[Senate Hearing 109-]
[From the U.S. Government Publishing Office]
DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2006
----------
TUESDAY, MAY 17, 2005
U.S. Senate,
Subcommittee of the Committee on Appropriations,
Washington, DC.
The subcommittee met at 2:28 p.m., in room SD-192, Dirksen
Senate Office Building, Hon. Ted Stevens (chairman) presiding.
Present: Senators Stevens, Bond, and Inouye.
NONDEPARTMENTAL WITNESSES
OPENING STATEMENT OF SENATOR TED STEVENS
Senator Stevens. Good afternoon. This is the afternoon for
public witnesses for consideration for the fiscal year 2006
defense budget. We have 25 witnesses who have indicated they
want to testify or submit statements for the record. To keep us
on schedule, we are going to have to ask that you limit your
testimony to 4 minutes each. I have to warn you there is going
to be votes throughout the afternoon and Senator Inouye and I
are going to be leapfrogging back and forth, and we have
scheduled this this afternoon because we believe that there is
going to be all sorts of problems on the floor tomorrow.
We do appreciate your interest and want you to know, as we
have every year, we are going to review carefully the items you
present to us. Your prepared statements will be included in the
record in full, and when my good friend comes, Senator Inouye,
our co-chairman, we will, as I indicated, share listening to
your presentations.
Our first witness is Susan Lukas, the Legislative Director
of the Reserve Officers Association of the United States. Ms.
Lukas.
STATEMENT OF SUSAN E. LUKAS, LEGISLATIVE DIRECTOR,
RESERVE OFFICERS ASSOCIATION OF THE UNITED
STATES
Ms. Lukas. Mr. Chairman, on behalf of over 75,000 members
of the Reserve Officers Association (ROA), I would like to
thank you for this opportunity to speak today.
The Reserve components have always relied on Congress to
provide appropriations for their equipment requirements. While
active duty considers Guard and Reserve needs, as you know,
they do not always rate high enough to be funded in the
President's budget. In particular, your subcommittee's support
has been invaluable.
Our testimony this year mainly focuses on equipment needed
for force protection and mission support. While one would not
necessarily think of Army trucks as offering personal
protection, this war has shown us how vulnerable our people are
when driving vehicles.
At a recent ROA convention, an Army non-commissioned
officer (NCO) said he worked hard to train his soldiers how to
drive in convoy, but nothing could prepare them for the
conditions they had to operate under. He said one of the first
things he learned was to drive as fast as if your life depended
on it, because it did.
You can well imagine, between those conditions, the
environment and demands, the fleet is aging quickly. For
example, there are about 1,800 long haul tractor-trucks being
used in Iraq. Forty percent of the fleet is at a 20-year life
expectancy level. The new trucks will reduce fuel and can
accept 2,900 pounds of up-armoring. This is but one example of
the trucks that need replacement in the Army.
The Naval Reserve needs to meet mission requirements by
replacing their C-9 fleet as it is not compliant with either
future global navigation requirements or European flight
restrictions.
Congress has supported appropriations for the littoral
surveillance system and continuing support would allow the
Naval Reserve to meet their homeland security mission and
deploy this equipment with the fleet.
The Air Force Reserve equipment requirements focus on
countermeasure protections such as the large aircraft infrared
countermeasures system (LAIRCM), LITENING Pods, color radar for
C-130s, and C-5 Airlift Defense Systems. I will not go into
detail on the equipment as it is covered in our written
testimony.
Several years ago ROA suspected stop-loss and mobilization
would reduce recruiting and retention. Unfortunately, this has
happened. The Reserve chiefs recently testified before your
subcommittee that increased bonus authority has made a
difference. While bonuses are an effective tool, ROA asks for
consideration to fully fund advertising and marketing, tuition
assistance, family support, special training, and school tours.
In closing, the bond between the United States (U.S.)
military and our civilian communities is strengthened by the
mobilization of neighbors and fellow workers, our reservists
and National Guardsmen. The move toward using the Guard and
Reserve to meet operational requirements is a natural evolution
of this very capable force. However, force transformation needs
to retain surge capability in order to meet emerging threats or
demands. The Guard and Reserve can be configured to meet both
operational and surge requirements.
I look forward to answering any questions you may have and
again thank you for allowing me to speak to the subcommittee.
[The statement follows:]
Prepared Statement of Susan E. Lukas
INTRODUCTION
ROA's legislative goals for this year have focused on mobilization
and recruiting and retention. These goals come from our members as they
identify problems or suggest improvements to the situations they
encounter. Since we are not in the Department of Defense's chain of
command we provide a source for candid discourse without fear of
retaliation. ROA will continue to support the troops in the field in
any way we can.
A key factor in supporting the Reserve Components is funding their
training needs. Cost avoidance cuts for the past 2 years have forced
the services to take reductions in mobilization training,
demobilization training, recruiting training, annual training, special
training, and bonus authorities' accounts. ROA urges Congress to fully
fund these accounts and reverse the cost avoidance reductions.
NATIONAL GUARD AND RESERVE EQUIPMENT
Army Reserve
Equipping both existing units and new units will be a considerable
task. Units that deployed and took their equipment to combat have left
the equipment in the theater. It may have even been damaged or
destroyed. Many units were already short critical equipment. As the
Army Reserve creates its ``force packages'' it is understood that the
earlier deploying force package units will be equipped first. Other
units will have ``mission essential equipment for training'' and as
they move closer to their respective rotation dates, they will receive
more of their needed equipment. There will also likely be increased use
of pre-positioned equipment much the same as was done during the Cold
War and to an extent is being done today. The Army Reserve has
identified fiscal year 2006 as the ``Year of Equipping.'' In doing so,
they are giving particular emphasis to critical equipment shortfalls
that will impact the transformation to rotational force packages,
training, and mission accomplishment. Many of the items on the
``Unresourced Equipment and Modernization Requirements'' have not
changed. Priorities may have moved up or down and quantities may have
increased.
Light Medium Tactical Vehicle (LMTV)
This critical item was No. 1 in fiscal year 2005 and will remain
the No. 1 equipment priority in fiscal year 2006. As indicated earlier,
the Army Reserve's transportation role is crucial to mission
accomplishment. The FMTV replaces many Vietnam-era trucks whose
effective life cycle ended some time ago.
Required.--4,512; Short.--2,683; Fiscal Year 2006 Buy.--600;
Cost.--$91.8 million.
Medium Tactical Vehicle (MTV)
This item was No. 2 last year and remains the No. 2 equipment
priority. The vehicles that the MTV's replace are past their useful
life and the cost to keep them running can challenge the cost of
procuring the newer and more efficient MTV. The requirement has not
changed and the number that is currently on hand is staggeringly low.
Required.--8,784; Short.--6,712; Fiscal Year 2006 Buy.--800;
Cost.--$146 million.
Multi-Band Super High Frequency Terminal
The Army Reserve provides the majority of the Theater Signal
management in the Army. The terminal provides inter-theater and intra-
theater range extension support. The fiscal year 2005 buy would fill
the requirement of one integrated Theater Signal Brigade.
Required.--50; Short.--46; Fiscal Year 2006 Buy.--10; Cost.--$30
million.
Truck, Cargo PLS 10X10 M1075 and PLS Trailer
Again, the combat service support role of the Army Reserve
highlights the need for the most current model. This requirement also
includes the Tactical Fire Fighting Truck.
Truck/Trailer Required.--929/1,484; Short.--275/769; Fiscal Year
2006 Buy.--88/56; Cost.--$25.4 million/$3.0 million.
Improved High Frequency Radio (IRFR)
Provides voice transmission for battle command and is the primary
means of communications for maneuver battalions.
Required.--1,750; Short.--937; Fiscal Year 2006 Buy.--937; Cost.--
$39.8 million.
High Mobility Multi-Purpose Wheeled Vehicle (HMMWV)
This is the standard version of the much used workhorse of the
Army. All units need them. Many in the Army Reserve are older models
and Active Army ``hand-me-downs'' that might not meet deployment
standards when a unit is mobilized.
Required.--13,919; Short.--1,543; Fiscal Year 2006 Buy.--321;
Cost.--$24.0 million.
Up Armored High Mobility Multi-Purpose Wheeled Vehicle
(HMMWV)
Much has been reported about the need for this critical vehicle in
the combat zones. Many units are attempting to ``up-armor'' their
vehicles in the theater with whatever might be available. This is a
survival item and needs to be resourced.
Required.--738; Short.--705; Fiscal Year 2006 Buy.--308; Cost.--
$55.1 million.
Truck, Tractor Line Haul (M915A3)
These vehicles haul bulk fuel and supplies from port to combat
areas for disbursement to brigades. About 1,800 trucks are currently
being used in Iraq. Forty percent of the fleet is at their life
expectancy level of 20 years and the current replacement plan would
take many out to over 30 years old. The Line Haul Tractor would
decrease fuel demands and maintenance costs. Fuel savings alone could
buy 140 trucks. Most importantly the suspension system is configured to
accept the 2,900 pounds of up-armoring required for each truck.
Required.--2,445; Short.--1,389; Fiscal Year 2006 Buy.--92; Cost.--
$87 million.
HEMTT Load Handling System
This requirement would fill the much needed requirement for the
Improved Cargo Handling Operations and Medical Supply Companies. At the
present time, there are none on hand in these units.
Required.--44; Short.--44; Fiscal Year 2006 Buy.--44; Cost.--$10
million.
Tactical Fire Fighting Truck
This improved item of equipment is critical to both the Army
Reserve's Engineer Fire Fighting units as well as Ammunition Support
Teams.
Required.--72; Short.--43; Fiscal Year 2006 Buy.--10; Cost.--$6.0
million.
Prior to 1997, the National Guard and Reserve Equipment
Appropriation was a critical resource to ensure adequate funding for
new equipment for the Reserve Components. The much-needed items not
funded by the respective service budget were frequently purchased
through this appropriation. In some cases it was used to bring unit
equipment readiness to a needed state of state for mobilization.
Frequently the funds were used to purchase commercial off the-shelf
items that units were unable to obtain through traditional sources.
However, in 1997 an agreement between the administration and Congress
eliminated the account with the objective of the active component
providing the needed funds through their individual appropriations.
The Reserve and Guard are faced with mounting challenges on how to
replace worn out equipment, equipment lost due to combat operations,
legacy equipment that is becoming irrelevant or obsolete, and in
general replacing that which is gone or aging through normal wear and
tear. Today, the ability to use NGREA funds for cost effective
acquisition is virtually non-existent as the amount appropriated is a
fraction of what the Army Reserve requires to meet immediate needs. An
analysis has shown that with the implementation of the post-1997
policy, there has been an overall decrease in procurement for the
reserve components. In fiscal year 2004, procurement for the Reserve
Components as a percentage of the DOD procurement budget is at its
second lowest in recorded history at 3.19 percent. This comes even
after a congressional add of $400 million for NGREA. Meanwhile,
procurement for the Active Component continues to realize consistent
real growth from fiscal year 1998 through fiscal year 2009 of 108.6
percent. In the past, the use of ``cascading'' equipment from the
Active Component to the Reserve Component has been a reliable source of
serviceable equipment. However, with the changes in roles and missions
that have placed a preponderance of combat support and combat service
support in the reserve components, there has not been much left to
cascade. Also, funding levels, rising costs, lack of replacement parts
for older equipment, etc. has made it difficult for the Reserve
Components to maintain their aging equipment, not to mention
modernizing and recapitalizing to support a viable legacy force. The
Reserve Components would benefit greatly from a National Military
Resource Strategy that includes a National Guard and Reserve Equipment
Appropriation.
Naval Reserve
C-40
The Navy requires a Navy Unique Fleet Essential Airlift Replacement
Aircraft. This aircraft was designated as the C-40A and will replace
the aging C-9 fleet. Boeing offered the 737-700 new technology aircraft
in response to the Navy's request for proposal.
The C-40A, a derivative of the 737-700C is a Federal Aviation
Administration (FAA) certified, high performance, fixed wing aircraft
that will accommodate 121 passengers, or 8 pallets of cargo, or a
combination configuration consisting of 3 pallets and 70 passengers.
The C-40A is able to carry 121 passengers or 40,000 pounds of cargo,
compared with 90 passengers or 30,000 pounds for the C-9. In addition,
the maximum range for the Clipper is approximately 1,500 miles more
than the C-9.
Upgrading the aging C-9 Skytrain II airframe with new engines and
avionics was considered, but that would leave new equipment in a 30-
year-old+ airframe. The Navy's aging C-9 fleet is not compliant with
either future global navigation requirements or noise abatement
standards that restrict flights into European airfields. Twenty-two
aircraft remain to be replaced.
A recent study by the Center for Naval Analyses recommends three
additional C-40A be procured to meet global operational requirements
and replace the C-9.
Littoral Surveillance System
Two Littoral Surveillance System (LSS) have been authorized by
congress by fiscal year 2003. This provides timely assured receipt of
all-weather, day/night maritime and littoral intelligence, surveillance
and reconnaissance data. A third system would be used to support the
Navy and would be an ideal mission to support Naval and Coast Guard
Maritime Defense operations, when not deployed. The LSS system has been
incorporated into the Joint Fires Network (JFN) and the cost for this
new system is $2.0 million per set.
JFN provides near real time intelligence correlation, sensor
control and planning, target generation, precise target coordinates,
moving target tracks and battle damage assessment capabilities to
support more timely engagement of time critical targets. This
capability allows a ship with the full JFN suite to share a greatly
improved battlespace picture very quickly with other ships in the area
of operations.
The system, along with the Army's Tactical Exploitation System-
Forward and the Marines Tactical Exploitation Group, share a common
software baseline, ensuring joint interoperability.
At least 141 Reservists have been trained to run the two systems,
which is viewed as a Naval Reserve mission.
Air Force Reserve
C-5s
C-5s are unique national assets that are unrivaled in range and
payload. Air Force and industry studies confirm the viability of the C-
5 fleet (As and Bs) to serve until approximately 2040. These
assessments resulted in the Air Force initiating a two-phased
modernization program designed to improve C-5 reliability,
maintainability, and availability. Modernization of C-5As assigned to
the Air Force Reserve should be advanced concurrently with Air Force
active duty units to include both the Avionics Modernization Program
(AMP) and the Reliability Enhancement and Re-engining Program (RERP).
C-5 modernization is the most cost effective solution for generating
strategic airlift.
Requirement.--ROA urges Congress to authorize and appropriate funds
to modernize C-5As with AMP and RERP concurrent with active duty C-5Bs.
C-17
The C-17 Globemaster III is the newest, most flexible cargo
aircraft to enter the airlift force. The C-17 is capable of rapid
strategic delivery of troops and all types of cargo to main operating
bases or directly to forward bases in the deployment area. The aircraft
is also capable of performing tactical airlift and airdrop missions
when required. The C-17 is the Nation's lowest risk program to increase
capability.
Requirement.--Commitment needed beyond 180 in January 2006 due to
long lead items. Additionally, consideration for procurement beyond 180
aircraft will support C-17s in the AFR and will increase the Nation's
surge capability.
C-40C
Air Mobility Command's programmed force structure, based on C-9
retirement schedule, does not include more then three C-40s for the AFR
even though a hearing before Congress by the Air Force stated the
demand for airlift was more then the availability of aircraft. For
instance, the appropriate number of Operational Support Aircraft (OSA)
does not exist to sufficiently meet increasing Congressional
Delegation, Combatant Commander, or team travel requests. Operations
and Maintenance are unfunded in fiscal year 2006 and fiscal year 2007
for C-9s and C-40Cs.
Requirement.--Increase procurement of C-40 aircraft by at least six
additional aircraft to ensure an adequate special mission airlift force
for the AFR by at least two C-40s per year for 3 years.
C-130J
AFRC C-130E aircraft are reaching the end of their economic service
life, are becoming difficult to support, and must soon be replaced. The
Air Mobility Command has selected the C-130J to replace these 40+ year
old aircraft for both active, Reserve, and Guard C-130E units. The C-
130J is the latest version of the venerable C-130 Hercules and utilizes
advanced composite materials, integrated digital avionics and a state-
of-the-propulsion system to provide significant performance
improvements, new mission capabilities, and reduced life cycle costs.
The recently executed C/KC-130J Multiyear Contract provides these
aircraft at significant cost savings to the government while
accelerating deliveries to units currently in conversion such as the
53rd Wing at Keesler AFB, MS.
Requirement.--ROA urges Congress to authorize and appropriate funds
for the C/KC-130J Multiyear Procurement as requested in the President's
Budget Request for fiscal year 2006.
Large Aircraft Infrared Countermeasures System (LAIRCM)
The AN/AAQ-24 V (13) LAIRCM is an infrared countermeasure system
designed to protect both fixed and rotary wing aircraft against man-
portable (shoulder-launched) infrared-guided surface-to-air missiles.
Requirement.--HC-130/C-130H3, $225.1 million.
LITENING AT Advanced Targeting Pod
Precision Attack Targeting System program was developed to fill the
need for precision strike capability in the Air Reserve Component
(ARC). The 25 pods will be used in AFRC A/OA-10 and B-52 aircraft.
Requirement.--A/OA-10 and B-52, 25 pods, $53.0 million.
APN-241 Low Power Color Radar for C-130s
The AN/APN-241 combat aerial delivery radar provides enhanced
safety and operational performance for C-130 aircrews. It offers the
tanker/transport community some of the same advanced technologies
originally developed for fighter aircraft. These technologies include
high-resolution ground-mapping modes that enable very precise
navigational fixes and aerial cargo drops.
Requirement.--C-130H2, $37 million.
C-5A Airlift Defensive Systems
The Air Force Reserve Command has a total of 32 C-5A aircraft in
its inventory. Currently, that aircraft has no viable onboard defensive
system against surface to air (SAM) missiles. Funds to pay for the Part
A and B installation of AN-AAR-47 and ALE-47 defensive systems stripped
from C-141 aircraft as these systems become available to the SPO.
Requirement.--C-5A 32 A/C $30.0 million.
Situational Awareness Data Link for A-10s and HH-60s
The Situation Awareness Data Link (SADL) integrates U.S. Air Force
close air support aircraft with the digitized battlefield via the U.S.
Army's Enhanced Position Location Reporting System (EPLRS). More than
just a radio or a data modem, SADL provides fighter-to-fighter, air-to-
ground and ground-to-air data communications that are robust, secure,
jam-resistant and contention-free. With its inherent position and
status reporting for situation awareness, SADL provides an effective
solution to the long-standing air-to-ground combat identification
problem for preventing unintentional fratricide (http://
www.raytheon.com/products/sadl_eplrs/).
Requirement.--A/OA-10 and HH-60, $7.7 million.
MILITARY PERSONNEL
Recruiting and Retention
Army Reserve
As combat operations in Iraq and Afghanistan become ``stability''
operations, it is expected that the Army Reserve and National Guard
will make up 50 percent or more of the force. Both the Active Component
and the Reserve Component will move to a rotational plan that will
provide both predictability and stability for soldiers. The Army
Reserve will organize its units into ``force packages'' that will help
ensure that Reserve Component Soldiers will be available for 1 year out
of every 5 to 6 years. This predictability will ease the pressure on
soldiers, their families, and their employers.
According to the Army Public Affairs announcement, May 3, 2005,
``As of end of the April reporting period, Recruiting Command accessed
7,283 Soldiers for the U.S. Army Reserve, 79 percent of the year-to-
date mission. The fiscal year 2005 Army Reserve recruiting mission is
22,175.'' For the month of April the command fell short by 37 percent.
The bonus program from last year helped to reduce recruitment and
retention losses but with all other conditions remaining the same both
areas will still be below goals. To overcome this, the Army Reserve
needs to fully fund their bonus program to $149.5 million and increase
AGR recruiter positions with funding to $59.1 million.
Navy Reserve
There are several challenges facing the services with recruiting
and retention. The Naval Reserve recruiting is softer than many of the
Navy's leadership would like to admit. The USNR has been slow to
implement recruiting bonuses and the result is that the USNR is behind
the power curve when compared to the other services with recruiting
incentives for prior service members. The combined recruiting command
has falling short of USN and USNR goals, and its Reserves are receiving
short shrift for recruiting priorities. Even though the Navy is
supporting deep cuts for its Naval Reserve (10,300 in fiscal year 2006)
the need to recruit for the USNR has not lessened. To meet its
shortcomings, the USNR is turning to activating drilling Reservists to
fill the recruiter gap. When a problem exists, you call up the
Reserves.
Air Force Reserve
Prior Service Availability.--In a 10-year period the Air Force
Reserve went from accessing 50,507 in 1992 to 14,950 in 2005 and this
trend has continued for the past 3 years. All of the services are
experiencing this trend as the Guard and Reserve have gradually shifted
to an operational force. The significance of recruiting fewer prior
service personnel is lower average levels of experience residing in the
Reserve Components and loss of investment in specialty training.
According to the Air Force Reserve the most frequent reasons ADAF
separatees give for not joining AFRC are:
--Want to wait and see what happens (with world events);
--Have seen Reservists deployed and don't want to risk same;
--Done my time, not interested in continuing;
--Have been told Reservists are first to be deployed;
--Concerned Reserve status will negative impact civilian employment;
--Negative feedback from activated IMAs;
--Bad press coverage--impression active forces place Reservists &
Guardsman on front lines.
Recruiting Non-Prior Service Personnel.--A decrease in prior
service means an increase in the need for non-prior service personnel
to meet recruiting goals. A corresponding increase in the need for
training dollars results at a time when the administration wants to
decrease budgets. The use of non-prior service also results in less
availability of forces as they move through the training pipeline. Once
formal professional military education is completed training continues
in a member's specialty, which means it can take between 1 to 2 years
before an individual can perform duty somewhat independently.
ROA recommends supporting bonus incentives and reverse cost
avoidance reduction trends that cut the reserve personnel and
technician accounts.
Mobilization/Demobilization Impacts to Recruiting and Retention
The impact of mobilization and demobilization does not rest just
with the military member; it also affects their families and employers.
This is important to note because they in turn factor in an individuals
decision on whether or not to stay in the military.
Two of the biggest problem areas that ROA members continue to share
information on are with medical and pay problems.
Comment: I am a mob'd reserve COL at Walter Reed with PTSD. The
problem I see that Reservists and Guardsmen are seeing is that
the burden of proof for absence of preexisting is on us. I have
seen soldiers with severe PTSD (suicidal/homicidal) be valued
by the board here at Walter Reed with 0 percent because they
concluded he was bipolar when he entered service, never mind
the war exacerbating the condition. I am seeing extremely low
valuations of disabilities for loss of limb and other traumatic
wounds.
Comment: Here's the issue in a nutshell: Soldiers, according to
the Army Reserve Magazine, are eligible for Tricare benefits 90
days prior to mobilization. We have a group order from First
Army. When soldiers call Tricare they are told that they cannot
be enrolled in Tricare without an individual order. Soldiers
are eligible for this insurance but cannot get it. Individual
orders will not come until soldiers arrive at the Mobilization
station. Basically, we're eligible, but there is no vehicle to
provide this insurance. One example, our new officer's wife may
be pregnant. (the 2LT type) They currently have no medical
coverage. He is covered while on 29 day orders, but his wife
has no coverage. According to the AR Magazine, he should be
covered. This is a wonderful benefit, but de facto nothing has
changed since individual orders, which are required to get
coverage, don't come until the active duty period commences.
Comment: Just wanted you to know that DEERS has dropped my family
from Tricare dental for the 4th or 5th time.
Comment: Well, today is Day 12 of 12 in a row, with a 3-day
weekend ahead to recover. Of note, however--and I really hate
to continue to bring up pay issues, but I (and hundreds of
other recently demobilized reservists) have not been paid out
accrued pay--and it's been over 3 months now. SOMEONE has to do
something to force DFAS to pay us . . . but who? I'm convinced
no one cares or they simply can't fight the bureaucracy. I am
owed over $6,000 (after taxes) . . . the issues with DFAS
continue--that organization needs to be seriously investigated
and heads need to roll! I will have to take out a loan rather
than pay with the cash that I earned--how sad is that?
Comment: I just wanted to touch base with you prior to leaving
active duty. I wanted to check on the status of any potential
article that was being written and also any help from the ROA
regarding the way that reservists (especially Army reservists)
have been treated with regard to reimbursements and pay. Since
October 1, I have been receiving only one-third of my normal
paycheck. Fortunately, I will be demobilizing on November 9,/
2004. Regardless, a large portion of any article written MUST
include how DFAS (Indianapolis office) made multiple errors
and, yet, reservists (and their families) are paying for their
mistakes daily
Comment: In late September I received a letter from DFAS stating
that I had received per diem in error and now owed the
government $11,696. I contacted an individual at DFAS and he
said that the Army had decided to use DOD Directive 4515.14 as
a guide to determine payment of per diem for soldiers in the
Washington, DC area. He also told me that there were lots of
other soldiers in the same situation and everyone had been
assessed with a debt for travel advances paid. I asked what
could be done and he said that he will submit a request for
waiver of debt for me to DFAS Denver. A few months later we
learned that DFAS Denver had denied waivers close to 900
soldiers in this situation. We attempted to find out from DFAS
Denver how to file an appeal of their decision to the Defense
Office of Hearings and Appeals (DOHA) and received no help.
October 1, I checked my bank account and discovered that my
direct deposit was only $548, I quickly determined that amount
to be approximately one-third of my usual deposit and guessed
that DFAS had decided to collect on the debt in the punitive
manner of two-thirds confiscation. With no warning from DFAS or
the Army that this was about to occur I was placed immediately
in a dire financial situation. I sought help from Army
Community Services by applying for a no interest loan from Army
Emergency Relief only to be denied a loan because I only had 35
days left on active duty, which would not guarantee loan
repayment.
Force Shaping
The U.S. Naval Reserve has become a test bed for Active and Reserve
Integration (ARI) and Zero Based Review (ZBR). While these two policies
make for good endorsements on transformation, the impact of these
policies will have a negative impact on retention. The bottom line of
these new policies has been a recommendation within the Presidential
Budget of a cut of 10,300 to the USNR in fiscal year 2006. Many within
the Naval Reserve question the validity of these recommendations. The
near term plan for the USNR is to force shape to Army support; which
isn't necessarily preparing the force for the next at sea battle.
The force being fashioned by Iraq is a USNR made up of SeaBee's,
security forces, port security, custom agents and intelligence. This
will be a more junior force. While the gain may be less in pay and
compensation; the cost will be to experience and skill sets.
The Zero Based Review (ZBR) which has recommend cutting the Naval
Reserve from and end-strength of 84,300 to about 64,000 members did not
include all of the roles, missions and demands for Reservists. Among
the roles left out of this calculation were joint, and homeland
security requirements. Yet Congress is being asked to cut the USNR to
70,000.
To reverse a growing trend ROA recommends:
--Slow down and reduce the cuts planned for fiscal year 2006; at a
minimum the cut of 10,300 should be spread out over 4 to 5
years.
--Determine what future roles the USNR will be supporting which could
lead to increases in end-strength, and;
--Redo the USNR Zero Based Review to include joint and homeland
defense requirements. This ZBR should be ongoing rather than
periodic.
CONCLUSION
DOD, as we all know, is in the middle of executing a war--the
Global War on Terrorism and operations in Iraq are directly associated
with that effort. For the Department, worries have emerged about
additional spending during these military actions. Almost every
initiative to include proposed changes to personnel practices and
improvements in compensation programs are quickly placed under a ``what
will it cost?'' scrutiny. It is ROA's view that this scrutiny is too
often oriented toward immediate costs with a lack of appropriate regard
for long-term results versus life cycle costs. This is not to say that
prudent, fiscal personnel and budget policies and processes should be
ignored. At all times what is being achieved should respectfully be
balanced with how something is being achieved.
From a positive aspect, DOD's work to change and transform is
admirable. Although many issues effecting Reservists are difficult and
complex, the Departments of Defense, Homeland Security, Health and
Human Services have all accomplished much in streamlining and updating
mobilization and demobilization and in working health care challenges
of wounded military members. There are still areas that need scrutiny
such a depot support and regeneration costs for equipment and training.
The war on terrorism is our Nation's first threat and this threat will
not go away. The Reserve Components will take part in countering this
threat for many years to come which offers us the best opportunity to
resolve these issues once and for all.
Senator Stevens. Thank you very much, Ms. Lukas. I am sure
you realize that this base closure process we are going through
is to free up money to modernize some of that equipment, just
as you indicated. We do have a vast need for improved trucks
and improved vehicles. We are sending the Strykers over there
so that they can drive them 65 miles an hour and still be safe.
But there are not enough of them over there yet.
But I thank you very much for your testimony and hope you
will be pleased with the results.
Ms. Lukas. Thank you, sir.
Senator Stevens. Thank you very much.
Next is Command Master Sergeant Retired Mark Olanoff,
Retired Enlisted Association. Yes, sir. Nice to see you again,
sir.
STATEMENT OF COMMAND MASTER SERGEANT MARK H. OLANOFF,
U.S. AIR FORCE (RETIRED), EXECUTIVE
DIRECTOR, THE RETIRED ENLISTED ASSOCIATION
Sergeant Olanoff. Good to see you again, sir, Mr. Chairman.
First I would like to start and thank you and Senator
Inouye for everything you have done for us, because, you know,
over the years we have come to see you and talked about issues
that really are not within your purview, like concurrent
receipt and survivor benefit offsets and health care for those
over 65, which is now TRICARE for Life.
You told us at one hearing, you might remember, a few years
ago that we had to go to the authorizing committee to fix those
problems, and we did that. Here is the debate that happened in
the fiscal year 2001 conference report, in which virtually
every Senator who spoke supported the improvements for health
care. I just want to read a couple points that Senator Warner
had to say.
He said that: ``I turn now to what is the most important
single item in this conference report, military health care,
particularly for our retired personnel and their families.
History shows they are the best recruiters of all.''
In another part of the record he says: ``Two weeks ago in
the testimony before the Senate Armed Services Committee and
the House Armed Services Committee, General Hugh Shelton,
Chairman of the Joint Chiefs of Staff, and each of the service
chiefs strongly supported making this benefit permanent and
using the accrual amount method of financing. The Joint Chiefs
have repeatedly testified that failing to honor the commitment
to our retirees has been detrimental to their recruiting and
retention efforts.''
Yet today we see op-ed pieces put out by the Pentagon that
now say that military retirees are a drain on the active duty
force and the Reserve component. This is far from the truth. As
you know, Mr. Chairman, your subcommittee appropriates money
for discretionary funding. We won the battle on TRICARE for
Life through the Armed Services Committee, not here. We won the
battle on concurrent receipt through the authorizers and it was
paid for through the Treasury, not from the Defense Department.
The survivor benefit correction that was done in last year's
defense bill was offset by crazy accounting the way they do
things here, but there was an offset of mandatory funding. We
did not buy tankers that we were going to buy.
So for the Pentagon to now say that we are a drain on their
budget is totally unfair. The last point, Mr. Chairman, is I
did some checking to find out why the Pentagon does not talk
about civilian retirees, why they are not a drain on their
budget. There is a good reason. I found out that the health
care--72 percent that the Government funds for retirees of the
civil service--is funded through the Office of Personnel
Management (OPM) budget, which means there is no accrual
accounting like there is for TRICARE for Life.
So I believe that we have an obligation to fund military
health care for military retirees who have earned their
benefits. Again, I would like to thank you very much for
everything that you have done to help us over the years.
Thank you, Mr. Chairman.
Senator Stevens. Thank you very much.
I was just talking about looking into that. We will look
into that.
Sergeant Olanoff. Thank you, sir.
Senator Stevens. We appreciate it.
[The statement follows:]
Prepared Statement of Mark H. Olanoff
Mr. Chairman, it is an honor for The Retired Enlisted Association
to testify on our concerns for military and veterans' before your
committee.
The Retired Enlisted Association is a Veterans' Service
Organization founded 42 years ago to represent the needs and points of
view of enlisted men and women who have dedicated their careers to
serving in all the branches of the United States Armed Services active
duty, National Guard and Reserves, as well as the members who are doing
so today.
funding for active duty, national guard and reserve forces
The Retired Enlisted Association generally supports the
administration's request to support today's troops and looks forward to
working with the committee to that end. TREA is working on issues with
the Senate Armed Services Committee to improve the quality of life for
all components, retirees and their survivors.
DOD HEALTH CARE
I would like to start with a statement made by Senator John Warner
(Virginia), Chairman of the Senate Armed Services Committee during the
debate on the fiscal year 2001 National Defense Authorization Act
concerning the Healthcare provisions:
``I turn now to what is one of the most important single item in
this conference report--military healthcare, particularly for our
retired personnel and their families. History shows they are the best
recruiters of all.''
The conference report before the Senate fulfills an important
commitment of ``healthcare for life'' made by the recruiters--the U.S.
Government--beginning in World War II and continuing through the Korean
war and the Viet Nam war. The goal of making that commitment was to
encourage service members to remain in uniform and become careerists.
Simply put, a commitment of health care for life in exchange for their
dedicated career service.
Again, this convergence report fulfills the promise of healthcare
for life. I am proud of the bipartisan unanimity with which the Senate
Armed Services Committee supported this initiative--an initiative never
taken before by a congressional committee.
Let me describe for my colleagues and for our active and retired
service members around the world the legislation in this conference
report to authorize health care benefits for Medicare-eligible military
retirees and their families, and how we arrived at this outcome.
For as long as I can remember, military recruits and those facing
re-enlistment have been told that one of the basic benefits of serving
a full military career is health care for life. We all know now that
this commonly offered incentive was not based in statute, but was,
nonetheless, freely and frequently made; it is a commitment that we
must honor.
Let me briefly review the history of military health care. Military
medical care requirements for activity duty service members and their
families were recognized as early as the 1700's. Congressional action
in the last 1800's directed military medical officers to attend to
military families whenever possible, at no cost to the family. During
World War II, with so many service members on activity duty, the
military medical system could not handle the health care requirements
of family members. The Emergency Maternal and Infant Care Program was
authorized by Congress to meet this road. This program was administered
through state health agencies.
The earliest reference in statute defining the health care benefit
for military retirees was in 1956 when, for the first time, the
Dependent's Medical Care Act specified that military retirees were
eligible for health care in military facilities on a space-available
basis. In 1966, this Act was amended to create the Civilian Health and
Medical Program of the Uniformed Services, CHAMPUS, to supplement the
care provided in military facilities. This legislation, in 1966,
specifically excluded from coverage military retirees who were eligible
for Medicare--a program which had been enacted by the Congress 1 year
earlier, in 1965.
The exclusion of over age 65, Medicare-eligible military retirees
from guaranteed care from the military health care system was masked
for many years because the capacity of military hospitals an the
military medical system exceeded that required to care for active duty
service members; therefore, many Medicare-eligible retirees were able
to receive treatment, on a space-available basis, at military
facilities. In the 1990's, we began to reduce the size of our military
services and the base realignment and closure, BRAC, rounds began to
close bases--and military hospitals--all across the Nation. The
combined effect of fewer military medical personnel to provide care and
the closure of over 30 percent of the military hospitals eliminated the
excess capacity that had been so beneficial to military retirees. Also
during this decade the retiree population grew dramatically, adding
pressure to the military health care system. The true magnitude of the
problem was finally exposed.
All of us have heard from military retirees who served a full
career and, in so doing, made many sacrifices. Many times the
sacrifices these heroic veterans made resulted in serious medical
conditions that manifested themselves at the time in their lives when
they were pushed out of the military health care system. As a nation,
we promised these dedicated retirees health care for life, but we were
ignoring that promise.
On February 23, 2000, I introduced a bill, S. 2087, that provided
for access to mail order pharmaceuticals for ALL Medicare-eligible
military retirees, for the first time. The legislation also would
improve access to benefits under TRICARE and extend and improve certain
demonstration programs under the Defense Health Program.
On May 1, 2000, I introduced S. 2486, which added a retail pharmacy
component to the previous legislation, providing for a full pharmacy
benefit for all retirees, including those eligible for Medicare.
On June 6, Senator Tim Hutchinson and I introduced S. 2669, a bill
that would extend TRICARE eligibility to all military retirees and
their families, regardless of age. Later that same day, I amended the
defense authorization bill to add the text of S. 2669. This legislation
provided uninterrupted access to the Military Health Care System, known
as TRICARE, to all retirees.
Permanently funding the military retiree health care benefit will
be seen by retirees, active duty service members and potential recruits
as the Nation keeping its commitment of health care for life to
military retirees. Those serving today and those who are joining the
military will see that the promise of a lifetime of health care, in
return for serving a full career, will be honored in perpetuity.
Two weeks ago, in testimony before both the Senate Armed Services
Committee and the House Armed Services Committee, General Hugh Shelton,
Chairman of the Joint Chiefs of Staff, and each of the service chiefs
strongly supported making this benefit permanent and using the accrual
account method of financing. The Joint Chiefs have repeatedly testified
that failing to honor the commitment to our retirees has been
detrimental to their recruiting and retention efforts.''
TREA is very concerned with recent articles in national newspapers
that the Department of Defense is worried that costs for military
retiree benefits are taking funds away from the troops. These
statements are not accurate.
TREA urges the subcommittee to fully fund DOD's health care account
to include a seamless transition with the Department of Veterans'
Affairs. Further, TREA recommends report language that specifically
prohibits the Department of Defense from raising TRICARE co-payments in
fiscal year 2006. Finally, TREA recommends an oversight hearing with
the Department of Defense and stakeholders to discuss differences
between entitlement and discretionary spending.
BASE REALIGNMENT AND CLOSURE
TREA realizes that this subcommittee has very little to do with the
BRAC process, however, section 726 of the fiscal year 2004, National
Defense Authorization Act (Public Law 108-136) states ``Working group
on military health care for persons reliant on health care facilities
at military installations to be closed or realigned''. Although this
working group has been established by DOD and the group has had one
meeting, this issue will become very important after the BRAC list is
finalized.
TREA urges the subcommittee to be aware of this issue when
appropriations are made to fund BRAC.
CONCLUSION
TREA is very grateful for this opportunity to testify before the
Defense Appropriations Subcommittee and would like to thank Chairman
Stevens and Ranking Member Inouye for their many years of support to
the defense of our country.
Senator Stevens. Our next witness is Retired Captain
Marshall Hanson, Chairman of the Association for America's
Defense. Yes, sir.
STATEMENT OF CAPTAIN MARSHALL HANSON, U.S. NAVAL
RESERVE (RETIRED), CHAIRMAN, ASSOCIATIONS
FOR AMERICA'S DEFENSE
Captain Hanson. Thank you, sir. Mr. Chairman, the
Associations for America's Defense (A4AD) are very grateful to
testify today on issues of national defense equipment and force
structure. We would like to thank this subcommittee for its
stewardship on defense issues and setting the example by its
nonpartisan leadership.
Support for our deployed troops continues to be a priority
and warrants top importance. The Reserve Enlisted Association,
which belongs to A4AD, had one of its members mobilized by the
marines who is currently in Iraq. When asked about up-armoring
of vehicles in country, I got an answer from this sergeant by
e-mail just yesterday that I would like to share with the
subcommittee. He said:
``Sometimes I see soldiers going out in home-armored
vehicles. We call them grenade buckets. Our teams have two
vehicles and one of them is a bucket, though this week we will
be getting it refurbished. They are going to take off the
homemade armor and add higher sides, higher back gate,
generation three armor doors, and armor the cab's canvas roof.
Unfortunately, I was told that we will still need to add the
Kevlar blast pads on the rear wheel wells because the armor
does not protect the troops that sit in the back. Another
problem is that these pads can catch fire.
``The insurgents have started using antitank mines, which
have killed about four soldiers in the next area of operation.
We had a first sergeant here who may lose his leg. We cannot
really armor a Hummer enough to stop these mines. We do the
best we can with the armor and use our intel, tactics, and
procedures to stop the improvised explosive devices (IEDs) and
car bomb attacks.
``Overall, the main difficulty with the up-armoring is the
logistics with getting the vehicle to the up-armor location.
They expect us to take off the welded homemade armor without
technical support and then there is the risk of driving the
unprotected vehicle to the armoring sites. Both vehicles we use
have some wear and tear and could use refurbishing. This is the
standard around here, although the 7-ton truck and the light
medium tactical vehicles (LMTV) are in good condition.'' End
quote.
A4AD is concerned about this wear and tear on fielded
equipment and how our soldiers and marines who are returning
from the combat theater without equipment because they must
leave it behind. For the demobilized, readiness will become an
issue because there is no equipment left to train on. Included
in our written testimony is a list of unfunded equipment we
would like to see procured for Active and Reserve components.
It also should be remembered that equipment is only as good
as the people who use it. We believe Congress must continue to
make it a high priority to increase end strengths because this
type of combat we are seeing is stressing our military troops.
People are more than just human capital assets and if they are
overtasked and undervalued we will see a growing recruiting and
retention problem.
Further, proposed cuts to some of our Guard, Reserve, and
Active services may be sending out the wrong message to future
adversaries and to our troops in the field. Increases should be
made to both the Active and Reserve components as the
Department of Defense (DOD) missions will continue beyond just
the operational, to include strategic contingencies and
homeland defense.
We are at a point in our history where we are defending our
national interests at the same time that we are defining our
future security systems. Let us not overstep our capabilities
at the risk of defense. The responsibilities that you bear
toward the future are great and I am sure the opinions you are
given are many.
Thank you for your ongoing support of the Nation, the armed
services, and the fine young men and women who defend our
country. I am available for any questions.
[The statement follows:]
Prepared Statement of Marshall Hanson
INTRODUCTION
Mister Chairman and distinguished members of the committee, the
Associations for America's Defense (A4AD) are very grateful for the
invitation to testify before you about our views and suggestions
concerning current and future issues facing the defense appropriations.
The Association for America's Defense is an adhoc group of 12
military and veteran associations that have concerns about national
security issues that are not normally addressed by The Military
Coalition, and the National Military Veterans Alliance. Among the
issues that are addressed are equipment, end strength, force structure,
and defense policy. Collectively, we represent about 2.5 million
members, who are serving our Nation, or who have done so in the past.
The number of supporters expands to beyond 5 million when you include
family members and friends of the military.
A4AD, also, cooperatively works with other associations, who
provide input while not including their association name to the
membership roster.
CURRENT VERSUS FUTURE; ISSUES FACING DEFENSE
The Associations for America's Defense would like to thank this
committee for the on-going stewardship that it has demonstrated on
issues of Defense. At a time of war, its pro-defense and non-partisan
leadership sets the example.
Members of this group are concerned that U.S. Defense policy is
sacrificing future security for near term readiness. So focused are our
efforts to provide security and stabilization in Iraq, that risk is
being accepted as an element in future force planning.
A Pentagon criticism is that our Armed Forces are archaic;
structured for a Cold War. Instead, transformation is now being touted
that would now emphasize ``boots on the ground,'' while at the same
time it encourages technological improvements that would jump a
generation of weapons. Yet force planning is being driven by the Global
War on Terrorism, plans to democratize the Middle East, and to allow
for budget limitations. Cuts are being suggested for legacy weapons and
infrastructure to pay for current operations and future combat systems.
What seems to be overlooked is that the United States is involved
in a Cold War as well as a Hot war. While the United States is
preoccupied with the Middle East and with the near-term crisis posed by
North Korea's, China expands its influence over Africa, South America,
and the underbelly of the former Soviet Union. It builds a military
designed to counteract American military, and is erecting a Chinese
stronghold of territorial claims and international lawfare.
Our military leadership defends it policy with proud display,
testifying to the fact that our aircraft, missiles and ships have a
greater capability and effectiveness then ever in the past. Yet within
the last decade, our picket lines of defense have been gapped several
times to respond to distant crises. Platform numbers and location are
as significant as accuracy and payload.
China is the elephant in the war room that many force planners hope
will just go away. As the United States expends resources in the Middle
East and re-structures the military to fight terrorism, China patiently
waits for America to weaken by withdrawing itself globally by
transforming into a smaller force. China also awaits for another
advantage which could be caused by the GWOT: the erosion of the
American national will.
The Pentagon has suggested that technology will keep us ahead. By
reducing procurement of the next generation of systems that are already
planned by the armed services, and by pouring money into future combat
systems DOD claims that we will maintain a tactical advantage. The
question asked by many within the A4AD, will our adversaries wait until
we attain this future?
FORCE STRUCTURE CONCERNS
Aging Equipment
Tactical Air.--The rapidly aging F-15 Eagles first flew in the
1970's. In recent mock combat against MiG, Sukhoi and Mirage fighters,
foreign air forces scored unexpected successes against the Eagles. What
is characteristic of paradigm shifts in air superiority is that they
are invariably driven by one or another technological advance. New air
dominance platforms are urgently needed. The F/A-22 Raptor and the
Joint Strike F-35 fighters represent vital and complementary
capabilities.
Airlift.--Hundreds of thousands of hours have been flown, and
millions of passengers and tons of cargo have been airlifted. Both Air
Force and Naval airframes and air crew are being stressed by these lift
missions. Procurement needs to be accelerated and modernized, and
mobility requirements need to be reported upon.
Fleet Size.--The number of ships in the fleet is dropping. At the
end of April, the Navy had 288 ships. The Chief of Naval Operations,
Admiral Vern Clark, in testimony before Congress talked about a 260
ship fleet by the year 2035.
Under the 260-ship plan, ship purchases and spending would show a
peak-and-valley pattern over the 2006-2035 period. Through 2015, the
Navy would buy an average of 9.5 ships per year, at an annual cost of
about $14.4 billion. The fleet would peak at 326 ships in 2020 and then
gradually decline to 260 by 2035. The mid-to-late 2020's would be a
period of low ship purchases under the 260-ship plan.
As recently as 2003, the U.S. Navy was telling Congress that its
long-term goal was a 375-ship Navy. According to Admiral Clark, the
260-ship plan would cost about $12 billion a year for ship
construction, and the 325-ship plan would cost about $15 billion a year
for shipbuilding.
The administration procurement rate is too low and has yet to even
reach a 9.5 ships per year procurement rate to support a build-up
toward 2020. It appears that the Navy won't even attain the numbers
discussed by the CNO before Congress.
Admiral Clark has accepted the DOD premise that technology can
replace humans, and now seems to favor a smaller Navy because of lower
cost and reduced manpower. He has also instituted new procedures like
surging aircraft carriers to meet crises and keeping ships deployed
overseas while rotating the crews. To some this means the Navy will
need no more than 325 ships and possibly as few as 260. Yet this also
means we will wear out people and equipment faster.
A4AD favors a larger fleet because of an added flexibility to
respond to emerging threats. It is also believes that Congress should
explore options to current ship design, configuration, and shipbuilding
methods which have created billion dollar destroyers.
A Changing Manpower Structure
Air Force.--Compared to the Cold War Air Force, today's USAF is
small and based mostly in the United States, necessitating rapid,
large-scale deployments over long distances. Over the last two decades,
the active duty Air Force was reduced by nearly 40 percent--from
608,000 to 359,000 uniformed members. Higher retention rates have
caused the active duty force to expand temporarily to 375,000. Now the
Air Force must shrink by some 16,000 Airmen in order to meet the fiscal
year 2005 authorized force level of 359,000 people. While the force
shrinks, operations tempo at stateside and overseas bases remains high.
Airmen are working long hours, deploying with ever-increasing frequency
to hot spots around the world, and spending more time away from their
families. To accommodate the new steady state, service leaders have
extended overseas rotations for each Air and Space Expeditionary Force
(AEF), raising it from 90 days to 120 days. Combat deployments have
been extended. Crews are flying longer missions and have less ground
time between missions.
Air Guard and Reserve.--Across the board, the Total Force is
straining to meet new requirements and challenges. The Air National
Guard and Air Force Reserve have been activated at unprecedented
levels. Since September 11, 2001, the Air Force has mobilized nearly
65,000 Guardsmen and Reservists. Together, they constitute 20 percent
of Air Force AEF packages supporting operations in Southwest Asia.
Additionally, they conduct 89 percent of air patrols over American
cities in support of Operation Noble Eagle. In spite of enormous
challenges, morale throughout the Total Force remains high. Senior Air
Force leaders at present do not seek an increase in USAF end strength.
A4AD cautions that if the level of operations continues at the
current pace, a decision to request more manpower cannot be avoided.
The bottom line is that resources must be matched to tasking.
Army.--The Active Army is currently re-structuring all three
components (Active, Reserve, Guard) in an attempt to create 77 Brigade
Combat Teams and the necessary support organizations. To do this, the
Army has a short-term increase in end strength of 30,000. Many in
Congress feel that the increase should be permanent and possibly
increased further.
As part of its efforts to increase the number and deployability of
the Army's combat brigades, the Pentagon has begun the Army's
Modularity Program. The fiscal year 2006 request contains no funding
for the program.
Army Reserve.--The Army Reserve has a mandated end-strength of
205,000. It is likely that they will not end the year within the 2
percent variance authorized by Congress. It should be considered that
part of the Active Army end-strength increase should be devoted to
full-time support in the Army Reserve and Guard. This would enhance
readiness as well as provide important mentoring to soldiers in
anticipation of future deployments. At the present time, although
retention in the Army, Army Reserve and Army National Guard remains
high, recruiting challenges continue. A4AD anticipates that there will
be an increased need for monetary incentives in all components.
Navy.--The official Navy posture is that its force level will
reduce from approximately 360,000 sailors today to something in the
neighborhood of 315,000 by the year 2012. A4AD has had an internal
debate among its own membership on this manpower policy, some favor
cuts, while others favor increases. Manpower is expensive, but it is
people, not technology that have always won past battles and salvaged
ships. If we tailor our fighting force too tightly with a level that is
too low, we could create a force without indemnity.
Naval Reserve.--New Navy policies have lead to a recommendation
within the Presidential Budget of a cut of 10,300 to the USNR in fiscal
year 2006. A4AD disagrees. At a time when the USN plans to cut the
active force, these skillsets of these people should be placed into the
Naval Reserve. Yet rather than increase the USNR as a hedge against
policy, the Navy wants proportionally bigger cut from its Reserve.
The Zero Based Review (ZBR) which has recommended cutting the Naval
Reserve from an end-strength of 84,300 to about 64,000 members did not
include all of the roles, missions and demands for Reservists. Among
the missions not included in this review were joint, homeland security
requirements, spec-ops and non-planned M-day demands. Aviation hardware
units were also not included in the ZBR.
Further, proposed civilianization of drilling Reserve and Full Time
Staff billets do not address the call for war fighting skills and
risks. A prime example is the Naval Reserve Construction Seabees
Battalions, which were proposed for reduction prior to 9/11, are now
touted as the USNR's best assets.
At a minimum, the proposed USNR fiscal year 2006 cut needs to be
spread over a number of years, and the Naval Reserve roles and missions
needed to be examined.
Marines.--As the Marine Corps is increased in size, the USMC wants
to maintain the right number and mix of trained experienced Marines
with first tour recruits. Ideally, 70 percent of the USMC is first
tour, with the remaining 30 percent on extended service. With an
expanded force, this ratio has been changing so that the number of
first tour Marines is growing beyond the 70 percent. The Marine Corps
will need to retain a greater number of individuals to offset new
trainees with experienced leadership. Gradual increases need to be
implemented to maintain the ratio of first tour to experienced Marine.
Marine Forces Reserve.--With a similar ratio as the Active
component, historically 70 percent of the USMCR force has been non-
prior service. But this ratio has now climbed past 74 percent which
causes concern. Retention is also becoming a challenge which
exasperates the non-prior service ratio. No immediate increase beyond
500 additional would be recommended for the USMCR.
Coast Guard Reserve.--The Coast Guard Selected Reserve has been
held to 8,100 members by appropriation restriction, and no one in the
Coast Guard leadership has been an advocate to ask for additional
funding to even cover for the 10,000 billets that have been authorized
by the Armed Services Committees.
The 8,100 manning level is no higher than it was prior to the
terrorist attacks on September 11. Yet, the number of missions for the
Coast Guard Reserve has increased. Coastal maritime defense is
considered by many to be the most important challenges facing the
United States today. Two requirements based studies conducted since 9/
11 recommended that the USCGR strength be increased to 17,353 and
18,031 respectively. USCGR appropriations need to support authorization
levels.
Increasing End Strength
The Army's fiscal year 2006 budget request does not include funding
for its 30,000-troop increase, nor does the Marine Corps request
include funding for a 3,000-troop increase. Total estimated cost for
the additional forces is $3.5 billion.
A4AD has continuing concerns about the mismatch between reducing
active duty and reserve force strengths and the increasing mission
requirements. While retention rates remains highs, the effects of the
heightened OPTEMPO are beginning to have a measured impact. If the
current Active Duty end strength was adequate, the demand for Reserve
and Guard call-up would not be so urgent.
End strengths need to be closely examined by both the House and
Senate as a first step in addressing this situation.
Regeneration/Resetting of Equipment
Aging equipment, high usage rates, austere conditions in Iraq, and
combat losses are affecting future readiness. Equipment is being used
at 5 to 10 times the programmed rate.
Additionally, to provide the best protection possible for Soldiers
and Marines in the combat theater, many units have left their equipment
behind for follow-on units, and are returning with no equipment.
Without equipment on which to train after de-mobilization, readiness
will become an issue.
The Army, Army Reserve, Army National Guard, Marines and Marine
Forces Reserve need continued funding by Congress for equipment
replacement.
Counter-measures to Improvised Explosive Devices
A4AD would like to commend the committee for supporting enhanced
countermeasures for air and ground troops now deployed. For ground
troops, the biggest threat to safety remains the improvised explosive
device or IED. As you know, these devices use simple electronic
transmitters--like garage door openers, remote controls for toys or
cell phones--to detonate a disguised explosive as a convoy or unit on
patrol passes by. These devices are usually well concealed in ordinary
roadside debris like tires or dead animals. One response of the
Congress to this extraordinary threat to our ground forces has been to
call for and fund the accelerated purchase and deployment of up-armored
Humvees.
A4AD would like to point out to the committee, however, that
Humvees are not the only vehicle operated in theater and that the
emphasis on up-armoring one type of vehicle has left others with little
to no protection. For example, by up-armoring Humvees, we provide a
greater degree of safety for troops escorting a convoy, but no
additional protection for those troops driving the large supply trucks
that are part of the same convoy. Cost-effective solutions that can
provide an enhanced degree of safety do exist, however, in the form of
electronic countermeasures. These devices work in one of two ways:
either by pre-detonating an IED or by preventing the detonation through
jamming of the signal. The committee has already seen fit to support
the deployment of these types of solutions through the reprogramming of
$161 million in last years' supplemental for Iraq and Afghanistan
operations, but we believe that more remains to be done. We would
encourage and request the committee to look at specifying that
additional funds be made available for the purpose of purchasing and
deploying more electronic countermeasures for ground troops. In this
way we can provide a greater degree of safety to all of the troops
facing the IED threat, no matter what type of vehicle they may be
operating.
Continued emphasis is needed for the procurement of sufficient
quantities of countermeasures to protect every unarmored personnel
carrier now deployed in the battle space.
Aircraft Survivability Equipment
As for air crews, they face non-traditional threats used by non-
conventional forces and deserve the best available warning and
countermeasure equipment available to provide the greatest degree of
safety possible. As an example of this threat, one need only look at
the downing of a privately-operated helicopter as recently as 1 month
ago. A4AD hopes that the committee will continue to support the
purchase and deployment of warning and countermeasures systems for both
fixed and rotary wing aircraft across all of the services and insure
that the latest and most advanced versions of these protections are
made available to all units now deployed or slated for deployment in
the future--be they active duty, Guard or Reserve.
Continue to support the purchase and deployment of warning and
countermeasures systems for both fixed and rotary wing aircraft across
all of the services and insure that the latest and most advanced
versions are available.
Maintaining the National Guard and Equipment List
Pressure continues within the Navy and the Coast Guard to combine
various appropriations so that Reserve equipment accounts would be
merged with that of the parent service.
A single equipment appropriation for each service would not
guarantee that the National Guard and Reserve Components would get any
new equipment. The National Guard and Reserve Equipment Account (NGREA)
is vital to ensuring that the Guard and Reserve has some funding to
procure essential equipment that has not been funded by the services.
Without Congressional oversight, dollars intended for Guard and Reserve
Equipment might be redirected to Active Duty non-funded requirements.
This will lead to decreased readiness.
This move is reminiscent of the attempt by DOD to consolidate all
pay and O&M accounts into one appropriation per service. Any action by
the Pentagon to circumvent Congressional oversight should be resisted.
A4AD asks this committee to continue to provide appropriations
against unfunded National Guard and Reserve Equipment Requirements. To
appropriate funds to Guard and Reserve equipment would help emphasize
to the Active Duty that it is exploring dead-ends by suggesting the
transfer of Reserve equipment away from the Reservists.
Unfunded Equipment Requirements
(The services are not listed in priority order.)
