    [House Hearing, 111 Congress]
    [From the U.S. Government Publishing Office]

      A CALL TO ARMS: A REVIEW OF BENEFITS FOR DEPLOYED FEDERAL EMPLOYEES

    =======================================================================

                                    HEARING

                                   before the

                       SUBCOMMITTEE ON FEDERAL WORKFORCE,
                        POSTAL SERVICE, AND THE DISTRICT
                                  OF COLUMBIA

                                     of the

                             COMMITTEE ON OVERSIGHT
                             AND GOVERNMENT REFORM

                            HOUSE OF REPRESENTATIVES

                         ONE HUNDRED ELEVENTH CONGRESS

                                 FIRST SESSION

                                   __________

                               SEPTEMBER 16, 2009

                                   __________

                               Serial No. 111-40

                                   __________

    Printed for the use of the Committee on Oversight and Government Reform

      Available via the World Wide Web: http://www.gpoaccess.gov/congress/
                                   index.html
                          http://www.house.gov/reform

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                  COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

                       EDOLPHUS TOWNS, New York, Chairman
    PAUL E. KANJORSKI, Pennsylvania      DARRELL E. ISSA, California
    CAROLYN B. MALONEY, New York         DAN BURTON, Indiana
    ELIJAH E. CUMMINGS, Maryland         JOHN M. McHUGH, New York
    DENNIS J. KUCINICH, Ohio             JOHN L. MICA, Florida
    JOHN F. TIERNEY, Massachusetts       MARK E. SOUDER, Indiana
    WM. LACY CLAY, Missouri              JOHN J. DUNCAN, Jr., Tennessee
    DIANE E. WATSON, California          MICHAEL R. TURNER, Ohio
    STEPHEN F. LYNCH, Massachusetts      LYNN A. WESTMORELAND, Georgia
    JIM COOPER, Tennessee                PATRICK T. McHENRY, North Carolina
    GERALD E. CONNOLLY, Virginia         BRIAN P. BILBRAY, California
    MIKE QUIGLEY, Illinois               JIM JORDAN, Ohio
    MARCY KAPTUR, Ohio                   JEFF FLAKE, Arizona
    ELEANOR HOLMES NORTON, District of   JEFF FORTENBERRY, Nebraska
        Columbia                         JASON CHAFFETZ, Utah
    PATRICK J. KENNEDY, Rhode Island     AARON SCHOCK, Illinois
    DANNY K. DAVIS, Illinois             BLAINE LUETKEMEYER, Missouri
    CHRIS VAN HOLLEN, Maryland
    HENRY CUELLAR, Texas
    PAUL W. HODES, New Hampshire
    CHRISTOPHER S. MURPHY, Connecticut
    PETER WELCH, Vermont
    BILL FOSTER, Illinois
    JACKIE SPEIER, California
    STEVE DRIEHAUS, Ohio
    ------ ------

                          Ron Stroman, Staff Director
                    Michael McCarthy, Deputy Staff Director
                          Carla Hultberg, Chief Clerk
                      Larry Brady, Minority Staff Director

    Subcommittee on Federal Workforce, Postal Service, and the District of
                                    Columbia

                   STEPHEN F. LYNCH, Massachusetts, Chairman
    ELEANOR HOLMES NORTON, District of   JASON CHAFFETZ, Utah
        Columbia                         JOHN M. McHUGH, New York
    DANNY K. DAVIS, Illinois             MARK E. SOUDER, Indiana
    ELIJAH E. CUMMINGS, Maryland         BRIAN P. BILBRAY, California
    DENNIS J. KUCINICH, Ohio
    WM. LACY CLAY, Missouri
    GERALD E. CONNOLLY, Virginia
                         William Miles, Staff Director

                                C O N T E N T S

                                  ----------
                                                                       Page
    Hearing held on September 16, 2009...............................     1
    Statement of:
        Farrell, Brenda S., Director, Defense Capabilities and
          Management, U.S. Government Accountability Office; Marilee
          Fitzgerald, Director, Workforce Issues and International
          Programs, Office of the Deputy Under Secretary of Defense
          for Civilian Personnel Policy, U.S. Department of Defense;
          Steven A. Browning, Principal Deputy Assistant Secretary,
          Bureau of Human Resources, U.S. Department of State; Jerome
          D. Mikowicz, Deputy Associate Director, Pay and Leave
          Administration, Strategic Human Resources Policy Division,
          U.S. Office of Personnel Management; and Shelby Hallmark,
          Acting Assistant Secretary, Employment Standards, U.S.
          Department of Labor........................................     9
            Browning, Steven A.......................................    43
            Farrell, Brenda S........................................     9
            Fitzgerald, Marilee......................................    29
            Hallmark, Shelby.........................................    57
            Mikowicz, Jerome D.......................................    51
        Shay, Jonathan, M.D., Ph.D.; and Susan R. Johnson, president,
          American Foreign Service Association.......................    77
            Johnson, Susan R.........................................    82
            Shay, Jonathan...........................................    77
    Letters, statements, etc., submitted for the record by:
        Browning, Steven A., Principal Deputy Assistant Secretary,
          Bureau of Human Resources, U.S. Department of State,
          prepared statement of......................................    45
        Connolly, Hon. Gerald E., a Representative in Congress from
          the State of Virginia, prepared statement of...............     4
        Farrell, Brenda S., Director, Defense Capabilities and
          Management, U.S. Government Accountability Office, prepared
          statement of...............................................    12
        Fitzgerald, Marilee, Director, Workforce Issues and
          International Programs, Office of the Deputy Under
          Secretary of Defense for Civilian Personnel Policy, U.S.
          Department of Defense, prepared statement of...............    31
        Hallmark, Shelby, Acting Assistant Secretary, Employment
          Standards, U.S. Department of Labor, prepared statement of.    59
        Johnson, Susan R., president, American Foreign Service
          Association, prepared statement of.........................    84
        Lynch, Hon. Stephen F., a Representative in Congress from the
          State of Massachusetts, prepared statement of..............     2
        Mikowicz, Jerome D., Deputy Associate Director, Pay and Leave
          Administration, Strategic Human Resources Policy Division,
          U.S. Office of Personnel Management, prepared statement of.    53
        Shay, Jonathan, M.D., Ph.D., prepared statement of...........    79

      A CALL TO ARMS: A REVIEW OF BENEFITS FOR DEPLOYED FEDERAL EMPLOYEES

                                  ----------

                         WEDNESDAY, SEPTEMBER 16, 2009

                      House of Representatives,
    Subcommittee on Federal Workforce, Postal Service,
                          and the District of Columbia,
                  Committee on Oversight and Government Reform,
                                                        Washington, DC.
        The subcommittee met, pursuant to notice, at 2:03 p.m., in
    room 2154, Rayburn House Office Building, Hon. Gerald E.
    Connolly presiding.
        Present: Representatives Norton, Cummings, Connolly, and
    Bilbray.
        Staff present: William Miles, staff director; Aisha
    Elkheshin, clerk/legislative assistant; Jill Crissman,
    professional staff member; Daniel Zeidman, deputy clerk/
    legislative assistant; Dan Blankenburg, minority director of
    outreach and senior advisor; Adam Fromm, minority chief clerk
    and Member liaison; Alex Cooper, minority professional staff
    member; and Lt. Glenn Sanders, minority Defense fellow.
        Mr. Connolly. The hearing will now come to order. And I
    welcome Ranking Member Bilbray of California and members of the
    subcommittee, hearing witnesses, and all those here in
    attendance.
        The purpose of the hearing is to examine existing policies
    and the range of employee benefits available to Federal
    civilian employees serving in designated combat areas. The
    Chair, ranking member and subcommittee members will each have 5
    minutes to make opening statements, and all Members will have 3
    days in which to submit statements and additional questions for
    the record.
        I would like to welcome everybody here to this afternoon's
    subcommittee hearing intended to explore critical yet
    frequently forgotten issues relating to the pay, protection,
    and other personnel policies of Federal civilian employees
    serving in high-risk environments abroad.
        Although our chairman, Congressman Stephen Lynch, could not
    chair this hearing, his interest in this policy area is the
    motivation for this hearing. Chairman Lynch has requested that
    his full statement for the hearing be submitted for the record.
    Without objection, it is so ordered.
        [The prepared statement of Hon. Stephen F. Lynch follows:]

        [GRAPHIC] [TIFF OMITTED] T5103.001

        Mr. Connolly. As an advocate for the Federal community
    myself--I represent 56,000 Federal workers and maybe as many
    retirees--I'm especially pleased to serve as Chair of today's
    hearing, ``A Call to Arms: A Review of Benefits for Deployed
    Federal Employees.''
        Today's hearing affords us the opportunity to examine a
    host of benefit challenges and discrepancies currently
    confronting deployed Federal employees. Federal workers who
    serve our Nation in the combat areas of Iraq and Afghanistan
    and other war zones deserve assurance that the Federal
    Government has a uniformed strategy in place to handle both
    pre- and post-deployment issues no matter the employing agency.
        With tens of thousands of Federal employees having served
    overseas in combat theater in this decade, it greatly disturbed
    me to learn this from comments a former deployed Federal
    employee, made who was gravely injured by enemy fire last year
    in Iraq, that: The military saves your life, gets you home, and
    then it's totally up to you.
        In addition to ensuring seamless medical care upon return
    and efficient and straightforward processing of Workers'
    Compensation claims, I believe Federal agencies need to do more
    in support of these individuals stateside, following their
    deployment, in the areas of medical screening, mental health
    support services, and then dealing with their home and other
    agencies when filing for benefits and seeking treatment.
        Unlike their military counterparts, deployed Federal
    employees do not operate within an established framework, and
    often have to navigate bureaucratic hurdles to get their health
    care coverage, unaided. Given the expanding role of Federal
    civilian employees in support of ongoing military operations
    and statecraft endeavors, agencies are in a position of needing
    to recruit Federal workers who are willing to serve in hostile
    environments. As a result, addressing pay inconsistencies,
    leave flexibilities, and holes in post-deployment medical care
    and Workers' Compensation are key to guaranteeing such an
    abundant and dedicated work force.
        I would like to thank the witnesses for appearing here
    today as we take a hard look into what's being done and what
    options may need to be considered to guarantee that deployed
    Federal employees, brave men and women who serve their country,
    and their family members are receiving the proper support and
    treatment they deserve from a grateful Nation.
        [The prepared statement of Hon. Gerald E. Connolly
    follows:]

