    [Senate Hearing 111-122, Part 2]
    [From the U.S. Government Publishing Office]

                                                            S. Hrg. 111-122

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

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

                                    HEARINGS

                                    before a

                              SUBCOMMITTEE OF THE

                COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE

                         ONE HUNDRED ELEVENTH CONGRESS

                                 FIRST SESSION

                                       ON

                                   H.R. 3326

      AN ACT MAKING APPROPRIATIONS FOR THE DEPARTMENT OF DEFENSE FOR THE
         FISCAL YEAR ENDING SEPTEMBER 30, 2010, AND FOR OTHER PURPOSES

                                   __________

                                    PART 2

                             Department of Defense
                           Nondepartmental Witnesses

                                   __________

             Printed for the use of the Committee on Appropriations

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

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                          COMMITTEE ON APPROPRIATIONS

                       DANIEL K. INOUYE, Hawaii, Chairman
    ROBERT C. BYRD, West Virginia        THAD COCHRAN, Mississippi
    PATRICK J. LEAHY, Vermont            CHRISTOPHER S. BOND, Missouri
    TOM HARKIN, Iowa                     MITCH McCONNELL, Kentucky
    BARBARA A. MIKULSKI, Maryland        RICHARD C. SHELBY, Alabama
    HERB KOHL, Wisconsin                 JUDD GREGG, New Hampshire
    PATTY MURRAY, Washington             ROBERT F. BENNETT, Utah
    BYRON L. DORGAN, North Dakota        KAY BAILEY HUTCHISON, Texas
    DIANNE FEINSTEIN, California         SAM BROWNBACK, Kansas
    RICHARD J. DURBIN, Illinois          LAMAR ALEXANDER, Tennessee
    TIM JOHNSON, South Dakota            SUSAN COLLINS, Maine
    MARY L. LANDRIEU, Louisiana          GEORGE V. VOINOVICH, Ohio
    JACK REED, Rhode Island              LISA MURKOWSKI, Alaska
    FRANK R. LAUTENBERG, New Jersey
    BEN NELSON, Nebraska
    MARK PRYOR, Arkansas
    JON TESTER, Montana
    ARLEN SPECTER, Pennsylvania

                        Charles J. Houy, Staff Director
                      Bruce Evans, Minority Staff Director
                                     ------

                            Subcommittee on Defense

                       DANIEL K. INOUYE, Hawaii, Chairman
    ROBERT C. BYRD, West Virginia        THAD COCHRAN, Mississippi
    PATRICK J. LEAHY, Vermont            CHRISTOPHER S. BOND, Missouri
    TOM HARKIN, Iowa                     MITCH McCONNELL, Kentucky
    BYRON L. DORGAN, North Dakota        RICHARD C. SHELBY, Alabama
    RICHARD J. DURBIN, Illinois          JUDD GREGG, New Hampshire
    DIANNE FEINSTEIN, California         KAY BAILEY HUTCHISON, Texas
    BARBARA A. MIKULSKI, Maryland        ROBERT F. BENNETT, Utah
    HERB KOHL, Wisconsin                 SAM BROWNBACK, Kansas
    PATTY MURRAY, Washington
    ARLEN SPECTER, Pennsylvania

                               Professional Staff

                                Charles J. Houy
                                Nicole Di Resta
                                Kate Fitzpatrick
                                   Katy Hagan
                                  Kate Kaufer
                                Ellen Maldonado
                                   Erik Raven
                                   Gary Reese
                                  Betsy Schmid
                                 Bridget Zarate
                           Stewart Holmes (Minority)
                           Alycia Farrell (Minority)
                             Brian Potts (Minority)
                            Brian Wilson (Minority)

                             Administrative Support

                                 Renan Snowden

                                C O N T E N T S

                                  ----------

                           Wednesday, March 18, 2009

                                                                       Page

    Department of Defense: Medical Health Programs...................     1

                           Wednesday, March 25, 2009

    Department of Defense:
        National Guard...............................................   117
        Reserves.....................................................   171

                             Tuesday, May 12, 2009

    Department of Defense: Department of the Army: Office of the
      Secretary......................................................   235

                             Tuesday, June 2, 2009

    Department of Defense: Department of the Navy: Office of the
      Secretary......................................................   279

                             Thursday, June 4, 2009

    Department of Defense: Department of the Air Force: Office of the
      Secretary......................................................   349

                             Tuesday, June 9, 2009

    Department of Defense: Office of the Secretary...................   399

                            Thursday, June 18, 2009

    Nondepartmental Witnesses........................................   469

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                           WEDNESDAY, MARCH 18, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:30 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Murray, Cochran, and Bennett.

                             DEPARTMENT OF DEFENSE

                            Medical Health Programs

    STATEMENT OF LIEUTENANT GENERAL ERIC B. SCHOOMAKER,
                M.D., Ph.D., SURGEON GENERAL, U.S. ARMY
                MEDICAL COMMAND

                 opening statement of senator daniel k. inouye

        Chairman Inouye. I'd like to welcome all of the witnesses
    today as we review the Department of Defense (DOD) medical
    programs. There'll be two panels this morning. First we'll hear
    from the service surgeon generals: General Eric Schoomaker,
    Vice Admiral Adam Robinson, Jr., General James Roudebush. Then
    we'll hear from our chiefs of the Nurse Corps: General Patricia
    Horoho, Rear Admiral Christine M. Bruzek-Kohler, and General
    Kimberly Siniscalchi. Did I get it correct?
        I'd like to welcome back all of the three surgeon generals
    to our subcommittee once again. I look forward to continuing
    our work together to ensure the future of our military medical
    programs and personnel.
        As you may have noted, this is the first defense hearing
    that the subcommittee will be holding this year. We
    deliberately selected the medical programs as our inaugural
    topic to underscore the importance that this issue has to our
    subcommittee. Our surgeon generals and the chiefs of the Nurse
    Corps have been called upon to share their insight on what is
    working and what is not working.
        Military medicine is a critical element in our defense
    strength. Our ability to care for our wounded soldiers on the
    modern battlefield is a testament both to the hard work and
    dedication of our men and women in uniform and to the
    application of the new technology which is a hallmark of the
    U.S. armed forces, and so to our medical programs' demonstrated
    commitment to provide for our servicemembers and their
    families, which is unsurpassed in any other military. It is a
    vital component in our military compensation package, one that
    is necessary to sustain the all-volunteer force, a force, I
    might add, which by all measurement is the finest in the world.
        This is a unique medical hearing because we have not
    received the details of the fiscal year 2010 DOD budget, nor
    have we received the remaining fiscal year 2009 supplemental
    request. While we may not be able to discuss detailed budget
    issues, we'll focus on various medical personnel and medical
    technology issues facing the Department, our servicemembers and
    their families.
        On a personal note, when I was in the Army some time ago 4
    percent of the men in my regiment were married, just 4 percent.
    I think that was about the average in the United States Army.
    Now 56 percent of the Army, 54 percent of the Navy, and 45
    percent of the Marine Corps, and 59 percent of the Air Force
    are married. This completely alters the dynamic of the service
    I remember to the one you see today.
        Not only that, but the demographics of our servicemembers
    have drastically changed. We also have more than a few dual-
    service parents and couples, both of which deploy to theater.
        We've all read about the rising rates of suicide, divorce,
    substance abuse in our military. This is not something that can
    only be addressed with the service member. This must be
    approached with the service member, their family, their fellow
    soldiers, sailors, marines, and airmen. The solutions are not
    one size fits all or one service fits all. Instead, all ideas
    must be on the table for everyone to consider. What works for
    the Army may not necessarily work for the Navy.
        In addition, we need to take a unified approach to medical
    research in areas directly tied to the warfighter that we are
    currently tackling and those that could be right around the
    corner. This coordinated approach should cross the entire
    Federal Government, utilizing the resources and expertise of
    the Department of Veterans Affairs, the National Institutes of
    Health, Department of Homeland Security, and the Substance
    Abuse and Mental Health Services Administration, just to name a
    few.
        The Department stands at a very pivotal juncture in its
    efforts to modernize the medical technology enterprise
    architecture. I'm certain each one of you can share a story or
    two about the various versions of the Department's medical
    health records and how challenging it can be, at the least. Now
    you are tasked to both modernize the system and make it
    interoperable with the Veterans Administration (VA) to
    facilitate seamless transitions for our servicemembers and to
    enable joint DOD-VA locations to care for both veterans and
    servicemembers.
        These are not simple tasks and I know that there are many
    challenges ahead. These are some of the issues we'll face in
    the years ahead. We continue to hold this valuable hearing with
    the service surgeon generals and the chiefs of the Nurse Corps
    as an opportunity to raise and address these and many other
    issues.
        I look forward to your statements and note that your full
    statements will be made part of the record.
        Before we proceed with witnesses, may I call upon the vice
    chairman of the subcommittee, Senator Cochran.

                       statement of senator thad cochran

        Senator Cochran. Mr. Chairman, thank you very much. I'm
    pleased to join you in welcoming our two panels of witnesses
    today, the service surgeon generals and the chiefs of the Nurse
    Corps. We have an important duty to provide for the medical
    needs of our active, Guard, and Reserve personnel. The joint
    approach in managing the military medical programs has been
    very important in supporting our soldiers, sailors, airmen, and
    marines, especially during wartime.
        The men and women of the medical service corps deserve our
    thanks for their services they've provided and continue to
    provide. I'm pleased to join the chairman in being here to
    receive your testimony and working with you as we try to
    identify the priorities that need special attention in the
    funding cycle that we are approaching.
        Thank you very much.
        Chairman Inouye. Thank you very much.
        I am especially pleased to have with us in the subcommittee
    this morning Senator Bennett of Utah. He's our newest member.
    Welcome, sir. Would you like to make a statement?
        Senator Bennett. Your being pleased is only exceeded by my
    being pleased at the opportunity to be here. Thank you for your
    welcome.
        Chairman Inouye. Thank you very much.
        May I call upon the first witness, Lieutenant General Eric
    B. Schoomaker. He's a doctor, a Ph.D. He's also the Surgeon
    General of the U.S. Army.
        General Schoomaker. Thank you, sir. Chairman Inouye, Vice
    Chairman Cochran, Senator Bennett: Thank you for providing all
    of us here a forum for discussing our service medical programs
    and to allow me to discuss Army medicine and the defense health
    program (DHP).
        As you mentioned earlier, sir, I'm joined by our Chief of
    the Army Nurse Corps, Major General Patty Horoho, and the
    Commander of the Western Regional Medical Command at Madigan
    Army Medical Center at Fort Lewis, Washington.
        Also, in recognition of the Army's having declared 2009 as
    the year of the NCO, the noncommissioned officer, I'm joined
    today by my senior--the senior enlisted medic in the Army, who
    is my command sergeant major, Althea Dixon. She is one of the
    finest soldiers and leaders with whom I have had the pleasure
    to serve and is an invaluable member of my command team.
    Command Sergeant Major Dixon has been my battle buddy and my
    conscience and my unwavering standardbearer throughout these
    last three commands and through some of the most difficult
    challenges that Army medicine has faced. We've traveled
    together throughout the United States, especially throughout
    the southeast United States when we worked together in the
    Southeast Regional Medical Command, but also in Europe and in
    Kenya, Thailand, Korea, and most recently in Afghanistan and in
    Iraq.
        She embodies really the ethos of the noncommissioned
    officer. She's the person to whom I turn for unvarnished truth
    about my command and my effectiveness as a commander. She's my
    constant reminder of what is one of the most distinguishing and
    powerful features of our Army, which is our noncommissioned
    officer corps.
        For my oral statement today I'd like to highlight just a
    handful of key points that I raise in my written testimony.
    First I'd like to thank the Congress and this subcommittee in
    particular for the very generous and much appreciated funding
    support that you provided for the military health system and
    for Army medicine over the last year. Congress has been
    attentive to the needs we have in military medicine,
    particularly in our sustainment, restoration, and modernization
    (SRM) funding, SRM funding for facilities, and our research and
    development funds for research.
        Our sustainment, restoration, and modernization funding
    really gets put to great use by our facilities managers who
    keep our facilities operating safely and reliable. Some of our
    older hospitals are not ideal for practicing a 21st century
    form of medicine, but our SRM funding has really allowed us to
    keep them in good shape and running safely and smoothly.
        Our research and development dollars are going toward some
    very promising research. I think the chairman alluded to that
    earlier. It's aimed at saving and improving the lives of
    soldiers on future battlefields. Frankly, although I use the
    term ``soldiers'' to describe the recipients of these efforts,
    increasingly we conduct our research programs really as a joint
    effort among my three colleagues here, so that all warriors--
    soldiers, sailors, airmen, marines, coast guardsmen, and other
    Federal agency partners--as well as the public at large are
    beneficiaries of our work.
        Examples are biomarkers for traumatic brain injury, tissue
    re-engineering, interventions to build resilience and prevent
    psychiatric hazards--just a few examples of where innovative
    research initiatives that were funded through our fiscal year
    2009 core medical research budget are working. I eagerly await
    the outcomes of these and other research efforts that can
    better the lives of our soldiers and other warriors.
        Next I'd like to briefly mention the latest developments in
    our warrior care and transition program. This is probably one
    of the most important advances that we've made over the last
    several years. In our first year of standing up the warrior
    care and transition program through the Army medical action
    plan, we heavily invested in the structure of our units. We
    focused on proper ratios of care providers and cadre that
    oversee our warriors in transition. That's what we call our
    soldiers who are in these programs. They are transitioning into
    uniform, back into uniform, or into civilian life, or into
    continued care in the private sector or in the VA.
        Now in our second year, we're directing our efforts at
    optimizing the transition for our soldiers and families. In
    March 2008 we launched a comprehensive transition plan
    initiative for our warriors in transition. Instead of focusing
    solely on their injury or illness, the comprehensive transition
    plan fosters an holistic approach to a warrior's rehabilitation
    and transition. These are the lessons which wounded, ill, and
    injured soldiers from former wars, such as the chairman himself
    and Senator Dole, general retired, now Secretary, Shinseki, and
    general retired Fred Franks, have told us were the most
    important lessons to be gained from their own experiences in
    recovery and rehabilitation.
        This is accomplished through a collaboration of a
    multidisciplinary team of physicians, of case managers,
    specialty care providers, occupational therapists, and others.
    Together with a soldier and the family, we develop an
    individually tailored set of goals, emphasize the transition
    phase to civilian life or return to duty. I'm confident that
    this is really where we need to be doing that and it's going to
    come up with the right outcomes for our folks.
        An even newer Army program that I have high expectations
    for is our comprehensive soldier fitness program. The Army
    Chief of Staff, General George Casey, has established a vision
    of an Army comprised of balanced, healthy, self-confident
    soldiers and families and Army civilians whose resilience and
    total fitness enable them to thrive even in this area of high
    operational tempo and persistent conflict and engagement.
        To achieve this ambitious vision, he's instituting a
    comprehensive soldier fitness program. The intent of this
    program is to increase the resilience of soldiers and families
    by developing the five dimensions of strength: physical,
    emotional, social, spiritual, and family.
        It's currently in development. It's under the leadership of
    Brigadier General Rhonda Cornum, an Army Medical Department
    physician. I expect this program to have a positive effect and
    a profound effect upon our soldiers, their families, and our
    Army civilians.
        Last, I wanted to share with you a copy of our new combat
    medic handbook. Our combat medics, which we call 68-Whiskeys,
    68-Ws, are the best trained battlefield medics in the world,
    alongside our Navy and Air Force colleagues of course. As the
    Army and the joint force have labored to provide better body
    armor and protection from ballistic and burn and blast injury
    and have altered the tactics, techniques, and procedures in a
    complex urban terrain to reduce combat casualties and improve
    on our killed in action rates, that is survival from the
    initial wounding incident, our medics have enhanced these
    improvements and have further contributed to a historically low
    died of wound rates despite more destructive weapons that are
    wielded by our enemies.
        The medics of this 68-Whiskey generation are trained to
    perform advanced airway skills, hemorrhage control techniques,
    shock management, and evacuation. Examples are: Sergeant First
    Class Nadine Kahla and Sergeant First Class Jason Reisler, who
    are 68-Whiskey NCOs assigned to the Army Medical Department
    Center and School in San Antonio, Texas. They are
    representatives of the other 17 68-Whiskey NCO authors that
    contributed to this new advanced fieldcraft combat skills
    textbook, a state-of-the-art manual for combat medics. This
    delineation of combat medic skills is newly published. It'll be
    issued to every graduating new combat medic beginning this
    month. It's an incredible resource developed by some truly
    incredible NCOs.
        In closing, I wanted to thank the subcommittee for the
    terrific support that you have given to the defense health
    program and to Army medicine. I greatly value the insight of
    this subcommittee and I look forward to working with you
    closely over the next year.
        I also want to salute our noncommissioned officers for
    their professionalism, competence, and leadership. They're
    truly the backbone of the Army and of Army medicine.

                               prepared statement

        Thank you for holding this hearing. Thank you for your
    continued support of Army medicine and the warriors and
    families that we're most honored to serve. Thank you, sir.
        Chairman Inouye. Thank you very much, General Schoomaker.
        [The statement follows:]
      Prepared Statement of Lieutenant General Eric B. Schoomaker, M.D.,
                                     Ph.D.
        Chairman Inouye, Vice Chairman Cochran, and distinguished members
    of the Subcommittee, thank you for providing me this forum to discuss
    Army Medicine and the Defense Health Program. I appreciate this
    opportunity to talk with you today about some of the very important
    work being performed by the dedicated men and women--military and
    civilian--of the U.S. Army Medical Department (AMEDD) who personify the
    AMEDD value ``selfless service.'' In recognition of 2009 being ``The
    Year of the NCO'', throughout my testimony I will highlight the
    contributions of the AMEDD's Non-Commissioned Officer Corps, the
    backbone of Army Medicine. Non-Commissioned Officers comprise 18
    percent of the Army Medical Department and play critical roles in every
    aspect of the organization. I am joined today by the senior enlisted
    medic in the Army, my Command Sergeant Major Althea Dixon, one of the
    finest Soldiers and leaders with whom I have had the privilege to serve
    and an invaluable member of my command team.
        As the Commander of the U.S. Army Medical Command (MEDCOM), I
    oversee with the assistance of Command Sergeant Major Dixon a $10
    billion international healthcare organization staffed by 70,000
    dedicated Soldiers, civilians, and contractors. We are experts in
    medical research and development, medical logistics, training and
    doctrine, the critical elements of public health--health promotion and
    preventive medicine, dental care, and veterinary care--in addition to
    delivering industry-leading healthcare services to 3.5 million
    beneficiaries around the world. But central to everything we do in Army
    Medicine is the warfighter--we exist as a military medical department
    to support the warfighter. I am happy to report that we are
    accomplishing that mission phenomenally well. I can say this with great
    confidence after spending the first week of this month with the U.S.
    Central Command (CENTCOM) Surgeon at the Multi-National Force/Multi-
    National Corps--Iraq Surgeon's Conference in Iraq. Seeing first hand
    the care and civil-military medical outreach from Brigade and Division
    to Corps and Theater was a clear demonstration of the Joint Medical
    Force providing top-notch medical support across the full-continuum of
    care and nation building.
        To determine how successful we are at executing our mission, Army
    Medicine uses the Balance Scorecard (BSC) approach developed in the
    1990s by Harvard's Doctors Robert Kaplan and David Norton. Simply put,
    the BSC serves as an organizational strategic management system which
    can help improve organizational performance while remaining aligned to
    our strategy. The MEDCOM began BSC implementation in 2001 under LTG
    (Ret) James Peake's leadership. Since then, we have continued to refine
    the BSC to grow and direct our dynamic organization. I use the enclosed
    Army Medicine Strategy Map (published in April 2008 and revised in
    January 2009) and Scorecard as the principal tool by which to guide and
    track the Command to improve operational and fiscal effectiveness, and
    better meet the needs of our patients, customers, and stakeholders. The
    BSC communicates to our MEDCOM workforce and drives top-to-bottom
    organizational understanding and alignment, focusing our day-to-day
    efforts to ensure we execute our Mission successfully.

        ----------------------------------------------------------------

                Army Medicine Balanced Scorecard (BSC) Overview
    Purpose
        The Balanced Scorecard strategic management framework has been and
    continues to serve as the centerpiece of the Army Medicine's
    enterprise-wide Strategic Management System. The first AMEDD strategy
    map was approved by LTG James B. Peake on April 2001 and the framework
    has continued through today with LTG Eric B. Schoomaker's January 2009
    strategy map. The BSC is used to drive top-to-bottom organizational
    understanding and alignment, focus day-to-day efforts, and ensure that
    we are executing our Mission.
    Overview
        The BSC is a concept introduced by Doctors Robert Kaplan and David
    Norton in 1992. The BSC is a framework to translate the organization's
    strategy into terms that can be easily understood, communicated, and
    acted upon (measurable action).
        The foundation and main driver of a BSC is the organization's
    Mission and Vision. Four perspectives then define the organization:
    Patient/Customer/Stakeholder (Ends), Internal Processes (Ways),
    Learning and Growth (Means), and Resource (Means). The April 2008
    strategy map (one page schematic) describes Army Medicine's strategy
    via the strategic objectives (located in the bubbles on the strategy
    map) in each perspective. Behind each strategic objective is a detailed
    objective statement that clearly defines the meaning of the strategic
    objective and measure, which will drive behavior to accomplish each
    objective. Each measure will have a target and supporting initiatives
    that will drive the change required to allow the organization to move
    closer to its intended outcomes (ends).
        The BSC is a dynamic, living document that will be refined due to
    mission and priority changes, organizational learning, as well as when
    targets are met. Periodic reviews are conducted to ensure proactive
    change.
    Organizational Cascading and Alignment
        To ensure enterprise-wide alignment to the Army Medicine BSC, Major
    Subordinate Command Commanders and Corps Chiefs are required to build a
    supporting BSC and conduct an alignment brief with TSG.
    Additional Information
        Detailed information, to include the Army Medicine BSC, is located
    at https://ke2.army.mil/bsc.
    Contacts
        Mr. Randy Randolph, Director Strategy and Innovation, commercial
    (703) 681-3015 or DSN 761-3015 gaston.randolph@amedd.army.mil.
        LTC Rex Berggren, Strategic Planning Officer, commercial (703) 681-
    5683 or DSN 655-5683 rex.berggren@amedd.army.mil.
        Ms. Sylvia Pere, Strategic Planner, commercial (210) 221-7172 or
    DSN 471-7172 sylvia.pere@amedd.army.mil.

        ----------------------------------------------------------------

        The Army Medicine BSC measures and improves organizational
    performance in four ``balanced'' Strategic Perspectives: ``Resources''
    and ``Learning and Growth'' which are the ``Means''; ``Internal
    Processes'' which is the ``Ways''; and ``Patients, Customers and
    Stakeholders'' which is the ``Ends'' by which we show best value in
    products and services. These ``Ends'' are how I've organized my
    statement in order to best communicate the significant and varied
    accomplishments of Army Medicine over the last year.
        The Six Army Medicine ``Ends'': Improved Healthy and Protected
    Families, Beneficiaries, and Army Civilians; Optimized Care &
    Transition of Wounded, Ill, and Injured Warriors; Improved Healthy and
    Protected Warriors; Responsive Battlefield Medical Force; Improved
    Patient and Customer Satisfaction; and Inspire Trust in Army Medicine.
       improved healthy and protected families, beneficiaries, and army
                                   civilians
        Improve the health of beneficiaries thru cost-effective evidence-
    based care, proactive disease management, demand management, and public
    health programs.
        Use of HEDISR Measures.--The Healthcare Effectiveness
    and Data Information Set (HEDISR) is a tool used by more
    than 90 percent of America's health plans (> 400 plans) to measure
    performance on important dimensions of care. The measures are very
    specifically defined, thus permitting comparison across health plans.
    The DOD is not a member of the HEDIS program, but uses the HEDIS
    methodology to measure and compare its performance to the HEDIS
    benchmarks. The Military Health System (MHS) Population Health Portal
    takes administrative data and electronic health record data and
    provides reports on the status of our beneficiaries on each measure.
    Currently, we track 9 measures and compare our performance to HEDIS
    benchmarks. In October 2008, the Army was in the 90th percentile
    compared to HEDIS health plans for 2 of 9 measures. We are in the 50th
    to 90th percentile for 6 measures and below the HEDIS 50th percentile
    for one measure. Marked improvement is seen in colorectal cancer
    screening which improved 8.9 percent (October 2005 to October 2008) and
    approaches the HEDIS 90th percentile. In addition, the Army has very
    high compliance with Pneumovax, the vaccine against pneumococcal
    pneumonia, for our enrolled patients over age 65. Since 2007, we've
    been providing financial incentives to our hospitals for superior
    compliance in key HEDIS measures. The Army was the pioneer for what the
    Assistant Secretary of Defense for Health Affairs is now terming Pay-
    for-Performance. We have shown that these incentives work to change
    behavior and achieve desired outcomes in our system.
        MEDCOM Reorganization.--The MEDCOM is engaged in a phased
    reorganization designed to optimize the delivery of healthcare to our
    Army and to support a deploying force. With the support of senior Army
    leadership, I approved phase one of this reorganization which aligns
    CONUS Regional Medical Commands (RMCs) with their supporting TRICARE
    regions. MEDCOM is restructuring in order to be better aligned and
    positioned to support our transforming Army. Command Sergeant Major
    Matthew T. Brady was instrumental in developing the structure and
    functions for the newly designed Western RMC headquarters--his
    contributions are emblematic of the significant role played by NCOs
    across the MEDCOM in our restructuring efforts.
        Healthcare support today is outstanding and it must remain so for
    our Army to succeed during an era of persistent conflict. As the Army
    changes its structures, relationships and organizational designs
    through transformation and other initiatives to better support our
    Nation in the 21st Century, the AMEDD must adapt to ensure it remains
    reliable and relevant for our Army. The main restructuring is from 4
    CONUS RMCs to 3 CONUS RMCs. While reorganizing RMCs, we intend to
    further integrate healthcare resources, capabilities and assets to
    foster greater unity of effort and synergy of our healthcare mission.
    The restructuring will posture us to better provide the best support
    for Army Force Generation (ARFORGEN) and improve readiness through
    enhanced health care services for our Soldiers, their Families, and
    Army units.
        Clinical Information Systems.--The AMEDD has long recognized a need
    for an information system to help us grow as a knowledge-driven
    organization. The AMEDD energetically assumed lead for the DOD during
    the implementation of the Composite Health Care System I (CHCS I), now
    known as AHLTA. Unfortunately, AHLTA has not always kept pace with
    expectations at the user-level or at the corporate level for data
    mining and other uses. The Army has taken significant steps to leverage
    the data from AHLTA and other clinical information systems to improve
    clinical quality and outcomes as well as patient safety. To address
    identified shortcomings with AHLTA at the provider level, the AMEDD has
    invested in the MEDCOM AHLTA Provider Satisfaction (MAPS) initiative.
    This includes investment in tools like Dragon MedicalTM and
    As-U-Type, individualized training and business process re-engineering
    led by clinical champions, and use of wireless and desktop
    virtualization. At the Heidelberg Health Center in Germany, Staff
    Sergeant Kenneth M. Melick is the workhorse who took the physician
    vision for business process reengineering from construction to final
    implementation and ensured success. MAPS is beginning to show
    significant improvements in provider usability and satisfaction. Direct
    interviews with providers and staff reveal that MAPS implementation has
    generated a dramatic change in attitude among our staff.
        The most recent version of AHLTA has presented us with challenges,
    but it is showing improvements and gaining provider acceptance. AHLTA
    provides significant benefit to beneficiaries, especially in the areas
    of patient safety, security, improved clinical and readiness outcomes,
    and global availability of records. In addition, a new enterprise
    architecture for the MHS will likely result in a significant
    improvement in managing our information systems. The next update to
    AHLTA (3.3) is being deployed and its additional functionality and
    improved speed is well-liked by the providers who have tested it.
        Force Health Protection and Public Health Programs.--The U.S.
    Army's Center for Health Promotion and Preventive Medicine (CHPPM) is a
    subordinate command of the MEDCOM that affects the lives of Soldiers
    and Families everyday. Its mission is to provide worldwide technical
    support for implementing preventive medicine, public health, and health
    promotion/wellness services into all aspects of America's Army and the
    Army community. The CHPPM team supports readiness by keeping Soldiers
    fit to fight, while also promoting wellness among their Families and
    the Federal civilian workforce. CHPPM integrates public health efforts
    to develop and export primary prevention based products by using
    epidemiologic data of disease and injury to identify the best
    prevention programs to implement for overall population health
    improvement. One member of the CHPPM team--Sergeant Kerri Washington--
    made a notable impact on the health and safety of our U.S. Army and
    Iraqi Forces in the Multi National Division--Baghdad area of
    responsibility. Sergeant Washington deployed as a Preventive Medicine
    (PM) Specialist with the 61st Medical Detachment (PM) and applied his
    preventive medicine skills, leadership ability, and unique health
    surveillance training to enhance Soldier health and disease prevention.
        CHPPM is establishing a Public Health Management System to evaluate
    the programs and policies developed to promote optimal health in the
    Army community which will use the public health process to provide
    metrics indicating the success or lack of success in these endeavors.
    This will allow leaders to make informed decisions on effective or
    ineffective public health issues in the Army. Army veterinarians play a
    key role in public health as well, ensuring the safety of food and
    water and the prevention of animal-borne diseases. As part of the
    MEDCOM Reorganization addressed earlier, I have directed my staff to
    assess the feasibility and benefits of establishing a Public Health
    Command which better synchronizes and integrates the efforts of all
    AMEDD members who contribute to public health programs. This will
    enhance comprehensive health and wellness and optimize delivery of
    public health support to the Army.
      optimized care and transition of wounded, ill, and injured warriors
        Warrior Care and Transition Program.--The transformation of U.S.
    Army Warrior Care began in April 2007 with the development of the Army
    Medical Action Plan (AMAP), which outlined an organizational and
    cultural shift in how the Army cares for its wounded, ill, and injured
    Soldiers. Over the past 22 months, the AMAP has evolved into the Army
    Warrior Care and Transition Program (WCTP), fully integrating Warrior
    Care into institutional processes across the Army, and is achieving
    many of the Army's goals for enhancing care and improving the
    transition of wounded warriors back to duty or into civilian life as
    productive veterans. At the heart of the Warrior Care and Transition
    Program is the successful establishment of 36 Warrior Transition Units
    (WTUs) at major Army installations worldwide, and nine Community Based
    Warrior Transition Units (CBWTUs) located regionally around the United
    States. These units replace the Medical Holdover (MHO) system of the
    past and provide holistic care and leadership to Soldiers who are
    expected to require 6 months of rehabilitative treatment, and/or need
    complex medical case management.
        Comprehensive Transition Plan.--In our first year of Warrior Care
    and Transition, we heavily invested in the structure of our units and
    support systems. Now in our second year, we recognize that our focus
    needs to be on optimizing the transition for our Soldiers. In March
    2008, MEDCOM launched the Comprehensive Transition Plan initiative for
    Warriors in Transition. Instead of focusing solely on the injury or
    illness, the Comprehensive Transition Plan fosters a holistic approach
    to a Warrior's rehabilitation and transition. This is accomplished
    through the collaboration of a multidisciplinary team of physicians,
    case managers, specialty care providers, and occupational therapists.
    Together with the Soldier, they develop individually tailored goals
    that emphasize the transition phase to civilian life or return to duty.
    Goals are set and the transition plan developed within one month of the
    Soldier's arrival at the WTU.
        Physical Disability Evaluation System.--The Medical Evaluation
    Board (MEB) and Physical Evaluation Board (PEB) processes have been
    streamlined and paperwork requirements reduced to more efficiently move
    a Soldier's disability package through the adjudication process.
    Additionally, collaboration between the DOD and the Department of
    Veterans Affairs (VA) ensures that Warriors in Transition have priority
    processing by the Veterans Health Administration (VHA) and Veterans
    Benefits Administration (VBA) 60 to 180 days prior to separating so
    that they can receive their VA benefits and health care immediately
    upon discharge. General Frederick M. Franks, Jr., USA Ret. has been
    leading an Army task force to research and recommend improvements to
    the MEB/PEB process. His findings, recently delivered to the Secretary
    of the Army, recommended that DOD and VA eliminate dual adjudication
    from the current system and ``transition to a comprehensive process
    focusing on rehabilitation and transition back to either uniformed
    service or civilian life that promotes resilience, self-reliance, re-
    education, and employment, while ensuring enduring benefits for the
    Soldier and Family.'' This finding reaffirms the importance of the
    Comprehensive Transition Plan.
        Warrior Satisfaction.--Over the past 2 years, the Army has made
    tremendous progress in transforming how it provides healthcare to its
    Soldiers, with improvements impacting every aspect of the continuum of
    care. Over this period, overall Soldier and Family satisfaction with
    the care and support they have received as a result of the efforts of
    the Warrior Care and Transition Program has increased significantly.
    Two years ago, only 60 percent of those in the legacy medical hold
    units were satisfied with the care they received. Today, that number
    has increased to 80 percent of Soldiers and Families who now receive
    the focused and comprehensive care and support provided by WTUs.
    Considering that over 20,000 Soldiers, along with their Families, have
    transitioned through the Warrior Care and Transition Program over that
    time, this represents a significant number of ``satisfied'' customers.
    A key element of increased satisfaction has been the availability of a
    robust ombudsman program staffed primarily with retired NCOs. An
    ombudsman works at each of our WTUs on behalf of the Warriors in
    Transition and their Families to fix problems and cut through
    bureaucratic entanglements. It is a great example of our dedicated
    senior NCOs continuing to serve Soldiers even after they've taken off
    the uniform.
                    improved healthy and protected warriors
        Improve the health of service members through full spectrum health
    services to optimize mission readiness, health and fitness, and
    resiliency before, during, and after deployment.
        Evidence Based Practices.--The theme of evidence based practices
    runs through everything we do in Army Medicine and is highlighted
    throughout our Balanced Scorecard. Evidence based practices mean
    integrating individual clinical expertise with the best available
    external clinical evidence from systematic research. Typical examples
    of evidence based practice include implementation of clinical practice
    guidelines and dissemination of best practices. I encourage my
    commanders and subordinate leaders to be innovative, but across Army
    Medicine we must balance that innovation with standardization so that
    all of our patients are receiving the best care and treatment
    available.
        Comprehensive Soldier Fitness.--The Army Chief of Staff has
    established a vision of an Army comprised of balanced, healthy, self-
    confident Soldiers, Families and Army Civilians whose resilience and
    total fitness enable them to thrive in an era of high operational tempo
    and persistent conflict. To achieve this ambitious vision, he is
    instituting the Comprehensive Soldier Fitness Program. General Casey
    identified several shortcomings in his own Army experience. For
    example, the Army does not routinely assess all the elements of
    wellness, fitness, and optimal human performance, other than physical.
    Resilience, life skills, and mental coping techniques are not fully
    trained across the Army. The Army does not always link available life
    skills and performance programs and interventions with Soldiers and
    Families until the need has been demonstrated by a negative behavior.
    And the Army does not teach Soldiers about the potential for Post
    Traumatic Growth (PTG), nor give Soldiers the opportunity to validate
    their post traumatic growth during Post Deployment assessments. The
    intent of the Comprehensive Soldier Fitness Program is to increase the
    resiliency of Soldiers and Families by developing the five dimensions
    of strength--physical, emotional, social, spiritual, and family. This
    program is in early development, but under the leadership of Brigadier
    General Rhonda Cornum, an AMEDD physician, and with the commitment of
    passionate non-commissioned officers like her Non-Commissioned Officer
    in Charge, Master Sergeant Richard Gonzales, I expect this program to
    have a profound positive effect on the lives of Soldiers, Families, and
    Army Civilians.
        Brain Health.--Commanders and leaders are responsible for the
    mental and physical well-being and care of Soldiers. They play a
    critical role in encouraging Soldiers to seek prompt medical care for
    traumatic brain injuries (TBI). This responsibility begins on the
    battlefield, as close as possible in time and space to the injury. The
    AMEDD is developing the best process to evaluate and treat every
    Service member involved in an event that may result in TBI. Commanders
    and medics throughout theater are emphasizing early recognition of
    brain injuries followed by examinations and care rendered in accordance
    with clinical practice guidelines developed by the AMEDD in conjunction
    with the CENTCOM Surgeon. The Army is also working closely with the
    National Guard to implement a personnel tracking instrument that
    provides identification of individuals who may have been involved in a
    blast and require screening.
        In coordination with the VA and the Defense Center of Excellence
    for Psychological Health and Traumatic Brain Injury, the Army continues
    to expand resources dedicated to TBI research and treatment. The
    Defense Centers of Excellence (DCoE), directed by Army Brigadier
    General Loree Sutton, lead a collaborative effort toward optimizing
    psychological health and TBI treatment for all Service members. The
    DCoE establishes quality standards for: clinical care; education and
    training; prevention; patient, family and community outreach; and
    program excellence. The DCoE mission is to maximize opportunities for
    warriors and families to thrive through a collaborative global network
    promoting resilience, recovery, and reintegration for psychological
    health and TBI.
        Fort Campbell's Warrior Resiliency and Recovery Center for mild TBI
    is showing very promising results in the identification and treatment
    of mild TBI. The post concussive syndrome appears to exist in these
    Soldiers with a natural clinical history separate from that of Post
    Traumatic Stress Disorder (PTSD) or other psychiatric conditions. The
    syndrome is effectively treated with an intensive and comprehensive
    interdisciplinary approach. Early data indicate significant improvement
    in all treated cases and complete return to duty recovery in over 77
    percent of treated Soldiers.
        Battlemind Training.--One validated evidence-based practice that
    reduces the impact of post traumatic stress is the Battlemind Training
    System (BTS). The Battlemind Training System (BTS) reflects a strength-
    based approach, using buddy aid and focusing on the leader's role in
    maintaining our Warriors' mental health. The BTS targets all phases of
    the deployment cycle as well as the Warrior life cycle and medical
    education system. BTS includes training modules designed for Warriors,
    Leaders, and military spouses. Key teaching points about PTSD and
    concussion were recently incorporated into the deployment cycle and
    life cycle Battlemind modules.
        RC Dental Readiness.--Maintaining dental readiness in the Reserve
    Components (RC) has been challenging. During the past year, new program
    developments have provided an integrated Army solution for RC dental
    readiness throughout the ARFORGEN cycle. The Army Dental Command
    (DENCOM) executes First Term Dental Readiness (FTDR) at Initial Entry
    Training (IET) installations, and focuses on examining and treating
    dental conditions in recruits that could otherwise render a Soldier
    non-deployable. Upon graduation from IET, RC Soldiers return to their
    units where the Army Selected Reserve Dental Readiness System (ASDRS),
    initiated in September of 2008, maintains RC Soldier dental readiness
    throughout the three ARFORGEN phases. If the RC Soldier is mobilized,
    they are validated for their deployment dental readiness by DENCOM-
    operated facilities and if found to be deficient, are examined and
    treated to a deployable status by dedicated AC and RC dental personnel
    such as Sergeant First Class Dexter Leverett, a USAR NCO mobilized
    since 2004, who has managed RC mobilization and demobilization dental
    operations at both Fort Hood and Camp Shelby, MS--two sites which have
    processed over 26,000 RC Soldiers in the past 5 months alone. Upon
    return from deployment, DENCOM resets RC Soldier dental readiness by
    conducting a Demobilization Dental Reset (DDR) which provides a dental
    exam and readiness care that can prudently be completed during the
    abbreviated demobilization process. Since July 2008 we have dentally
    reset 88 percent of RC Soldiers demobilizing from overseas. I expect
    this integrated approach to generate improved RC dental readiness.
        Armed Forces Health Surveillance Center.--The new Armed Forces
    Health Surveillance Center (AFHSC), a DOD Executive Agency supported by
    CHPPM, performs comprehensive medical surveillance and reporting of
    rates of diseases and injuries among DOD service members. AFHSC's main
    functions are to analyze, interpret, and disseminate information
    regarding the status, trends, and determinants of the health and
    fitness of U.S. military (and military-associated) populations and to
    identify and evaluate obstacles to medical readiness. AFHSC is the
    central epidemiological resource for the U.S. Armed Forces providing
    regularly scheduled and customer-requested analyses and reports to
    policy makers, medical planners, and researchers. It identifies and
    evaluates obstacles to medical readiness by linking various databases
    that communicate information relevant to service members' experience
    that has the potential to affect their health.
                      responsive battlefield medical force
        Ensure health service assets of all three components are trained,
    modular, strategically deployable, and can support full spectrum
    operations and joint force requirements.
        Pre-deployment Trauma Training.--Adhering to the policy that no one
    should be initially exposed to a medical challenge while on deployment
    or on the battlefield, pre-deployment trauma training is now mandatory
    for individual providers and medical units to improve survival rates.
    It is a critical link between standard medical care and the intense
    battlefield environment Soldiers face in the current conflicts. By
    recreating the high-stress situations medics will face in Iraq and
    Afghanistan, this training allows for the refinement of advanced trauma
    treatment skills and sensitization to hazardous conditions which allow
    medics to increase their confidence and proficiency in treatment. This
    training includes a surgical skills laboratory, the principles of
    International Humanitarian Law, and mild TBI and Combat Stress
    identification. Returning Soldiers cite this as the best training they
    have ever received.
        Medical Simulation Training Centers.--The Medical Simulation
    Training Center (MSTC) grew from an Army Chief of Staff directive to
    create and quickly implement medical simulation training to prepare
    combat medics for the battlefield. Command Sergeant Major David
    Litteral and Sergeant First Class William Pilgrim were active in the
    early development of the MSTC program, and are two of the many NCOs
    instrumental in the program's success. In fiscal year 2008 the 14
    stateside MSTCs provided training to 27,136 Combat Medics and non-
    medical Soldiers in the Tactical Combat Casualty Care (TC\3\) and Medic
    sustainment courses. Also in fiscal year 2008, at four locations within
    the CENTCOM Area of Responsibility (AOR), 26,132 Medics and Soldiers
    validated their TC\3\ skills and received just in time training. This
    success has carried into fiscal year 2009 as 20,235 Medics and Soldiers
    have passed through the now 16 stateside MSTCs and four CENTCOM
    locations for training and or validation of critical battlefield
    lifesaving skills.
        Joint Forces Combat Trauma Medical Course (JFCTMC).--This is a 5-
    day trauma training course developed by the AMEDD Center and School and
    designed for providers deploying to Level III (Combat Support Hospital)
    medical missions. The course is a series of lectures with breakout
    sessions by specialty, which include laboratory sessions. JFCTMC
    prepares deploying providers to care for patients with acute war-
    related wounds and incorporates lessons learned from Operation Iraqi
    Freedom and Operation Enduring Freedom. Sergeant First Class Theresa
    Smith, Sergeant First Class Pearell Tyler, Sergeant First Class David
    Estrada, Sergeant First Class Robert Lopez, and Staff Sergeant Cedric
    Griggs conduct the much-praised Emergency Surgical Procedures portion
    of this course and provide Point of Wounding training. That's right--
    non-commissioned officers training physicians and other health care
    providers.
        Combat Development.--AMEDD NCO Combat Developers, like Master
    Sergeant (MSG) Christian Reid and Sergeant First Class Raymond Arnold,
    have been front and center in product improvements of the Mine
    Resistant Ambush Protected (MRAP) ambulance, Army Combat Helmet, Combat
    Arms Ear Plugs, Improved Outer Tactical Vest, and Fire Retardant Army
    Combat Uniform. Additionally, MSG Reid has been pivotal in the
    development of the Improved First Aid Kit (IFAK) from concept to
    fielding in 6 months and the Warrior Aid and Litter Kit (WALK) of which
    more than 25,000 have been procured to support current combat
    operations. The MRAP-Ambulance provides increased protection to our
    crews and patients. To make the MRAP-Ambulance the most capable ground
    ambulance in the Army today, we integrated ``spin-out'' technology from
    the Future Combat System (FCS) Medical Vehicles. The combat medic is
    now able to leave the Forward Operating Bases to conduct medical
    evacuation missions and can provide world class en-route care to
    wounded soldiers. The AMEDD also developed Casualty Evacuation Kits
    (CASEVAC) for both the MRAP and HMMV ambulances to increase capability.
    These efforts provided the combat medic with field ambulances built for
    survivability in the challenging environment of asymmetric warfare.
        Fresh Blood Distribution.--Recognizing that fresher blood has been
    associated with increased survival on massively transfused patients,
    the Armed Services Blood Program Office (for which Army maintains
    oversight as Executive Agent) has been working with the Services to
    decrease the time it takes for blood to arrive in theater with the
    overall goal of getting 80 percent of the units in theater by day
    seven. The average age of red blood cells arriving in theater prior to
    November 2008 was 13.3 days. Sergeant First Class Peter Maas and others
    in the Blood Program Office identified 13 action items necessary to
    improve blood collection, manufacture, and distribution to the CENTCOM
    AOR. Since implementing these action items in November, 2008, the
    average age of red blood cells arriving in theater has dropped to 9.2
    days. The most recent shipment had an average age of 5.6 days. In the
    last month, we have managed to bypass blood delivery to Bagram and are
    shipping blood directly to Kandahar from Qatar. This has resulted in
    blood reaching Kandahar that is 2-3 days fresher than before. In
    addition to delivering fresher blood to theater, we are actively and
    aggressively pursuing new blood technologies that should lead to
    improved warrior care on the battlefield in the near future.
        Armed Forces Institute of Regenerative Medicine.--The U.S. Army
    Medical Research and Materiel Command (USAMRMC) in partnership with the
    Office of Naval Research, the U.S. Air Force, the National Institutes
    of Health, and the VA established the Armed Forces Institute of
    Regenerative Medicine (AFIRM) in March 2008. The AFIRM is a multi-
    institutional, interdisciplinary network working to develop advanced
    treatment options for our severely wounded servicemen and women. The
    AFIRM is made up of two civilian research consortia working with the
    U.S. Army Institute of Surgical Research (USAISR) in Fort Sam Houston,
    Texas. One consortium is led by Wake Forest University Baptist Medical
    Center and the McGowan Institute for Regenerative Medicine in
    Pittsburgh and one is led by Rutgers, the State University of New
    Jersey, and the Cleveland Clinic. Each of these civilian consortia is
    itself a multi-institutional network.
        Regenerative medicine, which has achieved success in the
    regeneration of human tissues and organs for repair or replacement,
    represents great potential for treating military personnel with
    debilitating, disfiguring, and disabling injuries. Regenerative
    medicine uses bioengineering techniques to prompt the body to
    regenerate cells and tissues, often using the patient's own cells
    combined with degradable biomaterials. Technologies for engineering
    tissues are developing rapidly, with the ultimate goal of delivering
    advanced therapies, such as whole organs and engineered fingers and
    limbs.
        Joint Theater Trauma System and Joint Trauma Analysis and
    Prevention of Injury in Combat.--The Joint Medical Force continues to
    show great improvements in battlefield care as a consequence of linking
    all information from Level 2 and 3 care thru the entire continuum of
    care via the Joint Theater Trauma System (JTTS). The JTTS, coordinated
    by the Institute for Surgical Research of the USAMRMC, provides a
    systematic approach to coordinate trauma care to minimize morbidity and
    mortality for theater injuries. JTTS integrates processes to record
    trauma data at all levels of care, which are then analyzed to improve
    processes, conduct research and development related to trauma care, and
    to track and analyze data to determine the long term effects of the
    treatment that we provide. The JTTS also plays an active role as a
    partner in the Joint Trauma Analysis and Prevention of Injury in Combat
    (JTAPIC) program, another MRMC asset under the DOD Executive Agency for
    Blast Injury Research.
        The JTAPIC Program links the DOD medical, intelligence,
    operational, and materiel development communities with a common goal to
    collect, integrate, and analyze injury and operational data in order to
    improve our understanding of our vulnerabilities to threats and enable
    the development of improved tactics, techniques, and procedures (TTPs),
    and materiel solutions that will prevent or mitigate traumatic
    injuries. The JTAPIC Program has already made a difference in the way
    we protect our Warfighters from combat injuries as illustrated in the
    following key accomplishments:
      --Provided actionable information which has led to modifications and
            upgrades to vehicle equipment and protection systems, such as
            seat design, blast mitigating armor, and fire suppression
            systems;
      --Established a near-real time process for collecting and analyzing
            combat incident data that confirmed the presence of threat
            weapons of interest;
      --Analyzed combat incident data to identify vulnerabilities in
            operational procedures, and rapidly conveyed those
            vulnerabilities to commanders in theater;
      --Established a process for collecting and analyzing damaged personal
            protective equipment (PPE), such as body armor and combat
            helmets, to provide PPE developers with the information they
            need to develop enhanced protection systems.
        The JTAPIC Program received the 2008 Department of the Army
    Research and Development Laboratory of the Year Award for Collaboration
    Team of the Year in recognition of its accomplishments.
        Combat Medic Skills Textbook.--Our combat medics (68W) are the best
    trained battlefield medics in the world. The historically low ``died of
    wounds'' rate is evidence of their enhanced skills. The medics of the
    68W generation are trained to perform advance airway skills, hemorrhage
    control techniques, shock management, and evacuation. Sergeant First
    Class Nadine Kahla and Sergeant First Class Jason Reisler are 68W NCOs
    assigned to the AMEDD Center & School. They are representative of the
    17 other 68W NCO authors that contributed to the new 68W Advanced Field
    Craft Combat Medic Skills Textbook, a state of the art training manual
    for the combat medic. This delineation of combat medic skills is newly
    published and will be issued to every graduating combat medic beginning
    this month. We are currently looking at ways to distribute this
    textbook to every medic in the force--Active, National Guard, and Army
    Reserve.
                   improved patient and customer satisfaction
        Improve stakeholder satisfaction by understanding, managing, and
    exceeding their expectations.
        Improved Infrastructure.--On behalf of the Army Medical Department
    team, I want to thank the Congress for listening to our concerns about
    military medical infrastructure and taking significant action to help
    us make needed improvements to our facilities. Funding provided for
    military hospitals in the fiscal year 2008 supplemental bill and in the
    American Recovery and Reinvestment Act of 2009 will positively impact
    the quality of life of thousands of Service Members, Family Members,
    and Retirees as we build new state of the art facilities in places like
    Fort Benning, Georgia, Fort Riley, Kansas, and San Antonio, Texas.
    Additional funding provided by Congress for Sustainment, Restoration,
    and Modernization of our facilities has been put to great use and
    allowed us to make some valuable improvements that have been noted by
    our staff and patients.
        The Army requires a medical facility infrastructure that provides
    consistent, world class healing environments that improve clinical
    outcomes, patient and staff safety, staff recruitment and retention,
    and operational efficiencies. The quality of our facilities--whether
    medical treatment, research and development, or support functions--is a
    tangible demonstration of our commitment to our most valuable assets--
    our military family and our MHS staff. The environment in which we work
    is critical to staff recruitment and retention in support of our All
    Volunteer Force. Not only are these facilities the bedrock of our
    direct care mission, they are also the source of our Generating Force
    that we deploy to perform our operational mission. To support mission
    success, our current operating environment needs appropriate platforms
    that support continued delivery of the best healthcare, both preventive
    and acute care, to our Warfighters, their Families and to all other
    authorized beneficiaries. I am currently working closely with the
    Assistant Secretary of Defense for Health Affairs, Dr. S. Ward
    Casscells, and the leadership of the DOD to determine the level of
    investment our medical facilities will need. I respectfully request the
    continued support of DOD medical construction requirements that will
    deliver treatment and research facilities that are the pride of the
    Department.
        Access to Care.--Army leadership and MEDCOM are decisively engaged
    in improving access to care for our Soldiers and their Families. These
    efforts will result in markedly improved access and continuous
    situational awareness at each medical treatment facility. Access means
    that patients are seen by the right provider, at the right time, in the
    right venue; and this applies equally to the Direct Care System &
    Purchased Care System (TRICARE). Key elements identified for improving
    access to care include: Aligning treatment facility capacity with the
    number of beneficiaries; enhancing provider availability; reducing
    friction at key points of access; managing clinic schedules; and
    leveraging technology.
        We have developed a campaign plan to improve access by giving
    hospital commanders the tools they need along with the responsibility
    and accountability to generate results.
        Sustainable Cost of Operations.--While focusing on quality
    outcomes, the MEDCOM is also concerned with ensuring that we maintain a
    sustainable cost of operation for the AMEDD. Our efforts to improve
    access are coupled with initiatives to improve efficiency. Our
    Performance Based Adjustment Model (PBAM) provides financial incentives
    for improving efficiency, patient satisfaction, and quality. PBAM and
    other incentive programs have resulted in the Army being the only
    Service to achieve planned workload gains every year since 2003. A key
    author of PBAM is Master Sergeant (now retired) Richard Meyer.
        Disseminating Best Practices.--The MEDCOM has embraced the Lean Six
    Sigma approach to sustaining improved performance. As an example, a
    Lean Six Sigma project to improve the telephone appointing process was
    initiated at Carl R. Darnall Army Medical Center (CRDAMC), the largest
    telephone appointing call center in the MEDCOM. The call center was
    plagued with high call volume, low patient satisfaction, long process
    cycle time, and high variation. The project sought to decrease process
    cycle time and the call abandon rate to improve patient satisfaction.
    By the conclusion of the project, the overall average hold time was
    reduced to 33 seconds (a 6-fold improvement); the call abandon rate was
    reduced to 3 percent (a 10-fold improvement); calls handled increased
    from 4,700 to 7,300 per week; and call agent turnover was reduced.
    Today the mean hold time at CRDAMC is 3 seconds. This project's
    successful action plan and metrics have been disseminated across the
    command as a best practice.
                         inspire trust in army medicine
        Increase stakeholder support of Army Medicine by inspiring trust,
    building confidence, and instilling pride.
        Improving civilian medical practices.--The implementation of
    tactical combat casualty care (TC\3\) principals for point of injury
    treatment on the battlefield has changed long-standing hemorrhage
    control protocols in the civilian Emergency Medical Services (EMS)
    community. The nation's EMS community has altered long-standing
    treatment protocols that formerly considered tourniquet use a last
    resort. The use of tourniquets, based on the success of their
    application by military medics in theater, is now not only seen as safe
    by our nation's healthcare providers, but as the intervention of choice
    for control of severe hemorrhage. Hemorrhage control is the leading
    cause of death in trauma. The change in philosophy regarding tourniquet
    use will result in more lives saved in both urban and rural areas of
    our country.
        Establishing Successful Interservice Partnerships (San Antonio
    Military Medical Center).--Wilford Hall Medical Center (WHMC) and
    Brooke Army Medical Center (BAMC) are quickly evolving towards the San
    Antonio Military Medical Center (SAMMC) which is an integrated
    healthcare platform in which patient care is delivered in two
    facilities operating under one organizational structure. The SAMMC
    organizational structure has been operational for over 1 year. The
    organizational structures of BAMC and WHMC were both realigned to form
    a functional organization for delivery of healthcare, maintenance of
    our readiness and deployment platforms, sustainment of training of all
    levels of healthcare providers, and promotion of research. Many
    physical moves of medical services have already occurred across the
    SAMMC platform. SAMMC is planning for the migration of the two military
    level one trauma centers in San Antonio to one military level one
    trauma center, capable of handling the same patient care volume that is
    being delivered today in the two centers. Planning and coordination
    with the City of San Antonio have been an integral part of this process
    to ensure continued trauma support in the city. SAMMC enjoys strong
    collaborations with both the University of Texas Health Science Center,
    local government leaders, and the Audie Murphy Veterans Memorial
    Hospital in support of the large tri-service beneficiary population in
    the San Antonio community.
        Establishing Successful Interagency Partnerships (Behavioral and
    Social Health Outcomes).--CHPPM resources are partnered with civilian
    academia, the VA and HHS (including the Centers for Disease Control and
    Prevention, and the National Institute of Mental Health) to work in the
    mitigation of rising rates of suicide, depression, PTSD and other
    adverse behavioral and social health outcomes in our Families,
    Retirees, Active Duty, Reserve and National Guard Soldiers. MEDCOM is
    working with other key organizations to build a robust public health
    capability in the area of Behavioral and Social Health outcomes (to
    include suicides and homicides). This effort includes the construction
    of an Army-level relational database that draws critical information
    from numerous sources to enable comprehensive analysis of adverse
    outcomes in Army organizations and communities.
        Establishing Successful Interagency Partnerships (National
    Interagency Biodefense Campus).--Fort Detrick, Maryland hosts and is
    intimately involved in the development of the National Interagency
    Biodefense Campus (NIBC) to fill gaps in national biodefense and
    integrate agencies for a whole of government approach to national
    security. As a charter member of the National Interagency Confederation
    for Biological Research (NICBR), a collaboration of the National Cancer
    Institute along with the NIBC partners, the Army is breaking ground in
    building on a model for interagency cooperation at Fort Detrick. During
    2008, members of the NICBR/NIBC were involved in developing national
    policy on biodefense and biotechnology as well as collaborating on
    research. Research includes work on developing vaccines, diagnostics,
    forensics, and therapeutics. While focusing on protecting people from
    disease and bioterrorism, members of the NICBR/NIBC participated in
    multiple national assessments to prioritize and focus biodefense
    missions, all while continuing united scientific discovery. During
    2009, the NICBR/NIBC will continue to work with Congress and others to
    define and scope gaps and seams in our Nation's biodefense posture.
        In closing, I want to thank this Committee for their terrific
    support of the Defense Health Program and Army Medicine. I greatly
    value the insight of this Committee and look forward to working with
    you closely over the next year. I also want to salute our non-
    commissioned officers for their professionalism, competence, and
    leadership--they are truly the backbone of Army Medicine. Thank you for
    holding this hearing and thank you for your continued support of the
    Army Medical Department and the Warriors and Families that we are most
    honored to serve.

        Chairman Inouye. May I now call upon Vice Admiral Robinson.
    STATEMENT OF VICE ADMIRAL ADAM M. ROBINSON, JR.,
                SURGEON GENERAL OF THE NAVY, UNITED STATES
                NAVY
        Admiral Robinson. Thank you very much, Chairman Inouye,
    also Vice Chairman Cochran, Senator Murray, and Senator
    Bennett, and other distinguished members of the subcommittee.
        Since I last testified, we have seen the emergence of
    impressive changes and unique challenges to this Nation and the
    global community. A historic presidential election has made
    significant national and international political impact, a war
    effort sustained with military troops deploying into hostile
    areas, and an increasing military medicine presence playing a
    key role to support the humanitarian civil assistance mission.
        We are seeing uncertainty, change, and fluctuation in our
    economy that will impact all of us, including military
    medicine. Navy medicine continues on course because our focus
    has been and will always be providing the best healthcare to
    our sailors, marines, and their families, all while supporting
    our Nation's maritime strategy.
        In response to our most critical demand to support the
    Marine Corps, we are realigning medical capabilities to
    emerging theaters of operation. As the Marine Corps forces
    shift their efforts to Afghanistan, Navy medicine will support
    them and sustain our efforts in medicine, in trauma medicine,
    and surgery capabilities.
        The Navy's maritime strategy calls for proactive
    humanitarian assistance and disaster response efforts, and
    these are now preplanned engagements. These missions deploy
    from sea-based, land-based, or expeditionary platforms and aim
    to meet a great spectrum of medical needs. Our Nation's
    humanitarian efforts serve as a unique opportunity for medical
    diplomacy to positively impact the perception of the United
    States by other nations.
        In addition, these missions have become another avenue for
    improved recruiting and retention of Navy medicine healthcare
    providers. Filling vacancies in our medical department corps is
    critical to meeting our mission of maintaining medical
    readiness of the warfighter and providing healthcare to all
    eligible beneficiaries. The Chief of Naval Personnel and I have
    worked together on this issue, making medical recruiting a
    continued priority for fiscal year 2009.
        In spite of successes in the health professions scholarship
    program (HPSP), medical and dental corps recruitment, meeting
    our direct accession mission still remains a challenge. I
    anticipate increased demand for medical service corps
    personnel, in particular to better meet our increasing
    requirements. From individual augmentation requirements to
    planned humanitarian assistance missions and unexpected
    disaster relief missions, as well as to meet the growing needs
    of a Marine Corps that is, in fact, growing, these demands will
    impact medical service corps specialties linked to mental,
    behavioral, and rehabilitative health and operational support.
        Consistent with increased operational demand signals, as
    well as to compensate for prior shortfalls in recruiting, the
    overall recruiting goals for uniformed medical service corps
    officers have nearly doubled since fiscal year 2007. The Navy
    has been successful during the past year recruiting and
    retaining Nurse Corps officers using a combination of
    accession, retention, and loan repayment incentives. For the
    first time in over 5 years, Navy Nurse Corps officers gains in
    2008 outpaced losses. The Chief of the Navy Nurse Corps, Rear
    Admiral Chris Bruzek-Kohler, is here and will follow up in her
    statement and testimony.
        Our graduate medical education is a critical part of the
    foundation for Navy medicine's ongoing success. Despite the
    demands on faculty and staff for operational support, our Navy
    GME programs continue to be highly rated by the Accreditation
    Council for Graduate Medical Education, and our program
    graduates continue to pass their board certification
    examinations at rates significantly higher than the national
    average in almost every specialty.
        More importantly, Navy-trained physicians continue to prove
    themselves to be exceptionally well prepared to provide care in
    austere settings ranging from the battlefield to humanitarian
    assistance and disaster relief efforts.
        Over the last year Navy medicine expanded services so that
    wounded warriors would have access to timely, high quality
    medical care. In 2008, we consolidated all wounded, ill, and
    injured warrior healthcare support, with the goal of
    establishing global policy implementation guidance and
    oversight in order to deliver the highest quality customer-
    focused, comprehensive and compassionate care to servicemembers
    and their families.
        As of March 2009, 161 medical care case managers were
    assigned to 45 medical treatment facilities and ambulatory care
    clinics, caring for approximately 1,500 Operation Iraqi
    Freedom/Operation Enduring Freedom (OIF-OEF) casualties. The
    medical care case managers collaborate with Navy Safe Harbor
    and Marine Corps Wounded Warrior Regiment, both line programs,
    in working directly with wounded warriors, their families,
    caregivers, and multidisciplinary medical teams.
        We work diligently to coordinate the complex services
    needed for improved healthcare outcomes and to ensure that
    servicemembers return closer to home as soon as possible.
        Navy and Marine Corps liaisons at medical treatment
    facilities aggressively ensure that orders and other
    administrative details, such as extending reservists, are
    completed. Last year, we established a centralized operational
    stress control program and coordinator who is working in
    conjunction with our line leadership to indoctrinate mental
    health stigma reduction into the broader Navy-Marine Corps
    culture. Over 11,000 sailors have received operational stress
    control training to date, and formal curriculum will be
    introduced in the fall 2009 at key points throughout the
    careers of sailors--from accession to flag officer.
        Also, to anticipate emerging mental health threats, Navy
    medicine actively conducts real-time in-country surveillance
    and assessment of the mental health of our troops.

