Sexual Assault: Better Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army Reserve
Published: 2017-02-27T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: Sexual assault in the Army is often discussed in terms of its incidence among active-duty forces. Sexual assault is a crime that similarly confronts the more than 550,000 members who collectively serve in the Guard and Reserve, who together reported 604 sexual assault incidents in fiscal year 2015; however, sexual assault is generally an underreported crime. Congress included a provision in statute for GAO to review sexual assault prevention and response in the Army's reserve components.
This report addresses the extent to which (1) the Guard and Reserve face any challenges implementing programs to prevent and respond to sexual assault; and (2) medical and mental health-care services are available to victims in the Guard and Reserve. GAO reviewed DOD and Army policies; administered two web-based surveys; conducted site visits to four installations; and interviewed officials.
section_title: What GAO Found
paragraphs: The Army National Guard (Guard) and Army Reserve (Reserve) have implemented sexual assault prevention and response programs, but face challenges in areas such as staffing, budget management, and investigation timeliness that may hinder program implementation.
Staffing: The Guard and the Reserve have staffed their sexual assault prevention and response programs, but their use of full-time and collateral-duty personnel has produced sizeable workload disparities. For example, the Guard allots two full-time staff to each state and territory, which provides Rhode Island—a state with about 2,000 soldiers—the same number of staff as Texas, which has about 18,600 soldiers. Similar imbalances exist in the Reserve, with one full-time staff at one command responsible for about 9,000 soldiers located in 16 different states, while the one full-time staff member at another command is responsible for 300 soldiers in 4 states. Officials said that collateral-duty personnel are used to mitigate workload disparities, but these positions are not always filled in the Guard, and the Reserve does not know the number filled. Without evaluating their staffing structures, the Army does not know the extent of such issues and their effect.
Budget Management: The Guard has developed budget guidance on the use of funds but has not effectively communicated it to program staff, and the Reserve has not developed or distributed this guidance to its staff. Thus, Guard and Reserve program staff do not have information needed to develop their budget allocations and help ensure the efficient use of program funds.
Investigation Timeliness: Data on Guard cases investigated by its Office of Complex Administrative Investigations (OCI) in fiscal year 2015 show that 57 percent, or 45 of 79 cases, took 6 to 9 months to complete; 39 percent, or 31 of 79 cases, took 3 to 6 months; and the remaining 4 percent (3 of 79 cases) took longer than 9 months. According to OCI officials, investigations take longer to complete because OCI does not have enough personnel to handle its growing caseload, which more than doubled from 2014 to 2015. The Army and the Guard have not reassessed OCI's resources since the increase in investigation requests to help ensure it has the staff needed to complete investigations within 3 weeks, as required by OCI guidance.
Eligibility for follow-up or long-term health-care services paid for or provided by the Department of Defense (DOD) varies based on a Guard or Reserve victim's duty status at the time of an assault. Victims in the Guard and Reserve must go through a process, known as a line of duty determination, to determine their eligibility for care. The Guard has established an expedited process for making a determination within 72 hours of the process being initiated. However, the Reserve's process is lengthy, and in prior work GAO found that 80 percent of these determinations were overdue. Reserve officials said they plan to include an expedited process in the new Army regulation that is being drafted; however, Reserve officials did not provide details about the planned process or documentation about how it would be implemented. Without an expedited process to provide more timely decisions, sexual assault victims in the Reserve may continue to pay for their care up front, or else face delayed access to care.
section_title: What GAO Recommends
paragraphs: GAO is making six recommendations, including that DOD evaluate program staffing structure, communicate and develop budget guidance, assess the Guard's investigation timeliness and resources, and develop an expedited process for determining Reserve eligibility for healthcare services. DOD concurred with three recommendations partially concurred with two, and did not concur with assessing Guard investigation timeliness, stating that the Army has limited authority over OCI. GAO continues to believe that actions are needed to fully address the two recommendations, and redirected the OCI recommendation to the Guard, as recommended by DOD.

section_title: Letter
paragraphs: Sexual assault in the military is frequently discussed in terms of its  occurrence in and effect on active-duty forces. However, the reserve  components face similar issues, which is of importance in particular due  to the size of the reserve-component forces. The Army’s reserve  components, which include the Army National Guard and the Army  Reserve, collectively comprise over 550,000 members compared to the  nearly 490,000 soldiers serving in the active-duty Army. In fiscal year  2015, 604 sexual assault incidents involving  Army reserve-component  victims were reported to Army and National Guard personnel; however,  sexual assault is generally an underreported crime. Based on a survey of  reserve-component members conducted by the Defense Manpower Data  Center in 2015, the Department of Defense (DOD) estimated that 8,386  reserve component members were sexually assaulted during the same  period. Further, DOD determined that, in fiscal year 2015, of those  reserve-component members who indicated in the survey that they had  experienced a sexual assault, only about 22 percent of women serving in  the reserve component and 16 percent of men reported the incident to  DOD.
For more than a decade, Congress and DOD have taken a variety of  steps to prevent and respond to sexual assault in the military. In 2004,  following a series of high-profile sexual assault cases involving  servicemembers, Congress required the Secretary of Defense to develop,  among other things, a comprehensive policy for DOD on the prevention of  and response to sexual assaults involving servicemembers. In response  to statutory requirements, DOD established its sexual assault prevention  and response program in 2005 to promote prevention, encourage  increased reporting of sexual assault crimes, and improve victim  response capabilities. Starting with its fiscal year 2007 report on sexual  assault in the military, DOD began to distinguish between reports of  sexual assault involving members serving on active duty and those  involving activated members of the National Guard and the Reserve.
Since 2008 we have issued multiple products and made numerous  recommendations related to DOD’s efforts to prevent and respond to  incidents of sexual assault involving  servicemembers on active duty. Most  recently, in November 2015, we reported on the extent to which DOD had  developed and implemented a strategy to prevent sexual assault. In  general, we found that DOD had developed a sexual assault prevention  strategy but that it did not link specified activities to desired outcomes.  Furthermore, we reported that DOD had not taken steps to help ensure  that the prevention-focused activities being implemented at installations  were consistent with the overarching objectives of its prevention strategy.  We recommended that DOD, among other things, link the activities  specified in its prevention strategy with desired outcomes and that it  communicate and disseminate its prevention strategy to all program  personnel. DOD concurred with all of our recommendations and is in the  process of implementing them. For additional information on our prior  work related to sexual assault in the military, see the list of related GAO  products at the end of this report.
The National Defense Authorization Act for Fiscal Year 2016 included a  provision for us to review implementation of sexual assault prevention  and response efforts in the Army’s two reserve components. This report  assesses the extent to which (1) the Army National Guard and the Army  Reserve face any challenges implementing their programs on the  prevention of and response to sexual assault involving their members;  and (2) medical and mental health-care services are available to  members of the Army National Guard and the Army Reserve following a  sexual assault.
For our first objective, we reviewed DOD’s, the Department of the Army’s  and the National Guard’s sexual assault prevention and response  guidance. We also interviewed headquarter-level officials with the  Department of the Army, the Army National Guard, and the U.S. Army  Reserve, as well as officials from DOD’s Sexual Assault Prevention and  Response Office (SAPRO) on efforts to implement this guidance in the  Army National Guard and the Army Reserve, and asked about any  challenges that they had identified or experienced during implementation.  In reviewing this guidance and in our discussions with officials, we  identified challenges related to department and service-level program  responsibilities for the assignment of program staff, budget development  and execution, and investigations. We obtained May 2016 data from the  Army National Guard and April 2016 data from the Army Reserve—the  most recent available at the time of our review—on the number,  geographical dispersion, and types of personnel used to staff full-time and  collateral-duty program positions. We also obtained data from the  Department of the Army and the Army National Guard on the amount of  time it took to conduct sexual assault investigations in fiscal years 2012  through 2015, which is the period available in the system used to  maintain these data at the time of our review. We assessed the reliability  of the data sources by reviewing information on data quality and the systems that produced them, and by discussing the data with  knowledgeable agency officials. We determined these data sources were  sufficiently reliable for describing the Army National Guard and the Army  Reserve staffing of program positions and the length of investigations.  Further, we compared Army National Guard and Army Reserve efforts to  staff and develop budgets for their respective programs with Standards  for Internal Control in the Federal Government that emphasize the  importance of (1) establishing an organizational structure and assigning  responsibilities that enable an agency or department to operate in an  efficient and effective manner and to achieve its objectives, (2)  communicating quality information to make informed decisions, especially  as it relates to the prioritization of and accountability for funds, and (3)  providing accountability for resources and ensuring that only valid  transactions to use or commit resources are initiated or entered into.
Additionally,  we conducted site visits to four installations—two for the  Army National Guard and two for the Army Reserve—that were selected  based on a variety of factors, including installations that had a higher  number of reported sexual assault incidents, as well as the size and  geographic dispersion of different installations. Although the information  obtained during our site visits is not generalizable to other installations, it  enabled us to obtain the perspectives of a variety of personnel  responsible for implementation of the Army National Guard’s and the  Army Reserve’s sexual assault prevention and response programs. We  also administered and analyzed the results of two web-based surveys,  one for each component, that solicited perspectives from all full-time  sexual assault response coordinators (SARC) and victim advocates (VA)  serving in the Army National Guard and the Army Reserve. Of the full-time SARCs and VAs who were available during the period of survey  administration, we received completed survey responses from 68 out of  92 potential respondents, or 74 percent, for the Army National Guard, and  from 27 out of 46 potential respondents, or 59 percent, for the Army  Reserve.
For our second objective, we reviewed provisions in DOD, Department of  the Army, and Veterans Health Administration guidance pertaining to  medical and mental health-care services available to members of the  Army National Guard and Army Reserve following a sexual assault. In  our web-based survey of full-time SARCs and VAs serving in the Army  National Guard and the Army Reserve, we asked about the availability  of  medical and mental health-care services for sexual assault victims, and  analyzed the results to determine how services are identified and the  extent to which they vary by location. We also interviewed officials from  DOD and the Department of the Army, and met with officials during our  site visits, to discuss the medical and mental health services available to  sexual assault victims serving in the Army National Guard and the Army  Reserve, including any care that can be obtained through the local  community, and the extent to which the availability of such care may be  affected by a member’s duty status. We also discussed any potential  barriers that may affect the availability of and access to such care by  reserve-component members. A more detailed description of our scope  and methodology appears in appendix III.
We conducted this performance audit from July 2015 to February 2017 in  accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit 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.
subsections: section_title: Background
subsections: section_title: Overview of the Army National Guard’s and the Army Reserve’s Purpose and Structure
paragraphs: The Army National Guard and the Army Reserve are composed primarily  of citizen soldiers who serve in the military on a part-time basis, balancing  the demands of civilian careers with their military service. Collectively,  these part-time forces make up more than 50 percent of the Army’s total  force, and these soldiers at any time may be called upon to meet a full  spectrum of defense requirements and operations around the globe. In  addition to these part-time forces, both the Army National Guard and the  Army Reserve use full-time personnel for duties that can include pay  processing, personnel actions, preparing and monitoring training  schedules, and other tasks that cannot be effectively executed through  the use of part-time personnel. While similarly composed of mostly part- time forces, the Army National Guard and the Army Reserve have distinct  missions and organizational structures.
Army  National Guard: The Army National Guard has a dual role as  both a state and a federal force and may be called upon to provide  trained and equipped units to (1) defend the 54 states and territories  of the United States, and (2) respond to overseas combat missions,  counterdrug efforts, reconstruction missions, and other operations as  needed. When mobilized for a federal mission, the Army National  Guard is under the command and control of the President. When they  are not conducting a federal mission, Army National Guard units are  under the control of the governors for state responsibilities. In  addition, Army National Guard forces can be mobilized under Title 32  of the United States Code for certain federally funded, domestic  missions conducted under the command of the governors. Past  missions included providing security at the nation’s airports in the  immediate aftermath of the September 11 terrorist attacks and  assisting the Gulf Coast in the aftermath of Hurricane Katrina. The  Chief of the National Guard Bureau is responsible for creating and  implementing policy and guidance so that National Guard  servicemembers meet the overarching standards set by DOD. In  addition, the Chief of the National Guard Bureau is responsible for  ensuring that Army National Guard soldiers are accessible, capable,  and ready to protect the homeland and to provide combat resources  to the Army.
Army  Reserve: The Army Reserve is a federal force that is organized  primarily to provide operational support to combat forces. The Office  of the Chief of the Army Reserve and the U.S. Army Reserve  Command are commanded by the same Lieutenant General who, by  law, is a member of the Headquarters, Department of the Army Staff.  The Chief of the Army Reserve is generally responsible for advising  the Secretary of the Army and the Chief of Staff of the Army on all  issues related to the Army Reserve Command.
section_title: Overview of DOD’s Sexual Assault Prevention and Response Program and Office
paragraphs: In response to statutory requirements, in 2005 DOD established its sexual  assault prevention and response program to promote the prevention of  sexual assault, encourage increased reporting of such incidents, and  improve victim response capabilities. DOD’s Sexual Assault Prevention  and Response Office (SAPRO) serves as the department’s single point of  authority, accountability, and oversight for its sexual assault prevention  and response program. SAPRO provides the military services with  guidance and technical support, and develops programs, policies, and  training standards for the prevention and reporting of, and response to,  sexual assault. Other responsibilities include overseeing the department’s  collection and maintenance of data on reported sexual assault incidents  involving servicemembers; establishing mechanisms to measure the  effectiveness of the department’s program; and preparing the  department’s mandated annual reports to Congress on sexual assaults  involving servicemembers.