    [GRAPHIC] [TIFF OMITTED] T5103.002

    [GRAPHIC] [TIFF OMITTED] T5103.003

        Mr. Connolly. I now call upon the ranking member, Mr.
    Bilbray, for any opening statement he may have.
        Mr. Bilbray. Thank you, Mr. Chairman.
        Mr. Chairman, let me ask for unanimous consent to introduce
    a written statement.
        Mr. Connolly. Without objection.
        Mr. Bilbray. And basically you said it very appropriately.
    I think that we've just got to understand that the rule of law
    has always been a cultural given, at least we assumed to have
    been, since Mesopotamia started using a concept on clay
    tablets. So I think that we need to have some kind of
    understanding of what is the restraints, where are the limits,
    and where are the opportunities. And people should know that up
    front. We shouldn't be making the rules as we go on. And I
    think the concept of written law and regulation is just not
    only a cultural given in our society, it's common decency. And
    so I will look forward to this hearing.
        I think that the new Obama administration's commitment to
    creating a civilian surge in Afghanistan really is an example
    of where we need to get our act together on this, we need to
    set out these lines. The new administration obviously expects
    this to be a critical part of our national presence around the
    world, so we need to make sure that presence is under the rule
    of law.
        I yield back, Mr. Chairman.
        Mr. Connolly. I thank the gentleman from California.
        I now call upon the gentleman from Maryland, Mr. Cummings.
        Mr. Cummings. I want to thank the chairman for calling this
    hearing today. And certainly I thank our witnesses who have
    come today to examine policy disparities that exist across
    Federal agencies that deploy civilian employees to serve our
    country in deployed environments.
        Since 2001, more than 41,000 civilians have served or are
    currently serving in Iraq or Afghanistan. One of the realities
    of fighting concurrent wars in both Iraq and Afghanistan is
    that our military cannot conduct its missions alone. The
    military has to use every available soldier on the front lines.
    Additionally, the nature of how we fight our current enemy has
    caused us to rely more heavily on civilians not only to provide
    assistance in service-support roles, but also to be actively
    engaged in the day-to-day stability and reconstruction efforts
    alongside our troops.
        Rightfully, we go out of our way to ensure that our
    deployed military troops receive the proper medical and
    compensation benefits while they fight for our Nation. Well,
    our deployed civilian population should be no different, as
    they face dangerous situations also.
        Studies have found disparities with approving Workers'
    Compensation and post-deployment medical screening affecting
    benefits. Regardless of whether a deployed civilian originates
    from the Department of Defense, State Department, or the U.S.
    Agency for International Development, these volunteers are
    placed in harm's way and deserve equitable treatment when it
    comes to medical care benefits and compensation.
        DOD and State already have the infrastructure to provide
    medical care while civilians are deployed in the theater of
    operations; but unlike the military, when our civilians return
    home, their medical wellness is forgotten. We mandate that the
    military complete post-deployment health assessments to
    identify symptoms related to posttraumatic stress disorder;
    yet, DOD and State are the only agencies that require medical
    screening of civilians upon return from deployments. Therefore,
    we need to do a better job of communicating the policies that
    govern medical care, benefits, and compensation for our
    deployed civilians.
        As we have learned from casualty reports, there are
    numerous risks that a civilian accepts when he or she decides
    to work in a combat zone. It is no secret that money and
    benefits are lucrative enticements for agencies to attract
    individuals willing to deploy. As such, individuals should
    receive comparable compensation commensurate with their skill
    levels and the amount of risk involved in their daily
    functions.
        Finally, understanding that Federal agencies operate under
    different pay systems, compensation packages will differ to a
    degree, but the Office of Personnel Management should provide
    overarching compensation and benefit policy for deployed
    civilians and the authorities given to the agencies for
    implementation. Given the course of our military, I do not
    foresee a change in the near future on our reliance of
    civilians on the battlefields. As we continue a ``whole of
    government'' approach to stabilizing and reconstructing other
    regions around the world, we must be creative in utilizing
    existing systems to meet our current challenges. I think that
    it would be worthwhile to expand DOD and State procedures to
    incorporate the civilian aspect.
        And, Mr. Chairman, with that I thank you again for calling
    this hearing, and I yield back.
        Mr. Connolly. I thank the gentleman.
        At this time, I would ask the witnesses to stand. It is
    committee policy that all witnesses before this committee are
    sworn in.
        [Witnesses sworn.]
        Mr. Connolly. Let the record show that each witness
    answered in the affirmative. I thank you.
        If I may give a brief introduction to our panelists.
        Brenda Farrell was appointed Service Director in GAO's
    Defense Capabilities and Management Team in April 2007. She is
    responsible for military and civilian personnel issues,
    including those related to GAO's high-risk area personnel
    security clearances. Ms. Farrell began her career at GAO in
    1981 and has served in a number of issue areas associated with
    national security issues.
        Marilee Fitzgerald was appointed as the Director of
    Workforce Issues and International Programs in the Office of
    Deputy Under Secretary of Defense for Civilian Personnel Policy
    in June 2005. Ms. Fitzgerald is responsible for the oversight
    and approval of the Department of Defense human resource
    policies and programs that affect over 700,000 employees
    worldwide. She also serves as the Principal Deputy to the
    Deputy Under Secretary of Defense for Civilian Personnel
    Policy.
        Steven Browning is Ambassador Steven Browning, a career
    member of the Senior Foreign Service, holding the rank of
    Career Minister. Ambassador Browning assumed his duties as
    Principal Deputy Assistant Secretary of State in the Bureau of
    Human Resources in August 2009. Most recently, Ambassador
    Browning served as Ambassador to the Republic of Uganda. Prior
    to that, he served as the Minister Counselor for Management in
    the U.S. Embassy in Baghdad.
        Robin Heard. Robin Heard is the current Deputy Assistant
    Secretary for Administration at the U.S. Department of
    Agriculture. Ms. Heard also served as Acting Budget Analyst at
    OMB. She is not with us today, but I believe that there is
    somebody here from the Department of Agriculture who can answer
    some questions. Is that correct?
        Voice. I am here.
        Mr. Connolly. OK. Jerome Mikowicz is the Deputy Associate
    Director for Pay and Leave Administration with the Strategic
    Human Resources Policy Division of the U.S. Office of Personnel
    Management. He is a career member of Senior Executive Service
    and manages the Center for Pay and Leave Administration
    responsible for administering dozens of governmentwide
    statutory authorities related to pay, leave, work, and--work
    schedules for civilian Federal employees.
        And finally, but not least, Shelby Hallmark. Shelby
    Hallmark is the Acting Assistant Secretary for Employment
    Standards Administration of the U.S. Department of Labor and
    Director of the Office of Workers' Compensation Programs, and
    is also the permanent OWCP Director.
        Welcome, all of you.
        Before we begin hearing from members of the panel, Ms.
    Norton, the Delegate from Washington, DC, has joined us. And I
    now call on the gentlelady for her opening remarks. Welcome.
        Ms. Norton. Thank you very much, Mr. Chairman. I wanted to
    be here for as long as I could.
        This subcommittee has done an excellent job of taking care
    of Federal employees at home, but our own work indicates that
    we've not been nearly--the Congress, at least, has not been
    nearly as vigilant when we deploy--and that's the right word
    for it--civilian workers abroad.
        Whenever I visit abroad, in fact the first people we come
    in contact with are Federal employees, just like the ones who
    are our own constituents here, except there they are far away
    from home. And more and more of them have been deployed to
    combat zones and serve under what can only be called, Mr.
    Chairman, hardship posts. Try going to parts of Africa and
    Iraq, other parts of the Mideast which are under fire, and you
    are categorized as civilian, something happens to you there,
    and you don't have the same access that those who courageously
    serve us in the Armed Forces have always had, and so
    unintentionally there is a distinction among our Federal
    employees. We are responsible for them not just in this
    country, but most especially when they are abroad.
        And, Mr. Chairman, I recall speaking with employees who had
    been deployed for some time in various parts of the Mideast,
    and were astounded to learn--one of the complaints indeed was
    that there has to be turnover. There's too much turnover; that
    our employees come for a while, and then they go. Well, the
    reasons are very clear. This is hardship with capital letters.
    They are away from home, from family. And then they have
    uncertain benefits, particularly when they incur unexpected
    events in their own lives.
        We have to make it attractive to go abroad. We have to make
    it less of a hardship to go abroad. This is not Paris, my
    friends. These are not posts in the great cities that are
    legendary in history where in your off hours you can go
    sightseeing. I have seen Federal employees in places where
    there was nothing in the evening. I hope they like books. And I
    think because our employees tend to be fairly bookish and
    intelligent and intellectual, they use the time, of course, to
    good effect. We need to pay the kind of attention you, Mr.
    Chairman, and this subcommittee is paying now.
        And I will stay for as long as I can, but I wanted to be
    here to thank you and the subcommittee, and particularly to
    thank the witnesses who come to educate us about these out-of-
    sight, out-of-mind employees of the United States of America
    serving their country. Thank you again.
        Mr. Connolly. I thank the gentlewoman from the District of
    Columbia, and thank her for her commitment to all of the
    employees of the Federal Government.
        Witnesses have been sworn in. I want to just say to
    everybody that your entire statement has been entered into the
    record. Everybody has 5 minutes in which to summarize their
    testimony. The green light will go on to indicate that your 5
    minutes has begun; the yellow light means you have 1 minute
    remaining to complete your statement; and the red light
    indicates that the hook is coming.
        So if we can begin with you, Ms. Farrell.

    STATEMENTS OF BRENDA S. FARRELL, DIRECTOR, DEFENSE CAPABILITIES
    AND MANAGEMENT, U.S. GOVERNMENT ACCOUNTABILITY OFFICE; MARILEE
       FITZGERALD, DIRECTOR, WORKFORCE ISSUES AND INTERNATIONAL
     PROGRAMS, OFFICE OF THE DEPUTY UNDER SECRETARY OF DEFENSE FOR
     CIVILIAN PERSONNEL POLICY, U.S. DEPARTMENT OF DEFENSE; STEVEN
     A. BROWNING, PRINCIPAL DEPUTY ASSISTANT SECRETARY, BUREAU OF
    HUMAN RESOURCES, U.S. DEPARTMENT OF STATE; JEROME D. MIKOWICZ,
       DEPUTY ASSOCIATE DIRECTOR, PAY AND LEAVE ADMINISTRATION,
       STRATEGIC HUMAN RESOURCES POLICY DIVISION, U.S. OFFICE OF
      PERSONNEL MANAGEMENT; AND SHELBY HALLMARK, ACTING ASSISTANT
       SECRETARY, EMPLOYMENT STANDARDS, U.S. DEPARTMENT OF LABOR

