[Senate Hearing 111-701, Part 6]
[From the U.S. Government Printing Office]
S. Hrg. 111-701 Pt. 6
DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
2011
=======================================================================
HEARINGS
before the
COMMITTEE ON ARMED SERVICES
UNITED STATES SENATE
ONE HUNDRED ELEVENTH CONGRESS
SECOND SESSION
ON
S. 3454
TO AUTHORIZE APPROPRIATIONS FOR FISCAL YEAR 2011 FOR MILITARY
ACTIVITIES OF THE DEPARTMENT OF DEFENSE, FOR MILITARY CONSTRUCTION, AND
FOR DEFENSE ACTIVITIES OF THE DEPARTMENT OF ENERGY, TO PRESCRIBE
PERSONNEL STRENGTHS FOR SUCH FISCAL YEAR, AND FOR OTHER PURPOSES
__________
PART 6
PERSONNEL
__________
MARCH 10, 24; APRIL 28; MAY 12, 2010
__________
Printed for the use of the Committee on Armed Services
Available via the World Wide Web: http://www.fdsys.gov/
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COMMITTEE ON ARMED SERVICES
CARL LEVIN, Michigan, Chairman
ROBERT C. BYRD, West Virginia JOHN McCAIN, Arizona
JOSEPH I. LIEBERMAN, Connecticut JAMES M. INHOFE, Oklahoma
JACK REED, Rhode Island JEFF SESSIONS, Alabama
DANIEL K. AKAKA, Hawaii SAXBY CHAMBLISS, Georgia
BILL NELSON, Florida LINDSEY GRAHAM, South Carolina
E. BENJAMIN NELSON, Nebraska JOHN THUNE, South Dakota
EVAN BAYH, Indiana ROGER F. WICKER, Mississippi
JIM WEBB, Virginia GEORGE S. LeMIEUX, Florida
CLAIRE McCASKILL, Missouri SCOTT P. BROWN, Massachusetts
MARK UDALL, Colorado RICHARD BURR, North Carolina
KAY R. HAGAN, North Carolina DAVID VITTER, Louisiana
MARK BEGICH, Alaska SUSAN M. COLLINS, Maine
ROLAND W. BURRIS, Illinois
JEFF BINGAMAN, New Mexico
EDWARD E. KAUFMAN, Delaware
Richard D. DeBobes, Staff Director
Joseph W. Bowab, Republican Staff Director
______
Subcommittee on Personnel
JIM WEBB, Virginia, Chairman
JOSEPH I. LIEBERMAN, Connecticut LINDSEY GRAHAM, South Carolina
DANIEL K. AKAKA, Hawaii SAXBY CHAMBLISS, Georgia
E. BENJAMIN NELSON, Nebraska JOHN THUNE, South Dakota
CLAIRE McCASKILL, Missouri ROGER F. WICKER, Mississippi
KAY R. HAGAN, North Carolina GEORGE S. LeMIEUX, Florida
MARK BEGICH, Alaska DAVID VITTER, Louisiana
ROLAND W. BURRIS, Illinois SUSAN M. COLLINS, Maine
JEFF BINGAMAN, New Mexico
(ii)
C O N T E N T S
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CHRONOLOGICAL LIST OF WITNESSES
Active, Guard, Reserve, and Civilian Personnel Programs
march 10, 2010
Page
Stanley, Hon. Clifford L., Under Secretary of Defense for
Personnel and Readiness........................................ 6
Lamont, Hon. Thomas R., Assistant Secretary of the Army for
Manpower and Reserve Affairs................................... 30
Garcia, Hon. Juan M., III, Assistant Secretary of the Navy for
Manpower and Reserve Affairs................................... 38
Ginsberg, Hon. Daniel B., Assistant Secretary of the Air Force
for Manpower and Reserve Affairs............................... 42
Barnes, Master Chief Joseph L., USN (Ret.), National Executive
Director, Fleet Reservse Association........................... 71
Moakler, Kathleen B., Government Relations Director, National
Military Family Association.................................... 77
Cline, Master Sergeant Michael, USA (Ret.), Executive Director,
Enlisted Association of the National Guard of the United States 96
Holleman, Deirdre Parke, Executive Director, The Retired Enlisted
Association.................................................... 98
Strobridge, Steven P., USAF (Ret.), Director of Government
Relations, Military Officers Association of America............ 100
Military Health System Programs, Policies, and Initiatives
march 24, 2010
Cardin, Hon. Benjamin L., U.S. Senator from the State of Maryland 181
Rice, Charles L., M.D., Performing the Duties of the Assistant
Secretary of Defense for Health Affairs, and Acting Director,
Tricare Management Activity.................................... 185
Hunter, RADM Christine S., USN, Deputy Director, Tricare
Management Activity............................................ 192
Schoomaker, LTG Eric B., USA, Surgeon General of the U.S. Army,
and Commander, U.S. Army Medical Command....................... 194
Robinson, VADM Adam M., Jr., USN, Surgeon General of the U.S.
Navy, and Chief, Navy Bureau of Medicine and Surgery........... 218
Green, Lt. Gen. Charles B., USAF, Surgeon General of the U.S. Air
Force.......................................................... 227
Jeffries, RADM Richard R., USN, Medical Officer of the U.S.
Marine Corps................................................... 235
Military Compensation and Benefits, Including Special and Incentive
Pays
april 28, 2010
Carr, William J., Deputy Under Secretary of Defense for Military
Personnel Policy............................................... 313
Farrell, Brenda S., Director, Defense Capabilities and
Management, Government Accountability Office................... 317
(iii)
Murray, Carla Tighe, Senior Analyst, National Security Division,
Congressional Budget Office.................................... 323
Hosek, James R., Director, Forces and Resources Policy Center,
RAND National Security Research Division....................... 330
Reserve Component Programs
may 12, 2010
McCarthy, Hon. Dennis M., Assistant Secretary of Defense for
Reserve Affairs................................................ 369
McKinley, Gen. Craig R., USAF, Chief, National Guard Bureau...... 378
Wyatt, Lt. Gen. Harry M., III, USAF, Director, Air National Guard 379
Carpenter, MG Raymond W., ARNG, Acting Director, Army National
Guard.......................................................... 380
Stultz, LTG Jack C., USAR, Chief of Army Reserve; and Commanding
General, U.S. Army Reserve Command............................. 396
Debbink, VADM Dirk J., USN, Chief of Navy Reserve; and Commander,
Navy Reserve Force............................................. 401
Kelly, Lt. Gen. John F., USMC, Commander, Marine Forces Reserve;
and Commander, Marine Forces North............................. 409
Stenner, Lt. Gen. Charles E., Jr., USAF, Chief of Air Force
Reserve; and Commander, Air Force Reserve Command.............. 419
Stosz, RADM Sandra L., USCG, Acting Director of Reserve and
Training, U.S. Coast Guard..................................... 428
DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
2011
----------
WEDNESDAY, MARCH 10, 2010
U.S. Senate,
Subcommittee on Personnel,
Committee on Armed Services,
Washington, DC.
ACTIVE, GUARD, RESERVE, AND CIVILIAN PERSONNEL PROGRAMS
The subcommittee met, pursuant to notice, at 10:33 a.m. in
room SR-232A, Russell Senate Office Building, Senator Jim Webb
(chairman of the subcommittee) presiding.
Committee members present: Senators Webb, Hagan, Begich,
Graham, and Chambliss.
Majority staff members present: Jonathan D. Clark, counsel;
Gabriella Eisen, counsel; and Gerald J. Leeling, counsel.
Minority staff members present: Diana G. Tabler,
professional staff member; and Richard F. Walsh, minority
counsel.
Staff assistants present: Jennifer R. Knowles and Brian F.
Sebold.
Committee members' assistants present: Juliet Beyler and
Gordon Peterson, assistants to Senator Webb, Lindsay Kavanaugh,
assistant to Senator Begich; Clyde Taylor IV, assistant to
Senator Chambliss; and Adam Brake, assistant to Senator Graham.
OPENING STATEMENT OF SENATOR JIM WEBB, CHAIRMAN
Senator Webb. Good morning. The subcommittee will come to
order.
The subcommittee meets today to receive testimony on the
Active, Guard, Reserve, and civilian personnel programs in
review of the National Defense Authorization Request for Fiscal
Year 2011 and the Future Years Defense Program.
We will have two panels today. The first panel's witnesses
are the senior civilian officials in the Department of Defense
(DOD) and the military departments who are responsible for
personnel matters. I welcome The Honorable Clifford Stanley,
Under Secretary of Defense for Personnel and Readiness; The
Honorable Thomas Lamont, Assistant Secretary of the Army for
Manpower and Reserve Affairs; The Honorable Juan Garcia,
Assistant Secretary of the Navy for Manpower and Reserve
Affairs; and The Honorable Daniel Ginsberg, Assistant Secretary
of the Air Force for Manpower and Reserve Affairs.
Nobody wants to sit in this center seat, here? [Laughter.]
Dr. Stanley, feel free to be the major focal point of the
room. [Laughter.]
Our second panel will include witnesses drawn from
associations that represent and advance the interests of Active
Duty, Reserve, and retired servicemembers and their families.
I'll introduce our second panel when it convenes, but I wish to
express my appreciation to all our witnesses for joining us
this morning.
This is my first hearing as chairman of this subcommittee.
The subcommittee's jurisdiction extends to virtually all
matters of personnel policy--compensation, military healthcare,
military nominations, civilian personnel. I'd like to say, at
this point, that I intend for this subcommittee to exercise
continuous and active oversight of all our military personnel
matters, through hearings, through consideration of the
Department's budget and legislative proposals, and also through
day-to-day interaction with you and people who work with you,
and with our committee staff, as well. This hearing is one
part, and one part only, of that process.
There's no greater responsibility for Congress and military
leaders, as our witnesses all know, than to care and provide
for our servicemembers and for their families. This is a
concept of stewardship that I, and I think all of my
compatriots up here, feel about very strongly.
I grew up in the military, as many of you know. I know what
it's like to have a parent deployed. I also know what that
means, in terms of the responsibilities and the challenges of
family members. I can remember, at one point, when--my father
was career Air Force--I went to a different school in the fifth
grade, sixth grade, seventh grade, three different schools in
the eighth grade, the ninth grade, two different schools in the
tenth grade, from England to Missouri to Texas to Alabama to
California to Nebraska, and I know how that stresses the
families, and I know how important it is for us to always keep
that in mind.
I had the honor of serving with the Marine Corps infantry
in Vietnam. I understand a lot of the stresses of what it means
to be deployed in combat. I'm a father of a Marine NCO who had
some hard time in Iraq, and also the father-in-law of a Marine
infantry sergeant, who is now, at the age of 24, looking to be
deployed for the fourth time, coming this July.
That, coupled with the experience that I was able to gain
through 5 years in the Pentagon--one as a Marine officer, three
having responsibility for our Guard and Reserve programs, about
which I feel very strongly, and the other as Secretary of the
Navy--we got a very good look, in the 1980s, at the evolution
of the total-force concept, where the manpower challenges came
from, force-structure issues, and those sorts of things, and
they will come to play here, in this subcommittee, as we move
forward.
We're very cognizant of the fact DOD, supported by this
committee, has instituted many innovative programs over the
past several years in order to deal with the challenges that
have occurred since September 11, 2001.
I would mention, briefly, since this is my first hearing as
chairman of this subcommittee, that the Commonwealth of
Virginia has a long history, in terms of taking care of, and
being host to, one of the largest Active Duty and retired
military populations in our country, and I'm honored to serve
in the tradition of John Warner, who is no longer in the
Senate, but gave tremendous service to this committee and also
to the people of Virginia, in this area.
Our military is now engaged in its 9th year of combat
operations since September 11. Our Guard and Reserve components
have played critical roles during this period, in ways that
were not envisioned at the inception of the All-Volunteer Force
and, quite frankly, were not envisioned when I was Assistant
Secretary of Defense for Reserve Affairs.
It's also important for us to remember that the All-
Volunteer Force is not an all-career force. Sometimes we lose
that focus when we have people from the Pentagon coming over
here talking to us about programs. The Services do a very fine
job of attending to the needs of its career force, but we
should always keep in mind our stewardship to those who feel,
in the citizen-soldier tradition of this country, that they
should come in and obligate themselves for one enlistment, and
return to their communities.
The data that we received when we were formulating the GI
Bill was that 75 percent of the Army enlisted folks, and 70
percent of the Marine Corps, and roughly half of the other two
Services, leave the military on or before the end of their
first enlistment. Those numbers may have varied a bit with the
economic conditions right now, but those are the people that we
should never forget when we come up--in talking about these
other programs.
I'm look forward, greatly, to serving with our
subcommittee's ranking member, Senator Graham, in addressing
these challenges, and to ensure the long-term viability of the
All-Volunteer Force, not simply in numbers, but also in
quality. Everyone in this room is very familiar with Senator
Graham's service, not only on this committee, but also to our
country, continuing to serve as a colonel in the Air Force
Reserve. He brings valuable perspective, I think, as everyone
has seen, as we've attempted to work through the issues of the
Guantanamo Bay detainees and many other areas. He's served
regularly on Active Duty, and his duties have allowed him to
keep his finger on the pulse of the men and women in our
military today. He and I have collaborated on a number of
important issues over the past 3 years, and I welcome this
opportunity to work with him even more closely during the
months and years ahead.
The All-Volunteer Force is stressed by the past 9 years of
conflict. Having experienced multiple deployments, extended
deployments to Afghanistan, Iraq, this is especially true of
our ground forces. We're entering uncharted territory, in terms
of the long-term consequences of past rotation cycles and an
unsatisfactory deployment-to-dwell ratio that is only now
beginning to be corrected. Despite authorizing more than 55,000
additional Active-Duty servicemembers in the last year, today's
dwell times are still inadequate to ensuring the vital
recuperation, revitalization, and reset of the force and their
families. I'm concerned about that impact on the resilience of
the force, and we'll have some questions, during your
testimony, with respect to those issues.
This subcommittee faces a very clear and immediate
challenge, and that is in addressing the rising costs of
personnel. The combination of rising end strengths and an
increasing compensation package continues to send personnel-
related costs soaring. As Secretary Gates recently said, ``The
costs of healthcare are eating the Department alive.'' The
total personnel-related budget in the Department's fiscal year
2011 request, including the cost of providing healthcare to
servicemembers, their families, and retirees, amounts to $178
billion, or 32 percent of the overall DOD base budget. By
contrast, when I was Secretary of the Navy in 1987, I think the
entire Navy budget was right about $100 billion. Compare that
with the fiscal year 2003 total personnel-related spending,
including healthcare, amounted to $114 billion. That's an
increase of 56 percent from fiscal year 2003 to fiscal year
2011. By all accounts, that growth is going to continue.
Though these challenges are steep, we should also be
thankful for the successes that the Department and our Services
have enjoyed. The combination of patriotism, a stagnant
economy, a robust compensation package, including retirement,
healthcare, and education benefits, have allowed the Services
to achieve historic highs in recruiting and retention.
The quality of our people has also been sustained. Waivers
are down across the Services, test scores are up, and the vast
majority of new recruits are high school graduates, a higher
percentage than just a couple of years ago. These are all
strong indicators of the quality of character and service that
our people in uniform exhibit, across the board, day after day.
I look forward to hearing from both panels this morning. I
would encourage you to express your views candidly and, in
addition relating to what you see going well, to address your
concerns in those issues that you believe this subcommittee
needs to pay attention to. I, along with Senator Graham and our
colleagues, are dedicated to the prospect of ensuring that our
military remains the very best in the world.
Senator Graham.
STATEMENT OF SENATOR LINDSEY GRAHAM
Senator Graham. Thank you, Mr. Chairman.
As I listened to your opening statement, it really struck
me that, of all of the people in the Senate, you're clearly, I
think, the most qualified person to lead this subcommittee
right now, in the sense of your understanding the personnel
issues and just your personal history.
I want to also acknowledge that Senator Nelson was a
complete joy to work with, and he's gone to another
subcommittee. But, Mr. Chairman, I promise, when it comes to
the troops, we'll be as bipartisan as possible. I think we've
proven, between the two of us, that we can disagree, but also
find common ground on things that really do matter.
I was on a plane not long ago, and on that one plane I had
a young man come up to me who had just gotten out of the
military, he's going to Harvard, and he mentioned the GI bill
that you authored and we worked together to pass. It really is
working. There's a lot of implementation problems, but the fact
that this young man is able to get most of his college
education paid for, if not all, for serving 4 years, going to
Harvard, I think, is a testament to that bill. The guy sitting
right by me was a 28-year service Air Force colonel who is
going to transfer his benefits to his youngest daughter going
to college, and he was just telling me how much that meant to
his family. So, what we're able to accomplish there, with your
leadership, is really helping people.
The one thing I would suggest is, the President's budget--
I'm going to try to support as much as possible. The 1.4-
percent pay raise is the least we can do. We all wish it would
be more, but we do have budget problems up here. The
sustainability of healthcare is the issue, I think, for us on
this committee, and maybe the Congress as a whole, because, as
you talked about your time with the Navy, the budgets have
grown, the obligations are great, so few people are doing so
much for so long. Here we are, 9 years almost into this war,
and we're growing the military. I think that's a wise thing to
do. Personnel costs are 30-something percent of the budget, but
the healthcare component is 8 percent of the budget, growing,
it's going to be hard to sustain that. We haven't had a premium
increase in TRICARE since 1995. I want to do everything I can
to help the families and retirees and military members, but
eventually we're going to have to deal with that problem: How
do you sustain the growth of TRICARE and other medical benefits
within the budget before you start taking away from the
warfighter? That means some hard decisions are to come.
When it comes to ``Don't Ask, Don't Tell,'' I think we all
are waiting to see what this survey shows, and try to make an
intelligent decision based on input from the military, and I
would just urge my colleagues to let that run its course.
With that, Mr. Chairman, I will listen to the witnesses and
look forward to working with you. Again, I think, between the
two of us and the members of this committee, we can do some
good things for our men and women in uniform.
One last thought. Senator Chambliss has a bill that I've
been working with to lower retirement age for Guard and Reserve
members who have served on Active Duty since September 11,
2001. For every year they would serve, or 90 days they would
serve, they could retire a bit earlier, all the way down to 55.
That has a cost associated with it, but I think it's an idea
whose time has come, and I look forward to working with you to
see if we can make that possible.
Mr. Chairman, I look forward to being your ally and
colleague on this. Now is the time for me to shut up and let
the people who are in charge talk.
Senator Webb. Let me say that I can't think of a better
person to be working with than Senator Graham on these issues,
as well.
Senator Graham. Thank you.
Senator Webb. We've received statements for the record from
the Fleet Reserve Association, the Reserve Officer Association,
and, without objection they will be included in the record at
this point.
We've also received a statement for the record from Senator
Bill Nelson, who could not be here, and, without objection,
that will be included in the record after the principal
statements of our witnesses.
[The prepared statement of Senator Bill Nelson follows:]
Prepared Statement by Senator Bill Nelson
Mr. Chairman, thank you for allowing me to speak about one of the
last injustices plaguing the veterans' benefits system. I am talking
about the offset between the Department of Defense (DOD) Survivor
Benefit Plan (SBP) annuity and the Department of Veterans Affairs (VA)
Dependency and Indemnity Compensation (DIC) benefit.
SBP is an annuity paid by the DOD to survivors when either a
military retiree pays a premium as income insurance for their survivors
or when a servicemember dies on active duty. DIC is a survivor benefit
paid by the Veterans Administration. Survivors receive DIC when
military service caused the servicemember's death.
There is a longstanding problem in our military survivor benefits
system, the requirement for a dollar-for-dollar reduction of survivor
benefits from the SBP paid by DOD by the amount of DIC received from
the VA. I have fought for 9 years to eliminate the offset for SBP
beneficiaries whose loved ones purchased or earned this annuity.
Following the bloodiest of America's wars, President Abraham
Lincoln, in his second inaugural address, said that one of the greatest
obligations in war is to ``finish the work we are in; to bind up the
Nation's wounds; to care for him who shall have borne the battle, and
for his widow, and his orphan.''
To truly honor our servicemembers, we all agree that the U.S.
Government must take care of our veterans, their widows and orphans. In
keeping with that moral principle, we must repeal the unjust offset
that denies widows and orphans the annuity their deceased loved ones
have earned on active duty or purchased for them.
In the 2008 National Defense Authorization Act, we cracked the door
to eliminating the offset. In conference negotiations with the House,
we made some progress when we got a ``special payment'' of $50 per
month, which will increase to $310 per month by 2017 because of money
savings found in Tobacco Legislation passed last year.
Our efforts have been important steps in the right direction, but
they are not enough. We must meet our obligation to the widow and
orphan with the same sense of honor as was the service their loved one
had rendered. We must completely eliminate the SBP-DIC offset.
I commend many of the organizations represented by the witnesses
today for the support they have shown and hard work put in for full
repeal of the offset. I ask DOD to work with Congress to honor the
retirees, the fallen, and their families, and budget for full repeal of
the SBP-DIC offset.
Thank you, Mr. Chairman.
Senator Webb. With that, we would begin with Dr. Stanley,
and then move to Mr. Lamont, Mr. Garcia, and Mr. Ginsberg, in
that order.
Dr. Stanley, welcome.
STATEMENT OF HON. CLIFFORD L. STANLEY, UNDER SECRETARY OF
DEFENSE FOR PERSONNEL AND READINESS
Dr. Stanley. Good morning, Senator Webb and Senator Graham
and other distinguished members of the subcommittee.
First of all, let me just say I'm honored to be here, and
particularly with colleagues and, in some cases, just meeting
today.
As I speak to you concerning DOD's personnel programs and
readiness, for the past 3 weeks, as the Under Secretary of
Defense, I've had the honor of working and interacting with
some of the greatest men and women in uniform, DOD civilians,
contractors, and their great families. It is truly a privilege
to serve them in this position.
I first want to thank you for your support of these men and
women over the years. They have fought our wars, protected our
interests and our allies around the globe. I look forward to
working closely with this committee to improve support for
those in uniform, the civilian employees of the Department, and
their families.
Just a few short months ago, I appeared before you as
President Obama's nominee to be the Under Secretary of Defense
for Personnel and Readiness. At that time, I emphasized several
top priorities: the All-Volunteer Force, support to wounded
warriors, personnel readiness, family programs, and the stress
that is affecting our military today.
In terms of military personnel, the Services are
experiencing historic success in recruiting and retention. It
is a tribute to both the dedication of our military personnel
and to the patriotism of our Nation's citizens that we continue
to maintain an All-Volunteer Force of unprecedented quality
after more than 8 years in active combat operations.
I am happy to report that in fiscal year 2009, the Services
have had the most successful recruiting year of all the All-
Volunteer Force era. All four Active Services and all six
elements of the Reserve component achieved both numerical and
recruit quality targets for the first time, which is a banner
year. To continue to secure sufficient personnel for the Armed
Forces, the Department must provide a compensation package
comparable and competitive to the private sector at the same
time we balance the demands of an All-Volunteer Force in the
context of growing equipment and operational costs.
The Department continues this commitment through the
President's request for a 1.4-percent increase in military pay
for all servicemembers in the fiscal year 2011 budget, an
amount that equals earning increases in the private sector, as
measured by the Employment Cost Index. Of note, from the
January 1, 2002, through the January 1, 2010, pay raises,
military pay rose about 42 percent, and the housing allowance
rose by 83 percent. During the same period, private-sector
wages and salaries rose only 32 percent.
While there is little question that those increases were
necessary in the past, rising personnel costs could
dramatically affect the readiness of the Department. We are at
a point where discretionary spending offers the best ability to
target specific skills, and the quality and quantity of those
filling such positions. I believe the Services still require
the use of special pay and bonuses to ensure sufficient
operational readiness and our mission.
Our military forces maintain an exceptionally high level of
readiness, but multiple deployments to Iraq and Afghanistan
have certainly increased the stress on our servicemembers and
their families. We have a number of initiatives underway to
address this stress, and have set clear limits and goals for
the deployment lengths and the amount of time, or ``dwell,''
between deployments.
To that end, we have limited our unit deployments to 1 year
in theater, a minimum of 1 year between deployments for our
Active component. Our goal is to increase the time between
deployments to 2 years for every year deployed, commonly called
a 1-to-2 dwell ratio. For the Reserve component, we have
limited the mobilization period to 1 year, and we strive to
have a minimum 3-year break between mobilizations. The goal of
the Reserve component dwell ratio is 1 year mobilized, with a
5-year break between mobilizations, or a 1-to-5 dwell ratio.
Although we are not there yet, we are making progress toward
those goals.
The Department is focused on care for our wounded, ill, and
injured military members. As Secretary Gates stated last month,
aside from winning the wars themselves, this is the
Department's highest priority. Initiatives are currently
underway to achieve a seamless transition from Active Duty to
veteran status, and to increase cooperation between DOD and the
Department of Veterans Affairs (VA). In addition, efforts to
create a Disability Evaluation System that is simpler, faster,
fairer, and more consistent are underway.
Finally, in support of President Obama's commitment, the
Department is partnering with the VA to establish Virtual
Lifetime Electronic Records that will improve veteran care and
services through increased availability and administrative and
health information.
We are also committed to further improving support to our
military families. For fiscal year 2011, we have requested for
a 41-percent increase in family assistance baseline funding
across the Department to ensure that we are on target, in the
sense of investing in programs that are needed by
servicemembers and their families. We have initiated an
extensive strategic planning process to address the current
issues facing family readiness programs. This begins with a
thorough assessment of existing needs, programs, and related
issues.
Unfortunately, we have had stumbles in this area. As I'm
sure you're aware, we announced a temporary pause to the My
Career Advancement Account (MyCAA) program on February 16,
2010. Due to unforeseen, unprecedented, but welcome, demand in
enrollments that overwhelmed the infrastructure, we nearly
reached the budget threshold. While it was necessary to pause
the program immediately, we failed to communicate properly the
reasons for the pause. Over the past few weeks, DOD has worked
tirelessly on mapping out solutions, for both the short and
long term, that honors our commitment to our military spouses
while accounting for fiscal realities.
Our proposals are in the final stage of approval and we
hope to restart the program very soon. We know we must make a
concerted effort to restore our credibility and confidence with
our military spouses, servicemembers, and the American public.
Our military has proven its resilience during the most
challenging of times, but the stress on the force is obvious.
The Department's civilian and military leadership remain
focused on employing numerous strategies to reduce the
incidence of suicide in the Armed Forces. In calendar year
2009, there were a total of 312 suicides, 285 Active component
and 26 in the Reserve component, marking an increase, up from
268 in 2008. I know this committee shares our belief that even
one suicide is too many.
There are many other critical issues facing the Department
and this Nation, and I am exceedingly grateful to this Congress
and this committee for their continuous commitment to
supporting our men and women in DOD.
I look forward to your questions and thank you for your
time.
[The prepared statement of Dr. Stanley follows:]
Prepared Statement by Hon. Clifford L. Stanley
Mr. Chairman and members of this distinguished subcommittee, thank
you for inviting us to testify before you.
As I humbly assume my role as the new Under Secretary of Defense
for Personnel and Readiness, I am resolute in my determination to
honor, protect and improve the lives of U.S. airmen, soldiers, sailors,
and marines. I am here today to describe our mission as I see it and
share my thoughts on how compassion, excellence and heightened sense of
urgency will help me and my organization fulfill our duty.
I am mindful we are at war and we must prevail. We win when we help
our troops succeed in combat, and be healthy and happy with their
families when at ease. We win when our troops can be confident their
families have easy access to the resources and support they need while
their loved ones are deployed. Maintaining our incredible All-Volunteer
Force is our highest priority as we strive to recruit, attract, retain,
and reward American's best and brightest, and their families.
active duty
Recruiting
After more than 5 years of the most challenging recruiting
environment since the inception of the All-Volunteer Force (AVF) in
1973, the Services emerged in fiscal year 2009 with the most successful
recruiting year of the AVF era--all four Active Services and all six
Reserve components achieved both numerical and recruit quality targets
for the first time, a banner year. Previous years were marked by a
growing economy, low unemployment, reluctance of influencers of youth
to recommend military service, propensity among youth themselves at an
all-time low, and recruiting goals of the Army and Marine Corps
increasing. Yet since 2005, the Services met or exceeded recruiting
goals--the AVF concept has proven itself amidst some of the greatest
stressors it could face.
The recruiting environment has now changed. Unemployment has risen
considerably. Generally, times like this make recruiting less
challenging, and a regrettable trend in national unemployment operates
to the advantage of those who are hiring, including the U.S. military.
In addition, interest in the military among young people has increased.
On the other hand, challenges remain--the lower likelihood of
influencers of youth (e.g., parents and teachers) to recommend service,
a large and growing proportion of youth population who are ineligible
to serve in the military principally as a consequence of rising
obesity, high numbers of youth going to college directly from high
school, and the continuing concerns about overseas contingency
operations with its concomitant high operations tempo, particularly the
announced increases in force levels in Afghanistan. Therefore, we are
in uncharted waters--with significant factors, both negative and
positive, directly affecting military recruiting efforts.
As a result, we continually review our recruiting programs to align
funding and policies with current realities, recognizing that stable
and adequate investments in recruiting resources are necessary to
maintain success, especially in the long term. These reviews have
allowed the Services to reduce recruiting resources in fiscal year 2010
and 2011. While this results in a decreasing reliance on bonus
incentives to meet recruiting goals, each Service knows it must be
judicious in its cuts--reducing budgets gradually, and in the right
places--using those targeted incentives to ensure we attract high
quality youth into our most critical skills. We are mindful of the
past, when fluctuating resources--up in tough recruiting environments,
down in favorable ones--jeopardized recruiting missions, often
resulting in sporadic failures.
The recruiting environment is less challenging today, but we know
that a tough recruiting environment will return. If we enter those
difficult recruiting periods with insufficient resources and
inexperienced recruiters, it will only exacerbate the problem and
contribute to the ``boom and bust'' recruiting cycle which has
characterized the past. Such a cyclical resourcing strategy also
ignores the ongoing and significant role recruiting resources--
particularly advertising--have on both youth and influencer awareness,
attitudes, and propensity. Therefore, it is imperative that we
stabilize necessary recruiting resources. We appreciate this
committee's untiring support of our recruiting programs and look
forward to working together to ensure future success.
As previously stated, fiscal year 2009 was a banner year for active
duty recruiting. Altogether, the Services exceeded their goal of
163,880 accessions by 5,088, accessing 159,374 first-term enlistees and
an additional 9,594 individuals with previous military service.
Fiscal year 2010 active duty recruiting efforts, to date, are even
better. Through December, all Services met or exceeded both quantity
and recruit quality objectives for the active force, with the Army
achieving 13,977 of its 13,716 recruiting goal, for a 102 percent year-
to-date accomplishment (Table 1). Especially notable is the fact that
for the second year in a row, after 4 years of falling below the 90
percent DOD Benchmark for High School Diploma Graduates, the Army is
now exceeding that measure, with an impressive 99.9 percent of new
recruits holding that credential.
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We should not lose sight of the fact that, although the overall
youth population is large, only a relatively small proportion of
American youth is qualified to enlist. It is an unfortunate fact that
much of the contemporary youth population is currently ineligible to
serve. Medical disqualification, with obesity a large contributing
factor, removes 35 percent, drug or alcohol abuse removes 18 percent,
and another 23 percent do not meet our standards for reasons such as
criminal misbehavior, have more dependents than can reliably be
accommodated in the early career, or low aptitude scores. Another
estimated 10 percent are qualified, but are attending college.
To expand the recruiting pool and assist the Services in meeting a
special category of critical readiness needs, the Department initiated
a 1-year pilot program, Military Accessions Vital to National Interest
(MAVNI), allowing the enlistment of up to 1,000 of a select group of
non-U.S. citizens who had been in the United States for at least 2
years. Enlistments under this pilot are open only to health care
professionals in critically short specialties and individuals with
language skills and cultural backgrounds in a limited list of
languages. We are currently reviewing results of this pilot program.
But, given the overall limited pool of eligible youth, our
continuing recruiting success does not come easily. It remains the
result of long hours and hard work by the 15,100 dedicated and
professional, active-duty military recruiters. These recruiters often
are the sole representative of our military forces in local
communities, and they have both my and the Department's most sincere
respect and gratitude.
This past August, we implemented the post-September 11 GI Bill--the
most extensive restructuring of post-service education benefits since
the introduction of the original World War II GI Bill. As I am sure you
are aware, the Montgomery GI Bill (MGIB) has been a cornerstone of our
active-duty military recruiting efforts since 1985. There is little
doubt that the MGIB has met or even exceeded the expectations of its
sponsors when it was enacted, and has been a major contributor to the
success of the All-Volunteer Force.
This new post-September 11 GI Bill should enhance our recruiting
efforts even more. However, we remain cautious about the impact of such
a major, new benefit on retention, particularly first-term retention.
We hope that the provision in the new program that allows career
servicemembers to share or transfer their GI Bill with immediate family
members, long requested by both members and their families, will
mitigate negative retention impacts. Early results look favorable, with
over 100,000 career servicemembers already requesting authority to
share their earned educational benefits with their family members. We
are monitoring the effects of this implementation very closely.
Military Decorations and Awards
The Department continues to work in concert with the Services to
appropriately recognize and laud the accomplishments, both valorous and
non-valorous, of our soldiers, sailors, marines, and airmen. In the
AVF, appropriately recognizing the accomplishments of our
servicemembers is fundamental to maintaining esprit-de-corps and a
motivated force. It is most important that the Services recognize the
significant acts and achievements of our servicemembers while
simultaneously maintaining the time-honored prestige of our most
revered military decorations such as the Medal of Honor, Distinguished
Service Cross, Navy Cross, Air Force Cross, and Silver Star. I am aware
of the concern from some Members of Congress in regard to the award of
valor decorations and will closely examine the results of the ongoing
review and report on the Medal of Honor awards process as requested in
the House Armed Services Committee report language that accompanied the
National Defense Authorization Act of Fiscal Year 2010.
Leave and Liberty Enhancements
Given the ongoing operations tempo associated with Operations Iraqi
Freedom and Enduring Freedom, the Department is acutely aware of the
need to provide all soldiers, sailors, marines, and airmen with
adequate leave and liberty opportunities, especially during and after
deployments, for respite and reintegration, respectively.
servicemembers serving in Iraq and Afghanistan are provided a much
needed break from combat through the Rest and Recuperation (R&R) leave
program. This vital program provides servicemembers, who are on long
deployments, government funded transportation to the airport closest to
their leave destination, and allows them to take 15 days of respite
leave in an area of their choosing. For those servicemembers serving in
the most dangerous and arduous areas of the combat zone, the R&R leave
is not chargeable which not only recognizes their stressful duty but
also provides more accrued leave to utilize upon redeployment for
reintegration into their family and community. Additionally, the Post
Deployment/Mobilization Respite Absence (PDMRA) program provides Active
and Reserve component members who are deployed or mobilized above and
beyond the Secretary of Defense's established deployment--dwell time
ratios with respite nonchargeable administrative absence upon return
from deployment or mobilization.
I thank Congress for passing legislation, through the NDAA for
Fiscal Year 2010, which allows our servicemembers to temporarily
increase, from 60 to 75, the number of leave days authorized for carry
over from 1 fiscal year to the next. This provision will reduce the
frequency of lost leave for those servicemembers who have fewer
opportunities to take longer leaves due to the persistent operational
demands. The Department continues to monitor leave balances and lost
leave to preclude avoidable loss of the benefit.
Retention
For fiscal year 2009, the Department was very successful in
attaining enlisted retention goals. All Active components met or
exceeded their respective retention goals in every measurable category.
The Services and the Department anticipate continued success in the
upcoming year and are already meeting or exceeding the monthly goals
for early fiscal year 2010.
Despite the overall strength of enlisted retention over the last
few years, there remain critical shortages in many low density/high
demand skills and other ``hard-to-retain'' skills, such as explosive
ordnance disposal specialists, linguists, intelligence and
counterintelligence analysts, and pararescue operators, that justify
the continuation and application of the statutory bonus authorities.
The Selective Reenlistment Bonus (SRB) and the Critical Skills
Retention Bonus (CSRB) are among the most effective and are authorized
by 37 U.S.C. 308 and 37 U.S.C. 355, respectively, as incentives to
attract/retain qualified personnel in critical military specialties.
The Department's process to manage bonuses is very well defined. A
skill is critical if it meets one or more of the following: (a)
technical skills requiring high training and/or replacement costs; (b)
skills in high demand in the civilian sector; (c) challenging to
recruit into; (d) crucial to combat readiness or capabilities; and (e)
low density/high demand (those skills that are in high demand for
current operations yet are low density due to less requirements during
peacetime). All requests from the Services must have a rigorous
business case that clearly outlines the need for the bonus for that
skill, payment amount and method, and expected retention results.
Designations do not exceed 3 years, subject to congressional extension
of the statutory bonus authority. The complementary authority of the
CSRB is the Selective Reenlistment Bonus (SRB). The SRB is under the
authority of the Service Secretaries and is not centrally managed by
the Department. However, applications of the bonus authorities are
reviewed at the Department and sent as an annual report to Congress.
Stop Loss
The Army is the only Service with members currently extended under
the Stop Loss authority. From a peak of 15,758 in 2005, the Army
reduced the number of soldiers affected by Stop Loss to approximately
8,000 at the end of December 2009. The Department is progressing as
planned to completely end the use of the Stop Loss authority. Army
units deploying after January 1, 2010, are no longer using the Stop
Loss authority. The Department further expects to reduce the number of
servicemembers on Stop Loss to less than 6,600 by June 2010. This is a
50 percent reduction from February 2009 (date that the Secretary of
Defense announced the milestones to end Stop Loss). All use of the Stop
Loss authority will end by March 2011.
Two Stop Loss Special Pays have been enacted which allow a payment
of up to $500 per month for members whose active duty (retroactive to
September 11, 2001) is or was extended by use of the Stop Loss
authority. These pays were appropriated and authorized by the Congress,
with the Department's support, to mitigate the impact and disruption
that extensive use of Stop Loss had and has on the lives of
servicemembers and their families. The Department implemented both
pays, active and retroactive, and appreciates the support of Congress
to compensate members for the unique circumstances presented by the use
of this policy, while still preserving our ability to react with
discretionary authority as dictated by future circumstances.
Separation Policy
The Department continues to improve military discharge policies in
response to conditions of the current war and its effects on those who
serve. As we reported to Congress earlier, one such improvement is the
addition of increased rigor when using a personality disorder as the
basis for administratively separating servicemembers who had deployed
to imminent danger areas. This more rigorous process now includes a
review by the Surgeon General of the Military Department concerned,
yielding greater confidence that servicemembers who should be separated
due to post-traumatic stress disorder (PTSD) or traumatic brain injury
(TBI) are appropriately processed for disability separation as opposed
to personality disorder. The immediate evidence of the positive effect
of the increased rigor is that the number of personality discharges has
decreased from 81 at the policy's promulgation in September 2008 to an
average of 16 per month in 2009. Also, in response to section 512 of
the NDAA for Fiscal Year 2010, the Department is prescribing policy
regarding a more in-depth medical examination to assess whether the
effects of PTSD or TBI relate to the basis for an administrative
separation for those servicemembers who are pending discharge or who
were discharged under conditions other than honorable.
End Strength Management
Meeting end strength is a priority of the Department. The table
below depicts the fiscal year 2009 Active Duty authorizations
(prescribed and actual) and fiscal year 2010 authorized levels which
the Department intends to achieve. The Secretary of Defense has
authority granted under the terms of the President's national emergency
declaration to increase statutory strength levels prescribed by the
National Defense Authorization Act if needed. The Services have
implemented recruiting, retention, and force shaping policies and
programs to achieve end strengths for fiscal year 2010. The Department
appreciates the congressional support of the fiscal year 2010 end
strength levels. These end strengths will provide the ground forces to
meet strategic demands, eliminate the need for the use of Stop Loss,
and mitigate persistent capability shortfalls which will reduce stress
and demands on servicemembers and families by increasing dwell time.
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Force Development
The Department continues to emphasize joint officer development and
has made great strides in implementing the extraordinary authorities
authorized in the 2007 NDAA. Active and Reserve component participation
continues to grow, and the adjudication of over 3,200 joint experiences
from nontraditional joint duty assignments attests to the Department's
ability to recognize joint experiences whenever and wherever they
occur.
Joint officer management is not the only area of significant
improvement for the officer corps. We appreciate the authorities
provided by Congress in the fiscal year 2009 and 2010 NDAAs that allow
the development of general and flag officers with the joint knowledge
and skills necessary to lead and counter emerging threats. This
landmark general and flag officer management legislation apportioned
general and flag officer authorizations between internal and external
Military Service requirements, ensuring the statutory responsibilities
of the military departments and the joint warfighter can be met.
The enactment of conforming legislation from the Department's 2010
legislative package is also serving to dramatically accelerate the
development of joint experience in the Reserve components. The
legislation expanded on the previously enacted statutory framework
affording the Military Departments the opportunities to purposefully
develop officers from the Reserve components for senior posts in joint
warfighting organizations. This delivered on the promise of the charter
Goldwater-Nichols legislation by institutionalizing joint officer
development through the senior officer grades regardless of component.
Compensation
The Department and Congress continue their strong commitment to
provide a secure standard of living and quality of life to those who
serve in uniform. Today, we find ourselves empowered with a never
before seen set of flexible and targetable pay authorities which enable
the Department to dynamically address recruiting and retention and
achieve specific and desirable effects. We also find ourselves with
large fixed costs encompassed in our entitlements, and the prospect of
continued growth in that area. To secure sufficient personnel for the
Armed Forces, the Department must provide a compensation package
comparable and competitive in the private sector while at the same time
balancing the demands of an All-Volunteer Force in the context of
growing equipment and operations costs.
The Department continues this commitment through the President's
request for a 1.4 percent increase in military pay for all
servicemembers in the fiscal year 2011 budget--an amount that equals
earnings increases in the private sector as measured by the Employment
Cost Index. Of note, since January 1, 2002 through the January 1, 2010
pay raise, military pay has risen by 42 percent, the housing allowance
has risen by 83 percent, and the subsistence allowance has risen by 40
percent. During this same period, private sector wages and salaries
have only risen by 32 percent. Government Accountability Office (GAO)
is currently auditing the overall adequacy of military pay, as well as
the appropriateness of the benchmarks used to measure any gaps relative
to the private sector and its report is due April 2010. We are
confident regular military compensation will compare favorably with pay
in the private sector. While there is little question that those levels
of increase were necessary in the past, the Department now finds itself
at a point where discretionary spending offers the best ability to
target specific skills, and the quantity and quality of those filling
such positions.
Collateral to the GAO review, the President recently commissioned
the eleventh Quadrennial Review of Military Compensation. The four
themes he has asked the panel to focus on continue the thesis of
tailoring pays beyond entitlements to target groups and behaviors. This
review, in general terms, will be looking at the compensation package
for service performed in combat of hostile areas; compensation for our
Reserve components in light of current and planned utilization;
compensation benefits available to our wounded, those who care for them
and the survivors of those fallen; and the pay and incentives for some
of our most critical fields, including mental health professionals,
special operators, operators of remote systems and those with
specialized linguistic skills. With the recently consolidated pay
authorities, I am confident in saying Congress has given us the tools
we need to address each of these areas; what remains is identifying the
best combination of the pays to achieve the ideal combination of outlay
to impact. The Department, as always, welcomes the continuance of these
authorities, but would be generally opposed to continued entitlement
growth beyond indexed levels in the absence of specific goals and
outcomes supported by studies such as those just discussed.
Similar to our efforts to target and define the impacts of each pay
with our active personnel, we must continue to ensure we support those
who have already served, but again, we must do so in an equitable
manner and one that is consistent with the overall demands of the
Department. As an example, the Department continues to oppose efforts
to eliminate the offset between the Survivor Benefit Plan (SBP) and
Dependency Indemnity Compensation (DIC) programs. Allowing concurrent
receipt of SBP and DIC without offset would create an inequity with one
select group receiving two survivor annuities, while survivors of most
military retirees and survivors of veterans who died of service
connected cause, but were not retired, would receive only one or the
other. At the same time, in seeking that broader equity and Department-
wide impact, we see a win-win opportunity in expanding the concurrent
receipt program to include military disability retirees with less than
20 years of service regardless of disability rating. This expansion
would cover our most challenged retirees by allowing them to receive
retired pay for their years of service performed and VA disability
compensation for their future reduced earning capability.
Overall, the state of military compensation is healthy. We have
improved our overall entitlements to the point that all of our
personnel are paid at or above the 70th percentile of their civilian
counterparts. We have eliminated out-of-pocket expenses for housing to
fully cover, on average, the costs of comparable civilian housing.. We
have gained a new and dynamic set of authorities which we are in the
midst of implementing. For the first time, we truly have the ability to
target pay with pinpoint accuracy to achieve desired aims and maximize
effects of dollars spent. Our challenge today is to maintain this
position without imposing greater long term bills, while using our
targetable tools to shape and manage our force.
Legislative Fellowship Program:
The Legislative fellowship program is a unique and excellent
opportunity for members with great potential to serve to learn the day-
to-day functions of the Legislative Branch of Government and is a
valuable experience in the professional development of career military
members or civilian employees in the Department. The Services and
Components assign their Legislative Fellows to appropriate follow-on
tours, which the Department monitors for each Fellowship cycle. Typical
of the follow-on assignments are positions in: the House and Senate
Liaison Divisions of the Services; the Office of the Secretary of
Defense (Legislative Affairs); the Combatant Command Headquarters with
duties associated with interacting with Congress; Service primary
staffs responsible for legislation development and interaction with
Congress; and the Staffs of senior leaders. The Secretary of Defense
established the maximum number of Legislative Fellows at 100. The 100
Legislative Fellowships are broken out in calendar year 2011 as
follows:
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Legislative Fellows serve no more than 12 months in the House or
Senate. The Legislative Fellowship Program is the only program that
authorizes Department of Defense personnel to work in Congress on a
more than temporary basis and the program and policies are clearly
promulgated in a DOD Instruction. Legislative Fellows are selected
under Service competitive selection process and approved by the OUSD
(P&R).
reserve component
Achieving the defense strategy articulated in the Quadrennial
Defense Review (QDR) requires a vibrant National Guard and Reserve
seamlessly integrated into the Total Force. National Guard and Reserve
units and individual members are heavily utilized across the full
spectrum of current military operations, ranging from combat missions
in support of the global war on terror to homeland emergencies. The
Guard and Reserve have demonstrated their readiness and ability to make
sustained contributions, and to prevail in today's wars, the Reserve
components must serve in an operational capacity--available, trained,
and equipped for predictable routine deployment--as well as a strategic
capacity. Preventing and deterring conflict will likely necessitate the
continued use of some elements of the Reserve Component (RC) in an
operational capacity well into the future, especially in high-demand
skill sets. Accordingly, the Department will use the Guard and Reserve
where needed as an operational Reserve, rather than the ``force of last
resort,'' to fulfill requirements for which they are well suited in the
United States and overseas. Today's Citizen Warriors have made a
conscious decision to serve, with full knowledge that their decision
means periodic recalls to active duty under arduous and hazardous
conditions.
Consistently averaging about 140,000 National Guard and Reserve
members mobilized to support ongoing operations on a daily basis, the
Reserve components continue to make significant contributions to the
national defense. The fiscal year 2011 budget provides about $50
billion for pay, training, equipping, and facilities to support the
Reserve components of the Army, Navy, and Air Force in their respective
Reserve components as operational Reserve Forces. The budget includes
an across-the-board pay raise of 1.4 percent, along with pay and
allowances for over 1 million personnel. Operating funds support
necessary training requirements to ensure deploying personnel are fully
mission-ready.
The fiscal year 2011 budget request supports the Department's Ready
Reserve totaling about 1.1 million members contributing about 43
percent of the total military end strength at a cost of about 9 percent
of the total base budget. The Ready Reserve consists of the Selected
Reserve (about 838,300), the Individual Ready Reserve (IRR) about
(250,000), and the Inactive National Guard (ING) (about 2,000). This
budget request includes about $53.3 billion to fund pay and allowances
and costs of Reserve component training, incentives, equipment
operation and maintenance costs, and readiness training costs for
eligible military personnel. This amount includes $5.5 billion for
Reserve component equipment procurement, which is funded by the
military departments as a subset of their Active component procurement
budget.
Managed as strategic and operational forces, the total Reserve
component structure operates across the continuum of military missions
performing both strategic and operational roles in peacetime, wartime,
contingency, domestic emergencies and homeland defense operations. As
such, the Services organize, resource, equip, train, and utilize their
Guard and Reserve components to support mission requirements to the
same standards as their Active components. The budget supports
preparation of both units and individuals to participate in missions,
across the full spectrum of military operations, in a cyclic or
periodic manner that provides predictability for the combatant
commands, the Services, servicemembers, their families, and civilian
employers, while potentially increasing the Department's overall
capacity and reducing costs.
To help reduce Active component ``dwell to deployment'' ratio, all
Reserve components are moving towards a more rotational process,
characterized by a period of active service thereby relieving active
force burden, and then followed by an extended period at home. The
current mobilization policy issued in January 2007 by the Secretary of
Defense mandated involuntary mobilizations be limited to no more than
12 months, which does not include individual skill training days
required for mobilization or deployment or terminal leave. The
Secretary of Defense also set a goal of not more than 1 year mobilized
in any 6 year period for the Reserve components. The Services are
moving toward this goal as quickly as possible given current
operational requirements. Unlike before, when the RCs were usually
funded at less than full readiness because they were not first to
fight, specific units now must be fully resourced in any given year.
This new train-mobilize-deploy construct means that the RCs must be
ready, manned, trained, medically and dentally prepared, and equipped
when their scheduled availability comes up, and they must be funded
accordingly.
Resourcing Operational Reserve Forces
Managing the Reserve components as operational forces affects
training schedules and funding requirements, including medical
readiness. In the past, normal training profiles meant training about 2
days per month plus 14 to 15 days of active duty for training annually,
during which time Reserve component personnel were required to train to
the same standards as their Active counterparts. While that training
profile remains for some units, current Department policy states that
for those with planned deployments, training days prior to mobilization
must increase. This training profile, with more training pre-deployment
and less post-deployment, minimizes mobilized time away from families
and civilian jobs and will require a different resourcing approach. In
general, the land based (Army and Marine Corps) Reserve components
train according to this new profile, meaning that funds which had been
consumed after mobilization from the active accounts are now required
and expended prior to mobilization from the Reserve accounts. This
change in training profiles means a simple comparison to prior year
execution funding models can be misleading. For fiscal year 2011,
Congress has authorized Reserve component military personnel budgets to
be consolidated into a single budget activity, allowing much improved
management of Reserve component assets and more agile fund allocation.
This flexibility is especially crucial for managing funds for the new
operational Reserve, and the Department greatly appreciates this
Congressional approval.
Equipping and Basing Operational Reserve Forces
The fiscal year 2011 budget requests $5.5 billion for Reserve
component equipment, and provides greater transparency and more robust
funding for vital equipment needs as the Department continues to ensure
that deployed and next-to-deploy units, whether in the active or
Reserve component, receive the highest equipping priority. Effective
and realistic readiness training at home requires that the National
Guard and Reserve have access to equipment compatible with the active
components and used in the assigned operational environment.
Modernization, mission transformation, equipment replacement due to the
war losses, and homeland defense are all catalysts for a new approach
to equip the Reserve components.
In the past, the Reserve components often relied on cascaded or
``hand-me-down'' equipment from the Active components and they often
were short in their equipment inventories. The fiscal year 2011 budget
contains funds needed for Reserve component equipment procurement to
continue that transition, repair and replace war-damaged equipment, and
to correct longstanding deficiencies. The budget request includes funds
for equipment that will not only improve combat readiness but will also
allow the National Guard to further improve its ability to respond to
local domestic emergencies.
Additionally, the Guard and Reserves previously have been a low
priority for receiving new equipment. But today that standard has
changed and these Forces receive the same equipment as their Active
counterparts. We have achieved major progress in programming funds and
equipping our Reserve components for an operational role. With this
operational role comes the requirement for equipment transparency in
form of increased visibility and accountability for the National Guard
and Reserve in the programming and budgeting process.
Institutionalizing this process will ensure an adequate mission
capability for foreign and domestics responses and we are proceeding in
that direction.