DOD’s program allows servicemembers to make a restricted or  unrestricted report of sexual assault. Specifically, DOD’s restricted  reporting option is designed to allow sexual assault victims to  confidentially disclose an alleged sexual assault to selected individuals without initiating an official investigation and to receive medical and  mental health care. In cases where a victim elects restricted reporting,  first responders may not disclose confidential communications to law  enforcement or command authorities unless certain exceptions apply.  Improper disclosure of confidential communications and medical  information may result in discipline pursuant to the Uniform Code of  Military  Justice or other adverse personnel actions. In contrast, DOD’s  unrestricted reporting option triggers an investigation by a military criminal  investigative organization.
Each military service provides specific guidance on sexual assault, as  well as standard operating and reporting procedures for responding to  alleged sexual assault incidents. In contrast to the other services, the  Department of the Army is the only military service to combine its efforts  to prevent and respond to incidents of sexual assault as well as sexual  harassment. Specifically, based on the view that sexual harassment is a  potential precursor to sexual assault, the Secretary of the Army directed  that Army efforts to address sexual assault and sexual harassment be  restructured and integrated. Pursuant to this direction, the Army in 2009  established what is currently known as its Sexual Harassment/Assault  Response and Prevention (SHARP) program.
section_title: Applicability of DOD and Army Policies to the Army National Guard and the Army Reserve
paragraphs: The Army National Guard and the Army Reserve have primarily used  DOD and Department of the Army policies to implement their respective  sexual assault prevention and response programs. The Army’s sexual  assault prevention and response guidance is currently a chapter in the  Army’s general personnel regulation, and Department of the Army  SHARP officials told us that they are in the process of updating this  regulation to consolidate guidance currently contained in several different  Army policies, directives, and other related documents. In addition, the  officials said that they are developing a new Army regulation that will be  focused solely on the SHARP program, with separate chapters for the  Army National Guard and the Army Reserve. The officials expect this new  guidance to be issued in May 2017.
Under DOD’s and the Army’s current sexual assault prevention and  response policies, members of the Army National Guard and the Army  Reserve who are sexually assaulted while in certain duty statuses are  subject to the same provisions and are eligible for the same services  provided to active-duty servicemembers. For example, members of the  Army National Guard and the Army Reserve who are sexually assaulted  while performing active-duty service (as defined by Section 101(d)(3) of  Title 10, U.S. Code) or inactive-duty training are generally eligible for  DOD-provided medical treatment and counseling for injuries and illness  incurred from a sexual assault. Members of the Army National Guard and  the Army Reserve who report a sexual assault that occurred prior to or  outside of active-duty service or inactive-duty training are eligible for  some benefits, but not the full range of services. For example, all reserve- component members—regardless of their duty status at the time of the  assault—may file a restricted or unrestricted report; are eligible for timely  access to advocacy services from a SARC and a VA and appropriate  nonmedical referrals, if requested; and have access to Special Victims  Counsel. However, reserve-component members that report a sexual  assault that occurred prior to or outside of active-duty service or inactive- duty training are not eligible for medical treatment provided or paid for by  DOD. Detailed data on sexual assault incidents involving members of the  Army National Guard and Army Reserve appear in appendix IV.
section_title: Sexual Assault Prevention and Response Program Roles and Responsibilities
paragraphs: Various offices and personnel within DOD and the Department of the  Army play a role in preventing and responding to sexual assault incidents.
Under Secretary of Defense for Personnel and Readiness: The  Under Secretary of Defense for Personnel and Readiness is  responsible for developing the overall policy and guidance for the  department’s sexual assault prevention and response program,  except for criminal investigative policy matters assigned to the Judge  Advocates General of the military departments, the Staff Judge  Advocate to the Commandant of the Marine Corps, and the DOD  Inspector General and for legal processes in the Uniform Code of  Military  Justice. The Under Secretary of Defense for Personnel and  Readiness oversees SAPRO.
Assistant Secretary of Defense for Health Affairs: The Assistant  Secretary of Defense for Health Affairs is generally responsible for  advising the Under Secretary of Defense for Personnel and  Readiness on DOD’s sexual assault health-care policies, clinical  practice guidelines, and related procedures and standards of DOD  health-care programs for sexual assault victims.
Army  Deputy Chief of Staff, Army  G-1 (Personnel): The Deputy  Chief of Staff, Army G-1, is generally responsible for Army-wide  policies and the overall implementation, evaluation, and assessment  of the sexual assault prevention and response program.
Director, Department of the Army’s  SHARP Office: The Director is  responsible for program-management functions that include  coordinating policy development and training requirements; ensuring  that periodic program evaluations and assessments are conducted;  and collecting, recording, and maintaining data on sexual assault  cases.
Director of the Army  National Guard and Chief of the Army  Reserve: The heads of the Army reserve components are generally  responsible for developing, implementing, and monitoring sexual  assault prevention and response policies and programs in their  respective components.
Sexual Assault Response Coordinators (SARC): SARCs—military  or civilian employees at the discretion of the military services—serve  as the single point of contact for coordinating appropriate and  responsive care for sexual assault victims at an installation or within a  geographic area. SARCs oversee sexual assault awareness,  prevention, and response training; coordinate medical treatment,  including emergency care, for victims of sexual assault; and track the  services provided to a victim of sexual assault from the initial report  through final disposition and resolution.
Victim Advocates (VA):  Victim advocates (VA) report directly to the  SARC when performing victim advocacy duties and may provide  nonclinical crisis intervention, referral, and on-going nonclinical  support to adult sexual assault victims, such as providing information  on available options and resources to victims, and providing liaison  assistance with other organizations and agencies on victim care  matters.
Other Sexual Assault Responders: DOD’s instruction identifies  other responders, including judge advocates, medical and mental  health providers, criminal investigative personnel, law-enforcement  personnel, and chaplains, and specifies that commanders,  supervisors, and managers at all levels are responsible for the  effective implementation of both the policy and the program.
section_title: The Army National Guard and the Army Reserve Face Several Challenges with Implementation of Their Sexual Assault Prevention and Response Programs
paragraphs: The Army National Guard and the Army Reserve have implemented  sexual assault prevention and response programs, but face challenges in  areas such as staffing, budget management, and investigation timeliness  that may hinder program implementation. Specifically, the Army National  Guard and the Army Reserve have staffed their sexual assault prevention  and response programs, but the number, distribution, and types of  personnel assigned to these positions has produced challenges that may  limit the responsiveness of SARCs and VAs. Further, limited oversight of  budget development and execution may also impede effective program  implementation in the Army National Guard and the Army Reserve.  Finally, the authority to investigate sexual assault cases involving  reserve-component members varies, depending on duty status and  location, and the timeliness of investigations of some cases involving  Army National Guard soldiers has posed a challenge.
subsections: section_title: Army National Guard and Army Reserve Staffing Structures Hinder Achievement of Program Objectives
paragraphs: The Army National Guard and the Army Reserve have provided full-time  and collateral duty staff for their sexual assault prevention and response  programs; however, their approach to the number and distribution of  personnel assigned to the full-time positions and low fill rates for the  collateral duty positions may hinder their ability to achieve program  objectives. Further, the use of military technicians to fill full-time positions  poses challenges for program implementation due to their dual status  role, a prohibition from performing civilian duties while serving in military  capacity, and a requirement to provide compensatory time for after-hours  work. However, National Guard, Army Reserve, and Department of the  Army leadership have not evaluated how the existing mix and types of  full-time and collateral-duty staff affects program implementation, or their  ability to achieve program objectives.
subsections: section_title: The Reserve Components Face Staffing Challenges Due to Workload Imbalances Associated with the Number and Location of Full-Time SARCs and VAs and Unfilled Collateral Duty Positions
paragraphs: The National Guard and the Army Reserve have staffed their sexual  assault prevention and response programs with a mix of full-time and  collateral-duty personnel, but their staffing approach has produced  sizeable workload disparities among full-time program personnel, and the  collateral-duty positions have not been fully filled. Army Regulation 600- 20 specifies that the Chief of the National Guard Bureau and the Chief of  the U.S. Army Reserve will establish requisite staff positions within their  organizations and make resources available to adequately implement  program requirements, among other things. The National Defense  Authorization Act for Fiscal Year 2012 directed that at least one full-time  SARC and one full-time VA be assigned to each brigade or equivalent  unit level of the armed forces. The National Guard and the Army  Reserve have applied different interpretations of this requirement in their  assignment of full-time SARCs and VAs to manage sexual assault  prevention and response efforts in their respective components.  Specifically, the National Guard authorized one full-time SARC and one  full-time VA for the Joint Force Headquarters in each of the United States’  54 states and territories for a total of 108 full-time personnel. The Army  Reserve assigned its full-time personnel so that they are co-located with  its major commands, but it interpreted the statutory sizing construct as  having different applicability to SARCs and VAs and did not establish both  full-time positions at every location. Instead, the Army Reserve assigned  a full-time SARC to each of its 35 major commands, whereas only 13 of  these locations also have a full-time VA. While such decisions fall within  their designated authorities, we found that the National Guard’s and Army  Reserve’s current approaches to staffing pose several challenges to  program implementation.
The National Guard’s decision to allot the same number of full-time staff  to each state and territory has produced varying levels of responsibility  among individuals hired for the same position. Specifically, Rhode Island  has just over 1,000 square miles of land area and an Army National  Guard population of about 2,000 soldiers and is assigned the same  number of staff—one full-time SARC and one full-time VA—as Texas,  which has more than 260,000 square miles of land area and a Guard  population of about 18,600 soldiers. Figure 1 identifies the size of the  Army National Guard population served in each state and territory to  further illustrate the varying magnitude of responsibilities among full-time  SARCs and VAs serving in the Army National Guard.
According to Army National Guard officials, each state and territory  operates independently,  which limits the National Guard’s ability to shift or  realign SARC and VA positions from one state to another. Further,  officials stated that there were no additional personnel authorized to meet  the statutory requirement to establish SARC and VA positions, and  individual states have reallocated existing full-time support authorizations  to fill these positions.
Similar imbalances exist among the full-time program personnel assigned  to the Army Reserve’s major commands. For example, the 807th Medical  Command has one full-time SARC who is responsible for more than  9,000 soldiers assigned to units located in 16 states, whereas the 81st  Regional Support Command has one full-time SARC who is responsible  for fewer than 300 soldiers located in 4 states. Figure 2 lists major  commands and their program staff according to the size of the population  served to further illustrate the varying magnitude of responsibilities for full- time SARCs and VAs serving in the Army Reserve.
Officials we interviewed in the Department of the Army, the Army National  Guard, and the Army Reserve stated that workload disparities are  mitigated by using collateral-duty personnel, who perform SARC and VA  functions as a secondary responsibility to their primary military  occupation. However, Army National Guard and Army Reserve officials  explained that the part-time nature of reserve-component service  provides members limited time to complete the responsibilities of their  primary occupation, much less collateral duties. Further, we found the  actual number of collateral-duty SARCs and VAs available to assist full- time staff was less than the number authorized. Specifically, data  provided as of October 2016 showed that the Army National Guard had  assigned 237 collateral duty SARCs, or 89 percent of the 266 positions  authorized; and had assigned 1,388 collateral duty VAs, or 78 percent of  the 1,790 positions that had been authorized. In our survey of full-time  SARCs and VAs, 23 out of 68 Army National Guard respondents (34  percent) similarly reported that there were too few screened and  credentialed collateral-duty SARCs for their current workload, and 30 out  of 68 (44 percent) said that they had too few screened and credentialed  collateral-duty VAs for their current workload.
Army Reserve officials said that they currently do not have a process for  tracking the total number of collateral duty SARCs and VAs in the Army  Reserve, or how many of those positions are filled or vacant. Our visits to  selected installations suggested that a substantial gap exists between the  actual and authorized number of collateral duty SARCs and VAs. For  example, we visited one of the Army Reserve’s major commands and  were told that it had 7 trained collateral-duty VAs out of an authorization  for more than 200. During a visit to another major command, an official  told us it has 136 collateral-duty VAs out of an authorization for 328 and  that the command often relies on and uses another military service’s  SARCs to mitigate the effect of the shortage. In our survey of full-time  SARCs and VAs, 16 out of 27 Army Reserve respondents (59 percent)  said that they had too few screened and credentialed collateral-duty  SARCs for their current workload, and 21 out of 27 (78 percent) said that  they had too few screened and credentialed collateral-duty VAs for their  current workload.
section_title: Use of Dual-Status Military Technicians as Full-Time SARCs and VAs Poses Challenges for Program Implementation
paragraphs: The National Guard’s and the Army Reserve’s heavy reliance on dual- status military technicians to fill the full-time SARC and VA positions in  their components also poses challenges for program implementation in  three areas, due to: (1) their dual-status role, (2) a prohibition from  performing civilian duties while serving in a military capacity, and (3) a law  mandating compensatory time for after-hours work.
Dual-status role: The majority of military technicians are designated  as “dual-status,” which requires that they maintain membership in a  reserve component as a condition of their employment. As of October  2016, about 70 percent of full-time SARC and VA positions in the  National Guard were filled by dual-status technicians, and Army  Reserve officials told us that all of the full-time SARC and VA  positions in the Army Reserve were filled by dual-status technicians.  However, aspects of the military technician occupation limit the ability  of those serving in these positions from effectively executing the role  and responsibilities of a SARC or VA. For example, we identified  instances in which technicians would serve as a SARC or VA in their  civilian capacity and then would serve as part of the unit command  team when in their military capacity. This is problematic because  according to DOD policy only selected individuals—to include SARCs  and VAs—are authorized to receive a restricted or confidential report  of sexual assault from a victim that will not disclose the name of the  victim to the chain of command. In our survey of full-time SARCs  and VAs, 10 out of 61 Army National Guard respondents (16 percent)  and 6 out of 24 Army Reserve respondents (25 percent) indicated that  they served as part of the unit command team when on military duty.
