6 We 

also reviewed our prior work on DOD’s actions to address sexual assault in the 

military, which focused on DOD’s SAPR programs, as well as the resources it has 

dedicated to the investigation and adjudication of sexual assault allegations. To 

conduct our prior work, we interviewed senior officials in OSD and the DOD Office of 

the Inspector General. Also, for each military service, we interviewed Sexual Assault 

Response Coordinators, judge advocates, medical and mental health personnel, 

criminal investigative personnel, law enforcement personnel, and chaplains. We 

visited military installations representing all of the military services in the United 

States and overseas to assess implementation of the sexual assault programs and 

met with various military commanders, including company and field grade officers, 

and senior enlisted servicemembers. In addition, we obtained the perspectives of 

numerous servicemembers through confidential surveys and one-on-one, structured 

interviews.7 Prior to its publication, we shared a draft copy with and solicited 

comments on this product from officials in OSD’s Sexual Assault Prevention and 

Response Office. Officials provided us with technical comments, which have been 

incorporated as appropriate.

We conducted the performance audits that we reference in this product from 

February 2007 through June 2011 in accordance with generally accepted 

government auditing standards. We developed this product from October 2011 

through March 2012. Generally accepted government auditing standards require that 

GAO plan and perform audits to obtain sufficient, appropriate evidence to provide a 

reasonable basis for our findings and conclusions based on our audit objectives. We 

believe that the evidence obtained provides a reasonable basis for our findings and 

conclusions based on our audit objectives.

In summary, our work resulted in 25 recommendations on various aspects of the 

SAPR program, and DOD concurred or partially concurred with all of our 

recommendations. DOD has since begun or completed action on each of these 

recommendations. To date, our analysis shows that DOD has fully implemented 

13 recommendations and has partially implemented the remaining 12 

recommendations, which we will continue to monitor.

Our previous work has included information about how cases of alleged sexual 

assault in the military are reported, documented, and investigated.

 

5

Department of Defense Directive 6495.01; Department of Defense Instruction 6495.02, Sexual 

Assault Prevention and Response Program Procedures (June 23, 2006), as updated by subsequent 

changes.

6

Department of Defense, Fiscal Year 2010 Department of Defense Annual Report on Sexual Assault 

in the Military (March 2011).

7

Because we did not select survey and interview participants using a statistically representative 

sampling method, our survey results and the comments provided during our interview sessions were 

nongeneralizable and therefore cannot be projected across DOD, a service, or any single installation 

we visited. However, the survey results and comments provided insight into the command climate 

and implementation of sexual assault prevention and response programs at each location at the time 

of our visit.
4 GAO-12-571R Military Personnel

• Reporting: The department has established two methods for reporting sexual 

assaults—unrestricted and restricted. Under the unrestricted reporting option, the 

chain of command is informed about the alleged sexual assault, and according to 

DOD, an investigation will be initiated. The restricted reporting option permits a 

victim to confidentially disclose an alleged sexual assault to select individuals 

and receive care without initiating an investigation.

• Documenting: In February 2010, we reported8 that DOD was not using a 

centralized, case-level database for documenting reported cases of sexual 

assault as required by a law enacted in 2008.9 Accordingly, we made 

recommendations that DOD adhere to key system development and acquisition 

management processes and controls in developing its database, and DOD 

concurred with these recommendations. In a March 2011 status report to 

Congress, DOD indicated that it expected the database to be operational by 

August 2012 and noted that it will adhere to key standard information technology 

practices.10

• Investigating: We also reported that absent DOD-level guidance, the military 

services have developed and implemented their own guidance on sexual assault 

investigations and, in some cases, take different approaches to conducting their 

investigations.11 In June 2011, we recommended that DOD develop and 

implement a policy that specified procedures for conducting sexual assault 

investigations and that the services leverage each other’s resources for 

investigating and adjudicating alleged sexual assault incidents. The department 

concurred with these recommendations and is taking actions to address both of 

them by drafting a sexual assault investigations policy that would be applicable to 

the services’ military criminal investigative organizations and by taking other 

steps to coordinate the expertise and resources of the services’ criminal 

investigative organizations. 

Our previous work also included information about sexual assault prevention and 

response training for servicemembers and investigators.