The Reserve components request $1.4 billion for military
construction (MILCON) projects. These projects will meet both current
and new mission requirements for RC operations, readiness, and training
facilities.
readiness and training
Deployment and Dwell
Multiple deployments to Iraq and Afghanistan have certainly
increased the stress on our servicemembers and their families. We have
a number of initiatives underway to address this stress, and have set
clear limits and goals for deployment lengths and the amount of time or
``dwell'' between deployments.
To that end, we have limited unit deployments to 1 year in theater,
with a minimum of 1 year between deployments for our Active component.
Our goal is to increase the time between deployments to 2 years for
every year deployed, commonly called a 1:2 ``dwell'' ratio. For the
Reserve component, we have limited the mobilization period to 1 year,
and strive to have a minimum 3 year break between mobilizations. The
goal for Reserve component dwell ratio is 1 year mobilized with a 5
year break between mobilizations, or a 1:5 dwell ratio.
Dwell time is driven by the number of forces deployed for missions
around the world against the supply of available forces. We have
increased the supply of forces by increasing the end strength for the
Army, the Marine Corps, and Special Operations Forces. We also expect
to make progress toward meeting the dwell goals as we drawdown forces
in Iraq.
Defense Mishap Reduction Initiative.
As Chair of the Defense Safety Oversight Council (DSOC), I have
been chartered to ensure that the Department is making steady progress
toward the Secretary's goal of a 75 percent reduction in all accidents.
The Department has made considerable progress to date due to the
tremendous effort of our military and civilian leaders. From our 2002
baseline, we have reduced our civilian lost workday rate 41 percent,
are down 31 percent in our private motor vehicle fatality rate, and
dropped our Class A aviation accident rate 56 percent.
The DSOC is supporting the Military Departments' pursuit of the
Occupational Safety and Health Administration's (OSHA) Voluntary
Protection Program (VPP) at more than 200 DOD installations and sites.
We have 30 sites that have already attained OSHA's Star recognition and
we expect 17 more sites by the end of 2010. Their OSHA Star status
designates them as exemplary worksites with comprehensive, successful
safety and health management systems, and improved labor/management
relations.
We recently completed a comprehensive, data driven assessment to
further prevent aircraft crashes, save military lives, and reduce the
need for replacement aircraft. The task force, consisting of a variety
of experts from across the Department, recommended that the military
aviation communities acquire technologies for collision awareness,
crash survivability, and risk management. As a result of this important
work, the military departments are making further investments in
hardware and software that will avert aircraft crashes. With your
continued support, we can make further progress in preventing injuries,
fatalities, and aircraft crashes; and be well on our way towards
attaining the Secretary's accident reduction goal.
military health system
Health Budgets and Financial Policy
The fiscal year 2011 budget reflects several areas of continued
emphasis, including the modernization of our medical infrastructure and
full funding and support of our Wounded, Ill and Injured programs. The
Unified Medical Budget, the Department's total request for health care
in fiscal year 2011, is $50.7 billion. This includes the Defense Health
Program, Military Personnel, Military Construction, and Medicare-
Eligible Retiree Healthcare. Major increases in the budget request
include $0.8 billion for medical and general inflation; $1.2 billion
for private sector care costs due to an increase in users of TRICARE
and an increase in utilization of the TRICARE benefit; $0.6 billion for
enhancements for the Direct Care system; and $0.3 billion for
modernizing the Department's electronic health record to enable data
compatibility for the Virtual Lifetime Electronic Record, and
correcting critical system problems, increasing user satisfaction, and
improving system reliability and availability.
Our primary and enduring responsibility is to provide the highest
quality care to our beneficiaries, using the most current medical
evidence to drive our clinical decisionmaking; and one of our
fundamental tenets is that quality of care is also cost-effective. In
addition, there are a number of actions we have undertaken and will
continue in fiscal year 2011 to continue to provide value to the
Department and the taxpayer. The ways we are addressing cost
effectiveness in fiscal year 2011 include:
continued implementation of Federal Ceiling Pricing of
retail pharmaceuticals ($842 million savings);
continued implementation of the Outpatient Prospective
Payment System, which reduces the reimbursement paid for
outpatient care at inpatient private sector care facilities
($366 million savings)
standardization of medical supply chain management
across the full range of military health care operations ($27
million savings);
increasing efforts to identify and detect fraud,
waste, abuse, and overpayments to civilian medical providers
($68 million savings); and
additional VA and DOD facilities sharing--most notably
the first fully integrated Joint DOD/DVA healthcare
collaboration consisting of the North Chicago Veterans Affairs
Medical Center and the Navy Ambulatory Care Center, Great
Lakes, IL.
Health Affairs/TRICARE Management Activity Strategic Direction
In 2002, the assistant Secretary of Defense for Health Affairs
(ASD/HA) aligned policy and program execution strategies under Health
Affairs/TRICARE Management Activity (HA/TMA). In HA/TMA, as in most
organizations, the bridge from strategy to execution was challenging,
and the organizational alignment, still in effect today, was intended
to streamline processes for faster and more effective execution of
policies and programs. Under this arrangement, HA is setting clear
strategic direction for the Military Health System (MHS) in partnership
with the Services.
For the past 12 months, HA/TMA has worked closely with the Service
Surgeons General on initiatives that have coalesced around a strategic
initiative known as the ``Quadruple Aim.'' Borrowing liberally (and
with permission) from the nonprofit Institute for Healthcare
Improvement's (IHI) ``Triple Aim,'' the Department is focusing on four
strategic imperatives:
Readiness - Ensuring that the total military force is
medically ready to deploy and that the medical force is ready
to deliver health care anytime, anywhere in support of the full
range of military operations, including humanitarian missions.
Population Health - Improving the health of a
population by encouraging healthy behaviors and reducing the
likelihood of illness through focused prevention and the
development of increased resilience.
Experience of Care - Providing a care experience that
is patient and family centered, compassionate, convenient,
equitable, safe, and always of the highest quality.
Responsibly managing the total health care costs -
Creating value by focusing on measuring and enhancing quality
healthcare; eliminating inefficiencies; reducing unwarranted
variation; and emphasizing investments in health that reduce
the burden and associated cost of preventable disease in the
long term.
There are many important initiatives that will emerge from this
strategic direction. One of the most vital, because it will have
effects across all four components of the Quadruple Aim, is the
``medical home'' concept being piloted by all three Services. This
approach takes the existing construct of a primary care manager and
enhances it through improved access to care. Features will include 24/7
access to a provider through multiple avenues--that will include
leveraging technology to avoid unnecessary visits or emergency room
visits. More importantly, it will enhance continuity of care and
greatly improve satisfaction with service. The early results from pilot
sites are very encouraging, and we are applying lessons learned from
these sites to improve the program as we proliferate it across the
Department.
With the shared vision of the Quadruple Aim and a revised decision-
making process, the MHS is laying the groundwork for a smooth
transition under the BRAC-directed co-located medical headquarters in
the National Capital Area (affecting HA/TMA and the Services' Surgeons
General staffs). The co-location initiative offers significant
opportunities to achieve even greater unity of effort.
Mental Health Professionals
Significant effort has been made to recruit additional mental
health personnel in order to meet the growing demand for behavioral
health services in the Department. Since 2007, the number of active-
duty mental health providers has remained relatively constant, yet we
expect the Consolidation of Special Pay language (10 U.S.C. Sec. 335)
recently implemented will have a significant effect on retention of
psychologists and social workers.
Our work to recruit civilian mental health providers has been very
effective. Table 3 shows the Services total mental health needs/
requirements as compared to the number of providers on-hand as of the
third quarter of fiscal year 2009. The Navy and the Air Force compare
assigned personnel versus requirements. The Army's growing needs are
not completely reflected by official requirement documents yet, and
thus they are identified as ``needs.'' Table 4 shows the significant
improvements in total Mental Health personnel that have been made since
2007, including in the TRICARE Network.
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Suicide Prevention
The Department's civilian and military leadership remain focused on
employing numerous strategies to reduce the incidence of suicide in the
Armed Forces. In calendar year 2009, there were a total of 312
suicides--285 in regular components and 26 in Reserve Components--
marking an increase from 268 in calendar year 2008. Suicides within the
Regular Components increased from 235 in calendar year 2008 to 285 in
calendar year 2009. Demographic risk factors are: male, Caucasian, E-1
to E-2, younger than 25 years old, GED/less than high school education,
divorced, and in the Active Duty component. Other factors associated
with suicide, which are consistent with data from the civilian
population, are: substance abuse, relationship problems, legal,
administrative (article 15), and financial problems. Although the
impact of role of deployment on suicide risk is still under
investigation, a majority of suicides do not occur in the theaters of
operation.
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When a servicemember has a problem, he or she can, in most cases,
receive confidential help from military and other mental health
providers. However, if the individual is unable to perform his/her
duties, is homicidal or suicidal, or is in a sensitive duty, the
commander will be notified for safety reasons. Resources available to
servicemembers and their families include: confidential problemsolving
counseling through Military OneSource, online information and tools at
militarymentalhealth.org and afterdeployment.org, confidential pastoral
counseling with chaplains, Military Family Life Consultants (active
duty and families), military mental health providers, Service-level
counseling centers, and access to information and referral to mental
health professionals through the Defense Centers of Excellence for
Psychological Health and Traumatic Brain Injury (DCoE) Outreach Center.
The Department and Services recognize suicide prevention begins
long before an individual exhibits suicidal ideation. Comprehensive
programs focus on enhancing resilience and early identification
designed to reduce psychological health issues or disorders that may
contribute to suicide risk. Leadership at every level receives training
on warning signs, resources, healthy lifestyle choices, and actions to
take if an intervention is deemed necessary. The Suicide Prevention and
Risk Reduction Committee (SPARRC) is a forum for developing/expanding
partnerships among the Services, VA, Federal and civilian partners. The
SPARRC's goal is to improve policies, programs and systems across the
Department while providing support for medical, line, and community
leaders. Chaired by DCoE, the SPARRC includes representatives from all
Services, VA, SAMHSA, Center for Disease Control, Medical Examiners,
Chaplains, Telehealth/Technology and National Guard/Reserves.
The Department also collaborates with VA and the Substance Abuse
and Mental Health Services Administration (SAMHSA) on suicide
prevention efforts. This includes an annual joint DOD/VA conference on
reducing the rate of suicides in the Active Duty components, Reserve
components, and veteran populations. The January 2010 DOD/VA Suicide
Prevention Conference, ``Building Strong and Resilient Communities,''
brought together over 900 servicemembers, family members, and mental
health professionals throughout DOD, VA, and other Federal agencies.
The conference highlighted practical tools, personal stories, and
ongoing efforts in supporting the community.
The Department's mental health initiatives dovetail with both the
Readiness and Population Health components of the Quadruple Aim. We
have developed metrics that we closely monitor to determine if our
programs are effective and if our policies are being effectively
implemented. We are also broadening our view of readiness, to include
perspective on the ``readiness'' of an entire family for a
servicemember's deployment. In 2010, we will expand our measures to
include this more expansive view of readiness--and consequently, better
manage pre-deployment, deployment, and post-deployment activities for
the Total Force.
We recognize the number of suicides continues to increase and
suicide has a multitude of causes, and no simple solution. There are
many potential areas for intervention, and it is difficult to pinpoint
the best approach because each suicide is unique. Recognizing this, DOD
is tackling the challenge using a multi-pronged strategy involving
comprehensive prevention education, research, and outreach. We believe
in fostering a holistic approach to treatment, leveraging primary care
for early recognition and intervention, and when needed, providing
innovative specialty care. The areas of focus to reduce risk include:
(1) conducting data collection and analysis to detect contributing risk
factors; (2) facilitating partnerships across DOD, Federal, and
civilian organizations to increase collaboration and communication; (3)
reducing stigma and increasing access to resources to provide needed
care; and (4) using research to close gaps and identify best practices.
Health Informatics
The DOD's Electronic Health Record (EHR) continues to be a key
enabler of military medical readiness; giving healthcare providers
secure, 24/7, worldwide access to medical records of our highly mobile
patient population. Across the enterprise, the EHR supports uniform,
high-quality health promotion and healthcare to more than 9.5 million
MHS beneficiaries. Using the EHR, our healthcare providers access the
electronic medical records of MHS beneficiaries from any point of care
throughout the direct care system.
The MHS Information Management/Information Technology Strategic
Plan for 2010--2015 provides the roadmap for improving the EHR, and
lists EHR improvement as a top IM/IT priority. Using this roadmap, MHS
will effectively execute its action plan to stabilize the current
system while transitioning to a suite of EHR applications and
supporting infrastructure that will improve reliability, speed, user
interface and data integrity, and achieve higher satisfaction from all
users. These improvements will enhance IT interoperability within the
MHS and support planned improvements in electronic health data sharing
with VA and our private sector care partners.
For future years, ICIB will prioritize additional health related
sharing capabilities or usability enhancements to continue the
advancement of DOD/VA interoperability in a manner that supports
clinicians in healthcare delivery. The Departments will continue to
work together to improve and expand upon the interoperability of
appropriate healthcare data as appropriate and necessary.
Virtual Lifetime Electronic Record (VLER)
On April 9, 2009, President Obama announced that DOD and VA would
work together to create of a ``virtual lifetime electronic record''
(VLER) for servicemembers and veterans. While the Department and VA
already share an unprecedented amount of health care information
between the two systems, a very large portion of health care to our
beneficiaries comes from private sector contract providers. The DOD,
VA, and the Department of Health and Human Services are working
together to promote access of electronic health care information for
care provided in DOD, VA, and private sector facilities while DOD and
VA continue to leverage work already done to improve our capabilities
for sharing information.
VLER will rely on the Nationwide Health Information Network (NHIN)
as the mechanism to share standards-based health data between DOD, VA,
and private sector partners. Well-defined standards are the essential
foundation for interoperability among systems. These standards will be
guided by the Department of Health and Human Services (HHS) and will be
consistent with the NHIN model based on the Federal Health
Architecture.
DOD and VA have been active participants and among the leaders in
the development of the NHIN working with the HHS Office of the National
Coordinator for Health Information Technology. The NHIN will tie
together health information exchanges, integrated delivery networks,
pharmacies, government health facilities and payers, diagnostic
laboratories, providers, private payers, and other stakeholders into a
``network of networks.'' The NHIN provides a national standards-based
mechanism for previously unconnected electronic health records and
other sources of healthcare information to share information securely
while respecting and enforcing mandates for guarding patient privacy.
Working together with HHS and private health care providers, DOD
and VA are creating a capability that will take a huge step towards
modernizing the way health care is delivered and services are
administered for our Nation. VLER will allow health care providers
access to servicemembers' and veterans' military medical records,
providing the information needed to deliver high-quality care. VLER
will do all of this with the strictest and most rigorous standards of
privacy and security, so that our servicemembers and veterans can have
confidence that their medical records can only be shared at their
direction.
VLER is not a large acquisition program nor will VLER result in one
single DOD/VA Information Technology (IT) system. Rather, VLER builds
on the electronic health care systems already in place in DOD, VA and
the private sector. Even if DOD and VA were to embark on a huge
acquisition program to implement a single system, they would still not
be able to access the critical information captured by the private
sector. The VLER solution is viable for the entire health care
community and enables each individual entity to develop and maintain
their own internal systems. It creates an opportunity for competition
since it uses well-documented standards that can be implemented through
a variety of electronic health initiatives that can be linked to the
NHIN.
military family support and wounded warrior care
This past year, due to the high level interest in supporting
military families, resources were increased to institutionalize
servicemember and family support programs across the Department. A 41
percent increase in the Defense-wide family assistance baseline funding
in fiscal year 2011 from fiscal year 2010 will provide lifelines of
support for servicemembers and their families through outreach to Guard
and Reserve members and families, Military OneSource 24/7 accessible
family support assistance, referrals for counseling, financial
education and training, and access to education, training certification
opportunities leading to a portable career for spouses.
To ensure we are on-target in investing in programs needed by
servicemembers and their families, we initiated an extensive strategic
planning process to address the current issues facing family readiness
programs, beginning with a thorough assessment of existing needs,
programs, and related issues. A variety of methods were used to gain
input from key players across the system, including family members,
support professionals, non-governmental organizations, land-grant
universities, and senior DOD leadership.
Child Care
Access to child care remains a top priority for the Department.
Efforts are ongoing to meet the needs of our deployed families,
including National Guard and Reserve families. We have expanded respite
child care options through the YMCA program, offering opportunities for
geographically isolated families to help mitigate the stress
experienced by the parent at home. These efforts augment the respite
child care provided by the Military Services.
We continue to reduce the unmet need for child care, yet are
cognizant of the ongoing need to recapitalize our aging child and youth
facilities. We need to eliminate barriers to hiring practices key to
expanding our partnerships with community child care providers. The
temporary program to use minor military construction authority for the
construction of child development centers provided a means to increase
the availability of quality, affordable child care for servicemembers
and their families. This authority expired at the end of fiscal year
2009, and we have proposed legislation to reinstate the authority. The
legislation would also expand age limit requirements from 5 years old
to 12 years old to include children in school age care programs,
broaden the authority to include other family support initiatives
(e.g., family center, fitness facilities, etc.), and increase the
funding authority to $15 million for all projects.
Youth Programs
We are also deeply committed to addressing the needs of our
military youth. More than 350 dynamic, innovative and successful youth
programs serve more than 500,000 military connected children and youth
between the age of 6-18 worldwide. Programs promote positive youth
development and prepare pre-teens and teenagers to meet the challenges
of military life, adolescence, and adulthood. Partnerships with other
youth-serving organizations enable the Department to offer resources in
a variety of domains, including physical fitness and sports; arts and
recreation; training in leadership; life skills; career/volunteer
opportunities; mentoring; intervention; and support services.
Programming supports character and leadership development, sound
education choices, healthy life skills, the arts, and sports and
recreation. Many programs offer summer day camp and youth employment
opportunities. Twenty-two youth facilities were funded in 2008 and
2009, totaling $145.6 million in non-appropriated funds; this support
constitutes a critical aspect of family support. Six youth facilities
are funded for fiscal year 2010 and fiscal year 2011, totaling $49.7
million.
Family Advocacy Programs
The DOD Family Advocacy Program (FAP) plays a key role in
addressing familial physical, sexual, and emotional abuse and neglect
involving military personnel in the active component as victims and
abusers. On each military installation with command-sponsored families,
there is a FAP that provides services in prevention, identification,
intervention and treatment of child abuse and neglect and domestic
abuse. Two key programs, the New Parent Support Program and treatment
programs for substantiated spouse abusers have been tied to outcomes
for prevention.
Casualty and Mortuary Affairs Programs
The Department remains committed to providing the highest quality
of compassionate and caring assistance to families of fallen
servicemembers for as long as they determine assistance is needed.
After which, additional assistance can be obtained by a simple phone
call or letter written to the appropriate Service Casualty Office.
Since early 2006, the Department has worked extensively with the
Military Services; the Department of Veterans Affairs; the Social
Security Administration; family support organizations; nonprofits
groups, and more importantly, survivors, to ensure our policies and
procedures are standardized to the maximum extent possible, more
customer focused, and flexible enough to address unique situations.
While the Department has made many enhancements to the Casualty
Assistance Program, we recognize there is always room for improvement
and therefore we strive every day to make it better, simpler, more
respectful, and more compassionate. As the Secretary stated, ``When
young Americans step forward of their own free will to serve, they do
so with the expectation that they and their families will be properly
taken care of should anything happen to them.'' We listen to those we
serve and to those organizations who have dedicated their existence to
providing valuable support and services to survivors of the fallen.
Together, our collaborative efforts will ensure our program will
continue to be enhanced and our families provided the very best
assistance possible.
Military OneSource
Military OneSource (MOS) continues to have a positive impact on
servicemembers and their families. OneSource offers a 24-hour/365-day
centralized assistance program to provide diverse information and
referral services by credentialed counselors to Active Duty, Guard,
Reserves and their family members, regardless of physical location or
activation status. Assistance can be provided in many languages. Since
inception, Military OneSource has experienced exponential expansion.
Over 739,000 telephone calls were received in fiscal year 2009, more
than doubling the number of calls received in fiscal year 2008. The
website received over 4 million visits, almost doubling the number of
visits received during the prior year. Nearly one in three
servicemembers uses Military OneSource.
In general, the most common reasons for which a person sought MOS
counseling were marital and intimate relationships, stress management,
family relationships, and anger management. In addition, MOS financial
counseling support is offered in-person and telephonically. In fiscal
year 2009, MOS conducted 4,501 financial counseling sessions. The most
common reasons for which a person sought financial counseling support
from MOS were budgeting and money management, overextension with bills,
credit management, loans and consolidating loans, and mortgages and
refinancing. In fiscal year 2009, OneSource assisted members and
families with almost 600,000 tax filings at no cost to the family.
The Wounded Warrior Resource Center (WWRC), accessed via Military
OneSource, provides immediate assistance to the wounded and their
families with issues related to health care, facilities, or benefits.
The WWRC works collaboratively with the Military Services' wounded
warrior programs and the Department of Veterans Affairs to ensure
callers are promptly connected to the resources that can help address
their needs. In fiscal year 2009, 1,200 cases for wounded warriors were
handled.
Dependents' Education Programs
A key quality of life issue is the education of military children.
Servicemembers often make decisions about assignments based on the
availability of quality educational opportunities for their children.
The Department of Defense Education Activity (DODEA) provides quality
pre-kindergarten through 12th grade educational opportunities and
services to eligible military dependents around the globe where DODEA
schools are located. Of the approximately 1.2 million military
dependent children, DODEA educates nearly 85,000 in 192 schools in 12
foreign countries, 7 States, Guam, and Puerto Rico with 8,700
educators. DODEA also assists eligible military dependent students
through a tuition reimbursement program for military assigned to
overseas locations without a DODEA school.
The ongoing relocation of military dependent students through force
structure changes created a need to enrich and expand partnerships with
military-connected communities to ensure the best possible educational
opportunities for military dependent children. Through its Educational
Partnership Initiative, DODEA was given expanded authority to assist
local education agencies (LEA's) who educate military dependent
students through efforts focused on highest student achievement. DODEA
works collaboratively with the Department of Education to ease the
transition of military students by sharing experience and expertise
with LEAs who educate larger populations of military dependent
students.
Data from the Department of Education reports that there are 300
LEAs with a military child enrollment of 5 percent or more. Of the 300
LEAs with 5 percent military child enrollment, 153 of the LEAs are not
meeting the State academic standards in reading/language arts and/or
math using annual tests aligned to academic indicators. In addition,
there is significant research surrounding the psychosocial effects of
multiple deployments on school performance and student behavior. In
fiscal year 2009, DODEA extended support through grants focusing on
enhancing student learning opportunities to 44 school districts serving
approximately 77,000 military children in over 284 schools.
Through new technologies, DODEA is developing additional academic
opportunities for its students. The focused efforts are to expand
access to education and provide curricular options to eligible students
within DODEA through the expanded use of distance learning. DODEA plans
to transition its distance learning program into a virtual school
program beginning with the implementation of fully accredited virtual
high school in School Year in 2010-2011. These tools include real-time
audio and video, document sharing, screen sharing and web collaboration
to stimulate active teacher-student, student-student and student-
content interaction. A ``virtual hub'' model has been put into place
that puts the teachers in locations closer to the students to
facilitate interaction that simulate traditional classroom discussion
and one-on-one tutoring.
Beginning in 2008, DODEA implemented a new process for advising
decision-making that focuses on highest student achievement and a
thorough review of data, implementation, and effectiveness of programs.
Part of the advisory process includes educator-led task groups which
review and analyze data. DODEA task groups are convened for various
reasons such as instructional and curricular topics, issues of interest
from the field, or management needs. All task groups spend considerable
time reviewing and analyzing information and data on a specific issue
and then, through consensus, developing systemic recommendations sent
to the Director to guide future educational actions. Currently, DODEA
has seven on-going task groups.
Korea Tour Normalization
United States Forces Korea (USFK), through the Tour Normalization
Program, is aggressively increasing command-sponsored military families
on the Korean peninsula for the primary purpose of establishing a
higher quality of life for military families. In addition to the
housing needs, this impacts educational needs. DODEA anticipates adding
25 schools in Korea over the next 10 years, providing an end state
program by 2020 of 31 DODEA schools in Korea. Student growth is
expected to grow from 4,422 DODEA students currently in the Republic of
Korea to 21,758 at the end state. This is approximately a 500 percent
increase in the student population. DODEA is actively working
programmatic details with USFK and local Military Service communities
to support this effort.
MWR Support to Troops in Combat
The ability to communicate with family and friends is the number
one factor in being able to cope with longer and more frequent
deployments. We continue to balance the most effective use of available
bandwidth between mission and personal requirements, including wireless
access. Currently, servicemembers have free access to the non-secure
military Internet by using their military e-mail address, including
aboard ships. They also have free Internet access at over 1,008 MWR
Internet Cafes in Iraq and Afghanistan with 9,241 computers and 4,101
Voice Over IP phones (with call rates of less than 4 cents a minute).
Another 197 cafes, 2,191 computers and 1,154 phones have been funded
for fiscal year 2010 for use in Afghanistan. To enhance MWR provided
services, the Exchanges provide personal information services for a
usage fee for this customer convenience. Back home, computers and
Internet service located in our family support centers, recreation
centers, libraries, and youth centers help ensure families can connect.
DOD-State Initiatives
The Department continues to work with State governments to educate
their policymakers on the life-challenges faced by servicemembers and
their families and to ensure that state-level policies do not
disadvantage military families' transient life style. States have
addressed several key quality of life issues, to include the impact of
frequent school transitions experienced by military children, the loss
income by military spouses as a result of military moves, and the
enforcement of the congressionally-mandated DOD predatory lending
regulation. The response from states has affirmed their commitment to
supporting the well-being of the Nation's fighting force. For example,
27 States have joined the Interstate Compact on Educational Opportunity
for Military Children, 36 States now provide eligibility for
unemployment compensation to military spouses, and 30 States enforce
the DOD predatory lending regulation. The Department is continuing this
effort in the 2010 session and has added child custody to the slate of
issues. In this regard, the Department is asking States to
appropriately balance the interests of servicemembers who are absent
due to military service with the best interests of the child by
ensuring absences caused by military deployments are not the sole basis
for permanent custody decisions and addressing delegation of visitation
rights while the servicemember is deployed.
Special Needs
The establishment of the Office of Community Support for Military
Families with Special Needs was mandated by NDAA 2010. The purpose of
the Office is to enhance and support Department of Defense support for
military families with special needs to ensure parity across the
Services. The Office will be headed by a member of the Senior Executive
Services. It will be staffed with personnel in the fields of medicine,
education, early intervention, social work, personnel and information
technology, as well as members of the armed services to ensure
appropriate representation by the military departments. Currently,
plans are underway to identify the specific mix of staff and to create
an umbrella Office of Community and Family Support with an emphasis on
special needs, which will synchronize all family support needs with
those of families with special needs.
Disability Evaluation System
The Disability Evaluation System (DES) Pilot simplifies and
restructures how servicemembers are evaluated for continued service and
compensation as a result of a wound, injury, or illness. Based on the
recommendations of several commissions and task forces, DOD and VA
implemented the DES Pilot on November 26, 2007, at three National
Capital Region (NCR) locations (Walter Reed, Bethesda, and Malcolm
Grow). Since November 2007, this program has been administered jointly
by the DOD and VA. The Pilot eliminates duplicate disability
examinations and disability ratings by the Departments. The DOD
determines fitness for duty; the VA examines and rates for disability.
The rating is used by DOD for unfitting conditions and by VA for all
service-connected or aggravated conditions. After March 2010, the DES
Pilot will operate at 27 locations across the continental United States
and Alaska and encompass 47 percent of all potential servicemembers'
cases. Compared to the legacy system, case processing time has been
nearly cut in half (46 percent decrease) for Active and Reserve
component servicemembers. The Pilot will be expanded to encompass 100
percent of the DES by December 2012. The DES Pilot Final Report which
includes the results and recommendations for the DES Pilot-model
worldwide implementation will be forwarded to Congress by May 31, 2010.
Transition Initiatives
The Department has several initiatives relating to the Department
of Defense (DOD) Transition Assistance Program (TAP). We began this
fiscal year by convening the first Joint Interagency Strategic Working
Group on the Transition Assistance Program in November 2009. We are
also working on several employment initiatives with our partners at the
Department of Labor. As an ex-officio member of the Secretary of
Labor's Advisory Committee on Veterans Employment, Training and
Employer Outreach (ACVETEO), the Department is looking at more
efficient ways to connect employers with transitioning Services
members, veterans and their spouses. We are also looking at revamping
the Department of Labor (DOL) TAP Employer Workshop to make it more
dynamic and ensure it is meeting the needs of our warriors. Finally, we
continue to collaborate with DOL on how to ensure our wounded, ill and
injured are being prepared for and get meaningful jobs.
In addition to our work with DOL, this office assisted with the
Office of Personnel Management (OPM) strategic plan as well as an
executive order signed by the President in November 2009, which
directed all Executive Branch Federal Agencies to increase the hiring
of veterans. We are pursuing other initiatives like our work with the
U.S. Interagency Council on Homelessness. The Department is assisting
the council in developing a Federal Strategic Plan on Homeless. The
plan will address ideas and ways to end homeless for our veterans,
families, and youth.
One of our most exciting initiatives was joining the social network
community with the launching of the DOD TAP Facebook. We are taking
advantage of the popularity of social media as another communication
resource to promote transition services and benefits to military
personnel and their families.
Finally, we are working to improve outreach and education to all
servicemembers to increase their participation in the Benefits Delivery
at Discharge and Quick Start Programs. These programs allow eligible
servicemembers to submit their application for disability compensation
prior to separation or retirement.
civilian personnel
National Security Personnel System Transition
The National Defense Authorization Act for Fiscal Year 2010 (NDAA
2010) repealed the authority for the National Security Personnel System
(NSPS) and requires the Department to transition out all employees and
positions from NSPS to the appropriate non-NSPS personnel and pay
system no later than January 1, 2012. The law provides no employee will
suffer any loss of or decrease in pay upon conversion from NSPS.
Planning for terminating NSPS is well under way with the goal of
transitioning employees and organizations from NSPS back into their
pre-NSPS personnel and pay system during fiscal year 2010. The rules of
the gaining pay and personnel system will be followed in determining
placement of NSPS employees. Since the majority of the 226,000
employees covered by NSPS will transition to the General Schedule
system, government-wide rules issued by the Office of Personnel
Management (consistent with title 5, U.S.C.) are applicable. Until the
transition takes place, organizations and employees currently covered
by NSPS will continue to follow NSPS regulations, policies, and
procedures. While the Department did not transition any bargaining unit
employees into NSPS, approximately 900 employees organized after their
organizations moved into the system. The Department plans to meet with
representatives of national unions representing these NSPS bargaining
unit employees to discuss transition issues and will ensure that local
collective bargaining obligations are fully satisfied as these
employees transition from NSPS back to the General Schedule. Transition
timelines are being determined based on organizational readiness as
evidenced by avoidance of undue interruption to mission and hardship to
employees; established processes to classify NSPS positions into the
appropriate non-NSPS personnel system; existence of an appropriate
performance management system; and information technology capability.
Prior to their transition out of NSPS, employees will be informed of
their position classification under the non-NSPS personnel system. With
limited, approved exceptions, no new appointments to NSPS will be made
after March 1, 2010. The Department is tracking transition costs as it
did with NSPS implementation costs. The organization that is guiding
and directing transition planning and execution is the National
Security Personnel System Transition Office (NSPSTO). The Director,
NSPSTO is responsible for the development, coordination, and
dissemination of supporting procedures, policies, and tools; and for
developing training products and services for use by the Components in
training employees and supervisors on all aspects of the transition. In
addition, the Department is committed to providing open and frequent
communications during the transition. The NSPSTO has redesigned its Web
site to publicize up-to-date information on the transition, including
transition toolkits that contain a variety of products such as
conversion guides, fact sheets, brochures, articles, frequently asked
questions, performance management guidance, timelines, and town hall
briefings on the transition. The website and communications will be
updated periodically as new information becomes available and new
products are developed. In addition, the Department will deliver a
report to Congress at the end of April 2010, as required by NDAA 2010,
that covers the steps taken for the reclassification of NSPS positions
and the initial plan for transitioning employees and organizations from
NSPS; semiannual reports that cover transition progress will also be
provided until all organizations and employees are out of NSPS.
Civilian Strategic Human Capital Planning and Forecasting
With over 760,000 civilian employees, in over 600 occupations,
supporting a myriad of critical missions, it is essential the
Department have a structured plan to ensure civilian talent is in place
to meet current and future mission requirements. To meet this demand,
the Department is leading an enterprise-wide effort to establish a more
structured, standard approach to Strategic Human Capital Management
(SHCM), based on a combined effort of competency assessment and
workforce analysis trending. The Department recognizes the need for a
civilian workforce with the attributes and capabilities to perform
seamlessly in an environment of uncertainty and surprise, execute with
a wartime sense of urgency, and create tailored solutions to multiple
complex challenges. We are institutionalizing an updated, integrated
human capital strategy for the development of talent, that is
consistent with 21st century workforce demands and a new generation of
workers, and that is competency-focused, performance-based, agile,
responsive to mission impacts, and focused on employee engagement and
respect.
Civilian Expeditionary Workforce
The Department is working to better employ the talents of our
civilian workforce to meet expeditionary mission challenges, especially
those not directly related to warfighting. Global security challenges
require adequate civilian capacity to conduct complex operations,
including those missions that require close military-civilian planning
and cooperation in theater. Since 2001, more than 43,000 Department
civilians have been involved in contingency operations around the
globe. Currently, approximately 5,100 civilian employees are serving in
theater. In response to these imperatives, the Department
institutionalized the Civilian Expeditionary Workforce (CEW) to provide
deployable civilian experts to support military operations,
contingencies, emergency operations, humanitarian missions, disaster
relief, and stabilization and reconstruction operations. The CEW is
designed to enhance the Department's ability to work alongside and help
build the capacity of partner defense ministries and provide surge
support where needed. The CEW encompasses a pre-identified subset of
the Department's emergency essential and volunteer civilian workforce
by skill sets and capabilities, who are trained, ready, cleared, and
equipped for rapid response and quick assimilation into new
environments.
Civilians deployed under the CEW receive general and theatre-
specific, urban training, and are eligible for the same health care
benefits as deployed military personnel, including medical evacuation
and access to hospital services in-theatre. With the support of
Congress, the Department has obtained important incentives and benefits
to help compensate for the inherent risks of deployment. The Department
continues to identify pertinent issues and propose fully integrated
solutions to ensure force health protection, surveillance, deployment
benefits, and medical care for civilians who have been injured,
wounded, or have contracted diseases while deployed in support of
contingency operations. We have worked in partnership with the Office
of Personnel Management, the Department of State, and the Department of
Labor to ensure all similarly-situated Federal civilians receive
consistent and equitable benefits commensurate with the risks of
deployment.
Civilian Leadership Development
The Department is currently working on the recruitment and
development of entry-level leaders in conjunction with Section 1112 of
the NDAA for Fiscal Year 2010, which requires the establishment of a
DOD Civilian Leadership Program. The Department recognizes the need for
an improved model to attract, retain, and deliberately develop civilian
leaders to support pipeline readiness and enhance bench strength. In
fiscal year 2010, the Department will fully develop the entry-level
program to grow emerging leaders. We will launch an initial program
pilot in fiscal year 2011 and expand the pilot and implementation in
fiscal year 2012. Our communities of initial focus for this effort
include acquisition and finance specialists to meet the Department's
needs.
Recruitment for Critical Positions and Competencies
The Department has an aggressive approach for identifying mission
critical recruitment requirements, to include health, acquisition,
linguists and emerging mission-essentials such as IT specialists in
cyber warfare. We have a plan in place and a robust forecasting model
that indicates those areas where recruitment surges may be needed.
Where such surges are indentified, we craft staffing strategies, such
as expedited hiring authority and scholarship programs, to meet those
needs. Our integrated approach to Strategic Human Capital Management
(SHCM) will prove to enhance our ability to analyze demographic trends,
forecast requirements, assess gaps, and further define recruitment and
hiring strategies.
Increasing Veterans Opportunities
The Department values the experience and commitment of our
servicemembers and places special emphasis on supporting transitioning
servicemembers, wounded warriors, and veterans in their search for
employment. We continue our efforts to actively reach out to our
veterans to assist them in their civilian employment search with
aggressive outreach programs, transition assistance programs, career
and job fairs, and benefits counseling and assistance.
The Department continues this tradition in support of Executive
Order 13518, the Veterans Employment Initiative. In January 2010, the
Department stood up the DOD Veterans Employment Program Office to
promote veterans recruitment, training and development throughout the
Department. We are promoting the Veterans Initiative through DOD's
Hiring Heroes Program, through which we conduct eight to ten Hiring
Heroes Career Fairs throughout the U.S. for wounded, ill and injured
servicemembers, transitioning military, veterans, and their families.
In-sourcing
The Department is on track to reduce the level of contracted
support service from the current 39 percent of our workforce to the
pre-2001 level of 26 percent, and perform those services with full-time
government employees. Over the next 5 years, DOD expects to hire up to
33,400 new civil servants to fill positions established as a result of
insourcing contracted services. This includes 5,000 acquisition
personnel over fiscal year 2010/2011 and 10,000 through fiscal year
2014. On January 4, 2010, the Department submitted to Congress a report
on ``fiscal year 2010 Insourcing Initiative and Plans.'' DOD Components
estimated they would establish nearly 17,000 new civilian
authorizations in fiscal year 2010 to perform currently contracted
work.
There are no artificial limits placed on DOD Components'
identification of in-sourcing candidates (i.e., contracted services
that would more appropriately be performed by government employees).
The Department considers insourcing as a well-reasoned part of Total
Force management that:
Rebalances the workforce and rebuilds organic
capabilities.
Ensures that inherently governmental functions that
support the readiness/management needs of the Department are
performed by government employees.
Implements Congressional direction on in-sourcing
(NDAA for Fiscal Year 2008).
Contractors remain a vital part of the Department's Total Force.
The Department is not ``replacing'' or ``converting'' contractors but
rather in-sourcing contracted services--contractors remain a vital
source of expertise to the Department and are an integral part of our
Total Force.
other personnel concerns
Foreign Language, Regional, and Cultural Capabilities
The Department is continuing its work to ensure our commissioned
and noncommissioned officers are prepared for a full range of varying
and complex missions that our current and future security environment
requires which includes building expertise in foreign languages,
regional and cultural skills. The fiscal year 2011 budget focuses on
sustaining gains achieved in previous years and continuing to build a
solid infrastructure in which to meet future demands. Baseline funding
of $793 million in fiscal year 2011 supports redirected language and
culture instruction to achieve higher proficiencies for the Total Force
in these skills. During the most recent programming cycle, the
Department committed an additional $29 million in fiscal year 2011 to
establish Language Training Detachments to provide and sustain
commanders' needs, support the Afghanistan/Pakistan Hands program, and
expand the role of English language training for partner nation
personnel. The Department's continuing efforts feature the following
significant initiatives and accomplishments.
Military Leadership Diversity Commission
As mandated by NDAA 2009, the Department established the Military
Leadership Diversity Commission (MLDC) to conduct an independent review
and comprehensive evaluation and assessment of policies that provide
opportunities for the promotion and advancement of minority members of
the Armed Forces, including minority members who are senior officers.
Led by General Lester Lyles (ret.), the Commission consists of 26
appointed members to include retired and active duty officers,
enlisted, and civilian representation from all the Service components
and the Coast Guard. The Commission will expand to 32 members.
The Commission conducted its first meeting in Washington, DC in
September 2009. Several monthly meetings are planned throughout the
country during the independent review, culminating with a written
report to the President and Congress no later than September 2010. The
report shall include the Commission's findings and conclusions,
recommendations for improving diversity within the Armed Forces, and
other relevant information and proposals considered appropriate.
Sexual Assault Prevention and Response
The Department's position on sexual assault is a simple one: Sexual
assault is a crime that is incompatible with service in the U.S. Armed
Forces. It undermines core values, degrades military readiness,
subverts strategic goodwill, and forever changes the lives of victims
and their families. To address this crime, the Department has put
numerous broad-based programs in place to achieve our vision of
enhancing military readiness by establishing a culture free from sexual
violence.
The Department's goal is to prevent sexual assault through
institutionalized prevention efforts that influence the knowledge,
skills, and behaviors of servicemembers to stop a sexual assault before
it occurs. We have developed a comprehensive prevention strategy built
around the concept of bystander intervention. Throughout the
Department--from the newest recruits to the most senior leaders--
servicemembers are getting educated on the role they can play as
individuals in preventing this crime.
In conjunction with prevention, we are working to increase
awareness so when a crime does occur, it is reported. We want any
victims within the military to come forward, first and foremost, to get
treatment, and if so desired, provide details of the crime so the
perpetrator can be held accountable.
The Department is committed to ensuring the sexual assault
prevention and response program works as intended. This ``system
accountability'' is achieved through data collection, analysis, and
reporting of case outcomes. In order to improve data collection,
analysis, and case management, the Department initiated the development
of the Defense Sexual Assault Incident Database (DSAID). In January
2010, a Request for Proposal was issued to identify a vendor for the
database, with selection expected by the fall.
The Department has participated in several external reviews in
recent years, most recently by the Government Accountability Office
(GAO) and the Defense Task Force on Sexual Assault in the Military
Services (DTF-SAMS). DTF-SAMS released their report in December 2009
and GAO released their report in February 2010. We are currently
reviewing and responding to their recommendations.
Child Custody
The Department believes the States are in the best position to
balance the competing interests within the context of their own
domestic relations laws. Approximately 30 States have passed
legislation that addresses the special circumstances facing military
parents who have custody of children but who are not married to the
other parent.
The American Bar Association, National Military Family Association,
and the Senate support the Department's position. Although the Senate
has continued to reject Federal child custody legislation, it did
include language in the NDAA for Fiscal Year 2010 that requires a
report to Congress on military child custody issues by March 31, 2010.
Senate Armed Services Committee staff indicate this report will form
the basis for hearings anticipated in April 2010.
The Department has committed to several efforts to address the
unique challenges facing military members who have custody of a child
but are not married to the other parent. The Department is working with
its State liaisons to encourage those 20 States who have not addressed
military child custody issues in their domestic relations laws to do
so. The Department is also looking for opportunities to increase
participation in and support of the American Bar Association's Military
Pro Bono project, which provides free in-court representation to
military members for domestic relations cases (and other cases).
Finally, the Department is updating and reissuing its Family Care Plan
instruction, which can, if used properly, significantly reduce custody
problems without the detrimental effects of the proposed Federal law.
Federal Voting
The Department vigorously assists our men and women in uniform,
their voting-age dependents and U.S. citizens residing overseas to
successfully participate in the 2010 primary and general elections.
Initial indications are that the Department's programs are having a
significant impact: for the 2008 general election, the active duty
military voter registration rate exceeded that of the general
population's: 77 percent for the military as compared to 71 percent for
the general population.
Unfortunately, while more than 91 percent of absentee ballots were
successfully returned by general electorate voters in the 2008 general
election, only 67 percent of uniformed services and overseas voter
absentee ballots were successfully returned. Unsuccessful return of
ballots represents the single greatest point of failure for military
and overseas voters, and is largely due to absentee ballots being sent
out too close to the election, with insufficient time for the voter to
successfully receive, vote and return the ballot by the States'
mandated deadlines. In fact, more than 81 percent of all the voting
failure suffered by military and overseas voters was because of ballots
transmitted to them, but never returned.
The Department is focusing its voting assistance programs to
address the overwhelming point of failure by focusing on those programs
that will expedite both the delivery and return of ballots from
military and overseas voters. First, the Federal Voting Assistance
Program is developing an online wizard that will allow military and
overseas voters to receive and mark their complete Federal, State, and
local ballot online, and then print it out for voter verification,
signature of the voter's oath, and postal mail return of the paper
ballot. Second, the Military Postal System is also preparing an
expedited ballot return system which will return ballots by Express
Mail, as well as provide the voter with an online tracking system all
the way to delivery to the local election official. The Military Postal
System's desired delivery time is no more than 7 days from receipt of
the ballot from the voter to delivery to the local election official.
The Department is also taking full advantage of the authority
granted it under the Military and Overseas Voter Empowerment (MOVE) Act
of 2009 to designate all military installation voting assistance
offices as National Voter Registration Act voter registration agencies.
This will allow the Department to also collect from and mail in for
those voters (who desire the assistance), the FPCAs or other
registration forms completed by those voters.
The Department has been working closely with States to identify
those changes in State law necessary to achieve the requirements of the
MOVE Act, and to provide sufficient opportunity for military and
overseas voters to successfully complete the absentee voting process.
conclusion
We face two fundamental, and related, challenges. First, we must
continue to attract and retain high quality, motivated individuals for
Active and Reserve military service and we must maintain an
enthusiastic and skilled civilian workforce. Second, we must weigh
sufficiency against the risks of an uncertain future. As we invest in
our human capital, we must do so judiciously. While our future
challenges may often seem without bounds, our resources are not. We
must make hard choices, as a Department and as a Nation, of allocating
our resources the best we can to win the war at hand while taking care
of our most valuable asset--our men and women in uniform. I look
forward to working with this Congress in this effort.
Senator Webb. Thank you very much, Secretary Stanley.
Secretary Lamont.
STATEMENT OF HON. THOMAS R. LAMONT, ASSISTANT SECRETARY OF THE
ARMY FOR MANPOWER AND RESERVE AFFAIRS
Mr. Lamont. Chairman Webb, Senator Graham, distinguished
members of the committee, thank you for the opportunity to
appear before you today.
I appear before you on behalf of 1.1 million men and women
serving here and abroad in peaceful, as well as hostile,
environments. This combat-seasoned force is resilient and
professional, yet strained and out of balance. More than 1
million of this Nation's finest citizens have deployed, over
the past 8 years, into harm's way. We realize, very well, that
there are costs associated with this conflict, both visible and
invisible.
Our current programs to relieve stress on the force are
critical to maintaining a healthy, balanced, and prepared
force. These programs help us defend our country against some
of the most persistent and wide-ranging threats in our Nation's
history. The success of these programs is due, in large part,
to the support Congress has given us since this Army went to
war in 2001.
First and foremost, you have enabled us, through
appropriate resources, to meet a temporary end-strength
increase for our agile Army. As a result, this will, in part,
alleviate the stress and strain on the total Army. This is a
step in the right direction to get our personnel structure back
in balance.
Congress has also given us the means to improve the quality
of life for our soldiers and their families. Soldiers remain in
the Army based on the established incentive programs, such as
an excellent healthcare system, educational opportunities,
financial stability with sufficient bonuses, general vacation
time, soldier and family services, and frankly, out of a true
sense of duty to our country. This Congress has embraced our
needs, and for that, we are very grateful.
The Army continues to face challenges, which we will
encounter today and well into the future. Armed with lessons
learned, it is our intent to stay in front of those challenges,
anticipate them, develop strategies and programs to address
them, and hopefully, keep them from becoming problems in the
future.
Specifically, one of the challenges that we are addressing
is the concept of the Operational Reserve. The Army's Reserve
component continues to transition from a strategic Reserve to
an operational force. The Army will require recurrent, assured,
and predictable access to the Reserve component to meet
operational requirements. This transformation of the Reserve
component into an operational force will provide an opportunity
for the Army to provide the most cost-effective total force by
investing resources in the most cost-efficient portion of the
Army's total force.
Our focus this year centers on restoring the balance,
resilience, and sustainment of the force, growth in talent, and
our ability to meet the Nation's needs with the highest-quality
force available. The Army will continue to work hard to attract
and retain the best, but we need your help in taking on this
larger problem. The challenging environments that our soldier's
serve in demand that we maintain the standards as set, and we
must remain ever-vigilant that our force is manned with both
physically and mentally qualified soldiers, as it is today.
As you are well aware, we have some tough challenges ahead
of us. I'm confident, however, that with the operational and
institutional agility this Army has developed over the past 9
years, we will meet all the challenges that will come our way.
It is always easy to commit to a plan of action when we know
that Congress supports us. Your leadership and your support
have been unwavering.
I appreciate this opportunity to come before the committee,
both now and in the future, and I look forward to your
questions.
Senator Webb. Thank you very much, Secretary Lamont.
[The prepared statement of Mr. Lamont follows:]
Prepared Statement by Hon. Thomas R. Lamont
introduction
Chairman Webb, Senator Graham, distinguished members of this
subcommittee, thank you for the opportunity to appear before you on
behalf of America's Army. Our greatest heroes are America's most
precious resource--our soldiers. These soldiers and their families,
backed by our civilian workforce, represent the very best of America's
values and ideals and faithfully shoulder the load that our Nation asks
of them. This fighting force of 1.1 million soldiers is continually
tested at home and abroad. Repeatedly our Nation's men and women step
forward and pledge to serve. They recognize the challenges facing our
Nation, answer the call, and become part of something larger than
themselves. Their dedicated service and sacrifice are deserving of the
very best services, programs, equipment, training, benefits, lifestyle,
and leadership available. Our focus this year centers on restoring the
balance, resilience, and sustainment of the force, growth in talent,
our ability to meet the national challenges, and the importance of
maintaining this strength to meet the demands now and for the future.
Thank you for your steadfast commitment to ensuring our soldiers, their
families, and our civilian workforce by supporting our personnel
initiatives to ensure growth, sustainment and well being of our All-
Volunteer Force.
strategic overview
America's Army, strained by over 8 years of persistent conflict,
remains a resilient force. Our Army, however, is also stretched and out
of balance while demand has continued to grow. The Army has added
nearly 100,000 more soldiers since 2004. More than one million of our
country's finest men and women have deployed to combat, with over 5,000
lives sacrificed in the line of duty. The Army appreciates your recent
support in providing the Army with temporary end strength increase of
22,000 to provide some relief to our stressed force. We will complete
the initial ramp of 15,000 by the end of fiscal year 2010 and will
evaluate the need to complete the remaining amount later this year.
Even with this temporary increase, we face many challenges ahead, but
must remain vigilant and supportive to the needs of our people. We must
continue to address these needs and find a way to get our Army back to
a balanced force.
end strength
To alleviate the stress and strain on the force, the Department of
Defense authorized the Army a Temporary End Strength Increase (TESI) of
up to 22,000 Active Duty soldiers. Currently the plan is to use 15,000
of the 22,000 with a decision on the remaining 7,000 expected at the
end of the second quarter, fiscal year 2010. This temporary increase
provides additional, primarily skill level one, soldiers within highly
deployed Military Occupational Specialties (MOSs) to combatant
commanders. TESI has already increased unit readiness and will provide
increased manning and readiness until fiscal year 2013 when the Army
returns to its base end strength level of 547,400 in the Active
component. While the majority of these additional soldiers are
enlisted, the officer ranks will also experience a slight increase.
Another advantage of TESI is a reduction in the use of Stop Loss.
The Army expects to achieve a 50 percent reduction in the number of
soldiers affected by Stop Loss by June 2010. As of January 2010, 7,861
soldiers were affected by Stop Loss, a 41 percent reduction from the
January 2009 baseline of 13,217. By January 2011, the Army will have no
soldiers deployed under Stop Loss. However, soldiers in post-deployment
reintegration or demobilization may still be in Stop Loss until early
spring 2011. TESI and the implementation of voluntary stabilization
programs for each component have made significant contributions to the
Army's ability to eliminate Stop Loss, while minimizing the potentially
detrimental impact to unit readiness.
We continue to make significant progress in our efforts to restore
balance. Increasing time between deployments for our soldiers and
building greater predictability for soldiers and families continues to
be one of our key concerns. Despite the short term impact of the recent
surge of troops to Afghanistan, we expect the ratio of Boots on Ground
(BOG) time to dwell time at 1:2 for the Active Force and 1:4 for the
Reserve component to improve as demand decreases. Eventually, increased
dwell time will be achieved by lowering the demand on our forces while
increasing the size of the active Army. This will ease the constant
pressures on our forces as we move into the rotational cycle of the
Army Forces Generation (ARFORGEN) model. The Army Senior Leadership
remains committed to meet these deployment goals while eliminating Stop
Loss, and without any increase in tour length for our soldiers.
recruiting and retention (officer and enlisted)
Our soldiers are the Army's most important resources, and our
ability to meet the challenges of the current and future operational
environments depends on our ability to sustain the All-Volunteer Force.
