Military Attrition:

DOD Could Save Millions by Better Screening Enlisted Personnel

NSIAD-97-39: Published: Jan 6, 1997. Publicly Released: Jan 10, 1997.

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Pursuant to a congressional request, GAO reviewed the attrition rates of first term, active-duty military personnel who are separated within the first 6 months of their enlistments, focusing on: (1) how much the services could save by achieving their goals for reducing 6-month attrition; (2) the adequacy of the data that the Department of Defense (DOD) uses to allow it to establish realistic goals for reducing attrition; and (3) the principal reasons that enlistees are separated from the services while they are still in training.

GAO found that: (1) all the services agree that reducing attrition is desirable; (2) three services have attrition-reducing targets ranging from 4 to 10 percent; (3) if the services reach their goals, they would realize immediate short-term annual savings ranging from around $5 million to $12 million; (4) the services may not be able to realize savings through reductions in their related training and recruiting infrastructure for many years, but possible long-term savings could range from more than $15 million to $39 million; (5) despite the fact that the services have these goals, DOD, at present, lacks consistent and complete information on the causes of attrition; (6) implementing arbitrary attrition-reduction goals could result in a reduction in the quality of recruits; (7) DOD's primary database for managing attrition cannot be used to adequately determine the reasons that recruits separate and to set appropriate targets for reducing attrition for two reasons: (a) the services interpret and apply DOD's uniform set of separation codes differently because DOD has not issued directives on how to interpret them; and (b) current separation codes capture only the official reason that an enlistee leaves the service; (8) thousands of recruits are separated in the first 6 months because the services do not adequately screen applicants for disqualifying medical conditions or for preservice drug use; (9) one reason that this screening is inadequate is that recruiters do not have sufficient incentives to ensure that their recruits are qualified; (10) thousands of recruits also are separated who fail to meet minimum performance criteria; and (11) recruits have problems meeting performance standards because they are not physically prepared for basic training and because they lack motivation.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: All services now test applicants for military service at MEPS.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should direct all the services to test applicants for drugs at the MEPS to prevent the enlistment of those who now test positive for drugs upon arrival at basic training.

    Agency Affected: Department of Defense

  2. Status: Closed - Not Implemented

    Comments: DOD stated that the purpose of MEPCOM's review of medical separations is for internal quality control; DOD believes that this does not represent a conflict of interest. DOD's position is that not only would new costs be incurred, but valuable information would be lost, if the review process were transferred to some other entity. Therefore, DOD will take no further action. MEPCOM will continue its education practices with respect to reviewing medical separation files.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should place the responsibility for reviewing medical separation files, which currently resides with the Military Entrance Processing Command, with an organization completely outside the screening process. Such a review would ensure that no conflict of interest interfered with the objective review of which medical conditions should have been detected by MEPS physicians.

    Agency Affected: Department of Defense

  3. Status: Closed - Implemented

    Comments: DOD has already revised its medical history form filled out by incoming applicants to include International Classification of Diseases codes for all medical disqualifications and waivers. After this form is fielded, it will allow DOD to collect this information into a database that can be used for analyses of the survivability of enlistees who receive medical waivers. In fact, the Walter Reed Institute of Research has already completed studies for DOD on the advisability of granting waivers to enlistees with asthma, flat feet, knee problems, and skin conditions. DOD has also tasked Walter Reed with using its studies to recommend whether further medical screening tests for applicants would be cost-effective. Walter Reed is now encouraging the development of a new asthma test that may be added to the MEPS examination in the future to screen out persons with severe asthma. DOD has issued guidance to the services on how to capture medical information on applicants' specific diagnoses. The database is now being developed that will allow DOD to determine whether new screening tests should be added to the Military Entrance Processing Station physical examinations.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should use DOD's newly proposed database of medical diagnostic codes to determine whether adding medical screening tests to the MEPS examinations and/or providing more thorough medical examinations to selected groups of applicants could cost-effectively reduce attrition at basic training.

    Agency Affected: Department of Defense

  4. Status: Closed - Implemented

    Comments: DOD has fielded a new medical history form with more precisely worded questions on past problems.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should direct the services to revise their "Applicant Medical Prescreening Form" (DD Form 2246) and their "Report of Medical History" (SF 93) to ensure that medical questions are specific, unambiguous, and tied directly to the types of medical separations most common for recruits during basic and follow-on training.

    Agency Affected: Department of Defense

  5. Status: Closed - Implemented

    Comments: DOD now requires all military applicants to list their past medical providers and insurers.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should direct the services to require all applicants for enlistment to: (1) provide the names of their medical insurers and providers; and (2) sign a release form allowing the services to obtain past medical information. Taking these two steps would provide the services with the tools to identify applicants' past medical problems and add an incentive for applicants to be forthcoming in reporting past medical conditions. To ensure that applicants are made aware that the services do follow up in researching medical histories, the services could determine how frequently they need to obtain applicants' medical records. To ensure that recruiters do not know which applicants will have their medical histories researched and that recruiters are not further burdened by paperwork, records should be obtained by someone who is not a recruiter. Medical records obtained through this process should be included in the file reviewed by the Military Entrance Processing Station (MEPS) physician at the applicant's preenlistment physical examination.

    Agency Affected: Department of Defense

  6. Status: Closed - Implemented

    Comments: Three services have directly tied the measurement of success for recruiters to their recruits' successful completion of basic training. In the Navy and the Army, recruiters are awarded points when their recruits graduate from basic training. In the Marine Corps, recruiters must replace each recruit who does not graduate. In the Air Force, the recruiter's goal system is not directly tied to recruits' successful completion of basic training, but attrition rates are considered for award purposes.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should require: (1) all the services to review and revise their recruiter incentive systems to strengthen incentives for recruiters to thoroughly prescreen persons with medical histories; and (2) the Marine Corps, the Air Force, and the Army to more closely link recruiting quotas to recruits' successful completion of basic training. The services may wish to consider such ideas as awarding recruiters partial credit for thoroughly screening applicants or using a "floating goal" system.

    Agency Affected: Department of Defense

  7. Status: Closed - Implemented

    Comments: DOD has revised the separations codes and is circulating them for internal comment. It plans to issue the codes and implementing guidance telling the services how and when to apply these codes. At this time, the codes have not been issued service-wide, and the guidance has not been drafted. In addition, GAO believes that the approach DOD used to revise the codes will not serve the intended objective.

    Recommendation: To provide a reliable database for DOD to manage attrition and for the services to set appropriate targets for reducing attrition, the Secretary of Defense should issue implementing guidance for DOD's separation codes.

    Agency Affected: Department of Defense

  8. Status: Closed - Implemented

    Comments: All four services have taken actions to encourage new recruits to undergo physical fitness training while awaiting basic training. For example, the Navy and the Army now offer recruits an advanced paygrade if they complete a list of tasks, including physical training, before they are sent to basic training. All four services now allow recruits access to military fitness facilities while they are in the Delayed Entry Program.

    Recommendation: To reduce the attrition of enlisted personnel during the first 6 months of their terms of enlistment, the Secretary of Defense should direct the Navy, the Marine Corps, and the Air Force to consider adopting a program similar to the Army's new Delayed Entry Program, under which recruits are encouraged to participate in voluntary physical activities with their recruiters and may be granted military retirement points for their participation. Also, direct the services to provide those in the Delayed Entry Program with access to military fitness facilities and to military medical facilities if they are injured while participating in physical activities with their recruiters.

    Agency Affected: Department of Defense

 

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