                               PREPARED STATEMENT

        Chairman Inouye, Vice Chairman Cochran, I want to express
    my gratitude on behalf of all who work for Navy medicine,
    uniformed, civilian, contractor, and volunteer personnel, who
    are committed to meeting and exceeding the healthcare needs of
    our beneficiaries. I would also like to thank you and the
    members for your continued support of Navy medicine and of the
    military health system.
        Thank you.
        Chairman Inouye. Thank you very much, Admiral Robinson.
        [The statement follows:]
              Prepared Statement of Vice Admiral Adam M. Robinson
        Chairman Inouye, Senator Cochran, distinguished members of the
    committee, since I testified last spring we have seen the emergence of
    impressive changes and unique challenges to this nation and the global
    community. A historic Presidential election which has made significant
    national and international political impact, a war effort sustained
    with military troops deploying into hostile areas; and an increasing
    military medicine presence playing a key role to support the
    humanitarian civil assistance mission. We are seeing uncertainty,
    change and fluctuation in our economy that will impact all of us,
    including military medicine.
        Navy Medicine continues on course, because our focus has been, and
    will always be providing the best healthcare for our Sailors, Marines,
    and their family members while supporting the CNO's Maritime Strategy.
    We are focused on strengthening Navy Medicine today, and are
    proactively planning to meet future healthcare requirements.
        Navy Medicine is built on a solid foundation of proud traditions
    and a remarkable legacy of Force Health Protection. Our focus has not
    changed and every day in Navy Medicine we are preparing healthy and fit
    Sailors and Marines to protect our nation and be ready to deploy.
        Navy Medicine is playing a major part in supporting the Maritime
    Strategy. You will find us at home and around the world providing
    preventive medical care; health maintenance training and education;
    direct combat medical support; medical intelligence; and operational
    planning mission support. Our Navy Medicine teams are flexible enough
    to perform a Global War on Terror mission, a homeland security mission,
    a humanitarian assistance mission, and a disaster relief mission; while
    at the same time provide direct healthcare to our nation's heroes and
    their family members at home and overseas.
        In spite of all of the missions we are currently prepared to
    participate in, we are continuously making the necessary changes and
    improvements to meet the requirements of the biggest consumer of our
    operational support efforts--the Marine Corps. Currently, we are
    realigning medical capabilities to support operational forces in
    emerging theaters of operation. We are working on enhancing our
    strategic ability, operational reach, and tactical flexibility. As
    Marine Corps forces shift their efforts to Afghanistan, Navy Medicine
    stands prepared to make the necessary adjustments to provide the
    highest quality combat medical support. Since the global operations to
    combat terrorism began, Navy Medicine's combat medical support has
    proven exceptionally successful at bringing wounded service member's
    home. We hope, through our ability to remain agile and flexible, to
    sustain those efforts--like the record-high survivability rates--and
    improve them wherever possible.
        The Navy's Maritime Strategy calls for proactive humanitarian
    assistance and disaster response efforts. These missions have been
    taking place since 1847, and have come a long way since then. The
    Navy's Humanitarian Civil Assistance missions are now pre-planned
    engagements deployed from sea-based, land-based or expeditionary
    platforms to meet a great spectrum of medical needs. From basic medical
    evaluation and treatment, to optometry, to general surgery, and
    immunizations, our physicians, nurses, dentists, ancillary healthcare
    professionals, and hospital corpsmen are ready.
        Our efforts have continued to grow and this year, the U.S. Southern
    Command will sponsor four multi-service Medical Readiness Training
    Exercises (MEDRETEs). These missions will visit Jamaica, Honduras, the
    Dominican Republic and Guyana and will include a Navy Medicine Reserve
    Component. These two-week deployments will provide primary care in
    remote locations in conjunction with the Ministry of Health of each
    host nation. The medical services provided will include preventive
    medicine education, pediatrics, primary medical care, immunizations,
    pharmacy services, and dental care.
        Over 400 Navy Medicine personnel are ready to provide humanitarian
    civil assistance later this year in two ship-based missions. In April,
    the USNS COMFORT (TAH 20) will deploy for a 120-day mission to South
    and Central America as part of Continuing Promise 09. Later in 2009,
    the USS DUBUQUE (LPD 8) will deploy for a 125-day mission as part of
    Pacific Partnership 09.
        Our nation's humanitarian efforts serve as a unique opportunity to
    positively impact the perception of the United States by other nations.
    These often joint missions serve as examples of how increased
    collaboration between the other services, other government agencies,
    and non-governmental organizations can maximize available resources in
    order to improve worldwide response capability. From our experience, we
    have developed a successful model of healthcare education and training
    for host country providers. This will lead to local sustainable
    activities that will provide long-lasting benefits to help overcome
    healthcare barriers in resource poor countries. Furthermore, these
    missions have become another avenue for improved recruiting and
    retention of Navy Medicine healthcare providers.
        While our humanitarian civil assistance missions provide us with
    some amazing opportunities as providers of medical care, Navy Medicine
    is acutely aware and incredibly proud of our operational commitment to
    the United States Marine Corps. We continue to fine tune our deployable
    medical capabilities to support every Marine who deploys to emerging
    theaters of operation. We never stop improving our strategic ability,
    operational reach, and tactical flexibility. As the Marine Corps forces
    shifts their efforts to Afghanistan, Navy Medicine will be there
    providing the highest quality combat medical support from the corpsmen
    who stand by their Marines on the battlefield, to fleet hospitals, to
    the care provided at a military hospital and world-class restorative
    and rehabilitative care facilities in the continental United States.
        We continue to make improvements to meet the needs of Sailors and
    Marines who may become injured--while serving in theater or training at
    home. Over the last year, Navy Medicine significantly expanded services
    so that wounded warriors would have access to timely, high-quality
    medical care. Our response is two-tiered, first to uncompromisingly
    increase specialized multidisciplinary teams, and second, to expand
    sharing with other government agencies and the private sector of
    clinical resources, research and expertise.
        In addition, Navy Medicine's Concept of Care is always patient and
    family focused. We never lose our perspective in caring for all our
    beneficiaries--everyone is a unique human being in need of
    individualized, compassionate, and professionally superior healthcare.
    At our military treatment facilities (MTFs), we recognize and embrace
    the military culture and incorporate that into the healing process.
    Based on the progress in a patient's care and healing, from initial
    care to rehabilitation and life long medical needs, we determine the
    best clinical location and treatment plan for that patient. Families
    are a critical part of the healthcare delivery team, and we integrate
    the family's needs into the healing process as well.
        In 2008, the Bureau of Medicine and Surgery (BUMED), Headquarters
    for Navy Medicine, consolidated all wounded, ill and injured warrior
    healthcare support, with the goal of establishing global policy,
    implementation guidance, and oversight in order to deliver the highest
    quality customer-focused, comprehensive and compassionate care to
    service members and their families.
        As of March 2009, 161 Medical Care Case Managers were assigned to
    45 MTFs and ambulatory care clinics caring for approximately 1,500 OIF/
    OEF casualties. The Medical Care Case Managers collaborate with Navy
    Safe Harbor and Marine Corps Wounded Warrior Regiment in working
    directly with wounded warrior, family, caregivers and the multi-
    disciplinary medical team to coordinate the complex services needed for
    improved health outcomes.
        The BUMED Wounded Warrior Regiment Medical Review team and the
    Returning Warrior Workshop support Marines and Navy Reservists, and
    their families by focusing on key issues faced by reservists during
    their transition from deployment to home. Navy and Marine Corps
    Liaisons at MTFs aggressively ensure that orders and other
    administrative details, such as extending reservists, are completed.
        Traumatic Brain Injury (TBI) is considered the signature wound of
    OIF/OEF, due to the proliferation of improvised explosive devices
    (IED). Navy Medicine continues to improve ways to identify and treat
    TBI. The traumatic stress and brain injury programs at National Naval
    Medical Center (NNMC) Bethesda, Naval Medical Center San Diego (NMCSD),
    Naval Hospital Camp Pendleton (NHCP), and Naval Hospital Camp Lejeune
    (NHCL) are collaborating to identify and treat service members who have
    suffered blast exposure. Navy Medicine has partnered with the Navy and
    Marine Corps community to identify specific populations at risk for
    brain injury such as front line units, SEALS, and Navy Explosive
    Ordinance disposal units. Navy Medicine also expanded social work
    assets to provide clinical mental health support in theater, at Navy
    MTFs and regional treatment centers.
        Much attention has been focused on ensuring service members'
    medical conditions are appropriately addressed on return from
    deployment. The Pre-Deployment Health Assessment (Pre-DHA) is one
    mechanism that is used to identify physical and psychological health
    issues prior to deployment. The Post Deployment Health Assessment
    (PDHA) and the Post Deployment Health Re-Assessment (PDHRA) identify
    deployment related healthcare concerns on return to home station and
    90-180 days post deployment.
        Navy Medicine's innovative Deployment Health Centers--currently 17
    in high Fleet and Marine Corps concentration areas--support the
    deployment health assessment process and serve as easily accessible
    non-stigmatizing portals for mental healthcare. The centers are staffed
    with primary care and mental health providers to address deployment-
    related health issues such as TBI, Post Traumatic Stress Disorder
    (PTSD), and substance misuse. Approximately 15 percent of Navy and
    Marine Corps Post Deployment Health Assessments result in a medical
    referral, while the PDHRA medical referral rate is approximately 22
    percent for both Active and Reserve Component service members.
        Navy Medicine's partnership with the Department of Veterans Affairs
    (VA) medical facilities is evolving into a mutually beneficial
    partnership. This coordinated care for our warriors who transfer to or
    are receiving care from a VA facility ensures their needs are met and
    their families concerns are addressed. Full-time VA staff members are
    located at several Navy MTFs where they focus on the healthcare needs
    of service members and their families.
        Filling vacancies in the Medical, Dental, Nurse and Medical Service
    Corps of the Active and Reserve Components is critical in meeting our
    mission of maintaining medical readiness of the warfighter and
    providing healthcare to all eligible beneficiaries. My goal is to
    maintain the right workforce to deliver medical capabilities across the
    full range of military operations through the appropriate mix of
    accession, retention, education and training incentives. As a result,
    the Chief of Naval Personnel and I have worked together on this issue
    making medical recruiting a continued priority for fiscal year 2009.
        Navy Medicine not only equips and trains our current healthcare
    professionals; we also prepare our future reliefs for the challenges
    ahead. To build the future force for Navy Medicine we must reach out to
    America's students and young professionals. We must invite them to our
    hospitals, our classrooms, and our research facilities so they can see
    what we do and they can ask career-making questions.
        Congress has been very generous and attentive to the Special Pay
    and Bonus authorities. The Services are implementing those new
    programs--in some cases with limited success. An example of this is
    that the Critical Wartime Skills Accession Bonus offered to physicians
    and dentists as an incentive to directly access trained specialists was
    not effective in fiscal year 2008. Multi-Year Retention pays and
    Bonuses have historically provided the highest return for obligated
    service, but we thought it was important to try new authorities
    provided by Congress.
        Navy Medicine offers one of the most generous and comprehensive
    scholarships in the healthcare field. The Armed Forces Health
    Professions Scholarship Program (HPSP) provides tuition assistance for
    up to 4 years of school. In addition all professional school required
    fees and expenses, books and equipment are paid for by the Navy. The
    value of this program could be well over $200,000 during the course of
    a 4 year professional school program. Graduates join the Navy's active
    duty healthcare team as commissioned officers. During fiscal year 2008,
    the Navy Medical and Dental Corps met its HPSP goal for the first time
    in several years.
        In spite of the successes in HPSP Medical and Dental Corps
    recruitment, meeting our direct accession mission may remain a
    challenge. The Medical Services Corps is our most diverse Corps with 31
    specialties under three general groupings consisting of clinicians,
    healthcare administrators, and research scientists.
        I anticipate increased demand for Medical Service Corps personnel
    with respect to Individual Augmentation missions supporting the present
    course in Iraq and the anticipated role the military in Afghanistan,
    planned Humanitarian Assistance and unexpected disaster relief
    missions, as well as to meet the needs of Marine Corps manning
    increases and the many wounded warrior programs they support. These
    demands will impact Medical Service Corps specialties linked to mental,
    behavioral and rehabilitative health and operational support; Clinical
    Psychologists, Social Workers, Occupational Therapists, Physician
    Assistants and Physical Therapists to name a few.
        While it is anticipated that the Assistant Secretary of Defense,
    Health Affairs guidance for recruiting and retention incentives for
    Clinical Psychologists, Social Workers, and Physician Assistants will
    be released this fiscal year, similar incentives may need to be
    expanded to other specialties where limited incentives currently exist.
    Consistent with increased operational demand signals, as well as to
    compensate for prior shortfalls in recruiting, the overall recruiting
    goals for uniformed Medical Services Corps officers have nearly doubled
    since fiscal year 2007.
        The Navy has been successful during the past year recruiting and
    retaining Nurse Corps officers using a combination of accession,
    retention, and loan repayment incentives. Over 4,000 active duty and
    reserve Navy nurses are serving in operational, humanitarian, and
    traditional missions at home and overseas. These men and women are
    essential to Navy Medicine's Force Health Protection mission. Navy
    nurses, in particular the wartime nursing specialties of mental health,
    nurse anesthesia, critical care, family nurse practitioners, emergency
    medicine, preoperative and surgical care, have been exemplary in all
    theaters of operations and healthcare settings.
        For the first time in over 5 years, Navy Nurse Corps officer gains
    in 2008 outpaced losses. Despite the growing national nursing shortage
    and the civilian nursing community proving to be recession resistant,
    the recruitment and retention of nurses continues to improve.
    Additional requirements will be placed on the recruiting and retention
    efforts of the Nurse Corps in the near future as nursing billets are
    restored due to changes in the Military to Civilian Conversion program.
    Future success in the recruitment and retention of nurses will continue
    to be dependent on incentive packages that are competitive with the
    civilian sector.
        Like recruiting and retention, our Graduate Medical Education (GME)
    is a critical part of the foundation for Navy Medicine's ongoing
    success. Navy Medicine provides world-class graduate medical education
    at nine sites with 60 programs involving over 1,000 trainees. Despite
    the demands on faculty and staff for operational support, our Navy GME
    programs continue to be highly rated by the Accreditation Council for
    Graduate Medical Education. Navy program graduates continue to pass
    their board certification examinations at rates significantly higher
    than the national average in almost every specialty. More importantly,
    Navy-trained physicians continue to prove themselves to be
    exceptionally well prepared to provide care in austere settings ranging
    from the battle field to humanitarian assistance and disaster relief
    efforts.
        Along with our successes, Navy GME is facing challenges. Advances
    in medicine and technology are resulting in longer and in some case
    completely new types of training which stress the fixed number of
    funded positions available. Additionally, we did not meet medical
    student accession goals 3 and 4 years ago, and this is beginning to
    impact our current GME programs. The lower number of uniformed
    graduates will challenge our ability to support our operational
    healthcare mission while placing an adequate number of graduates into
    training to meet our need for specialists in the future.
        Navy Medicine scientists conduct basic, clinical, and field
    research directly related to current and future military requirements
    and operational needs. In today's unsettled world, we face not only the
    medical threats associated with conventional warfare, but also the
    potential use of weapons of mass destruction and terrorism against our
    military forces and our citizens at home and overseas and our allies.
    Navy Medicine's research efforts focus on finding solutions to
    traditional battlefield medical problems such as bleeding, Traumatic
    Brain Injury, combat stress, and naturally occurring infectious
    diseases; as well as the health problems associated with non-
    conventional weapons including thermobaric blast, biological agents,
    and radiation.
        The DOD Center for Deployment Health Research at the Naval Health
    Research Center reported that 8.7 percent of U.S. troops who were
    deployed and exposed to combat duty in Iraq or Afghanistan reported
    symptoms of PTSD on a screening survey. We anticipate that this ongoing
    research will prove helpful in identifying populations at especially
    increased risk of PTSD from combat, and lead to improved diagnosis and
    prevention strategies.
        The Naval Institute for Dental and Biomedical Research helped to
    prove the military utility of a new product ``Dent Stat,'' a temporary
    dental filling material used in treating dental emergencies in all
    forward deployed settings. This user-friendly temporary restorative
    material helps stabilize and reduce pain from fractured teeth and lost
    or broken fillings so warfighters can quickly return to their units.
        The Navy Medical Research Center developed an updated vaccine
    against Japanese encephalitis (JE) allowing for U.S. Food and Drug
    Administration licensure. The JE vaccine should prevent this mosquito-
    borne potentially fatal brain infection, and will save lives of
    military personnel who deploy to the Asia-Pacific region, and also
    civilian travelers to JE-endemic regions.
        These are just a few examples of how Navy Medicine's biomedical and
    dental research, development, testing and evaluation, including
    clinical investigations, will protect and improve the health of those
    under our care.
        It is important to recognize the unique challenges before Navy
    Medicine at this particularly critical time for our nation. Growing
    resource constraints for Navy Medicine are real, as is the increasing
    pressure to operate more efficiently without compromising healthcare
    quality and workload goals. The Military Healthcare System (HMS)
    continues to evolve, and we are taking advantage of opportunities to
    modernize management processes that will allow us to operate as a
    stronger innovative partner within the MHS.
        Integration of care between the military direct care and our
    civilian network, and across the services, has implications related to
    both the quality and cost of care. The National Capital Area and the
    San Antonio military markets have become pilots for a ``joint''
    healthcare system. While the models are different, the end goal is the
    same: a single approach to healthcare. With the current economic
    situation driving the need for cost effectiveness, movement toward a
    Unified Medical Command construct will likely accelerate. Identifying
    those functions that can be joint--along with those that need to remain
    service specific--is a critical component of the success of the
    project. Bringing the direct care system and the TRICARE Management
    Activity under a single command structure offers significant advantages
    and might be the next best step as military healthcare evolves. Navy
    Medicine supports and is actively engaged in these efforts.
        Chairman Inouye, Ranking Member Cochran, I want to express my
    gratitude on behalf of all who work for Navy Medicine--uniformed,
    civilian, contractor, volunteer personnel--who are committed to meeting
    and exceeding the healthcare needs of our beneficiaries. Thank you
    again for providing me this opportunity to share with you Navy
    Medicine's mission, what we are doing today, and our plans for the
    future. It has been my pleasure to testify before you today and I look
    forward to answering any of your questions.

        Chairman Inouye. May I now call upon Lieutenant General
    Roudebush.
    STATEMENT OF LIEUTENANT GENERAL JAMES G. ROUDEBUSH, AIR
                FORCE SURGEON GENERAL, UNITED STATES AIR
                FORCE
        General Roudebush. Mr. Chairman, Mr. Vice Chairman, Senator
    Murray, Senator Bennett: Thank you for this opportunity to
    share our issues, our concerns, but also our accomplishments
    with you this morning.
        I believe your comments frame it very appropriately and
    very correctly in terms of the importance of what we bring both
    individually and collaboratively to the care of the men and
    women who have raised their right hand and sworn to support and
    defend and go into harm's way for our Nation. It's important
    that we do care for them, and it's important that we work with
    each one, one by one, as they transition perhaps to care within
    the Department of Veterans Affairs, to assure that that
    transition is as smooth, effortless, and user-friendly as it
    can be.
        So I think your comments set this up very, very well. Thank
    you, sir. And thank you and the subcommittee for your
    unwavering support in our endeavors in this regard. We simply
    could not do it without you, and we truly appreciate that.
        This morning, sir, I'd like to talk a bit about Air Force
    medicine, understanding that Air Force medicine is part of a
    joint capability, and we keep that issue very clearly in mind.
    Air Force medicine contributes significant capability to the
    joint warfight in combat casualty care, wartime surgery, and
    aeromedical evacuation.

                           AIR FORCE THEATER HOSPITAL

        On the ground, at both the Air Force theater hospital at
    Balad and Craig Joint Theater Hospital in Bagram we are leading
    numerous combat casualty care initiatives that will positively
    impact combat and peacetime medicine for years to come. Air
    Force surgeons laid the foundation for the state-of-the-art
    intervascular operating room at Balad, the only DOD facility of
    its kind, and their use of innovative technology and surgical
    techniques has greatly advanced the care of our joint
    warfighter and coalition casualties, and their work within the
    joint theater trauma system, collaborative joint work, their
    work within this joint system, has literally rewritten the book
    on the use of blood in trauma resuscitation.
        To bring our wounded warriors safely and rapidly home, our
    critical care aeromedical transport teams, or CCATs, provide
    unique intensive care unit (ICU) care in the air within DOD's
    joint en route medical care system. We continue to improve the
    outcomes of CCAT wounded warrior care by incorporating lessons
    learned into clinical practice guidelines and modernizing the
    equipment we use to support this important mission.

           MEDICAL LIFESAVING OPERATIONS--HURRICANES KATRINA AND RITA

        But it's important to note that this Air Force-unique
    expertise also pays huge dividends back home. When Hurricanes
    Katrina and Rita struck in 2005, Air Force active duty, Guard,
    and Reserve medical personnel were in place conducting
    lifesaving operations. Similarly, hundreds of members of this
    total force team were in place September 1, 2008, when
    Hurricane Gustav struck the Louisiana coast and when Hurricane
    Ike battered Galveston, Texas, less than 2 weeks later.
        During Hurricane Gustav, Air Mobility Command coordinated
    the movement of more than 8,000 evacuees, including 600
    patients. Air crews transported post-surgical and intensive
    care unit patients from Texas-area hospitals to Dallas
    principally. I'm extremely proud of this incredible team
    effort.
        The success of our Air Force mission, however, directly
    correlates with our ability to build and maintain a healthy and
    fit force at home station and in theater. Always working to
    improve our care, our family health initiative establishes an
    Air Force medical home. This medical home optimizes healthcare
    practice within our family healthcare clinics, positioning a
    primary care team to better accommodate the enrolled population
    and streamline the processes for care and disease management.
    The result is better access, better care, and better health.

                       PSYCHOLOGICAL HEALTH OF OUR AIRMEN

        The psychological health of our airmen is critically
    important. To mitigate their risk for combat stress symptoms
    and possible mental health problems, our program known as
    Landing Gear takes a proactive approach, with education and
    symptom recognition both pre- and post-deployment. We educate
    our airmen that recognizing risk factors in themselves and
    others, along with a willingness to seek help, is the key to
    effectively functioning across the deploying cycle and
    reuniting with their families. Likewise, we screen carefully
    for traumatic brain injury at home and at our forward deployed
    medical facilities.
        To respond to our airmen's needs, we have over 600 active
    duty and 200 civilian and contract mental health providers.
    This mental health workforce has been sufficient to meet the
    demand signal that we have experienced to date, but, that said,
    we do have challenges with respect to active duty psychologists
    and psychiatrists recruiting and retention and we're pursuing
    special pays and other initiatives to try to bring us closer to
    100 percent staffing in these two very important specialties.
        For your awareness, over time we are seeing an increasing
    number of airmen with post-traumatic stress disorder (PTSD).
    1,759 airmen have been diagnosed with PTSD within 12 months of
    returning from deployment from 2002 to 2008. As a result of our
    efforts at early post-traumatic stress identification and
    treatment, the majority of these airmen continue to serve with
    the benefit of treatment and support.
        Also, understanding that suicide prevention lies within and
    is integrated into the broader construct of psychological
    health and fitness, our suicide prevention program, a
    community-based program, provides the foundation for our
    efforts. Rapid recognition, active engagement at all levels,
    and reducing any stigma associated with help-seeking behaviors
    are hallmarks of our program. One suicide is too many and we're
    working hard to prevent the next.

                    SUSTAINING THE AIR FORCE MEDICAL SERVICE

        Sustaining the Air Force medical service requires the very
    best in education and training for our professionals. In
    today's military that means providing high-quality programs
    within our system as well as strategically partnering with
    academia, private sector medicine, and the Department of
    Veterans Affairs to ensure that our students, residents, and
    fellows have the best training opportunities possible.
        While the Air Force continues to attract many of the finest
    health professionals in the world, we still have significant
    challenges in recruiting and retention. We're working closely
    with our personnel and recruiting communities using accession
    and retention bonus plans to ensure full and effective staffing
    with the right specialty mix to perform our mission. At the
    center of our strategy is the health professions scholarship
    program. HPSP is our most successful recruiting tool. But we're
    also seeing positive trends in retention from our other
    financial assistance programs and pay plans. Thank you for your
    unwavering support in this critical endeavor.
        In summary, Air Force medicine is making a difference in
    the lives of airmen, soldiers, sailors, marines, family
    members, coalition partners, and our Nation's citizens. We are
    earning their trust every day. As we look forward to the way
    ahead, I see a great future for the Air Force medical service
    built on a solid foundation of absolutely top-notch people,
    outstanding training programs, and strong partnerships. It's an
    exciting, challenging, and rewarding time to be in Air Force
    and military medicine. I couldn't be more proud of this joint
    team.

                               PREPARED STATEMENT

        We join our sister services in thanking you for your
    enduring support, and I look forward to your questions.
        Chairman Inouye. I thank you very much, General Roudebush.
        [The statement follows:]
       Prepared Statement of Lieutenant General (Dr.) James G. Roudebush
        Mr. Chairman and esteemed members of the Committee, it is my honor
    and privilege to be here today to talk with you about the Air Force
    Medical Service. Our Air Force medics work directly for the Line. To
    that end, we too are focused on reinvigorating the Air Force nuclear
    enterprise; partnering with the joint and coalition team to win today's
    fight; developing and caring for Airmen and their families; modernizing
    our Air and Space inventories, organizations, and training, and
    recapturing acquisition excellence.
        In support of our Air Force priorities, our Air Force Medical
    Service (AFMS) is on the cutting edge of protecting the health and
    well-being of our Service men and women everywhere. Our experience in
    battlefield medicine is shaping America's healthcare for the 21st
    century and beyond. We are actively enhancing readiness; ensuring a
    fit, healthy force, and building/sustaining the model health system for
    DOD. In short, it's a great time to be in Air Force medicine!
                           advancements in readiness
        Air Force medics contribute significant capability to the joint
    warfight in aeromedical evacuation, combat casualty care and wartime
    surgery. Our advancements in these areas are unparalleled in previous
    combat experience.
        Our Critical Care Air Transport Teams (CCATTs) provide unique ``ICU
    care in the air'' within DOD's joint enroute medical care system. We
    continue to improve the outcomes of CCATT wounded warrior care by
    incorporating lessons learned into clinical practice guidelines and
    modernizing equipment to support the mission. For example, we are
    developing a joint electronic in-flight patient medical record to
    ensure effective patient care documentation and record availability. We
    are working to improve CCATT equipment, such as mobile oxygen storage
    tanks and airborne wireless communication systems, and continuing to
    evaluate existing equipment to ensure safety for our patients.
        On the ground, at both the Air Force Theater Hospital at Balad,
    Iraq and Craig Joint Theater Hospital at Bagram, Afghanistan, Air Force
    medics lead numerous combat casualty care initiatives that will
    positively impact combat and peacetime medicine for years to come. The
    Air Force surgeons garnered invaluable experience in the field of
    vascular surgery that laid the foundation for a state-of-the-art
    endovascular operating room at Balad--the only DOD facility of its
    kind. The inaugural use of diagnostic angiography and vena caval
    filters, along with coil embolization and stent grafts in select
    vascular surgeries in-theater have truly modernized care of our joint
    warfighter and coalition casualties. Colonel (Dr.) Jay Johannigman, the
    332nd Expeditionary Medical Operations Squadron lead trauma surgeon,
    said, ``Our Joint combat hospitals, be they Army, Navy, or Air Force,
    are all beginning to think alike and do things similarly. These efforts
    help us improve and speed the care to the patient.''
        Working with the Armed Services Blood Program Office, Air Force
    medics have improved the supply of crucial life-saving blood products
    in-theater, supplementing fresh blood with a new frozen red blood cell
    product with an extended shelf life. An in-theater apheresis center was
    established to collect fresh platelets needed to support aggressive
    treatment of trauma patients requiring massive transfusions.
        The ability to collect and analyze data is critical to our success
    in combat casualty care. The Joint Theater Trauma Registry (JTTR),
    established in 2004, has made significant strides in these efforts.
    Their work led to major changes in battlefield care, including
    management of extremity compartment syndromes, burn care resuscitation,
    and blood transfusion practices. Their results are setting military-
    civilian benchmarking standards. The JTTR is truly a joint effort, with
    full participation of the Air Force. An Air Force physician is the JTTR
    system deputy director, and our critical care nurses are key players in
    the in-theater JTTR team. Through the JTTR we're capturing and
    implementing best practices for management of the extensive trauma
    cases seen.
        Air Force-unique expertise pays dividends back home, as well as in
    theater, and is saving lives. Many Americans who have become victims of
    natural disasters benefited from our humanitarian support. When
    Hurricanes Katrina and Rita struck in 2005, Air Force Active Duty,
    Guard, and Reserve medics were in place conducting lifesaving
    operations. Similarly, hundreds of members of this Total Force team
    were in place September 1, 2008 when Hurricane Gustav struck the
    Louisiana coast and when Hurricane Ike battered Galveston, Texas, less
    than 2 weeks later. During Hurricane Gustav, Air Mobility Command
    coordinated the movement of more than 8,000 evacuees, including 600
    patients. Aircrews transported post-surgery/post-intensive care unit
    patients from Galveston area hospitals to Dallas medical facilities. I
    am extremely proud of this incredible team effort.
                        ensuring a fit and healthy force
        The success of our medical readiness mission directly correlates
    with our ability to build and maintain a fit and healthy force at home
    station and in-theater. One way we do this is through optimization of
    health care delivery. Our Family Health Initiative, our Air Force
    ``medical home,'' optimizes health care practice within our family
    health clinics, increasing the number of medical technicians on the
    family health teams to better accommodate the enrolled population and
    streamlining the processes for care and disease management.
        We achieve a fit and healthy force by measuring our health care
    outcomes. The AFMS has used the Healthcare Effectiveness Data and
    Information Set measures for more than 8 years to assess the care we
    deliver. Our outcome measures for childhood immunization delivery,
    asthma medication management, LDL cholesterol control in diabetics, and
    screening for Chlamydia all exceed the 90th percentile in comparison to
    civilian benchmarks. We also compare very highly with civilian hospital
    care for all 40 of our measures developed by the Agency for Healthcare
    Research and Quality, which evaluates patient safety, inpatient
    quality, pediatric care quality, and prevention-related quality for our
    hospital services. We recently began measuring 30-day mortality rates
    for myocardial infarction, pneumonia and congestive heart failure, and
    found that the AFMS is well below the national benchmark in all three
    measures. In 2009, we will implement measurement of well-child visits
    and follow-up after mental health hospitalization. While this is all
    good news, we must remain vigilant in analyzing and evaluating the
    effectiveness of our healthcare delivery--our patients deserve the very
    best.
        The exposure of our Airmen to battlefield trauma puts psychological
    health at the forefront of our health and fitness mission. To mitigate
    their risk for combat stress symptoms and possible mental health
    problems, our Landing Gear program takes a proactive approach with
    education and symptom recognition, both pre- and post-deployment. We
    educate our Airmen that recognizing risk factors in themselves and
    others, along with a willingness to seek help, is the key to
    effectively functioning across the deployment cycle and reuniting with
    their families.
        We have over 600 Active Duty and over 200 civilian and contract
    mental health providers. This includes 97 additional contract Mental
    Health providers we added in 2007 to manage increased workload. This
    mental health workforce has been sufficient to meet the demand signal
    that we have experienced to date. That said, we do have challenges with
    respect to Active Duty psychologist and psychiatrist recruiting and
    retention, and we are pursuing special pays and other initiatives to
    try to bring us closer to 100 percent staffing in those two
    specialties. We continually assess and reassess the demand based on
    mission requirements as well as the need for clinical services. We are
    seeing a gradual increase in the incidence of post-traumatic stress
    disorder (PTSD) in our Airmen and we are also seeing a persistent
    demand at the 1:2 dwell rate for mental health providers in the
    deployed environment. This demand is not likely to decrease, and could
    well increase over time. We are tracking this demand closely to ensure
    that we have the resources to meet tomorrow's demand.
        With regard to what we are doing about PTSD, we address post-
    traumatic stress (PTS) in our Airmen by combining resilience training
    with frequent screening and ready access to mental healthcare.
    Resilience training is conducted via an Air Force developed program
    Landing Gear, where Airmen learn what to expect while deployed, and
    when and how to get help for stress symptoms. Screening occurs before
    deployment, at the end of deployment, 90-180 days post-deployment and
    annually via the Physical Health Assessment. Each screening asks about
    PTS and other psychological symptoms. Healthcare providers fully assess
    all symptoms noted on the screening, and refer to mental health
    providers for further care as needed. We also train frontline
    supervisors and have positioned mental health personnel in our primary
    care clinics in order to increase access and reduce stigma. Quality
    healthcare for our Airmen requires our mental health providers to have
    the best tools available to treat PTS. To that end, we have sent 490 of
    our mental health providers to 2 and 3-day workshops conducted by
    civilian subject matter experts on the two widely recognized methods of
    PTSD treatment. All our providers, mental health and primary care, are
    trained and follow nationally/Veterans Affairs (VA) approved clinical
    practice guidelines to assure that all treatment for PTSD is state of
    the art and meets the highest standards.
        For your awareness, 1,758 Airmen have been diagnosed with PTSD
    within 12 months of return from deployment (fiscal year 2002-fiscal
    year 2008). The vast majority of these Airmen continued to serve with
    the benefit of treatment and support. Of these Airmen, 255 have been
    enrolled in our Wounded Warrior program secondary to PTSD, and are not
    expected to be returned to duty. Our efforts at early PTS
    identification and treatment strive to maximize the number of Airmen we
    are able to return to full duty and health. As noted, however, we are
    seeing an increase over time in the number of our Airmen with diagnosed
    PTSD.
        Understanding that suicide prevention lies within and is integrated
    into the broader construct of psychological health and fitness, we
    continue to aggressively work our eleven suicide prevention
    initiatives, which include frontline supervisor training and suicide
    risk assessment training for mental health providers. We have mental
    health providers in our family health units to provide the full
    spectrum of care for both our active duty and family members. This
    allows us to approach issues in a way conducive to quick recognition
    and resolution, while reducing any perceived stigma associated with
    visits to mental health clinics. Suicide prevention requires a total
    Air Force community effort, using all tools available. We are expanding
    our ability to identify, track and treat Airmen dealing with PTSD,
    Traumatic Brain Injury (TBI), or other mental health problems to ensure
    no one is left behind who needs help. We have the resources, the
    opportunity, and clearly the need to better understand, and care for
    these injuries.
        Current treatment/management for TBI is based on Defense and
    Veterans Brain Injury Center (DVBIC) TBI Clinical Guidance. The Air
    Force TBI treatment is done by a multidisciplinary team guided by
    comprehensive brain injury and mental health assessment tools. All TBI
    patients receive education on TBI symptoms and management as well as
    appropriate referrals for occupational therapy, physical therapy,
    speech and language, pharmacy, audiology and optometry. Cognitive
    rehabilitation is initiated after medical issues have subsided and the
    patient's pain is managed. In fiscal year 2009, video teleconferencing
    equipment will be installed in all mental health clinics to allow
    direct consult with the DVBIC.
        We have also taken the lead in DOD with diabetes research and
    community outreach. We have a very productive partnership with the
    University of Pittsburgh Medical Center (UPMC) and the Army. Wilford
    Hall Medical Center (WHMC), Lackland AFB, Texas, is designated as the
    initial DOD roll-out site for diabetes initiatives developed at UPMC.
    Major Mark True, an endocrinologist, is the WHMC project lead and
    director for the Air Force diabetes program. He established a Diabetes
    Center of Excellence (DCOE) program and, in August 2007, introduced
    several inpatient diabetes protocols and initiatives in the hospital,
    including an intravenous insulin protocol that substantially improved
    glucose control in critical care units. We are working to open an
    outpatient regional DCOE that will impact clinical outcomes across a
    regional population. This will be supported by the Mobile Diabetes
    Management with Automated Clinical Support Tools project beginning this
    year, which will demonstrate improved diabetic management through cell
    phones and web-based technology use.
                   building and sustaining a pre-eminent afms
        Sustaining the AFMS as a premiere organization requires the very
    best in education and training for our professionals. In today's
    military, that means providing high quality programs within our system,
    as well as strategically partnering with academia, private sector
    medicine and the VA to assure that our students, residents and fellows
    have the best training opportunities possible.
        With the ongoing demand for well trained surgeons in our trauma
    care mission, we have focused on Surgical Care Optimization. This
    initiative identified eleven medical treatment facility (MTF) platforms
    to provide the capacity necessary to keep critical wartime medics
    proficient in battlefield trauma care. It also seeks to increase MTF
    recapture of DOD beneficiary specialty care by optimizing operating
    room access and efficiency.
        Our Graduate Medical Education programs consistently graduate
    residents fully prepared to provide excellent clinical care in the
    inpatient, outpatient and deployed settings. The outstanding
    performance of our residents on board certification exams is just one
    marker of the success of our numerous training programs, many of which
    are partnered with leading civilian institutions throughout the
    country, including Wright State and Cincinnati University in Ohio;
    Saint Louis University in Missouri, and the Universities of
    Mississippi, Texas, Nevada and California.
        We partner with local civilian medical facilities to support the
    Sustainment of Trauma and Resuscitation Skills Program, enabling home-
    station clinical currency rotations in private sector level one trauma
    centers. Our Centers for Sustainment of Trauma and Resuscitation Skills
    is an immensely successful partnering endeavor that provides immersion
    trauma skills training with some of the great trauma centers in the
    Nation--R. Adams Cowley Shock Trauma Center in Baltimore, Maryland;
    University Hospital in Cincinnati, Ohio; and St. Louis University
    Medical Center, Missouri. Nearly 800 physicians, nurses and technicians
    completed this training in 2008; many of them deployed soon after and
    reported being very well prepared for their roles in combat medicine.
        Working closely with our Department of Veterans Affairs partners,
    we continuously strive to streamline the system for all our personnel
    to include our wounded, ill and injured Airmen. A major success in this
    partnership is our joint ventures. The Air Force has four of the eight
    existing DOD/VA joint venture sites--Elmendorf AFB, Alaska; Kirtland
    AFB, New Mexico; Nellis AFB, Nevada; and Travis AFB, California. Three
    additional sites are under consideration or in development at Keesler
    AFB, Mississippi; Buckley AFB, Colorado; and Eglin AFB, Florida. These
    joint ventures offer optimal healthcare delivery capabilities for both
    our patient populations, while also serving to make the most of
    taxpayer dollars.
        The Disability Evaluation System pilot program is a joint effort
    that resulted from the Commission on Care for America's Returning
    Wounded Warriors. The goal is to simplify healthcare and treatment for
    injured Service members and veterans and to deliver benefits as quickly
    as possible. Malcolm Grow Medical Center at Andrews AFB, Maryland was
    one of the initial three military medical treatment facilities in the
    National Capital Region to participate. The pilot streamlined and
    increased transparency of both the medical examination board process
    and the VA disability and compensation processes. In the pilot, both
    processes now occur concurrently, provide more information for the
    member during the process, and supply comprehensive information
    regarding entitlements from both agencies at the time of the
    separation. Continued evaluation of the study is slated to occur at 19
    more military installations, to include Elmendorf AFB, Alaska.
        Cutting-edge research and development initiatives are critical to
    building the future AFMS. The Virtual Medical Trainer is a continuation
    of existing efforts to develop advanced distributed learning. This
    project focuses on the development of training for disaster
    preparedness and medical care contingencies, addressing such areas as
    equipment, logistics, and war readiness skills training. Extensive work
    has been done to increase simulation in all of our hospitals and trauma
    training centers. Shared simulation with our university partners
    improves care and patient safety for both civilian and military
    patients. Virtual or simulation capabilities are a very cost-effective
    way to train and prepare our medics to do a variety of missions.
        Keesler AFB, Mississippi is studying advanced technologies to
    include robotic microscopy and virtual (whole slide) imaging. Eight
    MTFs have the robotic microscopes, and efforts are underway to obtain
    connectivity between MTFs and the VA Medical Center at Omaha, Nebraska.
    Once fully operational, this system allows general clinicians remote
    access to expert advice, diagnosis, and mentoring, and provides high
    quality standard of care independent of location.
        Similarly, telemedicine is vastly expanding the capabilities of our
    existing resources. Wright-Patterson AFB, Ohio radiologists and
    clinicians are successfully providing consultation services across the
    Air Force, and this year the project is slated to extend to Landstuhl
    Army Medical Center, Germany, and RAF Lakenheath, England. Automated
    Identification and Data Collection, a new business process study at
    Keesler AFB, Mississippi will identify opportunities for radiofrequency
    identification and barcode technologies in military medicine. We are
    exploring how to improve clinical and administrative processes in
    medical equipment management and repair, patient flow analysis and
    management, bedside services, medication administration, and surgical
    tray management.
        Successfully building and sustaining the AFMS requires continued
    focus on the physical plants we occupy to perform our mission. We
    greatly appreciate the tremendous support you have provided to
    recapitalize Air Force aging medical infrastructure. We're excited
    about our plans to improve facility restoration and sustainment and to
    move forward with sorely needed medical military construction (MILCON)
    projects.
        Green design initiatives and energy conservation continue to be
    high priorities for the Air Force. We are incorporating these into AFMS
    MILCON and restoration projects for our MTFs. We use the nationally
    accepted benchmark--Leadership in Energy and Environmental Design--to
    design and construct buildings with sustainable design elements. I'm
    pleased to share some recent examples, such as exterior solar shading
    panels used in Keesler AFB's Base Realignment and Closure (BRAC) Tower
    and Diagnostic Imaging Center projects. A grey water system
    incorporated into Tinker AFB, Oklahoma MILCON recycles treated
    wastewater generated from MTF hand-washing for use in toilets or
    irrigation systems, decreasing or eliminating the amount of fresh water
    used for those purposes. Our projected fiscal year 2010 Air Force
    MILCON projects will incorporate enhanced day lighting concepts
    allowing more natural light into buildings and office spaces. Our
    energy optimization efforts are both environmentally and fiscally
    beneficial and enable us to better serve military members and their
    families.
        Our most critical building block for the future is our people. With
    these unprecedented advances in training and research, it is
    understandable that the Air Force continues to attract many of the
    finest health professionals in the world. In fiscal year 2008, the Air
    Force Medical and Dental Corps exceeded their Health Professions
    Scholarship Program (HPSP) recruiting goals. HPSP is our most
    successful recruiting tool, and we are seeing positive early trends in
    retention from our other financial assistance programs and pay plans.
    We are working closely with our personnel and recruiting communities at
    targeting accession and retention bonus plans to ensure full and
    effective staffing with the right specialty mix to perform our mission.
             building a joint and effective military health system
        The AFMS is committed to working with our Sister Services to
    support joint medical capabilities and leverage common operating
    platforms such as logistics, research and development and information
    management/information technology. We are well on the way to bringing
    BRAC plans to fruition. The Joint Task Force National Capital Region
    Medical, or JTF CapMed, is moving forward with plans to combine the
    Army, Navy, and Air Force assets into the new Walter Reed National
    Military Medical Center. Malcolm Grow Medical Center at Andrews AFB,
    Maryland is our component to JTF CapMed and serves as an important care
    delivery platform in the NCR as the east coast hub for aeromedical
    evacuation. Since late 2001, Andrews AFB has welcomed home and cared
    for more than 33,000 patients arriving from Operations Enduring Freedom
    and Iraqi Freedom, U.S. Central Command, U.S. European Command and U.S.
    African Command.
        The BRAC plans are also moving forward in San Antonio, Texas, to
    integrate Army and Air Force MTFs into the new San Antonio Military
    Medical Center (SAMMC), creating the largest inpatient facility in DOD.
    SAMMC has integrated nearly all clinical activities and has led the way
    in bringing the Air Force and Army together in an integrated platform
    that meets the Air Force, Army, and joint mission requirements all the
    while maximizing the use of existing resources.
        Also in San Antonio is the Medical Education and Training Campus
    (METC). This is an important step toward what leaders are calling the
    largest consolidation of training in the history of the Department of
    Defense. Upon completion in 2011, the joint campus, led by tri-Service
    leadership, will centralize all Army, Navy and Air Force basic and
    specialty enlisted medical training at Fort Sam Houston, Texas. At
    Wright-Patterson AFB, Ohio, the 711th Human Performance Wing has been
    activated and will serve as a cutting-edge joint center of excellence
    for human performance and aerospace medicine.
        These are but some of the ways and places we are working toward
    joint solutions that enhance mission support and benefit the quality of
    medical care for our warfighters and their families.
       bright future and good time to be in the air force medical service
        Air Force medics make a difference in the lives of Airmen,
    Soldiers, Sailors, Marines, family members, coalition partners and
    civilians. They take pride in every patient encounter and earn our
    Nation's trust--everyday!
        As we look to the way ahead, I see a great future for the AFMS,
    built on a solid foundation of top-notch people, outstanding training
    programs and strong partnerships. It is indeed an exciting, challenging
    and rewarding time to be in Air Force medicine! I couldn't be more
    proud.
        We join our Sister Services in thanking you for your enduring
    support.

                   FEDERAL HEALTH CARE CENTER AT GREAT LAKES

        Chairman Inouye. I'd like to begin questioning now. Admiral
    Robinson, on October 1 of this year the Great Lakes Naval
    Health Center and the North Chicago Veterans Center will be
    merging. It's not the first DOD-VA activity, but it is without
    question the largest. I'm certain you have, as we have learned,
    legislative and other problems, problems with labor unions,
    problems on the commingling of funds and such.
        Can you tell this subcommittee what is being done at this
    moment?
        Admiral Robinson. The Department of the Navy, working in
    conjunction with the Department of Veterans Affairs, are coming
    together to establish the Federal Health Care Center (FHCC) at
    Great Lakes. We are working to make sure we have a seamless
    healthcare operation in north Chicago that will take care of
    the healthcare needs of the uniformed servicemembers in the
    Great Lakes area, as well as the beneficiaries of the VA
    system.
        There are a number of significant obstacles that I think
    will be overcome, but that is not to say they are not there.
    The first and most notable among them is the IM/IT system. That
    revolves around using VISTA and using ALTA, which system is the
    best. They are incompatible in the sense that we can't use both
    of them together. They do different things for both systems.
    Yet, we need to have one IT system that we can utilize in the
    facility.
        There have been a number of work-arounds. This is not an
    insoluble issue, but it is a major issue that we have to get
    resolution with, and in fact Navy medicine is pledged, along
    with VA, to make sure that we can come to some understanding of
    how we can use the best parts from both systems so that we
    don't destroy either VISTA or ALTA, but at the same time we can
    have one system at the VA.
        There are also issues around recruitment and employee
    relationships at Great Lakes. There are also issues that from
    my perspective as Surgeon General are very large issues in
    terms of credentialing, particularly of our ancillary
    healthcare providers. The VA and how they credential is
    different than what we do in DOD because very few VA providers,
    perhaps none, but very few VA providers are operationally
    oriented or deploy. But I have to make sure my providers
    maintain their operational medical skills so that when I tap
    them to deploy to an operational area they are full up. So I
    have to make sure that we have the credentialing issues that
    are taken care of and that we are going to solve problems that
    I may have in the Navy.
        Then there are the funding streams for both DOD and DVA,
    how those funds matriculate through our services, and the
    oversight of those funds. All of those issues, and this is just
    a very small example, have to be dealt with and we have to
    maintain the equities and missions of both DVA and DOD.
        Again, these are a few examples of the issues that are
    involved. Mr. Chairman, I think that we are going to solve all
    of these issues, but I will also say, with openness, that these
    are very difficult issues, and we're working them hard. So
    there are not easy solutions, but I do think that we can get to
    a place where we can have an excellent healthcare facility at
    FHCC.
        Chairman Inouye. So you're telling us that on October 1 all
    of the issues will not be fully addressed?
        Admiral Robinson. All the issues are not going to be fully
    addressed on October 1. But I think that if we take an
    iterative approach to the issues of how we serve our
    beneficiary population, how we serve our patients, can the
    doors open and can we, in fact, be an effective healthcare
    institution for DVA and DOD patients, I think the answer is
    yes.
        I do not think that all of the issues that I have talked
    about will be fully resolved, and in fact I think that that is
    absolutely essential in order to get to the quality care and
    the quality of service that we in DOD and DVA have to have in
    order to take care of patients.
        Chairman Inouye. There is a problem that is not in your
    jurisdiction, but as a result of these joint facilities we have
    a Veterans Committee, we have an Armed Services Committee, and
    so the matter of who has control is becoming a bit sensitive
    now. But that's not your problem.
        Admiral Robinson. Yes, sir.

                             CENTER FOR EXCELLENCE

        Chairman Inouye. Can I ask a question of General
    Schoomaker. Everywhere you turn there seems to be a center for
    excellence. We have been creating one for traumatic brain
    injury. I support that. We have one for amputees, for hearing
    and vision. Do you believe that by creating centers we give the
    impression that only these centers are the ones that we are
    concerned with and other matters are not of interest to us?
        General Schoomaker. Well, sir, I think I understand your
    question and I understand the concern. I think the efforts of
    those that have chartered those centers, as well as the
    execution of the centers, the leadership of the centers, are
    working very hard not to focus so much on brick and mortar
    solutions, but to act as clearinghouses. I think increasingly,
    with the generosity of the American public and the innovation
    that occurs within the academic community, with other Federal
    research and treatment entities like the National Institutes of
    Health, we are seeing--and the use, that's already been alluded
    to by Admiral Robinson, the use of information technology--we
    have an opportunity for these centers really to be the nexus of
    knowledge networks and to harvest best ideas, to find potential
    solutions, while also monitoring where problems are arising,
    and to move funding, to move energy, to move focus to those
    physical brick and mortar sites where that can be done.
        I think this is--certainly the effort that's underway in
    the Defense Center of Excellence for Traumatic Brain Injury and
    Post-Traumatic Stress Disorder and Psychological Health, I
    don't think anyone--certainly I do not conceive of this new
    center of excellence as being the sole brick and mortar site
    and only repository of good research and clinical activity. But
    certainly it is in a position to reach out to anyone who can
    offer solutions to the problems that are arising.

                     SERVICEMEMBER WELLNESS/FAMILY ADVOCACY

        Chairman Inouye. Admiral and General Roudebush, as you've
    indicated, there's been a rise in suicides, substance abuse,
    spousal abuse, children abuse. Are we making a joint effort of
    all services, or just each service on its own?
        General Roudebush. Well, sir, in terms of approaching what
    are very complex problems that cross a variety of areas when
    you're caring for the active duty soldiers, sailors, marines,
    and caring for their family members, we do approach that in a
    service-specific way which attends to the culture that those
    families both exist within and operate within, whether it's an
    Army post or a Navy station or an Air Force base.
        So we each have an approach that I think is adapted to the
    operational perspective of how we operate, but also attends to
    that culture. But we also work across services in terms of
    sharing both successes and issues, sharing programs, sharing
    insight into what we're doing, and operate I think effectively
    across those areas.
        Now, I will tell you that as we are able to reduce stigma,
    as we are able to increase visibility of issues, we are seeing
    more. Perhaps we're seeing more because there are more, and we
    need to be very attentive to that. But I think we're also
    seeing more because we are able to see more, and give us the
    opportunity to engage, hopefully intervene, to assure that
    proper care is provided at a time when it can make a
    difference, and do it either within the service construct or
    within the joint construct, because we certainly care for Navy
    and Army families in our Air Force facilities, and likewise our
    Air Force families are very well cared for in Army and Navy
    facilities.
        So it's incumbent upon us to work jointly, but we also need
    to work separately to assure that we are getting at the issues
    within our operational platforms.
        Chairman Inouye. Thank you very much.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you.

                              MEDICAL EVACUATIONS

        Admiral Robinson, more marines will be deployed to
    Afghanistan in coming months, and I've been informed that the
    standard time required for medical evacuations in Afghanistan
    are considerably different from those in Iraq. Would you
    comment on the adequacy of the resources that will be available
    and the response time for medical evacuations as more marines
    and corpsmen are involved in that theater of operation?
        Admiral Robinson. Yes, sir, Mr. Vice Chairman. The
    Afghanistan area of operation is substantially different than
    the area of operation in Iraq, both from a terrain and an
    infrastructure point of view. Afghanistan has desert terrain,
    which can reach upwards of 140 degrees Fahrenheit, all the way
    to mountains, which are very, very cold, very sub-zero weather.
    Additionally, infrastructure in terms of roads are almost
    completely lacking in Afghanistan, as opposed to other areas,
    which makes the necessity for how we operate there from a
    medical point of view a lot different in terms of mobility and
    in terms of air evacuation.
        The golden hour which I as a surgeon and as a former chief
    of surgery at Portsmouth Naval Hospital, having trained many
    general surgeons in trauma, is an age-old edict that we've used
    in surgery since it was first developed at the University of
    Maryland Shock Trauma. It's based upon the work from the
    Vietnam war and also the fact that if we can utilize air
    evacuation of critically injured personnel and get them to
    immediate definitive medical facilities we can save lives, and
    in fact that is absolutely true.
        One of the things that we in Navy, Army, and Air Force
    medicine also utilize is the effective resuscitative capability
    that the Army medic, the Navy corpsman, and the Air Force medic
    utilize on the ground at the time of injury, such that we can
    start definitive care. We can start adequate resuscitation of
    injured personnel, stabilize them, control their airway, until
    adequate evacuation capability is there.
        So the 60 minutes and the air evacuation, which is more
    difficult in Afghanistan, is not something that is necessarily
    going to reduce either the capability or the success of trauma
    surgery or trauma capability that we've had in the past. I only
    emphasize that from a medical and a surgical point of view
    because very often the golden hour appears to be truly a 60-
    minute evolution. It actually includes the ability to stop
    bleeding, to make sure that we have ABC, airway breathing, and
    circulation reestablished, to make sure that we have
    resuscitation reestablished, to make sure that we've done those
    definitive measures for the injured personnel who are going to
    in fact survive such that we can get them to definitive care.
    And in fact, if we get them there 2 or 3 hours after injury,
    that is usually adequate as long as resuscitation has occurred.
        So the long answer to the short answer: We, Navy medicine,
    Air Force and Army medicine, will be capable of making sure
    that we give the same care to our trauma victims in
    Afghanistan.
        Senator Cochran. That's very impressive and I think
    deserves commendation for the excellent leadership you're
    providing in this area.

               SUFFICIENT SUPPLIES AND PERSONNEL FOR AFGHANISTAN

        General Schoomaker, with the increase in personnel deployed
    to Afghanistan, do you believe that you will have sufficient
    medical personnel and medical supplies to support this troop
    increase?
        General Schoomaker. Sir, I think medical supplies is
    probably the easier of the two to answer. I don't envision any
    rate-limiting element of medical supplies or equipment there.
    We have I think evolved the medical logistics capability of the
    entire CENTCOM area of operation dramatically over the last 6,
    7 years, focusing on the so-called theater level medical
    material centers, one of which is in Europe, one of which is in
    Qatar, and we have distribution sites within Afghanistan.
        So I don't have concerns so much about that. Medical
    personnel I think is a challenge to us. This is one of those
    areas, quite frankly, that the coordination among the three
    services is most important. The Army right now is very heavily
    engaged both in Afghanistan and in Iraq in providing medical
    support. As we draw down troop levels in Iraq, we're going to
    continue to have fairly robust medical support because, as we
    all know, you have to support the areas in which troops are
    operating in.
        So we're going to continue to see Army medics and, for that
    matter, Navy and Air Force as well, maintained in Iraq. So
    we're cooperating I think with the CENTCOM planners and with
    the joint medical planners within Afghanistan to provide the
    resources that we can and the Navy and the Air Force, I think
    as you heard earlier, the air base at Bagram now, and that
    level three or role three facility now is largely Air Force,
    after having been started by the Army and transitioned to the
    Air Force. The Navy is going to play a more important role in
    the south.
        So yes, we're stretched. But we're working as closely as we
    can with our joint partners to cover those areas of
    responsibility.

                         TROOP INCREASE IN AFGHANISTAN

        Senator Cochran. Will the increase in deployment affect
    rotation schedules and deployments of surgeons, as well as
    medical specialists? What is your expectation?
        General Schoomaker. Well, sir, everybody plays a role in
    this in Army medicine. It's not recognized by many people, but
    some of our most heavily deployed specialties are not surgeons
    at all; they're pediatricians, who serve as general field
    surgeons, physicians assistants. Our psychologists,
    psychiatrists, our mental health workers, are very heavily
    engaged.
        Do I think it's going to change the rotation length? No,
    sir, it's not going to change the rotation length. In fact,
    we're working to come closer to what our colleagues in the Air
    Force and the Navy have, which are shorter rotations, even if
    they're more frequent. We know from talking with our families
    and talking with our specialists that not only can they
    maintain the broad range of skills that they require in their
    specialties if they're deployed for a shorter period of time,
    even if that turns into more frequent deployments, but the
    families are much more tolerant of shorter rotations,
    especially 6 month or so rotations.
        So we're working very hard to do that and getting support
    from the line for that.
        Senator Cochran. Thank you very much.
        General Roudebush, what role will the Air Force have in
    supporting the troop increase in Afghanistan?
        General Roudebush. Sir, the Air Force is in Afghanistan, as
    General Schoomaker pointed out. We have the Air Force theater
    hospital at Bagram, which is jointly manned with the Army, but,
    as General Schoomaker pointed out, primarily Air Force, as well
    as a number of other smaller facilities that are either Air
    Force or jointly manned. We will certainly sustain those and
    over time being increasing Air Force medical laydown to support
    what you initially pointed out with Admiral Robinson in terms
    of working the medevac support time, which I believe you know,
    but I will note, our line leadership has really leaned into
    supporting that with additional rotor capability. The Air Force
    is providing additional helicopter assets and other assets to
    assure that we can be as timely as we need to be, and I think
    Admiral Robinson laid that out very well.
        So we will be certainly supporting the increased troop
    laydown. However, I think there's two other points that I would
    note. The Air Force and Navy and Army are also deeply involved
    in rebuilding the nation. We have embedded training teams
    working with the Afghan military and police to rebuild their
    medical infrastructure, to mentor the Afghanis, so that they
    can be ultimately self-sufficient; provincial reconstruction
    teams doing a great deal of work to bring that nation forward
    to the point where it can in fact operate on its own
    recognizance.
        The second point I would make is that we have significant
    support from our North Atlantic Treaty Organization (NATO)
    allies on the ground in Afghanistan from a medical perspective,
    which we also integrate and leverage to assure that we have not
    only a joint approach to this, but we also have a coalition
    approach. So as we look at the overall military laydown in
    Afghanistan, there are a variety of perspectives that play into
    this that I think will assure that our forces are best
    positioned to do the mission that they are being sent there to
    do.
        Senator Cochran. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Bennett.
        Senator Bennett. Thank you very much, Mr. Chairman.
        Gentlemen, let me thank you for your service and your
    expertise. I come to this subcommittee new, so I don't have as
    intelligent or well-informed questions, but the only way I'm
    going to learn is to ask some stupid ones. So bear with me.