The pace and demand of the operational environment over the last
several years has caused us to dedicate our focus to reaching a high
volume of recruits. The shift in the economy, however, has allowed us
to demand even higher quality recruits. Despite the challenges of an
Army engaged in two protracted conflicts, the Army exceeded its
enlisted recruiting and retention missions for fiscal year 2009 and is
confident it will meet its goals for fiscal year 2010. The Army met 104
percent of its recruiting goals for fiscal year 2009, while at the same
time, meeting its quality benchmarks for new recruits. Successfully
meeting these critical benchmarks moves us closer to restoring balance.
As we dedicate ourselves to the fiscal year 2010 recruiting mission, we
will continue to monitor trends and make adjustments as required.
In fiscal year 2009, with congressional support, the total Army
spent $4.9 billion on recruiting and retention. In fiscal year 2010,
these programs received $4.4 billion due to a more favorable recruiting
and retention environment. Our $4.6 billion, fiscal year 2011 request
is based on the need to continue funding for contracts written between
fiscal year 2006 and fiscal year 2009 and to ensure the success of the
total Army's recruiting and retention missions. The amount budgeted for
contractual payments is anticipated to decrease in fiscal year 2012 and
subsequent years.
Because of this funding, the Army is now a higher quality All-
Volunteer Force. For example, the Army's percentage of ``high quality''
enlisted soldiers with a high school diploma have increased by 2.1
percent since the end of fiscal year 2009. Additionally, recruits
scoring in the upper range (50-99 percent) on the Armed Forces
Qualification Test (AFQT) increased 2.0 percent; and recruits who
scored poorly (30 percent and below) on the AFQT decreased 0.4 percent.
The Army was able to decrease the amount of ineligibility waivers
previously provided for enlistments and appointments. Also, the Army
was able to repair mid-grade officer shortages in the Regular Army,
which provided the opportunity to aggressively target mid-grade
shortages in the Reserve components.
Overall, the Army's programs are effective in recruiting and
retaining both officers and enlisted soldiers with critical skills. For
enlisted soldiers, the Enlistment Bonus (EB), the Selective
Reenlistment Bonus (SRB), Critical Skills Retention Bonus (CSRB), Army
College Fund (ACF), and the Student Loan Repayment Program (SLRP)
remain as proven and effective tools for filling critical skills. The
ACF and SLRP are especially effective in attracting quality recruits
who have some college experience or plan to attend college after the
Army.
To assist in recruiting critical skills, the Army launched the
``Military Accessions Vital to the National Interest'' (MAVNI) Pilot
Program which the Secretary of Defense authorized on November 25, 2008
and Army launched on February 23, 2009. The purpose was to attract high
quality individuals with exceptional skills in health care professions
or native speaking skills in at least 1 of 35 critical foreign
languages. MAVNI recruits are non-U.S. citizens who have been legally
present in the United States for 2 or more years and speak a critically
needed foreign language or are U.S. licensed health care professionals
who meet or exceed all requirements for military service but for U.S.
citizenship. They do not have permanent residency (i.e. Green Cards).
We recruited 788 MAVNI with language skills and 143 health care
professionals during the 12 months since the program launched. Without
spending a single dollar on marketing or advertising, Army received
over 12,000 leads for the MAVNI program and positive media coverage. Of
the foreign language speakers recruited, 66 percent have a bachelor's
degree or higher, and 30 percent have at least a master's degree. Half
the MAVNI recruits speak and comprehend the foreign language for which
they were recruited at the 3/3 level or higher which is akin to a
college graduate. Their loss from the Delayed Entry Program (DEP) is
one-third that of non-MAVNI recruits and their attrition rate once in
the Service is virtually nil. We reached the cap for this program
established by the Secretary of Defense so until the program is
extended we are unable to recruit the many applicants waiting to be
processed.
Through a separate program, the Army has recruited more than 1,600
soldiers as military interpreters and translators under the MOS O9L
Program. This MOS enlists native speakers of Arabic, Pashtu, Dari,
Farsi, and Kurdish into all components of the Army to serve as
interpreters in uniform. Combatant Commanders have found them to be
force multipliers as they bring high levels of proficiency in these
languages as well as firsthand cultural knowledge.
In fiscal year 2009, all components exceeded the annual retention
goal. The Active Army achieved 124 percent of the annual goal, the Army
Reserve achieved 105 percent, of the annual goal, and the Army National
Guard achieved 106 percent of the annual goal. During fiscal year 2009,
retention bonuses were carefully monitored and adjusted to achieve the
maximum result, ensuring the Army met its retention goals while
remaining fiscally responsible. The economic environment allowed the
Army to reduce incentive levels as well as the number of occupations
offering bonuses, while focusing on our most critical skills. In
addition, use of the Army's Critical Skills Retention Bonus greatly
assisted in retaining very experienced senior enlisted soldiers with
invaluable leadership and combat experience. Retention of combat
experienced veterans remains critical to current and future readiness.
In fact, 39 percent of all reenlistments occurred while soldiers were
deployed. The Active Army also continued to support and encourage
Active Duty soldiers who elected not to reenlist to transfer to the
Reserve component upon completion of their Active Duty tour.
The Army retention mission is also on track to meet the goals set
for fiscal year 2010. The Active Army has reenlisted 41,262 soldiers
for 68 percent of the annual goal, the Army Reserve has reenlisted
4,291 for 42 percent of the annual goal, and the Army National Guard
has reenlisted 10,771 soldiers for 35 percent of the annual goal. In
all components, the Army expects to finish successfully in every
category.
The Post-September 11 GI Bill, which took effect August 1, 2009,
provides a significantly enhanced level of educational benefits for
Active Duty servicemembers. Additionally, it serves as a valuable
incentive to attract and retain quality soldiers of all ranks. The Army
expects the Post-September 11 GI Bill to serve as an inducement for
college oriented teens to join the Army, while transferability should
increase retention within our mid-career (6-10 years of service),
category of soldiers. Although it is too early to fully determine the
impact of the Post-September 11 GI Bill on both recruiting and
retention, initial signs are positive. In particular, we've kept a
watchful eye on the retention of our initial term soldiers who some
feared might separate under expiration of their term of service in
order to use their educational benefits. However, the Army exceeded its
retention goals for first-term soldiers in fiscal year 2009 and
continues to do so in fiscal year 2010.
Shortages remain within our officer corps due to overall structural
growth of the Army. To correct this, the Army initiated the Captains'
Retention Incentive Menu in September 2007. The Army spent $443.6
million from fiscal year 2007 to present on this incentive program. The
goal of the program was to recruit, retain, and manage critical skills
to increase the retention of lieutenants and captains for 3 years. The
Captains' Retention Incentives Menu program included a cash option
based on the officer's branch, resident graduate school attendance for
up to 18 months, or attendance at the Defense Language Institute for 1
year. As a result, the Army's retention rate for Captains increased in
fiscal year 2008 to 89.1 percent and again in fiscal year 2009 to 89.9
percent over the 10-year average of 88 percent. The program guaranteed
retention through fiscal year 2011 for over 16,000 of the 23,000
captains who were eligible to participate. The timing of our Captains'
Retention Incentives Menu program, concurrent with the dramatic
downturn of the economy and job market, helped support our retention
goals. The cash and Defense Language Institute options ended in
November 2008. The remaining retention incentive, the Expanded Graduate
School Program, has been funded at $7.5 million in fiscal year 2010.
Overall, the single most effective retention incentive for junior
officers was the cash bonus. Over 94 percent of the more than 16,000
officers who took incentives in fiscal year 2008 elected to take the
cash bonus. Department of Defense survey data analysis showed that most
officers who intended to separate or were undecided, took the incentive
and committed to further obligated Army service.
The U.S. Military Academy (USMA) and ROTC both continue to offer
pre-commissioning incentives. These consist of offering new officers
their Post or Branch of Choice or Graduate Schooling. In fiscal year
2006 through fiscal year 2009 there were approximately 6,000
participants. These incentives have increased longevity by 40 percent
for newly-commissioned, high-performing USMA and ROTC officers.
In spite of a dramatically changed recruiting climate, based on the
economy, our message to our soldiers and their families must resound
with assurance that they will be cared for in a manner commensurate
with their service and sacrifice. Incentives, bonuses, and pay are only
part of the equation in creating balance in our soldiers and families
lives. In the event of a life changing injury or the loss of life, our
soldiers are assured that their families will receive financial and
programmatic support for their loss and sacrifice. This support
includes full-earned benefits and disability compensation. The Army is
working closely and aggressively with soldiers and their families to
streamline access to assistance from other Federal agencies, such as
the Social Security Administration, Department of Labor, and Department
of Veterans Affairs.
In direct support of President Obama's Veteran's Day Executive
Order on employment of veterans in the Federal Government, we have
begun a Veterans Employment Transition Initiative to streamline,
synchronize, and integrate existing policies, programs, and initiatives
to assist soldiers and their families as they transition out of the
military. The intent is to ensure that they have timely visibility of
every opportunity available to them as they transition to civilian
life, whether as Federal workers or as contributing members of the
private sector.
The Army carefully manages its resources, reviewing and adjusting
incentives at least quarterly to ensure we attract and retain quality
individuals in needed occupations, while remaining fiscally responsible
to avoid excessive payments. The economic environment has allowed us to
reduce incentive amounts and the number of occupations offered bonuses
or education incentives. Enlistment Bonuses are at the lowest levels
since the 1990s drawdown. However, we must retain the flexibility to
apply incentives as necessary to retain soldiers with critical or
specialized skills. The continued authorities and funding of these
programs by Congress remain critical to the sustainment of the Army.
individual ready reserve mobilization
The Individual Ready Reserve (IRR) is a category of the Ready
Reserve, and is composed of those members of the Ready Reserve who are
not serving in Selected Reserve units or assignments, or in the
Inactive National Guard. The availability of IRR soldiers is critical
to the Army's mission of providing properly trained and equipped units
of sufficient strength to meet contingency operation or mobilization
requirements. As of February 28, 2010, there are 59,413 soldiers in the
IRR. Since September 11, 2001, a total of 29,997 soldiers received
mobilization orders and a total of 12,018 soldiers deployed to the
CENTCOM Area of Responsibility. The Army applies specific screening
criteria and a tiered systemic approach regarding involuntary
mobilization of the IRR. These actions align with the January 2007 DOD
policy on Utilization of the Total Force and take into account a
soldier's dwell time, Military Service Obligation (MSO), and previous
deployments in support of OCONUS Contingency Operations (OCO).
An effective IRR program is based on several factors, including the
soldiers' understanding of their obligations, access to benefits and
support, and time to adjust personal affairs prior to mobilizations. In
an ongoing effort to validate the readiness of the IRR, the Army
continues to implement the IRR Muster program. Approximately 5 months
after entering the IRR program, soldiers will be ordered to muster
duty. Afterward, soldiers are required to muster each year they remain
in the IRR. Through the muster program, the Army established a
partnership with the Department of Veterans Affairs to use VA medical
centers as muster sites for the added opportunity of connecting
soldiers to VA services. During fiscal year 2009, the Army spent
approximately $3.6 million to muster 13,500 soldiers, contributing to
3,300 soldiers returning to Army Reserve formations. The Army plans to
muster 14,000 IRR soldiers at an estimated cost of $4.2 million in
fiscal year 2010 and expect to impact 3,500 soldiers returning to Army
Reserve Formations.
operational reserve
As the Army continues to institutionalize the Operational Reserve,
our first and greatest challenge is to effectively and efficiently
deliver ready and trained soldiers. Transforming the Reserve components
(RC) into an operational force in the near-term (fiscal year 2012-2014)
will provide a means for RC forces to provide proportional support to
the Army's Force Supply model of a Corps Headquarters, 5 division
headquarters (4 Active component (AC), 1 RC), 20 Brigade Combat Teams
(15 AC, 5 RC), and 90,000 enablers (41,000 AC, 49,000 RC) to support
combatant command requirements through 2014 time period. It is
important to note that programming decisions are required in the near
term to ensure RC forces are sufficiently ready to support the Army's
force generation plans. Without sufficient resources in unit
management, collective training and medical/dental readiness, the RC
will not be ready to support the planned 1/5/20/90 force supply
construct.
The Army will require recurrent, assured and predictable access to
the RC to meet operational requirements as requirements increase for
Army forces to conduct overseas engagement activities over the
remaining years of the program period (fiscal year 2015-2017). During
this period, RC forces will be mobilized and employed in full spectrum
operations at rates proportional to AC forces within force utilization
goals of 1:3 (AC) and 1:5 (RC). Continued investments in RC unit
management, collective training and medical/dental readiness are
required to achieve required readiness levels in accordance with these
ARFORGEN goals. Moreover, these investments are required within the
base funding to ensure the RC achieves a level of institutional
transformation that cannot be achieved through the year-by-year
allocation of resources from overseas contingency operations funds.
Finally, transforming the RC into an operational force provides an
opportunity for the Army to provide the most cost-effective Total Force
and mitigate any decline in resources by investing now in the most
cost-efficient portion of the Army's Total Force. The Army National
Guard (ARNG) and the U.S. Army Reserve account for 51 percent of the
Army's military end strength for 16 percent of the base budget. When
comparing the cost per soldier, the relative value of the RC is even
greater. A 2008 comparison of AC/RC manpower by HQDA G-8 identified the
approximate total costs per Regular Army soldier in manpower, training,
equipping, organization costs and operating costs as $135,000, compared
to $36,000 for ARNG soldiers and $35,000 for Army Reserve soldiers.
Given the relative value is a reasoned investment for the Army's Total
Force, this will make targeted investments improve RC readiness.
Moreover, such investments in the near-term (POM 2012-2017) will
position the Army to better manage the risks of declining resources for
the Army, should such a reduction be required in the next 2 to 5 years.
However, delays in these investment decisions reduce the Army's
flexibility to consider strategic alternatives to a larger Active Force
structure model in the long-term.
quality of life
Recognizing that the strength of our Army comes from the strength
of our Army families, the Secretary of the Army and Chief of Staff of
the Army initiated the Army Family Covenant in October 2007 and
reaffirmed this commitment by resigning the Covenant this past October.
The Covenant institutionalizes the Army's commitment to provide
soldiers and families a quality of life commensurate with the quality
of service they provide our Nation. The Army Family Covenant
incorporates programs designed to build strength and resilience in our
families. These improved services and programs help to mitigate the
stress from mutiple deployments and frequent military moves.
The Covenant focuses on the following: standardizing soldier and
family programs; increasing access and quality of health care;
improving soldier and family housing; ensuring excellence in our
schools, youth and child care services; expanding the education and
employment opportunities for family members; improving soldier quality
of life in recreation, travel, and the Better Opportunities for Single
Soldiers program; and improving relationships with local communities
and marketplaces.
From fiscal year 2007 to fiscal year 2010, the Army more than
doubled its investment in family programs. To ensure they remain
enduring, these increases have been included in the fiscal year 2010
base budget. Furthermore, this funding will increase from $1.7 billion
in fiscal year 2010 to $1.9 billion in fiscal year 2015.
We must never forget that we are one Army made up of Active Duty,
National Guard, and Army Reserve components and must often reach
``beyond the gates of the garrison'' to ensure we support our
geographically dispersed families. We are thankful for all the citizens
and community based organizations that have stepped up to support our
soldiers and their families, regardless of their location.
civilian personnel and workforce development
Department of the Army civilian employees provide vital support to
soldiers and families in this era of persistent conflict. They share
responsibility for mission accomplishment by delivering combat support
and combat service support--at home and abroad. More than ever, Army
civilians are an absolutely essential component of readiness and a key
element in restoring balance. Today, the Army Civilian Corps has nearly
300,000 employees with 3,832 currently serving in harm's way in the
U.S. Central Command area of operations.
Since September 11, 2001, we increased the civilian workforce from
222,000 to 263,169 (plus 24,357 Civil Works) due to overseas
contingency operations, Defense Health Program increases, Family and
Soldier Support initiatives, acquisition workforce growth, in-sourcing
contracts associated with inherently governmental functions, military
technician increases, and military-to-civilian conversions. Future
Civilian employee growth is critical to supporting current plans to
rebalance the Army to 73 brigade combat teams and associated combat
support/combat service support units by fiscal year 2011.
In fiscal year 2009, the Army saved significant resources by in-
souring more than 900 core governmental functions to Army civilians. We
plan to in-source 7,162 positions in fiscal year 2010, and are
programmed to in-source 11,084 positions during fiscal year 2011-2015,
of which 3,988 are acquisition positions. These positions were
identified in the Army's on-going contractor inventory review process.
Current workforce development programs, such as the Army Intern
Program; the Army Fellows Program; the Presidential Management Fellows
Program; the Senior Fellows Program, and the Army Senior Leader
Development Program, to name a few, are helping the Army to ``build a
bench'', of future Army leaders. In an era of persistent conflict,
however, the operational and budgetary realities of fighting terrorism
on multiple fronts have simultaneously increased the requirements for
development and decreased the available funding. Simply put, the Army's
resources to develop our Civilians have not kept pace with the need.
While current training and development programs provide highly
competitive growth opportunities, better incentives for self-
development and professional development are needed to ensure the
Civilian cohort is as prepared to meet future missions as their
military counterparts. The Department of the Army also has several
initiatives to focus and invigorate development of the civilian
workforce, which complement the strategic workforce plan requirements
outlined in the National Defense Authorization Act for Fiscal Year
2010.
The Army is developing a Civilian Human Capital Strategy to better
focus on the full life-cycle needs of Civilian Workforce, from
recruitment to replacement. Because of the increasing complexity of
today's operational environment, the Army must invest more resources
into recruiting, sustaining, and developing its Civilian workforce. The
Initial emphasis of our Civilian Human Capital Strategy will be on
identification of the competencies needed by employees in mission
critical occupations, assessment of the current competency levels of
the workforce, and strategies for closing the gaps. This focus will
enable the Army to develop competency-based civilian recruiting and
hiring strategies as well. This approach will help ease the transition
from one generation to the next as we implement Base Realignment and
Closure and begin to experience the next wave of baby boomer
retirements.
army equal opportunity policy
The Army leads the Nation in Equal Opportunity (EO) policy and
practice. Commanders at all levels are responsible for sustaining
positive EO climates within their organizations to enhance Army
Readiness. Remaining applicable and relevant within the ever-changing
environment in which we operate, the Army is transforming EO policy/
program by integrating and institutionalizing equal opportunity and
diversity goals, objectives and training practices. This effort will
strengthen the foundation of the Army's Human Capital Strategy. Since
fiscal year 2008, the Army has invested $3.4 million and expects to
invest another $0.9 million in fiscal year 2010 for EO personnel and
services support, database and survey systems, outreach support, and
training contracts.
sexual assault and harassment prevention
The Army's goal is to eliminate sexual assault and harassment by
creating a climate that respects the dignity of every member of the
esteemed band of brothers and sisters. The Secretary of the Army
(SECARMY) and the Chief of Staff (CSA) remain personally involved in
reinforcing to all soldiers and leaders the importance of preventing
sexual assault and harassment. Under their guidance and leadership, the
Army launched a comprehensive sexual assault prevention strategy that
requires leaders to establish a positive command climate where sexual
assault is clearly not acceptable. The strategy further encourages
soldiers to execute peer-to-peer intervention personally, and to not
tolerate behavior that could lead to sexual assault.
The cornerstone of the Army's prevention strategy is the ``I. A.M.
Strong'' campaign, where the letters I, A, and M stand for Intervene--
Act--Motivate. The ``I. A.M. Strong'' campaign features soldiers as
influential role models and provides peer-to-peer messages outlining
the Army's intent for all its members to personally take action in the
effort to protect our communities. Leaders have embraced ``I. A.M.
Strong'' initiatives and are motivating soldiers to engage proactively
and prevent sexual assault.
The Army's sexual assault prevention strategy consists of four
integrated phases and extends through calendar year 2014 as we work to
be the Nation's leader in sexual harassment and sexual assault
prevention.
The SECARMY introduced the ``I. A.M. Strong'' campaign at the
Sexual Assault Prevention Summit in September 2008. The Summit served
as a platform to launch Phase I (Committed Army Leadership) by
providing training on best practices and allowing commands the
opportunity to develop prevention plans to support the Army strategy.
Phase II of the prevention strategy (Army-wide Conviction) includes
educating soldiers to understand their moral responsibility to
intervene and stop sexual assault and harassment. Phase II began at the
2009 Sexual Assault Prevention Summit (6-10 Apr 09) during which the
SECARMY, CSA, and Sergeant Major of the Army addressed attendees, which
included over 100 sergeants major and 50 general officers.
Phase III culminates the dedicated effort of leaders and soldiers
under Phase I and Phase II by ``Achieving Cultural Change'' that truly
reflects Army values and fosters an environment free from sexual
harassment and sexual assault.
The final phase is ``Sustainment, Refinement, and Sharing,'' during
which the prevention program continues to grow while motivating
national partners to support our efforts to change generally accepted
negative social behaviors; thus eliminating the crime of sexual
assault.
With the implementation of the strategy, a likely near-term
consequence will be an increase in the number of reported cases as
soldiers' and other victims' propensity to report increases. This
increase in cases will require more sexual assault responder support,
specifically: victim advocates, healthcare personnel, investigators,
and prosecutors.
suicide prevention program
The loss of any soldier is a tragedy, particularly when it could
have been prevented. There were 160 suicides by active-duty soldiers
during 2009, continuing the 5-year trend of increased suicides within
the Army. As a result, we have instituted a multi-level, holistic
approach to health promotion, risk reduction and suicide prevention.
Although the total number and rate of suicides in the Army remains of
deep concern, we should remember each of these suicides represents an
individual and a family that has suffered an irreparable loss---and, as
a result, our suicide prevention efforts are focused on directly
assisting soldiers, their families, and our Army civilians.
On 16 April 2009, the Vice Chief of Staff of the Army (VCSA) signed
the Army Campaign Plan for Health Promotion, Risk Reduction, and
Suicide Prevention, a comprehensive plan setting in motion
unprecedented changes in Army doctrine, policy, and resource
allocation, as well as immediate guidance to commanders, in order to
address the problem of suicides in the overall context of risk
reduction and health promotion.
The Army Suicide Prevention Task Force has addressed more than 240
different tasks related to suicide prevention doctrine, organization,
training, materiel, leadership, personnel, and facilities. Over 90
percent of these tasks have been implemented.
To build on the Army Campaign Plan's accomplishments during
calendar year 2009, the Army Suicide Prevention Task Force is leading
an effort to review and assess the effectiveness of Army Health
Promotion, Risk Reduction and Suicide Prevention programs at all
levels. Army has partnered with National Institute of Mental Health to
conduct a long-term study (Army Study to Assess Risk and Resilience on
Servicemembers) of risk and protective factors to inform health
promotion and suicide prevention efforts. The VCSA Task Force is also
reviewing all Army programs at all levels that are related to health
promotion, risk reduction, suicide prevention, or were implemented to
address soldier, family, or DA civilian stressors to ensure that the
programs provide appropriate levels of support and address current
problems, risk factors, and are relevant to today's soldiers' families'
and DA civilians needs.
comprehensive soldier fitness program
The Army's Comprehensive Soldier Fitness (CSF) program is a
structured, long-term assessment and development program designed to
build the resilience and enhance the performance of the Army's
soldiers, families, and civilian personnel. The CSF program uses
individual assessments, tailored virtual training, classroom training
and embedded resilience experts to provide soldiers with the critical
skills needed to take care of themselves, their families and their
teammates in this era of persistent conflict. By developing the five
dimensions of strength--physical, emotional, social, spiritual, and
family--CSF equips soldiers with the skills to become more self-aware,
fit, balanced, confident, and competent, and ultimately better prepared
to face the physical and psychological challenges of sustained
operations.
army substance abuse program
The Nation's persistent conflict has created symptoms of stress for
our soldiers, including an increase in alcohol and drug abuse. This
commander's program uses prevention, education, deterrence, detection,
and rehabilitation, to reduce and eliminate alcohol and drug abuse. It
is based on the expectations of readiness and personal responsibility.
A team recently returned from deployment to U.S. Army Forces, U.S.
Central Command. To support our commanders, clear and effective
procedures for random drug testing in theater are under development,
such as the implementation of online tools to train unit prevention
leaders and to quickly inform commanders of test results. Another area
under development is the review of portable prevention education
packages for deployed soldiers, soldiers at home, and soldiers in the
RC. Additionally, the Army is conducting a pilot program that provides
confidential education and treatment to soldiers who self-refer to the
Army substance abuse program for assistance with alcohol issues. In
addition to the pilot program, we are conducting a broader, more
detailed study to determine the exact nature and extent of any stigma
in the Army associated with substance abuse treatment. This study will
run concurrently with the pilot program. The pilot program and detailed
study were concluded on March 1, 2010 and we expect to report to
Congress in April 2010. We want to ensure that all soldiers who may
need assistance can get assistance without the barrier of stigma.
congressional assistance
Recruiting, retention, and providing for the well-being of the best
Army in the world requires a significant commitment by the American
people. The Army is grateful for the continued support of Congress for
competitive military benefits and compensation, along with incentives
and bonuses for soldiers and their families and for the civilian
workforce. These are critical in helping the Army be the employer of
choice.
conclusion
We must maintain an appropriate level of investment to ensure a
robust and high-quality force. The well-being and balance of our force
are absolutely dependent upon your tremendous support. The Army is
growing and transforming in a period of persistent conflict. We will do
so with men and women of the highest caliber whose willingness to
serve, is a credit to this great Nation.
Senator Webb. Secretary Garcia.
STATEMENT OF HON. JUAN M. GARCIA III, ASSISTANT SECRETARY OF
THE NAVY FOR MANPOWER AND RESERVE AFFAIRS
Mr. Garcia. Chairman Webb, Senator Graham, distinguished
members of the committee, it's my pleasure to be here today to
testify on behalf of our Navy and Marine Corps personnel.
For the past 5 months as an Assistant Secretary of the
Navy, I've had the honor of representing and advocating for the
nearly 650,000 sailors and marines, both Active Duty and
Reserve, and 180,000 civilian employees who, together, are
globally engaged across a spectrum of operations ranging from
major combat to humanitarian assistance.
Across the Department of the Navy, we are asking our
sailors, marines, and civilians to take on extraordinary tasks
ranging from combat operations in Afghanistan to unplanned
disaster relief in Haiti. The men and women who comprise the
Navy and Marine Corps have invariably risen to meet the
challenge presented.
Our leadership team--Secretary Mabus, Under Secretary Work,
Admiral Roughead, and General Conway--have set a course for the
Department of the Navy that drives our human capital strategy,
focusing on our greatest asset: our people. In order to achieve
our best, we promote an environment in which every person can
excel, where each person is treated with dignity and respect,
and where all are recognized for the contributions they make.
Both the Navy and Marine Corps are experiencing historic
success in recruiting and retention of Active Duty
servicemembers. I assess that both Services will continue
meeting their recruiting and end-strength goals for the
foreseeable future. It's a tribute to both the dedication of
our military personnel communities and to the patriotism of our
Nation's young men and women that we are able to maintain an
All-Volunteer Force of unprecedented quality through more than
8 years of active combat operations.
Recruiting and retention in certain fields--healthcare,
Special Forces, nuclear power--continue to pose challenges and
will require the use of special pays and bonuses to ensure
adequate numbers of qualified personnel are available in those
critical specialties.
Despite its high operational tempo, the Marine Corps was
able to grow to 202,000 Active Duty end strength 2 years ahead
of schedule. This focus on Active Duty recruiting and retention
resulted in a slight shortfall of the Marine Reserve component
end strength for 2009. For this same reason, 2010 Reserve
strength may also be slightly below target.
The health of the Reserve components is of particular
concern because of our dependence on them to meet our global
obligations. Since September 11, more than 142,000 mobilization
requirements have been met by members of the Navy and Marine
Corps Reserve.
A high tempo, high stress environment appears to be the new
normal for the Department of the Navy. One of the lessons to be
learned from recent years is that our people step up and
perform superbly in times of greatest need. But, the reality of
continuing operations in Afghanistan, combined with our other
deployment commitments, undeniably places great stress on our
forces. The Department of the Navy is employing every measure
available to help identify consequent risks, and we continue to
assess and reevaluate these programs daily.
As Secretary Gates has said, apart from the war itself, we
have no higher priority than taking care of the wounded, ill,
and injured. Through the Marine Corps Wounded Warrior Regiment
and the Navy Safe Harbor Program, the sea Services strive to
provide the best possible support for our personnel struck
down, to include reintegration into society and a new emphasis
on post-service employment.
I'd like to thank the committee members for their
continuous commitment to the support of our expeditionary
fighting men and women, especially to those who have returned
from the front line of battle with broken bodies but unbroken
spirits, our wounded warriors.
I look forward to your questions.
[The prepared statement of Mr. Garcia follows:]
Prepared Statement by Hon. Juan M. Garcia
Chairman Webb, Senator Graham, and distinguished members of the
subcommittee, it is my pleasure to be here today to testify on behalf
of our Navy and Marine Corps personnel. For the past 5 months as an
Assistant Secretary of the Navy, I have had the honor of representing
and advocating for the nearly 650,000 sailors and marines, both Active
Duty and Reserve, and 180,000 civilian employees who, together, are
globally engaged across a spectrum of operations ranging from major
combat to humanitarian assistance. Across the Department of the Navy,
we are asking our sailors, marines, and civilians to take on
extraordinary tasks ranging from combat operations in Afghanistan to
unplanned disaster relief in Haiti. The men and women who comprise the
Navy and Marine Corps have invariably risen to meet the challenges
presented.
Our leadership team, Secretary Mabus, Under Secretary Work, Admiral
Roughead, and General Conway, have set a course for the Department of
the Navy that drives our Human Capital Strategy--focusing on our
greatest asset--our people. In order to achieve our best, we promote an
environment in which every person can excel, where each person is
treated with dignity and respect, and where all are recognized for the
contributions they make.
Let me address some particular areas of interest and concern
related to the Department's manpower and personnel.
In terms of military personnel, both the Navy and Marine Corps are
experiencing historic success in recruiting and retention of active
duty servicemembers. I assess that both Services will continue meeting
their recruiting and end-strength goals for the foreseeable future. It
is a tribute to both the dedication of our military personnel
communities and to the patriotism of our Nation's young men and women
that we are able to maintain an All-Volunteer Force, of unprecedented
quality, through more than 8 years of active combat operations.
Recruiting and retention in certain fields--including health care,
Special Forces, and nuclear power--continue to pose challenges, and we
still require the use of special pays and bonuses to ensure adequate
numbers of qualified personnel are available in critical specialties
such as these.
The Navy expects to continue to need an additional 4,400 end-
strength for Overseas Contingency Operations. In considering that
requirement, it is important to remember that the number of active duty
sailors has been in gradual decline since the Vietnam war. As recently
as 1993 the Navy had half-again as many sailors on active duty, and
available for assignments, as it does today.
Despite its high operational tempo, the Marine Corps was able to
grow to 202,000 active duty end strength 2 years ahead of schedule.
This focus on active duty recruiting and retention resulted in a slight
shortfall of the Marine Reserve component end strength for 2009. For
this same reason, 2010 Reserve strength may also be slightly below
target. The health of the Reserve components is of particular concern
because of our dependence on them to meet our global obligations. Since
September 11, more than 142,000 mobilization requirements have been met
by members of the Navy and Marine Corps Reserve.
Another topic of particular interest is the introduction of female
personnel on submarines. On February 19, 2010, the Secretary of Defense
notified Congress of our intent to change the policy prohibiting the
service of women in submarines. After the requisite notification period
has expired, it is the Navy's intent to have the first cadre of female
officers commence training on nuclear prototypes and begin a pipeline
that will ultimately lead them to qualification as Naval Submariners,
removing one of the last gender barriers in the U.S. Navy, and helping
to insulate us from the anticipated surge in hiring by the civilian
nuclear power industry in the decades to come. Because of the critical
mission and demanding environment of the submarine force, we envision a
gradual, and measured approach to this integration. Our initial efforts
will focus on officers only and will concentrate on our large boats
(SSGNs and SSBNs), where the existing infrastructure will accommodate
these changes without material alteration. As a measure of extra
caution, the Navy will not reduce the number of male officers trained
and qualified for submarine duty until we have experience with
successfully placing female officers in those roles.
Some might argue that such initiatives should not be undertaken
during a period of high operating tempo and stress on the force. But a
high tempo, high stress environment appears to be the new normal for
the Department of the Navy. One of the lessons to be learned from
recent years is that our people step up and perform superbly in times
of greatest need. Yet the reality of continuing operations in
Afghanistan combined with our other deployment commitments undeniably
places great stress on our forces.
Stress on the force has many causes and manifests in many forms.
The Secretary of Defense asked former Secretary West and Retired
Admiral Clark to lead an independent review of the tragic events at
Fort Hood. Their review produced 86 recommendations for changes in, or
reviews of, procedures and policies. Currently, the Department of the
Navy is working with the other Services and the Office of the Secretary
of Defense to evaluate those recommendations and implement those that
seem appropriate. Well before the shootings at Fort Hood, the
Department of the Navy had in place its Caregiver Occupational Stress
Control Program, which is designed to enhance the resilience of
caregivers, including mental health professionals, chaplains, corpsmen,
and other counselors and advisers. Additionally, for reservists and
individual augmentees returning from mobilization, the Department
created the Returning Warrior Workshops (which are a part of the Yellow
Ribbon Reintegration Program) to help with the adjustment to life back
home.
Stress on our personnel has likely played a role in the
heartbreaking increase in suicide rates among the active duty in recent
years. The Department of the Navy has employed every measure available
to help identify those at risk, encourage them to seek help, and
prevent these tragedies. We continue to assess and re-evaluate our
programs daily, and will not stop, believing that even a single suicide
by those wearing our Nation's cloth is one too many.
As Secretary Gates has said, apart from the war itself, we have no
higher priority than taking care of the wounded, ill, and injured.
Through the Marine Corps's Wounded Warrior Regiment and the Navy's Safe
Harbor Program, the sea services strive to provide the best possible
support for our personnel struck down, to include reintegration into
society, and a new emphasis on post-Service employment.
Thanks to advances in military medicine, many of our most seriously
wounded, who even a few years of ago would have died of injuries, are
recovering and, in many cases, able to resume their military jobs.
Others will require special accommodations and support for the rest of
their lives. We are working in close partnership with the Department of
Veterans' Affairs to ensure the best and most dignified treatment
possible for those sailors and marines.
Members of our civilian workforce continue their crucial
contributions to our mission while coping with two significant
transitions of their own.
Consistent with your direction in the National Defense
Authorization Act for Fiscal Year 2010, we are currently in the process
of moving all of our civilian employees out of the National Security
Personnel System. Those who are returning to the General Schedule will
be converted no later than the end of the fiscal year. Those who will
move to one of the various alternative pay systems will be transitioned
during 2011.
While this is occurring, the DOD is also engaged in a significant
in-sourcing initiative, expected to add more than 33,000 civilian
positions over the next 5 years to perform currently contracted
services--the Department of Navy expects to establish 10,000 new
civilian positions as part of this effort. This initiative will
rebalance our workforce; rebuild organic capabilities; reduce
operational risk by ensuring that inherently governmental and functions
that support the readiness/management needs of the Department are
performed by government employees; and that services are delivered in
the most cost effective manner. Nearly a third of these new positions
are expected to be part of the crucial acquisition workforce. These
insourcing initiatives are consistent with DOD's High Priority
Performance Goals in the President's fiscal year 2011 Budget's Analytic
Perspectives volume.
Finally, I would like to thank the committee members for their
continuous commitment to the support of our expeditionary fighting men
and women, especially to those who have returned from the front line of
battle with broken bodies but unbroken spirits--Our Wounded Warriors.
I look forward to your questions.
Senator Webb. Thank you, Secretary Garcia.
Secretary Ginsberg.
STATEMENT OF HON. DANIEL B. GINSBERG, ASSISTANT SECRETARY OF
THE AIR FORCE FOR MANPOWER AND RESERVE AFFAIRS
Mr. Ginsberg. Thank you, Chairman Webb, Ranking Member
Graham, and members of the subcommittee.
It is my honor to testify before you today about our
airmen. They are doing incredible work every day to serve our
Nation and accomplish the missions that our Nation has asked of
them. Our Air Force has been engaged in continuous operations
for over 19 years. We have never been more engaged than today.
We have over 38,000 airmen deployed around the world, and
thousands more airmen providing direct support to the
warfighter through our space systems, global mobility
operations, and remotely-piloted operations, to name just a few
of the critical capabilities that we provide.
Overall, our force structure is healthy. We are working
internal challenges to ensure we meet the increased demand for
new and emerging missions, such as our remotely piloted
aircraft, cyberoperations, and irregular warfare. We are
meeting our total-force recruiting goals, except for a few
hard-to-fill specialties in our officer medical specialties.
To address this, we are aggressively pursuing a three-
pronged approach to, first, grow our own through expanded
scholarship opportunities and commissioning opportunities for
our enlisted force; second, increase compensation through
special and incentive pays; and third, to improve quality of
life.
Although the Air National Guard will meet end strength, we
are having challenges recruiting enough officers. That may be
related to our high retention rates we are currently
experiencing with our Active component. Historically, the Guard
and Reserve rely heavily on recruiting prior-service trained
airmen who separate from the Active side.
An efficient and smooth transfer between each component and
Civil Service allows the Air Force to access and retain
important skill sets and balance our mission needs over time.
To make this process work even better, we are focusing on our
Continuum of Service Program. Through Continuum of Service, we
are reviewing all Air Force, Office of the Secretary of Defense
(OSD), and statutory requirements to identify areas where we
can streamline the transfer between components. When statutory
issues are identified, we will work with OSD and our
counterparts in other Services to identify and support
legislative proposals to you.
Taking care of our airmen and their families is a top Air
Force priority. In the spring of 2009, the Air Force renewed
its longstanding commitment to our airmen and families by
designating July 2009 through July 2010 as ``The Year of the
Air Force Family.'' The observance serves two primary purposes.
First, we examined our family support services and policies
across the Air Force in order to expand or refine them as
required to meet the emerging needs and expectations of our
airmen, their families, and the larger Air Force family.
Second, we set aside specific time to recognize the
sacrifices and contributions of the members of our entire Air
Force family--our Active, Guard, Reserve, civilian, spouses,
and family members. We have focused our efforts to ensure we
provide robust programs to meet the unique needs of our Guard
and Reserve members and their families.
In conjunction with the Year of the Air Force Family, we
are also focused on reducing the stressors and mission
detractors that impact our airmen and their families. We have
taken a holistic approach to addressing airmen resiliency. We
are strengthening our Exceptional Family Member Program to
ensure we better meet their unique needs. We are dedicated to
reducing incidence of sexual assault and suicide among our
force. One is too many.
Diversity is an integral part of our mission accomplishment
and success in today's Air Force, and will remain in the
forefront of that area, as we continue to exclusively attract,
develop, and retain highly qualified professionals for the
betterment of the total force.
Across all of our programs, we continually strive to
improve as we accomplish the Air Force's and the Nation's
priorities. I am committed to ensuring we provide the best
possible programs that increase our combat capability and take
care of our most important asset: our airmen.
I look forward to working with this committee, which has
helped shape DOD into the world's premier defense organization.
I thank you for the opportunity to appear before you today.
[The prepared statement of Mr. Ginsberg follows:]
Prepared Statement by Hon, Daniel B. Ginsberg
introduction
Mr. Chairman, members of the subcommittee, thank you for this
opportunity to discuss the Air Force's most important resource--our
airmen. This diverse group of highly-skilled and dedicated men and
women ensure our Air Force remains the most powerful in the world. Our
airmen have been continuously deployed and globally engaged in combat
missions for over 19 straight years. Approximately 38,800 airmen are
currently deployed in support of joint operations across the globe. Of
these, over 4,000 airmen are filling Joint Expeditionary Taskings in
non-traditional roles in Iraq, Afghanistan and elsewhere. Thousands
more are providing critical direct support to our combatant commanders
from their home station. These critical capabilities include space
systems such as GPS, rapid global mobility of people and supplies, as
well as intelligence, surveillance, and reconnaissance from space and
remotely piloted aircraft. Our airmen are committed to winning today's
fight and prepared for tomorrow's challenges.
As the Air Force's assistant Secretary for Manpower and Reserve
Affairs, I am focused on accomplishing the Air Force's priorities by
developing and implementing programs and policies to best leverage our
total force--Active, Guard, Reserve, and civilians--to maximize our
combat capability for the joint commanders. To that end, I have made
Continuum of Service (CoS), which will allow for smooth transfer of
skilled airmen between components, and increasing the diversity of our
force high priorities. I am also attuned to the overall health of our
force. We are working essential programs that support our wounded
warriors, help airmen reintegrate after deployments, provide families
with the support they need and minimize the incidents of sexual assault
and suicide to name just a few.
end strength and force management
With the National Defense Authorization Act for Fiscal Year 2010,
our current approved total force end strength is 686,944. This includes
331,700 Active component; 179,044 civilians; 69,500 Reserve; and
106,700 Air National Guard. In the fiscal year 2011 budget request, our
programmed total force end strength is 702,669. This includes 332,200
Active component, 192,569 civilians, 71,200 Reserve, and Air National
Guard end strength remaining at 106,700.
The Air Force's fiscal year 2011 budget request preserved end
strength in the face of fiscal constraints, realigned Active component
and Reserve manpower within existing resources, and grew civilian end
strength to meet Air Force priorities. Major manpower drivers include
initial investment toward remotely piloted aircraft fleet operational
capability to 65 combat air patrols; enhancing cyberspace/irregular
warfare/command and control capabilities; and resourcing required Air
Force priorities to include Acquisition Excellence, further
enhancements to Nuclear Enterprise, and developing and caring for our
airmen and their families while rebalancing our total force mix for
agile combat support.
Maintaining the optimum overall force size as well as balancing
critical skill-sets is a routine part of the Air Force's force
management efforts. The current downturn in the economy has had a
direct impact on the Air Force's lower attrition rates projected in
fiscal year 2010. As a result, the Air Force is expected to exceed end
strength by about 3,700 airmen (2,100 officers and 1,600 enlisted) in
fiscal year 2010. Although this increase would fall under the Secretary
of the Air Force's purview of 2 percent over authorized end strength,
the Air Force implemented a force management plan to bring this back in
alignment. In fiscal year 2010, we made small adjustments in several
areas including limited reductions of officer and enlisted accessions,
increased service commitment waivers, waived enlisted time-in-grade
requirements for retirement, and we are implementing an additional
enlisted date-of-separation rollback. We are continually monitoring
results from these actions and to date we have achieved about 50
percent of our fiscal year 2010 force management goal. Even with these
efforts, we do not expect these actions to fully achieve the reductions
targeted for fiscal year 2010. As a result, we will likely continue
many of these actions and consider other force management options for
the remainder of fiscal year 2010 and in fiscal year 2011 as needed.
Utilizing force management tools is a necessary and routine leadership
obligation to ensure the Air Force remains within authorized strength
levels and get the right balance of grades and skills to meet our
evolving mission requirements. However, we strive to use these force
management tools in a deliberate manner with the least disruption to
the cohesion of the force.
recruiting
Even in a time of higher retention and a struggling economy,
recruiting the highest quality airmen is as important as ever. Our
recruiting force continues to achieve the enlisted accession mission
with integrity and excellence. In fiscal year 2009, we met mission
requirements for enlisted recruiting in all components (Active, Guard,
and Reserve). To date in fiscal year 2010 we have achieved 100 percent
of our active-duty accession goals and 100 percent and 112 percent of
our Reserve and Guard accession goals, respectively.
Although we have achieved mission goals in our line officer
accession programs, we continue to struggle with health professions
officer recruitment and retention. In fiscal year 2009, we recruited
approximately 70 percent of officer health professions requirements
exceeding the fiscal year 2008 production of 62 percent. The ongoing
high-demand for medical professionals in the lucrative civilian market
makes it difficult for the Air Force to attract and retain fully
qualified individuals. As a result, in 2006 the Air Force implemented a
long-term ``grow our own'' strategy by offering more medical school
scholarships in student-based markets. In fiscal year 2008, we filled
431 of 437 available scholarships (98.6 percent) and for fiscal year
2009, we accessed 376 of 371 scholarships (101 percent). In fiscal year
2010, we are on track to achieve a 100 percent scholarship fill rate.
Our main shortfall in recruiting is attracting fully-qualified medical
professionals to come straight into the service particularly in the
Biomedical Science Corps. Psychology, Pharmacy, Optometry and Public
Health Officers continue to be challenging to recruit. Our continued
challenges in the health professions are why we have submitted $85.7
million in this year's budget request for officer bonuses to attract
and retain more medical professionals on active duty. We are
appreciative of and ask for your continued support in this area.
Although recruitment is also strong in the Reserve and Air National
Guard, they face challenges with fewer prior-servicemembers due to
lower Active component attrition rates and increased requirements for
new and emerging mission specialties. As a result, both the Air
National Guard and the Air Force Reserve have had to increase their
non-prior service recruitment efforts. In fact, the Reserve non-prior
service recruiting requirement has nearly doubled since the end of
fiscal year 2007. Increased recruitment of non-prior servicemembers for
both Air National Guard and the Air Force Reserve has directly resulted
in increased recruitment costs as well as increased training costs over
that of already trained prior-servicemembers. The continued support of
the Air Force, Department of Defense and Congress will undoubtedly
shape the foundation of their success.
retention
Although overall officer retention has remained strong, we have had
challenges with retention of rated officers, some critical skills and
some health profession specialties. To address our rated officer
shortages, we implemented a rated recall program to bring back 500
trained pilots to help fill our rated staff positions allowing more
current pilots to return to the cockpit. The Air Force prudently
employs Special and Incentive (S&I) pays to compensate for and
incentivize the performance of hazardous and arduous duties, the
acceptance of duty in hostile or remote and isolated locations, and the
recruiting and retention of personnel with specific skills or in
specific career fields. Fiscal year 2010 Active component recruiting
and retention S&I pays total $465.9 million. For fiscal year 2011, we
have requested this be increased to $480.1 million. This increase is
due to changing eligible populations, anniversary payments, and the
addition of retention bonuses for five stressed officer career fields.
Our S&I pays are critical as we shape the force to meet new and
emerging missions and support the combatant commanders in today's
fight.
The quality of Air National Guard recruits has not declined and
their retention rate remains strong at 96.9 percent. The Air National
Guard saves on average $62,000 in training costs for every qualified
member retained or recruited. Our focus in this area allows us to
retain critical skills lost from the Active component and save valuable
training dollars. In 2009, through the use of our 14 In-Service Air
National Guard recruiters strategically placed at active duty bases,
the Air National Guard garnered approximately 896 confirmed accessions
of a total of 5,309 accessions. The bonuses and incentive programs are
a key component to that success.
Retention for the Air Force Reserve remains solid with first-term
airmen retention being the highest in recent history. Likewise, second-
term and career airmen retention has rebounded following a drop in
recent years due in-part to force structure changes. Although we have
not formally studied the causes, we attribute this increase in
retention rates primarily to the recent legislative authorizations
congress has approved that enhance incentives to remain in the service
like inactive duty training (IDT) travel pay, streamlining of TRICARE
Reserve Select premiums, enhanced bonuses and the Post-September 11 GI
Bill. We anticipate this positive trend in retention will continue for
the foreseeable future.
civilian personnel
Management of the civilian workforce will continue to be a priority
for the Air Force. We are working collaboratively with the Deputy Under
Secretary of Defense for Civilian Personnel Policy on Strategic Human
Capital Planning efforts, in particular, to address the provisions in
NDAA for Fiscal Year 2010 which require reporting by the Military
Departments. We support this effort that will result in the Air Force
and the Department of Defense (DOD) having the skills and competencies
necessary to meet our current and future mission requirements.
In October, 2009, the President signed into law the NDAA 2010 that
repeals the authority for NSPS and requires DOD to transition civilian
employees from NSPS to the appropriate statutory non-NSPS personnel and
pay system not later than January 1, 2012. The Air Force has
approximately 44,000 employees in NSPS. We are aggressively planning
and preparing to transition these Air Force employees in an orderly and
timely manner. We have begun the process of reclassification of
positions, where necessary. We will soon issue a conversion plan that
will inform and assist our human resource practitioners, supervisors,
managers and employees to understand the transition process and to
facilitate the transition. The NDAA also provided additional personnel
flexibilities which we will be pursuing in conjunction with DOD and the
Office of Personnel Management.
diversity
Diversity is an integral part of mission accomplishment and success
in today's Air Force and will remain in the forefront as we continue to
inclusively attract, develop, and retain highly qualified professionals
for the betterment of the Total Force. The capacity to educate, manage,
lead, and train a diverse force is a core competency of Air Force
leadership. Currently, we are pursuing collaborative diversity outreach
initiatives with Air University, Civil Air Patrol, Junior and Senior
Reserve Officer Training Corps, Officer Training School and the United
States Air Force Academy. Additionally, strategic plans are being
formalized to utilize the Air Force Diversity Champions to promulgate
the aims of diversity within the Air Force and the community. Areas of
interests and emphasis to cultivate and develop future leaders of the
Total Force will include reaching out to students enrolled in science,
technology, engineering and mathematics programs in high schools,
colleges and universities across the Nation.
As the demographics of the Nation continue to change, the Air Force
must position itself to optimize the true benefits of a diverse force
and respectfully request appropriate Congressional funding for the
sustainment of the aforementioned outreach initiatives. By
incorporating diversity management leadership principles and strategies
to leverage the unique qualities and talents of all citizens, the Air
Force will achieve mission excellence and sustain dominance in air,
space, and cyberspace.
continuum of service
An important aspect of retention is our ability as a Service to
allow skilled airmen to easily transfer from one component to another
providing the Air Force flexibility while retaining valuable skills.
CoS transforms the operating culture and paradigms to shape the future
of personnel and manpower delivery throughout the Air Force to meet
global mission requirements.
CoS efforts have already positively impacted our Air Force members
through a number of initiatives. Through our on-line CoS Tracking Tool
(CoSTT), any airman can submit a proposal for a CoS initiative. Our
tool was modified for use by the Army and is now being adapted for use
throughout the Department of Defense. CoS initiatives have already
improved our joint-spouse PCS process, interservice transfer of rated
officers and helped facilitate the establishment of the Religious
Professional Scholarship Program (RPSP) allowing members to attend
seminary and later return to active duty. The RPSP is designed to help
fill manning shortfalls within the chaplaincy for underrepresented
faiths within the Air Force. This program is now being considered for
utilization by my Navy and Army counterparts. In addition, CoS helped
modify the chaplain accession age ceiling from 42 to 47.
Some current Air Force CoS initiatives include: (1) aligning the
Air Reserve Component pregnancy policy with that of the Army and Marine
Corps to allow pregnant women to work until her orders expire; (2)
changing Air Force policy on ``Lawful Permanent Resident'' accessions
for critical specialties by utilizing current laws permitting the
appointment of a Reserve Component officer who has been lawfully
admitted to the United States; (3) evaluating the authority provided in
the NDAA for Fiscal Year 2009 by considering a ``Career Intermission
Pilot Program'' to determine whether a more flexible career path will
prove to be an effective retention tool; and (4) examining the effects
of changes to Air Force policy that would bring fully qualified
personnel into stressed career fields faster than traditional methods
by recognizing the value of nongovernmental experience.
The Air Force CoS program is an important force multiplier as it
not only helps our airmen transition between components, but also
balances people and mission to ensure the right airman is in the fight.
We greatly appreciate the outstanding support of the Senate Armed
Services Committee Personnel Subcommittee on many of our CoS
initiatives.
suicide prevention
Preventing suicide among our airmen is extremely important to the
well-being of our force. The Air Force developed the basis for its
suicide prevention program in 1993 and it is one of ten suicide
prevention programs listed on the Substance Abuse and Mental Health
Services Administration's National Registry of Evidence-Based Programs
and Practices. Although this program resulted in a reduction in the
number of suicides among airmen, within the Air Force we have
recognized the importance of a multi-faceted approach to meet the
varied needs of our people. Since the initial program began, we have
placed a strong emphasis on leadership involvement in preventing
suicides. Training has been implemented in various professional
military education curricula to create awareness among Air Force
leaders and frontline supervisors of behaviors that may lead to suicide
and to inform leadership of actions they can take to prevent suicide.