• Servicemember training: We found that, although servicemembers received initial 

and annual refresher training on sexual assault prevention and response, the 

training was not consistently administered and had not been systematically 

evaluated for effectiveness by DOD.12

 

8

GAO-10-215.

Further, we reported that OSD found that a 

greater level of detail was needed in policy to guide the execution of the 

9

The Duncan Hunter National Defense Authorization Act for Fiscal Year 2009, Pub. L. No. 110-417, 

§ 563, 122 Stat. 4356, 4470-71 (2008).

10In technical comments on a draft of this report, officials in OSD’s Sexual Assault Prevention and 

Response Office noted that they expect the database to be initially operational on March 30, 2012, 

and fully operational by August 2012.

11GAO-11-579.

12GAO-08-924.
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department’s training requirements.13 Accordingly, we recommended that DOD 

review and evaluate its sexual assault prevention and response training

programs for greater effectiveness—a recommendation that DOD has 

implemented.

• Investigator training: We also reported that the DOD Office of the Inspector 

General has not worked with the military services to assess the content or the 

effectiveness of the sexual assault training that is being provided to investigators 

and has not evaluated how many agents are currently meeting a minimum 

standard of competency.14 In June 2011, we recommended that DOD develop 

and implement clear goals and objectives for monitoring and evaluating the 

services’ sexual assault investigations and related training. DOD also concurred 

with this recommendation and has begun evaluating the military criminal 

investigative organizations’ sexual assault investigation training.

Additionally, our previous work included information on mental health care as well as 

other health care provided to servicemembers who are sexually assaulted.

• Mental health care: We found that program officials, such as Sexual Assault 

Response Coordinators, generally took steps to ensure that servicemembers 

who are sexually assaulted are made aware of their options for seeking mental 

health care and are able to access it, if desired.15 However, there are barriers 

that affect access to mental health care, including a DOD-reported shortage of 

mental health care providers and perceptions of stigma associated with seeking 

care. In August 2008, we recommended that DOD systematically evaluate and 

develop an action plan to address any factors that may prevent or discourage 

servicemembers from accessing mental health services following a sexual 

assault. DOD concurred with our recommendation and, in response, chartered 

the Health Affairs Sexual Assault Task Force, which made a number of 

recommendations intended to improve the availability of health care.

Other health care: DOD’s Directive states that it is DOD policy to ensure victims 

of sexual assault receive timely access to appropriate treatment and services.16

Victims are entitled to a Sexual Assault Forensic Medical Exam, which may occur 

at a non-military facility under a memorandum of understanding, as well as 

treatment for sexually transmitted diseases and pregnancy, and an assessment 

for follow-up care.

 

13GAO-10-215.

14GAO-11-579.

15GAO-08-924.

16Department of Defense Directive 6495.01. In technical comments on a draft of this report, officials in 

OSD’s Sexual Assault Prevention and Response Office noted that its recently revised Directive now 

specifies that sexual assault patients shall be given priority and treated as emergency cases, 

regardless of whether physical injuries are evident. Officials added that DOD has also adopted the 

Department of Justice’s “National Protocol for Sexual Assault Medical Forensic Examinations” as its 

standard for care of sexual assault victims.
6 GAO-12-571R Military Personnel

– – – – – 

As we agreed with your office, unless you publicly announce the contents of this 

report earlier, we plan no further distribution until 30 days from the report date. At 

that time, we will send copies of this report to the Secretary of Defense, appropriate 

congressional committees, and other interested parties. In addition, the report is 

available at no charge on GAO’s website at http://www.gao.gov. 

If you or your staff have any additional questions, please contact Brenda S. Farrell at 

(202) 512-3604 or farrellb@gao.gov or Randall B. Williamson at (202) 512-7114 or 

williamsonr@gao.gov. Contact points for our Offices of Congressional Relations and 

Public Affairs may be found on the last page of this report. Major contributors to this 

report were Bonnie Anderson, Assistant Director; David E. Moser, Assistant Director; 

Jennie F. Apter; Helen Desaulniers; Ashley R. Dixon; Erin Henderson; 

Natalie Herzog; Wesley A. Johnson; Kim Mayo; Lisa Motley; Mario D. Ramsey; 

and K. Nicole Willems.