                            MEDICAL HEALTH SCREENING

        General Schoomaker, you talked about general wellness, that
    is physical, psychological, spiritual, et cetera, et cetera. I
    think that ties into this whole question of mental health. The
    discussion about suicides and child abuse and other things has
    been an interesting one to listen to. In this process of trying
    to make sure that the individuals who serve in the armed forces
    are well-rounded and balanced in every area, is there any
    prescreening of people who might be susceptible, more
    susceptible to some kind of mental trauma and preparation prior
    to their going into deployment, so that they might, if
    something happens to them, have some previous training or
    preparation or expectation that could help them after the fact
    deal with the problem more than if it just hit them for the
    first time?
        General Schoomaker. Yes, sir. I think let me talk first
    about the screening because I think that's fairly--that I can
    deal with fairly quickly. That is that, aside from the usual
    accession screening, to include medical and psychological
    screening that occurs on any inductee, we don't have any
    specific screens that are used or selections that are used,
    because, quite frankly, I don't know that we have any
    determinants right now for success or failure in terms of the
    whole fitness of an individual. We use physical fitness
    monitors and assessments of general health, but other than that
    none.
        I think one of the promises of the research that is now
    being conducted in traumatic brain injury, and especially in
    psychological health potentially, is finding early markers, if
    you will, and determinants of psychological injury. There are
    emerging theories and I think there's some empiric evidence to
    support that post-traumatic stress reaction, for example, which
    occurs in a very large number of people subjected to trauma,
    whether that's in combat or the trauma of natural disaster or
    rape or violent crime or family violence, motor vehicle
    accidents, might be the persistence of a dysfunctional flight
    or fight reaction, and that there may be markers that we can
    discover and alert people very early to that emergence.
        In the meantime, what we're doing in the Army is, through
    the use of a set of tools, a suite of training tools called
    Battlemind training, developed by the Walter Reed Army
    Institute of Research, we are building resilience in deploying
    soldiers before they deploy, during the deployment, and then
    upon redeployment. This suite of tools, Battlemind, which has
    become sort of our branded name for that, is one of the
    cornerstones of resiliency training. It's been one of the only
    instruments that we're aware of that has actually been shown to
    reduce during deployment the incidence of new post-traumatic
    stress problems.
        The chief of staff's initiative in comprehensive soldier
    fitness is that attempt writ large. The idea here is that we
    have spent a lot of our time as a corporation, as an
    institution, looking only at the negative events--suicides,
    family violence, driving while intoxicated or drug-associated
    crimes or misconduct, and emergence of post-traumatic stress
    reactions and post-traumatic stress disorder if not addressed
    early enough and reversed. What the Army is trying to do is to
    find those determinants of resilience and growth and post-
    traumatic growth, rather than to turn adversity into a trauma
    and into an irreversible psychological injury, is to build the
    capacity of individuals through a multidisciplinary approach
    which works on the positive.
        So we're working with some of the leaders in positive
    psychology and other tools to promote that aspect, rather than
    only measure in terms of what negative events occur. In so
    doing we hope to move the whole population of soldiers and
    families away from the threshold where they become
    dysfunctional.
        Senator Bennett. Thank you. That's really helpful.
        Now, I was interested in the comment that you get
    significant increases, to use the business language,
    significant increases in productivity out of the troops if you
    alter the length of their deployment. I'm guessing here, but
    are there any studies going toward the question of frequency of
    patrols, for example, during the deployment, where you send
    marines into a nasty neighborhood in Fallujah day after day
    after day, as opposed to every other day or every third day or
    something of that kind?
        Is there any research in this regard or any attempt to find
    research in this regard that might have the same impact that
    you have found with respect to the overall length of
    deployment, 6 months gives you better soldiers even if there
    are more deployments than if you put them there, say, for 18
    months and kind of leave them alone. Is there any further
    research in the area I've talked about, about their exposure to
    traumatic situations on deployment?

                          IMPACT OF DEPLOYMENT LENGTH

        General Schoomaker. Well, sir, first of all, you may have
    inferred something that I did not intend to imply, that is that
    productivity of a soldier in general is somehow linked to the
    length of deployment. The chairman I think or the vice chairman
    earlier asked about the tolerance of recurrent deployments of
    medical specialists or surgical specialists as a function of
    the length of the deployment. My comment there is that we
    observe that the skills of, for example, a general surgeon
    begin to deteriorate after a certain amount of time in theater
    because they're not exploring and not using the full spectrum
    of what a general surgeon would use.
        Senator Bennett. I did misunderstand you, then. I got the
    impression that there were data that suggested the front line
    troops would benefit from more frequent, but shorter,
    deployments. You're saying that that's not the case, and I
    misunderstood you.
        General Schoomaker. Yes, sir. I think we have ample
    evidence through a series of annual iterative surveys called
    the mental health advisory teams, MHAT. We're in our sixth
    iteration of this, the sixth year. That team is right now in
    Iraq gathering data. We do have ample evidence that the length
    of deployment is associated with increased problems of the
    development of post-traumatic stress and other problems of
    soldiers in theater.
        So I think you got that exactly right, sir. As we were in
    that period of the surge when we had 15 month long deployments,
    there was no question that the longer that deployment went the
    more problems soldiers had.
        We do find, as I mentioned earlier, that if those soldiers
    pre-deployment and during deployment are exposed to Battlemind
    training and sort of re-inoculation with this, it reduces the
    incidence of that. So as I said before, it has been shown to be
    effective.
        But as far as, so to speak, the productivity of the soldier
    or the effectiveness of a soldier, I would not ask you to infer
    from what I've been describing here that a soldier's
    effectiveness is improved by shortening the length of
    deployment. In fact, operational commanders would probably take
    me--take exception with some of that as a grand statement.
        Senator Bennett. Thank you. I appreciate that clarification
    because as I've studied the Vietnam war one of the things that
    was said was that you just got your unit cohesion going and
    then you'd pull them out and put in a bunch of green troops in,
    and that was one of the problems. So I'm glad to get that
    resolved.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Murray.
        Senator Murray. Thank you very much, Mr. Chairman.
        Thank you all for your testimony today.

                             DISABILITY EVALUATIONS

        General Schoomaker, let me start with you. How are things
    going with the DOD and the Department of Veterans Affairs
    expansion of the pilot programs to expedite the processing of
    injured troops through the disability evaluation system?
        General Schoomaker. Ma'am, I think that's going very well.
    As you know, or at least I've gone on record to say that the
    pilot, although a very, very good effort and one that we
    support very, very vigorously--in fact, once the pilot was
    established in those few sites like Walter Reed, I've done
    everything in my power to implement it as widely as we can.
    Once we learned that we can simplify bureaucratic morass and we
    can make it more user-friendly for families and soldiers, I
    think we ought to be doing it as quickly as we can.
        But I've also said that I'm concerned that it doesn't get
    at one of the most important and most disaffecting parts of our
    system of physical disability and evaluation, which is the dual
    adjudication of disability, one by the Department of Defense
    for the unfitting condition, for which the soldier, sailor,
    airman, marine, coast guardsman is awarded a specific
    disability rating linked to benefits, not the least of which is
    benefits for TRICARE for him or herself and their families; and
    then the Veterans Administration adjudicates a second,
    comprehensive level of disability based upon the whole person.
        Senator Murray. I thought we were all going to go to the
    same system.
        General Schoomaker. Ma'am, until we change the law, my
    understanding is that we cannot get away from the dual
    adjudication of disability for anyone in uniform. We still have
    the single unfitting condition for the service member and the
    whole person concept for the VA. What we need in my
    understanding is legislative relief to be able to bring those
    two together.
        But every other aspect of this highly bureaucratized system
    I think we're working very hard with the VA in doing, and we're
    encouraging that and supporting that in every way we can.
        Senator Murray. Admiral?
        Admiral Robinson. I think that General Schoomaker has
    summed up well what the issues are. I think that the Federal
    Health Care Center in Chicago actually underscores some of the
    difficulties of the DVA and DOD system in terms of trying to--
    your question is specifically with the disability evaluation
    system. But we have two chains of command that work vastly
    different, with different sets of rules and regulations, and
    trying to bring them together has been the real challenge.
        Additionally, the same issues that affect the FHCC, the
    Federal Health Care Center in Chicago, regarding IM/IT--that
    is, VISTA and ALTA--are the same sorts of things that affect
    the merger of the disability evaluation system. How does that
    relate? If we have one system, we're going to have to have one
    medical IT way of dealing with those beneficiaries and whatever
    their medical needs may be.
        That's a very small example, but those come together. In
    terms of my eyes-on Surgeon General of the Navy at the
    Department of Defense for the oversight committees that very
    often General Roudebush and General Schoomaker attend with me,
    both DOD and DVA and all of the reps in between and the Marine
    Corps, and all the other people involved have been working
    tirelessly to make this work, looking first at our patients and
    their needs and not at bureaucratic or other issues.
        I will say that across the board we have done that. We're
    looking at patients and what they need, not at the
    institutional obstacles. I only bring the institutional
    obstacles up because at the end of the day they exist and they
    make a difference.
        Senator Murray. General Roudebush.
        General Roudebush. Yes, ma'am, I think you raise a very
    interesting question. I'd like to offer perhaps an observation
    on your question, but also give it perhaps a little different
    perspective.
        The Department of Defense and the Department of Veterans
    Affairs have different missions. Where we come together, the
    interface really most directly is as we transition an
    individual from Department of Defense--Army, Navy, Marine
    Corps, Air Force--to the Department of Veterans Affairs. We do
    need to assure that that transition is seamless.
        Now, DOD, in my instance the Air Force, needs to determine
    fitness for duty in terms, is that individual fit to serve in
    the mission for which they're trained. The VA takes a rather
    broader look at how that individual is going to function back
    in the private sector. So these are two rather different
    determinations, and I think to the extent that we simplify the
    transition to assure that these great men and women are cared
    for, only have to fill out paperwork once, have a smooth move
    from DOD activities to VA, to include benefits, all benefits,
    is very important.
        Our pilot projects I think are helping in that regard. For
    us, we're going to be expanding to a variety of locations, very
    small, Vance in Oklahoma for example, to very large or larger,
    Elmendorf in Alaska. I think that will continue to be
    instructive.
        The metrics show that we are, in fact, reducing the time,
    but not to the time that we would consider to be appropriate.
    But as we bring these two great institutions, DOD and VA,
    together, we also have other experiences. DOD joint ventures,
    for example. We've got a great example at Keesler, where we use
    centers of excellence, what the VA brings very well within
    their operation, what the Air Force brings in our operation,
    and we leverage each other's capabilities, maintaining mission
    focus for the Air Force, for the VA, but really leveraging each
    other's capabilities.
        So I think those kinds of opportunities and experiences are
    important, and also help instruct such things or inform such
    processes as how to best transition these men and women from
    DOD to VA. So I think we're making progress. We are not where
    you want us to be. We are not where we want to be. But I think
    we are making progress in really identifying the issues that
    need to be attended to as we work this.
        Senator Murray. No one said it was going to be easy.
        General Schoomaker. No, ma'am.
        Senator Murray. But we're working, and we need to get
    there. Okay.
        General Schoomaker. Thank you.
        Senator Murray. Can you provide me with an update on the
    implementation of the comprehensive TBI registry that we
    started, I guess it was 1 year or so ago, including a single
    point of responsibility to track incidence and recovery,
    General Schoomaker?
        General Schoomaker. I will take that for the record, ma'am.
        Senator Murray. Could you?
        General Schoomaker. Yes, ma'am.
        [The information follows:]
                                  TBI Registry
        Traumatic brain injury incidence and recovery is tracked through
    various complementary mechanisms at the VA and the Department of
    Defense (DOD). The National Defense Authorization Act for Fiscal Year
    2008 states that the Secretary of Veterans Affairs shall establish a
    registry to be known as the ``Traumatic Brain Injury (TBI) Veterans
    Health Registry.'' The Act further specified that the Secretary of the
    VA collaborate with facilities that conduct research on rehabilitation
    for individuals with TBI, facilities that receive grants for such
    research from the National Institute on Disability and Rehabilitation
    Research (NIDRR), and the Defense and Veterans Brain Injury Center
    (DVBIC) of the DOD and other relevant programs of the Federal
    Government. The VA, NIDRR, and DOD have collaborated in this initiative
    with the VA as lead. The summary below is based upon those
    collaborations. Further details can be provided by the VA.
    TBI operational Surveillance: TBI Veterans Health Registry
        The VA has developed a mechanism to collect and consolidate all
    relevant medical data relating to the health status of an individual
    who served as a member of the Armed Forces in OIF or OEF and who
    exhibits symptoms associated with TBI, and who applies for care and
    services furnished by the VA; or files a claim for compensation on the
    basis of any disability associated with such service. Relevant data
    will be merged, and de-identified. The VA will then enlist NIDRR to
    assist with analysis of the data and timely production of reports.
        Status: All components of this program have been designed and will
    be initiated very shortly.
    Research Database: TBI Veterans Health Registry with Additional
            Information
        As per the NDAA for fiscal year 2008, additional information the
    Secretary considered relevant and appropriate with respect to
    individuals will be included in the Registry if the individual grants
    permission to include such information, or is deceased at the time the
    individual is listed in the Registry. The additional information to be
    collected for patients providing informed consent in any of the VA
    PolyTrauma Centers includes a structured TBI Registry with additional
    data elements developed in coordination with the agencies listed in the
    NDAA for fiscal year 2008. These collaborations permit comparisons of
    Registry information with data collected on civilian TBI patients and
    DOD patients and returning service members. The VA TBI Registry has
    substantial overlapping data elements with the civilian Model Systems'
    TBI Registry and the existing DOD TBI Registry, which will facilitate
    future comparative studies.
        Status: This program, involving additional information for patients
    providing informed consent, has been submitted as a protocol to the
    Institutional Review Boards at the PolyTrauma Centers.
    National Archive Database
        In addition to the secure database developed as a collaboration
    between VA and NIDRR, additional databases may facilitate the sharing
    of selected elements of the TBI Veterans Health Registry with
    Additional Information with data collected within the DOD and across
    other civilian agencies and centers. The pooling of shared, common data
    elements will facilitate understanding of the course, diagnosis, and
    correlates of TBI in returning service members. The National Data
    Archive, a recent collaboration between NIH and DVBIC will provide for
    secure upload and storage of all original and processed images,
    associated clinical and genomics data for TBI, Post Traumatic Stress
    Disorder (PTSD) patients, and other relevant patient populations.
        Sharing of phenotypic, imaging, and genomic data from a central
    secure repository will include the ability for researchers to validate
    research results, pool standardized information to improve statistical
    significance, use data collected by others to explore new hypotheses
    all in effort to improve PH and TBI treatments, use sophisticated
    analysis tools to gain a better understanding of risk factors and
    mitigating factors in PH and TBI.

        General Schoomaker. That is being--the focus in Army
    medicine is to direct all of our energies and our talents
    toward the Defense Center of Excellence for Traumatic Brain
    Injury and Psychological Health under Brigadier General Loree
    Sutton.
        Senator Murray. Could you get back to me on that? It was
    one of our huge questions 1 year ago; making sure that people
    were registered and we were tracking them. So if you could
    please get back to me on that.
        General Schoomaker. Yes, ma'am.

                        RESERVE HEALTHCARE REQUIREMENTS

        Senator Murray. Let me ask all of you: The Reserves and
    particularly the National Guard have some unique concerns when
    they're deployed. We continue to hear from our folks out in our
    States about this, and obviously as we transition from Iraq to
    Afghanistan they're going to continue to be used. So my
    question for each of you is: Have you budgeted properly to
    accommodate for the Reserve components as they are going to
    need DOD healthcare into the future? General Roudebush, we'll
    start with you.
        General Roudebush. Ma'am, in the Air Force and I believe in
    the other services, we have separate funding streams. The Guard
    comes from the States, the Reserve comes from the Reserve
    dollars, and DOD comes from the defense health programs. Now,
    to the extent that we merge our interests and our activities we
    do cross-flow that very, very carefully.
        For us, for example, we assure that our Guard members and
    our Reserve members and our active duty members are tracked for
    completion of the post deployment health assessment and the
    post deployment health re-assessment (PDHA-PDHRA), and, in
    fact, our Guard and Reserve members are kept on active duty
    status, man-day status, until issues are resolved. So they
    retain full benefits as we work them through.
        But they do come from different streams of money. However,
    the oversight and the application of that is very coordinated
    and very integrated for the Air Force.
        Senator Murray. Admiral.
        Admiral Robinson. Your question is do we have adequate
    funds for the Reserve forces, and the answer is yes. Our
    Reserve forces have adequate funds. We have methods of making
    sure that our Reserve forces, once they come on active duty,
    are cared for just as any other active component member would
    be. As that Reserve component member goes off of active duty,
    the service member and his or her dependents are covered by
    TRICARE for approximately a 180-day period.
        If there is some limiting mental or physical disease or
    condition that would make it better for them to stay on active
    duty, they will remain on active duty. As they transition to
    the Navy mobilization platforms, NMPS, to the Reserve
    component, to the NOSCS, which are the local Reserve units back
    in their home towns or their home cities, they will go back
    into how we fund them from the Reserve component perspective.
        But the key is that we have a number of medical, mental
    health, and other areas that we track our Reserve forces, that
    we integrate our Reserve forces, and that we care for our
    Reserve forces, and we are funded adequately to do that.
        Senator Murray. General.
        General Schoomaker. My comments would echo my colleague's
    here, that we're well funded. They are separate lines for the
    Army National Guard, Reserve, and Army Reserve, and the active
    component. As the Admiral just commented, we're working very
    hard to ensure that any mobilized reservists or National
    Guardsmen while on active duty is kept healthy; if they incur
    an injury, a combat wound or an illness, that it';s fully
    treated and they're restored to health, including dental
    health. We made a major effort to restore dental health and
    hygiene before mobilized reservists and National Guardsmen are
    put back out into civilian life.
        Our warrior transition units are roughly 8,000 in total
    right now across 36 units and nine States, are made up of both
    active--of all three elements, all three components, to include
    National Guard and Reserve. They have full access to those
    warrior transition units. In fact, about one-third of our
    warrior transition units warriors in transition are soldiers
    who are returning from deployments or mobilizations who
    identified a problem that they have, and they're brought in and
    they're retained on active duty until we can take care of the
    problem.
        Senator Murray. Thank you.
        I appreciate a lot of the conversation that's already gone
    on regarding the increase in suicides and mental health. We
    have to stay focused on that, and I appreciate all of your
    earlier comments, so I won't ask you about that.

    DEPARTMENT OF DEFENSE FISCAL YEAR 2008 REPORT ON SEXUAL ASSAULT IN THE
                                    MILITARY

        But I did want to ask you about another issue, because
    yesterday DOD made public the fiscal year 2008 report on sexual
    assault in the military, and it showed an 8 percent increase of
    reports of sexual assaults. Now, some are arguing that that
    increase illustrates the fact that victims are now more likely
    to report those crimes, but I find the trend very disturbing
    because these crimes are happening at all.
        I was part of the Women's Military History Month. A week
    ago I participated in the Army's panel on sexual harassment,
    assault prevention and response program, and clearly we all
    share the goal of eliminating sexual assaults in the military.
    But until that goal is achieved, I am very interested to hear
    from all of you about how the medical community is supporting
    the efforts to care for these victims' physical and
    psychological wounds in general.

                      SEXUAL ASSAULT AND RESPONSE PROGRAM

        General Schoomaker, I want to start with you.
        General Schoomaker. Yes, ma'am. First of all, I would say
    that the Army leadership and the Army as a whole shares your
    outrage with sexual assault and any increase in the incidence
    of these crimes. The Army has taken the approach that this is
    an assault, not just on the individual woman, but on the ethos
    of soldiers, of the warrior ethos, that this is not to be
    tolerated, and is taking a very active proactive role in
    education and prevention, which is on the shoulders of
    commanders.
        The medical side of this is that we are the response. We
    provide the examination. We help the woman through the stages
    of forensic evaluation. We have in all of our facilities, to
    include, as General Horoho can tell you, in our visit there
    last week her review of what's taking place in the deployed
    setting in Iraq.
        We have sexual assault response coordinators in each of
    these facilities, either working with the assets we have in
    uniform in the uniformed facility, or in a case when I was the
    installation commander at Fort Dietrich, Maryland, we leveraged
    expertise of the community of Frederick, Maryland, to assist us
    through Frederick Memorial Hospital.
        So we do the counseling, we do the examination. We help the
    woman. We go--we help her through the process that she has to
    go through in order to gather the necessary information about
    the assault and to investigate the crime. But we also do the
    follow-on counseling and help coordinate all those services
    that are necessary for her.
        Senator Murray. Admiral.
        Admiral Robinson. Senator Murray, the Navy has the Sexual
    Assault Victims Intervention Program (SAVI), which was
    established in 1994. From that program has come an effort to
    not only educate people as to what is a sexual assault and to
    bring it to a level of visibility so that we are talking about
    it in our commands and it becomes a leadership issue on a daily
    basis, but we've also grown from that to develop a lot of the
    sexual assault response and prevention programs (SARP) that
    you've seen and participated in some of the workings with DOD.
        From the medical point of view specifically, we help in the
    training of SAVI. The SAVI Program is also interesting because
    it takes the victim and puts the victim at the center of the
    activity. In other words, it makes sure that the victim
    understands, is affirmed, and actually has the counseling that
    he or she may need is a critical element in how we run the
    program.
        The second one is to make sure that we then train the
    forensic experts that need to come along and do the
    investigations, which is what General Schoomaker was referring
    to, which is critically important. I would suggest that if
    those folks are not trained in the military treatment facility
    that we utilize our civilian forensic police and forensic
    facilities to make sure that that's done properly.
        Then the third point is the education and the prevention,
    which is something that needs to be done at the beginning of
    training in the military. This is for men and women, and it
    goes through some of the very didactic, but very necessary
    thoughts regarding training, regarding definitions: What is a
    sexual assault? What does consent mean? What does ``yes'' mean?
    What does ``no'' mean? All of these types of things which men
    and women have to listen to.
        Then the last part is to make sure that after we've done
    that, that we have a program that's sensitive to the needs of
    those people who fall victim the sexual assault. That includes
    psychological and the mental health issues. Additionally, we
    need to make sure that their families are cared for. Very often
    men and women are married or they have other family issues, and
    we have to make sure that that's cared for.
        We in the Navy have taken this full-bore and are very
    sensitive to what you've talked about. We have been working
    this very hard for a long time.
        Senator Murray. I appreciate that answer. Thank you.
        Admiral Robinson. Thank you.
        Senator Murray. General.
        General Roudebush. Ma'am, I think your approach is the one
    that I would echo. We know there are increased numbers. Now,
    whether it's increased reporting or increased incidence, we can
    certainly discuss. The fact that there is one is too many.

                                 SEXUAL ASSAULT

        Senator Murray. That's correct.
        General Roudebush. So beginning with that as the going-in
    position is precisely where the Air Force leadership is
    attacking this issue. It's a matter of respect. It's a matter
    of respecting each other. It's a matter of honoring each
    other's integrity and their person and treating each other as
    we would want to be treated.
        It's an operational issue. It has direct mission impact.
    It's a cultural issue. It's a family issue, because we strive
    individually, we execute as a team, but we take care of each
    other as a family. So this is a family issue.
        We come at it in a very structured way. We learned
    important lessons as we assessed the issues at our Air Force
    Academy, which we have implemented across the board in terms of
    a sexual assault program that works to prevent sexual assault,
    but if it occurs we respond in a very sensitive and coordinated
    way, to include restricted reporting if the individual prefers,
    to perhaps help them come forward and get the help that they
    will need.
        We have a sexual assault response coordinator at every
    installation wired into the wing leadership. Medical is a key
    part of it. As General Schoomaker pointed out, we have
    important responsibilities and we are postured and do execute
    those responsibilities. But really, it's a matter of taking
    care of each other, respecting each other, and that's precisely
    where our program is going in terms of training, education, and
    sensitization, and establishing the fact that it will not be
    tolerated any way, any shape, any form, anywhere, any time.
    It's a matter of respect.
        Senator Murray. Well, I appreciate your comprehensive
    answers, all three of you, and I hope that's echoed throughout
    the forces. I think that the worst thing we can do is to not
    talk about it. This is an issue I'm going to continue to
    follow. I encourage all of you as well, to make sure that those
    policies are implemented, so that no one fears coming forward;
    that we start at the very beginning, so that it's not
    tolerated; and then if it does occur, that people get services
    and support and it doesn't become a crime that no one talks
    about.
        So I appreciate all of your answers on that.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        I have many questions I'd like to submit to you, but one
    final one if I may. When I was wounded in World War II, from
    the battlefield to the hospital it took me 9 hours to be
    evacuated, most of the evacuation carried out by stretcher
    bearers. Today if I were wounded with the same injury in
    Baghdad, I suppose I'd be in a hospital within 30 minutes
    because of helicopters and such.
        As a result, a lot of things have happened. For example, in
    my regiment I don't believe we have one double amputee
    survivor. Today most double amputees survive. And you have many
    brain injuries and such, which in World War II very few ever
    survived.
        But equally as important, I spent 22 months in a hospital.
    Today if I were at Walter Reed I'd be out in 6 months on the
    street. But when I left Percy Jones in Michigan I knew a little
    about carpentry, electrical work, plumbing. I knew how to play
    basketball and swim. I knew how to drive. I knew how to go to a
    restaurant and order food, dine, dance. I knew how to defend
    myself. I knew what sex was all about.

                       COMPREHENSIVE TRANSITION PLANNING

        My question is, do you believe that the men and women who
    are being wounded in this war leave the service as I did,
    reassured, confident that I can tackle the world?
        General Schoomaker. Sir, if I might start the answer from
    the standpoint of the Army, I think your eloquent description
    of what you went through and your sharing that with me
    personally and with my staff in the office visits with you I
    think really captures the essence of what we're attempting in
    this comprehensive transition planning. What we observed--and
    quite frankly, Senator Murray's question about the physical
    disability evaluation system is really incomplete without
    addressing one aspect of this system.
        We have a system that, its name alone telegraphs what it's
    about, ``physical disability.'' It's a system that is rooted in
    the industrial age. It's 50 years old. It's highly bureaucratic
    and it's contentious and adversarial. We're trying to change
    the culture of disability and permanent dependency toward one
    of growth, of rehabilitation, of your experience, without
    leaving any soldier, family without the necessary safety nets
    and transition support that they may require in the case of a
    very severe injury or illness.
        So candidly, we've turned away from--the chief of staff of
    the Army engaged another former wounded soldier, General
    retired Fred Franks, a veteran of Vietnam, where he lost part
    of a leg, and went on to retire as a four-star general, as the
    commander of the 7th Corps in Desert Storm. General Franks has
    looked at the physical disability evaluation system and has
    concluded some of the same things that, much of what I've said
    here today, which is that we need to move the culture away from
    one that's focused on disability and permanent dependency
    toward one that is aspirational, that's positive, that builds
    back a capability and potential in every individual soldier,
    sailor, airman, marine, coast guardsman, and their family.
        We draw upon the experiences of soldiers such as yours.
    Today I will tell you that with your injury you very likely
    would remain in our hospitals the same length of time that you
    were there before, only because it may take that long to fully
    recover from the wounds that you had and to be fully
    rehabilitated to do what you needed to do, to include remaining
    on active duty.
        We've turned away from looking at time as a goal or an
    outcome measure for this system of transition. We look at--
    we're beginning to look at and assess the goodness of the
    outcome for the individual soldier and family based upon what
    their comprehensive transition planning is. So have we reached
    that point? At this point I would have to say no, sir, we have
    not. Does every soldier who's wounded grievously or is injured
    or ill to the degree that you suffered or others have have the
    confidence and realize the full potential? At this point I'd
    have to say no. But we won't be successful in this program of
    transitioning until we have all of our soldiers aspiring to
    what you've achieved.
        Admiral Robinson. Mr. Chairman, I think your question and
    your comments are very profound, and it makes me think of a
    movie in 1947 or 1948, ``The Best Years of Our Lives,'' in
    which a sailor is depicted, Homer, a double amputee coming out
    of the war, and spending approximately 24 to 30 months in a VA
    hospital. I think he learned all of the things that you
    learned. I don't think that they ever stated it as you did
    here, but he learned so much.
        But one of the things that was lacking in that movie and in
    that whole scenario was the family, because he was scared to
    death as to how he was going to be received by his mother, his
    father, his sister, and his girlfriend next door.
        The difference now is that we've brought families into the
    whole rehabilitation issue. The second part is that the length
    of time--I absolutely agree with General Schoomaker--it's not
    the time element, although it can be, but the length of time
    that one takes is not commensurate with the length of time that
    they stay in hospital. It's the length of time that they have
    in that rehabilitative process with their families and in that
    re-engagement in the community and to be a full-up member
    economically, socially, spiritually in each community
    everywhere.
        The Marine Corps and the Navy take a much different view
    than the Army, and we think that we need to get them out of
    that care facility environment and into that rehabilitative
    environment that's more community-based and that is run by the
    line element and their leaders, that in fact have those men and
    women take care of those men and women, and place them back
    into those original slots that they have come from if possible,
    or back into their communities, so that they can learn many of
    the things that you learned at the VA hospital in Michigan.
        So I think that what I see as different is that we're no
    longer hiding people away or putting you in a position where
    you are, I won't say warehoused, but you are at least put away,
    and then you reemerge into your communities and into societies
    wondering if in fact you are going to be fully received back
    into those areas. We've merged those systems now. When you're
    wounded, not only are you off the battlefield quicker, not only
    are you back to a definitive care facility faster because of
    the great work that we do across Army, Navy, Air Force
    medicine, but we also make sure that as you get into the
    definitive care facilities we bring your families and we
    include them from day one in that care. That also extends as we
    transition to the VA to make sure that your family and you also
    have an opportunity to do that.
        So it's a completely different model, but I think it is
    trying to in fact do the same things, and that is to make sure
    that when you go out you are prepared to re-integrate into your
    communities and become productive citizens and reestablish
    yourself for the future.
        One last comment. The only thing that you point out and
    underline dramatically is this: wounds of war which are
    incurred during battle in a time sphere become the
    responsibility of the military health system and Department of
    Veterans Affairs for the lifetime of the member and that
    member's family. That means that the wounds of war of 2006,
    2007, and 2008 will be the responsibility of all of us sitting
    here through the out-years in 2040 and 2050. So we have to
    prepare for that and we have to take care of those individuals.

                              DOD/VA COORDINATION

        Chairman Inouye. Thank you.
        General Roudebush. Sir, you frame both a compelling
    argument and a compelling challenge. To the extent that we are
    meeting that today, I offer two quick observations. One, we do
    not even begin the disability evaluation process until we
    believe the individual has recuperated and recovered to the
    full extent, and there is time involved in that and we are
    willing to invest that time.
        As part of that time involved, the wounds that we're seeing
    are not singular in many cases; they are multiple. An amputee
    probably has some aspects of traumatic brain injury, some
    aspects perhaps of post traumatic stress disorder or PTSD. So
    we have to approach each individual holistically and work those
    issues through.
        Now, as we do that, my two observations: One, we have been
    I believe wonderfully assisted by our centers of excellence.
    Walter Reed has done a magnificent job of really centering the
    care of amputees and the Fisher Foundation in building the
    Center for the Intrepid in San Antonio really begins to get at
    a number of those issues you talked about: How do you function
    within a living environment, an apartment, a house? How do you
    ambulate? How do you interact?
        They have done I think wonderful service to our men and
    women in assisting with that. And our centers of excellence at
    Bethesda in terms of head injuries. As we work through this, it
    really is a joint and collaborative issue.
        But I would leave you with one observation. My wife's
    uncle, a delightful gentleman who now resides in Phoenix, was
    injured when a German 88 blew up in his bridging squad bridging
    a river in World War II. He was never the same after that
    injury in terms of his physical capabilities and had
    significant issues through life.
        But he has been a tremendous force in our family, just as
    you have been a tremendous force in our Nation, perhaps based
    on some of those experiences and perhaps based on perspectives
    coming from a position that is different than others who might
    be walking down the street.
        So I think we need to listen very carefully. We need to
    honor, we need to respect, and we need to support. I think
    Admiral Robinson has it just right. This is our challenge, but
    this is our duty.
        Thank you, sir.
        Chairman Inouye. Gentlemen, I thank you.
        Do you have any questions, Senator?
        Senator Cochran. Mr. Chairman, I have no questions. This
    has been an excellent hearing. I thank you.
        Chairman Inouye. I thank you very much, gentlemen.
        Now the second panel, the important one.
        I'd like to welcome back: Rear Admiral Christine Bruzek-
    Kohler, Director of the Navy Nurse Corps, also Major General
    Patricia Horoho, Chief of the Army Nurse Corps, and Major
    General Kimberly Siniscalchi, Chief of the Air Force Nurse
    Corps.
        There are many things I'd like to say at this point, but
    it's been my pleasure to work with all of you for many years.
    I'd like to extend my congratulations to Admiral Bruzek-Kohler,
    who has been selected to serve as the first Nurse Corps officer
    ever to be in command of Navy Medicine West and Navy Medical
    Center--San Diego, along with her continued role as Corps Chief
    of the Navy Nurse Corps. I look forward to listening to your
    testimony.
        So may I call upon the Admiral first.
    STATEMENT OF REAR ADMIRAL CHRISTINE M. BRUZEK-KOHLER,
                DIRECTOR, NAVY NURSE CORPS, UNITED STATES
                NAVY
        Admiral Bruzek-Kohler. Good morning, Chairman Inouye, Vice
    Chairman Cochran, and distinguished members of the
    subcommittee. As the 21st Director of the Navy Nurse Corps, I
    am honored to offer my testimony to you and your esteemed
    colleagues. My written statement has been submitted for the
    record and today I would like to highlight some of the
    remarkable work being accomplished by Navy nurses.
        The role of Navy nursing is unquestioned in today's Navy.
    We are at the forefront of all operations, and are accepted as
    mission essential within Navy medicine in support of the Navy
    and Marine Corps. Under my leadership, we have developed a
    model of professional military nursing, the essence of nursing
    relevance and practice in the Nurse Corps today. Built upon a
    solid foundation of clinical skills, Navy nursing encompasses
    clinical specialization via advanced education and
    certification, operational readiness, and leadership
    development.
        When combined, these yield clinical nursing leaders and
    future executives for Navy medicine who are business-savvy,
    operationally experienced, and clinically adept. These nurses
    can and will impressively lead our people and organization into
    the future.
        As Navy nurses, we are renowned for our steadfast
    commitment to our patients, and respected for our impressive
    ability to collaborate with a host of other healthcare
    disciplines. We are integral in the provision of superb care to
    America's fighting forces, their families, and the retired
    community.
        While we are a corps of many specialties, I have identified
    eight which are the critical wartime mission essential
    specialties: medical/surgical, psychiatric/mental health,
    critical care, perioperative, emergency/trauma, maternal-child,
    certified registered nurse anesthetists, and nurse
    practitioners. Of all of these, medical surgical nursing is the
    bedrock of our practice. For this reason, it is my expectation
    that all nurses in the Navy Nurse Corps maintain their clinical
    relevance in medical surgical nursing, particularly if they
    function in purely administrative roles.
        Our total Navy nursing workforce is composed of over 5,500
    active, Reserve, and Federal civilian nurses. Our active
    component manning is at 96 percent. For the third consecutive
    year, I am proud to share with you that the Navy Nurse Corps
    has met its active duty direct accession goal and, as we heard
    from my Surgeon General, for the first time in over 5 years
    Navy Nurse Corps gains have outpaced our losses.
        In speaking with Nurse Corps officers, I have found that
    their engagement in local recruiting initiatives from
    elementary schools to colleges, opportunities to provide
    nursing support via disaster relief and humanitarian assistance
    missions, and pursuit of advanced education via our Duty Under
    Instruction Program have all contributed to their decision to
    stay Navy.
        While recruiting to the active component remains robust,
    manning in the Reserves is of concern to me and my Reserve
    component deputy director, Rear Admiral Cynthia Dullea, who is
    here with us today. Despite meeting 107 percent of the
    recruiting goal in 2008, deficits from shortfalls in the 3
    previous years have led to challenges in filling junior officer
    billets. To that end, Reserve component recruiting initiatives
    will be targeted toward these vacancies.
        Last year we saw the release of a new retention initiative,
    the registered nurse incentive specialty pay (RNISP), uniquely
    designed to incentivize military nurses to remain at the
    bedside providing direct patient care. We targeted RNISP
    eligibility toward our critical wartime undermanned specialties
    with inventories of less than 90 percent.
        This year we were able to expand the RNISP to include
    psychiatric/mental health nurses and nurse practitioners,
    women's health nurse practitioners, and certified nurse
    midwives. In the future I look forward to being able to offer
    an incentive such as this to all of my nurses practicing within
    their specialties.
        In addition, targeted recruiting efforts for both active
    and Reserve assets will be focused not only on the acquisition
    of medical/surgical nurses, but also on fortifying high
    operational tempo communities of critical care and
    perioperative nurses and family nurse practitioners.
        Recognizing the efforts of those who diligently serve our
    beneficiaries when Navy nurses deploy, we have recently
    implemented two innovative programs to expand the professional
    development of our valued Federal civilian registered nurses.
    One of these programs offers training in perioperative nursing,
    augmenting a high-deploying critical nursing specialty and
    providing service continuity to patients at our military
    treatment facilities.
        The graduate program for Federal civilian registered nurses
    provides funding for competitively selected candidates to
    pursue their master of science degree in nursing, adding to our
    pool of clinical nurse specialists who help mentor and train
    our junior nurses and hospital corpsmen.
        I remain an ardent supporter of the Tri-Service Nursing
    Research Program (TSNRP), and am duly committed to its
    sustainment. Navy nurses throughout our military treatment
    facilities are engaged in research endeavors that promote not
    only the health and wellness of our servicemembers, but that of
    their families as well.
        Nurses have always been recognized for their expertise in
    disease prevention, health promotion, and patient education.
    The melding of Navy nurses' clinical proficiency in the
    aforementioned areas, and their keen operational focus, ensures
    success in Navy deployments and encounters in rural isolated
    villages with impoverished communities.
        My nurses are agile, adaptable, capable, and ready to
    deploy. The Navy's newest nurses graduating from the Officer
    Development School in Newport, Rhode Island, eagerly inquire
    how soon they might deploy after reporting to their very first
    command. All of my nurses from ensign to captain, because of
    their clinical relevance, have the potential opportunity to
    deploy. Today's deployment environments involve locations in
    harm's way and include practice settings that require the
    application of clinical expertise in a myriad of areas.
        Line-type commanders recognize our nurses' value
    immediately and champion their assumption of key operational
    leadership roles previously held by other professional corps
    and services. Recently returned from deployment as the officer
    in charge of the combined joint task force cooperative medical
    assistance team in Afghanistan, a Navy pediatric nurse
    practitioner offered and I quote ``I would be willing to
    redeploy to an operational setting and endure separation from
    my family and even sacrifice my safety because of the
    overwhelming sense of fulfillment that I received in helping
    empower the women of Afghanistan. Even the smallest changes
    that we made to increase their education, economic stability,
    and improve their health will ultimately make a profound
    difference in their lives and that of their children.''
        A Navy nurse deployed as an individual augmentee assumed
    the role of team leader for an embedded training team in Kabul.
    She served as a mentor to a senior nursing leader of the Afghan
    National Army and was instrumental in the development of a
    variety of educational programs for over 80 military nurses and
    140 health aides. She shared that she and her team empowered
    these nurses to become not only teachers, but leaders, and in
    doing such they became role models to others within their
    organization.
        The maturity, sense of personal fulfillment and confidence
    of having done something that their peers have not done is
    readily identifiable among my nurses returning from these
    unique deployments. From the way they act, talk, and perhaps
    even the swagger in their walk, one can tell that they have
    returned with experiences foreign to many, accomplished goals
    unrealized in the past, and matured in a way years could never
    have provided. Indeed, they are forever changed.
        However, in order to remain resilient we are committed to
    ensuring they have access to all resources via our Care of the
    Caregiver Program and can continue to live in a healthy manner
    as members of our corps.
        Last year we celebrated the 100th anniversary of the Navy
    Nurse Corps. Within the next century we have identified what we
    must do to continue to prepare our nurses to deploy in any
    environment to care for America's heroes. We are not the same
    Nurse Corps of our ancestry. We are moving into assignments and
    uncharted roles that were never held by Navy nurses before.
        For example, within this coming year a Navy nurse will
    become the first nurse assigned to headquarters, Marine Corps.
    Are the marines in for a surprise.
        We are models of interoperability as we function seamlessly
    in missions beside our sister services on land, sea, and air.
    Our skillful integration and translation between services is
    perhaps best exemplified in this last vignette. At the
    conclusion of one of my nurses' briefs in Afghanistan during a
    transfer of authority between incoming and outgoing personnel,
    a colleague turned to her and said: ``While you might not have
    learned a lot of Dari while you were here, you can sure speak
    Army well. Hoo-ah.''