We have identified specific career fields in which the requirements of
the job place enormous stress on airmen and we are developing targeted
programs to improve resiliency and encourage airmen to seek help early.
To facilitate the seeking of mental health services, we have placed
behavioral health specialists in our primary care clinics.
Additionally, we emphasize community involvement in suicide
prevention, combining the efforts of chaplains, family counselors, and
other non-medical counselors to meet the psychological health needs of
airmen. Finally, we collaborate with our sister Services, with the
Defense Center of Excellence for Traumatic Brain Injury and
Psychological Health, and with the Department of Veterans Affairs to
identify best practices and continuously improve our existing suicide
prevention program. Recently, the Air Force Surgeon General took the
lead in implementing a two-tiered program to create and enhance
psychological resiliency in deploying and returning airmen. This
program includes a 2-day decompression program when the airmen return
from theater. We believe one suicide is one too many and are strongly
committed to preventing suicides and caring for our airmen.
sexual assault prevention and response
Preventing sexual assault is also a top Air Force priority. Since
program implementation in 2005, the Air Force has maintained a multi-
disciplinary approach to addressing sexual assault that supports home-
stationed and deployed airmen. A robust Air Force response to victims
includes dedicated full-time civilian and military Sexual Assault
Response Coordinators (SARCs) and more than 2,600 volunteer victim
advocates who provide 24/7/365 support. Our robust Air Force Sexual
Assault Prevention and Response program budget funds 80 civilian and 29
military officer SARCs at the installation level, who work directly for
the Vice Wing Commander. Our military SARCs provide a full-time
deployed capability at seven primary deployment locations. The
Secretary of the Air Force recently approved the addition of 24 Air
Force Office of Special Investigations agents trained and dedicated to
investigate sexual assault. Caring and professional response to victims
has been a focus of the Air Force program but equally important is our
focus to prevent the crime before it occurs.
The primary challenge of addressing sexual assault in the military
and society at large is to confront a culture where sexual assault is
allowed to exist. It requires a positive, ongoing effort to educate our
airmen and others, about the realities of sexual assault, debunking
myths that continue to be propagated by media and entertainment, and
maintained by peer pressure or other societal convention. The Air Force
has developed a prevention-based approach that directly focuses on
fostering positive behavior that is in concert with our core values.
The approach includes leadership focus from the top down, risk
reduction, and bystander intervention training. The later is a strategy
that motivates and mobilizes people who may see, hear, or recognize
signs of an inappropriate or unsafe situation, to act.
We will be working with Dr. Stanley, OSD (P&R), and our sister
Services, to address the recommendations in the report of the Defense
Task Force on Sexual Assault in the Military Services. Sexual assault
is a crime. The Air Force is dedicated to the elimination of this crime
and we recognize the challenges dealing with this very complex issue.
year of the air force family
In the spring of 2009, the Air Force renewed its longstanding
commitment to taking care of our airmen and families by designating
July 2009 through July 2010 as ``Year of the Air Force Family.'' The
observance serves two primary purposes. Across the Air Force, we
examined our support services and policies in order to expand or refine
them as required to meet the emerging needs and expectations of our
airmen, their families, and the larger Air Force Family. Second, we set
aside specific time to recognize the sacrifices and contributions of
all of the members of our Air Force family--our Active, Reserve, and
Guard--civilians, spouses, and family members.
We have focused our efforts to ensure we provide robust programs to
meet the unique needs of our Guard and Reserve members and their
families. The Yellow Ribbon Reintegration Program is one important way
we are accomplishing this. The Air Force is working alongside other
services in this DOD-wide effort to ensure the Air National Guard and
Air Force Reserve airmen and their families are connected with all of
the appropriate resources before, during and after deployments. We
continue to focus on the reintegration phase after returning home and
ensure that commanders are involved and aware throughout. We continue
to improve our effectiveness and relationships with other associations
such as the Department of Veterans Affairs and the Department of Labor
in providing current and relevant information to members. The Air Force
remains focused on airmen and their families and will ensure the
oversight and success of the Yellow Ribbon Reintegration Program.
Additionally, we are ensuring the Year of the Air Force Family does
not overlook our ``extended Family'' our retirees, parents and the
nongovernmental and community partners that support Air Force people
every day across the Nation. We are using this year long period to
launch our sharper focus on improving support to airmen and families.
Under Secretary Donley's leadership, our concerted attention on
providing the support that results in stronger, more resilient airmen
and families will remain a priority in the years to come.
In April 2010, we will hold a Caring for People Forum that will
bring together helping professionals, airmen, and family members to
develop an action plan to address the pressing and longer term concerns
of airmen and families which will be briefed to senior leadership at
the end of the forum.
We are working to strengthen all of the partnerships that
contribute to the quality of life for our members. These will include
close rapport with local school districts (to enhance quality education
and garner on-site support for children impacted by repeated
deployments), housing privatization projects and agreements between our
bases and city or county services.
wounded warrior and survivor care
The Air Force Wounded Warrior program focuses on the needs of
recovering airmen and their families, as well as families of the
fallen. We now have 17 Recovery Care Coordinators (RCC) in 15
locations, with an additional 10 RCCs being hired this year. Our RCCs
are the primary point of contact for our wounded, ill, and injured
airmen and ensure the health care, financial, informational, and
personal needs of airmen and their families are available in a timely
manner. Because of the range of questions airmen and families have
after an injury or illness has incurred, it is critical to the healing
process to have relevant and accurate information available to our
airmen. Recovery Care Coordinators are in place to ensure those
knowledgeable in medical and other areas of expertise are available to
provide the requested information. This assistance is provided for as
long as the airmen and families want assistance during recovery,
rehabilitation, and reintegration. The Air Force also continues to work
closely with the Office of Wounded Warrior Care and Transition Policy
in the Office of the Secretary of Defense to ensure our programs
continue to support all wounded, ill, and injured servicemembers. It is
our solemn duty that these airmen receive the utmost support and care.
conclusion
I am continually impressed, but not surprised, by the tremendous
hard work and focus our airmen display daily as they accomplish their
missions. I am dedicated to providing them the best programs and
support, removing any policy barriers and pursuing innovative ways to
streamline our processes to allow them to be even more effective. Our
Air Force is a critical component to our Nation's defense as we are
faced with uncertain and ever changing threats.
We appreciate your unfailing support to the men and women of our
Air Force, and I look forward to your questions.
Senator Webb. Thank you very much.
I thank all of you for your testimony.
I think what I would like to do is--since I took a good bit
of time in my opening statement, I think I would like to just
start with an 8-minute round, and Senator Graham could begin,
and then we could go to Senator Hagan and Senator Begich, and
then I'll follow on after you.
Senator Graham. Well, thank you, Mr. Chairman.
Secretary Stanley, when it comes to the personnel part of
the budget, we're going to grow the Army and Marine Corps. I
think we need to. The healthcare component--how do we get a
grip on this? What are some ideas that you all are talking
about there?
Dr. Stanley. Well, Senator, in my 3 weeks, we haven't
really talked a lot about details on----
Senator Graham. You mean, you haven't fixed this in 3
weeks? [Laughter.]
Dr. Stanley. What we have done--in fact, the very first
thing I did--and I think we would--working with Congress even
then--was to bring someone over with the skills and qualities
to at least fill the position temporarily while we wait on the
person, who is to be confirmed at some point in the future, to
work with. And so, this has been an actual priority from day
one, actually, because we recognize the healthcare costs.
Senator Graham. Okay, well, that's fair--and
congratulations, to all of you, by the way, for having your
job. This time last year we were looking for people like you,
and now we have them.
The idea of the Guard and Reserve recruitment and
retention--with the economy like it is, it's a good time for
the military, but I think the economy's going to get better--I
hope it will, and I'm sure it will eventually--TRICARE benefits
for the Guard and Reserve--I'd just like to get your impression
about how that program has worked, from each of the Services.
Secretary Stanley, how is it being received by our Guard and
Reserve Force, that they are now eligible for TRICARE? They
have to pay a premium.
The second issue, what effect do you believe it would have
if we allowed people to retire at 55 if they would do more
Active Duty service--earn their way from 60 to 55?
Starting with Secretary Stanley.
Dr. Stanley. Well, Senator, I know that, the TRICARE
programs, all of those programs are under review right now
because it's all a part of the gestalt of looking at all of
healthcare. I don't have answers for you today.
Senator Graham. Okay.
Dr. Stanley. But, we look forward to working with Congress
on that.
Senator Graham. From the Services' point of view, what are
you hearing from the Army, the Marines, and the Air Force?
Mr. Lamont. From the Army's perspective, TRICARE Reserve
has gone over very well. But, we're finding, among particularly
our Reserve component, they don't fully appreciate or are
educated enough to understand its availability to them. We
think it's incumbent upon this to broaden that perspective so
they avail themselves of what's out there.
It's an excellent program, and it's a wonderful incentive.
On the Reserve side, we may also, at some point in time, need
to look at some potential other incentives, from the healthcare
side, as we continue operationalizing the Reserve. But, it's a
resource issue, of course, as well, for all of us.
Senator Graham. Okay.
Secretary Garcia?
Mr. Garcia. Senator, I have the opportunity and the honor
to continue to serve in the Reserves, and had a Reserve
squadron, until coming to take this appointment. I will tell
you the--among those circles, the program is--there's a lot of
awareness of it, and it's very popular.
The piece that many members have read about, and are very
interested in, is what's been called the ``gray area'' piece;
that is, for retired reservists, not yet 60, being able to
access TRICARE Select and some of those programs before their
retirement.
As Secretary Lamont said, there's a price tag that comes
with that. I look forward to wrestling with that, with you.
But, I can tell you that, among my circles, on the Navy and
Marine side, it's very popular and well thought of.
Mr. Ginsberg. Senator, TRICARE Reserve Select is a very
well-liked program. We have good participation rates, as I
understand it, within the Air Guard and Air Reserve. It's not
just a benefit, it provides a tool to our airmen to make sure
that they're medically ready for deployment.
One of the challenges we need to look at this
systematically--is whether--the health of the provider network,
and whether maybe a stand-alone Air Guard base, whether we have
a sufficient network in place, or we're taking imbursements.
It's something we want to look at to ensure that this program
is moving along helpfully.
Senator Graham. Well, one last question. The sexual
harassment, sexual assault problem is being better identified,
and the number of reported cases is growing, which I think is
probably an indication, not that there are more activity, it's
just getting easier to report it, and people feel more
confident about reporting it. But, we're not nearly where we
need to be.
Just very quickly, from each Service's perspective, what
are you doing in that regard to enhance the ability of a
servicemember to report sexual harassment or assaults in a way
they feel will not be detrimental to their career?
Mr. Lamont. From the Army perspective, we're looking at it
from a couple of different directions. First, we want to make
it easier for them to report. We have initiated programs that
allow for the confidentiality of the report. Plus, we're also,
as I think we----
Senator Graham. In that regard, do we need to look at
changing our laws? Because there's a lot of privileges
available maybe in the civilian side, not available to military
members. I know you have a priest-penitent privilege and
limited medical privilege, but just look at that and see if
there are some changes we need to make on the Personnel
Subcommittee to expand privileges to healthcare providers. I'd
just----
Mr. Lamont. All right.
Senator Graham. Okay.
Mr. Lamont. Otherwise, as we try to build resilience within
the force, particularly on our Sexual Harassment/Assault
Response Prevention situation, we have initiated a program
called ``I. A.M. Strong''--``I'' being ``Intervene,'' ``A''
being ``Act,'' ``M'' being ``Motivate.'' Though it's a command-
oriented climate that we're trying to address, that would
respect the dignity of all of our soldiers, we've looked for
this ``I. A.M. Strong'' program to educate and train our
soldiers, on a peer-to-peer basis, to remove any stigma of
going forward to make those reports.
We believe it's working, at least as we've seen the number
of reports increase. We still believe, unfortunately, that only
roughly a third of sexual assaults are being reported.
Senator Graham. Thank you.
Mr. Garcia. Senator, Secretary Mabus has stood up the
Sexual Assault Prevention Response Office. The dedicated
officer--civilian SES--reports directly to him for the first
time and a network of Sexual Assault Response Coordinators
(SARCs) implemented in each unit across the fleet. As you
indicated, we are seeing a rise in reported incidents. The
challenge is to discern whether that's availability to
reporting or whether it's a true spike in incidents. It's
something we wrestle with every day.
Mr. Ginsberg. Senator, I think from the Air Force
perspective, this is an issue of leadership, it's an issue of
investment, and it's just a leader--an issue of communication.
Leadershipwise, it's about showing from the highest levels on
down, that sexual assault absolutely won't be tolerated and
that from our perspective, goes against everything--all of
those core values that we hold dear.
It's about putting in money for a strong, baseline program,
a good, strong, healthy organization, along with funding for
investigations, and very active and aggressive investigations.
It's also a matter of just making sure that those who are
victims know that their resources and reporting channels are
available to them. We have an ability for somebody who is a
victim to come forward and provide limited information about
what happened so they'll come forward. It's called restricted
reporting, and that's provided a useful channel for victims.
Senator Graham. Thank you, all, for your service. I'm going
to have to run to another hearing, but I shall return.
Senator Webb. Thank you very much, Senator Graham.
Senator Hagan.
Senator Hagan. Thank you very much, Mr. Chairman.
I do, too, want to thank all of you for your service to our
country. I really do appreciate it.
Secretary Stanley, you mentioned, in your opening remarks,
about the Military Spouse Career Advancement Account--as it's
being referred to MyCAA--and about the stop in the
implementation of it. I have a serious concern with that,
because, one, neither Congress nor the people who were
beneficiaries of this program were given any sort of upfront
notification about any of the problems that were being seen in
the program. This pause has certainly caused a lot of concern
to many people in my State, in North Carolina, because it's an
excellent program and a lot of people are taking advantage of
it. I think the uncertainty that's been put forth right now has
resulted in the Department's decision--has certainly negatively
impacted and affected the morale of our servicemembers and
their families. It certainly has had, I think, an adverse
impact on family readiness.
But, one of the questions I have in the President's fiscal
year 2011 budget, which reflects increased funding for this
enhanced career and educational opportunities, does it address
the longer-term needs of the program?
Dr. Stanley. First of all, we are addressing the concerns,
short-term and long-term. The Secretary is now, at this time,
making a decision, looking at options that have been presented
to him. But I will say that there are still some unanswered
questions on long-term, but I feel confident that they're going
to be addressed. I certainly share your concern about what's
happened, in terms of the program being stopped. I understand
that.
Senator Hagan. Well, the lack of notification was certainly
alarming too, I think, Members of Congress and the people who
were the beneficiaries.
As far as improving the implementation of the program, do
you need more specialists on staff to help with that? Or is
that some of the things you're looking into?
Dr. Stanley. Actually, in my arrival--just to be very
blunt.
Senator Hagan. Okay.
Dr. Stanley. I was sworn in on the 16th, and I learned
about it on the 16th.
Senator Hagan. Wow.
Dr. Stanley. So----
Voice. Welcome aboard. [Laughter.]
Dr. Stanley.--I'm going to----
Senator Hagan. Wow.
Dr. Stanley. So, we're addressing the issues dealing with
MyCAA----
Senator Hagan. Okay.
Dr. Stanley.--as we move forward. I'm very optimistic about
it working out okay.
Senator Hagan. Okay.
Another question, concerning the Census. I'm concerned that
servicemembers that are deployed during the conduct of the 2010
Census will be counted in a negative way that impacts the
communities that host military installations. For the 1990 and
2000 Census, the decision was made to count deployed
servicemembers as overseas.
North Carolina currently has approximately 41,200
servicemembers deployed as a part of the overseas
contingencies, and in the event that they are counted as
prescribed by the Census Bureau, areas with large
concentrations of military personnel, I believe, will be
significantly undercounted and underfunded for the next 10
years.
What's preventing the Defense Manpower Data Center from
providing the Census Bureau with information regarding the base
of last assignment or permanent U.S. duty station as the
primary response for our deployed servicemembers that are
currently engaged in overseas contingencies?
Dr. Stanley. Senator, I'm going to ask to take that
question for the record.
Senator Hagan. Okay. That's fair.
Dr. Stanley. Because I'd like to get back to you with a
very specific----
Senator Hagan. Okay.
Dr. Stanley.--and correct answer.
[The information referred to follows:]
This issue falls under the purview of the Census Bureau, and we
must follow its guidance on how to count our personnel. The Census
Bureau, in turn, is following what it perceives to be existing
Congressional guidance.
We are aware of no law specifying how to count military members
deployed overseas. The Census Bureau is using a bill passed in the
House in 1990, H.R. 4903, as the methodology for counting overseas
servicemembers and their accompanying dependents. This current
methodology, used in 1990 and 2000, counts overseas military personnel
in this order (where the data is available): State home of record,
State of legal residence, and State of last duty station (i.e., base of
last assignment).
The Department recognizes the decision to use the current
methodology will result in overseas military personnel being assigned
to a home State without counting them toward the populations of towns
or counties. We also understand counting ``last duty station'' first
would have a beneficial effect on States with a large military
population. We have discussed with the Census Bureau methodologies
other than using ``home of record'' first, and these methodologies
might provide a more accurate snapshot of the current residence of the
military personnel and also the desired town and county specificity.
However, the current methodology does have the benefit of consistency
over time.
The Department stands ready to discuss all possible methodologies
with the Census Bureau. We also look forward to continuing to work with
Congress on this important matter.
Senator Hagan. Well, let me go to one other one. We were
talking about suicide. One of you referred to that. So,
Secretaries Lamont, Garcia, and Ginsberg, I think we have
witnessed an unacceptable number of suicides within our
military population, and some of these losses, hopefully, could
have been prevented if servicemembers had the ability to access
professional care during the early stages of emotional
distress. I'm sure we all agree that we have to reduce those
numbers. What measures are being taken within the Services to
ensure that our military men and women receive and gain easier
access to mental healthcare without being stigmatized--that's,
obviously, sometimes associated with that--and with going
through the chain of command?
Secretary Lamont?
Mr. Lamont. First, you're absolutely right, we take the
loss of any soldier, through any means, very, very seriously.
It truly is one of the very highest priorities that we have. We
look at it from early identification of risk factors, as well
as early intervention when we recognize those risk factors, to
move in and encourage, as best we can, to have those
individuals who may exhibit those risk factors to seek out
help.
We have instituted a program designed to reduce the stigma
of reaching out for mental health care. Actually, what we're
finding out with some of our younger soldiers, who, for
whatever reasons, do not wish to meet personally with a
healthcare provider, for instance--we have a software program,
that they go online and they self-address----
Senator Hagan. Right.
Mr. Lamont.--their issues. It's become a very valuable tool
for us. But, it's going to take a lot of effort.
Also, we clearly have to address the resiliency side, and
we're making our effort to do that through a program called
Comprehensive Soldier Fitness, where we explore, not only just
the physical health, but the mental, the emotional and the
spiritual well-being of the soldier, as well, to build that
mental health resiliency as best we can to address the issues
going on in his or her life.
Senator Hagan. Thank you.
Mr. Garcia. Senator, I appreciate your question. For the
first time, last year, our Marine rate approached that of the
national rate; we normed for age and gender. It's an issue we
brief daily and constantly look for a correlation that we can
zero in on.
We focused much of our training at the NCO level. We feel
that they have the most insight and perspective to what our
young sailors and marines are wrestling with, those issues. But
every marine, every sailor receives training and is made aware
that they have access to master's-level counseling. It is
confidential unless, in the aftermath of that training, the
counselor feels that the individual is suicidal, homicidal, or
is unfit for duty. But, everyone is aware of it from boot-camp
level on.
Senator Hagan. Do you think these things are making a
difference in the attitude and the health of our men and women?
Mr. Garcia. I think there is a----
Senator Hagan. Great.
Mr. Garcia.--undeniably, a new level of awareness from E-1
to O-10. I've seen the training that takes place at Marine Boot
Camp, at Marine Corps Recruit Depot. It's the first time where
a Marine drill instructor to--a new boot camp marine sees that
drill instructor take his cover off and address him personally,
in a way that he has not, yet. It speaks to the importance and
the significance, I think, that the Corps and the Department
are placing on this.
Senator Hagan. Okay.
Mr. Ginsberg. Well, Senator, obviously it's a tremendous
tragedy even when one servicemember takes their life. We pride
ourselves, in the Air Force, being a family, and when one feels
so alienated that it becomes a major problem at the highest
reaches.
This is a matter--this goes to our staffing--our capacity
levels, in terms of having enough psychiatrists and trained
psychologists. We, in the Air Force, are doing well, but
obviously there's tremendous competition with the private
sector for trained psychiatrists and trained psychologists. The
bonuses that you provide us are absolutely essential for us to
grow our force and to bring in psychiatrists and trained
psychologists.
I'd also say that this is--and to address the stigma, one
of the things that we're doing in the Air Force is to locate
our mental health clinics within military treatment facilities,
within regular divisions within the hospital, basically, where
somebody who's going in to get treatment is not seen as going
to some special clinic, but is just part of--accessing regular
care. We want to normalize care.
Senator Hagan. That's good.
All right, thank you, Mr. Chairman.
Senator Webb. Thank you, Senator Hagan.
Just to follow on for a moment on that line of questioning,
I believe you could show--and, in fact, the Chief of Staff of
the Army recently brought me a chart to this effect--that there
is a direct correlation between dwell time--the amount of time
that people have between deployments--and the percentage of
emotional difficulties that are in these units. That's why I
introduced this dwell-time amendment in 2007. When the Chief of
Staff of the Army called me and said they were going to 15-
month deployments, with only 12 months dwell time back in the
United States before they redeployed--having spent 4 years as a
committee counsel over in the House Veterans' Affairs
Committee, when we first started examining the difficulties of
people who had served in Vietnam, first of all, I said, ``I
can't believe you're going to do that. I don't think there's
any operational requirement that should cause you, at this
point in our history, to put that kind of pressure on our
people. You're going to have challenges on the other end of
doing this.'' Quite frankly, we're seeing that.
All of your responses basically go to the means--and I
salute these means--of addressing the situation once it occurs,
but I don't think there's anything more valuable than putting
the right kind of dwell time on our units. Particularly, when
you look at the young age of the people who are doing these
multiple deployments, and where they are in terms of addressing
issues of adulthood.
Mr. Lamont. If I may----
Senator Webb. Mr. Lamont, do you want to----
Mr. Lamont.--just add a comment to that. We have any number
of programs that are well intentioned, well resourced, it
doesn't matter. There is nothing more important than exactly
what you say--is the dwell time of our soldiers, with their
families and others, that will help them decompress and serve
them so much better in this kind of situation. It is dwell
time.
Senator Webb. I totally agree. Thank you for saying that.
Senator Begich.
Senator Begich. Thank you very much, Mr. Chairman.
I want to talk about TRICARE for a second, but then I
actually want to get back to the SARC. In Anchorage, in
municipal government, we call it SART, a very similar program,
I think, but I want--that's what I want to ask you.
But, Secretary Stanley, let me--I represent Alaska. It's
very unique when it comes to TRICARE. It's the one that is not
managed by a contractor, out of the whole system. We have some
very unique situations. Alaska's population, in total, is--
about two-thirds has Federal healthcare in some form or
another: Medicaid, Medicare, Indian Health Services, VA,
Federal employed. So, it's probably the highest percentage, I
would bet, or per capita, in the country. So, it has some
unique challenges. Then, geographically, the geography of
Alaska is very vast, and so we have some great challenges.
I have introduced a piece of legislation to set up a task
force for Alaska to bring all the different agencies that deal
with healthcare and TRICARE as part of that--and DOD would be
at that table--to try to figure out what's the best way to
deliver services. I don't know if you've had any chance to see
that legislation, have any comment on it. If you haven't seen
it yet, I'd be anxious to get your comment for the record, at
some point, if you think the task force will be of help for
something very unique, I think, in Alaska. I don't know if you
have any comment on that.
Dr. Stanley. Yes, Senator. I haven't seen the legislation,
but I've seen what I can best describe now are anecdotal pieces
of information that tell me, in Alaska, we have some unique
issues that deal with healthcare, as you've already described.
So, I look forward to not only looking at the legislation, but
working very closely with you to address some very significant
issues.
Senator Begich. Great, I would love to get your response
for the record, I appreciate that.
[The information referred to follows:]
Since two-thirds of Alaskans use a Federal health care program,
creating an interagency task force \1\ would be helpful in working
together to assess and plan improvements to health care access for our
Alaskan beneficiaries in a coordinated manner. TRICARE has tested
alternate means of reimbursement and other Alaska-unique initiatives to
improve access to care, and we are happy to discuss our findings with
the task force and learn the successes other Federal agencies have
experienced as they face the unique challenges Alaska presents.
---------------------------------------------------------------------------
\1\ Note: The creation of the Interagency Access to Health Care in
Alaska Task Force was mandated by section 5104 of H.R. 3590, the
Patient Protection and Affordable Care Act (P.L. 111-148 (124 Stat.
119)).
---------------------------------------------------------------------------
Our TRICARE Regional Office-West team has already begun engaging
other Federal partners in Alaska in anticipation of establishment of
the interagency task force. We look forward to discussing a potential
rate schedule that recognizes the uniqueness of the health care system
in Alaska.
Senator Begich. The other thing I want to say--and the
folks from the Federal Government that have been working on the
TRICARE, that have been managing it for us, have done a great
job. But, I'm also very pleased to see that there is kind of a
reexamination. How would a contractor work? Would there be a
benefit? Is there some advantage, or maybe not advantage,
depending on how it's all looked at? So, I am pleased with
that, and that perspective, and I want you to know that. But,
do you have, from your view, working with TRICARE contractors,
what would you consider some of the advantages that you have
seen in the value of delivering that healthcare? From a
contractor delivering it, versus the way it's done in Alaska?
Dr. Stanley. I'm afraid my answer would probably be
personal, only because----
Senator Begich. Personal is sometimes better.
Dr. Stanley.--I'm a recipient----
Senator Begich. Very good.
Dr. Stanley.--of TRICARE benefits and the contractor, and
from what I've benefited from. It's been pretty transparent to
me, in being able to use a system that works very well. But, I
don't think that's going to address some of the macro issues
we're talking about. I'm also aware of the fact that there are
some, already, challenges that exist with the TRICARE system as
it's presently presented, with our contractors as we address
contracting issues. So, I'm looking into those issues now, but
I will tell you that there are some pluses--some significant
pluses--but, there are also some--probably some negatives
that--as we look at that. But, I don't know what all of those
are right now.
Senator Begich. As you develop that, will you share it with
the committee?
Dr. Stanley. Absolutely.
[The information referred to follows:]
TRICARE-eligible beneficiaries make up almost 14 percent of the
overall population in Alaska. In recognition of the challenges placed
on military treatment facilities, we are working with TriWest, the
TRICARE West Regional Contractor, to develop a preferred provider
listing which would aid in providing more access to civilian providers.
Our regional contractors are experienced in the identification and
credentialing of qualified providers who are willing to provide care to
our beneficiaries. In the future, we plan to identify primary care
managers in the civilian community in the Fairbanks area to support
beneficiaries assigned to Fort Wainwright and Eielson Air Force Base.
Senator Begich. At least my side would be very interested
in that.
Dr. Stanley. I'll look forward to it.
Senator Begich. Then, again, as we examine the role of
TRICARE, the contractor who delivers TRICARE, as a potential
option or augmentation to what we do in Alaska, I'm going to be
very interested as we move through this over the next several
months.
Two other things. One more on TRICARE, and that is, one of
the situations--and I use Alaska, obviously, because I
represent Alaska--one of the things we do, if you take
Medicare, Medicaid, TRICARE, Indian Health Services, VA, we're
always chasing the highest rate, the reimbursement rate. Now,
the problem we have in Alaska is, we have very high rates, no
matter what. I mean, it's just delivery of care, that cost of
care. We don't have a teaching hospital, for example. We lack a
lot of things that other communities can tap into and,
therefore, keep their costs more competitive. Ours, we've been
very high-cost in. But, we've also been very fortunate,
because, under the rules, you've been able to--DOD and--or, the
Federal Government has been able to utilize, under a
demonstration ability, to have a higher-rate reimbursement in
Alaska. It's only been in a demonstration capacity they've been
able to do it. Obviously, we're very interested. I know there's
a study going on, or at least a potential study, that will talk
about how those rates are different; and if they are, how do we
make them more permanent? Because, obviously, doctors--and I
think some of the comments made here is getting those doctors
to perform those services under TRICARE. The reimbursement rate
is critical.
In Anchorage, for example, which is the largest provider,
or largest city--about 43 percent of the State's population--I
think we're down to--on Medicare, for new Medicare patients, I
think we're down to less than three or four docs that will
accept them. That's it. So, we are the tip of the iceberg of
what's going to happen in this country, very rapidly, because
our cost differential is now getting to a point where primary-
care doctors can't afford to do it; and second, there are less
and less of them being produced, in the sense of the system.
So, I would like, if you have any comment on, one, the
demonstration project. Again, if you're not familiar, I'd be
very interested. Then, how we go about getting some permanency
to this, because when docs see a pointer that's not permanent,
then they just say, ``We're just done waiting, we have to move
on to others,'' honestly, business has to continue for what
they do. So, do you have any comment on that? The demonstration
project, how do we move it to permanency, and is that a
realistic viewpoint?
Dr. Stanley. Well, thank you, Senator.
Let me just say that I've been briefed on the project, in
general.
Senator Begich. Good.
Dr. Stanley. My commitment is to work closely with you, not
to study the problem to death----
Senator Begich. Now you're talking. [Laughter.]
Dr. Stanley.--but to move forward with a solution.
Senator Begich. Good.
Dr. Stanley. So, I'm aware of it. Now the issue is, okay,
addressing this on the degree of permanency, which is why I put
in place someone to help--with expertise, immediately--that's a
physician--until we get somebody confirmed. I can't wait that
long.
Senator Begich. Right.
Dr. Stanley. Which is the reason we're moving, kind of,
like at flank speed, for lack of a better word----
Senator Begich. Good.
Dr. Stanley.--to put things in place and address these
issues. There are other issues, too.
Senator Begich. Absolutely. We would love to see
confirmations happen very rapidly, but don't wait for that.
Move forward on progress, and I appreciate your comments.
I will end, Mr. Chairman, just on one--and this is more of
a comment to the--as a former mayor, we worked on a project
called SART, which is Sexual Assault Response Team, which is a
combination public service, police--and they all are
centralized into one location. They work with the community
hospitals. It's good for investigation purposes. It has a kids'
unit. It has a variety of things that--one of the pieces to
this equation--and I haven't asked the--and I'm not asking for
a response, at this point. I just want you to become aware, if
you can, with what we're doing in Anchorage, which is the SART
team.
Why I say that, there's a very important component of how
the person who has been the victim works through the process,
and how that's handled, which is critical to your
investigations, conviction rates, as well as to the care that's
necessary. Then, if there are family members engaged in this,
in the sense of a child who's also been assaulted, there's a
whole process that is much different than the adult process.
The SART program has been recognized around the Nation as a
very cohesive and--like you, we saw rates go up, in the sense
of reporting, but we also saw conviction rates go up, education
capacity increasing--and young people, children especially,
which is probably the hardest to deal with, with sexual assault
or violence in a household or in a home.
I'd just ask you--and we'd be happy to supply you some
information--it's very unique and has been very, very
successful. In Anchorage, we have two large military bases,
literally as far as that door is from our facilities and our
population. We have a great relationship with the military
that--we know this program has had some impact.
So, I'd just encourage you, as you work through this very
troubling issue, to be very frank with you, but one we have to
deal with, not only from a sexual assault on the officer, but
also so many families are now part of the military family that,
30 years ago, was not the case, but today, it's 70 or 75
percent of the families. So the kids of this population, also,
we need to make sure they're getting the services they need,
and education they need. So, I would just encourage you to----
Dr. Stanley. Will do, sir.
Senator Begich. Okay, and we'll get you some information
from staff.
Dr. Stanley. Great. Thank you.
Senator Webb. Thank you very much, Senator Begich.
Senator Chambliss.
Senator Chambliss. Thank you very much, Mr. Chairman.
Gentlemen, first of all, let me just say that I want to
thank all of you for what you do. You're charged with managing
the most important aspect of our military, and that's the
people and the programs that support them.
I know much of what you do deals with numbers, but I also
know you have an appreciation for what those numbers represent,
in terms of the individual and his or her family, and what it
means to our Nation.
You all, along with our second panel, will help give us a
sense of how we're doing, and how we can best continue to
support the men and women of the Armed Forces and their
families. So, I thank you for being here.
Secretary Ginsberg, it's always great to see a Georgian on
a panel like this--
Mr. Ginsberg. It's my honor to be here. Thank you, Senator.
Senator Chambliss.--so thanks for your service.
Secretary Stanley, let me just ask you if you are familiar
with the situation of the commissary at Dobbins and the one
that we're transferring from Gillem to Dobbins. Does that ring
a bell at all with you?
Dr. Stanley. Vaguely. If you keep talking, Senator, I think
I might pull something up, here. [Laughter.]
Senator Chambliss. I'm not surprised that you don't, but--
Dr. Stanley. Okay.
Senator Chambliss.--basically, a BRAC decision was made to
close Fort Gillem, in Atlanta, and that's the commissary that
has served our retired population for decades. A decision was
made, by your predecessor, to construct a new commissary at
Dobbins that obviously will continue to operate, and it's going
to serve our retired population. And it's in the hands of DeCA
right now. That's why I'm not surprised you're not familiar
with it. But, I wish you would familiarize yourself with it. At
some point, you're going to have some significant input into
it, and it may just be an issue of DeCA trying to find the
funding for it. But, in any event, it is obviously a critical
issue for the retired population, as well as for our active
duty folks in the area.
Dr. Stanley. Yes, sir.
Senator Chambliss. Secretary Lamont, in light of the Fort
Hood incident last November, can you elaborate on specific
steps that the Army is taking to better recognize the presence
of soldiers who may have become radicalized, as Major Hasan
was?
Mr. Lamont. I can tell you this. We are going through a
very extensive internal review to look at all components of
extremism that may have crept into society and, of course, may
touch more and more into our Military Services, and what we can
do to address those. We're aware of some apparent shortcomings
in our officer evaluation forms and in our enlisted
evaluations, and how some of the right questions may just not
get asked. Some of the identifying risk factors may not just be
exposed, as well.
There is a Defense-wide Fort Hood review in progress right
now. As I understand it--and perhaps Dr. Stanley knows more
than I--that perhaps sometime this summer there will be a full
report, as all of the Services, I believe, are involved in that
report. But, certainly the Army is drilling down very deeply to
see, what in the world did we miss here?
Senator Chambliss. Let me just mention to all of you--I
think Senator Graham may have mentioned this in his opening
comments--the Guard and Reserve retirement initiative, early
retirement initiative, that we have been successful at having
put in place, that we're now looking to extend the retirement
date back to service beginning on September 11, 2001. If there
are any stumbling blocks out there, I would appreciate hearing
from you now, if you're aware of anything. Obviously, funding
is an issue. We're going to continue to work that until we,
ultimately, have that retirement date, or that service date to
qualify for retirement, go back to September 11, 2001, when so
many of our men and women began being called up. Any comments
any of you have, relative to any issues that are outstanding,
that might be in our way on that issue?
Dr. Stanley. Senator, I hadn't heard anything, I'm not sure
if my colleagues have.
Mr. Lamont. I've heard very little.
Senator Chambliss. Okay.
Mr. Lamont. But, as you say, the number one thing that we
always look on something like that, of course, is the resource
concerns----
Senator Chambliss. Yes.
Mr. Lamont.--as you are well aware.
Senator Chambliss. Yes. Well, we'll continue to work that
from our end.
One other question. Secretary Lamont, I understand that the
Vice Chief of Staff of the Army is currently hosting an online
virtual conference regarding the future of the U.S. Army
Officer Corps. The central premise behind this virtual
conference is the recruitment and employment of talent within
the Army. This sounds like a great idea, and a great way to
look at the caliber of the young men and women who are--who
make up our officer corps, from flag officers on down--could
you give us any comment on that? Are any of the other Services
doing something similar to this, or have plans for it?
Mr. Lamont. Well, I understand the goal of what the Vice
Chief is after, here. Our officer structure is not where we
need it to be, given some of the demands that we've had over
the past 8 or 9 years, and as we've moved to our modular
rotational model in ARFORGEN, it has caused some fairly serious
changes in how our officer structure is handled.
I think there is an effort out there, particularly in the
grades of major, for instance, or that--there are serious
shortcomings there, in the numbers that we have available. I
think these--through--what he is trying to do is look for any
acceptable options and alternatives to how we identify our
officer corps, and where we can move them within the structure
that's available now, our other grade challenges, grade-plate
challenges, that we have.
Mr. Ginsberg. I'm not familiar with the program, but we
work very closely with the Army. I'd love to reach out with my
colleague, here, and learn more about it. Certainly provide
some formal views to you.
Senator Chambliss. Okay.
Secretary Garcia, Secretary Stanley, anything going on in
your branch, similar to this?
Dr. Stanley. I'm not familiar with the program. I'm, in
fact, learning about it as he's talking, Senator.
Senator Chambliss. Yeah. Well, it does sound like a good
idea, because everybody has the same issues, relative to the
makeup of our officer corps. The Army and the Marine Corps, I
guess, have a little bit different situation, just because
you've been taxed more than anybody else, but it is an issue
that sounds to me like it has a lot of merit to it, and I would
encourage every branch to follow suit, there.
Thank you, Mr. Chairman.
Senator Webb. Thank you, Senator Chambliss.
I'm going to ask a couple of service-specific questions,
and then, Secretary Stanley, I'd like to ask you a series of
questions.
Let me say, I was a boxer for 8 years. You've been bobbing
and weaving for an hour and 15 minutes, here. [Laughter.]
So, I'm going to ask you a series of questions to sort of
get us all looking forward, since you just came to this job and
I just assumed the chairmanship. But, first, I want to put
something in front of the Service Assistant Secretaries.
There was an article in Military Times last week on
prescription drug use in the military. I don't know if you all
saw that article, or not. But, it pointed out that one in six
servicemembers is on some form of psychiatric drug; 17 percent
of the Active-Duty Force, and as much as 6 percent of the
deployed troops are on antidepressants; and the use of
psychiatric medications has increased about 76 percent since
the start of these current wars.
First, I would like to express my appreciation to Senator
Cardin for having brought this issue to the attention of people
here in the Senate. But, these statistics, quite frankly, are
astounding to me. I'd like to know if--how familiar the three
Assistant Secretaries are with this issue inside your
departments, and what your thoughts are. Is this an indication
of the overall fatigue of the force, with these constant
deployments, or is it an indication of a different approach to
medical treatment? Are we on top of this?
I know that last year there was a provision in the Defense
bill to require the Department to report on the administration
and prescription of these drugs.
But, Secretary Lamont, let me start with you. What are your
thoughts on this?
Mr. Lamont. Well, I'm not specifically aware of the article
you're speaking about. I was TDY last week. However, I am well
aware of the concerns we have with our pain management program.
Those are the prescription drugs that we have found to have
really crept into our system in much wider usage than we were
ever aware of before.
I'll also suggest to you, drugs like Oxycontin, I
understand is used both in pain management and as an
antidepressant. That's caused a number of concerns, because--
the fear that they may be prescribed by separate healthcare
providers.
What we have done to try to address the pain management
side, what we found was, depending on where you went for
treatment, there could be an entirely different model, if you
would, of how pain is treated and how pain drugs are
prescribed. There was no consistency there. So, with the
various Services, we began a joint task force, this last fall,
which is due to report, at any date now, on how we can come
together with some kind of consistency in how we handle our
pain management problem--pain management equals the drugs--and
how we administer the proliferation of drugs in our military
system.
Our soldiers are coming back wounded, sore, injured, in
need of rehab, and that's--perhaps the easy answer, early on,
was pain-managed prescription. But, there are other means. We
hope this joint task force report will come to grips with how
we can provide some consistency, not just throughout the Army--
I mean, we found that every Army Medical Center was dealing
with pain in altogether different ways, all individual to their
situation. But, not an Army-wide program at all. I think, with
this task force, we'll have the Services all together, and
hopefully all in sync, of how we can address this growing
problem.
[Additional information supplied by Secretary Lamont
follows:]
Pain management has a significant behavioral health component, and
drugs like Oxycontin and antidepressants may be simultaneously
prescribed by different health care providers for better symptom
management. While drugs like Oxycontin are used for pain management,
what we have found is that pain has a strong behavioral health
component requiring the addition of drugs like antidepressants for
better symptom management. These prescription combinations are often
managed by different health care providers. The issue of multiple-
prescribers exists in our health system and others. It concerns me that
patients can receive different agents like narcotics and psychiatric
drugs from different sources.
Senator Webb. Secretary Garcia?
Mr. Garcia. Senator, I'm familiar with the piece, and, as I
understood it, it also posited, or suggested, that there were--
elicit drug use, to include in theater. We continue to drug
test randomly across the fleet, forward-deployed and at home.
On the prescription side, our Special Assistant for Health
Affairs has initiated a working group, generated by the piece,
to research this apparent spike, especially on the Marine side.
That's where we are. All I can do is continue to keep you
posted on the results.
Senator Webb. Secretary Ginsberg.
Mr. Ginsberg. Senator, I'm not familiar with the article,
but I think you raise, obviously, a very important question
about the extent of prescription drug use and whether this is
an indicator of stress, or is this a new push to medicine? I'd
very much like to get some concrete data from our surgeon-
general community, and would be more than happy to provide that
to you.
[The information referred to follows:]
Thank you for the opportunity to address this concern regarding the
health and well-being of our Air Force members and their use of
psychotropic medications. Based upon this inquiry we made two distinct
efforts to review psychopharmacology utilization data for our active
duty servicemembers. The first data set we reviewed was provided by
LCDR Joseph B. Lawrence, USN, MSC as the Deputy Director, Department of
Defense (DOD) Pharmacoeconomic Center COR, DOD Pharmacy Operation
Center. LCDR Lawrence's data pull from the Military Health System (MHS)
Pharmacy Data Transaction Service (PDTS) demonstrated that in the U.S.
Air Force active duty psychotropic drug prescriptions increased from
58,102 annually in 2005 to 113,010 annually in 2009. The most notable
increases related to use of stimulant and sleep medications. Stimulants
prescriptions increased from 6,886 in 2005 to 11,522 in 2009. The
number of prescriptions for sleep medication went from 33,175 in 2005
to 64,166 in 2009. These two classes of psychotropic medications
accounted for approximately 65 percent of the total prescription
increase over this time period. While prescription sleep medications do
carry a low risk of abuse, they are also highly effective and
beneficial when used appropriately for short-term use to address the
maintenance of health sleep patterns with international travel and
fluctuating operational work schedules.
The second data pull was provided by Air Force Medical Operations
Agency, Michael Squires. Mr. Squires extracted data from the PDTS table
in the M2 which resulted in all Air Force active duty servicemembers
who had received a psychotropic prescription (including
antidepressants) between October 2009 and March 2010. The number of
unique Air Force servicemembers who had one or more prescriptions for
any psychotropic medication, including controlled prescription pain
medications during this 6 month period was 81,253 or 22 percent of the
Active Force. When controlled prescription pain medications are
removed, the number of unique servicemembers on a psychotropic
medication changes to 48, 233. This reflects a calculated user
prevalence rate during a 6 month period of 1 in 8, or 13 percent , of
the Active-Duty Force for psychotropic medications. This figure is a 6-
month period prevalence; point prevalence on a specific day would be
lower. Additionally, this data pull illustrated a utilization rate over
a 6 month period of controlled pain medications as 51 for every 400
servicemembers (12.75 percent), an antidepressant utilization rate of
23 for every 500 servicemembers (4.6 percent), a sleep medication
utilization rate of approximately 19 of every 421 servicemembers (4.4
percent), a stimulant utilization rate of approximately 4 out of every
425 servicemembers (0.94 percent), and an antipsychotic utilization
rate of approximately 2 for every 1,000 servicemembers (0.2 percent).
Senator Webb. I'd just say as an observation, one, we do
have a really stressed, young force, because of these
deployments. This is an indicator I think we really should be
tracking very closely, with repeated deployments and these
sorts of things.
The other is, just purely as an observation, from looking
at where they are deployed and the restriction of the use of
alcohol, I would say it's--having been a journalist in
Afghanistan before I started doing this, it is always rather
ironic to me that, for reasons of comity with these other
countries, we didn't allow our troops to use alcohol, but, I'll
tell you, I was in a lot of villages in Afghanistan where
everybody had their marijuana patch and their opium patch.
The relief of stress on individuals is handled differently
in different cultures, and that may be something you want to
look into. It's a very troubling statistic, to me. I hope we
can look at it, not simply medically, but in these other ways,
as well.
Secretary Ginsberg, can you give this subcommittee, some
insight on this decision to provide aviation pay to nonrated
pilots in the Remotely-Piloted Aircraft Program, what the
justification is and--how does that fit into traditional
definitions of flight pay, and those sorts of things?
Mr. Ginsberg. Absolutely. Senator, the Air Force is meeting
a very high demand to provide remotely-piloted aircraft--combat
air patrols (CAPs) to our combatant command commander in
Afghanistan and Iraq. We are currently providing 41 CAPs to the
theater. We're working, by the end of fiscal year 2013, to
provide 65 CAPs. What we're trying to do is develop a career
field, where our airmen, who are providing this critical
support to our forces on the ground, our brothers in the Marine
Corps and the Army, as well as many are Air Force officers and
enlisted on the ground, providing them this direct support. We
want to make sure they can grow and develop.
The incentive pays are a critical part of maintaining a
robust pipeline of airmen who are operating these systems.
Senator Webb. Under what category are they paid now?
Mr. Ginsberg. I'm sorry?
Senator Webb. Under what category are they being paid?
Mr. Ginsberg. Well, this is an OSD-approved--under a--of
course, the broad authority that Congress provides, under the--
it's the--it's aviation continuation-paylike pay, and it----
Senator Webb. It's not called ``flight pay''?
Mr. Ginsberg. It's not called ``flight pay,'' but it's a--
it's a different authority that we're providing under. This
about just making--this--these officers and enlisted members
are providing absolutely critical direct support to our forces
on the ground, and we are putting tremendous stresses on them.
Our crew ratios are not sufficient, at this point. They have a
hard time getting leave, regular leave. We need to provide
them--we're not giving them the opportunity to move to new
assignments as flexibly as other career areas. We need to
provide them pay and bonuses that will help make sure that this
career field remains attractive.
I went to Creech early in my tenure, to Creech Airfield,
where we have a lot of our operators. It is absolutely
astounding, what those airmen are doing to provide day-in and
day-out support, truly lifesaving work.
Senator Webb. Okay, thank you.
Mr. Ginsberg. So, again, it's about making sure that they
get the right pay--
Senator Webb. I think that----
Mr. Ginsberg.--and benefits that they deserve.
Senator Webb. Secretary Stanley, I believe that this is a
good time, with your coming in, to get a strong analytical look
at how all of the special incentive pays, bonus pays,
reenlistment pays, enlistment--how all of these fit together in
a way that is beneficial to the people who are serving, and
also to the efficiency of our programs.
What I would like to do in a--rather than taking a great
deal of time this morning, what I would like to do is to work
with you and your staff to develop a matrix, so that we can
fully understand what we're doing in these programs. I believe
that the best way to address issues is, first, to assemble,
clearly, the facts. So we are going to come to you with some
questions about the incentive pays, the special pays, the
reenlistment bonuses, the whole panorama, to get an
understanding of how they are used, how many people are used,
what the criteria are, how many of these are directed by
Congress, how many of them are subject to the discretion of the
implementers--your staff and the other----
Dr. Stanley. Yes.
Senator Webb.--Service departments--so that we can have a
clear picture, as we move forward in these programs. I'm not
sure of the last time that that's been done. I don't want to go
through every one of these and ask for your justifications, but
we're going to be having some questions. I don't want these to
be considered questions for the record that are going to be
answered----
Dr. Stanley. Yes, sir.
Senator Webb.--a month or 2 months. I really want to work
on this so we can aggressively address it.
There's a couple of other areas that I would like to get
some feedback from you on. One of them, I'm sure you're
familiar with, this mentor program that there were numerous
articles, particularly USA Today, about where retired flag
officers are getting up to $2,600 a day to come in and
basically give advice. You know the situation, you're a retired
flag. A retired four-star can be making in excess of $200,000 a
year and then be working for a defense company, and then come
in and be getting this sort of pay to give advice that, quite
frankly, traditionally, has been a part of having worn the
uniform, a sort of a continuing stewardship.
So, there's a lot of questions, here in Congress, about how
that reflects upon the dignity of Service, quite frankly. We
want to get to the bottom of how that program is run.
Then there's another area which relates to military
fellowships, to think tanks. I would like to get some data on
this with respect to the numbers of people who are involved in
this and how taxpayer dollars are being spent, beyond regular
military compensation, on areas that are called ``tuition'' for
Active Duty military officers to go over and work on a think
tank and not only be paid by the taxpayers for their regular
military compensation, but actually being paid tens of
thousands of dollars into these think tanks for this office
space, et cetera. I don't think I have a full understanding of
how this works, and we'd like to get specific data from you.
Each Service may be doing it differently, but we'd like to
assemble that data.
With that, I thank all of you for your testimony, and look
forward to working with you on a very close basis. Our door is
open for any issues that you want to bring to the subcommittee,
or to my office, personally.
Thank you very much.
Dr. Stanley. I appreciate that.
Mr. Lamont. Thank you.
Mr. Garcia. Thank you very much. [Pause.]
Senator Webb. Our second panel will have members of the
military coalition, a consortium of nationally prominent
uniformed service and veteran organizations: Master Chief
(Retired) Joseph Barnes, National Executive Director of the
Fleet Reserve Association; Ms. Kathleen Moakler is the
Government Relations Director of the National Military Family
Association; Master Sergeant Michael Cline (Retired) is the
Executive Director of the Enlisted Association of the National
Guard of the United States; Ms. Deirdre Parke Holleman is the
Executive Director of The Retired Enlisted Association; and
Colonel Steven Strobridge (Retired) is the Director of
Government Relations for the Military Officers Association of
America.
I mentioned earlier that we had two statements that would
be put in the record. Probably more appropriate, they would be
put in at this point rather than at the beginning of the
hearing.
[The joint prepared statement of the Reserve Officers
Association and Reserve Enlisted Association follows:]
Joint Prepared Statement by the Reserve Officers Association of the
United States Reserve Enlisted Association
introduction
On behalf of our members, the Reserve Officers Association (ROA)
and the Reserve Enlisted Association (REA) thank the committee for the
opportunity to submit testimony on military personnel issues. ROA and
REA applaud the ongoing efforts by Congress to address readiness,
recruiting and retention as evidenced by incentives in several
provisions included in the National Defense Authorization Act (NDAA)
for Fiscal Year 2010.
executive summary
The Reserve Officers Association Calendar Year 2010 Legislative
Priorities are:
Reset the whole force to include fully funding
equipment and training for the National Guard and Reserves.
Assure that the Reserve and National Guard continue in
a key national defense role, both at home and abroad. Support
citizen warriors, families and survivors.
Provide adequate resources and authorities to support
the current recruiting and retention requirements of the
Reserves and National Guard.
Support warriors, families, and survivors.
Issues supported by the Reserve Officers and Reserve Enlisted
Associations are to:
Changes to retention policies:
Permit service beyond the current Reserve Officers
Personnel Management Act (ROPMA) limitations.
Support incentives for affiliation, reenlistment
retention and continuation in the Reserve component.
Education:
Increase MGIB-Selected Reserve (MGIB-SR) to 47 percent
of MGIB-Active.
Include 4-year reenlistment contracts to qualify for
MGIB-SR.
Mobilization:
Provide differential pay for deployed Federal
employees permanently.
Permit reservists the option of accumulating leave
between active duty orders, as well as selling it back.
Pay and Compensation:
Reimburse a Reserve component member for expenses
incurred in connection with round-trip travel in excess of 100
miles to an inactive training location, including mileage
traveled, lodging and subsistence.
Obtain professional pay for Reserve component medical
professionals, consistent with the Active component.