Prohibition from performing civilian duties while serving in a  military capacity:  Under DOD policy, military technicians are  prohibited from performing their civilian duties while serving in a  military capacity unless the duties for both roles are identical.  However, due to the way some program personnel have interpreted  the 24/7 response capability requirement, this policy may conflict with  another DOD policy that designates SARCs and VAs as the single  point of contact for ensuring that a 24-hours-a-day, 7-days-a-week  victim response capability exists. Although Army Headquarters and  Army National Guard officials told us that the DOD Safe Helpline was  designed to provide this 24/7 response capability, some of the Army  National Guard and the Army Reserve SARCs and VAs that we  interviewed interpret DOD’s requirement for a 24/7 victim response  capability to mean that they are on call at all times regardless of their  civilian or military duty status—especially since they are the only  individuals in their respective units who have been assigned these  responsibilities. In our survey, 52 out of 68 of Army National Guard  respondents (76 percent) and 19 out of 27 of Army Reserve  respondents (70 percent) said that they continued to perform their  SARC or VA duties during drill weekends, while the remaining  respondents noted that they identified other individuals to perform  those duties.
Compensatory time for after-hours work: A law mandating that  military technicians receive compensatory time for after-hours work  and general expectations about what constitutes a “typical” work day  have raised concerns related to the requirement that SARCs and VAs  have around-the-clock availability.  During a site visit, one Guard  SARC told us that the SARC could easily claim comp time each week,  but did not feel right claiming the hours. Another Army Reserve SARC  we interviewed told us that the command had denied the SARC’s  request for compensatory time despite having spent hours beyond the  normal workday on the phone assisting victims. In our survey, 65 out  of 68 Army National Guard respondents (96 percent) and 100 percent  of Army Reserve respondents said that they accept calls about sexual  assault incidents “at any time.” In May 2016, the Director of the Army  National Guard issued guidance to its personnel directing that the  DOD Safe Helpline be used after regular duty hours. However,  Guard officials could not provide any information about the extent to  which this guidance has affected the amount of after-hours work  performed by its SARCs and VAs.
The National Defense Authorization Act for Fiscal Year 2016 directed the  Secretary of Defense to convert no fewer than 20 percent of dual-status  military technician positions identified as general administration, clerical,  finance, and office service occupations as of January 1, 2017 to civilian  positions. Department of the Army, Army National Guard, and Army  Reserve officials acknowledged that using civilians to fill full-time SARC  and VA positions would help to mitigate the challenges posed by using  military technicians. Army Reserve officials said that they had proposed  converting their full-time SARC and VA positions to civilian positions; as  of September 2016, they told us that they would be converting their 35  full-time SARC positions to civilian positions, but that conversion of their  full-time VA positions had not been approved at that time. Army National  Guard officials stated that they were still considering whether they would  convert any of their full-time SARC and VA positions.
section_title: National Guard, Army Reserve, and Department of the Army Leadership Have Not Comprehensively Evaluated Program Staffing
paragraphs: Staffing-related issues, such as those previously identified, have  persisted in part because National Guard and Army Reserve leadership  have not evaluated how their use of full-time and collateral-duty staff  affects program implementation, and Department of the Army leadership  has not evaluated how staff utilization affects the ability of their active and  reserve components to achieve program objectives. To help agencies run  efficient and effective operations, Standards for Internal Control in the  Federal Government states that management should establish an  organizational structure, assign responsibility, and delegate authority to  achieve the entity’s objectives. Further, the standards emphasize that  management should periodically evaluate the organizational structure to  ensure that it meets the entity’s objectives and has adapted to any new  objectives for the entity, such as a new law or regulation.
With additional authorizations unlikely, the combined number of full-time  SARCs and VAs in the active and reserve components coupled with the  general proximity of some active-duty and reserve forces presents a  possible opportunity to leverage the collective capabilities of the Army’s  active and reserve components. For example, some officials with the  Department of the Army, the Army National Guard, and the Army Reserve  supported the idea of sharing the Army’s active and reserve-component  resources to establish a regional support structure for the program. In  addition, a SHARP official from Army Forces Command stated that  staffing program personnel on a regional basis would align well with the  regional staffing approach that the Department of the Army has  successfully used to provide other victim services, such as its special  victims counsel and criminal investigators. However, we also met with  Army National Guard and Army Reserve officials who were opposed to  the concept of a regional approach. For example, some commanders in  the Army National Guard and Army Reserve expressed concerns about  who would be responsible for supervising SHARP personnel and  ensuring accountability for performance and response times, while the  chief of staff of a Reserve command commented that the idea needed  further analysis.
Officials with the Department of the Army said that active-component  SHARP personnel may provide support to Army National Guard and  Army Reserve personnel and that sexual assault victims may seek  assistance from any SARCs or VAs, regardless of their duty status or  service affiliation. However, Army National Guard and Army Reserve  officials said that if a reserve-component soldier goes to an active-duty  SARC for assistance, that SARC will often contact a Guard or Reserve  SARC to provide help to the victim. After the August 2015 SHARP  Program Improvement Forum, the Department of the Army SHARP  Program Office directed its staff to comprehensively evaluate the  structure used to staff full-time SHARP program personnel. In September 2016, officials from the Department of the Army stated that they plan to  consider the full-time staffing structure employed by the National Guard  and the Army Reserve in this evaluation.  However, the only  documentation provided by the Army about their planned evaluation was  a draft SHARP Campaign Plan, which referred to assessing the current  manning levels and caseload rate, and stated that the assessment would  consider staffing requirements, whether full-time staff should be civilian or  military, and staff turnover. Neither Army officials nor the draft  Campaign Plan provided details about what the assessment would  evaluate, such as the allocations of full-time and collateral-duty personnel  and the use of military technicians versus civilians for the positions, or  when the assessment would be conducted or completed. Without an  evaluation that assesses how staffing levels, staff allocation and  utilization, and the types of positions used for full-time and collateral-duty  staff affect the achievement of SHARP program objectives across all  Army components, the Department of the Army may be missing  opportunities to achieve efficiencies within current authorization levels  and will not have the information necessary to comprehensively develop  and support future resource requests.
section_title: Challenges with Communication and Development of Budget Guidance and with Oversight of Budget Execution Can Impede Program Implementation
paragraphs: The Army National Guard has developed budget guidance but has not  effectively communicated this guidance to its full-time program staff, and  the Army Reserve has not developed or distributed such guidance to the  full-time program staff at its subordinate commands. Further, while the  Department of the Army’s SHARP office has taken some steps to improve  oversight of how SHARP program funds are used, its efforts are focused  on the general execution of funds and do not provide visibility over the  National Guard’s and the Army Reserve’s use of program funds at the  state and command level. SARCs in the Army National Guard and the  Army Reserve serve as program managers who oversee implementation  and execution of the SHARP program, which National Guard and Army  Reserve officials told us includes the responsibility for annually submitting  budgets and accounting for program expenditures. Standards for Internal  Control in the Federal Government state that management should  internally communicate the necessary quality information to achieve the  program’s objectives. Further, management must clearly communicate  authorizations for proper execution of transactions to ensure only valid  transactions to use or commit resources are initiated or entered into.
For fiscal year 2015, the Army National Guard issued funding guidance  that specifically identified the types of training and other materials that  could be purchased with SHARP funds. However, this guidance was not  communicated or disseminated in its entirety to National Guard SHARP  personnel by the National Guard SHARP program office. Instead, in  2015, the Army National Guard’s SHARP office distributed a summary of  the guidance to its SARCs in the form of a two-page e-mail that consisted  of a general solicitation of funding requests; a paragraph that described  marketing, outreach, and administrative resources that could be  purchased with program funds; and another paragraph that addressed  personnel training expenditures. As a result, Army National Guard SARCs  and VAs expressed uncertainty in response to our survey about what  would qualify as an authorized use of program funds. Specifically, 19 out  of 30 Army National Guard respondents (63 percent) who provided  supplemental written responses to our survey question about whether any  additional funding guidance would be useful indicated a desire for  additional guidance about how to spend their funds, such as whether  spending on things such as conferences, training, and promotional items  were permissible. A summary of the Army National Guard’s funding  guidance was given to SHARP personnel, but a copy of the actual  guidance was not provided. Without communication and dissemination of  the National Guard Bureau’s funding guidance by the National Guard  SHARP program office, SHARP personnel in the Army National Guard  may not have the necessary information to develop their budgets and to  help ensure the efficient and effective use of program funds.
We also found that the Army Reserve Command SHARP program office  has not developed or communicated budget guidance for SARCs to use  in preparing annual budget requests or submitting expenses for approval.  For example, SARCs and other officials at the Army Reserve installations  that we visited told us that they did not receive budget guidance in 2015  from the Army Reserve Command’s SHARP office. Specifically, Army G-1 officials we spoke with during a site visit to an Army Reserve major  subordinate command stated they receive no funding guidance for the  SHARP program from Army Reserve Command, and from their  perspective there is no formal budget process. Similarly, during our visit  to another Army Reserve major command, the full-time SARC told us that  the SARC called the Army Reserve Command’s SHARP office three  times to ask for budget guidance, and that the guidance the individual  finally received was unclear and consisted of a spreadsheet and a due  date. Another full-time SARC at a different Army Reserve major  command told us that the SARC’s command would not allow program  funds to be spent without a specific authorization, and that the absence of  funding guidance from Army Reserve Command meant that the SARC  does not have the information needed to fill out these authorizations and  was thus limited in his or her ability to purchase promotional items and  plan activities. The concerns expressed during our site visits were further  corroborated by responses to our survey, with 15 out of 27 Army Reserve  respondents (56 percent) indicating that they had never received any  guidance from Army Reserve Command about how to spend SHARP  program funds.
Officials from the Army Reserve Command’s SHARP office said they  have provided budget guidance many times and that they were unaware  of a unit that asked for, but did not receive, requested guidance.  Specifically, officials stated that specific budget training was presented by  its Budget Integration  Office at the Annual SHARP training held in March  2015, and then again at the training provided in September 2016.  However, while the March 2015 training provided an overview of the  funding process and preparing a budget, the materials from that training  that we reviewed did not provide any information or other guidance about  what specific items should be included in their annual budget requests or  what would qualify as an authorized use of program funds. Without the  Army Reserve Command SHARP office developing and communicating  guidance that provides clear information about what to include in budget  requests, SHARP personnel in the Army Reserve will not have the  necessary information to develop their budgets and to help ensure the  efficient and effective use of program funds.
In addition to issues with budget guidance, we found that the Department  of the Army’s SHARP office has limited visibility over the use of SHARP  program funds by the states and territories in the National Guard and by  the Army Reserve commands. According to Army Regulation 600-20, the  Director of the Army’s Sexual Assault Prevention and Response Program  is responsible for the program’s management functions. Moreover,  Standards for Internal Control in the Federal Government state that  management should design control activities to provide, among other  things, accountability for resources, which can be done by periodically  comparing resources with the recorded accountability to help reduce the  risk of errors, fraud, misuse, or unauthorized alteration; and should  ensure that only valid transactions to use or commit resources are  initiated or entered into. Officials from the Department of the Army’s  SHARP office stated that they oversee the general execution of the Army  National Guard’s and the Army Reserve’s SHARP program budgets.  These officials also stated that in fiscal year 2016, they began conducting  midyear reviews to provide additional oversight of SHARP funding  execution in the Army National Guard and the Army Reserve by  comparing their spending plans to the Army’s long-term budget plan, also  known as the Program Objective Memorandum. However, they said that  these reviews are focused on the general execution of program funds by  the Army National Guard and the Army Reserve and do not provide the  Department of the Army’s SHARP office with visibility over expenditures  at the Army National Guard state or Army Reserve major command level.
As a result, the Army SHARP program office does not know the extent  that SHARP program funds provided to the states and commands are  actually being spent on the SHARP program, or the extent that SHARP  funds may have been moved by commanders to other areas of need. To  help address this concern, Army National Guard SHARP officials said that  in fiscal year 2016, they started requesting monthly execution reports  from the states to provide additional visibility over how SHARP funds are  being used. Similarly, officials from the Army Reserve SHARP program  office said that every month they review the difference in the command’s  funding allocations and execution, and will contact commands to discuss  any deviations as needed. While these are positive steps that may  facilitate increased oversight, this level of information had not yet been  included in the scope of the midyear reviews conducted by the  Department of the Army. Until the scope of the midyear reviews is  expanded to facilitate increased oversight of specific SHARP program  expenditures in the Army National Guard and the Army Reserve at the  state and command level, the Department of the Army will be limited in its ability to make informed budget decisions and to help ensure the  appropriate use of program funds.
section_title: Sexual Assaults Involving Reserve Component Members Can Be Investigated by Different Organizations, and Investigation Timeliness Can Pose a Challenge for Some Cases Involving Army National Guard Members
paragraphs: The organization responsible for investigating a sexual assault incident  involving a member of the Army reserve components varies depending on  the circumstances of the situation, and the timeliness of some  investigations involving Army National Guard members can pose a  challenge. Investigative  authority of sexual assaults involving a member  of the reserve component is determined by the victim’s or accused’s duty  status and location at the time of the incident and may be assigned to a  military criminal investigative organization, civilian law enforcement  organization, or, in certain incidents involving an Army National Guard  member, the National Guard’s Office of Complex Administrative  Investigations (OCI). Table 1 summarizes some factors that generally  determine which organization has the authority to investigate sexual  assault incidents that involve a member of the Army National Guard or  the Army Reserve.