                               PREPARED STATEMENT

        I appreciate the opportunity to share some of these
    accomplishments of my wonderful nurses and I look forward to
    continuing our work together as I lead Navy nursing. Thank you.
        Chairman Inouye. Thank you very much, Admiral.
        [The statement follows:]
         Prepared Statement of Rear Admiral Christine M. Bruzek-Kohler
                                opening remarks
        Good Morning, Chairman Inouye, Senator Cochran and distinguished
    members of the subcommittee, I am Rear Admiral Christine Bruzek-Kohler,
    the 21st Director of the Navy Nurse Corps. Nursing relevance and
    practice is the Navy Nurse Corps of today. Navy nurses are inculcated
    into our organization based on the development of a solid clinical
    skills foundation. It is my expectation that all nurses in the Navy
    Nurse Corps maintain clinical relevance from the day they are
    commissioned until the day they retire.
        Today I will highlight the accomplishments of a total Navy Nurse
    Corps force composed of over 5,500 active, reserve and federal civilian
    nurses who play an invaluable role in Navy Medicine as clinicians,
    mentors, teachers, and leaders. We are renowned for our steadfast
    commitment to our patients and respected for our impressive ability to
    collaborate with other healthcare disciplines in the provision of
    superb care to America's fighting forces, their families and the
    retired community.
             clinical excellence/readiness and clinical proficiency
        My goal is to establish a culture of clinical excellence for all
    nurses in all missions and support a consistent, interoperable standard
    of nursing practice throughout Navy Medicine, one that easily
    transitions to interoperability as we work more and more
    collaboratively with our sister services. We assessed the current state
    of clinical proficiency in various nursing specialties and developed
    and delivered standardized nursing core competencies. These
    competencies transition to all nursing practices throughout Navy
    Medicine ensuring clinical proficiency. Competencies in the nursing
    fields of medical/surgical, emergency/trauma, psychiatric/mental health
    and critical care have been deployed throughout Navy Medicine for
    almost a year. We are currently developing competencies in the
    following practice areas: neonatal intensive care, maternal infant,
    pediatrics, perioperative, multi-service ward, operational nursing,
    case management, and immunizations.
                                    training
        Today's Navy nurses face unprecedented challenges in caring for
    America's returning wounded warriors. They are confronted with injury
    and wound complexities that they have never seen or treated before.
    From the moment the service members reach our medical facilities until
    the day they are discharged home with their families, Navy nurses have
    served as a galvanizing force among a cadre of healthcare professionals
    in helping the wounded, ill and injured successfully transition to a
    life post combat.
        Navy nursing is spearheading the development and implementation of
    the Combat Wound Initiative, composed of two programs: Complex Wound
    and Limb Salvage Clinic (CWLSC); and, Integrated Wound Care Programs at
    Walter Reed Army Medical Center (WRAMC) and National Naval Medical
    Center (NNMC). Over the past year, there were approximately 2,000
    patient encounters between the two programs. The CWLSC is an advanced,
    multi-disciplinary wound care center which uses state-of-the-art
    assessment, testing, and evidence-based treatment for the care of
    complex wounds in the combat wounded and DOD beneficiary. The CWLSC, a
    portion of the Combat Wound Initiative, integrates targeted clinical
    and translational research incorporating advanced technology and
    treatment, informatics, and tissue banking.
        At NNMC, a Navy nurse serves as the Medical Evacuation (MEDEVAC)
    team leader and expertly orchestrates staffing and equipment decisions
    which were essential to the safe transportation of over 220 patients on
    100 inbound MEDEVAC missions from Andrews Air Force Base to NNMC over
    the course of the past year.
        Our nurse at Fleet Forces Command facilitates a quarterly Tidewater
    Medical Coordination Council consisting of Type Commander (TYCOM)
    Medical Leadership and the local Military Treatment Facility's (MTF)
    executive officer, clinic directors, officers-in-charge, and
    Operational Forces Medical Liaison Services. The purpose of these
    meetings is to bring both sides together to ensure fleet Sailors are
    receiving the care they need in a timely manner and to address any
    concerns from the MTF perspective.
        Navy nursing leaders partnered with the Navy Chaplain Corps to
    develop and implement the Combat and Operational Stress Control
    Training for Caregivers course to provide state of the art knowledge to
    a full range of caregivers in the recognition of deployment related
    reactions, planning of effective interventions, enhancing caregiver
    collaboration, and facilitating the use of mental health services for
    individual service members and military families. Phase one of this
    training included over 1,500 participants. This year's training is
    designed specifically to address the deployment experiences of families
    and is being offered to over 3,000 caregivers at 19 sites worldwide.
      joint training and mutual support with other uniformed services and
                                   countries
        In highlighting perhaps some of the most publicly recognized joint
    initiatives in which Navy nurses have participated, one must include:
    the Federal Health-Care Center in North Chicago, the merger of two
    highly acclaimed Army and Navy medical centers into the Walter Reed
    National Military Medical Center in the national capital area, and
    missions aboard the USNS MERCY (T-AH 19) and USS KEARSARGE (LHD 3) and
    BOXER (LHD 4).
        Navy nurses from the Naval Health Clinic Great Lakes diligently
    work on both local and national level committees with their colleagues
    from the North Chicago VA Medical Center (NCVAMC) in preparation for
    the merger of the two facilities to become the first Federal Health-
    Care Center in 2010.
        Collaborating with medical department members from all three armed
    services and other partners, the Navy nurses at Joint Task Force
    National Capital Region Medical (JTF CAPMED) are actively developing
    the master transition plan to close Walter Reed Army Medical Center,
    develop the first integrated regional military medical command and
    expand the National Naval Medical Center into the ``world-class''
    Walter Reed National Military Medical Center.
        The nurses at NNMC and WRAMC held two nursing integration kick-off
    meetings in 2008 to network with their counterparts and strategize
    plans of actions for the new Walter Reed National Military Medical
    Center-Bethesda (WRNMMC). These meetings were well attended and the
    nurses are committed to ensuring the success of this venture.
        USNS MERCY (T-AH 19) departed San Diego, California in May 2008
    with a 1,000-person joint, multi-national, Military Sealift Command
    Civilian Mariner, U.S. Public Health Service and non-governmental
    organization (NGO) team to conduct Pacific Partnership 2008 (PP08). The
    core nursing team consisted of 40 Navy and five Air Force Nurse Corps
    Officers. Additional nursing augmentation was provided by 84 colleagues
    from the Navy Reserves. Supplemental support was available via military
    nurses from partner nations Australia, Canada, Indonesia, New Zealand,
    and the Republic of the Philippines, as well as NGO nurses from
    International Relief Teams, Project HOPE and Operation Smile.
        USNS MERCY's Casualty Receiving (CASREC) nursing team processed
    over 1,900 patients, of which more than 1,500 were admitted. A total of
    1,369 shipboard surgeries were performed, with Navy nurses involved in
    every phase of the operative process. During Pacific Partnership 08
    (PP08), the ship's reduced operating status (ROS) perioperative nurse
    was selected as Medical Advance Team Leader in Chuuk, Federated States
    of Micronesia (FSM). In this role, he identified prime locations and
    established logistical support for medical clinics ashore, facilitating
    the treatment of 12,000 patients in 8 days. In addition, he worked with
    local and U.S. public health and government officials to contain a
    deadly outbreak of multi-drug resistant tuberculosis. He coordinated
    efforts between the FSM President's Office, Chuuk Governor's Office,
    U.S. Ambassador, and Centers for Disease Control, ensuring that 100
    percent of suspected cases were contacted, screened and prescribed
    appropriate treatment.
        Navy nurses also served aboard both USS KEARSARGE (LHD 3) and USS
    BOXER (LHD 4) as they delivered relief services and provided medical
    care to over 71,000 patients from eight Latin American and Caribbean
    nations during Operation Continuing Promise.
     collaboration with civilian medical institutions/communities/outreach
        We will soon mark the 1 year anniversary of the merger of the Navy
    Nurse Corps Anesthesia Program with the Uniformed Services University
    (USU) Graduate School of Nursing anesthesia program. The inaugural
    class of this federal nurse anesthesia program will graduate in 2010.
        At the Expeditionary Medical Facility, Camp Lemonier, Djibouti
    City, Djibouti, Africa, our nurses are members of a small surgical team
    who provide teaching assistance in areas such as laparoscopic surgery,
    regional anesthesia, and sterilization at Africa Peltier General
    Hospital, Djibouti via a request the hospital made to the U.S. Embassy
    and the United States Agency for International Development. While the
    surgeons focus on teaching laparoscopic techniques, the nurses foster
    collegial relationships and offer classes on improved sterilization
    techniques, laparoscopic equipment care and use, epidural catheter
    placement for surgery and pain control, and caudal anesthesia in
    pediatrics.
        In collaboration with a Chief Naval Operations (CNO) working group,
    Bureau of Navy Medicine and Surgery (BUMED) and Navy Medicine East
    (NME), a plan has been approved to redesign a building into a 28 bed
    long term care facility to house aging Special Category Residents
    (formerly Cuban Exiles) who receive assisted living or total nursing
    care on the wards of the Naval Hospital Guantanamo Bay, Cuba. At times,
    these patients can absorb 50 percent of the naval hospital bed
    capacity. Navy nurses are working with civilian facilities in the
    Portsmouth, VA area to obtain requisite training as they move forward
    with this one of a kind Navy facility. Staffing will consist of a
    combination of military, civilian and foreign national home health
    aides.
        Senior nursing leaders from Naval Hospital Camp Lejeune join their
    civilian peers from Onslow County, North Carolina in monthly meetings
    as partners in the East Carolina Center for Nursing Leadership Robert
    Wood Johnson Grant for ``Partners for Rural Nursing.'' The grant's
    objective is to mobilize rural nurse leaders' ability to partner,
    evaluate, and develop interventions to solve local nursing workforce
    issues and create healthier communities in eastern North Carolina. The
    long-term goal of this project is the creation of a permanent county
    nurse association that will recruit more nurses to the county and
    increase the overall educational level of the nurses and educators.
                        deployments/operational missions
        Coinciding with the advancement of their professional practice is
    the simultaneous development of our nurses as naval officers who are
    operationally ready to meet any call to deploy in any mission at a
    moment's notice. As such, the Navy Nurse Corps continues to be a
    mission critical asset in supporting Navy Medicine deployments.
        From January 2008 to January 2009, 441 Navy nurses have deployed--
    Active (257) and Reserve (184). They served admirably in operational
    roles in Kuwait, Iraq, Djibouti, Afghanistan, Bahrain, Qatar,
    Indonesia, Thailand, Southeast Asia, Pakistan, Guantanamo Bay, Cuba,
    Germany, and aboard both hospital ships, USNS MERCY and USNS COMFORT,
    and on grey-hulls such as USS KEARSARGE and USS BOXER. They are part of
    Provincial Reconstruction Teams (PRTs), Expeditionary Medical
    Facilities (EMFs) and Flight Surgery Teams. They participate in the Sea
    Trial of the Expeditionary Resuscitative Surgery System (ERSS) and
    perform patient movement via Enroute Care at or near combat operations.
        Nurses in our Reserve Component (RC) have made significant
    contributions to operational missions over the past year with Medical
    Readiness Training Exercises (MEDRETE) in Peru, Suriname, Honduras, and
    Trinidad and Tobago. Additionally, there are currently 101 RC nurses
    mobilized to Landsthul Regional Medical Center, Germany.
        In Afghanistan, Navy Nurse Corps officers have assumed the role of
    Officer in Charge (OIC) of the Combined Joint Task Force-101/82 joint
    Cooperative Medical Assistance (CMA) team. Previously held by Army
    Medical Officers, this position was most recently held by a senior Navy
    Nurse Corps officer who was also a pediatric nurse practitioner. The
    mission of the Cooperative Medical Assistance (CMA) team is to plan,
    coordinate and execute medical and veterinarian humanitarian civil-
    military operations across the combined joint operations area of
    Afghanistan. Under Navy Nurse Corps leadership, the CMA team has
    mentored and taught over 250 Afghanistan physicians, midwives, and
    nurses in the past year. Additionally, the CMA team provided direct
    medical and veterinarian care in over 200 rural villages in hostile
    areas along the Pakistan border and in Southern Afghanistan. In an
    effort to fight the overwhelming infant and childhood mortality rates
    in Afghanistan, the first Navy Nurse OIC of the CMA team authored a
    U.S. CENTCOM's Humanitarian Assistance, Disaster Recovery and Mine
    Resistance grant to fund three projects in Regional Command--East,
    Afghanistan. Currently in the execution phase, this $50,000 grant will
    provide medical intellectual capacity building to Afghan healthcare
    providers in some of the most remote, hostile and rural areas of
    Afghanistan; directly impacting the lives of Afghan infants and
    children.
        We continue to monitor our deploying specialties within the Navy
    Nurse Corps. While earlier deployments were more aligned with our
    critical wartime specialties of certified registered nurse
    anesthetists, advanced practice nurses, psychiatric/mental health,
    medical/surgical, critical care, perioperative and emergency/trauma
    nurses; we have noted the communities of pediatrics and women's health
    are also being engaged for roles on Provincial Reconstruction Team and
    Humanitarian Assistance missions.
                             care of the caregiver
        Navy Medicine leaders have recognized that operational and
    occupational demands impact the quality of patient care and caregiver
    quality of life. Consequences of untreated cumulative stress can result
    in medical errors, physical illness, decreased job satisfaction, and
    emotional difficulties. The Navy Medicine Caregiver Occupational Stress
    Control (OSC) Program, sometimes called Care for the Caregiver, has
    three fundamental principles; early recognition, peer intervention, and
    connection with services as needed. There are many strategies and
    resources that are being developed to assist Navy Medicine caregivers
    with the operational, occupational, and compassion demands of the care
    we provide to Sailors, Marines, and their families. One of the main
    strategies for addressing the psychological health needs of our
    caregivers is to develop occupational stress training and intervention
    teams for our major treatment centers.
            the warfighter, their families and the continuum of care
        Navy nursing encompasses the care of warriors and their families in
    countless interactions in locations at home and abroad.
                                 the warfighter
        A Nurse Corps officer at Naval Medical Clinic Patuxent River plays
    an invaluable role in their local ongoing Individual Augmentee (IA)
    pre-deployment program by ensuring that all medical records are pre-
    screened as soon as the active duty member receives IA orders. This
    early screening affords sufficient time to explore potential deployment
    medical disqualifiers and provides the squadron's time to identify an
    alternate in the event the augmentee is deemed non-deployable.
        The Department head of the Occupational Health Clinic at Naval
    Hospital Camp Lejeune, a civilian nurse, along with the local military
    audiologist, identified that a significant number of 17-27 year old
    active duty members were being fitted bilaterally for hearing aids
    after returning from war. This led to the inception of a new initiative
    called ``Warriors Silent Wound'' hearing conservation program
    addressing readiness, education and hearing protection for the Camp
    Lejuene based Marines.
        The Medical Rehabilitation Platoon (MRP) Case Manager position at
    Camp Geiger, Branch Medical Clinic, Naval Hospital Camp Lejeune is held
    by a Nurse Corps officer who coordinates the care for over 80 Marines,
    ensuring that every patient in MRP receives accurate and timely
    healthcare reducing the time spent in MRP and increasing the amount of
    Marines returning to training and eventually to the Fleet Marine Force.
        A Navy Nurse Corps officer currently runs a Warrior Return Unit at
    Expeditionary Medical Facility Kuwait for injured/ill warfighters.
    Located on Camp Arifjan and initiated in 2005, its mission is to
    maximize the quality of life for coalition forces during the period of
    convalescence, expediting return to duty or transfer to definitive
    care. The Warrior Return Unit (WRU or ``Roo'') is a three-building
    complex, 136 bed capacity, dedicated solely for the purpose of
    providing a place for service members to live, relax, and heal from
    their illnesses, injuries, or surgical procedures and, ideally, return
    to duty. The WRU also provides an entertainment lounge, DSN lines for
    business or morale calls, gaming stations, and internet access, as well
    as 24 hour staffing, with a nurse on site and dedicated transportation
    to and from the hospital. Approximately 80 percent of all wounded
    warriors do indeed return to duty from the WRU and almost three-
    quarters of them return directly back to Iraq. Those who cannot return
    to duty are medically evacuated to Landsthul Regional Medical Center or
    back to Military Treatment Facilities in the continental United States
    (INCONUS).
        At NNMC, the Casualty Affairs Office consists of a Navy nurse and a
    Hospital Corpsman. They meet with every combat casualty and their
    family in order to insure all of their needs are met; allowing them to
    focus solely on the healing process. The Casualty Affair Office employs
    the ethos ``their feet never hit the ground''; referring to the fact
    that no request goes unnoticed for the 110 patients and families they
    have met in the past year.
       growing mental health requirements/psychiatric and mental health
                                    nursing
        The Navy Nurse Corps has met the Surgeon General's guidance for
    psychiatric/mental health nurse practitioners (PMHNPs). We have
    programmed 18 PMHNPs through the Future Years Defense Plan (FYDP) to
    meet currently projected growth of the Marine Corps, Blue in Support of
    Green (BISOG) and the development of the Operational Stress Control and
    Readiness (OSCAR) teams.
        Our psychiatric nursing leaders are critical members of the
    multidisciplinary team writing the maritime doctrine for combat and
    operational stress control for the U.S. Marine Corps and U.S. Navy. A
    Nurse Corps officer has been appointed as the first Coordinator for the
    Line owned and led Navy Operational Stress Control (OSC) program.
    Secretary of the Navy and the Chief of Naval Operations have directed a
    Navy stress control program to specifically (1) define doctrine and
    organization; (2) address mental health stigma; (3) define curricula,
    develop training and exercise requirements for pre-deployment and post-
    deployment of all personnel; and (4) build resilient Sailors and
    families. Operational Stress Control is leader-focused actions and
    responsibilities to promote resilience and psychological health in
    Sailors, commands, and families exposed to the stress of routine or
    wartime military operations in all environments, whether at sea, in the
    air, or on the ground, and in both operational and supporting roles.
    The goals of OSC are to create an environment where Sailors, commands,
    and families can thrive in the midst of stressful operations.
        EMF Kuwait mental health nurses are providing outreach training for
    more than 200 personnel at various units on anger/stress management and
    improving communication skills. One Navy mental health nurse
    practitioner from EMF Kuwait forward deployed for a 3 week period into
    Iraq, backfilling a transitioning Army psychiatrist billet providing
    mental health services throughout Iraq.
        A newly hired civilian mental health nurse practitioner at Naval
    Medical Clinic Quantico's Deployment Health Center assumes the
    continuation of care for patients who require more than eight
    encounters at the center, providing continuity of care and bolstering
    patient/provider rapport.
        The newly opened Post Deployment Health Center in Groton, CT, part
    of the DOD initiative to respond to mental health needs of returning
    veterans, provides individual and group counseling services to active-
    duty members from all branches of the military from throughout the
    Northeast. Prior to the opening of this clinic, patients would have had
    to travel as far as Bethesda, MD for this same type of care milieu.
        The first active duty PMHNP assigned to the Deployment Health
    Center at Naval Hospital Twentynine Palms, closely follows 80 of the
    clinic's 225 active cases.
        She provides initial psychological evaluations, medication
    screenings, and shares valuable information with colleagues, general
    medical providers, and commands on recommendations about service
    members' fitness for deployments. She also serves as the clinic
    spokesperson and is closely involved with the family advocacy program
    and substance abuse counseling center, ensuring that information is
    provided to dependents as well as the active duty member. This PMHNP
    candidly offers that this has been her ``most fulfilling job in the
    Navy''.
                                   the family
        Last year, several Outside Continental United States (OCONUS) and
    geographically remote Continental United States (CONUS) military
    treatment facilities (MTFs) received fourteen junior Nurse Corps
    officers who attended our new 4 week Perinatal Pipeline training
    program at Naval Medical Center San Diego, Naval Medical Center
    Portsmouth, and National Naval Medical Center. The program was designed
    to train medical-surgical nurses who expect to work in labor and
    delivery or the newborn nursery at OCONUS or geographically isolated
    facilities. This program has increased the nurses' knowledge,
    confidence, and subsequently the quality of care and patient safety for
    these commands. Along this same theme, Naval Hospital Okinawa hosted
    the Western Pacific Perinatal Orientation Education Program/Neonatal
    Orientation Education Program (PEOP/NEOP) training for 40 staff from
    Okinawa, Yokosuka and Guam; yielding over $160,000 in training cost
    savings to the aforementioned facilities.
        At Naval Medical Center Portsmouth, a pediatric nurse practitioner
    with a passion for early detection and prevention of child abuse
    identified an opportunity to improve communication between her facility
    and outside protective services. With the help of the hospital's web
    designer, and 2 years of diligent dedication, she created an online
    algorithm and reporting system nicknamed C.A.N.A.R.E.E.S., which stands
    for Consolidated Abuse, Neglect, Assault, Reporting Electronic Entry
    System. This program, presently piloted in the facility's Emergency
    Department, links to the Composite Health Care System and provides
    consolidation of all demographic data and patient encounter information
    into required report formats. This new reporting mechanism alleviates
    illegible handwriting and streamlines reporting agency notifications.
    It also serves as a data repository that may be used in quality
    assurance and statistical analysis to target training or educational
    offerings as indicated by set thresholds.
                       the wounded warrior care continuum
        Wounded Warrior Case Management is quite different now than it was
    2 years ago. Many of the more severely injured are cared for at one of
    Navy's large medical centers or at one of four VA Polytrauma centers
    closest to the service members' homes.
        The Wounded Warrior Berthing, also known as the ``Patriot Inn,'' at
    Naval Medical Center Portsmouth continues to provide temporary lodging,
    monitoring, and close proximity to necessary recovery resources for
    active duty ambulatory patients in varying stages of their health
    continuum.
        At Naval Hospital Camp Pendleton, active duty Nurse Corps officers
    work directly with the Wounded Warrior Battalion to manage the wounded
    warrior cases, providing a comprehensive plan of care throughout the
    healthcare system. The patients assigned to this battalion are
    primarily ambulatory patients who are receiving continuing care for
    orthopedic or mental health issues.
        The Naval Medical Center San Diego's (NMCSD) Comprehensive Combat
    and Complex Casualty Care (C\5\) Program (recipient of the 2008
    Military Health System Healing Environment Award) recently expanded its
    Primary Care division to include two government service nurse
    practitioners (one former Army veteran), one physician assistant, two
    civilian health technicians (one former Independent Duty Corpsman) and
    two Hospital Corpsmen. This group provides continuity in medical
    management of these service members; ensuring primary health care needs
    are addressed during their rehabilitation. Recently, the C\5\ lead
    nurse case manager received the prestigious San Diego Regional Chamber
    of Commerce Military Honoree Award for 2008.
        NMCSD is also home to an Army Warrior Transition Unit (WTU), the
    only one of its kind in a non-Army treatment facility. This staff is
    comprised of a provider, nurse case managers, licensed clinical social
    worker and administrative support staff who oversee the medical and
    non-medical case management of soldiers transferred here for
    rehabilitation services.
                               graduate education
        Continuation of a Navy nurse's professional development via
    advanced educational preparation, specialization, and pursuit of
    national certification is necessary to better serve our beneficiary
    population, as well as strengthen their respective communities of
    practice and prepare the officer for promotion. Our training plan this
    year included the opportunity for 70 officers to seek advanced degrees.
    We focused on fortifying our critical wartime inventories of certified
    registered nurse anesthetist, psychiatric/mental health clinical nurse
    specialist and nurse practitioner, and critical care and medical/
    surgical nursing.
                                nursing research
        I remain an ardent supporter of the Tri-Service Nursing Research
    Program (TSNRP) and am duly committed to its sustainment. Navy nurses
    assigned throughout our MTFs are engaged in research endeavors that
    promote not only the health and wellness of our warriors, but that of
    their families too. My senior nurse executives have identified creative
    ways to pique junior officer's interest in research activities.
        At Naval Hospital Oak Harbor, a Navy nurse has a research study
    entitled, ``Breastfeeding Rates among Active Duty Military Women across
    the First Year Postpartum'' with Independence University. A novice
    researcher, she is being mentored in her first endeavor by the Senior
    Nurse Executive at her command and a nurse researcher assigned to Naval
    Medical Center San Diego.
        The Senior Nurse Executive at NMCSD has implemented the Senior
    Nurse Executive Nursing Fellowship Awards. This competitive award
    recognizes two junior nurses/Clinical Nurse Specialist (CNS)/Nurse
    Researcher team dyads and provides them the resources and man-hours to
    conduct a year long research proposal. Both junior nurse/CNS dyads
    attend research methods or evidence based nursing courses to assist
    them in the development and implementation of their studies. The
    results have been quite impressive.
        One dyad completed a pilot study to determine whether an
    educational intervention could be designed to reduce Compassion Fatigue
    in the healthcare providers caring for C\5\ (Comprehensive Combat and
    Complex Casualty Care) patients. The findings demonstrated that the
    study participants' scores in compassion satisfaction increased and
    burnout scores decreased after viewing the Compassion Fatigue
    intervention. The dyad presented a poster at the Karen Rieder Federal
    Nursing Poster Presentation titled Compassion Fatigue in C\5\ Staff
    Caring for Wounded Warriors. A study-designed educational intervention
    was developed from this study and was implemented to 43 staff caring
    for Wounded Warriors, awarding 172 contact hours.
        The second dyad was awarded the Research Award for Best Evidence
    Based Practice from the Zeta Mu Chapter of the Sigma Theta Tau
    organization. The proposed project was titled ``Implementation of An
    Open Crib Phototherapy Policy: Adaptation of an Evidence Based
    Guideline Project''. The dyad's work has resulted in the local
    implementation of the guideline to include standardizing physician
    order sets and staff education. One member of the dyad has been invited
    as a presenter to the annual National Association of Neonatal Nurses
    (NANN) Research Summit.
                            educational partnerships
        Navy nurses, at our hospitals in the United States and abroad,
    passionately support the professional development of America's future
    nursing workforce by serving as preceptors and mentors for a myriad of
    colleges and universities.
        Because of the vast array of clinical specialties available at our
    medical centers at Bethesda, Portsmouth and San Diego, they have
    multiple Memoranda of Understandings (MOUs) with surrounding colleges
    and universities to provide clinical rotations for nurses in various
    programs from licensed practical/vocational nursing, baccalaureate, and
    graduate degrees which include nurse practitioner and certified nurse
    anesthetist tracks.
        Not to be outdone, nurses at our smaller facilities such as Naval
    Hospital Twentynine Palms, Beaufort, Bremerton, Charleston, Cherry
    Point, and Guam coordinate training opportunities with local hospitals
    in resuscitative medicine, medical/surgical and obstetrical nursing and
    serves as clinical rotation sites for local colleges.
        During Pacific Partnership 2008, Navy nurses from USNS Mercy (T-AH
    19) served as subject matter experts to nurses in five host nation
    hospitals on topics such as basic and advanced life support, critical
    care and pediatric nursing, isolation techniques, and blood transfusion
    therapy. In total, at least 200 hours of classroom instruction were
    presented to over 1,000 students.
        Navy nurses deployed to the Expeditionary Medical Facility, Camp
    Lemonier, Djibouti City, Djibouti, collaborated with the Djibouti
    School of Nursing to review nursing fundamentals and discuss nursing
    issues important to Djibouti nurses as part of an English language
    skills enhancement class.
                              nursing publications
        Navy nurses are accomplished authors whose works encompass all
    specialty areas of nursing and have appeared in nationally recognized
    publications as follows: Advances in Neonatal Care, AORN Journal,
    Critical Care Nursing Clinics of North America, Journal of Advanced
    Nursing, Journal of Forensic Nursing, Journal of Pediatric Healthcare,
    Journal of Psychosocial Nursing, Journal of Trauma Nursing, Nursing
    Administration Quarterly, Military Medicine and Viewpoint.
                            productivity initiatives
        At Naval Hospital Lemoore, Nurse Corps officers in the Primary Care
    Clinics spearhead various clinical functions such as telephone triage,
    dysuria protocol, and newborn infant well-baby visits saving
    approximately 80 appointments per month for higher level providers and
    yielding improved access to care for patients.
        A Navy nurse midwife who serves as both the Director of Health
    Services and the Department Head of Obstetrics and Gynecology at Naval
    Hospital Charleston was also the second highest provider in patient
    care encounters compared to peers who practice at the same facility.
        A women's health nurse practitioner at Naval Hospital Beaufort is
    solely responsible for the women's health visits of 4,000 female
    recruits. Other nurse-run clinics at this facility medically in-
    processed 22,234 Marine recruits and administered over 154,000
    immunizations.
                    force shaping/recruitment and retention
    Recruitment
        Today's Navy Nurse Corps (AC) is 95.7 percent manned with 2,780
    nurses serving around the globe. We expect to make Navy Nursing's
    recruiting goal for 2009 within the next few months and this will be
    the third year in a row that we have achieved this important milestone.
    Our recruiting efforts this year have outpaced those of 1 year ago. Our
    nurses' diligent work and engagement with local recruiting initiatives
    have certainly contributed to these positive results.
        The top three programs that we should credit to this accomplishment
    include the increases in Nurse Accession Bonus (NAB) now at $20,000 for
    a 3 year commitment and $30,000 for a 4 year commitment; the Health
    Professions Loan Repayment Program (HPLRP) amounts up to $40,000 for a
    2 year consecutive obligated service and the Nurse Candidate Program
    (NCP), offered only at non-Reserve Officer Training Corps (ROTC)
    Colleges and Universities, which is tailored for students who need
    financial assistance while in school. NCP students receive a $10,000
    sign on bonus and $1,000 monthly stipend. Other factors contributing to
    our recruiting success include the location of our duty stations and
    the opportunity to participate in humanitarian missions.
        Last year we created a Recruiting and Retention cell at the Bureau
    of Medicine and Surgery (BUMED) with a representative identified from
    each professional corps. These officers serve as liaisons between Navy
    Recruiting Command (NRC), Naval Recruiting Districts (NRD), Recruiters
    and the MTFs and travel to and or provide corps/demographic specific
    personnel to attend local/national nursing conferences, or collegiate
    recruiting events. In collaboration with the Office of Diversity, our
    Nurse Corps recruitment liaison officer coordinates with MTFs to have
    ethnically diverse Navy personnel attend national conferences and
    recruiting events targeting ethnic minorities. This has allowed us to
    broaden our reach and recruit at national nursing conferences that we
    never before attended.
        The Nurse Corps Recruitment liaison officer works with a speaker's
    bureau comprised of junior and mid-grade Nurse Corps officers
    throughout the country who reach out to students at colleges, high
    schools, middle and elementary schools. We recognize that the youth of
    America are contemplating career choices at a much younger age than
    ever before. Over the course of the past year, we have tailored more of
    our recruiting initiatives to engage this younger population. Our
    nurses realize that each time they speak of the Navy Nurse Corps they
    serve as an ambassador for our corps and the nursing profession too.
        Since returning from Pacific Partnership 08, USNS MERCY (T-AH 19)
    has collaborated with the Navy Recruiting Region WEST Medical Programs
    Officer to host two recruiting tours. In total, 40 potential Navy
    Medicine candidates visited the ship. Both the USNS MERCY and USNS
    COMFORT are invaluable tools in the Nurse Corps recruiting arsenal.
    Shipboard tours are frequently requested by faculty and students alike.
        Naval Hospital Camp Lejeune, in conjunction with Navy Recruiting
    District Raleigh, NC, has initiated a joint effort to recruit Nurse
    Corps officers from the Eastern North Carolina area. In supporting the
    Nurse Corps recruiting and retention initiatives, Naval Hospital Camp
    Lejeune has created the Nurse Recruiting and Retention team. The team,
    co-chaired by two senior Nurse Corps officers works closely with the
    medical department recruiter to coordinate visits to area universities
    to speak with students regarding benefits of joining the Navy Nurse
    Corps. The team members also provide real life testimony to the
    students and provide insight into the personal experiences of team
    members. The team also serves as points of contact for interested
    students and is available to entertain questions or concerns via email
    or telephone. This mentoring provides yet another example of why the
    Navy Nurse Corps is so attractive to the students. The team encourages
    and sponsors visits to the Naval Hospital and gives them the
    opportunity to see Navy nurses, civilian nurses and hospital corpsmen
    working together to provide world class care. The team also supports
    the Recruiting District by coordinating and conducting the personal
    interviews required as a portion of the Nurse Corps application
    process. Since its inception in September 2008, this effort has led to
    25 potential Navy Nurse Corps officers accessioned into the recruiting
    pipeline for NRD Raleigh, North Carolina.
        A senior Nurse Corps officer at Fleet Forces Command serves as a
    liaison between the fleet shore-based Sailors and the MTF. She and
    other officers around the world have become mentors to the Medical
    Enlisted Commissioning Program (MECP) applicants. The MECP program is a
    robust enlisted commissioning track that selects and educates 55
    Sailors and Marines to become Navy nurses each year.
        Last year the Navy Nurse Corps reserve component (RC) met 107
    percent of their recruiting goal. Over 56 percent of the goal was
    comprised of NAVETS (nurses coming to the RC from active duty) and the
    remainder were direct accessions to the Navy Reserve. Success in
    recruiting NAVETS is related to the initiation of an affiliation bonus
    of $10,000 and the policy that guarantees NAVETS coming into the RC
    will be granted a 2 year deferral from deployment. Recruiting
    initiatives targeting direct accessions offer entry grade credit for
    advanced education and work experience among the critical wartime
    specialties of psychiatric/mental health, emergency room, and
    perioperative nursing. The RC recruiting shortfall in fiscal year 2005,
    2006, and 2007, coupled with the national nursing shortage and
    increased competition with both the civilian and federal employment
    healthcare sectors, had a detrimental impact on filling RC Nurse Corps
    billets with junior officers.
        Today, the Reserve Component is 1,189 nurses strong and manned at
    89.1 percent. The last 4 years of missed reserve nurse recruiting goal
    has impacted critical wartime specialties in nurse anesthesia (59
    percent), perioperative (73 percent), and critical care nursing (80
    percent) and subsequently contributed to their 145 unfilled billets.
    Retention
        Recruiting is just one-half of the story for Navy nursing.
    Retention tells the other important half. Last year was the first time
    in the past 5 years that the Navy Nurse Corps' losses nearly matched
    our gains. In talking to Nurse Corps officers around the globe, I have
    found that we are implementing creative mentoring and leadership
    programs designed to get the information to the officers before they
    make a career decision to leave the Navy.
        Naval Hospital Bremerton's senior Nurse Corps officers conduct
    quarterly Career Development Boards for officers at various decision
    points in their career (first tour, promotion eligible, considering
    Duty under Instruction, considering release from active duty). Nurse
    Corps officers also participate with medical programs recruiters in
    Seattle and Denver to provide tours, interview candidates, answer
    questions, join them for local college career days and attend
    conferences.
        Naval Medical Center San Diego established a Nursing Retention and
    Recruitment Committee. There was an exceptional response to the request
    for volunteers. Members of the committee include a wide cross-section
    of nurses throughout the command, to include active duty (all ranks),
    government service, contract, reservists and recruiters. The committee
    meets monthly and reports to the Senior Nurse Executive.
        The Registered Nurse Incentive Special Pay (RNISP) program was a
    new retention initiative begun in February 2008 and included critical
    care and perioperative nursing, pediatric nurse practitioners, and
    family nurse practitioners. We have noted improvements in overall
    manning percentages for the aforementioned nursing communities. The
    RNISP program is designed to encourage military nurses to continue
    their education, acquire national specialty certification and remain at
    the bedside providing direct care to wounded Sailors, Marines,
    Soldiers, Airmen and Coastguardsmen. This year the RNISP program was
    expanded to include four additional communities: psychiatric/mental
    health nurses, psychiatric/mental health nurse practitioners, women's
    health nurse practitioners, and certified nurse midwives. Certified
    Registered Nurse Anesthetists (CRNAs) have been long standing
    recipients of the ISP, and they are currently manned at 99 percent.
        Continuing deployment cycles and Individual Augmentee roles
    continue to pose a challenge to retaining nurses in our service, yet
    our fiscal year 2008 Nurse Corps continuation rate after 5 years is 68
    percent, up slightly from last year. We continue to work issues to
    retain mid-grade officers at the 4 to 9 year point of commissioned
    service.
        The Operational Stress Control program has an indirect impact on
    the shape of the force, military retention, and Navy nurses. By
    developing and providing education and training opportunities
    throughout the career of the nurse, ``from Accessions through Flag
    Officer'', OSC will build resilience and increase effective responses
    to stress and stress-related injuries and illnesses. The art of nursing
    service members and their families through illness to wellness is
    frequently stressful. Strengthening the resilience of Navy nurses will
    assure they are better equipped to meet the day-to-day challenges of
    both naval service and their profession.
        Our total Navy nursing workforce, active and reserve components
    plus federal civilian registered nurses, is over 5,500 strong.
    Recognizing the invaluable contribution that our civilian nursing
    workforce provides in regards to continuity of care and access to
    services for our patients, especially during our deployments, we have
    established two new education programs exclusively for them.
        The Perioperative Nurse Training Program is a competitive program
    in which federal civilian registered nurses may apply to attend the
    fully funded 12 week Navy perioperative nurse training program. Upon
    completion of the training, the federal civilian nurse incurs a 1 year
    continued service agreement and works in the perioperative setting.
        The Graduate Program for Federal Civilian Registered Nurses
    provides funding for competitively selected federal civilian registered
    nurses to pursue their Master of Science in Nursing. Selected
    candidates agree to work a compressed work schedule during the time
    they are in graduate school and incur a 2 year continued service
    agreement. Our hope is that these new programs will not only serve to
    retain our current civilian nurses but also entice new nurses to
    consider entry into federal service with Navy Medicine.
                                 communication
        The overarching goal for communications is to optimize the
    dissemination of official information that is easily accessible,
    current, and understood. This has been accomplished via monthly ``Nurse
    Corps Live'' video tele-conferences on a variety of topics relevant to
    our nursing communities, electronic publication of ``Nurse Corps News''
    newsletter and the Nurse Corps webpage.
                                   mentorship
        The development of our career planning guide will serve as a
    mentoring tool for all nurses. Core nursing mentors will be identified
    at each command to facilitate mentorship to officers, enlisted members,
    civilians and students alike.
        Naval Hospital Bremerton received the University of Washington
    School of Nursing's Preceptor of the Year Award for 2008 in recognition
    of the 14 years that the hospital's clinicians, administration and
    staff have provided exceptional learning opportunities for all nurse
    practitioner and certified nurse midwife students.
        The Director for Nursing Services at Naval Hospital Oak Harbor is
    working with local Career Counselors to schedule ``board interviews''
    for Naval Air Station Whidbey Island sailors interested in pursuing
    careers in Navy nursing via one of our commissioning pipeline programs.
        The ``Nurse Corps Roundtable'' is a forum used by nurses from Naval
    Health Clinic, Great Lakes with local Navy Reserve Officer Training
    Corps nursing students, to facilitate their understanding of ``life as
    a Navy nurse.'' Topics include deployment opportunities, duty stations
    and assignments, and the unique camaraderie that military nurses enjoy.
        The division officer of the inpatient mental health unit at Naval
    Hospital Camp Lejeune has sparked the interest in mental health nursing
    in five junior nurses. He established a new mental health nurse
    teaching program, developed 15 individual lectures and provided
    individual mentoring over a 9 month period to five new military nurses
    who will be given an opportunity to gain the mental health subspecialty
    code. He is helping to change the stigma of mental health nursing to
    positively reflect a fulfilling and respected form of nursing practice
    to our young staff.
                                   leadership
        It is the amalgamation of our officers' clinical skills foundation,
    education, specialization and operational experiences that develop the
    highest caliber leaders for Navy Medicine today and in the future.
        CDR Michele Kane's work on ``Genotoxic and Cytotoxic Carcinogenesis
    Effects of Embedded Weapons Grade Fragments of Tungsten Alloy
    Shrapnel'' was recognized with awards for best in research by the
    Association of Military Surgeons of the United States, the Uniformed
    Services University for Health Sciences top award for Research
    Excellence from the Graduate School of Nursing, and the prestigious
    Uniformed Service University Board of Regents Scholastic Award for
    Research (an award normally reserved for medical students).
        The Bureau of Medicine and Surgery (BUMED) has partnered with the
    Chief of Naval Personnel (CNP, N1) to temporarily assign a Nurse Corps
    officer to establish the position of Navy Operational Stress Control
    Coordinator (OSC). CAPT Lori Laraway is responsible for OSC program
    development and execution across the entire Navy Enterprise and chair's
    the OSC Governance Board. Networking, reducing duplication of effort
    and formulating effective lines of communication have resulted in a
    Navy-wide program that addresses the needs of line leaders, Sailors and
    families.
        Previous team leaders for all Embedded Training Teams (ETT) have
    been Medical Service Corps Captains, until CDR Judith Bellas was
    selected as team Lead for Kabul ETT. CDR Bellas was recently recognized
    for her contributions during this year long deployment with the Bronze
    Star Medal. LCDR Keith B. Hoekman, a nurse practitioner, was awarded
    the Bronze Star Medal while deployed as the Medical Officer for the
    Provincial Reconstruction Team (PRT) in Ghazni Province, Afghanistan.
    Additionally, he received a Certificate of Recognition from the
    Ministry of Health, Kabul, Afghanistan for his community outreach
    initiatives on Women's Health that ultimately reached 30,000 villagers.
        LT Tony Wade from Naval Hospital Camp Pendleton recently received a
    Navy Commendation Medal with ``Combat V'' as he was directly
    responsible for saving Marine lives under austere and dangerous
    conditions in Afghan in support of the 2/7 Marines. When his trauma bay
    was hit by a mortar round and the surgeon was incapacitated, LT Wade
    and two corpsmen continued the trauma treatment for a Marine who had
    sustained life threatening injuries, their efforts directly resulted in
    saving his life.
                                closing remarks
        Chairman Inouye, Senator Cochran, distinguished members of the
    committee, thank you again for providing me this opportunity to share
    with you the remarkable accomplishments of Navy nurses as we partner
    with our colleagues in meeting Navy Medicine's mission. I look forward
    to continuing our work together over the course of the next year.

        Chairman Inouye. General Horoho.
    STATEMENT OF MAJOR GENERAL PATRICIA D. HOROHO, CHIEF,
                ARMY NURSE CORPS, UNITED STATES ARMY
        General Horoho. Chairman Inouye, Vice Chairman Cochran, and
    distinguished members of the subcommittee: It's an honor and
    truly a privilege to be able to speak before you today on
    behalf of over 40,000 officers, enlisted and civilians of the
    Army Nurse Corps. It has been your continued unwavering support
    that has enabled Army nurses as part of the larger Army medical
    department team to provide the highest quality of care to all
    those that are entrusted to our care.
        Army nurses are a corps of seasoned combat veterans that
    are highly trained, highly skilled and highly committed. We
    deploy an average of 400 to 500 Army nurses a year, so we've
    moved well beyond lessons learned to lessons applied.
        For example, Army nurses in Iraq, in the Iraq theater, who
    fly medevac with critically wounded patients have developed a
    set of tactics, techniques, and protocols over the last 7 years
    that we've codified into an intra-theater flight nursing
    program, a program we'll sustain for the future. Our flight
    nurses have decreased the incidence of hypothermia for the
    patients that fly in the back of these medevacs from 20 percent
    to less than 5 percent.
        On my recent trip to Iraq I was absolutely humbled to see
    the level of care that is provided to not only our
    servicemembers, but to coalition forces, contractors, and the
    detainee populations that we serve. I was told how at the Ibn
    Sina Hospital that's in Baghdad Army nurses moved patients into
    the hallways away from the glass windows when the hospital was
    under mortar fire and covered them with their own bodies so
    that they were protected. These patients were wounded Iraqis.
        Army nurses are partnering with Iraqi nurse leaders to help
    them begin to rebuild their profession of nursing. The nurses
    of the 345th Reserve Component Combat Support Hospital
    established training programs on the fundamentals of emergency
    nursing and subsequently are providing medical diplomacy at the
    most crucial interface, between two nursing cultures.
        During this year of the noncommissioned officer, I want to
    share a story with you about a particular NCO that established
    an automatic external defibrillator (AED) program for the
    entire Iraq theater. This NCO recognized the need to have
    emergency cardiac care equipment in theater that provides our
    soldiers with the same standard that we offer in the United
    States. He created the theater-wide policy that mandated easy
    accessibility to AEDs. This NCO had an opportunity to put into
    action his own policy when he encountered a sergeant major that
    was in cardiac arrest. He quickly responded with the AED and
    saved the sergeant major's life.
        I'd like to introduce to you Sergeant Major Brewer, who's
    in the audience today. He is my sergeant major--could you
    please stand. He is my Corps sergeant major and is returning
    from his second deployment in Iraq. We could not be more proud
    to have him as part of our team.
        Furthermore, I would like to highlight the nurse case
    management program at Camp Cropper and Camp Bucca detainee
    camps in Iraq, built and managed by our NCO licensed practical
    nurse Army nursing team members. To date the program has
    provided specialized medicine care for over 1,000 Iraq
    detainees requiring case management care for diabetes,
    hypertension, and medical management. I am proud of the Army
    nursing team as they shape the face of deployed nursing.
        We are sustaining best practice strategies to provide
    standardized nursing care from the combat zone to an Army
    medical treatment facility, through the warrior transition
    unit, all the way into our VA hospitals.
        The Army Nurse Corps is undergoing the most massive
    transformation that I've seen in my 25 years on active duty.
    We're using the first-ever Army Nurse Corps campaign plan to
    operationalize a Nurse Corps that consistently achieves
    performance excellence, fosters innovation, builds knowledge
    and capabilities, and ensures organizational credibility and
    sustainability. We are piloting an in-patient and an ambulatory
    nursing care delivery system that uses best practices and
    evidence-based data to optimize patient outcomes.
        These pilots are already showing improvements in staff
    satisfaction and interdisciplinary communication. We're also
    incorporating data from the military nursing outcomes database
    study, as well as evidence-based research from the Tri-Service
    Nursing Research Program, funded studies of which we are
    extremely grateful for your support into our practice, to
    reduce the incidence of care indicators like patient falls and
    medication errors.
        We are standardizing nursing care delivery systems to
    decrease patient variance and improve patient outcomes. For
    example, nurses at Walter Reed Army Medical Center collaborated
    with our VA nurse colleagues to develop the first-ever
    evidence-based nursing transfer note that is electronically
    exported to a web-based portal, allowing staff to
    bidirectionally exchange critical patient information in real
    time. This effort significantly optimized Army and VA nurses'
    ability to tell the patient's story via the electronic medical
    record.
        We are harnessing the power, the pride and the passion of
    Army nurses to transform into a corps that by 2012 is leading a
    culture of performance innovation and improvement across the
    entire continuum of care. This is unequaled in the delivery of
    nursing excellence. We will use the vision to embrace the past,
    engage the present, and envision the future.

                               PREPARED STATEMENT

        On behalf of the entire Army Nurse Corps team serving
    worldwide, I'd like to thank each of you for your unwavering
    support, and I look forward to continuing to work with you.
    Thank you.
        Chairman Inouye. Thank you very much, General.
        [The statement follows:]
             Prepared Statement of Major General Patricia D. Horoho
        Mr. Chairman and distinguished members of the committee, it is an
    honor and great privilege to speak before you today on behalf of the
    nearly 10,000 officers, enlisted, and civilians of the Army Nurse
    Corps. It has been your continued unwavering support that has enabled
    Army Nurses, as part of the larger Army Medical Department (AMEDD)
    team, to provide the highest quality care for our service members,
    families and all those entrusted to our care.
        As I assumed the responsibility of this great Corps, I realized
    that 4 years as Corps Chief is not much time. Although we cannot
    eliminate or predict the uncertainty of the future, we are developing a
    framework to harness every opportunity and manage ambiguity. To this
    end we have embarked on a campaign plan that will transform the Army
    Nurse Corps over the next 4 years and prioritize a 15 year blueprint
    for a vibrant, relevant, and flexible Army Nurse Corps.
        The Army Nurse Corps Campaign Plan, which was developed at the
    first ever Army Nurse Corps Strategic Planning Conference in October,
    is built around four strategic objectives: Leader Development and
    Sustainment, Warrior Nursing Care Delivery, Evidence-Based Management
    and Clinical Practice, and Optimization of Human Capital. It reflects
    our mission and is aligned with the Department of Defense's, Army's and
    Army Medical Department's goals and objectives. At the heart of the
    Campaign Plan is what I call, ``the triad of nursing.'' This triad
    consists of the active and reserve component officers, Non-commissioned
    Officers (NCOs), and civilians that make up our great Corps and are
    vital for ensuring that those who wear and have worn the cloth of our
    Nation and the families that support them, receive timely,
    compassionate and high quality care.
        Execution of the Campaign Plan will be driven by courage to do the
    right thing, ingenuity to meet the rapidly evolving battle and medical
    demands of the 21st century, and constant compassion for those we serve
    and those with whom we serve.
                       leader development and sustainment
        The success and sustainability of our campaign plan rests squarely
    on the shoulders of Army nurse leaders. Accordingly, my first priority
    is to develop full-spectrum Army nurse leaders through a leader
    succession plan.
        We are creating the next generation of inspiring leaders who are
    agile in responding to the Army's evolving needs and who have the
    capabilities and capacities that are required for current and future
    missions. These leaders will be adaptive to any conditions-based
    mission, able to provide a persuasive voice at key echelons of
    influence in the AMEDD, and provide innovative doctrine to blueprint
    the future of the Army Nurse Corps.
        Over half of our Corps has deployed in support of Operation Iraqi
    Freedom (OIF) and Operation Enduring Freedom (OEF). We are leveraging
    the experience of these returning Army nurse combat veterans to
    incorporate and codify their lessons learned into our leader training
    programs and nurse care delivery systems.
        Army nurse leaders adapted readily to the intra-theater flight
    nursing mission in Iraq. Their lessons learned on over 300 missions
    transporting approximately 500 critically injured patients have been
    codified into a flight nursing program that includes standardized
    clinical practice guidelines and patient outcome metrics. On-board
    flight nurses decreased the incidence of patient hypothermia during
    transports from 20 percent to less than 5 percent. One of our Army
    nurses transported a Soldier who sustained severe burns over 70 percent
    of his body from a forward surgical team to the 86th Combat Support
    Hospital (CSH). Last month we heard from the Soldier's wife and three
    children that he is undergoing full rehabilitation and has made a
    remarkable recovery. Thanks to our adaptive Army nurse leaders, we are
    working to develop the role of the intra-theater flight nurse and
    codify it with the additional skill identifier of N5.
        Army Nurse Leaders are currently commanding two Combat Stress
    Control (CSC) units in Baghdad and Mosul. In Mosul, the 528th Medical
    Detachment (Combat Stress Control) is commanded by MAJ Chris Weidlich,
    a psychiatric nurse practitioner, leading a 46-member team with an area
    support mission to mentally sustain coalition forces at nine Forward
    Operating Bases (FOBs) and surrounding areas within the Multi-National
    Division North (MND-N). Since their deployment from Fort Bragg, North
    Carolina in March 2008, MAJ Weidlich and his team have led the way in
    improving far forward mental health assessment and treatment,
    evaluating approximately 10,000 Soldiers to date. Additionally, they
    are bringing far forward the latest on mental health resiliency
    training and assessment of mild Traumatic Brain Injury to over 50 Joint
    Security Stations (JSS), Military Transition Teams (MiTTs) and Combat
    Outposts (COP); all while maintaining a 99.4 percent return to duty
    rate.
        Army Nurse Corps leaders are also furthering medical diplomacy aims
    by continuing to expand Iraqi nurse training partnerships. Nurses with
    the 345th CSH are helping to re-build Iraq's medical infrastructure by
    instituting a train-the-trainer emergency nursing program. The first
    iteration of the ``Emergency Nursing Train-the-Trainer Program''
    concluded its first ``Partnership in Patient Care,'' program with
    thirteen Iraqi nursing students--four females and nine males. This 6-
    week course is building sustainability into the Iraqi nurse education
    program. In the future, these nurses will teach other Iraqi nurses of
    Salah ad Din Province thereby expanding the expertise of the Iraqi
    nursing professionals.
        345th CSH nurses worked with the local Provisional Reconstruction
    Team (PRT) to develop, build, and furnish the Iraqi Nursing Skills
    Learning Lab in the International Business Iraqi Zone (IBIZ). This
    skills learning lab is known as the ``Salah Ad Din Victory Health Care
    Training Center'' and provides classroom space and a separate skills
    training lab for the Iraqi nursing program and other Iraqi healthcare
    programs. The training center also facilitates a safe training and
    collaboration site for both Iraqi medical and nursing professionals and
    allows our combat support hospital nurses to share knowledge as
    consultants. This sharing provides the Iraqis with the most up to date
    nursing education processes that are positively impacting the state of
    healthcare in Iraq.
        While the experiences of deployment produce exceptional nurse
    leaders, I am concerned about the resiliency and ability of our
    returning nurses to reintegrate with their families and return to
    hospital positions where they continue to provide care to wounded
    warriors--in some cases, the same warriors they helped to resuscitate
    in theater. Their compassion fatigue is evident when I talk with them,
    many of whom are on their third and fourth deployments. We are
    developing retention strategies that allow these caregivers to ``take a
    knee'' so they can re-charge their mental, physical, and emotional
    energies in order to re-engage as Army Nurses.
        With respect to leadership training, we currently have 255 new Army
    Nurse Officers at nine of our Regional Medical Centers receiving
    individual training and mentoring that emphasizes development and
    acquisition of clinical deployment skill sets and competencies to
    bridge the gap between academic preparation and the clinical practice
    environment. We are leveraging courses such as the Emergency Pediatric
    Nurse Course and the Trauma Nurse Competency Course (TNCC) to ensure
    every one of our nurse officers has the right capabilities to deploy in
    support of any condition-based mission.
        Trauma nursing is our core competency. Subsequently we are focusing
    on emergency and critical care skills required in a disaster or
    deployed setting to increase the quality of care we provide. To
    accomplish this, I have directed a top-to-bottom review of all Army
    Nurse Leader development training programs. This strategic objective
    emphasizes development of clinical, leader, and deployment skill sets
    and competencies for Army Nurse Corps personnel as they progress in
    rank and clinical experience.
        Last, we are looking at redesigning the entire leadership
    lifecycle, from staff nurse through Deputy Commander for Nursing. Our
    goal is to create a robust program that ensures nurses have the
    required skill sets and experiences at each step in their careers. This
    means ensuring that there are appropriate training opportunities phased
    throughout the lifecycle and a clearly defined job description and
    associated competencies for each role. In addition, we are looking at a
    set of potential structural changes to the lifecycle aimed at
    increasing flexibility and creating new career pathways for our diverse
    set of nurses.
    Warrior Nursing Care Delivery
        My second strategic objective is to get back to the basics of
    delivering high-touch, supported by high tech, nursing care. We are
    designing nursing care delivery systems that wrap nursing capability
    around The Surgeon General's goals and mission. I'd like to talk about
    five special initiatives we are pursuing in support of providing model
    nursing care.
        In our first initiative, we completed a comprehensive evaluation of
    best practice civilian and federal nurse care delivery systems in order
    to distill elements into standardized Army Nurse in-patient and
    ambulatory care delivery systems. For example, nurses at Walter Reed
    Army Medical Center (WRAMC) are using several patient discharge
    management tools that are decreasing length of stay, re-admission
    rates, and improving patient satisfaction. Nurses at Tripler Army
    Medical Center (TAMC) implemented Relationship Based Care (RBC), a
    nursing care delivery model, in 2007. This model emphasizes patient and
    family centered care, a primary-within-team nursing model, as well as
    well-defined scopes of practice for all nurses. Since implementation of
    RBC, nursing at TAMC has experienced an increase in both nursing and
    patient satisfaction, as well as a decrease in civilian nursing staff
    turnover.
        We incorporated several of these perspectives into the professional
    nursing pilot at Blanchfield Army Community Hospital at Fort Campbell,
    Kentucky. This pilot combines and capitalizes on care delivery
    advancements made at individual military treatment facilities (MTFs)
    and has three aims: develop nursing practice standards across all MTFs,
    improve patient satisfaction and outcomes, and increase staff
    satisfaction and retention. These aims will be reached through
    combining increased nurse autonomy and skill building with structured
    interdisciplinary communication and patient-centered and evidence-based
    care. The pilot is still underway, but after only a few weeks there has
    been a marked improvement in how the nursing staff communicates with
    their patients and physicians, as well as how they feel their input is
    valued by hospital leadership. We are implementing results of the pilot
    across all of Blanchfield's wards, and ultimately to all MTFs, to
    decrease practice variance and improve inpatient nursing care delivery.
        Our second initiative focused on ambulatory nurse role redefinition
    and developing appropriate, functional nurse staffing models. The Army
    Nurse Corps ambulatory workgroup developed a primary care staffing
    model that changes the role of the Registered Nurse (RN) from a
    reactive, episodic-focused role to a proactive, population-focused
    role. In September 2008 we initiated a year-long pilot study at
    Moncrief Army Hospital focusing on nurse role redefinition, staffing
    mix, and professional nursing care. We were able to develop a model by
    which patients with unmet medical requirements were targeted by a
    specific nurse assigned to their case (``My Nurse''), who would then
    work with the provider to review the patient appointment list prior to
    appointments and identify tests, labs, x-rays, etc. that a patient may
    need ahead of time. This not only provides a new role for the clinic
    nurses, but also expedites the ambulatory care process for both the
    patient and medical team. Outcome measures for the pilot include
    improving patient and staff satisfaction, decreased urgent care and
    emergency rooms visits, improved compliance with Health Effectiveness
    Data and Information Set (HEDISR), Clinical Practice Guidelines (CPGs)
    and other health metrics, increased percentage of time seeing their
    assigned provider and increasing access to care. Initial feedback from
    patients is that they love the personal attention they receive from
    ``My Nurse'' and appreciate having someone they can call with questions
    or having someone call them to remind them of appointments or follow-up
    with them with educational materials, etc. The role of ``My Nurse'' is
    a paradigm shift in outpatient nursing and will require education and
    training of all outpatient nurses if identified as a best practice.
        Our next initiative is focused on the case management role, both in
    theatre and stateside. Nurse Case Managers (NCM) remain an integral
    member of the triad of care in Warrior Transition Units since their
    inception in April 2007. In addition to ensuring high patient
    satisfaction with care, NCMs have continued to facilitate other patient
    care improvements. In October 2008 the Warrior Care Transition Office,
    in coordination with the AMEDD Center and School conducted the first
    resident Warrior Transition Unit Cadre Orientation Course. The course
    is 2 weeks in duration with a 3 day track focused specifically on case
    management standards and skills. To date, the course has been conducted
    three times, with over 100 NCMs completing the training. NCMs continue
    to assist in decreasing the average length of stay for Warriors in
    Transition.
        In the Iraqi Theater of Operations, we established a NCM role aimed
    at caring for patients who have chronic, complex care requirements. The
    theater NCM's role includes monitoring average length of stay according
    to diagnosis, as well as by classification of personnel, such as United
    States, detainee, contractor, Iraqi Army, Iraqi Police, and civilian.
    In addition, the NCM helps facilitate the discharge plan with the
    physician and the inter-disciplinary team. COL Ron Keene was
    instrumental in establishing the first Nurse Case Management Program
    for detainees in a wartime theater with huge patient successes in the
    management of hypertension, wound care, and even chronic diabetic care
    management. The dedication of the Army Nurses and physicians focusing
    on the total care of our chronically ill detainees can be demonstrated
    by the decrease in admissions for the management of chronic illness by
    38 percent. This success has actually enabled reductions in bed
    requirements at the 115th CSH. Close management of chronically ill
    detainees follows strict adherence to the DOD/VA Clinical Practice
    Guidelines (CPG's) which are incorporated in daily detainee healthcare
    practices. With education and routine contacts, a growing percentage of
    the detainees have come into greater compliance and medication levels
    are either reduced or ultimately removed. Detainees are offered
    customer satisfaction surveys in Arabic and have reflected above
    average satisfaction with their care--results that rival the best
    customer satisfaction scores in our premiere Army hospitals.
    Additionally, Army NCMs insure that Iraqi Imams visit our patients
    weekly to provide religious support and guidance as a part of their
    health recovery.
        Another Warrior Care initiative focuses on developing a practice
    model that incorporates the use of our outstanding enlisted corps. At
    the Bucca detainee hospital, one of the senior NCO Licensed Practical
    Nurses (LPN's) oversees the 68W (medic) primary care screening of over
    14,000 detainees. The LPN ensures that each 68W has completed the
    Algorithm Directed Troop Medical Care (ADTMC) screening classes and
    demonstrates a sound understanding of the screening process,
    documentation and medication administration within the guidelines of
    the ADTMC scope of practice.
        The NCO LPN's are also integral to the new Iraqi nurse partnership.
    For the first time, an Operating Room and Intensive Care Unit team
    (includes one NCO/LPN) from one of our small hospitals at Al Kut will
    be going to one of the local hospitals to help train the Iraqi staff in
    operating room and post operative care procedures. The RN and LPN team
    provided hands on demonstrations to the Iraqi nurses helping them
    improve their clinical practice skills. At the Jamenson Combat Medical
    Training Center (JCMTC) in Iraqi, 1SG Eric Woodrum volunteered to work
    in the Air Force hospital Emergency Room to observe Point of Injury
    care. Those lessons learned were taken back and used at the Jamenson
    schoolhouse to improve Combat Lifesaver training and patient outcomes.
        Last, we are working with other Federal Nursing Service Chiefs to
    align initiatives and develop compatible practice models. For example,
    through strong Congressional support, the Army Nurse Corps, along with
    the Federal Nursing Services Chiefs, started the Psychiatric Nurse
    Practitioner program at the Uniformed Services University (USU). This
    program, while providing traditional curriculum, adds clinical training
    addressing some of the military unique behavioral health challenges and
    leadership building. The program will pay dividends in the future as we
    address the behavioral health challenges faced by our Service Members
    in theaters of operation and after they return home.
        We are also furthering cooperation through the Tri-Service Nursing
    Research Program (TSNRP) to improve trauma and deployment competencies
    for nurses in all military services. One example of that cooperation is
    the publication of the evidence-based ``Battlefield and Disaster
    Nursing Pocket Guide''. This guide provides a portable, up-to-date,
    evidence-based source of information for nurses on the battlefield and
    those responding to disaster or humanitarian situations. TSNRP has
    provided 7,500 copies of this handbook to both deployed and non-
    deployed nurses throughout the services. We are also leveraging TSNRP
    funded research to improve Warrior care delivery. For example: Pain and
    Sleep Disturbance in Soldiers with Extremity Trauma; Impact of Body
    Armor on Physical Work Performance; A Comparison of PTSD and Mild TBI
    in Burned Military Service Members, and Sleep Disturbances in U.S. Army
    Soldiers after Deployment to Afghanistan and Iraq.
    Evidence-based Management and Clinical Practice
        Evidence-based management aims to merge best practices in both
    clinical care and business practice to produce outstanding outcomes.
    These goals are supported by blending data measurement and analysis and
    system redesign into the daily performances of all our nurses.
        In support of our aims, we are working to train the next generation
    of nurse researchers by leveraging TSNRP and Army Nurse Corps
    researchers both stateside and in deployed environments. Developing the
    expertise of military nursing researchers is paramount to TSNRP's
    mission, as evidenced through its courses in grant writing, publishing,
    and advanced research methods. In addition, it is one of the only
    research programs to require its investigators to attend a post-award
    workshop where they are given information pertaining to the regulations
    of managing a grant. TSNRP provides a very high level of oversight of
    its awardees, ensuring the research is conducted with the highest
    rigor. We in the Army Nurse Corps appreciate their dedication to
    developing nurse researchers of the highest caliber.
        Besides training top-notch researchers, we are working to focus our
    research on improved systems and clinical outcomes, preferably with
    real-world recommendations that can be easily applied at the patient's
    bedside. One such research project was the Military Nursing Outcomes
    Database (MilNOD). Facilitated and implemented as an Army Nurse Corps
    initiative, MilNOD is the most comprehensive and historical effort of
    its kind in the United States. Analysis of data from 115,000 nurse
    shifts established significant associations between nurse staffing and
    patient outcomes, such as the occurrence of falls and medication
    administration errors as well as nurse needle stick injuries.
    Participating MilNOD MTFs decreased patient fall rates by 69 percent,
    medication administration errors rates by 50 percent and hospital
    acquired pressure ulcer prevalence by 62 percent, all of which were
    statistically significant reductions. Participating MTFs also
    experienced considerable cost avoidance (falls--$900,000/year;
    medication errors--$230,000/year; pressure ulcers--$450,000/year). As
    one of the most seminal studies linking nurse care practices with
    patient outcomes, the study results will be published in an upcoming
    edition of The New England Journal of Medicine.
        Army nursing has made a special effort to support research at all
    levels, as young researchers of today will become leaders in their
    fields in years to come. To that end, the nurses of Tripler Army
    Medical Center (TAMC) started a funded Evidence Based Practice (EBP)
    research project in 2007 that is now a part of their nursing practice
    culture. This fiscal year, nurses throughout the facility initiated
    seven new Evidence Based Practice Projects (EBPP). These studies ranged
    from improving infection control in ICU settings, to patient
    satisfaction for pregnant patients on bedrest, to improving
    communication between nurses on different hospital units. The range of
    topics studied demonstrates an impressive effort to improve systems
    while bringing research back to the bedside. I thank our officers,
    ranging from Lieutenants to Lieutenant Colonels, for their dedication
    to improving nursing care at every level.
        As we move forward with this strategic objective, we are making a
    special effort to use the power of technology to develop and
    disseminate best practices throughout the Corps. Integrating technology
    into best practices has started with ensuring patient safety through
    proper patient handoffs. Research has demonstrated that smooth,
    seamless patient handoffs are vital to safe patient care. Nurses at
    WRAMC in collaboration with the Department of Veterans Affairs (VA)
    Poly-Trauma Centers have developed a researched based nurse's note that
    is sent directly to the VA electronic medical record. This nurse-driven
    project resulted in increased nursing knowledge of patient conditions
    which enabled the receiving facility to put in place safety mechanisms
    to improve patient care and diminish risk of patient injury or poor
    outcomes. This project is one of the first times we have been able to
    transmit patient data directly from one electronic medical record into
    another agency's electronic record.
        Without dissemination of our collective knowledge, our advances
    would mean little to the Corps at large. Thus, we have developed a new
    ANC interactive website that allows for real time exchange of ideas and
    best practices, and improves communication across the Corps. We are
    also making a special effort to link research cells at different MTFs
    to promote Corps-wide collaboration.
    Optimization of Human Capital
        My final objective, Optimization of Human Capital, is the strategic
    and coherent approach to the management of our organization's most-
    valued assets, our people, who individually and collectively contribute
    to the achievement of the ANC objectives. Investing in human capital
    requires special attention to the recruitment and retention of our
    civilian and active duty nurses, while trying to influence the
    profession of nursing through academic partnerships.
        Recognizing that the majority of our organization is our civilian
    workforce, we are continuing to break down the barriers in recruiting
    and retaining stellar civilian healthcare professionals. We are
    committed to streamlining and reducing the gates in the personnel
    hiring process by setting accountability timelines compared to local
    averages. To maintain an influence on civilian nursing recruitment and
    retention, we have placed an ANC Officer in the Civilian Personnel
    Office in order to partner and facilitate progress on these issues.
        We have also started focusing on retention efforts for our civilian
    workforce. We have been very successful with our civilian nurse loan
    repayment program which was initially implemented 2 years ago. For
    fiscal year 2009, 169 of 186 applicants participated in the nurse loan
    repayment program. As a result of this program, we will be required to
    expend fewer resources to recruit and train new nurses. In addition, we
    have consulted with VA nursing to leverage their concept of clinical
    ladders for our civilian workforce. We are evaluating how best to use
    this program to promote clinical leadership opportunities for civilians
    and establish glide paths for their success in order to retain them on
    our team.
        Turning our focus toward active duty and reserve officers, the Army
    Nurse Corps has been very successful in recruiting this past year. For
    the first time in 7 years, United States Army Recruiting Command
    exceeded mission for both the active and reserve components. Regular
    Army Nurse Recruiters produced 297 nurse recruits against a mission of
    205 and the Army Reserve Recruiters produced 528 nurse recruits against
    a mission of 362. In addition, the Reserve Officer Training Corps
    (ROTC) experienced great success this past year and expects the same
    for the next 2 years. In fiscal year 2008 ROTC was responsible for
    producing 173 Army Nurses against a mission of 225. This was the
    highest number of accessions in 10 years. In fiscal year 2009, ROTC
    predicts a production of 221 Army Nurses against a mission of 225. And
    in fiscal year 2010, ROTC is projected to exceed their mission of 225
    by over 20 nurses (for a total number of 249).
        One of our most crucial retention tools is developing a track that
    will take our ANC officers through a lifecycle that focuses on clinical
    competencies even at the senior level. We are also evaluating our
    current force structure to ensure we have the right mix of skills and
    rank, and that we are assigning based upon capabilities. In addition,
    one of our most successful programs for retention has been the
    implementation of Incentive Specialty Pay (ISP) and Critical Skills
    Retention Bonus (CSRB). To date, 962 (44 percent) Army Nurse Corps
    officers have taken either the ISP or CSRB.
        Looking forward to the recruitment and retention of all our
    nurses--civilian, active, and reserve--we decided to optimize one of
    our most important retention strategies: responsive listening to our
    nurses. Accordingly, I directed dissemination of a Corps-wide
    organizational survey that asked our nurses what's on their minds. As a
    result, more than 2,000 Army Nurses identified areas for improvement in
    Corps performance. A key opportunity area identified is to increase
    junior officer involvement in setting the Nurse Corps' strategic
    agenda. In response, we incorporated the voices of Army Nursing's
    future leaders at our annual ``CJ Reddy Junior Leadership Conference'',
    held this past October in Washington, DC. This Conference brings
    together the most promising junior officers in the Corps for an
    intensive session built around learning, skill building, and
    networking. When asked what motivates them each day as a member of the
    Nurse Corps, these officers answered with five consistent themes: (1)
    the mission of serving their country and caring for Soldiers; (2) the
    diversity of opportunities the Corps provides; (3) the Corps'
    camaraderie and sense of family; (4) the available leadership training;
    and (5) the abundant rewards and benefits. We believe these five
    attributes create an unparalleled environment to practice nursing and,
    under my Human Capital imperative, plan to reinforce each of them to
    become an even stronger recruiting power.
        Last, we feel that to truly optimize our human capital strategy, we
    must pursue academic partnerships. The professional staff at several
    MTF's have worked diligently to support the clinical experiences of
    advanced practice nursing students. In addition, in cooperation with
    all the Federal Corps Chiefs, we are supporting Uniformed Services
    University in their active engagement of academic partnerships with
    nursing leadership organizations and schools of nursing to maintain an
    active and influential role in the future of nursing in America.
    Additionally, we are leveraging our retired AN officers, who are
    professors at a variety of civilian institutions, to serve as nursing
    role models, mentors, subject matter experts and ambassadors for the
    ANC.
                                   conclusion
        Since becoming Corps Chief last July, I see clearly how to harness
    the power, passion, and pride of the Army nurses to develop the Army
    Nurse Corps priorities in support of the national health agenda and our
    Nation at war. Over the next 2 years we will execute the Army Nurse
    Corps campaign plan and use it to codify best practices for
    sustainability. The third year we will begin campaign planning again to
    ensure we remain relevant and well-postured as a force multiplier for
    military medicine.
        I envision an Army Nurse Corps in 2012 that serves as a model for
    the Nation, leading a culture of performance improvement across the
    entire continuum of care that is without peer in the delivery of
    nursing care excellence--where we measure our successes in the
    improvement of healthcare outcomes for patients and families, retention
    and satisfaction of our staff, and improved stewardship of our precious
    resources.
        I am establishing a culture that evaluates every aspect of
    traditional practice to ensure that we achieve the desired improvements
    in our patient's emotional, physical and spiritual well-being. The Army
    Nurse Corps will be known for the ingenuity and innovation applied to
    the most challenging opportunities, so characteristic of Army Nurses
    for the past 233 years. Constant compassion will continue to fuel us,
    driven by the courage to always do the right thing.
        I would like to leave you with a story about one of our nurse
    heroes. In 2007 we tragically lost a Command Sergeant Major to an
    apparent heart attack at Camp Victory, Iraq. This incident sparked an
    NCO to develop and implement a theater-wide Automated External
    Defibrillator (AED) program. The magnitude of this program was so
    important that GEN Petraus endorsed the NCO's plan. Just several weeks
    after the NCO initiated this program, he was confronted with a Soldier
    who was in cardiac arrest. He used an AED to resuscitate the Soldier,
    who was treated and sent home to his family. The NCO I've been
    discussing is SGM Richard Brewer, the LPN I brought into my Corps Chief
    office to enable my concept of the Army Nurse Triad that includes our
    LPN colleagues.
        I am so proud of our Corps and look forward to speaking with you
    next year about the progress we've made on our campaign plan. I'll
    close with our new motto that is the way ahead for the Army Nurse
    Corps: ``Embrace the Past''--leverage our lessons learned; ``Engage the
    Present''--achieve performance excellence; and ``Envision the
    Future''--ensure organizational credibility and sustainability. Thank
    you.

        Chairman Inouye. Now General Siniscalchi.
    STATEMENT OF MAJOR GENERAL KIMBERLY A. SINISCALCHI,
                ASSISTANT AIR FORCE SURGEON GENERAL FOR
                NURSING SERVICES, UNITED STATES AIR FORCE
        General Siniscalchi. Mr. Chairman, Mr. Vice Chairman, and
    distinguished members of the subcommittee: It is an honor to
    come before you today to represent the United States Air Force
    Nurse Corps. I am proud to serve alongside Brigadier General
    Catherine Lutz, Air National Guard; Colonel Ann Manley, Air
    Force Reserves, and Chief Master Sergeant Joseph Potts,
    Aerospace Medical Service Career Field Manager. Together we
    represent a robust total nursing force supporting our Air Force
    chief of staff's top priorities.
        I would like to thank you for your continued support of our
    Air Force Nurse Corps. Thank you for providing the funding for
    our accession bonuses, health professions loan repayment and
    scholarship programs, and our first-ever incentive special pay
    program. We anticipate the incentive special pay program will
    positively impact our retention.
        Last year 55 percent of our nurses who separated had less
    than 20 years of military service and 61 percent of those were
    our young lieutenants and captains. We are diligently working
    with our Air Force personnelist and our Surgeon General to
    address and correct this issue. Although the incentive special
    pay will help retain our nurses, retention may further extend
    timing and reduce promotion opportunity until we correct our
    grade structure.
        Our enlisted medical technicians, in partnering with A1,
    secured funds for their critically manned specialties. Our
    independent duty medical technicians are heavily tasked with
    deployments and manned at only 72 percent. I along with Chief
    Potts am eager to see this initiative's impact.
        Through your sustained support of our Tri-Service Nursing
    Research Program, we recently published the ``Battlefield and
    Disaster Nursing Pocket Guide''. This guide is utilized
    throughout our deployed locations.
        We continue to conduct state-of-the-art research and
    validate evidence-based practice. Colonel Margaret McNeil, a
    Ph.D. Air Force nurse, is in Iraq as a member of the newly
    deployed combat casualty care research team, exploring
    advancements in medical therapies for our wounded warriors.
        The key to successful peacetime and wartime nursing
    operations is a robust nursing force, a force with the right
    numbers, right experience, and the right skills. Recruiting
    experienced nurses continues to be a significant challenge.
    Although we reached 93 percent of our accession goal, 56
    percent were novice nurses, validating the importance of our
    nurse transition program. I am pleased to inform you that our
    first civilian program at the University Hospital in Cincinnati
    graduated their first class on December 12.
        Our enlisted nurse commissioning program grows Air Force
    nurses from our highly skilled enlisted force. We had our first
    two graduates this year and we'll have 19 next year.
        Air Force nursing is an essential operational capability.
    In 2008 our total nursing force represented 34 percent of all
    deployments within our medical service. Our medics deployed to
    44 locations in 16 countries. Our total nursing force is well-
    trained, highly skilled and committed to saving lives. We are
    called to a mission of caring for America's sons and daughters,
    and here are a few examples.
        Captain James Stewart, a nurse anesthetist, deployed to
    Joint Base Bilad, received a message from his friend and co-
    worker Captain Dave Johnson informing him that his son, Army
    Staff Sergeant Curtis Johnson, had been wounded and was en
    route to Bilad. Captain Stewart met Curtis on arrival and
    recalls: ``He arrived stable, so we placed a call to his dad so
    they could talk before we started surgery. Curtis's spirits
    were high and I was amazed at how well he was taking the loss
    of both his lower legs.'' Following surgery, Curtis was
    aeromedically evacuated to Brooke Army Medical Center and is
    now undergoing rehabilitation at the Center for the Intrepid.
        The commemorative Air Force recognized Captain Bryce
    Vandersway with the Dolly Vincent Flight Nurse Award for
    aeromedical evacuation support to 651 sick and injured
    warriors, including two K9 military working dogs injured by
    improvised explosive devices (IEDs).
        As the trauma nurse coordinator at Joint Base Bilad,
    Captain Darcy Mortimer recalls her most precious memory: ``We
    simultaneously received five casualties from an IED blast. When
    the emergency department settled down, the hospital held a
    ceremony for the soldier we could not save. Two of his wounded
    comrades requested that their litters be placed so they could
    salute their fallen comrade and friend.''
        In the midst of death and heartache, there are stories of
    hope and joy. This past October, our staff delivered the first
    Afghan baby born at Craig Joint Theater Hospital, Bagram. The
    mother sustained massive injuries as a result of an explosion,
    but with the help of the Air Force medical team she delivered a
    healthy baby girl. According to Technical Sergeant Jeremiah
    Diaz: ``We had 15 minutes to come up with something. We used a
    warming blanket and made a little tent with coat hangers and an
    egg crate mattress. The newborn's presence was a ray of
    light.''
        Mr. Chairman and distinguished members of the subcommittee,
    thank you for allowing me to share today just a few of the many
    achievements of Air Force nursing. As our Air Force Medical
    Service celebrates its 60th anniversary, we recognize and we
    stand on the shoulders of giants. I commit to you we will
    continue to meet every challenge with professionalism, pride,
    and patriotism that have served as the foundation for our
    success. Our warriors and their families deserve the best
    possible care we can provide.
        It is the nurse's touch, compassion, and care that often
    wills a patient to recovery or softens the transition from life
    to death. There has never been a better time to be a member of
    this great Air Force nursing team.