Eliminate the 1l/30th rule for Aviation Career
Incentive Pay. Career Enlisted Flyers Incentive Pay. Diving
Special Duty Pay. and Hazardous Duty Incentive Pay.
Simplify the Reserve duty order system without
compromising drill compensation.
Spouse Support:
Expand eligibility of surviving spouses to receive
Survivor Benefit Plan (SBP)-Dependency Indemnity Clause (DIC)
payments with no offset.
Health Care:
Improve continuity of health care for all drilling
reservists and their families by:
Monitoring the implementation of the
Department of Defense (DOD) paying a stipend toward
employers health care for dependents.
Allowing gray-area retirees to buy-in to
TRICARE by mid-2010.
Providing Continuing Health Benefit Plan to
traditional drilling reservists who are beneficiaries
of TRICARE Reserve Select but are separated from the
Selected Reserve to provide COBRA protections,
Permitting active members in the Individual
Ready Reserve (IRR) who qualify for a 20-year
retirement to buy-into TRICARE.
Allowing demobilized retirees and reservists
involuntarily returning to IRR to qualify for
subsidized TRS coverage,
Providing TRS coverage to mobilization ready
IRR members; levels of subsidy would vary for different
levels of readiness.
Improve post-deployment medical and mental
health evaluations of returning Reserve component
members.
Fund restorative dental care prior to mobilization.
Extend military coverage for restorative dental care
following deployment to 90 days.
Evaluate the Post-Deployment Medical Evaluation
process.
Encourage a discussion on health care costs between
Congress, DOD, and nonprofits.
Protect military and veteran's health care from
inclusion in national health legislation.
Voting:
Ensure that every deployed servicemember has an
opportunity to vote by:
Working with the Federal Voting Assistance
Program
Supporting electronic voting
Ensure that every military absentee ballot is counted.
Only issues needing additional explanation are included below.
Self-explanatory or issues covered by other testimony will not be
elaborated upon, but ROA and REA can provide further information if
requested.
readiness discussion
Operational versus strategic missions for the Reserve component:
The Reserve Forces are no longer just a part-time strategic force
but are an integral contributor to our Nation's operational ability to
defend our soil, assist other countries in maintaining global peace,
and fight in overseas contingency operations.
National security demands both a Strategic and an Operational
Reserve. The Operational Reserve requires a more significant investment
of training and equipment resources, and places greater demands on its
personnel as compared to the Strategic Reserve. Those serving in
Operational Reserve units must be fully aware of the commitment
required to maintain the expected level of readiness. A similar
awareness and commitment is necessary for those responsible for
providing resources to the Operational Reserve.
Planners also must recognize that few individuals can remain in the
operational Reserve for an entire career. There will be times when
family, education, civilian career, and the other demands competing for
their time and talents take priority. Such an approach requires the
ability to move freely and without penalty between the operational and
strategic elements of the Reserve component as a continuum of service.
Each Service has its own force generation models and the Services
organize, train, and equip their Reserve components to a prescribed
level of readiness prior to mobilization to limit post-mobilization
training and to maximize operational deployment time. ROA and REA urge
Congress to continue to support and fund each Service's authority to
manage the readiness of its own Reserve Forces as one model does not
fit all.
Congress can play an important role by requiring reports from
Service leaders to ensure they have a plan for systematic augmentation,
that the plan is adequately resourced, and that Reserve training and
equipment will permit interoperability with the units they augment and
reinforce. In an era of constrained budgets, a capable and sustainable
Reserve and National Guard is a cost-effective element of national
security.
Junior Officer and Enlisted Drain:
As an initial obligated period draws to the end, many junior
officers and enlisted choose to leave, creating a critical shortage of
young people in the leadership conduit. This challenge has yet to be
solved. ROA and the National Guard Education Foundation published a
report suggesting solutions to the problem. Copies can be provided to
the committee, or be found at http://www.roa.org/JO-shortage.
End Strength and Preparedness:
It is noted that the only active service component to suffer cuts
in the fiscal year 2011 proposed budget was the Coast Guard which will
have a reduction of 1,100 personnel.
The other Active components appear to maintain their end strengths
with inclusion of temporary increases for the Army and the Navy. It
should be remembered that individuals cannot be brought quickly on to
active duly on a temporary basis, but it is an accumulation of
experience and training that is acquired over years that becomes an
asset for the military. Before cuts to the U.S. Coast Guard are made,
ROA and REA hope that Congress requests a report from the U.S. Coast
Guard, Department of Homeland Security, on the effect in the short and
long term.
Traditionally, it has been the Reserve component that has provided
the temporary surge to fill-in the active duty numbers. The end
strengths included in the President's budget appear to maintain current
numbers. ROA and REA are concerned that the ongoing cuts to the Navy's
Reserve will continue and this is a trend that needs to be reversed. A
new manpower study needs to be done and published by the Navy Reserve
to calculate the actual manning level: this study should be driven by
readiness and not budgetary requirements.
With pending withdrawals from Iraq and Afghanistan, there is
already talk within the beltway about future cuts to military end
strength to help offset rising deficits. Many blame the global war on
terrorism for our current national debt, but part of high cost of the
military is unpreparedness, and the bills borne by trying to create a
force to match the need.
Following World War I, Lieutenant General James Guthrie Harbord,
USA, General John J. Pershing's chief of staff, was quoted in a 1922
New York Times as saying. ``The size of our debt, incurred through
unpreparedness, brings a demand for economy, and we continue
unprepared. Thus unpreparedness brings the debt, and the debt continues
unpreparedness.''
Without external threats, the USA has traditionally reduced the
size of its Armed Forces. But since the 1990s the Pentagon has
recommended proportional cuts be taken in the Reserve component when
taken in the Active Force. This reasoning fails in many ways. It
results in a hollowing out of the force and preparedness, undermines
morale, and undercuts retention. national security is put at risk.
There is a need to maintain a national position of readiness, and the
Reserve component is a cost-effective solution of being prepared.
Should cuts be taken in the Active component, the Reserve component
should grow in size to allow a place for readiness capability.
proposed legislation
Retirement
ROA and REA again thank the committee for passing the early
retirement benefit in the National Defense Authorization Act for Fiscal
Year 2008, as a good first step toward changing the retirement
compensation for serving Guard and Reserve members, but. . .
Guard and Reserve members feel that with the change in the roles
and missions of the Reserve component, their contracts have changed.
Informal surveys keep indicating that earlier retirement remains a top
issue asked for by guardsmen and reservists. They ask why so many Guard
and Reserve members who have served in the global war on terrorism were
excluded from the new benefit; they also ask why even earlier duty is
not included: and if faced with the same risks as active duty, why
there is a 20 year difference in access to retirement pay?
1. ``ROA and REA'' endorse S.831. National Guard and Reserve
Retired Pay Equity Act of 2009, which is a corrective measure to the
National Defense Authorization Act for Fiscal Year 2008 including those
Guard and Reserve members who have been mobilized since September 11,
2001. Over 600,000 were unfairly excluded. We realize the expense of
this corrective measure scored by CBO is $2.1 billion over 10 years,
but hope that offset dollars can be found.
2. ROA and REA don't view this congressional solution as the final
retirement plan. The Commission on the National Guard and Reserve
recommends that Congress should amend laws to place the Active and
Reserve components into the same retirement system. Secretary of
Defense Robert Gates refers to the Tenth Quadrennial Review of Military
Compensation's comprehensive review of the military retirement systems
for suggested reform. The latter report suggests a retirement pay equal
to 2.5 percent of basic pay multiplied by the number of years of
service.
ROA and REA agree that a retirement plan, at least for the Reserve
component, should be based on accruement of active and inactive duty.
Early retirement should not be based on the type of service, but on the
aggregate of duty. It shouldn't matter if a member's contributions were
paid or non-paid; inactive duty, active duty for training, special
works or for mobilization. Under a continuum of service, this approach
would provide both the Active or Reserve component members with an
element of personal control to determine when they retire and will
encourage increased frequency of service beyond 20 years within the
Reserve.
3. An additional problem arises for O-4 officers who, after a break
in service, have returned to the Reserve component. After being
encouraged to return a number of officers find they are not eligible
for nonregular retirement. When reaching 20 years of commissioned
service they find they may have only 15 good Federal years. Current
policy allows these individuals to have only 24 years of commissioned
time to earn 20 good Federal years.
4. With an ongoing shortage of mid-grade officers (O-2 to O-3),
Congress should reexamine the DOPMA and ROPMA laws to permit O-3s
without prior enlisted service to be able to retire at 20 years of
service. Many of badly needed skills that the Services would like to
retain, yet must be discharged if passed over for promotion to often.
ROA urges Congress to make changes in U.S. Code to allow O-3s and
O-4s with 14 to 15 good Federal years to remain on Active Duty or in
the Reserve until they qualify for regular or non-regular retirement.
Education
1. Montgomery ``GI'' Bill-Selected Reserve (MGJB-SR): To assist in
recruiting efforts for the Marine Corps Reserve and the other uniformed
services, ROA and REA urge Congress to reduce the obligation period to
qualify for MGJB-SR (Section 1606) from 6 years in the Selected Reserve
to 4 years in the Selected Reserve plus 4 years in the Individual Ready
Reserve, thereby remaining a mobilization asset for 8 years.
2. Extending MGIB-SR eligibility beyond Selected Reserve Status:
Because of funding constraints, no Reserve component member will be
guaranteed a full career without some period in a non-pay status. BRAC
realignments are also restructuring the RC force and reducing available
paid billets. Whether attached to a volunteer unit or as an individual
mobilization augmentee, this status represents periods of drilling
without pay. MGIB-SR eligibility should extend for 10 years beyond
separation or transfer from a paid billet.
Leadership
Both the Army and Air Force Reserve Chiefs may only be selected
from general officers from that component's reserve, yet the Navy and
the Marine Corps can select its Reserve leadership from either Active
or Reserve flag officers. (U.S.C., title 10. section 3038 states that
``The President, by and with the advice and consent of the Senate,
shall appoint the Chief of Army Reserve from general officers of the
Army Reserve . . .'' and section 8038 uses similar language for the
appointment of the Chief of the Air Force Reserve, while U.S.C., title
10, section 5143, only requires the President to appoint the Chief of
Navy Reserve from flag officers of the Navy, and section 5144 only
requires the President to appoint the Commander. Marine Forces Reserve,
from general officers of the Marine Corps.) The Reserve Chief of a
Service's Reserve should have an understanding of both the citizen
warriors who are reporting to him or her, and the system through which
the report. ROA urges Congress to change sections 5143 and 5144 of
U.S.C., title 10 to only permit appointments from the Service's Reserve
component.
Military Voting
ROA thanks Congress for the improvements made to absentee voting in
the fiscal year 2010 Defense Authorization. Military personnel,
overseas citizens, and their families residing outside their election
districts deserve every reasonable opportunity to participate in the
electoral process. Yet, studies by Congressional Research Service show
that 25 percent of military member and family votes were not counted in
the 2008 election.
ROA and REA urge Congress to direct the Government Accountability
Office to report further on the effectiveness of absentee voting
assistance to Military and Overseas Citizens for the 2010 General
Election and determine how Federal Voting Assistance Program's efforts
to facilitate absentee voting by military personnel and overseas
citizens differed between the 2008 and 2010 national elections. ROA and
REA also hopes Congress encourages the Secretary of Defense, in
conjunction with States and local jurisdictions, to gather and publish
national data about the 2010 election by voting jurisdiction on
disqualified military and overseas absentee ballots and reasons for
disqualification.
health care discussion
1. ROA and REA hold concerns over the implementation of TRICARE for
gray area retirees. Rear Admiral Christine S. Hunter has shared that
enrollment could be as early as July or as late as November 2010, and
that it might be regionally rolled out. DOD wants to treat Reserve gray
area retirees as a separate health care risk group which will likely
drive up the cost of health care premiums as well. ROA and REA hope
that the committee will ask hard questions at a future hearing about
the process, as individuals in the health care industry question the
length of time and the approach being taken.
2. Sustaining Reserve Health care. ROA and REA was disappointed to
learn that Continued Health Care Benefit Plan is only allowed to
members of the Selected Reserve if they have had a tour of active duty
within the previous 18 months by DOD. This is denying COBRA protections
for traditional reservists who haven't been activated, and even
overlooks the Secretary of Defense's directive to mobilize National
Guard and Reserve members 1 year out of 6, which would be a dwell time
of 60 months between call-ups. There is little cost as the beneficiary
pays a premium of 102 percent of TRICARE Cost.
A continuity of health care is needed if a continuum of service is
to be seriously considered. Just as an Active Force needs to be
provided military health, the Reserve component needs to have a
seamless health protection during different duty statuses. As even
discharged active servicemembers have the benefit of the Continuing
Health Care Benefit Plan, those Guard and Reserve members who have
signed up for TRICARE Reserve Select need to have protections when they
leave the Selected Reserve.
ROA and REA encourage Congress to work with the Pentagon to open up
Reserve component member access to the Continued Health Care Benefit
Plan to any TRICARE Reserve Select beneficiary separating from the
Selected Reserve under conditions that are not punitive in nature.
3. Employer health care option: The ROA and REA continues to
support an option for individual reservists where DOD pays a stipend to
employers of deployed Guard and Reserve members to continue employer
health care during deployment. Because TRICARE Prime or Standard is not
available in all regions that are some distance from military bases it
is an advantage to provide a continuity of health care by continuing an
employer's health plan for the family members. This stipend would be
equal to DOD's contribution to Active Duty TRICARE.
4. Dental Readiness. Currently, dental readiness has one of the
largest impacts on mobilization. The action by Congress in the NDAA for
Fiscal Year 2010 was a good step forward, but still more needs to be
done.
In the first quarter of fiscal year 2009, the Army Reserve was 48.8
percent dental class 1 or 2 Navy Reserve was 92.8 percent, Air Force
Reserve 86.6 percent, Marine Corps Reserve 77 percent. Air Guard 91
percent Army Guard 48.2 percent, and Coast Guard Reserve 83.2 percent.
While there has been slight improvement since fiscal year 2007, the
Army Reserve and Marine Corps Reserve have actually decreased their
dental readiness which is due to large numbers of Class 4
servicemembers. Regardless none of the Services have met the 95 percent
dental readiness goal.
The Services require a minimum of Class 2 (where treatment is
needed, however no dental emergency is likely within 6 months) for
deployment. Current policy relies on voluntary dental care by the Guard
or Reserve member. Once alerted, dental treatment can be done by the
military, but often times there isn't adequate time for proper
restorative remedy.
ROA and REA continues to suggest that the Services are responsible
to restore a demobilized Guard or Reserve member to a Class 2 status to
ensure the member maintains deployment eligibility.
Because there are inadequate dental assets at Military Treatment
Facilities for active members, active families, and reservists, ROA and
REA further recommend that dental restoration be included as part of
the 6 months Transitional Assistance Management Program (TAMP) period
following demobilization. DOD should cover full costs for restoration,
but it could be tied into the TRICARE Dental program for cost and
quality assurance.
5. TRICARE Health costs: ROA and REA applaud the efforts by
Congress to address the issue of increasing Department of Defense
health care costs and its interest to initiate dialogue and work with
both the Pentagon and the beneficiary associations to find the best
solution. The time has come to examine the cost of TRICARE and the
level of beneficiary contribution.
ROA and REA are committed to our membership to sustain this health
care benefit. We fear that we will be unable to continue to sustain
prohibitions on health care fees into the future. We need to work
together to find a fair and equitable solution that protects our
beneficiaries and ensures the financial viability of the military
health care system for the future. Some associations seek to continue
to a freeze on premium fees permanently; others are joining ROA and REA
by admitting that some increases are necessary.
ROA and REA endorse a tiered enrollment fee and congratulate the
Task Force for developing one based on annual income. As most Guard and
Reserve members retire at 25 to 30 percent of active duty retirement
pay, it makes sense that G-R enrollment fees should be lower. ROA and
REA do suggest that if enrollment fees are based on income that it be
based just on military retirement income of Active and Reserve
retirees.
The ROA and REA do not endorse annual enrollment fees for
individuals who don't use the TRICARE Standard plan. Eligibility should
remain universal; a one-time administrative enrollment fee might be
implemented with first use of the program.
If TRICARE Standard enrollment fees are increased, Congress needs
to review the recommended deductibles and current copayment levels.
While TRICARE Prime is in the top 90 percent for cost generosity.
TRICARE Standard is at a lower level of the spectrum of plan
generosity.
6. National Health Care Plan. ROA and REA are concerned that the
national health care legislation does not include specific language
that preserves military and veteran health care programs under separate
authorities. While there have been verbal guarantees from congressional
members and the President, getting the pledge in writing would curtail
concerns.
conclusion
ROA and REA reiterate our profound gratitude for the progress
achieved by this committee by providing parity on pay and compensation
between the Active and Reserve components, with the subcommittee also
understanding the difference in service between the two components.
ROA and REA look forward to working with the personnel subcommittee
where we can present solutions to these and other issues, and offers
our support in anyway.
Senator Webb. Welcome, to all of you.
I suppose we can start with Mr. Barnes and move to Mr.
Strobridge.
Welcome, sir.
STATEMENT OF MASTER CHIEF JOSEPH L. BARNES, USN (RET.),
NATIONAL EXECUTIVE DIRECTOR, FLEET RESERVSE ASSOCIATION
Mr. Barnes. Good morning, Mr. Chairman, Senator Graham,
distinguished members of the subcommittee. Thank you for the
opportunity to appear before you today.
The Military Coalition's statement reflects the consensus
of coalition organizations on a broad range of important
personnel issues and extensive work by eight legislative
committees, each comprised of representatives from the
coalition's 34 military and veterans organizations.
The five of us will address key issues important to the
Active, Guard, and Reserve, retiree, and survivor communities,
and military families, and will conclude healthcare concerns
which impact everyone within these groups, including our
magnificent wounded warriors.
Before proceeding, I wish to thank you and the entire
subcommittee and your outstanding staff for effective
leadership and strong support of essential pay and benefit
program enhancements, and particularly for programs to
adequately care for our wounded warriors and their families.
Adequate service end strengths are absolutely essential to
success in Iraq and Afghanistan, and to sustaining other
operations vital to our national security. The coalition
strongly supports proposed Army and Navy end strength levels in
2011. A recent Navy Times story titled ``Sailor Shortage''
cites too much work to do in the Navy and not enough people to
do it, and lists the associated effects, which include little
time for rest, fewer people to maintain and repair shipboard
equipment, crew members with valuable skills being pulled for
other jobs and not replaced, and lower material ship readiness.
As referenced by the first panel, the strain of repeated
deployments continues, and is also related to the adequacy of
end strengths. Now we're tracking disturbing indicators of the
effects, which include increasing drug and alcohol use, more
mental healthcare appointments, alarming suicide rates, plus
more military divorces. The unrelenting stress on
servicemembers and their families is a serious and continuing
concern that can lead to very serious morale, readiness, and
retention challenges.
Pay comparability remains a top priority, and the Coalition
strongly supports the authorization of a 1.9-percent 2011
Active Duty pay hike. We appreciate your past support for
higher-than-ECI pay increases, which have collectively reduced
the pay gap to 2.4 percent.
Adequate funding for military recruiting efforts is
important. During high retention periods, it's natural to look
at reducing these accounts. However, sufficient resources are
essential to ensuring continuing recruiting success. It's
noteworthy that nearly three-quarters of the optimum
recruiting-aged young people do not qualify for Military
Service, and the Services must maximize efforts through our
military recruiters to recruit optimum-quality personnel across
the Armed Services.
The coalition strongly supports the authorization to ship
two personal vehicles in conjunction with PCS moves, along with
long overdue increases in PCS mileage rates. We appreciate the
distinguished Chairman's leadership on the enactment and
implementation of the post-September 11 GI Bill and DOD
policies on transferability options for personnel nearing
retirement. However, technical corrections are still needed to
ensure eligibility for members of the U.S. Public Health
Service and NOAA Corps.
Adequate programs, facilities, and support services for
personnel impacted by BRAC actions, rebasing, and global
repositioning is very important, particularly during wartime,
which alone, results in significant stress on servicemembers
and their families. The coalition notes with concern the 19-
plus-percent reductions in military construction and family
housing accounts in the proposed 2011 budget request.
Finally, the coalition remains committed to adequate
funding to ensure access to the commissary benefit for all
beneficiaries. This is an essential benefit, and the Defense
Commissary Agency is to be commended for highly cost-effective
management of 255 stores in 13 countries.
Thank you again for the opportunity to present our
recommendations.
[The prepared statement of Mr. Barnes follows:]
Prepared Statement by Master Chief Joseph L. Barnes, USN (Ret.)
the fleet reserve association
The Fleet Reserve Association (FRA) is the oldest and largest
enlisted organization serving active duty, Reserves, retired and
veterans of the Navy, Marine Corps, and Coast Guard. It is
Congressionally Chartered, recognized by the Department of Veterans
Affairs (VA) as an accrediting Veteran Service Organization for claim
representation and entrusted to serve all veterans who seek its help.
In 2007, FRA was selected for full membership on the National Veterans'
Day Committee.
FRA was established in 1924 and its name is derived from the Navy's
program for personnel transferring to the Fleet Reserve or Fleet Marine
Corps Reserve after 20 or more years of active duty, but less than 30
years for retirement purposes. During the required period of service in
the Fleet Reserve, assigned personnel earn retainer pay and are subject
to recall by the Secretary of the Navy.
FRA's mission is to act as the premier ``watch dog'' organization
in maintaining and improving the quality of life for Sea Service
personnel and their families. FRA is a leading advocate on Capitol Hill
for enlisted Active Duty, Reserve, retired and veterans of the Sea
Services. The Association also sponsors a National Americanism Essay
Program and other recognition and relief programs. In addition, the
newly established FRA Education Foundation oversees the Association's
scholarship program that presents awards totaling nearly $100,000 to
deserving students each year.
The Association is also a founding member of The Military Coalition
(TMC), a 34-member consortium of military and veteran's organizations.
FRA hosts most TMC meetings and members of its staff serve in a number
of TMC leadership roles.
FRA celebrated 85 years of service in November 2009. For over eight
decades, dedication to its members has resulted in legislation
enhancing quality of life programs for Sea Services personnel, other
members of the uniformed services plus their families and survivors,
while protecting their rights and privileges. CHAMPUS, now TRICARE, was
an initiative of FRA, as was the Uniformed Services Survivor Benefit
Plan. More recently, FRA led the way in reforming the REDUX Retirement
Plan, obtaining targeted pay increases for mid-level enlisted
personnel, and sea pay for junior enlisted sailors. FRA also played a
leading role in advocating recently enacted predatory lending
protections and absentee voting reform for servicemembers and their
dependents.
FRA's motto is: ``Loyalty, Protection, and Service.''
certification of non-receipt of federal funds
Pursuant to the requirements of House Rule XI, the FRA has not
received any Federal grant or contract during the current fiscal year
or either of the 2 previous fiscal years.
synopsis
The FRA is an active participant and leading organization in The
Military Coalition (TMC) and strongly supports the recommendations
addressed in the more extensive TMC testimony prepared for this
hearing. The intent of this statement is to address other issues of
particular importance to FRA's membership and the Sea Services enlisted
communities.
introduction
Mr. Chairman, the FRA salutes you, members of the subcommittee, and
your staff for the strong and unwavering support of programs essential
to Active Duty, Reserve component, and retired members of the uniformed
services, their families, and survivors. The subcommittee's work has
greatly enhanced care and support for our wounded warriors and
significantly improved military pay, and other benefits and enhanced
other personnel, retirement and survivor programs. This support is
critical in maintaining readiness and is invaluable to our uniformed
services engaged throughout the world fighting the global war on
terror, sustaining other operational commitments and fulfilling
commitments to those who've served in the past.
health care
Health care is exceptionally significant to all FRA shipmates
regardless of their status and protecting and/or enhancing this benefit
is the Association's top legislative priority. A recently released FRA
survey indicates that nearly 90 percent of all Active Duty, Reserve,
retired, and veteran respondents cited health care access as a
critically important quality-of-life benefit associated with their
military service. From 2006-2008 retirees under age 65 were targeted by
DOD to pay significantly higher health care fees. Many of these
retirees served before the recent pay and benefit enhancements were
enacted and receive significantly less retired pay than those serving
and retiring in the same pay grade with the same years of service
today. Promises were made to them about health care for life in return
for a career in the military with low pay and challenging duty
assignments and many believe they are entitled to free health care for
life.
Efforts to enact a national health care reform coupled with
inaccurate and widespread information on the associated impact on
retiree health care benefits has created unease and a sense of
uncertainty for our members. FRA opposes any effort to integrate
TRICARE and VA health care into any national health care program and
appreciates the exclusion of TRICARE and VA health care in the House
version of the national health care proposal. Military and VA health
care services are fundamental to military readiness and serve the
unique needs of current and former servicemembers, their families and
survivors. Merging these programs into a colossal bureaucracy designed
to provide health care to all Americans would broaden their focus and
reduce their effectiveness. That said, the Association is concerned
about proposed Medicare spending cuts associated with reform
initiatives which may negatively impact physician reimbursement rates
and access to care for Medicare and TRICARE beneficiaries.
FRA strongly supports Representatives Chet Edwards (TX) and Walter
Jones (NC) legislation, ``The Military Retirees' Health Care Protection
Act'' (H.R. 816) that would prohibit DOD from increasing TRICARE fees,
specifying that the authority to increase TRICARE fees exists only in
Congress.
FRA thanks this subcommittee for resisting past efforts to shift
increasing health care cost to beneficiaries and ensuring adequate
funding for the Defense Health Program in order to meet readiness
needs, fully fund TRICARE, and improve access for all beneficiaries
regardless of age, status or location. Adequately funding health care
benefits for all beneficiaries is part of the cost of defending our
Nation.
concurrent receipt
The Association appreciates President Obama's support for
authorizing Chapter 61 retirees to receive their full military retired
pay and veterans disability compensation and continues to seek timely
and comprehensive implementation of legislation that authorizes the
full concurrent receipt for all disabled retirees. The above referenced
FRA survey indicates that more than 70 percent of military retirees
cite concurrent receipt among their top priorities. The Association
strongly supports the fiscal year 2011 budget request of $408 million
to cover the first phase of the 5-year cost for concurrent receipt for
Chapter 61 beneficiaries that are 90 percent or more disabled.
wounded warriors
FRA appreciates the substantial Wounded Warriors legislation in the
National Defense Authorization Act (NDAA) for Fiscal Year 2008. Despite
jurisdictional challenges, considerable progress has been made in this
area. However, the enactment of legislation is only the first step in
helping wounded warriors. Effective oversight and sustained funding are
also critical for successful implementation and FRA supports the
following substantive changes:
Establish a permanent and independent office for the
DOD/VA Interagency program and expand it's authority to include
oversight of all components of achieving a true seamless
transition;
Authorizing full active duty TRICARE benefits,
regardless of accessibility of VA care, for 3 years after
medical retirement to help ease transition from DOD to VA;
Extend and make permanent the charter of the ``Special
Oversight Committee'' to ensure improved coordination with DOD
and VA initiatives to help wounded warriors;
Exempt severely wounded medically retired Medicare
part B premiums until age 65;
Providing up to 1 year of continuous habitation in
onbase housing facilities for medically retired, severely
wounded and their families;
Eliminate the servicemember's premium for the
Traumatic Servicemember Group Life Insurance;
Ensure the creation and full implementation of a joint
electronic health record that will help ensure a seamless
transition from DOD to VA for wounded warriors; and
Establishment of the Wounded Warriors Resource Center
as a single point of contact for servicemembers, their family
members, and primary care givers.
Achieving an effective delivery system between DOD and VA to
guarantee seamless transition and quality services for wounded
personnel, particularly those suffering from Post Traumatic Stress
Disorder and Traumatic Brain Injuries is very important to our
membership. DOD should also make every effort to destigmatize mental
health conditions that should include outreach, counseling, and mental
health assessment for all servicemembers returning from the combat
zone. Family support is also critical for success, and should include
compensation, training, and certification, and respite care for family
members functioning as full-time caregivers for wounded warriors. FRA
supports ``The Caregivers and Veterans Omnibus Health Services Act''(S.
1963), and parallel legislation to improve compensation, training and
assistance for caregivers of severally disabled active-duty
servicemembers.
suicide rates
FRA is deeply concerned that more servicemembers have taken their
own lives by November 2009 than have been killed in either the
Afghanistan or Iraq wars. Congressional Quarterly reports that as of
November 24, 334 servicemembers have committed suicide in 2009,
compared with 297 killed in Afghanistan and 144 who died in Iraq. In
response to this, Congress has significantly increased funding for
mental health in the DOD and VA budgets that established a suicide
hotline. DOD and VA also sponsor annual conferences on this issue.
Jurisdictional challenges notwithstanding, it is critically important
that Congress further respond and enhanced coordination between the
Veterans Affairs and Armed Services Committees is key to addressing
this. As of the above date the Army has had 211 of the 334 suicides,
while the Navy had 47, the Air Force had 34 and the Marine Corps
(active duty only) had 42. Increases in the number of suicides are not
limited to active duty members only, the Department of Veterans Affairs
(VA) has indicated that veterans suicides have also been increasing at
an alarming rate.
uniform services former spouses protection act reform
The Association believes that the increasing divorce rates among
active duty personnel and reservists is related to stress caused by
repeated deployments in conjunction with 8 years of fighting a two-
front war. According to the Los Angeles Times, ``The 3.6 percent rate
is a full percentage point above the 2.6 percent reported in late 2001,
when the U.S. began sending troops to Afghanistan in response to the
terrorist attacks. As in previous years, women in uniform suffered much
higher divorce rates than their male counterparts--7.7 percent in 2009.
An Army 2009 battlefield survey indicated that 22 percent of married
soldiers were considering divorce, compared to 12.4 percent in 2003.''
\1\ The divorce rate for women in uniform is especially troubling, and
these numbers do not take into account divorce rates for veterans. The
FRA has long advocated introduction of legislation addressing the
inequities of the Uniform Services Former Spouses Protection Act
(USFSPA) and associated hearings on this issue. The Association
believes that this law should be more balanced in its protection for
both the servicemember and the former spouse.
---------------------------------------------------------------------------
\1\ Associated Press, November 28, 2009, Divorce Rate Rises in
Military, Los Angeles Times.
---------------------------------------------------------------------------
The recommendations in the Department of Defense's (DOD) September
2001 report, which assessed USFSPA inequities and offered
recommendations for improvement is a good starting point for
considering badly needed reform of this onerous law.
Few provisions of the USFSPA protect the rights of the
servicemember and none are enforceable by the Department of Justice or
DOD. If a State court violates the right of the servicemember under the
provisions of USFSPA, the Solicitor General will make no move to
reverse the error. Why? Because the act fails to have the enforceable
language required for Justice or the Defense Department to react. The
only recourse is for the servicemember to appeal to the court, which in
many cases gives that court jurisdiction over the member. Another
infraction is committed by some State courts awarding a percentage of
veterans' compensation to ex-spouses, a clear violation of U.S. law;
yet, the Federal Government does nothing to stop this transgression.
FRA believes Congress needs to take a hard look at the USFSPA with
the intent to amend it so that the Federal Government is required to
protect its servicemembers against State courts that ignore provisions
of the act. Other provisions also weigh heavily in favor of former
spouses. For example, when a divorce is granted and the former spouse
is awarded a percentage of the servicemember's retired pay, this should
be based on the member's pay grade at the time of the divorce and not
at a higher grade that may be held upon retirement. The former spouse
has done nothing to assist or enhance the member's advancements
subsequent to the divorce; therefore, the former spouse should not be
entitled to a percentage of the retirement pay earned as a result of
service after the decree is awarded. Additionally, Congress should
review other provisions considered inequitable or inconsistent.
adequate personnel end strength
Insufficient end strength levels and the rigors of supporting
Operations Iraqi Freedom and Enduring Freedom are having a negative
impact on the quality of life of servicemembers which will ultimately
lead to retention and recruitment challenges. FRA urges this
distinguished subcommittee to ensure funding for adequate end strengths
and people programs consistent with the Association's DOD funding goal
of at least 5 percent of the gross domestic product for fiscal year
2011.
active duty pay improvements
Our Nation is at war and there is no more critical morale issue for
active duty warriors than adequate pay. This is reflected in the more
than 96 percent of active duty respondents to FRA's recent survey
indicating that pay is ``very important.'' The Employment Cost Index
(ECI) for fiscal year 2011 is 1.4 percent and based on statistics from
15 months before the effective date of the proposed active duty pay
increase. The Association appreciates the strong support from this
distinguished subcommittee in reducing the 13.5 percent pay gap to the
current level during the past decade. In addition, FRA notes that even
with a fiscal year 2011 pay increase that is 0.5 percent above the ECI,
the result will be the smallest pay hike since 1958. FRA urges the
subcommittee to continue the increases at least 0.5 percent above the
ECI until the remaining 2.4 percent pay gap is eliminated.
reserve early retirement
The effective date of a key provision in the NDAA for Fiscal Year
2008, the Reserve retirement age provision that reduces the age
requirement by 3 months for each cumulative 90-days ordered to active
duty is effective upon the enactment of the legislation and NOT
retroactive to October 7, 2001. Accordingly the Association supports
``The National Guardsmen and Reservists Parity for Patriots Act'' (H.R.
208) sponsored by the subcommittee's ranking member Representative Joe
Wilson (SC), to authorize reservists mobilized since October 7, 2001,
to receive credit in determining eligibility for receipt of early
retired pay. Since September 11, 2001 the Reserve component has changed
from a Strategic Reserve to an Operational Reserve that now plays a
vital role in prosecuting the war efforts and other operational
commitments. This has resulted in more frequent and longer deployments
impacting individual reservist's careers. Changing the effective date
of the Reserve early retirement would help partially offset lost salary
increases, lost promotions, lost 401K and other benefit contributions.
The Association urges the subcommittee to support this important
legislation.
paid-up survivor benefit annuities
Under current law, retirees are no longer required to pay survivor
benefit annuities (SBP) premiums after they have paid for 30 years and
reach age 70. This is an inequity for those who may have entered the
service at age 17 or 18 and will be required to pay for 33 or 32 years
respectively until attaining paid-up SBP status. Therefore, FRA
supports changing the minimum age for paid-up SBP from age 70 to age 67
to ensure that those who joined the military at age 17, 18, or 19 and
serve 20 years will only have to pay SBP premiums for 30 years.
retention of final full month's retired pay
FRA urges the subcommittee to authorize the retention of the full
final month's retired pay by the surviving spouse (or other designated
survivor) of a military retiree for the month in which the member was
alive for at least 24 hours. FRA strongly supports ``The Military
Retiree Survivor Comfort Act'' (H.R. 613), introduced by Rep. Walter
Jones (NC) which addresses this issue.
Current regulations require survivors of deceased military retirees
to return any retirement payment received in the month the retiree
passes away or any subsequent month thereafter if there is a processing
delay. Upon the demise of a retiree, the surviving spouse is required
to notify the Defense Finance and Accounting Service (DFAS) of the
death. DFAS then stops payment on the retirement account, recalculates
the final payment to cover only the days in the month the retiree was
alive, forwards a check for those days to the surviving spouse or
beneficiary. If not reported in a timely manner, DFAS recoups any
payment(s) made covering periods subsequent to the retiree's death.
The measure is related to a similar Department of Veterans Affairs
policy. Congress passed a law in 1996 that allows a surviving spouse to
retain the veteran's disability and VA pension payments issued for the
month of the veteran's death. FRA believes military retired pay should
be no different. This proposal is also in response to complaints from
surviving spouses who were unaware of the notification requirement and
those with joint bank accounts, in which retirement payments were made
electronically, who gave little if any thought that DFAS could access
the joint account and recoup overpayments of retirement pay. This
action could easily clear the account of any funds remaining whether
they were retirement payments or money from other sources.
To offset some of the costs, if the spouse is entitled to SBP on
the retiree's death, there will be no payment of the annuity for the
month the retirement payment is provided the surviving spouse.
mandate travel cost reimbursement
FRA appreciates the NDAA for Fiscal Year 2008 provision (section
631) that permits travel reimbursement for reservist's weekend drills,
not to exceed $300, if the commute is outside the normal commuting
distance. The Association urges the subcommittee to make this a
mandatory provision. This is a priority issue with many enlisted
reservists who are forced to travel lengthy distances to participate in
weekend drills without reimbursement for travel costs. Providing this
travel reimbursement would assist with retention and recruitment for
the Reserves--something particularly important to increased reliance on
these personnel in order to sustain our war and other operational
commitments.
family readiness
Military deployments create unique stresses on families due to
separation, uncertainties of each assignment and associated dangers of
injury or death for the deployed servicemember. Further, adapting to
new living arrangements and routines adds to the stress, particularly
for children.
Fortunately men and women in uniform continue to answer the calls
to support repeated deployments--but only at a cost of ever-greater
sacrifices for them and their families. Now more than ever before the
support of their families is essential to enduring the mounting
stresses of the war effort and other operational commitments. This
stress has resulted in doubling the number of outpatient mental health
visits (1 million in 2003 to 2 million in 2008) for children with an
active duty parent.\2\ It's most important that DOD and the military
services concentrate on providing programs for the families of our
servicemembers. DOD should improve programs to assist military families
with deployment readiness, responsiveness, and reintegration. There are
a number of existing spousal and family programs that have been fine
tuned and are successfully contributing to the well-being of this
community. The Navy's Fleet and Family Centers and the Marines' Marine
Corps Community Services and Family Services programs are providing
comprehensive, 24/7 information and referral services to the
servicemember and family through its OneSource links. OneSource is
particularly beneficial to mobilized reservists and families who are
unfamiliar with varied benefits and services available to them.
---------------------------------------------------------------------------
\2\ Military.Com More Troops' Kids Seeking Counseling Associated
Press, July 8, 2009
---------------------------------------------------------------------------
It's true that ``the servicemember enlists in the military
service--but it's the family that reenlists.'' To ensure the family
opts for a uniformed career, the family must be satisfied with life in
the military.
conclusion
FRA is grateful for the opportunity to present these
recommendations to this distinguished subcommittee. The Association
reiterates its profound gratitude for the extraordinary progress this
subcommittee has made in advancing a wide range of military personnel
and retiree benefits and quality-of-life programs for all uniformed
services personnel and their families and survivors. Thank you again
for the opportunity to present the FRA's views on these critically
important topics.
Senator Webb. Thank you very much, Mr. Barnes.
Ms. Moakler, welcome.
STATEMENT OF KATHLEEN B. MOAKLER, GOVERNMENT RELATIONS
DIRECTOR, NATIONAL MILITARY FAMILY ASSOCIATION
Ms. Moakler. Thank you. Chairman Webb, Senator Graham,
thank you for the opportunity to speak today on behalf of
military families, our Nation's military families.
Many families are facing their ninth year of deployment,
many have dealt with multiple deployments. We have second-
graders who have only known a lifestyle with a parent absent
from their lives for months at a time, over and over again. We
appreciate the many initiatives and programs supported by this
subcommittee in the past. Military OneSource, increased
benefits and support for surviving families, and the Yellow
Ribbon Program are just a few. We have expanded access to
mental health counseling across components, although the need
continues to grow.
Now military families expect these programs. They have
become part of the overall fabric of family readiness. The
challenge that now faces us is making sure that our family
readiness programs receive sustained funding and continue to be
included in the annual budget process. As the war has
progressed, family readiness requirements have evolved. Some
new programs have been initiated without evaluating already
existing programs to see how they might have been adapted.
The congressionally-mandated Military Family Readiness
Council has begun an evaluation process. We endorse this
process and hope that it will result in the elimination of
repetitive or redundant programs. Existing programs can be
improved, such as adding provisions for travel for family
members participating in the Reserve-component Yellow Ribbon
Program.
With budget cuts and shortfalls looming, we should not
randomly reduce funding to family programs, across the board.
As redundant programs are identified, their elimination can add
to efficiencies. Servicemembers and their families cite MWR
programs, like gyms, libraries, and other installation-provided
services, as important to their well-being during deployments.
Substantial cuts to these programs make them wonder why
Services talk about support, yet often cut or reduce the same
programs that are identified as the most important by our
families.
One of the ways to evaluate the efficacy of programs is
research. Our Association has spoken, for several years,
concerning research into the effects of continuing deployments
on our most vulnerable population: our military children. We
appreciate the inclusion of a provision calling for a study in
last year's NDAA. In May 2008, we commissioned the RAND
Corporation to do a longitudinal study on the experience of
1,500 families. Over the course of a year, RAND interviewed
both the nondeployed caregiver parent and one child per family
between the ages of 11 and 17. We addressed two key questions:
How are school-aged children faring? What types of issues do
military children face, related to deployment?
The baseline findings were published in the January issue
of the Journal of Pediatrics. The study found, as the months of
parental deployment increased, so did the child's challenges.
The total number of months away mattered more than the number
of deployments. Older children experienced more difficulties
during deployment, and there is a direct correlation between
the mental health of the caregiver and the well-being of the
child. It was interesting to note that in the initial findings,
there were no differences in results between Service or
components.
What are the implications? Families facing longer
deployments need targeted support, especially for older teens
and girls. Supports need to be in place across the entire
deployment cycle, including reintegration, and some nondeployed
parents may need targeted mental health support.
We still hear about needs for childcare. While most
traditional childcare needs are being met, innovative
strategies for after-hours care and respite care should be
explored. These strategies need to be implemented across the
Services, as well. Drop-in care for medical appointments,
either at the Center for Disease Control or at the military
treatment facility itself, can go a long way in improving
access to care and eliminating missed appointments.
I, too, must bring up the MyCAA Program, with an underline
and an exclamation point. Several years ago, Congress mandated
DOD create a program to promote portable careers for military
spouses. The result was a very popular MyCAA program. Recent
numbers indicate that 98,000 spouses already are enrolled in
the program, an additional 38,000 have applied but have not yet
completed the process. Unfortunately, DOD, as we have heard
today, has recently had to suspend the program. We have heard,
from many concerned military spouses using the MyCAA program,
about the loss of funding for courses in which they were
enrolled, and how they are scrambling to come up with the funds
to continue, be it for an individual course that they are
taking online or a semester.
But, I think what bothered them the most was the way the
notification was handled. There was no advance notification,
information was sent via a press release. This, when the
program was in possession of everyone's email address. Many
view this as one more frustration in 8 long years of
frustrations.
The program may be a victim of its own success. We are
unsure as to whether it was the lack of funds or an application
overload, or both, that caused the suspension. We ask that the
program be resumed as soon as possible, and that it be properly
funded.
We thank you for your support of our servicemembers and
their families. We urge you to remember their service as you
work to resolve the many issues facing our country. Working
together, we can improve the quality of life for all these
families.
Thank you, and I await your questions.
[The prepared statement of Ms. Moakler follows:]
Prepared Statement by Kathleen B. Moakler
Chairman Webb and distinguished members of the subcommittee, the
National Military Family Association would like to thank you for the
opportunity to present testimony on the quality of life of military
families--the Nation's families. As the war has continued, the quality
of life of our servicemembers and their families has been severely
impacted. Your recognition of the sacrifices of these families and your
response through legislation to the increased need for support have
resulted in programs and policies that have helped sustain our families
through these difficult times.
We endorse the recommendations contained in the statement submitted
by The Military Coalition. In this statement, our Association will
expand on several issues of importance to military families:
I. Family Readiness
II. Family Health
III. Family Transitions
i. family readiness
The National Military Family Association believes policies and
programs should provide a firm foundation for families buffeted by the
uncertainties of deployment and transformation. It is imperative full
funding for these programs be included in the regular budget process
and not merely added on as part of supplemental funding. We promote
programs that expand and grow to adapt to the changing needs of
servicemembers and families as they cope with multiple deployments and
react to separations, reintegration, and the situation of those
returning with both visible and invisible wounds. Standardization in
delivery, accessibility, and funding are essential. Programs should
provide for families in all stages of deployment and reach out to them
in all geographic locations. Families should be given the tools to take
greater responsibility for their own readiness.
We appreciate provisions in the National Defense Authorization Acts
and Appropriations legislation in the past several years that
recognized many of these important issues. Excellent programs exist
across the Department of Defense (DOD) and the Services to support our
military families. There are redundancies in some areas, and times when
a new program was initiated before looking to see if an existing
program could be adapted to answer an evolving need. Servicemembers and
their families are continuously in the deployment cycle, anticipating
the next separation, in the throes of deployment, or trying to
reintegrate after the servicemember returns. Dwell times seem shorter
and shorter as training, schools, and relocation impede on time that is
spent in the family setting.
``My husband will have 3 months at home with us between deployment
and being sent to school in January for 2 months and we will be PCSing
soon afterwards. . . . This does not leave much time for reintegration
and reconnection.''--Army Spouse
We feel that now is the time to look at best practices and at those
programs that are truly meeting the needs of families. In this section
we will talk about existing programs, highlight best practices, and
identify needs.
Child Care
At every military family conference we attended last year, child
care was in the top five issues affecting families--drop-in care being
the most requested need. Some installations are responding to these
needs in innovative ways. For instance, in a recent visit to Kodiak,
Alaska, we noted the gym facility provided watch care for its patrons.
Mom worked out on the treadmill or elliptical while her child played in
a safe carpeted and fenced-in area right across from her. Another area
of the gym, previously an aerobics room, had been transformed into a
large play area for ``Mom and me'' groups to play in the frequently
inclement weather. These solutions aren't expensive but do require
thinking outside the box.
Innovative strategies are needed to address the non-availability of
after-hours child care (before 6 a.m. and after 6 p.m.) and respite
care. We applaud the partnership between the Services and the National
Association of Child Care Resource and Referral Agencies that provides
subsidized child care to families who cannot access installation based
child development centers. We also appreciate the new SitterCity.com
contract that will help military families find caregivers and military
subsidized child care providers.
Still, families often find it difficult to obtain affordable,
quality care especially during hard-to-fill hours and on weekends. Both
the Navy and the Air Force have programs that provide 24/7 care. These
innovative programs must be expanded to provide care to more families
at the same high standard as the Services' traditional child
development programs. The Army, as part of the funding attached to its
Army Family Covenant, has rolled out more space for respite care for
families of deployed soldiers. Respite care is needed across the board
for the families of the deployed and the wounded, ill, and injured. We
are pleased the Services have rolled out more respite care for special
needs families, but since the programs are new we are unsure of the
impact it will have on families. We are concerned, however, when we
hear of some installations already experiencing shortfalls of funding
for respite care early in the year.
At our Operation Purple* Healing Adventures camp for families of
the wounded, ill, and injured, families told us there is a tremendous
need for access to adequate child care on or near military treatment
facilities. Families need the availability of child care in order to
attend medical appointments, especially mental health appointments. Our
Association encourages the creation of drop-in child care for medical
appointments on the DOD or VA premises or partnerships with other
organizations to provide this valuable service.
We appreciate the requirement in the National Defense Authorization
Act for Fiscal Year 2010 calling for a report on financial assistance
provided for child care costs across the Services and components to
support the families of those servicemembers deployed in support of a
contingency operation and we look forward to the results.
Our Association urges Congress to ensure resources are available to
meet the child care needs of military families to include hourly, drop-
in, and increased respite care across all Services for families of
deployed servicemembers and the wounded, ill, and injured, as well as
those with special needs family members.
Working with Youth
Older children and teens must not be overlooked. School personnel
need to be educated on issues affecting military students and must be
sensitive to their needs. To achieve this goal, schools need tools.
Parents need tools, too. Military parents constantly seek more
resources to assist their children in coping with military life,
especially the challenges and stress of frequent deployments. Parents
tell us repeatedly they want resources to ``help them help their
children.'' Support for parents in their efforts to help children of
all ages is increasing, but continues to be fragmented. New Federal,
public-private initiatives, increased awareness, and support by DOD and
civilian schools educating military children have been developed.
However, many military parents are either not aware such programs exist
or find the programs do not always meet their needs.
Our Association is working to meet this pressing need through our
Operation Purple* Summer Camps. Unique in its ability to reach out and
gather military children of different age groups, Services, and
components, our Operation Purple program provides a safe and fun
environment in which military children feel immediately supported and
understood. Now in our seventh year, we have sent more than 30,000
children to camp for free with the support of private donors. This
year, we expect to send another 10,000 children to camp at 67 locations
in 34 States and Guam, and Germany. We also provided the camp
experience to families of the wounded. In 2009, we introduced a new
program under our Operation Purple umbrella, offering family
reintegration retreats in the national parks. They have been well
received by our families and more apply than can attend. We are
offering 10 retreats this year.
Through our Operation Purple camps, our Association has begun to
identify the cumulative effects multiple deployments are having on the
emotional growth and well being of military children and the challenges
posed to the relationship between deployed parent, caregiver, and
children in this stressful environment. Understanding a need for
qualitative analysis of this information, we commissioned the RAND
Corporation to conduct a pilot study in 2007 aimed at the current
functioning and wellness of military children attending Operation
Purple camps and assessing the potential benefits of the Operation
Purple program in this environment of multiple and extended
deployments.
In May 2008, we embarked on phase two of the project--a
longitudinal study on the experience of 1,507 families, which is a much
larger and more diverse sample than included in our pilot study. RAND
followed these families for 1 year, and interviewed the nondeployed
caregiver/parent and one child per family between 11 and 17 years of
age at three time points over the year. Recruitment of participants was
extremely successful because families were eager to share their
experiences. The research addressed two key questions:
How are school-age military children faring?
What types of issues do military children face related to
deployment?
In December, the baseline findings of the research were published
in the journal Pediatrics. Findings showed:
As the months of parental deployment increased, so did
the child's challenges.
The total number of months away mattered more than the
number of deployments.
Older children experienced more difficulties during
deployment.
There is a direct correlation between the mental
health of the caregiver and the well-being of the child.
Girls experienced more difficulty during
reintegration, the period of months readjusting after the
servicemember's homecoming.
About one-third of the children reported symptoms of
anxiety, which is somewhat higher than the percentage reported
in other national studies of children.
In these initial findings, there were no differences
in results between Services or components.
What are the implications? Families facing longer deployments need
targeted support--especially for older teens and girls. Supports need
to be in place across the entire deployment cycle, including
reintegration, and some nondeployed parents may need targeted mental
health support. One way to address these needs would be to create a
safe, supportive environment for older youth and teens. Dedicated Youth
Centers with activities for our older youth would go a long way to help
with this. Our Association, as an outgrowth of the study results, will
be holding a summit in early May, where we will be engaging with
experts to isolate action items that address the issues surfaced in the
study. We will be happy to share these action items with you.
Our Association feels that more dedicated resources, such as youth
or teen centers, would be a first step toward addressing the needs of
our older youth and teens during deployment.
Families Overseas
Families stationed overseas face increased challenges when their
servicemember is deployed into theater. One such challenge we have
heard from families stationed in EUCOM concerns care for a family
member, usually the spouse, who may be injured or confined to bed for
an extended illness during deployment. Instead of pulling the
servicemember back from theater, why not provide transportation for an
extended family member or friend to come from the States to care for
the injured or ill family member? This was a recommendation from the
EUCOM Quality of Life conference for several years.
Our Association asks that transportation be provided for a
designated caregiver to an overseas duty station to care for an
incapacitated spouse when a servicemember is deployed.
Military Housing
In the recent RAND study of military children on the home front
commissioned by our Association, researchers found that living in
military housing was related to fewer caregiver reported deployment-
related challenges. For instance, fewer caregivers who lived in
military housing reported that their children had difficulties
adjusting to parent absence (e.g., missing school activities, feeling
sad, not having peers who understand what their life is like) as
compared to caregivers who needed to rent their homes. In a subsequent
survey, the study team explored the factors that determine a military
family's housing situation in more detail. Among the list of potential
reasons provided for the question, ``Why did you choose to rent?''
researchers found that the top three reasons parents/caregivers cited
for renting included: military housing was not available (31 percent);
renting was most affordable (28 percent), and preference to not invest
in the purchase of a home (26 percent).
Privatized housing expands the opportunity for families to live on
the installation and is a welcome change for military families. We are
pleased with the annual report that addresses the best practices for
executing privatized housing contracts. As privatized housing evolves
the Services are responsible for executing contracts and overseeing the
contractors on their installations. With more joint basing, more than
one Service often occupies an installation. The Services must work
together to create consistent policies not only within their Service
but across the Services as well. Pet policies, deposit requirements,
and utility polices are some examples of differences across
installations and across Services. How will Commanders address these
variances as we move to joint basing? Our families face many
transitions when they move, and navigating the various policies and
requirements of each contractor is frustrating and confusing. It's time
for the Services to increase their oversight and work on creating
seamless transitions by creating consistent policies across the
Services.