Air Force
F/A-22 and F/35 Joint Strike Fighter
Accelerate C-17 and C-130J procurement
Update Tanker Fleet
E-10 multi-sensor Command and Control Aircraft
Space Radar
Air Force Reserve
C-9/C-40 Personnel Sustainment (O&M) Scott AFB--$40.8 million
C-130/HC-130 Large Aircraft I/R Counter Measures--$225.1 million
A-10 LITENING Advanced Targeting Pod Procurement--$53.0 million
C-130 APN-241 Radar--$37.0 million
Tactical Data Link for A-10/HH-60--$7.7 million
Air Guard
Accelerate C-17 Airlifter (8) add (7)--$180 million each
Aircraft Rescue and Fire Fighting Vehicles
E-8C Joint STARS Aircraft Re-engine
Patient Decontamination Assemblages (20)--$3.4 million
Bioenvironmental Assemblages (10)--$1.0 million
Army
The Army spent $62.4 billion on O&M in fiscal year 2004, is
estimating O&M spending of $45.4 billion in fiscal year 2005, and is
requesting only $31.8 billion in fiscal year 2006. If these figures are
accurate, then Army O&M spending has declined by roughly 50 percent in
the space of 2 years for a military that's the same size and actively
engaged in combat operations in Iraq, Afghanistan, and other regions of
the world.
Army Reserve
Light Medium Tactical Vehicles [LMTV] (600)--$92 million
Medium Tactical Vehicles [MTV] (800)--$146 million
Multi-Band Super High Frequency Terminal (10)--$30 million
Truck, Cargo PLS 10 10 and PLS Trailer (44/88)--$12.7/$4.8 million
High Mobility Multi-Purpose Wheeled Vehicle (279)--$21 million
Army Guard
Funding for Rapid Field Initiative, special equipment and
protective garments. RFI is a kit of approximately 50 essential items
that provide the most up-to-date equipment to Soldiers at war.
High Mobility Multi-Purpose Wheeled Vehicle (HMMWV, short 13,265)
Single Channel Ground Air Radio Sys. (SINCGARS, retire obsolete
20,000 VRC-12)
Night Vision Goggles (NVG, short 100,000)
Marine Corps
Mountain and Cold Weather Clothing Equipment--$24.9 million
Modernization of Medical Allowance Lists--$19 million
Shelters and Tents--$23.4 million
Portable Tent Lighting--$8.5 million
Tactical Radios (PRC-117 and 150)--$25 million
Reserve Marine Corps
Initial Issue equipment--$10 million
Mountain and Cold Weather Clothing Equipment--$8.4 million
Portable Tent Lighting--$3.5 million
Shelters and Tents--$5.2 million
Light Armored Vehicles (LAV -25, 48)--$104 million
Navy
Aircraft Survivability Equipment--(5) MH-53E, (18) H/MH-60, (37) P-
3 AIP--$22.1 million
Low Band Transmitter (Jammer) pods (11)--$16.4 million
SH-60B/H Armed Helo Kits (28)--$58.3 million
Expand Maritime Interdiction Outfitting--personal protection,
secure comms & cargo access --$10.5 million
Accelerate repair/replace theater small arms--$24.0 million
Naval Reserve
C-40 A Inter-theater Transport (2)--$135 million
Littoral Surveillance System, LSS coastal defense (1)--$19 million
Explosive Ordnance Disposal/Naval Coastal Warfare Tactical Vehicles
and Support Equipment --$14.5 million
EOD/NWC Small Arms--$36.8 million
Funds for activation--Funds associated for Reservist mobilize for
GWOT
CONCLUSION
A core of military and veteran associations is looking beyond
personnel issues to the broader issues of National Defense. As a group,
we will continue to meet in the future, and hope to provide your
committee with our inputs.
Cuts in manpower and force structure, simultaneously in the Active
and Reserve Component are concerns in that it can have a detrimental
effect on surge and operational capability.
This testimony is an overview, and expanded data on information
within this document can be provided upon request.
Thank you for your ongoing support of the Nation, the Armed
Services, and the fine young men and women who defend our country.
Please contact us with any questions.
Senator Stevens. We do not have any questions. He is right,
of course, and the difficulty is we still have to find a way to
build them that way to start with. The up-armoring is costing
us too much money. We have to go back sometimes two or three
times to get it right.
We appreciate your testimony, though. We will continue to
work with you on that.
Captain Hanson. Thank you, sir.
Senator Stevens. The next witness is Dr. Jennifer Vendemia
of the American Psychological Association.
STATEMENT OF JENNIFER VENDEMIA, Ph.D., ON BEHALF OF THE
AMERICAN PSYCHOLOGICAL ASSOCIATION
Dr. Vendemia. Thank you, Mr. Chairman. I am Dr. Jennifer
Vendemia from the University of South Carolina Psychology
Department and I am testifying today on behalf of the American
Psychological Association (APA), a scientific and professional
organization of more than 150,000 psychologists and affiliates.
Although I am sure you are aware of the large number of
psychologists providing clinical services to our military
members here and abroad, you may be less familiar with the
extraordinary range of research conducted by psychological
scientists within the Department of Defense. Our behavioral
researchers work on issues critical to national defense with
support from the Army Research Institute and Army Research
Laboratory, the Office of Naval Research, the Air Force
Research Laboratory, and additional smaller human systems
research programs in the Office of the Secretary of Defense,
Defense Advanced Research Projects Agency (DARPA), the Marine
Corps, and the Special Operations Command.
For example, my own brain imaging research, which received
generous funding through this committee in fiscal year 2005,
seeks to model the neurocognitive processes of lying in order
to formulate new deception detection techniques using measures
of specific brain activity. As a university researcher, I also
collaborate with scientists conducting credibility assessment
studies at the nearby DOD Polygraph Institute at Fort Jackson
and the DOD Counterintelligence Field Activity here in
Washington. Deception and its accurate detection is of course
at the heart of counterintelligence work and the research
collaborations with DOD are designed to bridge results from my
investigations in basic psychophysiology to the more applied
mission-specific science and technology work that supports
counterintelligence activities. APA encourages the subcommittee
to increase funding for these very small but critical research
programs.
In terms of the overall defense science and technology
(S&T) account, the administration requested less in fiscal year
2005 than the enacted fiscal year 2004 amount and congressional
appropriators in turn provided a significant increase over both
the budget request and the fiscal year 2004 level, for a total
of $13.33 billion. For fiscal year 2006, the President's budget
request of $10.52 billion for DOD S&T has again fallen short of
both the fiscal year 2005 budget request and the fiscal year
2005 enacted level, representing a 21 percent decrease.
As a member of the Coalition for National Security
Research, APA recommends the DOD science and technology program
be funded at a level of at least 3 percent of total DOD
spending in fiscal year 2006 in order to maintain global
superiority in an ever-changing national security environment.
Total spending on behavioral and cognitive research, in
other words human-centered research, within DOD has declined
again in the President's fiscal year 2006 budget. Specific
human factors and manpower-personnel-training programs were cut
in the Army. The Navy's applied programs in human systems and
warfighter sustainment took substantial hits. Support for the
Air Force's applied human effectiveness, crew systems, and
personnel protection accounts were down in the President's
budget request.
We urge you to support the men and women on the front lines
by reversing another round of dramatic detrimental cuts to the
human-oriented research within the military laboratories and by
increasing support to behavioral research programs within DOD
activities related to credibility assessment and
counterintelligence.
Thank you very much.
Senator Stevens. Thank you very much.
[The statement follows:]
Prepared Statement of Jennifer Vendemia
``Conflict is, and will remain, essentially a human activity in
which man's virtues of judgment, discipline and courage--the moral
component of fighting power--will endure . . . It is difficult to
imagine military operations that will not ultimately be determined
through physical control of people, resources and terrain--by people .
. . Implicit, is the enduring need for well-trained, well-equipped and
adequately rewarded soldiers. New technologies will, however, pose
significant challenges to the art of soldiering: they will increase the
soldier's influence in the battlespace over far greater ranges, and
herald radical changes in the conduct, structures, capability and ways
of command. Information and communication technologies will increase
his tempo and velocity of operation by enhancing support to his
decision-making cycle. Systems should be designed to enable the soldier
to cope with the considerable stress of continuous, 24-hour, high-tempo
operations, facilitated by multi-spectral, all-weather sensors.
However, technology will not substitute human intent or the decision of
the commander. There will be a need to harness information-age
technologies, such that data does not overcome wisdom in the
battlespace, and that real leadership--that which makes men fight--will
be amplified by new technology. Essential will be the need to adapt the
selection, development and training of leaders and soldiers to ensure
that they possess new skills and aptitudes to face these
challenges.''--NATO RTO-TR-8, Land Operations in the Year 2020.
Mr. Chairman and members of the subcommittee, I'm Dr. Jennifer
Vendemia from the University of South Carolina Psychology Department. I
am submitting testimony on behalf of the American Psychological
Association (APA), a scientific and professional organization of more
than 150,000 psychologists and affiliates.
Although I am sure you are aware of the large number of
psychologists providing clinical services to our military members here
and abroad, you may be less familiar with the extraordinary range of
research conducted by psychological scientists within the Department of
Defense (DOD). Our behavioral researchers work on issues critical to
national defense, with support from the Army Research Institute (ARI)
and Army Research Laboratory (ARL); the Office of Naval Research (ONR);
the Air Force Research Laboratory (AFRL), and additional, smaller human
systems research programs in the Office of the Secretary of Defense,
the Defense Advanced Research Projects Agency (DARPA), the Marine
Corps, and the Special Operations Command.
For example, my own brain imaging research, which received generous
funding through this committee in fiscal year 2005, seeks to model the
neurocognitive processes of lying in order to formulate new deception
detection techniques using measures of specific brain activity. As a
university researcher, I also collaborate with scientists conducting
credibility assessment studies at the nearby DOD Polygraph Institute
(DODPI) at Fort Jackson and the DOD Counterintelligence Field Activity
(CIFA) here in Washington. Deception, and its detection, is of course
at the heart of counterintelligence work, and the research
collaborations with DOD are designed to bridge results from my
investigations in basic psychophysiology to the more applied, mission-
specific science and technology work that supports counterintelligence
activities.
I would like to address the fiscal year 2006 human-centered
research budgets for the military laboratories and programs within the
context of the larger DOD Science and Technology budget.
DOD SCIENCE AND TECHNOLOGY BUDGET
The President's budget request for basic and applied research at
DOD in fiscal year 2006 is $10.52 billion, a 21 percent decrease from
the enacted fiscal year 2005 level and a decrease from the President's
fiscal year 2005 budget request. APA joins the Coalition for National
Security Research (CNSR), a group of over 40 scientific associations
and universities, in urging the subcommittee to reverse this cut in
support and dedicate at least 3 percent of total DOD spending to 6.1,
6.2 and 6.3 level research in fiscal year 2006.
As our Nation rises to meet the challenges of current engagements
in Iraq and Afghanistan as well as other asymmetric threats and
increased demand for homeland defense and infrastructure protection,
enhanced battlespace awareness and warfighter protection are absolutely
critical. Our ability to both foresee and immediately adapt to changing
security environments will only become more vital over the next several
decades. Accordingly, DOD must support basic Science and Technology
(S&T) research on both the near-term readiness and modernization needs
of the department and on the long-term future needs of the warfighter.
In fiscal year 2005, the administration requested $10.55 billion
for defense S&T, less than the enacted amount in fiscal year 2004.
Congressional appropriators in turn provided a significant increase
over both the budget request and the fiscal year 2004 level, for a
total of $13.33 billion. For fiscal year 2006, the President's budget
request of $10.52 billion for DOD S&T again fell short--of both the
fiscal year 2005 budget request and the fiscal year 2005 enacted level
(a 21 percent decrease).
Despite substantial appreciation for the importance of DOD S&T
programs on Capitol Hill, and within independent defense science
organizations such as the Defense Science Board (DSB), total research
within DOD has remained essentially flat in constant dollars over the
last few decades. This poses a very real threat to America's ability to
maintain its competitive edge at a time when we can least afford it.
APA, CNSR and our colleagues within the science and defense communities
recommend funding the DOD Science and Technology Program at a level of
at least 3 percent of total DOD spending in fiscal year 2006 in order
to maintain global superiority in an ever-changing national security
environment.
BEHAVIORAL RESEARCH WITHIN THE MILITARY SERVICE LABS
In August, 2000 the Department of Defense met a congressional
mandate to develop a Report to the Senate Appropriations Committee on
Behavioral, Cognitive and Social Science Research in the Military. The
Senate requested this evaluation due to concern over the continuing
erosion of DOD's support for research on individual and group
performance, leadership, communication, human-machine interfaces, and
decision-making. In responding to the committee's request, the
Department found that ``the requirements for maintaining strong DOD
support for behavioral, cognitive and social science research
capability are compelling'' and that ``this area of military research
has historically been extremely productive'' with ``particularly high''
return on investment and ``high operational impact.''
Despite the critical need for strong research in this area, the
administration has proposed an fiscal year 2006 defense budget that
again would slash funding for human-centered research. APA urges the
committee to, at a minimum, restore proposed fiscal year 2006 cuts to
the military lab behavioral research programs.
Within DOD, the majority of behavioral, cognitive and social
science is funded through the Army Research Institute (ARI) and Army
Research Laboratory (ARL); the Office of Naval Research (ONR); and the
Air Force Research Laboratory (AFRL). These military service
laboratories provide a stable, mission-oriented focus for science,
conducting and sponsoring basic (6.1), applied/exploratory development
(6.2) and advanced development (6.3) research. These three levels of
research are roughly parallel to the military's need to win a current
war (through products in advanced development) while concurrently
preparing for the next war (with technology ``in the works'') and the
war after next (by taking advantage of ideas emerging from basic
research). All of the services fund human-related research in the broad
categories of personnel, training and leader development; warfighter
protection, sustainment and physical performance; and system interfaces
and cognitive processing.
Despite substantial appreciation for the critical role played by
behavioral, cognitive and social science in national security, however,
total spending on this research declined again in the President's
fiscal year 2006 budget. Specific human factors and manpower/personnel/
training programs within the applied 6.2 and 6.3 accounts were cut in
the Army, and the Navy's applied 6.2 programs in human systems and
warfighter sustainment took substantial cuts. Similarly, support for
the Air Force's applied 6.2 and 6.3 level human effectiveness and crew
systems and personnel protection accounts were down in the President's
budget request.
In addition, I know first-hand the value of supporting the smaller,
but mission-critical, behavioral research programs within DOD,
particularly those related to credibility assessment and detection of
deception. APA encourages the committee to increase funding for these
programs.
Behavioral and cognitive research programs eliminated from the
mission labs due to cuts or flat funding are extremely unlikely to be
picked up by industry, which focuses on short-term, profit-driven
product development. Once the expertise is gone, there is absolutely no
way to ``catch up'' when defense mission needs for critical human-
oriented research develop. As DOD noted in its own Report to the Senate
Appropriations Committee:
``Military knowledge needs are not sufficiently like the needs of
the private sector that retooling behavioral, cognitive and social
science research carried out for other purposes can be expected to
substitute for service-supported research, development, testing, and
evaluation . . . our choice, therefore, is between paying for it
ourselves and not having it.''
The following are brief descriptions of important behavioral
research funded by the military research laboratories:
ARMY RESEARCH INSTITUTE FOR THE BEHAVIORAL AND SOCIAL SCIENCES (ARI)
AND ARMY RESEARCH LABORATORY (ARL)
ARI works to build the ultimate smart weapon: the American soldier.
ARI was established to conduct personnel and behavioral research on
such topics as minority and general recruitment; personnel testing and
evaluation; training and retraining; and attrition. ARI is the focal
point and principal source of expertise for all the military services
in leadership research, an area especially critical to the success of
the military as future war-fighting and peace-keeping missions demand
more rapid adaptation to changing conditions, more skill diversity in
units, increased information-processing from multiple sources, and
increased interaction with semi-autonomous systems. Behavioral
scientists within ARI are working to help the armed forces better
identify, nurture and train leaders. One effort underway is designed to
help the Army identify those soldiers who will be most successful
meeting 21st century noncommissioned officer job demands, thus
strengthening the backbone of the service--the NCO corps.
Another line of research at ARI focuses on optimizing cognitive
readiness under combat conditions, by developing methods to predict and
mitigate the effects of stressors (such as information load and
uncertainty, workload, social isolation, fatigue, and danger) on
performance. As the Army moves towards its goal of becoming the
Objective Force (or the Army of the future: lighter, faster and more
mobile), psychological researchers will play a vital role in helping
maximize soldier performance through an understanding of cognitive,
perceptual and social factors.
ARL's Human Research & Engineering Directorate sponsors basic and
applied research in the area of human factors, with the goal of
optimizing soldiers' interactions with Army systems. Specific
behavioral research projects focus on the development of intelligent
decision aids, control/display/workstation design, simulation and human
modeling, and human control of automated systems.
Office of Naval Research (ONR)
The Cognitive and Neural Sciences Division (CNS) of ONR supports
research to increase the understanding of complex cognitive skills in
humans; aid in the development and improvement of machine vision;
improve human factors engineering in new technologies; and advance the
design of robotics systems. An example of CNS-supported research is the
division's long-term investment in artificial intelligence research.
This research has led to many useful products, including software that
enables the use of ``embedded training.'' Many of the Navy's
operational tasks, such as recognizing and responding to threats,
require complex interactions with sophisticated, computer-based
systems. Embedded training allows shipboard personnel to develop and
refine critical skills by practicing simulated exercises on their own
workstations. Once developed, embedded training software can be loaded
onto specified computer systems and delivered wherever and however it
is needed.
Air Force Research Laboratory (AFRL)
Within AFRL, Air Force Office of Scientific Research (AFOSR)
behavioral scientists are responsible for basic research on manpower,
personnel, training and crew technology. The AFRL Human Effectiveness
Directorate is responsible for more applied research relevant to an
enormous number of acknowledged Air Force mission needs ranging from
weapons design, to improvements in simulator technology, to improving
crew survivability in combat, to faster, more powerful and less
expensive training regimens.
As a result of previous cuts to the Air Force behavioral research
budget, the world's premier organization devoted to personnel selection
and classification (formerly housed at Brooks Air Force Base) no longer
exists. This has a direct, negative impact on the Air Force's and other
services' ability to efficiently identify and assign personnel
(especially pilots). Similarly, reductions in support for applied
research in human factors have resulted in an inability to fully
enhance human factors modeling capabilities, which are essential for
determining human-system requirements early in system concept
development, when the most impact can be made in terms of manpower and
cost savings. For example, although engineers know how to build cockpit
display systems and night goggles so that they are structurally sound,
psychologists know how to design them so that people can use them
safely and effectively.
SUMMARY
On behalf of APA, I would like to express my appreciation for this
opportunity to present testimony before the subcommittee. Clearly,
psychological scientists address a broad range of important issues and
problems vital to our national security, with expertise in
understanding and optimizing cognitive functioning, perceptual
awareness, complex decision-making, stress resilience, and human-
systems interactions. We urge you to support the men and women on the
front lines by reversing another round of dramatic, detrimental cuts to
the human-oriented research within the military laboratories, and by
increasing support to behavioral research programs within DOD
activities related to credibility assessment and counterintelligence.
Below is suggested appropriations report language which would
encourage the Department of Defense to fully fund its behavioral
research programs within the military laboratories:
``Department of Defense
``RESEARCH, DEVELOPMENT, TEST, AND EVALUATION
``Behavioral Research in the Military Service Laboratories.--The
Committee notes the increased demands on our military personnel,
including high operational tempo, leadership and training challenges,
new and ever-changing stresses on decision-making and cognitive
readiness, and complex human-technology interactions. To help address
these issues vital to our national security, the Committee has provided
increased funding to reverse cuts to basic and applied psychological
research through the military research laboratories: the Air Force
Office of Scientific Research and Air Force Research Laboratory; the
Army Research Institute and Army Research Laboratory; and the Office of
Naval Research.''.
Senator Stevens. Our next witness I hate to leave sitting
here, Dr. Polly. I will be right back. There is a vote. If you
look back and see all those lights, that means that we are in
the last part of the vote.
Our next witness is Dr. David Polly, Professor and Chief of
Spine Surgery at the University of Maryland, formerly of Walter
Reed Hospital, an eminent surgeon who made it possible for me
to walk straight up again.
STATEMENT OF DAVID W. POLLY, JR., M.D., PROFESSOR OF
ORTHOPAEDIC SURGERY AND CHIEF OF SPINE
SURGERY, UNIVERSITY OF MINNESOTA, ON BEHALF
OF THE AMERICAN ASSOCIATION OF ORTHOPAEDIC
SURGEONS
Dr. Polly. Thank you, sir.
Senator Stevens. Thank you very much.
Dr. Polly. Mr. Chairman and Senator Inouye: I thank you for
this opportunity to testify today. I am Dr. David Polly,
Professor of Orthopaedic Surgery at the University of
Minnesota, and I speak on behalf of the American Academy of
Orthopaedic Surgeons.
I have personally cared for injured soldiers at Walter Reed
during four different military conflicts and have been deployed
to a war zone as an orthopaedic surgeon in the military. My
last assignment was as Chair of the Department of Orthopaedic
Surgery and Rehab at Walter Reed.
I speak today in support of the proposal to establish an
Orthopaedic Extremity Trauma Research Program at the U.S. Army
Institute of Surgical Research (ISR) at Fort Sam Houston,
Texas, to fund intramural and extramural orthopaedic trauma
research. It is no surprise that approximately 70 percent of
all the trauma out of Afghanistan and Iraq is extremity trauma
and it is orthopaedic-related--upper extremity, lower
extremity, as well as spine trauma. Body armor has done a
remarkable job of protecting the soldier's torso, but his or
her extremities are very vulnerable to attacks, especially with
IEDs. Wounded soldiers who may have died in previous conflicts
from their injuries are now surviving and have to recover from
these devastating injuries.
There are remarkable examples of injured soldiers
overcoming all odds and returning to full function and even
Active duty, including the recent return of Captain David
Rozelle to duty in Iraq as the first amputee returning to a
combat zone in this conflict.
The American Academy of Orthopaedic Surgeons has worked
closely with top military orthopaedic surgeons at war class
facilities, including the Institute for Surgical Research,
Brooke Army Medical Center, and Walter Reed, to identify gaps
in orthopaedic trauma research, specifically the need for
improved anti-microbial bone replacement, systems for rapid
wound irrigation, cleaning and debridement, laboratory
investigations of pathogenesis and treatment of persistent
infections in orthopaedic trauma, and surgical and
pharmacologic methods to treat direct multiple trauma.
To ensure that sufficient research is being supported on
orthopaedic musculoskeletal trauma, it is critical that a
dedicated program be created within the DOD. Thus the
establishment of this orthopaedic trauma research program at
ISR.
It is important to note that military orthopaedic surgeons,
in addition to personnel at the U.S. Army Medical Research and
Material Command at Fort Detrick, have had significant input
into the creation of this proposal and fully support its goals.
I commend Congress for its commitment to the amputee care
funding, especially the establishment of the Amputee Center at
Walter Reed, which is near and dear to my heart. Thank you,
sir. But another goal must be to do everything possible to
salvage wounded limbs in the first place so that a soldier
ideally does not need the Amputee Care Center at all. An
expanded Federal commitment to orthopaedic extremity trauma
would move us closer to this goal.
National Institutes of Health (NIH) funding is directed at
problems facing the U.S. population as a whole. This type of
war extremity trauma is unique to DOD and not highly
prioritized within the NIH. With over 70 percent of military
trauma being orthopaedic-related, orthopaedic extremity trauma
research clearly would be of great benefits to the sons and
daughters of America serving in the global war on terror and in
future conflicts.
On behalf of America's soldiers, military orthopaedic
surgeons in every branch of the service, and the American
Academy of Orthopaedic Surgeons, I respectfully request that
this subcommittee establish and fund the Orthopaedic Trauma
Research Program to be administered at the U.S. Army Institute
of Surgical Research.
Thank you for this opportunity.
[The statement follows:]
Prepared Statement of David W. Polly, Jr.
Chairman Stevens, Ranking Member Inouye, Members of the Senate
Defense Appropriations Subcommittee, thank you for the opportunity to
testify today. My name is David W. Polly, Jr., MD., and I speak today
on behalf of the American Academy of Orthopaedic Surgeons, of which I
am an active member, as well as on behalf of military and civilian
orthopaedic surgeons involved in orthopaedic trauma research and care.
I am a graduate of the United States Military Academy at West Point
and was an airborne ranger serving as a line officer in the Army.
Subsequently, I attended medical school at the Uniformed Services
University of the Health Sciences and trained in orthopaedic surgery at
Walter Reed Army Medical Center. I have personally cared for injured
soldiers at Walter Reed during four different military conflicts and
have been deployed to a war zone as a military orthopaedic surgeon. My
last assignment was as Chair of the Department of Orthopaedic Surgery
and Rehabilitation at Walter Reed. I retired at the end of 2003 after
24\1/2\ years of service. I am currently Professor of Orthopaedic
Surgery and Chief of Spine Surgery at the University of Minnesota.
I would like to cover several topics today. First, I would like to
discuss the common types of orthopaedic trauma seen out of Iraq and
Afghanistan. Second, I will comment on the current state of orthopaedic
trauma research. Third, I would like to offer a military perspective,
as laid out yearly in extensive research priorities documents, of the
direction in which orthopaedic research should head in order to better
care for soldiers afflicted with orthopaedic trauma. Finally, I would
like to encourage subcommittee members to consider favorably a proposal
to create a peer-reviewed grant program, administered by the U.S. Army
Institute of Surgical Research (USAISR), to fund intramural and
extramural orthopaedic trauma research.
ORTHOPAEDIC TRAUMA FROM OPERATION IRAQI FREEDOM (OIF)
The Armed Forces are attempting to recover significantly injured
soldiers to return them to full function or by limiting their
disabilities to a functional level in the case of the most severe
injuries. The ability to provide improved recovery of function moves
toward the goal of keeping injured soldiers part of the Army or service
team. Moreover, when they do leave the Armed Forces, these
rehabilitated soldiers have a greater chance of finding worthwhile
occupations outside of the service and continuing to contribute
positively to society. The Army believes that it has a duty and
obligation to provide the highest level of care and rehabilitation to
those men and women who have suffered the most while serving the
country.
It probably comes as no surprise that approximately 70 percent of
trauma seen out of Iraq and Afghanistan, as well as in previous
conflicts, is orthopaedic-related, especially upper and lower extremity
and spine. For example, during the USNS Comfort's 6-month deployment,
surgeons on board performed 498 orthopaedic-related procedures
accounting for almost 85 percent of the total surgical procedures
performed. Of the 210 injured soldiers who have returned to Tripler
Army Medical Center in Honolulu, 70 percent have had orthopaedic
injuries. For the 447th Mobile Forward Surgical Team (FST) stationed in
Baghdad, the extent of orthopaedic injuries has been even greater with
89 percent of the injuries requiring orthopaedic stabilization.
While medical and technological advancements, as well as the use of
fast-moving Forward Surgical Teams, have dramatically decreased the
lethality of war wounds, wounded soldiers who may have died in previous
conflicts from their injuries are now surviving and have to learn to
recover from devastating injuries. The vast majority of the orthopaedic
injuries seen are to the upper and lower extremities. While body armor
does a great job of protecting a soldier's torso, his or her
extremities are particularly vulnerable during attacks.
Characteristics of Military Orthopaedic Trauma
According to the New England Journal of Medicine, blast injuries
are producing an unprecedented number of ``mangled extremities''--limbs
with severe soft-tissue and bone injuries. These can be devastating,
potentially mortal injuries (``Casualties of War--Military Care for the
Wounded from Iraq and Afghanistan,'' NEJM, December 9, 2004).
The trauma seen thus far is usually inflicted from close proximity
and is most often a result of blast devices, such as improvised
explosive devices (IEDs) and mortars. The result of such trauma is
open, complex wounds with severe bone fragmentation. Often there is
nerve damage, as well as damage to tendons, muscles, vessels, and soft-
tissue. In these types of wounds, infection is often a problem.
Military Versus Civilian Orthopaedic Trauma
While there are similarities between orthopaedic military trauma
and the types of orthopaedic trauma seen in civilian settings, there
are several major differences that must be noted. First, with
orthopaedic military trauma, there are up to five echelons of care,
unlike in civilian settings when those injured are most likely to
receive the highest level of care immediately. Instead, wounded
soldiers get passed from one level of care to the next, with each level
of care implementing the most appropriate type of care in order to
ensure the best possible outcome. The surgeon in each subsequent level
of care must try to recreate what was previously done. In addition, a
majority of injured soldiers have to be medevaced to receive care and
transportation is often delayed due to weather or combat conditions. It
has been our experience that over 65 percent of the trauma is urgent
and requires immediate attention.
Second, soldiers wounded are often in fair or poor health, are
frequently malnourished, and usually fatigued due to the demanding
conditions. This presents many complicating factors when determining
the most appropriate care.
Third, the setting in which care is initially provided to wounded
soldiers is less than ideal, to say the least, especially in comparison
to a sterile hospital setting. The environment, such as that seen in
Iraq and Afghanistan, is dusty and hot, leading to concerns about
sterilization of the hospital setting. For example, infection from
acinetobacter baumanni, a ubiquitous organism found in the desert soil
of Afghanistan and Iraq, is extremely common. In addition, the surgical
environment is under constant threat of attack by insurgents. In fact,
a considerable percentage of the care provided by military surgeons is
for injured Iraqis, both friendly and hostile. Finally, the surgical
team is faced with limited resources that make providing the highest
level of care difficult.
While, as I have stated, there are many unique characteristics of
orthopaedic military trauma, there is no doubt that research done on
orthopaedic military trauma benefits trauma victims in civilian
settings. Many of the great advancements in orthopaedic trauma care
have been made during times of war, such as the external fixateur,
which has been used extensively during the current conflict as well as
in civilian care.
THE CURRENT AND FUTURE STATE OF ORTHOPAEDIC TRAUMA RESEARCH
Since the Vietnam War there have been advances in medical science,
both on the civilian and the military side. One example is with
microvascular surgery, which is when reconstructive procedures are
performed to try to save limbs by putting blood vessels back together
again, providing definitive wound coverage of severe open wounds to get
vital structures covered, such as bone, nerves, and tendons. This means
taking tissue from one part of the body and moving it to another part
of the body and sewing in blood vessels with the use of a microscope.
This allows the surgeon to wash, clean, debride and cover severe open
contaminated wounds with some type of definitive coverage
At the annual meeting of the Advanced Technology Applications for
Combat Casualty Care (ATACCC), medical research priorities are laid out
for military research facilities and programs. Many of the priorities
expand on research that is currently underway at facilities such as the
U.S. Army Institute of Surgical Research (USAISR) and Walter Reed Army
Medical Center (WRAMC). I would like to provide you details of some of
the research that is already underway and the outlook for these medical
research advances.
Anti-microbial Bone-replacement Material
High-energy wounds on the battlefield produce contaminated wounds
with bone loss. The goal is to develop a product that can be placed
into an open fracture after initial debridement at far forward medical
treatment units. The product will deliver a time-release dose of
antibiotic into the wound as well as promote bone growth. Evaluation of
various materials has been conducted in animal models to determine the
best product for treating highly contaminated injuries. Future work
focuses on accelerating healing in larger defects, as well as
evaluation of antimicrobial bone replacement materials in humans.
Improved Long Bone Splint/cast
The current materials employed to splint injured limbs on the
battlefield do not provide optimal support of the injured limb and are
too bulky to be carried by the medic along with other required medical
supplies. The goal is to develop a smaller and lighter weight splint/
cast system that can be molded to the injured limb providing adequate
structural support. Research is currently underway on a self-contained
splint that can be molded to an injured extremity like a fiberglass or
plaster splint without the requirement of external water and extra
padding that fiberglass and plaster splinting requires.
System for Rapid Wound Irrigation and Cleaning
Decontamination for prevention of infection in open fractures is
essential in caring for battlefield extremity injuries. Development of
strategies for decontamination in the far forward environment includes
pulsatile irrigation with antimicrobial irrigation solutions. The goal
is to identify an antimicrobial irrigation solution that produces
optimal decontamination of open fractures. Activity against organisms
that are unusual in the United States but have been common and
problematic in the Iraq and Afghanistan conflicts are being considered.
Characteristics of the contaminated wound, such as bacterial biofilm
formation and its effect on the ability to decontaminate, are also
being explored. Research is currently being conducted in an animal
model.
Temporary Skin Substitute
Prevention of contamination of open wounds after battlefield injury
would prevent infection in minor to moderate wounds. The focus is on
the development of a rapid set polymer that can be applied to a wound
after cleaning.
System of Assessing Wound Tissue Viability and Cleaning
Determination of adequate debridement to remove contaminated and
dead tissue is essential in the treatment of battlefield injuries.
Research in this area to produce a hand held, portable device that can
provide a real time assessment of tissue viability as an adjunct to
surgical debridement is ongoing.
Measuring Physical and Psychological Outcomes for Survivors of Severe
Penetrating Upper Extremity Injury Sustained on the Battlefield
in Iraq and Afghanistan
A proposal to study the functional outcomes of U.S. casualties
following major limb injury is being finalized by the U.S. Army
Institute of Surgical Research. This study will help to determine the
effect of these injuries as well as to identify areas for research in
the future. The initial look will be a pilot study of the casualties
from the conflicts. The ultimate goal is to establish a project to
study these casualties prospectively throughout their treatment course.
Joint Theater Trauma Registry (JTTR)
The U.S. Army Institute of Surgical Research has developed this
registry modeled after trauma registries mandated by the American
College of Surgeons at U.S. trauma centers. This registry provides
demographic and injury data on U.S. casualties in Afghanistan and Iraq.
It will be very useful in determining outcomes from major limb
battlefield injury.
There are also many exciting proposals for orthopaedic trauma
research that have not been explored, such as:
--Laboratory investigations on the pathogenesis and treatment of
persistent infections in orthopaedic trauma.
--Those injured in Iraq are suffering from a significant rate of
wound infection, despite standard of care treatment.
Acinetobacter, a bacterium, has been identified as a frequent
cause of these infections, and research is needed into the
pathogenesis of this organism in traumatic wounds, and
evaluation of novel treatments.
--Surgical and pharmacologic methods for the treatment of direct
muscle trauma.
STORIES FROM THE FRONTLINES
There have been many heroic stories of injured soldiers struggling
to regain function and to return to normal life, or even back to
service. I am sure you heard about Captain David Rozelle, a Commander
in the 3rd Armored Cavalry Regiment, who was the first OIF amputee to
return to active duty back in March 2005 less than 2 years after having
his right foot blown off by a landmine. In an interview with the
National Review Online (2/14/05), when asked why he wanted to return to
duty, Capt. Rozelle responded, ``I am smarter, stronger, and more ready
to help create freedom for the Iraqi people.'' Before returning to
Iraq, Capt. Rozelle even completed the New York City Marathon. His
heroic attitude, coupled with the superior care he received following
his injuries, made Capt. Rozelle's return to service possible.
Another story was recently highlighted in a March 2005 National
Public Radio (NPR) series titled ``Caring for the Wounded: The Story of
Two Marines.'' The story followed two Marines injured in Iraq: 1st Sgt.
Brad Kasal and Lance Cpl. Alex Nicoll. Lance Cpl. Nicoll had to have
his left leg amputated as a result of his injuries from gunshot wounds.
While Nicoll continues to undergo physical therapy at Walter Reed to
get used to his new prosthetic leg, made from graphite and titanium,
his doctors, therapists, and he are confident that he will return to
full function. In fact, shortly after the NPR series ran, Nicoll
visited New Hampshire for a snowboarding vacation.
While Sgt. Kasal's was so seriously injured that he lost 4 inches
of bone in his right leg, due to medical advances in limb salvaging,
Sgt. Kasal did not have to have his leg amputated. Kasal is currently
undergoing a bone growth procedure, called the Illizarov Technique,
which grows the bone 1 millimeter a day. In about 4 months, it is
likely that Kasal will be able to walk on both of his own legs. These
stories clearly illustrate the benefits of orthopaedic trauma research
to America's soldiers.
ORTHOPAEDIC TRAUMA RESEARCH PROGRAM
The American Academy of Orthopaedic Surgeons (AAOS) and military
and civilian orthopaedic surgeons and researchers are grateful that the
committee included language in the fiscal year 2005 Defense
Appropriations Bill to make ``orthopaedic extremity trauma research'' a
priority research topic within the Peer Reviewed Medical Research
Program. From all indications, the number of grants submitted under
this topic has been incredibly high compared to other research
priorities listed in previous years. Clearly, there is both a need and
a demand for funding for orthopaedic trauma research.
With orthopaedic trauma being the most common form of trauma seen
in military conflicts, it is crucial that there be funding dedicated
specifically to the advancement of related trauma research. The
American Academy of Orthopaedic Surgeons (AAOS) has worked closely with
the top military orthopaedic surgeons, at world-class facilities such
as the U.S. Army Institute of Surgical Research, Fort Sam Houston, TX,
Brooke Army Medical Center, and Walter Reed Army Medical Center, to
identify gaps in orthopaedic trauma research and care, such as the need
for improved anti-microbial bone-replacement material; systems for
rapid wound irrigation, cleaning and debridement; laboratory
investigations on the pathogenesis and treatment of persistent
infections in orthopaedic trauma; and surgical and pharmacologic
methods for the treatment of direct muscle trauma.
The result of these discussions has been a proposal to create an
Orthopaedic Trauma Research Program, administered by the U.S. Army
Institute of Surgical Research (USAISR) at Fort Sam Houston, Texas, to
fund peer-reviewed intramural and extramural orthopaedic trauma
research. The USAISR is the only Department of Defense Research
laboratory devoted solely to improving combat casualty care. Having the
program administered by the USAISR will ensure that the research
funding follows closely the research priorities laid out by the Army
and the Armed Forces, will be of the most benefit to injured soldiers,
and will better ensure collaboration between military and civilian
research facilities. USAISR has extensive experience administering
similar grant programs.
It is important to note that military orthopaedic surgeons, in
addition to personnel at the U.S. Army Medical Research and Materiel
Command, Fort Detrick, have had significant input into the creation of
this proposal and fully support its goals.
CONCLUSION
I hope that I have given you a well-rounded perspective on the
extent of what orthopaedic trauma military surgeons are seeing and a
glimpse into the current and future research for such trauma. Military
trauma research currently being carried out at military facilities,
such as WRAMC and the USAISR, and at civilian medical facilities, is
vital to the health of our soldiers. The USAISR takes a leadership role
in the administration of funding for peer-reviewed intramural and
extramural orthopaedic trauma research. The research carried out at
these facilities is vital to the Armed Forces' objective to return
injured soldiers to full function in hopes that they can continue to be
contributing soldiers and active members of society.
Mr. Chairman, the American Academy of Orthopaedic Surgeons, as well
as the entire orthopaedic community, stands ready to work with this
subcommittee to identify and prioritize research opportunities for the
advancement of orthopaedic trauma care. Military and civilian
orthopaedic surgeons and researchers are committed to advancing
orthopaedic trauma research that will benefit the unfortunately high
number of soldiers afflicted with such trauma and return them to full
function. It is imperative that the Federal Government, when
establishing its defense health research priorities in the fiscal year
2006 Defense Appropriations bill, ensure that orthopedic trauma
research is a top priority.
I urge you to establish the Orthopaedic Trauma Research Program at
a funding level of $25 million. While Congress funds an extensive array
of medical research through the Department of Defense, with over 70
percent of military trauma being orthopaedic-related, no other type of
medical research would better benefit our men and women serving in the
War on Terror and in future conflicts.
Senator Stevens. Well, thank you very much, Dr. Polly.
Every time we go out to Walter Reed or Bethesda to visit the
wounded people, I am convinced in this war we are having fewer
deaths, but more severe injuries.
Dr. Polly. Yes, sir.
Senator Stevens. Those too are going to require a
considerable amount of research. As I said before, I do not
know anyone that could match your ability in that.
For the information of the audience, I had two back
operations. After each one I went back to the same condition of
not being able to stand up straight. Dr. Polly theorized that
there was something in the spine rather than in the disks and
he pursued his theory to my success. I run, I play tennis, I
lift weights and I swim because of your skill and research,
doctor. So we will follow you anywhere.
Dr. Polly. Thank you, sir.
Senator Stevens. Thank you very much.
Senator Inouye. Will you check me out?
Dr. Polly. Yes, sir. Right now?
Senator Inouye. May I ask a question.
Dr. Polly. Yes, Senator.
Senator Inouye. A few days ago the base realignment and
closure (BRAC) decisions were announced. Will that have any
impact on your program?
Dr. Polly. Sir, it is a needed realignment. There is some
overt redundancy between Bethesda and Walter Reed and there are
opportunities from the combination. The challenge is how to do
it right. I think if you keep the spirit alive--I know that you
spoke in 1988 at a dining-in at Walter Reed that I attended and
you inspired each and every one of us, and we will be terribly
sorry to lose the legacy of that institution and the 100 years
of service and the many, many, many great Americans who have
gone through there and received their care.
But I think we need to move forward and to the future. One
of the challenges at Walter Reed is simply parking and that
people cannot get on and off the campus there and they do not
have good public transportation. Bethesda is a better solution.
While as a West Point graduate I admit a bias toward the
Army, I recognize the overriding need for the good of DOD and
the concept of the Walter Reed National Military Medical Center
at Bethesda is a good idea. It should allow us to leverage the
benefits of the NIH and build the world-class--continue the
world-class facility that it is to provide the best care
possible today, tomorrow, and in the future for the sons and
daughters of America.
Senator Inouye. Do you have any thoughts on the Uniformed
Services University of the Health Sciences (USUHS)?
Dr. Polly. Yes, sir. I am a graduate of the Uniformed
Services University. I went to West Point, I served as a line
officer, and then decided I wanted to go to medical school. I
interviewed at the University of Virginia and had a deposit
down on a place to live there. I went and interviewed at USUHS
and was so inspired by J.P. Sanford and the program there that
I changed my mind at the last minute and went to school there.
That school is the reason that there was military medical
care coordination in Desert Storm, because the USUHS graduates
in the Army and the Navy and the Air Force called each other up
and said: I am short on fluids; what have you got? Well, I got
this and I got that. And there was a lot of horse-trading that
went on that coordinated the care because of the network of
interconnected people across the DOD.
USUHS now serves as the hub for thinking about military
medical care and we need to keep the best and brightest minds
either on a consulting basis or a full-time basis there to
stimulate the thoughts so that we can do a better job for the
next generation of people serving our country.
Senator Inouye. I thank you very much, doctor. You have
been most reassuring.
Dr. Polly. Thank you, sir.
Senator Stevens. Well said, doctor. We are going to pursue
you on that, too.
The next witness is Carolina Hinestrosa, the Executive Vice
President for Programs of the National Breast Cancer Coalition.
STATEMENT OF CAROLINA HINESTROSA, EXECUTIVE VICE
PRESIDENT OF PROGRAMS AND PLANNING,
NATIONAL BREAST CANCER COALITION
Ms. Hinestrosa. Good afternoon. Thank you, Chairman Stevens
and ranking member Inouye. Thank you and your subcommittee for
your great determination and leadership in helping us secure
funding for understanding how to prevent and cure breast cancer
through the Department of Defense breast cancer research
program.
I am a two-time breast cancer survivor. I am a wife and a
mother and, as you know, I am Executive Vice President of the
National Breast Cancer Coalition. On behalf of the coalition
and the more than 3 million women living with breast cancer, I
thank you for the opportunity to speak today.
We are requesting level funding for the breast cancer
research program this year. This program is a critical research
program that has transformed biomedical research. It has
established itself as a model that is admired around the world
for its accountability and innovation. This critical program--
it is important that this program maintains its structure and
integrity. The program fills critical gaps in breast cancer
research.
As the Institute of Medicine (IOM) has pointed out in two
separate reports, the DOD breast cancer research program fills
an unmet need in breast cancer research in this community and
is not duplicative of other programs. In both reports the IOM
recommends that the program continue. Any changes to the
structure of the program could significantly undermine its
innovation and its ability to fund cutting edge breast cancer
research.
An inherent component of this program has been the
inclusion of consumer advocates at every level, which has
created an unprecedented working relationship between advocates
and scientists and ultimately has led to new avenues of
research in breast cancer. Since 1992 over 400 breast cancer
survivors have served in the peer review panels for the DOD
breast cancer research program and their vital role is key to
the success of this model of biomedical research which is
imitated around the world.
The program is accountable to the public. Every cent that
is spent must be reported at a public meeting held every 2
years, called Era of Hope. The Era of Hope meeting this year is
just a few weeks away in Philadelphia, from June 8 through June
11. I hope you all will be able to attend this meeting to see
the incredible progress that is being made through this
program.
I want to provide you with a couple of examples of research
that has been funded through this program and that is making a
real difference. You have heard about Timoxicin, a drug that
was developed many years ago for a certain type of breast
cancer. About 50 percent of women respond to that drug and some
others and we do not know--we did not know who was able to
respond. Funding by this program has identified two genes that
can predict who would respond from this drug Timoxicin, so we
will be able to give it to the right people.
But most stunningly, last night I listened to a
presentation in Orlando at the American Society for Clinical
Oncology where they presented the results of a study of women
with earlier breast cancer which was unprecedented. Using a
biological monitor and an antibody of a drug, Receptin, they
were able to show a 50 percent improvement in survival for
women who have a particularly aggressive type of breast cancer.
This funding for this type of research was possible in the
early years by the Department of Defense breast cancer research
program. It was innovative research and visionary research that
was languishing and not being funded anywhere else. The DOD
breast cancer research program understood and recognized the
potential impact of this research and funded it in the early
years and then the research progressed to women with advanced
breast cancer and now with early breast cancer. The results
from this research are about a 50 percent improvement in
outcomes for these women.
So clearly the vision, the innovation of this program, is
paying in a very important way to the American taxpayer.
On behalf of the women with breast cancer and on behalf of
our daughters and granddaughters who are counting on us to do
the right thing, I thank you for your support and urge level
funding for this program.
[The statement follows:]
Prepared Statement of Carolina Hinestrosa
Thank you, Mr. Chairman and members of the Appropriations
Subcommittee on Defense, for the opportunity to speak to you today
about a program that, with little Federal investment, goes a long way
toward increasing and improving breast cancer research. You and your
committee have shown great determination and leadership in searching
for the answers by funding the Department of Defense (DOD) Peer-
Reviewed Breast Cancer Research Program (BCRP) at a level that has
brought us closer to eradicating this disease.
I am Carolina Hinestrosa, a two-time breast cancer survivor, a wife
and mother, and Executive Vice President for Programs and Planning of
the National Breast Cancer Coalition (NBCC). On behalf of NBCC, and the
more than 3 million women living with breast cancer, I would like to
thank you again for the opportunity to testify today.
The DOD BCRP's 13 years of progress in the fight against breast
cancer has been made possible by the Appropriations Committee's
investment in breast cancer research. To continue this unprecedented
progress, we ask that you support level funding for this program--a
$150 million appropriation for fiscal year 2006. As an Institute of
Medicine (IOM) report concluded last year, there continues to be
excellent science that goes unfunded, but for this small program, which
is why we believe that the BRCP should be appropriated level funding
for fiscal year 2006.
As you know, the National Breast Cancer Coalition is a grassroots
advocacy organization made up of more than 600 organizations and tens
of thousands of individuals and has been working since 1991 toward the
eradication of breast cancer through advocacy and action. NBCC supports
increased funding for breast cancer research, increased access to
quality health care for all women, and increased influence of breast
cancer activists at every table where decisions regarding breast cancer
are made.
WHY THE DOD BREAST CANCER RESEARCH PROGRAM NEEDS LEVEL FUNDING IN
FISCAL YEAR 2006
In the past 13 years, the DOD Peer-Reviewed Breast Cancer Research
Program has established itself as a model medical research program,
respected throughout the cancer and broader medical community for its
innovative and accountable approach. The groundbreaking research
performed through the program has the potential to benefit not just
breast cancer, but all cancers, as well as other diseases. Biomedical
research is being transformed by the BCRP's success.
This program is both innovative and incredibly streamlined. It
continues to be overseen by a group of distinguished scientists and
activists, as recommended by the IOM. Because there is no bureaucracy,
the program is able to respond quickly to what is currently happening
in the scientific community. It is able to fill gaps with little red
tape. It is responsive, not just to the scientific community, but also
to the public.
This program has matured from an isolated research program to a
broad-reaching influential voice forging new and innovative directions
for breast cancer research and science. The flexibility of the program
has allowed the Army to administer this groundbreaking research effort
with unparalleled efficiency and effectiveness.
In addition, an inherent part of this program has been the
inclusion of consumer advocates at every level, which has created an
unprecedented working relationship between advocates and scientists,
and ultimately has led to new avenues of research in breast cancer.
Since 1992, nearly 800 breast cancer survivors have served on the BCRP
review panels. Their vital role in the success of the BCRP has led to
consumer inclusion in other biomedical research programs at DOD. This
program now serves as an international model.
the dod peer reviewed bcrp provides unique funding opportunities
It is important to note that the DOD Integration Panel that designs
this program has a plan of how best to spend the funds appropriated.
This plan is based on the state of the science--both what scientists
know now and the gaps in our knowledge--as well as the needs of the
public. This plan coincides with our philosophy that we do not want to
restrict scientific freedom, creativity or innovation. While we
carefully allocate these resources, we do not want to predetermine the
specific research areas to be addressed.
Developments in the past few years have begun to offer breast
cancer researchers fascinating insights into the biology of breast
cancer and have brought into sharp focus the areas of research that
hold promise and will build on the knowledge and investment we have
made. The Innovative Developmental and Exploratory Awards (IDEA) grants
of the DOD program have been critical in the effort to respond to new
discoveries and to encourage and support innovative, risk-taking
research. The IDEA grants have been instrumental in the development of
promising breast cancer research. These grants have allowed scientists
to explore beyond the realm of traditional research and have unleashed
incredible new ideas and concepts. IDEA grants are uniquely designed to
dramatically advance our knowledge in areas that offer the greatest
potential.
IDEA grants are precisely the type of grants that rarely receive
funding through more traditional programs such as the National
Institutes of Health, and academic research programs. Therefore, they
complement, and do not duplicate, other Federal funding programs. This
is true of other DOD award mechanisms as well.
For example, the Innovator awards are structured to invest in world
renowned, outstanding individuals, rather than projects, from any field
of study by providing funding and freedom to pursue highly creative,
potentially breakthrough research that could ultimately accelerate the
eradication of breast cancer. The Era of Hope Scholar is intended to
support the formation of the next generation of leaders in breast
cancer research, by identifying the best and brightest independent
scientists early in their careers and giving them the necessary
resources to pursue a highly innovative vision toward ending breast
cancer.
Also, Historically Black Colleges and Minority Universities/
Minority Institutions Partnership Awards are intended to provide
assistance at an institutional level. The major goal of this award is
to support collaboration between multiple investigators at an applicant
Minority Institution and a collaborating institution with an
established program in breast cancer research, for the purpose of
creating an environment that would foster breast cancer research, and
in which Minority Institute faculty would receive training toward
establishing successful breast cancer research careers.
These are just a few examples of innovative approaches at the DOD
BCRP that are filling gaps in breast cancer research. It is vital that
these grants are able to continue to support the growing interest in
breast cancer research--$150 million for peer-reviewed research will
help sustain the program's momentum.
The DOD BCRP also focuses on moving research from the bench to the
bedside. A major feature of the awards offered by the BCRP is that they
are designed to fill niches that are not offered by other agencies. The
BCRP considers translational research to be the application of well-
founded laboratory or other pre-clinical insight into a clinical trial.
To enhance this critical area of research, several research
opportunities have been offered. Clinical Translational Research Awards
have been awarded for investigator-initiated projects that involve a
clinical trial within the lifetime of the award. The BCRP expanded its
emphasis on translational research by offering five different types of
awards that support work at the critical juncture between laboratory
research and bedside applications.
The Centers of Excellence awards mechanism brings together the
world's most highly qualified individuals and institutions to address a
major overarching question in breast cancer research that could make a
major contribution towards the eradication of breast cancer. These
Centers put to work the expertise of basic, epidemiology and clinical
researchers, as well as consumer advocates to focus on a major question
in breast cancer research. Many of these centers are working on
questions that will translate into direct clinical applications.
SOME OF THE MANY EXAMPLES OF SCIENTIFIC ACHIEVEMENTS BROUGHT ABOUT BY
THIS COMMITTEE'S INVESTMENT IN THE DOD PEER REVIEWED BCRP
The BCRP research portfolio is comprised of many different types of
projects, including support for innovative ideas, infrastructure
building to facilitate clinical trials, and training breast cancer
researchers.
One of the most promising outcomes of research funded by the BCRP
was the development of Herceptin, a drug that prolongs the lives of
women with a particularly aggressive type of advanced breast cancer.
This drug could not have been developed without first researching and
understanding the gene known as HER-2/neu, which is involved in the
progression of some breast cancers. Researchers found that over-
expression of HER-2/neu in breast cancer cells results in very
aggressive biologic behavior. Most importantly, the same researchers
demonstrated that an antibody directed against HER-2/neu could slow the
growth of the cancer cells that over-expressed the gene. This research,
which led to the development of the drug Herceptin, was made possible
in part by a DOD BCRP-funded infrastructure grant. Other researchers
funded by the BCRP are currently working to identify similar kinds of
genes that are involved in the initiation and progression of cancer.
They hope to develop new drugs like Herceptin that can fight the growth
of breast cancer cells.
Another example of success from the program is a study of sentinel
lymph nodes (SLNs). This study confirmed that SLNs are indicators of
metastatic progression of disease. The resulting knowledge from this
study and others has lead to a standard of care that includes lymph
node biopsies. If the first lymph node is negative for cancer cells,
then it is unnecessary to remove all the lymph nodes. This prevents
lymphoderma, which can be painful and have lasting complications.
Several studies funded by the BCRP will examine the role of
estrogen and estrogen signaling in breast cancer. For example, one
study examined the effects of the two main pathways that produce
estrogen. Estrogen is often processed by one of two pathways; one
yields biologically active substances while the other does not. It has
been suggested that women who process estrogen via the biologically
active pathway may be at higher risk of developing breast cancer. It is
anticipated that work from this funding effort will yield insights into
the effects of estrogen processing on breast cancer risk in women with
and without family histories of breast cancer.
One DOD IDEA award success has supported the development of new
technology that may be used to identify changes in DNA. This technology
uses a dye to label DNA adducts, compounds that are important because
they may play a role in initiating breast cancer. Early results from
this technique are promising and may eventually result in a new marker/
method to screen breast cancer specimens.
Investigators funded by the DOD have developed a novel imaging
technique that combines two-dimensional and three-dimensional digital
mammographic images for analysis of breast calcifications. Compared to
conventional film screen mammography, this technique has greater
resolution. Ultimately, this technique may help reduce the number of
unnecessary breast biopsies.
Despite the enormous successes and advancements in breast cancer
research made through funding from the DOD BCRP, we still do not know
what causes breast cancer, how to prevent it, or how to cure it. It is
critical that innovative research through this unique program continues
so that we can move forward toward eradicating this disease.
congress and taxpayers know how their investment is spent and that the
DOD PEER REVIEWED BCRP IS FEDERAL MONEY WELL SPENT
The DOD BCRP is as efficient as it is innovative. In fact, 90
percent of funds go directly to research grants. The flexibility of the
program allows the Army to administer it in such a way as to maximize
its limited resources. The program is able to quickly respond to
current scientific advances, and fulfills an important niche by
focusing on research that is traditionally underfunded. This was
confirmed and reiterated in an IOM report released last year. It is
responsive to the scientific community and to the public. This is
evidenced by the inclusion of consumer advocates at both the peer and
programmatic review levels. The consumer perspective helps the
scientists understand how the research will affect the community, and
allows for funding decisions based on the concerns and needs of
patients and the medical community.
Since 1992, the BCRP has been responsible for managing $1.66
billion in appropriations. From its inception through fiscal year 2003,
4,073 awards at 420 institutions throughout the United States and the
District of Columbia have been awarded. Approximately 150 awards will
be granted for fiscal year 2004. The areas of focus of the DOD BCRP
span a broad spectrum and include basic, clinical, behavioral,
environmental sciences, and alternative therapy studies, to name a few.
The BCRP benefits women and their families by maximizing resources and
filling in the gaps in breast cancer research. Scientific achievements
that are the direct result of the DOD BCRP grants are undoubtedly
moving us closer to eradicating breast cancer.
The outcomes of the BCRP-funded research can be gauged, in part, by
the number of publications, abstracts/presentations, and patents/
licensures reported by awardees. To date, there have been more than
6,200 publications in scientific journals, more than 4,200 abstracts
and 140 patents/licensure applications. The Federal Government can
truly be proud of its investment in the DOD BCRP.
RESEARCHERS, CONSUMERS AND POLICY MAKERS AGREE: THE DOD PEER REVIEWED
BCRP SHOULD CONTINUE
The National Breast Cancer Coalition has been the driving force
behind this program for many years. The success of the DOD Peer-
Reviewed Breast Cancer Research Program has been illustrated by several
unique assessments of the program. The IOM, which originally
recommended the structure for the program, independently re-examined
the program in a report published in 1997. They published another
report on the program in 2004. Their findings overwhelmingly encouraged
the continuation of the program and offered guidance for program
implementation improvements.