                     STATEMENT OF BRENDA S. FARRELL

        Ms. Farrell. I can project, but I think this will be
    better.
        Mr. Connolly, members of the subcommittee, thank you for
    the opportunity to discuss our recent report on actions needed
    to better track and provide timely and accurate compensation
    and medical benefits to deployed Federal civilians.
        As DOD has expanded its involvement in overseas military
    operations, it has grown increasingly reliant on its Federal
    civilian work force to provide support in times of war or
    national emergency. Other Federal agencies also play an
    important role in the stabilization and reconstruction of at-
    risk countries and regions consistent with the collaborative
    ``whole of government'' approach. Therefore, the need for
    attention to policies and benefits that affect the health and
    welfare of these individuals becomes increasingly significant.
        My main message today is that, given the importance of the
    missions these civilians support and the potential dangers in
    the environments in which they work, Federal agencies need to
    take additional actions to ensure that the compensation
    packages associated with such service are appropriate and
    comparable, and that these civilians receive all the
    compensation and benefits to which they are entitled.
        My written statement is divided into three parts. The first
    addresses compensation policies for deployed civilians.
    Although policies concerning compensation are generally
    comparable across the six selected agencies that we reviewed,
    we found some issues that affect the amount of compensation
    that they receive depending upon such things as the pay system
    and the accuracy, timeliness, and completeness of the
    compensation.
        For example, two comparable civilian supervisors who deploy
    under different pay systems may receive different rates of
    overtime pay, because this rate is set by the employee's pay
    system and grade or band.
        In April 2008, a congressional committee asked OPM to
    develop a comprehensive benefits package for all deployed
    civilians and recommend enabling legislation, if appropriate.
    At the time of our review, OPM had not done so.
        Also, implementation of some policies may not always be
    accurate or timely. For example, we estimate that about 40
    percent of the deployed civilians we surveyed reported
    experiencing problems with compensation, including not
    receiving danger pay, or receiving it late, in part because
    they were unaware of their eligibility or did not know where to
    seek assistance.
        The second part of my written statement addresses the
    medical benefits. We found some issues with policies related to
    medical care following deployment and with Workers'
    Compensation and post-deployment medical screenings that affect
    the benefits of deployed civilians.
        For example, while DOD allows its treatment facilities to
    care for non-DOD civilians following deployment, in some cases
    the circumstances are not always clearly defined, and some
    agencies were unaware of DOD's policy. Because DOD's policy is
    unclear, confusion exists within DOD and other agencies
    regarding civilians' eligibility for care at military treatment
    facilities. Thus, some civilians cannot benefit from the
    efforts DOD has undertaken in areas such as posttraumatic
    stress disorder.
        Also, civilians who deploy may be eligible for benefits
    through Workers' Compensation. Our analysis of 188 such claims
    revealed some significant delays resulting in part from a lack
    of clarity about the documentation required. Without clear
    information on what documents to submit, applicants may
    continue to experience delays.
        Further, while DOD requires medical screenings of civilians
    before and after deployment, State requires screenings only
    before deployment. Prior GAO work has found documenting the
    medical condition of deployed personnel before and after
    deployment was critical to identifying medical conditions that
    may have resulted from deployments.
        The third part of my written statement addresses the
    identification and tracking of deployed civilians. Each of the
    selected six agencies included in our review provided us with a
    list of deployed civilians, but none had fully implemented
    policies to identify and track these civilians. DOD, for
    example, had procedures to identify and track civilians, but
    concluded that its guidance was not consistently implemented.
    While other agencies had some ability to identify and track
    civilians, some had to manually search their systems. Thus,
    agencies may lack critical information on the location and
    movement of personnel, which may hamper their ability to
    intervene promptly to address emerging medical issues.
        Mr. Connolly, that concludes my remarks. I would be pleased
    to take questions when the committee so desires.
        Mr. Connolly. Thank you so much.
        [The prepared statement of Ms. Farrell follows:]

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        [GRAPHIC] [TIFF OMITTED] T5103.020

        Mr. Connolly. Ms. Fitzgerald.

                    STATEMENT OF MARILEE FITZGERALD

        Ms. Fitzgerald. Thank you.
        Good afternoon, Mr. Connolly, Mr. Bilbray, Mr. Cummings,
    and Ms. Norton. I am here today representing the Secretary of
    Defense and all of our civilian employees who deploy to austere
    environments like Iraq and Afghanistan. On their behalf, let me
    thank you for your strong support of our programs and benefits
    that help compensate and provide incentives for our deployed
    work force.
        The Department of Defense civilian employees play an
    integral role in supporting our military members around the
    globe in all types of operations. Since 2001, more than 41,000
    civilians have served or are currently serving in direct
    support of our U.S. military operations, including 26,000 to
    Iraq and 7,900 to Afghanistan. We are proud of our brave men
    and women who have served. Their sacrifice, service, and
    experience are valued, respected, and recognized as career-
    enhancing.
        Regrettably, our work force is not immune from the inherent
    risks of these missions. Some of our employees and their
    families have made the ultimate sacrifice for our country. For
    these brave injured and fallen civilians, for all their
    colleagues who have answered the call to serve, and for all
    those who will answer the call in the future, the Department is
    committed to ensuring these employees have the highest level of
    support and care as may be needed to serve our noble mission.
        The Department has learned that the dynamic and asymmetric
    21st century mission challenges require greater and more
    expeditionary capability within our work force. In response to
    these expeditionary missions, the Department developed a new
    framework through which an appropriately sized subset of the
    Department of Defense civilian work force is preidentified to
    be organized, trained, and equipped in a manner that
    facilitates the use of their capabilities for these operational
    requirements. These employees are collectively known as the
    Civilian Expeditionary Workforce [CEW].
        We have learned that our employees volunteer for these
    types of assignments primarily because of a desire to serve our
    country, to witness their results on the ground, to make a
    difference, and to engage in this type of work. They believe it
    is an honor and a privilege to serve our country and to support
    our warfighters, and, in return, they bring back broadened
    perspectives, critical experiences, and a deeper understanding
    of their role in support of our expanding missions. The men and
    women who answer this call are making a critical difference.
        Building a strong civilian expeditionary work force,
    however, also requires promoting the right incentives and
    benefits to help compensate for the inherent risks of these
    missions. Thanks to the strong support from Congress, we have
    been able to offer many additional financial incentives. They
    certainly include the 35 percent danger pay allowance and 35
    percent post differential, and allowances and benefits and
    gratuities comparable to those provided by the Foreign Service.
    That benefit was offered to all Federal civilian employees.
        They include such benefits as enhanced death gratuity,
    travel, home leave, and emergency visitation travel, and rest
    and recuperation trips. Our DOD civilians singled out the
    authorized R&R trips and the Foreign Service benefits as
    particularly critical to maintaining a level of effectiveness
    during these extended months of employment.
        We've have enhanced FEGLI options from the Congress,
    approved premium pay cap waivers, elimination of the aggregate
    pay caps. This incentive permits our deployed civilians to
    maximize their earning power in the year in which they are
    serving. In these economic times, this incentive has been most
    valued and appreciated.
        The Secretary of Defense Global War on Terrorism medal and
    the Defense of Freedom medal for those who are injured or
    killed in theater. This one is similar to those of the
    military's Purple Heart.
        In terms of medical screening and medical care for deployed
    civilians, the Department does take seriously the need to
    protect the health of our deployed civilians and to medically
    assess all those who serve our expeditionary requirements. And,
    as was stated earlier, prior to deploying all DOD civilians are
    required to obtain a physical examination. In addition, they
    are required to have a pre-deployment health assessment within
    60 days prior to their departure. These two pieces of
    information combined provide a baseline for wellness. Upon
    their return from deployment, the DOD civilians are required to
    have a post-health assessment within 30 to 60 days following
    their return from deployment and a health assessment and
    reassessment within 90 and 100 days from their return.
        We have also established the Armed Forces Health
    Surveillance Center, which now collects these data and is able
    to track and monitor the completion of both the pre- and post-
    health assessments.
        The Department of Defense-established medical treatment
    policies assure civilians who become ill, contract diseases, or
    who are injured or wounded while deployed in support of U.S.
    military forces engaged in hostilities receive medical
    evacuation and health care treatment and services at our
    military facilities at no cost and at the same level and
    service.
        The Department looks forward to the opening of the National
    Intrepid Center of Excellence on the campus of the National
    Naval Medical Center in Bethesda, which will be the premier
    health care resource in the Department of Defense for
    psychological disorders as well as PTSD and traumatic brain
    injury.
        And, finally, we must address the critical role families
    play in support of our DOD civilians who deploy. The Department
    continues to strengthen its capacity to serve families of DOD
    civilians better. We require family care plans to ensure that
    there are powers of attorney in effect, designated
    beneficiaries, to ensure that our families are aware of and
    understand the benefits and entitlements provided to them
    through their spouses' employment.
        Mr. Connolly. Thank you, Ms. Fitzgerald.
        Ms. Fitzgerald. Thank you.
        [The prepared statement of Ms. Fitzgerald follows:]

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        Mr. Connolly. And then we will get on to a round of
    questions and answers.
        Ambassador Browning.

                    STATEMENT OF STEVEN A. BROWNING

        Mr. Browning. Thank you, Mr. Connolly.
        Mr. Chairman, Ranking Member Bilbray, Ms. Norton, Mr.
    Cummings, thank you very much for this opportunity to testify
    before you today. I appreciate your interest in the State
    Department's efforts, as well as those of our sister agencies,
    to support our employees serving in difficult and dangerous
    places, including Afghanistan and Iraq. I look forward to
    sharing with you some of the concrete steps we have taken to
    address the critical needs of our employees and their families.
        Under the leadership of Secretary Clinton, our men and
    women are working to renew America's leadership through a
    diplomacy that enhances our security, advances our interests,
    and demonstrates our values. They are doing inspiring work
    under difficult conditions.
        Currently there are over 900 positions where no family
    members or only certain categories of family members may reside
    because of dangerous conditions or other severe hardships. In
    2001, there were approximately 200 such positions. This steady
    increase in assignments to difficult and dangerous regions
    reflects the Department's concerted effort to send the Foreign
    Service wherever it is most needed. Our men and women are
    answering the Nation's call to service and putting their lives
    at risk for the American people.
        The call to serve has been a hallmark of the Foreign
    Service. We have fully staffed our missions in Iraq and
    Afghanistan with volunteers, volunteers who have stepped
    forward to serve in these highly dangerous yet critical
    missions.
        In recognition of their service, we offer a broad package
    of benefits, incentives, and support structures. This package
    has improved greatly since when I served in Iraq in 2004 and
    2005.
        Mr. Chairman, let me share with you some of the benefits we
    now offer to our employees serving in Afghanistan and Iraq that
    other agencies may also be able to extend to their employees:
    hardship and danger pay allowances, overtime or an equivalent
    payment, rest and recuperation or R&R trips, pay cap increases,
    and onward assignment preferences.
        Mr. Chairman, we also know that the medical and mental
    well-being of our employees is critical, as is support for
    their families during and after their assignments. To address
    those needs we have expanded the medical services available
    pre-departure, at post, and after completion of the assignment,
    and we expanded the scope of our Family Liaison Office to
    provide support to employees and family members during an
    unaccompanied tour. All employees assigned to Afghanistan and
    Iraq attend pre-departure training that familiarizes them with
    security issues unique to combat zone assignments. It alerts
    them to the causes and the signs of stress-related conditions,
    and it provides them with techniques for managing the stress of
    being in a war zone.
        Following any high-stress assignment, we conduct a
    mandatory high-stress outbrief that helps employees recognize
    posttraumatic stress disorder. Our Office of Medical Services
    established a Deployment Stress Management Program with a
    board-certified psychiatrist to serve as director, two social
    workers, and an administrative assistant. Additional mental
    health personnel have been assigned to the health units in
    Baghdad and Kabul.
        Employees who are identified as possibly suffering from
    stress-related disorders and who require treatment that is not
    available locally are assigned to a 6- to 7-week program of
    treatment conducted by our medical office. To support essential
    continued monitoring, we have developed an assessment system
    for Department of State employees who have served in combat
    zones to screen for PTSD through our Deployment Stress
    Management Program, and our Family Liaison Office has expanded
    in size to work with our families while the employee is serving
    in an unaccompanied tour.
        We are currently working with our colleagues at the Office
    of Personnel Management and the Department of Defense to
    examine the compensation benefits available to deployed
    civilians to ensure that it meets our needs for recruiting and
    retention. If changes are needed, the administration will put
    forth a comprehensive proposal to address the issues identified
    with the goal of regularizing authorities across the agencies.
    This interagency approach has made considerable progress, and
    we look forward to working with Congress to support all Federal
    civilian employees serving in zones of armed conflict.
        In conclusion, Mr. Chairman, we believe that our employees
    and their families deserve comprehensive support before,
    during, and after their overseas assignments. The need is
    particularly great for those serving at our most difficult and
    dangerous posts. The Department of State has worked hard to
    provide benefits and programs that support our employees, but
    we recognize that our work may never be truly done as we adapt
    to a changing world. Thank you for providing me with this
    opportunity to appear before you and the members of the
    subcommittee, and I look forward to receiving your questions.
    Thank you.
        Mr. Connolly. Thank you.
        [The prepared statement of Mr. Browning follows:]