We are pleased the NDAA for Fiscal Year 2010 calls for a report on
housing standards and housing surveys used to determine the Basic
Allowance for Housing (BAH) and hope Congress will work to address BAH
inequities.
Privatized housing is working! We ask Congress to consider the
importance of family well-being as a reason for expanding the amount of
privatized housing for our military families.
Commissaries and Exchanges
The commissary is a vital part of the compensation package for
servicemembers and retirees, and is valued by them, their families, and
survivors. Our surveys indicate that military families consider the
commissary one of their most important benefits. In addition to
providing average savings of more than 30 percent over local
supermarkets, commissaries provide a sense of community. Commissary
shoppers gain an opportunity to connect with other military families,
and are provided with information on installation programs and
activities through bulletin boards and publications. Commissary
shoppers also receive nutritional information through commissary
promotions and campaigns, as well as the opportunity for educational
scholarships.
Our Reserve component families have benefited greatly from the
addition of case lot sales. We thank Congress again for the provision
allowing the use of proceeds from surcharges collected at these sales
to help defray their costs. Not only have these case lot sales been
extremely well received and attended by family members not located near
an installation, they have extended this important benefit to our
entire military community.
Our Association continues to be concerned that there will not be
enough commissaries to serve areas experiencing substantial growth,
including those locations with servicemembers and families relocated by
BRAC. The surcharge was never intended to pay for DOD and Service
transformation. Additional funding is needed to ensure commissaries are
built or expanded in areas that are gaining personnel as a result of
these programs.
Our Association believes that additional funding is needed to
ensure commissaries are built or expanded in areas that are gaining
personnel due to BRAC and transformation.
The military exchange system, like the commissary, provides
valuable cost savings to members of the military community, while
reinvesting their profits in essential Morale, Welfare and Recreation
(MWR) programs. Our Association strongly believes that every effort
must be made to ensure that this important benefit and the MWR revenue
is preserved, especially as facilities are down-sized or closed
overseas. In addition, exchanges must continue to be responsive to the
needs of deployed servicemembers in combat zones and have the right mix
of goods at the right prices for the full range of beneficiaries.
As a member of the Defense Commissary Patron Council and a strong
proponent of the military exchange system, our Association remains
committed to protecting commissary and exchange benefits which are
essential to the quality of life of our servicemembers, retirees,
families and survivors.
Flexible Spending Accounts
We would like to thank Members of Congress for the Sense of
Congress on the establishment of Flexible Spending Accounts for
uniformed servicemembers. We hope this subcommittee will press each of
the seven Service Secretaries to establish these important pre-tax
savings accounts in a consistent manner. Flexible Spending Accounts
would be especially helpful for families with out-of-pocket dependent
care and health care expenses. We ask that the flexibility of a
rollover or transfer of funds to the next year be considered.
Financial Readiness
Financial readiness is a critical component of family readiness.
Our Association applauds DOD for tackling financial literacy head-on
with their Financial Readiness Campaign. Financial literacy and
education must continue to be on the forefront. We are strong
supporters of the Military Lending Act (MLA) and hope Congress will
press States to enforce MLA regulations within their State borders.
With the depressed economy, many families may turn to payday lenders.
DOD must continue to monitor the MLA and its effectiveness of derailing
payday lenders.
Military families are not immune from the housing crisis. We
applaud Congress for expanding the Homeowners' Assistance Program to
wounded, ill, and injured servicemembers, survivors, and servicemembers
with Permanent Change of Station orders meeting certain parameters. We
have heard countless stories from families across the Nation who have
orders to move and cannot sell their home. Due to the mobility of
military life, military homeowners must be prepared to be a landlord.
We encourage DOD to continue to provide financial education to military
servicemembers and their families to help families make sound financial
decisions. We also encourage DOD to continue to track the impact of the
housing crisis on our military families.
We appreciate the increase to the Family Separation Allowance (FSA)
that was made at the beginning of the war. In more than 8 years,
however, there has not been another increase. We ask that the FSA be
indexed to the Cost of Living Allowance (COLA) to better reflect rising
costs for services.
Increase the Family Separation Allowance by indexing it to COLA.
ii. family health
Family readiness calls for access to quality health care and mental
health services. Families need to know the various elements of their
military health system are coordinated and working as a synergistic
system. Our Association is concerned the DOD military health care
system may not have all the resources it needs to meet both the
military medical readiness mission and provide access to health care
for all beneficiaries. It must be funded sufficiently, so the direct
care system of Military Treatment Facilities (MTFs) and the purchased
care segment of civilian providers can work in tandem to meet the
responsibilities given under the TRICARE contracts, meet readiness
needs, and ensure access for all military beneficiaries.
Military Health System
Improving Access to Care
In the question and answer period during a hearing of this
subcommittee on June 3, 2009, Senator Lindsey Graham (R-SC) asked panel
members to ``give a grade to TRICARE.'' Panel members rated TRICARE a
``B'' or a ``C minus.'' Our Association's Director of Government
Relations stated it was a two-part question and assigned a grade of
``B'' for quality of care and ``C-'' for access to care. We welcomed
this discussion focused on access issues in the direct care system--our
military hospitals and clinics--reinforcing what our Association has
observed for years. We have consistently heard from families that their
greatest health care challenge has been getting timely care from their
local military hospital or clinic.
Our Association continues to examine military families' experiences
with accessing the Military Health System (MHS). Families' main issues
are: access to their Primary Care Managers (PCM); getting someone to
answer the phone at central appointments; having appointments available
when they finally got through to central appointments; after hours
care; getting a referral for specialty care; being able to see the same
provider or PCM; and having appointments available 60, 90, and 120 days
out in our MTFs for follow-ups recommended by their providers. Families
familiar with how the MHS referral system works seem better able to
navigate the system. Those families who are unfamiliar report delays in
receiving treatment or sometimes decide to give up on the referral
process and never obtain a specialty appointment. Continuity of care is
important to maintain quality of care. The MTFs are stressed from 8
years of provider deployments, directly affecting the quality of care
and contributing to increased costs. Our Association thanks Congress
for requiring, in the NDAA for Fiscal Year 2009, a report on access to
care and we look forward to the findings. This report must distinguish
between access issues in the MTFs, as opposed to access in the civilian
TRICARE networks.
Our most seriously wounded, ill, and injured servicemembers,
veterans, and their families are assigned case managers. In fact, there
are many different case managers: Federal Recovery Coordinators (FRC),
Recovery Care Coordinators, coordinators from each branch of Service,
TBI care coordinators, VA liaisons, et cetera. The goal is for a
seamless transition of care between and within the two governmental
agencies, DOD and the VA. However, with so many coordinators to choose
from, families often wonder which one is the ``right'' case manager. We
often hear from families, some whose servicemember has long been
medically retired with a 100 percent disability rating or others with
less than 1 year from date-of-injury, who have not yet been assigned a
FRC. We need to look at whether the multiple, layered case managers
have streamlined the process, or have only aggravated it. Our
Association still finds families trying to navigate alone a variety of
complex health care systems, trying to find the right combination of
care. Individual Service wounded, ill, and injured program directors
and case managers are often reluctant to inform families that FRCs
exist or that the family qualifies for one. Many qualify for and use
Medicare, VA, DOD's TRICARE direct and purchased care, private health
insurance, and State agencies. Why can't the process be streamlined?
Support for Special Needs Families
Case management for military beneficiaries with special needs is
not consistent because the coordination of the military family's care
is being done by a non-synergistic health care system. Beneficiaries
try to obtain an appointment and then find themselves getting partial
health care within the MTF, while other health care is referred out
into the purchased care network. Thus, military families end up
managing their own care. Incongruence in the case management process
becomes more apparent when military family members transfer from one
TRICARE region to another and is further exacerbated when a special
needs family member is involved. Families need a seamless transition
and a warm handoff between TRICARE regions and a universal case
management process across the MHS. Each TRICARE Managed Care Contractor
has created different case management processes. The current case
management system is under review by DOD and the TRICARE Management
Activity.
We applaud Congress and DOD's desire to create robust health care,
educational, and family support services for special needs children.
But, these robust services do not follow them when they retire. We
encourage the Services to allow these military families the opportunity
to have their final duty station be in an area of their choice. We
suggest the Extended Care Health Option (ECHO) be extended for 1 year
after retirement for those already enrolled in ECHO prior to
retirement. If the ECHO program is extended, it must be for all who are
eligible for the program. We should not create a different benefit
simply based on diagnosis.
There has been discussion over the past years by Congress and
military families regarding the ECHO program. The NDAA for Fiscal Year
2009 included a provision to increase the cap on certain benefits under
the ECHO program and the NDAA for Fiscal Year 201O established the
Office of Community Support for Military Families with Special Needs.
The ECHO program was originally designed to allow military families
with special needs to receive additional services to offset their lack
of eligibility for State or federally provided services impacted by
frequent moves. We suggest that before making any more adjustments to
the ECHO program, Congress should direct DOD to certify if the ECHO
program is working as it was originally designed and if it has been
effective in addressing the needs of this population. We need to make
the right fixes so we can be assured we apply the correct solutions.
This new office will go a long way in identifying and addressing
special needs. However, we must remember that our special needs
families often require medical, educational and family support
resources. This new office must address all these various needs in
order to effectively implement change.
National Guard and Reserve Member Family Health Care
National Guard and Reserve families need increased education about
their health care benefits. We also believe that paying a stipend to a
mobilized National Guard or Reserve member for their family's coverage
under their employer-sponsored insurance plan while the servicemember
is deployed may work out better for many families in areas where the
TRICARE network may not be robust.
Grey Area Reservists
Our Association would like to thank Congress for the new TRICARE
benefit for Grey Area Reservists. We want to make sure this benefit is
quickly implemented and they have access to a robust network.
TRICARE Reimbursement
Our Association is concerned that continuing pressure to lower
Medicare reimbursement rates will create a hollow benefit for TRICARE
beneficiaries. As the 111th Congress takes up Medicare legislation, we
request consideration of how this legislation will impact military
families' health care, especially our most vulnerable service, access
to mental health.
National provider shortages in the mental health field, especially
in child and adolescent psychology, are exacerbated in many cases by
low TRICARE reimbursement rates, TRICARE rules, or military-unique
geographic challenges--for example large populations in rural or
traditionally underserved areas. Many mental health providers are
willing to see military beneficiaries on a voluntary status. However,
these providers often tell us they will not participate in TRICARE
because of what they believe are time-consuming requirements and low
reimbursement rates. More must be done to persuade these providers to
participate in TRICARE and become a resource for the entire system,
even if that means DOD must raise reimbursement rates.
Pharmacy
We caution DOD about generalizing findings of certain beneficiary
pharmacy behaviors and automatically applying them to our Nation's
unique military population. We encourage Congress to require DOD to
utilize peer-reviewed research involving beneficiaries and prescription
drug benefit options, along with performing additional research
involving military beneficiaries, before making any recommendations on
prescription drug benefit changes, such as co-payment and tier
structure changes for military servicemembers, retirees, their
families, and survivors.
We appreciate the inclusion of Federal pricing for the TRICARE
retail pharmacies in the NDAA for Fiscal Year 2008. However, we still
need to examine its effect on the cost of medications for both
beneficiaries and DOD. Also, we will need to see how this potentially
impacts Medicare, civilian private insurance, and the National Health
Care Reform affecting drug pricing negotiations.
We believe it is imperative that all medications available through
TRICARE Retail Pharmacy (TRRx) should also be available through TRICARE
Mail Order Pharmacy (TMOP). Medications treating chronic conditions,
such as asthma, diabetes, and hypertension should be made available at
the lowest level of co-payment regardless of brand or generic status.
We agree with the recommendations of the Task Force on the Future of
Military Health Care that over-the-counter (OTC) drugs be a covered
pharmacy benefit and there be a zero co-pay for TMOP Tier 1
medications.
The new T3 TRICARE contract will provide TRICARE Managed Care
Contractors and Express-Scripts, Inc. the ability to link pharmacy data
with disease management. This will allow for better case management,
increase compliance, and decrease cost, especially for our chronically
ill beneficiaries. However, this valuable tool is currently unavailable
because the T3 contract is still under protest and has not yet been
awarded.
National Health Care Proposal
Our Association is cautious about current rhetoric by the
administration and Congress regarding National Health Care Reform. We
request consideration of how this legislation will also impact TRICARE.
The perfect storm is brewing. TMA will hopefully be instituting the
new T3 contract in 2011. Currently, there is the possibility that two
out of three TRICARE Managed Care Contractors could change. This means
that the contracts of 66 percent of our TRICARE providers would need to
be renegotiated. Add the demands and uncertainties to providers in
regards to health care reform and Medicare reimbursement rate changes.
This leads to our concern regarding the impact on providers'
willingness to remain in the TRICARE network and the recruitment of new
providers. The unintended consequences maybe a decrease in access to
care due the lack of available health care providers.
DOD Must Look for Savings
We ask Congress to establish better oversight for DOD's
accountability in becoming more cost-efficient. We recommend:
Requiring the Comptroller General to audit MTFs on a
random basis until all have been examined for their ability to
provide quality health care in a cost-effective manner;
Creating an oversight committee, similar in nature to
the Medicare Payment Advisor Commission, which provides
oversight to the Medicare program and makes annual
recommendations to Congress. The Task Force on the Future of
Military Health Care often stated it was unable to address
certain issues not within their charter or the timeframe in
which they were commissioned to examine the issues. This
Commission would have the time to examine every issue in an
unbiased manner.
Establishing a Unified ``Joint'' Medical Command
structure, which was recommended by the Defense Health Board in
2006 and 2009.
Our Association believes optimizing the capabilities of the
facilities of the direct care system through timely replacement of
facilities, increased funding allocations, and innovative staffing
would allow more beneficiaries to be cared for in the MTFs, which DOD
asserts is the most cost effective. The Task Force made recommendations
to make the DOD MHS more cost-efficient which we support. They conclude
the MHS must be appropriately sized, resourced, and stabilized; and
make changes in its business and health care practices.
We suggest additional funding and flexibility in hiring practices
to address MTF provider deployments.
Our Association recommends a 1 year transitional active duty ECHO
benefit for all eligible family members of servicemembers who retire.
We believe that Reserve component families should be given the
choice of a stipend to continue their employer provided care during
deployment.
Behavioral Health Care
Our Nation must help returning servicemembers and their families
cope with the aftermath of war. DOD, VA, and State agencies must
partner in order to address behavioral health issues early in the
process and provide transitional mental health programs. Partnering
will also capture the National Guard and Reserve member population, who
often straddle these agencies' health care systems.
Full Spectrum of Care
As the war continues, families' need for a full spectrum of
behavioral health services--from preventative care and stress reduction
techniques, to counseling and medical mental health services--continues
to grow. The military offers a variety of psychological health
services, both preventative and treatment, across many agencies and
programs. However, as servicemembers and families experience numerous
lengthy and dangerous deployments, we believe the need for
confidential, preventative psychological health services will continue
to rise. It will remain high, even after military operations scale
down. Our study on the impact of the war on caregivers and children
found the mental health of the caregiver directly affects the overall
well-being of the children. Therefore, we need to treat the family as a
unit rather than as individuals because the caregiver's health
determines the quality of life for the children.
Access to Behavioral Health Care
Our Association is concerned about the overall shortage of mental
health providers in TRICARE's direct and purchased care network. DOD's
Task Force on Mental Health stated timely access to the proper
psychological health provider remains one of the greatest barriers to
quality mental health services for servicemembers and their families.
The Army Family Action Plan (AFAP) identified mental health issues as
their number three issue for 2010. While families are pleased more
mental health providers are available in theater to assist their
servicemembers, they are disappointed with the resulting limited access
to providers at home. Families are reporting increased difficulty in
obtaining appointments with social workers, psychologists, and
psychiatrists at their MTFs and clinics. The military fuels the
shortage by deploying some of its child and adolescent psychology
providers to combat zones. Providers remaining at home report they are
overwhelmed by treating active duty members and are unable to fit
family members into their schedules. This can lead to provider
compassion fatigue, creating burnout and exacerbating the provider
shortage problem.
We have seen an increase in the number of mental health providers
joining the purchased care side of the TRICARE network. However, the
access standard is 7 days. We hear from military families after
accessing the mental health provider lists on the contractors' web
sites that the provider is full and no longer taking TRICARE patients.
The list must be up-to-date in order to handle real time demands by
families. We need to continue to recruit more mental health providers
to join the TRICARE network and we need to make sure we specifically
add those in specialty behavioral health care areas, such as child and
adolescence psychology and psychiatrists.
Families must be included in mental health counseling and treatment
programs for servicemembers. Family members are a key component to a
servicemember's psychological well-being. Families want to be able to
access care with a mental health provider who understands or is
sympathetic to the issues they face. We recommend an extended outreach
program to servicemembers, veterans, and their families of available
mental health resources, such as DOD, VA, and State agencies. We
appreciate the VA piloting programs that incorporate active duty
servicemembers and their families into their newly established OIF/OEF
health care clinics. The family is accessed as a ``unit'' and educated
about the VA's benefits and services. These initiatives need to be
expanded throughout the VA and fully funded.
Frequent and lengthy deployments create a sharp need in mental
health services by family members and servicemembers as they get ready
to deploy and after their return. There is also an increase in demand
in the wake of natural disasters, such as hurricanes and fires. We need
to maintain a flexible pool of mental health providers who can increase
or decrease rapidly in numbers depending on demand on the MHS side.
Currently, Military Family Life Consultants and Military OneSource
counseling are providing this type of service for military families on
the family support side. The recently introduced web-based TRICARE
Assistance Program (TRIAP) offers another vehicle for nonmedical
counseling, especially for those who live far from counselors. We need
to make the Services, along with military family members, more aware of
resources along the continuum. We need the flexibility of support in
both the MHS and family support arenas, as well as coordination of
support between these two entities. We must educate civilian network
providers about our culture. Communities along with nongovernment
organizations are beginning to fulfill this role, but more needs to be
done.
Availability of Treatment
Do DOD, VA, and State agencies have adequate mental health
providers, programs, outreach, and funding? Better yet, where will the
veteran's spouse and children go for help? Many will be left alone to
care for their loved one's invisible wounds resulting from frequent and
long combat deployments. Who will care for them when they are no longer
part of the DOD health care system?
The Army's Mental Health Advisory Team (MHAT) IV report links
reducing family issues to reducing stress on deployed servicemembers.
The team found the top noncombat stressors were deployment length and
family separation. They noted soldiers serving a repeat deployment
reported higher acute stress than those on their first deployment and
the level of combat was the major contribution for their psychological
health status upon return. Our study on the impact of deployment on
caregivers and children found it was the cumulative time deployed that
caused increased stress. These reports demonstrate the amount of stress
being placed on our troops and their families.
Our Association is especially concerned with the scarcity of
services available to the families as they leave the military following
the end of their activation or enlistment. Due to the servicemember's
separation, the families find themselves ineligible for TRICARE,
Military OneSource, and are very rarely eligible for health care
through the VA. Many will choose to locate in rural areas lacking
available mental health providers. We need to address the distance
issues families face in finding mental health resources and obtaining
appropriate care. Isolated servicemembers, veterans, and their families
do not have the benefit of the safety net of services and programs
provided by MTFs, VA facilities, Community-Based Outpatient Centers and
Vet Centers. We recommend:
using alternative treatment methods, such as
telemental health;
modifying licensing requirements in order to remove
geographic practice barriers that prevent psychological health
providers from participating in telemental health services
outside of a VA facility;
educating civilian network psychological health
providers about our military culture as the VA incorporates
Project Hero; and
encouraging DOD and VA to work together to provide a
seamless ``warm hand-off'' for families, as well as
servicemembers transitioning from active duty to veteran status
and funding additional transitional support programs if
necessary.
National Guard and Reserve Members
The National Military Family Association is especially concerned
about fewer mental health care services available for the families of
returning National Guard and Reserve members. Some are eligible for
TRICARE Reserve Select but, as we know, National Guard and Reserve
members are often located in rural areas where there may be fewer
mental health providers available. Policymakers need to address the
distance issues that families face in linking with military mental
health resources and obtaining appropriate care. Isolated National
Guard and Reserve families do not have the benefit of the safety net of
services provided by MTFs and installation family support programs.
Families want to be able to access care with a provider who understands
or is sympathetic to the issues they face. We recommend the use of
alternative treatment methods, such as telemental health; increasing
mental health reimbursement rates for rural areas; modifying licensing
requirements in order to remove geographic practice barriers that
prevent mental health providers from participating in telemental health
services; and educating civilian network mental health providers about
our military culture. We urge DOD to expand information outreach about
the new TRIAP program, which provides access to non-medical counseling
via phone and web through the TRICARE managed care support contractors.
We hear the National Guard Bureau's Psychological Health Services (PHs)
is not working as designed to address members' mental health issues.
This program needs to be evaluated to determine its effectiveness.
Children
Our Association is concerned about the impact deployment and/or the
injury of the servicemember is having on our most vulnerable
population, children of our military servicemember and veterans. Our
study on the impact of the war on caregivers and children found
deployments are creating layers of stressors, which families are
experiencing at different stages. Teens especially carry a burden of
care they are reluctant to share with the non-deployed parent in order
to not ``rock the boat.'' They are often encumbered by the feeling of
trying to keep the family going, along with anger over changes in their
schedules, increased responsibility, and fear for their deployed
parent. Children of the National Guard and Reserve members face unique
challenges since there are no military installations for them to
utilize. They find themselves ``suddenly military'' without resources
to support them. School systems are generally unaware of this change in
focus within these family units and are ill prepared to lookout for
potential problems caused by these deployments or when an injury
occurs. Also vulnerable are children who have disabilities that are
further complicated by deployment and subsequent injury of the
servicemembers. Their families find stress can be overwhelming, but are
afraid to reach out for assistance for fear of retribution to the
servicemember's career. They often choose not to seek care for
themselves or their families. We appreciate the inclusion of a study on
the mental health needs of our children in the NDAA for Fiscal Year
201O.
The impact of the wounded, ill, and injured on children is often
overlooked and underestimated. Military children experience a
metaphorical death of the parent they once knew and must make many
adjustments as their parent recovers. Many families relocate to be near
the treating MTF or the VA Polytrauma Center in order to make the
rehabilitation process more successful. As the spouse focuses on the
rehabilitation and recovery, older children take on new roles. They may
become the caregivers for other siblings, as well as for the wounded
parent. Many spouses send their children to stay with neighbors or
extended family members, as they tend to their wounded, ill, and
injured spouse. Children get shuffled from place to place until they
can be reunited with their parents. Once reunited, they must adapt to
the parent's new injury and living with the ``new normal.'' We
appreciate the inclusion of a study to assess the impact on children of
the severely wounded in the NDAA for Fiscal Year 2010.
We encourage partnerships between government agencies, DOD, VA, and
State agencies and recommend they reach out to those private and
nongovernmental organizations who are experts on children and
adolescents. They could identify and incorporate best practices in the
prevention and treatment of mental health issues affecting our military
children. We must remember to focus on preventative care upstream,
while still in the active duty phase, in order to have a solid family
unit as they head into the veteran phase of their lives. School systems
must become more involved in establishing and providing supportive
services for our Nation's children.
Caregiver Burnout
In the eighth year of war, care for the caregivers must become a
priority. There are several levels of caregivers. Our Association hears
from the senior officer and enlisted spouses who are so often called
upon to be the strength for others. We hear from the health care
providers, educators, rear detachment staff, chaplains, and counselors
who are working long hours to assist servicemembers and their families.
They tell us they are overburdened, burnt out, and need time to
recharge so they can continue to serve these families. These caregivers
must be afforded respite care, given emotional support through their
command structure, and be provided effective family programs.
Education
The DOD, VA, and State agencies must educate their health care and
mental health professionals of the effects of mild Traumatic Brain
Injury (mTBI) in order to help accurately diagnose and treat the
servicemember's condition. They must be able to deal with polytrauma-
Post-Traumatic Stress Disorder (PTSD) in combination with multiple
physical injuries. We need more education for civilian health care
providers on how to identify signs and symptoms of mild TBI and PTSD.
The families of servicemembers and veterans must be educated about
the effects of TBI, PTSD, and suicide in order to help accurately
diagnose and treat the servicemember/veteran's condition. These
families are on the ``sharp end of the spear'' and are more likely to
pick up on changes attributed to either condition and relay this
information to their health care providers. Programs are being
developed by each Service. However, they are narrow in focus targeting
line leaders and health care providers, but not broad enough to capture
our military family members and the communities they live in. As
Services roll out suicide prevention programs, we need to include our
families, communities, and support personnel.
Reintegration Programs
Reintegration programs become a key ingredient in the family's
success. Our Association believes we need to focus on treating the
whole family with programs offering readjustment information; education
on identifying mental health, substance abuse, suicide, and traumatic
brain injury; and encouraging them to seek assistance when having
financial, relationship, legal, and occupational difficulties. We
appreciate the inclusion in the NDAA for Fiscal Year 2010 for education
programs targeting pain management and substance abuse for our
families.
Successful return and reunion programs will require attention over
the long term, as well as a strong partnership at all levels between
the various mental health arms of DOD, VA, and State agencies. DOD and
VA need to provide family and individual counseling to address these
unique issues. Opportunities for the entire family and for the couple
to reconnect and bond must also be provided. Our Association has
recognized this need and successfully piloted family retreats in the
national parks promoting family reintegration following deployment.
We recommend an extended outreach program to servicemembers,
veterans, and their families of available psychological health
resources, such as DOD, VA, and State agencies.
We encourage Congress to request DOD to include families in its
Psychological Health Support survey; perform a pre- and post-deployment
mental health screening on family members (similar to the PDHA and
PDHRA currently being done for servicemembers).
We recommend the use of alternative treatment methods, such as
telemental health; increasing mental health reimbursement rates for
rural areas; modifying licensing requirements in order to remove
geographic practice barriers that prevent mental health providers from
participating in telemental health services; and educating civilian
network mental health providers about our military culture.
Caregivers must be afforded respite care; given emotional support
through their command structure; and, be provided effective family
programs.
Wounded Servicemembers Have Wounded Families
Our Association asserts that behind every wounded servicemember and
veteran is a wounded family. It is our belief the government,
especially the DOD and VA, must take a more inclusive view of military
and veterans' families. Those who have the responsibility to care for
the wounded, ill, and injured servicemember must also consider the
needs of the spouse, children, parents of single servicemembers and
their siblings, and the caregivers. DOD and VA need to think
proactively as a team and one system, rather than separately; and
addressing problems and implementing initiatives upstream while the
servicemember is still on active duty status.
Reintegration programs become a key ingredient in the family's
success. For the past 2 years, we have piloted our Operation
Purple"'HealingAdventures camp to help wounded servicemembers and their
families learn to play again as a family. We hear from the families who
participate in this camp, as well as others dealing with the recovery
of their wounded servicemembers that, even with Congressional
intervention and implementation of the Services' programs, many issues
still create difficulties for them well into the recovery period.
Families find themselves having to redefine their roles following the
injury of the servicemember. They must learn how to parent and become a
spouse/lover with an injury. Each member needs to understand the unique
aspects the injury brings to the family unit. Parenting from a
wheelchair brings a whole new challenge, especially when dealing with
teenagers. Parents need opportunities to get together with other
parents who are in similar situations and share their experiences and
successful coping methods. Our Association believes we need to focus on
treating the whole family with DOD and VA programs offering skill based
training for coping, intervention, resiliency, and overcoming
adversities. Injury interrupts the normal cycle of deployment and the
reintegration process. We must provide opportunities for the entire
family and for the couple to reconnect and bond, especially during the
rehabilitation and recovery phases.
Brooke Army Medical Center (BAMC) has recognized a need to support
these families by expanding in terms of guesthouses colocated within
the hospital grounds and a family reintegration program for their
Warrior Transition Unit. The on-base school system is also sensitive to
issues surrounding these children. A warm, welcoming family support
center located in guest housing serves as a sanctuary for family
members. The DOD and VA could benefit from looking at successful
programs like BAMCs, which has found a way to embrace the family unit
during this difficult time.
The Vet Centers are an available resource for veterans' families
providing adjustment, vocational, and family and marriage counseling.
The VA health care facilities and the community-based outpatient
clinics (CBOCs) have a ready supply of mental health providers, yet
regulations have restricted their ability to provide mental health care
to veterans' families unless they meet strict standards. Unfortunately,
this provision hits the veteran's caregiver the hardest, especially if
they are the parents. We recommend DOD partner with the VA to allow
military families access to mental health services. We also believe
Congress should require the VA, through its Vet Centers and health care
facilities to develop a holistic approach to care by including families
when providing mental health counseling and programs to the wounded,
ill, and injured servicemember or veteran.
The Defense Health Board has recommended DOD include military
families in its mental health studies. We agree. We encourage Congress
to direct DOD to include families in its Psychological Health Support
survey; perform a pre- and post-deployment mental health screening on
family members (similar to the PDHA and PDHRA currently being done for
servicemembers). We appreciate the NDAA for Fiscal Year 2010 report on
the impact of the war on families and the DOD's Millennium Cohort Study
including families. Both will help us gain a better understanding of
the long-term effects of war on our military families.
Transitioning for the Wounded and Their Families
Transitions can be especially problematic for wounded, ill, and
injured servicemembers, veterans, and their families. The DOD and the
VA health care systems, along with State agency involvement, should
alleviate, not heighten these concerns. They should provide for
coordination of care, starting when the family is notified that the
servicemember has been wounded and ending with the DOD, VA, and State
agencies working together, creating a seamless transition, as the
wounded servicemember transfers between the two agencies' health care
systems and, eventually, from active duty status to veteran status.
Transition of health care coverage for our wounded, ill, and
injured and their family members is a concern of our Association. These
servicemembers and families desperately need a health care bridge as
they deal with the after effects of the injury and possible reduction
in their family income. We have created two proposals. servicemembers
who are medically retired and their families should be treated as
active duty for TRICARE fee and eligibility purposes for 3 years
following medical retirement. This proposal will allow the family not
to pay premiums and be eligible for greater access to care at certain
MTFs and for certain benefits offered to active duty families for 3
years. Following that period, they would pay TRICARE premiums at the
rate for retirees. servicemembers medically discharged from service and
their family members should be allowed to continue for 1 year as active
duty for TRICARE benefits and then move into the Continued Health Care
Benefit Program (CHCBP) if needed.
Caregivers
Caregivers need to be recognized for the important role they play
in the care of their loved one. Without them, the quality of life of
the wounded servicemembers and veterans, such as physical, psycho-
social, and mental health, would be significantly compromised. They are
viewed as an invaluable resource to DOD and VA health care providers
because they tend to the needs of the servicemembers and the veterans
on a regular basis. Their daily involvement saves DOD, VA, and State
agency health care dollars in the long run. Their long-term
psychological care needs must be addressed. Caregivers of the severely
wounded, ill, and injured servicemembers who are now veterans have a
long road ahead of them. In order to perform their job well, they will
require access to mental health services.
The VA has made a strong effort in supporting veterans' caregivers.
The DOD should follow suit and expand their definition. We appreciate
the inclusion in NDAA for Fiscal Year 2010 of compensation for
servicemembers with assistance in everyday living. However, our
Association believes this provision does not go far enough. In order to
perform their job well, caregivers must be taught the skills to be
successful.
Compensation of caregivers should be a priority for DOD and the
Secretary of Homeland Security. Caregivers must be recognized for their
sacrifices and the important role they play in maintaining the quality
of life of our wounded servicemembers and veterans. Financial
compensation must be established for caregivers of injured
servicemembers and veterans that begin while the hospitalized
servicemember is still on active duty and transitions seamlessly to a
VA benefit. Current law creates a potential gap in compensation during
transition from active duty to veteran status. Our Association proposes
that compensation should reflect the types of medical and non-medical
care services provided by the caregiver. The caregiver should be paid
directly for their services. Non-medical care should be factored into a
monthly stipend tied to severity of injury--cognitive and physical
injury and illness-and care provided. In order to perform their job
well, caregivers must be taught the skills to be successful. This will
require the caregiver to be trained through a standardized, certified
program. Compensation for medical care should be an hourly wage linked
to training and certification of the caregiver paid for by the VA and
transferrable to employment in the civilian sector if the care is no
longer needed by the servicemember or veteran.
Consideration should also be given to creating innovative ways to
meet the health care and insurance needs of the caregiver, with an
option to include their family. Current proposed legislation does not
include a ``family'' option. Additional services caregivers need are:
respite care, such as 24 hour in-home care, mental health services, and
travel and lodging expenses when accompanying servicemembers and
veterans for medical care.
There must be a provision for transition benefits for the caregiver
if the caregiver's services are no longer needed, chooses to no longer
participate, or is asked by the veteran to no longer provide services.
The caregiver should still be able to maintain health care coverage for
1 year. Compensation would discontinue following the end of services/
care provided by the caregiver. Our Association looks forward to
discussing details of implementing such a plan with members of this
subcommittee.
The VA currently has eight caregiver assistance pilot programs to
expand and improve health care education and provide needed training
and resources for caregivers who assist disabled and aging veterans in
their homes. DOD should evaluate these pilot programs to determine
whether to adopt them for caregivers of servicemembers still on active
duty. Caregivers' responsibilities start while the servicemember is
still on active duty.
Relocation Allowance and Housing
Active duty servicemembers and their spouses qualify through the
DOD for military orders to move their household goods when they leave
the military service. Medically retired servicemembers are given a
final PCS move. Medically retired married servicemembers are allowed to
move their family; however, medically retired single servicemembers
only qualify for moving their own personal goods.
Our Association suggests that legislation be passed to allow
medically retired single servicemembers the opportunity to have their
caregiver's household goods moved as a part of the medical retired
single servicemember's PCS move. This should be allowed for the
qualified caregiver of the wounded servicemember and the caregiver's
family (if warranted), such as a sibling who is married with children
or mom and dad. This would allow for the entire caregiver's family to
move, not just the caregiver. The reason for the move is to allow the
medically retired single servicemember the opportunity to relocate with
their caregiver to an area offering the best medical care, rather than
the current option that only allows for the medically retired single
servicemember to move their belongings to where the caregiver currently
resides. The current option may not be ideal because the area in which
the caregiver lives may not be able to provide all the health care
services required for treating and caring for the medically retired
servicemember. Instead of trying to create the services in the area, a
better solution may be to allow the medically retired servicemember,
their caregiver, and the caregiver's family to relocate to an area
where services already exist.
The decision on where to relocate for optimum care should be made
with the Federal Recovery Coordinator (case manager), the
servicemember's medical physician, the servicemember, and the
caregiver. All aspects of care for the medically retired servicemember
and their caregiver shall be considered. These include a holistic
examination of the medically retired servicemember, the caregiver, and
the caregiver's family for, but not limited to, their needs and
opportunities for health care, employment, transportation, and
education. The priority for the relocation should be where the best
quality of services is readily available for the medically retired
servicemember and higher caregiver.
The consideration for a temporary partial shipment of caregiver's
household goods may also be allowed, if deemed necessary by the case
management team.
Medical Power of Attorney
We have heard from caregivers of the difficult decisions they have
to make over their loved one's bedside following an injury. We support
the Traumatic Brain Injury Task Force recommendation for DOD to require
each deploying servicemember to execute a Medical Power of Attorney and
a Living Will.
Provide medically-retired wounded, ill, and injured servicemembers
and their families a bridge of extended active duty TRICARE e1igibility
for 3 years, comparable to the benefit for surviving spouses.
Servicemembers medically discharged from Service and their family
members should be allowed to continue for 1 year as active duty for
TRICARE and then start the Continued Health Care Benefit Program
(CHCBP) if needed.
Caregivers of the wounded, ill, and injured must be provided with
opportunities for training, compensation and other support programs
because of the important role they play in the successful
rehabilitation and care of the servicemember.
The National Military Family Association is requesting the ability
for medically retired single servicemembers to be allowed the
opportunity to have their caregiver's household goods moved as a part
of the medically retired single servicemember's PCS move.
DOD should require each deploying servicemember to execute a
Medical Power of Attorney and a Living Will.
Senior Oversiqht Committee
Our Association is appreciative of the provision in the NDAA for
Fiscal Year 2010 establishing a DOD Task Force on the Care, Management,
and Transition of Recovery, Wounded, Ill, and Injured Members of the
Armed Forces to access policies and programs. We understand the Office
of Wounded Warrior Care and Transition Policy (WWCTP), a permanent
structure for the Senior Oversight Committee, is in the process of
being established and manned. This Task Force will be independent and
in a position to monitor DOD and VA's partnership initiatives for our
wounded, ill, and injured servicemembers and their families, while this
organization is being created.
The National Military Family Association encourages all committees
with jurisdiction over military personnel and veterans matters to talk
on these important issues. We can no longer continue to create policies
in a vacuum and be content on focusing on each agency separately
because this population moves too frequently between the two agencies,
especially our wounded, ill, and injured servicemembers and their
families.
We would like to thank you again for the opportunity to provide
information on the health care needs for the servicemembers, veterans,
and their families. Military families support the Nation's military
missions. The least their country can do is make sure servicemembers,
veterans, and their families have consistent access to high quality
mental health care in the DOD, VA, and within network civilian health
care systems. Wounded servicemembers and veterans have wounded
families. The caregiver must be supported by providing access to
quality health care and mental health services, and assistance in
navigating the health care systems. The system should provide
coordination of care with DOD, VA, and State agencies working together
to create a seamless transition. We ask Congress to assist in meeting
that responsibility.
iii. family transitions
Survivors
In the past year, the Services have increased their outreach to
surviving families. In particular, the Army's Survivor Outreach
Services (SOS) program makes an effort to remind these families that
they are not forgotten. DOD and the VA must work together to ensure
surviving spouses and their children can receive the mental health
services they need, through all of VA's venues. New legislative
language governing the TRICARE behavioral health benefit may also be
needed to allow TRICARE coverage of bereavement or grief counseling.
The goal is the right care at the right time for optimum treatment
effect. DOD and the VA need to better coordinate their mental health
services for survivors and their children.
We thank Congress for extending the TRICARE active duty family
dental insurance benefit to surviving children. The current TRICARE
Management Activity policy directive allows for the surviving children
of Reserve component servicemembers who had not previously been
enrolled to be eligible for the expanded benefit. We ask that
eligibility be expanded to those active duty family members who had not
been enrolled in the active duty TRICARE dental insurance program prior
to the servicemember's death.
Our Association recommends that eligibility be expanded to active
duty survivors who had not been enrolled in the TRICARE Dental Program
prior to the servicemember's death. We also recommend that grief
counseling be more readily available to survivors.
Our Association still believes the benefit change that will provide
the most significant long-term advantage to the financial security of
all surviving families would be to end the Dependency and Indemnity
Compensation (DIC) offset to the Survivor Benefit Plan (SBP). Ending
this offset would correct an inequity that has existed for many years.
Each payment serves a different purpose. The DIC is a special indemnity
(compensation or insurance) payment paid by the VA to the survivor when
the servicemember's service causes his or her death. The SBP annuity,
paid by DOD, reflects the longevity of the service of the military
member. It is ordinarily calculated at 55 percent of retired pay.
Military retirees who elect SBP pay a portion of their retired pay to
ensure that their family has a guaranteed income should the retiree
die. If that retiree dies due to a service-connected disability, their
survivor becomes eligible for DIC.
Surviving active duty spouses can make several choices, dependent
upon their circumstances and the ages of their children. Because SBP is
offset by the DIC payment, the spouse may choose to waive this benefit
and select the ``child only'' option. In this scenario, the spouse
would receive the DIC payment and the children would receive the full
SBP amount until each child turns 18 (23 if in college), as well as the
individual child DIC until each child turns 18 (23 if in college). Once
the children have left the house, this choice currently leaves the
spouse with an annual income of $13,848, a significant drop in income
from what the family had been earning while the servicemember was alive
and on active duty. The percentage of loss is even greater for
survivors whose servicemembers served longer. Those who give their
lives for their country deserve more fair compensation for their
surviving spouses.
We believe several other adjustments could be made to the SBP.
Allowing payment of the SBP benefits into a Special Needs Trust in
cases of disabled beneficiaries will preserve their eligibility for
income based support programs. The government should be able to switch
SBP payments to children if a surviving spouse is convicted of
complicity in the member's death.
We believe there needs to be DIC equity with other Federal survivor
benefits. Currently, DIC is set at $1,154 monthly (43 percent of the
Disabled Retirees Compensation). Survivors of Federal workers have
their annuity set at 55 percent of their Disabled Retirees
Compensation. Military survivors should receive 55 percent of VA
Disability Compensation. We are pleased that the requirement for a
report to assess the adequacy of DIC payments was included in the NDAA
for Fiscal Year 2009. We are awaiting the overdue report. We support
raising DIC payments to 55 percent of VA Disability Compensation. When
changes are made, ensure that DIC eligibles under the old system
receive an equivalent increase.
We ask the DIC offset to SBP be eliminated to recognize the length
of commitment and service of the career servicemember and spouse. We
also request that SBP benefits may be paid to a Special Needs Trust in
cases of disabled family members.
We ask that DIC be increased to 55 percent of VA Disability
Compensation.
Education of Military Children
The National Military Family Association would like to thank
Congress for including a ``Sense of Congress'' in regards to the
Interstate Compact on Educational Opportunity for Military Children in
last year's National Defense Authorization Act. The Compact has now
been adopted in 27 States and covers over 80 percent of our military
children. The Interstate Commission, the governing body of the Compact,
is working to educate military families, educators, and States on the
appropriate usage of the Compact. The adoption of the Compact is a
tremendous victory for military families who place a high value on
education.
However, military families define the quality of that education
differently than most States or districts that look only at issues
within their boundaries. For military families, it is not enough for
children to be doing well in their current schools, they must also be
prepared for the next location. The same is true for children in under
performing school systems. Families are concerned that they will lag
behind students in the next location. With many States cutting
educational programs due to the economic downturn, this concern is
growing. A prime example is Hawaii, which opted to furlough teachers on
Fridays, cutting 17 days from the school calendar. With elementary
schools already on a shortened schedule for Wednesday, these students
are only getting 3\1/2\ days of instruction a week. In addition, the
recent cuts have made it increasingly hard for schools to meet IEP
requirements for special needs students. Furthermore, Hawaii is
requiring parents to pay more for busing, and the cost of school meals
have gone up 76 percent. Our Association believes that Hawaii's cuts
are just the ``tip of the iceberg'' as we are beginning to see other
States make tough choices as well. Although Hawaii's educational system
has long been a concern for military families, many of whom opt for
expensive private education, Hawaii is not the only place where parents
have concerns. The National Military Family Association believes that
our military children deserve to have a good quality education wherever
they may live. However, our Association recognizes that how we provide
that quality education may differ in each location.
We urge Congress to encourage solutions for the current educational
situation in Hawaii and recognize that servicemembers' lack of
confidence that their children may receive a quality education in an
assignment location can affect the readiness of the force in that
location.
While our Association remains appreciative for the additional
funding Congress provides to civilian school districts educating
military children, Impact Aid continues to be underfunded. We urge
Congress to provide appropriate and timely funding of Impact Aid
through the Department of Education. In addition, we urge Congress to
increase DOD Impact Aid funding for schools educating large numbers of
military children to $60 million for fiscal year 2011. We also ask
Congress to include an additional $5 million in funding for special
needs children. The DOD supplement to Impact Aid is critically
important to ensure school districts provide quality education for our
military children.
As increased numbers of military families move into new communities
due to Global Rebasing and BRAC, their housing needs are being met
further and further away from the installation. Thus, military children
may be attending school in districts whose familiarity with the
military lifestyle may be limited. Educating large numbers of military
children will put an added burden on schools already hard-pressed to
meet the needs of their current populations. We urge Congress to
authorize an increase in this level of funding until BRAC and Global
Rebasing moves are completed.
Once again, we thank Congress for passing the Higher Education
Opportunity Act of 2008, which contained many new provisions affecting
military families. Chief among them was a provision to expand in-State
tuition eligibility for military servicemembers and their families, and
provide continuity of in-State rates if the servicemember receives
Permanent Change of Station (PCS) orders out of State. However, family
members have to be currently enrolled in order to be eligible for
continuity of in-State tuition. Our Association is concerned that this
would preclude a senior in high school from receiving in-State tuition
rates if his or her family PCS's prior to matriculation. We urge
Congress to amend this provision.
We ask Congress to increase the DOD supplement to Impact Aid to $60
million to help districts better meet the additional demands caused by
large numbers of military children, deployment-related issues, and the
effects of military programs and policies. We also ask Congress provide
$5 million for school districts with Special Needs children.
Support for Military Voters
The National Military Family Association would like to thank
Congress for passing the Military and Overseas Voter Empowerment (MOVE)
Act which was included in the National Defense Authorization Act for
Fiscal Year 2010. As a member of the Alliance for Military and Overseas
Voting Rights (AMOVR), our Association worked hard to pass this
important legislation which resolves many of the absentee voting issues
for our military servicemembers and their families. The passage of the
MOVE ACT was a tremendous victory for our military community whose very
service helps protect the right to vote.
Spouse Education and Employment
Our Association wishes to thank Congress for recent enhancement to
spouse education opportunities. In-State tuition, Post-September 11
G.I. bill transferability to spouses and children, and other
initiatives have provided spouses with more educational opportunities
than previous years.
Since 2004, our Association has been fortunate to sponsor our
Joanne Holbrook Patton Military Spouse Scholarship Program, with the
generosity of donors who wish to help military families. Our 2010
application period closed on January 31, 2010. We saw a 33 percent
increase in applications from previous years with more than 8,000
military spouses applying to our program. Military spouses remain
committed to their education and need assistance from Congress to
fulfill their educational pursuits.
We have heard from many military spouses who are pleased with the
expansion of the Military Spouse Career Advancement Accounts, now
called MyCAA. Unfortunately the abrupt halt of the program on February
16, 2010 has created a financial burden and undue stress for military
spouses. Spouses who have established accounts and those who planned to
set-up accounts in the future have been barred for accessing funds. The
MyCAA system only permitted users to request financial assistance 30
days prior to a class start date. Many, who had planned on the funding,
will not receive it, if they didn't have a start date entered into the
system by February 16. We ask Congress to push DOD to restart this
critical program and find a way to assist spouses who have been
abruptly cut-off from receiving funding. We also ask Congress to fully
fund the MyCAA program, which is providing essential educational and
career support to military spouses. The MyCAA program is not available
to all military spouses. We ask Congress to work with the appropriate
Service Secretary to expand this funding to the spouses of Coast Guard,
the Commissioned Corps of NOAA and U.S. Public Health Service.
Our Association thanks you for establishing a pilot program to
secure internships for military spouses with Federal agencies. Military
spouse are anxious for the program to launch and look forward to
enhanced career opportunities through the pilot program. We hope
Congress will monitor the implementation of the program to ensure
spouses are able to access the program and eligible spouses are able to
find Federal employment after successful completion of the internship
program.
To further spouse employment opportunities, we recommend an
expansion to the Workforce Opportunity Tax Credit for employers who
hire spouses of active duty and Reserve component servicemembers, and
to provide tax credits to military spouses to offset the expense in
obtaining career licenses and certifications when servicemembers are
relocated to a new duty station within a different State.
The Services are experiencing a shortage of medical, mental health
and child care providers. Many of our spouses are trained in these
professions or would like to seek training in these professions. We
think the Services have an opportunity to create portable career
opportunities for spouses seeking in-demand professions. In addition to
the MyCAA funding, what can the Services do to encourage spouse
employment and solve provider shortages? We would like to see the
Services reach out to military spouses and offer affordable, flexible
training programs in high demand professions to help alleviate provider
shortages.
Our Association urges Congress to recognize the value of military
spouses by fully funding the MyCAA program, and by creating training
programs and employment opportunities for military spouses in high
demand professions to help fill our provider shortages.
Military Families--Our Nation's Families
We thank you for your support of our servicemembers and their
families and we urge you to remember their service as you work to
resolve the many issues facing our country. Military families are our
Nation's families. They serve with pride, honor, and quiet dedication.
Since the beginning of the war, government agencies, concerned citizens
and private organizations have stepped in to help. This increased
support has made a difference for many servicemembers and families,
yet, some of these efforts overlap while others are ineffective. In our
testimony, we believe we have identified improvements and additions
that can be made to already successful programs while introducing
policy or legislative changes that address the ever-changing needs of
our military families. Working together, we can improve the quality of
life for all these families.
Senator Webb. Thank you very much.
Mr. Cline.
STATEMENT OF MASTER SERGEANT MICHAEL CLINE, USA (RET.),
EXECUTIVE DIRECTOR, ENLISTED ASSOCIATION OF THE NATIONAL GUARD
OF THE UNITED STATES
Mr. Cline. Mr. Chairman, we thank you, on behalf of the
Enlisted Association of the National Guard of the United States
and the Military Coalition, for holding these hearings.
Mr. Chairman, over 142,000 National Guard and Reserve
servicemembers are serving on Active Duty. Since September 11,
2001, more than 752,000 of our citizens, soldiers, airmen,
sailors, marines, Guard and Reserve servicemembers, have been
called up, including well over 200,000 who have served multiple
tours.
With your permission, Mr. Chairman, I'd like to cut out the
fluff and just get to the point of the needs of our Guard and
Reserve people and their families.
The next step in modernizing the Reserve retirement system
is to provide equal retirement age reduction credit for all
activated service rendered since September 11, 2001. The
current law that credits only active service since January 28,
2008, disenfranchises and devalues the service of hundreds of
thousands of Guard and Reserve members who have served combat
tours, many with multiple combat tours, between 2001 and 2008.
The statute also must be amended to eliminate the inequity
inherent in the current fiscal year retirement calculation,
which only credits 90 days of active service for early
retirement purposes if it occurs within the same fiscal year.
The current rule significantly penalizes members who deploy in
July or August, versus those deploying earlier in the fiscal
year. It is potently unfair, as the current law requires giving
3 months retirement-age credit for 90-day tours served from
January through March, but only half credit for 120-day tours
served from August through November, because the latter covers
60 days in each of the 2 fiscal years.
Mr. Chairman, we fully understand the budgetary problems
facing our country, but we're also aware that more than $700
billion was given to banks, financial institutions, automakers;
$3 billion for Cash for Clunkers was spent, in 3 weeks, that
did nothing more than reduce the inventory of autodealers; the
American people, many of which are the very veterans who have
been passed by, are looking at a trillion-dollar healthcare
bill. If CBO figures are accurate, it will cost $2.1 billion
over 10 years, or just about $21 million a year, to provide
retroactivity for early retirement for those who have protected
our freedom. It's the right thing to do to honor the unselfish
heroes and their families who have given up so much to protect
us and our way of life.
For the near term, we place particular priority on
authorizing early retirement credit for all qualifying post-
September 11 Active Duty service performed by Guard and Reserve
members, and eliminating the fiscal-year-specific accumulator
that bars equal credit for members deploying for equal periods
during different months of the year. Ultimately, we believe we
must move forward to provide a reduced-age entitlement for
retired pay and health coverage for all Reserve component
members that is an age-service formula or outright eligibility,
if otherwise qualified, at age 55.
Further, we urge repeal of the annual cap of 130 days of
inactive duty points that may be credited towards a Reserve
retirement.
Yellow Ribbon. We urge the subcommittee to hold oversight
hearings and to direct additional improvements in coordination
and collaboration and consistency of Yellow Ribbon services.
DOD must ensure that State-level best practices, such as those
in Maryland, Minnesota, and New Hampshire, are applied for all
operational Reserve Force members and their families, and that
Federal Reserve veterans have equal access to services and
support available to National Guard veterans. Community groups,
employers, and Service organizations' efforts need to be
encouraged and better coordinated to supplement unit,
component, Service, and VA outreach and service.
We are grateful to you, in Congress, for inclusion of a
critical ``earn as you serve'' principle, in the post-September
11 GI Bill, which allows operational reservists to accumulate
additional benefits for each aggregate call-up of 90 days or
more on Active Duty. However, Active Duty members of the
National Guard serving under Title 32 orders were not included
in the new program, despite their critical role in homeland
defense, counterdrug, border control, and other missions. We
urge this subcommittee to work with the Veterans Affairs
Committee to include Title 32 AGRs in the post-September 11
statute.