The 1997 IOM review of the DOD Peer-Review Breast Cancer Research
Program commended the program and stated that, ``the program fills a
unique niche among public and private funding sources for cancer
research. It is not duplicative of other programs and is a promising
vehicle for forging new ideas and scientific breakthroughs in the
nation's fight against breast cancer.'' The IOM report recommended
continuing the program and established a solid direction for the next
phase of the program. The 2004 report reiterated these same statements
and indicated that is important for the program to continue. It is
imperative that Congress recognizes the independent evaluations of the
DOD Breast Cancer Research Program, as well as reiterates its own
commitment to the program by appropriating the funding needed to ensure
its success.
The DOD Peer-Reviewed Breast Cancer Research Program not only
provides a funding mechanism for high-risk, high-return research, but
also reports the results of this research to the American people at a
biennial public meeting called the Era of Hope. The Era of Hope meeting
has set a precedent, it is the first time a federally funded program
reported back to the public in detail not only on the funds used, but
also on the research undertaken, the knowledge gained from that
research and future directions to be pursued. The transparency of the
BCRP allows scientists, consumers and the American public to see the
exceptional progress made in breast cancer research.
At the 2002 Era of Hope meeting, all BCRP award recipients from
fiscal years 1998-2000 were invited to report their research findings,
and many awardees from previous years were asked to present
advancements in their research. Scientists reported important advances
in the study of cancer development at the molecular and cellular level.
Researchers presented the results of research that elucidates several
genes and proteins responsible for the spread of breast cancer to other
parts of the body, and, more importantly, reveals possible ways to stop
this growth. The meeting, which marked the 10th anniversary of the
program, also featured grant recipients who are working towards more
effective and less toxic treatments for breast cancer that target the
unique characteristics of cancer cells and have a limited effect on
normal cells. The next meeting will be held in June 2005.
The DOD Peer-Reviewed Breast Cancer Research Program has attracted
scientists with new ideas and has continued to facilitate new thinking
in breast cancer research and research in general. Research that has
been funded through the DOD BCRP is available to the public.
Individuals can go to the Department of Defense website and look at the
abstracts for each proposal at http://cdmrp.army.mil/
bcrp/.
COMMITMENT OF THE NATIONAL BREAST CANCER COALITION
The National Breast Cancer Coalition is strongly committed to the
DOD program in every aspect, as we truly believe it is one of our best
chances for finding cures and preventions for breast cancer. The
Coalition and its members are dedicated to working with you to ensure
the continuation of funding for this program at a level that allows
this research to forge ahead.
In May 1997, our members presented a petition with more than 2.6
million signatures to congressional leaders on the steps of the
Capitol. The petition called on the President and the U.S. Congress to
spend $2.6 billion on breast cancer research between 1997 and the year
2000. Funding for the DOD Peer-Reviewed Breast Cancer Research Program
was an essential component of reaching the $2.6 billion goal that so
many women and families worked for.
Once again, NBCC is bringing its message to Congress. Just over 1
month from now, many of the women and family members who supported the
campaign to gather the 2.6 million signatures will come to NBCCF's
Annual Advocacy Training Conference here in Washington, DC. More than
600 breast cancer activists from across the country will join us in
continuing to mobilize our efforts to end breast cancer. The
overwhelming interest in, and dedication to eradicate this disease
continues to be evident as people not only are signing petitions, but
are willing to come to Washington, DC from across the country to
deliver their message about their commitment.
Since the very beginning of this program in 1992, Congress has
stood in support of this important investment in the fight against
breast cancer. In the years since, Mr. Chairman, you and this entire
committee have been leaders in the effort to continue this innovative
investment in breast cancer research.
NBCC asks you, Defense Appropriations Subcommittee, to recognize
the importance of what has been initiated by the Appropriations
Committee. You have set in motion an innovative and highly efficient
approach to fighting the breast cancer epidemic. What you must do now
is support this effort by continuing to fund research that will help us
win this very real and devastating war against a cruel enemy.
Thank you again for the opportunity to submit testimony and for
giving hope to the 3 million women in the United States living with
breast cancer.
Senator Inouye [presiding]. Thank you very much. I think
you should also thank the members of the United States Senate,
because you may notice that this is in a defense account. It
should have been in the health account. But as we all know, the
health account is lacking in appropriate funds. Therefore, with
the permission of the Senate, we have put it in the defense
fund.
Ms. Hinestrosa. And I thank you for that.
Senator Inouye. You can be assured that will continue.
Ms. Hinestrosa. Thank you very much.
Senator Inouye. Thank you.
Our next witness is the Director of the Osteoporosis
Research Center on behalf of the National Coalition for
Osteoporosis and Related Bone Diseases, Dr. Robert Recker.
Doctor.
STATEMENT OF ROBERT RECKER, M.D., DIRECTOR,
OSTEOPOROSIS RESEARCH CENTER, ON BEHALF OF
THE NATIONAL COALITION FOR OSTEOPOROSIS AND
RELATED BONE DISEASES
Dr. Recker. Mr. Chairman, I am Robert Recker, Director of
the Osteoporosis Center at Creighton University in Omaha,
Nebraska. I am testifying on behalf of the National Coalition
for Osteoporosis and Related Bone Diseases. We appreciate the
opportunity to discuss the necessity for continued support and
funding of the bone health and military medical readiness
research program within the Department of Defense.
This research program addresses the problem of stress
fractures. These fractures are the most serious overuse
injuries that are the result of repeated stresses that occur in
vigorous training and not from a single traumatic event. Stress
fracture injury has a marked impact on the health and force
readiness of military personnel, imposing significant costs in
medical care, extended training time, attrition of personnel,
and ultimately military readiness.
It is one of the most common and disabling overuse injuries
seen in military recruits today, particularly in women.
Approximately 50 percent of all women and 30 percent of all men
sustain an overuse injury in basic training, and the majority
of soldiers pulled from training for rehabilitation suffer from
stress fractures. Worse, 40 percent of the men and 60 percent
of the women pulled from training due to stress fracture do not
return and are retired from the military and discharged. Those
who do return require 80 to 120 days of rehabilitation.
At Fort Jackson alone, an estimated $26 million was spent
in one year on training 749 soldiers later discharged due to
stress fracture. Our own archive from our experience and
research at Fort Leonard Wood shows that extent of these
fractures that range from pelvic fractures to upper hip
fractures, mid-leg fractures, lower limb fractures, foot
fractures. Some of them are disabling for life.
The bone health and military medical readiness research
program has provided some practical solutions to help protect,
sustain, and enhance the performance of military personnel.
Research with human and animal models has revealed the
following. The length of stride for women is related to
fracture. Genetics plays a role in bone marrowization and
structural processes of bone that influence strength. Calorie
restriction and calcium deficiency result in decreased
structural properties of bone and contribute to decreased bone
strength. Oral contraceptive use contributes to reduced bone
mass, which increases fracture risk. Chronic alcohol
consumption inhibits bone formation.
We at Creighton, collaborating with military scientists,
have demonstrated that heel ultrasound measurement and
assessment of risk factors, such as physical fitness, smoking,
use of injectable contraceptives, performed at the onset of
basic training predict risk of stress fractures. As a result of
such research, technologies such as positron emission
tomography, acoustic emission, are being developed for higher
imaging and better identification of stress fractures.
Modifications have been made to the U.S. Army physical fitness
training program to reduce fractures while hopefully not
decreasing the overall fitness of military recruits at the end
of basic training.
Studies are ongoing to determine whether Vitamin D or
calcium supplementation decreases the incidence of stress
fractures in new recruits. Additional research is needed. We
need better approaches to identify and improve bone health in
recruits, interventions to reduce stress fracture during
strenuous physical training and deployment, and acceleration of
stress fracture healing and return to full status.
Mr. Chairman, in summary, stress fractures continue to
occur, significantly impair military readiness, and delay the
time to battlefield deployment. It is imperative that the
Department of Defense build on recent findings and maintain an
aggressive and sustained bone health research program at a
level of $6 million in fiscal year 2006.
Thank you very much.
[The statement follows:]
Prepared Statement of Joan Goldberg, Executive Director, American
Society for Bone and Mineral Research
Mr. Chairman and members of the committee, I am Joan Goldberg,
Executive Director of the American Society for Bone and Mineral
Research and I am testifying on behalf of the National Coalition for
Osteoporosis and Related Bone Diseases. The members of the Bone
Coalition are the American Society for Bone and Mineral Research, the
National Osteoporosis Foundation, the Paget Foundation for Paget's
Disease of Bone and Related Disorders, and the Osteogenesis Imperfecta
Foundation. We appreciate this opportunity to discuss with you the
necessity for continued support and funding of the Bone Health and
Military Medical Readiness Research Program within the Department of
Defense (DOD).
The Bone Health and Military Medical Readiness Research Program
addresses a critical obstacle to military readiness and a major cause
of low soldier retention during basic training and thereafter. This
program supports research to improve our understanding of stress
fracture risk, to develop better assessment and prevention methods, all
aimed at the preservation of bone health in military men and women.
Currently, a significant research effort underway to protect and
enhance bone health is targeting the elimination of training-related
stress fractures.
Stress fracture injury has a marked impact on the health and force
readiness of military personnel, imposing significant costs to the
Department of Defense in terms of medical care, extended training time,
attrition of military personnel and, ultimately, military readiness. It
is one of the most common and potentially debilitating overuse injuries
seen in military recruits today, particularly in women. Recent
statistics show that approximately 50 percent of all women and 30
percent of all men sustain an overuse injury in basic training. The
majority of soldiers pulled from training for rehabilitation suffer
from stress fracture. Worse, 40 percent of the men and 60 percent of
the women pulled from training due to stress fracture do not return to
training. In fact, they are discharged from the military. Those who do
return to training require 80 to 120 days of rehabilitation. At Fort
Jackson alone, over a 1-year period an estimated $26 million was spent
on training 749 soldiers later discharged due to stress fracture. This
does not include costs related to health care.
Stress fractures occur when muscles transfer the overload of strain
to the bone, most commonly in the lower leg, and cause a tiny crack.
Anyone who suddenly increases his or her frequency, intensity, or
duration of physical activity, such as reservists or soldiers returning
from long deployments where physical activity could not be undertaken
on a regular basis, has an increased risk of developing lower body
stress fractures. There are several forms of stress fractures that
require more involved treatment. Stress fractures in the ``knobby''
part of the femur--the bone that fits into the hip socket or hip bone
itself--sometimes progress to full fractures or larger fractures and
interrupt the blood supply to the thigh bone portion of the hip joint.
This in turn can cause early degenerative changes in the hip joint.
Physicians consider this type of stress fracture to be a medical
emergency for this reason. Other particularly slowly healing stress
fractures include those of the navicular (foot bone), anterior cortex
of the tibia (front portion of the mid-shin bone) and proximal fifth
metatarsal (a bone in the foot). Healing takes months.
The Bone Health and Military Medical Readiness Research Program is
already providing the military with some practical solutions to help
protect, sustain and enhance the performance of military personnel.
Research using animal and human models to study the influence of
genetics, nutrition, exercise, and other influences on bone quality,
and fracture risk, has revealed the following:
--The length of stride for women is related to fracture.
--Genetics plays a role not only in bone mineralization, but
significantly influences other structural properties of bone
that influence bone strength. Further, genetics influences the
sensitivity of bone tissue to mechanical loading and unloading.
(``Loading'' is experienced when moving, with higher load
experienced when bending over, lifting weights, etc.)
--In identical environments, the genetic influence of mechanical
loading is site specific, and affects different kinds of bone
differently.
--In the tibia, the most common site of stress fracture injury, bone
tissue compensates for the smaller geometry of this bone
through variations in material properties that result in
increased susceptibility to bone damage under conditions of
repetitive loading.
--Caloric restriction and calcium deficiency--common to women on
diets--result in decreased structural properties of bone, and
may contribute to decreased bone strength. (Weaker bones may
suffer more damage.)
--Oral contraceptive use contributes to reduced bone mass
accumulation. (Low bone mass increases fracture risk.)
--Chronic alcohol consumption inhibited tibial bone formation,
possibly through observed decreases in production of the growth
factor IGF-I.
--The growth factor IGF-I is critical for puberty-induced bone
growth, further supporting a prominent role for IGF-I in bone
formation.
--Meta-analyses--reviews of multiple studies--confirm that both
aerobic exercise and resistance training improve bone density
at multiple sites in women.
--Short-term exercise was sufficient to elicit improvements in
mechanical properties of male but not female mice, indicating a
gender-specific response to exercise.
--Individuals with dark skin or who are receiving minimal sun
exposure--e.g. in late winter--demonstrate Vitamin D deficiency
and may benefit from supplementation with Vitamin D, important
in maintaining bone health.
As a result of research such as the above:
--A successful working prototype of a small-scale, high resolution
positron emission tomography (PET) device was developed, for
higher imaging and better identification of stress fractures.
--Acoustic emission, a promising new method to detect microdamage in
bone, detected changes in bone prior to its breaking in a
laboratory setting.
--Modifications have already been made to the U.S. Army physical
fitness training program to decrease the volume of running and
marching activities that take place during recruit training in
an effort to reduce stress fracture injuries. This impact is
being tracked.
--A study is ongoing to determine whether Vitamin D supplementation
decreases the incidence of stress fracture in new recruits.
Additional bone research is needed, including better approaches to
identify and improve bone health in at risk recruits, interventions to
reduce stress fracture during strenuous physical training and
deployment, and acceleration of stress fracture healing and return to
full duty status. Areas of need include:
--Utilizing genetic (bone density, bone geometry), lifestyle
(nutrition, exercise history), and other risk factors
(menstrual status, oral contraceptive use, smoking) to
establish a risk factor profile that identifies individuals at
high risk for stress fracture injury.
--Expanding on preliminary findings that revealed gender differences
in the response of bone to physical training.
--Conducting small pilot studies and larger clinical trials of
resistance training, aerobic exercise training, and diet and
nutrition interventions to improve bone quality in a military
population and to determine whether they can be successfully
implemented to prevent or reduce significantly the incidence of
stress fracture in a basic training population.
--Advancing non-invasive bone imaging technologies to assess risk,
identify stress fractures (easily missed by commonly used
technology) and monitor healing.
Mr. Chairman, the bottom line is that stress fractures continue to
occur, significantly impair military readiness, and delay the time to
battlefield/deployment. Therefore, it is imperative that the Department
of Defense build on recent findings and maintain an aggressive and
sustained bone health research program at a level of $6 million in
fiscal year 2006.
Senator Inouye. Doctor, does your research indicate that
there is a difference in the services? Does the Army suffer
more stress than the Navy or the Air Force?
Dr. Recker. No, the incidence of stress fractures seems to
occur across the military, because the military basic training
is pretty much similar in all the branches.
Senator Inouye. Do you believe that the training mode
should be studied?
Dr. Recker. Yes, it should, and it has been studied. On the
one hand, we cannot reduce the physical fitness of our training
at the end of training, and on the other hand we have to
arrange the training program so that we do not have so much
disability from and training loss from stress fractures and
other overuse injuries. But stress fractures are the worst. So
yes, we need to continue to study that to try to get training
programs that will give us----
Senator Inouye. So your program is cost effective?
Dr. Recker. I think so.
Senator Inouye. I thank you very much, sir.
Dr. Recker. Thank you very much.
Senator Inouye. Our next witness is a member of the Board
of Directors of the National Brain Injury Research, Treatment,
and Training Foundation, Mr. Martin B. Foil, Jr. Mr. Foil.
STATEMENT OF MARTIN B. FOIL, JR., MEMBER, BOARD OF
DIRECTORS, NATIONAL BRAIN INJURY RESEARCH,
TREATMENT, AND TRAINING FOUNDATION
Mr. Foil. Good morning, Senator Inouye--good afternoon, I
guess. Nice to see you again and good to be here.
Senator Inouye. It is morning in Hawaii, sir.
Mr. Foil. Point well taken.
I am happy to be here today and talk to you some about what
some people call the signature condition of the conflict in
Iraq, and that is traumatic brain injury (TBI), and to request
$14 million for the defense and veterans head injury program.
Over the past year this program has treated 1,000 troops with
TBI. You have probably seen this in the papers, including USA
Today and People magazine, copies of which have been attached
to the written statement.
Many of our service men and women are returning from Iraq
with TBI's and not all have been appropriately diagnosed and
treated. Through the work of the defense and veterans head
injury program (DVHIP), we are able to identify most of these
injuries, but unless we expand our research to areas where
there are no treatment facilities or Veterans Administration
(VA) hospitals many are going to fall through the cracks.
Last year you asked me how the DVHIP could assure the
optimum care beyond its eight lead sites and the regional
network of secondary VA hospitals. This has been a top priority
for DVHIP, but the agency administering has had other
priorities. So we are going to move the program to Fort
Detrick. We think it will be more successful, and ideally we
would like to have facilities much like Virginia NeuroCare
throughout the country, which last year had a 35 percent return
to active duty rate.
To meet immediate needs, DVHIP needs to offer a call for
proposals for innovative clinical programs that will support
distributed care networks. In addition, care coordinators will
be strategically placed throughout the country for patients
with TBI and their families in their home States.
DVHIP continues to focus on blast injury, especially for
those who are hit with IEDs, and is leading the effort to
provide guidelines for the assessment and follow-up care after
these blast-related TBIs within the military environment.
Another priority is evaluating the connection between post-
traumatic stress disorder (PTSD) and TBI. There are
similarities in the symptoms, yet treatment for the two
conditions is quite different. There is not much known about
combat PTSD in persons with TBI. Clinically focused research
initiatives by DVHIP would investigate this unique relationship
to ensure that the troops are receiving the best care available
for both their brain and their mind.
Mr. Chairman, there is $7 million in the DOD budget. We are
asking for a plus-up of $7 million, so in all $14 million is
being requested for this important program. The funding is
needed to continue training combat medics, surgeons, general
medical officers and reservists and the best practices of TBI
care, provide continuity of care from the battlefield to rehab
and back to Active duty, and to work to ensure that no one
falls through the cracks.
We are going to hope that you will continue to support our
efforts to provide the best care possible to our Nation's brave
men and women in uniform.
Thank you very much. Any questions?
[The statement follows:]
Prepared Statement of Martin B. Foil, Jr.
My name is Martin B. Foil, Jr. and I am the father of Philip Foil,
a young man with a severe brain injury. I serve as a volunteer on the
Board of Directors of the National Brain Injury Research, Treatment and
Training Foundation (NBIRTT) \1\ and Virginia NeuroCare in
Charlottesville, Virginia (VANC).\2\ Professionally, I am the Chief
Executive Officer and Chairman of Tuscarora Yarns in Mt. Pleasant,
North Carolina.
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\1\ NBIRTT is a non-profit national foundation dedicated to the
support of clinical research, treatment and training.
\2\ VANC provides brain injury rehabilitation to military
personnel, veterans and civilians through an innovative and cost
effective day treatment program.
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On behalf of the thousands of military personnel that receive brain
injury treatment and services annually, I respectfully request that a
total of $14 million be provided in the Department of Defense (DOD)
Appropriations bill for fiscal year 2006 for the Defense and Veterans
Head Injury Program (DVHIP). This request includes the $7 million in
the DOD's POM which we hope will be moved from the Uniformed Services
University of the Health Sciences to the Army Medical Research and
Materiel Command (AMRMC) at Fort Detrick. An additional $7 million plus
up would allow the important work of the program to continue, with
clinical care coordinated through Walter Reed Army Medical Center
(WRAMC) as the headquarters for the entire program.
TRAUMATIC BRAIN INJURY (TBI) MAY BE THE SIGNATURE CONDITION OF THE
CONFLICT IN IRAQ
Nearly 1,000 combat casualties from the Global War on Terrorism
have been served by DVHIP, and that does not include active duty
military injured in car crashes and other incidents occurring once they
return home.\3\
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\3\ Survivors of War Take Fatal Risks on Roads, Gregg Zoroya, USA
Today, May 3, 2005, pg A1. http://www.usatoday.com/news/nation/2005-03-
03-brain-trauma-lede_x.htm
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As we reported in last year's testimony, the incidence of TBI
sustained in theater was expected to be higher than in previous
conflicts. That indeed has been true, and continues to be the case. In
previous conflicts, TBI accounted for some 25 percent of combat
casualties. However, last spring one WRAMC study found 61 percent of
at-risk soldiers seen at WRAMC were assessed to have TBIs. Although
this one study does not reflect the entire population of wounded in
action, the high percentage suggests that TBI acquired in theater
continues to be a problem that needs to be addressed. The reasons for
the higher incidence of TBI include:
--The use of effective body armor has saved more lives;
--Medical personnel are more aware of the significance of mild closed
TBIs and concussions and are therefore more likely to identify
them; and
--The incidence of blast injuries in Iraq and Afghanistan is high.
There has also been an increase in awareness of TBI, mostly through
news media reports of injured troops (e.g. recent USA Today and People
articles are attached).\4\ Like Army Reserve Officer Alec Giess,
featured in the People magazine story, some troops may not be diagnosed
with TBI until months later. One of the greatest challenges the
military health care and veterans systems face is to assure that no one
falls through the cracks. The DVHIP is an important tool to assure a
continuum of care, but the program requires additional resources to
assure that no TBI is overlooked or misdiagnosed.
---------------------------------------------------------------------------
\4\T3AAfter Iraq, Devastating New Wounds, High-tech body
armor is saving soldiers' lives on the battlefield. But it's leaving
them with brain damage, T. Fields-Myer, V. Bane, J. Podesta, R.
Schlesinger, J. Voelker, People Magazine, May 9, 2005, pg. 223-5; Key
Iraq Wound: Brain Trauma, Body Armor Prevents Death, Not Damage, Gregg
Zoroya, USA Today, March 4, 2005, pg. A1. http://www.palo-
alto.med.va.gov/resources/docs/polytrauma/media/People Magazine050905-
Print.pdf
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THE DEFENSE AND VETERANS HEAD INJURY PROGRAM (DVHIP)
Established in 1992, the DVHIP is a component of the military
health care system that integrates clinical care and clinical follow-
up, with applied research, treatment and training. The program was
created after the first Gulf War to address the need for an overall
systemic program for providing brain injury specific care and
rehabilitation within DOD and DVA. The DVHIP seeks to ensure that all
military personnel and veterans with brain injury receive brain injury-
specific evaluation, treatment and follow-up. Clinical care and
research is currently undertaken at seven DOD and DVA sites and one
civilian treatment site.\5\ In addition to providing treatment,
rehabilitation and case management at each of the 8 primary DVHIP
centers, the DVHIP includes a regional network of additional secondary
veterans' hospitals capable of providing TBI rehabilitation, and linked
to the primary lead centers for training, referrals and consultation.
This is coordinated by a dedicated central DVA TBI coordinator and
includes an active TBI case manager training program. DVHIP also
provides education to providers and patients' families.
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\5\ Walter Reed Army Medical Center, Washington, DC; James A. Haley
Veterans Hospital, Tampa, FL; Naval Medical Center San Diego, San
Diego, CA; Minneapolis Veterans Affairs Medical Center, Minneapolis,
MN; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA;
Virginia Neurocare, Inc., Charlottesville, VA; Hunter McGuire Veterans
Affairs Medical Center, Richmond, VA; Wilford Hall Medical Center,
Lackland Air Force Base, TX.
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CONTINUING EFFORTS AND CURRENT CHALLENGES
Clinical Care
DVHIP continues to ensure optimal care, conduct clinical research,
provide educational programs on TBI as well as provide family support
for active duty military and veterans. All DVHIP sites have maintained
and many have increased treatment capacity. This has been a direct
response to the influx of patients seen secondary to Operation Iraqi
Freedom (OIF) and Operation Enduring Freedom (OEF). WRAMC receives more
casualties from theater than all of the other military treatment
facilities (MTFs) in the continental United States. Patients are often
seen at WRAMC within a week or two after injury and many of these
patients have multiple injuries (e.g., TBI, traumatic amputations,
shrapnel wounds, etc.).
To meet the increased demand, screening procedures were developed
by DVHIP headquarters and clinical staff. The DVHIP clinical staff
reviews all incoming casualty reports at WRAMC and screens all patients
who may have sustained a brain injury based on the mechanism of injury
(i.e., blast/explosion, vehicular accident, fall, gunshot wound to the
head, etc.). DVHIP screening is identifying TBI patients that might
otherwise go undetected, posing a potential threat to patients and, in
the case of premature return to active duty, military readiness.
Community Reentry and Return To Work
As of April 29, 2005, a full 35 percent of soldiers treated at
Virginia NeuroCare (VANC) returned to active duty. As a core program of
the DVHIP, VANC provides innovative community based rehabilitation
programs that maximize functional independence and facilitate re-entry
into family and community life. VANC's coordination with the Judge
Advocate General (JAG) school, in which active duty soldiers get back
into the military environment and develop work skills as well as
participate in military exercises has demonstrated its excellence in
the continuum of care received by injured military personnel. Housing
for eight additional beds is needed, however, to accommodate the
increase in active duty patients enrolled at VANC.
Blast Injury Research
Improved body armor, the significance of even mild brain injury,
and the high frequency of troops wounded in blasts all lead to blast-
induced TBI being an important health issue in this war. DVHIP at WRAMC
has identified over 400 patients who have sustained TBIs in OIF/OEF,
most of whom have been injured in blasts. The goal of TBI treatment is
to maintain individuals at duty whenever possible without negatively
affecting the unit mission or the individual service member and to
maximize the individual service member's potential for long term
productivity and quality of life.
The DVHIP is leading the effort to elucidate patterns of brain
injury from blast, including providing guidelines for the assessment
and follow-up care after blast-related TBI within the military
environment. Ongoing DVHIP research is linked to clinical care programs
to ensure that information learned from caring for these individuals
will be disseminated to military and veteran treatment facilities and
added to the medical literature. Continuing collaboration with military
experts on blast, working with preclinical subjects, also will help to
better understand the injuries our troops sustain.
Medic Training
In response to an unmet need identified at the March 2004 DVHIP co-
sponsored Neurotrauma in Theater: Lessons Learned from Iraq and
Afghanistan conference, DVHIP is developing a Combat Medic Training
module, to be made available online and in theater by November 2005.
DVHIP continues to proactively train deploying clinicians and care
providers at troop-intensive military treatment facilities. A military
first responder (Medic) online training course, which will offer CME
and CEU credits, will be available online and in theater by early
summer. Additional education initiatives include a Coordination of Care
Guide for TBI case managers, multiple Grand Rounds, and the
dissemination of DVHIP research and clinical practice publications.
Post Deployment Forms
DVHIP will continue its efforts to have blast and head injury
exposure added to the current Post Deployment form. DVHIP's experience
in identifying individuals with TBI and referring them for care at Ft.
Bragg and Camp Pendleton will be turned into management algorithms for
large scale use.
NEW INITIATIVES
Improving Access to TBI Specific Care
In order to assure that TBI specific care is available to
individuals after leaving specialty treatment centers, DVHIP will offer
a call for proposals for innovative clinical programs that will
establish distributed care networks. Outcomes measurement will include
patient level of independence, family education and satisfaction, and
cost savings analyses. TBI care is currently centralized at DVHIP lead
centers: four VA and three military medical centers, and one civilian
community re-entry center. Patients who need TBI specialty follow-up
care may be forced to travel great distances to receive it. Thus,
proposals will be solicited to address this need, including bringing
specialty TBI outpatient care to areas with no VA hospital (e.g.,
Alaska). Proposals for two types of programs will be elicited:
--TBI Community care.--Coordinated TBI case management, to include
family support initiatives, has the potential to greatly
facilitate community re-entry among TBI survivors. Proposals to
be considered include augmented clinics and telemedicine. To be
considered for funding, proposals must have clear outcome
measures designed to quantify improvements in patient self-
sufficiency and cost-savings to the Federal Government.
--Treatment of neurobehavioral consequences of TBI.--Often the most
disturbing to patients and families, neurobehavioral problems
such as memory, personality, and mood may complicate re-entry
to home and other relationships. Innovative, community-based
programs that add neurobehavioral expertise for ongoing care of
patients with TBI will be solicited.
TBI and Mental Health Evaluation
As soldiers return home, much attention is often paid to the
possibility of post-traumatic stress disorder (PTSD). One critical area
not to be overlooked is the relationship between TBI and PTSD. Research
suggests that patients with both PTSD and TBI are an important
population to identify, though not much is known about combat PTSD in
persons with TBI. While there are some similarities in initial symptoms
(headaches, trouble focusing, irritability), treatment for PTSD and TBI
are indeed very different. Clinically focused research initiatives by
DVHIP would investigate the unique relationship between TBI and PTSD to
ensure that the troops are receiving the best care available for both
their brain and their mind. Additional initiatives could focus on
mental health providers, who may where individuals with TBI present for
care.
TBI Assessment in Theater
DVHIP is leading the effort to provide evidence-based guidelines
for the assessment and follow-up care after blast-related TBI within
the military environment. An integral part of this effort is the
development of militarily relevant concussion guidelines that are
medically and scientifically based. Existing sports concussion
guidelines are not fully applicable to combat situations--particularly
because post injury symptoms may put the individual and fellow troops
at risk. Medics and clinicians in theater have voiced great interest in
objective tools to aide in the diagnosis and management of TBI. DVHIP
is continuing to work toward the final development and deployment of a
computerized assessment battery for concussion. DVHIP's unique role in
ensuring state of the art clinical care throughout the various levels
from battlefield to community reentry makes this possible.
A January 2005, GAO report on vocational rehabilitation for injured
service members emphasized that early intervention following TBI is
highly correlated with positive outcomes.\6\ By making it possible to
identify TBI immediately following an injury, America's war fighters
will receive the best care possible. Widespread use of a TBI assessment
battery will ensure that medics and clinicians in theater follow
evidence-based concussion guidelines.
---------------------------------------------------------------------------
\6\ Vocational Rehabilitation: More VA and DOD Collaboration Needed
to Expedite Services for Seriously Injured Service members, GAO-05-167
(Washington, DC: January 2005).
---------------------------------------------------------------------------
TBI Screening
The addition of a TBI clinician at key medical transfer points such
as Landstuhl Regional Medical Center (LRMC) in Germany and Andrews Air
Force Base will ensure that the screening process developed at WRAMC by
DVHIP identifies wounded service members who may also have a TBI. The
implementation of screening at WRAMC has identified TBI in many
soldiers who were not yet diagnosed with TBI. This effort would augment
the current Joint Theater Trauma Registry that has limited information
on brain injury, especially milder forms of TBI.
Clinical Registry Database
DVHIP proposes to develop a clinical registry, designed for
obtaining information on TBI patients far forward and following their
clinical outcomes. The database will also allow for rapid response to
clinical questions from military and VA medical leaders regarding the
incidence and outcome of TBI as well as permit the sharing of medical
information between clinicians and case managers. Additionally, this
will enable medical providers in theater to communicate questions
regarding TBI patients to the DVHIP, and facilitate the timely transfer
of patients to appropriate VA and military programs. This can be
completed as a stand alone project focused on hospital and in-theater
care, or as an augmentation of the Joint Theater Trauma Registry
database.
Educational Outreach
There is a need for greater educational outreach (teams of trainers
or other types of educational outreach) at specific non-DVHIP military
medical facilities and troop intensive sites (e.g. Fort Hood, Fort
Carson, etc.) to provide TBI training and education for providers with
direct contact with large numbers of troops, both troops stationed
locally and troops returning from theater (e.g., Reservists). This
effort could also increase DVHIP's reach in surveillance to include
centers beyond those in the core DVHIP network.
An educational outreach team was very successful in educating
providers of the 249th General Hospital who were deploying to
Afghanistan without a neurosurgeon, as allied neurosurgical injuries
were not anticipated. Training in neurocare was provided at Fort Gordon
and contact continued via email after the 249th reached Afghanistan.
CONCLUSION
In NBIRTT's view, the Congress has been very responsive to the
needs of our brave men and women in uniform who risk their lives for
us. We urge your continued support for active duty military men and
women sustaining brain injuries, whether in combat or at home. The
DVHIP has stepped up to the plate to meet the needs of soldiers with
brain injuries. Please support $14 million for the DVHIP in the fiscal
year 2006 Defense Appropriations bill under AMRMC, Fort Detrick to
continue this important program.
Thank you.
Senator Inouye. Will the VA benefit from your program?
Mr. Foil. Yes, sir.
Senator Inouye. Will you be able to seal up the cracks so
they will not fall through?
Mr. Foil. Well, nothing is 100 percent positive. But last
year, if you remember, you and Senator Stevens asked us how we
are going to help Hawaii and Alaska. You remember that?
Senator Inouye. Yes, we have got big cracks there.
Mr. Foil. That is right. Well, you heard me talk about care
coordinators. What we would like to do and what our agenda is
if we get this money is to take this--hold on just a minute.
Let us see.
There are a couple of places in Hawaii that we are looking
at that if we have the money to do this we would like to look
at, Tripler Army Medical Center in Honolulu and the VA Medical
Center in Honolulu. We would like to place a care coordinator
in there, and their job is going to be to start a program much
like we see here in the United States that has been so
successful.
In Alaska there are a couple of opportunities, Bassett Army
Community Hospital in Fort Wainwright, which is in Fairbanks,
and there is a medical facility at Elmendorf Air Base called
the Health and Wellness Center in Anchorage. Also, the VA
Medical Center in Alaska is in Anchorage with two other
outpatient clinics in both Fairbanks and Kenai--is that the way
you pronounce it?
Senator Stevens [presiding]. ``KEE-nie.''
Mr. Foil. ``KEE-nie.''
Senator Stevens. Kenai, it is the home of the greatest
salmon in the world.
Mr. Foil. All right, sir. I stand corrected.
But there is a lot to be done and I think we have the
opportunity to do this and do it properly. But we need your
support to be able to get it done, Senators. We would love to
have the opportunity to do this both in Hawaii and Alaska, and
there are other places where we do not have those
opportunities.
Senator Inouye. Thank you very much, sir.
Mr. Foil. Thank you, sir.
Senator Stevens. Doctor, we are going to try to make sure
that we do move that budget over to the Army Medical Research
and Material Command at Fort Detrick. We agree with you on that
and we will do our best to do that.
Mr. Foil. Thank you very much. We really appreciate it.
Senator Stevens. Our next witness is Dennis Duggan, Deputy
Director, National Security Commission for the American Legion.
Comrade, it is nice to see you.
STATEMENT OF DENNIS MICHAEL DUGGAN, DEPUTY DIRECTOR,
NATIONAL SECURITY COMMISSION, THE AMERICAN
LEGION
Mr. Duggan. Yes, sir, nice to see you again. Mr. Chairman
and ranking member, Senator Inouye: The American Legion, the
Nation's largest organization of wartime veterans, is extremely
grateful for this opportunity to present its views on defense
appropriations for fiscal year 2006. We have always valued your
leadership and your subcommittee's leadership in assessing and
authorizing adequate funding for quality of life,
modernization, and readiness features for the Nation's armed
forces, Active, Reserve, National Guard, as well as for our
Nation's military retiree veterans and their dependents.
As we know too well, the war on terrorism is being waged on
two fronts, overseas in a bitter, bloody struggle with armed
insurgents and at home, protecting and securing the homeland.
Most of what we hold dear as Americans was made possible by the
peace and stability that the armed forces have provided by
taking the fight to the enemy in overseas battlegrounds.
However, a decade of overuse of a smaller Army, a large-
scale use of reservists and National Guardsmen in combat, and a
past history of some underfunding has certainly warranted your
sustained investment. And, Mr. Chairman, it is deeply
appreciated.
The American Legion continues to urge an increase in Army
manpower strengths. We also are strongly supportive of
congressional authorization and funding of the necessary
recruiting tools, particularly for the Army, Army Reserve, and
Army National Guard, and perhaps the Marines. The funding of
even more recruiting bonuses, recruiters, advertising as
appropriate should be funded if needed.
Funding of an improved Montgomery Government Issue (GI)
bill for the Active and Reserve components was certainly
justified, and increased death gratuities and traumatic injury
insurance we believe are overdue as well.
We salute the Senate in protecting our troops and boosting
military benefits.
Mr. Chairman, while we are fighting what will likely be a
long, hard war on terrorism, we believe we must also keep an
eye on the Far East, particularly North Korea and China. Both
countries are flexing their military muscles in the Pacific
while the United States is distracted at war in Iraq and
Afghanistan. For that reason, we are extremely grateful that
the Senate is requiring the Navy to retain the 12-carrier fleet
Navy rather than scaling back.
As a concerned veterans organization, something tells us
perhaps that we should also be producing more than four Aegis
DDGs per year and perhaps not discharging as many as the 10,000
sailors that we seem to be doing.
Finally, with regard to the 2005 defense BRAC, the American
Legion would only urge that irreplaceable base facilities and
essential base facilities, perhaps such as military medical
facilities and commissaries and perhaps training areas, be
retained for use by Reserve components as needed or by military
retiree veterans and their families whenever such is possible.
Mr. Chairman, that concludes the oral statement of the
American Legion and we thank you again for this opportunity.
[The statement follows:]
Prepared Statement of Dennis Michael Duggan
Mr. Chairman, the American Legion is grateful for the opportunity
to present its views on defense appropriations for fiscal year 2006.The
American Legion values your leadership in assessing and authorizing
adequate funding for quality-of-life (QOL) features of the Nation's
armed forces to include the active, reserve and National Guard forces
and their families, as well as quality of life for military retirees
and their dependents.
Since September 2001, the United States has been involved in the
war against terrorism in Operations Iraqi Freedom and Enduring Freedom.
American fighting men and women are again proving they are the best-
trained, best-equipped and best-led military in the world. As Secretary
of Defense Donald Rusted has noted, the war in Iraq is part of a long,
dangerous global war on terrorism. The war on terrorism is being waged
on two fronts: overseas against armed insurgents and at home protecting
and securing the Homeland. Casualties in the shooting wars, in terms of
those killed and seriously wounded, continue to mount daily. Indeed,
most of what we as Americans hold dear is made possible by the peace
and stability that the Armed Forces provide by taking the fight to the
enemy.
The American Legion adheres to the principle that this Nation's
armed forces must be well-manned and equipped, not just to pursue war,
but to preserve and protect the peace. The American Legion strongly
believes past military downsizing was budget-driven rather than threat
focused. Once Army divisions, Navy warships and Air Force fighter
squadrons are downsized, eliminated or retired from the force
structure, they cannot be reconstituted quickly enough to meet new
threats or emergency circumstances. The Marine Corps, Army National
Guard and the Reserves have failed to meet their recruiting goals and
the Army's stop-loss policies have obscured retention and recruiting
needs. Clearly, the active Army is struggling to meet its recruitment
goals. Military morale undoubtedly has been adversely affected by the
extension and repetition of Iraq tours of duty.
The administration's fiscal year 2006 budget requests $419.3
billion for defense or about 17 percent of the total budget. The fiscal
year 2006 defense budget represents a 4.8 percent increase in defense
spending over current funding levels. It also represents about 3.5
percent of our Gross National Product. Active duty military manpower
end-strength is now over 1.388 million. Selected Reserve strength is
about 863,300 or reduced by about 25 percent from its strength levels
during the Gulf War of 14 years ago.
Mr. Chairman, this budget must advance ongoing efforts to fight the
global war on terrorism, sustain and improve quality of life and
continue to transform the military. A decade of over use of the
military and past under-funding, necessitates a sustained investment.
The American Legion believes the budget must continue to address
increases in Army end-strengths, accelerate improved Active and Reserve
Components quality of life features, provide increased funding for the
concurrent receipt of military retirement pay and VA disability
compensation (``Veterans Disability Tax''); and elimination of the
offset of survivors benefit plan (SBP) and Dependency and Indemnity
Compensation (DIC) that continues to penalize military survivors.
If we are to win the war on terror and prepare for the wars of
tomorrow, we must take care of the Department of Defense's greatest
assets--the men and women in uniform. They do us proud in Iraq,
Afghanistan and around the world. They need help.
In order to attract and retain the necessary force over the long
haul, the active duty force, Reserves and National Guard continue to
look for talent in an open market place and to compete with the private
sector for the best young people this Nation has to offer. If we are to
attract them to military service in the active and reserve components,
we need to count on their patriotism and willingness to sacrifice, to
be sure, but we must also provide them the proper incentives. They love
their country, but they also love their families--and many have
children to support, raise and educate. We have always asked the men
and women in uniform to voluntarily risk their lives to defend us; we
should not ask them to forego adequate pay and allowances, adequate
health care and subject their families to repeated unaccompanied
deployments and sub-standard housing as well. Undoubtedly, retention
and recruiting budgets need to be substantially increased if we are to
keep and recruit quality service members.
The President's fiscal year 2006 defense budget requests over $105
billion for military pay and allowances, including a 3.1 percent
across-the-board pay raise. It also includes billions to improve
military housing, putting the Department on track to eliminate most
substandard housing by 2007--several years sooner than previously
planned. The fiscal year 2005 budget further lowered out-of-pocket
housing costs for those living off base. The American Legion encourages
the Subcommittee to continue the policy of no out-of-pocket housing
costs in future years.
Together, these investments in people are critical, because smart
weapons are worthless to us unless they are in the hands of smart,
well-trained soldiers, sailors, airmen, Marines and Coast Guard
personnel.
The American Legion National Commanders have visited American
troops in Europe, the Balkans, and South Korea as well as a number of
installations throughout the United States, including Walter Reed Army
Medical Center and Bethesda National Naval Medical Center. During these
visits, they were able to see first hand the urgent, immediate need to
address real quality of life challenges faced by service members and
their families. Severely wounded service members who have families and
are convalescing in military hospitals clearly need to have their
incomes increased when they are evacuated from combat zones. Also, the
medical evaluation board process needs to be expedited so that military
severance and disability retirement pays will be more immediately
forthcoming. Our National Commanders have spoken with families on
Women's and Infants' Compensation (WIC), where quality-of-life issues
for service members, coupled with combat tours and other operational
tempos, play a role in recurring recruitment and retention efforts and
should come as no surprise. The operational tempo and lengthy
deployments, other than combat tours, must be reduced or curtailed.
Military missions were on the rise before September 11 and deployment
levels remain high. The only way to reduce repetitive overseas tours
and the overuse of the Reserves is to increase active duty and perhaps
reserve end-strengths for the services. Military pay must be on a par
with the competitive civilian sector. Activated reservists must receive
the same equipment, the same pay and timely health care as active duty
personnel. If other benefits, like health care improvements,
commissaries, adequate quarters, quality child care and impact aid for
DOD education are reduced, they will only serve to further undermine
efforts to recruit and retain the brightest and best this nation has to
offer.
To step up efforts to bring in enlistees, all the Army components
are increasing the number of recruiters. The Army National Guard sent
1,400 new recruiters into the field last February. The Army Reserve is
expanding its recruiting force by about 80 percent. If the recruiting
trends and the demand for forces persist, the Pentagon under current
policies could eventually ``run out'' of reserve forces for war zone
rotation, a Government Accountability Office expert warned. The
Pentagon projects a need to keep more than 100,000 reservists
continuously over the next 3 to 5 years. The Defense Appropriations
bill for fiscal year 2005 provides the funding for the first year force
level increases of 10,000. The Army's end-strength increased 30,000 and
the Marine Corps end-strength increased 3,000.
Army restructuring will increase the number of active Army maneuver
brigades by 30 percent by fiscal year 2007. The Army National Guard
will reach 34 brigades. The Marine Corps will increase by two
battalions.
The budget deficit is projected to be $427 billion; the largest in
U.S. history and it appears to be heading higher perhaps to $500
billion. National defense spending must not become a casualty of
deficit reduction.
FORCE HEALTH PROTECTION (FHP)
As American military forces are again engaged in combat overseas,
the health and welfare of deployed troops is of utmost concern to The
American Legion. The need for effective coordination between the
Department of Veterans Affairs and the DOD in the force protection of
U.S. forces is paramount. It has been 14 years since the first Gulf
War, yet many of the hazards of the 1991 conflict are still present in
the current war.
Prior to the 1991 Gulf War deployment, troops were not
systematically given comprehensive pre-deployment health examinations
nor were they properly briefed on the potential hazards, such as
fallout from depleted uranium munitions they might encounter. Record
keeping was poor. Numerous examples of lost or destroyed medical
records of active duty and reserve personnel were identified. Physical
examinations (pre- and post-deployment) were not comprehensive and
information regarding possible environmental hazard exposures was
severely lacking. Although the government had conducted more than 230
research projects at a cost of $240 million, lack of crucial deployment
data resulted in many unanswered questions about Gulf War veterans
illnesses.
The American Legion would like to specifically identify an element
of FHP that deals with DOD's ability to accurately record a service
member's health status prior to deployment and document or evaluate any
changes in his or her health that occurred during deployment. This is
exactly the information VA needs to adequately care for and compensate
service members for service-related disabilities once they leave active
duty. Although DOD has developed post-deployment questionnaires, they
still do not fulfill the requirement of ``thorough'' medical
examinations nor do they even require a medical officer to administer
the questionnaires. Due to the duration and extent of sustained combat
in Operations Iraqi Freedom and Enduring Freedom, the psychological
impact on deployed personnel is of utmost concern to The American
Legion. VA's ability to adequately care for and compensate our Nation's
veterans depends directly on DOD's efforts to maintain proper health
records/health surveillance, documentation of troop locations,
environmental hazard exposure data and the timely sharing of this
information with the VA.
The American Legion strongly urges Congress to mandate separation
physical exams for all service members, particularly those who have
served in combat zones or have had sustained deployments. DOD reports
that only about 20 percent of discharging service members opt to have
separation physical exams. During this war on terrorism and frequent
deployments with all their strains and stresses, this figure, we
believe, should be substantially increased.
MILITARY QUALITY OF LIFE
Our major national security concern continues to be the enhancement
of the quality of life issues for active duty service members,
reservists, National Guardsmen, military retirees and their families.
During the last Congressional session, President Bush and the Congress
made marked improvements in an array of quality of life issues for
military personnel and their families. These efforts are vital
enhancements that must be sustained.
Mr. Chairman: during this period of the War on Terrorism, more
quality of life improvements are required to meet the needs of
servicemembers and their families as well as military retiree veterans
and their families. For example, the totally inadequate $12,000 death
gratuity needs to be increased to $100,000 and the SGLI needs to be
increased to at least $400,000; the improved Reserve MGIB for education
needs to be completely funded as well; combat wounded soldiers who are
evacuated from combat zones to military hospitals need to retain their
special pay (combat pay, family separation pay, etc) and base pay and
allowances during the period of their convalescence continued at the
same level to not jeopardize their families' financial support during
recovery. Furthermore, the medical evaluation board process needs to be
expedited so that any adjudicated military severance or military
disability retirement payments will be immediately forthcoming;
recruiting and retention efforts, to include the provision of more
service recruiters, needs to be fully funded as does recruiting
advertising. The Defense Health Program and in particular the Uniformed
Services University of the Health Sciences must also be fully
appropriated. The American Legion appreciates the administration and
Congress's support of the Wounded Warrior bill designed to provide
financial help to soldiers and their families when they are wounded or
otherwise traumatically injured.
Likewise, military retiree veterans as well as their survivors, who
have served their Country for decades in war and peace, require
continued quality of life improvements as well. First and foremost, The
American Legion strongly urges that FULL concurrent receipt and Combat-
Related Special Compensation (CRSC) be authorized for disabled retirees
whether they were retired for longevity (20 or more years of service)
or military disability retirement with fewer than 20 years. In
particular, The American Legion urges that disabled retirees rated 40
percent and below be authorized CRPD and that disabled retirees rated
between 50 percent and 90 percent disabled be authorized non-phased-in
concurrent receipt. Additionally, The American Legion strongly urges
that ALL military disability retirees with fewer than 20 years service
be authorized to receive CRSC and VA disability compensation provided,
of course, they're otherwise eligible for CRSC under the combat-related
conditions.
Secondly, The American Legion urges that the longstanding inequity
whereby military survivors have their survivors benefit plan (SBP)
offset by the Dependency and Indemnity Compensation (DIC) be
eliminated. This ``Widows' Tax'' needs to be eliminated as soon as
possible. It is blatantly unfair and has penalized deserving military
survivors for years. A number of these military survivors were nearly
impoverished because of this unfair provision. As with concurrent
receipt for disabled retirees, military survivors should receive both
SBP AND DIC. They have always been entitled to both and should not have
to pay for their own DIC. The American Legion will continue to convey
that simple, equitable justice is the primary reason to fund FULL
concurrent receipt of military retirement pay and VA disability
compensation as well as the survivors benefit plan (SBP) and DIC for
military survivors. Not to do so merely continues the same inequity.
Both inequities need to be righted by changing the unfair law that
prohibits both groups from receiving both forms of compensation.
Mr. Chairman: the American Legion as well as the armed forces and
veterans continue to owe you and this subcommittee a debt of gratitude
for your support of military quality of life issues. Nevertheless, your
assistance is needed in this budget to overcome old and new threats to
retaining and recruiting the finest military in the world. Service
members and their families continue to endure physical risks to their
well-being and livelihood as well as the forfeiture of personal
freedoms that most Americans would find unacceptable. Worldwide
deployments have increased significantly and the Nation is at war. The
very fact that over 300,000 Guardsmen and Reservists have been
mobilized since September 11, 2001 is first-hand evidence that the
United States Army desperately needs to increase its end-strengths and
maintain those end-strengths so as to help facilitate the rotation of
active and reserve component units to active combat zones.
The American Legion congratulates and thanks congressional
subcommittees such as this one for military and military retiree
quality of life enhancements contained in past National Defense
Appropriations Acts. Continued improvement however is direly needed to
include the following:
--Completely Closing the Military Pay Gap with the Private Sector.--
With U.S. troops battling insurgency and terrorism in Iraq and
Afghanistan, The American Legion supports the proposed 3.1
percent military pay raise as well as increases in Basic
Allowance for Housing (BAH).
--Commissaries.--The American Legion urges the Congress to preserve
full Federal subsidizing of the military commissary system and
to retain this vital non-pay compensation benefit for use by
active duty families, reservist families, military retiree
families and 100 percent service-connected disabled veterans
and others.
--DOD Domestic Dependents Elementary and Secondary Schools (DDESS).--
The American Legion urges the retention and full funding of the
DDESS as they have provided a source of high quality education
for military children attending schools on military
installations.
--Funding the Reserve Montgomery GI Bill for Education.
--Increasing the death gratuity to $100,000 and $400,000 for SGLI for
all active duty or activated Reservists who are killed or who
die while on active duty after September 11, 2001 during the
War on Terror.
--Improving the pay of severely wounded service members and
expediting the medical evaluation board process.
--Providing FULL concurrent receipt of military retirement pay and VA
disability compensation for those disabled retirees rated 40
percent and less; providing non-phased concurrent receipt for
those disabled retirees rated between 50 percent and 90 percent
disabled by the VA; and authorizing those military disability
retirees with fewer than 20 years service to receive both VA
disability compensation and Combat-Related Special Compensation
(CRSC).
--Eliminating the offset of the survivors benefit plan (SBP) and
Dependency and Indemnity Compensation (DIC) for military
survivors.
OTHER QUALITY OF LIFE INSTITUTIONS
The American Legion strongly believes that quality of life issues
for retired military members and their families are augmented by
certain institutions which we believe need to be annually funded as
well. Accordingly, The American Legion believes that Congress and the
administration must place high priority on insuring these institutions
are adequately funded and maintained:
--The Uniformed Services University of the Health Sciences.--The
American Legion urges the Congress to resist any efforts to
less than fully fund, downsize or close the USUHS through the
BRAC process. It is a national treasure, which educates and
produces military physicians and advanced nursing staffs. We
believe it continues to be an economical source of CAREER
medical leaders who enhance military health care readiness and
excellence and is well-known for providing the finest health
care in the world.
--The Armed Forces Retirement Homes.--The United States Soldiers' and
Airmen's Home in Washington, DC and the United States Naval
Home in Gulfport, Mississippi, are under-funded as evidenced by
the reduction in services to include on-site medical health
care and dental care. Increases in fees paid by residents are
continually on the rise. The medical facility at the USSAH has
been eliminated with residents being referred to VA Medical
Centers or Military Treatment Facilities such as Walter Reed
Army Medical Center. The American Legion recommends that the
Congress conduct an independent assessment of these two
facilities and the services being provided with an eye toward
federally subsidizing these two Homes as appropriate. Both
facilities have been recognized as national treasures until
recent years when a number of mandated services have been
severely reduced and resident fees have been substantially
increased.
--Arlington National Cemetery.--The American Legion urges that the
Arlington National Cemetery be maintained to the highest of
standards. We urge also that Congress mandate the eligibility
requirements for burial in this prestigious Cemetery reserved
for those who have performed distinguished military service and
their spouses and eligible children.
--2005 Defense Base Realignment and Closure Commission.--The American
Legion urges that certain base facilities such as military
medical facilities, commissaries, exchanges and training
facilities and other quality of life facilities be preserved
for use by the active and reserve components and military
retirees and their families.
THE AMERICAN LEGION FAMILY SUPPORT NETWORK
The American Legion continues to demonstrate its support and
commitment to the men and women in uniform and their families. The
American Legion's Family Support is providing immediate assistance
primarily to activated National Guard families as requested by the
Director of the National Guard Bureau. The American Legion Family
Support Network has reached out through its Departments and Posts to
also support the Army' Disabled Soldier Support System (DS3). Many
thousands of requests from these families have been received and
accommodated by the American Legion Family across the United States.
Military family needs have ranged from requests for funds to a variety
of everyday chores which need doing while the ``man or woman `` of the
family is gone. The American Legion, whose members have served our
Nation in times of adversity, remember how it felt to be separated from
family and loved ones. As a grateful Nation, we must ensure than no
military family endures those hardships caused by military service, as
such service has assured the security, freedom and ideals of our great
Country.
CONCLUSIONS
Thirty-two years ago, America opted for an all-volunteer force to
provide for the National Defense. Inherent in that commitment was a
willingness to invest the needed resources to bring into existence and
maintain a competent, professional and well-equipped military. The
fiscal year 2006 defense budget, while recognizing the War on Terrorism
and Homeland Security, represents another good step in the right
direction. Likewise our military retiree veterans and military
survivors, who in yesteryear served this Nation for decades, continue
to need your help as well.
Mr. Chairman, This concludes our statement.
Senator Stevens. Thank you very much.
Do you have any comments?
Senator Inouye. I support.
Senator Stevens. We generally support what you have said. I
disagree with you on the aircraft carriers, but he agrees with
you, so you are ahead.
Thank you very much for your testimony.
Mr. Duggan. Thank you, sir.
Senator Stevens. Next is Lieutenant Colonel (retired) Paul
Austin of the American Association of Nurse Anesthetists. Yes,
sir.
STATEMENT OF LIEUTENANT COLONEL PAUL N. AUSTIN, CRNA,
Ph.D., U.S. AIR FORCE (RETIRED), ON BEHALF
OF THE AMERICAN ASSOCIATION OF NURSE
ANESTHETISTS
Dr. Austin. Chairman Stevens and Senator Inouye: Good
afternoon. My name is Dr. Paul Austin and I'm a certified
registered nurse anesthetist (CRNA), recently retired from the
U.S. Air Force after 24 years of proudly serving my country.
For the majority of this time I served as a nurse anesthesia
educator who was the Director of both the U.S. Air Force and
the Uniformed Services University nurse anesthesia programs.
The American Association of Nurse Anesthetists (AANA)
represents more than 30,000 CRNAs, including 483 Active duty
CRNAs, 790 reservists in the military. CRNAs continue to be
deployed to the Middle East for Operation Iraqi Freedom and
Operation Enduring Freedom, providing anesthesia in all types
of surgical procedures, both on ships and on the ground.
In many cases CRNAs are the sole anesthesia providers for
our troops, which General Brannon stated before this
subcommittee last week, and I quote: ``Lieutenant Colonel
Bonnie Mack and Major Virginia Johnson are CRNAs deployed to
Tallil Air Base in Iraq as the only anesthesia providers for
over 20,000 U.S. and coalition forces and civilian contract
personnel.''
Today maintaining adequate numbers of Active duty CRNAs is
of the utmost importance to the Department of Defense to meet
its military medical readiness mission. For several years the
number of CRNAs serving on Active duty has fallen somewhat
short of the number authorized by the DOD. This is complicated
by the strong demand for CRNAs in both the public and private
sectors. This considerable gap between civilian and military
pay was addressed in the fiscal year 2003 Defense Authorization
Act with an incentive specialty pay, or ISP, increase from
$15,000 to $50,000. The AANA appreciates this subcommittee's
continued support to fund the ISP to retain and to recruit
CRNAs.
Last, the establishment of the joint VA-DOD program in
nurse anesthetist education at Fort Sam Houston in San Antonio
holds the promise of making significant improvements in the VA
CRNA workforce and improving retention of VA registered nurses
(RNs) in a cost effective manner. This 30-month program
attracts RNs into VA service by sending RNs a strong message
that the VA is committed to their educational advancement.
Due to continued interest by VA RNs in the program, the
program will be expanding to five openings for the June 2005
class. In addition, this partnership enables the VA faculty
director to cover her Army colleagues' classes when they are
deployed at a moment's notice.
