Recommendation: The Secretary of the Army should develop targeted strategies for using its recruitment, training, and retention programs collectively to address key military physician gaps in a coordinated manner, and metrics that would monitor the effectiveness of its programs collectively in reducing gaps. (Recommendation 1)

Agency: Department of Defense
Status: Open

Comments: Army concurred with this recommendation. In October 2019, the Army reported that several steps have been taken, including creating a 6-year health professions officer retention bonus for critically short physician specialties; increased the number of Health Professions Scholarship Program scholarships to help decrease the overall physician shortfalls; and added a recruiting mission using Financial Assistance Program (FAP) scholarships to help decrease the physician shortfall in critical specialties. The FAP mission is to begin in fiscal year 2020. While the steps Army reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: The Secretary of the Navy should develop targeted strategies for using its recruitment, training, and retention programs collectively to address key military physician gaps in a coordinated manner, and metrics that would monitor the effectiveness of its programs collectively in reducing gaps. (Recommendation 2)

Agency: Department of Defense
Status: Open

Comments: Navy concurred with this recommendation. In October 2019, Navy officials stated that several steps have been taken, including exploring policy changes that would assist in meeting requirements. According to Navy officials, a working group has been formed which will address recruitment and retention of all critical specialties and plan to issue an end product by June 2020.

Recommendation: The Secretary of the Air Force should develop targeted strategies for using its recruitment, training, and retention programs collectively to address key military physician gaps in a coordinated manner, and metrics that would monitor the effectiveness of its programs collectively in reducing gaps. (Recommendation 3)

Agency: Department of Defense
Status: Open

Comments: Air Force concurred with our recommendation. In October 2019, the Air Force reported that several steps have been taken; including developing a sustainable process for improved marketing of key specialties to students and increasing the number of Health Professions Scholarship Program scholarships. While the steps Air Force reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: The Secretary of the Navy should track complete, accurate, and accessible information on the qualifications, performance, and progress of Navy AFHPSP medical students. (Recommendation 5)

Agency: Department of Defense
Status: Open

Comments: Navy concurred with this recommendation. In November 2018, the Navy changed its Navy Standard Integrated Personnel System (NSIPS) to allow tracking of qualification data fields. As of October 2019, the Navy reported it is taking steps to update NSIPS to track the complete performance and progress of AFHPSP medical students. While the steps Navy reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: The Secretary of the Air Force should track complete, accurate, and accessible information on the qualifications, performance, and progress of Air Force AFHPSP medical students. (Recommendation 6)

Agency: Department of Defense
Status: Open

Comments: Air Force concurred with this recommendation. In August 2018, the Air Force updated guidance to emphasize the requirement for accurate and complete reporting of qualification data of AFHPSP medical students. As of October 2019, the Air Force reported that it is partnering with the Army and Navy to secure a tri-service database to track students' performance across the continuum of learning. While the steps Air Force reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: The President of Uniformed Services University of the Health Sciences (USUHS) should track complete, accurate, and accessible information on the performance and progress of USUHS medical students. (Recommendation 7)

Agency: Department of Defense
Status: Open

Comments: Uniformed Services University of the Health Sciences concurred with our recommendation. In October 2019, the University reported that issues relevant to tracking its students continue to be researched and have offered to collaborate with the military departments. While the steps the University reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: The Secretary of the Navy should use information on medical student performance to evaluate Navy accession programs. (Recommendation 8)

Agency: Department of Defense
Status: Open

Comments: Navy concurred with this recommendation. In October 2019, the Navy reported that the Navy Standard Integrated Personnel System (NSIPS) now contains qualification data of AFHPSP medical students and also has some performance data of these students as they compete their post graduate training. NPSIS is capable of being queried and this data, according to the Navy, can be used to evaluate its accession programs. While the steps Navy reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: The Secretary of the Air Force should use information on medical student performance to evaluate Air Force accession programs. (Recommendation 9)

Agency: Department of Defense
Status: Open

Comments: Air Force concurred with our recommendation. In October 2019, the Air Force reported it plans to annually track and analyze information regarding its AFHPSP medical students and it is in the process of performing its annual review. While the steps Air Force reported demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: Congress should consider requiring that states notify parents/guardians of changes in students' federal special education rights when a student with a disability is moved from public to private school by their parent.

Agency: Congress
Status: Open

Comments: As of August 2019, Congress has not considered this matter.

Recommendation: The Assistant Secretary for Special Education and Rehabilitative Services should review information provided by states related to changes in federal special education rights when a parent places a student with a disability in a private school and work with states to correct inaccurate information.

Agency: Department of Education: Office of Special Education and Rehabilitative Services
Status: Open
Priority recommendation

Comments: Education generally agreed with this recommendation. However, the agency believes it is necessary to review the full documents containing information provided by states, so that it can determine the context in which the information was presented. We will coordinate with Education as appropriate to facilitate such a review. As of March 2020, the agency worked with relevant states to improve the information provided, and reviewed states' revised information to parents about federal rights of children with disabilities who are placed by parents in private schools. Education stated that this effort did not identify any inaccurate or inconsistent information. However, some states appear not to have modified language that Education previously identified as inaccurate. Education did not explain why it has determined that this information is now accurate. To fully address this recommendation, Education should either provide this explanation or have these states correct any inaccurate information.

Recommendation: To help improve the oversight and accountability of the military services' ROTC programs, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to coordinate with the military services to ensure that service ROTC guidance aligns with the updated DOD instruction.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation in written comments on our report. An April 2016 letter from the Director of Accession Policy, MPP, ASD(M&RA) to the DOD OIG states that the services reviewed and adjusted their current procedures and metrics in advance of the projected DODI publication date. However, in August 2018, we requested documentation of the services' efforts outlined in the letter to the DOD OIG and to verify that the services had taken the requisite steps to address our recommendation--namely, that their ROTC guidance aligned with the updated DODI. As of June 2020, DOD had provided documentation of updated service ROTC guidance, aligning with the updated DODI, for the Department of the Navy and the Air Force. However, according to DOD, the relevant Army Regulation update remains in draft, and thus the recommendation remains open. We will continue to monitor DOD's efforts to implement this recommendation and will update it as more information becomes available.

Recommendation: To help improve the oversight and accountability of the military services' ROTC programs, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to develop and implement, in conjunction with the Secretaries of the military services, a strategy to periodically communicate with Congress and other key stakeholders on ROTC program performance.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation in written comments on our report. The March 2018 version of DODI 1215.08 directs the services to provide criteria, annual assessments, and decisions about establishment/disestablishment of ROTC units to institution presidents. It also states that the ROTC resources summary report will be the basis for responding to congressional and public inquiries. In addition, updated service guidance from the Department of Navy includes a provision for annual communication with host institutions. The DODI did not include and DOD has not developed a strategy to periodically communicate with Congress on ROTC program performance, as we recommended. According to DOD, as of July 2020, a congressional communication plan has been developed for the ROTC program, including dates and topics for discussion. However, DOD has not yet provided documentation of this plan, and, thus, the recommendation remains open. We will continue to monitor DOD's efforts to implement this recommendation and will update it as more information becomes available.