Sincerely yours,

Brenda S. Farrell

Director, Defense Capabilities and Management

Randall B. Williamson

Director, Health Care

Enclosure – 1 
Enclosure I

7 GAO-12-571R Military Personnel

1

GAO’s Review of DOD Actions to Prevent and 

Respond to Sexual Assaults in the Military

Briefing for staff of Representative Slaughter 

Ranking Member, Committee on Rules 

House of Representatives

Updated
Enclosure I

8 GAO-12-571R Military Personnel

2

Overview

• Introduction

• Request Letter Questions

• Briefing Topics

• Scope and Methodology

• Background

• Findings from Our Previous Reports

• Recommendations from Our Previous Reports

• Our Previous Reports and Testimonies
Enclosure I

9 GAO-12-571R Military Personnel

3

Introduction

• Following a series of high-profile sexual assault cases 

involving servicemembers, in 2004 Congress directed the 

Secretary of Defense to develop a comprehensive policy 

for the Department of Defense (DOD) on the prevention of 

and response to sexual assaults involving 

servicemembers. Among other things, the legislation 

required DOD to establish a standardized departmentwide 

definition of sexual assault and procedures for 

confidentially reporting sexual assault incidents.
Enclosure I

10 GAO-12-571R Military Personnel

4

Introduction (cont.)

• DOD defines sexual assault as intentional sexual contact, 

characterized by use of force, threats, intimidation, abuse 

of authority, or when the victim does not or cannot 

consent.

• Sexual assault includes rape, forcible sodomy (oral or anal 

sex), and other unwanted sexual contact that is 

aggravated, abusive, or wrongful (to include unwanted 

and inappropriate sexual contact), or attempts to commit 

these acts.
Enclosure I

11 GAO-12-571R Military Personnel

5

Introduction (cont.)

• Sexual assault is a crime that has a far-reaching negative 

impact on individuals, families, and communities and has 

additional implications for the military services because it 

undermines their core values, degrades mission readiness 

and esprit de corps, subverts strategic goodwill, and 

raises financial costs. 

• According to a Department of Defense Annual Report on 

Sexual Assault in the Military, in fiscal year 2010, the 

military services received 3,158 reports of alleged sexual 

assault involving servicemembers.
Enclosure I

12 GAO-12-571R Military Personnel

6

Request Letter Questions

You asked us the following:

1. How are cases of acute sexual assault reported, documented, and 

investigated, when victims are treated at a military treatment facility 

(MTF)?

2. What training is provided to health care professionals working in MTFs 

on the treatment of victims of sexual assault?

3. How do MTFs provide acute treatment and care to victims of sexual 

assault, including forensic medical-legal exams and mental health 

counseling, as well as preventative treatment for the human 

immunodeficiency virus (HIV), sexually transmitted diseases, and 

pregnancy? 

4. What types of long-term services, support, and follow-up, including 

mental health services, do MTFs provide to victims of sexual assault?
Enclosure I

13 GAO-12-571R Military Personnel

7

Briefing Topics

This briefing includes information on the following topics from 

our body of work, which correspond with the questions asked 

in the request letter: 

• DOD’s approach for reporting, documenting, and investigating 

alleged sexual assault incidents. (Question 1*)

• DOD training of servicemembers related to sexual assault. 

(Question 2)

• DOD care and treatment provided to victims of sexual assault, 

including mental health counseling and medical care. (Questions 3 

and 4)

*

Our previous audit work focused on alleged sexual assault incidents within the military services and was not limited to only those incidents 

when the victim was treated at a MTF. 
Enclosure I

14 GAO-12-571R Military Personnel

8

Scope and Methodology

• Since 2008, our body of work has helped to inform 

Congress on issues related to sexual assault in the 

military. 

• The content of this briefing is primarily based on our body 

of work on DOD’s actions related to sexual assault in the 

military. Additionally, to compile this briefing we used 

information from the Fiscal Year 2010 Department of 

Defense Annual Report on Sexual Assault in the Military 

(the most recent year available) and DOD’s policies for 

medical care of alleged victims of sexual assault.
Enclosure I

15 GAO-12-571R Military Personnel

9

Background

• DOD Directive 6495.01, issued in October 2005, is the 

department’s comprehensive policy for the prevention of, 

and response to, sexual assault.*

• DOD Instruction 6495.02, issued in June 2006, provides 

guidance for implementing the department’s policy.**

• In addition to DOD’s policy, each military service provides 

sexual assault–specific guidance as well as standard 

operating and reporting procedures for responding to 

alleged sexual assault incidents. *

Department of Defense Directive 6495.01, Sexual Assault Prevention and Response (SAPR) Program (Oct. 6, 2005). DOD released 

revisions to its Directive in January 2012. 