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        Mr. Connolly. Just an advisory. I am hopeful that we can
    hear the last two pieces of testimony before we break for
    votes. Votes are going to be called very shortly, they are at
    the last votes of the day, so we will take an appropriate break
    when we are notified of that and come back. Forgive the
    imposition, but it is the way of the world here in the House of
    Representatives.
        Mr. Mikowicz.

                    STATEMENT OF JEROME D. MIKOWICZ

        Mr. Mikowicz. Representative Connolly, Delegate Norton,
    Representative Bilbray, on behalf of our Director John Berry, I
    want to thank you for inviting the Office of Personnel
    Management at this hearing today and for your commitment to
    Federal pay and benefits. We are deeply grateful for the
    service of Federal civilian employees deployed to areas of
    armed conflict. They put their lives in danger, and they work
    under extraordinary challenges to get the job done. OPM is
    committed to ensuring the government has fair and accurate
    compensation necessary to attract and retain an effective
    civilian work force.
        Federal civilian employees who are deployed to work in Iraq
    and Afghanistan and other overseas locations are entitled to
    compensation that is controlled by three factors, and these
    three factors influence the application of pay and benefits.
        First, deployed civilians continue to serve under normal
    pay system, and most pay and benefits are across the board, but
    some are entitlements, and some are discretionary
    flexibilities, but the flexibilities are determined on a case-
    by-case basis. Entitlements include things like annual pay
    adjustments, step increases, overtime, and leave. Flexibilities
    are applied on a case-by-case basis. For example, the use of
    recruitment, retention, and relocation incentives are
    discretionary and may vary based on staffing needs.
        The rules provide for some exceptions overseas. For
    example, since deployment to a war zone is considered a life
    event, employees have an opportunity to elect different health
    insurance coverage or enhanced insurance coverage.
        The second factor is that multiple pay systems exist at
    home and overseas, and employees working side by side in close
    quarters in combat zones become very aware of these
    differences. These differences are often based on different
    mission and work force requirements and are the result of
    separate laws that have been authorized over many years.
    However, current law does allow agencies not otherwise covered
    by the Foreign Service Act to provide certain Foreign Service
    benefits to their employees serving in Iraq and Afghanistan,
    and this has been very helpful.
        The third factor is that the standardized regulations
    administered by the Secretary of State do provide a common
    framework for payment of allowances and differentials to all
    civilian employees overseas. Such payments include danger pay
    and post hardship differential, which, combined, are worth 70
    percent of basic pay in Iraq and Afghanistan.
        OPM itself administers two special temporary provisions
    affecting most civilian employees in Iraq and Afghanistan, and
    we are grateful that Congress has provided them. First, OPM
    administers a waiver that allows a higher premium pay cap
    ceiling on the amount of basic pay plus overtime and other
    premium pay. The higher cap permits the payment of premium pay
    that otherwise would not have been payable.
        Second, OPM also administers a waiver of the aggregate pay
    limitation, which means that in addition to base pay, employees
    can receive all of their Title 5 payments the year they earn it
    instead of having it rolled over to following calendar year.
    Normally the limit is the rate for Level I of the Executive
    Schedule, which is 196,700 currently.
        Now I would like to comment on some OPM initiatives. In
    June 2008, we issued a memorandum to Agency Chief Human Capital
    Officers, describing the existing pay and benefits available to
    civilian employees working in combat zones. OPM strongly urged
    Federal agencies to become informed of and to take full
    advantage of those authorities.
        In September 2008, OPM wrote to the Committees on Armed
    Services in the House and Senate concerning the National
    Defense Authorization Act. OPM supported providing appropriate
    benefits to employees in combat zones and the extension of
    existing temporary authorities. We continue to work
    collaboratively with DOD and State and other agencies to
    determine how we can provide better and more consistent pay and
    benefits, and this is a work in progress.
        So, in conclusion, for the changes that we find are needed,
    the administration will put forth a comprehensive proposal to
    address the issues identified. We believe that the outcome of
    this process will also help assure greater consistency in the
    compensation of employed civilians. We want to do all we can to
    ensure that the civilian employees who put their lives on the
    line for the American people are appropriately rewarded and
    supported by the Federal Government as their employer.
        Thank you for the opportunity to discuss this important
    issue. I will be happy to respond to your questions.
        Mr. Connolly. Thank you.
        [The prepared statement of Mr. Mikowicz follows:]

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        Mr. Connolly. And finally, Mr. Hallmark.

                      STATEMENT OF SHELBY HALLMARK

        Mr. Hallmark. Thank you, Mr. Chairman, Ranking Member
    Bilbray.
        Mr. Connolly. Mr. Hallmark, you're going to have to speak
    into the mic. We can't hear you. Thank you. And if you can
    speak directly into that mic. I don't mean to suggest my
    hearing is going, but it would be helpful.
        Mr. Bilbray. So people hundreds of years from now can hear
    your sweet words.
        Mr. Connolly. None of us are getting any younger here.
        Mr. Hallmark. It's my pleasure to appear here today to
    discuss the Office of Workers' Compensation Programs' role in
    providing benefits to the brave Federal civilian employees who
    serve in Iraq, Afghanistan, and other dangerous areas around
    the world. We deliver services to these employees under the
    Federal Employees Compensation Act [FECA].
        Starting at the top with Secretary Solis, all of us at the
    Department of Labor are fully committed to ensuring that our
    deployed Federal colleagues and their families receive the care
    and compensation they deserve. We know they have undertaken
    assignments that involve significant hardship, substantial
    risk, and that their work is critical to the success of
    American efforts in the Middle East.
        OWCP has reached out to the Departments of Defense, State,
    and other agencies to see that Workers' Comp claims from these
    deployed civilians are handled promptly and appropriately, and
    to coordinate on related issues such as pre- and post-
    deployment counseling. We will continue to work with our sister
    agencies to make further improvements in the administration of
    the FECA in this respect, and to assist where we can in the
    overall delivery of services and benefits to these deserving
    Americans.
        To ensure that claims from deployed employees are handled
    expertly, we have assigned that work to a special unit located
    in our Cleveland FECA district office. This unit has received
    special training and experience in dealing with various types
    of extraordinary claims, including those resulting from
    overseas injuries. They've developed ongoing relationships with
    their counterparts at the major overseas agencies, and they
    work closely with them.
        For example, as a result of a recent specific agreement put
    in place following an interagency meeting last year, our
    Cleveland staff now notify the employing agency whenever they
    find themselves at the point of needing to deny a claim because
    they haven't received the information they need to pay it. That
    allows the agency the chance to investigate, determine whether
    there is more information that they can help to provide, or if
    perhaps the injury is simply resolved.
        Cleveland has also relaxed their normal FECA timeliness
    standards for receipt of such documentation so that there is
    adequate opportunity to obtain that medical or other
    information that may be difficult to track down from an
    overseas location.
        As noted in my written testimony, FECA coverage for
    deployed individuals, although universal, extends to an
    extremely wide range of circumstances beyond the normal
    workplace nexus. This includes while eating, sleeping, and
    during travel and a whole range of other circumstances.
        In practice, the great majority of claims received from
    Iraq and Afghanistan are quickly and accurately handled and are
    approved. Of those that are not approved, the great majority
    involved injuries for which OWCP simply never receives any
    followup medical. On more severe cases, OWCP engages closely to
    address ongoing disability or complicated medical conditions,
    and assigns occupational nurses to assist such workers in
    navigating the medical delivery system and in returning to work
    when medically able to do so.
        GAO recently conducted a review of our FECA claims process
    for civilians injured in war zones. Their report included only
    two recommendations: One, suggesting that we provide a better
    explanation of the type of medical evidence required to support
    a claim for compensation, and another to speed the issuance of
    our regulations concerning the death gratuity which was enacted
    in the Defense Authorization Act of fiscal year 2008. That new
    FECA death gratuity provides $100,000 in benefits to specified
    survivors of workers killed while supporting a contingent
    operation such as Iraq or Afghanistan, and our interim final
    rule was published with respect to that gratuity on August
    19th, this past month, making that benefit fully operative for
    deployed civilian workers.
        With respect to the medical evidence issue, we agree with
    GAO's recommendation that we review those instructions that
    accompany our claim forms, and, in fact, we expect to issue a
    separate instruction form for use by deployed Federal employees
    within the next few weeks. This fact sheet will address
    coverage issues as well as the type of medical documentation
    needed in certain circumstances, and will be distributed
    through the key employing agencies as well as via the OWCP Web
    site.
        I would like to end by commending the actions reported by
    my colleagues today at Defense and State and at other agencies
    with respect to the overall health and safety of their
    employees. Complex issues such as PTSD need to be addressed in
    comprehensive ways, and many key services must come not after
    the fact from Workers' Compensation or medical assistance, but
    in advance via enlightened preparation and assistance on the
    part of the employer. In ensuring that workers get, for
    example, pre- and post-deployment screening and counseling,
    these agencies are serving their employees while they're
    maximizing their ability to perform both in the stressful
    environments and when they return, and they are reducing the
    likelihood of serious injury and trauma.
        Mr. Chairman, I would be glad to answer your questions.
        Mr. Connolly. Thank you, Mr. Hallmark.
        [The prepared statement of Mr. Hallmark follows:]