In conclusion, the AANA believes that the recruitment and
retention of CRNAs in the services is critical to our men and
women in uniform. Continued funding of the ISP will help meet
this challenge. The AANA thanks this subcommittee for your
continued support for CRNAs in the military.
[The statement follows:]
Prepared Statement of Lieutenant Colonel (Ret.) Paul N. Austin
Chairman Stevens, Ranking Member Inouye, and members of the
subcommittee, the American Association of Nurse Anesthetists (AANA) is
the professional association representing over 30,000 certified
registered nurse anesthetists (CRNAs) in the United States, including
482 active duty and 799 reservists in the military. The AANA
appreciates the opportunity to provide testimony regarding CRNAs in the
military. We would also like to thank this committee for the help it
has given us in assisting the Department of Defense (DOD) and each of
the services to recruit and retain CRNAs.
BACKGROUND INFORMATION ON NURSE ANESTHETISTS
Let us begin by describing the profession of nurse anesthesia, and
its history and role with the military medical system.
In the administration of anesthesia, CRNAs perform the same
functions as anesthesiologists and work in every setting in which
anesthesia is delivered including hospital surgical suites and
obstetrical delivery rooms, ambulatory surgical centers, health
maintenance organizations, and the offices of dentists, podiatrists,
ophthalmologists, and plastic surgeons. Today CRNAs participate in
approximately 65 percent of the anesthetics given to patients each year
in the United States. Nurse anesthetists are also the sole anesthesia
providers in more than two-thirds of rural hospitals, assuring access
to surgical, obstetrical and other healthcare services for millions of
rural Americans.
CRNAs have a personal and professional commitment to patient
safety, made evident through research into our practice. In our
professional association, we state emphatically ``our members' only
business is patient safety.'' Safety is assured through education, high
standards of professional practice, and commitment to continuing
education. Having first practiced as registered nurses, CRNAs are
educated to the master's degree level and meet the most stringent
continuing education and recertification standards in the field. Thanks
to this tradition of advanced education, the clinical practice
excellence of anesthesia professionals, and the advancement in
technology, we are humbled and honored to note that anesthesia is 50
times safer now than 20 years ago (National Academy of Sciences, 2000).
Research further demonstrates that the care delivered by CRNAs,
anesthesiologists, or by both working together yields similar patient
safety outcomes. In addition to studies performed by the National
Academy of Sciences in 1977, Forrest in 1980, Bechtholdt in 1981, the
Minnesota Department of Health in 1994, and others, Dr. Michael Pine,
MD, MBA recently concluded once again that among CRNAs and physician
anesthesiologists, ``the type of anesthesia provider does not affect
inpatient surgical mortality'' (Pine, 2003). Thus, the practice of
anesthesia is a recognized specialty in nursing and medicine. Both
CRNAs and anesthesiologists administer anesthesia for all types of
surgical procedures from the simplest to the most complex, either as
single providers or together.
NURSE ANESTHETISTS IN THE MILITARY
Since the mid-19th Century, our profession of nurse anesthesia has
been proud to provide anesthesia care for our past and present military
personnel and their families. From the Civil War to the present day,
nurse anesthetists have been the principal anesthesia providers in
combat areas of every war in which the United States has been engaged.
Military nurse anesthetists have been honored and decorated by the
U.S. and foreign governments for outstanding achievements, resulting
from their dedication and commitment to duty and competence in managing
seriously wounded casualties. In World War II, there were 17 nurse
anesthetists to every one anesthesiologist. In Vietnam, the ratio of
CRNAs to physician anesthesiologists was approximately 3:1. Two nurse
anesthetists were killed in Vietnam and their names have been engraved
on the Vietnam Memorial Wall. During the Panama strike, only CRNAs were
sent with the fighting forces. Nurse anesthetists served with honor
during Desert Shield and Desert Storm. Military have CRNAs provided
critical anesthesia support to humanitarian missions around the globe
in such places as Bosnia and Somalia. In May 2003, approximately 364
nurse anesthetists had been deployed to the Middle East for the
military mission for ``Operation Iraqi Freedom'' and ``Operation
Enduring Freedom.''
Data gathered from the U.S. Armed Forces anesthesia communities'
reveal that CRNAs have often been the sole anesthesia providers at
certain facilities, both at home and while forward deployed. For
decades CRNAs have staffed ships, isolated U.S. Bases, and forward
surgical teams without physician anesthesia support. The U.S. Army
Joint Special Operations Command Medical Team and all Army Forward
Surgical Teams are staffed solely by CRNAs. Military CRNAs have a long
proud history of providing independent support and quality anesthesia
care to military men and women, their families and to people from many
nations who have found themselves in harm's way.
In the current mission ``Operation Iraqi Freedom'' CRNAs will
continue to be deployed both on ships and on the ground, as well as in
U.S. special operations forces. This committee must ensure that we
retain and recruit CRNAs now and in the future to serve in these
military overseas deployments, and to ensure the maximum readiness of
America's armed services.
CRNA RETENTION AND RECRUITING--HOW THIS COMMITTEE CAN HELP THE DEFENSE
DEPARTMENT
In all of the Services, maintaining adequate numbers of active duty
CRNAs is of utmost concern. For several years, the number of CRNAs
serving in active duty has fallen somewhat short of the number
authorized by the Department of Defense (DOD). This is further
complicated by strong demand for CRNAs in both the public and private
sectors.
However, it is essential to understand that while there is strong
demand for CRNA services in the public and private healthcare sectors,
the profession of nurse anesthesia is working effectively to meet this
workforce challenge. Our evidence suggests that while vacancies exist,
there is not a crisis in the number of anesthesia providers. The
profession of nurse anesthesia has increased its number of accredited
CRNA schools, from 88 to 94 in the past year. Each CRNA school
continues to turn away qualified applicants--bachelor's educated nurses
who had spent at least 1 year serving in a critical care environment.
Recognizing the importance of nurse anesthetists to quality healthcare,
the AANA has been working with its 94 accredited schools of nurse
anesthesia to increase the number of qualified graduates, and to expand
the number of CRNA schools. The Council on Accreditation of Nurse
Anesthesia Educational Programs (COA) reports that in 1999, our schools
produced 948 new graduates. By 2004, that number had increased to
1,628, a 72 percent increase in just 5 years. The growth is expected to
continue. The COA projects CRNA schools to produce 1,800 graduates in
2005.
This committee can greatly assist in the effort to attract and
maintain essential numbers of nurse anesthetists in the military by
their support to increase special pays.
INCENTIVE SPECIAL PAY (ISP) FOR NURSE ANESTHETISTS
According to a March 1994 study requested by the Health Policy
Directorate of Health Affairs and conducted by the Department of
Defense, a large pay gap existed between annual civilian and military
pay in 1992. This study concluded, ``this earnings gap is a major
reason why the military has difficulty retaining CRNAs.'' In order to
address this pay gap, in the fiscal year 1995 Defense Authorization
bill Congress authorized the implementation of an increase in the
annual Incentive Special Pay (ISP) for nurse anesthetists from $6,000
to $15,000 for those CRNAs no longer under service obligation to pay
back their anesthesia education. Those CRNAs who remain obligated
receive the $6,000 ISP.
Both the House and Senate passed the fiscal year 2003 Defense
Authorization Act Conference report, H. Rept. 107-772, which included
an ISP increase to $50,000. The report included an increase in ISP for
nurse anesthetists from $15,000 to $50,000. There had been no change in
funding level for the ISP since the increase was instituted in fiscal
year 1995, while it is certain that civilian pay has continued to rise
during this time. The AANA is requesting that this committee support
funding increases for the ISP for all the branches of the armed
services to retain and recruit CRNAs now and into the future.
In addition, there still continues to be high demand for CRNAs in
the healthcare community leading to higher incomes, widening the gap in
pay for CRNAs in the civilian sector compared to the military. The
fiscal year 2004 AANA Membership survey measured income in the civilian
sector by practice setting. The median income in a hospital setting is
$135,000, anesthesiologist group $120,000, and self-employed CRNA
$159,000 (includes Owner/Partner of a CRNA Group). These median
salaries include call pay, overtime pay, and bonus pay. These salaries
are still higher than the median CRNA's salary of $88,000 across all
military service branches.
In civilian practice, all additional skills, experience, duties and
responsibilities, and hours of work are compensated for monetarily.
Additionally, training (tuition and continuing education), healthcare,
retirement, recruitment and retention bonuses, and other benefits often
equal or exceed those offered in the military.
Salaries in the civilian sector will continue to create incentives
for CRNAs to separate from the military, especially at the lower grades
without a competitive incentive from the military to retain CRNAs.
Therefore, it is vitally important that the Incentive Special Pay (ISP)
be increased to ensure the retention of CRNAs in the military
AANA thanks this committee for its support of the annual ISP for
nurse anesthetists. AANA strongly recommends the continuation and an
increase in the annual funding for ISP for fiscal year 2006. The ISP
recognizes the special skills and advanced education that CRNAs bring
to the Department of Defense healthcare system.
BOARD CERTIFICATION PAY FOR NURSE ANESTHETISTS
Included in the fiscal year 1996 Defense Authorization bill was
language authorizing the implementation of a board certification pay
for certain healthcare professionals, including advanced practice
nurses. AANA is highly supportive of board certification pay for all
advanced practice nurses. The establishment of this type of pay for
nurses recognizes that there are levels of excellence in the profession
of nursing that should be recognized, just as in the medical
profession. In addition, this type of pay may assist in closing the
earnings gap, which may help with retention of CRNAs.
While many CRNAs have received board certification pay, there are
many that remain ineligible. Since certification to practice as a CRNA
does not require a specific master's degree (though all CRNAs
graduating and being certified today do so as master's graduates), many
nurse anesthetists have chosen to diversify their education by pursuing
an advanced degree in other related fields. But CRNAs with master's
degrees in education, administration, or management are not necessarily
eligible for board certification pay since their graduate degrees are
not in a clinical specialty. To deny a bonus to these individuals is
unfair, and will certainly affect their morale as they work side-by-
side with their less-experienced colleagues, who will collect a bonus
for which they are not eligible. In addition, in the future this bonus
will act as a financial disincentive for nurse anesthetists to
diversify and broaden their horizons.
AANA encourages the Department of Defense and the respective
services to reexamine the issue of awarding board certification pay
only to CRNAs who have clinical master's degrees.
DOD-VA RESOURCE SHARING: DOD-VA NURSE ANESTHESIA SCHOOL UNIVERSITY OF
TEXAS HOUSTON HEALTH SCIENCE CENTER, HOUSTON, TX
The establishment of the joint Department of Defense-VA program in
nurse anesthesia education at Fort Sam Houston in San Antonio, TX holds
the promise of making significant improvements in the VA CRNA
workforce, as well as improving retention of VA registered nurses in a
cost effective manner. The current program utilizes existing resources
from both the Department of Veterans Affairs Employee Incentive
Scholarship Program (EISP) and VA hospitals to fund tuition, books, and
salary reimbursement for student registered nurse anesthetists (SRNAs).
This VA nurse anesthesia program started in June 2004 with three
openings for VA registered nurses to apply to and earn a Master of
Science in Nursing (MSN) in anesthesia granted through the University
of Texas Houston Health Science Center. Due to continued success and
interest by VA registered nurses for the school, the program will be
increasing to five openings for the June 2005 class. This program
continues to attract registered nurses into VA service, by sending RNs
the strong message that the VA is committed to their professional and
educational advancement. The faculty director would like to expand the
program to seven students for the June 2006 class. In order to achieve
this goal, it is necessary for full funding of the current and future
EISP to cover tuition, books, and salary reimbursement.
The 30-month program is broken down into two phases. Phase I, 12
months, is the didactic portion of the anesthesia training at the U.S.
AMEDD Center and School (U.S. Army School for Nurse Anesthesia). Phase
II, 18 months, is clinical practice education, in which VA facilities
and their affiliates would serve as clinical practice sites. In
addition to the education taking place in Texas, the agency will use VA
hospitals in Augusta, Georgia, increasing Phase II sites as necessary.
Similar to military CRNAs who repay their educational investment
through a service obligation to the U.S. Armed Forces, graduating VA
CRNAs would serve a 3-year obligation to the VA health system. Through
this kind of Department of Defense-VA resource sharing, the VA will
have an additional source of qualified CRNAs to meet anesthesia care
staffing requirements.
At a time of increased deployments in medical military personnel,
DOD-VA partnerships are a cost-effective model to fill these gaps in
the military healthcare system. At Fort Sam Houston nurse anesthesia
school, the VA faculty Director has covered her Army colleagues'
didactic classes when they are deployed at a moments notice. This
benefits both the VA and DOD to ensure the nurse anesthesia students
are trained and certified in a timely manner to meet their workforce
obligation to the Federal Government as anesthesia providers.
We are pleased to note that the U.S. Army Surgeon General and Dr.
Michael J. Kussman, MD, MS, FACP (Department of Veterans' Affairs
Acting Deputy Under Secretary for Health) approved funding to start
this VA nurse anesthesia school in 2004. In addition, the Army program
director COL Norma Garrett, Ph.D., CRNA with VA director Dr. Maureen
Reilly, CRNA, MSN, MHS, Ph.D. working under her guidance continue to
work together for the continued success in this DOD-VA partnership,
with the support of Anesthesia Service Director Dr. Michael Bishop, MD.
With modest levels of additional funding in the EISP, this joint DOD-VA
nurse anesthesia education initiative can grow and thrive, and serve as
a model for meeting other VA workforce needs, particularly in nursing.
Department of Defense and VA resource sharing programs effectively
maximize government resources while improving access to healthcare for
Veterans.
CONCLUSION
In conclusion, the AANA believes that the recruitment and retention
of CRNAs in the armed services is of critical concern. The efforts
detailed above will assist the military services in maintaining the
military's ability to meet its wartime and medical mobilization through
the funding both the ISP and board certification pay. Last, we commend
and thank this committee for their continued support for CRNAs in the
military.
Senator Stevens. Senator Inouye.
Senator Inouye. About 2 years ago I had laser surgery in
the eye and the anesthesia was administered by a nurse
anesthetist. They are very good.
Dr. Austin. Thank you, sir. We are very proud and very
proud to serve the men and women in uniform.
Senator Stevens. We have supported this annual funding for
incentive pay. Tell us how it worked?
Dr. Austin. Increasing the ceiling from the former level to
the level it is now, it is a bit too soon to tell whether or
not it is going to make a difference. That increased the
ceiling and that ceiling then can be dealt with by the
individual services to meet the needs of the services. The Army
was the service that was and is most impacted and it is
probably too soon to tell whether or not it is going to make a
difference, but we are very optimistic that it is going to help
maintain those billets.
Senator Stevens. Let us know, because with the record of
your profession's participate in the military, I think we might
have to mandate its use rather than authorize its use. But tell
them to keep us informed, will you, please?
Dr. Austin. Thank you very much, sir.
Senator Stevens. Thank you.
Senator Inouye. What is the national shortage of registered
nurse anesthetists?
Dr. Austin. Currently the national shortage, as far as a
percentage, we would have to get you that data. But there
continues to be a shortage. For instance, in the State of
Maryland there is a hospital that has an immediate need for 11
full-time nurse anesthetists that they have not figured out by
July 1 how they are going to fill. So that is a local example
that really does serve as an example nationally.
The exact number, though, sir, we can get to you.
Senator Inouye. Thank you very much.
Dr. Austin. I am sorry. A staff member brought up: In 2003
there is an 11 percent vacancy rate nationwide.
Senator Inouye. Thank you.
Senator Stevens. Thank you very much.
I believe we have Jim Hoehn to testify for the Coalition of
Experimental Program to Stimulate Competitive Research; is that
correct?
STATEMENT OF JIM HOEHN, ON BEHALF OF THE COALITION OF
EPSCoR (EXPERIMENTAL PROGRAM TO STIMULATE
COMPETITIVE RESEARCH) STATES
Mr. Hoehn. Yes, Senator. Jim Hoehn.
Senator Stevens. Hoehn, thank you very much.
Mr. Hoehn. Good afternoon, Mr. Chairman and Senator Inouye.
Thank you for the opportunity to testify regarding the
Department of Defense's basic science research program and the
Defense Experimental Program to Stimulate Competitive Research,
or DEPSCoR. I am a senior associate at the EPSCoR Idea
Foundation, which is a nonprofit organization that promotes the
importance of strong science and technology research
infrastructure and works to improve the research
competitiveness of States that have historically received less
Federal research funding. Previously I spent 29 years with the
National Science Foundation (NSF), the last 5 of which I was
head of the EPSCoR Office at NSF, chairing the interagency
coordinating committee for EPSCoR.
I speak today on behalf of the coalition of 24 EPSCoR
States in support of both the Department of Defense's science
and engineering research program and an important component of
that program, DEPSCoR. Mr. Chairman, we regret that some of the
DEPSCoR researchers from Alaska could not be here because of
the change of the date of the hearing.
Mr. Chairman and Senator Inouye, thank you for your
leadership and support, which led to an increase in DEPSCoR
funding in 2005. This increase was a good first step in
bringing funding up to a level that will fully enable DEPSCoR
researchers to offer quality research directly related to the
mission of the Department of Defense. The Coalition of EPSCoR
States strongly supports the Department's budget request for
basic research. DEPSCoR is a small but significant part of this
larger multifaceted DOD research program.
The coalition recommends that Congress appropriate $25
million to the Department of Defense budget for the DEPSCoR
program in 2006. DEPSCoR was initially authorized in the 1995
National Defense Authorization Act and was created to help
build national infrastructure for research and education by
funding research activities in science and engineering fields
that are important to national defense. DEPSCoR's objectives
are to enhance the capability of institutions of higher
education in DEPSCoR States to develop, plan, and execute
science and engineering research that is competitive under the
merit review system used for awarding Federal research
assistance; and also to increase the probability of long-term
growth in competitively awarded financial assistance that
DEPSCoR universities receive for research.
I would like now to briefly highlight a few DEPSCoR-funded
success stories out of research projects that have and are
presently contributing to our national defense interests. The
University of Alaska Fairbanks Institute of Arctic Biology has
conducted research on the central nervous system with potential
applications for reducing the severity of combat casualties by
extending the window of opportunity for transport to medical
facilities.
The University of Hawaii at Manoa has developed tropical
cyclone forecasts for the Joint Typhoon Warning Center, which
is DOD's operational center for tropical cyclone forecasting in
the Pacific and Indian Oceans.
At Montana State University, research is being conducted to
protect pilots and sensors from attacks from laser weaponry.
The University of Nevada researchers are working on a project
to mitigate the noise in the drive systems of ships and
submarines. North Dakota State University is conducting
research aimed at lengthening the life of ship structures. This
research, like the other research, will lead to significant
savings in military spending on marine fuel, maintenance, and
replacement of ships. Again, these are just a few of the
examples of DEPSCoR-funded recent initiatives that are adding
to our national body of knowledge on various national security
issues.
DEPSCoR awards are provided to the mission-oriented
individual academic investigators to conduct research that has
practical military applications. However, the program as
currently implemented has not taken into account the
significant benefits that can be derived from pooling
individual investigators' efforts into the centers of research
that meet the ever-increasing challenges and needs of the
Department of Defense and the services.
The DEPSCoR States propose restructuring the program into
two components. The first component would retain the current
structure whereby the single investigators are invited to
compete for research awards in areas identified by the
Department. The second component would award funding to
mission-oriented centers. These centers of defense excellence
would be interdisciplinary and would build defense capacity. We
believe that $25 million could be broken out for $10 million
obligated for the individual investigator awards and $15
million for the mission-oriented centers.
In conclusion, DEPSCoR is a wise and worthwhile investment
of scarce public resources and will continue to contribute
research that supports national defense needs. Thank you for
your consideration of this request.
Senator Stevens. Well, I assume Senator Inouye agrees with
me, if we have the money we will continue to do it. But we do
not know yet. The House has knocked $3.3 billion off. We do not
know what our allocation is going to be, but assuming that we
have the money to do so, we want to continue to support your
programs.
Mr. Hoehn. Thank you, Mr. Chairman.
Senator Stevens. Thank you very much.
[The statement follows:]
Prepared Statement of Dr. Jerome Odom, Distinguished Provost Emeritus,
University of South Carolina on Behalf of the Coalition of EPSCoR
States
Mr. Chairman and members of the subcommittee, I thank you for the
opportunity to submit this testimony regarding the Defense Department's
basic scientific research program and the Defense Experimental Program
to Stimulate Competitive Research (DEPSCoR).
My name is Jerome Odom. I am Distinguished Provost Emeritus and a
Professor of Chemistry and Biochemistry of the University of South
Carolina. I am here today to speak in support of both the Defense
Department's science and engineering research program and an important
component of that research, the Defense Department's Experimental
Program to Stimulate Competitive Research (EPSCoR). This statement is
submitted on behalf of the Coalition of EPSCoR States and the 21 States
and Puerto Rico that participate in the Coalition.
Mr. Chairman and Senator Inouye, on behalf of the EPSCoR States, I
want to thank the subcommittee for increasing DEPSCoR funding over the
administration request for fiscal year 2005. This increase is a good
first step to bringing funding up to a level that will enable
researchers from EPSCoR States to offer quality research of direct
benefit to the mission of the Department of Defense.
The Coalition of EPSCoR States strongly supports the Department's
budget request for basic research. The Defense EPSCoR program is a
small, but significant, part of this larger program. The Coalition
recommends that Congress appropriate $25 million to the Defense
Department's budget for the Defense Experimental Program to Stimulate
Competitive Research (Program Element PE 61114D).
EPSCoR is a research and development program that was initiated by
the National Science Foundation. Through a merit review process, EPSCoR
is improving our Nation's science and technology capability by funding
research activities of talented researchers at universities and non-
profit organizations in States that historically have not received
significant Federal research and development funding. EPSCoR helps
researchers, institutions, and States improve the quality of their
research capabilities in order to compete more effectively for non-
EPSCoR research funds. EPSCoR is a catalyst for change and is widely
viewed as a ``model'' Federal-State partnership. EPSCoR seeks to
advance and support the goals of the program through investments in
four major areas: research infrastructure improvement; research cluster
development and investigator-initiated research; education, career
development and workforce training; and outreach and technology
transfer.
The Defense Experimental Program to Stimulate Experimental Research
(DEPSCoR) was initially authorized by Section 257 of the fiscal year
1995 National Defense Authorization Act (Public Law 103-337). The
Defense Department's EPSCoR program helps build national infrastructure
for research and education by funding research activities in science
and engineering fields important to national defense. DEPSCoR's
objectives are to:
--Enhance the capabilities of institutions of higher education in
eligible States to develop, plan, and execute science and
engineering research that is competitive under the peer-review
systems used for awarding Federal research assistance; and
--Increase the probability of long-term growth in the competitively
awarded financial assistance that universities in eligible
States receive from the Federal Government for science and
engineering research.
The Defense EPSCoR program contributes to the States' goals of
developing and enhancing their research capabilities, while
simultaneously supporting the research goals of the Department of
Defense. DEPSCoR grants are based on recommendations from the EPSCoR
State committees and the Department's own evaluation and ranking.
Research proposals are only funded if they provide the Defense
Department with research in areas important to national defense. The
DEPSCoR States have established an impressive record to research that
has directly contributed to our Nation's security interests. If you
will allow me, I would like to highlight some of DEPSCoR's success.
In my State of South Carolina, researchers from Clemson University
have produced communications protocols to enhance the effectiveness of
radio networks on the battlefield. Researchers are focused on the
development of protocols for mitigating the limitations of radio
devices of widely disparate capabilities that will be required in
future tactical communication networks used by the Army. The new
technique will yield a significant improvement in performance and allow
for more robust radio system operation for the Army. The University of
South Carolina has completed a study to help the Navy revolutionize
data processing methods for battlefield operations through the use of
sophisticated mathematical techniques. Funded by the Navy, the research
project, carried out at the internationally recognized Industrial
Mathematics Institute of the University of South Carolina, develops
state of the art compression methods that can be used in a variety of
military scenarios including: automated target recognition, mission
planning, post battlefield assessment, intelligence and counter
intelligence.
The University of Alaska Fairbanks Institute of Arctic Biology has
conducted research into the central nervous system and the University's
Institute of Northern Engineering and Water has conducted research into
the measurement of soil moisture. Both studies have important Defense
applications.
The University of Hawaii at Manoa has developed tropical cyclone
forecasts for the Joint Typhoon Warning Center (JTWC), which is DOD's
operational center for tropical cyclone (TC) forecasting for the
Pacific and Indian Oceans. The project will develop new tropical
cyclone forecasting capabilities in collaboration with the JTWC. The
research is closely related to U.S. Navy research and operational
needs. An important aspect of the project is to closely collaborate
with the JTWC locally. This will enhance the cooperation between DOD's
operational site and the State of Hawaii university research community.
University of Alabama researchers have conducted important work to
reducing gearbox noise in Army helicopters. By reducing the noise
levels, the crew will be more alert and able to communicate more
effectively while in such a vehicle, thus improving safe operation of
the rotorcraft. Additionally, reducing structural vibrations can
decrease fatigue damage in the rotorcraft.
Montana State University has received funding from the Air Force
conduct research into protecting pilots and sensors from attack from
laser weaponry. This project is of particular interest for protecting
pilots using Night Vision Goggles (NVG), for laser range finders and
target designators.
University of Nevada at Reno investigators are exploring novel
military applications for non-lethal weaponry for use by the Air Force.
This research could be used for ultimately developing ``stunning/
immobilizing'' weapons that do not rely on chemicals and that do not
cause human injury. University of Nevada researchers are working on a
project to mitigate the noise in the drive systems of ships and
submarines. The mitigation of noise and the accompanying vibration will
significantly improve stealth performance of naval vessels.
North Dakota State University obtained funding to develop
mechanisms that allow the Navy's unmanned airborne vehicles (UAVs) to
carry out mission tasks with little external supervision and control.
The development of this technology will lead to individual or teams of
UAVs efficiently carrying out search, surveillance, reconnaissance, and
delivery of weapons missions in the presence of enemy threat and
without risk to the lives of military personnel. University of North
Dakota researchers received Army funding to develop weather models for
improving the availability of weather information worldwide.
Improvements in satellite technology research will lead to a better
forecasting tool that can be utilized by Army personnel to help
maximize their advantage in a battlefield or homeland defense
environment. North Dakota State obtained funding from the Navy to
conduct a project to lengthen the life of ship structures. This
research will lead to significant savings in military spending on
marine fuel, maintenance and replacement of ships.
University of Vermont researchers conducted a study to decompose
chemical warfare agents such as mustard gas in a safe and
environmentally sustainable system. This method is similar to one used
in industry to remove toxic compounds from the smokestacks of coal-
burning plants. This process can decompose nearly 100 percent of half
mustard from a gas sample. The chemical by-products of this process are
environmentally friendly and non-toxic. Similar technologies can be
used to decompose sarin, soman, and VX simulants.
Currently, DEPSCoR awards are provided to mission-oriented
individual investigators from universities and other institutions of
higher education. The individual investigators conduct extremely
important research that has practical military applications. However,
the program as it is currently implemented has not taken into account
the significant benefits that can be derived from individual
investigators pooling their efforts to provide ``centers'' of research
that meet the ever increasing challenges and needs of the Department of
Defense and the Services.
Therefore, the DEPSCoR States propose restructuring the program
into two components. The first component would retain the current
program whereby the individual investigators are invited to compete for
research awards in areas identified by the Department and the Services.
The second and new component would award funding to mission-oriented
``centers.'' These centers of defense excellence would be mission
oriented interdisciplinary areas to build defense research capacity.
To achieve important defense research objectives of both the
components of the program, the DEPSCoR States need the program to be
funded at $25 million for fiscal year 2006 with approximately $10
million obligated to the individual investigator awards and $15 million
for the mission-oriented centers initiative. This twin approach to
funding will significantly enhance the Department's ability to tap into
the best ideas that the DEPSCoR States have to offer in support of the
Nation's security needs.
The Defense Department's Experimental Program to Stimulate
Competitive Research is a wise and worthwhile investment of scarce
public resources. It will continue to contribute significantly to
efforts to build scientific and engineering research efforts in support
of national defense needs.
Finally, the Coalition of EPSCoR States believes a $25 million
Defense EPSCoR program with the modifications suggested will ensure
that Federal dollars are being used in a cost-effective way and that
the EPSCoR States are contributing to the Nation's Defense efforts.
Thank you for your consideration of this request.
Senator Stevens. Next witness, Major General Paul Weaver,
Juvenile Diabetes Research Foundation International.
STATEMENT OF MAJOR GENERAL PAUL A. WEAVER, JR., U.S.
AIR FORCE (RETIRED), ON BEHALF OF THE
JUVENILE DIABETES RESEARCH FOUNDATION
INTERNATIONAL
General Weaver. Good afternoon, sir.
Senator Stevens. Nice to see you again.
General Weaver. Nice seeing you both, sir.
Mr. Chairman and Senator Inouye, thank you for the
opportunity to speak with you on behalf of the Juvenile
Diabetes Research Foundation. I am retired Major General Paul
Weaver, former Director of the Air National Guard. I am here
today to report on the success and continued progress of the
technologies for metabolic monitoring, also known as the Julia
Weaver Fund after my 6-year-old daughter. I would also like to
thank you for your past support and encourage an additional $10
million this year for this innovative program.
Metabolic measuring research has had great successes and
continuing progress as we work to understand metabolism and the
lifesaving insight new technologies can provide for our
warfighting men and women. Metabolic measuring truly holds the
potential to improve and save lives. It will give our troops an
immediate advantage when the unthinkable occurs.
I ask you to imagine for a moment this all too real and
common scenario. A soldier is wounded by an Iraqi insurgent
mortar attack. With this technology's remote real-time capacity
to provide an online window into the body, monitoring metabolic
alterations, field surgeons will have the potential to
immediately assess the extent of the soldier's injuries.
Ultimately, metabolic measuring can be integrated with other
automated medical devices and Objective Force warrior
equipment, activating devices such as the automatic tourniquets
or injections to respond appropriately to injuries even before
medical help arrives.
This amazing technology will ultimately allow soldiers to
wear a uniform that will actually provide treatment on the
spot. In the critical moments after an injury, metabolic
measuring could treat injuries and give doctors at a field
hospital miles away information to prepare for a soldier's
specific wounds.
While the possibility of such lifesaving measures through
technologies from metabolic measuring is still on the horizon,
we are moving closer and closer to this reality every day.
Already there are excellent examples of metabolic measuring
funded research like a gel that responds to the concentration
of glucose in your tears by changing colors, allowing soldiers
to survive and recover from injuries, making our armed forces
stronger.
In essence, metabolic measuring research will provide a
real-time access to the warfighter's metabolic state, improved
health and lifesaving measures for women and men in the
military. Access to the soldier's real-time metabolic state
will have an enormous impact, sir. The technology will enhance
our knowledge of basic metabolism, enabling the military to
tailor fundamental elements of training and nutrition and
ultimately be able to tailor their medical care to not only
improve their survival, but, almost as important, reduce their
healing time and the long-term effects of their injuries.
Congress' investment in this innovative technology and
progressive approach has been vital to our national security
and national health. A continued investment in this program
will enable technologies for metabolic measuring partners, such
as the Department of Defense, the NIH, NASA, and Juvenile
Diabetes Research Foundation, to continue to develop and
improve technologies to measure the physiology and the
viability of our fighting men and women accurately,
consistently, and non-evasively.
I have seen firsthand the fruits of your investment:
Velcro, global positioning system (GPS), and the Internet. With
funding through your subcommittee, technologies for metabolic
measuring has the potential to be this kind of innovative and
even lifesaving tool.
It is critical for your support of this lifesaving research
by funding $10 million for technologies for metabolic
measuring, the Julia Weaver Fund Initiative. Not only will this
improve the lives of our soldiers and their families, but it
will be a great step toward an even more personal wish for me
and many families, a cure for juvenile diabetes. Giving my
daughter even the possibility of a non-invasive option to her
multiple shots each day and the potential of avoiding the
devastating complications of diabetes, like blindness, kidney
failure, and heart disease are promises that would provide hope
to so many suffering with juvenile diabetes.
Finally, sir, my son Brett is an 18 year old marine headed
to Iraq. Please give him and all the men and women like him who
are already there in the front lines absolutely the best chance
to survive if the unthinkable occurs.
Thank you for your time and your support, sir.
Senator Stevens. Thank you very much. The best to your son.
General Weaver. Thank you, sir.
Senator Stevens. Nice to see you again.
General Weaver. Nice seeing you, sir.
Senator Stevens. Do you have a question, Senator?
Senator Inouye. We will do our best.
[The statement follows:]
Prepared Statement of Major General Paul A. Weaver, Jr. (Ret.)
program overview
Mr. Chairman and members of the subcommittee, thank you for the
opportunity to appear before you today to support $10 million in
funding for the Technologies for Metabolic Monitoring/Julia Weaver Fund
(TMM/JWF) Initiative on behalf of the Juvenile Diabetes Research
Foundation International.
I am here to report on the great success and continued progress of
the TMM program thanks to your past support of this innovative project.
The TMM program is working to improve understanding of metabolism and
subsequently develop monitoring technology to provide our military with
critical information about the physiology and viability of soldiers in
the field, and astronauts orbiting the earth, accurately, constantly
and non-invasively. The real life application of this technology will
offer healthcare professionals an online window into the body;
information which can ultimately provide life saving insight.
I am pleased to report that Congress's investment in this inventive
technology and progressive approach to a vital national security, as
well as national health need since fiscal year 2001, has yielded
remarkable successes. We come before you this year to request an
additional $10 million to elevate this research, and move it rapidly to
the soldiers in the field who will benefit the most from the results of
this exciting program. A continued investment in the program will
enable TMM's partners--the Department of Defense, the National
Institutes of Health and the National Aeronautics and Space Agency, as
well as the Juvenile Diabetes Research Foundation and the many TMM
participants from academia, industry and government--to continue to
develop and improve technologies to measure the physiology and
viability of our fighting men and women.
After 35 years of military service, including 8 years as the
Director and Deputy Director of the Air National Guard, I am proud of
the Department of Defense's long and distinguished tradition of funding
research, driven by genuine mission necessity. While in uniform, I saw
the benefits of your commitment to the brave who serve. As an American
out of uniform, I know that the fruits of your investments yield some
of the most used applications in American culture. Some items on this
list are part of our American lexicon--Velcro, GPS and the Internet.
The program I speak of today has the potential to join this list, but
it won't just make lives easier, it has the potential to improve and
save lives as well.
A CRITICAL BATTLEFIELD TOOL
As we know all too well from the fields of Iraq and Afghanistan,
providing our military's medical units with the most sophisticated
cutting edge technology has significantly improved their ability to
tackle battlefield trauma, ultimately saving the lives of our fighting
men and women. Our soldiers, sailors, airmen and marines wounded in
Iraq, Afghanistan and elsewhere are much more likely to survive their
injuries today than in past wars. As recently reported by the Army News
Service, only 1.6 percent of soldiers injured in Operation Iraqi
Freedom and Operation Enduring Freedom have died of their wounds. This
is less than half the 3.68 percent death rate for wounded soldiers in
Vietnam. The technologies developed by the TMM program will accelerate
this trend.
TMM will provide our soldiers with an immediate advantage when the
worst occurs. Imagine the following all too real and common scenario: A
soldier is wounded by an Iraqi insurgency's mortar attack. With the
technology's remote real time capacity to monitor metabolic
alterations, field surgeons will have the potential to assess the
extent of his injuries in such an acute incident. TMM can be integrated
with other automated medical devices in Objective Force Warrior
equipment, activating devices such as automatic tourniquets or
injections to respond appropriately to his injuries. ``Knowledge of the
metabolic status of the warfighter, both prior to injury and during
treatment, is vital to providing medical care. While in the past there
have been numerous individual programs addressing various aspects of
telemetry and metabolic monitoring, TMM has finally provided the
opportunity to look at the whole issue end to end. We are especially
excited about the opportunity to work more closely with our colleagues
in NASA and NIH using the TMM program as a framework,'' said Colonel
John Holcomb, Commander, U.S. Army Institute of Surgical Research. It
is this capability that will potentially have a truly dramatic impact
on reduction of our died-of-wounds numbers, not to mention ultimately
improving the long-term quality of life, as well as reducing the cost
of our military's medical obligations to its veterans.
TMM sensors also will have the potential to measure a soldier's
metabolism in response to exertion, particularly in an environment of
extreme heat. In another real scenario, this technology could direct an
over-exerted soldier to take actions to optimize his performance, such
as when and how much fluid to drink, or to consume a MRE specially
formulated to optimize his performance for the task at hand. The
sensors could also inform his commander that the soldier is too
exhausted to make good decisions, protecting not only him but also the
mission.
Access to a soldier's real time metabolic state will have enormous
impact. The technology will enhance our knowledge of basic metabolism,
enabling the military to tailor fundamental elements of training,
nutrition and soldier health and performance. and ultimately be able to
tailor their medical care to not only improve their survival, but
almost as important reduce their healing time and the long term effects
of their injuries. Saving the warfighters life is of tantamount
importance, but we must also reduce the impact of their injuries on the
rest of their lives.
According to Dr. Frazier Glenn, Technical Director, U.S. Army
Medical Research and Materiel Command at Fort Detrick, ``current
technology investments have been somewhat divergent and the overall
metabolic research area needed some way to coalesce around a central
effort. TMM has fulfilled that role admirably.'' As a result, the DOD
research in this area is even more effective, with the assistance of
the TMM program.
A STRONG INVESTMENT WITH DEMONSTRABLE RESULTS
To demonstrate this program's dramatic success in the 5 years since
its inception, in fiscal year 2001 the U.S. Army Medical Research and
Materiel Command (USAMRMC), which manages this initiative, received 16
applications and supported 5 novel metabolic monitoring research
projects and a highly successful workshop. In fiscal year 2002, the
program received $2.5 million in appropriations and was expanded to
include academic, industry, civilian and defense researchers. As a
result, 48 applications were received and following a highly
competitive review, an additional 12 novel metabolic monitoring
research projects received seed grants for 1 year. This year we have
received nearly 60 proposals that have been reviewed by an expert
scientific panel. The work of previously funded TMM researchers is
among the highest scoring submissions. As this program continues to
progress with the addition of an intramural component, we will utilize
highly skilled laboratories with unique complementary skills, such a
high-powered computer models of human disease, to realize the potential
of these technologies to the benefit of both soldiers and civilians.
A critical component of the success of this project has been a
structure which emphasized and encouraged innovative thinking.
Fostering such an atmosphere resulted in new discoveries, some of which
built upon existing ideas, and others which took this promising
research in bold new directions. As a result of our continued combined
effort, the TMM program has brought several highly attractive
technologies from the drawing board to successful laboratory and field
demonstrations.
Some of the intriguing examples of TMM-funded research include a
polyacrylamide gel technology that responds to changes in the
concentration of glucose in tear fluid by changing color--a high-tech
contact lens if you will. In another project, researchers developed
miniaturized implantable sensors, one of which wirelessly transmits
glucose concentrations, and another measures multiple metabolites.
Other projects included the development and validation of several
portable devices to monitor the energy expended during physical
activity, and determine the general energy costs of physical training
in ROTC cadets.
Now, it is time to build upon this investment. The TMM program is
ready to begin to transition from a basic research focus to a
development and implementation process in order to expedite the
clinical application of technology sooner. We hope not only to continue
the current exciting direction of the program, but also to have the
resources to begin to expand and truly maximize some of our real
successes.
In addition to the work we have been doing, in partnership with
DOD, NASA and NIH's academic and industrial partners in all 50 States,
we hope to refine, manufacture and begin testing these technologies so
they may rapidly enter the developmental and approval pipeline. Our
goal is to create centrally organized programs that can utilize the
strengths of the many facilities that can support this effort. This
will be done in addition to our continued efforts to ensure a constant
supply of new and novel capabilities.
PROGRAMMATIC SUCCESS WILL HAVE A BROAD REACH
There is no question that TMM holds great promise and is a superb
investment for our soldiers in the field. Just like numerous other
Defense Department programs before it, this technology teems with
potential for those out of uniform.
As a military man, I am optimistic about the real life application
of this technology for our fighting men and women, but I must be honest
that my real passion for this research is my daughter Julia. One month
after my retirement from military service, my wife and I took our 2\1/
2\-year-old daughter Julia to the emergency room at Mary Washington
Hospital in Fredericksburg, Virginia, a day that truly changed our
lives. Prior to that day, we had been told Julia had the flu. Her
condition continued to worsen. On New Years Day morning, we noticed a
severe degradation with her overall health. She lost 10 pounds in 1
week and was losing mental awareness of her surroundings. We proceeded
to the emergency room at Mary Washington Hospital where we were told,
after her blood was tested, that she had developed juvenile diabetes.
Julia, whom we call ``The Precious'', was transported by a helicopter
ambulance to the Pediatric Intensive Care Unit at Walter Reed Army
Medical Center. As the chopper lifted off, I could never explain the
feeling in our hearts that we may never see our little girl alive
again.
She was in the Intensive Care Ward for approximately 2 days and
then moved to a regular ward after her condition became stable. The
great medical staff at Walter Reed saved her life and for that, my wife
and I will be eternally grateful. My daughter's daily regimen with
juvenile diabetes consists of having her finger pricked 6-8 times a day
and receiving 2-4 shots a day. I made a commitment to God that if I
could ever do anything to help find a cure for diabetes, I would do it.
THE PROMISE FOR DIABETES
What you must know about the promise of this research effort as it
applies to diabetes is that it offers more than an improvement in a
diabetic's quality of life. As a parent, the simple act of eliminating
the daily regimen of the 6 to 8 finger pricks and 2 to 4 shots my
daughter endures would be a great relief. TMM offers the potential to
replace this painful routine and provide a more complete picture of the
disease. The real benefit of TMM is its ability to greatly reduce--or
ideally eliminate--the daily risk of the diabetic emergencies of
hypoglycemia and hyperglycemia, and most significantly, the long term
damage caused by the fluctuations in blood glucose. JDRF reports that
on average, the life expectancy of a child with type 1 diabetes is
shortened by 15 years because of this long-term damage. As Julia's
father, this is a statistic I cannot accept.
Anyone who has a loved one with this disease, or has the disease
him or herself, knows the difficulties of controlling ever-fluctuating
glucose levels with insulin and diet. Current technology is good but it
is extremely difficult to maintain tight control of blood glucose
levels, especially over long periods of time. New and improved
technologies would help to ward off the devastating complications, such
as blindness, kidney failure, amputation, heart disease, and nerve
damage, which are often the inevitable result of a lifetime with this
disease.
Technologies that would non-invasively monitor a diabetic's
metabolism, coupled with an ability to provide information remotely (or
wirelessly), would allow individuals with the disease to monitor their
blood sugar levels accurately, constantly, and non-invasively, which
could ultimately improve the control of fluctuations in their blood
glucose levels and potentially reduce the severity of debilitating
complications. In this way, this technology could offer a significant
and immediate improvement in the quality of life of 18 million
Americans who suffer from this disease and relieve much of the economic
burden of this disease on our Nation.
APPLICATION IN THE INTENSIVE CARE UNIT
Insulin resistance and hyperglycemia often accompany the critical
injuries and illnesses of patients in the intensive care unit (ICU),
placing them at high risk for multiple organ failure and death. TMM
could have a profound impact for these people as well. Recent studies
show that preventing hyperglycemia by maintaining insulin levels
substantially improves outcomes for these critically ill patients. TMM
holds the potential to improve glycemic control in injured soldiers and
other ICU patients that could ultimately be implemented in every
hospital's intensive care unit, saving countless lives.
CONCLUSION
JDRF and I thank you Mr. Chairman and members of the subcommittee
for your generous funding of this program, which allowed it to prosper
into a unique and successful initiative. The attached research
summaries demonstrate the high level of innovation that has been
pursued with these funds. I respectfully ask that you continue your
strong support for this initiative by providing $10 million for fiscal
year 2006. This funding will allow the U.S. Army Medical Research and
Materiel Command (USAMRMC), in combination with its partners at NASA,
the NIH and JDRF to capitalize on the opportunities provided by the
previous 5 years of funding. Such funding will enable this truly
unconventional consortium to expand this initiative, and transition
from development to evaluation and application of these novel
technologies in soldiers in the field and patients in the clinic.
This subcommittee is faced with difficult choices as it looks to
stretch limited resources in a way that makes our military more lethal,
robust and sustaining. I urge you to recognize the promise of this
program to protect our most valuable asset, the men and women in
uniform, when they need it most, which is following an injury. The
science and technology in the TMM initiative is real; it holds the
promise to assist wounded warriors immediately in times of trauma, and
to optimize war fighter performance when it is most needed. While the
health care cost savings it offers are significant, the cost of the
lives, and the improvement in their quality, is truly incalculable.
I thank you for the opportunity to appear before you today.
TMM/JWF PROGRAM SUCCESSES
Development of a mouse/mammalian model for test and validation of
implantable glucose sensors. This is vital to allow the progress of
implantable research to move forward. TMM allowed this vital base-line
infrastructure work to occur that will have wide ranging impact on many
technology and research efforts that would not have been nearly as
effective without it.
Numerous papers and research into Iontophoresis and other non-
invasive/minimally invasive techniques of analysis and extraction of
glucose and other analytes for assessment of metabolism.
Acceleration of research in implantable sensors to apply to
numerous applications, including glucose monitoring. TMM allowed
significant forward movement and acceleration in various industrial
programs leading to earlier commercialization, and thereby more rapid
move to the public of new techniques and devices.
TMM initiative has sharpened the focus and galvanizing the relevant
research and development community in developing techniques for
continuous monitoring of metabolic status in day-to-day activities,
vital data to determine the effectiveness of new sensors and systems.
This has led to seminal publications in peer-reviewed scientific
journals to establish the technical foundations and, in conjunction
with industrial collaborators, the beginnings of translation of the
technology from the university research lab to the hands of the public.
As a result of TMM, there are clear prospects for novel implantable
sensors that can be of use in a variety of metabolic monitoring
situations in the next several years.
TMM allowed the development and validation of several portable
techniques for monitoring the amount of physical activity and its
associated energy expenditure, and to determine the general energy
costs of physical training in ROTC cadets. The TMM program has
successfully completed tests in April of 2004, and is in the active
process of analyzing the abundant data that was ascertained.
TMM funded research toward developing and characterizing a
minimally invasive near-infrared fluorescence affinity glucose sensor
for transdermal monitoring of subdermal interstitial fluid in diabetics
and soldiers (fitness control). TMM allowed the successful completion
of the optimization of a sensor in-vitro under simulated body
conditions. The excellent long-term stability data of the TMM sensor,
which performed satisfactorily over a period of 6 months on the
benchtop, can be considered to be a scientific breakthrough in the
field of optical affinity sensors for glucose monitoring.
TMM INVESTIGATORS--BRIEF PROJECT SUMMARIES 2004
Sanford Asher, Ph.D.--University of Pittsburgh, Department of
Chemistry.--(a) Novel Approaches to Glucose Sensing Based on
Polymerized Crystalline Colloidal Array Hydrogel Sensors; (b) Fabricate
superparamagnetic particle hydrogels responsive to glucose which will
report on the interstitial glucose concentration noninvasively through
a magneto-acoustic response; (c) Interstitial measurement; (d)
Implantable; (e) Particles will have a natural frequency of oscillation
which is glucose dependent; (f) Oscillating particles will generate an
ultrasonic acoustic response which we detect by a piezoelectric
transducer.
Ralph Ballerstadt, Ph.D., Biotex, Inc.--(a) Implantable
Fluorescence Sensor For in vivo Glucose Monitoring; (b) Fluorescent
properties of the sensor will vary in response to local glucose
concentrations.
Diane J. Burgess, Ph.D.--University of Connecticut.--(a)
Miniaturized, Wireless, Implantable Glucose Sensors; (b) With the help
of fiscal year 2002 TMM-support: assembled an interdisciplinary team
who designed, built and tested various components of a miniaturized,
wireless-integrated and totally-implantable glucose sensor; (c)
Development of an advanced hydrogel coating containing tissue response
modifiers (TRMs) capable of minimizing inflammation, preventing fibrous
encapsulation and promoting neovascularization; (d) Glucose-oxidase
technology; (e) Implanted, wireless technology.
Matthew R. Glucksberg, Ph.D.--Northwestern University.--(a)
Surface-Enhanced Raman Spectroscopy for Monitoring Lactate and Glucose;
(b) Raman spectroscopy: powerful analytical tool that permits the
unambiguous identification of molecules based on their unique
vibrational modes; (c) Surface Enhanced Raman Scattering (SERS)
phenomenon increases by up to a trillion fold the Raman signal from
molecules near gold and silver nanoscale materials; (d) Project aims to
develop and test these SERS active substrates on the tip of an
indwelling, percutaneously implanted fiber optic probe.
Krzysztof C. Kwiatkowski, Ph.D.--Lynntech, Inc.--(a) A New Non-
Invasive Continuous Glucose Sensor; (b) Micro-needle arrays created by
Lawrence Livermore National Laboratory (LLNL) as the basis for a
glucose sensor; (c) Interstitial fluid glucose measurement; (d) Similar
to CGMS, but with new micro-needle technology.
Joseph Y. Lucisano, Ph.D.--GlySens, Inc.--(a) Dependable Detection
and Warning of Hypoglycemia; (b) A very small, sensor array that can be
inserted through a needle into the subcutaneous tissues of healthy
individuals and that can be retrieved after 2 weeks of intensive
monitoring; (c) A larger, disc-shaped version of the sensor array for
long-term (1 year) implantation, especially in diabetic children to
detect and warn of hypoglycemia; (d) Sensors indicative of the
metabolic state, including sensors for glucose, oxygen, lactate,
temperature, heart rate, breathing rate and physical activity.
Michael Pishko--Penn State, Dept Chemical Engineering.--(a)
Microfabricated Multianalyte Sensor Arrays for Metabolic Monitoring;
(b) Electrochemical biosensors based on redox polymer/enzyme thin films
fabricated using conventional wafer fabrication technologies; (c)
Implantable.
J. Bruce Pitner, Ph.D.--Becton, Dickinson and Company.--(a) Real-
Time Energy Metabolite Monitoring Developing in vivo Sensors for
Glucose, Fatty Acids, and Lactate; (b) Fluorophore-labeled binding
proteins specific to metabolites such as glucose, lactate, and fatty
acids; (c) Fluorophores are located at the binding site of the protein.
Upon ligand attachment, the binding site undergoes conformational
changes, which causes changes of the fluorescence response of the
labeled dye.
Leah Tolsa, Ph.D.--University of Maryland Baltimore County.--(a)
Low-Cost Portable System for Multianalyte Metabolic Monitoring; (b)
Specific binding of each analyte to a corresponding binding protein. A
sample of set volume is pumped into a microfluidic cassette, diluted
accordingly, and channeled into three chambers containing the protein
biosensors; (c) Proteins will be labeled with an environment-sensitive
fluorophore (acrylodan) at a site that responds to analyte binding.
2003
Tadeusz M. Drzewiecki, Ph.D.--Defense Research Technologies, Inc.--
(a) Non-Invasive Metabolic Monitoring Using a Breath-by-Breath
Microfluidic Gas Monitoring System.
Jeffrey I. Joseph, D.O.--Thomas Jefferson University.--(a)
Artificial Pancreas for Control of BG and Insulin Levels in
Hospitalized Patients with Diabetes and Stress Hyperglycemia; (b)
MiniMed technologies--with inclusion of 3 rather than 1 sensor and
intravenous monitoring.
Thomas Joseph--Becton Dickinson Technologies.--(a) Indwelling
Metabolite Sensors for Optical Reading Through Skin: A Platform Based
on NIR Dyes Conjugated to Binding Proteins: NIR Fluorescent Dyes
conjugated to binding proteins.
David Gough--University of California, San Diego.--(a)
Implementation of Implantable Disc, long-lived lactate sensor, monitor
heart and breathing into animal models.
Donald Kreutzer--University of Connecticut.--(a) Uses of
Neovascularization to Enhance Glucose Sensor Function In Vivo: Local
delivery of angiogenic factors to enhance glucose sensor function; (b)
Role of Macrophages in the Function and Lifespan of Glucose Sensors In
Vivo.
Michael J. McShane, Ph.D.--Louisiana Tech University.--(a) Novel
Micro/Nano Approaches for Glucose Measurement Using pH-Sensitive
Hydrogels: pH-sensitive microgels for glucose measurement.
Jackie Y. Ying, Ph.D.--Massachusetts Institute of Technology.--(a)
Glucose-Responsive Nanoparticles for Controlled Insulin Delivery.
2002
Daniel Moran, Institute of Military Physiology, Israel.--(a) Non-
invasive metabolic rate monitor and predict energy expenditure.
Kong Chen, Vanderbilt University Medical Center.--(a) Non-invasive
physical activity monitor, predict energy expenditure, determine energy
costs and physiological responses.
Richard Guy, University of Geneva, Switzerland.--(a) Transdermal
ionophoretic metabolic monitoring.
Ralph Ballerstadt, Biotex, Inc.--(a) Minimally invasive nearIR
fluorescent polymer sensor for transdermal glucose monitoring.
Diane Burgess, University of Connecticut.--(a) Autonomous sensory
device, low-power CMOS microelectronics, glucose oxidase based,
improved stability via coatings.
David Gough, University of California, San Diego.--(a) Implantable
Disc, multi-sensor array.
Stuart Harshbarger, Johns Hopkins University.--(a) Metabolic
activity at wound site, prediction of wound healing.
James Mansfield, Hypermed, Inc., Watertown MA.--(a) Hyperspectral
Imaging, focal changes in cutaneous hemoglobin.
Bradley Nindl, Military Performance, U.S. Army Research Institute
of Environmental Medicine, Natick, Massachusetts.--(a) Non-invasive
IGF-1 monitoring during warfighter training, interstitial micropore
measurement.
Kenneth W. Ward, iSense Corporation.--(a) 300 m wire sensor for
continuous amperometric monitoring of glucose and lactose.
Babak Ziaie, U. of Minnesota.--(a) Hydrogel-based implantable
micromachined transponder for wireless glucose measurement.
2001
Jerome Shultz, NASA-AMES Research Center.--(a) Non-invasive,
physiological evaluation system.
Bradley Nindl, Military Performance, U.S. Army Research Institute
of Environmental Medicine.--(a) IGF-I and IGFBP-3 analysis--Filter
Paper Spot Assay.
Amanda O'Donnell, Naval Aerospace Medical Research Laboratory.--(a)
Telemetric Device, heart rate variability, non-invasive assessment of
operational performance.
Kaveh Zamani, Medical Research and Materiel Command.--(a) Real-time
stress monitoring, non-invasive, stress hormone.
Motilal Pamanani, Henry M. Jackson Foundation for the Advancement
of Military Medicine.--(a) Interstitial vs. Intravascular changes in
hemorrhagic shock.
Senator Stevens. Our next witness, Dr. Harry Armen,
President of the American Association of Mechanical Engineers.
Yes, sir.
STATEMENT OF HARRY ARMEN, Ph.D., PRESIDENT, AMERICAN
SOCIETY OF MECHANICAL ENGINEERS
Dr. Armen. Good afternoon, Mr. Chairman, Senator Inouye. I
am Harry Armen and I serve as the elected President of the
American Society of Mechanical Engineers (ASME), a 120,000-
member professional engineering society founded in 1880. I am
an engineer with over 40 years of experience in defense
aerospace.
Engineers are a major part of this Nation's technology
base, a base that is essential for defense and for our economic
vitality. We therefore appreciate the opportunity to appear
before your subcommittee to present our views on the DOD
science, engineering, and technology programs, the S&T
programs.
I want to specifically thank the subcommittee and
especially you, Mr. Chairman and Senator Inouye, for your past
and ongoing support you have shown for these programs. A stated
goal of this administration and Congress is to maintain defense
S&T funding at 3 percent of the overall defense budget. That
level would require $13.4 billion for fiscal year 2006. We urge
you to support this level of funding for the S&T programs.
While we appreciate your continued support for the overall
program, we remain very concerned about critical shortages in
specific DOD S&T areas, particularly in those that support
basic research, the 6.1 account. And we are concerned about the
trends for funding for scientific and technical education.
Basic research supports science and engineering research and
technical education at universities in all 50 States. Many of
the technically talented engineers who have developed and are
developing our current weapons systems received funding for
their education as a result of working on basic research
projects and other programs funded by DOD that promoted
technical education. On a personal level, I am a product of the
National Defense Education Act of 1961.
In the early 1980s basic research was 20 percent of S&T
funding. That level has declined to 12 percent. The
technological superiority our young men and women in the
services have been given in the campaigns in Afghanistan and
Iraq were a direct result of investments made in science and
technology several decades ago. We strongly encourage this
subcommittee to reverse the declining trend and support robust
investment in basic research.
We also urge the members of the subcommittee to support
advanced technical education. As the need for a more highly
skilled workforce which includes a higher percentage of
individuals with master's and doctoral degrees increases and
the available technical workforce decreases, corporations that
must hire engineers who are U.S. citizens and have appropriate
security clearances will be faced with critical shortages.