**Department of Defense Instruction 6495.02, Sexual Assault Prevention and Response Program Procedures (June 23, 2006), as updated. 
Enclosure I

16 GAO-12-571R Military Personnel

10

Background (cont.)

• DOD and the military services rely largely on Sexual 

Assault Response Coordinators (SARCs) to implement 

Sexual Assault Prevention and Response (SAPR) 

programs at military installations, including coordinating 

the response to and reporting of sexual assault incidents. 

• Other responders include victim advocates, military 

lawyers (known as judge advocates), medical and mental 

health providers, criminal investigative personnel, law 

enforcement personnel, and chaplains.
Enclosure I

17 GAO-12-571R Military Personnel

11

Background (cont.)

• DOD Instruction 6495.02 requires the DOD Office of the 

Inspector General to oversee investigations of sexual 

assault and develop policy for conducting sexual assault 

investigations. Specifically, it directed the DOD Inspector 

General to:

• Develop policy for DOD criminal investigative organizations—the 

U.S. Army Criminal Investigation Command, the Naval Criminal 

Investigative Service, and the Air Force Office of Special 

Investigations—and oversee their investigations of sexual assaults. 

• Oversee sexual assault training within the DOD investigative and 

law enforcement communities.

• Collaborate with the Sexual Assault Prevention and Response 

Office as necessary on sexual assault matters. 
Enclosure I

18 GAO-12-571R Military Personnel

12

1: DOD’s Approach for Reporting, Documenting, 

and Investigating Cases of Sexual Assault

• Our previous work included information on reporting, 

documenting, and investigating allegations of sexual 

assault involving servicemembers.
Enclosure I

19 GAO-12-571R Military Personnel

13

1: Reporting, Documenting, and Investigating Sexual 

Assault

Options for Reporting Sexual Assault Incidents

• Under DOD’s policy, active duty servicemembers have 

two options for reporting an alleged sexual assault: 

(1) unrestricted, and (2) restricted.

1. Under the unrestricted reporting option, the chain of command is 

informed of the alleged sexual assault and may initiate an 

investigation by the military criminal investigative organization of 

jurisdiction.

2. The restricted reporting option permits a victim to confidentially 

disclose an alleged sexual assault to select individuals and receive 

care without initiating a criminal investigation. Generally, a 

restricted report may only be made to SARCs, victim advocates, or 

medical personnel. 
Enclosure I

20 GAO-12-571R Military Personnel

14

1: Reporting, Documenting, and Investigating Sexual 

Assault

Data Collection and Reports to Congress

DOD’s Sexual Assault Prevention and 

Response Office serves as the 

department’s single point of 

responsibility for sexual assault policy 

matters.* The office oversees the 

department’s collection and 

maintenance of data on reported 

sexual assaults involving 

servicemembers and is responsible for 

preparing the department’s annual 

report to Congress. 

*

Except for legal processes provided under the Uniform Code of Military Justice and Manual for Courts-Martial that are assigned to the 

Judge Advocates General of the military services and criminal investigative policy matters that are assigned to the DOD Office of the 

Inspector General.
Enclosure I

21 GAO-12-571R Military Personnel

15

1: Reporting, Documenting, and Investigating Sexual 

Assault

Centralized Sexual Assault Incident Database 

• In October 2008, Congress required DOD to implement a centralized, 

case-level database for collecting and maintaining information on sexual 

assaults involving members of the Armed Forces by January 2010.*

• The law specified that the database include information, if available, about the nature of 

the assault, the victim, the offender, and the outcome of any legal proceedings 

associated with the assault. 

• In February 2010, we reported that DOD had not met the January 2010 

deadline, though it had taken preliminary steps to implement a 

centralized, case-level sexual assault incident database. Accordingly, 

we recommended that DOD adhere to key system development and 

acquisition management processes and controls in developing its 

database.DOD concurred with our recommendations.