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        Mr. Connolly. And that buzzing you're hearing is a call for
    votes. I am going to start, and then we will--if Mr. Bilbray
    wants to go, he can, or we will recess and reconvene after the
    series of votes. And thank you all very much for your
    testimony.
        By the way, before we begin my 5 minutes, I know that if
    Chairman Lynch were here, he would want to announce that a
    wonderful bill has been introduced by myself and my colleague,
    my friend from California, Mr. Bilbray, H.R. 3264, the Federal
    Internship Improvement Act, and that this subcommittee would
    want to hold hearings on that act. And I know were he here, he
    would join Mr. Bilbray and me in committing to that and urging
    our staff to prepare for those hearings.
        Mr. Bilbray. And this was an unpaid advertisement.
        Mr. Connolly. That will teach him for putting me in the
    chair.
        OK. Let me ask first, Mr. Mikowicz, a little earlier an
    interagency working group was put together for Federal
    employees, civilian employees deployed overseas in combat
    areas. OPM at that time declined to chair that interagency
    working group. Why is that? And is that decision now up for
    reconsideration?
        And, Ms. Farrell, welcome your comments as well if you have
    any.
        Mr. Mikowicz.
        Mr. Mikowicz. Thank you.
        From the way I would characterize it is that we've had a
    very collaborative approach all along. One thing that you
    always have to consider is what's going to be your vehicle for
    introducing legislation. DOD Authorization Act certainly has
    been the vehicle for the premium pay cap and the waiver and for
    other provisions that are in there. The Foreign Service Act
    sometimes is another vehicle.
        DOD, obviously having the most employees that are directly
    affected in any single agency across government, took the lead,
    and we attended all the meetings. We were working along with
    them. The GAO report did come out, did recommend that we form
    an executive group or that we submit a legislative proposal.
        We have continued to work with the agencies. All of our
    meetings have not been at Department of Defense. Some have been
    at State. And we are all working for the same end product. So I
    think, from OPM's point of view, we will be looking at interest
    governmentwide, just as DOD and State are, but we will have a
    special role.
        Mr. Connolly. But given that fact, Mr. Mikowicz, doesn't it
    make sense for you to chair it?
        Mr. Mikowicz. I am sorry?
        Mr. Connolly. Given that fact that you're looking at it
    agencywide--Federal agencywide, does it make sense OPM chair
    that interagency working group?
        Mr. Mikowicz. I would say OPM needs to have a leadership
    role, and we will do that. We will vet proposals with the
    agencies. Some of our proposals might be guidance, but if
    there's a legislative proposal--obviously we work with OMB, and
    all agencies get a chance.
        Mr. Connolly. Thank you.
        Ms. Farrell.
        Ms. Farrell. Thank you, Mr. Connolly.
        Our report had 10 recommendations, and the first
    recommendation was directed at OPM to lead such a comprehensive
    review as requested last year by the Oversight and
    Investigation Subcommittee of the House Armed Services
    Committee to determine if legislative changes were needed. And
    we don't want to not give credit to OPM and especially with DOD
    for the meetings that they have had to try to organize such a
    review, but we do think it's time for OPM to step up and have
    the leadership role.
        As you may know, strategic human capital management has
    been on GAO's high-risk list since 2001, and it has remained on
    that list. Our most recent list was January 2009, where we
    noted that leadership was needed in this area of human capital
    reform to make sure that there was a level playing field. And
    there is much concern about the number of pay systems that we
    are talking about today that often result in differences, and
    the amount of pay or what pay one receives, and this is a
    responsibility of OPM where they could step up and show the
    leadership role.
        Mr. Connolly. Thank you.
        Ms. Fitzgerald.
        Ms. Fitzgerald. Yes. I would like to add to this. I think
    the spirit of that recommendation is now in full play, because
    OPM, Department of State, and the Department of Defense are
    coming together, and including OMB actually, jointly. It is
    almost a triumvirate of leadership. So I think your concerns
    about having OPM in the lead have been addressed through this
    interagency working group. They're working as full partners,
    full leaders in this, and issues such as the disparities in pay
    systems are being addressed through the proposals that we'll be
    sending through Congress.
        Mr. Connolly. Thank you.
        Let me ask again, Mr. Mikowicz and Ms. Farrell--and we're
    probably going to have to break after this. Increasingly, we
    are using term-limited employees, Notice 3161 employees. One of
    the concerns I would have and I think the subcommittee would
    have is, with the best of intentions, what happens to those
    folks should they suffer a medical condition in the service of
    their country and/or should PTSD, posttraumatic stress
    syndrome, occur or make itself manifest long after the 5-year
    term is over? We know that if you were in the military, we'd
    deal with that. But if you're a limited-term employee of 3161,
    presumably we would not unless there's special provisions for
    that. So I wonder if you would comment on that.
        Mr. Mikowicz. Well, I can say that's one of the issues
    we're looking at. GAO did start with pre- and post-deployment
    assessments, but obviously there's traumatic injury and other
    benefits, and those are on the table for discussions. We just
    haven't reached an administration position yet, but we are
    concerned.
        Ms. Farrell. Again, this is one of our recommendations.
    Much is to be learned from DOD in this area of how they have
    tracked their military personnel and conducted the pre- and
    post- and now the reassessments after deployment. It is a
    lessons learned, I think, from DOD of what should be with the
    civilians, because, as we noted in our statement, many of the
    civilians do not have assessments after deployment, and, as you
    mentioned, posttraumatic stress disorder often shows up 6
    months after they return.
        Mr. Connolly. We are going to have to vote, and we have
    five votes. The first one is a 15-minute vote. That's the one
    right now. And then there are four 5-minute votes, presuming
    that's it, and hopefully that's it for the day in terms of
    votes. So bear with us. It is going to be about maybe
    sometime--quarter after, roughly, if you can hang in there with
    us, because I think there's a lot more we'd like to get to and
    talk about. Forgive the interruption, but as I said, it's the
    nature of the beast here. I appreciate your indulgence.
        Obviously, one of the things we are going to want to talk
    about is the unevenness of how we are treating men and women
    who serve overseas, and what services are allowed and what
    services are made available by sufferance, and what, if any,
    changes we ought to make to try to move toward a uniform policy
    and make sure that quality services are available to our men
    and women who serve overseas. I also want to get back to the
    problem of time lags on claims and complaints.
        Mr. Hallmark. Before you go, though, I just might note that
    if--the 3161 employees you were just referring to are, I
    believe, Federal employees, so they have FECA coverage
    regardless of the limitation of their appointment. And that
    coverage would continue in perpetuity for the latent diseases
    such as PTSD.
        Mr. Connolly. OK. We will come back. This hearing is in
    recess until our votes are over and we recall the hearing.
    Thank you.
        [Recess.]
        Mr. Connolly. The hearing is reconvened. I hope you had a
    chance in the brief interval to address the subject at hand.
    Rhode Island is neither a road nor an island. Welcome back.
    Forgive us for the length of voting on the floor of the House
    of Representatives, but it is always a little unpredictable.
    So, anyway, welcome back.
        We were discussing 3161 term employees, and I wonder, Ms.
    Farrell, if you might comment from GAO's perspective on the
    deployment of term employees and the issue, I think Mr.
    Hallmark had indicated, that they had health care benefits in
    the event of PTSD showing up, for example, years later. I
    thought the words you used were in perpetuity; is that correct?
        Ms. Farrell. That is our understanding as well. What has
    been conveyed is correct about those temporary employees.
        Mr. Connolly. Combat-related or environment-related.
    Obviously they don't have health care benefits in perpetuity.
        Ms. Farrell. Correct.
        Mr. Connolly. Could you expand?
        Ms. Farrell. Let's take DOD's memo regarding non-DOD
    employees who have compelling reasons for care would be
    eligible for that at military treatment facilities. So they
    would fall into that temporary, whether they served for less
    than 180 days or more than 180 days. Despite the
    classification, they would be eligible for certain care.
        Mr. Connolly. Eligible, but let me turn to Ms. Fitzgerald
    then in response to your response. It was my understanding that
    is still up to DOD whether somebody who is not a DOD employee
    would actually have the benefits of a DOD facility and that is
    being determined on a case-by-case basis at the moment; is that
    correct?
        Ms. Fitzgerald. That is correct. So in the case I think
    where we are, for those who are under the 3161 authority who
    are not DOD employees, and even those who are DOD employees,
    fall under the worker's compensation program. And so for life
    they have access to medical care, free of charge, if you will,
    if it has been determined to be covered by this, at their own
    private medical care facilities. If they are DOD, 3161s, there
    is an added benefit that they do and they can since they were a
    former DOD employees have access to our military treatment
    facilities.
        Mr. Connolly. So let me get this straight. If I am a
    Department of Agriculture employee, I am sorry, if the
    Department of Agriculture hires me as a 3161 term limited
    employee, I am limited for a 5-year term; is that correct?
        Ms. Fitzgerald. Correct.
        Mr. Connolly. OK. I am deployed to Afghanistan to help in
    the poppy eradication program and the crop substitution
    program, and I am unwittingly witness to, and involved in,
    hostile fire, some kind of traumatic incident. I am not hurt. I
    get on with my business. As a matter of fact, I resume my
    duties in Afghanistan, and when my term is up I feel fine. I
    come home. Ten years later, out of the clear blue, I am
    shopping at the mall, and all of the sudden I hear a loud noise
    and I am back in Afghanistan, and all of the sudden I am not
    the person my wife thinks I am, and neither am I, and clearly I
    need some help.
        Am I eligible still for Federal medical care and where do I
    go as a non-former DOD employee who was hired by DOA, not DOD?
    Anybody?
        Mr. Hallmark. Well, if I can interrupt----
        Mr. Connolly. You are not interrupting; you are answering.
        Ms. Fitzgerald. Do you want to take the answer?
        Mr. Hallmark. Sure. The individual in the example you give
    would have the opportunity to file a claim under FECA if they
    learn of the connection between this condition that has evolved
    10 years later and their employment and they file the claim
    within I believe it is 3 years of the time they knew or should
    have known of that connection. So there is plenty of space for
    that person to be able to come forward and file a claim. It
    would then be adjudicated by OWCP to determine whether, in
    fact, there was a causal relationship between that medical
    condition and the events that occurred in Afghanistan. And if
    there was, then that, as Ms. Fitzgerald indicated, then
    benefits for that condition would be paid 100 percent by the
    Department of Labor.
        The issue that would arise, and that probably is of concern
    to the folks at the table, is making sure that people know that
    they have that capability, because if they are a temporary
    employee and they have gone off to work somewhere entirely
    different--they are no longer within the Federal civilian
    structure--there would be a need to make sure that people, as
    they are exiting out of that position, have knowledge about
    what they are eligible for in the future.
        Mr. Connolly. Mr. Hallmark, if I could stick with the
    example I had and your response to it, under the example we are
    both talking about, but I would be sent--you may or may not
    approve the claim I submit, but it would be a claim to a
    private provider.
        Mr. Hallmark. It would be a claim to the Federal
    Government, and the individual's medical treatment would be
    through a physician of their choice.
        Mr. Connolly. Yeah, but----
        Mr. Hallmark. It would not be military.
        Mr. Connolly. But my physician is not an expert in post-
    traumatic stress syndrome. That expertise, by and large,
    resides in the military side of medicine in this country, not
    the civilian side of medicine. Most hospitals in America don't
    have in-depth experience with combat-related PTSD. So why would
    you limit me to my private physician or a series of private
    physicians who have no expertise in my problem, which was
    acquired because of my experience in a military combat
    environment, a civilian employee nonetheless?
        Mr. Hallmark. The Labor Department doesn't limit the
    civilian's ability. We simply will pay for the physician that
    you choose.
        Mr. Connolly. I choose to get the best expertise in the
    world, which happens to be in a military health care facility.
        Ms. Fitzgerald. Then, sir, this policy----
        Mr. Connolly. You need to speak up, Ms. Fitzgerald.
        Ms. Fitzgerald. Then the policy that Ms. Farrell talks
    about would apply. Then the individual would have to come to
    DOD and request a special permission to use the military
    treatment facility for their continued care.
        Mr. Connolly. But there is no policy going forward that
    would guarantee 10 or 15 years hence, and we still have Vietnam
    veterans 30 years later suffering PTSD. So right now the policy
    is on a case-by-case basis, and frankly, it is at your
    sufferance; it is not my right. It is at your sufferance.
        Ms. Fitzgerald. That is correct.
        Mr. Connolly. You are being generous under those rules in
    saying yes to most cases who apply, but there is no guarantee
    20 or 30 years hence you will continue that policy.
        Ms. Fitzgerald. That is correct.
        Mr. Connolly. Whereas, if I were in the military and had
    the same symptoms at the same time--in fact, everything I
    described applied to me wearing a uniform or having worn it,
    then by entitlement I would have access to military care and
    the expertise of post-traumatic stress syndrome intervention.
        Ms. Fitzgerald. That is true. But the Department has
    always, as long as we can trace this back, has always provided
    for the exception for individuals to come into the military