While there are general guidelines for determining investigative authority,  there are various circumstances that may affect the extent to which such  incidents are investigated. For example, Army National Guard and Army  Reserve officials explained that the specific crimes enumerated under the  category of “sexual assault” in the Uniform Code of Military  Justice in  some cases differ from what is classified as a sexual assault under state  and local laws. Further, the National Guard Bureau has reported that  the military’s definition for sexual assaults may be more stringent than  state statutes, resulting in reports that may not be fully investigated by  civilian law-enforcement organizations or in situations where civilian  authorities have declined to prosecute. The National Guard Bureau has  also reported that the lack of a unifying code of military justice applicable  to all states is a particular challenge, because there can be considerable  variance among the different state codes of military justice as well as  state criminal statutes that may be applicable for members of the Army  National Guard. While these variations are consistent with existing law,  Army National Guard and Army Reserve officials stated that this can send  a mixed message to soldiers, because reserve component members  involved in a sexual assault incident may not receive the criminal  investigation that their active-duty counterparts routinely receive for the  same or similar offense.
To help address the instances when Guard members are not subject to  Uniform Code of Military Justice jurisdiction, in 2012, the National Guard  Bureau established its Office of Complex Administrative Investigations  (OCI) to conduct administrative investigations of sexual assault incidents  involving Guard members that were declined a criminal investigation by  civilian law-enforcement organizations. In 2014, OCI’s mission was  refined to include the investigation of sexual assault cases that occur  within the states but were not investigated by a military criminal  investigative organization due to the lack of jurisdiction or when it is  determined that the civilian law enforcement agency with jurisdiction did  not process a case sufficiently. OCI officials stated that they use DOD’s  definition of sexual assault to conduct their investigations and  substantiate or unsubstantiate an allegation of sexual assault based on  the evidence collected, and they then refer the case to the subject’s  commander for appropriate action.
While OCI helps to fill a gap in investigating sexual assault cases  involving National Guard members, timely investigations are a challenge  that may affect the extent to which OCI is used to conduct investigations.  According to National Guard guidance, OCI investigations should typically  be completed in 3 weeks. However, OCI investigation data show that of  the 79 investigations it conducted in fiscal year 2015, 57 percent or 45  cases took 6 to 9 months from the time a case was referred until when  the investigation was completed, and 39 percent or 31 cases took 3 to 6  months to complete. In contrast, we analyzed timeliness data on  investigations conducted by CID—the Army’s military criminal  investigative organization—that were recorded in DOD’s sexual assault  incident database and found that, for sexual assault cases investigated in  fiscal year 2015, 81 percent of the cases with Army National Guard  victims (68 out of 84) and 48 percent of the cases with Army Reserve victims (45 out of 93) were completed within 3 months of receiving the  request for an investigation.
According to OCI and CID officials, a timely investigation is important  because it becomes increasingly more difficult to gather useful evidence  the farther out an investigation is conducted from when the incident  occurred. During one of our site visits, we met with the state’s Adjutant  General who called OCI’s investigation delays “unconscionable”, and as a  result, said that they prefer to work with civilian law-enforcement  organizations instead. However, the Adjutant General acknowledged that  civilian law-enforcement organizations may decline to investigate, in  which case an OCI investigation is the only option. Figure 3 shows more  detailed information about OCI investigation time frames compared to  CID investigation time frames for fiscal years 2013 through 2015.
While OCI officials did not comment on the reasonableness of the typical  length of an investigation, they did express concern with the timeliness of  OCI’s investigations, and explained that the lengthy investigations are the  result of OCI not having enough full-time personnel to meet the current  demand for investigations. To assist in alleviating the issue, OCI officials  told us that OCI received additional funding from the National Guard  Bureau to increase the number of full-time trained investigators from 12 in  fiscal year 2015 to 18 in fiscal year 2016. While the number of  investigators has increased, OCI officials stated that they are only  authorized to place investigators on short-term active-duty orders for 1  year, which has resulted in constant turnover and has further exacerbated  delays because new personnel have to be trained each year. Army  National Guard and OCI officials also stated that a 2014 manpower study  conducted by the Army Manpower Analysis Agency validated OCI’s need  for five Army civilian investigator positions, which would provide greater  continuity in the office since those positions could be filled with personnel  that could serve longer than the 1-year limit that the military personnel  have been subject to. However, the officials added that funding was not  approved to fill the civilian positions. Since the 2014 study, OCI’s  caseload has increased. Specifically, referrals of cases to OCI for  investigation have consistently increased since the office was  established—starting with 3 referrals in fiscal year 2012, 20 referrals in  2013, 35 referrals in 2014, and more than doubling to 80 referrals in  2015. Based on the caseload increase since 2014, one senior OCI official  estimated that 22 investigators are needed to help with the current  backlog of cases. However, the official added that future funding for OCI  staffing is in question largely because the Department of the Army did not  validate OCI’s requirement for any personnel in its most recent long-term  budget plan, the Program Objective Memorandum for 2017–2021.
To help agencies run efficient and effective operations, Standards for  Internal Control in the Federal Government states that management  should establish an organizational structure, assign responsibility, and  delegate authority to achieve the entity’s objectives. Further,  management periodically evaluates the organizational structure so that it  meets the entity’s objectives. In addition, the Department of the Army’s  personnel regulation specifies that the Chief of the National Guard  Bureau will establish the requisite staff positions and make resources  available to adequately implement program requirements, among other  things. However, the Army and National Guard Bureau have not  reassessed OCI’s resources and timeliness since 2014 to take into  account OCI’s growing caseload and to determine how to improve the  timeliness of sexual assault investigations in light of the increased  number of requests for investigations conducted by OCI. Until the Army  and the National Guard Bureau reassess OCI’s resources and timeliness  to determine how to conduct sexual assault investigations more quickly  and to identify the resources needed to improve the timeliness of  investigations, Army National Guard victims may continue to experience  lengthy investigations and the ability to gather usable evidence will be  increasingly more difficult.
section_title: Medical and Mental Health Services Available to Army National Guard and Army Reserve Victims of Sexual Assault Vary Availability of Medical and Mental Health Services Varies for Army Reserve and Army National Guard Victims of Sexual Assault
paragraphs: The availability  of medical and mental health services paid for or provided  by DOD varies based on a National Guard or Reserve victim’s duty status  at the time of an assault. In addition, sexual assault victims serving in  the Army National Guard or in the Army Reserve must go through a  process to determine whether they are eligible for any follow-up or long- term medical and mental health care related to the assault that is  provided by or paid for by DOD; the Army National Guard established an  expedited process to make this determination, but the Army Reserve has  not, which can delay a soldier’s access to services.
Immediate emergency medical care is available at DOD or civilian health- care facilities—free of charge—to victims of sexual assault serving in the  Army National Guard and the Army Reserve, regardless of duty status at  the time of the assault. However, their eligibility  for follow-up or long-term  medical and mental health-care services that are paid for or provided by  DOD varies based on the victim’s duty status at the time of the assault.  Under DOD guidance, members of the reserve components, whether they  file a restricted or unrestricted report, shall have access to medical  treatment and counseling for injuries and illness incurred from a sexual  assault inflicted upon a servicemember when serving in an “eligible duty  status,” including active service and inactive duty training. For example,  a member of the Army National Guard or the Army Reserve who is  sexually assaulted while in an active-duty status, such as during the 2- week annual training period, would be eligible for treatment at a military  medical treatment facility or for care that is paid for by DOD.
For reserve-component members who are sexually assaulted while  serving in an “ineligible duty status,” DOD guidance specifies that they  may receive advocacy services from a SARC or VA employed by the  department, appropriate non-medical referrals, and a forensic medical exam at no cost, in accordance with statutory requirements. However,  members who are assaulted while serving in an “ineligible duty status”  are not eligible for medical or mental health-care services that are paid for  or provided by DOD. For example, a member of the Army National Guard  or the Army Reserve who is sexually assaulted while in a civilian status or  an Army National Guard member who is assaulted while in a state active- duty status would not be eligible for follow-up or long-term treatment at a  military medical treatment facility or for care that is paid for by DOD.  Rather, officials with the Army National Guard and the Army Reserve told  us that under these circumstances, a sexual assault victim would be  referred to state and local community resources to receive care.
In addition to duty status, there are other factors that may affect a  reserve-component member’s ability to obtain medical or mental health- care services following a sexual assault, such as the availability  of care in  rural areas, quality of care, and affordability of care.
Availability  of care in rural areas: As noted above, state and local  community medical and mental health resources are the primary  treatment options for reserve-component members who are sexually  assaulted while serving in an ineligible duty status, and are also  options for care paid for by DOD if a reserve component member was  assaulted in an eligible duty status. However, the availability  of such  resources for sexual assault victims can vary depending on the  geographic location of where the victim lives. Officials from the Army  National Guard, the Army Reserve, and SAPRO told us that some  reserve-component members who live in rural or remote areas may  have difficulty finding available resources. For example, an Army  National Guard SARC told us that soldiers who live in very rural areas  of the state might have a 3 to 4 hour drive to reach a medical facility  that can conduct a sexual assault forensic examination.
In our survey of full-time SARCs and VAs in the Army National Guard  and the Army Reserve, respondents reported varying degrees of  challenges in finding geographically accessible medical and mental  health care for sexual assault victims in their state or command.  Specifically, 10 out of 66 Army National Guard respondents (15  percent) and 10 out of 26 Army Reserve respondents (39 percent)  reported that it was extremely or moderately challenging to find  geographically accessible medical care. Further, 13 out of 66 Army  National Guard respondents (20 percent) and 13 out of 26 Army  Reserve respondents (50 percent) reported that it was extremely or  moderately challenging to find geographically accessible mental  health care. In March 2016, we identified similar challenges in our  report on the availability  of certified sexual assault forensic  examiners—noting that there were few or in some cases no  examiners available in rural areas, as well as a limited availability  of  examiners in some urban areas.
Quality of care: Some Army National Guard and Army Reserve  survey respondents highlighted concerns with the quality of medical  and mental health care services available to sexual assault victims in  their state or command. Specifically, 11 out of 66 Army National  Guard respondents (17 percent) and 2 out of 27 Army Reserve  respondents (7 percent) reported that they were aware of victim  complaints about the quality of medical care; and 12 out of 66 Army  National Guard respondents (18 percent) and 3 out of 26 Army  Reserve respondents (11 percent) were aware of victim complaints  about the quality of mental health care. SAPRO officials told us that  they have explored trying to address the availability  and quality of  care by using telemedicine, where a care provider communicates  electronically with the victim through a computer or tablet, which  would expand the choice of potential providers. However, they said  that state licensure laws prohibit DOD from delivering telemedicine to  a servicemember when he or she is in a civilian status, or is not  eligible for care in a federal facility.
Affordability of care: As previously noted, DOD does not pay for or  provide medical or mental health care to reserve-component soldiers  who are sexually assaulted while serving in an ineligible duty status,  which Army National Guard and Army Reserve officials stated raises  concerns about the affordability of care for these soldiers, particularly  for those who do not have health insurance. To help address  concerns about the affordability of care, Army National Guard and  Army Reserve officials developed a proposal for a pilot program  through the Army Family Action Plan process that would provide its  members with vouchers for treatment for duty-limiting mental health  conditions regardless of duty status. According to Army National  Guard officials, these vouchers could potentially be used for  counseling related to a sexual assault, as well as other issues such as  suicide prevention or substance abuse. The officials said that in April  2016, the Army Family Action Plan tabled this proposal until fall 2016,  due in part to concerns that it could conflict with insurance  requirements under the Affordable Care Act. However, Army National  Guard and Army Reserve officials explained that even if a reserve  member has health insurance, the out-of-pocket or copayment  expenses can still be significant enough to inhibit a sexual assault  victim from getting care. Army National Guard officials and members  of the Joint Psychological Staff met in July 2016 with leaders of the  Psychological Health Multi-Disciplinary Working Group to discuss  issues such as funding for the pilot program and voucher eligibility.  The group decided to present the pilot proposal at the October 2016  Reserve Psychological Health Council Meeting to further develop  support from other military services. They said that they also plan to  pursue the pilot through a federal legislative change proposal for fiscal  year 2019.
section_title: Process for Determining Care Eligibility Can Affect Reserve Soldiers’ Access to Care
paragraphs: The Army’s process for determining a reserve-component soldier’s  eligibility  for follow-up or long-term medical and mental health care can  negatively affect Army Reserve soldiers’ access to care because the  process in the Army Reserve is lengthy, and currently does not enable  Army Reserve victims to receive medical care if they choose to keep a  sexual assault incident confidential. The Army National Guard has  established an expedited process to determine whether sexual assault  victims are eligible for medical and mental health care that is provided by  or paid for by DOD, but the Army Reserve has not, potentially resulting in  a delay to a soldier’s access to services. Specifically, DOD’s instruction  specifies that National Guard and Army Reserve personnel who are  assaulted while serving in an eligible duty status, such as during inactive  duty training, are eligible for medical and mental health services that are  either provided or funded by DOD. However, before DOD will pay for or  provide any follow-up or long-term medical and mental health care for  sexual assault victims serving in the Army National Guard or the Army  Reserve, DOD requires that a line-of-duty determination be made to  establish whether the incident was service-connected (i.e., occurred in  the line of duty). According to Army Reserve officials, the line-of-duty  determination process can be lengthy and consequently can delay a  soldier’s access to certain long-term mental and medical health-care  services.