*

The Duncan Hunter National Defense Authorization Act for Fiscal Year 2009, Pub. L. No. 110-417, § 563, 122 Stat. 4356, 4470-71 

(2008). 
Enclosure I

22 GAO-12-571R Military Personnel

1: Reporting, Documenting, and Investigating Sexual 

Assault

Centralized Sexual Assault Incident Database (cont.)

16

• DOD noted that it expects the database to be fully 

operational by August 2012.*

• Specifically, according to a March 2011 status report from DOD’s 

Office of Personnel and Readiness, a contract was awarded in 

August 2010 for the development, implementation, and 

maintenance of the database.

• The report also highlighted the department’s adherence to key 

information technology management practices and that its actions 

were consistent with the recommendations in our February 2010 

report.

*

Officials in DOD’s Sexual Assault Prevention and Response Office noted that they expect the database to be initially operational on March 30, 2012.
Enclosure I

23 GAO-12-571R Military Personnel

17

1: Reporting, Documenting, and Investigating Sexual 

Assault 

Military Services’ Approaches to Investigating Sexual Assaults

• In June 2011, we reported that absent DOD-level guidance, the military services 

have developed and implemented their own guidance on sexual assault 

investigations, and in some cases they take different approaches to conducting 

their investigations. Accordingly, we recommended that DOD develop and 

implement a policy that specified procedures for conducting sexual assault 

investigations. In addition, we recommended that the services leverage each 

other’s resources for investigating and adjudicating alleged sexual assault 

incidents.

• DOD concurred and has drafted a sexual assault investigations policy that would 

be applicable to the services’ military criminal investigative organizations and 

has taken other steps to coordinate expertise and resources of the services’ 

criminal investigative organizations.

• We also reported that, according to the judge advocates from each of the 

military services, the administration of justice in sexual assault cases is often 

complicated by limited availability of forensic evidence and conflicting testimonial 

accounts by the parties involved.
Enclosure I

24 GAO-12-571R Military Personnel

18

1: Reporting, Documenting, and Investigating Sexual 

Assault 

Forensic Evidence Maintenance Standards Vary across Military Services

Comparison of Sexual Assault Forensic Maintenance Standards Across Military Services

Army Criminal 

Investigation Command

Air Force Office of 

Special Investigations

Naval Criminal 

Investigative Service

Forensic evidence 

maintenance standards

Unrestricted cases: 

Unsolved rapes and 

aggravated sexual assault 

evidence is retained 

indefinitely.

Restricted cases: 

Evidence stored by 

installation-level law 

enforcement for 1 year. 

Unrestricted cases: Air 

Force Office of Special 

Investigations’ guidance does 

not specify time frames for 

maintaining evidence in these 

cases, but officials told us 

that evidence is disposed of 

when no longer required, 

after a judge advocate 

approves the disposition.

Restricted cases: Evidence 

is stored for at least 1 year, 

then destroyed if the victim 

does not convert to an 

unrestricted report after being 

notified of the expiration of 

the storage period.

Unrestricted cases: 

Unsolved rape case 

evidence is held for a 

minimum of 50 years.

Restricted cases: Forensic 

examination kits are stored 

for 12 months, then 

destroyed if victim does not 

convert the restricted report 

to an unrestricted report. 

Source: GAO analysis of the military services' investigative organizations' policies and procedures.
Enclosure I

25 GAO-12-571R Military Personnel

19

2: DOD’s Sexual Assault Prevention and 

Response Training

• Our previous work included information on training 

provided to servicemembers related to sexual assault 

prevention and response.
Enclosure I

26 GAO-12-571R Military Personnel

20

2: Sexual Assault Prevention and Response Training

SAPR Training and Resulting GAO Recommendations

• In August 2008, we reported that DOD’s SAPR training was not 

consistently administered and that the effectiveness of the training 

provided to servicemembers on SAPR policies had not been 

systematically evaluated by DOD. Accordingly, we recommended that 

DOD review and evaluate SAPR training programs for greater 

effectiveness. DOD concurred with this recommendation and has 

implemented it. 