    treatment facility if they needed care.
        Then there are a couple of things that are happening that
    might be helpful, too. They are not perhaps adequate
    substitutes, but we are setting up the centers for traumatic
    brain injury, and one of those centers is a repository of where
    physicians and employees can go to get the latest information
    on care and so on. So that may be helpful as a resource center,
    and certainly the Department has and continues to make
    available its knowledge and transports knowledge across the
    civilian community in these cases.
        And then--for now, that is what the policy is, that they
    would come to the Department of Defense and seek special
    permission to come into a military treatment facility. I have
    not been aware of any that we have denied.
        Mr. Connolly. Professor Browning, we have talked about a
    lot of subjects. Anything you wanted to comment on in terms of
    the range of questions, albeit with an interruption?
        Mr. Browning. I just admit that I have only been on the job
    less than 2 months, so I am not an expert by any means in the
    full scope of what we as a department do. I have, in
    preparations for this testimony, have been educating myself on
    it, and I am learning the difficulties that are out there in
    tracking former employees.
        When an employee at the State Department retires, we give
    them a copy of their medical records if they ask for it. They
    sign the papers, they go away, and we don't hear from them
    again. We don't track them, we don't keep in touch with them,
    and they have no benefits accrued to them that we would have to
    offer them for their continued service.
        It is an excellent point that the expertise in dealing with
    PTSD is centered around veterans hospitals in Washington, DC,
    and quite frankly, the number of cases we have seen are so
    small--I think the total is six for the universe of our
    population--that we right now haven't set up a program to
    address it beyond our tracking the employees.
        Ms. Fitzgerald. In terms of what the Department is doing to
    track our 3161s who have left us, we know that this has been a
    problem, those who leave us after short periods of service, how
    do we stay connected with them, and we do feel the obligation
    to do that, take that very seriously. When we stood up a new
    civilian readiness unit, we have built in the capability there
    to track those folks. So now all these post-deployment
    physicals, we have a place to track those who take part in
    these assessments. So we know who they are, and then we are
    taking on an outreach effort so that we stay in touch with them
    through their period of departure, even if we do it annually
    through a note that says, hi, we are still worried about you,
    we care about you, any services that you need, please feel free
    to contact us, to be very deliberate about it. But we had to
    install a separate organizational capability to do that.
        It still remains a challenge once they leave here.
        Mr. Connolly. Ms. Fitzgerald, let me ask you a question
    then, and I think in some ways it does come back, Mr. Mikowicz,
    to, frankly, OPM's abrogation of leadership in not chairing the
    Interagency group. But we have found that some Federal agencies
    were unaware of the fact that their employees could avail
    themselves of DOD services when they come back with service-
    related medical problems, including injuries, which is a little
    stunning given the fact that they served, too, and why wouldn't
    they have available to them the same services as anybody else.
        So what proactively is DOD doing or planning to do to make
    sure that all Federal agencies are aware of the availability on
    an equal basis?
        Ms. Fitzgerald. We did three things. When the report first
    came out about making the communication more widespread and
    known and the benefit more known among our communities, we sent
    out a communication to our Federal agencies, and we did a
    briefing. We brought our Federal agencies in, and we provided a
    briefing to them about the benefits that are available. That
    was the first thing we did.
        The second thing we did, we institutionalized that
    communication effort and put it on our Web site so they could
    have access to it.
        And the third thing that we are doing is we have developed,
    or I am developing, ready to launch by the end of the month--
    the end of October, I am sorry, it is a short PowerPoint
    presentation that takes someone through the process sort of in
    a way that speaks to them in more easily understood terms than
    perhaps the policy would. So that this PowerPoint presentation
    could be used in any forum where our Federal agencies are
    orientating, giving a pre-deployment orientation to their
    folks.
        We think the combination of those three efforts may be
    helpful in showing that this knowledge is institutionalized in
    all of our Federal agencies. We will be ready to roll out that
    training module, as I said, sometime in October.
        Mr. Connolly. I am sure that will be helpful because I am
    sure you are aware of the fact that the two individuals to your
    left actually represent agencies that were not aware of that
    fact. State Department and Department of Agriculture were not
    aware of the fact apparently, based on our information, that
    DOD offered this service and it was available to their
    employees when they came back. So I mean we have work to do.
        Ms. Farrell, from GAO's point of view, I think--I ask you,
    is this not a weakness in the system: lack of communication,
    lack of uniformity, different policies, different benefits,
    sort of a hodgepodge and even problems tracking how many of our
    employees, or as Mr. Mikowicz indicated, former employees, have
    in fact served and may or may not over some period of time
    needed to be tracked because, even if they don't need it today,
    they may in the future need medical help and services that is a
    future claim on the Federal Government?
        Your comment.
        Ms. Farrell. I think you have hit upon several of the
    issues that our report brings to light, especially that of
    identification and tracking. You probably noticed, and our
    report will note, according to DOD and State Department
    officials, over 10,000 employees have been deployed since 2001,
    and DOD has a more current number now, stating somewhere in the
    neighborhood of 41,000. This has been a challenge that DOD has
    been working on since 1995, and they have made some progress in
    trying to get a handle on it, but we still need to know about
    the other agencies, and you are exactly right. You need to
    identify them, track their movements. Issues can develop years
    after the deployment, and in order to have that communication,
    you have to be able to identify them and know where they are.
        Mr. Connolly. Thank you. And Mr. Mikowicz, I think--I hope
    that is a message to be brought back to OPM leadership because
    if OPM isn't going to take the lead in trying to create some
    sense of equity and uniformity across the board for our
    civilian work force serving in dangerous environments, who is?
    It can't be DOD. They have their hands full with their own
    challenges. I just think it has be somebody like OPM, and that
    is why I would hope that with the new administration, new
    leadership, the issue of chairing that interagency group would
    be revisited and swiftly.
        Mr. Mikowicz. We will certainly take this information back.
        Mr. Connolly. And because we have time and we have one more
    panel, I have one more question, and that has to do, Mr.
    Hallmark, among the GAO findings was one that is pretty
    stunning. Approximately 80 percent of deployed civilians who
    filed a claim with the Office of Workmen's Compensation
    reported experiencing problems. By the way, much higher
    satisfaction among those filing claims with DOD, nowhere near
    80 percent. What kinds of changes do you think are going to be
    necessary to try to bring that number down to something more
    satisfactory?
        Mr. Hallmark. I am not aware of the 80 percent satisfaction
    finding, but we are working, as I said in my comments, every
    day to try to improve the performance. FECA process is a joint
    interactive process that involves OWCP at Labor and the
    employing agency, and that is true wherever the injury occurs.
    I know it is something that we need to work together
    increasingly well to make the outcomes appropriate.
        As I said, one of the things that we have done is set up
    processes whereby we communicate out of our Cleveland office
    with the employing agencies where a claim has reached the point
    where we don't believe we can accept it so that we give the
    agency a chance to help us come to the right outcome. I think
    that is working. That may result in some cases the case taking
    a little longer than it would in the normal course, but we
    think that is the right outcome in that circumstance to make
    sure we get to the right answer.
        Mr. Connolly. Ms. Farrell, can you confirm for me, Mr.
    Hallmark indicated he was not aware of that 80 percent. That is
    a finding of the GAO study, is it not?
        Ms. Farrell. Yes. You are referring to the 125 of the 188
    claims that took significantly longer than the goal of 45 days,
    in some cases 20 percent longer than that. So, again, it dates
    back to the person filing the claim not having a clear
    understanding of what documentation is required so that when
    they do submit it, it is facilitated, and those particular
    claims that we broke down also were related to TBIs, which
    someone has a TBI it is very difficult I think for them to put
    the package----
        Mr. Connolly. Do you know what the comparable statistic
    would be for DOD?
        Ms. Farrell. No, I do not.
        Mr. Connolly. But not 80 percent?
        Ms. Farrell. Not 80 percent.
        Mr. Connolly. Ms. Fitzgerald.
        Ms. Fitzgerald. I don't know what the satisfaction rate is
    with the services at DOL. I can tell you that we have had by
    our statistics, in 2008 there was about a 50 percent increase
    in the swiftness in which the documentation was processed and
    received at DOL, and part of that goes to what Mr. Hallmark
    talked about. Some things have changed since the day the report
    was done by the GAO to fix the problems that were found at that
    time.
        Obtaining the appropriate evidentiary documentation is very
    difficult in a war zone and early on we learned that. These
    folks would come back and the physicians who even attended to
    them in the beginning were no longer even a part of the Federal
    Government. And so it was hard to go back and try and
    accumulate the documentation that was needed. So today there
    are systems in place to try and help gather that documentation,
    and with the intervention of the Federal agencies by allowing a
    little time for us to intervene before they deny a claim,
    allowing us to get in, help assemble that documentation, we
    have been able to help improve the processing and I think the
    outcomes for the individuals.
        Mr. Connolly. Thank you. And let me just say to all of you
    and to Mr. Hallmark in particular, you know, this is the
    Oversight and Government Reform Committee. We are at war. We
    are running two wars right now, and irrespective of how one may
    feel about that, the men and women who serve, whether they are
    in uniform or they are civilian Federal employees, are brave
    men and women who have answered the call of their country.
        In theory, you could have two people in a vehicle who are
    hit by an RPG or they hit an IED, one is in uniform and one is
    a civilian employee of Federal agency X. Both of them lose
    their left arm. Both of them are treated in field combat
    medical facilities with expert care. But one of them comes home
    to a military medical system, and the other does not
    necessarily. And over time, we have two different approaches to
    two different individuals who served the same purpose and were
    involved in the same accident with the same injuries.
        And there are issues of equity that flow from that, and
    fairness, and we want to make sure that at the very least there
    isn't a delay and that if we need to facilitate their having
    the evidentiary documentation they need, then let's help them,
    but 80 percent doesn't cut the muster.
        Final point, Ms. Fitzgerald, we get complaints from a lot
    of civilians who do have access to military medical care in
    these circumstances who, because of a bureaucratic snafu,
    however, cannot get the necessary credentialing to, in fact,
    have access to the base.
        Now, when I was chairman of Fairfax County, I had my own
    stickers on my car by virtue of that capacity for Fort Belvoir,
    and I wasn't seeking medical care daily or weekly. We need to
    facilitate these brave men and women's access to the base
    without bureaucratic hassle. And security is one thing; these
    people have been through hell and back. We need to help them.
        So I am going to count on you to please take that back to
    DOD. We don't want to be hearing about those kinds of problems.
    They have enough to manage without that.
        Ms. Fitzgerald. Absolutely. I think you will be happy to
    hear that we are going to be modifying the credentialing card
    that we give so that the back of it--they can have swipe access
    to the bases and so on. So hopefully we fix that problem.
        Mr. Connolly. I thank you all so much. Thank you for your
    forbearance in the schedule of the House of Representatives,
    and thanks for serving your country. We may be submitting some
    additional questions for the record and would appreciate your
    getting back to us. Thank you all very much.
        Our second panel--and I am going to read this while you are
    shuffling seats. We have two members on our second panel, Dr.
    Jonathan Shay, who is a clinical psychiatrist who recently
    retired from the Department of Veterans Affairs outpatient
    clinic in Boston, MA, my hometown, where he garnered eminent
    expertise in the treatment of combat trauma suffered by Vietnam
    veterans. In 2004 to 2005 he served as Chair of Ethics,
    Leadership and Personnel Policy in the Office of the U.S. Army
    Deputy Chief of Staff of Personnel. Dr. Shay is also the
    renowned author of ``Achilles in Vietnam: Combat Trauma and the
    Undoing of Character'' and has written more recently a book,
    ``Odysseus in America: Combat Trauma and the Trials of
    Homecoming,'' and he promotes the adoption of policies to
    minimize future psychological trauma.
        Also serving on this panel is Ms. Susan Johnson. Ms.
    Johnson is the current president of the American Foreign
    Service Association and has served in Iraq as senior adviser to
    the Ministry of Foreign Affairs and in the Office of the High
    Representative in Bosnia and Herzegovina as Deputy High
    Representative and Supervisor of BrckoDistrict, and she
    recently served as senior coordinator in the front office of
    the Bureau of Democracy, Human Rights and Labor.
        Welcome both and if you would rise to be sworn in.
        [Witnesses sworn.]
        Mr. Connolly. I thank you. Let the record show both
    witnesses indicated in the affirmative.
        We have your prepared testimony, and I would ask that you
    summarize in the space of 5 minutes the basis of that
    testimony. Dr. Shay.