The Military Coalition's longstanding recommendation of
coordinating and integrating various educational benefit
programs has been made more challenging with the post-September
11 GI Bill. For example, benefits for initially joining the
Guard and Reserve, as authorized under Chapter 1606 of title
10, continue to decline in proportion to the Active Duty
Montgomery GI Bill, Chapter 30, title 38, in the new post-
September 11 GI Bill. Reserve MGIB benefit levels have slipped
to 24 percent of the Active Duty MGIB benefit, compared to 47
to 50 percent during the first 15 years of the program.
Restoration of the original ratio would raise basic Reserve
rates from the current $333 a month to $643 to $684 a month for
full-time duty. TMC maintains that restoring the ratio is not
only a matter of equity, but essential to long-time success of
the Guard and Reserve recruiting program.
Continuing healthcare insurance options for the Guard and
Reserve. The Coalition is very grateful for the passage of
TRICARE for gray-area retirees; however, we're very
disappointed that it's going to take DOD 18 months to implement
the new program. As we have sent letters to you, we ask that
you intervene with DOD to speed this program up. It's a
benefit----
Senator Graham. Absolutely.
Mr. Cline.--that is needed.
Senator Graham. Absolutely.
Mr. Cline. When we look at the TRICARE Reserve Select
Program, a disturbing fact is that only 6 to 7 percent of our
eligible beneficiaries are taking advantage of the TRICARE
Reserve Select Program. DOD and the Services and the Reserve
components must do more to advertise the TRS program.
The Coalition also believes that Congress is missing an
opportunity to reduce long-term healthcare costs and increase
beneficiary satisfaction by authorizing eligible members the
option of electing a DOD subsidy of their civilian insurance
during periods of activation. Current law already authorizes
payment of up to 24 months of FEHBP premiums for activated
members who are civilian employees of the Defense Department.
Over the long term, the Guard and Reserve activations can be
expected at a reduced pace. This option would offer
considerable savings opportunities, relative to DOD permanent,
year-round TRICARE.
We recommend to the subcommittee--require a GAO review of
DOD's methodology for determining TRS costs for premium
adjustment purposes to assess whether it includes any costs of
maintaining readiness or ``costs of doing business'' for DOD
that don't contribute to beneficiary benefit values, and thus
excluded from cost premium calculations.
Mr. Chairman, I look forward to any questions that you or
Senator Graham may have.
Senator Webb. Thank you very much.
Ms. Holleman.
STATEMENT OF DEIRDRE PARKE HOLLEMAN, EXECUTIVE DIRECTOR, THE
RETIRED ENLISTED ASSOCIATION
Ms. Holleman. Good morning. Mr. Chairman----
Senator Webb. Good afternoon, actually. [Laughter.]
Ms. Holleman. Good afternoon.
Senator Graham. My stomach says it's afternoon.
Ms. Holleman. Life goes quickly, right?
It is an honor to speak to you today about the Military
Coalition's legislative goals concerning military retirees and
military survivors. I know you will not be surprised that TMC
is urging you to, once and for all, end the unfair offset of
military retired pay by VA disability pay.
We are grateful for the great strides that have been made
in ending this practice, which we all now acknowledge is
terribly unfair. But, there are two groups of valiant retirees
who are not getting the relief that you ordered for the others.
One group is those longevity retirees with VA disabilities of
10 to 40 percent. The other group is those servicemembers who
were forced to medically retire with less than 20 years, due to
an injury or medical condition that is not deemed combat-
related under the Combat Related Special Compensation program.
Even in these tough economic times, simple fairness should call
for the end of the offset for all. But, even more dramatically,
the President, for the second year, has proposed, in his
budget, to end the offset for medical retirees. To have the
administration propose a change that, in the past, was the goal
of only you, in Congress, is a historic opportunity. We
strongly urge you to join the President in this laudable goal
and end the offset for medical retirees now.
It is also clearly time to finally end the Survivor Benefit
Plan (SBP)/Dependency and Indemnity Compensation (DIC) offset.
SBP is an employee benefit, while DIC is an indemnity program
for survivors of those who died because of their service in the
military. The present practice of taking a dollar from a
survivor's SBP payment for every dollar paid by the VA's DIC
program is unfair and illogical. Legislation to end this offset
is pending in both Houses of Congress. Now that Senator Bill
Nelson's S. 535 has 55 cosponsors, and Representative Ortiz's
H.R. 811 has 319 cosponsors, it is clear that a majority of the
Members of Congress agree that this offset should end. It
should end now, while our servicemembers are fighting in two
wars and at risk throughout the world.
While these two issues are of great and continuing concern
to all of the members of the Coalition, there are several
additional matters that we believe are critically important. We
urge you to support Senator Blanche Lincoln's soon-to-be-
introduced legislation that will be a companion bill to
Representative Walter Jones's H.R. 613. Their Military Retirees
Survivor Comfort Acts would authorize the retention of the full
month's retired pay of the last month of a retiree's life by
his or her surviving spouse. Presently, DFAS removed the
month's retired pay from the retiree account, calculates how
much is owed by how many days the retiree lived in the month
that he or she died in, and then returns the prorated share to
the survivor. This method can cause confusion and even bounce
checks during a tremendously tense and sorrowful time. Senator
Lincoln's bill would stop this, and treat military retiree
survivors the same way as disabled veteran survivors are
treated concerning the disability payments.
The Uniformed Services Former Spouse Protection Act
desperately needs improvement. While some organizations want
dramatic fundamental changes, and other groups adamantly do
not, it truly is time that we had a hearing on this rather
explosive issue. There are already several improvements that
DOD has supported, for years, that could be made during this
session. These changes include basing the amount awarded in a
divorce on the grade and years of service at the time of the
divorce, rather than at the time of retirement, and prohibiting
the inclusion of imputed income in a divorce property award,
which often forces Active Duty members into retirement. A full
list of our suggestions can be found in our written testimony.
Finally, we urge that DFAS be allowed to make SBP payments
into a Special Needs Trust. Presently, they may only pay SBP to
a person. This means that a permanently disabled survivor
cannot make use of this State-created legal device that allows
a disabled person to protect their eligibility for SSI,
Medicaid, and State means-tested programs. With the help of
supporters like you, Chairman Webb, we hope that this change
will be made. It would only affect a few people, but for those
survivors, this small change would be an enormous help.
Thank you for your time, and may I have the honor to
introduce Colonel Strobridge.
Senator Webb. Thank you very much for your testimony.
Colonel Strobridge.
STATEMENT OF STEVEN P. STROBRIDGE, USAF (RET.), DIRECTOR OF
GOVERNMENT RELATIONS, MILITARY OFFICERS ASSOCIATION OF AMERICA
Colonel Strobridge. Mr. Chairman, Senator Graham, my
testimony is going to focus on healthcare and Wounded Warrior
issues.
The primary issue for all beneficiaries is access. The
primary threat to access continues to be the perpetual threat
of major cuts in Medicare and TRICARE payments to doctors. We
fully realize that's beyond the authority of this subcommittee,
but it is the number-one healthcare issue among our
beneficiaries.
On national healthcare reform, the principal issues for our
members in the coalition are ensuring protection of military-
unique health benefits, including TRICARE For Life, and
protection of uniformed services beneficiaries from taxation on
the value of those benefits.
On TRICARE fees, we're grateful that the administration has
not proposed any increases for fiscal year 2011, however,
without congressional action, the TRICARE standard outpatient
deductible will be increased administratively by more than $110
per day as of October 1. Last October, the subcommittee acted,
during conference action on the National Defense Authorization
Act, to stop that change. We urge you to put a provision in
law, capping the outpatient deductible at the current $535 per
day, which the coalition believes is plenty high enough and
should not be increased for the foreseeable future.
We also ask you to put a ``Sense of Congress'' provision in
the National Defense Authorization Act, as the Senate approved
last year, highlighting the importance of military health
benefits in offsetting the adverse conditions of service and
recognizing that military people pay large upfront premiums
through decades of service and sacrifice, over and above their
cash fees.
On Wounded Warriors, we're concerned that the change of the
administration has left many senior positions vacant for more
than a year, and that close joint oversight previously provided
by top leaders has been delegated and diffused back along
agency-centric lines. The coalition is particularly concerned
that the diminution of the Senior Oversight Committee, or SOC,
has weakened day-to-day oversight of, and priority on, joint
agency operations and management. We urge revitalization of the
SOC, or a similar joint agency staffed with senior officials
with full-time primary oversight responsibility for seamless
transition initiatives.
Similarly, the transition from Active Duty to retiree care
or to VA coverage still catches many wounded warriors and their
families unaware. They need the same protections that we
provide when someone dies on Active Duty: 3 years of continued
Active Duty-level coverage to ensure a smooth transition to the
next phase of their life.
We appreciate the subcommittee's efforts last year to
provide caregiver benefits on a par with what's provided by the
VA. The Veterans Affairs Committees are now finalizing
significant upgrades for caregivers, and we hope you'll act to
reestablish comparability of DOD programs once that happens.
Regarding psychological health, PTSD, and TBI, we know the
subcommittee and DOD and the Services are pursuing a wide range
of initiatives to enhance access to care and counseling, and to
remove the stigma from seeking care. Unfortunately, some facets
of the military environment continue to undermine those
efforts. In that regard, many who suffer after-effects of
combat continue being barred from reenlistment, or separated
for other reasons, because service disciplinary and
administrative systems are much less flexible and resilient
than we're asking military people to be. We hope the
subcommittee will continue its efforts to protect returnees
from these lower profile, but still devastating, secondary
effects of war.
Mr. Chairman, that concludes my remarks.
[The prepared statement of The Military Coalition follows:]
Prepared Statement by The Military Coalition
Mr. Chairman and distinguished members of the subcommittee. On
behalf of The Military Coalition (TMC), a consortium of nationally
prominent uniformed services and veterans' organizations, we are
grateful to the committee for this opportunity to express our views
concerning issues affecting the uniformed services community. This
testimony provides the collective views of the following military and
veterans' organizations, which represent approximately 5.5 million
current and former members of the 7 uniformed services, plus their
families and survivors.
Air Force Association
Air Force Sergeants Association
Air Force Women Officers Associated
American Logistics Association
AMVETS (American Veterans)
Army Aviation Association of America
Association of Military Surgeons of the United States
Association of the United States Army
Association of the United States Navy
Chief Warrant Officer and Warrant Officer Association, U.S.
Coast Guard
Commissioned Officers Association of the U.S. Public Health
Service, Inc.
Enlisted Association of the National Guard of the United
States
Fleet Reserve Association
Gold Star Wives of America, Inc.
Iraq and Afghanistan Veterans of America
Jewish War Veterans of the United States of America
Marine Corps League
Marine Corps Reserve Association
Military Chaplains Association of the United States of
America
Military Officers Association of America
Military Order of the Purple Heart
National Association for Uniformed Services
National Guard Association of the United States
National Military Family Association
National Order of Battlefield Commissions
Naval Enlisted Reserve Association
Noncommissioned Officers Association
Reserve Enlisted Association
Reserve Officers Association
Society of Medical Consultants to the Armed Forces
The Retired Enlisted Association
United States Army Warrant Officers Association
United States Coast Guard Chief Petty Officers Association
Veterans of Foreign Wars of the United States
The Military Coalition, Inc., does not receive any grants or
contracts from the Federal Government.
executive summary
Wounded Warrior Care
Institutional Oversight
The Coalition believes there's no substitute for a permanent
Department of Defense (DOD)-Department of Veterans Affairs (VA) Senior
Oversight Committee or other Joint Seamless Transition Office, staffed
with senior officials working together full-time and charged with
innovation and daily oversight of initiatives to institutionalize and
sustain a culture of cross-department seamless transition.
Continuity of Health Care
The Coalition recommends:
Authorizing active-duty level TRICARE benefits,
independent of availability of VA care, for 3 years after
medical retirement to help ease transition from DOD to VA;
Authorizing blanket waiver authority for VA physicians
treating active duty patients with multiple medical trauma
conditions for all aspects of the member's treatment, including
referral outside the VA/TRICARE system if needed; and
Either exempting severely wounded, ill, or injured
members who must be medically retired from paying Medicare Part
B premiums until age 65 or authorizing a special DOD allowance
to help offset the cost of such premiums until age 65.
Mental/Behavioral Health Issues
TMC recommends:
Increased efforts to promote the destigmatization on
all levels in service/unit administrative and strict
accountability programs with outlined and enforced consequences
to non-compliancy to ensure unit actions are consistent with
leadership pronouncements;
Continuing priority efforts to deliver information and
assistance on-line, confidential options for counseling and
uniformed access and availability to telemedicine services;
Substantial increases in outreach efforts to provide
such services and resources to Guard and Reserve members, rural
populations and all families who don't live near military or VA
facilities;
Priority efforts to educate private sector providers
on the unique needs of military and veteran patients and family
members, and deliver needed information via on-line services,
including contact points for discussion/consultation with
military and VA providers;
Consistent implementation of pre- and post-deployment
evaluations and follow-up programs, particularly for Guard and
Reserve members who may be leaving active duty;
Establishing common DOD and VA protocols for
diagnosis, treatment, and rehabilitation for Traumatic Brain
Injury (TBI) conditions, as well as an electronic system to
share and exchange a patient's medical history and other key
medical information;
Expanding Traumatic Servicemember Group Life Insurance
(TSGLI) criteria to include moderate and severe TBI, without
onerous ``functions of daily living'' standards that aren't
required for other (and often much more functional) TSGLI-
eligibles;
Increasing availability and outreach on substance
abuse counseling options;
Pursuing aggressive medication reconciliation and
management programs to protect against inadvertent over
medication and adverse reactions and or accidental or
intentional overdose;
Requiring TBI and psychological health assessments for
members who have been deployed to a combat zone as part of the
disciplinary process prior to a decision concerning nonmedical
separation; and
Implementing recommendations from the 2008 RAND report
(``Invisible Wounds of War Psychological and Cognitive
Injuries, Their Consequences, and Services to Assist
Recovery'').
DOD-VA Disability Evaluation Systems (DES)
TMC recommends:
Barring ``fit, but unsuitable'' separations when a
member's medical condition prevents continued service;
Authorizing automatic enrollment in the VA health care
system for any medically separated or medically retired
servicemember (Chapter 61);
Ending distinctions between disabilities incurred in
combat vice non-combat;
Monitoring the effectiveness of recent DOD
compensation for catastrophically injured or ill servicemembers
requiring assistance with activities of daily living authorized
in the 2010 NDAA;
Ensuring benefits afforded members wounded, ill, or
disabled in the line of duty are applied equally for all
uniformed services;
Ensuring that the VA is the single authority for
rating service-connected disabilities for military disability
retirements and separations;
Preserving the statutory 30 percent disability
threshold for medical retirement and lifetime TRICARE coverage
for members injured while on active duty;
Continued monitoring of Service/DOD Medical-Physical
Evaluation Boards, DOD DES Pilot Project, and the Physical
Disability Board of Review, to assess needed DES changes;
Eliminating member premiums for TSGLI;
Barring ``pre-existing condition'' determinations for
any member who deploys to a combat zone;
Ensuring that any adjustment to the disability
retirement system does not result in a member receiving less
disability retired pay than he or she would receive under the
current system; and
Ensuring that members electing accelerated disability
retirement/separation are fully counseled on any possible
negative changes in compensation, health care and other
benefits, with consideration to allowing a limited time to
reverse a regrettable decision.
Caregiver/Family Support Services
The Coalition recommends:
Upgraded compensation and assistance for caregivers of
severely disabled active duty members, consistent with pending
legislative action to improve compensation/assistance for
caregivers of veterans; and
Authorizing up to 1 year of continued residence in on-
base housing facilities for medically retired, severely wounded
servicemembers and their families.
Active Forces and Their Families
Military End Strength
The Coalition urges the subcommittee to:
Continue end strength growth as needed to sustain the
war and other operational commitments while materially
increasing dwell time for servicemembers and families;
Sustain adequate recruiting and retention resources to
enable the uniformed services to achieve required optimum-
quality personnel strength; and
Seek a 2011 defense budget of at least 5 percent of
Gross Domestic Product that funds both people and weapons
needs.
Military Pay Comparability
The Coalition believes a basic pay raise of at least 1.9
percent--.5 percent above the Employment Cost Index (ECI) standard--is
the bare minimum the Nation should do to sustain its military pay
comparability commitment for 2011.
Family Readiness and Support
The Coalition recommends that the subcommittee:
Press DOD to assess the effectiveness of programs and
support mechanisms to assist military families with deployment
readiness, responsiveness, and reintegration;
Ensure that effective programs--including the Family
Readiness Council--are fully funded and their costs are
included in the annual budget process;
Provide authorization and funding to accelerate
increases in availability of child care to meet both Active and
Reserve component requirements;
Insist DOD implement flexible spending accounts to let
active duty and Selected Reserve families pay out-of-pocket
dependent and health care expenses with pre-tax dollars;
Monitor and continue to expand family access to mental
health counseling;
Promote expansion of military spouse opportunities to
further educational and career goals;
Ensure additional and timely funding of Impact Aid
plus continued DOD supplemental funding for highly-impacted
military schools; and
Mitigate the impact of Service transformation,
overseas rebasing initiatives, housing privatization and base
realignment on school facility needs and educational programs
affecting military children.
Permanent Change of Station (PCS) Allowances
The Coalition urges the subcommittee to continue its efforts to
upgrade permanent change-of-station allowances to better reflect
expenses imposed on servicemembers, with priority on:
Shipping a second vehicle on overseas accompanied
assignments;
Authorizing at least some reimbursement for house-
hunting trip expenses; and
Increasing PCS mileage rates to more accurately
reflect members' actual transportation costs.
Education Enhancements
The Coalition urges the subcommittee to support amending the
statute to authorize all otherwise-qualifying members of the
``uniformed services'' to transfer Post-September 11 GI Bill benefits
to family members.
Morale, Welfare, and Recreation (MWR) and Quality of Life (QoL)
Programs
TMC urges the subcommittee to:
Protect funding for critical family support and QoL
programs and services to meet the emerging needs of
beneficiaries and the timelines of the Services' transformation
plans;
Oppose any initiative to withhold or reduce
appropriated support for family support and QoL programs to
include: recreation facilities, child care, exchanges and
commissaries, housing, health care, education, family centers,
and other traditional and innovative support services;
Prevent any attempts to consolidate or civilianize
military service exchange and commissary programs; and
Sustain funding for support services and
infrastructure at both closing and gaining installations
throughout the entire transformation process, including
exchange, commissary, and TRICARE programs.
National Guard and Reserve
Operational Reserve Sustainment and Reserve Retirement
For the near term, the Military Coalition places particular
priority on authorizing early retirement credit for all qualifying
post-September 11 active duty service performed by Guard/Reserve
servicemembers and eliminating the fiscal-year-specific accumulator
that bars equal credit for members deploying for equal periods during
different months of the year.
Ultimately, TMC believes we must move forward to provide a reduced
age entitlement for retired pay and health coverage for all Reserve
component members--that is, an age/service formula or outright
eligibility, if otherwise qualified, at age 55.
Further, TMC urges repeal of the annual cap of 130 days of inactive
duty training points that may be credited towards a reserve retirement.
Guard and Reserve Yellow Ribbon Readjustment
TMC urges the subcommittee to hold oversight hearings and to direct
additional improvements in coordination, collaboration, and consistency
of Yellow Ribbon services. DOD must ensure that State-level best
practices--such as those in Maryland, Minnesota, and New Hampshire--are
applied for all Operational Reserve Force members and their families,
and that Federal Reserve veterans have equal access to services and
support available to National Guard veterans. Community groups,
employers and service organization efforts need to be encouraged and
better coordinated to supplement unit, component, Service and VA
outreach and services.
Guard/Reserve GI Bill
TMC urges the subcommittee to work with the Veterans Affairs
Committee to include Title 32 AGRs in the Post-September 11 statute.
Based on the DOD/Services' 10-year record of indifference to the
basic Selected Reserve GI Bill under Chapter 1606, 10 U.S.C., TMC
recommends either: restoring Reserve benefits to 47-50 percent of
active duty benefits or transferring the chapter 1606 statute from
title 10 to title 38 so that it can be coordinated with other
educational benefits programs in a 21st century GI Bill architecture.
TMC also supports assured academic reinstatement, including guaranteed
re-enrollment, for returning operational reservists.
Special and Incentive Pays
The Coalition urges the subcommittee to ensure equitable treatment
of Guard and Reserve vs. active duty members for the full range of
special and incentive pays.
Retiree Issues
Concurrent Receipt
The Coalition's continuing goal is to fully eliminate the deduction
of VA disability compensation from earned military retired pay for all
disabled retirees. In pursuit of that goal, the Coalition's immediate
priorities include:
Phasing out the disability offset for all Chapter 61
(medical) retirees; and
Correcting the Combat-Related Special Compensation
(CRSC) formula to ensure the intended compensation is
delivered.
Proposed Military Retirement Changes
TMC urges the subcommittee to:
Reject any initiatives to ``civilianize'' the military
system without adequate consideration of the unique and
extraordinary demands and sacrifices inherent in a military vs.
a civilian career; and
Eliminate the Career Status Bonus for servicemembers
as it significantly devalues their retirement over time. In the
short term, the Services should be required to better educate
eligible members on the severe long-term financial penalty
inherent in accepting the REDUX option.
Disability Severance Pay
The Coalition urges the subcommittee to amend the eligibility rules
for disability severance pay to include all combat--or operations--
related injuries, using same definition as CRSC. For the longer term,
the Coalition believes the offset should be ended for all members
separated for service-caused disabilities.
Former Spouse Issues
The Coalition requests a hearing to address Uniformed Services
Former Spouse Protection Act (USFSPA) inequities. In addition, we
recommend legislation to include all of the following:
Base the award amount to the former spouse on the
grade and years of service of the member at time of divorce
(and not retirement);
Prohibit the award of imputed income, which
effectively forces active duty members into retirement;
Extend 20/20/20 benefits to 20/20/15 former spouses;
Permit the designation of multiple Survivor Benefit
Plan (SBP) beneficiaries with the presumption that SBP benefits
must be proportionate to the allocation of retired pay;
Eliminate the ``10-year Rule'' for the direct payment
of retired pay allocations by the Defense Finance and
Accounting Service (DFAS);
Permit SBP premiums to be withheld from the former
spouse's share of retired pay if directed by court order;
Permit a former spouse to waive SBP coverage;
Repeal the 1-year deemed election requirement for SBP;
and
Assist DOD and Services with greater outreach and
expanded awareness to members and former spouses of their
rights, responsibilities, and benefits upon divorce.
Survivor Issues
SBP-DIC Offset
The Coalition urges repeal of the SBP-DIC offset. TMC further
recommends:
Authorizing payment of SBP annuities for disabled
survivors into a Special Needs Trust;
Allowing SBP eligibility to switch to children if a
surviving spouse is convicted of complicity in the member's
death; and
Reinstating SBP for survivors who previously
transferred payments to their children at such time as the
youngest child attains majority, or upon termination of a
second or subsequent marriage.
Final Retired Paycheck
TMC urges the subcommittee to authorize survivors of retired
members to retain the final month's retired pay for the month in which
the retiree dies.
Health Care Issues
Defense Health Program Cost Requirements
The Coalition urges the subcommittee to take all possible steps to
ensure continued full funding for Defense Health Program needs.
National Health Reform
TMC urges that any national health reform legislation must:
Protect the unique TRICARE, TRICARE For Life (TFL),
and VA health care benefits from unintended consequences such
as reduced access to care;
Bar any form of taxation of TRICARE, TFL, or VA health
care benefits, including those provided in nongovernmental
venues; and
Preserve military and VA beneficiaries' choices.
TRICARE Fees
Establish a ``Sense of Congress'' which recognizes that military
retiree health benefits are an essential offset to arduous service
conditions which have been paid for upfront.
Military vs. Civilian Cost-Sharing Measurement
The Coalition believes that military beneficiaries from whom
America has demanded decades of extraordinary service and sacrifice
have earned coverage that is the best America has to offer.
Large Retiree Fee Increases Can Only Hurt Retention
Reducing military retirement benefits would be particularly ill-
advised when an overstressed force already is at increasing retention
risk despite the current downturn of the economy and current recruiting
successes.
Pharmacy
The Coalition urges the subcommittee to ensure continued
availability of a broad range of medications, including the most-
prescribed medications, in the TRICARE pharmacy system, and to ensure
that the first focus on cost containment should be on initiatives that
encourage beneficiaries to take needed medications and reduce program
costs without shifting costs to beneficiaries.
Alternative Options to Make TRICARE More Cost-Efficient
The Coalition has offered a long list of alternative cost-saving
possibilities, including:
Positive incentives to encourage beneficiaries to seek
care in the most appropriate and cost effective venue;
Encouraging improved collaboration between the direct
and purchased care systems and implementing best business
practices and effective quality clinical models;
Focusing the military health system, health care
providers, and beneficiaries on quality measured outcomes;
Improving MHS financial controls and avoiding overseas
fraud by establishing TRICARE networks in areas fraught with
fraud;
Establishing TRICARE networks in areas of high TRICARE
Standard utilization to take full advantage of network
discounts;
Promoting retention of other health insurance by
making TRICARE a true second-payer to other insurance (far
cheaper to pay another insurance's co-pay than have the
beneficiary migrate to TRICARE);
Encouraging DOD to effectively utilize their data from
their electronic health record to better monitor beneficiary
utilization patterns to design programs which truly match
beneficiaries needs;
Sizing and staffing military treatment facilities to
reduce reliance on network providers and develop effective
staffing models which support enrolled capacities;
Reducing long-term TRICARE Reserve Select (TRS) costs
by allowing servicemembers the option of a government subsidy
of civilian employer premiums during periods of mobilization;
Doing far more to promote use of mail-order pharmacy
system and formulary medications via mailings to users of
maintenance medications, highlighting the convenience and
individual expected cost savings; and
Encouraging retirees to use lowest-cost-venue military
pharmacies at no charge, rather than discouraging such use by
limiting formularies, curtailing courier initiatives, etc.
TMC Healthcare Cost Principles
The Coalition strongly recommends that Congress establish statutory
findings, a sense of Congress on the purpose and principles of military
health care benefits earned by a career of uniformed service that
states:
Active duty members and families should be charged no
fees except retail pharmacy co-payments, except to the extent
they make the choice to participate in TRICARE Standard or use
out-of-network providers under TRICARE Prime;
The TRICARE Standard inpatient copay should not be
increased further for the foreseeable future. At $535 per day,
it already far exceeds inpatient copays for virtually any
private sector health plan;
There should be no enrollment fee for TRICARE Standard
or TFL, since neither offers assured access to TRICARE-
participating providers. An enrollment fee implies enrollees
will receive additional services, as Prime enrollees are
guaranteed access to participating providers in return for
their fee. Congress already has required TFL beneficiaries to
pay substantial Medicare Part B fees to gain TFL coverage;
All retired servicemembers earned equal health care
coverage by virtue of their service; and
DOD should make all efforts to provide the most
efficient use of allocated resources and cut waste prior to
proposing additional or increased fees on eligible
beneficiaries.
TRICARE Prime
The Military Coalition urges the subcommittee to require reports
from DOD and from the managed care support contractors, on actions
being taken to improve Prime patient satisfaction provide assured
appointments within Prime access standards, reduce delays in
preauthorization and referral appointments, and provide quality
information to assist beneficiaries in making informed decisions.
TRICARE Standard
TRICARE Standard Provider Participation
The Coalition urges the subcommittee to insist on immediate
delivery of an adequacy threshold for provider participation, below
which additional action is required to improve such participation. The
Coalition also recommends requiring a specific report on participation
adequacy in the localities where Prime Service Areas will be
discontinued under the new TRICARE contracts.
TRICARE Reimbursement Rates
The Coalition places primary importance on securing a permanent fix
to the flawed statutory formula for setting Medicare and TRICARE
payments to doctors.
To the extent a Medicare rate freeze continues, we urge the
subcommittee to encourage DOD to use its reimbursement rate adjustment
authority as needed to sustain provider acceptance.
The Coalition urges the subcommittee to require a Comptroller
General report on the relative propensity of physicians to participate
in Medicare vs. TRICARE, and the likely effect on such relative
participation of a further freeze in Medicare/TRICARE physician
payments along with the effect of an absence of bonus payments.
Dental Care
Active Duty Dependent Dental Plan
The Coalition recommends increasing the DOD subsidy for the Active
Duty Dependent Dental Plan to 72 percent and increasing the cap on
orthodontia payments to $2,000.
Guard and Reserve Healthcare
Continuum of Health Care Insurance Options for The Guard and
Reserve
The Coalition recommends the subcommittee:
Require a GAO review of DOD's methodology for
determining TRS costs for premium adjustment purposes to assess
whether it includes any costs of maintaining readiness or
``costs of doing business'' for the Defense Department that
don't contribute to beneficiary benefit value and thus should
be excluded from cost/premium calculations;
Authorize development of a cost-effective option to
have DOD subsidize premiums for continuation of a Reserve
employer's private family health insurance during periods of
deployment as an alternative to ongoing TRS coverage;
Allow eligibility in Continued Health Care Benefits
Program (CHCBP) for Selected reservists who are voluntarily
separating and subject to disenrollment from TRS;
Authorize members of the IRR who qualify for a Reserve
retirement at age 60 to participate in TRICARE Retired Reserve
(TRR) as an incentive for continued service (and higher
liability for recall to active duty);
Monitor implementation of the new TRR authority to
ensure timely action and that premiums do not exceed 100
percent of the TRS premium; and
Allow FEHB plan beneficiaries who are selected
reservists the option of participating in TRS.
Guard and Reserve Mental Health
TMC believes that Guard and Reserve members and their families
should have access to evidence-based treatment for PTSD, TBI,
depression, and other combat-related stress conditions. Further, Post
Deployment Health examinations should be offered at the member's home
station, with the member retained on active duty orders until
completion of the exam.
Guard and Reserve Health Information
The Coalition believes there should be an effort to improve the
electronic capture of non-military health information into the
servicemember's medical record.
TRICARE For Life
Coalition priorities for TFL-eligibles include:
Securing a permanent fix to the flawed formula for
setting Medicare/TRICARE payments to providers;
Resisting any effort to establish an enrollment fee
for TFL, given that many beneficiaries already experience
difficulties finding providers who will accept Medicare
patients; and
Including TFL beneficiaries in DOD programs to
incentivize compliance with preventive care and healthy
lifestyles.
Restoration of Survivors' TRICARE Coverage
The Coalition recommends restoration of TRICARE benefits to
previously eligible survivors whose second or subsequent marriage ends
in death or divorce.
Base Realignment and Closure (BRAC) and Rebasing
The Coalition recommends requiring an annual DOD report on the
adequacy of health resources, funding, services, quality and access to
care for beneficiaries affected by BRAC/rebasing.
overview
Mr. Chairman, The Military Coalition extends our thanks to you and
the entire subcommittee for your steadfast support of our Active Duty,
Guard, Reserve, retired members, and veterans of the uniformed services
and their families and survivors. Your efforts have had a dramatic,
positive impact in the lives of the entire uniformed services
community.
Last year was an extremely tumultuous, difficult year. As our
servicemembers continued to fight terror on two separate fronts, our
Nation slowly started to recover from an economic crisis, the worst
seen since the great depression. Congress and the administration had
difficult choices to make as they attempted to ``jump start'' the
economy while faced with a record budget deficit.
We are grateful that both the Defense Department and Congress put
top priority on personnel issues last year. As we enter the ninth year
of extremely stressful wartime conditions, the Coalition believes that
this prioritization should continue for fiscal year 2011.
Despite ever-increasing pressures on them at home and abroad, men
and women in uniform are still answering the call--thanks in no small
measure to the subcommittee's strong and consistent support--but only
at the cost of ever-greater sacrifices.
Troubling indicators such as dramatic increases in suicide and
divorce rates may reflect the effects of the long-term consequences we
know are coming as we require the same people to return to combat again
and again and yet again.
In these times of growing political and economic pressures, the
Coalition relies on the continued good judgment of the Armed Services
Committees to ensure the Nation allocates the required resources to
sustain a strong national defense, and in particular, to properly meet
the pressing needs of the less than 1 percent of the American
population--servicemembers and their families--who protect the freedoms
of the remaining 99 percent.
In this testimony, The Coalition offers our collective
recommendations on what needs to be done to meet these essential needs.
wounded warrior care
Much has been done in the last 3 years to address the grievous and
negligent conditions that were brought to light since the tragic
incident at Walter Reed Army Medical Center, where wounded and disabled
troops and their families had fallen through the cracks as they
transitioned from the military to VA health care and benefits systems.
Subsequently, the subcommittee has worked hard to address these
difficulties, and significant progress has been made on that score.
But the extent and complexity of the challenges remain daunting,
requiring continuing coordination of effort between the military
services; the Department of Defense (DOD); the Department of Veterans
Affairs (VA); several Centers of Excellence; a multitude of civilian
contractors and nongovernmental agencies; and the two Armed Services,
two Veterans Affairs, and two Appropriations Committees.
The Coalition looks forward to working with the subcommittee this
year in its ongoing efforts to identify and ease significant remaining
problems.
DOD-VA Seamless Transition
Institutional Oversight
While many legislative and fiscal changes have improved the care
and support of our wounded and disabled members, the Coalition is
concerned that the recent dissolution of the Senior Oversight Committee
(SOC) poses significant risks for effective day-to-day leadership and
coordination of DOD and VA seamless transition efforts.
Last year, the Coalition expressed concern that the change of
administration would pose a significant challenge to the two
departments' continuity of joint effort, as senior leaders whose
personal involvement had put interdepartmental efforts back on track
left their positions and were replaced by new appointees who had no
experience with past problems and no personal stake in ongoing
initiatives.
Unfortunately, those concerns are being realized, as many
appointive positions in both departments have gone unfilled for a year,
responsibilities have been reorganized, and oversight duties previously
assumed by senior officials have been divested to lower-level
administrators who are less regularly engaged with their cross-
department counterparts.
The result has been more uncertainty and degradation of
cooperation, communication, and collaboration between the two
departments over the last year.
The Coalition is concerned that, having exerted major efforts to
address the most egregious problems, there is a significant potential
to fall victim to a ``business as usual'' operating mode, even though
the difficult journey to true seamless transition between the
departments has just begun.
While many well-meaning and hard working military and civilians are
doing their best to keep pushing progress forward, transitions in
leadership and mission changes clearly are challenging and require
formal and more standardized structures, policies, and programs that
won't be as subject to disruption by one participant's unilateral
organizational changes.
It sends a message about departmental priorities when these
responsibilities are pushed to lower-level officials.
The Coalition believes there's no substitute for a permanent DOD-VA
Senior Oversight Committee or other Joint Seamless Transition Office,
staffed with senior officials working together full-time and charged
with innovation and daily oversight of initiatives to institutionalize
and sustain a culture of cross-department seamless transition.
Continuity of Health Care
Transitioning between DOD and VA health care systems remains
challenging, confusing, and overwhelming to those trying to navigate
and use these systems. Systemic, cultural, and bureaucratic barriers
often prevent the servicemember or veteran from receiving the necessary
continuity of care they need to heal and have productive and a high
level of quality of life they so desperately need and desire.
While servicemembers and their families tell us that DOD has done
much to address trauma care, acute rehabilitation, and basic short-term
rehabilitation, they are less satisfied with their transition from the
military health care systems to longer-term care and support in
military and veterans medical systems.
We hear regularly from members who experienced significant
disruptions of care upon separation or medical retirement from service.
One is in the area of cognitive therapy, which is available to
retired members under TRICARE only if it is not available through the
VA. Unfortunately, members are caught in the middle because of
differences between DOD and VA authorities on what constitutes
cognitive therapy and the degree to which effective, evidenced-based
therapy is available.
The NDAA for Fiscal Year 2010 requires a report on such issues, but
action is needed to protect the wounded and disabled. The subcommittee
has acted previously to authorize 3 years of active-duty-level TRICARE
coverage for the family members of those who die on active duty. The
Coalition believes we owe equal transition care continuity to those
whose service-caused illnesses or injuries force their retirement from
service.
Another significant issue faced by many members forced from active
duty by severe service-caused disabilities is that the severity of
their disability qualifies them for Medicare. In such cases, TRICARE is
second-payer to Medicare.
Under laws that were designed for elderly retirees but apply
equally to all Medicare-eligible military beneficiaries, these younger
disabled warriors must pay Medicare Part B premiums ($110 per month in
2010) to retain any coverage under TRICARE.
The Coalition believes it's wrong that members whose service caused
them to become severely wounded, ill or injured should have to pay more
for their care than they would if not injured by service, and believes
they should either be exempt from paying the Part B premium until age
65 or DOD should help them offset the cost of such payments.
Finally, doctors at VA polytrauma centers indicate that one of
their biggest problems is the requirement to get multiple
authorizations from DOD to provide a variety of specialty care for
active duty members with multiple medical problems.
When an active duty member is referred to VA facility for care, DOD
should grant an automatic waiver of preauthorization/referral
requirements to allow the VA providers to deliver needed care without
bureaucratic delays.
The Coalition recommends:
Authorizing active-duty-level TRICARE benefits,
independent of availability of VA care, for 3 years after
medical retirement to help ease transition from DOD to VA;
Authorizing blanket waiver authority for VA physicians
treating active duty patients with multiple medical trauma
conditions for all aspects of the member's treatment, including
referral outside the VA/TRICARE system if needed; and
Either exempting severely wounded, ill, or injured
members who must be medically retired from paying Medicare Part
B premiums until age 65 or authorizing a special DOD allowance
to help offset the cost of such premiums until age 65.
Mental/Behavioral Health Issues
The military community is experiencing a crisis of demand for
mental/behavior health care, both for servicemembers and their spouses
and children.
The subcommittee included several initiatives in the NDAA for
Fiscal Year 2010 aimed at increasing the number of military providers
in this field and improving access for members and families.
While the Coalition is very grateful for these initiatives, we
respectfully request that the subcommittee continue, and more
importantly expand, its efforts in addressing the growing epidemic of
difficulties regarding post-traumatic stress disorder (PTSD), traumatic
brain injuries (TBI), depression, and other mental/behavioral health
issues disproportionally plaguing our military and veteran communities.
Today our servicemembers, their spouses and children are facing
immense stresses and uncertainties associated with repeated deployments
and protracted separations. Our country is at war on multiple fronts
and we must take all the necessary actions to ensure the mental well
being of all those involved, at home and those on the frontlines.
One of the most prevalent obstacles in successfully identifying and
treating mental/behavioral health conditions is the stigma which the
military's warrior culture continues to associate with such conditions
and the threat or fear that admission of experiencing them may affect
one's peer standing, security clearance, promotions, or ability to
remain in service.
Despite the continued efforts by senior leaders to reduce the
stigmas associated with mental health issues, the unit-level reality is
far different. The reality is that many officers, NCOs, and peers
continue to view these conditions as signs of weakness or inability to
coup.
Furthermore, many servicemembers are deterred from seeking care by
cases of friends who have been disciplined or separated as a result of
using the available support systems the military has implemented.
As a direct result, the suicide and divorce rates, as well as
childhood depression diagnosis' continue to climb within the military
and veteran communities. DOD openly acknowledges that stigmas remain
within the ranks, despite their efforts of significantly ramping up
efforts and outreach programs composed of anti-stigma campaigns, upper-
level training programs, and easier access to mental health providers.
The Coalition stresses our grave concerns to the subcommittee
regarding the current state of DOD's inability to effectively handle
the increasing demands/need for mental health services and outreach to
all demographics of today's military forces. While our forces and their
families display extraordinary strengths, resiliency and undaunted
tenacity in the face of all stresses associated with service; it is
vital that we never forget that these same stressors of service to this
country are in all likelihood, leading to untreated mental and physical
health conditions.
The Coalition believes that due to the numerous unrealistic
standards and high expectations of resiliency and coping abilities we
have somehow come to expect from our servicemembers and their families,
that the current military administrative and disciplinary systems being
used are not effectively meeting the mental health needs, whether
proactive or reactive, of the same people to whom we expect so much.
DOD and VA have an obligation to provide the best care available to any
servicemember who sustains an injury as a result of their service.
Unfortunately, many of today's servicemembers have mental wounds
that are undiagnosed and thus untreated. This lack of care or treatment
for PTSD, TBI, or any one of the numerous stressors associated with
service, is leading to an increased number of early separations or even
more alarming, being barred from reenlisting due to a charge of
misconduct, such as a driving under the influence (DUI) or other such
incident, by a servicemember who has never previously displayed any
such behaviors. These uncharacteristic behaviors are only one of the
symptoms associated with untreated mental/behavioral health conditions.
Ironically, some civil authorities often are more tolerant and offer
more assistance in dealing with such cases involving combat veterans
than military authorities.
As a result of such circumstances, thousands, if not countless, of
affected servicemembers, veterans and their family members have gone
unidentified, untreated, or deterred from being given the opportunity
to seek the care they deserve. Moreover, many have difficulty accessing
and utilizing programs that are in place.
In addition to expanding the availability of providers, the
Coalition believes that two key elements will be in expanding the
opportunities for confidential access to counseling or treatments and
achieving more consistency between leadership campaigns for
destigmatization/individual resiliency and the practical demonstration
of greater resiliency and rehabilitation initiatives at the unit/
administrative level.
TMC recommends:
Increased efforts to promote the de-stigmatization on
all levels in service/unit administrative and strict
accountability programs with outlined and enforced consequences
to non-compliancy to ensure unit actions are consistent with
leadership pronouncements;
Continuing priority efforts to deliver information and
assistance on-line, confidential options for counseling and
uniformed access and availability to telemedicine services;
Substantial increases in outreach efforts to provide
such services and resources to Guard and Reserve members, rural
populations and all families who don't live near military or VA
facilities;
Priority efforts to educate private sector providers
on the unique needs of military and veteran patients and family
members, and deliver needed information via on-line services,
including contact points for discussion/consultation with
military and VA providers;
Consistent implementation of pre-and post-deployment
evaluations and follow-up programs, particularly for Guard and
Reserve members who may be leaving active duty;
Establishing common DOD and VA protocols for
diagnosis, treatment, and rehabilitation for TBI conditions, as
well as an electronic system to share and exchange a patient's
medical history and other key medical information;
Expanding Traumatic Servicemember Group Life Insurance
(TSGLI) criteria to include moderate and severe TBI, without
onerous ``functions of daily living'' standards that aren't
required for other (and often much more functional) TSGLI-
eligibles;
Increasing availability and outreach on substance
abuse counseling options;
Pursuing aggressive medication reconciliation and
management programs to protect against inadvertent over
medication and adverse reactions and/or accidental or
intentional overdose;
Requiring TBI and psychological health assessments for
members who have been deployed to a combat zone as part of the
disciplinary process prior to a decision concerning non-medical
separation; and
Implementing recommendations from the 2008 RAND report
(``Invisible Wounds of War, Psychological and Cognitive
Injuries, Their Consequences, and Services to Assist
Recovery'').
DOD-VA Disability Evaluation Systems (DES)
Several recommendations made by various commissions, task forces
and committees were addressed in the National Defense Authorization
Acts for Fiscal Year 2008, 2009, and 2010; however, more needs to be
done.
One of the most emotional issues that emerged from the Walter Reed
scandal was the finding that Services were ``low-balling'' disabled
servicemembers' disability ratings, with the result that many
significantly disabled members were being separated and turned over to
the VA rather than being medically retired (which requires a 30 percent
or higher disability rating).
Encouraging rhetoric was heard from leadership in both the DOD and
VA that this would be addressed by having DOD accept the (usually
higher) disability ratings awarded by the VA.
Congress has taken positive steps to correct previous ``low-ball''
ratings and streamline the DES. Congress created the Physical
Disability Board of Review (PDBR) to give previously separated
servicemembers an opportunity to appeal their ``low-balled'' disability
rating.
They also authorized a jointly executed DOD-VA DES pilot in the
2008 NDAA, and feedback from members and families who participated in
the pilot program is that it has simplified the process and provided a
more standardized disability rating outcome.
TMC was further encouraged that wounded, ill, and injured members
would benefit from the 19 Dec 07 Under Secretary of Defense (Personnel
and Readiness) Directive Type Memorandum (DTM) which added
``deployability'' as a consideration in the DES decision process--
permitting medical separation/retirement based on a medical condition
that renders a member nondeployable.
Unfortunately, several cases have surfaced indicating the Services
have failed to incorporate the DTM in their DES process.
In this regard, the services continue to issue findings that a
member is ``fit, but unsuitable'' for service. Under this system, a
member found ``fit'' by the PEB, is deemed by the service to be
``unsuitable'' for continued service--and administratively separated--
because the member's medical condition prevents them from being able to
deploy or maintain their current occupational skill.
The Coalition believes strongly that medical conditions which
preclude servicemembers from continuing to serve should be deemed
``unfitting''--not ``unsuitable.''
In addition, we remain concerned about language used by some
indicating a wish to remove DOD from the DES process (i.e., DOD
determines fitness and VA determines disability). This simplified
process could result in neglect of DOD's employer responsibilities,
such as TRICARE eligibility for disabled members and their families.
The Coalition believes strongly that members determined by parent
service to be 30 percent or more disabled should continue to be
eligible for a military disability retirement with all attendant
benefits, including lifetime TRICARE eligibility for the member and
his/her family. We do not support efforts to disconnect health care
eligibility from disability retired pay eligibility. The Coalition also
agrees with the opinion expressed by Secretary Gates that a member
forced from service for wartime injuries should not be separated, but
should be awarded a high enough rating to be retired for disability.
TMC recommends:
Barring ``fit, but unsuitable'' separations when a
member's medical condition prevents continued service;
Authorizing automatic enrollment in the VA health care
system for any medically separated or medically retired
servicemember (Chapter 61);
Ending distinctions between disabilities incurred in
combat vice non-combat;
Monitoring the effectiveness of recent DOD
compensation for catastrophically injured or ill servicemembers
requiring assistance with activities of daily living authorized
in the 2010 NDAA;
Ensuring benefits afforded members wounded, ill, or
disabled in the line of duty are applied equally for all
uniformed services;
Ensuring that the VA is the single authority for
rating service-connected disabilities for military disability
retirements and separations;
Preserving the statutory 30 percent disability
threshold for medical retirement and lifetime TRICARE coverage
for members injured while on active duty;
Continued monitoring of Service/DOD Medical-Physical
Evaluation Boards, DOD DES Pilot Project, and the Physical
Disability Board of Review, to assess needed DES changes;
Eliminating member premiums for Traumatic
Servicemember Group Life Insurance (TSGLI);
Barring ``pre-existing condition'' determinations for
any member who deploys to a combat zone;
Ensuring that any adjustment to the disability
retirement system does not result in a member receiving less
disability retired pay than he or she would receive under the
current system; and
Ensuring that members electing accelerated disability
retirement/separation are fully counseled on any possible
negative changes in compensation, health care and other
benefits, with consideration to allowing a limited time to
reverse a regrettable decision.
Caregiver/Family Support Services
The sad reality is that, for the most severely injured
servicemembers, family members or other loved ones are often required
to become full-time caregivers. Many have lost their jobs, homes, and
savings in order to meet caregiver needs of a servicemember who has
become incapacitated due to service-caused wounds, injuries or illness.
The Coalition believes the government has an obligation to provide
reasonable compensation and training for such caregivers, who ever
dreamed that their own well-being, careers, and futures would be
devastated by military-caused injuries to their servicemembers.
Last year, the subcommittee authorized a special payment to an
active duty servicemember to allow compensation of a family member or
professional caregiver. The authorized payment was in the same amount
authorized by the VA for veterans' aid-and-attendance needs, reflecting
the subcommittee's thinking that caregiver compensation should be
seamless when the member transitions from active duty to VA care, as
long as the caregiver requirements remain the same.
The Coalition supported this initiative, but recognizes that both
chambers have since approved legislation to authorize more significant
VA assistance and compensation for caregivers.
Once the House and Senate versions of the VA caregiver legislation
have been reconciled in conference, the Coalition hopes the
subcommittee will propose similar upgrades for caregivers of members
while on active duty, consistent with the ``seamless transition''
philosophy adopted last year.
In a similar vein, many wounded or otherwise-disabled members
experience significant difficulty transitioning to medical retirement
status. To assist in this process, consideration should be given to
authorizing medically retired members and their families to remain in
on-base housing for up to 1 year after retirement, in the same way that
families are allowed to do so when a member dies on active duty.
The Coalition recommends:
Upgraded compensation and assistance for caregivers of
severely disabled active duty members, consistent with pending
legislative action to improve compensation/assistance for
caregivers of veterans; and
Authorizing up to 1 year of continued residence in on-
base housing facilities for medically retired, severely wounded
servicemembers and their families.
active forces and their families
In our overview, the Coalition expressed our collective concern
over the stressors our servicemembers and their families are
experiencing due to the long, repeated deployments and unrelenting
operations tempo. In order to sustain a sufficient, highly trained and
highly capable Active Force, the continuing overriding requirement is
to find additional ways to ease the terrible burden of stress on
servicemembers and their families.
Military End Strength
Increased end strength is the only effective way to reduce stress
on forces and families as long as deployment requirements not only
continue, but actually increase.
The creators of the All-Volunteer Force never envisioned that the
force would be deployed into combat 1 year out of 3--let alone every
other year, as has been the case with many ground units.
Regrettably, the scenario faced by today's forces is not unlike the
World War II ``Catch-22'' situation described by Joseph Heller, in
which aircrews braving horrendous enemy flak had their wartime mission
requirements increased again and again, until they perceived that the
terrible sacrifices being demanded of them would never end.
Unfortunately, many in government and among the public seem to have
become desensitized to the truly terrible sacrifices that the current
mismatch between missions and force levels has already imposed on those
in uniform. They acknowledge the problem, but most assume that
servicemembers and families will simply continue to accept these--or
even greater--levels of sacrifice indefinitely.
Many point to the achievement of service recruiting and retention
goals as indicators that all is well.
Such perceptions grossly underestimate the current stresses on the
force and the risk that poses for readiness and national security. The
Coalition believes any complacency about retention is sadly misplaced,
and that the status of the current force should be viewed in the
context of a rubber band that has been stretched to its limit. The fact
that it has not yet broken is of little comfort.
Well-respected studies have shown that 20 to 30 percent of combat
returnees have experienced PTSD, TBI, or depression, and that the
likelihood of a servicemember returning as a changed person rises with
each subsequent deployment. Other studies have shown that rising
cumulative family separations are having significant negative effects
on servicemembers' children.
These are not mere academic exercises. They are well-known facts of
life to those who are alone in actually experiencing them.
A far truer, and truly tragic, indicator of these extremely
troubling circumstances has been the significant rise in
servicemembers' suicide and divorce rates.
So the Coalition is very grateful for the subcommittee's support
for end strength increases for all Services in the National Defense
Authorization Act for Fiscal Year 2010, and for fending off the efforts
of those who proposed cutting force levels to fund hardware needs.
But we must not understate the reality that the increases approved
to date will not significantly improve dwell time for military families
anytime in the near future, given increasing operational requirements
in Afghanistan.
New requirements for massive humanitarian aid in Haiti and
elsewhere only exacerbate the already grievous situation.
The Coalition is relieved that the administration is requesting an
increase to the overall defense budget by $100 billion over the next 5
years--we just hope it's enough.
The Coalition urges the subcommittee to:
Continue end strength growth as needed to sustain the
war and other operational commitments while materially
increasing dwell time for servicemembers and families;
Sustain adequate recruiting and retention resources to
enable the uniformed services to achieve required optimum-
quality personnel strength; and
Seek a 2011 defense budget of at least 5 percent of
Gross Domestic Product that funds both people and weapons
needs.
Military Pay Raise
The Coalition thanks the subcommittee for its sustained commitment
to restoring full military pay comparability--a fundamental
underpinning of the All-Volunteer Force.
To that end, we are grateful for the committee's leadership in
approving a 3.4 percent military pay raise for 2010--vs. the 2.9
percent proposed in the defense budget submission.
Throughout the 1980s and 1990s, military pay raises consistently
were capped below private sector pay growth, causing a ``pay
comparability gap'' that reached 13.5 percent in 1998-1999, and
contributed significantly to serious retention problems.