These shortages are a result of our own students declining
to pursue careers in engineering and science, compounded by the
fact that almost 60 percent of the current civilian science and
technology defense workforce will be eligible for retirement or
early retirement within the next 5 years.
Mr. Chairman and members of the subcommittee, we have a
serious problem. The questions that must be addressed are the
following: Will the United States, which is now dependent upon
foreign suppliers for our energy and foreign financial
resources to underwrite our deficits, also be dependent on
foreign sources for science and engineering knowledge?
The second question: Will this Nation be the leader or just
an observer in the next technological revolution, involving the
confluence of bio, nano, and information technologies? That
confluence will result in remarkable breakthroughs that will
alter virtually every aspect of our lives. Or as Al Jolson once
said, ``You ain't seen nothing yet.''
In summary, I urge the members of the subcommittee to
continue your support to strengthen DOD's science and tech
programs. It will take a great deal of continued attention and
a commitment to defense research and development (R&D) to
ensure that the best engineering and scientific minds are once
again willing to apply their talents to meeting the future
defense needs of this Nation.
Thank you for the opportunity to present our views.
Senator Stevens. Well, thank you very much, doctor. We are
pleased to have you appear before us.
Senator Inouye?
Senator Inouye. Thank you.
Senator Stevens. We appreciate your comments. Thank you.
Dr. Armen. Thank you.
[The statement follows:]
Prepared Statement of Harry Armen
Mr. Chairman and distinguished members of the subcommittee, the
ASME Department of Defense (DOD) Task Force of the Committee on Federal
Research and Development is pleased to comment on the fiscal year 2006
budget request for the Research, Development, Test and Evaluation
(RDT&E) and the Science and Technology (S&T) portion of the Department
of Defense budget request.
ASME is a nonprofit, worldwide engineering Society serving a
membership of 120,000. It conducts one of the world's largest technical
publishing operations, holds more than 30 technical conferences and 200
professional development courses each year, and sets many industrial
and manufacturing standards. The work of the Society is performed by
its member-elected Board of Governors through five Councils, 44 Boards,
and hundreds of Committees operating in 13 regions throughout the
world.
This task force is comprised of experts from universities,
industry, and members from the engineering and scientific community who
contribute their time and expertise to evaluate the budgets requests
and legislative initiatives the DOD sends to Congress.
We appreciate the opportunity to provide input on these areas that
are critical to the national security and economic vitality of the
United States. This subcommittee under your leadership has shown strong
support for maintaining growth in Defense Research and Engineering in
general and more specifically in Defense Science and Technology
funding. We understand that Congress is faced with a more highly
constrained budget environment this year and that there are many areas
where increased funding could provide benefits. However, these Science
and Technology accounts not only contribute directly to national
security by creating the technology that will be inserted into our next
generation of weapon systems, they also contribute through direct
benefits, such as workforce development, job creation, and economic
growth which are also vital to a strong national defense.
Our testimony addresses three primary funding areas: overall
Engineering (RDT&E); Science and Technology (S&T); and the University
Research Initiative (URI). In addition, the consequences of inadequate
funding for defense research are outlined. These include a degraded
competitive position in developing advanced military technology versus
potential peer competitors. This could have profound consequences to
the United States' economic and military position in the world.
The fiscal year 2006 request, if implemented, would represent a
significantly reduced investment in Defense S&T. We strongly urge this
committee to consider additional resources to maintain stable funding
in the S&T portion of the DOD budget. At a minimum, $13.4 billion, or
about $2.9 billion above the President's Request is required just to
maintain inflation adjusted level funding.
DOD REQUEST FOR RDT&E
The administration requested $69.356 billion for the Research,
Development, Test and Evaluation (RDT&E) portion of the fiscal year
2006 DOD budget. These resources are used mostly for developing,
demonstrating, and testing weapon systems, such as fighter aircraft,
satellites, and warships. This amount represents growth from last
year's appropriated amount of $69.199 billion of about 0.2 percent.
Therefore, when adjusted for inflation, this represents a reduction of
about 2 percent in real terms. One of the largest percentage cuts is in
the Operational Test and Evaluation (OT&E) function, where the proposed
funding of $168 million is little more than half of the 2005
appropriated amount of $310 million. The OT&E organization and the
testing it conducts was mandated by Congress, and is intended to insure
that weapon systems are thoroughly tested so that they are effective
and safe for our troops.
While this testimony focuses on the fiscal year 2006 budget, the
task force notes that the multi-year spending plan, as provided in the
Future Years Defense Program (FYDP), generally shows reduced spending
in RDT&E accounts over the next 5 years, with spending in fiscal year
2011 being just $59.7 billion, or a 14 percent reduction from current
levels. This reduced spending in R&D is inconsistent with the goal of
developing new systems with advanced capabilities that support military
transformation.
In recent years, the task force has supported the overall RDT&E
request. However, this request falls short in meeting requirements and
hence we request that the top line RDT&E be increased to $73.1 billion.
The specific areas that most need augmentation will be addressed in
subsequent sections. While no specific recommendation on OT&E funding
is provided, the committee should consider the level of funding
required to ensure that the approximately $70 billion worth of weapon
systems that the Department is procuring are adequately tested and
shown to be safe and effective.
DOD REQUEST FOR SCIENCE AND TECHNOLOGY
The fiscal year 2006 budget request for Defense Science and
Technology (S&T) is $10.522 billion, which is $2.549 billion less than
the fiscal year 2005 appropriated amount of $13.069 and represents a
19.5 percent reduction. The S&T portion of overall DOD spending of $419
billion would fall to 2.5 percent with this request. The 2001
Quadrennial Defense Review (QDR), the Defense Science Board (DSB), as
well as senior Defense Department officials and commanders from the Air
Force, Army, and Navy have voiced strong support for the future
allocation of at least 3 percent for S&T programs. Clearly, this budget
request moves the country in the wrong direction, by reducing S&T
funding.
A relatively small fraction of the RDT&E budget is allocated for
S&T programs. Specifically, the S&T request for $10.522 billion
represents only about 15 percent of the RDT&E total, but these accounts
support all of the new knowledge creation, invention and technology
developments for the military. These S&T funds support Basic Research
(6.1), Applied Research (6.2), and Advanced Technology Development
(6.3) and all categories are programmed for significant funding
reductions.
Basic Research (6.1) accounts would decrease from $1.513 billion to
$1.318 billion, a 12.9 percent decline. While these basic research
accounts comprise less than 12 percent of the S&T budget and less than
2 percent of the RTD&E total, the programs that these accounts support
are critically important to fundamental, scientific advances and to the
generation of a highly skilled science and engineering workforce.
Basic research accounts are used mostly to support science and
engineering research and graduate, technical education at universities
in all 50 States. Almost all of the current high-technology weapon
systems, from laser-guided, precision weapons, to the global
positioning satellite (GPS) system, have their origin in fundamental
discoveries generated in these defense-oriented, basic research
programs. Proper investments in basic research are needed now, so that
the fundamental scientific results will be available to create
innovative solutions for the future defense needs of this country. Many
of the technical leaders in corporations and government laboratories
that are developing current weapon systems, such as the F-22 and Joint
Strike Fighter, were educated under basic research programs funded by
DOD. Failure to invest sufficient resources in basic, defense-oriented
research will reduce innovation and weaken the future scientific and
engineering workforce. The Task Force recommends that Basic Research
(6.1) be funded at the level of $1.6 billion.
Applied Research (6.2) would be reduced from $4.849 billion to
$4.139 billion, a 14.6 percent reduction. The programs supported by
these accounts are generally intended to take basic scientific
knowledge, perhaps phenomena discovered under the basic research
programs, and apply them to important defense needs. These programs may
involve laboratory proof-of-concept and are generally conducted at
universities, government laboratories, or by small businesses. Many of
the successful demonstrations create or foster small companies, such as
those done in the Small Business Innovative Research (SBIR) programs.
Some devices created in these defense technology programs have dual
use, such as GPS, and the commercial market far exceeds the defense
market. Many small companies that fuel job growth in many states
obtained their start in defense programs, but later broadened their
markets. However, without initial support many of these companies would
not exist. Failure to properly invest in applied research would prevent
many ideas for devices from being tested in the laboratory, and would
stunt the creation and growth of small entrepreneurial companies.
The largest reduction would occur in Advanced Technology
Development (6.3), which would experience a 24.5 percent decline, from
$6.707 billion to $5.046 billion. These resources support programs that
develop technology to the point that they are ready to be transitioned
into weapon systems. Without the real system level demonstrations
funded by these accounts, companies are reluctant to incorporate new
technologies into weapon systems programs. The individual service's S&T
accounts reflect the general trend of large reductions described above.
However the largest reductions are in the Army's accounts, where Basic
Research would be cut by 21.6 percent, Applied Research by 39.9
percent, and Advanced Technology Development by 45.4 percent. The only
major S&T component with an increase is ``Defense-Wide'' Applied
Research (6.2) where a 2.8 percent increase is proposed, mainly due to
a 3.6 percent increase for the Defense Advanced Research Projects
Agency (DARPA), an increase we strongly endorse.
We urge this subcommittee to support an appropriation of $13.4
billion for S&T programs, which is 3 percent of the overall fiscal year
2005 DOD budget. This request is consistent with recommendations
contained in the Quadrennial Defense Review and made by the Defense
Science Board (DSB), as well as senior Defense Department officials and
commanders from the Air Force, Army, and Navy, who have voiced support
for the future allocation of 3 percent as a worthy benchmark for
science and technology programs.
DOD REQUEST FOR THE UNIVERSITY RESEARCH INITIATIVE (URI)
The University Research Initiative (URI) supports graduate
education in Mathematics, Science, and Engineering and would see a
$46.1 million decrease from $294.2 million in fiscal year 2005 to
$248.1 million next year, a 15.7 percent reduction. While these amounts
are small in comparison with the overall defense budget, they are
critical to educating the next generation of engineers and scientist
for the defense industry. Lack of funding for the URI will prevent or
discourage students from pursuing careers in defense related
technologies. This will have a serious long-term negative consequence
on the ability of companies to hire highly skilled scientific and
engineering workforce to build weapons systems in the years to come.
DOD has shown a lack of commitment to these programs, first by
devolving these programs to the services 3 years ago and over the last
2 years not maintaining adequate funding. The reduction in funding will
directly translate into fewer Americans having an opportunity to pursue
advanced study in engineering, science, and mathematics, and therefore
will reduce the pool of qualified workers with advanced technical
skills for companies that design and manufacture defense systems.
While DOD has enormous current commitments, these pressing needs
should not be allowed to squeeze out the small but very important
investments required to create the next generation of highly skilled
technical workers for the American defense industry. This would be
shortsighted.
The task force recommends that the subcommittee support advanced
technical education and provide $325 million to the URI program for
fiscal year 2006.
REDUCED S&T FUNDING IS A THREAT TO NATIONAL SECURITY
Since World War II the United States has led the world in science,
innovation, and defense technology. This preeminent position in
science, engineering and technology has made us an economic and
military superpower, second to none. However, this lead is quickly
eroding and within the next few years may be substantially reduced or
may completely evaporate in some areas. Many European and Asian
countries are educating far more engineers and scientists per capita
and investing a greater portion of gross domestic product (GDP) in
basic research and innovation than is the United States. If these
trends continue, the United States, which relies heavily on advanced
technology for military superiority, may find its dominant military
position compromised. In the longer term the United States may become a
second tier economic and military power.
A recent study performed by the Task Force on the Future of
American Innovation, entitled ``The Knowledge Economy: Is the United
States Losing Its Competitive Edge'' evaluated the position of the
United States in several critical measures of technology, innovation,
and scientific workforce development. While the report indicated that
the United States maintains a slight lead in research and discovery,
there was concern expressed that, ``Nations from Europe and Eastern
Asia are on the fast track to pass the United States in scientific
excellence and technological innovation''.
The report compared the United States to other advanced, industrial
countries in education, science and engineering workforce, scientific
knowledge, innovation (as measured by the number of patent
applications), investment in R&D, and trade balances in high technology
goods and services.
Of all the measures considered the United States fared worst in the
state of technical education. The United States already lags most
advanced countries in several important measures of natural science and
engineering education. These findings are supported by a 2002 Rand
report titled, ``Federal Investment in R&D'', which noted that,
``numerous competitor nations have made greater advances than the
United States in terms of developing human resources for science and
technology. Many countries in the European Union and Asia have exceeded
U.S. degree production in the natural sciences and engineering. Europe
overtook the United States in degree production in 1988 and has stayed
ahead, and Asia pulled ahead in 1998. During this same period, U.S.
degree attainment in these fields has declined.'' Currently 5.7 percent
of U.S. bachelor degrees are in engineering or natural science. In
European and developed or developing Asian counties this ranges from
about 8 to 13 percent. For science and engineering doctoral degrees,
which are becoming widely needed in industries that use advanced
technology, the U.S. share of the worldwide total has been steadily
decreasing. In 2000 only 22 percent of all doctoral degrees in
engineering and natural science were awarded by American universities.
This has fallen from more than 40 percent in the 1970's.
A useful measure of knowledge creation and the generation of new
ideas is the number of technical papers published. The total number of
U.S. publications has been nearly flat over the last 15 years. However,
other countries have seen steady, and in some cases remarkable growth.
Therefore, the U.S. share of worldwide technical papers published has
fallen from 38 percent in 1988 to 31 percent in 2001. The EU countries
when taken in total now lead in this area, accounting for 36 percent of
world wide scientific publications. Asian countries, while still far
behind at only 17 percent of the total, have experienced the most rapid
growth in this category, more than doubling their output in the past 15
years. These countries will surpass the United States in about 6 years
if current trends continue.
One area where the United States maintains a lead over developing
Asian countries is in total R&D investment. Currently the United States
invests over $250 billion in combined private and public financed R&D
compared with about $100 billion for China, Singapore, South Korea, and
Taiwan. However, even in this area the gap is rapidly closing. If
current trends persist, the combined R&D expenditures of these
countries will match the United States by about 2015. One of these
reasons is the relatively slow growth in U.S. R&D funding. In 1970
about 0.1 percent of the GDP was invested in engineering and physical
science research, mostly in the defense area. This proportion has
steadily decreased and by 2000 less than half this much, or 0.05
percent of GDP, was allocated to research in these areas.
Finally the report compared U.S. balance of trade in advanced
technology products, such aircraft, computers, communications
equipment, pharmaceuticals, and precision and optical instruments. In
1990 the United States had a $30 to $40 billion trade surplus in these
industries. This situation has steadily eroded to the point that in
2003 the United States ran a trade deficit in high technology products
of nearly $30 billion. One of the consequences of the growing economic
power of China, which is increasing based on higher technology
industries and an increasingly educated technical work force, is that
China has surpassed the United States as the world's leading recipient
of foreign direct investment (FDI).
There is a general belief among defense strategist that the United
States must have the industrial base to develop and produce the
military systems required for national defense.
Many members of Congress also hold this view. In order to have this
capability, a native, skilled, scientific and engineering work force is
required. There is a growing and alarming trend in many commercial
industries to outsource engineering and other high-skilled service
activities to foreign workers. In the past outsourcing was largely
driven by cost considerations and was limited to low-cost, low-skilled
workers. However, there is an emerging trend to outsource highly
skilled engineering workforce products such as software and systems
design and integration. A U.S.-based defense contractor cannot rely on
engineers and scientists in other countries. Domestic content
legislation for defense procurement makes little or no sense if the
foremost scientists, engineers and manufacturers of sophisticated
defense systems ultimately reside outside the United States. As the
need for a more highly skilled workforce, which includes a higher
percentage of employees with Masters and Doctoral level technical
educations, increases, and the available technical workforce decreases,
corporations that must hire engineers who are U.S. Citizens with the
appropriate security clearances, will be faced with serious shortages.
A critical issue to be faced is: Will the United States, now dependent
on foreign energy sources and finances to underwrite our deficits, now
be dependent on foreign sources for scientific and engineering
leadership?
We believe that protectionist measures will not be able to serve
the long-term policy objective of having the capability to design,
develop, and manufacture defense systems within the United States. In
order to assure this capability, sufficient manpower, particularly
those with the critical skills needed for creating advanced defense
systems, needs to be available in sufficient numbers in the United
States. Therefore, prudent investments in programs that create a
robust, domestic supply of engineers and scientist with masters and
doctoral level educations are in the national interest. Demographic
data indicate that participation of U.S. students in science and
engineering students will continue to decline. Retirements of
scientists and engineers currently in the workforce will accelerate
over the coming years. This will create a critical shortage of American
citizens able to create the innovative, effective defense systems of
the future.
As Congress considers the allocation of resources in the fiscal
year 2006 defense appropriations, proper attention to the vital role
that S&T plays in future innovations and defense workforce should be
considered. There are critical shortages in the DOD S&T areas,
particularly in those that support in basic research and technical
education. These programs protect the stability of the Nation's defense
base, will lead to technological superiority in future weapons systems,
and educate new generations of scientists and engineers, who maintain
our position as the world's technological leader.
Study after study has linked over 50 percent of our economic growth
over the past 50 years to technological innovation. U.S. leadership in
technological innovation is being seriously threatened by the
accelerating pace of investments by other nations in R&D, their
innovative capacity and their efforts in technical workforce
development. All of these trends are occurring within the framework of
an increasingly competitive global economy.
CONCLUSION
Leadership in engineering research, education and practice is a
prerequisite to global leadership in technology innovation. A soon-to-
be released National Academy of Engineering report entitled ``Assessing
the Capacity of the U.S. Engineering Research Enterprise'' provides a
roadmap for balancing the Federal R&D portfolio and re-establishing
basic engineering research as a priority for this Nation. We strongly
urge this committee to review the recommendations outlined in this
report, particularly those pertaining to discovery-innovation
institutes, strengthening linkages between industry and research
universities, and human capital. The report is available at http://
www.nae.edu/NAE/engecocom.nsf/weblinks/MKEZ-68JK55/$File/
Engineering%20Research.pdf.
In conclusion, we thank the subcommittee for its ongoing strong
support of Defense S&T. The Task Force believes that proposed funding
levels are inadequate and the increased investments that are outlined
are necessary and will make a vital contribution to our national
security and to a stronger, more vibrant economy.
ASME International is a non-profit technical and educational
organization with 125,000 members worldwide. The Society's members work
in all sectors of the economy, including industry, academic, and
government. This statement represents the views of the ASME Department
of Defense Task Force of the Committee on Federal R&D of the Council on
Engineering and is not necessarily a position of ASME as a whole.
Senator Stevens. Our next witness is William Destler of the
University of Maryland, is that correct? Is it ``Doctor
Destler?''
STATEMENT OF WILLIAM W. DESTLER, Ph.D., PROVOST,
UNIVERSITY OF MARYLAND, COLLEGE PARK, ON
BEHALF OF THE ASSOCIATION OF AMERICAN
UNIVERSITIES
Dr. Destler. It is.
Senator Stevens. Thank you, sir.
Dr. Destler. Mr. Chairman, Senator Inouye: I am here to
represent the American Association of Universities (AAU), which
consists of 60 prominent public and private universities that
together conduct about 60 percent of all federally sponsored
research and produce about half of the Nation's Ph.D.'s each
year.
I want to thank the two of you and the rest of the
subcommittee for your past strong support of defense science
and technology research efforts. I think it is no surprise to
any of us that in the United States the combined research
capabilities of our Federal laboratories, including our DOD
labs, together with our corporate research assets, which are
frankly in decline, and those in our research universities,
represent one of our last unfair advantages over potential
adversaries abroad. Spinoffs from defense science and
technology, moreover, have resulted in the introduction of many
new products and services in the private sector and are a key
element in the maintenance of our national standard of living.
So as the subcommittee begins its work on the fiscal year
2006 defense appropriations bill, the AAU offers two major
recommendations. One, strengthen support for basic research in
defense science and technology. Funding for 6.1 research has
steadily declined over the last decade, despite the fact that
basic research is the seed corn that leads to technological
superiority in defense systems. It is this technological
superiority that has materially shortened military conflicts in
which the United States has engaged in recent years and saved
the lives of countless U.S. citizens.
Funding for 6.1 basic research, moreover, is a two-fer. It
not only engages our top scientists and engineers nationwide in
support of national defense interests, but it also supports the
training of tomorrow's experts in these critical disciplines.
Second, the AAU supports the full funding of DOD's new
National Defense Education Act phase I initiative, a program
that many years ago benefited our previous speaker. In recent
years the United States has failed to attract enough of its own
best students to study in areas of critical importance to our
national security. The new National Defense Education Act is
intended to provide scholarships and fellowships to
undergraduates and graduate students entering critical fields
such as science, mathematics, engineering and foreign languages
in return for a commitment of national service after completion
of their studies--a perfect match in my opinion.
The AAU therefore fully supports the funding of the $10.3
million requested for this program in fiscal year 2006 and
recommends a greatly expanded program in fiscal year 2007 if
funding will permit.
I am very grateful for the chance to speak to you today
and, as you know, I am a very efficient speaker and I will give
you a little bit of time back.
[The statement follows:]
Prepared Statement of William W. Destler
Mr. Chairman and members of the subcommittee, I am William W.
Destler, Senior Vice President for Academic Affairs and Provost,
University of Maryland, College Park. I appear before you today on
behalf of the Association of American Universities, which represents 60
of America's most prominent public and private research universities.
AAU's member universities perform 60 percent of federally funded
university-based research and award approximately half of all Ph.D.
degrees granted annually.
I greatly appreciate this opportunity to testify on behalf of AAU
on the important role the Department of Defense (DOD) plays in
supporting both research and education in fields critical to our
national defense. Before going further, I would like to thank Chairman
Stevens, Ranking Member Inouye, and the members of the subcommittee for
your strong support for Defense Science and Technology (S&T) programs
in the past. For each of the past 4 years the final funding levels for
Defense S&T have met or exceeded 3 percent of the total defense
budget--a target originally established in 1989 by the Defense Science
Board and then included in the Quadrennial Defense Review in 2001. This
strong support for Defense S&T has been due in large part to your
efforts. Your support of Defense S&T is even more significant given
that in each of these years, the budget proposed by the Pentagon for
S&T programs fell short of the 3 percent target.
As the subcommittee begins its work on the fiscal year 2006 defense
appropriations bill, AAU offers the subcommittee two major
recommendations.
Within funds provided for Defense S&T, strengthen support for basic
research.--While significantly more resources have been allocated to
Research, Development, Testing and Evaluation (RDT&E) in recent years
and as referenced above, the 3 percent target for Defense S&T has been
met, the percentage of this funding devoted to basic 6.1 research has
declined. In fact, over the last 20 years, basic 6.1 research funding
has declined in inflation-adjusted dollars, despite the demonstrated
benefit of such funding.
In December 2004, the Council on Competitiveness--a national
consortium of industrial, university and labor leaders--released a
report entitled Innovate America, which identified innovation as ``the
single most important factor in determining America's success in the
21st century.'' Among its recommendations, the report urged that DOD
restore its historic commitment to pioneering discoveries by devoting
not less than one-fifth of the Defense S&T budget to basic research. To
achieve that goal, AAU recommends increasing funding for defense basic
research (budget category 6.1) programs by $200 million in fiscal year
2006 to $1.7 billion.
Fully fund DOD's New National Defense Education Act (NDEA)--Phase I
Initiative.--This year, in addition to the existing University Research
Initiative, the National Defense Science and Engineering Graduate
Fellowship Program, and the National Security Education Program
(NSEP)--all programs for which AAU urges your continued support--the
Pentagon has proposed $10.3 million for a new National Defense
Education Act--Phase I program. The NDEA initiative would provide
scholarships and fellowships to undergraduate and graduate students
entering critical fields of science, mathematics, engineering and
foreign languages in return for a commitment of national service after
completion of their studies.
AAU applauds this new initiative and believes it is a positive step
toward addressing U.S. science and engineering (S&E) workforce needs.
AAU encourages you to provide the $10.3 million requested for this
program in fiscal year 2006 and recommends greatly expanding this
exciting new initiative in fiscal year 2007. AAU has called for an even
more comprehensive, multi-agency national defense education initiative
to be developed aimed at stemming national educational deficiencies and
encouraging more U.S. students to study in critical fields of
knowledge.
In the time I have remaining, let me briefly outline some key
reasons why your support for basic defense research is critical. Then I
will conclude with some final remarks about why AAU supports DOD's
National Defense Education Act proposal.
WHY INVESTING IN DOD RESEARCH IS CRITICAL FOR NATIONAL DEFENSE
DOD basic (6.1) research is the foundation for the scientific and
technological breakthroughs required to meet future military needs.--
During the Cold War, DOD provided robust support for breakthrough basic
research performed at the Nation's universities and national
laboratories. This support resulted in many of the highly-effective
technologies currently fielded in the war on terrorism today, such as
global navigation, radar, laser targeting systems and ``smart'' bombs;
lightweight body armor; the Internet; night vision and thermal imaging;
unmanned aerial vehicles; and biological and chemical sensors. This
funding was also critical to supporting some of the Nation's top
scientific talent.
Since the end of the Cold War, DOD's focus on basic research has
declined significantly, dropping from 20 percent of total defense S&T
funds in 1980 to less than 12 percent in fiscal year 2005. According to
an assessment of DOD basic research released earlier this year, the
decline in funding for 6.1 basic research in real terms from 1993 to
2004 was 10 percent according to the inflation indexes used by the DOD
and 18 percent using the Consumer Price Index (CPI). Growing concerns
about declining investments in fundamental research have been
highlighted in a number of recent news articles which have brought
attention to DARPA's move away from support of high risk, high payoff
basic research.
As the threats we face have grown more complex, the need for new
knowledge is greater now than ever before.--New dangers facing the
military, such as high technology terrorism, information warfare, and
the proliferation of weapons of mass destruction, require new and more
sophisticated technologies. To meet these threats, DOD must strengthen
its front-end commitment to basic research in areas such as:
nanotechnology; high-speed microchips; computing and microchip
capacity; composites research and stealth technology; explosive
detection devices; self-healing wound technology; cybersecurity and
encryption; and biological and chemical defense. The knowledge required
to generate cutting edge technologies in these areas is critically
dependent upon DOD's sustained investments in long-term, high risk,
defense-oriented research performed at U.S. universities.
At the University of Maryland, for example, DOD support has enabled
the University to bring together researchers from academia, industry,
and DOD laboratories to work together on problems ranging from
energetic materials to advanced electronic devices. This year, for
example, we are partnering with DOD to establish a new Joint Institute
for Knowledge Discovery which will assist the agency with the
extraordinary problem of sifting important information from the huge
quantities of information collected daily by our intelligence services,
including NSA. This effort will involve researchers from several
universities, the private sector, and DOD.
Defense support for research enlists today's top scientists in
support of national defense while training tomorrow's experts in
critical disciplines.--DOD's basic research investment produces not
only military technology but also the people without whom technology
would never see the light of day. DOD support to universities and DOD
laboratories keeps top scientists and engineers involved in the
academic disciplines that underpin national defense. It also plays a
vital role in training the next generation of scientists and engineers
who will become the future defense workforce and implement new defense
innovations well into the 21st century.
DOD is the third-largest Federal sponsor of university-based
research. More than 300 universities and colleges conduct DOD-funded
research. This research is concentrated in fields where advances are
most likely to contribute to national defense: DOD provides 71 percent
of Federal funding for electrical engineering, 46 percent for materials
engineering, 38 percent for computer sciences, and 30 percent for ocean
sciences. DOD also sponsors fellowships and provides significant
support for graduate students in critical defense fields such as
computer science and aerospace and electrical engineering.
But there are still too few U.S. students studying these critical
fields. The need to attract and retain them is the reason that AAU has
endorsed DOD's proposal for the new National Defense Education Act and
has called for an even greater multi-agency initiative in future years.
WHY AAU SUPPORTS A NEW NATIONAL DEFENSE EDUCATION ACT
As you know, a concerted effort to increase government investment
in security-related research, education, and training is not novel. In
response to the launch of Sputnik and the emerging threat posed by the
Soviet Union, Congress in 1958 created NASA and adopted the National
Defense Education Act (NDEA). The NDEA inspired generations of U.S.
students to pursue fields critical to our national security, and
enabled the United States to establish dominance in science and
technology for military and civilian purposes.
Our future military challenges simply cannot be met without an
appropriately educated and trained U.S. defense workforce. These needs
have been highlighted by several sources, including the Hart/Rudman
Commission on National Security, the National Science Board, and most
recently, the defense industry and the Pentagon itself.
The sad truth is that in recent years, our country has failed to
attract enough of our own best students to areas of critical importance
to our security. This has left us critically dependent upon foreign
talent to fulfill our workforce needs.
Since 9/11, however, there has been a drop in the number of foreign
students coming to the United States to study. Moreover, most of these
foreign students cannot obtain security clearances and cannot be
employed in DOD laboratories or by the defense industry. Based on
numerous benchmarks contained in a recent report by the Task Force on
the Future of American Innovation, the scientific and technological
advantage that the United States has held over other nations is
eroding.
Rapidly developing economies, particularly those in Asia, are
vigorously investing in their own research and higher education
infrastructures, which is thus increasing their ability to both educate
their people at home and to perform cutting-edge research.
SUMMARY
For reasons of national, homeland, and economic security, the
United States must produce more graduates in critical fields. Not only
are DOD and the defense and aerospace industries experiencing
significant difficulty in attracting and retaining the science and
engineering talent they require, but as many as 13,000 DOD laboratory
scientists will be eligible to retire in the next decade. There may not
be sufficient numbers of graduating, security-clearable U.S. students
to replace them. In addition, thousands more scientists and engineers
will be needed in other governmental agencies such as NASA and the
Department of Energy, and in energy-related industries. And the
military and intelligence communities face an acute shortage of
linguists and area specialists in key parts of the world. We must act
now to fill the pipeline of U.S. students trained in fields vital to
our national and economic security.
The Nation should not wait until we face a national security
workforce crisis. It should act now. With your help, AAU believes that
the DOD should and will play a leadership role in this effort.
We urge your support for the $10.3 million requested for the NDEA-
Phase I proposal and encourage you to recognize the need for additional
resources for defense basic research. This is a small, but vital,
investment in addressing the monumental national defense challenges we
now face.
Again, I would like to thank the subcommittee for its continued
support of Department of Defense research and look to your continued
leadership in this area.
Senator Stevens. Well, doctor, tell me. Does this money
really flow into the students or just into the university and
the fixed staff?
Dr. Destler. It goes entirely to the students. It provides
scholarships and fellowships for the students to encourage them
to study.
Senator Stevens. This amount goes beyond the grants for
research. It really reaches out to the students?
Dr. Destler. That is exactly correct.
Senator Stevens. Well, you will have our support on that. I
just finished a meeting with some of the people that loan money
to students and they tell me there is not enough incentive for
the science and engineering students. So we want to try to help
you on that.
Dr. Destler. Exactly. Thank you very much for your support.
Senator Stevens. Thank you very much.
Sydney Hickey of the National Military Family Association.
STATEMENT OF SYDNEY HICKEY, ON BEHALF OF THE NATIONAL
MILITARY FAMILY ASSOCIATION
Ms. Hickey. Yes, sir.
Mr. Chairman, Senator Inouye: the National Military Family
Association (NMFA) appreciates this opportunity to express its
views and the views of the families that we represent. We
continue to be very grateful to you for your strong support of
military family issues. Tremendous strides have been made in
predeployment, deployment, and return and reunion support for
families. Our families are concerned, however, about the long-
term effects of frequent deployments, both on their service
member and on their own family's integrity. Return and reunion
programs must be long-term and include the families even when
the service member is no longer on Active duty.
Families are also concerned about the availability of
quality child care. NMFA believes the situation will only
worsen as rebasing, transformation, and BRAC cause significant
shifts in population. Alternatives are being developed by the
Department of Defense and we support these initiatives and urge
funding for their rapid expansion.
Transformation, overseas rebasing, and BRAC will require
significantly more resources than are currently available to
ensure that quality of life programs remain in effect at losing
installations until the last family has left and are in place
at gaining installations before the first families arrive. NMFA
is therefore very concerned about recent reports that basic
family support is short of funding.
NMFA appreciates the many schools that have stepped up to
the plate to provide needed counseling and other services to
the children of deployed military parents. We believe that the
extraordinary workload currently being placed on school systems
necessitates an increase in the DOD impact aid supplement to
$50 million and continued congressional oversight of the
resources requested by DOD for their own schools.
We also believe additional funds will be required in the
out-years to assist those school districts that will receive
many thousands of new military children from overseas areas and
because of BRAC. NMFA believes robust funding of family support
programs, including the education of children, is imperative
for readiness.
Significant beneficiary turmoil occurred during the
changeover to the new TRICARE contracts. While progress has
been made, difficulties remain. Access standards for Prime
enrollees, particularly those enrolled in military treatment
facilities, are not being met in many cases. Families returning
stateside due to overseas rebasing will not be able to be
accommodated in many instances in military treatment facilities
(MTFs). If the BRAC proposals for MTFs are implemented,
significant inpatient workload will also shift out of the MTFs.
NMFA believes the military health care system should be
realistically and fully funded to provide quality and promised
care to all beneficiaries wherever they receive that care.
NMFA is very grateful for the significant increase in the
death gratuity and the servicemen's group life insurance
(SGLI), but strongly believes that all in line of duty deaths
must be treated the same; and we continue to believe that
removing the dependency indemnity compensation offset to the
survivor benefit plan is the best way to establish the long-
term financial stability of the surviving family.
NMFA thanks you, Mr. Chairman and Senator Inouye, and your
fellow members of this subcommittee for your support of
military families and respectfully requests that it continue.
Senator Stevens. Thank you very much.
Senator Inouye.
Senator Inouye. If I did not do that my wife would not let
me home. If I did not support you my wife would throw me out.
Ms. Hickey. More power to her.
Thank you.
Senator Stevens. Thank you very much.
[The statement follows:]
Prepared Statement of Kathleen B. Moakler, Deputy Director, Government
Relations, the National Military Family Association
The National Military Family Association (NMFA) is the only
national organization whose sole focus is the military family and whose
goal is to influence the development and implementation of policies
which will improve the lives of those family members. Its mission is to
serve the families of the seven uniformed services through education,
information and advocacy.
Founded in 1969 as the Military Wives Association, NMFA is a non-
profit 501(c)(3) primarily volunteer organization. NMFA today
represents the interests of family members and the active duty, reserve
components and retired personnel of the seven uniformed services: Army,
Navy, Air Force, Marine Corps, Coast Guard, Public Health Service and
the National Oceanic and Atmospheric Administration.
NMFA Representatives in military communities worldwide provide a
direct link between military families and NMFA staff in the Nation's
capital. Representatives are the ``eyes and ears'' of NMFA, bringing
shared local concerns to national attention.
NMFA receives no Federal grants and has no Federal contracts.
NMFA's web site is located at http://www.nmfa.org.
Mr. Chairman and distinguished members of this subcommittee, the
National Military Family Association (NMFA) would like to thank you for
the opportunity to present testimony on quality of life issues
affecting servicemembers and their families. NMFA is also grateful for
your leadership in the 108th Congress in securing funds to:
--Make increases in the Family Separation Allowance and Imminent
Danger Pay permanent.
--End the age-62 Survivor Benefit Plan offset.
--Help DOD support the education of military children.
--Support family readiness programs and military health care.
As a founding member of The Military Coalition, NMFA subscribes to
the recommendations contained in the Coalition's testimony presented
for this hearing. We especially endorse the Coalition's request that
this subcommittee work to protect the benefits depended upon by members
of the all-volunteer force, retirees, their families, and survivors.
According to DOD statistics, approximately one-fourth of today's
servicemembers came from military families. Ensuring a robust support
network for today's military families and fulfilling promises made to
military retirees will enhance the capabilities of tomorrow's force.
NMFA also endorses The Military Coalition's recommendations to:
--Enhance education and outreach to improve military family readiness
and support families of deployed active duty, National Guard,
and Reserve servicemembers.
--Fully-fund the commissary benefit and scrutinize proposals to close
commissaries or combine exchange services.
--Ease the transition of Guard and Reserve families to TRICARE when
the servicemember is mobilized by providing a choice of
purchasing TRICARE coverage when in drill status or receiving
Federal payment of civilian health care premiums when the
servicemember is mobilized.
--Fully-fund the Defense Health Program budget to provide access to
quality care for all beneficiaries.
--Authorize full Basic Allowance for Housing (BAH) for Guard and
Reserve members mobilized for more than 30 days.
In this statement, NMFA will address issues related to military
families.
FAMILY READINESS THROUGHOUT THE DEPLOYMENT CYCLE
The Services continue to refine the programs and initiatives to
provide support for military families in the period leading up to
deployments, during deployment, and the return and reunion period. Our
message to you today is simple: increased funding to support family
readiness is paying off! Family readiness over the long term requires
that resources must be directed not just at deployment-related support
programs, but also to sustain the full array of baseline installation
quality of life programs. As referenced in NMFA's 2004 analysis report,
``Serving the Home Front: An Analysis of Military Family Support from
September 11, 2001 through March 31, 2004,'' consistent levels of
targeted family readiness funding are needed, along with consistent
levels of command focus on the importance of family support programs.
NMFA is very concerned about recent reports from Service leadership
and from individual installations about potential shortfalls in base
operations funding and appropriated fund support for Morale, Welfare
and Recreation (MWR) and other quality of life programs. While some of
these cuts may be temporary, in programs and facilities seeing declines
in patronage due to the deployment of units from the installations,
others are in services that support families, such as spouse employment
support, volunteer support, child development center hours, or family
member orientation programs. These core quality of life programs make
the transition to military life for new military members easier and
lessen the strain of deployment for all families. NMFA does not have
the expertise to ferret out exact MWR funding levels from Service
Operations and Maintenance budgets. We are concerned about the state of
this funding--both appropriated and non-appropriated fund support--
because of what we hear from servicemembers and families, what we read
in installation papers chronicling cutbacks, and from Service leaders
who have identified shortfalls in base operations funding in the
administration's fiscal year 2006 budget request. Resources must be
available for commanders and others charged with ensuring family
readiness to help alleviate the strains on families facing more
frequent and longer deployments.
NMFA is particularly troubled by what we see as mixed signals
regarding DOD's long-term commitment to quality of life services and
programs. In recent testimony, several DOD and Service leaders have
focused on the costs of many benefit programs and emphasized plans to
increase bonuses, as opposed to other types of benefits or
compensation. NMFA regards this narrow focus on bonuses as an
inadequate quick fix to recruiting and retention woes. We agree with
the Senior Enlisted Advisors who, in recent testimony, emphasized the
importance of addressing quality of life issues for active, National
Guard and Reserve servicemembers and their families. They listed child
care and housing as top priorities, in addition to pay, health care,
and educational opportunities for servicemembers and their families.
NMFA believes military leaders must recognize that the robust military
benefit package needed to recruit and retain a quality force demands
attention to both pay and non-pay elements of that package.
WHAT'S NEEDED FOR FAMILY SUPPORT?
Family readiness volunteers and installation family support
personnel in both active duty and reserve component communities have
been stretched thin over the past 3\1/2\ years as they have had to
juggle pre-deployment, ongoing deployment, and return and reunion
support, often simultaneously. Unfortunately, this juggling act will
likely continue for some time. Family member volunteers support the
servicemembers' choice to serve; however, they are frustrated with
being called on too often during longer than anticipated and repeated
deployments. Military community volunteers are the front line troops in
the mission to ensure family readiness. They deserve training,
information, and assistance from their commands, supportive unit rear
detachment personnel, professional backup to deal with family issues
beyond their expertise and comfort level, and opportunities for respite
before becoming overwhelmed. NMFA is pleased to note that the Army's
paid Family Readiness Support Assistants are getting rave reviews from
commanders and family readiness volunteers--funding is needed so that
more of these positions can be created.
NMFA knows that complicated military operations can result in
deployments of unexpected lengths and more frequent deployments. But we
also understand the frustrations of family members who eagerly
anticipated the return of their servicemembers on a certain date only
to be informed at the last minute that the deployment will be extended
or that the unit will be deployed again within a year or less of its
return. Other than the danger inherent in combat situations, the
unpredictability of the length and frequency of deployments is perhaps
the single most important factor frustrating families today. Because of
this unpredictability, family members need more help in acquiring the
tools to cope. They also need consistent levels of support throughout
the entire cycle of deployment, which includes the time when
servicemembers are at the home installation and working long hours to
support other units who are deployed or gearing up their training in
preparation for another deployment. As one spouse wrote to NMFA:
``This is really starting to take a toll on families out here since
some families are now on the verge of their third deployment of the
servicemember to Iraq. Families are not so much disgruntled by the
tempo of operations as they are at a loss for resources to deal with
what I've started calling the `pivotal period.' This is the point where
the honeymoon from the last deployment is over, the servicemember is
starting to train again for the next deployment in a few months and is
gone on a regular basis, the family is balancing things with the
servicemember coming and going and also realizing the servicemember is
going to go away again and be in harm's way. We have deployment briefs
that set the tone and provide expectations for when the servicemember
leaves. We have return and reunion briefs that prepare families and
provide expectations for when the servicemember returns. These two
events help families know what is normal and what resources are
available but there is an enormous hole for that `pivotal period.' No
one is getting families together to let them know their thoughts,
experiences and expectations are (or aren't) normal in those in between
months. Deployed spouses have events, programs, and free child care
available to them as they should--but what about these things for the
in-betweeners who are experiencing common thoughts and challenges?''
Efforts to improve the return and reunion process must evolve as
everyone learns more about the effects of multiple deployments on both
servicemembers and families, as well as the time it may take for some
of these effects to become apparent. Information gathered in the now-
mandatory post-deployment health assessments may also help identify
servicemembers who may need more specialized assistance in making the
transition home over the long term. NMFA applauds the announcement made
in January by the Assistant Secretary of Defense for Health Affairs
that DOD would mandate a second assessment at the 4- to 6-month mark
following the servicemember's return. We urge Congress to ensure the
military Service medical commands have the personnel resources needed
to conduct these assessments.
NMFA is concerned that much of the research on mental health issues
and readjustment has focused on the servicemember. More needs to be
done to study the effects of deployment and the servicemembers' post-
deployment readjustment on family members. Return and reunion issues
are long-term issues. More also needs to be done to ensure proper
tracking of the adjustment of returning servicemembers. Post-deployment
assessments and support services must also be available to the families
of returning Guard and Reserve members and servicemembers who leave the
military following the end of their enlistment. Although they may be
eligible for transitional health care benefits and the servicemember
may seek care through the Veterans' Administration, what happens when
the military health benefits run out and deployment-related stresses
still affect the family?
NMFA is pleased that DOD has intensified its marketing efforts for
Military OneSource as one resource in the support for families
throughout the entire deployment cycle. Military OneSource provides 24/
7 access, toll-free or online, to community and family support
resources, allowing families to access information and services when
and where they need them. DOD, through OneSource, has committed to
helping returning servicemembers and families of all Services access
local community resources and receive up to six free face-to-face
mental health visits with a professional outside the chain of command.
NMFA is concerned that some of the recent cuts in family program staff
at installations suffering a shortfall in base operations funding may
have been made under the assumption that necessary support could be
provided remotely through OneSource. The OneSource information and
referral service must be properly coordinated with other support
services, to enable family support professionals to manage the many
tasks that come from high optempo.
Geographically-isolated Guard and Reserve families must depend on a
growing but still patchy military support network. Countless local and
State initiatives by government organizations and community groups have
sprung up to make dealing with deployment easier for Guard and Reserve
family members. One new initiative that has the potential to network
these local efforts is the National Demonstration Program for Citizen-
Soldier Support. This community-based program is designed to strengthen
support for National Guard and Reserve families by building and
reinforcing the capacity of civilian agencies, systems, and resources
to better serve them. Initiated by the University of North Carolina at
Chapel Hill, with $1.8 million in seed money provided in the fiscal
year 2005 Defense Appropriations Act, the Citizen-Soldier Support
Program will be coordinated closely with existing military programs and
officials in order to avoid duplication of effort and to leverage and
optimize success. Leveraging community programs with Federal funding
and programs can be a win-win situation. NMFA recommends continued
funding of this program to allow it time to develop a model that can be
replicated in other locations and to set up training to achieve this
replication.
HEALTH CARE
This year, NMFA is monitoring the after-effects of the transition
to the new round of TRICARE contracts and the continued transition of
mobilized Guard and Reserve members and their families in and out of
TRICARE. We are concerned that the Defense Health Program may not have
all the resources it needs to meet both military medical readiness
mission and provide access to health care for all beneficiaries. The
Defense Health Program must be funded sufficiently so that the direct
care system of military treatment facilities and the purchased care
segment of civilian providers can work in tandem to meet the
responsibilities given under the new contracts, meet readiness needs,
and ensure access for all TRICARE beneficiaries. Families of Guard and
Reserve members should have flexible options for their health care
coverage that address both access to care and continuity of care
NMFA believes that ``rosy'' predictions when significant contract
changes are being made are a disservice to both beneficiaries and the
system. NMFA is appreciative of the intense effort being made to
improve the referral and authorization process, but is concerned about
the cost of the work-around and the prospect of a new round of
disruptions when DOD's electronic referral and authorization system is
implemented. It is imperative that whatever changes are made, the
promised Prime access standards must be met.
NMFA again notes that more must be done to educate Standard
beneficiaries about their benefit and any changes that might occur to
that benefit. To end the TRICARE Standard access problem that is a
constant complaint of beneficiaries, DOD must work harder to attract
providers and understand the reasons why providers do not accept
TRICARE Standard.
We are closely watching the impending implementation of the TRICARE
Reserve Select health care benefit for the reserve component. We have
several concerns about the implementation of this program, especially
regarding beneficiary education. Both the servicemember and the family
need to understand the coverage provided under Reserve Select, the
costs, and, most importantly, how Reserve Select differs from the
TRICARE Prime or Prime Remote benefit the family used while the
servicemember was on active duty. Emphasis must continue on promoting
continuity of care for families of Guard and Reserve servicemembers.
NMFA's recommendation to enhance continuity of care for this population
is to allow members of the Selected Reserve to choose between buying
into TRICARE when not on active duty or receive a DOD subsidy allowing
their families to remain with their employer-sponsored care when
mobilized. NMFA also recommends that the rules governing health care
coverage under TAMP be updated to allow the servicemember and family to
remain eligible for TRICARE Prime Remote.
ALARMING DISCOVERY
Over the years, NMFA has received anecdotal information from family
members that providers are not accepting them as TRICARE patients
because the TRICARE reimbursement level was below that provided by
Medicaid. Needless to say, family members have been outraged! However,
since TRICARE reimbursement is tied by law to Medicare reimbursement,
NMFA has believed the problem to be far larger than the military health
care system. Alarm bells sounded, however, when NMFA was recently
informed of the situation in several locations where differences
between Medicaid and TRICARE rates for obstetrical care or pediatric
procedures have added to the reasons providers give for not accepting
TRICARE patients. NMFA does not know how prevalent this problem may be
across the country and urgently requests that Congress require DOD to
compare the reimbursement rates of Medicaid with those of TRICARE. We
are particularly concerned with the rates for pediatric and
obstetrical/gynecological care where Medicare has little experience in
rate setting.
SURVIVORS
NMFA believes that the government's obligation as articulated by
President Lincoln, ``to care for him who shall have borne the battle
and for his widow and his orphan,'' is as valid today as it was at the
end of the Civil War. We know that there is no way to compensate those
who have lost their servicemember, but we do owe it to these families
to help ensure a secure future. NMFA strongly believes that all
servicemembers' deaths should be treated equally. Servicemembers are on
duty 24 hours a day, 7 days a week, 365 days a year. Through their
oath, each servicemember's commitment is the same. The survivor benefit
package should not create inequities by awarding different benefits to
families who lose a servicemember in a hostile zone versus those who
lose their loved one in a training mission preparing for service in a
hostile zone. To the family, the loss is the same. NMFA was pleased
that both the House and Senate included increased survivor benefits in
their versions of the fiscal year 2005 Emergency Supplemental
Appropriations Act. We urge this subcommittee to ensure that these
increased benefits will be funded for fiscal year 2006.
NMFA recommends the following changes to support surviving family
members of active duty deaths:
--Treat all active duty deaths equally. The military Services have
procedures in place to make ``line of death'' determinations.
Do not impose another layer of deliberation on that process.
--Eliminate the DIC offset to SBP. Doing so would recognize the
length of commitment and service of the career servicemember
and spouse. Eliminating the offset would also restore to those
widows/widowers of those retirees who died of a service-
connected disability the SBP benefit that the servicemember
paid for.
--Improve the quality and consistency of training for Casualty
Assistance Officers and family support providers so they can
better support families in their greatest time of need.
--In cases where the family has employer sponsored dental insurance,
treat them as if they had been enrolled in the TRICARE Dental
Program at the time of the servicemember's death, thus making
them eligible for the 3-year survivor benefit.
--Update the TRICARE benefit provided in 3-year period following the
servicemember's death in which the surviving spouse and
children are treated as their active duty family members and
allow them to enroll in TRICARE Prime Remote.
--Allow surviving families to remain in government or privatized
family housing longer than the current 6-month period if
necessary for children to complete the school year, with the
family paying rent for the period after 6 months.
--Expand access to grief counseling for spouses, children, parents,
and siblings through Vet Centers, OneSource, and other
community-based services.
--To provide for the long-term support of surviving families,
establish a Survivor Office in the Department of Veterans'
Affairs.
WOUNDED SERVICEMEMBERS HAVE WOUNDED FAMILIES
Post-deployment transitions could be especially problematic for
servicemembers who have been injured and their families. NMFA asserts
that behind every wounded servicemember is a wounded family. Wounded
and injured servicemembers and their families deserve no less support
than survivors. Spouses, children, and parents of servicemembers
injured defending our country experience many uncertainties, including
the injured servicemember's return and reunion with their family,
financial stresses, and navigating the transition process to the
Department of Veterans Affairs (VA).
Support, assistance, and above all, counseling programs, which are
staffed by real people who provide face to face contact, are needed for
the families of wounded/injured servicemembers. Whenever feasible,
Military OneSource should be used as a resource multiplier. Mental
health services and trained counselors need to be available and easily
accessible for all servicemembers and their families who may suffer
``invisible'' injuries like combat stress and PTSD. Distance from MTFs
or VA Centers should not preclude servicemembers and their families
from seeking and receiving care. Respite care options should be
provided and accessible for family members who care for the seriously
wounded.
NMFA recommends the following changes to support wounded and
injured servicemembers and their families:
--Direct the military Services, OSD, and the VA to improve their
coordination in support of the wounded servicemember and
family.
--Consider initiatives to enhance the short term financial stability
of the wounded servicemember's family, such as: continuing
combat pays and tax exclusion, creating a disability gratuity,
or implementing a group disability insurance program.
--Extend the 3-year survivor health care benefit to servicemembers
who are medically retired and their families.
--Enhance servicemember and spouse education benefits and employment
support.
--Establish a Family Assistance Center at every Military Treatment
Facility (MTF) caring for wounded servicemembers.
EDUCATION FOR MILITARY CHILDREN
A significant element of family readiness is an educational system
that provides a quality education to military children, recognizing the
needs of these ever-moving students and responding to situations where
the military parent is deployed and/or in an armed conflict. Addressing
the needs of these children, their classmates, and their parents is
imperative to lowering the overall family stress level and to achieving
an appropriate level of family readiness. But it does not come without
cost to the local school system. Schools serving military children,
whether DOD or civilian schools, need the resources available to meet
military parents' expectation that their children receive the highest
quality education possible.
NMFA is appreciative of the support shown by Congress for the
schools educating military children. You have consistently supported
the needs of the schools operated by the DOD Education Activity
(DODEA), both in terms of basic funding and military construction. The
commitment to the education of military children in DOD schools between
Congress, DOD, military commanders, DODEA leadership and staff, and
especially military parents has resulted in high test scores,
nationally-recognized minority student achievement, parent involvement
programs and partnership activities with the military community. This
partnership has been especially important as the overseas communities
supported by DODDS and many of the installations with DDESS schools
have experienced high deployment rates. DOD schools have responded to
the operations tempo with increased support for families and children
in their communities. NMFA is concerned that 3 years of a weak dollar
has forced the DODDS schools, especially in Europe, to divert funds
from maintenance and other accounts to pay necessary increases in
employee allowances. Given the high level of deployment from European
communities, we ask that Congress work with DOD to ensure DOD schools
have the resources they need to handle their additional tasks.
NMFA is also appreciative of the approximately $30 million Congress
adds in most years to the Defense budget to supplement Impact Aid for
school districts whose enrollments are more than 20 percent military
children and for the additional funding to support civilian school
districts who are charged with educating severely disabled military
children. NMFA does not believe, however, that this amount is
sufficient to help school districts meet the current demands placed on
them. Additional counseling and improvements to security are just two
needs faced by many of these school districts. NMFA asks this
subcommittee to increase the DOD supplement to Impact Aid to $50
million so that the recipient school districts have more resources at
their disposal to educate the children of those who serve.
SPOUSE EMPLOYMENT
Sixty-nine percent of all military spouses and 86 percent of junior
enlisted spouses are in the labor force. For many families this second
income is a critical factor in their financial well being. Concerned
that spouses desiring better careers will encourage servicemembers to
leave the military, DOD has instituted several programs to support
military spouses in their career goals. With 700,000 active duty
spouses, however, the task of enhancing military spouse employment is
too big for DOD to handle alone. Improvements in employment for
military spouses and assistance in supporting their career progression
will require increased partnerships and initiatives by a variety of
government agencies and private employers.
Despite greater awareness of the importance of supporting military
spouse career aspirations, some roadblocks remain. State laws governing
unemployment compensation vary greatly and very few states generally
grant unemployment compensation eligibility to military spouses who
have moved because of a servicemember's government ordered move. NMFA
has been pleased to note that some States are examining their in-state
tuition rules and licensing requirements. These changes ease spouses'
ability to obtain an education or to transfer their occupation as they
move. NMFA is appreciative of the efforts by DOD to work with States to
promote the award of unemployment compensation to military spouses,
eligibility for in-state tuition, and reciprocity for professional
licenses. Its website, usa4militaryfamilies.org, provides details on
these State initiatives.
CHILD CARE
On a recent visit to Europe, President and Mrs. Bush stopped at
Ramstein Air Base, Germany, to thank the troops for their service and
dedication to our Nation. While visiting with families there, Mrs. Bush
was made aware of the lack of child care providers in the community.
This information is not new to NMFA. We have been hearing from our
field Representatives that this is an on-going problem, especially
OCONUS where child care options are limited. As one of our members in
Germany stated: ``Drawing from the pool of military spouses is no
longer working over here. Big shortages. They are asking too much of
the spouses as it is.'' Families in Europe state that funding targeted
to pay raises for child care providers and increased subsidies for in-
home providers could help the Services recruit more child care workers.
A recent online survey conducted by NMFA further outlines the need
for more child care. Of special interest in the survey results was the
frustration from dual military parents. Dealing with deployments, drill
weekends and lack of child care facilities were of great concern.
Families also cited concerns about finding child care after relocating
to a new area. Because the servicemember is often quickly deployed
after relocation, the spouse must deal with the added stress as he/she
looks for employment and childcare in the new location. At a recent
hearing, three of the four Service Senior Enlisted Advisors cited child
care as their number one concern for their servicemembers and families.
The advisors spoke of lost duty time by servicemembers unable to find
child care. DOD officials estimate that the Department needs at least
38,000 more slots. According to the Enlisted Advisors, the need may be
greater. All spoke of waiting lists stretching into the thousands.
DOD is expanding partnerships to meet the demand described by the
NMFA survey respondents and the Senior Enlisted Advisors. The National
Association of Child Care Resource and Referral Agencies (NACCRRA)
initiated a program entitled Operation Child Care to provide donated
short term respite and reunion child care for members of the National
Guard and Reserve returning from Operation Enduring Freedom/Operation
Iraqi Freedom for the 2-week Rest and Recreation leave period. Another
initiative through Military OneSource offers 10 hours of free childcare
to each service member returning on R&R leave. NACCRA is also
partnering with DOD on ``Operation Military Child Care,'' which will
help provide much needed government-subsidized, high quality child care
for mobilized and deployed military parents who cannot access a
military child development center. More funding dedicated to support
families' access to child care and subsidize the costs is still needed.
TRANSFORMATION, GLOBAL RE-BASING, AND BRAC
As the Base Realignment and Closure (BRAC) Commission prepares to
receive DOD's list of installations recommended for realignment and
closure, military beneficiaries are looking to Congress to ensure that
key quality of life benefits and programs remain accessible. Members of
the military community, especially retirees, are concerned about the
impact base closures will have on their access to health care and the
commissary, exchange, and MWR benefits they have earned. They are
concerned that the size of the retiree, Guard, and Reserve populations
remaining in a location will not be considered in decisions about
whether or not to keep commissaries and exchanges open. In the case of
shifts in troop populations because of Service transformation
initiatives, such as Army modularity, or the return of servicemembers
and families from overseas bases, community members at receiving
installations are concerned that existing facilities and programs may
be overwhelmed by the increased populations. NMFA does not have a
position on whether or not downsizing overseas should occur or how or
where troops should be based. Our interest in this discussion is in
raising awareness of the imperative that military family and quality of
life concerns be considered by policy-makers in their decision-making
process and in the implementation of any rebasing or transformation
plans.