    STATEMENTS OF JONATHAN SHAY, M.D., PH.D.; AND SUSAN R. JOHNSON,
            PRESIDENT, AMERICAN FOREIGN SERVICE ASSOCIATION

                       STATEMENT OF JONATHAN SHAY

        Dr. Shay. Thank you, Mr. Chairman. I see that the ranking
    member is no longer here, so--I am, as you so kindly pointed
    out, someone who learned his chops from combat veterans as a
    psychiatrist in the VA. Veterans have been wonderful teachers.
    You were kind enough to mention my two books, and as much of an
    obsessed author as I am, I don't have to mention them again.
        The veterans have made me their missionary to the military
    forces on prevention of psychological and moral injury in
    military service, and it has been an amazing trip for me. In
    the course of it--and you mentioned that I have worked for
    General Jim Jones, now the President's National Security
    Adviser; for the Army G-1, the Lieutenant General Hagenbeck;
    and, most recently, an interesting gig at the Army War College.
        I am not a universal expert. I believe that what I have
    learned about soldiers and veterans probably has applicability
    to other populations, other folks who are going into harm's
    way.
        My riff to the military people as to how to protect their
    people is threefold: to provide for stable face-to-face
    community when going into danger. Train them together, send
    them into danger together, and bring them home together. It is
    not rocket science.
        The second is expert, ethical, and properly supported
    leadership.
        The third is prolonged cumulative training for actually
    what they have to do in trade.
        So my mantra is over and over: cohesion, leadership,
    training; cohesion, leadership, training, as the keys to
    preventing psychological and moral injury.
        Now, this is an easy sell to military folks because they
    are also combat strength multipliers. I do not know the world
    of the diplomat or the agricultural specialist or the person
    from the FBI assigned to some investigative duties in Iraq.
    People would have to make these translations for themselves,
    and in my written testimony I tried to use my imagination as to
    how non-DOD agencies might hear my words to the military for
    their own purposes.
        I apologize for any way these recommendations might be off
    base. It comes out of my ignorance. I am not a universal
    expert, but I do feel quite confident that some of the things
    that I say are of merit, and that is to always as far as
    possible to be thinking in terms of teams, that you are not
    deploying people to a war zone one by one by one by one, but as
    work communities.
        In the matter of leadership and policy or leadership
    policy, if you wish, I want to emphasize something that is
    probably counterintuitive, and that is that there needs to be
    policy on sleep. Sleep crops up again and again as a cause of
    psychological injury and something that keeps it going once it
    is established.
        Finally, on training, I would hope that our Federal
    agencies are making use of hostile environment training. I know
    that journalists sometimes get it. The BBC trains all their war
    correspondents. They give them hostile environment training,
    and that the teams, to the extent that they are deployed as
    teams, must cross train so they know each other's jobs. That is
    a very positive thing.
        Now, this is really good for the agencies to do this, not
    out of pure humanitarian impulse or a sense of responsibility,
    but it is good for you because terrible things happen when your
    employees acquire bad psychological injuries. And the worst of
    these are operational paralysis, desertion. People check out
    psychologically or physically, and unfortunately, there is
    always the potential for recruitment to extremist causes,
    people who carry these injuries.
        And I am not running the riff that somehow it is the
    political right that has a unique attraction. The sorry history
    of Weimar, Germany indicates that both the political right and
    the political left and the anarchists and the criminals are
    equally capable of recruiting people who are vulnerable to it
    because of their psychological injuries.
        [The prepared statement of Dr. Shay follows:]

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        [GRAPHIC] [TIFF OMITTED] T5103.054

        Mr. Connolly. Thank you, Dr. Shay, and we will come back
    obviously to that thesis in questioning.
        Ms. Johnson.

                     STATEMENT OF SUSAN R. JOHNSON

        Ms. Johnson. Mr. Chairman, on behalf of AFSA and the
    employees of the member agencies, I thank you for the
    opportunity to speak before this committee on the subject of
    benefits for Federal employees deployed abroad. AFSA warmly
    welcomes the renewed bipartisan commitment to investing in our
    civilian diplomatic and development services.
        Key to that investment is ensuring that all of the men and
    women who are patriotically serving our country overseas,
    particularly in combat zones, whether military or civilian, are
    being taken care ofand receiving well-earned benefits, making
    the focus of this hearing both urgent and welcome. So thank you
    again.
        The GAO report on human capital highlights the major
    compensation equity issue facing members of the Foreign
    Service, the loss of locality pay when junior and mid-level
    members of our services are deployed abroad. This overseas pay
    gap represents a major inequity within our agencies. Junior and
    mid-level Foreign Service members now take a pay cut to serve
    at 183 of 267 overseas posts--that is 68 percent of them--which
    often effectively zeroes out the hardship and danger pay
    allowances for everyone except those at the senior levels.
        This problem faces Foreign Service personnel across the
    U.S. Government, not just at State, but also at USAID, the
    Foreign Commercial Service, the Foreign Agricultural Service,
    and the International Broadcasting Bureau.
        I am pleased to report that the first steps to resolve this
    issue through a phased approach over 3 years have been taken,
    but further authorization language is needed to finish the job
    by 2011. Completely closing this gap and ending a longstanding
    and divisive inequity remains a top AFSA priority.
        I would like to thank Secretary Clinton and Under Secretary
    for Management Pat Kennedy for their dedication and efforts on
    this issue and for working closely with AFSA to find a
    solution. And of course, we would like to thank the many
    Members of Congress that have helped correct this unintended
    inequity.
        Turning to the other recommendations of the GAO report,
    overall AFSA supports the recommendations that GAO made to the
    State Department in this report. We also agree with State's
    response and its action plan to implement these
    recommendations, particularly the mandatory medical screenings
    upon completion of assignment in a combat zone. Members of the
    Foreign Service should not have to worry about being able to
    receive the medical care they need while deployed abroad,
    particularly in war zones.
        AFSA agrees with the GAO that this policy needs
    clarification and encourages the Department of Defense and the
    State Department to coordinate and communicate the policy more
    clearly to employees deployed abroad.
        AFSA applauds State Department's new Deployment Stress
    Management Program [DSMP], a community-based program to support
    psychological health of members of our Foreign Service assigned
    to high stress, high threat, unaccompanied tours. We look
    forward to working with the State Department to ensure that
    DSMP continues to meet the needs of the Foreign Service.
        One area that the GAO report does not address, and that we
    would encourage this committee and the GAO to review, is
    support for dependents of Foreign Service members and other
    civilian employees who are deployed abroad at unaccompanied
    posts. We would like to see the services provided to family
    left at home brought more closely in line with those provided
    by the Department of Defense to military dependents in similar
    situations through the military one-source program.
        Thank you for the opportunity to testify and for your
    support. We appreciate your leadership in convening this
    hearing and AFSA hopes to continue to be a resource to you and
    this subcommittee in representing the views of the Foreign
    Service.
        I will be happy to answer any questions you may have.
        [The prepared statement of Ms. Johnson follows:]

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        [GRAPHIC] [TIFF OMITTED] T5103.056