DOD’s sexual assault prevention and response instruction requires the  commander of the Army Reserve Command and the Director of the Army  National Guard to designate individuals to process line-of-duty  determinations for victims of sexual assault. The instruction also  provides that line-of-duty determination requests for sexual assault cases  that meet certain criteria must be decided within 30 days from the date of  the request. To meet this requirement, given the lengthy nature of the  determination process, the National Guard established an expedited line- of-duty investigation process for sexual assault victims, which Army  National Guard officials said generally enables them to make a  determination within 72 hours of when a request is made. Army National  Guard officials explained that for this process, the Army National Guard  developed an automated, secure web-based system that is accessible to  the Joint Force Headquarters SARC. The SARC inputs all line-of-duty  determination data into this system, and the determination is then  reviewed and approved as appropriate by the Army National Guard  SHARP Office.
However, the Army Reserve does not have an expedited version of the  line-of-duty determination process. Army Reserve officials told us that  they have no documented average or baseline timeframe for getting a  line-of-duty determination approved, and that the timeframe varies based  on the commander, the local facilities, and the needs of victim, among  other things. They explained that the determinations depend heavily on  the commander’s knowledge of the process, but acknowledged that the  Army Reserve SHARP program office should do a better job in assuring  that these requests are expedited. In July 2015, we reported on the time it  can take to complete the determination process—noting that more than  three-fourths of all Army Reserve line-of-duty investigations, including  those not related to sexual assault incidents, were overdue. We found  that for the Army Reserve, 82 percent of formal investigations took longer  than the required 75 days, and 80 percent of informal investigations took  longer than the required 40 days. In our survey, 15 out of 27 Army  Reserve respondents (56 percent) indicated that completing the line-of- duty process was “extremely or moderately challenging”, and 11 out of 27  Army Reserve respondents (41 percent) identified that ensuring victims  get care while waiting for a duty determination to be “extremely or  moderately challenging.” Figure 4 further details survey responses from  Army Reserve SARCs and VAs on challenges associated with the line-of- duty determination process.
During a site visit to an Army Reserve command, we met with Army  medical personnel who told us that because of the lengthy line-of-duty  process, it was possible that a victim in the Army Reserve who received  care at a DOD facility may be billed for his or her care before a  determination of duty status is made. Reserve officials also stated that the  primary issue associated with the line-of-duty process is that medical  costs for victims are not paid up front by DOD. As a result, victims will  either have to pay out of pocket, use their civilian health insurance if they  have any, or let the bills go into collection while they are waiting for the  line-of-duty determination to be approved.
As of September 2016, Army Reserve officials said that they plan to  include an expedited process for line-of-duty determinations for Army  Reserve sexual assault victims in the Army Reserve chapter of the new  Army SHARP regulation that is currently being drafted. However, Army  Reserve officials did not elaborate on the details about the planned  process or provide any documentation about how this process would be  implemented for the Army Reserve. In addition, they told us that they  continue to coordinate with Human Resources Command, the  Department of the Army SHARP office, and the Department of the Army  G1 medical policy office to consider methods to process line-of-duty  requests for Army Reserve victims that would allow the same access to  care and benefits as an active component victim. Without an expedited  line-of-duty determination process in the Army Reserve that provides for  more timely decisions, along with a method for tracking the length of time  to make the determinations so that officials have visibility over the extent  that they are meeting the required time frames, sexual assault victims in  the Army Reserve may continue to have to pay for their care up front,  even if an assault occurred during an eligible duty status, or else face  delayed access to care provided or paid for by DOD.
In addition to challenges posed by the length of the determination  process, Army Reserve victims who choose to keep the incident  confidential by making a restricted report have not been able to receive  medical or mental health care provided or paid for by DOD. The National  Defense Authorization Act for Fiscal Year 2012 provides that for restricted  reports, a member of the armed forces who is a victim of sexual assault  may elect to confidentially disclose the details of the assault and to  receive medical treatment, among other services specified in the law. In  addition, DOD guidance states that line-of-duty determinations may be  made without identifying  the victim to the command or DOD law- enforcement organizations to enable the victim to access medical care  and psychological counseling. However, Army Reserve officials  explained that if an Army Reserve victim wants to file a restricted report  but also wants to receive medical care covered by DOD, his or her  command would need some knowledge of the case to approve the line- of-duty determination. This is because the Army’s regulation on line-of- duty determinations requires that a formal investigation be conducted by  a commissioned or warrant officer who is senior in grade to the soldier  being investigated, and that an informal investigation be conducted by the  unit commander. Further, the Army regulation provides that a general or  special court-martial convening authority for the soldier is still the final  approving authority for either a formal or informal line-of-duty  determination.
In April 2016, DOD issued an updated version of its line-of-duty  instruction, which states that line-of-duty determinations for restricted  reporting of sexual assault cases require modified procedures in  accordance with DOD Instruction 6495.02. The Department of the  Army’s regulation has not been updated to align with DOD’s revised  instruction; however, Army Reserve officials said that they were provided  with new guidance in September 2016 that allowed limited health-care  benefits to be provided to reserve component victims with a restricted  line-of-duty determination. However, Army Reserve officials could not  provide a copy of this guidance, and did not elaborate on the details  about how these benefits would be provided to Reserve members, or  what the restricted benefits would include. Without a modified line-of-duty  determination process that enables soldiers to both file a confidential or  restricted report and receive medical or mental health care paid for or provided by DOD if an assault occurred while they were in an eligible duty  status, sexual assault victims in the Army Reserve may continue to have  to pay for their care if they choose to file a confidential or restricted report,  contrary to the provisions in the 2012 Act.
section_title: Conclusions
paragraphs: The Army National Guard and the Army Reserve have implemented  sexual assault prevention and response programs, but challenges with  staffing, budget management, investigation timeliness, and eligibility  determinations for care provided or paid for by DOD may hinder program  implementation over the long term if they are not addressed. Specifically,  the Army has not evaluated the use of program staff by its active and  reserve components, thus limiting its ability to discern, for example, how  workload disparities affect responsiveness to victims and its capacity to  address such issues within current resource levels. Further, Army  National Guard and Army Reserve staff will not be able to plan for and  use program funds without the necessary budget guidance, and Army  leadership will not be able to effectively oversee and account for program  funds without greater visibility of program expenditures at the state and  command level. Finally, the length of OCI investigations in the Army  National Guard and care eligibility determinations in the Army Reserve  may unnecessarily limit a reserve-component member’s access to the full  range of services generally available to victims of sexual assault in the  military.
section_title: Recommendations for Executive Action
paragraphs: We recommend that the Secretary of Defense take the following six  actions.
To help ensure that program staff are being used in an effective and  efficient manner, and to facilitate the consideration and identification of  total force solutions for staffing sexual assault prevention and response  and SHARP programs throughout the Department of the Army, direct the  Secretary of the Army, in coordination with the Chiefs of the National  Guard Bureau and the Army Reserve, to conduct an evaluation of staffing  approaches used to administer the sexual assault prevention and  response program, and consider opportunities to leverage resources  across all Army components. This evaluation should include an  assessment of the number and allocation of full-time and collateral-duty  personnel, the fill rates for program positions, and the types of positions  used.
To help ensure that Army National Guard and Army Reserve program  staff have the necessary information to develop their budgets and to help  ensure the efficient and effective use of program funds, direct the  Secretary of the Army to  (1) direct the Army National Guard SHARP Program Office to  communicate and disseminate its guidance on budget development  and execution for the SHARP program to all full-time SHARP program  personnel  (2) direct the Army Reserve SHARP Program Office to develop clear  guidance on budget development and execution for the SHARP  program and disseminate this guidance to its full-time SHARP  program personnel and  (3) direct the Director of the Army SHARP Program Office to expand the  scope of the midyear review to include monitoring and providing  oversight of SHARP program expenditures at the Army National  Guard state and Army Reserve command level.
To help ensure that sexual assault crimes involving Army National Guard  members are investigated in a timely manner, with a full investigation of  the offense regardless of the reserve component or duty status of the  victim, direct the Chief of the National Guard Bureau, in collaboration with  the secretaries of the military departments as appropriate, to reassess the  Office of Complex Administrative Investigation’s (OCI) timeliness and  resources to determine how to improve the timeliness of processing  sexual assault investigations involving members of the Army National  Guard, and identify the resources needed to improve the timeliness of  these investigations.
To help ensure that victims of sexual assault in the Army Reserve have  timely access to medical and mental health-care services without having  to pay for their care upfront, if they are eligible for care paid for or  provided by DOD, direct the Secretary of the Army to direct the Chief of  the Army Reserve to develop and implement an expedited line-of-duty  determination process for Army Reserve sexual assault victims, along  with a method for tracking the length of time to make the determinations.  When developing this process, the Chief should ensure that it allows  soldiers who wish to file a confidential or restricted report to go through  the determination process without disclosing their circumstances to the  chain of command.
section_title: Agency Comments and Our Evaluation
paragraphs: We provided a draft of this report to DOD for review and comment. In  written comments, DOD concurred with three recommendations, partially  concurred with two recommendations, and did not concur with one  recommendation. DOD also provided technical comments, which we  incorporated as appropriate. DOD’s comments are summarized below  and reprinted in their entirety in appendix V.
DOD concurred with our recommendation to conduct an evaluation of  staffing approaches used to administer the sexual assault prevention and  response program. In addition, DOD responded to our three budget- related recommendations as a group, concurring with two and partially  concurring with one. Specifically, DOD stated that it agreed with our  recommendation for the Army National Guard SHARP Program Office to  communicate and disseminate its guidance on budget development and  execution for the SHARP program to all full-time SHARP program  personnel. DOD also agreed with our recommendation that the Army  Reserve SHARP Program Office develop clear guidance on budget  development and execution for the SHARP program and to disseminate  this guidance to its full-time SHARP program personnel.
However, DOD partially concurred with our recommendation for the Army  SHARP Program Office to expand the scope of its midyear review to  include monitoring and providing oversight of SHARP program  expenditures at the Army National Guard state and Army Reserve  command level. Specifically, DOD agreed that the Army SHARP Program  Office can provide additional oversight of expenditures through the  addition of compliance inspections in the SHARP Organization Inspection  Plan, but disagreed that it be done by expanding its midyear review— stating that such a change seemed excessive and would indicate a lack  of trust in the ability of its organizations to manage and properly execute  their resources. Instead, DOD stated that the Army Headquarters SHARP  Program Office recommends that program managers in the Army  National Guard and the Army Reserve continue to monitor individual  transactions at the command level. We disagree that further monitoring  would be excessive or that it would indicate a lack of trust in the  components’ ability to manage and execute their resources; instead, we  see this as a step that will enable the Army SHARP program office to fully  execute the program management functions that it has been assigned.  For example, our report credits the Army SHARP program office with  overseeing the general execution of program funds by the Army National  Guard and the Army Reserve. However, our report also notes that this  level of monitoring does not constitute the type of control activity that is  necessary to help reduce the risk of errors, fraud, and misuse.
Additionally,  this level of monitoring does not help to ensure that financial  resources are committed to valid and appropriate efforts in support of the  SHARP program. As such, we continue to believe that our  recommendation for the Army SHARP program office to expand the  scope of its midyear review is valid.
Furthermore, DOD did not concur with our recommendation for the  Secretary of the Army, in collaboration with the Chief of the National  Guard Bureau, to reassess the Office of Complex Administrative  Investigation’s (OCI) timeliness and resources to determine how to  improve the timeliness of processing sexual assault investigations  involving members of the Army National Guard, and identify the  resources needed to improve the timeliness of these investigations. In its  written comments, DOD stated that OCI is a National Guard Bureau  organization and the administrative investigations that it conducts are  outside the limited scope of authority the Secretary of the Army may  exercise over the Army National Guard. As such, DOD suggested that the  recommendation be redirected to have the Secretary of Defense direct  the Chief, National Guard Bureau to perform this task in collaboration, as  necessary, with the Secretary of the Army and Secretary of the Air Force.  Further, DOD stated that the Chief of the National Guard Bureau is  prepared to direct the National Guard Bureau Joint Staff, Army National  Guard, and Air National Guard to analyze current OCI case load and  requirements, coordinate with the Department of the Army to formally  document OCI civilian and military staffing requirements necessary to  timely conduct investigations, and recommend procedures to make OCI a  program of record with appropriate funding and personnel levels. We  agree with DOD’s suggestion to redirect the recommendation to the Chief  of the National Guard Bureau and we have incorporated this change in  our report, as appropriate. Furthermore, we are encouraged by the  actions that DOD stated the Chief of the National Guard Bureau is  prepared to take, and believe that if implemented, they would meet the  intent of our recommendation.
Finally, DOD partially concurred with our recommendation to develop and  implement an expedited line-of-duty determination process for Army  Reserve sexual assault victims, along with a method for tracking the  length of time to make the determinations. DOD stated that it agrees the  Army Reserve should develop and implement an expedited line of duty  process, but added that doing so would not correct or mitigate the  challenges of funding behavioral health care for Army Reserve soldiers,  particularly those who require coverage for trauma experienced in a non- duty/non-paid status. DOD further stated that in response to this issue, a  recommendation has been forwarded to the Secretary of Defense to  consider directing a study into the feasibility of funding behavioral health  care services for servicemembers who experience sexual assault while in  a non-duty status. We recognize that an expedited line of duty process  will not address challenges that reserve soldiers may encounter if an  assault occurred in a non-duty status. We are encouraged by this  additional action, and believe that, along with implementing an expedited  line-of-duty determination process, additional efforts to try and overcome  the impediments to health care for reserve members who are sexually  assaulted while not in an eligible duty status could have a positive effect  on readiness of the force.