• In February 2010, we reported that the Office of the Secretary of 

Defense’s (OSD) training subcommittee found that a greater level of 

detail was needed in policy to guide the execution of training 

requirements.
Enclosure I

27 GAO-12-571R Military Personnel

21

2: Sexual Assault Prevention and Response Training 

SAPR Training and Resulting GAO Recommendations (cont.)

• We also reported in February 2010 that OSD chartered the 

Health Affairs Sexual Assault Task Force to address a 

recommendation we made in 2008 to evaluate and 

develop an action plan to address factors that may prevent 

or discourage servicemembers from seeking mental health 

services. In March 2009, the task force made a number of 

recommendations intended to improve the availability of 

health care, such as chartering the Sexual Assault Health 

Care Integrated Policy Team to review SAPR training 

requirements and responsibilities.*

*

The Sexual Assault Health Care Integrated Policy Team was established by the Office of the Assistant Secretary of Defense for Health 

Affairs in October 2009 to facilitate effective and efficient coordination of sexual assault response matters in the DOD medical

community.
Enclosure I

28 GAO-12-571R Military Personnel

22

2: Sexual Assault Prevention and Response Training 

Evaluation of Investigator Training 

• In June 2011, we reported that while each of the military services has 

developed and implemented sexual assault-specific training for its 

respective investigators (per DOD policy), the DOD Office of the 

Inspector General has not worked with the services to assess the 

content or the effectiveness of the training that is being provided. 

• We also reported that the DOD Office of the Inspector General had not 

assessed the training that is provided by the services on sexual assault 

investigations, such as evaluating how many investigators are currently 

meeting a minimum standard of competency. Accordingly, we 

recommended that DOD develop and implement clear goals and 

objectives for monitoring and evaluating the services’ sexual assault 

investigations and related training. DOD concurred, and the DOD Office 

of the Inspector General has begun an evaluation of the military criminal 

investigative organizations’ training on sexual assault investigations. 
Enclosure I

29 GAO-12-571R Military Personnel

23

3: DOD Care and Treatment Provided to 

Victims of Sexual Assault

• Our previous work on care and treatment provided to victims of 

sexual assault included information on mental health services. 

• In addition to our previous work, this information is also based 

on a review of DOD health care related policies.

• Department of Defense Directive 6495.01, Sexual Assault 

Prevention and Response (SAPR) Program (Oct. 6, 2005).

• Department of Defense Instruction 6495.02, Sexual Assault 

Prevention and Response Program Procedures (June 23, 

2006).
Enclosure I

30 GAO-12-571R Military Personnel

24

3: Care and Treatment 

Coordination and Tracking of Victim Services

• SARCs are required to coordinate medical and counseling 

services between military installations and deployed units for 

victims of sexual assault. They also are to collaborate with local 

community crisis counseling centers to augment or enhance 

DOD’s program. 

• We found that program officials generally took steps to ensure 

that servicemembers who were sexually assaulted were made 

aware of their options for seeking mental health care and were 

able to access it, if desired.
Enclosure I

31 GAO-12-571R Military Personnel

25

3: Care and Treatment 

Factors that Affect Access to Mental Health Care

• In August 2008, we reported that a DOD-reported shortage of health 

care providers—specifically mental health care providers—could 

hinder servicemembers’ access to receiving mental health care. DOD 

established a memorandum of understanding (MOU) to allow 

uniformed providers of the Public Health Service to work in MTFs.*

• Perceptions of stigma associated with seeking mental health care also 

may discourage servicemembers from doing so following a sexual 

assault. DOD officials told us that stigma may prevent servicemembers 

from seeking health care. They also may believe that doing so could 

negatively impact their careers, such as by affecting their ability to 

obtain a security clearance.

*

The Public Health Service Commissioned Corps within the United States Department of Health and Human Services is a team of public 

health professionals that fills essential public health leadership and service roles within the nation's federal government agencies and 

programs. 
Enclosure I

32 GAO-12-571R Military Personnel

26

3: Care and Treatment 

Efforts to Improve the Availability of Health Care

• In August 2008, we recommended that DOD 

systematically evaluate and develop an action plan to 

address any factors that may prevent or discourage 

servicemembers from accessing mental health services 

following a sexual assault. DOD concurred and has 

implemented this recommendation.

• In March 2009, OSD chartered the Health Affairs Sexual 

Assault Task Force which made a number of 

recommendations intended to improve the availability of 

health care.
Enclosure I

33 GAO-12-571R Military Personnel

3: Care and Treatment

Efforts to Improve the Availability of Health Care (cont.)