Quality of life issues that affect servicemembers and families must
be considered on an equal basis with other mission-related tasks in any
plan to move troops or to close or realign installations. Maintaining
this infrastructure cannot be done as an afterthought. Planning must
include the preservation of quality of life programs, services, and
facilities at closing installations as long as servicemembers and
families remain AND the development of a robust quality of life
infrastructure at the receiving installation that is in place before
the new families and servicemembers arrive. Ensuring the availability
of quality of life programs, services, and facilities at both closing
and receiving installations and easing service members and families'
transition from one to another will take additional funding and
personnel. NMFA looks to Congress to ensure that DOD has programmed in
the costs of family support and quality of life as part of its base
realignment and closure calculations from the beginning and receives
the resources it needs. DOD cannot just program in the cost of a new
runway or tank maintenance facility; it must also program in the cost
of a new child development center or new school, if needed.
STRONG FAMILIES ENSURE A STRONG FORCE
Mr. Chairman, NMFA is grateful to this subcommittee for ensuring
funding is available for the vital quality of life components needed by
today's force. As you consider the quality of life needs of
servicemembers and their families this year, NMFA asks that you
remember that the events of the past 3\1/2\ years have left this family
force drained, yet still committed to their mission. Servicemembers
look to their leaders to provide them with the tools to do the job, to
enhance predictability, and to ensure that their families are cared
for. Further, they look to their leaders to make sure their children
are receiving a quality education and their spouses' career aspirations
can be met. They look for signs from you that help is on the way, that
their pay reflects the tasks they have been asked to do, and that their
hard-earned benefits will continue to be available for themselves,
their families, and their survivors, both now and into retirement.
Senator Stevens. Our next witness is Donetta D'Innocenzo.
STATEMENT OF DONETTA D'INNOCENZO, PUBLIC POLICY
COMMITTEE, THE LEUKEMIA & LYMPHOMA SOCIETY
Ms. D'Innocenzo. D'Innocenzo, Mr. Chairman.
Senator Stevens. Public Policy Committee of the Leukemia &
Lymphoma Society. Thank you very much.
Ms. D'Innocenzo. Mr. Chairman, Senator Inouye: My name is
Donetta D'Innocenzo and I am pleased to appear today to testify
on behalf of the Leukemia & Lymphoma Society. During its 56
year history, the society has been dedicated to finding a cure
for blood-related cancers. That includes leukemia, lymphoma,
and myeloma. The society has the distinction of being both the
largest private organization dedicated to blood cancers and the
Nation's second largest private cancer organization.
We are pleased to report that impressive progress is being
made in the treatment of many blood cancers. Over the last 20
years there have been steady and impressive strides in the
treatment of the most common form of childhood leukemia, and
just 3 years ago a new therapy called Gleevec was approved for
chronic myelogenous leukemia, which is a so-called targeted
therapy that corrects the molecular defect that causes the
disease and does so with few side effects.
The Leukemia & Lymphoma Society is proud to have played a
role in the development of this lifesaving therapy, but our
mission is far from complete. There is much work still to be
done and we believe the research partnership between the public
and private sectors, as represented in the Department of
Defense's congressionally directed medical research program is
an integral part of that effort and should be strengthened.
Hematological, or blood-related, cancers pose a serious
health risk to all Americans. In 2005 more than 115,000
Americans will be diagnosed with a form of blood-related cancer
and almost 56,000 will die. The Leukemia & Lymphoma Society,
along with its partners, the Lymphoma Research Foundation and
the Multiple Myeloma Research Foundation, believe this type of
medical research is particularly important to the Department of
Defense for a number of reasons.
First, research on blood-related cancers has significant
relevance to the armed forces as the incidence of these cancers
is substantially higher among individuals with chemical and
nuclear exposure. Higher incidences of leukemia have long been
substantiated in extreme nuclear incidents in both military and
civilian populations, and recent studies have proven that
individual exposure to chemical agents such as Agent Orange in
the Vietnam war cause an increased risk of contracting lymphoid
malignancies. In addition, bone marrow transplants were first
explored as a means of treating radiation-exposed combatants
and civilians following World War II.
Second, research in blood-related cancers has traditionally
pioneered treatments in other malignancies. This research
frequently represents the leading edge in cancer treatments
that are later applied to other forms of cancer. Chemotherapy
and bone marrow transplants are two striking examples of
treatments first developed in the blood cancers.
From a medical research perspective, it is a particularly
promising time to build a Department of Defense research effort
focused on blood-related cancers. That relevance and
opportunity were recognized over the last 4 years when Congress
appropriated $4.5 million annually, a total of $18 million, to
begin initial research into chronic myelogenous leukemia
through the congressionally directed medical research program.
As members of the subcommittee know, a noteworthy and
admirable distinction of the congressionally directed medical
research program (CDMRP) is its cooperative and collaborative
process that incorporates the experience and expertise of a
broad range of patients, researchers, and physicians in the
field. Since the chronic myelogenous leukemia (CML) program was
announced, members of the society, individual patient
advocates, and leading researchers have enthusiastically
welcomed the opportunity to become a part of this program.
Unfortunately for us, $4.5 million does not go very far in
medical research. Recognizing that fact and the opportunity
this research presents, a bipartisan group of 34 Members of
Congress have requested that the program be modestly increased
to $15 million and be expanded to include all blood cancers,
that is leukemias, lymphomas, and myeloma. This would provide
the research community with the flexibility to build on the
pioneering tradition that has characterized this field.
Department of Defense research on other forms of blood
cancers addresses the importance of preparing for civilian and
military exposure to weapons being developed by several hostile
nations and to aid in the march to more effective treatment for
all who suffer from these diseases.
We respectfully request inclusion of this in the 2006
legislation. Thank you.
[The statement follows:]
Prepared Statement of Donetta D'Innocenzo
INTRODUCTION
I am pleased to appear before the subcommittee today and testify on
behalf of The Leukemia & Lymphoma Society (LLS).
During its 56-year history, the Society has been dedicated to
finding a cure for the blood cancers--leukemia, lymphoma, and myeloma.
The Society has the distinction of being both the largest private
organization dedicated to blood-related cancers and the Nation's second
largest private cancer organization.
Our central contribution to the search for a cure is providing a
significant amount of the funding for basic and translational research
in the blood cancers. In 2005, we will provide approximately $50
million in research grants. In addition to our role funding research,
we provide a wide range of services to individuals with the blood
cancers, their caregivers, families, and friends through our 63
chapters across the country. Finally, we advocate responsible public
policies that will advance our mission of finding a cure for the blood
cancers.
We are pleased to report that impressive progress is being made in
the treatment of many blood cancers. Over the last two decades, there
have been steady and impressive strides in the treatment of the most
common form of childhood leukemia, and the survival rate for that form
of leukemia has improved dramatically.
And just 3 years ago, a new therapy was approved for chronic
myelogenous leukemia, a form of leukemia for which there were
previously limited treatment options, all with serious side-effects.
Let me say that more clearly, if 4 years ago your doctor told you that
you had CML, you would have been informed that there were limited
treatment options and that you should get your affairs in order. Today,
those same patients have access to this new therapy, called Gleevec,
which is a so-called targeted therapy that corrects the molecular
defect that causes the disease, and does so with few side effects.
LLS funded the early research on Gleevec, as it has contributed to
research on a number of new therapies. We are pleased that we played a
role in the development of this life-saving therapy, but we realize
that our mission is far from complete. Many forms of leukemia, lymphoma
and myeloma present daunting treatment challenges. There is much work
still to be done, and we believe the research partnership between the
public and private sectors--as represented in the Department of
Defense's Congressionally Directed Medical Research Program--in an
integral part of that effort and should be strengthened.
THE GRANT PROGRAMS OF THE LEUKEMIA & LYMPHOMA SOCIETY
The grant programs of the Society are in three broad categories:
Career Development Grants, Translational Research Grants for early-
stage support for clinical research, and Specialized Centers of
Research. In our Career Development program, we fund Scholars, Special
Fellows, and Fellows who are pursuing careers in basic or clinical
research. In our Translational Research Program, we focus on supporting
investigators whose objective is to translate basic research
discoveries into new therapies.
The work of Dr. Brian Druker, an oncologist at Oregon Health
Sciences University and the chief investigator on Gleevec, was
supported by a translational research grant from the Society. Dr.
Druker is certainly a star among those supported by LLS, but our
support in this field is broad and deep. Through the Career Development
and Translational Research Programs, we are currently supporting more
than 500 investigators in 38 States and ten foreign countries.
Our new Specialized Centers of Research grant program (SCOR) is
intended to bring together research teams focused on the discovery of
innovative approaches to benefit patients or those at risk of
developing leukemia, lymphoma, or myeloma. The awards will go to those
groups that can demonstrate that their close interaction will create
research synergy and accelerate our search for new therapies,
prevention, or cures.
IMPACT OF HEMATOLOGICAL CANCERS
Despite enhancements in treating blood cancers, there are still
significant research opportunities and challenges. Hematological, or
blood-related, cancers pose a serious health risk to all Americans.
These cancers are actually a large number of diseases of varied causes
and molecular make-up, and with different treatments, that strike men
and women of all ages. In 2005, more than 115,000 Americans will be
diagnosed with a form of blood-related cancer and almost 56,000 will
die from these cancers. For some, treatment may lead to long-term
remission and cure; for others these are chronic diseases that will
require treatments on several occasions; and for others treatment
options are extremely limited. For many, recurring disease will be a
continual threat to a productive and secure life.
A few focused points to put this in perspective:
--Taken together, the hematological cancers are fifth among cancers
in incidence and second in mortality.
--Almost 700,000 Americans are living with a hematological malignancy
in 2005.
--Almost 56,000 people will die from hematological cancers in 2005,
compared to 40,000 from breast cancer, 30,200 from prostate
cancer, and 56,000 from colorectal cancer.
--Blood-related cancers still represent serious treatment challenges.
The improved survival for those diagnosed with all types of
hematological cancers has been uneven. The 5-year survival
rates are: Hodgkin's disease, 83 percent; Non-Hodgkin's
lymphoma, 53 percent; Leukemias (total), 45 percent; Multiple
Myeloma, 29 percent; Acute Myelogenous Leukemia, 14 percent.
--Individuals who have been treated for leukemia, lymphoma, and
myeloma may suffer serious adverse events of treatment,
including second malignancies, organ dysfunction (cardiac,
pulmonary, and endocrine), neuropsychological and psychosocial
aspects, and quality of life.
TRENDS
Since the early 1970's, incidence rates for non-Hodgkin's lymphoma
(NHL) have nearly doubled.
For the period from 1973 to 1998, the death rate for non-Hodgkin's
lymphoma increased by 45 percent, and the death rate for multiple
myeloma increased by more than 32 percent. These increases occurred
during a time period when death rates for most other cancers are
dropping.
Non-Hodgkin's lymphoma and multiple myeloma rank second and fifth,
respectively, in terms of increased cancer mortality since 1973.
Recent statistics indicate both increasing incidence and earlier
age of onset for multiple myeloma.
Multiple myeloma is one of the top ten leading causes of cancer
death among African Americans.
Despite the significant decline in the leukemia death rate for
children in the United States, leukemia is still one of the two most
common diseases that cause death in children in the United States.
Lymphoma is the third most common childhood cancer.
CAUSES OF HEMATOLOGICAL CANCERS
The causes of hematological cancers are varied, and our
understanding of the etiology of leukemia, lymphoma, and myeloma is
limited. Chemicals in pesticides and herbicides, as well as viruses
such as HIV and EBV, play a role in some hematological cancers, but for
most cases, no cause is identified. Researchers have recently published
a study reporting that the viral footprint for simian virus 40 (SV40)
was found in the tumors of 43 percent of NHL patients. These research
findings may open avenues for investigation of the detection,
prevention, and treatment of NHL. There is a pressing need for more
investigation of the role of infectious agents or environmental toxins
in the initiation or progression of these diseases.
IMPORTANCE TO THE DEPARTMENT OF DEFENSE
The Leukemia & Lymphoma Society, along with its partners in the
Lymphoma Research Foundation and the Multiple Myeloma Research
Foundation, believe this type of medical research is particularly
important to the Department of Defense for a number of reasons.
First, research on blood-related cancers has significant relevance
to the armed forces, as the incidence of these cancers is substantially
higher among individuals with chemical and nuclear exposure. Higher
incidences of leukemia have long been substantiated in extreme nuclear
incidents in both military and civilian populations, and recent studies
have proven that individual exposure to chemical agents, such as Agent
Orange in the Vietnam War, cause an increased risk of contracting
lymphoid malignancies. In addition, bone marrow transplants were first
explored as a means of treating radiation-exposed combatants and
civilians following World War II.
Secondly, research in the blood cancers has traditionally pioneered
treatments in other malignancies. This research frequently represents
the leading edge in cancer treatments that are later applied to other
forms of cancer. Chemotherapy and bone marrow transplants are two
striking examples of treatments first developed in the blood cancers.
From a medical research perspective, it is a particularly promising
time to build a DOD research effort focused on blood-related cancers.
That relevance and opportunity were recognized over the last 4 years
when Congress appropriated $4.5 million annually--for a total of $18
million--to begin initial research into chronic myelogenous leukemia
(CML) through the Congressionally Directed Medical Research Program
(CDMRP). As members of the subcommittee know, a noteworthy and
admirable distinction of the CDMRP is its cooperative and collaborative
process that incorporates the experience and expertise of a broad range
of patients, researchers and physicians in the field. Since the CML
program was announced, members of the Society, individual patient
advocates and leading researchers have enthusiastically welcomed the
opportunity to become a part of this program and contribute to the
promise of a successful, collaborative quest for a cure.
Unfortunately, $4.5 million a year does not go very far in medical
research. Recognizing that fact and the opportunity this research
represents, a bipartisan group of 34 Members of Congress have requested
that the program be modestly increased to $15 million and be expanded
to included all the blood cancers--the leukemias, lymphomas and
myeloma. This would provide the research community with the flexibility
to build on the pioneering tradition that has characterized this field.
DOD research on the other forms of blood-related cancer addresses
the importance of preparing for civilian and military exposure to the
weapons being developed by several hostile nations and to aid in the
march to more effective treatment for all who suffer from these
diseases. This request clearly has merit for inclusion in the fiscal
year 2006 legislation.
The Leukemia & Lymphoma Society strongly endorses and
enthusiastically supports this effort and respectfully urges the
committee to include this funding in the fiscal year 2006 Defense
Appropriations bill.
We believe that building on the foundation Congress initiated over
the past 4 years would both significantly strengthen the CDMRP and
accelerate the development of cancer treatments. As history has
demonstrated, expanding its focus into areas that demonstrate great
promise; namely the blood-related cancers of leukemia, lymphoma and
myeloma, would substantially aid the overall cancer research effort and
yield great dividends.
Senator Stevens. We try each year to do our best on this.
These are very serious diseases and you have the great support
of members of this subcommittee. Whether we have the money to
do it is getting to be another matter. But we will do our best.
Thank you very much.
Ms. D'Innocenzo. Thank you, Mr. Chairman.
Senator Stevens. Senator Inouye.
Senator Inouye. No, thank you.
Senator Stevens. Our next witness is Patricia Goldman,
President Emeritus, and Ian Volvner, Ovarian Cancer National
Alliance. Good afternoon.
STATEMENTS OF:
PATRICIA GOLDMAN, PRESIDENT EMERITUS, ON BEHALF OF THE OVARIAN
CANCER NATIONAL ALLIANCE
IAN VOLVNER, ON BEHALF OF THE OVARIAN CANCER NATIONAL ALLIANCE
Ms. Goldman. Thank you, Mr. Chairman and Senator Inouye. I
am here today representing the Ovarian Cancer National Alliance
along with Ian Volvner. We are a patient-led organization and
we are here to give you our personal perspectives on this and
our activities.
I am a very lucky lady. I am a 12 year survivor of ovarian
cancer, and I suppose it is unusual to say you are lucky to
have had a cancer, but in my case, where in ovarian cancer over
half of the people who get this every year do not survive the
5-year mark with this.
One should not have to be lucky to survive ovarian cancer,
and one of the things we are very grateful for for the research
program that I am here to support is the progress we are
beginning to make. Unlike breast, colon, cervical, there is no
detection test that is applied for ovarian cancer. One of the
things you may have seen in recent news accounts--and these
have grown directly out of the research that has come from
that--are the announcements of various biomarkers. We are not
there yet, but it is exciting that the research is beginning to
promise that has come out of this program that there may be a
way if we keep at this to detect ovarian cancer.
As a further example, we formed this organization 8 years
ago. A third of the founding board members, all in their 50s,
have succumbed to the disease. So I think you get a sense of
where we are with this.
Despite, as I mentioned, the terrible toll, we are
beginning to make some progress. I am privileged, in addition,
to serve on, have served on both the scientific review panels
and the peer review panels of this very well managed program,
in which case the patient advocates, the scientists, and the
clinical physician sit together to review the programs. We have
begun to find not only the markers, but some clinical evidence
that can be applied. So we are very grateful for this program,
and we respectfully request that the program be continued as it
has been in the form, both with the request of $50 million for
this.
I will submit the rest of my examples for the record if I
may, and I thank you for that. I will turn to Mr. Volvner to
have Ian give you his perspective on this from his own
experience.
Senator Stevens. Please do.
Mr. Volvner. Mr. Chairman, Senator Inouye: I am here today
because my family----
Senator Stevens. Would you pull the mike up toward you,
please.
Mr. Volvner. I am here today because my family is a two-
time survivor of ovarian cancer. You do not know the terrible
toll that this insidious disease takes on a family, and I
cannot begin to try to explain it to you. What I can tell you
is that the very real gains that Pat Goldman referred to that
have been made as a result of the research performed under the
Defense Department's cancer research program, ovarian cancer
research program, made our second tour of duty, if you will,
considerably easier than the first time my wife incurred this
dreadful disease.
The funding request that the Ovarian Cancer National
Alliance has made is very modest. It is $15 million. The
returns in terms of the relief of burden on the social system,
on the health care program, on our country, are enormous, and
in simple human terms. I really do not know that my wife would
be here but for this program.
So we thank you very much and we ask for your continued
support of this very important but very modest financial
program. Thank you.
[The statements follow:]
Prepared Statement of the Ovarian Cancer Research Program
STATEMENT OF IAN D. VOLNER
Mr. Chairman and members of the committee, my name is Ian Volner,
and I am a lawyer here in Washington, DC. Over the years, I have
testified in my professional capacity before Congress on numerous
occasions on a variety of public issues. This is only the second time I
have testified in my personal capacity. On both occasions, I have
appeared before this subcommittee to thank you for your support of the
Department of Defense (DOD) Ovarian Cancer Research Program (OCRP) and
urge your continued support. I do so because my wife, Martha, our two
sons, and I have ``survived'' ovarian cancer--not once, but twice.
The purpose of my testimony is to assure you that the monies you
invested in the DOD Ovarian Cancer Research Program over the past 9
years have been wisely spent. We ask, therefore, that the funding level
for this vital and very successful program be set at $15 million for
fiscal year 2006.
I first testified in support of the OCRP before the subcommittee in
May of 2000. Two weeks later, Martha was diagnosed, for the second
time, with ovarian cancer. Our first battle with this insidious disease
occurred in 1994. At that time, Martha's cancer was not detected until
a very advanced stage; her chances of living 5 years was less than 1 in
3, and our sons were aged 13 and 10. Despite the odds, Martha survived
due to the skill and dedication of her physicians and, in no small
measure, because of their courage and hers. In 1994, the diagnostic
tools were imprecise, unreliable and costly. The chemotherapy Martha
underwent was designated as experimental, and its efficacy and side
effects were not well understood.
The situation was measurably different when Martha was diagnosed
with ovarian cancer for the second time, in late May of 2000. It was
clear even then that the research being done under the auspices of this
appropriation was bearing fruit. While the diagnostic tools were still
imprecise, the medical professional better understood the strengths and
weaknesses of the available tools. Treatment options had also improved.
Thus, while skill, dedication and courage were still vitally important
to Martha's survival of her second bout with ovarian cancer, it was
clear to our family that the research conducted by the OCRP was
beginning to have effects, both in its own terms and, no less
importantly, in fostering the development of a sustained commitment to
ovarian cancer research.
While the OCRP has been funded at a constant level for the past 3
fiscal years, progress in diagnostics and treatment of ovarian cancer
has been made. For example, research funded by the OCRP has resulted in
the identification of new biomarkers that have the potential to alert
doctors to the presence of ovarian cancer at an early stage. This could
mean that in the future, women will not be exposed to the risks of late
stage diagnosis as my wife was in 1994. Similarly, because of research
funded by the OCRP, new and more effective treatments for this
insidious disease are in development. In the future, women should not
have to undergo the long and exhausting chemotherapy regime that Martha
was subjected to in 1994.
There has been little or no improvement in the survival rate for
women who are diagnosed at a late stage. This disease moves with
daunting speed, and the mortality rates are alarming. Due to the
funding limits for this program, many research projects rated as
outstanding or excellent have not been funded. Even a modest increase
in funding would help to further the progress that has been made.
When the subcommittee views the work that has been accomplished by
the program in our written statements, I am sure it will agree that the
money Congress appropriates for OCRP is being well spent. In some,
perhaps immeasurable but nonetheless clear way, Martha is with us
today--and is able to attend the graduation of each of her sons (now 24
and 21) from college--thanks to this program. The human, economic and
social returns of the modest investment in this program are enormous.
As a proxy for the millions of women who will benefit from that
investment, I urge the committee to appropriate $15 million for the
Ovarian Cancer Research Program for fiscal year 2006.
I want to thank the members of the subcommittee for the opportunity
to testify at this important hearing today. I know it has been a long
day for you. I am ready to answer any questions you may have.
STATEMENT OF PATRICIA GOLDMAN
Senator Stevens, members of the subcommittee on Defense
Appropriations, I am here today representing the Ovarian Cancer
National Alliance (the Alliance), a patient-led organization that works
to increase public and professional understanding of ovarian cancer and
advocates for increased resources to support research on more effective
ovarian cancer diagnostics and treatments. I thank you for the
opportunity to submit comments for the record and to give you my very
personal perspective on the program you are reviewing.
I am a very lucky lady. I am a 12-year survivor of ovarian cancer--
the deadliest of all gynecologic cancers. I am lucky because I am one
of the rare women whose cancer was detected in an early and curable
stage. Currently, more than half of the women diagnosed with ovarian
cancer will die within 5 years of diagnosis. Therefore, I am here
representing thousands of women who could not be here. One shouldn't
have to be ``lucky'' to survive ovarian cancer.
Because of extensive research and generous, sustained Federal
investments, it is possible to diagnose and successfully treat many
forms of cancer like breast, colon and prostate. Unfortunately, that is
not yet the case for ovarian cancer. There is no screening test for
ovarian cancer and few standard treatments. Federal programs for
ovarian cancer continue to receive flat line funding for their already
minimal budgets. In the 8 years since the Alliance was founded, a third
of our founding board members have died and three more are being
treated for a recurrence of their disease.
The discouragement of this death toll is balanced by the hope
engendered by the progress we are making through research to fulfill
the mandate of the program you are reviewing today. Because of the
Federal investment in the DOD Ovarian Cancer Research Program,
researchers are identifying the mechanisms by which ovarian cancer is
initiated in the body and how the disease spreads. The research
community is also tantalizingly close to identifying a reliable and
easily administered screening test, an achievement that could
dramatically impact survival rates.
I have been privileged to serve as a patient advocate on both the
scientific and peer review panels for this program. One of the
program's mandates is to attract new researchers to the field, and it
has been encouraging to see the increase in the numbers of young
research scientists who are dedicating themselves to ovarian cancer
research. Yet, as a reviewer, I have been discouraged to see an
expanding number of worthwhile research proposals that have been
unfounded due to flat funding for the program over the past 3 years.
In the testimony I am submitting for the record, I have recounted
the accomplishments of this excellent program. I believe the program
has followed Congress's directives directly and completely, which makes
a strong case for it to be continued. For that reason the Alliance
respectfully requests the subcommittee to provide $15 million for the
program in fiscal year 2006. Thank you, Senator.
OVARIAN CANCER NATIONAL ALLIANCE STATEMENT FOR THE RECORD
Ovarian Cancer's Deadly Toll
According to the American Cancer Society, in 2005, more than 22,000
American women will be diagnosed with ovarian cancer, and approximately
16,000 will lose their lives to this terrible disease. Ovarian cancer
is the fourth leading cause of cancer death in women. Currently, more
than half of the women diagnosed with ovarian cancer will die within 5
years. Among African American women, only 48 percent survive 5 years or
more. When detected early, the 5-year survival rate increases to more
than 90 percent, but when detected in the late stages, as are most
diagnoses, the 5-year survival rate drops to 28 percent.
Today, it is both striking and disheartening to see that despite
progress made in the scientific, medical and advocacy communities,
ovarian cancer mortality rates have not significantly improved during
the past decade, and a valid and reliable screening test--a critical
tool for improving early diagnosis and survival rates--still does not
yet exist for ovarian cancer. Behind the sobering statistics are the
lost lives of our loved ones, colleagues and community members. While
we have been waiting for the development of an effective early
detection test--thousands of our sisters have lost their battle to
ovarian cancer.
Women should not have to rely on luck for their survival. Research
must continue on this disease through all possible avenues, building a
comprehensive knowledge of its symptoms, causes and treatments. All
women should have access to treatment by a specialist. All women should
have access to a valid and reliable screening test. We must deliver new
and better treatments to patients and the health care professionals who
treat them. The Ovarian Cancer Research Program at DOD has begun to
tackle the multiple gaps in our knowledge of this deadly disease,
providing a growing baseline understanding of ovarian cancer.
The Ovarian Cancer Research Program at the Department of Defense
Over the past 9 years, Congress has appropriated funds to support
the Ovarian Cancer Research Program at DOD, which is modeled after the
successful breast cancer program first included in the DOD budget in
1992. The Ovarian Cancer Research Program supports innovative,
integrated, multidisciplinary research efforts that will lead to better
understanding, detection, diagnosis, prevention, and control of ovarian
cancer. The program shares the Alliance's mission and objective of
reducing and preventing--and eventually--eliminating ovarian cancer.
Awards made by the Ovarian Cancer Research Program are designed to
stimulate research that will attract new investigators into the field,
challenge existing paradigms, and support collaborative ventures,
including partnerships with private and public institutions. Research
awards are determined using a two-tier review process of peer and
programmatic review that ensures scientific merit and attainment of
program goals. The two-tier process is the hallmark of the
Congressional Directed Medical Research Programs (CDMRP) and
increasingly has served as a model for research programs throughout the
world. Another important element in the execution of the Ovarian Cancer
Research Program is the collaboration of advisors from the scientific,
clinical, and consumer communities in the program. These advisors
provide important guidance regarding funding strategies and serve on
both levels of review.
In addition, the Ovarian Cancer Research Program has developed a
funding strategy to complement awards made by other agencies and has
taken steps to ensure that the duplication of long-term basic research
supported by the National Institutes of Health is avoided. Importantly
the program offers several awards that specifically seek to fill gaps
in ongoing research and complement initiatives sponsored by other
agencies.
Like all of the CDMRP Programs at DOD, the Ovarian Cancer Research
Program serves as an international model in administrative efficiency
for research programs. Integrating the latest technology and
communications, the Ovarian Cancer Research Program only has a 5.64
percent management cost. The program has a quick turnaround time of 6
months from the initial proposal review (including two-tier review), to
distribution of funds to investigators--speeding up the process of
study concept to research conclusion.
Scientific Achievements of the Ovarian Cancer Research Program
Since its inception, the Ovarian Cancer Research Program at DOD has
developed a multidisciplinary research portfolio that encompasses
etiology, prevention, early detection/diagnosis, preclinical
therapeutics, quality of life, and behavioral research projects. The
Ovarian Cancer Research Program strengthens the Federal Government's
commitment to ovarian cancer research and supports innovative and novel
projects that propose new ways of examining prevention, early detection
and treatment. The program also attracts new investigators into ovarian
cancer research and encourages proposals that address the needs of
minority, elderly, low-income, rural and other commonly
underrepresented populations.
The program's achievements have been documented in numerous ways,
including 131 publications in professional medical journals and books;
169 abstracts and presentations given at professional meetings; and six
patents, applications and licenses granted to awardees of the program.
The program has also introduced and supported 33 new investigators in
the field of ovarian cancer research.
Investigators funded through the Ovarian Cancer Research Program
have yielded several crucial breakthroughs in the study of prevention
and detection, including:
--Recognition of the role of the progestins, hormonal components
found in oral contraceptives, as a key agent in reducing the
risk of ovarian cancer;
--Identification of several new biomarkers that have the potential to
alert health care providers to the presence of early stage
ovarian cancer, and be used to develop an early detection tool
which would significantly improve early detection and survival;
and
--Discovery of three new agents that inhibit tumor growth and
spreading, as well as new blood vessel formation
(angiogenesis)--a development that will result in new and more
effective treatments.
Increased Investment Needed
In fiscal year 2005, the Ovarian Cancer Research Program received
222 proposals, but due to resource limitations, was only able to fund
17 awards. The program has received $10 million for the past 3 years
and when inflation is taken into account, the allocation of $10 million
actually represents an overall diminished level of funding. With new
funding, the Ovarian Cancer Research Program can support new grants,
provide funding to promising young investigators, and allocate
additional resources to grants that should be extended or renewed.
The Ovarian Cancer Research Program has helped leverage and
maximize both public and private sector funding. Awardees have cited
DOD support as an impetus for the maturation of clinical trials, which
led to an increase of locally funded ovarian cancer grants.
The fiscal year 1998-fiscal year 2003 awards have led to the
recruitment of more than 33 new investigators into the ovarian cancer
research field. Additionally, the Fox Chase Cancer Center in
Philadelphia and the Fred Hutchinson Cancer Research Center in Seattle
reported that the progress made during the first year of their DOD
Program Project Awards enabled both institutions to successfully
compete for National Cancer Institute SPOREs (Specialized Programs of
Research Excellence) Awards to fund additional long-term ovarian cancer
research.
Despite progress made, we still do not fully understand the risks
factors, symptoms and causes of ovarian cancer. No effective screening
tool exists to detect the disease at early stages and the devastating
mortality rates remain the same year after year. The DOD Ovarian Cancer
Research Program is developing science and scientists to help us
achieve the necessary breakthroughs desperately needed in the field of
ovarian cancer. Biomedical research--particularly in such insidious and
complex conditions as ovarian cancer--requires a sustained, long-term
investment and commitment in order to make significant gains. The
investment the Congress and the DOD have made in the Ovarian Cancer
Research Program to date is appreciated and has helped move the field
forward; however, without new resources the program will be unable to
maintain the status quo--let alone continue to reap benefits from
previous and current Federal investments.
Summary and Conclusion
As an umbrella organization with 46 State and local groups, the
Alliance unites the efforts of more than 500,000 grassroots activists,
women's health advocates, and health care professionals to bring
national attention to ovarian cancer. As part of this effort, the
Alliance advocates sustained Federal investment in the Ovarian Cancer
Research Program at DOD. The Alliance respectfully requests the
subcommittee to provide $15 million for the program in fiscal year
2006.
The Alliance maintains a longstanding commitment to work with
Congress, the administration, and other policymakers and stakeholders
to improve the survival rate from ovarian cancer through education,
public policy, research, and communication. Please know that we
appreciate and understand that our Nation faces many challenges, and
Congress has limited resources to allocate; however, we are concerned
that without increased funding to bolster and expand ovarian cancer
research efforts, the Nation will continue to see growing numbers of
women losing their battle with this terrible disease. Thank you for
your consideration of our views and for supporting increased funding
for the DOD Ovarian Cancer Research Program in fiscal year 2006.
On behalf of the entire ovarian cancer community--patients, family
members, clinicians and researchers--we thank you for your leadership
and support of Federal programs that seek to reduce and prevent
suffering from ovarian cancer.
Material in this testimony was partly taken from the
Congressionally Directed Medical Research Program's Ovarian Cancer
program Web site at http://cdmrp.army.mil.
Senator Stevens. Thank you very much. We appreciate your
testimony.
Senator Inouye.
Senator Inouye. Most people do not realize this, but a very
significant number of Members of the Senate or members of their
immediate family have been afflicted by this terrible, terrible
disease one way or the other.
Ms. Goldman. I am aware. I did not specify this in
particular, but we all know in fact one of the Senators' wife
is experiencing a recurrence again of her disease, which I am
sure is what you are referring to.
Senator Stevens. Despite differences, it is a very close
family. We all know that.
Ms. Goldman. Indeed.
Senator Stevens. Thank you very much.
Ms. Goldman. Thank you.
Senator Stevens. The next witness is Brigadier General
Stephen Koper, President of the National Guard Association. It
is nice to have you back, General.
STATEMENT OF BRIGADIER GENERAL STEPHEN KOPER, U.S. AIR
FORCE (RETIRED), PRESIDENT, NATIONAL GUARD
ASSOCIATION OF THE UNITED STATES
General Koper. I thank you, Mr. Chairman. Chairman Stevens,
members of the subcommittee, thank you for this opportunity to
testify today. You have always been champions of the citizen-
soldier and citizen-airman and the National Guard Association
(NGAUS) thanks you for your many years of outstanding support.
This subcommittee is well versed in the contributions being
made by the members of the National Guard in Operation Iraq,
Afghanistan, and the global war on terror.
As the Secretary of Defense has said repeatedly, the war on
terror could not be fought without the National Guard. Battles
would not be won, peace would not be kept, and sorties would
not be flown without the citizen-soldier and citizen-airmen. We
are asking on their behalf for the resources necessary to allow
them to continue to serve the Nation.
At the top of that list of resources is access to health
care. The National Guard Association believes every member of
the National Guard should have the ability to access TRICARE
coverage on a cost-share basis regardless of duty status. While
we are encouraged by the establishment of TRICARE Reserve
Select, which is a program where members earn medical coverage
through deployments, we do not believe it goes far enough.
Health care coverage for our members is a readiness issue.
If the Department of Defense expects Guard members to maintain
medical readiness, then it follows that they should also have
access to health care. As you know, when a National Guardsman
is called to full-time duty he or she is expected to report
ready for duty. Yet studies show that a significant percentage
of our members do not have access to health care. Making
TRICARE available to all members of the National Guard on a
cost-share basis would provide a solution to this problem and
it would finally end the turbulence visited on soldiers and
their families who are forced to transition from one health
care coverage to another each time they answer the Nation's
call.
In addition to addressing readiness concerns, access to
TRICARE will also be a strong recruitment and retention
incentive. In an increasingly challenging recruitment and
retention environment, TRICARE could make a significant
difference. Part-time civilian Federal employees are eligible
to participate in Federal health insurance programs. NGAUS
believes that National Guard members should receive at a
minimum the opportunity afforded to other Federal part-time
employees.
Another issue of serious concern is full-time manning for
the Army National Guard. For many years the Army National Guard
full-time manning has been funded at approximately 58 percent
of the validated requirements. All other Reserve components are
manned at significantly higher levels. Recognizing this
disparity, Congress, the Army, and the Army National Guard
agreed to increase the Army Guard's full-time manning to a
level of 71 percent by 2012. This increase was to be obtained
through gradual increases in Active Guard and Reserve (AGR) and
technician end strength. However, the wars in Iraq and
Afghanistan have further exacerbated the problem as it is the
full-time staff that bears the bulk of the increased workload
associated with mobilization.
Consequently, we believe acceleration in the ramp is
warranted. NGAUS believes there is a requirement to reach the
71 percent full-time level by 2010 versus the current target of
2012. This would require an increase in fiscal year 2006 of $12
million for an additional 292 AGRs and $6.2 million for 195
military technicians. Obviously, our ultimate goal is to reach
100 percent of validated requirements, and sooner rather than
later.
NGAUS is also very concerned about equipment for the Army
National Guard. When Army National Guard gets deployed to Iraq
they deploy with their equipment. In most cases this equipment
remains in theater when the unit returns home. The end result
is that units cannot adequately train for the next rotation and
they may not be equipped to meet an emergency at home, whether
it is a natural disaster or terrorist act.
High on the priority list of Army Guard equipment
shortfalls is the Humvee. The Army National Guard is critically
short more than 13,000 of the nearly 42,000 vehicles required.
In Alaska the Army Guard has only 62 of the 151 vehicles
required, leaving the State 41 percent short of requirements.
The current President's budget request does not fully
address the National Guard shortfall. Also, we understand there
is money for Humvees in the supplemental, but it is not clear
how much of the funds will go to provide equipment for the Army
National Guard. NGAUS urges Congress to continue to support
funding for Humvees and to ensure that the Army takes the needs
of the Guard into consideration while procuring these vehicles.
NGAUS also encourages the subcommittee to continue to support
the procurement of up-armored Humvees for the Guard. While the
Army has made a valiant commitment to procure armored Humvees
for use in theater, we also recognize the need for up-armored
vehicles for the homeland defense mission. Congress needs to
provide additional earmarked funds to guarantee continued
armored vehicle production.
Army Guard aviation is also a top priority. The extremely
high operational tempos of our Operation Enduring Freedom and
Iraqi Freedom have increased the demand for aviation assets.
For Guard units, aviation assets are also critical for many
State missions. HH-60 medevac units continue to have the
highest operational tempo of any fixed wing or rotary aircraft
in theater today and NGAUS requests the committee favorably
consider funding the UH-60s and medevac aircraft.
Mr. Chairman, I submitted testimony earlier and I have
revised my closing remarks and I would like to skip to that now
if I may. In closing, I will address a serious concern we have
regarding the Air Force Future Total Force, FTF, concept. With
the release of DOD's BRAC list on May 13, our worst fears for
the future of the Air National Guard have been confirmed. The
Future Total Force was developed over the course of the last 2
years, cloaked in secrecy, and it did not include the adjutants
general from its inception.
When reports of the direction and scope of the Air Force
plan began to surface in the Guard community, the adjutants
general individually and collectively expressed their concerns.
Those concerns were dismissed. The adjutants general were
finally admitted collectively to the process in October 2004.
Concurrently, the 2005 BRAC process provided an
opportunity, again secure from scrutiny and debate, for the Air
Force to carry out a reduction of fighter, transport, and
tanker force structure in the Air National Guard without
benefit of a detailed follow-on mission plan. It even spawned a
new category of BRAC action for the Air National Guard called
``enclaved.'' In layman's terms, that means the unit aircraft
have been removed but the personnel will either stay, commute
to a new base, or leave the force.
Now the challenge of airing out the full impact of FTF has
been dumped on the doorstep of the Congress and the BRAC
Commission. Our concerns include the question as to whether the
2005 BRAC will meet the requirements of the 2005 quadrennial
defense review (QDR), or will the QDR merely be written to
support the BRAC? Why not offer the continued upgrade of F-15
and F-16 aircraft and their systems that will have relevance
well into the 2020s as an informed alternative to increased
buys of new weapons platforms?
The enclaved units will threaten our ability to maintain a
skilled and stable workforce. While the active Air Force can
routinely move its personnel assets to follow its weapons
systems, we see the potential for severe personnel losses
because of their traditional ties to a community. It is the
cornerstone of the militia.
Our members fully understand the need to modernize the Air
Force, but we want to make sure that it is done in a prudent
manner that will best protect the interests of the Nation. We
will continue to urge the Congress and the BRAC Commission to
closely scrutinize these initiatives to ensure that decisions
regarding Air National Guard force structure are based on sound
strategic principles.
Mr. Chairman, members of the subcommittee, I sincerely
thank you for your time today and I am happy to answer any
questions.
Senator Stevens. Thank you very much.
[The statement follows:]
Prepared Statement of Brigadier General (Ret.) Stephen M. Koper
Chairman Stevens, members of the committee, thank you for this
opportunity to testify today. You have always been champions of the
citizen soldier and citizen airman and the National Guard Association
thanks you for your many years of outstanding support.
This committee is well versed in the contributions being made by
members of the National Guard in operations in Iraq, Afghanistan and
the Global War on Terror. As the Secretary of Defense has said
repeatedly, ``The War on Terror could not be fought without the
National Guard''. Battles would not be won, peace would not be kept and
sorties would not be flown without the citizen soldier and citizen
airman. We are asking on their behalf for the resources necessary to
allow them to continue to serve the Nation.
At the top of that list of resources is access to health care. The
National Guard Association believes every member of the National Guard
should have the ability to access TRICARE coverage, on a cost-share
basis, regardless of duty status.
While we are encouraged by the establishment of TRICARE Reserve
Select, which is a program where members ``earn'' medical coverage
through deployments, we don't believe it goes far enough. Healthcare
coverage for our members is a readiness issue. If the Department of
Defense expects Guard members to maintain medical readiness, then it
follows that they should also have access to healthcare. As you know,
when a National Guardsman is called to full time duty, he or she is
expected to report ``ready for duty''. Yet, studies show that a
significant percentage of our members do not have access to healthcare.
Making TRICARE available to all members of the National Guard, on a
cost-share basis, would provide a solution to this problem. And, it
would finally end the turbulence visited on soldiers and their families
who are forced to transition from one healthcare coverage to another
each time they answer the Nation's call.
In addition to addressing readiness concerns, access to TRICARE
would also be a strong recruitment and retention incentive. In an
increasingly challenging recruiting/retention environment, TRICARE
could make a significant difference. Part-time civilian Federal
employees are eligible to participate in Federal health insurance
programs. NGAUS believes that National Guard members should receive, at
a minimum, the opportunity afforded other Federal part-time employees.
Currently in the Senate, Senator Lindsey Graham and Senator Hillary
Clinton, have co-sponsored a bill which would provide TRICARE, on a
cost-share basis, to every member of the National Guard. NGAUS fully
supports this bill, and asks the members of the committee to do the
same by including the cost for this program in the Appropriations mark-
up.
Another issue of serious concern is full time manning for the Army
National Guard. For many years the Army National Guard full time
manning has been funded at approximately 58 percent of the validated
requirements. All other reserve components are manned at significantly
higher levels.
Recognizing this disparity, the Congress, the Army and the Army
National Guard agreed to increase the Army Guard's full time manning to
a level of 71 percent by 2012. This increase was to be attained through
gradual increases in AGR and technician end strength.
However, the wars in Iraq and Afghanistan have further exacerbated
the problem since it is the full time staff that bears the brunt of the
increased work load associated with mobilization. Consequently, we
believe acceleration in the ramp is warranted.
The National Guard Association of the United States believes there
is a requirement to reach the 71 percent full-time manning level by
2010 versus the current target of 2012. This would require an increase
in fiscal year 2006 of $12 million for an additional 292 AGRs and $6.2
million for 195 military technicians. Obviously, our ultimate goal is
to reach 100 percent of validated requirements and sooner, rather than
later.
NGAUS is also very concerned about equipment for the Army National
Guard. When Army National Guard units deploy to Iraq, they deploy with
their equipment. In most cases, this equipment remains in theater when
the unit returns home. The end result that units cannot adequately
train for the next rotation, and they may not be equipped to meet an
emergency at home, whether it is a natural disaster or terrorist
attack.
High on the priority list of Army Guard equipment shortfalls is the
HMMWV. The ARNG is critically short 13,581 of the nearly 42,000
vehicles required. In Alaska, the Army Guard has only 62 of the 151
vehicles required, leaving the State 41 percent short of its
requirements. The current President's Budget request does not fully
address the National Guard's shortfall. Also, we understand there is
money for HMMWVs in the supplemental but it is not clear how much of
the funds will go to provide equipment for the Army National Guard. The
National Guard Association of the United States urges the Congress to
continue to support funding for HMMWVs and to insure that the Army
takes the needs of the Guard into consideration when procuring these
vehicles.
NGAUS also encourages the committee to continue to support the
procurement of Up-Armored HMMWVs for the Guard. While the Army has made
a valiant commitment to procure Up-Armored HMMWVs for use in theater,
we also recognize a need for Up-Armored vehicles fort the Homeland
Defense mission. Congress needs to provide additional earmarked funds
to guarantee continued armored vehicle production until all deployed
combat units have properly armored vehicles and Army National Guard Up-
Armored HMMWV requirements inside the United States are backfilled.
Army Guard aviation is also a top priority. The extremely high
operational tempos of Operation Enduring Freedom and Operation Iraqi
Freedom have increased the demand for aviation assets while the
environment and enemy conditions have reduced the number of aircraft.
For Guard units, aviation assets are also critical for many State
missions. HH-60 MEDEVAC units continue to have the highest operational
tempo of any fixed wing or rotary aircraft in theater today.
NGAUS requests that the committee favorably consider funding for
UH-60s and MEDEVAC aircraft.
On the Air Guard side, our equipment needs are also directly tied
to operations in Iraq and Afghanistan. As you know, the C-130 is the
workhorse of the Air Force, and a large segment of that force resides
in the Air National Guard. These aircraft are vulnerable to enemy
attack when flying in hostile areas. One of the primary threats is the
proliferation of shoulder fired infrared missiles.
LAIRCM, Large Aircraft Infrared Countermeasures, would provide
added protection from infrared missiles to C-130 crews flying in
hostile areas. We are requesting $34.5 million for LAIRCM for the ANG
C-130 fleet.
Thanks to the Congress, one of the greatest Air Guard success
stories is the procurement of targeting pods for fighter aircraft.
Money added by the Congress over the past several years has enabled the
Air Guard to be on the front line of air operations in Iraq. To
continue this successful program, we are requesting an appropriation
for an additional 15 pods in fiscal year 2006.
This committee has always been particularly sensitive to the
equipment needs of the National Guard and generous in funding the
National Guard and Reserve Equipment Account. Mr. Chairman, each and
every dollar that has been appropriated over the years in the account
has purchased combat capability. This account is absolutely essential
to both the Army and Air National Guard and we thank you for your
continued support of NGREA.
Chairman Stevens, I've highlighted some of the top procurement
items which are urgently needed by the Army Guard and the Air Guard,
but unfortunately, that is not an exhaustive list. Your professional
staff has graciously agreed to meet with us and we will discuss
additional Guard equipment requirements with them.
In closing, I will address a serious concern we have regarding the
Air Force's Future Total Force concept. We urge the Congress to closely
scrutinize this initiative to ensure that decisions regarding Air
National Guard force structure are based on sound strategic principles.
Over the past several years, the Congress has wisely invested money
in upgrading the Air Guard's F-16 fleet to keep it relevant well into
the 2020's. Faced with a growing deficit and a turbulent world, it
seems imprudent to send capable aircraft to the bone yard. Yet, this is
what we fear the Air Force is planning to do when in fact we believe
they should be fully utilizing all the resources which the tax payers
have already funded.
The Air National Guard has been at the forefront of providing the
air defense of the Nation, as well as playing a major role in the Air
Expeditionary Force. Yet, the Air Force has not fully addressed how it
will meet these mission requirements with a significantly reduced Air
Guard fighter force.
NGAUS believes the Air Force should provide details to the Congress
on how it intends to meet critical national defense requirements at the
same time it plans to drawdown significant amounts of Air Guard fighter
force structure.
Our members fully understand the need to modernize the Air Force,
but we want to make sure that it is done in a prudent manner that will
best protect the interests of national defense. We hope that Congress
will continue to ask the Air Force for more details as the plan
unfolds.
Mr. Chairman, members of the committee, I sincerely thank you for
your time today and am happy to answer any questions.
Senator Stevens. Senator Bond has come in, General, and I
want to recognize Senator Bond. He came particularly on notice
that we gave him you would be here.
Senator Bond. Thank you very much, Mr. Chairman, Senator
Inouye. I had an Intelligence hearing, but this was so
important, and I very much appreciate your having Brigadier
General Koper, President of the National Guard Association,
speaking out about his concerns relating to the BRAC report.
As you know from previous sessions we have had with the
Secretary of Defense and the chief, Joint Chiefs of Staff, the
Chairman of the Joint Chiefs of Staff, I had concerns prior to
the release and now I think what General Koper has just cited
is something that should be read by every Member of the United
States Congress. When he said the Future Total Force was
developed over the course of the last 2 years cloaked in
secrecy and did not include the adjutants general from its
inception, well, I think that is accurate. It appears that the
Pentagon had its mind made up, and there are very, very
significant implications for maintaining the civilian force,
the civilian fighters that we have so often relied on and now
rely on for 50 percent of the force in Iraq.
As I said, I raised these concerns 2 months ago.
Unfortunately, those concerns and the concerns expressed by the
Guard leaders were ignored. The result is a BRAC list that is
absolutely stunning. It will eliminate over one-third of the
Air Guard's aviation assets. In the tactical air forces
(TACAIR) alone there would be 12 F-16 wings and 3 F-15 wings
gone, poof. It would adversely impact, as the General said,
community basing concept the Guard relies so heavily upon in
recruiting and retention. In an area that I do not know that we
have adequately touched on, it would adversely compromise our
Nation's ability to defend the skies over our homeland, because
it ignores the very significant role that the Air National
Guard provides in the homeland defense mission, specifically
the conduct of Operation Noble Eagle.
Finally, I think it shortsightedly undermines the Air
Guard's proven, effective, and invaluable expeditionary role.
If we continue to shortchange the Guard, if we treat them as an
unwanted stepchild, particularly in this Future Total Force of
our air assets--and I made a freudian slip last hearing when I
called it a ``feudal total force.'' I did not mean to do that,
but unfortunately my words have appeared to come true.
I have asked the chairman of the BRAC Commission to hold a
hearing in St. Louis, where I hope to discuss the shortfalls of
the Pentagon's BRAC plan and try to work with my colleagues who
also share my concern about and commitment to the National
Guard, the Pentagon's plan irreparably harming the Air National
Guard.
Mr. Chairman, I would just pose one question to the General
if it is appropriate now.
Senator Stevens. Yes, sir.
Senator Bond. In your view, General, were Guard leaders
allowed a substantive role in the planning of the Future Total
Force strategy, and if not what is the impact on the Guard of
the BRAC process? What are your conclusions from these actions
and the results?
General Koper. Mr. Chairman, Senator Bond, as I said in my
closing remarks, it is the view of the adjutants general that
collectively they were not included in the development of the
Future Total Force from its inception. They were fed bits and
pieces, and not until October 2004 did they manage to get some
regular representation in the general officer steering
committee on Future Total Force.
With respect to BRAC, the BRAC, as I also earlier
indicated, is by its very nature a process which deals in
confidentiality. The adjutants general were not a player in the
gathering of facts with respect to units of the Army and Air
National Guard.
I would say this to you, however. The Army National Guard,
as all of you are well aware, is loaded down with terribly
outdated facilities in armories across the country. The Army
National Guard and the Army full well recognize that the
military construction process is never going to be able to
solve that issue. The Army and the Army National Guard have
come up with a rather creative plan to utilize the BRAC process
to close and consolidate a large number of those kinds of
installations. It probably makes good sense.
So with respect to the Army National Guard, I believe there
was at least some long-term general conversations between State
adjutants general about Army National Guard facilities, not an
official part of the BRAC process because they don't have an
active role in that.
On the Air National Guard side, the adjutants general that
I have spoken to since the release of the list on Friday are
finding out things that of course they did not know. So we have
only had since Friday to determine the full impact of that, but
we will be continuing to do that.
Senator Stevens. Thank you very much.
Senator Inouye.
Senator Inouye. I am glad to learn that they consulted with
the Army National Guard.
General Koper. You bet. And I would add, sir, that as a
former blue suiter I am a little embarrassed. We have had a
reputation for a great relationship and we are at a total loss
to determine why this has come about.
Senator Stevens. Yes, General, and we are at a loss to
understand how this relates to the Total Force Concept, this
movement of forces to the South and to the East, particularly
with the almost denuding of the forces that face the Pacific.
Very difficult for us to understand. We intend to go into it
pretty deeply here soon. We have some other problems ahead of
us right now, but as soon as we can start scheduling some
hearings we are going to schedule some hearings on this process
and listen to some people.
I am not sure there is much we can do about it, now the
BRAC process has started, except to try to enlighten the BRAC
people themselves. I think we should do that.
So we thank you for your contribution.
General Koper. Thank you, Mr. Chairman.
Senator Stevens. Our next witness is Mary Ann----
Ms. Guerra. Guerra.
Senator Stevens. Guerra, thank you. Vice President,
Research Operations, for Translational----
Ms. Guerra. Genomics Research Institute, TGen. We call it
``TGen'' for short.
Senator Stevens. My eyes hurt today. Maybe you can tell me
a little bit of research about that.
STATEMENT OF MARY ANN GUERRA, SENIOR VICE PRESIDENT FOR
RESEARCH OPERATIONS, TRANSLATIONAL GENOMICS
RESEARCH INSTITUTE, ON BEHALF OF THE
NATIONAL PROSTATE CANCER COALITION
Ms. Guerra. Good afternoon, Mr. Chairman, Senator Inouye.
It is a pleasure to be here this afternoon. Thank you for your
time.
I enthusiastically offer testimony on behalf of the
National Prostate Cancer Coalition. From 1994 to 2001 I served
as the Deputy Director for Management of the National Cancer
Institute (NCI), where I watched this prostate cancer program
grow, launch, and flourish. I also recently served on the
congressionally sponsored Institute of Medicine panel that was
asked to evaluate alternative funding strategies that could
leverage DOD research programs.
My organization, TGen, is a leading private sector
biomedical research institute focused on identifying genes that
can quickly be translated into diagnostics and therapeutics to
serve the American public to improve health. Thus, these
combined career experiences have made me a congressionally
directed medical research program (CDMRP) convert and a strong
supporter of the prostate cancer research program (PCRP),
because they fill a research niche that is not served by other
programs, including the NCI.
These programs achieve two important objectives. First,
they provide innovative programs that support early stage high
risk and novel research. They also fund programs that
specifically support the translation of discoveries into
products that improve lives. The translational component is an
essential and sometimes missing ingredient in the discovery to
bedside process. You might find it astonishing that while the
rate of R&D spending at the NIH and in pharma has gone up since
1993, the number of new drug applications has gone down. In
simple words, discoveries are not being translated into drugs
that serve the people of the United States.
These principles of translation and acceleration govern the
venture research sponsored by the PCRP in its relentless effort
to change the course of prostate cancer, the most commonly
diagnosed non-skin cancer and the second leading cause of
cancer death in men. The facts are in 2005, 232,000 men will be
diagnosed with prostate cancer. They will join the 2 million
men already diagnosed. Over 30,000 of these men will die of
cancer this year.
African-Americans will be harder hit, with occurrence rates
nearly 65 percent greater and death rates 2.5 times greater
than Caucasian men.
The Veterans Administration estimates that there are
roughly 24.7 million male veterans living in the United States.
The impact of percent on them? 4.1 million veterans will be
diagnosed with prostate cancer in their lifetime. Nearly 5,000
patients in the VA system will be diagnosed with prostate
cancer this year.
A recent scientific study has also shown that cancer rates
are increased among service men who were in Southeast Asia and
that men whose assignments averaged more than the normal, the
average tour of duty, are at a greater risk of prostate cancer.
But let me bring this even closer to home. The Department
of Defense estimated that the direct costs of prostate cancer
on the military were expected to exceed $42 million in 2004 and
nearly 85 percent of the 1.4 million individuals serving in
America's military are men. The impact? 200,000 service men
will be diagnosed with prostate cancer. The DOD, America's
largest company, must be prepared to protect its employees from
the killer that will affect 14 percent of their workforce.
Thanks to your vision and leadership, the CDMRP has become
the gold standard for conducting and administering cancer
research. To effectively fight this war on prostate cancer and
to leverage your already earlier investments, the committee
must appropriate $100 million for the PCRP. Without such an
investment, the translation pipeline remains closed and this
investment in the valuable research already funded will not be
translated into discoveries that are used in the lab--in the
clinic.
Two years ago this subcommittee requested that the DOD, in
consultation with the Institute of Medicine, evaluate
opportunities for public and private sector funding
collaborations to reduce the burden of Federal appropriations
for the CDMRP. Those of us who served on that committee found
that there are no new funding sources because these programs
fund research that is not funded by the private sector. Our
panel found that we have--this program has been efficiently and
effectively managed, with only a 6 percent overhead rate. They
have created novel funding mechanisms for that early and
translational research that is not being done in other
institutions. They have been scientifically productive and they
play an important role in the national health research
enterprise.
The Prostate Cancer Research Foundation conference is a
great example of a private-public partnership. This panel
brings together all Government people that are working on
cancer research along with their private counterparts. This
parent consumer research group looks for innovation in
translation rather than funding small incremental science that
is sometimes funded in other agencies. As co-conveners of this
conference, the PCRP helps establish priorities.
For this conference to be successful, Federal agencies
engaged in cancer research should be required to participate in
this conference, and we are asking that you lend your
leadership to make this participation required. We need more
leveraging of the existing resources and a broader and more
active engagement of our Federal agencies to accomplish this
important objective. No one institution, scientific discipline,
or business sector is solely equipped to fully translate
discoveries into products. Government, academia, and industry
must be brought together to solve these complex problems that
are affecting our Nation and our families. Moreover, Congress
must encourage them to cooperate together.