                               PREPARED STATEMENT

        So on behalf of the men and women of nursing services,
    thank you for your tremendous advocacy and continued support.
        [The statement follows:]
          Prepared Statement of Major General Kimberly A. Siniscalchi
        Mister Chairman and distinguished members of the Committee, it is
    an honor and pleasure to come before you to represent Air Force Nursing
    Services and our Total Nursing Force (TNF). The TNF encompasses officer
    and enlisted nursing personnel of the Active Duty, Air National Guard
    (ANG), and Air Force Reserve Command (AFRC) components. The past year
    has brought many leadership changes to our TNF, and I look forward to
    serving alongside my senior advisors, Brigadier General Catherine Lutz
    of the ANG and Colonel Anne Manly of the AFRC. We are glad to have
    Colonel Manly back after her recent deployment to Joint Base Balad,
    Iraq where she served as Chief Nurse of the 332nd Expeditionary Medical
    Group, and saw first-hand the incredible work our nurses and
    technicians perform daily. Together we will continue to strengthen our
    TNF by supporting our nursing service personnel as they continue to
    meet ever-increasing commitments, deployments, and challenges with
    professionalism and distinction; and supporting the Chief of Staff of
    the Air Force's (CSAF) top priorities to (1) Reinvigorate the Air Force
    Nuclear Enterprise, (2) Partner with the Joint and Coalition Team to
    Win Today's Fight, (3) Develop and Care for Airmen and their Families,
    (4) Modernize our Aging Air and Space Inventories, Organizations and
    Training, and (5) Acquisition Excellence.
                            organizational structure
        On September 29, 2008, the Air Force Medical Service (AFMS)
    achieved the CSAF's directive to transform and consolidate headquarters
    management functions by establishing the Air Force Medical Operations
    Agency (AFMOA) in San Antonio, Texas. This single support agency was
    established through an Air Force Smart Operations 21 initiative, and is
    led by a cadre of experts from across the Air Force Medical Service.
    They provide premier support and guidance to nine Major Commands
    (MAJCOM), 75 Military Treatment Facilities (MTF), and 39,000 medics to
    reduce levels of oversight at the MAJCOM levels. Brigadier General Mark
    A. Ediger assumed command of AFMOA on September 29, 2008.
        This past summer, the AFMOA Surgeon General Nursing (SGN)
    directorate, led by Colonel Leslie Claravall, in conjunction with the
    MAJCOM SGNs, successfully transitioned the clinical oversight as well
    as education and training functions from United States Air Force Europe
    Command and Air Mobility Command. In May, June, and July of this year,
    the AFMOA SGN will take on the clinical oversight of Air Education and
    Training Command, Air Force Material Command and Air Force Special
    Operations Command respectively. In 2010, the remaining MAJCOM SGN
    functions will transition to AFMOA. As a result, areas such as
    education and training, provision of nursing care, inpatient and
    outpatient, and nursing service resourcing will be centrally located.
    In short, AFMOA is progressing to a centralized reach-back Field
    Operating Agency.
                         building enduring competencies
        The Air Force Nursing Service Education and Training programs are
    inherent to, and the foundation of the successful development of our
    core competencies. The Nurse Transition Program (NTP) is experience by
    providing hands-on patient care while working side-by-side with nurse
    preceptors. The program focuses on maximizing skills utilizing real-
    world patients and minimizing the use of simulation labs. In 2008 we
    had 10 NTP sites with 212 seats available to novice nurses entering the
    Nurse Corps with less than 6 months nursing experience. Last year Major
    General Rank reported the possibility of partnering with University
    Hospital in Cincinnati, Ohio for our NTP. I am pleased to inform you
    that our inaugural class of ten students graduated from our first
    civilian NTP Center of Excellence (CoE) at University Hospital on
    December 12, 2008. I had the privilege to attend and participate in the
    ribbon-cutting this past October and I am proud of the phenomenal work
    course supervisors, Major Chris Berberick and Captain Josh Lindquist,
    have accomplished. Due to the medical center's trauma census, students
    were able to acquire 95 percent of the required clinical skills from
    real-world patients after only 5 weeks into the 11 week course. As a
    result, we will decrease our Cincinnati course to 9 weeks to
    accommodate more classes. We have already expanded our total seats
    available to 241, and will soon add another civilian partner CoE as we
    open our eleventh site this July with the Scottsdale Healthcare System,
    in Scottsdale, Arizona. This facility has earned Magnet Status
    recognition from the American Nurses' Credentialing Center. Magnet
    status facilities are measured by excellent patient outcomes, high
    levels of job satisfaction, and low staff turnover. Additionally, they
    have a proven record of involving nurses in data collection and
    research-based nursing practice. We look forward to a long and
    productive partnership with the Scottsdale Healthcare System.
        Our enlisted medical technicians, led by Chief Master Sergeant
    Joseph Potts, are critical to the overall success of our TNF. Our need
    for highly skilled clinicians continues to rise and we are committed to
    training and developing enlisted clinical leaders. We continue to
    enhance our enlisted clinicians through our Critical Care Technician
    (CCT) Course, based out of Eastern New Mexico University. This program
    targets medical technicians working in intensive care units (ICU) that
    have low patient acuity levels, or medical technicians who have
    previously earned the Critical Care Technician identifier, but no
    longer work in that clinical setting. We offer twelve classes per year
    and have doubled the number of rotating training sites from two to four
    of our larger MTF/Medical Centers. Through this course, we have enabled
    115 Airmen to refresh and sharpen their critical care competencies,
    thus improving quality of care both at home station and abroad.
        July 10, 2008 marked another step toward what's being called the
    largest consolidation of training in the history of the Department of
    Defense, when the ceremonial groundbreaking service paved the way for
    the construction of the Medical Education and Training Campus (METC).
    Currently projected for completion in 2011, METC will serve as a joint
    campus, co-locating the Army, Navy, and Air Force's five major learning
    institutions currently spread across four states, into one consolidated
    medical training facility at Fort Sam Houston, Texas. The development
    of this tri-service training center will result in standardized
    training for medical enlisted specialties enhancing interoperability
    and joint training by educating Soldiers, Sailors, Marines, and Airmen
    on service-specific capabilities. Chief Master Sergeant Manuel Sarmina,
    chairman of the METC Tri-Service Enlisted Advisory Committee noted,
    ``America's best and brightest will begin arriving here to work and to
    train in an environment that will be known and recognized as the
    premier learning center for our enlisted medical force.''
        On another front, over the past year David Grant Medical Center at
    Travis Air Force Base, California has implemented an Optimized Upgrade
    Training program for nurses. Captain Linda Peavely, who spearheaded the
    development of this program explains, ``Our goal was to increase the
    knowledge of nurses on medical-surgical units and progress them from
    the `competent' to `proficient' stage of nursing practice.'' Students
    participate in both didactic and clinical training in the intensive
    care unit. The result has yielded many additional benefits including
    improved wartime readiness skills, increased clinical capability and
    care of higher acuity patients, improved communication among staff, and
    recaptured revenue by decreasing the need to transfer patients. To
    date, David Grant Medical Center has produced 33 graduates, many of
    whom have recently returned from deployment and commented on how much
    more prepared and confident they felt stepping into the wartime
    environment as a direct result of this program. In January, Captain
    Peavely's hard work paid even more dividends when the Air Force
    Personnel Center, Nursing Education Branch, recognized this training
    platform as an official Air Force course, granting 92 hours of
    education credits to each graduating student.
        The Uniformed Services University of the Health Sciences (USUHS)
    Graduate School of Nursing (GSN) is yet another source preparing
    advanced practice nurses and nurse researchers. In 2008, Lieutenant
    Colonel Julie Bosch and Colonel Lela Holden successfully defended their
    dissertations, completing their Doctorate in Nursing degree. Major
    Brenda Morgan and Lieutenant Colonel Karen O'Connell are students
    currently in the USUHS doctoral program. Major Morgan is focusing her
    research on ``Positive Emotion and Resiliency'', while Lieutenant
    Colonel O'Connell is pursuing a study on ``Mild Traumatic Brain
    Injury.''
                             expeditionary nursing
        The cornerstone of our profession is that Air Force Nursing is an
    essential operational capability. Combined with our enlisted medical
    forces, we are a critical component of the total AFMS network
    supporting our warfighters. In 2008, 18 percent (2,802) of our TNF
    deployed to 44 locations in 16 countries. Our medical forces deployed
    in support of Operations ENDURING FREEDOM and IRAQI FREEDOM, as well as
    a myriad of humanitarian missions spanning the globe. I am proud to
    report that our TNF represents 34 percent of all Total Force
    deployments within the AFMS. TNF nurses and medical technicians are
    providing remarkable operational support. We are well-trained, highly-
    skilled and are committed to saving lives, educating others, and
    improving quality of life through research. We serve in this capacity
    not out of obligation, for we are an all-volunteer force. We are called
    to a mission of putting others first--of caring for America's sons,
    daughters, brothers, sisters, fathers, and mothers. We are called to a
    mission of forging international partnerships for a common good, and to
    aid war-torn countries in developing medical infrastructures, while
    sharing the message of hope and goodwill. In this regard, I offer you a
    sampling of our nurses' and medical technicians' experiences.
        In September, Lieutenant Colonel Kathryn Weiss, a Certified
    Registered Nurse Anesthetist (CRNA) assigned to a Critical Care Air
    Transport Team (CCATT) deployed to Camp Cunningham in Bagram,
    Afghanistan. CCATTs are a three-person team made up of a physician,
    nurse, and respiratory therapist, specially trained in critical care
    transport. Lieutenant Colonel Weiss recalls flying on an Aeromedical
    Evacuation (AE) mission aboard a C-130 airframe to a Forward Operating
    Base (FOB) that had an unexpected surprise. She stated, ``We'd been
    told we'd be picking up one CCATT patient, but discovered we had two.
    Our unexpected patient was a very young boy who had been shot in the
    head and brought to this desolate outlying FOB by his father.'' The
    surgeon had stabilized him, but he was in dire need of more definitive
    care. Lieutenant Colonel Weiss and crew packaged their patients for
    transport and returned to Bagram. Most recently she reported ``this
    past month has been especially difficult as we responded to two mass
    casualties from improvised explosive device (IED) blasts, flying five
    times in 6 days as patients were stabilized for transport. Two young
    Servicemen suffered burns on up to 75 percent of their body. The
    emotional aspect of caring for these young 20-year olds is unimaginable
    . . . praying for them and their families. We have incredible support
    from our front-end crews . . . they bend over backwards to assure we
    have what we need to care for these young men. The bonds and friendship
    we form here will continue long past this deployment.''
        Major Terry Vida deployed as a Discharge Planner to Task Force Med
    in Afghanistan from Travis Air Force Base, California. Shortly after
    arriving she was instructed to establish relationships with the Afghan
    hospitals to coordinate supportive care of local nationals once
    discharged from U.S. facilities. Due to local security threats, she was
    accompanied by Special Forces. She successfully solidified working
    relationships with four of the local hospitals and in the process,
    noted their most compromised areas included patient safety, infection
    control, and lack of training. As Major Vida stated, ``It is evident
    through observation they need our mentorship. They know about isolation
    in theory, but have no means or resources to apply what they have
    learned.'' She was fortunate enough to make contact with an English-
    speaking worker at the local rehabilitation center and ultimately
    coordinated their first patient transfer for supportive orthopedic
    care. However, her most notable memory of the trip to Kabul was finding
    out she and her envoy had narrowly missed a suicide bomber's explosion
    by 10 minutes.
        These are but a few examples of the tremendous work our TNF is
    providing, saving lives, making a difference, and always rising to the
    challenge, whatever it may be.
                                   readiness
        In order to provide our TNF personnel the critical care, trauma,
    and deployment skills necessary, we utilize numerous training
    platforms. The AFMS and Nurse Corps continue to produce hundreds of
    deployment-ready medics through the Centers for Sustainment of Trauma
    and Readiness Skills (C-STARS) located at University Hospital in
    Cincinnati, Ohio, R. Adams Crowley Shock Trauma Center in Baltimore,
    Maryland, and Saint Louis University Hospital in Saint Louis, Missouri.
    Each C-STARS site is known for high-quality/high-volume trauma care,
    cutting-edge research and excellence in education. The C-STARS
    Baltimore focuses on surgical and emergency care, while the Cincinnati
    site is designed specifically for clinical sustainment of CCATTs. The
    C-STARS Saint Louis is a dual Active Duty and ANG platform, with half
    of the faculty and students represented by the ANG. In 2008, 781
    physicians, nurses, and technicians completed this vital operational
    training. When enrolled in this course, almost half of the students are
    hard-tasked to deploy, while the remaining students will deploy some
    time in the next scheduled deployment cycle.
        Another building block in our arsenal of educational programs is
    the Critical Care and Trauma Nursing Fellowships. This fellowship
    program has consistently produced skilled critical care and trauma
    nurses, and has helped us in meeting our requirements in these critical
    specialties. Recruiting fully qualified critical care and trauma nurses
    continues to be a challenge. Nurse Corps officers are competitively
    selected to enter an intense 12-month training program at one of the
    following locations; Wilford Hall Medical Center in San Antonio, Texas,
    St. Louis University Hospital in St. Louis, Missouri, or the National
    Naval Medical Center in Bethesda, Maryland. By the time students reach
    their seventh month in the program, they are clinically and
    didactically prepared to deploy in their specialty. Last year this
    fellowship program produced 23 nurses combined, and currently enrolled
    this academic year are 18 critical care and 5 trauma nurse fellows.
    Additionally, as part of the preparation for this course, the student
    must complete either the Essentials of Critical Care Orientation (ECCO)
    course or the Emergency Nurses Orientation (ENO) course, respective to
    their specific fellowship. Both courses are online, self-paced, and
    focus on the skills and theory required to successfully care for
    critically ill adults. These online courses are available to all Air
    Force critical care and emergency nurses, so they may continue to hone
    their skills while earning up to 68 hours of continuing education
    credits. Over the past year, 117 nurses have enrolled in the ECCO
    course and 63 nurses have enrolled in the ENO course.
        Two additional avenues employed to assist our TNF in remaining
    deployment-ready are clinical rotations established through Training
    Affiliation Agreements (TAA) and the Sustaining Trauma and
    Resuscitation Skills--Program (STARS-P). In 2006 we identified a need
    to ensure nurses who were assigned to outpatient or non-clinical
    settings, were maintaining their operational clinical currency, and
    therefore recommended nurses attain 168-hours of bedside nursing care.
    Over the past 3 years, this initiative opened the door for 57 TAAs,
    further strengthening our partnership with civilian and sister-service
    facilities. Where available, our medical technicians have also
    capitalized on these joint ventures. These relationships and training
    opportunities are critical in producing nurses and technicians prepared
    for diverse patient populations in the deployed environment. For
    example, in August 2008, nursing personnel from the 3rd Medical Group
    (MDG) DOD/Veteran's Administration (VA) Joint Venture Hospital and the
    Alaska Native Medical Center expanded their TAA partnership to include
    rotations in the pediatric intensive care unit. Unfortunately, up to 40
    percent of the patients in military hospitals in both Iraq and
    Afghanistan are local children. As Major Dais Huisentruit, who deployed
    to Balad as the Intensive Care Unit Flight Commander explains, ``we had
    nurses from different ICU backgrounds, but most worked with adults. It
    was amazing to see them work together taking care of these children. At
    one point we had a total of 6 burned kids in the unit at one time,
    ranging in age from 2 to 7 years-old. On another occasion, we even had
    a group of three brothers . . . two of them in the ICU. They all
    survived.'' The skills our TNF has garnered through these TAA is saving
    lives and paying immeasurable dividends.
        The STARS-P is a program whose focus will not be on pre-deployment
    immersion, but ongoing clinical rotations at local civilian treatment
    facilities with Level I, and in some cases Level II trauma programs.
    The AFMS currently has five TAAs for STARS-P training sites in
    cooperation with local MTFs (San Antonio Military Medical Center,
    Texas, Luke AFB, Arizona, Nellis AFB, Nevada, Wright-Patterson AFB,
    Ohio, and Travis AFB California), and is looking to add a sixth site
    connected to Scott AFB, Illinois later this year. Currently projected
    for full implementation in fiscal year 2010, clinical rotations will be
    scheduled for 1 to 2 weeks and may also include technically-advanced
    simulation centers.
                                  quality care
        After 9/11, medical leaders across the military health services
    enacted a plan to develop and implement a trauma system modeled after
    the successes of civilian systems, but modified to account for the
    realities of combat--this plan matured into what is now known as the
    Joint Theater Trauma System (JTTS). Nursing's role within the JTTS's
    trauma performance improvement program spans the trauma continuum.
    Nurses serve as Trauma Nurse Coordinators (TNC) in combat zone MTFs,
    flight nurses within the Air Force AE system, members of
    multidisciplinary trauma teams at overseas, stateside, and VA
    hospitals. Many of the trauma performance improvement initiatives that
    have occurred since the development of JTTS have been led by nurses
    serving within this system. One vitally important role is that of the
    TNC. The TNC is the critical link in the complex continuum of trauma
    care from point-of-injury to treatment facilities in the Continental
    United States (CONUS). The TNC provides data to affect local and
    system-wide changes, in addition to trauma care expertise. Their role
    is fast-paced and multi-faceted. At the local level, the TNC impacts
    people and processes in several spheres of influence including primary
    trauma care, education, process improvement, and collaboration with
    literally every hospital department and specialty. They review all
    trauma patients' charts, compile and analyze complex data, and channel
    the information into the trauma system to improve combat casualty care.
        Another program that has positively impacted patient outcomes and
    safety is the Rapid Response Team (RRT). This nurse-led program,
    initiated at David Grant Medical Center, was established to provide the
    nursing staff an avenue for early intervention at the first signs of
    negative changes in a patient's condition. When the RRT is called upon,
    an experienced critical care nurse and respiratory technician come to
    the bedside within 5 minutes to assess the patient and provide pre-
    emptive care, preventing further deterioration. This pro-active
    approach has resulted in earlier medical interventions, a lessening of
    the severity in patient conditions, improved communication, and
    expected seamless, well-coordinated transfers between units when
    necessary. RRT is an example of an ICU without walls where critical
    care teamwork makes a difference for both our patients and staff.
        Our enlisted forces have also made great achievements this past
    year. In August, Special Experience Indicator (SEI) 456 was approved
    for our enlisted medical technicians who maintain national currency as
    a Paramedic. Our Career Field Manager, Chief Master Sergeant Joseph
    Potts is leading a team of experts in building standardized Air Force
    Paramedic protocols. By establishing this SEI we ensure our medical
    technicians have a nationally defined advanced care capability to meet
    operational needs.
        One more example of our multi-faceted approach to quality care is
    the Center of Excellence for Medical Multimedia (CEMM),
    organizationally aligned at AFMOA. The CEMM's mission is to provide
    patient education material that improves knowledge, patient compliance,
    and patient satisfaction. Diseases or conditions must meet certain
    criteria to be targeted for CEMM program development. Some program
    examples include Women's Health, Traumatic Brain Injury, and Diabetes
    Prevention. As CEMM's Director of Education Services, Captain Laurie
    Migliore's role is diverse as she assists in program design,
    development, and product deployment. The CEMM has distributed 85,000
    programs per year and won over 75 national awards.
        Our profession is not one just of caring, but educating others as
    well. Members of our TNF are filling critical roles in medical Embedded
    Training Teams (ETT) in areas across Afghanistan. The mission of these
    ETTs is to strengthen and improve the Afghan National Army (ANA)
    healthcare system through education and training of Afghan medical
    personnel.
        Lieutenant Colonel Susan Bassett, deployed as a 205th Afghan
    Regional Security Integration Command Mentor, adds, ``We have taught 15
    classes so far, with an average of 25-30 attendees including nurses,
    medics, laboratory technicians, x-ray technicians, and pharmacists. I
    try to use very animated examples and write key words on the dry-erase
    board. They are extremely studious and eager to participate. They ask
    for handouts and complain if they are solely in Dari . . . they want
    them in English and Dari as they are trying to learn to read English.
    After giving them power point slides, several of the more experienced
    Afghan nurses volunteered to teach some of the modules themselves. They
    were proud as peacocks!'' She goes on to share, ``The other day one of
    the nurses told a visiting reporter, in very halted English, `We . . .
    love . . . Mama Bassett!' '' Lieutenant Colonel Bassett has certainly
    made a lifelong difference in the quality of care these Afghan nurses--
    provide just one more step in winning their hearts and minds.
                                    research
        The research initiative known as the Deployed Combat Casualty Care
    Research Team (DCCCRT) consists of six Army and three Air Force members
    with the purpose of facilitating mission-relevant research in the
    Multi-National Corps--Iraq Theater. In September 2008, a Balad research
    team was established which included Colonel Margaret McNeill, an Air
    Force Ph.D.-prepared nurse, a flight surgeon, and a podiatrist. Colonel
    McNeill is the first Air Force nurse researcher to join the DCCCRT. The
    role of the team is to provide guidance and initial review for all
    research conducted in Iraq. The Ph.D.-prepared nurses provide
    leadership on human subject protections and the ethical conduct of
    research. Each team member is involved in collecting data for a variety
    of research protocols focusing on the care of combat casualties. Over
    100 research studies have been conducted or are in planning stages as a
    result of the team's efforts. More than 12,000 subjects have been
    enrolled in studies. Areas of research conducted by the military in
    Iraq that have led to advancement in medical therapies include
    tourniquet application, resuscitation, blood product administration,
    burns, wound care, ventilation management, patient transport, Post
    Traumatic Stress Disorder (PTSD), Traumatic Brain Injury, and
    infectious diseases. Nurse-led studies have investigated pain
    management, carbon monoxide exposure, women's healthcare, sleep
    disturbances in soldiers, and PTSD/burnout and compassion fatigue in
    nursing personnel.
                            recruiting and retention
        According to the latest projections from the U.S. Bureau of Labor
    Statistics, more than 1 million new nurses will be needed by 2016. Of
    those, 587,000 are projected to be new nursing positions, making
    nursing the nation's top profession in terms of projected job growth
    (www.bls.gov/opub/mlr/2007/11/art5full.pdf). A separate report, titled
    ``The Future of the Nursing Workforce in the United States: Data,
    Trends, and Implications'', found that the shortage of RNs could reach
    as high as 500,000 by 2025 (www.jbpub.com/catalog/9780763756840). It is
    evident Air Force Nursing will need to take advantage of every
    opportunity to recruit and retain nurses.
        In fiscal year 2008, we accessed 302 nurses against our total
    accession goal of 325 (93 percent). The Air Force Recruiting Service
    ultimately delivered 226 nurse accessions, filling 69.5 percent of our
    total accession goal. Our challenge remains with recruiting fully
    qualified and specialty nurses in the areas of mental health,
    anesthesia, medical-surgical, emergency and critical care. While 93
    percent appears positive, only 44 percent of those were considered
    ``fully qualified,'' meaning they had a minimum of 6 months previous
    nursing experience. Fifty-six percent of all nurse accessions were
    ``novice nurses,'' having less than 6 months nursing experience. The
    shortage of experienced nurses is a direct reflection of our national
    nursing shortage. Additionally, it is difficult to compete with our
    civilian counterparts in recruiting experienced nurses, as they offer
    many lucrative incentives.
        We take advantage of numerous venues to access nurses. In addition
    to our recruiting services, we bring nurses into the Air Force through
    a variety of programs. Utilizing the Air Force Reserve Officers'
    Training Corps, Airmen Education and Commissioning Program, the
    Enlisted Commissioning Program, and the Health Professions Scholarship
    Program, we accessed 70 nurses in 2008.
        In 2007 we launched our Nurse Enlisted Commissioning Program
    (NECP). The goal is to grow Air Force nurses from our highly successful
    enlisted medics. The NECP is an accelerated program for enlisted Airmen
    to complete a full-time Bachelor of Science in Nursing (BSN) at an
    accredited university while on active duty. This program produces
    students completing their BSN and obtaining their nursing license in 24
    months or less through either a 2 or 1 year program, depending on their
    entry level. Airmen who complete this program are then commissioned as
    second lieutenants. Since its inception we have selected 73 students
    from 83 applicants and project a steady state NECP quota of 50 per year
    for the 2 year program beginning fiscal year 2011.
        We strive to sustain and exceed our recruitment goals, but Nurse
    Corps retention remains problematic. In 2008, 55 percent of the nurses
    who separated had less than 20 years of military service. In 2008
    alone, 61 percent of those separating were our young lieutenants and
    captains. The number of lieutenants separating has nearly tripled over
    the past 3 years. We are hopeful the implementation of the Nurse Corps
    Incentive Special Pay (ISP) program will make a positive impact on
    retention; however, we are concerned about the unintended consequences.
    A resulting increase in retention of company grade officers may further
    extend timing and reduce promotion opportunity due to our small number
    of field grade requirements.
        While we currently offer incentive special pay to CRNAs at variable
    rates, we have never had the resources to recognize clinical nurses for
    seeking and earning professional national certification and advanced
    academic degrees in various nursing specialties. With ISP we offer an
    even more appealing pay incentive if a nurse with an identified
    certification, additionally desires and commits to work in an approved
    clinical area and for a specific amount of time. We are pleased to be
    able to acknowledge our highly-skilled professional nurses in the
    clinical arena.
        Our active duty enlisted forces also scored a win this past year
    with their own Selective Re-enlistment Bonus (SRB). Even though their
    overall manning appears to be strong at 94 percent, our Independent
    Duty Medical Technicians (IDMT) are heavily tasked with deployments and
    manned at only 72 percent. This SRB is a first-ever for our IDMTs, and
    I, along with Chief Master Sergeant Potts, am eager to see the impact
    of this initiative.
                                   leadership
        As a Corps, we place heavy emphasis on purposefully developing
    leaders, clinically and professionally for the AFMS. Our Nurse Corps
    Development Team (DT) convenes three times a year to ensure Nurse Corps
    officers are provided deliberate career progression opportunities. The
    DT competitively selects our squadron commander and chief nurse
    candidates, both of which represent pivotal career leadership
    milestones. Furthermore, the DT identifies through a scored-board
    process, those leaders who would most benefit from developmental
    education in-residence. In 2008, the Nurse Corps garnered 90 annual
    quotas to send our best and brightest captains to Squadron Officer
    School.
        Another recent development on the topic of clinical leadership is
    the creation of master clinician authorizations. This affords an
    opportunity for our most clinically experienced senior nurses with
    advanced academic preparations to remain in patient care settings
    without sacrificing promotion or advancement opportunities. We
    currently have identified 20 master clinician positions scattered among
    our larger MTFs as well as the Uniformed Services University of Health
    Sciences representing the areas of CRNAs, Perioperative Nursing,
    Education and Training, ICU, Family Nurse Practitioner, and Nursing
    Research.
        Nurse leaders are critical in every environment, especially in
    deployed locations. Last year we successfully acquired a deployed
    Colonel Chief Nurse position at Joint Base Balad, Iraq, and we
    anticipate permanently adding another at Bagram's Craig Theater
    Hospital. The corporate experience of seasoned chief nurses in the
    grade of Colonel lends itself to mentoring not only nursing services
    personnel, but officers from across the AFMS.
        Not only do we deploy as chief nurses, but in the role of
    Commanders as well. Colonel Diana Atwell served as the 332nd
    Expeditionary Medical Operations Squadron Commander at Joint Base
    Balad. As commander, she led a squadron of approximately 200 combat
    medics ranging from trauma surgeons to medical technicians, whose
    efforts contributed to an overall survival rate of 98 percent at the
    DOD's largest and busiest level three theater hospital.
                                  ang and afrc
        The ANG and AFRC are vitally important contributors to our TNF and
    the backbone of our highly-successful global AE mission. Since 2007,
    all AFRC mobilization requirements have been met solely by volunteers.
    In 2008, 503 AFRC nurses and medics stepped up to meet deployment needs
    at home and abroad, with 133 of those personnel sourced for missions
    related to Hurricanes Gustav and Ike. The ANG also played a key role as
    they deployed 268 medics and AE personnel. They processed and moved 600
    patients prior to and after the hurricanes. In addition to activating
    AE crews, the ANG mobilized AE Liaison teams (AELT), Command and
    Control (C\2\) elements, and Mobile Aeromedical Staging Facilities
    (MASF). The MASF changed location three times ``chasing the storm'' and
    providing evacuation assets to the area in most need. Rounding out TNF
    representation, the 43d Aeromedical Evacuation Squadron (AES) from Pope
    AFB, North Carolina, also played a role in responding to Hurricanes
    Gustav, Hanna, and Ike by deploying MASFs, AELTs, AE crews, and C\2\
    elements to areas in Louisiana and Texas.
        Our AE system provides the vital link in uninterrupted world class
    medical care from the battlefield to definitive treatment facilities at
    home. We boast a 98 percent survival rate for those that reach a
    theater hospital; the highest survival rate in history. It is a total
    force human weapons system comprised of 32nd AE Squadrons representing
    12 percent Regular Air Force, 60 percent AFRC, and 28 percent ANG. The
    AE deployment requirements in support of Operations Iraqi and Enduring
    Freedom have moved nearly 71,000 patients since October 2001. The
    mission of AE is one close to all our hearts--a mission of carrying the
    most precious cargo of all, our wounded warriors.
                             humanitarian missions
        The TNF nurses and aerospace medical technicians represented a
    United States presence in locations crossing the globe including Iraq,
    Afghanistan, Qatar, Kuwait, Europe, Korea, Honduras, Trinidad, El
    Salvador, Guatemala, Morocco, Cambodia, Peru, and Suriname, to name
    only a few.
        Master Sergeant Jeffrey Stubblefield, an IDMT assigned to the 3rd
    MDG in Alaska, had the unique opportunity to deploy to Laos on a
    mission to recover remains of two Raven Intelligence Officers whose
    plane crashed after taking enemy fire during the Vietnam Conflict. As a
    medic assigned to Recovery Team One, he provided medical support to 51
    team members traversing treacherous terrain to reach our fallen
    comrades and enable the repatriation of their remains.
        Major Susan Perry, a CRNA assigned to Wright-Patterson AFB, Ohio,
    was part of JTF-Bravo, a medical element surgical team partnering with
    civilian surgeons in Comayagua, Honduras. Her team was pivotal in
    responding to and saving the lives of 30 civilians injured in a motor
    vehicle collision.
        Captain Troy Mefferd and First Lieutenant Ranjodh Gill deployed
    aboard the U.S. Naval Ship Mercy in support of joint humanitarian
    mission, Pacific Partnership 2008. Through this endeavor, medical care
    was provided to nearly 8,000 patients as well as 1,200 receiving dental
    care through Operation Smile.
        Lieutenant Colonel Tambra Yates, Flight Commander of Women's Health
    Services at Elmendorf AFB, was the first women's health provider to
    accompany a Family Practice Team to three remote Alaskan villages as
    part of Alaska Taakti Top Cover. She treated 32 patients, diagnosing
    three with cancer which required immediate surgery. As a result of her
    many contributions, future Taakti missions will include a Women's
    Health Service Provider as part of the team.
        Seven members of the 43rd AES participated in a historic mission
    which brought home three American contractors who'd been held captive
    for over 5 years by leftist Revolutionary Armed Forces of Colombia
    after their plane crashed in February 2003. The 43rd AES crew, along
    with 17 Airmen from Charleston AFB, South Carolina cared for and
    delivered them safely back to the United States on July 2, 2008. The
    close proximity to July fourth gave an all new meaning to
    ``Independence Day'' for these former captives.
                                  recognition
        It was a banner year as Air Force nurses and medical technicians
    were recognized for outstanding performance by a variety of
    professional organizations. Technical Sergeant David M. Denton captured
    the Airlift/Tanker Association's ``General P.K. Carlton Award for
    Valor.'' This annual award is presented to an individual who
    demonstrates courage, strength, determination, fearlessness, and
    bravery during a combat, contingency, or humanitarian mission.
    Technical Sergeant Denton was also named as the AFMS ``Outstanding Non-
    Commissioned Officer AE Technician of the Year.''
        Every year the Commemorative Air Force (CAF) recognizes one
    exceptional flight nurse who engaged in live aeromedical evacuation
    missions and contributed significantly to in-flight patient care, by
    awarding them the ``Dolly Vinsant Flight Nurse Award.'' This award pays
    tribute to Lieutenant Wilma ``Dolly'' Vinsant who was killed in action
    over Germany during an AE mission on August 14, 1946. This year the CAF
    recognized Captain Bryce Vanderzwaag of the 86th AES at Ramstein AB,
    Germany. Captain Vanderzwaag provided direct AE support to 651 sick and
    injured patients, including two K-9 military working dogs injured by
    IEDs, during his deployment.
        Lieutenant Colonel Mona P. Ternus, an AFRC nurse, was recognized by
    the Tri-Service Nursing Research Program, Federal Nursing Section, as
    she was awarded the ``Federal Nursing Service Essay Award'' for her
    research and essay entitled, ``Military Women's Perceptions of the
    Effect of Deployment on their Role as Mothers and on Adolescents'
    Health.'' These are but a few examples of the stellar work our nurses
    and medical technicians perform every day.
                                 our way ahead
        Nursing is a profession vital to the success of our healthcare
    system. Our top priorities include, first and foremost, delivering the
    highest quality of nursing care while concurrently staging for joint
    operations today and tomorrow. Second, we are striving to develop
    nursing personnel for joint clinical operations and leadership during
    deployment and at home station, while structuring and positioning the
    Total Nursing Force with the right specialty mix to meet requirements.
    Last, but not least, we aim to place priority emphasis on collaborative
    and professional bedside nursing care.
        Mister Chairman and distinguished members of the Committee, it is
    an honor to be here with you today and represent a dedicated, strong
    Total Nursing Force of nearly 18,000 men and women from our Active
    Duty, Air National Guard , Air Force Reserve, civilian, and contract
    forces. Our warriors and their families deserve nothing less than
    skilled and educated nurses and technicians who have mastered the art
    of caring. It is the medic's touch, compassion, and commitment that
    often wills the patients to recovery and diminishes the pain. As our
    Air Force Nurse Corps celebrates its 60th Anniversary, I look forward
    to working with our Sister Services and our Federal Nursing Team, as we
    partner to shape the future of our profession.

        Chairman Inouye. On behalf of the subcommittee, I thank all
    of you, but I have a few questions.
        There's no secret that there's a national nursing shortage.
    But somehow you gals have done a good job. The Air Force has
    met 93 percent of its goal. Army and Navy have exceeded their
    goals. What's the secret?

                        NURSE RECRUITMENT AND RETENTION

        General Horoho. Mr. Chairman, I think the secret is a
    couple things: the support that we've received from Congress
    with the different incentive specialty pay bonuses, that has
    had an overarching success with our nurses choosing to remain
    on active duty. The other is working very collaboratively with
    the Army Medical Recruiting Brigade. We stood up that brigade
    in 2007 that focused on recruiting nurses and the entire Army
    medical team, and so the first time last year since 2001 they
    actually exceeded the mission by 147 percent for recruitment of
    nurses on active duty.
        So having that specialized--there were also bonuses that
    were given to the recruiters to be able to target special
    critical categories. We've also been very, very proactive with
    telling the Army Nurse Corps story and having our nurses
    engaged in helping with the recruiting effort.
        Admiral Bruzek-Kohler. Mr. Chairman, there's no doubt that
    the support we received from you for our accession bonus
    increases and in particular our loan repayment program has made
    a tremendous difference in the numbers of direct accessions,
    particularly in light of the economic situation. For many of
    our new students, they come with extremely high student loans,
    more than I would have anticipated.
        In fact, I remember meeting a lieutenant in Bahrain who had
    not yet heard about the program, a new graduate with over
    $60,000 worth of school loans. So that has made a major, major
    difference in their lives.
        We've expanded our opportunities with our recruiters to use
    our own nurses in geographic areas, particularly nurses who are
    going to many of our professional organizations, both in terms
    of clinical skills, but also in terms of some of our diversity
    issues, and selling our story, telling our story as well. That
    has really made a difference in bringing in some of the
    diversity that we've not been able to get in the past.
        So we will continue to use all of those opportunities to
    bring in our direct accessions. We also have a huge pipeline,
    as we've heard from our sister service in the Air Force, with
    our medical enlisted programs, and using our corpsmen and other
    enlisted rating applicants to come into the Nurse Corps has
    really been our life's blood really for keeping our Corps at a
    level of being able to provide the kinds of care we provide. We
    will continue to support those programs, as well as our ROTC
    programs and our candidate programs.
        So again, we thank you for that support for all of those.
        General Siniscalchi. Senator Inouye, thank you, and I would
    like to reiterate my nursing colleagues' for our Air Force
    accessions. I can attribute our success has been with
    recruiting novice nurses, the nurses who are completing their
    baccalaureate degrees and are coming into the Air Force as
    novice with less than 6 months experience.
        Our loan repayment program, the increase that we received
    has been very successful. We were able to increase our quotas
    from 76 to 102. The increase in our health professions loan
    repayment quotas had a significant impact on our ability to
    recruit more novice nurses. The accession bonus has also been a
    very successful recruiting tool, and we appreciate the
    increased funds that we received in accession bonuses this
    year.
        We are finding that with the $30,000 in accession bonus and
    up to $40,000 in the loan repayment combination it's very
    helpful to those students who have large loan repayments. So I
    would like to thank you again for your support with those
    programs.
        We've taken several initiatives to continue success with
    recruiting. Dr. Cassells and Dr. Hinshaw from USU had organized
    a conference for academic partnerships addressing military
    nursing shortages, and that occurred this past weekend. We had
    the opportunity to meet with nursing deans and faculty across
    the country, and our objective was building collaborative
    relationships among military nursing services with the schools
    of nursing to foster additional educational opportunities and
    begin a campaign to educate the faculty from these schools, so
    as they are mentoring and advising their students they can help
    direct them toward military nursing as a potential career
    option.
        Chairman Inouye. Do you believe that we have enough nurse
    anesthetists, critical care nurses, operating room nurses,
    these specialties?
        Admiral Bruzek-Kohler. Those are our critical areas right
    now that we are looking at in terms of retention as well as
    accessing. We do not have enough. Critical care nurses are
    undermanned at about anywhere from 60 to 70 percent. We think
    anything below 90 percent is critical and we have to pay
    attention to them.
        I will say, our nurse anesthetists actually are very
    healthy. They aren't really one of the groups that we are
    focused on this year. Our perioperative nurses, our operating
    room nurses, our critical care nurses, and our nurse
    practitioners are below that critical 90 percent at this point
    in time.
        So we're doing a couple of things. When we're recruiting,
    we are looking to recruit those specialties, which means we
    will bring in a more seasoned, more experienced clinical nurse
    at a more senior rank. We don't anticipate, nor do we know at
    this point, whether these nurses would want to continue on a
    full naval career or at least be with us during a very critical
    time in our history while this war is still going on.
        For retention, again the loan repayment program has been
    helpful. The RNISP has been absolutely the most positive action
    we could have taken to entice our more senior nurses,
    particularly those who are at the point of either the 10-year
    mark where they either make the decision to leave now or they
    continue on for 20 years, or for some who have come in from the
    enlisted ranks, who at the 10-year officer mark now have 20
    years and can, in fact, retire. Those incentives have actually
    been positive in making the decision for them to stay in the
    Navy.
        Also, the opportunities to deploy have been remarkable
    incentives for our people to stay in the Navy.
        Chairman Inouye. General Horoho.
        General Horoho. Mr. Chairman, both the emergency nurse
    specialty as well as the ICU specialties are two of our highest
    deployers as we support two theaters of operations. So we have
    been working very aggressively to expand our critical skill
    sets by helping them with deployment skills and training. We
    have increased the number of seats to be able to train more.
        We have also started to target the population at the rank
    of major because I'm at 50 percent strength at that middle
    grade leadership, and we're trying to force more clinical
    expertise back at the bedside. So there's a pilot project
    that's ongoing that gives us the authority to be able to
    recruit individuals to come on active duty for a 2-year
    obligation. So what we are doing is working very closely with
    Recruiting Command and Accessions Command to be able to target
    that clinical expertise and bring them on active duty for a 2-
    year obligation to help us bridge that critical shortfall that
    we have.

                                NURSE RECRUITING

        Chairman Inouye. General Siniscalchi.
        General Siniscalchi. Sir, direct recruitment of our nurse
    specialties continues to be a challenge. We've come up with
    programs, very successful programs, to help us with retention
    and to help us develop those skill sets that we need ourselves.
        The biggest impact on retention has been the incentive
    specialty pay program. We just started this program in January
    and so far over 76 percent who decided to participate in the
    program accepted the 4-year active duty service commitment. So
    that will have a significant impact on our ability to retain
    those critical areas.
        We've developed fellowships that are year-long in critical
    care, emergency training, and trauma training. That helps us to
    grow nurses in those critical areas.
        We continue to select nurses annually to attend USU for
    advanced academic training in critical areas. We've increased
    our family nurse practitioner quotas from 5 to 20 this year. We
    have an operating room cross-training course at Wilford Hall
    and a neonatal intensive care course at Wilford Hall, which is
    helping us to meet those critical specialties.
        Our future plan for this year is to build a mental health
    nursing course at Travis Air Force Base. We've had difficulty
    recruiting mental health nurses and, as you know, they are very
    critical in the care of our wounded warriors. So we are hoping
    to see this program come to fruition this year.
        We're building master clinician opportunities at the
    colonel ranks so that we can have senior leaders in anesthesia,
    in the operating room, in emergency rooms, and in critical care
    areas that can help grow and mentor those nurses in those
    critical specialties.
        Chairman Inouye. Thank you very much.
        Mr. Vice Chairman.
        Senator Cochran. Mr. Chairman, thank you.
        I'm concerned that the challenges in view of the war and
    the constant separation from families and friends may have a
    very serious consequence in terms of the success of recruiting.
    I was sitting here thinking about what could we do as a
    subcommittee to be helpful to you in increasing the likelihood
    that your goals were met and that retention rates are high in
    what you need.
        Would additional funding of specific programs targeted to
    recruiting and retention be in order, or do you have enough
    money to do what you need to do?
        Admiral Bruzek-Kohler. Well, I'll begin by saying that the
    support that you have given us to this date in time has shown
    dramatic improvements in the numbers of accessions, direct
    accessions, and the retention numbers. They have shown that
    they are successful in enticing people to join the Navy, as
    well as retaining them for a full commitment to a full career
    in the Navy.
        So I thank you for those and certainly we would appreciate
    to be able to continue to offer those incentives both as
    accession bonuses as well as our loan repayment program. As I
    mentioned, they have been an amazing support to our new
    students and our new graduates. While there is competition from
    the civilian sector our retention bonuses give them the
    opportunity to want to continue to serve their country.
        We do exit interviews of all of the nurses that leave the
    service, and I will tell you that deployments are generally not
    the reason why they leave the Navy. Usually it's family issues,
    dual career families and they want to get stable in a
    community. We also find as we are doing recruiting,
    particularly at schools of nursing throughout the country, that
    deployments are not a reason not to join the Navy. In
    particular, with our ability to provide humanitarian assistance
    and that type of service to other countries, that again is very
    enticing to a nurse who really wants to feel like they are
    fulfilling what the purpose of being a nurse is in the first
    place.
        So at this point I would just say thank you for what you've
    done for us up to this juncture and we would certainly be
    thankful for that continued support.
        Senator Cochran. General Horoho.

                                NURSE RETENTION

        General Horoho. Yes, sir. I would echo and say continued
    support of the programs that we do have in place, because when
    we have looked at our nurses 97 percent of those that are
    eligible to take those loan repayment programs or the bonuses
    have accepted them. So I think it does show that they are
    positive incentives to helping individuals remain on active
    duty.
        The other incentive is that there is tremendous pride with
    our nurses that deploy, and most of them that come back have
    echoed that they found great self-worth to be able to know that
    they were helping to enhance the healthcare of those
    servicemembers that are supporting our freedoms, as well as
    helping with the nation building.
        One of the things that has truly impacted I think retention
    is that we have changed our policy for deploying nurses from 12
    months down to a 6-month rotation. That in itself has helped to
    help with the time, to decrease the time away from their family
    members. So when we look at that, it's the financial incentive
    programs as well as those support programs that we have in
    place.
        We did a survey across the entire Army Nurse Corps so that
    I could have a baseline understanding of kind of the health of
    the Corps. Out of that survey we found two areas that we're
    going to focus on. One of them is looking at the redefinition
    of our head nurse role, of wanting to make sure that that role
    is having the ability to impact patient care and is really
    focused on outcome-based as well as leader development.
        So we have got a team that has stood up to look at best
    practices across our entire Army medical department, as well as
    looking at what is being done within our civilian health
    sector. Then we're going to redesign that leader development
    role, and we're also looking at the entire leader development
    training programs that we have in place, because when you look
    at young nurses during the exit survey--and we do exit surveys
    on everybody who's leaving--a majority of it is because of
    family reasons, either starting families or an elderly parent
    and needing to be home.
        So two things that we're doing. We're looking at and
    partnering with the Army to see how is it that we can have a
    program in place to help nurses take a leave and be able to
    still meet their family needs as well as their military
    obligation. Then we're also looking at how do we ensure that
    we've got our nurses best prepared for the deployment. So we're
    redoing--this past year we had 186 lieutenants that were
    assigned to each one of our medical centers for a year-long
    clinical immersed program to help them get their clinical
    skills solidified as well as their critical thinking skills
    prior to deployment.
        So I think those were the major things that came out of the
    organizational survey.
        Senator Cochran. Thank you.
        General Horoho. Thank you.
        Senator Cochran. General Siniscalchi.

                            NURSE ACCESSION BONUSES

        General Siniscalchi. Sir, I would add, in addition to your
    support for our nurse accession bonuses and the health
    professions loan repayment program, it's more than just the
    financial incentives that incentivize our nurses. The
    opportunities for advanced education, the opportunities for
    increased leadership roles and leadership training, has a
    significant impact on retention.
        The support of the health professions scholarship program
    has been critical. That program, the funding for that program,
    has allowed us to take nurses who already have baccalaureate
    degrees and put them in programs, civilian nurses, sponsor
    their education, put them in programs for anesthesia training,
    to become family nurse practitioners, women's health
    practitioners. And that allows them the opportunity to have
    advanced education paid for by us and then come on active duty
    and serve in those critical areas.
        So I would submit that continued support of the health
    professions scholarship program is a big incentive. We do
    continue to look at opportunities to partner with civilian
    programs so our nurses can have increased opportunities for
    advanced education and leadership training.
        Senator Cochran. Thank you very much.
        Chairman Inouye. Senator Murray.
        Senator Murray. Thank you very much, Mr. Chairman.
        I apologize for having to step out and miss your testimony.
    But I wanted to personally thank all of you and everyone you
    oversee for the tremendous work that they do. General Horoho,
    it's good to see you here. I appreciate everything you've done
    out at Madigan Army Medical Center and appreciate your
    leadership.
        Time is getting late, so let me just ask one question. I'll
    submit the other ones for your answers later. General Horoho,
    as you know, the Army's deployment schedule and adequate care
    of both soldiers and their families is very important to me.
    We've had the chance to talk about that. I wanted just to ask
    you how you are planning to continue to take care of children
    and families of servicemembers?

                          MADIGAN ARMY MEDICAL CENTER

        General Horoho. Yes, ma'am. First I'd like to thank you for
    your support, because we get tremendous support from you and
    your entire team in Madigan Army Medical Center being able to
    meet its mission.
        Madigan Army Medical Center--the troop strength on Fort
    Lewis has grown over the years, and so our enrolled population
    at Madigan has increased from 84,000 to currently we have
    106,000 enrolled beneficiaries. When you add on the healthcare
    benefits of that reliant population, which are those reserve
    soldiers and National Guard that are able to get extended
    healthcare, that increases it about 33,000. So we have the
    third largest enrolled beneficiary population in the Army, so
    about 133,000.
        Of that, 20,000 of those are women, so it's a growing
    population. The increased strength is 20,000 for women and for
    children.
        So what we've done is we have looked at--we have submitted
    a proposal for funding for a women's health center that will
    allow us to consolidate all of those services together to
    better meet the needs of our women and our children, so it's
    more of a continuum from infants through the adult parent.
        With that, if it's awarded, in 2010 we would look at design
    and construction beginning and having it completed about 2014.
    What that would allow us to do is to be able to maximize the
    efforts. We have a DOD fellowship, the only one in the Army,
    for developmental pedes as well as maternal-fetal medicine. So
    we'd have that capability of having the right case mix to be
    able to help our residents grow and our physicians grow in that
    specialty.
        We also are looking at, if that building is built, then we
    would take that space that is relieved to further expand our
    primary care to be able to meet the increased demand that we
    have from that troop population growth.
        Senator Murray. Well, I really appreciate your strong push
    on that and I want to be supportive in any way I can. It's a
    great way to move forward, I think. Obviously, whatever I can
    do from my end to support that, I will do.
        General Horoho. Thank you.
        Senator Murray. I just want all of you to know I'm worried
    about compassion fatigue with our nurses, and I know that's a
    recruiting issue, and a retention issue. We have to look at
    what we can do, Mr. Chairman, to support them. General, you
    mentioned several good ways to do that, and I want to encourage
    all of us to continue to do that.
        I do have several other questions. I know you've been
    sitting here a long time, so I will submit them for the record.
    But I do really appreciate the work that all of you do. So
    thank you so much.
        General Horoho. Thank you, ma'am.
        Chairman Inouye. The nurses are fortunate to have Senator
    Murray here.
        Senator Murray. We all stick together.
        Chairman Inouye. One of the priority projects I had when I
    first got on this subcommittee was to make certain that nurses
    got full recognition for their service. The one way to do that
    in the service was by rank. At that time, I believe I met one
    nurse who was a colonel. Most of the nurses I knew were
    captains or lieutenants. I'm happy to see two stars all over
    the place.
        But I note that in the Navy you have a rear admiral one
    star, rear admiral upper half two stars. But in the Army and
    Air Force there's no billet for one stars. Why is that?
        General Horoho. I'll go first if you don't mind. Sir, one
    of the things is that we have the Surgeon General's full
    support of leader-developing all of our Army Medical Department
    leaders. Our general officer slots are branch and material.
    What we do is we work very, very hard as a collective force to
    be able to ensure that we have the right leadership skill sets,
    not only the education programs, but the command opportunities,
    as well as the clinical opportunities to lead at that level.
        So we are working very closely to ensure that we have a
    pool of personnel that will be competitive for general officer
    at the one-star rank.

                               COMPETITIVE GRADES

        General Siniscalchi. Sir, having gone from colonel directly
    to two stars, the current construct has worked very well, and
    I've had tremendous support from my senior leaders. Within the
    Air Force, we have a limited number of general officer
    authorizations and we have elected to allow each of our corps
    the opportunity to have a star as their pinnacle rank.
        So if we add a Nurse Corps one star, we will have to offset
    it elsewhere. So our current plan is to continue with the
    current construct and continue to develop our colonel nurses
    and select those nurses who have more time in grade and more
    time in service, so that we're selecting our senior colonels as
    we promote them to the rank of two stars.
        Chairman Inouye. So it would help if we authorize one star
    billets with the money that we can provide here. You won't be
    against that, would you?

                         ADDITIONAL COMMITTEE QUESTIONS

        General Siniscalchi. Sir, I would never turn down stars.
        Chairman Inouye. Well, I thank you ladies very much. I want
    to thank General Schoomaker, Admiral Robinson, General
    Roudebush, General Horoho, Admiral Bruzek-Kohler, and General
    Siniscalchi for your testimony and for your service to our
    Nation.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
          Questions Submitted to Lieutenant General Eric B. Schoomaker
                Questions Submitted by Chairman Daniel K. Inouye
                              joint dod/va clinics
        Question. General Schoomaker, since there are other joint DOD/VA
    clinics and presumably more to come, are all the Services involved in
    raising, discussing, and resolving the myriad of issues presented by
    these joint facilities or is it done on a facility unique basis?
        Answer. The Health Executive Council and Joint Executive Council
    provide the basis for managing efforts related to joint DOD/VA clinics.
    The recent revival of the VA/DOD Construction Planning Committee will
    facilitate future joint planning efforts. Army facility pre-planning
    efforts take into account existing/proposed Community Based Outpatient
    Clinics (CBOCs) and also consider the possibility of current and future
    Joint Ventures. For example, the U.S. Army Medical Command (MEDCOM) is
    currently working with the local VA medical center and the Veterans
    Integrated Service Network to define the scope for a William Beaumont
    Army Medical Center (WBAMC) hospital replacement at Fort Bliss, Texas.
    WBAMC currently shares services through a Joint Venture agreement with
    the co-located VA medical center. There is potential for additional
    sharing and this is the heart of the ongoing pre-planning effort.
    MEDCOM has also incorporated CBOCs within hospital replacement projects
    such as Bassett Army Community Hospital at Fort Wainwright, Alaska, and
    DeWitt Army Community Hospital at Fort Belvoir, Virginia. The VA and
    Army are also working to locate CBOCs on Army installations such as
    Fort Detrick, Maryland and Fort Meade, Maryland. The VA recently
    renovated space at the former Lyster Army Community Hospital at Fort
    Rucker, Alabama, as it was downsized to an Army Health Clinic. The VA
    was able to vacate a lease for its CBOC in downtown Dothan, Alabama,
    and move closer to its beneficiary population at Fort Rucker.
                             centers for excellence
        Question. General Schoomaker, there seems to be an insatiable
    appetite for creating Centers of Excellence for everything from sensor
    systems to urban training and now we are creating them for medical
    research. While I fully support the establishment of the Defense Center
    of Excellence for Traumatic Brain Injury and Psychological Health, we
    also created them for amputees, vision, and hearing. All of these areas
    are critical to the health of our service members but we can't create
    centers for every issue facing our service members. Therefore, how do
    we ensure the appropriate level of attention and allocation of
    resources are devoted to the issues we are faced with today and also
    those we might encounter in the future?
        Answer. A Center of Excellence designation serves to establish
    priority; whether directed by Congress or within the Department. It
    results in a specific activity gaining visibility and attention above
    other areas. COE designation to date has come with costs as we grow
    organizational structure to oversee a specific area of interest. There
    is a critical balance that must be kept in check. The Services are
    operating comprehensive healthcare systems. We are caring for Soldiers
    and Families with a very broad spectrum of healthcare needs--nearly the
    entire spectrum of medical practice. We must be careful not to focus
    too much effort in too few areas and cause us to fail to meet the true
    needs of our beneficiaries; the majority of which fall outside the
    sphere of established COEs. Moreover, every one of my Army hospitals is
    a Center of Excellence. We provide exceptionally high quality
    healthcare outcomes. I must be able to appropriately resource every
    hospital and every patient encounter because every patient is
    important. A robust and capable direct care system is essential to the
    Army. I ask for continued support in resourcing our direct care system,
    as a system with global responsibility, and not fragmenting our system
    into a series of new Centers of Excellence.
                         centers for vision and hearing
        Question. General Schoomaker, Congress is awaiting the Department's
    detailed plans for establishing the Centers for Vision and Hearing. Can
    you tell me if you and your colleagues are approaching the staffing and
    resourcing of all of these Centers strategically or as independent
    centers?
        Answer. The Service Surgeons General do not have an active role in
    the development of the Department of Defense Centers of Excellence for
    Hearing and Vision. The approach to funding and staffing these Centers
    is being managed by the Office of the Assistant Secretary of Defense
    for Health Affairs.
                    traumatic brain injury/malaria research
        Question. General Schoomaker, what are the specific mechanisms in
    place to ensure coordination at the planning, budgeting, and technical
    levels between the various Federal agencies (including NIH) on areas
    like Traumatic Brain Injury or Malaria research? Are there examples of
    DOD, VA, or NIH dollars being moved or redundant activities being
    terminated as a result of these coordination efforts?
        Answer. The U.S. Army medical research and development community
    coordinates closely with other services and agencies for both the
    President's Budget and the large Congressional Special Interest (CSI)
    funded programs to avoid redundancy. We include representation in our
    planning processes to identify various service or agency research
    portfolio lead, and gap areas across the spectrum of federally funded
    research. Through coordination with the other services and agencies we
    have not needed to terminate programs, but have instead been able to
    maximize our ability to direct research funds toward the gap areas.
    Traumatic Brain Injury (TBI) and Malaria are two of several extensively
    coordinated research areas.
        Planning and programming coordination is taking place through
    involvement of NIH and VA representatives on the expanded Joint
    Technical Coordinating Groups of the Armed Services Biomedical Research
    & Management (ASBREM) Committee, which are planning the investment for
    the future years Defense Health Program Research Development Test and
    Evaluation investment. At the technical levels, DOD, VA, and NIH
    scientists and research program managers actively participated in joint
    planning activities for major TBI and Psychological Health (PH)
    research programs, including the fiscal year 2007 Congressionally
    Directed Medical Research Program TBI/PH program and the fiscal year
    2008 Deployment Related Medical Research Program. These planning
    activities included joint program integration and review panels that
    were responsible for identifying research gaps, developing language for
    program announcements, and reviewing and recommending research
    proposals for funding. In fiscal year 2009, an integration panel with
    DOD, VA, and NIH members identified remaining TBI/PH knowledge gaps and
    developed a program announcement for research that addresses TBI/PH
    topics in response to a fiscal year 2009 CSI for TBI/PH research.
        The DOD is creating a collaborative network in the area of TBI/PH
    research. The DOD has partnered with Federal and non-Federal agencies
    to cosponsor several scientific conferences. The DOD recently partnered
    with NIH, VA, and the National Institute on Disability and
    Rehabilitation Research to sponsor a common data elements workshop,
    which will lead to the ability to compare results and variables across
    studies. The DOD is sponsoring a state-of-the-science meeting in May
    2009 to evaluate non-impact blast-induced mild TBI and identify for
    future research gaps in our current knowledge. Attendees have been
    invited from several Federal agencies (NIH, VA, and Environmental
    Protection Agency) as well as academia and industry. The DOD is
    planning a conference for November 2009 and will partner with several
    agencies to sponsor a TBI/PH research portfolio review to help identify
    gaps and assist with setting funding priorities among the various
    agencies. While new projects that address residual gaps in the science
    may overlap with ongoing research objectives, continuous
    interdepartmental and interagency portfolio analyses ensure that
    resources obligated through DOD funding mechanisms target residual and
    emerging gaps in TBI/PH research.
        The Defense Centers of Excellence (DCoE) for TBI and PH is
    establishing a strategic level TBI/PH research working group to further
    collaboration within the scientific community. This working group will
    help to prevent unnecessary redundancies and increase communications.
    The DCoE is collaborating with NIH on developing a research database,
    which may decrease the need to maintain several different databases.
        The U.S. Military Infectious Disease Research Program (MIDRP) is a
    joint Army/Navy program funded through the Army. To insure that
    research planning is coordinated between the major funders of malaria
    vaccine research, the U.S. Military Malaria Vaccine Program conducts an
    annual strategic review of its program by a Scientific Advisory Board.
    The membership of this board includes a broad range of internationally
    recognized experts including members from Vaccine Research Center at
    NIH; the Division of Intramural Research, National Institute of Allergy
    and Infectious Disease (NIAID), NIH; industry and academia, and the
    Bill and Melinda Gates supported Malaria Vaccine Initiative (MVI).
    Furthermore, a permanent member of the NIAID staff sits on the U.S.
    Army Medical Research and Materiel Command's Executive Advisory Panel.
    A broad strategic review was conducted recently by the Institute of
    Medicine (Battling Malaria Strengthening the U.S. Military Malaria
    Vaccine Program) and included a distinguished panel of both
    international experts and members from NIH, industry, and academia. The
    close review and coordination insures that there is no duplication of
    effort. The U.S. Army receives funding from the MVI. The U.S. Army
    malaria drug development program was also reviewed by the Institute of
    Medicine (Saving Lives, Buying Time, Economics of Malaria Drugs in an
    Age of Resistance). This program is coordinated and relies heavily on
    industry to bring anti-malarial drugs to the market. Essentially every
    U.S. Food and Drug Administration approved anti-malarial drug has been
    advanced, if not discovered by contribution from the U.S. Military
    Malaria Drug Program.
                                   caregivers
        Question. General Schoomaker, while attention must be focused on
    the resilience training of our servicemembers and their families, I
    also suspect that caring for our wounded takes a considerable toll on
    our caregivers. What efforts are underway to address the well-being of
    our caregivers in order to retain these critical personnel?
        Answer. In 2006, the Army recognized that there was a need for
    educating and training its healthcare providers on the signs and
    symptoms of Compassion Fatigue and Burnout. It began deploying mobile
    training teams through the Soldier and Family Support Branch, U.S. Army
    Medical Department Center and School, to various Medical Treatment
    Facilities (MTFs) to train healthcare providers on the prevention and
    treatment of Compassion Fatigue and Burnout.
        In June 2008, the Army implemented a mandatory Provider Resiliency
    Training (PRT) program to educate and train all MTF personnel, to
    include support staff, on the signs and symptoms of Compassion Fatigue
    and Burnout. Below is a brief description of the phased implementation
    the PRT program:
      --Phase I of the program focuses on organizational and personal
            assessment of Compassion Fatigue and Burnout using the
            Professional Quality of Life Scale (ProQol) which measures
            Compassion Fatigue, Burnout, and Compassion Satisfaction. Over
            55,000 medical personnel completed the survey and were provided
            a 30-minute introductory training session on provider
            resiliency.
      --Phase II involves developing a resiliency-based self-care plan
            through 2-hour classroom training with PRT trainers based at
            each major MTF.
      --Phase III is an annual reassessment of an individual's stress
            levels and adjustment to his/her self-care plan based on the
            reassessment.
        The Institute of Surgical Research at the Brooke Army Medical
    Center also offers a pilot provider resiliency program that supplements
    the above PRT program. This program provides a Respite Center for its
    healthcare providers. Providers have the opportunity to receive
    educational classes on meditation, Alpha-Stim therapy (microcurrent
    electrical therapy for acute or chronic pain) and relaxation.
                             competing initiatives
        Question. General Schoomaker, do you have any competing initiatives
    to the new health system architecture development efforts, such as a
    different Unified User Interface, or a separate electronic health
    record?
        Answer. No. I am not aware of any competing initiatives. Army
    leadership understands the importance of a coherent, central enterprise
    architecture.
                          new enterprise architecture
        Question. General Schoomaker, how do you ensure Service specific
    needs are incorporated in the new enterprise architecture and how do
    you make sure they don't drive up costs throughout the system?
        Answer. There is an established governance process by which the
    Services provide feedback on health information technology matters.
    This process is being improved to better meet the needs of the
    enterprise. However, a governance process for the new enterprise
    architecture has not yet been established. Once the process is
    established, the Army looks forward to full and active participation.
                                     ______