We are sending copies of this report to the appropriate congressional  committees, the Secretary of Defense, the Secretary of the Army, the  Chief of the National Guard Bureau, and the Chief of the Army Reserve.  In addition, this report will also be available at no charge on the GAO  website at http://www.gao.gov.
If you or your staff have any questions regarding this report, please  contact me at (202) 512-3604 or farrellb@gao.gov. Contact points for our  Offices of Congressional Relations and Public Affairs may be found on  the last page of this report. GAO staff who made major contributions to  this report are listed in appendix VI.
section_title: Appendix I: Army Reserve: Survey Questions Administered and Survey Responses
paragraphs: To obtain perspectives on issues regarding the Army’s sexual assault  prevention and response (SAPR) program, we conducted a web-based  survey of all full-time sexual assault response coordinators (SARC) and  victim advocates (VA) in the Army Reserve (see app. III  for the full scope  and methodology for the survey). Below are the questions from the  survey, and the results for the closed-ended questions. The responses to  the open-ended survey questions are not reprinted to help preserve the  confidentiality of the respondents. Of the 46 Army Reserve full-time  SARCs and VAs who received the survey, 27 Army Reserve SARCs and  VAs completed the survey, for a response rate of 59 percent. Some  survey questions were not answered by all respondents; those instances  are noted below for applicable survey questions.
subsections: section_title: SECTION A: Background
section_title: 1. Are you currently serving as a SARC or a VA? (Check one response.)
subsections: section_title: Response SARC VA
paragraphs: Response  Dual status military technician  Non-dual status military technician  Active  Guard or Reserve (AGR)  Active  Duty for Operational Support (ADOS)  Other (please specify)
section_title: 4. Approximately how many Army Reserve soldiers serve in your command?
section_title: 6. How many total reports—unrestricted and restricted—of sexual assault were filed by soldiers in units in your command in fiscal year 2015?
paragraphs: Number of respondents reporting each frequency of sexual assault reports  identity of the victim.
SECTION B: SARC and VA Responsibilities  7. When do you accept calls about sexual assault incidents? (Check all that apply.)
section_title: 8. How often do you request comp time or overtime pay when you accept calls about sexual assault incidents outside your normal scheduled duty hours?
section_title: 9. How often do you receive comp time or overtime pay when you accept calls about sexual assault incidents outside your normal scheduled duty hours?
section_title: 10. Who responds to calls about sexual assault incidents when you are on leave or unavailable?
section_title: 11. Have you ever been assigned any additional duties besides your role as a SARC or VA? Please do not consider your inactive duty training (IDT) responsibilities as an additional duty for this question.
section_title: 11a. How much of a positive or negative impact do your additional duties usually have on your ability to serve as a SARC or VA? (For those that answered “Yes” to question 11.)
section_title: 12. What type of position do you think would be most appropriate for the SARC and VA roles? (Check all that apply in each column.)
subsections: section_title: Response
section_title: Military technician DOD civilian, any service Army civilian Active Guard or Reserve (AGR) Other (please specify)
section_title: What other type of position do you think would be most appropriate for the SARC and VA roles?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
13. In what way(s), if any, would being a military technician affect the performance of SARC or VA  responsibilities?
Individual responses are not included in order to preserve confidentiality of respondents.
14. In addition to your work with sexual assault victims, do you think you spend too much, about the  right amount, or too little time on the following SARC or VA activities? (Check one response on each  row.)
Providing annual sexual assault unit refresher training  Providing oversight of or assistance to collateral duty SARCs  or VAs  Attending sexual assault related training to maintain  credentials  Entering information into DSAID  Other SHARP program administrative management tasks  Working with SHARP and SAPR counterparts in other  commands  Working with civilian and community-based sexual assault  victim assistance organizations  Traveling time within your command to perform any of your  SARC/VA  duties  Visiting units within your command  (SHARP) program.
SECTION C: Program Management and Collaboration  15. Do you record case information that is typically entered in DSAID  in any additional formal or  informal system (e.g., Excel spreadsheet, etc.) other than DSAID?
section_title: 15a. Why do you record case information in a system other than DSAID, and how do you use the information that you keep outside of DSAID? (For those that answered “Yes” to question 15.)
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
16. Does your command have too many, the right amount, or too few full-time SARCs or VAs for your  current workload? (Check one response on each row.)
section_title: 17. Does your command hold a regularly scheduled Sexual Assault Review Board (SARB)? This may also be referred to as the Case Management Group (CMG) meeting.
section_title: 17a. How often is the SARB (or CMG) scheduled to meet? (For those that answered “Yes” to question 17.)
section_title: 17c. How useful, if at all, are the SARB (or CMG) activities to your role as a SARC or VA? (For those that answered “Yes” to question 17.)
section_title: 17d. Why does your command not hold a regularly scheduled SARB (or CMG) meeting? (For those that answered “No” to question 17.)
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
18. Do you collaborate with the SAPR personnel outside of your command or outside the Army  Reserve?
section_title: In what ways do you collaborate, if any, with SAPR personnel outside of your command or the Army, and have you found that collaboration to be helpful?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
SECTION D: Reserve Component Service  19. Do you attend inactive duty training (IDT) while serving in the Army Reserve (or other Reserve or  Guard service)?
section_title: 19a. Who, if anyone, performs your SARC or VA responsibilities when you are in IDT status? (For those that answered “Yes” to question 19.)
paragraphs: Response  I continue to perform SARC or VA  responsibilities  Another guard or reservist performs SARC or VA  responsibilities  An active duty service member performs SARC or VA  responsibilities  A collateral duty SARC or VAC  performs SARC or VA  responsibilities  Victims are redirected to DOD Safe Helpline  Other (please specify below)
section_title: Who performs your SARC or VA responsibilities? (Other)
paragraphs: try  and send to higher command SARC as I have no full time VA  at this time.
section_title: 19b. While you are in IDT status, do you serve as part of the unit command team (e.g., command sergeant major, commander, first sergeant, etc.)?
section_title: 19c. At any time, has your role as a member of the unit command team conflicted with a sexual assault victim's ability to make a restricted report? (For those that answered “Yes” to question 19b.)
section_title: 19d. What challenges, if any, have sexual assault victims faced in making a restricted report while you were serving as a member of the unit command team?
section_title: SECTION E: Collateral Duty SARC and VA Personnel
section_title: 20. About how many authorized positions for collateral duty SARCs and VAs have been identified as necessary in your command?
paragraphs: See responses under Question 21.
section_title: 21. About how many collateral duty SARCs or VAs in your command have completed suitability screening and are credentialed?
section_title: 22. How much of a challenge, if any, are the following aspects of getting collateral duty SARCs or VAs credentialed or re-credentialed? (Check one response on each row.)
paragraphs: Identifying personnel who are willing to take  on SARC or VA  responsibilities as a collateral  duty  Having commanders complete the paperwork  and conduct interviews  Completing background suitability screening  process  Communicating with Reserve members  regarding appointment process or continuing  education training status  Completing 80-hour training course  Meeting continuing education training  requirements  Meeting the timeframes required for quarterly  DOD credentialing boards  Funding for orders and per diem for 80-hour  SHARP training courses  Other (please specify below)
What are the other challenges?
Individual responses are not included in order to preserve confidentiality of respondents.
23. Do you have too many, the right amount, or too few collateral duty SARCs or VAs for your current  workload?
section_title: 24. How easy or difficult is it for you to identify a collateral duty SARC or VA who is available to assist a victim when a sexual assault incident occurs?
section_title: 25. How easy or difficult is it for you to identify a collateral duty SARC or VA who the victim approves?
section_title: SECTION F: SARC and VA Resources
section_title: 26. What level of control do you have over how your command's SHARP funding gets spent?
section_title: 27. Have you ever received any guidance from the Army Reserve Command on how to spend SHARP program funds?
section_title: 27a. What additional guidance, if any, would be useful?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
28. Do you and/or units in your command maintain a community resource list of providers (e.g., local  rape crisis centers, hospitals and other medical facilities, law enforcement, mental health resources,  etc.) for your command's region or area of responsibility?
section_title: 28a. How are the providers included in the community resource list identified and updated?
section_title: 29. Have you or have units in your command established Memorandums of Agreement/Understanding (MOA/MOU) with any local medical or mental health providers to provide services to sexual assault victims?
section_title: 30. Do you feel it is necessary to have Memorandums of Agreement/Understanding (MOA/MOU) with local medical or mental health providers to provide services to sexual assault victims?
section_title: 31. In what way(s) do you think MOAs/MOUs are either necessary or unnecessary to have with local medical or mental health providers?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
32. In your experience, how many sexual assault victims in your command ever had difficulty obtaining  a SAFE  exam?
section_title: 33. What opportunities, if any, are there to leverage active component resources that could help improve the SHARP program for reserve component members?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
34. In general, how much of the Department of the Army training content do you use in the annual  refresher SHARP training given to units in your command?
Response  I only use the training content provided by the Army  I use some of the Army  training content, but supplement the content with  some Reserve specific information or other content  I do not use the Army training content and instead develop my own  Reserve-specific training content  Other (please specify below)
section_title: Other: How much of the Department of Army training do you use?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
35. How much of a challenge are the following aspects of the annual unit refresher SHARP training for  the units in your command?
36. What suggestions, if any, do you have to improve the annual unit refresher training for Reserve  members in your command?
Individual responses are not included in order to preserve confidentiality of respondents.
SECTION H: Challenges Related to Sexual Assault in the Army  Reserve  37. How much of a challenge is it for you and your collateral duty personnel to find geographically  accessible medical and mental health care for sexual assault victims in your command's region or area  of responsibility?
section_title: 38. Are you aware of any complaints from victims about the quality of medical and mental health care for sexual assault victims in your command's region or area of responsibility?
paragraphs: 39. IF YES TO QUESTION 38, what was the nature of the complaints you have heard about the quality  of medical and mental health care for sexual assault victims in your command's region or area of  responsibility?
Individual responses are not included in order to preserve confidentiality of respondents.
40. How much of a challenge are the following aspects of assisting a sexual assault victim?
41. In your experience, has combining sexual assault and sexual harassment into one Army SHARP  program resulted in confusion for soldiers?
section_title: 42. How has the broader definition of sexual assault affected the Army's sexual assault prevention and response efforts (i.e., the definition now incorporates sexual contact that includes touching any part of the body with the intent to arouse or gratify the sexual desire of another)?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
43. How likely, if at all, is local or state law enforcement to do the following?
44. How likely, if at all, is the Army Criminal Investigation Command (CID) to do the following?
section_title: SECTION I: Command Climate and Leadership
section_title: 45. Are the command climate survey results related to sexual assault issues for units in your command typically shared with you?
section_title: 46. Do subordinate unit commanders in your command consult with you to develop plans to address any sexual assault related issues identified in the command climate survey results?
section_title: 47. Which one of the following best describes how you communicate, if at all, with the Commanding General (CG) in your command about sexual assault issues?
section_title: 48. In your experience, how would you assess the level of support in your command for the following?
subsections: section_title: Senior officer support for victims Senior officer support to pursue investigation when allegation is against another senior officer Senior officer support to pursue investigation when allegation is against a lower ranking soldier Senior officer support for the SHARP program Senior enlisted support for victims Senior enlisted support to pursue investigation when allegation is against another senior enlisted Senior enlisted support to pursue investigation when allegation is against a lower ranking soldier Senior enlisted support for the SHARP program
section_title: 49. How would you assess the quality of the oversight and support for the Army Reserve SHARP program from the Army Reserve Command (USARC) and the Department of the Army Headquarters leadership and SHARP program offices?
section_title: SECTION J: Final Thoughts
section_title: 50. What changes, if any, could be made to improve the SHARP program staffing structure that could better serve Army National Guard and Army Reserve sexual assault victims, without increasing the total number of full-time SHARP personnel?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
51. Please provide any final thoughts you have on ways to improve the efficiency and effectiveness of  the SHARP program in the Army Reserve, or on how to better address the problem of sexual assault in  the Army Reserve, or in the Army or DOD overall.
Individual responses are not included in order to preserve confidentiality of respondents.
section_title: Appendix II: Army National Guard: Survey Questions Administered and Survey Responses
paragraphs: To obtain perspectives on issues regarding the Army’s sexual assault  prevention and response (SAPR) program, we conducted a web-based  survey of all full-time sexual assault response coordinators (SARC) and  victim advocate coordinators (VAC) in the Army National Guard (see app.  III  for the full scope and methodology for the survey). Below are the  questions from the survey, and the results for the closed-ended  questions. The responses to the open-ended survey questions are not  reprinted to help preserve the confidentiality of the respondents.. Of the  92 Army National Guard full-time SARCs and VACs who received the  survey, 68 Army National Guard SARCs and VACs completed the survey,  for a response rate of 74 percent. Some survey questions were not  answered by all respondents; those instances are noted below for  applicable survey questions.
subsections: section_title: SECTION A: Background
section_title: 1. Are you currently serving as a SARC or a VAC? (Check one response.)
subsections: section_title: Response SARC VAC
section_title: 2. For about how many years have you been in your current position as a National Guard JFHQ SARC or VAC?
section_title: 3. Which of the following best describes your position? (Check one response.)
paragraphs: Response  Dual status military technician  Non-Dual status military technician  Active  Guard or Reserve (AGR)  Active  Duty for Operational Support (ADOS)  Other (please specify)
section_title: 4. Approximately how many Army National Guard soldiers serve in your state?
section_title: 6. How many total reports—unrestricted and restricted—of sexual assault were filed by soldiers in units in your state in fiscal year 2015?
section_title: SECTION B: SARC and VA Responsibilities
section_title: 7. When do you accept calls about sexual assault incidents? (Check all that apply.)
section_title: 8. How often do you request comp time or overtime pay when you accept calls about sexual assault incidents outside your normal scheduled duty hours?
section_title: 10. Who responds to calls about sexual assault incidents when you are on leave or unavailable?
section_title: 11. Have you ever been assigned any additional duties besides your role as a SARC or VAC? Please do not consider your inactive duty training (IDT) responsibilities as an additional duty for this question.
section_title: 11a. How much of a positive or negative impact do your additional duties usually have on your ability to serve as a SARC or VAC? (For those that answered “Yes” to question 11.)
section_title: 12. What type of position do you think would be most appropriate for the SARC and VA roles? (Check all that apply in each column.)
subsections: section_title: Response Military technician DOD civilian, any service Army civilian Active Guard or Reserve (AGR) Other (please specify)
section_title: What other type of position do you think would be most appropriate for the SARC and VA roles?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
13. In what way(s), if any, would being a military technician affect the performance of SARC or VA  responsibilities?
Individual responses are not included in order to preserve confidentiality of respondents.