        [GRAPHIC] [TIFF OMITTED] T5103.057

        [GRAPHIC] [TIFF OMITTED] T5103.058

        Mr. Connolly. Thank you so much, Ms. Johnson. I thank you
    both again for your testimony and your forbearance as well with
    the vicissitudes of House voting patterns. Our earlier
    information, by the way, was we weren't going to have any votes
    until about 4 p.m. and of course so much for that. We voted a
    little after 2:30.
        Let me ask you, Dr. Shay, first, and Ms. Johnson, your
    comments would be welcome, to what extent do Federal civilian
    employees have the same kinds of risks when they are deployed
    in the hostile environments as the military for psychological
    injury?
        Dr. Shay. Clearly, there are certain risks that they don't
    face. Every soldier faces the risk that he is going to fire his
    weapon at someone that he then realizes he shouldn't have and
    carries that on his soul for the rest of his life, and that is
    terrible, and civilian employees, unless they are armed, don't
    face that.
        But in terms of the general exposure, both to personal
    threat but also, so to speak, the moral exposure to witnessing
    terrible things happening to other people, whether it is them
    getting blown up or, A, is brutalizing, B, and nobody is doing
    anything about it and the awful things that people witness in
    war zones can sear people.
        Mr. Connolly. Well, in other words, putting aside the first
    example you gave, presumably somebody for a given department,
    civilian employee is probably not armed or may not be
    authorized to be armed, but the second example you gave, we
    could witness the same horror and have----
        Dr. Shay. Absolutely.
        Mr. Connolly [continuing]. Virtually the same impact on us
    emotionally?
        Dr. Shay. That is right.
        Mr. Connolly. Ms. Johnson, your take on that.
        Ms. Johnson. I would agree with the comments that Dr. Shay
    has made. Naturally, in some respects, the risks differ, but
    since World War II, 160 Foreign Service members have been
    killed in the line of duty, the vast majority of those as a
    result of terrorist attack, either blowing up of embassies,
    snipers, blowing up of cars or other attacks of the sort.
        In addition, certainly in both Iraq and Afghanistan,
    civilian members who are serving in PRTs and are serving all
    over the country face many, if not all, of the same risks that
    their military counterparts do and certainly witness much of
    the violence and, you know, danger experienced by the military.
        Dr. Shay. If I may adjust that, military officers face
    strain--moral strain and moral injury based on things that they
    know were done by other people on the basis of their decisions
    or the information that they gave to others, and I would not be
    surprised if there are analogous injuries in the Foreign
    Service world where people know they made decisions or gave
    information that led to a horrific outcome, unintended outcome,
    but they carry that with them.
        Ms. Johnson. I don't know to what extent this exactly
    relates to that--perhaps Dr. Shay would know better--but
    certainly we saw--and I served in Iraq from July through
    December 2003--and several of the Iraqis in the Foreign
    Ministry that I worked with were assassinated--targeted and
    assassinated directly as a result of visibly working and
    cooperating with us. So that is something that you do carry
    that here is someone that you have worked closely with and who
    has worked with the United States who is then assassinated as a
    result of that.
        Mr. Connolly. Sure. You could feel terribly guilty
    unwittingly putting someone in a terrible risk.
        Ms. Johnson. Exactly. Those are the things that you have to
    try to deal with.
        Mr. Connolly. Let me ask you a question. In light of that,
    the comparability of trauma exposure, when folks come home in
    the civilian work force, should they have available to them
    Veterans Affairs medical care? Should the VA be open to
    previously deployed Federal civilian employees?
        Dr. Shay. It appears to me that the VA or the vet centers
    were--as I have heard about for the first time today, I was
    unaware of this or the military treatment facilities. This is
    an obvious opportunity for Congress, should it wish to by
    legislation, to create that eligibility. That is sort of an
    obvious avenue for the Congress.
        Mr. Connolly. Ms. Johnson, any opinion on that matter.
        Ms. Johnson. Well, I think that having options generally,
    you know, increases the ability to handle whatever issues that
    you are facing. So I think it is good, to the extent that we
    are facing a very complex, difficult problem and, to a certain
    degree, some uncharted territory. So my instincts tell me that,
    in those cases, having options are better than not having them.
        Dr. Shay. And, as I mentioned in another option for
    Congress, some entity like the GAO could do a study of what
    kind of expertise is out there outside of the normal places to
    find it--the VA, the vet centers, the military medicine
    establishment--and where these people are. I am not suggesting
    that they create a directory, but I think it is important,
    given the need, that these data be gathered and analyzed so
    that we know what the resources are.
        Mr. Connolly. You both heard the previous discussion with
    your previous panel members, and I wonder what your take is. I
    mean, some of the resident expertise in the world on, for
    example, brain injuries is at Bethesda.
        Dr. Shay. That is correct.
        Mr. Connolly. Some of the resident expertise in the world
    on fitting of prosthetic devices, dealing with amputations and
    rehabilitation related to that, including the emotional
    management of both, is at Walter Reed.
        Dr. Shay. Brooke Army Medical Center.
        Mr. Connolly. That is right, or the Army Medical Center,
    exactly.
        So someone comes back from the State Department similarly
    injured with similar needs. He or she is, in theory, shepherded
    to the civilian side of medicine where comparable expertise
    does simply not exist.
        And, as you heard, the State Department and the Department
    of Agriculture who were at this table weren't aware, actually
    were not aware, of the fact that DOD had opened its door in
    these circumstances on a case-by-case basis at their
    acceptance--my words, not theirs--and they have been good about
    it.
        But if you don't know about it, you are not going to get
    the high-quality care available to your military counterpart
    who comes back a wounded warrior and veteran. I wonder what
    your observations would be about that situation.
        Dr. Shay. Well, it is something that one becomes very
    familiar with when dealing with combat veterans, and that is
    that it is a matter of luck and can be very capricious as to
    whether the injured veteran and the resources get together
    smoothly and quickly and effectively, or they pass each other
    like ships in the night, or they collide in some terribly messy
    crash and everybody gets hurt.
        So finding ways that this wonderful phrase, ``seamless
    transition''--that is a great line of public prayer. The hard
    part is making it actually happen and happen reliably.
        Mr. Connolly. Ms. Johnson.
        Ms. Johnson. I think it is excellent that the committee is
    focusing on some of these, I would say, over the horizon, but
    actually they are closer than that now. We are increasingly
    seeing civilians deployed in what we are calling, I guess,
    zones of armed conflict. It is inevitable, sadly, that more of
    them are going to be suffering various types of injuries,
    whether physical or psychological, moral, emotional.
        I think we need to be looking at what is the sensible and
    effective way to provide, you know, fair and equivalent
    treatment. I don't know if it is the same. As Dr. Shay said,
    maybe this would be a very suitable topic for, you know, a
    study to take a look at it and see what is the best solution.
        But the civilian side needs to be looking at what are we
    going to do to support our civilians who are serving in zones
    of armed conflict along with their military counterparts.
        Mr. Connolly. You all, AFSA, published its third annual
    poll about a year and a half ago now. Did you pick up anything
    in that poll in terms of attitudes of your members with respect
    to compensation and benefits while deployed in either Iraq or
    Afghanistan, on the quality of each?
        Ms. Johnson. Well, if I could quickly summarize sort of the
    main results of that poll--and I hope that we will have a
    chance to do a followup one in the not-too-far future--
    certainly the pay disparity and the locality pay and the
    canceling out of hardship and danger pay was a top priority.
        Iraq and Afghanistan staffing concerns of a broad variety
    came a close second.
        Other things relate more to internal State Department
    procedures: unfair assignment and promotion policies. And one
    thing that maybe relates to this is a perception that the
    workplace in the foreign service is one of diminishing family
    friendliness and becoming more and more difficult to, you know,
    sustain or maintain family units and putting more and more
    stress on them, not just the members, the direct employees, but
    their dependants and their family.
        I don't believe that it addressed directly the question
    that you asked, but that could be something we could look at in
    the future.
        Mr. Connolly. Yes. On the family friendly thing, I earlier
    this year was on a trip to a country I won't name, whose
    Ambassador, U.S. Ambassador, was married to another U.S.
    Ambassador who was in a very different country in a very
    different part of the world. And it made you wonder. I am sure
    that is a good thing; I am glad we are tapping into their
    talent. But it has to be a strain on their marriage and their
    family.
        OK, Dr. Shay, I have to give you this opportunity. You have
    written two wonderful books. And if you were to write a third,
    ``From Achilles to Odysseus,'' how would you compare the
    experience you document on Vietnam? I mean, what are the
    differences and similarities with the experience we are now
    experiencing in Iraq and Afghanistan compared to Vietnam?
        Dr. Shay. Well----
        Mr. Connolly. Don't write the third book here, but give us
    sort of a preview.
        Dr. Shay. I have a third book that is really for military
    professionals and policymakers called ``Trust Within Fighting
    Forces'' that has been hanging around my neck like an
    albatross, and I am trying to get it off its bottom.
        But I am the guy that said war is war is war is war, and it
    hasn't changed in 3,000 years as far as what matters in the
    heart of the soldier. And the obstacles to returning to
    civilian life, many of those haven't changed in 3,000 years. As
    long as humans pursue this hideous practice of war, it is going
    to hurt people, physically and psychologically. And we have to
    protect them as best we can and heal them as best we can when
    they do get hurt.
        Mr. Connolly. Anything in particular strike you as either
    absolutely similar to or absolutely different from the previous
    experience in Vietnam when you are looking at it?
        Dr. Shay. The climate in Vietnam is very different than the
    climate in Iraq and Afghanistan, or at least most parts of it.
    I think there are some quite tropical parts of Iraq. But,
    honestly, not much strikes me. I don't know of anybody who
    talked about the dust storms in Vietnam.
        Mr. Connolly. I guess I was getting at not so much the
    difference in climate and geography as the similarities or
    differences in trauma or injuries suffered by our----
        Dr. Shay. Well, insurgencies are wicked hard on the
    combatants, in that the enemy is intentionally blurring the
    distinction between armed combatant and, ``legitimate''
    targets, necessary targets, and protected persons, to use the
    terminology of the law of warfare.
        I think it is clear in this conflict, as it was in Vietnam,
    that the distinction between a legitimate target and a
    protected person means everything for the future mental health
    and moral integrity of the person who has been in war. And
    those people who glibly say, ``Oh, there are no rules in war,''
    don't understand the heart of the soldier. They don't want to
    know themselves to be murderers.
        And I know for a fact that this is the point of view of our
    military leadership today. I just, a couple weeks ago, spoke to
    the commanders' conference at the 101st Airborne. And they made
    it very clear that the moral dimension of what they do is
    critically important to them. And I, for one, stand up and
    cheer, because it is what will protect their mind and spirit.
        If I can just make one comment about what we have heard in
    the previous panel, I got a clarification on the fly about this
    41,000 civilians number. And I am told that is 41,000
    Department of Defense civilians. So this number does not
    include any other Federal employees, No. 1. And, No. 2, it
    totally leaves out Federal contractors who are working either
    directly under Federal contracts or are working for
    subcontractors.
        Mr. Connolly. Right. And that number could be in the
    hundreds of thousands.
        Dr. Shay. So the population that we are talking about is
    not 41,000; it is much larger.
        Mr. Connolly. Very good point. Because we know that there
    are AID folks and contractors associated with that. We know
    that there are Department of Agriculture people, Department of
    Labor people, so forth and so on. So there are lots more than
    just the 41,000 that serve with DOD.
        I want to thank you both so much for sharing today and your
    thoughts. If you have additional material you want to submit
    into the record, we would be delighted to have it.
        And I want to thank you again for your forbearance with our
    schedule today. It is very helpful to this committee and to the
    subcommittee.
        We stand adjourned.
        [Whereupon, at 5:15 p.m., the subcommittee was adjourned.]
        [Additional information submitted for the hearing record
    follows:]

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