                  Questions Submitted by Senator Patty Murray
                            enterprise architecture
        Question. In your opinion, what additional steps need to be taken
    to ensure that electronic medical information is available to VA?
        Answer. We currently exchange an enormous amount of information
    with the VA, some of which are computable through the bidirectional
    health information exchange (BHIE). Clearly more can be done, and one
    recommendation we have is to accelerate the overhaul of our BHIE
    framework to a National Health Information Network (NHIN) compliant
    exchange. Not only would this conversion improve the data exchange
    between VA and DOD, but it would also allow us to exchange information
    with other Federal and civilian healthcare organizations. Given that
    over 60 percent of our 9.2 million DOD beneficiaries receive care from
    the civilian healthcare sector, we have a growing need to be able to
    exchange information. Furthermore, this is a great opportunity for DOD
    and VA to help execute President Obama's vision for electronic health
    records in the United States and to establish a national model for
    Health Information Exchange. Given the establishment of joint VA-DOD
    Federal healthcare facilities, we will need to migrate to an
    interoperable information system that is more closely coupled to meet
    healthcare, business, and benefits requirements.
        Question. How are each of your services obtaining medical records
    for servicemembers who receive contract care and how big of a problem
    is this for creating a complete record of care?
        Answer. Many facilities currently receive a fax or e-fax from the
    managed care contractor or from the facility that provided the care.
    Some facilities manually attach the records into our electronic health
    record, but others do not. This process varies from treatment facility
    to treatment facility. There is also no enterprise referral and
    authorization system that interfaces with our electronic health record,
    which is a problem. Our adoption of a National Health Information
    Network will help to address this problem. Further, as part of the
    managed care support contracts we should require TRICARE contractors to
    collect and send medical records electronically back to DOD.
    Furthermore, our central document management system (HAIMS) under
    development by TMA for military treatment facilities should allow
    TRICARE contractors to submit consult results to AHLTA. This capability
    would provide an automated method for tracking and incorporating
    consult results into AHLTA as the comprehensive electronic health
    record repository.
                                jag prosecutions
        Question. JCS Chairman Mullen has said publically he's trying to
    break the stigma of psychological health in the active force, yet the
    JAGs are still prosecuting as a ``crime'' depressed people who attempt
    suicide. While the Surgeons General aren't responsible for the UCMJ, it
    seems to me that they might be concerned about JAG prosecutions of
    people who have severe mental distress while serving or after serving
    in combat.
        Generals, do you think that the continued criminal prosecution of
    troops who commit suicide is a problem for the military's efforts to
    break the stigma of psychological health?
        Answer. From a healthcare perspective as The Surgeon General of the
    Army, I acknowledge that charges of this sort are not helpful to a
    patient's mental state and probably increase the stress the Soldier is
    under. The Army and the DOD are working to deal honestly and directly
    with the behavioral health needs of our Soldiers and Families. This
    requires that our Soldiers are forthcoming about their own personal
    histories of behavioral health challenges and actively seek the care of
    available professional mental health providers both in garrison and on
    deployments when/if they encounter problems. We cannot help to remove
    the stigma associated with behavioral health and its treatment without
    this proactive approach. Such charges could be counterproductive to the
    creation of such an environment of trust and healing.
        As a Commander, I understand the necessity of good order and
    discipline. Commanders decide whether to refer cases for prosecution in
    the military justice system. In every case involving misconduct, the
    background and needs of the individual must be weighed along with the
    needs of the Army and the Nation it protects. Commanders and senior
    leaders weigh these competing needs in the context of often complex
    cases involving allegations of serious misconduct and equally serious
    potential psychiatric explanations for this behavior, which may or may
    not amount to a lack of competence or capacity or negate individual
    responsibility. All leaders work together in due process under the
    Uniform Code of Military Justice (UCMJ) where the advice and findings
    of medical professionals is certainly heard so we do the right thing
    for the Soldier and the Army. Finally, I assure you that each case is
    judged on its own merits by individual commanders after a thorough
    review of the facts, and after advice and counsel by a judge advocate.
        I must note that there is no offense under the UCMJ for attempted
    suicide. There is an offense for malingering, which can include self-
    injury with intent to avoid duty or service, and another for self-
    injury without intent to avoid service. I note that while these are
    technically options under the UCMJ, I am unaware of Soldiers being
    charged for attempted suicide and, as a result, do not believe it to be
    a problem as the question suggests.
              vision center of excellence and eye trauma registry
        Question. The NDAA fiscal year 2008 Section 1623, required the
    establishment of joint DOD and VA Vision Center of Excellence and Eye
    Trauma Registry. Since then, I am not aware of any update on the
    budget, current and future staffing for fiscal year 2009, the costs of
    implementation of the information technology development of the
    registry, or any associated construction costs for placing the
    headquarters for the Vision Center of Excellence at the future site of
    the Walter Reed National Medical Center in Bethesda.
        What is the status on this effort?
        Answer. As the Army Surgeon General and Commanding General of the
    U.S. Army Medical Command, I do not have an active role in the
    establishment of the joint DOD and VA Vision Center of Excellence and
    Eye Trauma Registry. Responsibility for this organization and the
    registry belongs to the Office of the Assistant Secretary of Defense
    for Health Affairs.
                                     ______

                   Question Submitted by Senator Thad Cochran
                                   deployment
        Question. Over the past few years, new programs have been
    implemented to assess the health of soldiers after deployment. With the
    large group of Guardsmen alerted for deployment and who have been
    deployed, including many from my home state of Mississippi, I am
    concerned about the continuum of care upon their return into their
    communities. Are you confident that their medical needs are being met
    after returning from deployment?
        Answer. During the current conflict, the Department of Defense
    (DOD) developed new strategies to support Soldiers upon redeployment.
    As a result of these initiatives, I am extremely confident our Reserve
    Component (RC) Soldiers' medical and dental needs are being met.
        Prior to demobilization, each Soldier completes a Post Deployment
    Health Assessment (PDHA) using DD Form 2795 which includes a
    questionnaire completed by the Soldier and a face-to-face interview
    with a privileged healthcare provider. This is the best opportunity for
    the Soldier to document any health concerns related to their
    deployment. If significant concerns exist, the Soldier may remain on
    Active Duty for treatment. It may however be advantageous for some RC
    wounded warriors, at their discretion, to be released from active duty
    before the optimal medical benefit has been attained. This option does
    not release DOD from its moral obligation to render care for conditions
    sustained in the line of duty. Care for lesser concerns occurs when the
    Soldier returns home using the 180-day Transitional Assistance
    Management Program (TAMP) as a TRICARE benefit.
        Also at the demobilization station, each Soldier receives a dental
    exam as part of the Dental Demobilization Reset (DDR) program.
    Treatment is also now available to Soldiers at the demobilization
    station. However, treatment that would cause a delay in returning a
    Soldier home is deferred and provided at their home station using the
    Army Selected Reserve Dental Readiness System (ASDRS).
        Each Soldier must complete a Post Deployment Health Re-Assessment
    (PDHRA) using DD Form 2900 between 90-180 days after demobilization and
    complete another interview. This is a key opportunity for Soldiers to
    highlight issues they did not document at demobilization or surface
    after returning home. This documentation is critical to establish a
    line of duty connection, enabling continuing medical benefits through
    TRICARE and VA eligibility. Reserve Component Soldiers may also be
    voluntarily returned to active duty for medical treatment if we
    identify that treatment is warranted for a medical issue incurred while
    on active duty.
        All Soldiers undergo annual Periodic Health Assessments (PHA),
    where the Soldier completes an on-line questionnaire and is assessed by
    a provider using the latest recommendations of the U.S. Preventive
    Services Task Force.
        The PDHA, PDHRA, and PHA create a system of continuous visibility
    of the medical concerns of our Soldiers and provide regular
    opportunities for Soldiers to raise deployment-related concerns.
                                     ______

               Questions Submitted by Senator Christopher S. Bond
                            servicemembers treatment
        Question. Thank you for your service and for taking the time to
    present to us your insights into our medical service programs. I know
    the U.S. Army takes the health of our warfighters personally, and it is
    clear that our active and reserve medical practitioners are the best in
    the world.
        Johns Hopkins Medical Center defines osteoarthritis as a type of
    arthritis characterized by pain and stiffness in the joints, such as
    those in the hands, hips, knees, spine or feet, due to breakdown of
    cartilage; the gradual breakdown of cartilage that occurs with age and
    is due to stress on a joint.
        Many of our active, reserve, and former servicemembers are
    currently struggling with cases of severe ligament and joint damage
    that will later manifest themselves into long term cases of
    osteoarthritis.
        Our service men and women bear the largest physical burden during
    combat. I am concerned with the large amount of weight our warfighters
    are forced to carry across considerable distances and unforgiving
    terrain. Particularly, I am concerned with the physical toll that war
    exacts from our men and women, most notably in the forms of
    osteoarthritis that arise when injuries go untreated during combat.
        Is the U.S. Army doing everything it can to properly treat our
    servicemembers' injured limbs and joints while they are simultaneously
    fighting in austere environments in order to lessen the chance that
    these particular injuries will manifest themselves into debilitating
    cases of osteoarthritis later in life?
        Answer. This challenge of equipping Soldiers on the battlefield
    with the right technology and level of protection--without overloading
    them, is a difficult one. The U.S. Army Research Institute of
    Environmental Medicine (USARIEM) has an extensive research program
    aimed at documenting the physiological demands of war fighting,
    identifying biomedical solutions that facilitate meeting those demands,
    and optimizing the health and performance of Warriors during
    operational missions and garrison training.
        Arthritis is a degeneration of bone and cartilage that results in
    progressive wearing down of joint surfaces. Arthritis in a non-
    rheumatoid patient under 50 is almost uniformly due to post-traumatic
    conditions. Treatment of injuries leading to arthritis in young people
    has to do with prevention as well as acute and chronic treatment to
    mitigate progression. In 2008, U.S. Army orthopedic surgeons performed
    over 5,000 knee arthroscopies on Soldiers. These joint procedures do
    not necessarily delay the progression of arthritis. In addition, joint
    preserving techniques such as cartilage implants and alignment
    procedures like osteotomies or knee replacement procedures can
    substantially prolong the useful and functional years of a Soldier's
    joints. Optimal outcomes from these procedures require coordination
    between orthopedic surgeons and physical therapists. The bottom line is
    we do not know how treatment interventions impact long term outcomes.
        Currently, a team from the University of Pittsburgh is conducting
    research on the injury prevention and performance enhancement practices
    used by 101st Airborne (Air Assault) Soldiers at Fort Campbell,
    Kentucky. The comprehensive assessment initially evaluated Soldiers'
    nutrition, anaerobic/aerobic capacity, strength, body composition,
    balance/agility, etc. Based upon those findings, new training programs
    were developed. Soldiers participated in an 8-week physical training
    course, and then a reassessment was conducted. Initial reports are
    positive and show a decrease in injury rates and an improvement in
    overall unit performance.
        We know that prevention is a key component to mitigate the
    progression of arthritis and Soldiers who train and condition properly
    are much less likely to sustain an injury during or after deployment.
    To that end, the Army is doing several things to improve the medical
    readiness of the force. First, the Army is in the process of changing
    the physical fitness doctrine and training programs to better prepare
    Soldiers for the demands of military operations. ``Physical Readiness
    Training'' (PRT) is the emerging U.S. Army physical training doctrine
    designed by the U.S. Army Physical Fitness School to improve Soldiers'
    physical capability for military operations. PRT follows the exercise
    principles of progressive overload, regularity, specificity, precision,
    variety, and balance. The Army plans to begin implementing the new PRT
    doctrine across the Force over the next year.
        In the meantime, units across the Army have physical therapists
    assigned to special operations units, Initial Entry Training, and
    Brigade Combat Teams that use a sports medicine approach to identify,
    treat, and rehabilitate musculoskeletal injuries expeditiously--which
    is critical in a wartime environment as Soldiers are able to stay
    healthy and ``in the fight.'' Treatments for Soldiers with
    musculoskeletal injuries include joint manipulation, specific
    therapeutic exercises, soft tissue mobilization as well as a variety of
    modalities to mitigate pain, promote healing, and prevent reoccurrence.
        Programs focusing on injury prevention and performance enhancement
    emphasize core strengthening, aerobic endurance, muscular strength and
    power, muscular endurance (anaerobic endurance), and movement
    proficiency (incorporates balance, flexibility, coordination, speed and
    agility) to better prepare Soldiers to physically withstand the rigors
    of combat.
        The U.S. Military Health System is doing a tremendous amount to
    preserve the active function of Soldiers with limb injuries but more
    research efforts on clinical outcomes is necessary to determine if what
    we are doing makes a difference. By making sure Soldiers receive early
    identification and treatment of their musculoskeletal injuries and
    improving Soldiers' physical strength and conditioning, we also improve
    the overall medical readiness of our Force.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
                                soldier suicides
        Question. LTG Schoomaker, Congress has established a national
    suicide hotline for returning troops, as well as increased funding for
    mental health for active military personnel. However, there remains a
    high number of soldier suicides. What preventative measures is DOD
    taking to address this problem? What, if any, legislative action would
    DOD need Congress to take to expand suicide awareness and education on
    posts?
        Answer. The Army has been vigorously pursuing suicide prevention
    and intervention efforts. Nevertheless the number of suicides continues
    to rise, which is an issue of great concern to us.
        In March 2009, the Vice Chief of Staff of the Army established a
    new Suicide Prevention Task Force to integrate all of the efforts
    across the Army. A Suicide Prevention General Officer Steering
    Committee (GOSC) was previously established in March 2008. The GOSC's
    efforts are ongoing, with a focus on targeting the root causes of
    suicide, while engaging all levels of the chain-of-command.
        From February 15, 2009 to March 15, 2009, the Army conducted a
    total Army ``stand-down'' to ensure that all Soldiers learned not only
    the risk factors of suicidal Soldiers, but how to intervene if they are
    concerned about their buddies. The ``Beyond the Front'' interactive
    video is the core training for this effort. It was followed by chain
    teaching which focuses on a video ``Shoulder to Shoulder; No Soldier
    Stands Alone'' and vignettes drawn from real cases. The Army continues
    to use the ACE ``Ask, Care, Escort'' tip cards and strategy.
        The Army established the Suicide Analysis Cell at the Center for
    Health Promotion and Preventive Medicine (CHPPM) in July 2008. This is
    a suicide prevention analysis and reporting cell that has
    epidemiological consultation capabilities. The Cell gathers suicidal
    behavior data from numerous sources, including the Army Suicide Event
    Report (ASER), The U.S. Army Criminal Investigation Division Reports,
    AR 15-6 investigations, and medical and personnel records.
        The Army Suicide Prevention Plan's overarching strategies include:
    (1) raising Soldier and Leader awareness of the signs and symptoms of
    suicide and improving intervention skills, (2) providing actionable
    intelligence to Leaders regarding suicides and attempted suicides; (3)
    improving Soldiers' access to comprehensive care; (4) reducing the
    stigma associated with seeking mental healthcare; and (5) improving
    Soldiers' and their Families' life skills. In the fall of 2008, the
    Army Science Board studied the issue of suicides in the Army. While
    their report has not been officially released, it reiterated the Army's
    strategies and the need for a comprehensive multi-disciplinary
    approach. It did not find easy, simple solutions to the problem.
        The Army has also developed a Memorandum of Agreement (MOA) with
    the National Institutes of Mental Health (NIMH), which was signed in
    the fall of 2008. This is an ongoing, 5-year research effort to better
    understand the root causes of suicide and develop better prevention
    efforts. This NIMH effort is being coordinated with the CHPPM Suicide
    Analysis Cell, as well as with suicide prevention efforts from the
    Walter Reed Army Institute of Research (WRAIR).
        These extensive new efforts build upon: (1) development and
    deployment of numerous updated training and education efforts,
    including Battlemind and the Chain Teach Program on mTBI/PTSD; (2)
    widespread training of Soldiers by Chaplains and behavioral health
    providers; (3) robust combat stress control efforts and Chaplain
    presence in theater; (4) hiring and recruiting additional behavioral
    health providers; (5) ``Strong Bonds'', a relationship-building program
    developed by the Chaplains; (6) surveillance of all completed suicides
    and serious suicide attempts via the Army Suicide Event Report; and (7)
    suicide risk assessment screening of all Soldiers who enter the Warrior
    Transition Units (WTUs).
        We are also partnering with the Defense Centers of Excellence for
    Psychological Health and Traumatic Brain Injury to work on identifying
    best practices for the identification and intervention of mental health
    issues that include suicide, PTSD, TBI, and depression. Both the Army
    and the DOD are studying the addition of tools which will further query
    Soldiers for symptoms of suicide and depression. All suicide screening
    tools must be evaluated carefully for sensitivity, specificity, and
    positive and negative predictive values.
        An enhanced and integrated public health approach is needed. We
    must continue to emphasize Leadership involvement, reducing stigma,
    training and education, access to mental health care, and a
    multidisciplinary community approach to suicide prevention.
        We must continue to: (1) expand the capacity for behavioral health
    treatment throughout the system; (2) improve continuity of care between
    different helping agencies and providers; (3) improve training of all
    medical personnel and Chaplains in identification and mitigation of
    risky behaviors; and (4) continue a multi-pronged approach to decrease
    stigma and encourage help-seeking behavior.
        Awareness and education are needed across the nation, as well as on
    military installations. I am currently unaware of any legislative
    action required to expand suicide awareness and education on military
    posts.
                ireland army hospital/blanchfield army hospital
        Question. LTG Schoomaker, what are the authorized manning levels
    for nurses and medical personnel at the Ireland Army Hospital at Fort
    Knox and Blanchfield Army Hospital at Fort Campbell? Is there a minimum
    threshold that must be met under Army rules, regulations or custom? Is
    that threshold being met at Ireland and Blanchfield Hospitals and is it
    sufficient?
        Answer. The Army Medical Command is meeting minimum staffing
    requirements at both Blanchfield and Ireland Army Hospitals. Across the
    command we face staffing challenges due to medical personnel deploying
    in support of contingency operations, lack of some specialty provider
    backfills from the Reserve Component, and difficulty with recruiting
    civilian and/or contract providers in and around some military
    communities. Despite these obstacles, we are able to staff our
    treatment facilities and deliver high-quality, evidence-based care to
    our deserving beneficiaries.
        The authorized manning levels for nurses and medical personnel at
    the Ireland Army Hospital at Fort Knox and Blanchfield Army Hospital at
    Fort Campbell are as follows:
    Ireland Army Hospital
        Nurse Authorizations: 57 Military, 87 Civilian equals 144 total
        Medical Authorizations: 37 Military, 16 Civilian equals 53 total
        Other Medical ancillary personnel that clinically support patients
    equals 406
        Grand total of authorized clinical nurses, physicians and other
    ancillary personnel equals 603
    Blanchfield Army Hospital
        Nurse Authorizations: 83 Military, 195 Civilian equals 278 total
        Medical Authorizations: 84 Military, 20 Civilian equals 104 total
        Other Medical ancillary personnel that clinically support patients
    equals 635
        Grand total of authorized clinical nurses, physicians and other
    ancillary personnel equals 927.
        Authorization numbers above do not include counts of non-clinically
    focused personnel, in such purely administrative mission areas such as
    Logistics, Medical Library, Quality Mgt, File Clerks/Transcription,
    Environmental Services (Housekeeping/Linen Mgt/Facilities), Patient
    Admin Medical Records, Patient Affairs, Uniform Business Office, Third
    Party Collections, and Troop Command.
        Finally, clinical staffing levels for a hospital are a function of
    the reliant population to be supported and/or workload demand. Where
    work centers are open 24/7, there are always minimum staffing
    requirements independent of workload. All direct patient care units
    requiring 24/7 staffing at Fort Knox and Fort Campbell have sufficient
    workload and staffing levels that exceed required manning thresholds
    and minimums.
                                    ptsd/tbi
        Question. LTG Schoomaker, what are the typical steps taken for
    soldiers who may have post-traumatic stress disorder (PTSD) and
    traumatic brain injuries (TBI) to ensure they get the proper care? Are
    there any further legislative steps that Congress could take to improve
    screening and the delivery of care to soldiers with PTSD and TBI?
        Answer. Army Leadership is taking aggressive, far-reaching steps to
    ensure an array of behavioral health services are available to Soldiers
    and their Families to help those dealing with PTSD and other
    psychological effects of war.
        The following list of continually evolving programs and initiatives
    are examples of the integrated and synchronized web of behavioral
    health services in place to help Soldiers and their Families heal from
    the effects of multiple deployments and high operational stress:
      --The Post Deployment Health Assessment (PDHA), originally developed
            in 1998, was revised and updated in 2003. All Soldiers receive
            the PDHA upon re-deployment, usually in the Theater of
            Operations shortly prior to departure.
      --In the fall of 2003, the first Mental Health Assessment Team (MHAT)
            deployed into Theater. Never before had the mental health of
            combatants been studied in a systematic manner during conflict.
            Four subsequent MHATs in 2004, 2005, 2006, and 2007 continue to
            build upon the success of the original and further influence
            our policies and procedures not only in theater, but before and
            after deployment as well. Based on MHAT recommendations, the
            Army has improved the distribution of behavioral health
            providers and expertise throughout the theater. Access to care
            and quality of care have improved as a result. An MHAT is
            currently in Iraq, and will be deploying to Afghanistan within
            the next 3 months.
      --In 2004, researchers at the Walter Reed Army Institute of Research
            (WRAIR) published initial results of the groundbreaking ``Land
            Combat Study'' which has provided insights related to care and
            treatment of Soldiers upon return from combat and led to
            development of the Post Deployment Health Reassessment (PDHRA).
      --In 2005, the Army rolled out the PDHRA. The PDHRA provides Soldiers
            the opportunity to identify any new physical or behavioral
            health concerns they may be experiencing that may not have been
            present immediately after their redeployment. This assessment
            includes an interview with a healthcare provider and has been a
            very effective new program for identifying Soldiers who are
            experiencing some of the symptoms of stress-related disorders
            and getting them the care they need before their symptoms
            manifest as more serious problems. We continue to review the
            effectiveness of the PDHRA and have added and edited questions
            as needed.
      --In 2006 the Army Medical Command (MEDCOM) piloted a program at Fort
            Bragg intended to reduce the stigma associated with seeking
            mental healthcare. The Respect-Mil pilot program integrates
            behavioral healthcare into the primary care setting, providing
            education, screening tools, and treatment guidelines to primary
            care providers. It has been so successful that medical
            personnel have implemented this program at 15 sites across the
            Army. Another 17 sites should implement it in 2009.
      --Also in 2006, the Army incorporated into the Deployment Cycle
            Support program a new training program developed at WRAIR
            called ``BATTLEMIND'' Training. Prior to this war, there were
            no empirically validated training strategies to mitigate
            combat-related mental health problems. This post-deployment
            training is being evaluated by MEDCOM personnel using
            scientifically rigorous methods, with good initial results. It
            is a strengths-based approach highlighting the skills that
            helped Soldiers survive in combat instead of focusing on the
            negative effects of combat ( www.battlemind.org).
      --Two DVD/CDs that deal with Family deployment issues are now
            available: an animated video program for 6 to 11 year olds,
            called ``Mr. Poe and Friends,'' and a teen interview for 12 to
            19 year olds, ``Military Youth Coping with Separation: When
            Family Members Deploy.'' Viewing the interactive video programs
            with children can help decrease some of the negative outcomes
            of family separation. Parents, guardians and community support
            providers will learn right along with the children by viewing
            the video and discussing the questions and issues provided in
            the facilitator's guides with the children during and/or after
            the program. This reintegration family tool kit provides a
            simple, direct way to help communities reduce tension and
            anxiety, use mental health resources more appropriately, and
            promote healthy coping mechanisms for the entire deployment
            cycle that will help Families readjust more quickly on
            redeployment.
      --In mid-July 2007 the Army launched a PTSD and mTBI Chain Teaching
            Program that reached more than one million Soldiers, a measure
            that will help ensure early intervention. The objective of the
            chain teaching package was to educate all Soldiers and Leaders
            on PTSD and TBI so they can help recognize, prevent and treat
            these debilitative health issues.
      --In 2008 the Department of Defense revised Question #21, the
            questionnaire for national security positions regarding mental
            and emotional health. The revised question now excludes non-
            court ordered counseling related to marital, family, or grief
            issues, unless related to violence by members; and counseling
            for adjustments from service in a military combat environment.
            Seeking professional care for these mental health issues should
            not be perceived to jeopardize an individual's professional
            career or security clearance. On the contrary, failure to seek
            care actually increases the likelihood that psychological
            distress could escalate to a more serious mental condition,
            which could preclude an individual from performing sensitive
            duties.
      --In 2008, the Army began piloting Warrior Adventure Quest (WAQ). WAQ
            combines existing high adventure, extreme sports and outdoor
            recreation activities (i.e., rock climbing, mountain biking,
            paintball, scuba, ropes courses, skiing, and others) with a
            Leader-led after action debriefing (L-LAAD). The L-LAAD is a
            Leader decompression tool that addresses the potential impact
            of executing military operations and enhances cohesion and
            bonding among and within small units. L-LAAD integrates WAQ and
            bridges operational occurrences to assist Soldiers transition
            their operational experiences into a ``new normal'', enhancing
            military readiness, reintegration, and adjustment to garrison
            or ``home'' life.
      --Beginning February 15, 2009, the Army started a 30 day ``stand-
            down'' to ensure that all Soldiers learned not only the risk
            factors of suicidal Soldiers, but how to intervene if they are
            concerned about their buddies. The ``Beyond the Front''
            interactive video is the core training for this effort. It will
            be followed by a chain teach which focuses on a video
            ``Shoulder to Shoulder; No Soldier Stands Alone'' and vignettes
            drawn from real cases.
        Presently, we are partnering with the Defense Centers of Excellence
    for Psychological Health and Traumatic Brain Injury and working to
    identify best practices for the identification and intervention for
    mental health issues that include suicide, PTSD, TBI, and depression.
    We are also directing special attention to the processes and procedures
    by which we transfer care for affected Soldiers as they redeploy or
    move from one installation to another or one treatment facility to
    another.
        I am not aware of any legal or regulatory obstacles that impede our
    efforts to improve screening and the delivery of care to Soldiers with
    PTSD or TBI.
                ireland army hospital/blanchfield army hosptial
        Question. LTG Schoomaker, do the Ireland and Blanchfield hospitals
    refer soldiers to regional hospitals that specialize in brain and
    spinal cord injury rehabilitation? What formal partnerships are
    established between post hospitals and regional hospitals in Kentucky
    to ensure soldiers with these conditions are given the best care? If
    there are no formal partnerships, what is the process for establishing
    such an affiliation?
        Answer. Yes, both Blanchfield Army Community Hospital and Ireland
    Army Community Hospital refer Soldiers to specialized hospitals for
    brain and spinal cord injury rehabilitation. Both hospitals use the
    Department of Veterans Affairs Polytrauma Centers and other Veterans
    Affairs medical centers within the region, such as the DVA Medical
    Center in Memphis, Tennessee.
        At Blanchfield Army Community Hospital, we use two facilities in
    Nashville, Skyline and Vanderbilt University Medical Center, for
    beneficiaries with brain and spinal cord injuries. These facilities are
    in the TRICARE Managed Care Support Contracts network.
        At Ireland Army Community Hospital, Soldiers with brain and spinal
    cord injuries are regularly referred to regional resources such as
    Frazier Rehabilitative Services, located in Louisville, Kentucky for
    comprehensive TBI services as well as to the program at the University
    of Kentucky at Lexington.
        The criteria for selection of the appropriate facility includes the
    Soldier's unique needs, the ability of the brain and spinal cord injury
    program to accommodate those needs and related considerations such as
    the Soldier's hometown and location of family.
        The primary mechanism for establishing relationships with regional
    hospitals is through the Managed Care Network established by our
    TRICARE Region business partner. The TRICARE Managed Care Support
    Contractor contacts area facilities to establish the relationship. When
    Ireland or Blanchfield hospital identifies a facility that is not part
    of the network, we notify TRICARE with a request that the facility be
    contacted and considered for credentialing to network status.
                               dod/va facilities
        Question. LTG Schoomaker, per the Wounded Warrior legislation
    enacted in 2007 and the Dole-Shalala Commission's recommendations that
    were reported in 2007, improvements were to be made to the coordination
    between DOD and VA facilities to better care for our injured troops who
    are transitioning between the two healthcare systems. What steps have
    already taken place to improve coordination between the two
    Departments? What steps remain? Are these provisions sufficient to
    provide a seamless transition for wounded warriors from the DOD to the
    VA system? Does DOD need further legislation to improve matters? If so,
    what?
        Answer. On October 12, 2007, the Vice Chief of Staff of the Army
    (VCSA), General Cody requested assistance from the Acting Secretary,
    Department of Veterans Affairs (VA) to reduce transition obstacles
    between the DOD managed care system and the VA system of care. The VCSA
    specifically asked the VA Secretary to support three initiatives to
    ease servicemember transition. The three initiatives include: co-
    locating one Veterans Benefits Administration (VBA) Counselor with the
    Army Nurse Case Managers at each Warrior Transition Unit (WTU), provide
    Social Workers (MSW) at seven Army Installations which include, Forts
    Drum, Stewart, Campbell, Benning, Knox, Riley, and Fort Bliss, and
    provide VBA Counselors at all Soldier Family Assistance Centers
    (SFACs).
        As of February 2009, there are 57 VA Regional Offices and 10
    Satellite VA Offices established at Military Treatment Facilities to
    provide VA expert counsel on Veterans Benefit Administration (VBA)
    compensation and entitlement benefits programs as well as clinical care
    offered to Warriors in Transition (WTs) and their Families by the
    Veterans Health Administration (VHA). The VBA has representatives at
    all 35 WTUs. For those WTs that are assigned to Community Based WTU's
    (CBWTUs), the VA has contracted service providers to care for their
    administrative and clinical needs. The DVA does not intend to place VA
    Liaisons in overseas assignments. However, the VA has numerous outreach
    programs such as www.va.gov, direct mail pieces, booklets, pamphlets,
    videos, and broadcast shows on AFN (Armed Forces Network) to assist
    Service and Family Members at remote locations. Soldiers and family
    members may also contact the VA via telephone worldwide at 800-827-
    1000.
        The Army has also assigned liaison officers to the four VA poly-
    trauma centers (Richmond, Virginia; Tampa, Florida; Palo Alto,
    California; and Minneapolis, Minnesota). Furthermore, we have assigned
    60 advocates from the Army Wounded Warrior Program to 51 VA medical
    centers to assist Soldiers and Veterans receiving care.
                                     ______

              Questions Submitted to Vice Admiral Adam M. Robinson
                Questions Submitted by Chairman Daniel K. Inouye
        Question. Admiral Robinson, North Chicago Veterans Center is
    scheduled to merge with the Naval Health Clinic Great Lakes on October
    1, 2010. Aside from technology requirements, there are several
    regulatory and legislative challenges that remain unresolved. Could you
    please describe each of the outstanding issues, the difference between
    the VA and the Department's positions and a timeline for their
    resolution?
        Answer. Legislation addressing the four issues was introduced as an
    amendment to the National Defense Authorization Act (NDAA) 2009 but was
    not included. H.R. 1267 was introduced by Congresswoman Bean (D-IL) and
    Congressman Kirk (R-IL) to the House of Representatives on March 3,
    2009. H.R. 1267 was based on an old legislative version and does not
    contain the Department of Navy and Veteran's Affairs agreed upon
    language. Senators Durbin (D-IL) and Akaka (D-HI) are currently working
    on introducing the legislation on the Senate side and this version
    contains the agreed upon language. Strategies to reconcile language
    differences between the two versions are underway. There is
    anticipation that the legislative package could be passed within 30-40
    days as part of a Defense supplemental bill.
        The legislation will address four challenges to Great Lakes/North
    Chicago integration:
      --Designation of the Federal Health Care Center (FHCC) as a Uniformed
            Treatment Facility.--Legislative relief is required for the
            designation of the FHCC as a Uniformed Treatment Facility
            (UTF). This will determine the cost of available care to DOD
            beneficiaries. If UTF designation is not achieved, the FHCC
            will require cost shares for retired TRICARE beneficiaries
            using the VA portion of the FHCC. Beneficiaries over age 65
            enrolled in TRICARE for Life will not be eligible to use the VA
            portion of the FHCC without significant cost shares. VA and DOD
            concur on the need for UTF designation.
      --Permission to transfer all DOD civilian employees into the VA
            personnel system.--Legislative relief is required to establish
            a single integrated personnel system that transfers DOD
            civilian employees into the VA personnel system. This will
            streamline management functions and reduces the disparity in
            pay and benefits for individuals working side by side. NHCGL
            civilian personnel are appointed under Title 5 authority while
            VA employees are appointed under Title 38. Approximately 450
            civilian NHCGL employees will be impacted by this transfer.
            This includes those working in the Recruit and Student Medical
            and Dental Clinics on DOD property. The proposed Senate
            legislation contains language designed to protect DOD civilians
            transitioning into the VA personnel system by eliminating
            probationary periods for those that have already completed this
            as a DOD employee. Additionally, staff will retain at least the
            same pay and seniority (tenure) as they have in the DOD system.
          Long-term success depends on identifying and retaining adequate
            numbers of leadership positions for uniformed staff at the
            FHCC. An organizational leadership structure addressing this
            requirement is in draft form.
          Both DOD and VA support the Transfer of Personnel with the agreed
            upon language as contained in the bill sponsored by Senator
            Durbin. The National AFGE does not concur, as they do not
            support the Title 38 appeal process with the loss of Merit
            Systems Protection Board appeal rights currently afforded for
            the Hybrid Title 38 and Title 5 employees.
      --Create a funding mechanism to provide a single unified funding
            stream to the FHCC.--The VA and DOD have separate
            appropriations for meeting the healthcare missions of each
            agency. Each have multiple funding streams that support the
            various cost components, that when combined, currently comprise
            the totality of funding required to meet the healthcare mission
            assigned to each facility. The intent at the FHCC is to have a
            single budget at the FHCC for the management of all medical and
            dental care for all beneficiaries. To create a single budget,
            the proposed solution is to extend Joint Incentive Fund (JIF)
            authority with the intent to use this authority for dual agency
            funding of the FHCC. The VA fully supports this but DOD has
            expressed concern about using this mechanism to fund the FHCC.
            A JIF-like alternative is being considered by DOD and VA.
      --Create a legislative mechanism to allow DOD to transfer the Navy
            Ambulatory Care Clinic, parking structure, support facilities,
            and related personal property and medical equipment to the VA
            if desired at a later date.--Both VA and DOD agree with the
            need to establish a transfer mechanism. DOD plans to retain
            ownership of the new Ambulatory Care Clinic initially. The
            transfer of personal property is dependent on the ability of VA
            systems to effectively track the property and provide
            accountable data back to DOD. Logistics staff on Navy and VA
            sides are analyzing this.
        NDAA 2009 Section 706 requires nine specific areas be addressed in
    a written agreement for a Combined Federal Medical Facility. An
    Executive Sharing Agreement (ESA) is currently being written to address
    all nine areas. Target date for SECDEF/SECVA signature on this document
    is November 2009. The framework of this document is dependent on the
    legislative issues as indicated above.
        Question. Admiral Robinson, what are the specific mechanisms in
    place to ensure coordination at the planning, budgeting, and technical
    levels between the various federal agencies (including NIH) on areas
    like Traumatic Brain Injury or Malaria research? Are there examples of
    DOD, VA, or NIH dollars being moved or redundant activities being
    terminated as a result of these coordination efforts?
        Answer. In regards to malaria research, the Navy has a long history
    of recognizing the importance of coordination in those areas mentioned
    by the Senator. For the past 2 years, the Navy and the Army have run a
    joint program, the U.S. Military Malaria Vaccine Program. Leaders of
    this program are members of the Federal Malaria Vaccine Coordination
    Committee (FMVCC) chaired by USAID which provides a forum for
    interagency collaboration and coordination in this important area of
    research so that resources are optimized and overlap minimized.
        The Navy collaborates with USAID, NIAID, CDC, and indirectly with
    NIST on several vaccine projects including recombinant protein-based
    vaccines, adenovirus-vectored vaccines, an attenuated whole sporozoite
    vaccine and the development of field testing sites in Africa and
    elsewhere.
        The military uniquely targets its funding for developing vaccines
    for deployed military populations and civilian travelers where the
    required level and duration of protection required is much higher, and
    is currently significantly underfunded for the mission. Currently, the
    vaccine products in development by all federal agencies except DOD are
    aimed at the vulnerable populations of children and pregnant women in
    malaria endemic countries. The primary non-government funding source,
    the Bill and Melinda Gates Foundation, likewise supports this
    humanitarian mission.
        For TBI, Navy medicine works closely with the Defense Center of
    Excellence (DCoE) for Psychological Health and Traumatic Brain Injury
    to coordinate TBI programs. BUMED also collaborates with NIH, CDC, the
    Uniformed Services University, the Army and Air Force, and the VA for
    TBI initiatives. The DCoE is planning to fund a central database at NIH
    which will also include Navy TBI information, for example. In addition,
    Navy medicine is responsible for tracking/surveillance for TBI and is
    developing and testing an automated neurocognitive test instrument,
    called Braincheckers. The Naval Health Research Center is conducting
    TBI research projects related to surveillance and force protection. The
    Naval Medical Research Center recently completed a study on the effect
    of acute blast exposure on cognition in Marine Corps Breachers, an
    effort funded jointly by the Defense Advanced Research Projects Agency
    and the Office of Naval Research. The BUMED consultant for TBI programs
    meets regularly with counterparts in the other services, the DCoE, NIH,
    CDC, and VA to discuss new collaborative efforts.
        Question. Admiral Robinson, while attention must be focused on the
    resilience training of our service members and their families, I also
    suspect that caring for our wounded takes a considerable toll on our
    care givers. What efforts are underway to address the well-being of our
    caregivers in order to retain these critical personnel?
        Answer. Navy Medicine is dedicated to doing what is right for our
    active duty and retired Sailors, Marines and their families; and, we
    are just as committed to doing what is right for our caregivers.
    Occupational stress and compassion fatigue can undermine professional
    and personal performance, impact job satisfaction, and result in poor
    retention. The Navy Medicine Caregiver Occupational Stress Control
    (OSC) Program, sometimes called ``Care for the Caregiver'', comprises
    several strategies designed to enhance individual resilience,
    strengthen unit cohesion, and support command level assessment of the
    work environments of caregivers. A main strategy of the Navy Medicine
    Caregiver OSC program is to provide Navy Medicine personnel
    multidisciplinary occupational stress training that matches the
    treatment facility OPTEMPO and creating trained intervention teams,
    with a mix of officer and enlisted, at our major treatment facilities.
    This strategy will provide staff with skills and knowledge about the
    stress continuum model, stress first-aid, buddy care assessment and
    intervention, self-care/compassion fatigue skills, work-environment
    assessment, and education outreach. The foundation of dedication,
    knowledge, skills, and passion that results in Navy Medicine's superior
    quality of care is also the foundation of caring for our caregivers.
    Program Elements:
        ``Rule Number Two'' Lecture Series.--Started in January 2008 to
    educate Navy Medicine Leaders about the operational and occupation
    stress on caregivers and leadership strategies to mitigate that stress.
        Caregiver Occupational Stress Training Teams.--Completed training
    of 90 team members for 15 medical treatment facilities in January 2009.
    Expanded MTF team training started in March 2009 designed to have 20 or
    more stress and coping peer trainers at each MTF.
        All Hands Awareness Training.--Medical treatment facility (MTF)
    focused training to initiate all hands awareness and core peer support
    skills started in February 2009.
        Caregiver OSC Training Resources.--Caregiver OSC video vignettes
    and Corpsmen focused graphic training novel in production.
        Caregiver Stress Assessment.--Navy Medicine wide assessment of
    caregiver resilience and stress.
        Question. Admiral Robinson, the Department and the VA are working
    on creating an interoperable medical health record that will allow for
    a seamless transition for our service members and also provide
    continuity of care at joint DOD/VA facilities like the future James A
    Lovell Federal Health Care Center. I understand that premature steps
    have been taken to procure systems for the Lovell Center that would
    repeat the mistakes of focusing on site specific fixes rather than our
    joint enterprise as a whole. Since Navy is an equal partner in this
    endeavor with the VA, could you please detail us on the current
    situation, the path forward, and how it integrates into the overarching
    medical enterprise architecture?
        Answer. The electronic medical record is an area where there is
    pressure to move to one system or the other. Neither AHLTA nor VISTA
    can sustain the requirements of both DOD and VA. The IM/IT solution
    being crafted must sustain missions of both organizations. The FHCC
    establishment date of October 1, 2010 creates mounting time pressures.
    The time passage of pending Congressional legislation is crucial to
    implementing the full vision of this project. Because Great Lakes is
    being touted as the model for future fully integrated federal
    healthcare, there is enormous self-imposed pressure to do it right.
    System solutions (financial reconciliation, electronic medical record,
    information management, etc.) cannot be local fixes, but must be
    crafted in a manner that lends to exportability throughout the
    enterprise.
        Question. Admiral Robinson, how do you ensure Service specific
    needs are incorporated in the new enterprise architecture and how do
    you make sure they don't drive up costs throughout the system?
        Answer. The Navy will engage with the central program offices
    developing the solutions to make sure that they meet the needs of the
    Navy as well as being in line with the direction of the TriCare
    Management Activity. If the needs are a part of the overarching
    architecture then that should not drive up the cost any more than would
    occur as both agencies are charged with more and more sharing of
    patient data between DOD and VA. The Navy was identified as the first
    service branch to complete a single site integration with a VA facility
    but Army and Air Force are in the queue with four proposed integration
    sites.
                                     ______

                  Questions Submitted by Senator Patty Murray
        Question. JCS Chairman Mullen has said publically he's trying to
    break the stigma of psychological health in the active force, yet the
    JAGs are still prosecuting as a ``crime'' depressed people who attempt
    suicide. While the Surgeons General aren't responsible for the UCMJ, it
    seems to me that they might be concerned about JAG prosecutions of
    people who have severe mental distress while serving or after serving
    in combat. Do you think that the continued criminal prosecution of
    troops who commit suicide is a problem for the military's efforts to
    break the stigma of psychological health?
        Answer. The decision whether to court-martial a sailor and, if so,
    for what offense, is within the sole discretion of the cognizant
    commander, usually with the benefit of input from a judge advocate.
    However, our research covering the last 5 years does not reveal any
    instance of a Sailor being charged with a criminal offense relating to
    a failed suicide attempt.
        Even in those cases where a Sailor is determined to be free of any
    serious mental defect, the Uniform Code of Military Justice does not
    criminalize suicide or attempted suicide. A charge does exist to
    address malingering (feigning a debilitating condition or intentionally
    inflicting self-injury specifically to avoid duty). Similarly, a charge
    exists to address self-injury in those cases where it is prejudicial to
    good order and discipline. Either of those charges, in certain
    circumstances, could conceivably support a prosecution arising out of a
    failed suicide attempt where a commander believes that the attempt was
    actually an attempt to avoid duty or was otherwise prejudicial to good
    order and discipline.
        In cases where a Sailor's mental health is in question, the Manual
    for Courts-Martial requires the commander contemplating charges to
    request a mental health inquiry pursuant to Rule for Court-Martial
    (RCM) 706. Although the RCM 706 request is issued by the commander, the
    need for the request, if not immediately identified by the commander
    him/herself, may be raised by any investigating officer, the trial
    counsel, defense counsel, military judge, or a member of the court-
    martial, if one is already in progress. Pursuant to the rule, the
    Sailor's mental health will be evaluated by a board which must normally
    include at least one psychiatrist or clinical psychologist, and may
    also include one or more physicians.
        If a 706 board determines that a Sailor was unable to appreciate
    the wrongfulness of his actions at the time of the alleged offense, or
    does not currently have the mental capacity to assist in his own
    defense, depending on the stage of the proceedings, charges may be
    dismissed; or the determination may result in a finding of not guilty
    due to lack of mental responsibility. In any case, such determination
    would act as a bar to conviction, if not prosecution. If a 706 board
    determines that no mental defect exists that would affect the Sailor's
    mental responsibility at the time of the alleged offense or his ability
    to assist in his own defense, there is nothing to preclude lawful
    prosecution.
        Question. In your opinion, what additional steps need to be taken
    to ensure that electronic medical information is available to VA?
        Answer. Currently we use the Bidirectional Health Information
    Exchange (BHIE) but it is considered inadequate as not all of the data
    is available in an easy to read format. BHIE, or a modernized
    replacement of BHIE, needs to be made more robust and improvements made
    in the presentation of the data to the provider. Establishment of
    trusted networks between the DOD and VA would allow greater access to
    the data by both agencies. Differences in the information assurance
    regulations of both Departments, and between the military Services,
    makes this a cumbersome, time consuming, and difficult process.
        Question. How are each of your services obtaining medical records
    for service members who receive contract care and how big of a problem
    is this for creating a complete record of care?
        Answer. There is limited information sharing for patients who
    receive care in the direct care system but who may also receive some
    care in the civilian health care sector. For example, in some cases a
    military healthcare provider may refer a patient to a civilian
    healthcare specialist for a consult. These consult results are
    frequently only returned to the military provider in the form of a
    written document. In some cases they may be sent as a fax or as an
    email message (or attachment to an email message).
        Regardless of whether the information is received in paper form or
    via an electronic transfer of a scanned document, there are limitations
    as to how that information can be incorporated into AHLTA (Armed Forces
    Health Longitudinal Technology Application). Those limitations make it
    difficult for military healthcare providers to access that information
    effectively.
        In order to address the current limitations, DOD is pursuing a
    number of initiatives. We are implementing a capability to capture
    scanned documents and other images as part of our electronic health
    record. And, we will index those documents so that they are readily
    retrievable by military healthcare providers. We are also piloting a
    more robust interchange capability with the civilian sector through the
    Nationwide Health Information Network (NHIN) initiative. As the
    civilian healthcare providers adopt electronic health records, we will
    be able to take advantage of the NHIN infrastructure to share
    information in a more flexible form.
        Question. The NDAA fiscal year 2008 Section 1623, required the
    establishment of joint DOD and VA Vision Center of Excellence and Eye
    Trauma Registry. Since then, I am not aware of any update on the
    budget, current and future staffing for fiscal year 2009, the costs of
    implementation of the information technology development of the
    registry, or any associated construction costs for placing the
    headquarters for the Vision Center of Excellence at the future site of
    the Walter Reed National Medical Center in Bethesda. What is the status
    on this effort?
        Answer. As the DOD/VA Vision Center of Excellence is an Army run
    program, they will best be able to provide the status of this effort.
                                     ______

                  Questions Submitted by Senator Thad Cochran
        Question. The Active Duty Navy has only had a 39 percent completion
    rate on the Post Deployment Health Reassessment form (PDHRA). This is
    the lowest of all the Services. What are the reasons for this low
    input? Is it an issue of resources?
        Answer. Navy is committed to protecting and promoting the long term
    health of our Sailors, especially those facing post deployment stress
    challenges. Navy leadership led efforts to increase the completion rate
    of the Post Deployment Health Reassessment (DD 2900). These efforts
    included communicating its importance; issuing PDHRA guidance and
    lessons learned; distributing by name lists of Sailors required to
    complete the PDHRA to individual commands; and committing human and
    fiscal resources to the administration and execution of the program.
        As of March 24, 2009, the Medical Readiness Reporting System
    (MRRS), Navy's designated database for PDHRA compliance tracking,
    indicates a Navy-wide compliance rate of 57.4 percent, with the Active
    Component (AC) at 46 percent and the Reserve Component (RC) at 93.4
    percent. Navy, in an effort to ensure no Sailor is overlooked, used two
    indicators to identify Sailors required to complete the PDHRA. These
    ``identifiers'' are a previously completed Post Deployment Health
    Assessment (DD 2796) or a Sailor's concurrent receipt of Hardship Duty
    and Imminent Danger Pays. It has since been determined that the use of
    these two identifiers ``cast the net'' too wide and erroneously
    identified persons who do not meet current criteria for completion of
    the PDHRA as set forth in DOD Instruction 6490.3, Deployment Health,
    and OPNAVINST 6100.3, The Deployment Health Assessment (DHA) Process.
    (This erroneous identification affected the active component almost
    exclusively and accounts for some of the difference in active and
    reserve reported compliance rates.)
        Approximately 25 percent of the overdue PDHRAs for USN personnel
    are identified by the two pays and the vast majority (approximately 73
    percent) of overdue PDHRAs for USN personnel is due to the completion
    of a PDHA. Navy has taken a conservative approach to reporting PDHRA
    compliance. For example, all Sailors have been individually canvassed
    to confirm the requirement for the Deployment Health Assessment process
    followed by a manual check of records for the presence of a completed
    DD 2900. Additionally, early in the DHA administrative process, many
    Sailors who made routine ship deployments erroneously completed a post
    DHA. Correcting these data entries has proven to be a time consuming,
    manpower intensive effort.
        A more accurate method to determine Navy PDHRA compliance is being
    implemented. This new method will eliminate those Sailors who are
    identified as overdue, but in actuality do not require a PDHRA (e.g.,
    Shipboard Sailors). On March 10, 2009, the PDHRA compliance rate was
    calculated by the use of the more accurate method to identify Sailors
    required to complete the PDHRA: a completed Post-deployment Health
    Assessment (DD 2796) preceded by a Pre-deployment Health Assessment (DD
    2795). The PDHRA compliance rate was determined to be 78.4 percent for
    the Active Component and 96.8 percent for the Reserve Component with a
    Navy-wide level of 85.0 percent.
        Navy is making steady improvements in the PDHRA compliance rate. We
    are pressing to ensure that those Sailors who need the PDHRA complete
    the assessment and are working to correct the erroneous method for
    identifying Sailors required to complete the PDHRA. Efforts toward
    meeting objectives include:
      --In fiscal year 2006, Navy Medicine established Deployment Health
            Centers (DHCs) with the primary mission to augment military
            treatment facilities to ensure the availability of adequate
            medical resources to support PDHRA compliance. There are
            currently 17 DHCs with 117 medical contract positions,
            including psychiatrists and psychologists, funded with annual
            costs of $15 million.
      --MRRS now provides the capability to reconcile the overdue status of
            Sailors if indicated by a previously completed PDHA not meeting
            today's criteria.
      --The capability to reconcile the status of those erroneously
            identified by the two pays will be implemented in MRRS in May.
      --Navy (BUMED) has identified the need for additional temporary
            resources to clear any data entry backlogs that currently
            exist.
        Navy's low compliance rate is not an issue of resources.
        Question. This Committee is aware of some of the challenges that
    the Great Lakes consolidation has come up against. Can you talk about
    some of the pressures that the Navy is experiencing with this
    consolidation? Would integration like Keesler-Biloxi make more sense
    than total consolidation?
        Answer. Cultural differences between the Navy and the VA are large,
    and they present challenges in establishing the template for future
    integrated federal healthcare facilities. This consolidation will not
    work unless each agency is willing to waive agency specific policies in
    order to accommodate the broader mission of the Federal Health Care
    Center (Health Care and Operational Readiness).
        The Great Lakes consolidation model was driven from the Health
    Executive Council (HEC) and Joint Executive Council (JEC) level to the
    deckplate level in Great Lakes and North Chicago. There is significant
    interest by Congressional and Senate members in executing a new model
    of interagency cooperation, and the North Chicago/Great Lakes
    consolidation is being looked at as the test bed.
        Navy Operational Readiness is our number one mission and our
    primary reason for existence. As we deal with Command and Control, IM/
    IT, fiscal and clinical support decisions, this Operational Readiness
    mission has to constantly be re-affirmed as it is a new concept for the
    VA. The electronic medical record is an area where there is pressure to
    move to one system or the other. Neither AHLTA nor VISTA can sustain
    the requirements of both DOD and VA. The IM/IT solution being crafted
    must sustain missions of both organizations.
        The FHCC establishment date of October 1, 2010 creates mounting
    time pressures. The timely passage of pending Congressional legislation
    is crucial to implementing the full vision of this project. Because
    Great Lakes is being touted as the model for future fully integrated
    federal healthcare, there is enormous self-imposed pressure to do it
    right. System solutions (financial reconciliation, electronic medical
    record, information management, etc.) cannot be local fixes, but must
    be crafted in a manner that lends to exportability throughout the
    enterprise.
        The Keesler-Biloxi venture is not an integration. It is a joint
    side-by-side sharing relationship. Construction decisions made 5 years
    ago, along with direction from the HEC and JEC, are driving the need
    for a tighter integration in North Chicago. There is not enough
    physical space to accommodate two organizations (the original space
    plan was decreased by 50 percent) working side by side with all the
    necessary additional infrastructure (personnel, equipment, IM/IT
    systems and support services) required. We must integrate in a tighter
    fashion compared with Keesler-Biloxi.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
        Question. Congress has established a national suicide hotline for
    returning troops, as well as increased funding for mental health for
    active military personnel. However, there remains a high number of
    soldier suicides. What preventative measures is DOD taking to address
    this problem? What, if any, legislative action would DOD need Congress
    to take to expand suicide awareness and education on posts?
        What preventive measures is Navy taking to reduce suicides?
        Answer. The Navy recognizes that multiple demands on our Sailors
    has become a significant source of stress and limits the time available
    for addressing problems at an early stage. In response, the Navy is
    increasing dedicated resources to the development of leadership tools
    for Operational Stress Control (OSC) and suicide prevention. Current
    efforts focus on inspiring leaders to understand and take suicide
    prevention efforts as critical to their ability to do their jobs and
    missions. Other actions include:
      --The Chief of Naval Operations (CNO) directed the establishment of
            the Navy Preparedness Alliance (NPA) to address a continuum of
            care that covers all aspects of individual medical, physical,
            psychological and family readiness across the Navy.
      --In February 2009, an interdisciplinary Suicide Prevention Cross
            Functional Team was established to review current efforts,
            identify gaps, and develop the way ahead.
      --Top leadership vigilance. CNO maintains awareness through monthly
            and ad hoc suicide reports, quarterly Tone of the Force
            reports, Behavioral Health Needs Assessment Surveys, and
            targeted surveys of Sailors and Family members.
      --Increased Family Support. Navy hired 40 percent more professional
            counselors to address Sailor and family needs, resulting in
            improved staffing from 1,044 to 1,444 at Fleet and Family
            Service Centers. A Family Outreach Working group was
            established to improve suicide awareness communication and
            education of family members.
      --Operational Stress Control (OSC), a comprehensive approach designed
            to address the psychological health needs of Sailors and their
            families, is a program led by operational leadership and
            supported by Navy Medicine. To date, more than 13,000 Sailors
            have received an initial OSC familiarization brief. Formal
            training curriculum at key points throughout a Sailor's career
            is under development. The OSC Stress Continuum Model has been
            integrated into Fleet and Family Service Center programs and
            education and training programs.
      --Reserve Psychological Health Outreach Coordinators Program was
            implemented in 2008 and provides 2 coordinators and 3 outreach
            team members (all licensed clinical social workers), to each of
            the 5 Navy Reserve Regions, to engage in training, active
            outreach, clinical assessment, referral to care, and ensure
            follow up services for reserve Sailors.
      --Personal Readiness Summits and Fleet Suicide Prevention
            Conferences/Summits are providing waterfront training
            opportunities for leaders, command Suicide Prevention
            Coordinators, and installation first responders.
      --Front Line Supervisor Training, train-the-trainer, has been
            provided at six locations throughout CONUS with additional
            training scheduled throughout 2009. The Front Line Supervisor
            Training is an interactive half-day workshop designed to assist
            deck-plate leaders in recognizing and responding to Sailors in
            distress.
      --First Responder Seminars provide those individuals likely to
            encounter a suicide crisis situation (security, fire, EMS,
            medical, chaplains, or counselors) with a review of safety
            considerations and de-escalation techniques.
      --Commands are required to have written command crisis response plans
            to guide duty officer actions in response to a suicidal
            individual or distress call. Navy has been training a network
            of command Suicide Prevention Coordinators (SPC) to assist
            Commanding Officers in implementing command level prevention
            efforts and policy compliance.
      --Communications and outreach efforts continue. The new
            www.suicide.navy.mil web URL went live in September 2008 to
            provide an easy-to-remember link to helpful information. A new
            four-poster series was distributed to all installations in
            November 2008 along with a new tri-fold brochure. A new
            training video will be distributed this summer.
      --Warrior Transition Program (WTP) provides a 3-day respite in Kuwait
            to all Individual Augmentees returning from theater. Conducted
            by counselors, chaplains, and peers, the WTP provides time for
            reflection, rituals of celebration or grief, restoration of
            normal sleeping patterns, and time to say good-byes.
      --Safe Harbor. Non-clinical Case Managers are assigned to individuals
            who are severely or very severely ill or injured to provide
            continued support through the treatment and transition process
            and beyond.
      --Chaplain Support. Chaplain education in 2008 and 2009 focused on
            Operational Stress Control for non-mental healthcare givers and
            resilience and family care. The Chaplain Corps Human Care
            initiative is working to understand, evaluate and realign
            chaplain resources for efficient and effective care.
        Question. What, if any, legislative action would DOD need Congress
    to take to expand suicide awareness and education on posts?
        Answer. There are no legislative barriers to expanding suicide
    awareness and education on posts.
        Question. What are the typical steps taken for sailors who may have
    post-traumatic stress disorder (PTSD) and traumatic brain injuries
    (TBI) to ensure they get the proper care? Are there any further
    legislative steps that Congress could take to improve screening and the
    delivery of care to sailors with PTSD and TBI?
        Answer. Sailors and Marines are provided unit-level pre- and post-
    deployment education about signs and symptoms of post-traumatic stress
    disorder and traumatic brain injury. Navy Medicine has developed the
    Stress Injury Model to promote early identification and appropriate
    referral; early identification of symptoms is the best way to mitigate
    the effects of combat stress.
        Unit medical personnel also receive training in PTSD and TBI
    surveillance. The Post-Deployment Health Assessment and Post-Deployment
    Health Reassessment contain screening questions specific to both PTSD
    and TBI, and can assist healthcare providers in making timely and
    appropriate referrals for specialty evaluation and treatment. After a
    diagnosis of PTSD or TBI is made the service member is offered the
    appropriate medical care. For those diagnosed with PTSD, care would
    include additional psychological assessment to rule out other mental
    health conditions followed by appropriate evidence-based cognitive
    therapies (e.g., Cognitive Processing Therapy, Prolonged Exposure). For
    those diagnosed with TBI, care may range from 7 days of rest to
    evacuation from theater and surgical treatment. Service Members
    diagnosed with TBI are assigned a medical case manager to assist with
    coordinating medical care. For those Sailors and Marines unable to
    remain on active duty, Navy Medicine has partnered with the VA to
    ensure a seamless, coordinated transition of care.
        Question. Per the Wounded Warrior legislation enacted in 2007 and
    the Dole-Shalala Commission's recommendations that were reported in
    2007, improvements were to be made to the coordination between DOD and
    VA facilities to better care for our injured troops who are
    transitioning between the two healthcare systems. What steps have
    already taken place to improve coordination between the two
    Departments?
        Answer.
    Disability Evaluation System (DES) Pilot
        The Pilot originally began in 2007 and was expanded January 2009.
    Features of the pilot are:
      --Single physical exam serving DOD separation and VA disability
            decisions; and
      --Single disability rating (by VA) used by DOD in separation/
            retirement decision and VA in benefits determination.
    Case Management--Federal Recovery Coordinator Programs
        The Federal Recovery Coordination Program was created in late 2007
    and implemented in 2008 through the signing of two memoranda of
    understanding between DoN and DVA. The goal of the program is to
    provide assistance to recovering service members, veterans and their
    families through recovery, rehabilitation and reintegration and
    benefits.
        The first Recovery Coordinators were hired and trained in early
    2008 and placed at military treatment facilities where most newly
    evacuated wounded, ill or injured service members are taken. NNMC
    Bethesda and NMC San Diego have Recovery Coordinators assigned to work
    in their facilities. This program is fully supported and endorsed by
    both departments and additional Recovery Coordinators will be hired in
    2009.
        The FRC program also includes DOD liaisons and VA detailed staff.
      --1 Navy Liaison, 1 Army Liaison, 2 Marine Liaison Officers, 2 Public
            Health Service staff members.
    Post Traumatic Stress Disorder/Traumatic Brain Injury (PTSD/TBI)
        Established Defense Center of Excellence and appointed director;
    private sector benefactors building facility on Bethesda campus of
    National Military Medical Center. Both DOD and VA established a policy
    of Mental health access standards and standardized TBI definitions and
    reporting criteria.
        TBI questions added to Post Deployment Health Assessment and Post
    Deployment Health Reassessment which may trigger a referral.
    DOD/VA Data Sharing
        Expanded the availability of DOD theater clinical data to all DOD
    and VA facilities. As of the beginning of 2008, added the bi-
    directional transmission of provider/clinical note, problem lists,
    theater inpatient medical data from Landstuhl and medical images
    between three Military Treatment Facilities and the VA Polytrauma
    Centers
        DOD and VA have signed Information Technology (IT) Plan to support
    the Federal Recovery Care Coordinator program. A tri-fold on Wounded
    Warrior pay and travel entitlements (also on web).
        Question. What steps remain?
        Answer. Further growth and expansion of DES will greatly assist in
    this endeavor. Involvement of Case Mangers and education of both
    staff's on the intent of DES is critical to success.
        Further efforts to ensure smooth data sharing between DOD and VA
    are critical to the transition of care.
        Question. Are these provisions sufficient to provide a seamless
    transition for wounded warriors from the DOD to the VA system?
        Answer. Yes, although continued efforts to refine the processes
    supporting seamless transition should be encouraged.
        Question. Does DOD need further legislation to improve matters? If
    so, what?
        Answer. No needs identified at this time.
                                     ______