14. In addition to your work with sexual assault victims, do you think you spend too much, about the  right amount, or too little time on the following SARC or VAC activities? (Check one response on each  row.)
section_title: SECTION C: Program Management and Collaboration
section_title: 15. Do you record case information that is typically entered in DSAID in any additional formal or informal system (e.g., Excel spreadsheet, etc.) other than DSAID?
section_title: 15a. Why do you record case information in a system other than DSAID, and how do you use the information that you keep outside of DSAID? (For those that answered “Yes” to question 15.)
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
16. Does your command have too many, the right amount, or too few full-time JFHQ SARCs or VACs  for your current workload? (Check one response on each row.)
section_title: 17. Does your command hold a regularly scheduled Case Management Group (CMG) meeting?
section_title: 17c. How useful, if at all, are the CMG activities to your role as a SARC or VAC? (For those that answered “Yes” to question 17.)
section_title: 17d. Why does your command not hold a regularly scheduled CMG meeting? (For those that answered “No” to question 17.)
paragraphs: No respondents answered “no” to question 17 or provided a response here.
18. Do you ever participate in the sexual assault prevention and response advisory council (SAPRAC)  with other SARCs and VACs?
section_title: 18a. How often does the sexual assault prevention and response advisory council (SAPRAC) meet? (For those that answered “Yes” to question 18.)
subsections: section_title: Response
section_title: 18b. How often does the SAPRAC meet? (Other)
paragraphs: I am the regional rep for my region, I work closely with SAPRAC  on a weekly basis.
section_title: 18c. How useful, if at all, are the SAPRAC activities to your role as a SARC or VAC?
section_title: SECTION D: Reserve Component Service
section_title: 19. Do you attend inactive duty training (IDT) while serving in the Army National Guard?
section_title: 19a. Who, if anyone, performs your SARC or VAC responsibilities when you are in IDT status? (For those that answered “Yes” to question 19.)
paragraphs: Response  I continue to perform SARC or VAC  responsibilities  Another guard or reservist performs SARC or VAC  responsibilities  An active duty service member performs SARC or VAC  responsibilities  A collateral duty SARC or VAC  performs SARC or VAC  responsibilities  Victims are redirected to DOD Safe Helpline  Other (please specify below)
section_title: 19x. Who performs your SARC or VA responsibilities? (Other)
paragraphs: The SARC is on duty while I am IDT.  I continue to perform my SARC responsibilities, however, I will appoint the closest VA to provide assistance.  There is an mday SARC, but if I'm at drill and she is not in IDT status, I still respond and handle the issue.
section_title: SECTION E: Collateral Duty SARC and VA Personnel
section_title: 20. About how many positions for collateral duty SARCs and VAs are currently authorized in your state?
paragraphs: See responses under Question 21.
section_title: 21. About how many collateral duty SARCs or VAs in your state have completed suitability screening and are credentialed?
section_title: 22. How much of a challenge, if any, are the following aspects of getting collateral duty SARCs or VAs credentialed or re-credentialed? (Check one response on each row.)
paragraphs: Identifying personnel who are willing to take  on SARC or VA  responsibilities as a collateral  duty  Having commanders complete the paperwork  and conduct interviews  Completing background suitability screening  process  Communicating with Reserve members  regarding appointment process or continuing  education training status  Completing 80-hour training course  Meeting continuing education training  requirements  Meeting the timeframes required for quarterly  DOD credentialing boards  Funding for orders and per diem for 80-hour  SHARP training courses  Other (please specify below)
What are the other challenges?
23. Do you have too many, the right amount, or too few collateral duty SARCs or VAs for your current  workload?
section_title: 24. How easy or difficult is it for you to identify a collateral duty SARC or VA who is available to assist a victim when a sexual assault incident occurs?
section_title: 27. What level of control do you have over how your state’s SHARP funding gets spent?
section_title: 28a. What additional guidance, if any, would be useful?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
29. Do you and/or units in your state maintain a community resource list of providers (e.g., local rape  crisis centers, hospitals and other medical facilities, law enforcement, mental health resources, etc.) for  your state?  29a. How are the providers included in the community resource list identified and updated?
section_title: 30. Have you or have units in your state established Memorandums of Agreement/Understanding (MOA/MOU) with any local medical or mental health providers to provide services to sexual assault victims?
section_title: 32. In what way(s) do you think MOAs/MOUs are either necessary or unnecessary to have with local medical or mental health providers?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
33. In your experience, how many sexual assault victims in your state ever had difficulty obtaining a  SAFE  exam?
Number of respondents  2  4  7  25  12  15  Individual responses are not included in order to preserve confidentiality of respondents.
35. In general, how much of the Department of the Army training content do you use in the annual  refresher SHARP training given to units in your state?
Response  I only use the training content provided by the Army  I use some of the Army  training content, but supplement the content  with some Guard specific information or other content  I do not use the Army training content and instead develop my own  Guard-specific training content  Other (please specify below)
section_title: How much of the Department of Army training do you use?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
36. How much of a challenge are the following aspects of the annual unit refresher SHARP training for  the units in your state?
37. What suggestions, if any, do you have to improve the annual unit refresher training for Guard  members in your state?
Individual responses are not included in order to preserve confidentiality of respondents.
SECTION H: Challenges Related to Sexual Assault in the Army  National Guard  38. How much of a challenge is it for you and your collateral duty personnel to find geographically  accessible medical and mental health care for sexual assault victims in your state?
section_title: 39. Are you aware of any complaints from victims about the quality of medical and mental health care for sexual assault victims in your state?
paragraphs: 40. IF YES TO QUESTION 39, what was the nature of the complaints you have heard about the quality  of medical and mental health care for sexual assault victims in your state?
Individual responses are not included in order to preserve confidentiality of respondents.
41. How much of a challenge are the following aspects of assisting a sexual assault victim?
section_title: 43. How has the broader definition of sexual assault affected the Army's sexual assault prevention and response efforts (i.e., the definition now incorporates sexual contact that includes touching any part of the body with the intent to arouse or gratify the sexual desire of another)?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
44. How likely, if at all, is local or state law enforcement to do the following?
section_title: 45. How likely, if at all, is the Office of Complex Administrative Investigations to do the following?
section_title: 47. Do commanders in your state consult with you to develop plans to address any sexual assault related issues identified in the command climate survey results?
section_title: 48. Which one of the following best describes how you communicate, if at all, with The Adjutant General (TAG) in your state about sexual assault issues?
section_title: 49. In your experience, how would you assess the level of support in your state for the following?
section_title: 50. How would you assess the quality of the oversight and support for the ARNG SHARP program from the National Guard Bureau (NGB) and the Department of the Army Headquarters leadership and SHARP program offices?
section_title: SECTION J: Final Thoughts
section_title: 51. What changes, if any, could be made to improve the SHARP program staffing structure that could better serve Army National Guard and Army Reserve sexual assault victims, without increasing the total number of full-time SHARP personnel?
paragraphs: Individual responses are not included in order to preserve confidentiality of respondents.
52. Please provide any final thoughts you have on ways to improve the efficiency and effectiveness of  the SHARP program in the National Guard, or on how to better address the problem of sexual assault  in the National Guard, or in the Army or DOD overall.
Individual responses are not included in order to preserve confidentiality of respondents.
section_title: Appendix III: Scope and Methodology
paragraphs: To assess the extent that the Army National Guard and the Army Reserve  face any implementation challenges in their programs to prevent and  respond to sexual assault involving  their members (objective 1), we  reviewed the Department of Defense’s (DOD), the Department of the  Army’s, and the Army National Guard’s sexual assault prevention and  response guidance. We also interviewed headquarters-level officials with  the Department of the Army, the Army National Guard, and the U.S. Army  Reserve, as well as officials from DOD’s Sexual Assault Prevention and  Response Office (SAPRO), and asked about areas where they had  identified or experienced implementation challenges. In reviewing the  guidance and in our discussions with officials, we identified challenges  related to department and service-level program responsibilities  pertaining to the assignment of program staff, budget development and  execution, and investigations. We analyzed the guidance to assess the  extent to which responsibilities for program development and  implementation in the Army’s reserve components have been carried out  in these areas. In our interviews with officials, we also discussed the  applicability of and efforts to implement this guidance in the Army’s  reserve components and about whether the unique nature of reserve- component service poses any challenges to efforts to prevent and  respond to sexual assault. We compared the testimonial evidence  obtained during these interviews with relevant provisions in the guidance  and documents obtained to assess whether any of these provisions, or  the lack thereof, were contributing factors in the challenges identified.
In addition, we interviewed officials during site visits to four selected  installations—two for the U.S. Army Reserve and two for the Army  National Guard—on the implementation of sexual assault prevention and  response programs in their respective components. We selected the  locations for our site visits based on a variety of factors, such as  installations having a higher number of reported sexual assaults per total  number of soldiers, as well as to select installations of varying size and  geographic region. In addition, for the Army National Guard, we  considered the number of reported sexual assault incidents that were  referred to the Office of Complex Administrative Investigations. During  these visits, we met with sexual assault response coordinators (SARC),  victim advocates (VA), staff judge advocates, chaplains, medical and  mental health personnel, commanders, and non-commissioned officers.  At two of the site visit locations, we also met with special victims’ counsel  and investigators located at these sites. While we did not employ  methodology that would allow us to generalize to the four installations as  a whole or furthermore to all Army reserve component installations, the  information we gathered at these four installations enabled us to obtain  perspectives of a sample of commanders, servicemembers, and other  officials who implement and provide services or support to sexual assault  victims. In our discussions with noncommissioned officers at the site  visits, we used a standard set of questions and asked to meet with a  group of 3–10 full-time personnel, rather than putting part-time reservists  on orders to come in and meet with us. We asked to meet with soldiers  who worked in a mix of combat-arms and combat-support occupations,  and in ranks that would be closest to or would have the most interaction  with enlisted soldiers. By interviewing a small group of noncommissioned  officers at each installation we visited, we were able to obtain a non- generalizable sample of servicemember perspectives on the Army’s  sexual assault prevention and response, or SHARP, program and its  response to sexual assaults. In addition to our site visits, we also  interviewed officials in SAPRO and the Army Medical Command to obtain  a more comprehensive understanding of the Army’s efforts to implement  its sexual assault and prevention program in its reserve components.
To assess the assignment of SHARP program staff, we requested and  obtained data from the Army’s reserve components on the number,  geographical dispersion, and types of personnel used to staff key  program positions; the authorized end strength, or total number of  soldiers, for each state in the Army National Guard and for each Army  Reserve major command; and the locations of all subordinate units for  each Army Reserve major command. For the Army Reserve, we received  a data file with data as of April 2016 that we tabulated using SAS in  order to compile the summary level information for the categories of  interest, whereas for the Army National Guard we received the  information as of May 2016 already tabulated for our tables. For both  sources of data, we assessed the reliability of the information for our  reporting objectives by (1) reviewing the data for accuracy and  completeness, (2) reviewing available documentation about the data  collection and management, and (3) collecting information from  knowledgeable agency officials during interviews and by having them  complete a questionnaire about the data. We also compared the  collection and use of data with relevant DOD guidance and with the  Standards for Internal Control in the Federal Government, specifically the  importance of using appropriate, accurate, complete, and accessible  information to help management make informed decisions. We  determined that the data provided by the Army Reserve Command and  the Army National Guard were sufficiently reliable for reporting on the  number and types of SHARP program staff, and the number and  geographical dispersion of soldiers served by assigned SHARP program  staff. We also compared these results with relevant DOD and Army  guidance to assess the extent to which responsibilities for establishing  staff positions needed to adequately implement program requirements  have been met. In addition, we compared these efforts with the standards  for internal control about the importance of establishing an organizational  structure and assigning responsibilities that enable an agency or  department to operate in an efficient and effective manner and to achieve  its objectives.
In addition, we reviewed relevant documents related to budget  development and oversight, and identified any corresponding actions  taken and compared them with standards for internal control about the  importance of communicating quality information to make informed  decisions, especially as it relates to the prioritization of and accountability  for funds, and providing accountability for resources and ensuring that  only valid transactions to use or commit resources are initiated or entered  into.