Every year since then, the subcommittee has acted to pare the gap
by approving military raises that have been at least .5 percent above
private sector pay growth.
Now that significant progress has been made and the ``erosion of
pay and benefits'' retention-related problems have abated, some have
renewed calls to cut back on military raises, create a new
comparability standard, or substitute more bonuses for pay raises in
the interests of ``efficiency.''
The Defense Department has proposed a new comparability standard
under which each pay and longevity cell would represent the 70th
percentile of compensation for similarly-educated civilians. A recent
Congressional Budget Office report asserted that, considering
adjustments in housing allowances, military people actually are paid 10
percent more than their civilian counterparts in terms of Regular
Military Compensation (RMC), composed of basic pay, food and housing
allowances, and the tax advantage that accrues because the allowances
are tax-free.
The Coalition believes such assertions are fundamentally flawed.
First, the RMC concept was developed in the 1960s, when all
servicemembers received the same allowances, regardless of location,
and the allowances were arbitrary figures that weren't actually based
on anything. In the interim, Congress has transformed the allowances
into reimbursements for actual food costs and median locality-based
housing costs.
If one were to use the RMC comparability methodology in this
scenario, basic pay--the largest element of military pay and the one
that drives retired pay--would become ``flex'' compensation element.
With tax rates and allowances figures set independently, a year in
which average housing allowances rose (e.g., based on growth in high-
cost areas) and taxes increased could actually yield a requirement to
cut basic pay (and future retirement value) to restore
``comparability.''
Second, the Coalition is not convinced that the civilian comparison
cohort or percentile comparison point proposed by DOD are the proper
ones, given that the military:
Recruits from the top half of the civilian aptitude
population;
Finds that only about 25 percent of America's youth
qualify for entry;
Requires career-long education and training
advancement;
Enforces a competitive ``up-or-out'' promotion system;
and
Imposes severe limits on personal freedoms (e.g., not
being able to quit when you want; risking a felony conviction
for refusing an order).
A fundamental requirement for any pay comparability standard is
that it should be transparent and understandable. The Coalition has
asked for, but has never been provided by DOD, any data on what
civilian comparison cohort was selected and why, and what rationale was
used to establish a specific percentile comparison point.
Third, the Coalition believes it is essential to recognize that
compensation is not simply the amount one is paid. It is pay divided by
what's required of the recipient to earn that pay. If we increase pay
25 percent but require 100 percent more sacrifice to earn it, that's
not a pay raise.
In that context, today's conditions of service are far more arduous
than anything envisioned 40 years ago by the creators of the All-
Volunteer Force, who believed a protracted war would require
reinstitution of the draft.
Finally, private sector pay growth between 2008 and 2009 would set
the military pay raise for 2011 at 1.4 percent--the smallest military
pay raise in almost 50 years, even while servicemembers are being asked
to endure the most arduous service conditions in more than 60 years.
Further, the Coalition observes that there is a lag of more than a year
between the time the civilian pay growth is measured and the time it is
applied to the military.
The Coalition agrees with the approach the subcommittee has taken
consistently -that the best comparability measure is a comparison of
the military basic pay raise percentage with the percentage growth in
the ECI.
The government uses the ECI for every other measure of private pay
growth, and it's very transparent to government leaders and
servicemembers alike. As of 2010, cumulative military basic pay
increases lag cumulative private sector pay growth by 2.4 percent since
1982--the last time it was generally agreed that a state of
comparability existed.
Given the historic low raise produced by the ECI for 2011, the
historic sacrifices being asked of servicemembers in this time of
protracted war, and the dubious rationale for alternative pay raise
proposals, any assertion that military people are overpaid is grossly
off the mark.
The Coalition believes a basic pay raise of at least 1.9
percent--.5 percent above the ECI standard--is the bare minimum the
Nation should do to sustain its military pay comparability commitment
for 2011.
Family Readiness and Support
A fully funded, robust family readiness program continues to be
crucial to overall readiness of our military, especially with the
demands of frequent and extended deployments.
Resource issues continue to plague basic installation support
programs. At a time when families are dealing with increased
deployments, they often are being asked to do without in other
important areas. We are grateful that the subcommittee included a
provision in last year's defense bill that will help improve family
readiness and support though greater outreach. The Department's
establishment of a comprehensive benefits web site for servicemembers
and their families will help provide virtual assistance regardless of
their physical proximity to installation-supported networks.
Additionally, we could not agree more with last year's ``Sense of
Congress'' regarding the establishment of flexible spending accounts
(FSAs) for members of the uniformed services. We urge the subcommittee
to continue to press the Defense Department until servicemembers are
provided the same eligibility to participate in FSAs that all other
Federal employees enjoy.
Quality education is a top priority to military families.
Servicemembers are assigned all across the United States and the world.
Providing appropriate and timely funding of Impact Aid through the
Department of Education is critical to ensuring quality education
military children deserve, regardless of where they live.
The Coalition believes that several initiatives could have
unintended negative consequences on school facility needs and
educational programs affecting military children. Service
transformation, overseas rebasing initiatives, housing privatization,
base realignment and closure actions all have the potential to affect
the military family and their access to quality education programs.
The Coalition recommends that the subcommittee:
Press DOD to assess the effectiveness of programs and
support mechanisms to assist military families with deployment
readiness, responsiveness, and reintegration;
Ensure that effective programs--including the Family
Readiness Council--are fully funded and their costs are
included in the annual budget process;
Provide authorization and funding to accelerate
increases in availability of child care to meet both Active and
Reserve component requirements;
Insist DOD implement flexible spending accounts to let
active duty and Selected Reserve families pay out-of-pocket
dependent and health care expenses with pre-tax dollars;
Monitor and continue to expand family access to mental
health counseling;
Promote expansion of military spouse opportunities to
further educational and career goals;
Ensure additional and timely funding of Impact Aid
plus continued DOD supplemental funding for highly-impacted
military schools; and
Mitigate the impact of Service transformation,
overseas rebasing initiatives, housing privatization and base
realignment on school facility needs and educational programs
affecting military children.
Permanent Change of Station (PCS) Allowances
It's an unfortunate fact that members and their families are forced
to incur significant out-of-pocket expenses when complying with
government-directed moves.
For example, the current Monetary Allowance in Lieu of
Transportation (MALT) rate used for PCS moves still fall significantly
short of meeting members' actual travel costs. The current rate of 24
cents per mile is less than half of the 50 cents per mile authorized
for temporary duty travel. Also, military members must make any advance
house-hunting trips at personal expense, without any government
reimbursements such as Federal civilians receive.
DOD states that the MALT rate was not intended to reimburse
servicemembers for travel by automobile, but simply a payment in lieu
of providing transportation in-kind.
The Coalition believes strongly that the MALT concept is an
outdated one, having been designed for a conscripted, single, non-
mobile force.
Travel reimbursements should be adjusted to reflect the reality
that today's all-volunteer servicemembers do, in fact, own cars and
that it is unreasonable not to reimburse them for the cost of driving
to their next duty stations in conjunction with PCS orders.
Simply put, PCS travel is no less government-ordered than is TDY
travel, and there is simply no justification for paying less than half
the TDY travel rate when personal vehicle use is virtually essential.
Additionally, the government should acknowledge that reassigning
married servicemembers within the United States (including overseas
locations) usually requires relocation of two personal vehicles. In
that regard, the overwhelming majority of service families consist of
two working spouses, making two privately owned vehicles a necessity.
Yet the military pays for shipment of only one vehicle on overseas
moves, including moves to Hawaii and Alaska, which forces relocating
families into large out-of-pocket expenses, either by shipping a second
vehicle at their own expense or selling one car before leaving the
States and buying another upon arrival.
At a minimum, the Coalition believes military families being
relocated to Alaska, Hawaii, and U.S. territories should be authorized
to ship a second personal vehicle, as the subcommittee has rightly
supported in the past.
The Coalition urges the subcommittee to continue its efforts to
upgrade permanent change-of-station allowances to better reflect
expenses imposed on servicemembers, with priority on:
Shipping a second vehicle on overseas accompanied
assignments;
Authorizing at least some reimbursement for house-
hunting trip expenses; and
Increasing PCS mileage rates to more accurately
reflect members' actual transportation costs.
Education Enhancements
The Post-September 11 GI Bill was a truly historic achievement that
will provide major long-term benefits for military people and for
America; however, the Coalition remains sensitive that transferability
of the benefit to family members was restricted to members of the
``Armed Forces.''
The Coalition believes all members of the uniformed services,
including commissioned officers of the U.S. Public Health Service and
NOAA Corps, should be able to transfer their benefit to family members.
All previous GI Bill provisions have applied equally to all uniformed
services, and the Post-September 11 GI Bill should not be an exception.
The Coalition urges the subcommittee to support amending the
statute to authorize all otherwise-qualifying members of the
``uniformed services'' to transfer Post-September 11 GI Bill benefits
to family members.
Morale, Welfare, and Recreation (MWR) and Quality of Life (QoL)
Programs
MWR activities and QoL programs have become ever more critical in
helping servicemembers and their families cope with the extended
deployments and constant changes going on in the force.
The availability of appropriated funds to support MWR activities is
an area of continuing concern for the Coalition. We are especially
apprehensive that additional reductions in funding or support services
may occur due to slow economic recovery and record budget deficits.
BRAC actions pose an additional concern as DOD is struggling to
meet the 2011 deadline at many BRAC locations. Two reports issued by
the Government Accountability Office indicate significant challenges
remain in areas of funding, facilities, and overall management.
The Coalition is very concerned whether needed infrastructure and
support programs will be in place in time to meet families' needs.
TMC urges the subcommittee to:
Protect funding for critical family support and QoL
programs and services to meet the emerging needs of
beneficiaries and the timelines of the Services' transformation
plans;
Oppose any initiative to withhold or reduce
appropriated support for family support and QoL programs to
include: recreation facilities, child care, exchanges and
commissaries, housing, health care, education, family centers,
and other traditional and innovative support services;
Prevent any attempts to consolidate or civilianize
military service exchange and commissary programs; and
Sustain funding for support services and
infrastructure at both closing and gaining installations
throughout the entire transformation process, including
exchange, commissary and TRICARE programs.
national guard and reserve
Over 142,000 Guard and Reserve service men and women members are
serving on active duty.
Since September 11, 2001, more than 752,000 Guard and Reserve
service men and women have been called up, including well over 200,000
who have served multiple tours. There is no precedent in American
history for this sustained reliance on citizen-soldiers and their
families. To their credit, Guard and Reserve combat veterans continue
to reenlist, but the current pace of routine, recurring deployments
cannot be sustained indefinitely.
Guard and Reserve members and families face unique challenges in
their readjustment following active duty service. Unlike active duty
personnel, many Guard and Reserve members return to employers who
question their contributions in the civilian workplace, especially as
multiple deployments have become the norm. Many Guard-Reserve troops
return with varying degrees of combat-related injuries and stress
disorders, and encounter additional difficulties after they return that
can cost them their jobs, careers and families.
Despite the continuing efforts of the Services and Congress, most
Guard and Reserve families do not have access to the same level of
counseling and support that active duty members have. In short, the
Reserve components face increasing challenges virtually across the
board, including major equipment shortages, end-strength requirements,
wounded-warrior health care, and pre- and post-deployment assistance
and counseling.
Operational Reserve Retention and Retirement Reform
Congress took the first step in modernizing the Reserve
compensation system with enactment of early retirement eligibility for
certain reservists activated for at least 90 continuous days served
since January 28, 2008. This change validates the principle that
compensation should keep pace with service expectations and work as an
inducement to retention and sustainment of the Operational Reserve
Force.
Guard/Reserve mission increases and a smaller Active-Duty Force
mean Guard/Reserve members must devote a much more substantial portion
of their working lives to military service than ever envisioned when
the current retirement system was developed in 1948.
Repeated, extended activations make it more difficult to sustain a
full civilian career and impede reservists' ability to build a full
civilian retirement, 401(k), etc. Regardless of statutory protections,
periodic long-term absences from the civilian workplace can only limit
Guard/Reserve members' upward mobility, employability and financial
security. Further, strengthening the Reserve retirement system will
serve as an incentive to retaining critical mid-career officers and
NCOs for continued service and thereby enhance readiness.
As a minimum, the next step in modernizing the Reserve retirement
system is to provide equal retirement-age-reduction credit for all
activated service rendered since September 11, 2001. The current law
that credits only active service since January 28, 2008 disenfranchises
and devalues the service of hundreds of thousands of Guard/Reserve
members who served combat tours (multiple tours, in thousands of cases)
between 2001 and 2008.
The statute also must be amended to eliminate the inequity inherent
in the current fiscal year retirement calculation, which only credits
90 days of active service for early retirement purposes if it occurs
within the same fiscal year. The current rule significantly penalizes
members who deploy in July or August vs. those deploying earlier in the
fiscal year.
It is patently unfair, as the current law requires, to give 3
months retirement age credit for a 90-day tour served from January
through March, but only half credit for a 120-day tour served from
August through November (because the latter covers 60 days in each of 2
fiscal years).
For the near term, the Military Coalition places particular
priority on authorizing early retirement credit for all qualifying
post-September 11 active duty service performed by Guard/Reserve
servicemembers and eliminating the fiscal-year-specific accumulator
that bars equal credit for members deploying for equal periods during
different months of the year.
Ultimately, TMC believes we must move forward to provide a reduced
age entitlement for retired pay and health coverage for all Reserve
component members--that is, an age/service formula or outright
eligibility, if otherwise qualified, at age 55.
Further, TMC urges repeal of the annual cap of 130 days of inactive
duty training points that may be credited towards a Reserve retirement.
Guard and Reserve Yellow Ribbon Readjustment
Congress has provided increased resources to support the transition
of warrior-citizens back into the community. But program execution
remains spotty from State to State and falls short for returning
Federal Reserve warriors in widely dispersed regional commands.
Military and civilian leaders at all levels must improve the
coordination and delivery of services for the entire Operational
Reserve Force. Many communities are eager to support and many do that
well. But, yellow ribbon efforts in a number of locations amount to
little more than PowerPoint slides and little or no actual
implementation.
TMC is grateful for the subcommittee's attention to this issue and
for including reporting requirements on progress in the National
Defense Authorization Act for Fiscal Year 2010.
Making Yellow Ribbon work effectively is a major Coalition
priority, and our hope is that the NDAA-required reports will point the
way for further subcommittee action in this important area.
TMC urges the subcommittee to hold oversight hearings and to direct
additional improvements in coordination, collaboration, and consistency
of Yellow Ribbon services. DOD must ensure that State-level best
practices--such as those in Maryland, Minnesota and New Hampshire--are
applied for all Operational Reserve Force members and their families,
and that Federal Reserve veterans have equal access to services and
support available to National Guard veterans. Community groups,
employers, and service organization efforts need to be encouraged and
better coordinated to supplement unit, component, Service and VA
outreach and services.
Guard/Reserve GI Bill
TMC is grateful to Congress for inclusion of a critical ``earn as
you serve'' principle in the new Post-September 11 GI Bill, which
allows operational reservists to accrue educational benefits for each
aggregate call-up of 90 days or more active duty. Inexplicably,
however, active duty members of the National Guard serving under Title
32 orders were not included in the new program despite their critical
role in homeland defense, counter-drug, border control, and other
missions.
TMC urges the subcommittee to work with the Veterans Affairs
Committee to include Title 32 AGRs in the Post-September 11 statute.
TMC's longstanding recommendation of coordinating and integrating
various educational benefit programs has been made more challenging
with the Post-September 11 GI Bill.
For example, benefits for initially joining the Guard or Reserve as
authorized in Chapter 1606, 10 U.S.C. continue to decline in proportion
to the active duty Montgomery GI Bill (Chap. 30, 38 U.S.C.) and the new
Post-September 11 GI Bill. Reserve MGIB benefit levels have slid to 24
percent of the active duty MGIB benefit, compared to 47-50 percent
during the first 15 years of the program. Restoration of the original
ratio would raise basic Reserve rates from the current $333 per month
to $643-$684 per month for full-time study.
TMC maintains that restoring the ratio is not only a matter of
equity, but essential to long-term success of Guard and Reserve
recruiting programs.
Based on the DOD/Services' 10-year record of indifference to the
basic Selected Reserve GI Bill under Chapter 1606, 10 U.S.C., TMC
recommends either: restoring Reserve benefits to 47-50 percent of
active duty benefits or transferring the Chapter 1606 statute from
title 10 to title 38 so that it can be coordinated with other
educational benefits programs in a 21st century GI Bill architecture.
TMC also supports assured academic reinstatement, including guaranteed
re-enrollment, for returning operational reservists.
Special and Incentive Pays
Increased reliance on Guard and Reserve Forces to perform active
duty missions has highlighted differentials and inconsistencies between
treatment of active duty vs. Guard and Reserve members on a range of
special and incentive pays. Congress has acted to address some of these
disparities, but more work is needed.
The Coalition urges the subcommittee to ensure equitable treatment
of Guard and Reserve vs. Active Duty members for the full range of
special and incentive pays.
retiree issues
The Military Coalition remains grateful to the subcommittee for its
support of maintaining a strong military retirement system to help
offset the extraordinary demands and sacrifices inherent in a career of
uniformed service.
Concurrent Receipt
In the NDAA for Fiscal Year 2003 and Fiscal Year 2004, Congress
acknowledged the inequity of the disability offset to earned retired
pay and established a process to end or phase out the offset for many
disabled retirees. The Coalition is extremely grateful with the
subcommittee's efforts to continue progress in easing the adverse
effects of the offset.
Last year we were very optimistic that another very deserving group
of disabled retirees would become eligible for concurrent receipt when
the White House included a concurrent receipt proposal in the Budget
Resolution--the first time in history any administration had ever
proposed such a fix.
The administration's proposal, again submitted in this year's
budget, would expand concurrent receipt eligibility over a 5 year
period to all those forced to retire early from Service due to a
disability, injury, or illness that was service-connected (chapter 61
retirees).
Thanks to the strong support of Armed Services Committee leaders,
the proposal was included in the House version of the NDAA for Fiscal
Year 2010. The Coalition was dismayed that, despite your leadership
efforts and White House support, the provision failed to survive
conference--an extremely disappointing outcome for a most deserving
group of disabled retirees.
Our fervent hope is that the subcommittee will redouble its efforts
to authorize this initiative for fiscal year 2011.
Additionally, the Coalition is concerned that an inadvertent
problem exists in the statutory Combat-Related Special Compensation
(CRSC) computation formula causes many seriously disabled and clearly
eligible members to receive little or nothing in the way of CRSC. The
Defense Department has acknowledged the problem in discussions with the
subcommittee staff, and the Coalition urges the subcommittee to correct
this technical problem.
The Coalition believes strongly in the principle that career
military members earn their retired pay by service alone, and that
those unfortunate enough to suffer a service-caused disability in the
process should have any VA disability compensation from the VA added
to, not subtracted from their service-earned military retired pay and
this remains a key goal in 2010--regardless of years of service or
severity of their disability rating.
The Coalition's continuing goal is to fully eliminate the deduction
of VA disability compensation from earned military retired pay for all
disabled retirees. In pursuit of that goal, the Coalition's immediate
priorities include:
Phasing out the disability offset for all Chapter 61
(medical) retirees; and
Correcting the CRSC formula to ensure the intended
compensation is delivered.
Proposed Military Retirement Changes
The Coalition remains concerned that as budgets get tighter and
calls to establish a new entitlement or debt-reduction commission grow
louder, the military retirement system may come under greater scrutiny
to seek savings or ``efficiencies.''
Our concern is based on past experience that seeking to wring
savings from military retirement programs poses a significant threat to
long-term retention and readiness by decreasing the attractiveness of
serving for 2 or 3 decades in uniform, with all of the extraordinary
demands and sacrifice inherent in such extended career service.
For example, the Coalition is very concerned that proposals to
``civilianize'' military retirement benefits, such as the changes
recommended by the 10th Quadrennial Review of Military Compensation
(QRMC) fail utterly to recognize the fundamental purpose of the
military retirement system in offsetting service conditions that are
radically more severe than those experienced by the civilian workforce.
The QRMC proposed converting the military retirement system to a
civilian-style plan under which full retired pay wouldn't be paid until
age 57-60; vesting retirement benefits after 10 years of service; and
using flexible ``gate pays'' and separation pay at certain points of
service to encourage continued service in certain age groups or skills
and encourage others to leave, depending on service needs for certain
kinds of people at the time.
Reduced to its essence, this admittedly cost-neutral plan would
take money from people who stay for a career in order to pay additional
benefits to those who leave the military short of a career.
If this system were in place today, a 10-year infantryman facing
his or her fourth combat tour would be offered a choice between: (a)
allowing immediate departure with a vested retirement; vs. (b)
continuing under current service conditions for another 10-20 years and
having to wait until age 58 for immediate retired pay.
The Coalition believes strongly that, if such a system existed for
today's force under today's service conditions, the military services
would already be mired in a deep and traumatic retention crisis.
Further, the QRMC proposal is so complicated that people evaluating
career decisions at the 4- to 10-year point would have no way to
project their future military retirement benefits. Gate pays available
at the beginning of a career could be cut back radically if the force
happened to be undergoing a strength reduction later in a member's
career.
In contrast, the current military retirement system makes it very
clear from the pay table what level of retired pay would be payable,
depending how long one served and how well one progressed in grade.
The sustained drawing power of the 20-year retirement system
provides an essential long-term moderating influence that keeps force
managers from over-reacting to short-term circumstances. Had force
planners had such a system in effect during the drawdown-oriented
1990s, the Services would have been far less prepared for the post-
September 11 wartime environment.
Many such proposals have been offered in the past, and have been
discarded for good reasons. The only initiative to substantially
curtail/delay military retired pay that was enacted--the 1986 REDUX
plan--and only a remnant remain as the mandatory REDUX was scrapped 13
years later after it began inhibiting retention.
The only remnant that remains--and has been in place unchanged
since 1999--is a voluntary program known as the Career Status Bonus--a
$30,000 ``bonus'' bait and switch--where the servicemember can receive
$30,000 at their 15 year point as long as they accept REDUX.
That ``bonus'' was a bad deal at the time and it gets worse with
every passing year as pay (and retired pay) increases.
After taxes, the so-called bonus is more like $22,000 or $23,000.
To get that, the typical NCO who retires with 20 years of service must
agree to sacrifice more than $300,000 in future retired pay (those who
live longer than average sacrifice far more). That's how much less
REDUX is worth compared to the normal system.
TMC urges the subcommittee to:
Reject any initiatives to ``civilianize'' the military
system without adequate consideration of the unique and
extraordinary demands and sacrifices inherent in a military vs.
a civilian career; and
Eliminate the Career Status Bonus for servicemembers
as it significantly devalues their retirement over time. In the
short term, the Services should be required to better educate
eligible members on the severe long-term financial penalty
inherent in accepting the REDUX option.
Disability Severance Pay
The Coalition is grateful for the subcommittee's inclusion of a
provision in the NDAA for Fiscal Year 2008 that ended the VA
compensation offset of a servicemember's disability severance for
people injured in the combat zone.
However, we are concerned that the language of this provision
imposes much stricter eligibility than that used for Combat-Related
Special Compensation.
The Coalition urges the subcommittee to amend the eligibility rules
for disability severance pay to include all combat--or operations--
related injuries, using same definition as CRSC. For the longer term,
the Coalition believes the offset should be ended for all members
separated for service-caused disabilities.
Former Spouse Issues
For nearly a decade the recommendations of the Defense Department's
September 2001 report to Congress on the Uniformed Services Former
Spouse Protection Act (USFSPA) have gone nowhere. For several years,
DOD submitted many of the report's recommendations annually to Congress
only to have one or two supported by the subcommittee while many others
were dropped.
The USFSPA is a very emotional topic with two distinct sides to the
issue--just as any divorce has two distinct parties affected. The
Coalition believes strongly that there are several inequities in the
act that need to be addressed and corrected that could benefit both
affected parties--the servicemember and the former spouse.
But in order to make progress, we believe Congress cannot piecemeal
DOD's recommendations. We support a collective grouping of legislation
that would provide benefit to both affected parties. Absent this
approach, the legislation will be perceived as supporting one party
over the other and go nowhere.
To fairly address the problems with the act, all affected parties
need to be heard--and the Coalition would greatly appreciate the
opportunity to address the inequities in a hearing before the
subcommittee.
The Coalition requests a hearing to address USFSPA inequities. In
addition, we recommend legislation to include all of the following:
Base the award amount to the former spouse on the
grade and years of service of the member at time of divorce
(and not retirement);
Prohibit the award of imputed income, which
effectively forces active duty members into retirement;
Extend 20/20/20 benefits to 20/20/15 former spouses;
Permit the designation of multiple Survivor Benefit
Plan (SBP) beneficiaries with the presumption that SBP benefits
must be proportionate to the allocation of retired pay;
Eliminate the ``10-year Rule'' for the direct payment
of retired pay allocations by the Defense Finance and
Accounting Service (DFAS);
Permit SBP premiums to be withheld from the former
spouse's share of retired pay if directed by court order;
Permit a former spouse to waive SBP coverage;
Repeal the 1-year deemed election requirement for SBP;
and
Assist the DOD and Services with greater outreach and
expanded awareness to members and former spouses of their
rights, responsibilities, and benefits upon divorce.
survivor issues
The Coalition is grateful to the subcommittee for its significant
efforts in recent years to improve the Survivor Benefit Plan (SBP),
especially its major achievement in eliminating the significant benefit
reduction previously experienced by SBP survivors upon attaining age
62.
SBP-DIC Offset
The Coalition believes strongly that current law is unfair in
reducing military SBP annuities by the amount of any survivor benefits
payable from the DIC program.
If the surviving spouse of a retiree who dies of a service-
connected cause is entitled to DIC from the Department of Veterans
Affairs and if the retiree was also enrolled in SBP, the surviving
spouse's SBP annuity is reduced by the amount of DIC. A pro-rata share
of the SBP premiums is refunded to the widow upon the member's death in
a lump sum, but with no interest. This offset also affects all
survivors of members who are killed on active duty.
The Coalition believes SBP and DIC payments are paid for different
reasons. SBP is insurance purchased by the retiree and is intended to
provide a portion of retired pay to the survivor. DIC is a special
indemnity compensation paid to the survivor when a member's service
causes his or her premature death. In such cases, the VA indemnity
compensation should be added to the SBP annuity the retiree paid for,
not substituted for it.
It should be noted as a matter of equity that surviving spouses of
Federal civilian retirees who are disabled veterans and die of
military-service-connected causes can receive DIC without losing any of
their Federal civilian SBP benefits.
The reality is that, in every SBP-DIC case, active duty or retired,
the true premium extracted by the Service from both the member and the
survivor was the ultimate one--the very life of the member. This
reality was underscored by the August 2009 Federal Court of Appeals
ruling in Sharp v. U.S. which found ``After all the servicemember paid
for both benefits: SBP with premiums; DIC with his life.''
The Veterans Disability Benefits Commission (VDBC) was tasked to
review the SBP-DIC issue, among other DOD/VA benefit topics. The VDBC's
final report to Congress agreed with the Coalition in finding that the
offset is inappropriate and should be eliminated.
In 2005, Speaker Pelosi and all House leaders made repeal of the
SBP-DIC offset a centerpiece of their GI Bill of Rights for the 21st
Century. Leadership has made great progress in delivering on other
elements of that plan, but the only progress to date on the SBP-DIC
offset has been the enactment a small monthly Special Survivor
Indemnity Allowance (SSIA).
The Coalition recognizes that the subcommittee's initiative in the
fiscal year 2008 defense bill to establish a special survivor indemnity
allowance (SSIA) was intended as a first, admittedly very modest, step
in a longer-term effort to phase out the Dependency and Indemnity
Compensation (DIC) offset to SBP.
We appreciate the subcommittee's subsequent work to extend the SSIA
to survivors of members who died while on active duty in the NDAA for
Fiscal Year 2009, as well as its good-faith effort to provide a
substantial increase in SSIA payments as part of the Family Smoking
Prevention and Tobacco Control Act.
The Coalition was extremely disappointed that the final version of
that legislation greatly diluted the House-passed provision and
authorized only very modest increases several years in the future.
While fully acknowledging the subcommittee's and full committee's
good-faith efforts to win more substantive progress, the Coalition
shares the extreme disappointment and sense of abandonment of the SBP-
DIC widows who are being forced to sacrifice up to $1,110 each month
and being asked to be satisfied with a $60 monthly rebate.
For years, legislative leaders touted elimination of this ``widow's
tax'' as a top priority. The Coalition understands the mandatory-
spending constraints the subcommittee has faced in seeking redress, but
also points out that those constraints have been waived for many, many
far more expensive initiatives. The Coalition believes widows whose
sponsors' deaths were caused by military service should not be last in
line for redress.
The Coalition urges repeal of the SBP-DIC offset. TMC further
recommends:
Authorizing payment of SBP annuities for disabled
survivors into a Special Needs Trust; (Certain permanently
disabled survivors can lose eligibility for Supplemental
Security Income (SSI) and Medicaid and access to means-tested
State programs because of receipt of SBP. This initiative is
essential to put disabled SBP annuitants on an equal footing
with other SSI/Medicaid-eligibles who have use of special needs
trusts to protect disabled survivors.)
Allowing SBP eligibility to switch to children if a
surviving spouse is convicted of complicity in the member's
death; and
Reinstating SBP for survivors who previously
transferred payments to their children at such time as the
youngest child attains majority, or upon termination of a
second or subsequent marriage.
Final Retired Pay Check
Under current law, DFAS recoups from military widows' bank accounts
all retired pay for the month in which a retiree dies. Subsequently,
DFAS pays the survivor a pro-rated amount for the number of days of
that month in which the retiree was alive. This often creates hardships
for survivors who have already spent that pay on rent, food, etc., and
who routinely are required to wait several months for DFAS to start
paying SBP benefits.
The Coalition believes this is an extremely insensitive policy
imposed by the government at the most traumatic time for a deceased
member's next of kin. Unlike his or her active duty counterpart, a
retiree's survivor receives no death gratuity. Many older retirees do
not have adequate insurance to provide even a moderate financial
cushion for surviving spouses.
The VA is required by law to make full payment of the final month's
VA disability compensation to the survivor of a disabled veteran. The
disparity between DOD and VA policy on this matter is simply
indefensible. Congress should do for retirees' widows the same thing it
did 10 years ago to protect veterans' widows.
TMC urges the subcommittee to authorize survivors of retired
members to retain the final month's retired pay for the month in which
the retiree dies.
health care issues
The Coalition appreciates the subcommittee's strong and continuing
interest in keeping health care commitments to military beneficiaries.
We are particularly grateful for your support for the last few years in
refusing to allow the Department of Defense to implement
disproportional beneficiary health care fee increases.
The Coalition is encouraged that the current administration so far
has declined to pursue such increases, but has worked to reestablish a
mutually constructive dialogue with beneficiary representatives.
The unique package of military retirement benefits--of which a key
component is a top-of-the-line health care benefit--is the primary
offset afforded uniformed servicemembers for enduring a career of
unique and extraordinary sacrifices that few Americans are willing to
accept for 1 year, let alone 20 or 30. It is an unusual, and essential,
compensation package that a grateful Nation provides for a relatively
small fraction of the U.S. population who agree to subordinate their
personal and family lives to protecting our national interests for so
many years. This sacrifice, in a very real sense, constitutes a pre
paid premium for their future healthcare.
Defense Health Program Cost Requirements
The Coalition is grateful for the subcommittee's support for
maintaining--and expanding where needed--the healthcare benefit for all
military beneficiaries and especially for the Guard, Reserve, and
military children, consistent with the demands imposed upon them.
It's true that many private sector employers are choosing to shift
an ever-greater share of health care costs to their employees and
retirees, and that's causing many still-working military retirees to
fall back on their service-earned TRICARE coverage. Fallout from the
recent economic recession is likely to reinforce this trend.
In the bottom-line-oriented corporate world, many firms see their
employees as another form of capital, from which maximum utility is to
be extracted at minimum cost, and those who quit are replaceable by
similarly experienced new hires. But that can't be the culture in the
military's closed, all-volunteer personnel system, whose long-term
effectiveness is dependent on establishing a sense of mutual, long-term
commitment between the servicemember and his/her country.
The Coalition believes it's essential to bear other considerations
in mind when considering the extent to which military beneficiaries
should share in military health care costs.
First and foremost, the military health system is not built for the
beneficiary, but to sustain military readiness. Each Service maintains
its unique facilities and systems to meet its unique needs, and its
primary mission is to sustain readiness by keeping a healthy force and
to be able to treat casualties from military actions. That model is
built neither for cost efficiency nor beneficiary welfare. It's built
for military readiness requirements.
When military forces deploy, the military medical force goes with
them, and that forces families, retirees and survivors to use the more
expensive civilian health care system in the absence of so many
uniformed health care providers.
These military-unique requirements have significantly increased
readiness costs. But those added costs were incurred for the
convenience of the military, not for any beneficiary consideration, and
beneficiaries should not be expected to bear any share of that cost -
particularly in wartime.
The Coalition urges the subcommittee to take all possible steps to
ensure continued full funding for Defense Health Program needs.
National Health Reform
The Coalition opposes any effort to integrate TRICARE and VA health
care systems in any proposal that Congress may develop as part of
national health care reform. These two programs are integral to
military readiness and are designed expressly to meet the unique needs
of servicemembers, military retirees, veterans, wounded servicemembers,
guardsmen and reservists, their families, and survivors.
TMC urges that any national health reform legislation must:
Protect the unique TRICARE, TRICARE For Life, and VA
health care benefits from unintended consequences such as
reduced access to care;
Bar any form of taxation of TRICARE, TRICARE For Life,
or VA health care benefits, including those provided in
nongovernmental venues; and
Preserve military and VA beneficiaries' choices.
Military vs. Civilian Cost-Sharing Measurement
Defense leaders have in the past, and may in the future, assert
that substantial military fee increases are needed to bring military
beneficiary health care costs more in line with civilian practices. But
merely contrasting military vs. civilian cash cost-shares is a grossly
misleading, ``apple-to-orange'' comparison.
For all practical purposes, those who wear the uniform of their
country are enrolled in a 20- to 30-year prepayment plan that they must
complete to earn lifetime health coverage. In this regard, military
retirees and their families paid enormous ``upfront'' premiums for that
coverage through their decades of service and sacrifice. Once that
prepayment is already rendered, the government cannot simply pretend it
was never paid, and focus only on post-service cash payments.
DOD and the Nation--as good-faith employers of the trusting members
from whom they demand such extraordinary commitment and sacrifice--have
a reciprocal health care obligation to retired servicemembers and their
families and survivors that far exceeds any civilian employer's to its
workers and retirees.
The Coalition believes that military beneficiaries from whom
America has demanded decades of extraordinary service and sacrifice
have earned coverage that is the best America has to offer.
Large Retiree Fee Increases Can Only Hurt Retention
The reciprocal obligation of the government to maintain an
extraordinary benefit package to offset the extraordinary sacrifices of
career military servicemembers is a practical as well as moral
obligation. Mid-career military losses can't be replaced like civilians
can.
Eroding benefits for career service can only undermine long-term
retention/readiness. Today's servicemembers are very conscious of
Congress' actions toward those who preceded them in service. One reason
Congress enacted TRICARE For Life in 2000 is because the Joint Chiefs
of Staff at that time said inadequate retiree health care was affecting
attitudes among active duty servicemembers.
That's more than backed up by two independent Coalition surveys. A
2006 Military Officers Association of America survey drew 40,000
responses, including more than 6,500 from active duty servicemembers.
Over 92 percent in all categories of respondents opposed the DOD-
proposed fee hikes. There was virtually no difference between the
responses of active duty servicemembers (96 percent opposed) and
retirees under 65 (97 percent opposed). A Fleet Reserve Association
survey showed similar results.
Reducing military retirement benefits would be particularly ill-
advised when an overstressed force already is at increasing retention
risk despite the current downturn of the economy and current recruiting
successes.
Pharmacy
The Coalition supports a strong TRICARE pharmacy benefit which is
affordable and continues to meet the pharmaceutical needs of millions
of eligible beneficiaries through proper education and trust. The TMC
will oppose any degradation of current pharmacy benefits, including any
effort to charge fees or copayments for use of military treatment
facilities.
The Coalition would oppose the need for pharmacy co-pay increases
now that Congress has approved Federal pricing for the TRICARE retail
pharmacy system. The Coalition notes that due to continued legal
maneuvering, Federal pricing still has not been implemented by the
executive branch, and this failure is costing DOD tens of millions of
dollars with every passing month. This is an excellent example of why
the Coalition objects to basing beneficiary fees on a percentage of DOD
costs--because DOD all-too-frequently does not act, or is not allowed
to act, in a prudent way to hold costs down.
The Coalition has volunteered to conduct a joint campaign with DOD
to promote beneficiary use of lower-cost medications and distribution
venues--a ``win-win'' opportunity that will reduce costs for
beneficiaries and the government alike.
The Coalition also believes that positive incentives are the best
way to encourage beneficiaries to continue medication regimens that are
proven to hold down long-term health costs. In this regard, TMC
believes eliminating copays for medications to control chronic
conditions (e.g., diabetes, asthma, high blood pressure, and
cholesterol) are more effective than negative ones such as copayment
increases.
The Coalition urges the subcommittee to ensure continued
availability of a broad range of medications, including the most-
prescribed medications, in the TRICARE pharmacy system, and to ensure
that the first focus on cost containment should be on initiatives that
encourage beneficiaries to take needed medications and reduce program
costs without shifting costs to beneficiaries.
Alternative Options to Make TRICARE More Cost-Efficient
TMC continues to believe strongly that DOD has not sufficiently
investigated options to make TRICARE more cost-efficient without
shifting costs to beneficiaries. The Coalition has offered a long list
of alternative cost-saving possibilities, including:
Positive incentives to encourage beneficiaries to seek
care in the most appropriate and cost effective venue;
Encouraging improved collaboration between the direct
and purchased care systems and implementing best business
practices and effective quality clinical models;
Focusing the military health system, health care
providers, and beneficiaries on quality measured outcomes;
Improving MHS financial controls and avoiding overseas
fraud by establishing TRICARE networks in areas fraught with
fraud;
Establishing TRICARE networks in areas of high TRICARE
Standard utilization to take full advantage of network
discounts;
Promoting retention of other health insurance by
making TRICARE a true second-payer to other insurance (far
cheaper to pay another insurance's co-pay than have the
beneficiary migrate to TRICARE);
Encouraging DOD to effectively utilize their data from
their electronic health record to better monitor beneficiary
utilization patterns to design programs which truly match
beneficiaries needs;
Sizing and staffing military treatment facilities to
reduce reliance on network providers and develop effective
staffing models which support enrolled capacities;
Reducing long-term TRICARE Reserve Select (TRS) costs
by allowing servicemembers the option of a government subsidy
of civilian employer premiums during periods of mobilization;
Doing far more to promote use of mail-order pharmacy
system and formulary medications via mailings to users of
maintenance medications, highlighting the convenience and
individual expected cost savings; and
Encouraging retirees to use lowest-cost-venue military
pharmacies at no charge, rather than discouraging such use by
limiting formularies, curtailing courier initiatives, etc.
The Coalition is pleased that DOD has begun to implement some of
our suggestions, and stands ready to partner with DOD to investigate
and jointly pursue these and other options that offer potential for
reducing costs.
TMC Healthcare Cost Principles
The Military Coalition believes strongly that the recent fee
controversy is caused in part by the lack of any statutory record of
the purpose of military health care benefits and the specific benefit
levels earned by a career of service in uniform. Under current law, the
Secretary of Defense has broad latitude to make administrative
adjustments to fees for TRICARE Prime and the pharmacy systems. Absent
congressional intervention, the Secretary can choose not to increase
fees for years at a time or can choose to quadruple fees in 1 year.
Until a few years ago, this was not a particular matter of concern,
as no Secretary had previously proposed dramatic fee increases. Given
recent years' unsettling experience, the Coalition believes strongly
that the subcommittee needs to establish more specific and permanent
principles, guidelines, and prohibitions to protect against dramatic
budget-driven fluctuations in this most vital element of
servicemembers' career compensation incentive package.
The Coalition strongly recommends that Congress establish statutory
findings, a sense of Congress on the purpose and principles of military
health care benefits earned by a career of uniformed service that
states:
Active duty members and families should be charged no
fees except retail pharmacy co-payments, except to the extent
they make the choice to participate in TRICARE Standard or use
out-of-network providers under TRICARE Prime;
The TRICARE Standard inpatient copay should not be
increased further for the foreseeable future. At $535 per day,
it already far exceeds inpatient copays for virtually any
private sector health plan;
There should be no enrollment fee for TRICARE Standard
or TRICARE For Life (TFL), since neither offers assured access
to TRICARE-participating providers. An enrollment fee implies
enrollees will receive additional services, as Prime enrollees
are guaranteed access to participating providers in return for
their fee. Congress already has required TFL beneficiaries to
pay substantial Medicare Part B fees to gain TFL coverage;
All retired servicemembers earned equal health care
coverage by virtue of their service; and
DOD should make all efforts to provide the most
efficient use of allocated resources and cut waste prior to
proposing additional or increased fees on eligible
beneficiaries.
TRICARE Prime
The Coalition is very concerned about growing dissatisfaction among
TRICARE Prime enrollees--which is actually higher among active duty
families than among retired families. The dissatisfaction arises from
increasing difficulties experienced by beneficiaries in getting
appointments, referrals to specialists, and sustaining continuity of
care from specific providers.
Increasingly, beneficiaries with a primary care manager in a
military treatment facility find they are unable to get appointments
because so many providers have deployed, PCSed, or are otherwise
understaffed/unavailable.
The Coalition supports the implementation of a pilot study by TMA
in each of the three TRICARE Regions to study the efficacy of
revitalizing the resource sharing program used prior to the
implementation of the TRICARE-The Next Generation (T-NEX) contracts
under the current Managed Care Support contract program.
The Coalition supports adoption of the ``Medical Home'' patient-
centered model to help ease such problems.
But the new TRICARE contracts and the attendant reduction of Prime
service areas outside the vicinity of military installations will
exacerbate anxieties by forcing disenrollment of many thousands of
current Prime beneficiaries.
The Coalition strongly advocates the transparency of healthcare
information via the patient electronic record between both the MTF
provider and network providers. Additionally, institutional and
provider healthcare quality information should be available to all
beneficiaries so that they can make better informed decisions.
The Military Coalition urges the subcommittee to require reports
from DOD and from the managed care support contractors, on actions
being taken to improve Prime patient satisfaction, provide assured
appointments within Prime access standards, reduce delays in
preauthorization and referral appointments, and provide quality
information to assist beneficiaries in making informed decisions.
tricare standard
TRICARE Standard Provider Participation
The Coalition appreciates the subcommittee's continuing interest in
the specific problems unique to TRICARE Standard beneficiaries. TRICARE
Standard beneficiaries need assistance in finding participating
providers within a reasonable time and distance from their home. This
is particularly important with the expansion of TRICARE Reserve Select
and the upcoming change in the Prime Service Areas, which will place
thousands more beneficiaries into TRICARE Standard.
The Coalition is concerned that DOD has not yet established any
standard for adequacy of provider participation, as required by section
711(a)(2) of the NDAA for Fiscal Year 2008. Participation by half of
the providers in a locality may suffice if there is not a large
Standard beneficiary population. The Coalition hopes to see an
objective participation standard (perhaps number of beneficiaries per
provider) that would help shed more light on which locations have
participation shortfalls of Primary Care Managers and Specialists that
require positive action.
The Coalition urges the subcommittee to insist on immediate
delivery of an adequacy threshold for provider participation, below
which additional action is required to improve such participation. The
Coalition also recommends requiring a specific report on participation
adequacy in the localities where Prime Service Areas will be
discontinued under the new TRICARE contracts.
TRICARE Reimbursement Rates
Physicians consistently report that TRICARE is virtually the
lowest-paying insurance plan in America. Other national plans typically
pay providers 25-33 percent more. In some cases the difference is even
higher.
While TRICARE rates are tied to Medicare rates, TRICARE Managed
Care Support Contractors make concerted efforts to persuade providers
to participate in TRICARE Prime networks at a further discounted rate.
Since this is the only information providers receive about TRICARE,
they see TRICARE as lower-paying than Medicare.
This is exacerbated by annual threats of further reductions in
TRICARE rates due to the statutory Medicare rate-setting formula.
Physicians may not be able to afford turning away Medicare patients,
but many are willing to turn away a small number of patients who have
low-paying, high-administrative-hassle TRICARE coverage.
The TRICARE Management Activity has the authority to increase the
reimbursement rates when there is a provider shortage or extremely low
reimbursement rate for a specialty in a certain area and providers are
not willing to accept the low rates. In some cases, a State Medicaid
reimbursement for a similar service is higher than that of TRICARE. But
the Department has been reluctant to establish a standard for adequacy
of participation to trigger higher payments.
The Coalition places primary importance on securing a permanent fix
to the flawed statutory formula for setting Medicare and TRICARE
payments to doctors.
To the extent a Medicare rate freeze continues, we urge the
subcommittee to encourage DOD to use its reimbursement rate adjustment
authority as needed to sustain provider acceptance.
The Coalition urges the subcommittee to require a Comptroller
General report on the relative propensity of physicians to participate
in Medicare vs. TRICARE, and the likely effect on such relative
participation of a further freeze in Medicare/TRICARE physician
payments along with the effect of an absence of bonus payments.
Dental Care
The Coalition appreciates the subcommittee's action in continuing
active duty-level dental coverage for dependent survivors and allowing
transitional dental care for Reserve members who separate after
supporting contingency missions.
Active Duty Dependent Dental Plan
TMC is sensitive to beneficiary concerns that Active Duty Dental
Plan coverage for orthodontia has been eroded by inflation over a
number of years.
The current orthodontia payment cap is $1,500, which has not been
changed since 2001. In the intervening years, the orthodontia cost has
risen from an average of $4,000 to more than $5,000.
The Coalition understands that, under current law, increasing this
benefit could require a reduction in some other portion of the benefit,
which we do not support.
The Coalition notes that current law assumes a 60 percent DOD
subsidy for the active duty dental plan, whereas other Federal health
programs (e.g., FEHB Plan and TRS) are subsidized at 72 percent.
The Coalition recommends increasing the DOD subsidy for the Active
Duty Dependent Dental Plan to 72 percent and increasing the cap on
orthodontia payments to $2,000.
Guard and Reserve Healthcare
Continuum of Health Care Insurance Options for The Guard and
Reserve
The Coalition is very grateful for passage of TRICARE Retired
Reserve (TRR) coverage for ``gray area'' reservists in the NDAA for
Fiscal Year 2010.
The Coalition notes that DOD complied with direction from Congress
to reduce TRICARE Reserve Select (TRS) premiums to the actual cost of
coverage. For 2009, monthly TRS premiums were reduced to $47.51 (vs.
$81) for member-only coverage and to $180.17 (vs. $253) for family
coverage.
TMC believes a review of the current statutory methodology for
adjusting premiums based on program costs should be conducted to assess
whether any of the costs currently included are, in fact, costs of
maintaining readiness or ``costs of doing business'' for the Defense
Department that don't contribute to delivering benefit value to
beneficiaries (and therefore should be excluded, with the expected
result that premiums would go down). In principle, TMC believes
Congress should establish a moratorium on TRS premium increases and
direct DOD to make a determined effort for the most efficient use of
resources allocated and to cut waste prior to the consideration of any
adjustment in such premiums.
Moreover, TMC believes that holding the line on TRS premiums will
encourage more families to enroll. DOD, the Services, and the Reserve
components must do much more to advertise the TRS program which stands
at only 6-7 percent of eligible beneficiaries.
The Coalition also believes Congress is missing an opportunity to
reduce long-term health care costs and increase beneficiary
satisfaction by authorizing eligible members the option of electing a
DOD subsidy of their civilian insurance premiums during periods of
activation.
Current law already authorizes payment of up to 24 months of FEHBP
premiums for activated members who are civilian employees of the
Defense Department. The Coalition believes all members of the Selected
Reserve should have a similar option to have continuity of their
civilian family coverage.
Over the long term, when Guard and Reserve activations can be
expected at a reduced pace, this option would offer considerable
savings opportunity relative to funding permanent, year-round TRICARE
coverage.
DOD could calculate a maximum monthly subsidy level that would
represent a cost savings to the government, so that each member who
elected that option would reduce TRICARE costs.
The Coalition recommends the subcommittee:
Require a GAO review of DOD's methodology for
determining TRS costs for premium adjustment purposes to assess
whether it includes any costs of maintaining readiness or
``costs of doing business'' for the Defense Department that
don't contribute to beneficiary benefit value and thus should
be excluded from cost/premium calculations;
Authorize development of a cost-effective option to
have DOD subsidize premiums for continuation of a Reserve
employer's private family health insurance during periods of
deployment as an alternative to ongoing TRS coverage;
Allow eligibility in Continued Health Care Benefits
Program (CHCBP) for Selected reservists who are voluntarily
separating and subject to disenrollment from TRS;
Authorize members of the IRR who qualify for a Reserve
retirement at age 60 to participate in TRR as an incentive for
continued service (and higher liability for recall to active
duty);
Monitor implementation of the new TRR authority to
ensure timely action and that premiums do not exceed 100
percent of the TRS premium; and
Allow FEHB plan beneficiaries who are Selected
reservists the option of participating in TRS.
Guard and Reserve Mental Health
The Coalition is concerned that Guard and Reserve members and their
families are at particular risk for undetected effects of the unseen
injuries of war. The risk is compounded by Reserve component members'
anxiety to return to their families as soon as possible, which
typically entails expedited departure from active duty and return to a
community where military health care and other support systems are
limited.
Unfortunately, most such members view the current post deployment
health self-assessment program at demobilization sites as an impediment
to prompt return to their families. Under this scenario, strong
disincentives for self-reporting exacerbate an already wide variation
in the diagnosis and treatment of post-traumatic stress disorder
(PTSD), traumatic brain injury (TBI), depression, and other combat-
related stress conditions.
The Coalition believes redeploying Reserve component members should
be allowed to proceed to their home station and retained on active duty
orders to complete post-deployment examination requirements at the home
station. This change is important to improve proper diagnosis,
reporting and treatment of physical and mental injuries; to help
perfect potential service connected disability claims with the VA; and
to help correct the non-reporting of injuries at the demobilization
site.
The Coalition believes that Guard and Reserve members and their
families should have access to evidence-based treatment for PTSD, TBI,
depression, and other combat-related stress conditions. Further, post-
deployment health examinations should be offered at the member's home
station, with the member retained on active duty orders until
completion of the exam.
Guard and Reserve Health Information
The Coalition is concerned that the current health records for many
Guard and Reserve members do not contain treatment information that
could be vital for diagnosis and treatment of a condition while on
active duty. The capture of nonmilitary treatment is an integral part
of the member's overall health status.
The Coalition believes there should be an effort to improve the
electronic capture of nonmilitary health information into the
servicemember's medical record.
TRICARE For Life (TFL)
When Congress enacted TFL in 2000, it explicitly recognized that
this coverage was fully earned by career servicemembers' decades of
sacrifice, and that the Medicare Part B premium would serve as the cash
portion of the beneficiary premium payment. The Coalition believes that
this remains true today and will oppose any new additional fees.
Additionally, the Coalition believes that means-testing has no place in
setting military health fees.
The Coalition is aware of the challenges imposed by Congress'
mandatory spending rules, and appreciates the subcommittee's efforts to
include TFL-eligibles in the preventive care pilot programs included in
the NDAA for Fiscal Year 2009. We believe their inclusion would, in
fact, save the government money and hope the subcommittee will be able
to find a more certain way to include them than the current
discretionary authority, which DOD has declined to implement.
The Coalition also hopes the subcommittee can find a way to resolve
the discrepancy between Medicare and TRICARE treatment of medications
such as the shingles vaccine, which Medicare covers under pharmacy
benefits and TRICARE covers under doctor visits. This mismatch, which
requires TFL patients to absorb the cost in a TRICARE deductible or
purchase duplicative Part D coverage, deters beneficiaries from seeking
this preventive medication.
Coalition priorities for TFL-eligibles include:
Securing a permanent fix to the flawed formula for
setting Medicare/TRICARE payments to providers;