          Questions Submitted to Lieutenant General James G. Roudebush
                Questions Submitted by Chairman Daniel K. Inouye
                          well-being of our caregivers
        Question. General Roudebush, while attention must be focused on the
    resilience training of our Service members and their families, I also
    suspect that caring for our wounded takes a considerable toll on our
    caregivers.
        What efforts are underway to address the well-being of our
    caregivers in order to retain these critical personnel?
        Answer. The Air Force is also concerned about the stress
    experienced by our healthcare providers, as well as their exposure to
    the injured and killed. In order to address this concern, we provide
    awareness education to healthcare providers prior to deployment, and we
    closely monitor psychological symptoms post-deployment. These
    educational and surveillance processes are provided to all deploying
    Airmen via Landing Gear; the post-deployment health assessment; the
    post-deployment health reassessment. A study is currently underway at
    the theater hospital in Balad that assesses risks and protective
    factors in our deployed medics. Furthermore, the Air Force has hired 97
    additional contract mental health providers in the last year to improve
    access to mental healthcare and to spread out the workload for our busy
    uniformed mental health providers.
                            enterprise architecture
        Question. How do you ensure Service specific needs are incorporated
    in the new enterprise architecture and how do you make sure they don't
    drive up costs throughout the system?
        Answer. The Air Force Medical Service has representation in the MHS
    integrated requirements and review working groups. These vetting bodies
    review the initial capability documents and analyze costing before
    recommending for inclusion in the Central Portfolio. As a general rule,
    we ensure cost is minimized by finding compatible Tri-Service solutions
    that use common standards that enhance interoperability.
                                     ______

                  Questions Submitted by Senator Patty Murray
                                    suicides
        Question. JSC Chairman Admiral Mullen has said publicly he's trying
    to break the stigma of psychological health in the active force, yet,
    the Judge Advocates General are still prosecuting as a ``crime''
    depressed people who attempt suicide. While the surgeons general aren't
    responsible for the enforcement of the Uniformed Code of Military
    Justice, it seems to me that they might be concerned about prosecutions
    of people who have severe mental distress while serving or after
    serving in combat.
        Generals, do you think that the continued criminal prosecution of
    troops who commit suicide is a problem for the military's efforts to
    break the stigma of psychological health?
        Answer. The Air Force is not aware of any instances in which an
    Airman has been prosecuted based solely on mental distress and/or a
    suicide attempt. AF leaders work hard to foster a ``wingman'' culture,
    in which Airmen look out for one another and seek timely help for both
    personal and psychological concerns. Our goal is to identify and
    address psychological concerns before they manifest themselves
    behaviorally in a way that threatens personal health or safety or that
    interferes with mission accomplishment. Should those efforts fail, we
    will continue to provide comprehensive, evidenced-based treatment.
                         electronic medical information
        Question. In your opinion, what additional steps need to be taken
    to ensure that electronic medical information is available to the
    Department of Veterans Affairs?
        Answer. Further interdepartmental collaboration on the creation of
    common data dictionaries and implementation of Services Oriented
    Architecture will set a firm footing towards sharing of our data. A
    dedicated integration program office and a sound funding strategy will
    do much to ensure data is available to our constituencies.
               accounting for contract care in the medical record
        Question. How are each of your Services obtaining medical records
    for Service members who receive contract care and how big of a problem
    is this for creating a complete record of care?
        Answer. There are two primary scenarios in which the Air Force
    Medical Service obtains medical records from contracted TRICARE network
    providers.
    Scenario 1:
        Military Treatment Facility (MTF) enrolled Active Duty Service
    Members (ADSMs) referred to a contract TRICARE network provider for
    specialized health care not available at the MTF.
        Records capture process: Following the civilian medical
    appointment, the referral results or consultation report(s) are
    submitted to the referring MTF where they are reviewed by the referring
    provider and permanently filed in the ADSM's record. This process is
    not considered to be a significant Air Force Medical Service problem or
    challenge that would otherwise prevent or delay its ability to create a
    complete record of care.
    Scenario 2:
        TRICARE Prime Remote (TPR) ADSMs enrolled to a TRICARE network
    primary care manager instead of an MTF provider.
        Records capture process: Health treatment records for Airmen
    assigned to geographically separated units (GSUs) or remote duty
    locations (e.g. recruiting squadrons, Military Entrance Processing
    Centers, unique military detachments, or other similar units without
    immediate military installation support), are usually maintained at the
    nearest Air Force MTF.
        Prior to PCS reassignment (from the TPR duty location or retirement
    or separation from the remote duty assignment), Airmen are required to
    ``out-process'' through the MTF responsible for maintaining their
    military health treatment records. At the time of the MTF records
    department out-processing encounter, MTF records managers and the
    service member complete a records copy request form. The form is
    submitted to the Airman's contracted TRICARE network primary care
    manager. Upon receipt of the requested information, the medical
    document copies are added to the Airmen's health record and the
    complete health record is forwarded to the gaining MTF or to the Air
    Force Personnel Center (for separating and retiring Airmen).
        The Air Force continues to educate Airmen regarding installation
    out-processing procedures whenever and wherever possible. However,
    sometimes Airmen assigned to GSUs do not always visit or ``out-
    process'' through the nearest Air Force MTF responsible for maintaining
    their military health treatment records. Consequently, the MTF doesn't
    always know to submit a records copy request to the Airman's contracted
    TRICARE network primary care manager. The records capture process for
    Airman assigned to TPR locations currently does not function as well as
    it should, and we are reviewing this process to identify improvement
    opportunities.
             va vision center of excellence and eye trauma registry
        Question. The fiscal year 2008 National Defense Authorization Act,
    Section 1623, required the establishment of a Joint Department of
    Defense and Department of Veteran's Affairs Vision Center of Excellence
    and Eye Trauma Registry. Since then, I am not aware of any update on
    the budget, current and future staffing for fiscal year 2009, the costs
    of implementation of the information technology development of the
    registry, or any associated construction costs for placing the
    headquarters for the Vision Center of Excellence at the future site of
    the Walter Reed National Medical Center in Bethesda, MD.
        What is the status on this effort?
        Answer. I believe Col. Donald A. Gagliano, the Executive Director
    for the DOD Vision Center of Excellence, addressed some of those issues
    during his March 17, 2009, testimony, and I would defer to the the Army
    as the lead agent to provide a more comprehensive response.
                                     ______

                  Questions Submitted by Senator Thad Cochran
                      post deployment health reassessment
        Question. One of the tools used to measure the health and well-
    being of Service members after they return home is the Post Deployment
    Health Reassessment form, which everyone is asked to fill out 90 and
    190 days after their redeployment. As of January 30, the Air Force
    Reserve had the second lowest completion rate of this form at 46
    percent.
        What are some of the reasons for this low number of completed
    responses and what is the Air Force doing to help ensure returning
    Airmen and women receive needed care?
        Answer. Initial rollout of the Post Deployment Health Reassessment
    was made available to Reservists through the Reserve Component Periodic
    Health Assessment (RCPHA) system. However, this system proved unable to
    monitor completion of the PDHRA (Form 2900) or measure unit compliance.
    The system was abandoned in July 2008 and the Reserve migrated to the
    medical information system used by the Air Force active component. The
    migration resulted in corrupted and incomplete records, reflected in a
    7 percent indicated compliance rate immediately following the
    transition. Efforts to correct these errors have rapidly improved the
    indicated compliance rate, which is currently at 51 percent. By late
    summer we project our PDHRA compliance to be on par with the active
    duty and Air National Guard.
              keesler medical center and biloxi veterans hospital
        Question. I understand the Department of Defense and the Department
    of Veterans Affairs are working to establish joint ventures in areas
    where both agencies have co-located facilities around the country. I
    would hope the goal of these joint ventures would be to increase the
    quality of care and efficiency without decreasing capability or
    capacity. I understand the Air Force has been working with the
    Department of Veterans Affairs to integrate Keesler Medical Center and
    the Biloxi Veterans Hospital.
        Can you give me your assessment on this process and if you believe
    it has been a good news story?
        Answer. Based on our experience to date, the joint venture process
    is effective and the results are good news stories across the board.
        When considering Joint Venture opportunities, the viability of a
    proposed joint facility is assessed across nine separate domains.
    Through this structured approach, the work group assesses the
    organizations' current relationship and the potential for a future
    joint relationship. Phase I and Ib sites are already joint facilities
    or are in the process of becoming joint facilities. The efforts at
    those sites have focused on further integration, and Keesler-Biloxi is
    part of that group. Detailed plans are complete for the integration of
    all clinical specialty services between Keesler Medical Center and
    Biloxi Veterans Hospital, with the exception of General Surgery, which
    will continue to be available at both facilities.
        All Phase II sites have the potential to increase their level of
    sharing and some sites may have the potential to become joint
    facilities. An example of Phase II efforts is the Colorado Springs
    Joint Market area, where the Air Force Academy's 10th Medical Group
    will share operating room time with the Eastern Colorado Health Care
    System.
        We anticipate all of our joint ventures will be win-win efforts
    that will improve efficiency and access to care for all participating
    facilities.
                 joint air force and veterans affairs projects
        Question. I have been informed that it is intended these joint
    ventures, such as the Keesler-Biloxi project, will achieve complete
    consolidation, much of what's being attempted at Great Lakes in
    Illinois with the Navy.
        Do you believe that the different mission sets in the Department of
    Defense and the Department of Veterans Affairs make complete
    consolidation possible or logical at all locations?
        Answer. In our experience, despite disparate missions, joint
    venture sites have been very successful in taking care of their
    beneficiaries and provide a win-win scenario for both partners. We
    believe that there are many forms of joint ventures, and not all joint
    ventures are, or should be, considered for complete consolidation.
        We appreciate your interest in the good news story at Keesler.
    Keesler Medical Center (KMC) and VA Gulf Coast Veterans Health Care
    System (VAGCVHCS) have had a long history of sharing, but it wasn't
    until after Hurricane Katrina that the full benefits of DOD/VA sharing
    were explored. Dual VA CARES and DOD BRAC funding projects caused the
    two large medical centers to develop an integration plan as an official
    joint venture site. Using a ``Centers of Excellence'' (COE) model, all
    KMC and VA inpatient and outpatient clinical product lines are being
    realigned/shared at the site where either party has the greater
    capability. This produces a synergy between the combined staffs and
    maximizes capabilities for the patient. This approach also reduces or
    eliminates duplication of effort of similar services. For services that
    cannot be realigned or fully integrated, we emphasize exploiting any
    opportunity to open service availability for each other's
    beneficiaries. The only limits are access to care and service
    availability itself.
        At the same time, this model retains the independent daily
    governing structures of both facilities, allowing the Air Force and the
    VA to carry on their important and distinctive missions unimpeded. An
    Executive Management Team co-chaired by KMC Commander and VA Director
    provides oversight linkage for sharing initiatives.
        We currently have seven signed operational plans for ongoing shared
    services. These plans detail the scope of care, business office
    functions and other important aspects of treating each others'
    patients. The seven signed plans are: Orthopedics, dermatology, plastic
    surgery, pulmonology/pulmonology function tests, shared nursing staff,
    shared neurology technicians and laundry.
        We have eight more operational plans we anticipated being signed
    within the next 60 days: Women's health, sleep lab, radiation oncology,
    MRI, cardiac cathorization, patient transfer, urology and shared
    referral staff. All services that are sharing in these areas are doing
    so under our resource sharing agreement and draft operational plans.
        We anticipate taking on a significant amount of VA surgical and
    inpatient workload as the VA's CARES construction project will limit
    their operating room usage for several months in fiscal year 2010. The
    VA will be bringing many of their operating room personnel and
    inpatient nursing staff.
        In summary, the integration process has been a great success thus
    far, and we anticipate this joint venture will be a win-win proposition
    for both facilities.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
                                    suicides
        Question. Congress has established a national suicide hotline for
    returning troops, as well as increased funding for mental health for
    active military personnel. However, there remains a high number of
    Soldier suicides.
        What preventive measures is the Department of Defense (DOD) taking
    to address this problem?
        Answer. The DOD has established the Suicide Prevention and Risk
    Reduction Committee to monitor and address suicide trends across the
    DOD. The DOD has implemented the DOD Suicide Event Reporting System to
    improve data tracking, and hosts an annual DOD/Veterans Affairs suicide
    prevention conference that draws experts from around the world.
        The military Services each execute their own suicide prevention
    programs tailored to the needs and culture of their own Service. We are
    carefully studying each other's best practices to maximize the
    effectiveness of our programs. The Air Force Suicide Prevention Program
    (AFSPP) includes 11 initiatives that must be implemented by every Wing
    Commander. Our program focuses on a total community effort that has
    helped to reduce our suicide rate by 28 percent since it was
    implemented in 1996. The AFSPP is listed on the Department of Health
    and Human Services National Registry of Evidence-based Programs and
    Practices.
        Question. What, if any, legislative action would the Department of
    Defense need Congress to take to expand suicide awareness and education
    on posts?
        Answer. The Air Force defers to Department of Defense (DOD) on
    possible DOD legislative proposals. The Air Force Suicide Prevention
    Program (AFSPP) is intensely invested in awareness and education down
    to the grassroots level--the AFSPP is a commander's program that
    targets every Airman. Through our Landing Gear program, we teach all
    Airmen how to prepare for the psychological effects of deployment, how
    to recognize risk factors and to know when and how to get help for
    themselves or others. We have instilled a Wingman Culture in which we
    are each responsible for our fellow Airmen. The Air Force does not
    require any legislative action at this time to support the AFSPP, but
    we greatly appreciate the Congress' efforts to help us address this
    critical issue.
                                    ptsd/tbi
        Question. What are the typical steps for Airmen who may has post-
    traumatic stress disorder (PTSD) and traumatic brain injuries (TBI) to
    ensure they get the proper care?
        Answer. The Air Force uses a three-part strategy to address and
    manage PTSD, TBI and other deployment related health concerns. The
    first component of our strategy involves training and education efforts
    to enhance awareness and recognition of common deployment-related
    health concerns. The second component involves repeated health
    surveillance before, during, and after deployments, as well as
    annually. The final component involves intervention. Screening that
    identifies PTSD and TBI symptoms (as well as other health concerns)
    results in more thorough assessments and referrals to specialists when
    indicated. We work closely with the Defense Center of Excellence for
    Psychological Health and TBI as well as civilian subject matter experts
    to ensure our treatment efforts are in line with clinical practice
    guidelines and established standards of care.
        Question. Are there any further legislative steps that Congress
    could take to improve screening and the delivery of care to Airmen with
    post-traumatic stress disorder (PTSD) and traumatic brain injuries
    (TBI)?
        Answer. The entire Department of Defense has put considerable
    resources and effort into addressing the identification and treatment
    of service members with PTSD and TBI in a very short period of time.
    Any additional legislative support for these critical issues would be
    best recommended by the newly formed Defense Center of Excellence for
    Psychological Health and TBI. However, we caution against proposed
    legislation that would mandate face-to-face provider-to-troop
    screenings for all redeploying military personnel, the majority of whom
    are not experiencing significant health concerns. We believe our
    existing program is successfully and expeditiously capturing those who
    need intervention and treatment. Expanding the program unnecessarily
    will further constrain resources needed to focus on those with
    identified health concerns.
                                wounded warrior
        Question. Per the Wounded Warrior legislation enacted in 2007 and
    the Dole-Shalala Commission's recommendations that were reported in
    2007, improvements were to be made to the coordination between the DOD
    and VA facilities to better care for our injured troops who are
    transitioning between the two healthcare systems.
        What steps have already taken place to improve coordination between
    the two departments? What steps remain? Are these provisions sufficient
    to provide a seamless transition for wounded warriors from the DOD to
    the VA system?
        Answer. With the passage of Wounded Warrior specific sections of
    the National Defense Authorization Acts of 2007 and 2008 and the
    creation of a joint DOD/VA disability evaluation system (DES)
    demonstration pilot, there now exists an unprecedented amount of
    cooperation, teamwork and cross-functional communication between the
    Services and the VA. Similar to our Army and Navy counterparts, the Air
    Force Medical Service is working very hard with the VA to ensure those
    Service Members who are ``medically'' separated or retired from the
    Armed Forces are fairly evaluated and receive the healthcare,
    compensation and benefits necessary to ensure a seamless lifestyle
    transition from military to civilian life.
        Representatives from each Service's medical and personnel
    headquarters offices (including physical evaluation board disability
    managers) routinely meet with VA and DOD policy officials to evaluate
    the joint departmental DES demonstration pilot targeted goals and
    objectives, review disability evaluation findings and trends, and
    analyze pilot metrics (including process timeliness). Furthermore, the
    VA/DOD DES demonstration pilot has expanded outside the greater
    Washington, DC, area (the initial VA/DOD demonstration pilot area) and
    now includes military installations throughout the Continental United
    States and Alaska. Within the Air Force, the participating VA/DOD DES
    pilot expansion sites include Andrews AFB, Maryland; Elmendorf AFB,
    Alaska; Keesler AFB, Mississippi; MacDill AFB, Florida; Travis AFB,
    California; and Vance AFB, Oklahoma; with other potential expansion
    sites currently being considered.
        The Office of the Assistant Secretary of Defense for Health Affairs
    (OASD/HA) has recently obligated an additional $5.5 million to enable
    our military treatment facilities to hire more Physical Evaluation
    Board Liaison Officers (PEBLOs). The PEBLOs are one of our most
    important non-clinical case managers. The individuals are responsible
    for providing Service Members traversing the DES with non-clinical
    benefits and referral support counseling.
        Additionally, at the direction of Mr. Michael Dominguez, Principal
    Deputy Under Secretary of Defense for Personnel and Readiness, the Air
    Force has created a centralized health treatment records disposition
    process designed to more efficiently transfer complete medical and
    dental treatment records for retiring and separating Airmen from the
    Air Force to the VA. This new process prohibits medical and personnel
    units at over 74 Air Force installations from directly sending health
    treatment records to the VA and instead funnels all health treatment
    records to a single military service personnel out-processing center
    before the records are forwarded to the VA. The process is designed to
    reduce the amount of ``orphaned'' or ``loose, late-flowing'' medical
    documents unintentionally separated from the Service Member's original
    health records package. This new process is also intended to ensure the
    medical and dental records for each retiring and separating Airman are
    shipped to the VA together and on-time. The main goal of the program is
    to ensure complete health treatments records for retiring or separating
    Airman are made available to the VA as soon as possible so VA benefits
    and disability compensation reviews can be completed with little to
    zero gaps in veteran benefits or healthcare coverage.
        With regard to what steps remain, everyday we move closer to
    totally transitioning from a paper-based health treatment record to an
    electronic health record. Billions of dollars and countless man-hours
    have been spent on improving and refining the information and
    technology necessary to make this transition a reality. The DOD and VA
    continue to improve and enhance their electronic health record computer
    systems, but we're still a few years away from an electronic health
    record system that offers unfettered bi-directional health information
    exchange between the two agencies.
        Working together with our parallel Service medics and with DOD and
    VA officials, I believe we're doing all we can to ensure the provisions
    identified in the NDAA of 2007, 2008, and 2009 are sufficient to
    provide a seamless transition for Wounded Warriors from the DOD to the
    VA system.
        Question. Does the Department of Defense need further legislation
    to improve matters? If so, what?
        Answer. Working together with our parallel Service medics and with
    DOD and VA officials, we're doing all we can to ensure the provisions
    identified in the NDAA of 2007, 2008, and 2009 are sufficient to
    provide a seamless transition for Wounded Warriors from the DOD to the
    VA system. The Air Force does not require any further legislative
    action at this time to improve transition between health systems.
                                     ______

         Questions Submitted to Rear Admiral Christine M. Bruzek-Kohler
                Questions Submitted by Chairman Daniel K. Inouye
        Question. Admiral Bruzek-Kohler, we recognize that Navy nurses play
    critical roles in supporting both Disaster Relief and Humanitarian
    Assistance missions. What staffing support have you received from the
    Air Force, Army, and civilian organizations to assist you in fulfilling
    the nursing need for these missions?
        Answer. Core nursing teams on these missions are composed of both
    active and reserve component Navy nurses. We are also supported by
    nursing colleagues from the Armed Services, U.S. Public Health Services
    (USPHS), Non Governmental Organizations (NGOs), and partner nation
    military nurses.
        From May 1 to September 25, 2008, USNS MERCY (T-AH 19) embarked a
    1,000-person joint, multi-national, Military Sealift Command Civilian
    Mariner, U.S. Public Health Service and non-governmental organization
    (NGO) team to conduct Pacific Partnership 2008 (PP08). The core nursing
    team consisted of active duty Navy and Air Force nurse corps officers.
    Additional nursing support was provided by Navy reservists. The nursing
    team was further augmented with partner nation military nurses from
    Australia, Canada, Indonesia, New Zealand, and the Republic of the
    Philippines, as well as NGO nurses from International Relief Teams,
    Project HOPE, and Operation Smile. Nursing specialties embarked for
    PP08 included medical-surgical, pediatric, neonatal intensive care,
    obstetric, critical care, and perioperative nursing.
        Certified registered nurse anesthetists and family, pediatric, and
    women's health nurse practitioners were also embarked.
        The USNS COMFORT (T-AH 20) is currently deployed in support of
    Continuing Promise 2009, a 4 month humanitarian assistance mission
    through Latin America and the Caribbean. Active and reserve component
    Navy nurses, as well as nurses from the U.S. Army and Air Force, USPHS,
    various NGOs, (to include Project Hope and Operation Smile) and Canada
    are embarked on this deployment.
        Question. Admiral Bruzek-Kohler, the University of Health Sciences
    (USU) has determined that conditions are not favorable for the creation
    of a Bachelors program in nursing at this time. What options for
    partnering with civilian Schools of Nursing have been discussed as a
    way to develop and recruit military nurse candidates?
        Answer. Navy nurses, at our hospitals in the United States and
    abroad, passionately support the professional development of America's
    future nursing workforce by serving as preceptors, mentors, and even
    adjunct faculty for a myriad of colleges and universities.
        Due to the vast array of clinical specialties available at our
    medical centers at Bethesda, Portsmouth, and San Diego, we have
    developed multiple Memoranda of Understandings (MOU) with surrounding
    colleges and universities to provide clinical rotations for nurses in
    various programs from licensed practical/vocational nursing,
    baccalaureate, and graduate degrees which include nurse practitioner
    and certified nurse anesthetist tracks.
        In completing their clinical rotations at our military treatment
    facilities, civilian nursing students are simultaneously exposed to the
    practice of Navy Nursing and our day to day interactions with members
    of the multidisciplinary Navy Medicine team. This exposure generates
    interest in career opportunities in both the active and reserve
    components of our Corps as well as in our federal civilian nursing
    workforce.
        The Nurse Corps Recruitment liaison officer in the Office of the
    Navy Nurse Corps at the Bureau of Navy Medicine and Surgery works with
    a speaker's bureau comprised of junior and mid-grade Nurse Corps
    officers throughout the country. These officers provide presentations
    on career opportunities in Navy nursing to students at colleges, high
    schools, middle and elementary schools. We recognize that the youth of
    America are contemplating career choices at a much younger age. Over
    the course of the past year, we have tailored our recruiting
    initiatives to engage this younger population.
        At a recent conference entitled ``Academic Partnerships Addressing
    the Military Nursing Shortage'' hosted by Dr. Ada Sue Hinshaw, Dean of
    the Graduate School of Nursing at the Unformed Services University of
    the Health Sciences (USUHS), the Navy Nurse Corps presented information
    on the state of our Corps and the incentive programs that we have
    successfully utilized to recruit nurses. The conference was sponsored
    by funding from the Office of the Assistant Secretary of Defense for
    Health Affairs and was attended by 35 Deans from Schools of Nursing,
    the Directors and Deputies from each of the Nurse Corps and leaders
    from national nursing organizations. The conference objectives
    included: building collaborative relationships among military nursing
    services and Schools of Nursing to foster education opportunities;
    exploring the types of educational programs in which additional
    military students can be enrolled and recommending the types of
    resources and incentives needed for the Schools of Nursing to be able
    to accommodate additional students. This meeting was very successful.
    USUHS also intends to conduct a survey to identify what incentives
    would be most attractive to recruit potential applicants into schools
    of nursing with obligations to serve in the military after graduation
    and successful licensure.
        Question. Admiral Bruzek-Kohler, Nurse Corps Officers are promoted
    to the senior rank of Captain (O-6) at a rate significantly less than
    their physician counterparts. Do you know if this promotion disparity
    has led to our more senior, experienced nurses leaving active duty
    service due to lack of promotion opportunities? What is your exit
    interview data telling you about why nurses are leaving active duty
    service?
        Answer. The Navy Nurse Corps has not identified promotion disparity
    as a factor in causing experienced nurses to leave active service.
        Exit interviews suggest that factors contributing to a decision to
    leave the service are often multi-faceted and maybe family related:
    spouse's employment, children's schools, and/or ill elderly parents.
        In May 2005, the Chief of Naval Personnel's Quick Poll of the Navy
    Medical Community identified the top five reasons for leaving the Navy
    Nurse Corps as: administrative barriers to doing one's job, civilian
    job opportunities, overall time spent away from home, impact of
    deployments on family, and the unpredictability of deployments.
        In fiscal year 2008, the Navy Nurse Corps implemented an incentive
    special pay targeted at retaining individuals with critical war-time
    specialties.
        The Bureau of Medicine and Surgery has contracted to do another
    retention poll and the results will be completed in late summer 2009.
        Question. Admiral Bruzek-Kohler, several professional nursing
    organizations have proposed that the Doctorate of Nursing Practice
    (DNP) be the entry level into practice for all advanced practice
    nurses. Many schools of nursing are proposing to convert their Master
    of Science nursing degrees to DNP programs over the next several years.
    The DNP educational track adds an extra year onto the typical Masters
    level curriculum plan. Has there been any discussion of how this might
    affect Duty under Instruction planning in upcoming years? Could
    offering this post-Master's education option serve as a retention tool
    for mid-levels officers who might otherwise choose to leave active duty
    service?
        Answer. The Navy Nurse Corps' Duty Under Instruction (DUINS)
    training plan is based on the projected losses in our nursing
    specialties, the number of nurses in each specialty training pipeline,
    and the overall nursing end-strength. The typical allotted training
    time is 24 months for completion of a Masters of Science in Nursing
    (MSN) and 48 months for a doctoral degree (Ph.D.). Post masters
    certificate programs are allotted 12-24 months for completion. DUINS
    exists as an avenue for the mid-level officer to apply for advanced
    education opportunities. This has served as an exceptional retention
    tool. Additionally, we have not appreciated a scarcity among quality
    MSN programs for our nurses to attend.
        The Doctorate of Nursing Practicum (DNP) curriculum of 36 months
    has an impact on DUINS, as it affects the overall number of training
    opportunities availed each year. Additionally, our current inventory of
    nursing specialties does not require the additional educational
    preparation conferred via a DNP. We are presently training master's
    prepared clinical nursing specialists and nurse practitioners to meet
    our military nursing requirements in only 24 months. They return to our
    deployable inventory of specialty nurses with greater knowledge and
    clinical expertise. If they were enrolled in a DNP program, they would
    still be matriculating and a lost deployable asset to the Navy Nurse
    Corps. Consideration of the DNP conferral via a post MSN certificate or
    bridge program may have greater appeal to the Navy Nurse Corps, as the
    officer would be lost from the deployable inventory for only 12-24
    months vice 36.
                                     ______

            Questions Submitted to Major General Patricia D. Horoho
                Questions Submitted by Chairman Daniel K. Inouye
                        humanitarian assistance missions
        Question. General Horoho, we recognize that Navy nurses play
    critical roles in supporting both Disaster Relief and Humanitarian
    Assistance missions. What challenges have you encountered when faced
    with the need to train Army nurses to administer humanitarian nursing
    care, to include the need to provide shipboard training to assist with
    U.S. Navy missions?
        Answer. The Army Nurse Corps is focused on ensuring all nurse
    officers deploy with skill sets required for the specific mission,
    whether that mission is for combat or a humanitarian mission. As such,
    the ANC has training venues to train the nurse officers for missions
    when deploying with Forward Surgical Teams, Combat Support Hospital,
    and Brigade Combat Teams. The Navy has pre-deployment training venues
    to train care providers for shipboard missions. If needed, the ANC will
    ensure the nurse officers receive this training prior to any deployment
    in support of the Navy.
                           military nurse candidates
        Question. General Horoho, the University of Health Sciences has
    determined that conditions are not favorable for the creation of a
    Bachelors program in nursing at this time. What options for partnering
    with civilian Schools of Nursing have been discussed as a way to
    develop and recruit military nurse candidates?
        Answer. The Army Nurse Corps, along with the Federal Nursing Chief
    partners, is actively building collaborative relationships among
    Military Nursing Services and Schools of Nursing to foster educational
    opportunities. The Uniformed Services University is taking the lead and
    has recently sponsored a conference that brought together the Deans
    from many prestigious Schools of Nursing throughout the nation to
    discuss partnering with Department of Defense assets. Additionally, the
    Army Nurse Corps is exploring the types of educational programs in
    which military students can be enrolled and evaluating the types of
    resources and incentives needed for civilian Schools of Nursing to
    accommodate additional students.
                         nurse corps officer promotion
        Question. General Horoho, Nurse Corps Officers are promoted to the
    senior rank of Colonel (O-6) at a rate significantly less than their
    physician counterparts. Do you know if this promotion disparity has led
    to our more senior, experienced nurses leaving active duty service due
    to lack of promotion opportunities? What is your exit interview data
    telling you about why nurses are leaving active duty service?
        Answer. Our current exit survey data does not demonstrate that
    senior Army Nurse Corps Officers are leaving due to lack of promotion
    opportunities. Recent increases in authorizations for Colonel have
    improved promotion rates. However, we are validating all O-5 and O-6
    positions in order to optimize the force structure.
        Our exit surveys demonstrate that junior and mid-grade officers are
    leaving for a myriad of reasons to include a perceived lack of ability
    to remain in the clinical setting as they progress through their
    careers. To address this concern, we are developing a lifecycle that
    will enable more senior leaders to remain at the bedside to ensure we
    have the right mix of experience and leadership available to develop
    our junior officers and to ensure we provide world-class care.
                         doctorate of nursing practice
        Question. General Horoho, several professional nursing
    organizations have proposed that the Doctorate of Nursing Practice
    (DNP) be the entry level into practice for all advanced practice
    nurses. Many schools of nursing are proposing to convert their Master
    of Science nursing degrees to DNP programs over the next several years.
    The DNP educational track adds an extra year onto the typical Masters
    level curriculum plan. Has there been any discussion of how this might
    affect Duty under Instruction planning in upcoming years? Could
    offering this post-Master's education option serve as a retention tool
    for mid-levels officers who might otherwise choose to leave active duty
    service?
        Answer. The Army Nurse Corps is actively evaluating the impact of
    the advent of the DNP educational track on our force modeling and
    selection opportunities. It is important that we maintain currency in
    our education options to maintain Long Term Health Education and
    Training as our primary retention and professional development tool.
    Both the Uniformed Services University Nurse Anesthesia Program and the
    U.S. Army Graduate Program in Anesthesia Nursing are transitioning to
    the DNP model to maintain their excellent standing in the civilian
    community.
                                     ______

          Questions Submitted to Major General Kimberly A. Siniscalchi
                Questions Submitted by Chairman Daniel K. Inouye
                                 nurse training
        Question. General Siniscalchi, we recognize that military nurses
    play critical roles in supporting both Disaster Relief and Humanitarian
    Assistant missions.
        What challenges have you encountered when faced with the need to
    train Air Force nurses to administer humanitarian nursing care, to
    include the need to provide shipboard training to assist with U.S. Navy
    missions?
        Answer. The fundamentals of nursing care remain the same regardless
    of environmental circumstance, whether humanitarian, disaster response,
    or contingency operations. Air Force nurses play an important role in
    joint operations. In 2008, U.S. Air Force nurses deployed aboard U.S.
    naval ships in support of numerous humanitarian missions including
    Pacific Partnership 2008. In addition to the standard medical
    deployment training, Air Force medics who are deployed onboard a U.S.
    Navy ship undergo ship-specific orientation to include: life raft
    training, ship fire drills, damage control training, and emergency ship
    egress.
        Additionally, Air Force nurses provided humanitarian support
    alongside U.S. Army personnel in South American locations during Joint
    Task Force Bravo and also to Central Command and European Command as
    part of a joint medical team in support of Operations IRAQI FREEDOM and
    ENDURING FREEDOM.
                    partnering with civilian nursing schools
        Question. General Siniscalchi, the University of Health Sciences
    has determined that conditions are not favorable for the creation of a
    Bachelors program in nursing at this time.
        What options for partnering with civilian Schools of Nursing have
    been discussed as a way to develop and recruit military nurse
    candidates?
        Answer. The USAF Nurse Corps is excited at the many opportunities
    to partner with our healthcare counterparts in civilian universities.
    As recently as March 14, Ada Sue Hinshaw, the Dean of the Graduate
    School of Nursing, Uniformed Services University, sponsored a
    conference that brought together Deans from Colleges of Nursing across
    the United States and the Tri-Service Military Nurse Corps Chiefs and
    their deputies. The conference was titled ``Conference for Academic
    Partnership Addressing the Military Nursing Shortage.'' The objective
    was to ``build collaborative relationships among military nursing
    services and schools of nursing to foster educational opportunities.''
    It was an invaluable opportunity to share and discuss challenges,
    options, and ideas among key stakeholders.
        As the USAF Nurse Corps continues its collegial relationship with
    the University of Cincinnati, and as we establish a similar partnership
    with the Scottsdale Healthcare System in Scottsdale, Arizona, we are
    encouraged that our presence within these two exceptional civilian
    medical centers will also draw interest from local nursing students and
    staff.
        The USAF Nurse Corps is also at the precipice of establishing a
    first-ever Masters in Flight Nursing in collaboration with Wright State
    University in Dayton, Ohio.
                                nurse retention
        Question. General Siniscalchi, Nurse Corps officers are promoted to
    the senior rank of colonel (O-6) at a rate significantly less than
    their physician counterparts.
        Do you know if this promotion disparity has led to our more senior,
    experienced nurses leaving active duty service due to lack of promotion
    opportunities?
        Answer. The Air Force Nurse Corps has experienced disparity with
    promotion opportunity, and we believe it may be a factor in some senior
    nurses leaving active duty. However, we are working closely with
    Lieutenant General Newton, his team of personnelists and the Air Force
    Surgeon General to correct this disparity.
        Question. What is your exit interview data telling you about why
    nurses are leaving active duty service?
        Answer. We are currently exploring options to initiate/capture data
    from a Nurse Corps-wide survey, as well as a specific exit-survey. We
    look forward to obtaining data that will provide us with a more
    accurate picture of why nurses choose to separate from active duty.
                         doctorate of nursing practice
        Question. General Siniscalchi, several professional nursing
    organizations have proposed that the Doctorate of Nursing Practice
    (DNP) be the entry level into practice for all advanced practical
    nurses. Many schools of nursing are proposing to convert their Master
    of Science nursing degrees to DNP programs over the next several years.
    The DNP educational track adds an extra year onto the typical Masters
    level curriculum plan.
        Has there been any discussion of how this might affect Duty under
    Instruction planning in upcoming years?
        Answer. One of the best recruiting tools in the Air Force is our
    educational opportunities. Our Nurse Corps officers have the ability to
    return to school full-time and earn a Masters and/or Doctoral degree.
    Most chief nurses use educational opportunities as an incentive to join
    when they do their recruiting interviews. The University of Health
    Sciences (USU) is uniquely situated in the Washington, DC, metropolitan
    area giving the university access to a variety of resources to include
    the National Institutes of Health, Office of the Secretary of Defense,
    Health Affairs, etc. Our students experience a very rigorous program
    that prepares them well for the future. Additionally, we are working
    very closely with Dean Hinshaw from USU to develop a curriculum in
    which our advance practice nurses can earn a Doctorate in Nursing
    Practice by 2015 as recommended by the American Nurses Association.
        Question. Could offering this post-Masters' education option serve
    as a retention tool for mid-level officers who might otherwise choose
    to leave active duty service?
        Answer. These opportunities for graduate education are significant
    retention tools, especially for our star performers. The University of
    Health Sciences (USU) allows our nurses to work with the other
    uniformed services in a very collaborative and joint way that is not
    possible in civilian universities. USU educational options are valuable
    in both recruitment and retention.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. This subcommittee will reconvene on
    Wednesday March 25 at 10:30 a.m. At that time we'll receive
    testimony from the Guard and Reserve. Until then we'll stand in
    recess.
        [Whereupon, at 12:52 p.m., Wednesday, March 18, the
    subcommittee was recessed, to reconvene at 10:30 a.m.,
    Wednesday, March 25.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                           WEDNESDAY, MARCH 25, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:04 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Leahy, Durbin, Murray, Cochran,
    and Bond.