• The Health Affairs Sexual Assault Task Force 

recommendations included:

• Chartering the Sexual Assault Health Care Integrated Policy Team 

to review department-level policies regarding clinical practice 

guidelines, standards of care, research gaps and opportunities, 

personnel and staffing, training requirements and responsibilities, 

continuity of care, and in-theater equipment and supplies.

• Drafting model MOUs for use by all service military treatment 

facilities as they establish continuity of care relationships with local 

community providers.

27
Enclosure I

34 GAO-12-571R Military Personnel

28

3: Care and Treatment 

Medical Care Policies

• According to DOD’s Instruction, SARC notification must not delay the 

treatment of any medical conditions requiring immediate attention for 

the health of a servicemember seeking care for an alleged sexual 

assault at an MTF.

• Once clinically stable, the healthcare provider shall consult with the 

servicemember regarding further healthcare options including, but not 

limited to:

• An optional sexual assault forensic exam. 

• Testing, prophylactic treatment options, and follow-up care for possible exposure to 

HIV and other sexually transmitted infections or diseases.

• Assessment of the risk of pregnancy, options for emergency contraception, and any 

necessary follow-up care and/or referral services.

• Assessment of the need for behavioral health services and providing a referral, if 

necessary and/or requested by the victim. 
Enclosure I

35 GAO-12-571R Military Personnel

29

3: Care and Treatment 

Sexual Assault Forensic Exams (SAFE)

• Victims are entitled to an optional SAFE exam.

• Installations that do not have a SAFE capability will transport a victim to 

a military facility or local off-base non-military facility that has a SAFE 

capability. 

• Whenever possible, military installations should have established 

formal MOUs with military facilities and off-base non-military facilities 

for the purpose of conducting sexual assault examinations. 

• The SARC or victim advocate will ensure that a victim is aware of any 

local or state sexual assault reporting requirements that may limit the 

possibility of restricted reporting, prior to proceeding with the SAFE at 

the local off-base non-military facility. 
Enclosure I

36 GAO-12-571R Military Personnel

30

Recommendations from Previous GAO 

Reports 

• In our work, we made 25 recommendations aimed at 

improving the implementation and oversight of DOD’s 

SAPR program. DOD concurred or partially concurred with 

all 25 recommendations.

• Our analysis shows that, to date, DOD has fully 

implemented 13 recommendations and has partially 

implemented the remaining 12 recommendations. 
Enclosure I

37 GAO-12-571R Military Personnel

31

Previous GAO Reports 

• Military Justice: Oversight and Better Collaboration Needed for Sexual 

Assault Investigations and Adjudications. GAO-11-579. Washington, 

D.C.: June 22, 2011. 

• Military Personnel: Additional Actions Are Needed to Strengthen DOD's 

and the Coast Guard's Sexual Assault Prevention and Response 

Programs. GAO-10-215. Washington, D.C.: February 3, 2010. 

• Military Personnel: DOD's and the Coast Guard's Sexual Assault 

Prevention and Response Programs Face Implementation and 

Oversight Challenges. GAO-08-924. Washington, D.C.: August 29, 

2008. 

• Military Personnel: DOD and the Coast Guard Academies Have Taken 

Steps to Address Incidents of Sexual Harassment and Assault, but 

Greater Federal Oversight Is Needed. GAO-08-296. Washington, D.C.: 

January 17, 2008.
Enclosure I

38 GAO-12-571R Military Personnel

32

Previous GAO Testimonies

• Military Personnel: DOD's and the Coast Guard's Sexual Assault 

Prevention and Response Programs Need to Be Further Strengthened. 

GAO-10-405T. Washington, D.C.: February 24, 2010. 

• Military Personnel: Actions Needed to Strengthen Implementation and 

Oversight of DOD's and the Coast Guard's Sexual Assault Prevention 

and Response Programs. GAO-08-1146T. Washington, D.C.: 

September 10, 2008.

• Military Personnel: Preliminary Observations on DOD's and the Coast 

Guard's Sexual Assault Prevention and Response Programs. 

GAO-08-1013T. Washington, D.C.: July 31, 2008. 

(291017)
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