Mr. Chairman, Senator Inouye, we have done remarkable work
and are making progress. I urge you to continue to support an
enhanced growth of PCRP, a program that is efficient, is driven
by scientific priorities, and is scientifically productive.
The war on prostate cancer must be funded appropriately so
researchers can get new drugs to patients who need them most.
For this to happen, the PCRP needs $100 million in fiscal year
2006 and I respectfully request that you appropriate this need.
Thank you for the time and I would be glad to answer any
questions.
Senator Stevens. Thank you very much.
Senator Inouye. Thank you.
[The statement follows:]
Prepared Statement of Mary Ann Guerra
Mr. Chairman and members of the Senate Defense Appropriations
Subcommittee, good morning. My name is Mary Ann Guerra, and I am Senior
Vice President for Operations at the Translational Genomics Research
Institute (TGen) in Phoenix, Arizona, a not-for-profit research
enterprise. From 1994 until 2001, I served as Deputy Director for
Management at the National Cancer Institute, and I am thoroughly
familiar with the prostate cancer research effort and portfolio at the
NCI. During my time at NCI, I watched the Department of Defense
Congressionally Directed Medical Research Program (CDMRP) in prostate
cancer grow and flourish since its inception at Fort Detrick in 1997. I
also served on the Institute of Medicine (IOM) panel that Congress
asked to evaluate leveraging strategies for funding of DOD peer
reviewed medical research programs in order to reduce the burden on
Federal appropriations. While our IOM panel did not include a formal
evaluation of the CDMRP programs, I can tell you that I was very
impressed by their scope and breadth--doing what parallel research
efforts the NCI cannot do, and serving as a crucial part of this
Nation's biomedical research effort to beat serious, often life
threatening diseases. I must say, my past experience at NCI and NIH, my
recent experience in the private sector, and the knowledge gained
through participating in the IOM review, made me a convert and strong
supporter of the CDMRP. Consequently, I am particularly pleased to
offer testimony on behalf of the National Prostate Cancer Coalition,
supporting an appropriation of $100 million for the CDMRP Prostate
Cancer Research Program (PCRP) for fiscal year 2006.
My organization, TGen, is among the world's leading private sector
biomedical research institutes. It strives to make and quickly
translate genomic discoveries into diagnostic and therapeutics that
improve the health of all Americans. Our prostate cancer research
program, headed by Dr. John Carpten, uses cutting edge technology to
search for genes predisposing to prostate cancer, particularly among
special populations including African American men, the population
hardest hit by this devastating disease. Using information generated
from mapping the human genome, coupled with our technology, TGen can
now conduct large family and population based studies not possible
before. With the patient who suffers from disease as our focus, TGen is
guided by three core principles: integration, translation and
acceleration. We integrate the best and brightest scientists across
disciplines to attack disease; we hasten the translation of research
discoveries into meaningful therapies; and, through our academic,
health and industry partnerships, we accelerate our research goals on
behalf of those who need them most.
The same kinds of principles govern venture research sponsored by
the PCRP in its effort to change the course of prostate cancer, the
nation's most commonly diagnosed nonskin cancer and the second leading
cause of cancer death among men. In 2005, the American Cancer Society
has estimated that more than 232,000 men will hear physicians tell
them, ``You have prostate cancer,'' as they join the nearly 2 million
Americans who already have the disease. Sadly, over 30,000 men will
lose their lives to prostate cancer this year. Although the wider use
of early detection along with changes in early treatment likely account
for the near 100 percent survival of men with localized disease, too
many men are still diagnosed with advanced disease, particularly at
younger ages (in their 40's and 50's), too many men suffer advanced
recurrences after an earlier successful treatment, and too many
ultimately face no cure.
However hard prostate cancer may hit among white families, it is
regularly a tragedy in African American communities. Prostate cancer
occurrences rates are nearly 65 percent higher among black Americans
and death rates are nearly 2\1/2\ times greater than those of Caucasian
men. Research dollars directed at special populations is not a high
priority as evidenced by the overall funding expended on such studies.
The Department of Veterans Affairs (VA) estimates that there are
roughly 24.7 million male veterans living in the United States. That
means at least 4.1 million veterans will be diagnosed with prostate
cancer at some point during their lifetimes. The Veterans Health
Administration currently estimates that nearly 5,000 patients in its
system are diagnosed with prostate cancer each year. While evidence is
not conclusive, it appears that America's servicemen, who stood in
harm's way for their country in the Asian theater and were directly
exposed to Agent Orange, may be at double the risk for prostate cancer.
Moreover, a recent scientific study has shown that cancer rates are
increased among men who were in uniform in Southeast Asia, even if they
were not directly involved in spraying herbicides, and that men who had
longer than average tours of duty in the Asian theater may be at
particular risk of prostate cancer. With our brave men in uniform in
mind, I am asking you today to take care of all of them, past, present
and future.
The Department of Defense estimated the direct health care costs of
prostate cancer on the military were expected to be over $42 million in
fiscal year 2004. Nearly 85 percent of the current 1,465,000
individuals serving in America's military are men. That means about
200,000 servicemen will be diagnosed with prostate cancer--without the
additional consideration of service related environmental factors, like
Agent Orange exposure, that may increase occurrences of the disease.
The DOD refers to itself as America's largest company; it must
therefore be prepared to protect its employees from a killer that will
affect 14 percent of its workforce.
Whether in battle or peacetime, the lives of men from coast to
coast depend on your decisions. You have the unique opportunity to
provide a brighter future for millions of men and families through
continued and expanded prostate cancer research. With proper funding we
can find a way to end the pain and suffering caused by this disease.
To effectively fight the war on prostate cancer for America's
families, your committee must appropriate $100 million for the PCRP. As
stated in its fiscal year 1997 business plan, PCRP needs at least $100
million to conduct human clinical trials research. Without that
appropriation, the program is unable to test new treatments and get
those new products to patients that could retard the course of their
disease and improve the quality of their lives. Without such an
investment, the translational pipeline remains closed, meaning that
valuable prostate cancer research remains stuck in laboratories instead
of at work in clinics.
Thanks to your vision and leadership, CDMRP has become the gold
standard for administering cancer research. Prostate cancer advocates
and scientists throughout this Nation have long applauded the program
and its peer and consumer driven approach to research. PCRP is a unique
program within the government's prostate cancer research portfolio
because it makes use of public/private partnerships, awards competitive
grants for new ideas, does not duplicate the work of other funders,
integrates scientists and survivors and uses a unique perspective to
solve problems. Its mission and its results are clear. The program
fills a niche that other Federal research programs do not. It funds
research with the end in mind; funding science that advances solutions
that will change the lives of the people who are diagnosed with this
disease. Each year, the program issues an annual report detailing what
it has done with taxpayer dollars to battle prostate cancer. PCRP's
transparency allows people affected by prostate cancer and people in
the consumer research community to clearly see what our government is
doing to fight the disease.
Two years ago, this committee requested that DOD, in consultation
with the Institute of Medicine, evaluate opportunities for public and
private sector funding collaborations to reduce the burden of Federal
appropriations for CDMRP--and maintain or improve efficiencies,
throughput and outcomes for its research programs. Those of us who
served on the IOM task force determined that, on the whole, there are
no new funding sources for CDMRP that would enhance its overall
research effort, because the redirection of dollars would reduce the
work those dollars provide in some other part of the research universe.
While it was not part of our charge, we also had an opportunity to
appreciate the special contribution that the CDMRP makes to the
research landscape.
Our panel noted that despite initial respect for the primacy of
NCI, skepticism about CDMRP in the scientific community, its location
in DOD and the participation of consumers in peer review and priority
setting, the program has been efficiently and effectively managed,
scientifically productive and a valuable component of the Nation's
health research enterprise. CDMRP's distinctive program features
include its rigorous peer review of proposals for scientific merit and
program relevance by outside reviewers--including consumers; its
inclusive priority setting process; its emphasis on exploratory high-
risk/high-gain basic, translational, and clinical research projects and
on research capacity building; and its holding of periodic national
meetings to share results among the investigators and with the
program's constituencies. It can also do what NCI cannot, speedily
evaluate proposed projects and rapidly change focus as research
discoveries offer new opportunities to America's scientific community.
CDMRP is a terrific reflection of a well-proved maxim: ``Give the Army
a problem, and you'll soon have a solution.'' The Army simply gets
things done in a thorough and novel manner.
The CDMRP structure is based on a model developed by an earlier IOM
report. Its mission and its philosophy for awarding research grants
reflect that of DOD's Defense Advanced Research Projects Agency
(DARPA). The DARPA model, performance through competition and
innovation, was specifically praised in President Bush's fiscal year
2005 budget. This DARPA-esque approach to cancer research allows PCRP
to identify novel research with large potential payoffs and to focus on
innovative methods that do not receive funding elsewhere. This is an
essential element of the research enterprise, that needs to be
expanded, not contracted.
One of the strongest aspects of the program is PCRP's Integration
Panel. The panel is composed of those who know prostate cancer research
and the issues facing it: scientists, researchers, and prostate cancer
survivors. This peer and consumer driven model allows the program to
select grants based on merit and their translational benefit while
incorporating the views of those who need research the most, prostate
cancer patients. It funds research that encourages innovation rather
than research that incrementally answers small scientific questions. No
other publicly funded cancer research entity effectively brings
together all those with a stake in curing prostate cancer.
Perhaps the best example of public-private partnerships in prostate
cancer research is the Prostate Cancer Research Funders Conference.
That panel brings together representatives of all the government
agencies that fund prostate cancer research along with their
counterparts in the private sector. Participants include NIH/NCI, DOD,
the Veterans Health Administration, the Centers for Disease Control and
Prevention, the Food and Drug Administration, Canadian and British
government agencies, private foundations/organizations and
representatives from industry. Members of the Conference have come
together to focus on shared objectives and address commonly recognized
barriers in research.
As a co-convener of the conference, PCRP plays an important role in
shaping its priorities. Currently, Federal agencies participate
voluntarily, but they can opt in or out based on the tenure of
executive leadership. For the conference to be successful, Federal
agencies engaged in prostate cancer research should, in my opinion, be
required to participate, and we ask for your leadership to make that
happen. We need to see more leveraging of existing resources and a
broader engagement of Federal agencies can help accomplish this
important objective. Moreover, Congress must also offer sufficient
incentives for the private sector to participate. However, these
incentives must not compromise the autonomy or integrity of PCRP's peer
review structure. I firmly believe that a collaborative, multifaceted
approach to prostate cancer research can bring about better results in
a more timely fashion. No one Institution is equipment to fully
translate discoveries into products; government, academia and industry
must be brought together to solve these very difficult and complex
problems that face our Nation and our families. Mr. Chairman, we have
done remarkable work and are making progress. Public-private
collaboration and new scientific discoveries are moving us toward a
better understanding of how prostate cancer kills, but, for our work to
be worthwhile, it must be translated into tangible goals and results
for patients.
I urge you to continue to support and enhance growth of PCRP, a
program that is efficient, driven by scientific priorities and
scientifically productive. The War on Prostate Cancer must be funded
appropriately so researchers can get new drugs to patients who need
them most. For this to happen, PCRP needs $100 million in fiscal year
2006, and I respectfully request that you appropriate this need.
Senator Stevens. Our next witness is Captain Robert Hurd
and Chief Petty Officer Michael Silver of the United States
Naval Sea Cadet Corps.
STATEMENT OF CAPTAIN ROBERT C. HURD, U.S. NAVY
(RETIRED)
ACCOMPANIED BY CHIEF PETTY OFFICER MICHAEL SILVER, UNITED STATES NAVY
SEA CADET CORPS
Captian Hurd. Good afternoon, Senators.
Senator Stevens. Yes, sir.
Captain Hurd. It is my pleasure today to have Chief Petty
Officer Michael Silver present our testimony. Just as a little
bit of background, out of 10,000 young men and women in the
Naval Sea Cadet Corps, about 50 a year attain the rank of chief
petty officer. So it is quite a significant accomplishment. We
have him for about 1 more month before he joins the Marine
Corps upon graduation from high school.
Senator Stevens. Good.
Nice to have you.
Mr. Silver. Thank you, sir. Good afternoon, Mr. Chairman,
Senator Inouye. I am a chief petty officer. I am with a
battalion based in the naval base in Ventura County in
California. I also go to El Camino Real High School in Woodland
Hills.
I am honored to represent over 10,000 Sea Cadets across the
Nation, and also 2,000 adult volunteers in the program. We are
a congressionally chartered youth development and education
program whose main goals are to develop young men and women
while promoting interest and skills in seamanship, aviation,
construction, and other military fields. We instill a sense of
patriotism, commitment, self-reliance, along with the Navy's
core values, honor, courage, and commitment. We also take pride
in molding strong moral character and self-discipline in a
drug- and gang-free environment.
Many young people join our program for our hands-on
experience. We try to maximize our opportunities as much as
possible all throughout the program with the armed services and
also the civilian workforce. Our program over any other youth
program, over Reserve Officer Training Corps (ROTC), Sea
Scouts, Boy Scouts, Devil Pups, we have the most in-depth
program that is offered outside of school.
We have the most hands-on experience. We were out there
with the actual Navy, with the actual Marine Corps, the Air
Force, different services. We go on the bases. There is no
other program that is offered that goes in depth as we do. We
go on Navy ships, on Coast Guard ships. I personally have
been--I participated in basic airman's training where it is
pretty much I am on a ground crew, on Navy aircraft. I have
been to medical training. I worked at a naval hospital for 2
weeks. I have worked in the emergency room (ER).
I have been to a leadership academy. I learned pretty much
how to be a successful leader to others and stuff like that. I
have also been to field training, which is pretty much on the
Marine Corps aspect of it; field ops aviation school in
Maryland. I have also been to an international exchange with
the Her/His Majesty's Ship (HMS) Bristol in England, where I
was there with Swedish, Canadian, South Korean, Chinese, and
Australian, because the Sea Cadets is also an international
program and they were there with over 50 other people from
different other countries.
Also, there are 473 former Sea Cadets now attending the
U.S. Naval Academy and approximately 400 former cadets annually
enlist in the armed services. These prescreened, highly
motivated and well prepared young people have shown that prior
Sea Cadet experience is an excellent indicator of high career
success rate, both in and out of the military. Whether or not
we choose a military career, we also carry forth the forged
values of good citizenship, leadership, and moral courage that
we believe will benefit our country and us as well.
The corps is particularly sensitive that no young person is
denied access to the program because of economic status, as for
the most part we are responsible for our own expenses, which
can amount to an average of $500 without outside assistance per
cadet per year. Federal funds have been used to help offset the
cadets' out of pocket training costs. However, for a variety of
reasons current funding can no longer adequately sustain the
program and we respectfully ask you to consider and support
funding that will allow for the full amount of $2 million
requested for the next fiscal year.
Thank you for the opportunity to speak today and I and the
entire Sea Cadet Corps appreciate your support for this fine
program that has meant so much to myself over the past 7 years
and which will continue to influence me for the rest of my
life. I would just like to thank you, and I am open to
questions.
[The statement follows:]
Prepared Statement of Captain Robert C. Hurd
REQUEST
Navy had originally requested full funding at the $2,000,000 level
in their fiscal year 2006 budget submission. This was in response to
last year's Senate/House conference committee language urging them to
include the NSCC in their fiscal year 2006 request. Navy initially
budgeted these funds at the $2,000,000 level but subsequently deleted
this funding to meet an imposed budget mark. Subsequent negations with
Navy after the President's Budget had been submitted have resulted in a
verbal promise to fund the NSCC in fiscal year 2006 at the fiscal year
2005 appropriated level of $1,700,000--to be funded from existing
budget lines. Because this action occurred after the budget submission,
no separate line item exists for NSCC and because it was originally
funded (Before the mark), no Unfunded Requirements List item was
submitted.
It is respectfully requested that $300,000 be appropriated for the
NSCC in fiscal year 2006, so that when added to the promised $1,700,000
will restore full funding at the $2,000,000 level. Further, in order to
codify the Navy's promised commitment and to ensure future funding,
consideration of including the following conference language is
requested: ``Congress is pleased to learn that Navy has agreed to fund
the U.S. Naval Sea Cadet Corps in the fiscal year 2006 budget as urged
by the Senate and House in the 2005 Defense Budget Conference Report.
Conferees include an additional $300,000 for the U.S. Naval Sea Cadet
Corps, that when added to the $1,700,000 in the fiscal year 2006 budget
request will fund the program at the full $2,000,000 requested.
Conferees urge the Navy to continue to fund this program in the fiscal
year 2007 budget request and out years.''
BACKGROUND
At the request of the Department of the Navy, the Navy League of
the United States established the Naval Sea Cadet Corps in 1958 to
``create a favorable image of the Navy on the part of American youth.''
On September 10, 1962, the U.S. Congress federally chartered the Naval
Sea Cadet Corps under Public Law 87-655 as a non-profit civilian youth
training organization for young people, ages 13 through 17. A National
Board of Directors, whose Chairman serves as the National Vice
President of the Navy League for Youth Programs, establishes NSCC
policy and management guidance for operation and administration. A
full-time Executive Director and small staff in Arlington, Virginia
administer NSCC's day-to-day operations. These professionals work with
volunteer regional directors, unit commanding officers, and local
sponsors. They also collaborate with Navy League councils and other
civic, or patriotic organizations, and with local school systems.
In close cooperation with, and the support of, the U.S. Navy and
U.S. Coast Guard, the Sea Cadet Corps allows youth to sample military
life without obligation to join the Armed Forces. Cadets and adult
leaders are authorized to wear the Navy uniform, appropriately modified
with a distinctive Sea Cadet insignia.
There are currently over 368 Sea Cadet units with a program total
of 10,980 participants (2,204 adult Officers and Instructors and 8,776
Cadets (about 33 percent female).
NSCC OBJECTIVES
--Develop an interest and skill in seamanship and seagoing subjects.
--Develop an appreciation for our Navy's history, customs, traditions
and its significant role in national defense.
--Develop positive qualities of patriotism, courage, self-reliance,
confidence, pride in our Nation and other attributes, which
contribute to development of strong moral character, good
citizenship traits and a drug-free, gang-free lifestyle.
--Present the advantages and prestige of a military career.
Under the Cadet Corps' umbrella is the Navy League Cadet Corps
(NLCC), a youth program for children ages 11 through 13. While it is
not part of the Federal charter provided by Congress, the Navy League
of the United States sponsors NLCC. NLCC was established ``. . . to
give young people mental, moral, and physical training through the
medium of naval and other instruction, with the objective of developing
principles of patriotism and good citizenship, instilling in them a
sense of duty, discipline, self-respect, self-confidence, and a respect
for others.''
BENEFITS
Naval Sea Cadets experience a unique opportunity for personal
growth, development of self-esteem and self-confidence. Their
participation in a variety of activities within a safe, alcohol-free,
drug-free, and gang-free environment provides a positive alternative to
other less favorable temptations. The Cadet Corps introduces young
people to nautical skills, to maritime services and to a military life
style. The program provides the young Cadet the opportunity to
experience self-reliance early on, while introducing this Cadet to
military life without any obligation to join a branch of the armed
forces. The young Cadet realizes the commitment required and routinely
excels within the Navy and Coast Guard environments.
Naval Sea Cadets receive first-hand knowledge of what life in the
Navy or Coast Guard is like. This realization ensures the likelihood of
success should they opt for a career in military service. For example,
limited travel abroad and in Canada may be available, as well as the
opportunity to train onboard Navy and Coast Guard ships, craft and
aircraft. These young people may also participate in shore activities
ranging from training as a student at a Navy hospital to learning the
fundamentals of aviation maintenance at a Naval Air Station.
The opportunity to compete for college scholarships is particularly
significant. Since 1975, over 178 Cadets have received financial
assistance in continuing their education in a chosen career field at
college.
ACTIVITIES
Naval Sea Cadets pursue a variety of activities including
classroom, practical and hands-on training as well as field trips,
orientation visits to military installations, and cruises on Navy and
Coast Guard ships and small craft. They also participate in a variety
of community and civic events.
The majority of Sea Cadet training and activities occurs year round
at a local training or ``drill'' site. Often, this may be a military
installation or base, a reserve center, a local school, civic hall, or
sponsor-provided building. During the summer, activities move from the
local training site and involve recruit training (boot camp),
``advanced'' training of choice, and a variety of other training
opportunities (depending on the Cadet's previous experience and
desires).
SENIOR LEADERSHIP
Volunteer Naval Sea Cadet Corps officers and instructors furnish
senior leadership for the program. They willingly contribute their time
and effort to serve America's youth. The Cadet Corps programs succeed
because of their dedicated, active participation and commitment to the
principles upon which the Corps was founded. Cadet Corps officers are
appointed from the civilian sector or from active, reserve or retired
military status. All are required to take orientation, intermediate and
advanced Officer Professional Development courses to increase their
management and youth leadership skills. Appointment as an officer in
the Sea Cadet Corps does not, in itself, confer any official military
rank. However, a Navy-style uniform, bearing NSCC insignia, is
authorized and worn. Cadet Corps officers receive no pay or allowances.
Yet, they do derive some benefits, such as limited use of military
facilities and space available air travel in conjunction with carrying
out training duty orders.
DRUG-FREE AND GANG-FREE ENVIRONMENT
One of the most important benefits of the Sea Cadet program is that
it provides participating youth a peer structure and environment that
places maximum emphasis on a drug and gang free environment. Supporting
this effort is a close liaison with the U.S. Department of Justice Drug
Enforcement Administration (DEA). The DEA offers the services of all
DEA Demand Reduction Coordinators to provide individual unit training,
as well as their being an integral part of our boot camp training
program.
Among a variety of awards and ribbons that Cadets can work toward
is the Drug Reduction Service Ribbon, awarded to those who display
outstanding skills in he areas of leadership, perseverance and courage.
Requirements include intensive anti-drug program training and giving
anti-drug presentations to interested community groups.
TRAINING
Local Training
Local training, held at the unit's drill site, includes a variety
of activities supervised by qualified Sea Cadet Corps Officers and
instructors, as well as Navy, Coast Guard, Marine and other service
member instructors.
Cadets receive classroom and hands on practical instruction in
basic military requirements, military drill, water and small boat
safety, core personal values, social amenities, drug/alcohol abuse,
cultural relations, naval history, naval customs and traditions, and
nautical skills. Training may be held onboard ships, small boats or
aircraft, depending upon platform availability, as well as onboard
military bases and stations. In their training, cadets also learn about
and are exposed to a wide variety of civilian and military career
opportunities through field trips and educational tours.
Special presentations by military and civilian officials augment
the local training, as does attendance at special briefings and events
throughout the local area. Cadets are also encouraged, and scheduled,
to participate in civic activities and events to include parades,
social work, and community projects, all part of the ``whole person''
training concept.
For all Naval Sea Cadets the training during the first several
months is at their local training site, and focuses on general
orientation to, and familiarization with, the entire Naval Sea Cadet
program. It also prepares them for their first major away from home
training event, the 2 weeks recruit training which all Sea Cadets must
successfully complete.
The Navy League Cadet Corps training program teaches younger cadets
the virtues of personal neatness, loyalty, obedience, courtesy,
dependability and a sense of responsibility for shipmates. In
accordance with a Navy orientated syllabus, this education prepares
them for the higher level of training they will receive as Naval Sea
Cadets.
Summer Training
After enrolling, all sea cadets must first attend a 2-week recruit
training taught at the Navy's Recruit Training Command, at other Naval
Bases or stations, and at regional recruit training sites using other
military host resources. Instructed by Navy or NSCC Recruit Division
Commanders, cadets train to a condensed version of the basic course
that Navy enlistees receive. The curriculum is provided by the Navy,
and taught at all training sites. In 2004 there were 19 Recruit
training classes at 18 locations, including 1 class conducted over the
winter holiday school break. These 18 nationwide regional sites are
required to accommodate the increased demand for quotas and also to
keep cadet and adult travel costs to a minimum. Over 2500 Naval Sea
Cadets attended recruit training in 2004, supported by another 230
adult volunteers.
Once Sea Cadets have successfully completed recruit training, they
may choose from a wide variety of advanced training opportunities
including basic/advanced airman, ceremonial guard, seamanship, sailing,
amphibious operations, leadership, firefighting and emergency services,
submarine orientation, seal and mine warfare operations, Navy diving,
and training in occupational specialties including health care, legal,
music, master-at-arms and police science, and construction.
The Naval Sea Cadet Corps is proud of the quality and diversity of
training opportunities offered to its Cadet Corps. For 2004
approximately 8,000 training opportunities were formally advertised for
both cadets and adults. Another 600 opportunities presented themselves
through the dedication, resourcefulness and initiative of the adult
volunteer officers who independently arranged training for cadets
onboard local bases and stations. This locally arranged training
represents some of the best that the NSCC has to offer and includes the
consistently outstanding training offered by the U.S. Coast Guard. The
total cadet and adult opportunity for 2004 stood at about 8,500 quotas,
including all recruit training. Approximately 7,800 NSCC members, with
about 7,050 being cadets, stepped forward and requested orders to take
advantage of these training opportunities. Cadets faced a myriad of
challenging and rewarding training experiences designed to instill
leadership and develop self-reliance. It also enabled them to become
familiar with the full spectrum of Navy and Coast Guard career fields.
This steady and continuing participation once again reflects the
popularity of the NSCC and the positive results of Federal funding for
2001 through 2004. The NSCC continues to experience increased recruit
and advanced training attendance of well over 2,000 cadets per year
over those years in which Federal funding was not available. While the
Global War On Terrorism (GWOT) following the events of 9/11 has
continued to preclude berthing availability at many bases and stations,
the NSCC maintained its strength and opportunity for cadets as other
military hosts offered resources in support of the NSCC. While recruit
training acquaints cadets with Navy life and Navy style discipline,
advanced training focuses on military and general career fields and
opportunities, and also affords the cadets many entertaining, drug
free, disciplined yet fun activities over the entire year.
Approximately 400-500 cadets per year further confirm the program's
popularity by performing multiple 2-week trainings, taking maximum
advantage of the opportunities presented. The NSCC also remains proud
that approximately 9 percent of the midshipman brigade at the U.S.
Naval Academy report having been prior Naval Sea Cadets, most citing
summer training as a key factor in their decision to attend the USNA.
Training Highlights for 2004
The 2004 training focus was once again on providing every cadet the
opportunity to perform either recruit or advanced training during the
year. To that end emphasis was placed on maintaining all traditional
and new training opportunities developed since federal funding was
approved for the NSCC. These include classes in sailing and legal (JAG)
training, expanded SEAL orientation opportunity, SCUBA classes, more
seamanship training onboard the NSCC training vessels on the Great
Lakes, and additional honor guard training opportunities. Other
highlights included:
--Maintained national recruit training opportunity for every cadet
wanting to participate with 19 evolutions in 2004.
--In spite of escalating costs and increased competition for base
resources, kept cadet summer training cost at only $40 per
week, an increase of only $10 per week per cadet for all
training.
--Continued NSCC's expanded use of Army and State National Guard
facilities to accommodate demand for quotas for recruit
training.
--Completed total rewrites and updates of the NSCC Officer
Professional Development Courses for all adults and implemented
programs for reducing adult volunteer out of pocket
participation expenses, dramatically improving the quality and
extent of training for adult volunteers.
--Expanded NSCC cadet training with Navy Explosive Ordnance Disposal/
Mobile Diving Salvage Units to include West Coast opportunities
in addition to the training in Norfolk, Virginia.
--Expanded SEAL training opportunities beyond NSCC's traditional two
annual classes to include an additional class with the Navy's
Special Warfare Combat Craft (SWCC) units in Norfolk.
--Developed and instituted the first ever Air Traffic Control
training class at NAS, Kingsville, TX.
--Maintained double the number of MAA classes and cadets taking this
training since 9/11.
--Implemented first ever opportunity for culinary arts training for
cadets onboard the USS Kiluea T-AE-26 at Alameda, CA in support
of traditional seamanship training annually conducted onboard
that MSC ship.
--Re-instituted at Naval Hospital Great Lakes NSCC's unique class for
advanced medical ``First Responder'' training.
--Expanded opportunities for music training beyond traditional
training with the Navy's School of Music in Norfolk, VA to
include training with the Atlantic Fleet Band in Jacksonville,
FL.
--Expanded and conducted NSCC's first advanced seamanship class for
outstanding cadets at the Massachusetts Maritime Academy at
Buzzards Bay, MA.
--For all adults volunteering to be escorts for summer training,
implemented the first ever and only program for reducing
volunteer out of pocket expenses. An extremely modest program
designed to offset travel cost only (15 cents a mile with a
mileage cap) it has promoted improved program commitment among
NSCC's adult volunteers and alleviated critical shortages of
adult escorts for summer training.
--Maintained expanded YP training on the Great Lakes, with 5 underway
cruises in 2004.
--Continued to place cadets onboard USCG Barque Eagle for multiple 3-
week underway orientation cruises.
--Continued to place cadets aboard USCG stations, cutters, and
tenders for what each year proves to be among the best of the
training opportunities offered in the NSCC.
--Again conducted the popular, merit based, International Exchange
Program for 2004, expanded to include the Asian opportunities
in Hong Kong and Korea that were suspended in 2003 due to the
SARS concern. Included Australia in the program for 2004.
--Maintained attendance at NSCC Petty Officer Leadership Academies,
(POLA) at approximately 280 cadets.
--Placed cadets onboard USN ships under local orders as operating
schedules and opportunity permitted, to include for 12 cadets a
60+ day transit and homeport relocation of the USS Ronald
Reagan from Norfolk to San Diego via the Straits of Magellan.
--And as in all prior years, again enjoyed particularly outstanding
support from members of the United States Navy Reserve, whose
help and leadership remain essential for summer training.
INTERNATIONAL EXCHANGE PROGRAM (IEP)
For 2004 the NSCC continued again for the third year its redesigned
and highly competitive, merit based, and very low cost to the cadet,
International Exchange Program. Cadets were placed in Australia, United
Kingdom, Sweden, Netherlands, Hong Kong, Korea, and Bermuda to train
with fellow cadets in these host nations. The NSCC and Canada
maintained their traditional exchanges in Nova Scotia and British
Columbia, and the NSCC hosted visiting cadets in Norfolk and at Fort
Lewis, WA for 2 weeks of U.S. Navy style training.
NAVY LEAGUE CADET TRAINING
In 2004, approximately 1,400 Navy League cadets and escorts
attended Navy League Orientation Training at 17 sites nationwide.
Participation in 2004 was very much like 2003. The diversity in
location and ample quotas allowed for attendance by each and every
League cadet who wished to attend. Approximately 270 League cadets and
their escorts attended Advanced Navy League training where cadets learn
about small boats and small boat safety using the U.S. Coast Guard's
safe boating curriculum. Other advanced Navy League training sites
emphasize leadership training. Both serve the program well in preparing
League cadets for further training in the Naval Sea Cadet Corps, and
particularly for their first ``boot camp.'' The continuing strong
numbers of participants for both Orientation and Advanced training,
support not just the popularity of the NSCC program but also the
positive impact the Federal training grant has had in helping cadets
afford the training and helping them take advantage of the increased
opportunities available to them.
SERVICE ACCESSIONS
The Naval Sea Cadet Corps was formed at the request of the
Department of the Navy as a means to ``enhance the Navy image in the
minds of American youth.'' To accomplish this, ongoing presentations
illustrate to Naval Sea Cadets the advantages and benefits of careers
in the armed services, and in particular, the sea services.
While there is no service obligation associated with the Naval Sea
Cadet Corps program, many Sea Cadets choose to enlist or enroll in
Officer training programs in all the Services.
Annually, the NSCC conducts a survey to determine the approximate
number of Cadets making this career decision. This survey is conducted
during the annual inspections of the units. The reported Cadet
accessions to the services are only those that are known to the unit at
that time. There are many accessions that occur in the 2-3 year
timeframe after Cadets leave their units, which go unreported. For
example, for the year 2000, with about 83 percent of the units
reporting, the survey indicates that 510 known Cadets entered the armed
forces during the reporting year ending December 31, 2000. Of these, 30
ex-Sea Cadets were reported to have received appointments to the U.S.
Naval Academy. Further liaison with the USNA indicates that in fact,
there are currently 472 Midshipmen with Sea Cadet backgrounds--almost 9
percent of the entire Brigade. Navy accession recruiting costs have
averaged over $14,000 per person, officer or enlisted, which applied to
the number of Sea Cadet accessions represents a significant financial
benefit to the Navy. Equally important is the expectation that once a
more accurate measurement methodology can be found, is, that since Sea
Cadets enter the Armed Forces as disciplined, well trained and
motivated individuals, their retention, graduation and first term
enlistment completion rates are perhaps the highest among any other
entry group. USNA officials are currently studying graduation rates for
past years for ex-Sea Cadets as a group as compared to the entire
Brigade. Their preliminary opinion is that these percents will be among
the highest. It is further expected that this factor will be an
excellent indicator of the following, not only for the USNA, but for
all officer and enlisted programs the Sea Cadets may enter:
--Extremely high motivation of ex-Cadets to enter the Service.
--Excellent background provided by the U.S. Naval Sea Cadet
experience in preparing and motivating Cadets to enter the
Service.
--Prior U.S. Naval Sea Cadet Corps experience is an excellent pre-
screening opportunity for young men and women to evaluate their
interest in pursuing a military career. This factor could
potentially save considerable tax-payer dollars expended on
individuals who apply for, then resign after entering the
Academy if they decide at some point they do not have the
interest or motivation.
--U.S. Naval Sea Cadet experience prior to entering the Service is an
excellent indicator of a potentially high success rate.
Data similar to the above has been requested from the United States
Coast Guard Academy and the United States Merchant Marine Academy.
Whether or not they choose a service career, all Sea Cadets carry
forth learned values of good citizenship, leadership and moral courage
that will benefit themselves and our country.
PROGRAM FINANCES
Sea Cadets pay for all expenses, including travel to/from training,
uniforms, insurance and training costs. Out-of-pocket costs can reach
$500 each year. Assistance is made available so that no young person is
denied access to the program, regardless of social or economic
background.
Federally funded at the $1,000,000 level in fiscal years 2001,
2002, and 2003, $1,500,000 in fiscal year 2004 and $1,700,000 for
fiscal year 2005 (of the $2,000,000 requested), all of these funds were
used to offset individual Cadet's individual costs for summer training,
conduct of background checks for adult volunteers and for reducing
future enrollment costs for Cadets. In addition to the Federal fund
received, NSCC receives under $700,000 per year from other sources,
which includes around $226,000 in enrollment fees from Cadets and adult
volunteers. For a variety of reasons, at a minimum, this current level
of funding is necessary to sustain this program and the full $2,000,000
would allow for program expansion:
--All time high in number of enrolled Sea Cadets (and growing).
--General inflation.
--Some bases denying planned access to Sea Cadets for training due to
increased terrorism threat level alerts and the associated
tightening of security measures--requiring Cadets to utilize
alternative, and often more costly training alternatives.
--Reduced availability of afloat training opportunities due to the
Navy's high level of operations related to the Iraq war.
--Reduced training site opportunities due to base closures.
--Non-availability of open bay berthing opportunities for Cadets due
to their elimination as a result of enlisted habitability
upgrades to individual/double berthing spaces.
--Lack of ``Space Available'' transportation for group movements.
--Lack of on-base transportation, as the navy no longer ``owns''
busses now controlled by the GSA.
--Navy outsourcing of messing facilities to civilian contractors
increases the individual Cadet's meal costs.
Because of these factors, Cadet out-of-pocket costs have
skyrocketed to the point where the requested $2,000,000 alone would be
barely sufficient to handle cost increases
It is therefore considered a matter of urgency that the full amount
of the requested $2,000,000 be provided for fiscal year 2006.
Senator Stevens. Thank you very much.
It is a very successful program and we know that costs have
gone up. But we will do our best to stretch that money,
General, and see to it that you have the ability to produce
young men like this for us every year.
Thank you very much. We appreciate your statement of your
past experience.
Senator Inouye. How many naval sea cadets are there in the
United States at this moment?
Captain Hurd. It is about 10,000. The mix of males, females
is the same as it is in the Navy for the most part, about a
three to one mix. We have units in every State except Wyoming.
Senator Stevens. They are seeking $300,000 more this year.
It is a modest request, General. We will do our best to achieve
it. Do you have anything else, Senator?
Senator Inouye. I am impressed at the number, 472 cadets
have received appointments to the Naval Academy.
Captain Hurd. That are currently at the Naval Academy now,
yes, sir. The admissions folks love them because these young
men and women for the most part know what they are getting into
and our graduation rates at the Academy and through boot camp
far exceed the general Navy completion rates as well. We are
quite proud of that.
Mr. Silver. And the training, the background, what you
learn through the program, the experiences--when we do the
hands-on training, because you are training with the actual
military that do the jobs that you want to do, you do the same
courses that the Navy does or the Marines, and they go through
it with you. The training that you learn through this program,
there is no other program that you can get that will even come
close to what you learn in this program.
That is why the military allows us when we enlist to go in
as advanced pay grades, through the knowledge that we learned
and the reputation of what we learned in the program.
Senator Inouye. Your testimony is most reassuring at a time
when our services are all experiencing problems in recruiting
and retaining. Thank you very much.
Senator Stevens. Are you in all 50 States?
Captain Hurd. All except Wyoming. We have units in Guam and
Iceland as well.
Senator Stevens. Thank you very much. We appreciate your
testimony.
Captain Hurd. We appreciate your support.
Senator Stevens. Our next witness is the President of the
National Association of Uniformed Services, Retired Major
General William Matz, formerly Deputy Commander, U.S. Army in
the Pacific. Nice to see you, sir.
STATEMENT OF MAJOR GENERAL WILLIAM MATZ, JR., U.S. ARMY
(RETIRED), PRESIDENT, NATIONAL ASSOCIATION
FOR UNIFORMED SERVICES
General Matz. Yes, sir, nice to see you again.
Mr. Chairman and Senator Inouye, on behalf of the over
200,000 members and supporters of the National Association for
Uniformed Services (NAUS), I want to thank you for this
opportunity to present our views on defense funding. We also
thank you, Mr. Chairman, and the other members of your
subcommittee for your leadership and your continued efforts to
support and care for the men and women of the armed forces and
for our military retirees and their survivors.
The primary purpose of our association is to support a
strong national defense and this support includes being an
advocate for the earned benefits of our Nation's warriors, both
Active and retired. We understand clearly that during a time of
severe budget deficits and with the country at war dollars for
all Government programs are tight. But we believe that funds
for the care and support of those who serve and have served
must always be one of the Nation's highest priorities.
As you are aware, some Government officials have stated
recently that providing the earned benefits for those who have
served is hurtful. In reality, from my perspective, taking care
of military personnel, their families and retirees is helpful
to the Nation's cause and it will also enhance the recruiting
efforts of our armed forces. Retired military and veterans can
be among the very, very best recruiters if they can report that
the promises were kept after their service was over.
We at NAUS join the other military and veterans services
organizations in asking for the necessary funding for the
proposed enhancements for those currently serving on active
duty. These include, just very quickly: The Crosby-Puller
Combat Wounds Compensation Act that requires that a member of
the uniformed services who was wounded in a combat zone
continue to be paid the monthly pay and allowances and receive
the combat zone tax exclusion during his recovery period.
We also ask for your support for the Supply Our Soldiers
Act, which would provide postal benefits for those serving in
combat zones. Should these initiatives be enacted individually
or as part of the National Defense Authorization Act, we simply
ask that the funds be made available for these needed
enhancements.
Now, while these issues, sir, are important, my main thrust
today is to emphasize the need for full funding of the defense
health program. Arriving at the point where we are now with the
TRICARE program has been a long and very arduous battle and a
fight that members of this subcommittee, joining with the
National Military Veterans Alliance and the Military Coalition,
made happen, and for this we thank you.
As you know, the defense health program is a critical piece
in ensuring the maintenance of a strong military. From my
perspective, each dollar is an investment in military
readiness. During my service in Vietnam as an infantryman, one
of the greatest fears of soldiers arriving in that country was
being wounded and not getting adequately timely medical care.
Because of this, we would assure them that every wounded
soldier would be recovered, every wounded soldier would be
treated and evacuated as a first priority, and that they would
get the very best medical care in the world.
Our military medical system is the best in the world. To
stay the best, it must be fully funded. So unless we have a
strong, vital military medical program here in the continental
United States (CONUS) we will not be able to continue to deploy
the highly trained medical units and personnel supporting our
combat forces in the overseas theaters. This includes funding
the network of stateside military hospitals and clinics and of
course the Uniformed Services University of the Health
Sciences, which I know you are both familiar with.
In my view this is at the core of medical professionalism
for our Nation's uniformed services. It also includes the
funding necessary to ensure adequate care for our military
families and retirees.
Mr. Chairman, your longstanding leadership and your support
for military medicine has been clearly stated over the years.
In fact, from my view it has been critical to its success,
indeed to its very survival. I am reminded of a like sentiment
expressed just recently by the chairman of the Senate Armed
Services Committee, who was opposing a proposal to shift money
from military health care to buy weapons rather than seeking
the funds for both. We absolutely agree on this point and also
that funding for both must be a national priority. Accordingly,
sir, we ask that you continue to support full funding for our
very vital defense health program.
Again, thank you for your support and thank you for these
few minutes to come before you today.
Senator Stevens. Senator.
Senator Inouye. Well, as you have indicated, the best
recruiting weapon that we have is a veteran who has served and
can tell the new American that the military is the best place
to serve.
General Matz. Absolutely, sir, yes.
Senator Inouye. He is the evidence, the proof.
General Matz. Yes, that is the evidence, absolutely.
Senator Inouye. We will do our best, sir.
Senator Stevens. I was amazed to find when we were in Iraq
and Afghanistan the number of young people we talked to that
talked to us about their fathers and their experience. There is
no replacing that generation to generation conveyance of the
duty to serve.
General Matz. Absolutely, sir.
Senator Stevens. Thank you very much, General.
General Matz. Thank you very much.
[The statement follows:]
Prepared Statement of William M. Matz, Jr.
Introduction
Mister Chairman and distinguished members of the committee, I
became the President of the National Association for Uniformed Services
(NAUS) on January 15 of this year. As the representative of our 190,000
members/supporters, I extend our gratitude for the invitation to
testify before you about our views and suggestions concerning the
following defense funding issues:
First, I would like to explain to you our association and why we
feel so very qualified to discuss our members' legislative concerns.
The National Association for Uniformed Services (NAUS) prides itself in
that it is the ``The Servicemember's Voice in Government--Focusing on
People.'' NAUS is unique. Founded in 1968, it's the only military
affiliated association whose membership represents the entire military/
veteran family. No other association provides such a broad
representation when dealing with Congress, the White House, and the
Pentagon. NAUS represents all seven branches of the uniformed services:
Army, Navy, Marine Corps, Air Force, Coast Guard, United States Public
Health Service (USPHS), and National Oceanic and Atmospheric
Administration (NOAA), including all components: Active Duty, Retired,
Reserve, National Guard, and other veterans, their spouses, widows/
widowers, other family members and survivors; and all grades and
ranks--enlisted/officer.
The primary purpose of our association is to support a strong
national defense and to promote and protect the interests and promised
benefits earned by members of the uniformed services for themselves,
their families and survivors and those of all American citizens with
common interests.
Accordingly, we support issues that directly affect those currently
serving on Active duty--Regular, National Guard and Reserve. Our
testimony will ask this committee's funding for the following pieces of
legislation upon passage:
Crosby-Puller Combat Wounds Compensation Act
We support this Act which would ensure that a member of the
uniformed services who is wounded or otherwise injured while serving in
a combat zone continues to be paid monthly military pay and allowances,
while recovering from the wound or injury at the same level received
while in the combat zone. This act will also ensure that the
servicemember continues to receive the combat zone tax exclusion during
recovery.
Position.--We urge that S. 461, the Crosby-Puller Combat Wounds
Compensation Act be funded in the Defense appropriation.
Montgomery GI Bill (MGIB) & Educational Benefits
The strain on the Reserve Component (Reserve and National Guard
units) caused by frequent and long call-ups to Active Duty has had a
negative affect on recruiting and retention efforts. Added enticements
are needed to help bolster these forces, which our National defense has
come to rely so heavily on in contingency operations.
We believe that extending the same MGIB and educational benefits to
the Reserve and Guard forces would help in their recruiting/retention
programs.
Position.--We urge the Defense subcommittee to provide the funding
of enhanced MGIB and Educational Benefits for the Reserve and National
Guard units.
Guard and Reserve Enhanced Benefits Act
Since the National Guard and Reserve make up a great portion of the
troops in the areas of current operations, we believe other measures
are needed to alleviate many of the hardships caused by these frequent
and prolonged deployments. Many are contained in the Guard and Reserve
Enhanced Benefits Act, such as Child Care, Non-reduction in pay for
Federal Employees, Tax Credit for Employers, Reduced minimum age for
eligibility for non-regular Service retired pay, and Expanded
eligibility of Ready Reserve Members under the Tricare Program.
Position.--We urge the Defense subcommittee to provide funding for
S. 38, the Guard and Reserve Enhanced Benefits Act.
Supply Our Soldiers Act of 2005
NAUS supports the ``Supply Our Soldiers Act of 2005,'' H.R. 887, a
bill to provide for a program under which postal benefits shall be made
available for purposes of certain personal correspondence and other
mail matter sent from within the United States to members of the Armed
Forces serving on active duty abroad who are engaged in military
operations, and for other purposes.
Position.--We urge the Senate to sponsor a companion bill and the
Defense subcommittee to provide the funding to assist families of
active duty and activated Reserve and National Guard servicemembers
with postal costs for packages and mail to troops in current
operations.
We contend that honoring the promises made to those veterans who
made a career of the military will help the military services in their
recruiting and retention efforts. Accordingly, we strongly urge the
Defense subcommittee's support of the following:
Combat Related Special Compensation (CRSC) for Chapter 61 Retirees
Many combat injured military veterans were forced by the severity
of their injuries to be medically retired under Chapter 61 regulations.
Quite a few of them would have completed 20 years of service towards a
full military retirement, but could not. These individuals are not
qualified for Combat Related Special Compensation because they served
less than 20 years. They deserve the same consideration for the award
of CRSC as a 20-year retiree and their level of award should be based
on their years of active service.
Position.--The House has introduced legislation to resolve this
issue (H.R. 1366). NAUS urges the Senate to introduce companion
legislation, and urges the Defense subcommittee to provide the funding
to resolve this issue.
Survivor Benefits Program/Dependency and Indemnity Compensation Offset
Currently, if the retired military sponsor, who enrolled in the
Survivor Benefits Program (SBP), dies of a service-connected
disability, the surviving spouse is eligible for both the SBP annuity
and Dependency and Indemnity Compensation (DIC) from the Department of
Veterans Affairs. However, the SBP annuity is offset by the full amount
of the DIC annuity. Each program's purpose is different, SBP's goal is
to provide for the loss of the sponsor's earned retired pay, and DIC's
goal is to provide the surviving spouse compensation for the loss of
their spouse due to injuries caused by his/her service to the country.
Position.--The National Association for Uniformed Services strongly
urges funding for S. 185 which would end the SBP offset with DIC.
30 Year Paid-Up Status
A secondary goal is the acceleration of the paid-up SBP provisions
by changing the effective date from October 1, 2008, to October 1,
2005, already 2 years beyond the 30th anniversary of the program.
Enrollees who have reached the age of 70 and have paid their SBP
premiums for more that 30 years (360 payments) are already being
penalized.
Position.--We ask that the Defense subcommittee provide funding to
allow those early enrollees to be paid up as described in S. 185.
Permanent ID Card for Dependents Age 65 and Over
One of the issues stressed by NAUS is the need for permanent ID
cards for dependents age 65 and over. Last year's NDAA authorized the
issuance of permanent ID card for dependents age 75 and over. We still
believe the age should be 65 and over. With the start of TRICARE for
Life, expiration of TFL-eligible spouses' and survivors' military
identification cards, and the threatened denial of health care claims,
causes some of our older members and their caregivers' significant
administrative and financial distress.
Position.--NAUS urges that the Defense subcommittee continue the
progress made last year by directing the Secretary of Defense to
authorize issuance of permanent military identification cards to
uniformed services family members and survivors who are age 65 and
older, with appropriate guidelines for notification and surrender of
the ID card in those cases where eligibility is ended by divorce or
remarriage.
Finally, NAUS urges the Defense subcommittee's consideration of the
following issues related to the benefit of military service:
Military Exchanges and Commissaries
Issue One.--NAUS believes that DOD wants to reduce/eliminate the
subsidy for the commissary system that provides food and other
essentials to troops and families around the world, which will result
in the military community losing the benefit.
Position.--The National Association for Unformed Services strongly
urges the committee to continue to provide the funding for the
commissary subsidy to sustain the current services. Commissaries are a
key component of the military pay and compensation package. Any action
that would reduce/eliminate this benefit would result in a diminished
quality of life and more out of pocket costs.
Issue Two.--Recent DOD initiatives towards exchange consolidation
and more recently shared services are an issue of interest for our
members. The Unified Exchange Task Force has been developing several
shared services models designed to reduce overhead costs in the areas
of logistics, finance and accounting, information technology, human
resources and non-resale procurement. This approach is based on
reducing ``backroom'' costs for the exchanges so that they will have
greater margins from which to offer their customers better pricing.
However, NAUS continues to view the proposals with cautious interest
until additional information becomes available. For example,
implementation costs and transition costs are important components in
the shared services decision and that information is not yet available.
While the Unified Exchange Task Force (UETF) has been extremely
open and informative throughout this process (associations have met
quarterly with the UETF leadership since its inception), NAUS will
reserve its support of shared services until a substantive, business-
based analysis is completed that clearly demonstrates the change will
enhance the benefit to the patron and increase the MWR dividend.
Position.--NAUS asks the Defense subcommittee to provide the
funding necessary to ensure that the exchanges, whether or not they
share services, continue to provide appropriate product choices,
competitive prices, and increased funding for MWR programs.
Current and Future Issues Facing Uniformed Services Health Care
The National Association for Uniformed Services would like to thank
the subcommittee and the full Appropriations Committee for its
leadership in the past for providing the landmark legislation extending
the Pharmacy benefit and TRICARE system to Medicare eligible military
retirees, their families and survivors, making the lifetime benefit
permanent, establishing the DOD Medicare Eligible Retiree Health Care
Fund, reducing the catastrophic cap and making other TRICARE
improvements. However, we must again urge that the Senate provide full
funding of the Defense Health Program.
Position.--DOD has projected an $11 billion shortfall in funding
between fiscal year 2006-2011. NAUS strongly urges the Defense
subcommittee to ensure that full funding is provided for this most
crucial of programs.
Federal Employees Health Benefits Program (FEHBP)
The National Association for Uniformed Services has been a long
time proponent of legislation that would provide military personnel the
option of participating in the Federal Employees Health Benefit
Program. Though confident that the TRICARE program and the TRICARE for
Life program will be successful, because they are an outstanding value
for most beneficiaries, in a few cases, the TRICARE/TRICARE for Life
options may not be the best choice, or may not be available for the
eligible beneficiary. For that reason, we believe the FEHBP option
should be enacted. Providing the FEHBP, as an option would help
stabilize the TRICARE program, provide a market based benchmark for
cost comparison and be available to those for whom TRICARE/TRICARE for
Life is not an adequate solution.
Position.--NAUS strongly urges the Defense subcommittee to provide
additional funding to support a full FEHBP program for military
personnel as an option.
Include Physician and Nurse Specialty Pay in Retirement Computations
Results of a recent Active Duty Survey show that pay and benefits
are the most important factors impacting retention. Improving specialty
pay/bonuses and including specialty pay/bonuses in retired pay
calculations would aid retention. Therefore, prompt action to retain
these and other highly skilled medical professionals is needed.
Position.--The National Association for Uniformed Services requests
funding to allow the military physicians and nurses to use their
specialty pay in their retirement computations. The military services
continue to lose top quality medical professionals (doctors and nurses)
at mid-career. A major reason is the difference between compensation
levels for military physicians and nurses and those in the private
sector.
Conclusion
Mr. Chairman and distinguished members of the Defense subcommittee,
we want to thank you for your leadership and for holding these hearings
this year. You have made it clear that the military continues to be a
high priority and you have our continuing support.
Senator Stevens. Our last witness is Retired Master Chief
Joseph Barnes, the U.S. Naval Executive Secretary of the Fleet
Reserve Association. Yes, sir.
STATEMENT OF MASTER CHIEF JOSEPH L. BARNES, U.S. NAVY
(RETIRED), NATIONAL EXECUTIVE SECRETARY,
FLEET RESERVE ASSOCIATION
Chief Barnes. Thank you, Mr. Chairman, Senator Inouye. The
Fleet Reserve Association (FRA) appreciates the opportunity to
present its views on the 2006 defense budget.
Before I address several priority issues, I wanted to thank
this distinguished subcommittee for its leadership, support,
and strong commitment to important quality of life programs
benefiting service members, reservists, military retirees, and
their families.
FRA's number one priority is supporting adequate funding
for protected devices and equipment and military personnel
serving in Operations Iraqi Freedom and Enduring Freedom. This
includes body armor, outer protective vests, and armor for
combat vehicles. The next priority is ensuring that wounded
troops, their families and survivors of those killed in action
are those cared for by a grateful nation. FRA fully endorses
continuing combat pay and other special pays until the
completion of hospital care or discharge from their respective
service and permanent increases to the death gratuity and
service members group life insurance.
Another top concern of FRA is to work with Congress and DOD
to ensure continued full funding of the defense health budget
and ensure access to health care for all uniformed services
beneficiaries. The new TRICARE Reserve Select health plan is
important to our Guard and Reserve personnel and their families
and a fully funded health care benefit is critical to readiness
and the retention of qualified uniformed services personnel.
FRA supports appropriations necessary to implement the 3.1
percent across the board military pay increase on January 1,
2006. The association also strongly supports continued progress
toward closing the military pay gap. Unfortunately, targeted
pay increases for senior enlisted personnel and certain officer
grades were not included in the administration's budget. At a
minimum, FRA supports funding pay increases at least comparable
to the annual employment cost index.
Adequate service end strengths are important to maintaining
readiness. If force size is inadequate and operational tempo
(OPTEMPO) too intense, the performance of individual service
members is negatively affected. FRA believes there are
inadequate numbers of uniformed personnel to sustain the war
effort and other operational commitments. This situation also
creates considerable stress on the families of service
personnel.
FRA appreciates the major reform of the military survivor
benefit plan authorized in this year's defense authorization
act and soon thousands of survivors will no longer have to
endure a reduction in their survivor benefits plan (SBP)
annuities upon reaching age 62.
Another SBP reform issue is also important to FRA's
membership, that being the acceleration of SBP paid-up date
from 2008 to 2005 for participants having paid premiums for 30
years and being at least 70 years of age. If authorized, the
association asks for support from this distinguished
subcommittee.
FRA supports funding to maintain the commissary benefit at
the current level, increased reserve Montgomery GI bill (MGIB)
education benefits, which are currently funded well below the
authorized level, funding for family awareness and spouse
employment opportunities, which are integral to our well-being
retention--their well-being and retention, excuse me--and
supplemental impact aid funding for school districts with large
numbers of military-sponsored students.
If authorized, FRA also strongly supports full concurrent
receipt of military retired pay and VA disability compensation,
retention of the full final month's retired pay by retirees'
surviving spouse, and the extension of the dislocation
allowance to retiring service members.
Thank you again, Mr. Chairman, for the opportunity to
present the association's recommendations and I stand ready to
answer any questions you may have.
[The statement follows:]
Prepared Statement of Joseph L. Barnes
INTRODUCTION
Mr. Chairman and other distinguished members of the subcommittee,
the Fleet Reserve Association (FRA) is most grateful for your support
of our military men and women and, particularly, those serving or
having served in Afghanistan, Iraq and other troubled spots around the
globe. At the top of the Association's gratitude list is the quality of
life improvements funded in the 108th Congress. Thanks so much for the
effort. FRA knows you have contributed in the previous year to making a
tough life much easier for those that might make the ultimate sacrifice
in the service of this Nation. BRAVO ZULU.
This Statement lists the concerns of our members, keeping in mind
that the Association's primary goal will be to endorse any positive
safety programs, rewards, and quality of life improvements that support
members of the uniformed services, particularly those serving in
hostile areas, and their families.
FRA is concerned that in spite of signs of bravado, many of our
Sailors, Marines and Coast Guardsmen serving in Operation Iraqi Freedom
(OIF) and Operation Enduring Freedom (OEF) may not be fully armed with
the protective devises available for their personal safety. Advocating
the funding for and receipt of these protective devices; i.e.--
interceptor body armor, outer protective vests, and small arms
protective inserts; to every uniformed member sent into harm's way is
FRA's No. 1 priority.
The Association's next priority is to see that our wounded troops,
their families, and the surviving families of the men and women killed
in action are cared for by a grateful Nation. In this respect, FRA
fully endorses funding any proposal that authorizes our wounded
veterans continuance of their combat pay and other special pays
received while in combat until the completion of their hospital care or
discharge from their respective military service. And any authorized
increases to the death gratuity and life insurance proposed by the
Congress.