Regarding the length of investigations, we obtained data from the  Defense Sexual Assault Incident Database (DSAID) from the Army and  from the National Guard Office of Complex Administrative Investigations  on the length of time it took to investigate sexual assault incidents  involving Army reserve-component victims from fiscal years 2012 through  2015, which is the period available in the DSAID database at the time of  our review. For cases reported to Department of the Army personnel, we  received a data file that included incident report date and date of  conclusion of the investigation for sexual assault incidents between 2012  and 2015, which enabled us to calculate the length of time it took to  investigate sexual assault incidents and tabulate this information for our  tables. For the National Guard, we received the information already  tabulated for our tables. For both sources of data, we assessed the  reliability of the information for our reporting objectives by reviewing the  data for accuracy and completeness, (2) reviewing available  documentation about the data collection and management, and (3)  collecting information from knowledgeable agency officials during  interviews and by having them complete a questionnaire about the data.  We also compared the collection and use of data with relevant DOD  guidance and with standards for internal control in the federal government  about the importance of using appropriate, accurate, complete, and  accessible information to help management make informed decisions. We  determined that the data provided by the Army and the Army National  Guard were sufficiently reliable for describing the length of time it takes to  investigate sexual assault incidents involving Army reserve component  victims. However, a limitation of these data is that they only include cases  with an Army Reserve or Army National Guard victim that were reported  to an Army or National Guard SARC; cases that were reported to or  handled by a SARC from another military service are not included in  these data.
To better understand and more comprehensively represent the  experiences and perspectives of key program personnel across the  Army’s reserve components, we administered and analyzed the results of  two web-based surveys, one for each component, that solicited the  perspectives on program guidance and implementation, among other  things, from all full-time SARCs and VAs identified within the Army’s  reserve components. We requested and were provided contact  information for all full-time SARCs and VAs/VACs in the Army Reserve  and Army National Guard from the components’ respective SHARP  program offices. These lists included 52 Army Reserve full-time SARCs  and VAs and 98 Army National Guard full-time SARCs and VACs.
To develop our survey questions, we sought input from knowledgeable  officials and reviewed relevant reports to identify themes and issues  affecting sexual assault prevention and response efforts in the Army  reserve components. Specifically, we interviewed officials from the  SHARP program offices of the Army Headquarters, Army Reserve, and  Army National Guard, and from the Army Medical Command for input on  our survey development. We also reviewed DOD and Army reports and  other research related to sexual assault and we reviewed our prior work  related to DOD’s sexual assault prevention and response program. We  also worked with GAO social-science survey specialists to develop our  survey questionnaires, applying generally accepted survey design  standards. Based on our review of information and consultation with  knowledgeable officials during the development of the survey, we  determined that slightly different variations of the survey were needed for  the Army Reserve and National Guard in order to tailor to questions or  response options to the specific components.
We took steps in the development of the questionnaires, the data  collection, and the data analysis to minimize any errors associated with  conducting surveys, such as differences in how questions are interpreted,  variations in respondents’ ability and knowledge or awareness for  answering a specific question, or how responses are entered in the  survey form. In addition to seeking input from officials in the Army  Reserve and Army National Guard SHARP program offices on our survey  questions, we also pretested the content and format of the questionnaire.  This pretesting helped us to determine whether (1) the survey questions  and response options were clear and unbiased, (2) the terms used were  accurate and precise, (3) respondents were able to provide the  information we were seeking, and (4) the questions and response options  were comprehensive. We chose the pretest subjects to include three  SARCs from the Army Reserve, and two Army National Guard SARCs.  We conducted two pretests in person and three over the telephone. We  made changes to the content and format of our final questionnaire after  our discussion with the program office personnel, as well as after each of  the first four pretests, based on the feedback we received. See appendix I  for the Army Reserve survey questions and response tabulations for each  closed question, and appendix II  for the Army National Guard survey  questions and response tabulations.
We administered the questionnaire through a Web-based application on a  secure GAO server. First we sent an e-mail announcement of the survey  to 52 Army Reserve full-time SARCs and VAs and 98 Army National  Guard full-time SARCs and VAs. Each SARC and VA was given a unique  password and username for completing the survey online. We sent up to  three follow-up e-mail messages to those who had not yet responded,  followed by an additional telephone outreach attempt for the remaining  nonrespondents. The questionnaire was available online for  approximately 6 weeks. Although our original survey was distributed to  the 52 Army Reserve individuals and 98 Army National Guard individuals,  we subsequently excluded from our recipient list 6 individuals from the  Army Reserve and 6 individuals from the Army National Guard, because  those individuals were unavailable  during the period of survey  administration for reasons such as deployment, maternity leave, extended  sick leave, or no longer serving in the SARC or VA position. Of the  remaining 46 Army Reserve full-time SARCs and VAs and 92 Army  National Guard full-time SARCs and VAs, 27 Army Reserve SARCs and  VAs, and 68 Army National Guard SARCs and VAs completed the  survey, for response rates of 59 percent for the Army Reserve and 74  percent for the Army National Guard.
We analyzed the electronic survey-response data set using SAS. We  first reviewed the data for electronic processing errors or other  inconsistencies in the data, and assessed the frequencies of item  nonresponse. After minor data cleaning and additional formatting, the  analysis included frequency distribution of responses to each question,  cross-tabulations of specific questions, and reviewing the open-ended responses to identify themes and areas of concern raised by the  respondents.
To identify medical and mental health-care services available to members  of the Army National Guard and the Army Reserve following a sexual  assault (objective 2), we reviewed relevant provisions in DOD,  Department of the Army, and Veterans Health Administration guidance  pertaining to medical and mental health-care services available to those  serving in the Army’s reserve components following a sexual assault. We  interviewed officials from SAPRO; Army Medical Command; and the  SHARP Program Offices for Army Headquarters, Army Reserve  Command, and the Army National Guard about the medical and mental  health services that are available to sexual assault victims serving in the  Army’s reserve components and the extent to which the availability  of  such care may be affected by a member’s duty status. Similarly, during  our visits to four selected locations, we met with behavioral health or  medical officials to discuss the medical and mental health-care services  that are available to reserve-component members who are sexually  assaulted, including any care that can be obtained through the local  community. We also discussed any potential barriers that may affect the  availability  of and access to such care by reserve-component members,  such as the line-of-duty determination process. In addition, we discussed  efforts to identify local medical and mental health providers. We also  interviewed a military sexual trauma coordinator at a Veterans Affairs  Medical Center to better understand the services and care that are  available to reserve-component members through the Department of  Veterans Affairs.
To identify the number of Army Reserve major commands with units  located in each state and territory, we requested and obtained data from  the Army Reserve Command on the number and size of each Army  Reserve major command’s subordinate units, and the locations of these  subordinate units. We received a data file that we tabulated using SAS in  order to compile the summary-level information for the categories of  interest. We assessed the reliability of the information for our reporting  objectives by (1) reviewing the data for accuracy and completeness, (2)  reviewing available documentation about the data collection and  management, and (3) collecting information from knowledgeable agency  officials during interviews and by having them complete a questionnaire  about the data. We also compared the collection and use of data with  relevant DOD guidance and with standards for internal control in the  federal government about the importance of using appropriate, accurate,  complete, and accessible information to help management make  informed decisions. We determined that the data provided by the Army  Reserve Command were sufficiently reliable for reporting on the number  of Army Reserve major commands that had units in each U.S. state and  territory.
In addition, to better understand and to more comprehensively represent  the perspectives of key program personnel within the Army’s reserve  components, we included questions on our web-based surveys  administered to full-time SARCs and VAs identified within the Army’s  reserve components regarding the medical and mental health-care  services for sexual assault victims. We analyzed the results of the  surveys to determine how the medical and mental health services  available at different installations were identified, and the availability  and  use of community medical and mental health-care services and  resources, and to gain a fuller understanding of the extent to which these  services may vary by location.
Regarding sexual assault incident data, we obtained data from the  Defense Sexual Assault Incident Database (DSAID) from the Army and  the Army National Guard on the number and type of reported sexual  assault incidents involving Army reserve-component victims from fiscal  years 2012 through 2015, which is the period available in the DSAID  database. For cases reported to Department of the Army personnel, we  received a data file that we tabulated using SAS in order to compile the  summary-level information, whereas for cases reported to National Guard  personnel, we received the information already tabulated for our tables.  For both sources of data, we assessed the reliability of the information for  our reporting objectives by (1) reviewing the data for accuracy and  completeness, (2) reviewing available documentation about the data  collection and management, and (3) collecting information from  knowledgeable agency officials during interviews and by having them  complete a questionnaire about the data. We also compared the  collection and use of data with relevant DOD guidance and with the  standards for internal control for the federal government about the  importance of using appropriate, accurate, complete, and accessible  information to help management make informed decisions. We  determined that the DSAID data provided by the Army and the Army  National Guard were sufficiently reliable for describing the reported  number and types of incidents and sexual assault victims. However, a  limitation of these data is that they only include cases with an Army  Reserve or Army National Guard victim that were reported to an Army or  National Guard SARC; cases that were reported to or handled by a SARC  from another military service are not included in these data.
We conducted this performance audit from July 2015 to February 2017 in  accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit 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.
section_title: Appendix IV: Data on Sexual Assault Reports with Army Reserve and Army National Guard Victims
paragraphs: Our analysis of reported sexual assault data from the Defense Sexual  Assault Incident Database (DSAID) for fiscal years 2012 through 2015  shows that the number of sexual assault reports in the Army National  Guard has increased each year over this period, and increased in the  Army Reserve from fiscal years 2012 through 2014. As we have  previously reported, the precise number of sexual assaults involving  servicemembers is not possible to determine, and studies suggest that  sexual assaults are generally underreported in the United States. Both  active and reserve component servicemembers may report an alleged  sexual assault using either the unrestricted or restricted reporting options.  An unrestricted report of an alleged sexual assault incident is provided to  the chain of command or a law enforcement organization for  investigation. A restricted report is a confidential report of an alleged  sexual assault that can be made without initiating an investigation or  notifying the chain of command.
In both the Army National Guard and Army Reserve, the majority of  reported incidents were made as unrestricted reports, as shown in figure  5. Data for Army National Guard victims are listed in two separate groups,  depending on whether an incident was reported to an Army sexual  assault response coordinator (SARC) or a National Guard SARC. For the  purposes of documenting sexual assault incidents in DSAID, officials from  the Department of Defense’s (DOD) Sexual Assault Prevention and  Response Office (SAPRO) said that DOD considers the National Guard  to be a separate military service. As a result, they told us that only  National Guard officials have visibility over cases entered into DSAID by a  National Guard SARC—even if the victim is a member of the Army  Reserve—and Army Headquarters Sexual Harassment/Assault Response  and Prevention (SHARP) program officials told us that they do not have  visibility over any cases involving Army National Guard soldiers that were  reported to a National Guard SARC. Similarly, Army National Guard  officials told us that the Army National Guard’s program office does not  have visibility over cases involving Army National Guard soldiers that  were reported to an Army SARC (active duty or Army Reserve).
These data could differ from the data that DOD reports to Congress,  because the data included in those reports do not necessarily represent  the service affiliation of the victim. According to DOD’s Annual Report to  Congress for fiscal year 2014, beginning with that annual report for fiscal  year 2014, SAPRO has reported sexual assault case data from DSAID  using the military service affiliation of the SARC handling the case.  SAPRO officials told us that the service affiliation data in DSAID refers to  the service affiliation of the SARC who is handling the case. In past fiscal  years, in the sexual assault incident data reported in the annual reports,  the service affiliation referred to the military service in which the victim  served.
The most commonly reported offenses from fiscal years 2012 through  2015 were rape and abusive sexual contact, as shown in figure 6.
In DOD’s annual report to Congress, the Army’s enclosed fiscal year  2015 Sexual Assault Report noted that the Army views the high rate of  reporting as an indicator of real progress in the Army SHARP program.  The report stated that the Army believes that the increase in the number  of reports of sexual assault reflected increased awareness and reporting,  and did not result from an increase in the number of sexual assault  incidents. It further noted that the unprecedented priority placed on sexual  assault prevention and response by Army leaders appeared to have  resulted in increased victim confidence.
section_title: Appendix V: Comments from the Department of Defense
section_title: Appendix VI: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact
section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, key contributors to this report  were Kimberly A. Mayo, Assistant Director; Tracy A. Barnes; Herbert J.  Bowsher; Renee S. Brown; Cynthia L. Grant; Amie M. Lesser; Amanda K.  Miller; Richard S. Powelson; and Amber H. Sinclair.
section_title: Related GAO Products
paragraphs: Military Personnel: DOD Has Processes for Operating and Managing Its  Sexual Assault Incident Database. GAO-17-99. Washington, D.C.:  January 10, 2017.
Sexual Assault: Actions Needed to Improve DOD’s Prevention Strategy  and to Help Ensure It Is Effectively Implemented. GAO-16-61.  Washington, D.C.: November 4, 2015.
Military Personnel: Actions Needed to Address Sexual Assaults of Male  Servicemembers. GAO-15-284. Washington, D.C.: March 19, 2015.
Military Personnel: DOD Needs to Take Further Actions to Prevent  Sexual Assault during Initial Military Training. GAO-14-806. Washington,  D.C.: September 9, 2014.
Military Personnel: DOD Has Taken Steps to Meet the Health Needs of  Deployed Servicewomen, but Actions Are Needed to Enhance Care for  Sexual Assault Victims. GAO-13-182. Washington, D.C.: January 29,  2013.
Military Personnel: Prior GAO Work on DOD’s Actions to Prevent and  Respond to Sexual Assault in the Military. GAO-12-571R. Washington,  D.C.: March 30, 2012.
Preventing Sexual Harassment: DOD Needs Greater Leadership  Commitment and an Oversight Framework. GAO-11-809. Washington,  D.C.: September 21, 2011.
Military Justice: Oversight and Better Collaboration Needed for Sexual  Assault Investigations and Adjudications. GAO-11-579. Washington,  D.C.: June 22, 2011.
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: 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: 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: 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: 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.
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.:  January 17, 2008.