OTHER GOALS
Health Care.--FRA and its membership are most grateful for the
improvements in accessing proper health care for the military community
and the expansion of the program to provide greater care for military
retirees and their families. Not everyone in the military community is
pleased, but Congress has done much with the resources available to
offer the best program for as many beneficiaries as possible. There are
other proposals on the table that would increase benefits for those not
satisfied with the current program. FRA endorses these proposals for
many of its members would be affected by their adoption. However, the
Association's primary concern is that existing programs be adequately
funded for fiscal year 2006 and beyond.
Active Duty/Reserve Programs.--Topping the list among the active
duty and reserve members of the Sea Services (Navy and Marines) are
adequate pay and allowances, child care and housing.
Pay and Allowances.--For the fiscal year 2006, the administration
has recommended a 3.1 percent across the board basic pay increase for
members of the Armed Forces. This is commensurate with the 1999 formula
to provide increases of 0.5 percentage points greater than that of the
previous year for the private sector. With the addition of targeted
raises, the formula has reduced the pay gap with the private sector
from 13.5 percent to 5.2 percent following the January 1, 2005, pay
increase.
FRA, however, is disappointed that there is no targeted pay
increase recommended, particularly for mid-grade and more senior
enlisted personnel. FRA, The Military Coalition, the 9th Quadrennial
Review of Military Compensation (9thQRMC), and the Department of
Defense have advocated the necessity for targeted pays. In spite of the
number of special pay increases in the last few years, the pay of our
noncommissioned and petty officers remains compressed; a situation that
has existed since the advent of the all-volunteer force.
FRA urges the subcommittee to appropriate the necessary funds for
the 3.1 percent pay increase for fiscal year 2006.
Other Pays and Allowances.--FRA supports funding to continue and
enhance enlistment and reenlistment bonuses and other compensatory
items necessary for the military services to function accordingly and
to provide the necessary incentives for the Nation's young men and
women to serve in the Armed Forces. Recruiting and retention are vital
to the success of the All-Volunteer Force and fulfilling the Nation's
commitments and should be funded adequately to meet the services needs.
Basic Allowance for Housing (BAH).--FRA is seeking revised housing
standards. Many enlisted personnel, for example, are unaware of the
standards for their respective pay grade and assume that the applicable
BAH level is determined by a higher standard than they may be
authorized. This causes confusion over the mismatch between the amount
of BAH they receive and the actual cost of their type of housing. As an
example, enlisted members are not authorized to receive BAH for a 3-
bedroom single-family detached house until achieving the rank of E-9--
which represents only 1 percent of the enlisted force--yet many
personnel in more junior pay grades do in fact reside in detached
homes. The Coalition believes that as a minimum, this BAH standard
(single family detached house) should be extended gradually to
qualifying service members beginning in grade E-8 and subsequently to
grade E-7 and below over several years as resources allow.
Through your leadership and support, the plan to reduce median out-
of-pocket expenses has been implemented. The aggressive action to
better realign BAH rates with actual housing costs has had a real
impact and provides immediate relief for many service members and
families struggling to meet rising housing and utility costs.
Unfortunately, housing and utility costs continue to rise and the pay
comparability gap, while diminished over recent years, continues to
exist. Members residing off base face higher housing expenses along
with significant transportation costs, and relief is especially
important to junior enlisted personnel living in the civilian
environment who do not qualify for other supplemental assistance.
FRA urges the subcommittee to appropriate the necessary funds to
cover authorized increases in housing allowances for uniformed
personnel.
Permanent Change of Station (PCS) Reimbursements.--FRA is most
appreciative of the significant increases in the Temporary Lodging
Expense (TLE) allowance authorized for fiscal year 2002 and the
authority to raise PCS per diem expenses to match those for Federal
civilian employees in fiscal year 2003. FRA greatly appreciates the
provision in the fiscal year 2004 defense bill to provide full
replacement value for household goods lost or damaged by private
carriers during government directed moves, and looks forward to the
timely implementation of the Department of Defense comprehensive
``Families First'' plan to improve claims procedures for service
members and their families.
These were significant steps to upgrade allowances that had been
unchanged over many years. Even with these changes, however, service
members continue to incur significant out-of-pocket costs in complying
with government-directed relocation orders.
For example, PCS mileage rates have not been adjusted since 1985.
The current rates range from 15 to 20 cents per mile--less than half
the 2005 temporary duty mileage rate of 40.5 cents per mile for
military members and Federal civilians. PCS household goods weight
allowances were increased for grades E-1 through E-4, effective January
2003, but weight allowance increases are also needed for service
members in grade E-5 and above to more accurately reflect the normal
accumulation of household goods over the course of a career. The
Association has recommended modifying weight allowance tables for
personnel in pay grades E-7, E-8 and E-9 to coincide with allowances
for officers in grades 0-4, 0-5, and 0-6, respectively. FRA also
supports authorization of a 500-pound professional goods weight
allowance for military spouses.
In addition, the overwhelming majority of service families own two
privately owned vehicles, driven by the financial need for the spouse
to work, or the distance some families must live from an installation
and its support services. Authority is needed to ship a second POV at
government expense to overseas' accompanied assignments. In many
overseas locations, families have difficulty managing without a second
family vehicle because family housing is often not co-located with
installation support services.
FRA is sensitive to the subcommittee's efforts to reduce the
frequency of PCS moves. But the Armed Services cannot avoid requiring
members to make regular relocations, with all the attendant disruptions
in their children's education and their spouse's career progression.
The Association believes strongly that the Nation that requires them to
incur these disruptions should not be requiring them to bear the
resulting high expenses out of their own pockets.
FRA urges additional funding to support further upgrades of
permanent change-of-station reimbursement allowances to recognize that
the government, not the service member, should be responsible for
paying the cost of government-directed relocations.
Combat and Incentive Pays during Hospitalization.--FRA strongly
urges the subcommittee to take action to ensure combat-wounded service
members do not have their pay reduced or their taxes increased during
periods of hospitalization. The Association believes that such
compensation treatment is essential for service members who continue to
suffer from the hazardous conditions that combat-related incentive pays
and tax relief were created to recognize.
Basic Allowance for Subsistence (BAS).--FRA is grateful for the
increases in BAS over the years. There is more to be done; however, to
permit single career-enlisted members greater individual responsibility
in their personal living arrangements. FRA believes it is inconsistent
to demand significant supervisory, leadership and management
responsibilities of noncommissioned and petty officers, but still
dictate to them where and when they must eat their meals while at their
home duty station.
FRA has urged the authorizers to repeal the statutory provision
limiting BAS eligibility to 12 percent of single members residing in
government quarters. As a long-term goal, extend full BAS eligibility
to all single career enlisted members, beginning with the grade of E-6
and, eventually, to the lower grades as budgetary constraints are
eased. FRA requests the subcommittee's support for the repeal by
appropriating the necessary funding to implement any increases in BAS
adopted by the authorization process.
MGIB. The Montgomery GI Bill often is characterized as a form of
compensation or as a ``recruiting tool.'' However, FRA would argue that
it would be more appropriate to consider the benefit an investment in
our nation's future. Military personnel can use the MGIB on active duty
to aid in their professional development, giving them the tools to
become better leaders, mentors and representatives of their respective
service. Our Nation has a responsibility to ensure the MGIB investment
remains a relevant supplement to completing one's education. We must
give our veterans the tools to excel in an academic environment.
There are 61,000 senior enlisted members in the Armed Forces who
entered military service during the Veterans Education Assistance
program (VEAP) era and did not have the opportunity to enroll in the
MGIB. FRA has urged the adoption of an open enrollment period offering
these enlisted leaders a chance to sign up for the education benefits
available through the MGIB. In fact, the Association believes the MGIB
should be expanded so that any uniformed member reenlisting in his or
her military service will have the opportunity to enroll in the
program.
FRA recommends funding enhancements of benefits in the MGIB as
authorized. The Association is grateful for the October 1, 2004
increases in basic rates but they cover only about 60 percent of
current tuition expenses. A creation of a benchmark for the MGIB will
keep pace with the cost of an average 4-year college education. For the
school year 2004-2005 ($20,082 for 4 yrs. at private institutions;
$5,132 at public institutions) the cost is much greater than what is
available through the MGIB. Enhancing the value of the MGIB would be an
improved incentive to enlist or reenlist in the Armed Forces.
FAMILY READINESS AND SUPPORT
It's most important that DOD and the military services concentrate
on providing programs for the families of our service members. 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 (MCCS) and Family Services programs are
providing comprehensive, 24/7 information and referral services to the
service member and family through its One Source links. One Source is
particularly beneficial to mobilized reservists and families who are
unfamiliar with varied benefits and services available to them.
It's true that ``the service member 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. To assist in bringing that satisfaction, FRA recommends
the following to the subcommittee.
Child and Youth Programs.--Both programs rank high in priority for
the families of Sailors and Marines. As an integral support system for
mission readiness and deployments, its imperative these programs
continue to be improved and expanded to cover the needs of both married
and single parents. Currently, the Navy's program cares for over 31,000
children 6 months to 12 years in 227 facilities and 3,180 on and off
base licensed child development homes. With the high priority tagged to
child care, FRA urges Congress to continue enhancing and increase
funding for this important benefit.
Pre-tax Treatment for Child Care Expenses.--FRA seeks the support
of the subcommittee to direct the Department of Defense to implement
flexible spending accounts for pre-tax payment of child-care expenses.
The Association urges the subcommittee to coordinate with the Ways and
Means Committee to enact such authority as may be needed as soon as
possible.
Spousal Employment.--Today's all-volunteer environment requires the
services to consider the whole family. It is no longer adequate to
focus only on the morale and financial well-being of the member. Now,
his or her family must be considered. One of the major considerations
for spousal employment is it could be a stepping-stone to retention of
the service member--a key participant in the defense of this Nation.
The Association urges Congress to continue its support of the
military's effort to affect a viable spousal employment program and to
authorize sufficient funds to assure the program's success.
Impact Aid.--FRA is most appreciative for the Impact Aid authorized
in previous Defense measures but must urge this subcommittee and its
full committee to support a substantial increase in the funding for
schools bearing the responsibility of educating the children of
military personnel and Federal employees. Current funds are not
adequate to ably support the education of federally sponsored children
attending civilian community elementary schools. Beginning with the
Nixon Administration, funding for Impact Aid has decreased
dramatically. For example, in the current fiscal year the Military
Impacted Schools Association (MISA) estimates Impact Aid is funded at
only 60 percent of need according to law. Our children should not be
denied the best in educational opportunities. Impact Aid provides the
children of our Sailors, Marines, Coast Guardsmen, Soldiers, and
Airmen, a quality education. FRA implores Congress to accept the
responsibility of fully funding the military Impact Aid program. It is
important to ensure our service members, many serving in harm's way,
have little to concern with their children's future but more to do with
the job at hand.
DOD Schools.--FRA notes with concern the Department of Defense's
(DOD's) repeated quest to close some or all DOD-sponsored schools
operating on military installations in CONUS. FRA is adamantly opposed
to reducing the quality of education now enjoyed by the children of
military personnel and Federal employees' by forcing them to enroll in
public schools. As long as the United States continues with an all-
volunteer force and as long as U.S. uniformed personnel and employees
of the Armed Forces are deployed to foreign shores, CONUS schools
provide a safe haven for their children. FRA recommends that Congress
provide the necessary funds to continue the effective operation of the
Department of Defense's school system and to cease and desist from
using appropriated funds to find ways and means to close or transfer
its school system to local school districts. There is no need for
further threats of closures that damage the morale of our Nation's
military personnel and families. In an all-voluntary force environment,
it's certain Congress doesn't want to add to the retention challenges
the military may face in the future.
Morale, Welfare, and Recreation Programs (MWR).--FRA can't help but
believe Congress and even the military services are less concerned with
MWR programs that are really vital to supporting the service member and
his or her family. The Navy's top enlisted chief, MCPON Terry Scott
USN, again this year advised a House panel on February 16 last he is
particularly troubled that current budget decisions will place a
greater burden on the Service in providing the necessary programs so
important in maintaining the well-being of its sailors and families.
The MWR programs of the Navy; Child Care, Fleet/Family Support Program
(FFSP), for example, include recreation, fitness, social and community
support activities, spouse employment, personal financial management,
counseling, family advocacy, safety, transition and relocation--all
having a positive affect on Fleet Readiness.
Currently, the shortage of funds is curtailing or closing some of
the activities while the costs of participating in others have
increased over the past year or two. One major problem is in Europe.
The weakening dollar has caused an increase in child-care rates, movie
tickets, etc., and placed a hiring freeze on MWR employees.
The lack of fiscal support for MWR programs is damaging the need to
provide mental and physical relief to both sailors and families from
the stress of deployments that have increased dramatically since the
military downsized in the 1990's. MWR programs build a community spirit
among those living on or near a military installation, something not
experienced by those who may seek comfort and well-being from a
civilian environment.
MWR facilities should be fully funded and include where and when
available the guard, reserve, and retired military population residing
in the area. One group aids the other. Who better to assist, comfort,
counsel, and encourage military family members concerned with the
conflict in Iraq, continuing deployments, and other military related
activities.
FORCE SIZE/READINESS/OPTEMPO/PERSTEMPO
FRA will again simultaneously address force size, readiness,
OPTEMPO, and PERSTEMPO as one issue. Readiness is achieved at its
highest if force size is adequate in numbers, OPTEMPO is not too
excessive, and PERSTEMPO is not adversely affecting the performance of
individual service members. FRA noted in its fiscal year 2005 statement
that all four were suffering from a shortage of uniformed members.
Since then Congress has added numbers to the uniformed manpower in both
the Army and Marine Corps. FRA is grateful for the increase and is
hopeful the added manpower will be the answer to the difficulty
experienced by the military in Iraq over the past few years. The
Association, however, is concerned that the Navy is going to the
extreme in downsizing its uniformed manpower. This concern has been
voiced to the authorizing committee in hope some action will be
directed to steady the outgoing tide of experienced naval personnel.
Meanwhile, FRA urges the subcommittee to continue funding our
military personnel to ensure the numbers remain sufficient to relieve
both OPTEMPO and PERSTEMPO, primarily the result of operations in
Afghanistan and Iraq.
RESERVE COMPONENT
Operational Tempo.--The increase in the use of reserve units to
serve along side active duty components in Iraq, as an example, has
caused considerable challenges for individual reservists. Not only has
their mobilization placed a strain on employment and income, but the
family as well. Employer support, once strong, decreases as more
essential employees are whisked-off to spend longer periods in uniform
leaving the employer frustrated with having to find a replacement and,
at the same time, hold the position open for the reservist's return.
FRA has always supported the Total Force Policy but is concerned
that the sustained use of reserve forces will eventually harm the
recruiting and retention of young men and women willing to serve as
future citizen Sailors, Marines, and Coast Guardsmen. The United States
must maintain a strong reserve force at all times in the event of a
greater need than at the present.
The fiscal year 2005 defense authorization bill established a
Commission on the National Guard and Reserves. FRA is in hope that it
will provide recommendations on what enhancements are necessary to
recruit and retain the number of reservists required for the defense of
the United States. There is a possibility the study may include
recommendations addressing such issues as tax relief, healthcare,
retirement upgrades, improvements in the MGIB-SR, and family support
programs.
Until the study is released, FRA urges this subcommittee to
appropriate funds to support reserve and guard programs authorized in
the fiscal year 2006 National Defense Authorization Act that:
--Increase in both enlisted and reenlistment bonuses.
--Enhance the MGIB-SR rates for those who choose to participate in
the program.
--Provide academic and financial protection to members who are
attending an institution of higher learning when called to
active duty.
--Support and fund programs for families, particularly those
geographically dispersed and not readily accessible to military
installations and inexperienced with the military.
--Authorize cost-share access to Tricare for members of the Selected
Reserve and their families.
RETIRED COMPONENT
Concurrent Receipt.--The fiscal year 2003 National Defense
Authorization Act (NDAA) authorizes a special compensation that
establishes a beachhead to authorizing full concurrent receipt, a term
for the payment of both military non-disability retired pay and any VA
compensation for service-connected disabilities without a reduction in
one or the other payment. The fiscal year 2004 and 2005 NDAA expanded
the benefit list through Combat Related Disability Pay (CRDP) and
Combat Related Special Compensation (CRSC). Although FRA is
appreciative of the effort of Congress to address the issue, it fails
to meet the resolution adopted by the Association's membership to seek
full compensation for both length-in-service military retirement and VA
compensation. Currently, the receipt of VA compensation causes a like
reduction to a retired service member's military retired pay. This
leads to the belief, and well-deserved, that retired service members,
earning retired pay as a result of 20 years or more of service, are
forced to pay for their own disablement.
Most disabilities are recognized after the service member retires.
Some are discovered while the member is still performing active duty or
as the result of a retirement physical. However, it is to the benefit
of the Department of Defense to retire the member without compensation
for any disability. Instead, the member is directed to the Department
of Veterans' Affairs for compensatory relief for the damages incurred
by the member while serving the Nation in uniform.
FRA has encouraged Congress to take the helm and authorize and fund
concurrent receipt for all qualified military non-disabled retirees who
are eligible for and receiving veterans' compensation.
CONCLUSION
FRA is grateful to the subcommittee for the opportunity to present
its goals for fiscal year 2006. Further information may be obtained by
contacting Mr. Matthew Schafer, FRA Acting Director for Legislative
Programs.
Senator Stevens. Thank you very much and thank you for your
patience in staying with us, the last witness of the day.
Chief Barnes. Not a problem, sir.
Senator Stevens. Questions, Senator?
Senator Inouye. I just wanted to say that the FRA has a
very, very active organization in Hawaii.
Chief Barnes. Thank you, Senator, and congratulations on
your recognition last year as our Pinnacle Award recipient----
Senator Inouye. Thank you, sir.
Chief Barnes. Following the distinguished chairman's
receipt a couple years ago.
Senator Stevens. That is right.
Thank you again for your testimony.
ADDITIONAL SUBMITTED STATEMENTS
If there are any additional statements that individuals
would like to submit for the record, it will be held open for 5
days.
[The statements follow:]
Prepared Statement of Sue Schwartz, DBA, RN, Co-Chairman, Health Care
Committee, Military Officers Association of America, on Behalf of The
Military Coalition (TMC)
OVERVIEW
Mr. Chairman, The Military Coalition (TMC) thanks you and the
entire subcommittee for your continued, unwavering support for funding
the needs of active duty, Guard, Reserve and retired members of the
uniformed services, and their families and survivors. The
subcommittee's work to greatly improve military pay, eliminate out of
pocket housing expenses, improve health care, and enhance other
personnel programs has made a significant difference in the lives of
active, Guard and Reserve personnel and their families. This is
especially true for our deployed servicemembers and their families and
survivors who are engaged throughout this world in the global war on
terror.
Despite these improvements in military compensation, we are deeply
troubled by how much harder troops have to work--and how much more
their families have to sacrifice--for that compensation.
Today's reality is simple--servicemembers and their families are
being asked to endure ever-greater workloads and ever-greater
sacrifices. Repeated deployments, often near back-to-back, have
stressed the force to the point where recruiting and retention are real
concerns for some Services; and, if it weren't for the Services' stop-
loss policies and massive recalls of Guard and Reserve members,
readiness would suffer. The hard fact is that we don't have large
enough forces to carry out today's missions and still be prepared for
any new contingencies that may arise elsewhere in the world. In
addition, the Coalition is concerned that the Navy and Air Force are in
the midst of ``transformation'' initiatives that include reducing their
respective end strengths despite continuing demanding operational
commitments.
In testimony today, The Military Coalition offers its collective
recommendations on what needs to be done to address these important
issues and sustain long-term personnel readiness.
BUDGET OVERVIEW
The Military Coalition is concerned that some in the Executive
Branch are now bemoaning Congress' efforts in recent years to reverse
military pay shortfalls and correct compensation and benefit inequities
affecting retired military members, military survivors and Guard and
Reserve members, contending that the cost of those initiatives impinges
on current defense budget needs, including the ability to support
compensation initiatives for the current force.
The Coalition objects strongly to any such efforts to pit one
segment of the military community against another. Our experience has
been that this subcommittee has rarely turned down Defense Department
requests for current force funding needs. If anything, Congress has had
greater sensitivity than the Executive Branch--regardless of the
political party of the administration--to the importance of career
military benefits to long-term retention and readiness.
Those who complain today about the cost of restoring military pay
comparability, repealing REDUX retirement penalties, and enacting
TRICARE For Life apparently do not recall that the Joint Chiefs of
Staff at the time all told Congress that fixes were needed in these
areas in order to address the significant retention problems
experienced in the late 1990's.
Congress has been wise enough to see what Executive Branch
officials of both parties have not in recent years--that it is not
enough to just meet the short term desires of the 19 year old new
enlistee with more cash in hand. Those members get older and have
families, and their families grow much more concerned at the second and
third reenlistment points, often after multiple family separations,
whether the long-term benefits of a military career offset the
extraordinary and persistent demands and sacrifices inherent in serving
20 to 30 years in uniform.
The Military Coalition believes this subcommittee will see past
penny-wise and pound-foolish efforts to rob one element of the military
community to pay another, and will continue to recognize the hard-
learned lessons of the past--that successfully sustaining readiness and
retention over the long term requires fair treatment for military
members and families at every stage: active duty, Guard and Reserve,
retired, and survivors.
ACTIVE FORCE ISSUES
Since the end of the Cold War, the size of the force and real
defense spending has been cut by more than a third. In fact, the
defense budget today is 3.8 percent of this Nation's Gross Domestic
Product--less than half of the share it comprised in 1986. But today
America's armed forces are engaged in a global war on terror--a
campaign that has made constant and repeated deployments a way of life
for today's servicemembers. There is no question that the stress of
today's sustained operations is taking a significant toll on our men
and women in uniform, and their families and survivors, and this is
being reflected in failure of the Army Guard and Reserve to meet its
recent recruiting goals. In addition, there are indications of growing
challenges in recruiting members of the other Services.
Congress has taken action to help relieve the stress of repeated
deployments by increasing Army and Marine Corps end strength and by
making family separation and danger area pays permanent. These are
notable and commendable improvements; however, sustaining a quality
force for the long-term remains a significant challenge, especially in
technical specialties. While some Services are meeting retention goals,
these goals may be skewed by post-9/11 patriotism and by Services'
intermittent stop-loss policies. This artificial retention bubble is
not sustainable for the long-term under the current pace of operations,
despite the reluctance of some to see anything other than rosy
scenarios.
From the servicemembers' standpoint, the increased personnel tempo
necessary to meet continued and sustained training and operational
requirements has meant having to work progressively longer and harder
every year. ``Time away from home'' is now a real focal point in the
retention equation. Servicemembers are enduring longer duty days;
increased family separations; difficulties in accessing affordable,
quality health care; deteriorating military housing; less opportunity
to use education benefits; and significant out-of-pocket expenses with
each permanent change of station move.
Intensified and sustained operations in Iraq and Afghanistan are
being met by servicemembers' patriotic dedication, but there is little
question that once Service stop-loss policies are lifted, the retention
of combat-experienced servicemembers is going to be problematic.
Experienced (and predominantly married) officers, NCOs and petty
officers are under pressure to make long-term career decisions against
a backdrop of a demand for their skills and services in the private
sector. Many servicemembers and their families debate among themselves
whether the rewards of a service career are sufficient to offset the
attendant demands and sacrifices inherent in uniformed service. Faced
with repeated deployments to a combat zone, the appeal of a more stable
career and family life, often including an enhanced compensation
package and less demanding working conditions, is attractive. When
allowed the option, many of our excellent soldiers, sailors, airmen and
Marines will opt for civilian career choices, not because they don't
love what they do, but because their families just can no longer take
the stress.
On the recruiting front, one only needs to watch prime-time
television to see powerful marketing efforts on the part of the
Services. But this strong marketing must be backed up by an ability to
retain these experienced and talented men and women. This is especially
true as the Services become more and more reliant on technically
trained personnel. Congress reacted to retention problems by improving
military compensation elements. But we also understand the pressures to
reduce spending and the challenges associated with proposed defense
budget increases. The truth remains that the finest weapon systems in
the world are of little use if the Services don't have enough high
quality, well-trained people to operate, maintain and support them.
The subcommittee's key challenge will be to ease servicemembers'
debilitating workload stress and continue to build on the foundation of
trust that you have established over the past 4 years--a trust that is
being strained by years of disproportional sacrifice. Meeting this
challenge will require a reasonable commitment of resources on several
fronts.
Personnel Strengths and Operations Tempo.--The Coalition has noted
with disappointment the Department of Defense's resistance to accept
Congress's repeated offers to permanently increase Service end strength
to relieve the stress on today's armed forces, which are clearly
sustaining a wearing operations tempo fighting today's global war on
terror. While we are encouraged by the subcommittee's support for
increased Army and Marine Corps end strength, we are deeply concerned
that administration-proposed plans for temporary manpower increases
rely too heavily on continuation of stop-loss policies, unrealistic
retention assumptions, overuse of the Guard and Reserves, optimistic
scenarios in Southwest Asia, and the absence of new contingency needs.
While the Department's transformation vision is an understandable
and necessary plan, its implementation will take a long time--time that
is taking its toll after years of extraordinary operational tempo that
is exhausting our downsized forces.
The Joint Chiefs testified that their forces were stressed before
9/11, and end strength should have been increased then. Now, almost 4
years later, heavily engaged in two major operations with no end in
sight, massive Guard and Reserve mobilizations, and implementation of
``stop-loss'' policies, action to provide substantial relief is late
and short of the need. Especially noteworthy is a recent memorandum
detailing serious Army Reserve readiness concerns referencing the
Reserves as ``rapidly degenerating into a broken force.''
Administration and military leaders warn of a long-term mission
against terrorism that requires sustained, large deployments to Central
Asia and elsewhere. The Services simply do not have sufficient numbers
to sustain the global war on terrorism, deployments, training exercises
and other commitments, even with the recall of large numbers of Guard
and Reserve personnel. Service leaders have tried to alleviate the
situation by reorganizing deployable units, authorizing ``family down
time'' following redeployment, or other laudable initiatives, but such
things do little to eliminate long-term workload or training backlogs,
and pale in the face of ever-increasing mission requirements. For too
many years, there has always been another major contingency coming, on
top of all the existing ones. If the administration does not recognize
when extra missions exceed the capacity to perform them, Congress must
assume that obligation.
Some argue that increasing end strengths wouldn't help the
situation, questioning whether the Services will be able to meet higher
recruiting goals. The Coalition believes strongly that this difficult
problem can and must be addressed as an urgent national priority, with
increases in recruiting budgets as necessary.
Others point to high reenlistment rates in deployed units in
certain Services as evidence that high operations tempo actually
improves morale. But much of the reenlistment rate anomaly is
attributable to tax incentives that encourage members to accelerate or
defer reenlistment to ensure this occurs in a combat zone, so that any
reenlistment bonus will be tax-free. Retention statistics are also
skewed by stop-loss policies. Experience has shown time and again that
family separation is the single greatest retention disincentive. The
Military Coalition believes that those who ignore this and argue there
is no retention problem are ``whistling past the graveyard.''
The Military Coalition strongly recommends additional funding for
permanent end strength increases to sustain the long-term global war on
terrorism and fulfill national military strategy. The Coalition
supports increases in recruiting resources as necessary to meet this
requirement and ease operational stresses on active, Guard and Reserve
personnel.
Accession and Retention Bonuses.--In the interim, maintaining and
increasing accession and retention bonuses is crucial to meet manning
requirements. The Services have requested increased bonus authority and
special pay authority, as well as more flexible authorities, to meet
specific manning, retention and assignment needs. The Coalition
strongly supports these efforts and hopes the Subcommittee will provide
the full funding needed to sustain these critical programs.
The Military Coalition strongly recommends additional funding to
increase accession and retention bonuses.
Combat and Incentive Pays During Hospitalization.--The Coalition is
concerned that current eligibility rules for combat zone compensation
programs are insensitive to the circumstances of wounded members during
hospitalization and rehabilitation.
Members assigned to combat zones, as well as those performing
hazardous duty elsewhere, are eligible for additional compensation
because the country recognizes the increased risk to life and limb
entailed in such duty. Yet the members who are injured or wounded lose
eligibility for hazardous duty/combat incentive programs during their
hospitalization and recovery from their injuries. In many cases, this
recovery can take months, and their families may be subject to
additional expenses because of their incapacity.
If we acknowledge that members deserve these extra pays for
incurring the risk inherent in a combat zone, we should also
acknowledge an obligation to continue such pays for those who actually
incur combat injuries until they can be returned to duty, retired, or
separated.
The Military Coalition strongly urges the subcommittee to take
action to ensure servicemembers injured or wounded as a result of
hazardous duty/combat do not have their compensation reduced during
periods of hospitalization. The Coalition believes funding support is
essential to sustain compensation for servicemembers who continue to
suffer from the wounds and injuries these incentive programs were
created to recognize.
Commissaries.--The Coalition is committed to preserving the value
of the commissary benefit--which is widely recognized as the
cornerstone of quality of life benefits and a valued part of
servicemembers' total compensation package.
In the fiscal year 2005 Defense Authorization Act, Congress enacted
stronger statutory protections for the commissary and exchange systems.
The Coalition supports cost savings through effective oversight and
management. However, we are concerned about the unrelenting pressure on
the Defense Commissary Agency to cut spending and squeeze additional
efficiencies from its operations--despite years of effective reform
initiatives and recognition of the agency for instituting improved
business practices.
The commissary is a highly valued quality of life benefit whose
savings and retention value for military members far exceeds the
appropriated amount.
The Military Coalition opposes initiatives that would reduce
Commissary benefits or savings for members, and strongly supports full
funding of the benefit in fiscal year 2006 and beyond to sustain the
current level of service for all patrons, including retirees, Guard and
Reserve personnel, and their families.
Family Readiness and Support.--Today, two-thirds of active duty
families and virtually all Guard and Reserve families live off military
installations, and approximately 60 percent of these servicemembers are
married. A fully funded family readiness program to include financial
education and benefit information has never been a more crucial
component to the military mission and overall readiness than it is
today.
More needs to be done to ``connect'' servicemembers and their
families with important resources. A more aggressive outreach effort is
needed to educate servicemembers and their families on the benefits and
programs to which they are entitled. A systematic and integrated family
support system will help families cope with the stresses of deployment
and the demands of military life. Addressing such issues as childcare,
spousal employment/education, flexible spending accounts, increases in
SGLI, and other quality of life concerns will go a long way in
enhancing family well-being and improving retention and morale of the
force.
The Military Coalition urges additional funding for improved family
readiness through further education and outreach programs and increased
childcare availability for servicemembers and their families and
associated support structure to assist families left behind during
deployments of active duty, Guard and Reserve members.
Death Benefits Enhancement.--Military insurance and death gratuity
fall short of what is needed when measured by private sector standards
for employees in hazardous occupations.
The fiscal year 2005 Emergency Supplemental Appropriations Act will
increase the death gratuity and upgrade military life insurance
programs. Continued funding for these significant upgrades is essential
for fiscal year 2006 and the out years.
The Military Coalition urges the subcommittee to fully fund
military death benefits improvements.
NATIONAL GUARD AND RESERVE ISSUES
More than 473,000 members of the National Guard and Reserve have
been mobilized since September 11, 2001, and many thousands more are in
the activation pipeline. Today, they face the same challenges as their
active counterparts, with a deployment pace greater than any time since
World War II.
Guard/Reserve operational tempo has placed enormous strains on
reservists, their family members and their civilian employers alike.
Homeland defense and war-on-terror operations continue to place demands
on citizen soldiers that were never anticipated under the ``Total
Force'' policy. The Coalition understands and fully supports that
policy and the prominent role of the Guard and Reserve forces in the
national security equation.
However, many Guard and Reserve members are facing increased
financial burdens under the current policy of multiple extended
activations over the course of a reserve career. Some senior reserve
leaders are rightly alarmed over likely manpower losses if action is
not taken to relieve pressures on Guard and Reserve troops. The
Coalition believes that addressing critical Guard and Reserve pay,
bonuses, benefits and entitlements issues--along with active duty
manpower increases--are needed to alleviate those pressures and help
retain these qualified, trained professionals.
Healthcare for Members of the National Guard and Reserve.--The
Military Coalition is very grateful that Congress established the
``TRICARE Reserve Select'' health benefit in the fiscal year 2005
National Defense Authorization Act. This new authority--along with
permanent pre- and post- activation TRICARE coverage--will help address
the needs of Guard and Reserve families in the call-up pipeline. We
anticipate that further improvements in this program are likely to be
forthcoming in the fiscal year 2006 Defense Authorization Act.
More specifically, with the increasing rate of utilization for all
areas of our Reserve Components increasing, we feel that Congress must
act to provide increased health care benefits for all our country's
Guardsmen, Reservists, and their families, to guarantee the Nation can
continue to call on them.
It is our strong recommendation that we must provide and fund a
permanent TRICARE program on a cost-share basis for our members of the
Guard and Reserve components who are being mobilized and deployed at
increasing rates.
Seventy percent of Guard and Reserve members have employer-
sponsored health insurance. The Coalition believes this is not a ``one
size fits all'' population. Usage of the TRICARE benefit when the
servicemember is activated may not be the best way to ensure continuity
of care for some families. As an option for these servicemembers, the
Coalition urges Congress to take action to have the government pay part
or all of private health insurance premiums when activation occurs, a
program already in effect for reservists who work for the Department of
Defense.
The Military Coalition recommends funding to allow permanent
authorization of cost-share access to TRICARE for all members of the
Selected Reserve and IRR members subject to activation under
Presidential call-up authority, to support readiness, family morale,
and deployment health preparedness.
Eliminate BAH II.--BAH II is paid to Guard and Reserve members in
lieu of regular BAH (Basic Allowance for Housing) who are on orders of
less than 140 days. BAH II is an antiquated standard that no longer
bears any relation to real housing expenses and is, on average, far
less than the BAH rate for any given locality. There is an exception to
this rule that applies, by public law, for those called up for a
contingency operation. The Coalition believes strongly that any member
activated for 30 days or more should be eligible for locality-based
BAH.
The Military Coalition urges appropriation of funding to permit
payment of locality-based BAH to all Guard and Reserve members
mobilized for 30 days or more.
Family Support Programs.--Providing a core set of family programs
and benefits that meet the unique needs of these families would go a
long way in improving morale and meeting family readiness challenges.
These programs would promote better communication with
servicemembers, specialized support for geographically separated Guard
and Reserve families, and training (and back-up) for family readiness
volunteers. Such access would include:
--Expansion of web-based programs and employee and family assistance
programs like Military One Source and Guard Family.org;
--Enforcement of command responsibility for ensuring that programs
are in place to meet the special information and support needs
of Guard/Reserve families;
--Expanded programs between military and community religious leaders
to support service members and families during all phases of
deployments;
--The availability of robust preventative counseling services for
service members and families and training so they know when to
seek professional help related to their circumstances;
--Enhanced education for Reserve component family members about their
rights and benefits;
--Innovative and effective ways to meet Reserve component community
needs for occasional child care, particularly for preventative
respite care, volunteering, family readiness group meetings and
drill time; and,
--A joint family readiness program to facilitate understanding and
sharing of information between all family members, no matter
what the service.
We applaud the support shown to families by DOD and military and
civilian community organizations. But with the continued and sustained
activation of the Reserve Component, a stronger support structure needs
to be implemented, funded, and sustained.
The Military Coalition urges Congress to increase funding for
military family support programs to meet the unique needs of the
families of mobilized Guard and Reserve component members.
HEALTH CARE
The Military Coalition (TMC) is most appreciative of the
subcommittee's efforts to honor the government's health care
commitments to all uniformed services beneficiaries. While much has
been accomplished, we are equally concerned about making sure that
subcommittee-directed changes are implemented and the desired positive
effects actually achieved.
FULL FUNDING FOR THE DEFENSE HEALTH BUDGET
Once again, a top Coalition priority is to work with Congress and
DOD to ensure full funding of the Defense Health Budget to meet
readiness needs--including graduate medical education and continuing
education, full funding of both direct care and purchased care sectors,
providing access to the military health care system for all uniformed
services beneficiaries, regardless of age, status or location. An
underfunded Defense Health Program inevitably compromises the
capability to deliver desired levels of quality care and undermines the
health care benefits military beneficiaries have earned. A fully funded
health care benefit is critical to readiness and the retention of
qualified uniformed service personnel.
The subcommittee's continued oversight of the defense health budget
is essential to avoid a return to the chronic under funding of recent
years that led to execution shortfalls, shortchanging of the direct
care system, inadequate equipment capitalization, failure to invest in
infrastructure, curtailed drug formularies, and reliance on annual
emergency supplemental funding requests as a substitute for candid and
conscientious budget planning. We are grateful that once again late
last year, Congress provided $683 million supplemental appropriations
to meet the last quarter's obligations--but not all of the growing
requirements in support of the deployment of forces to Southwest Asia
and Afghanistan in the global war against terrorism.
The Coalition is hopeful that fiscal year 2006 funding levels will
not fall short of current obligations. We fear that additional
supplemental funding will once again be required. Last year, citing
budgetary restraints, the Air Force made a unilateral decision to
remove certain drugs from military treatment facility (MTF)
formularies. We appreciate that these are extremely challenging budget
times for MTF commanders; however, we are greatly concerned that this
budget-driven action undermined the deliberative process by which the
Uniform Formulary must be developed.
In addition, this policy forced increased use of mail-order and
retail pharmacy programs, and thus increased costs to both DOD and
beneficiaries; inappropriately made budget considerations the primary
driver of formulary limits; and imposed regrettable inter-service
disparities in pharmacy benefits.
Health care requirements for members returning from the GWOT are
also expected to continue to strain the military delivery system in
ways that may not have been anticipated in the budgeting process.
Similarly, implementation of the TRICARE Standard requirements in the
fiscal year 2004 Authorization Act--particularly those requiring
actions to attract more TRICARE providers--will almost certainly
require additional resources that we do not believe are being budgeted
for. Financial support for these increased readiness requirements;
TRICARE provider shortfalls and other needs will most likely require
additional funding.
At the January 2005 TRICARE Conference, Assistant Secretary
Winkenwerder said that funding for fiscal years 2006 and 2007 was
adequate. However, he went on to state, ``looking to the longer term,
I'm candidly concerned.'' At the same conference Air Force Chief of
Staff Gen. John Jumper said that the health system faces an $11 billion
shortfall over the next few years.
The Military Coalition strongly recommends the subcommittee ensure
full funding of the Defense Health Program, including military medical
readiness, needed TRICARE Standard improvements, and the DOD peacetime
health care mission. It is critical that the Defense Health Budget be
sufficient to secure increased numbers of providers needed to ensure
access for TRICARE beneficiaries in all parts of the country.
TRICARE ISSUES
Provider Reimbursement.--The Coalition appreciates Congress's
efforts to address provider reimbursement needs in the fiscal year 2004
NDAA (Public Law 108-136). We recognize that part of the problem is
endemic to the flawed Medicare reimbursement system, to which TRICARE
rates are directly tied.
The Coalition is troubled to note that a flaw in the provider
reimbursement formula led the Centers for Medicare and Medicaid (CMS)
to propose cutting Medicare fees in recent years, which were only
forestalled by last-minute legislative relief. While the Coalition is
grateful for Congress's temporary fixes, the reimbursement formula
remains broken.
Once again, the Coalition wishes to bring to the subcommittee's
attention that the 2004 report of the Medicare Trustees predicts 5
percent annual cuts in Medicare reimbursements to providers for 2006
through 2012. However, MedPAC has recommended raising Medicare's
physician payment rate by 2.7 percent in 2006, stating that a ``small
but consistent share'' of beneficiaries have experienced some
difficulty in accessing providers.
Cuts in Medicare (and thus TRICARE) provider payments, on top of
providers' increasing overhead costs and rapidly rising medical
liability expenses, seriously jeopardizes providers' willingness to
participate in both these programs. Provider resistance is much more
pronounced for TRICARE than Medicare for a variety of social, workload,
and administrative reasons. Provider groups tell us that TRICARE is
seen as the lowest-paying program they deal with, and often causes them
the most administrative problems. This is a terrible combination of
perceptions if you are a TRICARE Standard patient trying to find a
doctor.
For patients in Prime the situation is growing increasingly
problematic as deployments of large numbers of military health
professionals continue to diminish the capacity of the military's
direct health care system. In this situation, more and more TRICARE
patients have to turn to the purchased care sector--thus putting more
demands on civilian providers who are reluctant to take an even larger
number of beneficiaries with relatively low-paying TRICARE coverage.
The Coalition firmly believes this is a readiness issue. Our
deployed service men and women need to focus on their mission, without
having to worry whether their family members back home can find a
provider. Uniformed services beneficiaries deserve the Nation's best
health care, not the cheapest.
Congress did the right thing by reversing the proposed provider
payment cuts previously planned for March 1, 2003 and January 1, 2004,
and instead providing 1.6 percent and 1.5 percent payment increases
respectively. Unless Congress or the administration acts soon,
effective next year, providers will have to absorb a 5 percent cut for
TRICARE patients as well as Medicare patients. More importantly, the
underlying formula needs to be fixed to eliminate the need for
perennial ``band-aid'' corrections.
The Military Coalition requests the subcommittee's support of any
means to stabilize, maintain and fund Medicare and TRICARE provider
payment rates to ensure beneficiary access.
CONCLUSION
The Military Coalition reiterates its profound gratitude for the
extraordinary progress this subcommittee has made in advancing a wide
range of personnel and health care initiatives for all uniformed
services personnel and their families and survivors. The Coalition is
eager to work with the subcommittee in pursuit of the goals outlined in
our testimony. Thank you very much for the opportunity to present the
Coalition's views on these critically important topics.
______
Prepared Statement of the Naval Reserve Association
Chairman Stevens, Senator Inouye and distinguished members of the
subcommittee, on behalf of our 22,000 members, and in advocacy for the
80,000 active Naval Reservists and the mirrored interest of Guard and
Reserve personnel, we are grateful for the opportunity to submit
testimony, and for your efforts in this hearing.
We very much appreciate the efforts of this subcommittee, the full
committee on Appropriations and like committees in the House of
Representatives to support our deployed personnel and their families.
Your willingness to address and correct issues facing Guardsmen and
Reservists affirms their value to the defense of our great Nation. Your
recognition of these men and women as equal partners in time of war
stands you well in the eyes of many. Our young Naval Reservists
indicate to us that they are watching and waiting to see our actions to
address their concerns. Your willingness to look at issues related to
the use of the Guard and Reserve on the basis of fairness sets the
Legislative Branch well above the Executive Branch which seemingly
develops its positions on the basis of cost.
That said, there are issues that need to be addressed by this
committee and this Congress.
Recruiting and retention issues are moving to center stage for all
services and their reserve components. In all likelihood the Navy will
not meet its target for 13,000 new Naval Reservists and the Naval
Reserve will be challenged to appreciably slow the departure of 17,000
experienced personnel this fiscal year. Other services and their
Reserve Components likely face these same challenges.
We believe that Congress and this committee should give the
services the tools targeted to mid-career personnel in the Guard and
Reserve: (1) appropriate critical skills bonuses for Guardsmen and
Reservists (G&R) that would provide $100,000 over an entire career (no
authorization exists for G&R personnel while one with a $200,000 limit
exists for active duty personnel); (2) increase affiliation bonuses to
$15,000 to attract veterans; (3) restore the Reserve MGIB to 50 percent
of the active duty entitlement (presently at 28 percent) and make it
available throughout a career; (4) Provide the resources to maintain
Navy Reserve end strength at 66,000 Selected Reservists and 13,500 for
FTS personnel; and (5) Provide supportive language that provides for an
earlier than age 60 retirement.
We've heard that Reserve Chiefs are in agreement, expressing
concern that senior personnel will leave in droves. Hopefully this is
more than conscript thinking. A compromise solution to this earlier
than age 60 retirement issue is something modeled after Social
Security--if you take reserve retirement as early as age 55 you do so
with a greatly reduced annuity for life. This NRA-conceived proposal
would significantly reduce the estimated costs to the government over
other plans being proposed. The money has been accrued; the costs then
would be those associated with administering monthly payments earlier
than expected and any lost interest on the accrued amount. The greatly
reduced annuity for life may very well serve as a disincentive to early
retirement for the senior leaders who truly have upwardly mobile
careers.
We ask you to fund Navy Reserve equipment in the NGREA accounts,
including an additional C-40 aircraft that is critical for supporting
Reserve forces in today's Global War on Terrorism. The Navy Reserve is
downsizing. Naval Reserve units are engaged in this Global War, and
these units, the people, and their families are responding to Combatant
Commanders calls. We must maintain the proper equipment for these Navy
Reserve units and Navy Reserve Sailors. The AC will not do it, yet will
call on them to respond. Only through the NGREA will your citizen-
Sailors be able to respond to the needs of the Nation and Combatant
Commanders.
These recommendations are relevant to the needs of the services
today, and to the future readiness of the Nation. The last two issues
(end-strength cap) and (early retirement) are on the minds of many
Guardsmen and Reservists. We urge you to address these issues as our
young Sailors are very concerned about these issues, and what it means
to their long term service.
In summary, we believe the committee needs to address the following
issues for our Guardsman and Reservists in the best interest of our
National Security:
--Increase funding for Naval Reserve equipment in NGREA
--Address and authorize recruitment and retention issues:
--Authorize critical skills bonuses for Guardsmen and Reservists--
$100,000 over an entire career
--Increase affiliation bonuses to $15,000 to attract veterans
--Restore Reserve MGIB to 50 percent of the active duty entitlement
--Establish 79,500 SelRes (66,000) and FTS (13,500) as a floor for
end strength to Navy Reserve manpower--providing for surge-
ability and operational support
--Substantiate that Navy Reserve equipment remain a part of the Chief
of Naval Reserve inventory
--Reduce annuity for reserve retirement before age 60 is a retention
issue, and must be addressed by this Congress.
For Navy Reserve NGREA accounts we recommend the following: (1) C-
40 Procurement--procure 1 additional C-40 for fiscal year 2006; (2)
Equipment for Naval Coastal Warfare/Small Arms--Emerging GWOT
requirement EOD/NCW equipment for Naval Coastal Warfare units; (3)
Reserve Requirements--for activation--Funds associated for Reservist
mobilize for GWOT.
The above are a part of the Navy's unfunded list; however, there
are other items that must be addressed in the NGREA account. Guard and
Reserve Components still need the funding Congress provides through
this means.
We thank the committee for consideration of these tools to assist
the Guard and Reserve in an age of increased sacrifice and utilization
of these forces.
______
Prepared Statement of Neurofibromatosis, Inc.--New England
Thank you, Mr. Chairman, for the opportunity to present testimony
to the subcommittee on the importance of continued funding for
Neurofibromatosis (NF), a terrible genetic disorder directly associated
with military purposes and closely linked too many common diseases
widespread among the American population.
I am Naomi Stonberg, representing Neurofibromatosis, Inc., New
England which is a participant in a national coalition of NF advocacy
groups. I am actively involved in creating awareness of NF and
promoting scientific research in this area. I am here on behalf of the
100,000 Americans who suffer from NF, including my daughter and nephew,
as well as approximately 175 million Americans who suffer from diseases
linked to NF, including some of the most common forms of cancer, brain
tumors, congenital heart disease, hypertension, memory loss and
learning disabilities.
Mr. Chairman, I am requesting increased support, in the amount of
$25 million, to continue the Army's highly successful NF Research
Program (NFRP), which is now at the critical point of establishing a
nation-wide clinical trials consortia. The program's great success can
be seen in the commencement of clinical trials only 10 years since the
discovery of the NF1 gene. Now, with NF in the expensive but critical
era of clinical and translational research, scientists closely involved
with the Army program have stated that the number of high-quality
scientific applications justify a much larger program.
WHAT IS NEUROFIBROMATOSIS (NF)?
NF is a genetic disorder involving the uncontrolled growth of
tumors along the nervous system which can result in terrible
disfigurement, deformity, deafness, blindness, brain tumors, cancer,
and/or death. NF can also cause other abnormalities such as unsightly
benign tumors across the entire body and bone deformities. In addition,
approximately one-half of children with NF suffer from learning
disabilities. NF is the most common neurological disorder caused by a
single gene. While not all NF patients suffer from the most severe
symptoms, all NF patients and their families live with the uncertainty
of not knowing whether they will be seriously affected one day because
NF is a highly variable and progressive disease.
Approximately 100,000 Americans have NF. It appears in
approximately one in every 3,500 births and strikes worldwide, without
regard to gender, race or ethnicity. It is estimated that 50 percent of
new cases result from a spontaneous mutation in an individual's genes
and 50 percent are inherited. There are two types of NF: NF1, which is
more common, and NF2, which primarily involves acoustic neuromas and
other tumors, causing deafness and balance problems. Advances in NF
research will benefit over 175 million Americans in this generation
alone because NF is directly linked to many of the most common diseases
affecting the general population, as indicated above.
NF'S CONNECTION TO THE MILITARY
NF research is directly linked to military purposes because NF is
closely linked to cancer, brain tumors, memory loss, learning
disabilities, heart disease, brain tissue degeneration, nervous system
degeneration, healing after wounding, deafness, and balance. Because NF
manifests itself in the nervous system, this subcommittee, in past
Report language, has stated that Army-supported research on NF includes
important investigations into genetic mechanisms governing peripheral
nerve regeneration after injury from such things as missile wounds and
chemical toxins. For the same reason, this subcommittee also stated
that NF may be relevant to understanding Gulf War Syndrome and to
gaining a better understanding of wound healing. Today, NF research now
includes important investigations into genetic mechanisms which involve
not just the nervous system but also other cancers.
LINK TO OTHER ILLNESSES
Researchers have determined that NF is closely linked to cancer,
heart disease, learning disabilities, memory loss, brain tumors, and
other disorders including deafness, blindness and orthopedic disorders,
primarily because NF regulates important pathways common to these other
disorders such as the RAS, cAMP and PAK pathways. Research on NF
therefore stands to benefit millions of Americans.
Cancer.--Research has demonstrated that NF's tumor suppressor
protein, neurofibromin, inhibits RAS, one of the major malignancy
causing growth proteins involved in 30 percent of all cancer.
Accordingly, advances in NF research may well lead to treatments and
cures not only for NF patients but for all those who suffer from cancer
and tumor-related disorders. Similar studies have also linked epidermal
growth factor receptor (EGF-R) to malignant peripheral nerve sheath
tumors (MPNSTs), a form of cancer which disproportionately strikes NF
patients.
Heart disease.--Researchers have demonstrated that mice completely
lacking in NF1 have congenital heart disease that involves the
endocardial cushions which form in the valves of the heart. This is
because the same ras involved in cancer also causes heart valves to
close. Neurofibromin, the protein produced by a normal NF1 gene,
suppresses ras, thus opening up the heart valve. Promising new research
has also connected NF1 to cells lining the blood vessels of the heart,
with implications for other vascular disorders including hypertension,
which affects approximately 50 million Americans. Researchers believe
that further understanding of how an NF1 deficiency leads to heart
disease may help to unravel molecular pathways affected in genetic and
environmental causes of heart disease.
Memory Loss and Learning Disabilities.--Because NF regulates and
controls pathways vital to cognition, the RAS and the cyclic AMP
pathways, researchers have determined that NF is directly linked to
memory loss and learning disabilities affecting over 25 million and 35
million Americans respectively. Indeed, 5 percent of the world's
population suffers from learning disabilities alone. NF researchers
have successfully rescued learning deficits, including memory loss and
learning disabilities, in pre-clinical animal models, which will
benefit all people suffering from these conditions, not just those with
NF. In addition, by curing learning disabilities, Federal, State, and
local governments and school districts will save billions of dollars in
special education costs.
Deafness.--NF2 accounts for approximately 5 percent of genetic
forms of deafness. It is also related to other types of tumors,
including schwannomas and meningiomas, as well as being a major cause
of balance problems.
THE ARMY'S CONTRIBUTION TO NF RESEARCH
Recognizing NF's importance to both the military and to the general
population, Congress has given the Army's NF Research Program strong
bipartisan support. After the initial 3-year grants were successfully
completed, Congress appropriated continued funding for the Army NF
Research Program on an annual basis. From fiscal year 1996 through
fiscal year 2005, this funding has amounted to $155.3 million, in
addition to the original $8 million appropriation in fiscal year 1992.
Between fiscal year 1996 and fiscal year 2004, 138 awards have been
granted to researchers across the country. The Army program funds
innovative, groundbreaking research which would not otherwise have been
pursued, and has produced major advances in NF research, such as the
development of advanced animal models, preclinical therapeutic
experimentation and clinical trials. The program has brought new
researchers into the field of NF, as can be seen by the nearly 60
percent increase in applications in the past year alone. Unfortunately,
despite this increase, the number of awards has remained relatively
constant over the past couple of years resulting in many highly
qualified applications going unfunded. Army officials administering
this program have indicated in the past that they could easily fund 30
percent more applications if funding were available because of the high
quality of the research applications received.
In order to ensure maximum efficiency, the Army collaborates
closely with other Federal agencies that are involved in NF research,
such as NIH and the VA. Senior program staff from the National Cancer
Institute (NCI) and the National Institute of Neurological Disorders
and Stroke (NINDS), for example, has sat on the Army's NF Research
Program's Integration Panel which sets the long-term vision and funding
strategies for the program. This assures the highest scientific
standard for research funding, efficiency and coordination while
avoiding duplication or overlapping of research efforts.
Because of the enormous advances that have been made as a result of
the Army's NF Research Program, research in NF has truly become one of
the great success stories in the current revolution in molecular
genetics, leading one major researcher to conclude that more is known
about NF genetically than any other disease. Accordingly, many medical
researchers believe that NF should serve as a model to study all
diseases. Indeed, in just over a dozen years since the discovery of the
NF1 gene, researchers have successfully cured both NF's cognitive and
tumor disorders in mice, have successfully removed NF tumors in at
least one clinical trial involving human patients and are now on the
threshold of developing a treatment and cure for this terrible disease.
In just the past few years, scientists have made major
breakthroughs bringing NF fully into the translational era, with
treatments close at hand. These recent advances have included:
--Phase II and Phase III clinical trials involving new drug
therapies;
--Creation of a National Clinical Trials Consortia and NF Centers;
--Successfully eliminating tumors in NF1 and NF2 mice with the same
drug;
--Developing advanced mouse models showing human symptoms;
--Rescuing learning deficits and eliminating tumors in mice with the
same drug;
--Linking NF to vascular disorders such as congenital heart disease
and hypertension, affecting more than 50 million Americans; and
--Conducting natural history studies to analyze the progression of
the disease.
FUTURE DIRECTIONS
NF research has now advanced to the translational and clinical
stages which hold incredible promise for NF patients, as well as for
patients who suffer from many of the diseases linked to NF. This
research is costly and will require an increased commitment on the
Federal level. Specifically, future investment in the following areas
would continue to advance research on NF:
--Clinical trials;
--Funding of a clinical trials network to connect patients with
experimental therapies;
--Development of NF Centers, tissue banks, and patient registries;
--Development of new drug and genetic therapies;
--Further development of advanced animal models;
--Expansion of biochemical research on the functions of the NF gene
and discovery of new targets for drug therapy; and
--Natural history studies and identification of modifier genes--
studies are already underway to provide a baseline for testing
potential therapies and differentiate among different
phenotypes of NF.
FISCAL YEAR 2006 REQUEST
Mr. Chairman, the Army's highly successful NF Research Program has
shown tangible results and direct military application with broad
implications for the general population. The program has now advanced
to the translational and clinical research stages, which are the most
promising, yet the most expensive direction that NF research has taken.
The program has succeeded in its mission to bring new researchers and
new approaches to research into the field. Therefore, increased funding
is now needed to take advantage of promising avenues of investigation,
to continue to build on the successes of this program, and to fund this
promising research thereby continuing the enormous return on the
taxpayers' investment.
I respectfully request an appropriation of $25 million in your
fiscal year 2006 Department of Defense Appropriations bill for the Army
Neurofibromatosis Research Program. This is level funding from the
fiscal year 2005 level of $25 million.
Mr. Chairman, in addition to providing a clear military benefit,
the DOD's Neurofibromatosis Research Program also provides hope for the
100,000 Americans who suffer from NF, as well as the tens of millions
of Americans who suffer from NF's related diseases such as cancer,
learning disabilities, memory loss, heart disease, and brain tumors.
Leading researchers now believe that we are on the threshold of a
treatment and a cure for this terrible disease. With this
subcommittee's continued support, we will prevail.
Thank you for your support of this program and I appreciate the
opportunity to present this testimony to the subcommittee.
CONCLUSION OF HEARINGS
Senator Stevens. This subcommittee will reconvene again
tomorrow morning at 10 a.m. for a closed session to review the
fiscal year 2006 defense intelligence budget. We will stand in
recess until that time.
[Whereupon, at 4:58 p.m., Tuesday, May 17, the hearings
were concluded, and the subcommittee was recessed, to reconvene
subject to the call of the Chair.]