                             DEPARTMENT OF DEFENSE

                                 National Guard

    STATEMENT OF LIEUTENANT GENERAL CLYDE A. VAUGHN,
                DIRECTOR, ARMY NATIONAL GUARD

                 OPENING STATEMENT OF SENATOR DANIEL K. INOUYE

        Chairman Inouye. This morning the subcommittee meets to
    receive testimony on the status of the National Guard and
    Reserve components. From the National Guard, we are pleased to
    have the Vice Chief of the Army National Guard, General Clyde
    Vaughn, and the Vice Chief of the Air National Guard, General
    Harry Wyatt.
        Before I proceed, I would like to apologize for this brief
    lateness, but the traffic is, as always, terrible.
        And from the Reserve, we welcome the Chief of the Army
    Reserve, General Jack Stultz, Chief of the Navy Reserve, Vice
    Admiral Dirk Debbink, Commander of the Marine Forces Reserve,
    Lieutenant General John Bergman, and the Chief of the Air Force
    Reserve, General Charles Stenner.
        We are very pleased to have you here today and look forward
    to working with you in the coming years in support of our
    guardsmen and our reservists.
        The subcommittee is sorry that General McKinley was not
    able to be here today to testify, but we thank him for
    submitting written testimony for the record.
        This hearing will be unlike prior years in that we have not
    received the fiscal year 2010 budget, nor the fiscal year 2009
    supplemental request. For this reason, many members of the
    subcommittee may wish to submit additional questions after we
    receive the budget request later this spring, and we ask for a
    timely response to these questions.
        Gentlemen, the National Guard and Reserve components have
    maintained a high operational tempo for over 6 years in support
    of the operations in Iraq and Afghanistan. Through the
    admirable service of thousands of guardsmen and reservists, the
    Reserve components have provided essential combat, logistics,
    and other support capabilities to these operations.
        However, the strain of these deployments is beginning to
    show. Suicide and divorce rates, for example, are on the rise,
    unfortunately. We must make certain that we are doing
    everything we can to provide our servicemembers the support
    they need during and after deployment. Reintegrating after
    deployment can be particularly difficult for guardsmen and
    reservists who lack the support network provided at an active
    duty installation. For this reason, reintegration programs are
    important in helping our guardsmen and reservists transition
    back to civilian life.
        Despite providing additional resources for these programs
    in the last year's supplemental funding bill, a Department-wide
    approach to reintegration activities has been very slow to
    develop, and our subcommittee hopes that the Department will
    work quickly to create an effective program that fits the needs
    of our returning servicemembers without using a one-size-fits-
    all for all of the Reserve components. What works for the Army
    may not work for the Navy Reserve.
        It is a testament to the dedication and patriotism of our
    guardsmen and reservists that retention levels remain strong
    despite the strain of frequent deployments. Recruiting has also
    continued to improve for all Reserve components. In fact, for
    the first time in several years, all of the Reserve components
    are consistently achieving their recruiting goals.
        However, as we all agree, challenges remain. Many of the
    Reserve components are increasing their end strength, which
    will require continued focus on recruiting and retention,
    particularly for high-demand specialties. And as the active
    components continue to grow, it will be increasingly difficult
    for the Reserve components to attract prior-service candidates.
    Therefore, we must continue to provide sufficient resources to
    attract and retain high-quality personnel.
        The success of the Guard and Reserve components would also
    not be possible without the support of our Reserve employers.
    Employers must fill the holes left by deployed reservists who
    are sometimes on their second deployment in only a few years'
    time. The strain has become even greater during the current
    economic recession, and I look forward to hearing what is being
    done to make certain that we continue to have the support of
    our business community in hiring and supporting our reservists.
        The subcommittee is pleased to see that equipment shortages
    continue to be reduced, although we know significant shortfalls
    still remain. It is important that the Department continues to
    focus on equipping the Reserve components by requesting
    sufficient funding in annual budget submissions and
    prioritizing the fielding of equipment to the Reserve
    components. We must make certain that the Guard and Reserves
    have the equipment they need for training and operations at
    home and abroad.
        I look forward to hearing your perspective on these issues
    and your recommendations for strengthening our forces during
    this most demanding time. And I thank you for your testimony
    this morning, and may I assure you that your full statements
    will be made part of the record.
        We will begin our hearing with the panel of the National
    Guard, but first, I would like to turn to my distinguished vice
    chairman, Senator Cochran of Mississippi, for any remarks he
    may wish to make.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you very much. I am
    pleased to join you in welcoming the leaders of our National
    Guard and Reserve components to today's hearing.
        Today's citizen soldiers, sailors, airmen, and marines are
    an indispensable and operational reserve. The days of the
    weekend warrior are history. These everyday people balance a
    day job, family interests, and are now volunteering for
    deployments, humanitarian missions, and nonservice traditional
    assignments around the globe. When they are not supporting
    operational needs of combatant commanders, they stand ready to
    assist in dealing with natural disasters here at home.
        We appreciate the service that you provide our Nation.
    Thank you very much. We look forward to your testimony.
        Chairman Inouye. Now may I call upon the man who is in
    charge of the Guard? General Vaughn.
        General Vaughn. Mr. Chairman, Mr. Vice Chairman, it is a
    privilege to be here with you. As you stated, we have turned in
    our statements for the record, and so I will be very brief, and
    I look forward to answering the questions.
        The first thing I would like to do is to introduce to this
    subcommittee a great noncommissioned officer. He happens to be
    the noncommissioned officer of the year for the entire 1.1
    million of our men and women Army. He is a National Guardsman
    from Montana, and his name is Sergeant Michael Noyce Marino,
    and he has his wife with him, Shelly.
        Of course, we talk very emotionally about what a close-knit
    family we are in the Guard and Reserve, and that is where our
    strengths come from, from our communities. So today, as we were
    having a discussion in my office before we started over here, I
    asked the typical question, where is everybody from. Shelly's
    mother and I grew up in the same 4,000-person town in Dexter,
    Missouri, and Senator Bond--I am sure you know I am going to
    tell him that deal too. Unbelievable sometimes.
        I really appreciate what you have done. You know we look to
    your leadership with the National Guard and Reserve equipment
    appropriations. We know what has been done there. We know the
    money that you put in there, especially for the full-time
    support piece. Your confidence in us has been well justified.
    You know we are the strongest Army National Guard right now of
    all time, and we are making progress every day. We are ready to
    do whatever the State and the Nation ask us to do, and it is
    because of your great support that has made that possible.
        As you know, the 2010 budget is not here, and so when it
    comes, we just ask for your help, again just like you have
    always given us in doing the right thing.
        Please take a look at funding for civil support teams
    (CSTs), a critical element in our organizations. We want to
    make sure that they are sufficiently taken care of.
        And the last thing is it is probably my last time to appear
    before this subcommittee, and it has been a privilege and an
    honor to come over here and testify, something that I will
    always cherish and remember. So thank you very much.
        I look forward to your questions.
        [The statement follows:]
            Prepared Statement of Lieutenant General Clyde A. Vaughn
                     national guard posture statement 2010
                      introduction and executive overview
            general craig r. mc kinley, chief, national guard bureau
                                 new beginnings
        2008 was a year filled with positive change for the National Guard.
    The National Defense Authorization Act (NDAA) of 2008, enacted in
    January, designated the National Guard Bureau (NGB) as a joint activity
    of the Department of Defense (DOD). The law also elevated the grade of
    the Chief, National Guard Bureau to the rank of General. With this new
    stature and an explicit linkage to the Secretary of Defense, through
    the Chairman of the Joint Chiefs of Staff (CJCS), NGB is better
    positioned to represent National Guard issues and concerns at the
    highest levels in the DOD.
        The Report of the Commission on the National Guard and Reserves and
    NDAA 2008 both identified the need for a new NGB charter. After almost
    a year of close collaboration among NGB, the Combatant Commanders, the
    CJCS, the Armed Services and the DOD staff, Secretary Robert M. Gates
    signed DOD Directive 5105.77, National Guard Bureau. This unprecedented
    directive formally lays out the full scope of NGB's functions, roles,
    and authorities--embedding NGB in DOD's strategic processes. It is
    sound DOD policy.
                              an operational force
        The depth provided by the National Guard is no longer the ``once in
    a lifetime'' use of a strategic reserve as envisioned during the Cold
    War. The National Guard has become an operational force that is an
    integral part of the Army and Air Force; it is populated by seasoned
    veterans with multiple deployments in support of operations in Iraq,
    Afghanistan, the Balkans, and many other locations around the world.
        In addition to the thousands of National Guard Soldiers and Airmen
    currently activated for ongoing federal missions, the National Guard
    provides significant response to unexpected contingencies. Despite
    major overseas commitments, during the 2008 hurricane season over
    15,000 Guardsmen responded on short notice to catastrophic events
    unfolding in Louisiana and Texas. The National Guard serving here at
    home also fought extensive fires and flooding and provided disaster
    relief to numerous states throughout the year.
                                   readiness
    Personnel
        Our most precious assets flow from our communities. Citizen-
    Soldiers and Airmen are employed by their Governors every day to
    protect American lives and property in the homeland from weather-
    related events to suspected biochemical contamination. Despite all we
    have asked of them in the overseas warfight as well as here at home, we
    are recruiting and retaining National Guard members in impressive
    numbers. Americans join and stay in the National Guard. But as
    successful as we have been to date, we need continued support for
    recruiting and retention efforts as well as increased endstrength
    authorizations.
    Equipment
        The National Guard must have modern equipment if we are to remain
    successful as defenders of the homeland at home and abroad.
        Army National Guard (ARNG) units deployed overseas have the most
    up-to-date equipment available and are second to none. However, a
    significant amount of equipment is currently unavailable to the Army
    National Guard in the states due to continuing rotational deployments
    and emerging modernization requirements. Many states have expressed
    concern about the resulting shortfalls of equipment for training as
    well as for domestic emergency response operations.
        The Army is programming $20.9 billion for ARNG equipment for fiscal
    year 2009 through fiscal year 2013 to procure new equipment and
    modernize equipment currently on hand. We appreciate that support and
    also the strong interest of the Congress and the Department of Defense
    in closing the gap between our domestic requirements and the available
    equipment in our armories and motor pools.
        The Air Force is in the midst of modernizing and recapitalizing its
    major weapons platforms, and the Air National Guard (ANG) must be
    concurrently recapitalized, particularly in order to avoid near to mid-
    term ``age out'' of the majority of its fighter force. Our primary
    concern is that 80 percent of our F-16s, the backbone of our Air
    Sovereignty Alert Force, will begin reaching the end of their service
    life in 8 years. To that end, we support the Air Force's
    recapitalization plan, but request that all roadmaps be inclusive of
    the Air National Guard as a hedge against this ``age out.''
                           state partnership program
        The National Guard State Partnership Program (SPP) establishes
    enduring and mutually beneficial partnerships between foreign countries
    and American states through the National Guard. This program is an
    important component of the Department of Defense's security cooperation
    strategy, the regional Combatant Commanders' theater engagement
    program, and the U.S. ambassadors' Mission Strategic Plans. A primary
    aim is to promote partnership among the many nations working with us to
    advance security, stability, and prosperity around the globe. Today,
    American states are partnered with 60 foreign nations (a 60 percent
    increase over the past 5 years) to focus on military-to-military,
    military-to-civilian, and civil security activities.
        Created in 1993, SPP has helped the United States European,
    African, Southern, Pacific, and Central Commands engage the defense and
    military establishments of countries in every region of the globe. The
    program's benefits include:
      --Providing Combatant Commanders and U.S. ambassadors with avenues
            for building international civil-military partnerships and
            interoperability during peacetime by linking state capacities
            to the goals and objectives in the Foreign Assistance Framework
            of the U.S. Government.
      --Enhancing current and future coalition operations by encouraging
            and assisting partner nations to support efforts such as NATO's
            Operational Mentor and Liaison Team program in Afghanistan, and
            exercises supporting the Association of Southeast Asian Nations
            region.
      --Building more cultural and global awareness into Citizen-Soldiers
            and Airmen to help them operate in today's complex multi-
            national and multi-agency operations.
        This valuable mutual security cooperation program will continue to
    expand in size and strategic importance to the Combatant Commanders,
    ambassadors, and broad U.S. Government interagency requirements as we
    enter the second decade of the 21st century.
                                   the future
        The National Guard, the nation's community-based force, will always
    answer the call of the President and the Governors.
        Our priorities are constant: Provide for the security and defense
    of our homeland at home and abroad; support the Global War on Terror;
    and respond to America's need for a reliable and ready National Guard
    that is transformed for the 21st century.
        It is an honor to be named the 26th Chief of the National Guard
    Bureau. As a synchronized joint activity, we will capitalize on
    momentum gained over the past several years and will build new
    relationships based on our new roles and responsibilities.
        The National Guard will remain ``Always Ready, Always There.''
        The following pages offer a full report on our recent
    accomplishments along with our ongoing responsibilities for fiscal year
    2010.
    lieutenant general clyde a. vaughn, director, army national guard, army
                                 national guard
                           message from the director
        Army National Guard (ARNG) Citizen-Soldiers continue the proud
    tradition of service to our nation both at home and around the world.
    Our Citizen-Soldiers consistently proved themselves capable of
    operating across a wide spectrum of missions in Iraq, Afghanistan,
    Belgium, Bosnia, Djibouti, Egypt, Germany, Honduras, Kosovo, Kuwait,
    and the Philippines.
        The ARNG continues to achieve outstanding results meeting
    recruiting and retention goals. As of December 31, 2008, Army National
    Guard assigned strength was 365,814 Citizen-Soldiers, a gain of
    approximately 35,000 Citizen-Soldiers in about 3 years. At the same
    time we have reduced our non-participating numbers to 5,404 (from 6,082
    in July 2005).
        With thousands of our Citizen-Soldiers ``on the ground'' in foreign
    lands, we are equally busy at home. National Guard units fought
    wildfires in California, aided hurricane victims on the Gulf Coast, and
    assisted numerous environmental clean-up activities around the country.
    These responses from across our land demonstrate the importance of
    training and equipping our Soldiers so they are ready to render service
    and assistance to home communities.
        We are committed to deploying Citizen-Soldiers with the best
    equipment and training possible. The U.S. Army's similar assurance and
    ongoing Congressional interest in the welfare of our people will ensure
    the success of the Army National Guard.
                     investing in present and future value
        Mobilizations, deployments, modular force conversions, counterdrug
    assistance, and disaster response dominated the ARNG's efforts to
    answer needs at home and abroad. But to remain America's vital force,
    the ARNG must invest in people, equipment, operations, and technology
    like never before.
    Meeting Mission Requirements
        Heavy demands on personnel and declines in equipment-on-hand due to
    increased mobilizations and deployments continued in fiscal year 2008.
    The Army National Guard effectively met mission requirements and
    continued to support ongoing conflicts. However, for some units
    returning from deployment, equipping and training levels decreased
    readiness.
    Modular Force Conversion and Rebalance
        The Army National Guard successfully met its 2008 goal of
    transforming 1,300 operating force units to a modular design. This
    brings the total number of units transformed to more than 2,800.
        Converting Army National Guard units to modular configuration in an
    era of persistent conflict has significantly increased equipment and
    modernization requirements and has also increased equipment readiness.
        The Army National Guard brigade combat teams (BCTs) are composed
    identically to the active Army and can be combined with other BCTs or
    elements of the joint force to facilitate integration,
    interoperability, and compatibility. The Army National Guard
    transformation into these modular formations provides an enhanced
    operational force. This is key to meeting the goal of making at least
    half of Army and Air assets (personnel and equipment) available to the
    Governors and Adjutants General at any given time. This transformation
    effort impacts over 87 percent of Army National Guard units across all
    50 states, three territories, and the District of Columbia, and crosses
    every functional capability in the force.
                             investing in personnel
        Our greatest asset is our people. We have the best trained force in
    the world. But we also have unparalleled support of our Citizen-
    Soldiers and their families. This support is paramount in maintaining
    our superior standing in the world.
    Endstrength: Recruiting and Retention
        As previously noted, recruiting and retention was exceptional with
    an end-of-calendar year assigned strength of 365,814 Citizen-Soldiers.
    The following programs provided the impetus for these gains.
      --The Army National Guard's Recruiting Assistance Program (G-RAP) is
            a civilian contract recruiting program that, as of December 9,
            2008, has processed 80,000 enlistments since its inception in
            December 2005. At the end of fiscal year 2008, approximately
            130,000 recruiting assistants were actively working. In August
            2007, G-RAP expanded to include incentives for officer
            accessions.
      --The Recruit Sustainment Program (RSP), launched in 2005, improves
            our training success rate by easing newly enlisted National
            Guard Soldiers into the military environment through Initial
            Entry Training--a combination of Basic Combat Training and
            Advanced Individual Training.
        The war on terror, transformation to modular formations, and
    domestic operations will continue to test the all-volunteer force.
    However, the Army National Guard is optimistic and confident that it
    will grow the force and have manned units to meet all missions at home
    and abroad.
    Full-Time Support
        Full-time support (FTS) personnel play a vital role in the ARNG's
    readiness both at home and abroad. Active Guard and Reserve (AGR)
    Soldiers and Military Technicians sustain the day-to-day operations of
    the entire Army National Guard. The AGR and Technician force is a
    critical component of readiness in the ARNG as the Reserve Components
    transition to an operational force.
    Medical Readiness
        Funding, treatment authorities, and medical readiness monitoring
    through Medical Operations Data Systems (MODS) have helped the ARNG
    increase medical readiness throughout the nation and allow deploying
    units to report at all-time high medical readiness levels.
        In 2008, 92 percent of ARNG Soldiers reporting to mobilization
    stations were determined to be medically deployable. This represents a
    significant improvement upon previous years. This increased readiness
    throughout the ARNG has reduced pre-deployment training time lost due
    to required medical corrective actions. The ARNG is implementing the
    Army Select Reserve Dental Readiness System that will enable commanders
    to achieve 95 percent dental readiness in support of DOD Individual
    Medical Readiness standards.
    Incapacitation Pay
        The Army National Guard Incapacitation (INCAP) benefit provides
    interim pay to ARNG Soldiers with a service-connected medical condition
    (provided that they are not on active duty). The INCAP pay software,
    released in early fiscal year 2008, facilitates the administration of
    this benefit.
        The INCAP process provides compensation in two situations. First, a
    Soldier who is unable to perform military duty may receive military pay
    less any civilian earnings. Second, a Soldier who can perform military
    duty, but not a civilian job, may receive lost civilian earnings up to
    the amount of the military pay. INCAP incorporates a detailed
    accounting system of tracking Soldiers who receive INCAP pay, the date
    initiated, the amount received, and when terminated. INCAP quickly
    compensates Soldiers, therefore allowing them to concentrate on the
    rehabilitation process, and focus on their families.
    Survivor Services
        The ARNG renders dignified Military Honors according to service
    tradition for all eligible veterans. The ARNG supports 79 percent of
    all Military Funeral Honors for the Army and 51 percent of all Funeral
    Honors for all services. In fiscal year 2008, the ARNG provided
    Military Funeral Honors for over 97,000 veterans and 200 Soldiers
    killed in action.
                     investing in equipment and facilities
        Upgrading and maintaining our equipment and facilities is becoming
    increasingly vital as we face challenges at home and abroad. The era of
    persistent conflict demands nothing less.
    Equipment on Hand and Equipment Availability
        The historic equipment on-hand (EOH) percentage for the ARNG has
    been about 70 percent. In fiscal year 2006, EOH declined to
    approximately 40 percent due to cross-leveling of equipment to support
    immediate deployment requirements. It increased to about 49 percent in
    fiscal year 2007. By the end of fiscal year 2008, the ARNG had 76
    percent of its required equipment on-hand when deployed equipment is
    included.
    Equipment Readiness Levels
        When items supporting mobilized and deployed units are subtracted
    out of this equation, the current warfighting equipment on-hand
    percentage falls to 63 percent of Modification Table of Organization
    and Equipment (MTOE) requirements available to the Governors of the 54
    states and territories.
        Domestic response is a critical ARNG mission. The Chief of the
    National Guard Bureau has pledged that 50 percent of Army and Air Guard
    forces will be available to a Governor at all times to perform state
    missions.
        The Army has taken positive steps to improve the Army National
    Guard equipping posture. The Army's goal is to fully equip all BCTs,
    regardless of components, by 2015.
        Congress has been very responsive to ARNG equipping requirements
    through funds in the National Guard and Reserve Equipment account. This
    much needed funding has been used to procure critical dual-use items to
    support the ``Essential 10'' capabilities.
    Ground and Air Operating Tempo
        The ground operating tempo (OPTEMPO) program is one of the
    keystones in equipment readiness. Direct ground OPTEMPO pays for
    petroleum, repair parts, and depot-level repairables. Indirect OPTEMPO
    pays for expenses such as administrative and housekeeping supplies,
    organizational clothing and equipment, medical supplies, nuclear,
    biological and chemical (NBC) supplies and equipment, and inactive duty
    training (IDT) travel which includes Command Inspection, staff travel,
    and cost of commercial transportation for Soldier movement.
        In 2008, ground OPTEMPO funding for the Army National Guard totaled
    $901 million in base appropriation plus $73 million in supplemental for
    a total of $974 million. This funding directly impacts the readiness of
    ARNG units to participate in global operations as well as domestic
    preparedness. Significant equipment remains in theater after Guard
    units return from deployments. Equipment shortages at home stations
    compel greater use of what is available. These demanding conditions
    have resulted in rapid aging of equipment. While the ground OPTEMPO
    sustains equipment-on-hand, it does not replace major-end items that
    are battle-lost or left in the theater of operations.
        The air operating tempo (OPTEMPO) program supports the ARNG Flying
    Hour Program which includes petroleum-oil-lubricants, repair parts, and
    depot-level repairables for the rotary wing helicopter fleet.
        In 2008, air OPTEMPO funding for the Army National Guard totaled
    $280 million in base appropriation plus $128 million in supplemental
    for a total of $408 million. This funding provides for fuel and other
    necessities so that 4,708 ARNG aviators can maintain currency and
    proficiency in their go-to-war aircraft. Achieving and maintaining
    desired readiness levels will ensure aircrew proficiency and risk
    mitigation, which helps to conserve resources. ARNG aviators must
    attain platoon level proficiency to ensure that they are adequately
    trained to restore readiness and depth for future operations.
    Reset Process
        The Army continued to work with Army National Guard leaders to
    refine requirements for critical dual-use equipment and to ensure that
    the states and territories can adequately protect the lives and
    property of American citizens during a catastrophic event.
        Several changes helped resolve reset issues during 2008. The
    biggest change provided funds directly to the Army National Guard. This
    allowed the ARNG to conduct reset operations at home stations. The Army
    National Guard's initial $127 million, plus $38 million from the Army,
    supported the ARNG's reset efforts. This streamlining process enabled
    the states to have their equipment immediately available.
    Logistics-Depot Maintenance
        The Army National Guard Depot Maintenance Program continued to play
    an integral part in the ARNG sustainment activities during 2008. This
    program is based on a ``repair and return to user'' premise as opposed
    to the equipment maintenance ``float'' (loaner) system used by the
    active Army.
        The amount of equipment qualifying for depot repair increased by
    26.7 percent in fiscal year 2009. This increase was due primarily to
    the rebuilding of the ARNG's aged tactical wheeled vehicle fleet.
    During 2008, the Army National Guard Depot Maintenance Program funded
    the overhaul of 3,405 tactical vehicles as well as calibration
    services.
    Facilities and Military Construction
        In more than 3,000 communities across America, the local National
    Guard readiness center (armory) is not only the sole military facility
    but also an important community center. For National Guard members,
    these facilities are critical places where we conduct training, perform
    administration, and store and maintain our equipment. Many of our aging
    facilities are in need of repair or replacement. The continuing strong
    support of the Congress for Army National Guard military construction
    and facilities sustainment, restoration, and maintenance funding is
    crucial to our readiness.
        In fiscal year 2008, Congress made $843 million available for
    facility operations and maintenance in the ARNG. This level of funding
    covered ``must fund'' operations including salaries, contracts,
    supplies, equipment leases, utilities, municipal services, engineering
    services, fire and emergency services, and program management.
    Environmental Program
        Recent success in the ARNG's Environmental Program underscores its
    mission to excel in environmental stewardship to ensure the welfare of
    all citizens and communities while sustaining military readiness.
    Program highlights include:
      --The Army Compatible Use Buffer (ACUB) program that supports Soldier
            training by protecting an installation's accessibility,
            capability, and capacity while sustaining the natural habitat,
            biodiversity, open space, and working lands. Since this program
            began in 2003, the National Guard, along with civilian
            partnership contributions, helped to protect 40,000 military-
            use acres from encroachment at nine ARNG training centers.
      --Cleanup and restoration programs that continue to make steady
            progress at Camp Edwards, Massachusetts, where five major
            groundwater treatment projects have been completed.
      --The final stages of cleaning up an open detonation area that will
            eventually become maneuver training land at Camp Navajo,
            Arizona.
                            investing in operations
        Sound management practices demand that we stay focused on
    operational issues and missions such as readiness, training, ground
    operating tempo, and aviation, including the Operational Support
    Airlift Agency.
    Domestic Operations
        The Army National Guard Domestic Operations Branch coordinates and
    integrates policies, procedures, and capabilities to ensure critical
    operations are continued in the event of an emergency, or threat of an
    emergency, anywhere in the United States and its territories.
        The following missions in 2008 exemplify the National Guard's
    resolve in protecting and preserving the homeland.
      --In June, National Guard troops provided sandbagging, search and
            rescue, power generation, logistical support, food and water
            distribution, debris removal, shelter set up, and support to
            law enforcement during Mississippi River flooding. Over a 3-
            week period, more than 6,800 Soldiers from Iowa, Indiana,
            Illinois, Missouri, and Wisconsin provided their respective
            states with critical capabilities.
      --In California last summer, 8,300 wildfires consumed over 1.2
            million acres. The California ARNG supplied 1,350 Citizen-
            Soldiers to protect people and property around the state,
            including 400 Citizen-Soldiers deployed to the front lines to
            fight fires. California air crews, assisted by Army and Air
            National Guard aviation teams from 12 other states, dumped 4.2
            million gallons of retardant to extinguish the blazes.
      --In August, over 15,000 Citizen-Soldiers from Texas, Louisiana, and
            other states supported relief efforts after Hurricanes Gustav
            and Ike. Their mission included food and water distribution,
            search and rescue, air medical evacuations, communication
            support, hazardous material assessments, shelter operations,
            and debris removal.
        Army National Guard Citizen-Soldiers stand ready throughout the 54
    states and territories to respond to any crisis.
    Operational Support Airlift Agency
        The Operational Support Airlift Agency is a Department of the Army
    field operating agency under the National Guard Bureau that supports
    114 aircraft worldwide and over 700 personnel. During 2008, these
    aircraft flew over 54,000 hours, transported about 21 million pounds of
    cargo, and carried more than 100,000 passengers. This included combat
    support in the Middle East and Africa, relief efforts for the Gulf
    Coast and California wildfires, and criminal investigation task force
    efforts in Columbia and Cuba.
    Training
                Muscatatuck Urban Training Center
        The 974-acre Muscatatuck Urban Training Center (MUTC), located in
    Indiana, is a self-contained, contemporary urban training environment.
        In its second year of operation, more than 19,000 trainees from
    military (including 13,000 Army National Guard and Reserve Soldiers),
    government, and private agencies used the facilities at MUTC. Training
    helps prepare Soldiers to fight in foreign cities and helps prepare
    Soldiers and others to deal with the aftermath of attacks on U.S.
    cities. In the future, MUTC could train as many as 40,000 troops
    annually at the urban warfare practice facility.
                ARNG eXportable Combat Training Capability
        The Army National Guard's eXportable Combat Training Capability
    (XCTC) is a fully instrumented group of field training exercises that
    provide tough, realistic training for every ARNG unit during pre-
    mobilization training.
        This training incorporates the most current tactics, techniques,
    and procedures used in theater. In fiscal year 2008, the ARNG conducted
    two XCTC rotations (Illinois and Oregon) and trained a total of eight
    battalions. Planning is underway to conduct six XCTC rotations that
    will provide training for 18 battalions.
        By training and certifying pre-mobilization training tasks, the
    XCTC reduces post-mobilization training time and thus increases the
    availability of units for ``boots on the ground'' time in the warfight.
                      investing in information technology
        During fiscal year 2008, ARNG information technology (IT) resources
    supported these network security projects:
    Network Services
        The ARNG IT organization reviewed the communications and network
    service capabilities that states and territories will require in the
    event of a natural or man-made disaster or contingency. The solution
    restores access to network services should a readiness center (armory)
    lose connectivity regardless of local infrastructure availability. Each
    deployment will bring a virtual Joint Force Headquarters (JFHQ) node to
    the affected area and provide voice, video, Internet Protocol (IP)
    data, and push-to-talk services to a site within 36 hours.
        Other specific actions include:
      --Acquiring network simulator training that provides network
            operators and defenders a safe network environment to conduct
            initial qualification, mission qualification, crew training,
            position certification, and exercises.
      --Planning and implementing secure network access for deploying
            Brigade Combat Teams and their supporting Battalions.
      --Strengthening the Enterprise Processing Center by incorporating
            backup and storage capability in accordance with the National
            Guard Bureau's continuity of operations requirements.
      lieutenant general harry ``bud'' wyatt, iii, director, air national
                                     guard
                           message from the director
        The Air National Guard (ANG) is both a reserve component of the
    Total Air Force (USAF) and the air component of the National Guard. As
    a reserve component of the Total Air Force, the ANG is tasked under
    Title 10 U.S. Code, ``to provide trained units and qualified persons
    available for active duty in the armed forces, in time of war or
    national emergency . . .''--in essence, a combat-ready surge
    capability. The ANG augments the regular Air Force by providing
    operational capabilities in support of Homeland Defense both
    domestically and overseas. As the air component of the National Guard,
    the ANG provides trained and equipped units and individuals to protect
    life and property, and to preserve peace, order, and public safety.
        As a reserve component of the Total Air Force, ANG members
    regularly perform operational missions both in the United States and
    overseas. For example, over 6,000 ANG members vigilantly stand guard
    protecting the homeland. Overseas, more than 7,000 National Guard
    Airmen are deployed at any given time, whether in Southwest Asia or
    little known locations around the world, providing airpower
    capabilities such as strike, airlift, air refueling, and intelligence,
    surveillance, and reconnaissance (ISR) to joint and coalition forces.
        The ANG provides a myriad of capabilities to support state and
    local civil authorities in protecting life and property. We provide
    capabilities in areas such as airlift, search and rescue, aerial
    firefighting, and aerial reconnaissance. We also furnish critical
    support capabilities such as medical triage and aerial evacuation,
    civil engineering, infrastructure protection, and Hazardous Materials
    (HAZMAT) response. During 2008, National Guard Airmen helped their
    fellow citizens after Hurricanes Gustav, Hanna, and Ike; protected life
    and property from wildfires in the West, tornados in the Midwest, and
    blizzards and ice storms across the country; and assisted with security
    at the Republican and Democratic National Conventions.
        The ANG faces today's challenges by examining the past, serving in
    the present, and planning for the future. We are preserving our
    heritage as a community-based, predominantly part-time force while we
    adapt to numerous force structure changes, placing our ANG on a clear
    path for future missions. While we cannot know every potential threat
    we will face, we do know that success depends on our ability to
    continually adapt and evolve toward new and exciting missions and
    capabilities. In order to adapt and effectively support our national
    security objectives, we must focus our efforts in three areas:
      --Modernize and recapitalize the aging ANG fleet of aircraft to
            ensure that we, as the proven leader in air dominance today, do
            not become complacent and fail in our vigilance against those
            who seek to challenge our mastery of the air.
      --Maximize the use of associations and community basing to better
            support the Air Force mission.
      --Evolve future mission areas to better support the overall Air Force
            mission.
                                 a quick review
        The ANG's global presence throughout 2008 was felt in the following
    ways:
      --Deployed 20,231 service members to 85 countries on every continent,
            including Antarctica.
      --Participated in missions in Iraq, Afghanistan, and Bosnia;
            humanitarian airlifts to Southeast Asia and Africa; drug
            interdiction in Latin and South America; exercises in Europe
            and Japan; and many other missions.
      --Provided not only airpower capabilities, but capabilities in
            medical, logistics, communications, transportation, security,
            civil support, and engineering.
        This was another crucial year for the ANG as its men and women
    continued to defend America's interests worldwide in waging the Global
    War on Terror. Simultaneously, we continued to bring our force
    structure into balance following historic mission changes initiated by
    Base Realignment and Closure (BRAC), and Air Force modernization and
    recapitalization initiatives.
                          developing adaptable airmen
        The Air National Guard values our Airmen, their families,
    employers, and our civilian employees as our greatest resources. The
    current corps of Air Guard members contains some of the most skillful
    and talented in our history. We remain committed to recruiting,
    retaining, and cultivating Airmen who are ready, willing, and capable
    of meeting 21st century challenges and leading with a vision that looks
    beyond tomorrow.
    Recruiting and Retention
        With the support of Congress, and the use of innovative approaches
    by our recruiters, the ANG finished fiscal year 2008 with an assigned
    strength of 107,679 Airmen. We surpassed our recruiting objective for
    the first time since 2002, achieving 126 percent of our goal. This
    accomplishment occurred despite a historically high operational tempo,
    executing BRAC decisions, and implementing Total Force Initiatives.
    G-RAP
        One program proving highly successful for ANG recruiters was the
    Guard Recruiting Assistance Program (G-RAP). With the help of current
    and former (including retired) members, our recruiters tapped into a
    larger circle of influence that let friends, family, and associates
    know about the tangible and intangible rewards that come with service
    in the Air National Guard. In fiscal year 2008, 3,676, or 34 percent,
    of our enlistments originated from leads generated by G-RAP volunteers.
    An overall 90 percent retention rate also bolstered our recruiting
    success for fiscal year 2008. By maintaining a high retention rate, the
    Air National Guard decreases the cost of replacing valuable members.
                                   readiness
        Even though we met our recruiting and retention goals this year, we
    face the growing challenge of training the right people with the right
    skills to meet mission changes while responding to high wartime
    commitments and dealing with resource constraints. To deal with this we
    must focus on the three primary areas of readiness--personnel,
    training, and equipment.
    Personnel
        Personnel readiness, including skills affected by equipment
    shortages which bear upon our ability to train, has the greatest impact
    upon ANG overall readiness rates. As previously mentioned, working
    through a period with such a large number of units changing missions
    also skews the percentages. To a lesser degree, but still important,
    are the numbers of personnel on medical or dental profiles--an issue
    that affects our ability to deploy worldwide. The Air National Guard is
    placing increased emphasis upon these many challenges that affect our
    personnel readiness.
        The ANG continues to maintain personnel readiness by supporting our
    people returning from deployments. We must maintain the ANG readiness
    posture by ensuring our Airmen receive appropriate and timely medical
    and dental assessment and treatment at all levels. We offer this
    through Frontline Supervisors and Landing Gear training programs, and
    through the Post Deployment Health Reassessment process.
    Training
        Training readiness is an ongoing challenge as we strive to meet
    training standards. In order to retain our highly qualified,
    experienced personnel, we must have the ability to train to both
    domestic operations and combat standards while meeting deployment
    demands. Equipment shortages of emergency management equipment for ANG
    civil engineers, weapons for security forces, and aircraft engines
    adversely impact training capabilities, and could negatively affect
    retention rates. While the volume of mission-related training
    requirements seems to grow exponentially, we will continue to explore
    and take advantage of every opportunity to meet training requirements
    in a timely manner.
        The most significant challenge for the ANG, however, has been to
    fit its wartime requirements and mission changes into the traditional
    framework of a community-based, predominately part-time force. Our
    members have a history of answering the call to service, and have not
    lost sight of their mission: to be a combat-ready Air Force composed of
    dedicated, professional Airmen serving in both state and federal roles.
    Equipment
        ANG equipment readiness presents greater challenges as long-term
    costs in operating and maintaining older aircraft continue to rise due
    to more frequent repairs, fuel prices, and manpower requirements.
    Although fuel prices have declined in recent months, the cost of
    aircraft maintenance continues to rise significantly as we struggle to
    extend the life of our aging fleet.
        The current air traffic control system is 1950s technology that
    received minor radar upgrades in the 1980s. Replacement parts are
    obsolete and no longer available on the market. Modifying and upgrading
    the old system would cost more than a new system. The Air National
    Guard provides 62.5 percent of the United States Air Force's air
    traffic control (ATC) wartime mission. In support of Operations
    Enduring Freedom and Iraqi Freedom, the ANG deployed five mobile ATC
    Radar Approach Controls. Additionally, the ANG has peacetime
    obligations to support the National Airspace System, providing ATC
    services at designated military/civil airports.
        In the final analysis, the Air National Guard will meet 21st
    century challenges by proactively shaping its future with combat-ready,
    adaptable Airmen at its core.
                           modernize and recapitalize
        The age of the ANG fleet is of grave concern. Aircraft and
    equipment in both the regular Air Force and the ANG are quickly wearing
    out. The average age of ANG aircraft is now over 25 years, with KC-135s
    being the oldest at 49 years. The high operational tempo since 1990 has
    added flying hours that have accelerated this aging process. As already
    mentioned, long-term costs to operate and maintain these older aircraft
    have increased. Additionally, our potential adversaries have improved
    their capabilities, raising concerns about the ability of our current
    aircraft to defend U.S. interests around the globe.
        Modernization of our equipment and training platforms is based on
    capabilities needed by the Air Force. As the ANG moves increasingly
    into the worlds of command and control, intelligence, reconnaissance,
    surveillance, unmanned systems, and cyberspace, the process has
    expanded to include expert warfighters in these areas. As a
    capabilities-based force, the ANG can better assess, plan, and support
    its federal (Title 10) and state (Title 32) missions, remain relevant
    to operations, and be interoperable with other forces.
        Changing the force structure and orientation of units away from
    airborne platforms to unmanned systems and capabilities is a difficult,
    yet necessary transition. These efforts to redefine the ANG will be
    expanded upon in the Future Mission Areas section of this report.
        The ANG is committed to seamlessly integrating into the operational
    environment. Our modernization program is based on Air Force and
    Combatant Command requirements and vetted among reserve component and
    active duty warfighters. Some examples include:
    Mobility Aircraft
        The ANG will pursue further modifications to flight instruments,
    communications, navigation, and terrain/traffic avoidance systems along
    with upgrades to engines and missile warning and countermeasures on ANG
    mobility aircraft (C-5, C-17, C-130, KC-135) and other aircraft.
    Combat Aircraft
        Air National Guard combat aircraft (A-10, F-15, and F-16) comprise
    about one-third of the Air Force's combat capability. Eighty percent of
    our F-16s will begin reaching the end of their service life in 8 years.
    While our maintainers continue to keep our fleet combat ready and
    available, we must replace our legacy systems to remain viable and
    relevant.
    Unmanned Aircraft Systems
        The Air National Guard expansion into the world of unmanned
    aircraft systems continues to move forward in Arizona, California,
    North Dakota, New York, Nevada, and Texas Air National Guard units, as
    illustrated with the development of integrated Predator and MQ-9 Reaper
    Operations Centers. These centers will not only allow smooth operation
    and control of current and future transformational warfighting and
    homeland defense missions, but will integrate multiple systems
    currently running independently. The RQ-4 Global Hawk continues to
    provide high quality intelligence, surveillance, and reconnaissance
    (ISR) support for Operation Iraqi Freedom while also supporting
    homeland missions.
    MC-12 and Project Liberty
        Mississippi's 186th Air Refueling Wing is taking on an additional
    mission, training aircrews for the Air Force's newest manned ISR
    platform, the MC-12. Designated Project Liberty, the program will train
    nearly 1,000 Airmen during the next 2 years at Key Field near Meridian,
    Mississippi, at a cost of about $100 million. The MC-12 is expected to
    bolster the Department of Defense's intelligence gathering capability
    in Operations Iraqi Freedom and Enduring Freedom.
    Dual-Use Capabilities
        Developing and fielding ``dual-use'' capabilities are the
    cornerstone to the ANG's cost effective contribution to combat and
    domestic operations. Many domestic operations capabilities are outlined
    in the National Guard Bureau's ``Essential 10'' core military
    capabilities relevant to Civil Support. In fiscal year 2010, with the
    support of Congress, we will address critical shortfalls in medical,
    communications, transportation, logistics, security, civil support
    teams, engineering, and aviation. The ANG will continue to increase
    capabilities for use during domestic missions for the foreseeable
    future.
        Competing sustainment costs and funding requirements for
    recapitalization present challenges for the Total Force. However, by
    similarly equipping the ANG and the regular Air Force, we directly
    support efforts in Total Force Integration (TFI). In short, the ANG
    needs to be concurrently equipped with the active duty force to support
    our total Air Force mission--to be the dominant air power, second to
    none.
    Maximize Associations and Community Basing
        Since Vietnam, the Air Force has understood the importance of unit
    integrity on combat effectiveness, and has reflected this in war plans
    for unit mobilizations. As such, the ANG, Air Force Reserve (AFRES),
    and active Air Force have formed unique alliances that promise to
    increase mission effectiveness while reducing costs.
        Under three types of constructs known as ``associations,'' ANG,
    AFRES, and active Air Force units share not only facilities and
    equipment, but knowledge and experiences (many ANG members spend their
    careers with the same unit and equipment).
      --Under ``classic associations'' the active duty unit retains
            principal responsibility for its equipment and the reserve unit
            shares in operating and maintaining it.
      --With ``active associations'' active duty personnel are assigned to
            reserve units in local communities where they share in the
            operation and maintenance of reserve-assigned assets.
      --The last association, called ``reserve associate,'' is similar to
            the ``active'' and ``classic'' relationships in that one air
            reserve unit retains ownership of the assets and another unit
            shares in operating and maintaining the equipment as an air
            reserve component associate unit.
        ``Community basing'' is a core characteristic that forms the
    foundation of our competitive edge as a cost effective combat-ready
    reserve. Over 60 percent of the ANG force consists of ``traditional''
    part-time, professional Airmen, who train to the same standards, supply
    the same capabilities and provide the same response times as the
    regular Air Force.
        The ANG is closely tied to our communities. Generally our members
    are recruited locally, hold civilian jobs there, and maintain close
    ties throughout most of their careers in the ANG. Unlike regular Air
    Force Bases which tend to be self-sufficient, we also depend on our
    local communities for many common resources needed to support the
    mission. Shared infrastructure, such as retail stores and housing,
    reduces operating costs significantly (66 of 88 ANG flying units are
    co-located at civilian airports, sharing runways, taxiways, and fire/
    crash emergency response).
        The synergy resulting from these relationships is fundamental to
    the mission readiness of the ANG in these ways:
      --Ties to the local area provide personnel stability, resulting in a
            high level of unit integrity and experience.
      --Long-term relationships position the ANG to plan, exercise, and
            respond to natural and man-made domestic emergencies.
      --Shared civil/military work force provides the ANG and the community
            with broad skill sets.
    Future Mission Areas
        The ANG is prepared to take on more mission sets to better support
    the overall Air Force mission. The ANG will continue to work with the
    Adjutants General to refine and update the modernization and
    recapitalization plans outlined previously. We will not only support
    our Governors at home with quick responses to natural and man-made
    disasters, but will also support the Combatant Commanders with improved
    mobility, agile combat support, and other mission sets, both tried and
    new.
                Rapid Global Mobility
        Continuing ANG participation in inter-theater or strategic airlift
    (C-5, C-17), intra-theater or tactical airlift (C-130, future C-27/
    JCA), and air refueling (KC-135, KC-10, future KC-45) is important.
    Within the Strategic Reserve construct, strategic airlift and air
    refueling are central due to their surge-to-demand operation and
    ability to meet scheduled operational force requirements rapidly.
    Tactical airlift fits well with dual capabilities required by the ANG's
    state and federal roles. Its versatility makes it especially valuable
    in responding to domestic needs, such as Modular Aerial Fire Fighting
    (MAFF), and aerial delivery of food and supplies to disaster victims,
    and in search and rescue.
                Agile Combat Support
        Expeditionary Combat Support (ECS) units will continue to provide
    essential combat service support in sustaining all elements of
    operating forces, providing medical support, services, security forces,
    civil engineers, transportation, logistics support, and airfield
    maintenance. ECS also includes ANG support to National Guard Civil
    Support Teams (CSTs) and Chemical, Biological, Radiological, Nuclear,
    and high-yield Explosives (CBRNE) Enhanced Response Force Packages (NG-
    CERFP) to assist civil authorities' response to domestic CBRNE
    incidents. These units are at the forefront of our dual-use
    capabilities in responding domestically to man-made and natural
    disasters as well as overseas disasters and operational missions.
                Intelligence, Surveillance, and Reconnaissance (ISR)
        The ANG can help meet rapidly increasing ISR requirements for the
    Joint Force, in areas such as the following: ISR in Special Operations;
    Distributed Ground Stations; Human Intelligence; National Tactical
    Integration; ISR Center of Excellence (Nellis AFB, Nevada); Air Force
    Expeditionary Signals Intelligence; Computer Network Exploitation;
    Tactics Analysis; Global Aviation Analysis Support Team; and All Source
    Intelligence Analysis.
        United States Special Operations Command (USSOCOM) requested
    investment in manning ISR aerial ports, which points to the need to
    further invest in small aircraft to support specific ISR requirements,
    something the ANG is uniquely qualified to do since it already
    possesses the appropriate aircraft and experienced aircrews. Platforms
    such as these have dual-use capability for both homeland and
    expeditionary operations. Specifically, it can support DOD's ``Building
    Partnership Capacity'' efforts with nations desiring a partnership
    arrangement involving a low-cost multi-utility platform, which could
    further enhance the National Guard State Partnership Program (SPP).
    This manned ISR mission, using the small aircraft platform, is
    potentially the most promising initiative for the ANG in the near
    future.
    Cyberspace
        This year the Air National Guard continued to grow into cyberspace
    by establishing three more information operations squadrons, raising
    the number of operational units to eight. These new units include the
    166th Network Warfare Squadron based at New Castle Airport, Delaware,
    the 273rd Information Operations Squadron (IOS), Lackland AFB, Texas,
    and the 229th IOS, located in the Vermont National Guard Armory. While
    the specifics of each unit's mission vary slightly, all are dedicated
    to deterring the ever growing number of daily attacks against this
    nation's cyber-based infrastructure.
    Space Operations
        ANG units support space and missile operations at several locations
    in Alaska and the continental United States. Air Force Space Command
    desires increased ANG involvement in space operations, to include
    Missile Warning associate squadrons, Missile Operations support
    squadrons, Distributed Command and Control Mission expansion, and Space
    Launch/Range operations.
    Continuing Missions
        The ANG will retain some existing mission sets, such as those
    associated with Global Persistent Attack. This mission is a surge task
    that requires a large number of fighter aircraft, particularly in the
    early stages of a conflict. The Air Force Reserve Components provide
    the most cost effective way to maintain this surge capability.
        The Air Force will not be able to recapitalize its fighter force
    structure on a one-to-one basis, which means that some ANG fighter
    units have been required to transition to other mission areas.
    Developing active and classic associations such as those mentioned
    above are now underway as we transform to new and promising mission
    sets.
        For fiscal year 2010, fully rebalancing and training will involve a
    complex interchange of people, training, and resources. These mission
    changes will directly impact about 15,000 Air National Guard members
    across the nation.
        In an environment where change is considered a constant instead of
    a variable, we continue to move forward knowing a more capable Air
    National Guard will better serve the needs of our nation tomorrow and
    far into the future.
     major general peter m. aylward, director, joint staff, national guard
                                     bureau
                           message from the director
        Today's National Guard faces a more complex and challenging world
    than ever before. There are no easy solutions to our comprehensive
    problems. America must remain ready to fight and win across the full
    range of military operations. Enemies are finding new ways to overcome
    the difficulties of geographic distance. The increase in travel and
    trade across U.S. borders has created new vulnerabilities for hostile
    states and actors to exploit opportunities to perpetrate devastating
    attacks on the U.S. homeland. U.S. military forces enjoy significant
    advantages in many aspects of armed conflict, but we will be challenged
    by adversaries who possess or design novel concepts to overcome our
    advantages.
        At home, the terrorism threat coincides with violent drug-
    trafficking organizations and border security challenges. These trends
    produce a geopolitical setting that is increasingly complex and
    unpredictable. Therefore, the National Guard must be flexible and
    prepared for the unexpected. In addition, the way the National Guard is
    organized, equipped, and trained provides the unique ability to respond
    quickly and effectively to natural disasters and man-made catastrophic
    events. The National Guard Bureau's Joint Staff has taken on these
    challenges with the following efforts, teams, and programs.
                              domestic operations
    Weapons of Mass Destruction Civil Support Teams (WMD-CST)
        The National Guard continues to strengthen its ability to respond
    to chemical, biological, radiological, nuclear, and high-yield
    explosive incidents with 55 WMD-CSTs and two newly established units
    going through the DOD certification process. These units are manned by
    22 full-time Army and Air Guard personnel who provide each Governor
    with an immediate response capability, specialized expertise, and
    technical assistance that can be provided to local incident commanders
    nationwide. WMD-CSTs do not duplicate state CBRNE response
    capabilities, but support civil authorities by identifying CBRNE agents
    or substances, assessing current or projected consequences, advising on
    response options, and assisting with requests for state support.
    Congress recently expanded the use of CSTs to include response to
    intentional or unintentional HAZMAT incidents and natural or manmade
    disasters.
        The National Guard's Civil Support Teams, which are so essential to
    the security of the American people on an almost daily basis, depend on
    the availability of adequate operations and maintenance funds to carry
    out their tasks. Any reduction in funding below that requested carries
    the risk of hindering the operational capability of these essential
    teams.
    Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive
            (CBRNE)--Enhanced Response Force Package (CERFP) Teams
        Army and Air National Guard Citizen-Soldiers and Airmen with
    technical response skills in this area make up 17 CERFP teams covering
    every region of the country. The CERFP team is designed to locate and
    extract victims from a collapsed structure in a contaminated
    environment, perform medical triage and treatment, and conduct
    personnel decontamination from a weapon of mass destruction incident.
    CBRNE Consequence Management Response Forces (CCMRFs)
        Each CCMRF provides 4,700 trained and equipped active and reserve
    component military personnel ready to assist civil authorities in
    response to a CBRNE incident. CCMRF capabilities include: CBRNE
    reconnaissance and detection; casualty search and extraction;
    decontamination; hazardous material handling and disposal; medical
    triage, treatment, and care; aero-medical evacuation; explosive
    ordnance disposal; air and land transportation; and mortuary affairs.
        The National Guard Bureau continues to support planning for the
    standup of all CCMRFs.
    Joint Force Headquarters-State (JFHQ-State)
        The National Guard continues to strengthen and refine the 54 Joint
    Force Headquarters throughout the United States. JFHQ-State works to
    enable effective domestic responses while conducting traditional state
    National Guard training responsibilities for Army and Air Force reserve
    component forces. Each JFHQ-State provides the Governor with
    information and command and control for effective National Guard
    response; provides improved situational awareness to DOD before,
    during, and after an emergency response; and facilitates unity and
    continuity of military (federal and state) effort during Continental
    U.S. (CONUS) operations.
    Critical Infrastructure Program--Mission Assurance Assessment (CIP-MAA)
            Teams
        National Guard CIP-MAA teams are comprised of Citizen-Soldiers and
    Airmen trained to assess the vulnerability of industrial sites and
    critical U.S. Government infrastructure to attack. Their analysis helps
    various government agencies direct prevention, deterrence, mitigation,
    and response efforts. Currently, three teams are assessing Defense
    industrial base sites and ten teams are assessing Department of
    Homeland Security sites.
    Joint Enabling Team (JET)
        The National Guard Bureau's highly trained professionals making up
    Joint Enabling Teams establish a logistics and support link between
    NGB, the supported state, and supporting states and agencies. The JETs
    help identify potential mission shortfalls and facilitate missions by
    assisting with the collection, reporting, and sharing of information.
    They ensure that resources are available and that personnel directly
    involved in the mission are effectively supported for domestic
    operations involving floods, hurricanes, and tropical storms.
    National Guard Reaction Force (NGRF)
        Within hours of an incident, upwards of 500 individuals can assist
    state and local law enforcement by providing site security, presence
    patrols, show-of-force, establishment of roadblocks and/or checkpoints,
    control of civil disturbances, force protection and security for other
    responders, and protection of DOD assets as required.
    Task Force for Emergency Readiness (TFER)
        The TFER program enlists National Guard officers at the state level
    to write comprehensive ``state'' Homeland Security Plans that address
    the eight national planning scenario sets. The Federal Emergency
    Management Agency (FEMA) is currently funding five pilot states
    (Hawaii, Massachusetts, South Carolina, Washington, and West Virginia)
    with the intent of expanding TFER to all states based on the
    anticipated success of the pilot program.
                              counterdrug programs
        In 2008, some 2,400 National Guard personnel supported law
    enforcement agencies in seizing illegal drugs with a street value of
    approximately $28 billion. The National Guard supports law enforcement
    counterdrug operations with 125 specially equipped Army National Guard
    OH-58A helicopters and 11 Air National Guard counterdrug RC-26B fixed-
    wing aircraft.
        Synchronizing counterdrug information-sharing among law enforcement
    agencies, the National Guard, and Department of Defense agencies has
    greatly increased the efficiency and speed of the effort.
    Stay on Track
        In 2008, National Guard personnel reached over 3 million people
    with their positive anti-drug messages. Drug demand reduction programs
    such as Stay on Track have reached over 115,000 middle school students
    in 215 schools around the country since 2007. In 2009, Stay on Track
    plans to reach out to another 150,000 students.
                              operation jump start
        The National Guard and the U.S. Border Patrol marked the end of the
    Operation Jump Start (OJS) mission in 2008 with ceremonies in
    Washington, D.C. Operation Jump Start began June 15, 2006, and
    officially ended July 15, 2008. At its peak, the operation saw up to
    6,000 National Guard Citizen-Soldiers and Airmen assisting the Border
    Patrol to increase security and vigilance along the nation's southern
    border.
        OJS assistance not only freed up hundreds of Border Patrol agents
    to perform their normal law enforcement duties, but it also allowed
    time for the Border Patrol to hire and train more agents. ``Within law
    enforcement, there is one word that we put a lot of weight on,'' said
    David V. Aguilar, Chief of the Border Patrol. ``That is the word
    `partner.' Today, I am very proud to call every individual who wears
    the uniform of the National Guard, has ever worn it, or will wear it,
    or is in any way affiliated with the National Guard . . . our true
    partners, and for that we truly thank you.''
        Over the 2-year period, more than 29,000 troops from all 54 states
    and territories participated. As we look back on this operation, we
    count the following successes:
      --Assisted with over 176,000 immigration violation apprehensions;
      --Aided in seizing over 315,000 pounds of marijuana;
      --Aided in seizing 5,000-plus pounds of cocaine;
      --Helped build more than 19 miles of road;
      --Helped repair more than 717 miles of road;
      --Helped construct 38 miles of fencing; and
      --Helped erect 96 miles of vehicle border barriers.
        The National Guard provided the Border Patrol logistical and
    administrative support by operating detection systems, providing
    communications, and analyzing border-related intelligence. Citizen-
    Soldiers and Airmen also built new infrastructure, conducted training,
    and provided additional aviation assets and ground transportation.
                         joint and interagency training
        To continue providing quick and effective support of local and
    state response forces, the National Guard must continue expanding its
    capacity to conduct joint and interagency training in a domestic
    environment. We can accomplish this by increasing the number of
    National Guard, state and local response forces, DOD, and federal
    agencies participating in the U.S. Northern Command (USNORTHCOM) and
    NGB Joint Interagency Training Capability (JITC) programs.
        Increased participation by these and other agencies will improve
    tactical interoperability as well as unity of effort among state,
    local, and federal agencies during catastrophic man-made or natural
    disasters. Increasing the number and scope of National Guard regional
    training centers (such as the Joint Interagency Training and Education
    Center (JITEC) in West Virginia) will also improve response proficiency
    and standardize tactics, techniques, and procedures for National Guard
    teams dealing with chemical, biological, radiological, nuclear, and
    high-yield explosives (CBRNE).
    Joint Interagency Exercise Program (VIGILANT GUARD)
        This exercise program conducts four National Guard regional
    exercises each year that provide valuable experience and training
    opportunities to the following force elements:
                JTF Commander Training Course
        This course prepares potential JTF commanders to operate, organize,
    and function in the unique federal and state environment. The 4-day in-
    residence course is conducted twice a year at USNORTHCOM in Colorado
    Springs.
                JFHQ/JTF Staff Training Course (JSTC)
        This course provides comprehensive training and education for joint
    staff to support JFHQ and JTF missions in state or federal status.
                Collective CBRNE Training Program
        Seventeen CBRNE Enhanced Response Force Packages (CERFPs) and 57
    Weapons of Mass Destruction--Civil Support Teams (WMD-CSTs) learn to
    respond to a catastrophic CBRNE event in this program.
                Joint Interagency Training and Education Center (JITEC)
        In addition to the Joint Interagency Training Capability, JITEC
    plays an integral part in continuing the National Guard's
    transformation for the future by building relationships and
    capabilities with our interagency partners. Joint Interagency
    highlights include:
      --Providing more than 30,000 duty-days of training and interaction in
            over 800 exercises to some 90 different organizations and
            agencies since September 11, 2001; and
      --Scheduling more than 200 training, exercise, or assessment
            activities in 2010.
        With continuing support from both DOD and Congress, the National
    Guard will continue to transform itself into a premier homeland
    security and defense organization, leveraging state and federal
    responses, capabilities, and expertise.
           technology revolutionizes emergency response and training
        Technology has played a key role in enhancing the National Guard
    Joint Staff's effectiveness in America's emergency preparedness and
    response. Emergency response training, information exchange, and
    command and control activities are more robust than ever to support
    local communities during a time of catastrophic events. The following
    highlights our progress.
    Joint CONUS Communications Support Environment (JCCSE)
        The JCCSE is the National Guard Bureau and USNORTHCOM umbrella
    platform that establishes communications and information sharing for
    Homeland Defense and Civil Support missions from the national to the
    state or territory level. The JCCSE platform ensures the National
    Guard's capacity to provide Command, Control, Communications, and
    Computer (C\4\) support necessary to carry out National Guard
    responsibilities. These capabilities directly supported FEMA operations
    during Hurricanes Gustav and Ike.
        Communications, situational awareness, and command and control were
    bolstered with the following JCCSE enhancements:
      --NGB acquired 84 Joint Incident Site Communications Capability
            (JISCC) systems to be distributed to the 54 states and
            territories. These sets provide interoperable communications at
            the incident site along with a satellite link to command and
            control centers to share information and tools needed to
            request or direct support.
      --NGB established a Joint Command, Control, Communications, and
            Computer (C\4\) Coordination Center (JCCC) to monitor the
            status of all National Guard communications to the Joint Force
            Headquarters in each state, FEMA, and all emergency agencies
            involved. During an incident, the JCCC provides help-desk and
            satellite link support to teams deploying with JISCC.
      --NGB established the Joint Information Exchange Environment (JIEE)
            as a web-based application to provide a common operating
            picture of all non-federalized National Guard activities. JIEE
            provides the ability to monitor, track, and share operational
            information with mission partners in a trusted domestic
            operations environment that extends down to the incident level.
            This capability is not currently available in DOD programs of
            record.
        The domestic information environment in which JCCSE must
    interoperate continues to evolve. Consequently, NGB will continue to
    request funding to both sustain and adapt JCCSE capabilities as the
    domestic response requirements emerge.
    Emergency Management Staff Trainer (EMST)
        The Emergency Management Staff Trainer is a new virtual training
    application that provides extremely low-cost, scenario-driven training
    that can be repeated as many times as needed. This capability offers
    training that is geographically specific, allowing National Guard and
    civilian emergency management personnel to engage in training specific
    to their own city or state.
        Scenarios developed to date include Hurricane Preparation and
    Response, Earthquake Response, Building Collapse, and Pandemic
    Influenza Answer.
    Regional and State Online Resource--Emergency Management (RaSOR-EM)
        RaSOR-EM supports training activities by combining commercially
    available mapping programs with links to thousands of emergency
    management databases and other information sources, dramatically
    enhancing speed and access to this critical information. All 54 states
    and territories, numerous federal agencies, and personnel from the
    Department of Homeland Security currently use the program. Data layers
    have been added to include critical infrastructure data, locations of
    schools and reserve centers, and other valuable data.
                           supporting the warfighter
        An effective Citizen-Soldier or Airman is one who knows his or her
    family is safe, secure, and able to function efficiently while he or
    she is deployed. An effective Soldier or Airman also needs support in
    transitioning back to civilian life after long deployments. Keeping our
    Soldiers and Airmen ready, both physically and mentally, requires the
    National Guard's support through programs for the individual and the
    family.
    Transition Assistance Advisors
        Sixty-two Transition Assistance Advisors (TAAs) were hired in the
    states, territories, and District of Columbia to provide personalized
    service to Guard and family members. They educate and assist them on
    constantly evolving benefits information, assist them in obtaining
    their federal and state benefits and entitlements, and help them file
    and track benefits claims. These personalized services include linking
    Guard members and families to behavioral health resources, disability
    claims filing, and obtaining disability compensation. These advisors
    work closely with the liaisons from the NGB and Department of Veterans
    Affairs (DVA) and have proven themselves invaluable by educating
    National Guard leadership, Guard members, and veterans on the myriad of
    complex benefits and entitlements earned through their military
    service.
        In one instance, the TAA, the Seattle Veterans' regional office,
    and the Washington National Guard teamed up to test an idea that allows
    persons to file for Veterans Administration benefits and process them
    within 6 to 8 days of their units returning from active duty--a method
    previously reserved only for returning active duty units. This is made
    possible by allowing access to military medical records, often a large
    factor for delays in claims. The units also complete medical benefits
    forms on site.
    National Guard Joint Family Program
        The National Guard Joint Family Program (JFP) provides direct
    support to the 54 state and territory family program directors, youth
    coordinators, and 92 Wing Family Program Coordinators. The JFP office
    provides guidance, resources, and support to National Guard families
    when Guardsmen are deployed at home or abroad. JFP conducts all
    training events and national-level seminars and workshops for all of
    the above positions as well as for an estimated force of over 10,000
    National Guard family volunteers.
        The program office provides training to families via computer-based
    training modules, centralized classes, and locally provided training to
    help make families self-reliant throughout the deployment cycle
    process.
    Family Assistance Centers
        Consider these actual family situations:
        A New Jersey National Guard Soldier, training for deployment to
    Afghanistan, receives word that his family's home is gutted by fire.
        A Soldier suffers from severe post traumatic stress disorder as he
    deals with his wife's declining health and the threat of losing their
    home.
        A catastrophic auto accident has left a Soldier a quadriplegic.
        These are just a few of the situations Family Assistance Centers
    (FACs) deal with each day to help our Soldiers. More than 300 FACs
    across the 54 states and territories provide information, referral, and
    outreach to families of geographically dispersed members from all
    services, whether active or reserve component. Family Assistance
    Centers are critical to mobilization and demobilization and to the
    long-term health and welfare of service members and their families. The
    FAC team believes that Soldiers who know their families are cared for,
    safe, and secure at home, can better concentrate on their tasks and
    missions in theater.
    Yellow Ribbon Reintegration Program
        The Yellow Ribbon Program provides information, services,
    referrals, and proactive outreach to service members, spouses,
    employers, and youth from the beginning through the end of the
    mobilization lifecycle.
        The program provides a flexible family support system to meet the
    service member and family readiness needs of the expeditionary service
    component and geographically dispersed families. The program focuses on
    ensuring service members and their families receive the information and
    tools necessary to cope during the mobilization lifecycle.
        Yellow Ribbon Program services include: Marriage Enrichment;
    Employer Support for the Guard and Reserve (ESGR); Warrior Transition
    Unit Information; Traumatic Brain Injury Information and Support; Child
    Behavioral Counselors; Veterans Affairs Information; TRICARE/Medical
    Benefit Information; Family Counseling; Legal Counseling; Financial
    Counseling; Community Relations; School Support; Child Care Services;
    Informational meetings and briefings; Preparations for reintegration;
    and Employment opportunities.
    Division of Psychological Health
        The newly created Division of Psychological Health will direct and
    manage a comprehensive psychological health service dedicated to Guard
    members and their families on a variety of conditions associated with
    post traumatic stress disorder(s) and/or traumatic brain injury. Fifty-
    four licensed mental health practitioners will cover all the states and
    territories.
        The Psychological Health service goals include:
      --Providing high quality services that are National Guard member-
            specific;
      --Overseeing an individual's mental health and readjustment needs to
            civilian life;
      --Addressing individual health care situations that may hinder
            reintegration to civilian life; and
      --Consulting state and territory National Guard senior management on
            specific mental health needs and trends based on membership
            demographics.
        The NGB Division of Psychological Health is committed to providing
    quality care and will develop and implement a program that is
    practical, meaningful, and beneficial for our Guard members and their
    families, thereby ensuring our maximum operational readiness.
    A Leader in Equal Opportunity
        In 2008, the National Guard Bureau Office of Equal Opportunity and
    Civil Rights developed Reasonable Accommodations procedures that are a
    model for other federal agencies. The National Guard Bureau is also
    officially partnering with Operation War Fighter through job fairs,
    resume reviews from the internet, and participation in ongoing work
    groups to enhance employment opportunities within NGB for wounded
    service members during their rehabilitation.
        This office ensures the effective management of National Guard
    Affirmative Action programs to achieve a military and civilian work
    force structure that reflects the diversity of the 54 states and
    territories.
        With the on-going support from Congress and the American people,
    the National Guard will continue to secure the American homeland while
    defending her interests abroad.
        Your National Guard is ``Always Ready, Always There.''
                            state adjutants general
        Alabama: Major General Abner C. Blalock Jr.
        Alaska: Major General Craig E. Campbell
        Arizona: Major General (AZ) Hugo E. Salazar
        Arkansas: Major General William D. Wofford
        California: Major General William H. Wade II
        Colorado: Major General H. Michael Edwards
        Connecticut: Major General Thaddeus J. Martin
        Delaware: Major General Francis D. Vavala
        District of Columbia: Major General Errol R. Schwartz, Commanding
    General
        Florida: Major General Douglas Burnett
        Georgia: Major General William T. Nesbitt
        Guam: Major General Donald J. Goldhorn
        Hawaii: Major General Robert G. F. Lee
        Idaho: Major General Lawrence F. Lafrenz
        Illinois: Major General William L. Enyart Jr.
        Indiana: Major General R. Martin Umbarger
        Iowa: Major General (Ret.) G. Ron Dardis
        Kansas: Major General Tod M. Bunting
        Kentucky: Major General Edward W. Tonini
        Louisiana: Major General Bennett C. Landreneau
        Maine: Major General John W. Libby
        Maryland: Brigadier General (MD) James A. Adkins
        Massachusetts: Major General (MA) Joseph C. Carter
        Michigan: Major General Thomas G. Cutler
        Minnesota: Major General Larry W. Shellito
        Mississippi: Major General (MS) William L. Freeman Jr.
        Missouri: Brigadier General (MO) Stephen L. Danner
        Montana: Brigadier General (MT) John E. Walsh
        Nebraska: Major General (NE) Timothy J. Kadavy
        Nevada: Major General Cynthia N. Kirkland
        New Hampshire: Major General (Ret.) Kenneth R. Clark
        New Jersey: Major General Glenn K. Rieth
        New Mexico: Major General (NM) Kenny C. Montoya
        New York: Major General Joseph J. Taluto
        North Carolina: Major General William E. Ingram Jr.
        North Dakota: Major General David A. Sprynczynatyk
        Ohio: Major General Gregory L. Wayt
        Oklahoma: Major General Myles L. Deering
        Oregon: Major General Raymond F. Rees
        Pennsylvania: Major General Jessica L. Wright
        Puerto Rico: Brigadier General (Ret.) Antonio J Vicens-Gonzalez
        Rhode Island: Major General Robert T. Bray
        South Carolina: Major General (Ret.) Stanhope S. Spears
        South Dakota: Major General Steven R. Doohen
        Tennessee: Major General Gus L. Hargett Jr.
        Texas: Major General Charles G. Rodriguez
        Utah: Major General Brian L. Tarbet
        Vermont: Major General Michael D. Dubie
        Virginia: Major General Robert B. Newman Jr.
        Virgin Islands: Major General (VI) Renaldo Rivera
        Washington: Major General Timothy J. Lowenberg
        West Virginia: Major General Allen E. Tackett
        Wisconsin: Brigadier General (WI) Donald P. Dunbar
        Wyoming: Major General Edward L. Wright
                                  in memoriam
        National Guard Soldiers and Airmen lost during the attacks on 9/11,
    Operation Noble Eagle, Operation Enduring Freedom and Operation Iraqi
    Freedom as of January 1, 2009.

    CPT Clayton L. Adamkavicius, KY
    PVT Algernon Adams, SC
    SGT Jan M. Argonish, PA
    SFC Brent A. Adams, PA
    SGT Leonard W. Adams, NC
    SGT Spencer C. Akers, MI
    SPC Segun F. Akintade, NY
    PFC Wilson A. Algrim, MI
    SPC Azhar Ali, NY
    SGT Howard P. Allen, AZ
    1LT Louis E. Allen, PA
    SSG William A. Allers III, KY
    SFC Victor A. Anderson, GA
    SPC Michael Andrade, RI
    SGT Travis M. Arndt, MT
    SSG Daniel L. Arnold, PA
    SSG Larry R. Arnold, MS
    SGT Jesse A. Ault, VA
    SGT Christopher J. Babin, LA
    SFC Travis S. Bachman, KS
    SSG Nathan J. Bailey, TN
    SPC William L. Bailey, NE
    SPC Ronald W. Baker, AR
    SGT Sherwood R. Baker, PA
    MSG Scott R. Ball, PA
    1LT Debra A. Banaszak, IL
    SGT Derek R. Banks, VA
    1LT Gerard Baptiste, NY
    SGT Michael C. Barkey, OH
    1LT Christopher W. Barnett, LA
    SPC Bryan E. Barron, MS
    SGT Michael Barry, KS
    SSG Robert J. Basham, WI
    SPC Todd M. Bates, OH
    SSG Tane T. Baum, OR
    SPC Alan Bean Jr., VT
    SGT Bobby E. Beasley, WV
    SSgt Brock A. Beery, TN
    CPL Joseph O. Behnke, NY
    SGT Aubrey D. Bell, AL
    SSG Keith A. Bennett, PA
    SGT Darry Benson, NC
    SPC Bradley J. Bergeron, LA
    LTC Richard J. Berrettini, PA
    SSG David R. Berry, KS
    SSG Sean B. Berry, TX
    SSG Harold D. Best, NC
    SSG Richard A. Blakley, IN
    SGT Dennis J. Boles, FL
    SFC Craig A. Boling, IN
    SSG Jerry L. Bonifacio Jr., CA
    SSG Darryl D. Booker, VA
    COL Canfield Boone, IN
    SPC Christopher K. Boone, TX
    CPL Samuel M. Boswell, MD
    SSG Collin J. Bowen, MD
    PFC Samuel R. Bowen, OH
    SGT Larry Bowman, NY
    SSG Hesley Box Jr., AR
    SSG Stacey C. Brandon, AR
    SPC Kyle A. Brinlee, OK
    SSG Cory W. Brooks, SD
    SFC John G. Brown, AR
    SGT Lerando Brown, MS
    PFC Nathan P. Brown, NY
    PFC Oliver J. Brown, PA
    SPC Philip D. Brown, ND
    SPC Timothy D. Brown, MI
    SGT Charles R. Browning, AZ
    SFC Daniel A. Brozovich, PA
    SSgt Andrew C. Brunn, NY
    SPC Jacques E. Brunson, GA
    PFC Paul J. Bueche, AL
    CPL Jimmy D. Buie, AR
    SSG James D. Bullard, SC
    SPC Alan J. Burgess, NH
    SGT Casey Byers, IA
    SGT Charles T. Caldwell, RI
    MAJ Jeffrey R. Calero, NY
    SSG Joseph Camara, MA
    1LT Jaime L. Campbell, WA
    LTC David C. Canegata III, VI
    SGT Deyson K. Cariaga, HI
    SPC Frederick A. Carlson, PA
    SSG Nicholas R. Carnes, KY
    SPC Jocelyn L. Carrasquillo, NC
    MSG Scott M. Carney, IA
    SGT James D. Carroll, TN
    SPC Dane O. Carver, MI
    SGT Frank T. Carvill, NJ
    SFC Virgil R. Case, ID
    CPT Christopher S. Cash, NC
    SPC Stephen W. Castner, WI
    SPC Jessica L. Cawvey, IL
    CPL Bernard L. Ceo, MD
    SPC James A. Chance III, MS
    SSG William D. Chaney, IL
    MSG Chris S. Chapin, VT
    SSG Craig W. Cherry, VA
    SPC Don A. Clary, KS
    MSG Herbert R. Claunch, AL
    SGT James M. Clay, AR
    SPC Brian Clemens, IN
    SSG Thomas W. Clemons, KY
    SGT Russell L. Collier, AR
    SFC Kurt J. Comeaux, LA
    SPC Anthony S. Cometa, NV
    SGT Brian R. Conner, MD
    SFC Sean M. Cooley, MS
    SSG Travis S. Cooper, MS
    SPC Marcelino R. Corniel, CA
    SGT Alex J. Cox, TX
    SFC Daniel B. Crabtree, OH
    MSG Clinton W. Cubert, KY
    SSG Daniel M. Cuka, SD
    SPC Carl F. Curran, PA
    CPT Patrick D. Damon, ME
    SGT Jessie Davila, KS
    SPC Daryl A. Davis, FL
    SSG Kevin D. Davis, OR
    SPC Raphael S. Davis, MS
    SSG David F. Day, MN
    PFC John W. Dearing, MI
    SGT Germaine L. Debro, NE
    MSG Bernard L. Deghand, KS
    SGT Felix M. Del Greco, CT
    SPC Daryl T. Dent, DC
    SPC Daniel A. Desens, NC
    CPT Bruno G. Desolenni, CA
    PFC Nathaniel E. Detample, PA
    CPL Scott G. Dimond, NH
    SPC Joshua P. Dingler, GA
    SGT Philip A. Dodson Jr., GA
    SPC Ryan E. Doltz, NJ
    SSgt Geronimo ``Jerome'' M. P. Dominguez, NY
    1LT Mark H. Dooley, NY
    SPC Thomas J. Dostie, ME
    SSG George R. Draughn Jr., GA
    SGT Duane J. Dreasky, MI
    SPC Christopher M. Duffy, NJ
    CPL Ciara M. Durkin, MA
    SGT Arnold Duplantier II, CA
    Sgt Lance O. Eakes, NC
    SFC Amos C. Edwards Jr., GA
    CWO Corry A. Edwards, TX
    SFC Mark O. Edwards, TN
    2LT Michael I. Edwards, AK
    SGT Michael Egan, PA
    SGT Christian P. Engeldrum, NY
    SGT Daniel M. Eshbaugh, OK
    CPT Phillip T. Esposito, NY
    SPC Michael S. Evans II, LA
    SPC William L. Evans, PA
    SSG Christopher L. Everett, TX
    SGT Justin L. Eyerly, OR
    SPC Huey P. Long Fassbender, LA
    SGT Gregory D. Fejeran, GM
    CPT Arthur L. Felder, AR
    SGT Robin V. Fell, LA
    SGT Christopher J. C. Fernandez, GM
    SPC William V. Fernandez, PA
    SPC Jon P. Fettig, ND
    SGT Damien T. Ficek, WA
    SGT Courtney D. Finch, KS
    SGT Jeremy J. Fischer, NE
    CPT Michael T. Fiscus, IN
    SPC David M. Fisher, NY
    SGT Paul F. Fisher, IA
    CW3 William T. Flanigan, TN
    CW3 John M. Flynn, NV
    SSG Tommy I. Folks Jr., TX
    SGT Joseph A. Ford, IN
    SGT Joshua A. Ford, NE
    SPC Craig S. Frank, MI
    SSG Bobby C. Franklin, GA
    SSG Jacob Frazier, IL
    SPC Carrie L. French, ID
    SPC Armand L. Frickey, LA
    SSG Joseph F. Fuerst III, FL
    SFC Michael T. Fuga, AS \1\
    SSG Carl R. Fuller, GA
    SPC Marcus S. Futrell, GA
    CSM Marilyn L. Gabbard, IA
    SGT Jerry L. Ganey Jr., GA
    SGT Seth K. Garceau, IA
    SPC Tomas Garces, TX
    SGT Landis W. Garrison, IL
    PFC Alva L. Gaylord, MO
    SGT Christopher Geiger, PA
    SPC Christopher D. Gelineau, ME
    SPC Mathew V. Gibbs, GA
    2LT Richard B. Gienau, IL
    SSG Charles C. Gillican III, GA
    SGT Terrell W. Gilmore, LA
    SPC Lee M. Godbolt, LA
    SGT Jaime Gonzalez, TX
    CPL Nathan J. Goodiron, ND
    SPC Richard A. Goward, MI
    SGT Shawn A. Graham, TX
    SGT Jamie A. Gray, VT
    SGT Kevin D. Grieco, IL
    SPC James T. Grijalva, IL
    SGT Shakere T. Guy, CA
    SGT Jonathon C. Haggin, GA
    SFC Peter J. Hahn, LA
    CSM Roger W. Haller, MD
    SSG Jeffrey J. Hansen, NE
    SGT Joshua R. Hanson, MN
    SGT Joshua W. Harris, IL
    SSG Asbury F. Hawn II, TN
    SPC Michael R. Hayes, KY
    CPT Bruce E. Hays, WY
    SGT Paul M. Heltzel, LA
    SPC Kyle M. Hemauer, VA
    1LT Robert L. Henderson II, KY
    SSG Kenneth Hendrickson, ND
    SFC John M. Hennen, LA
    SGT Gary M. Henry, IN
    SPC Michael L. Hermanson, ND
    SPC Brett M. Hershey, IN
    MSG Michael T. Hiester, IN
    SGT Stephen C. High, SC
    CPT Raymond D. Hill II, CA
    SGT Shawn F. Hill, SC
    SFC Matthew L. Hilton, MI
    SGT Jeremy M. Hodge, OH
    PFC Derek Holland, PA
    SFC Robert L. Hollar Jr., GA
    SPC Eric M. Holke, CA
    SPC James J. Holmes, MN
    SPC Jeremiah J. Holmes, ME
    SGT Manny Hornedo, NY
    SGT Jessica M. Housby, IL
    SPC Robert W. Hoyt, CT
    SPC Jonathan A. Hughes, KY
    SGT Buddy J. Hughie, OK
    SGT Joseph D. Hunt, TN
    MSG Julian Ingles Rios, PR
    SSG Henry E. Irizarry, NY
    SPC Benjamin W. Isenberg, OR
    SFC Tricia L. Jameson, NE
    SGT Brahim J. Jeffcoat, PA
    SPC William Jeffries, IN
    SPC David W. Johnson, OR
    SGT Joshua A. Johnson, VT
    SFC Charles J. Jones, KY
    SSG David R. Jones Sr., GA
    SFC Michael D. Jones, ME
    SGT Ryan D. Jopek, WI
    SGT Anthony N. Kalladeen, NY
    SPC Alain L. Kamolvathin, NJ
    SPC Mark J. Kasecky, PA
    SSG Darrel D. Kasson, AZ
    SPC Charles A. Kaufman, WI
    SPC James C. Kearney, IA
    SGT Michael J. Kelley, MA
    SSG Dale J. Kelly, ME
    COL Paul M. Kelly, VA
    SSG Stephen C. Kennedy, TN
    SSG Ricky A. Kieffer, MI
    SSG Bradley D. King, IN
    SGT James O. Kinlow, GA
    PFC David M. Kirchoff, IA
    SGT Timothy C. Kiser, CA
    SPC Rhys W. Klasno, CA
    SPC Chris Kleinwachter, ND
    SGT Floyd G. Knighten Jr., LA
    SPC Joshua L. Knowles, IA
    SGT Brent W. Koch, MN
    SSG Lance J. Koenig, ND
    SGT Allen D. Kokesh Jr., SD
    CW3 Patrick W. Kordsmeier, AR
    SPC Kurt E. Krout, PA
    SPC John Kulick, PA
    SFC William W. Labadie Jr., AR
    SGT Joshua S. Ladd, MS
    SGT Dustin D. Laird, TN
    SFC Floyd E. Lake, VI
    SPC Charles R. Lamb, IL
    SPC David E. Lambert, VA
    SGT Denise A. Lannaman, NY
    SFC Issac S. Lawson, CA
    CW4 Patrick D. Leach, SC
    SGT Terrance D. Lee Sr., MS
    SGT David L. Leimbach, SC
    PFC Ken W. Leisten, OR
    SSG Jerome Lemon, SC
    SPC Brian S. Leon Guerrero, GU
    SPC Timothy J. Lewis, VA
    SSG Nathaniel B. Lindsey, OR
    SGT Jesse M. Lhotka, MN
    SSG Victoir P. Lieurance, TN
    SFC Daniel R. Lightner Jr., PA
    SPC Justin W. Linden, OR
    SSG Tommy S. Little, AL
    SPC Jeremy Loveless, AL
    SSG David L. Loyd, TN
    CPT Robert Lucero, WY
    2LT Scott B. Lundell, UT
    SPC Audrey D. Lunsford, MS
    PFC Jonathan L. Luscher, PA
    SPC Derrick J. Lutters, CO
    SPC Wai Phyo Lwin, NY
    CPT Sean E. Lyerly, TX
    SGT Stephen R. Maddies, TN
    SPC Anthony L. Mangano, NY
    SSG William F. Manuel, LA
    SPC Joshua S. Marcum, AR
    SPC Jeremy E. Maresh, PA
    PFC Adam L. Marion, NC
    PFC Ryan A. Martin, OH
    Sgt Anthony L. Mason, TX
    SGT Nicholas C. Mason, VA
    SGT John R. Massey, AR
    SGT Randy J. Matheny, NE
    SGT Patrick R. McCaffrey Sr., CA
    SFC Randy D. McCaulley, PA
    1LT Erik S. McCrae, OR
    SPC Donald R. McCune, MI
    SPC Bryan T. McDonough, MN
    SGT John E. McGee, GA
    SPC Jeremy W. McHalffey, AR
    SFC Joseph A. McKay, NY
    SPC Eric S. McKinley, OR
    LTC Michael E. McLaughlin, PA
    SPC Scott P. McLaughlin, VT
    SGM Jeffrey A. McLochlin, IN
    SSG Heath A. McMillan, NY
    SSG Michael J. McMullen, MD
    SPC Robert A. McNail, MS
    MSG Robbie D. McNary, MT
    SSG Jeremiah E. McNeal, VA
    SPC Curtis R. Mehrer, ND
    PV2 Bobby Mejia II, MI
    SPC Mark W. Melcher, PA
    SPC Jacob E. Melson, AK
    SPC Kenneth A. Melton, MO
    SPC Jonathan D. Menke, IN
    SSG Chad M. Mercer, GA
    SPC Chris S. Merchant, VT
    SSG Dennis P. Merck, GA
    SGM Michael C. Mettille, MN
    SPC Michael G. Mihalakis, CA
    SSG Brian K. Miller, IN
    SPC John W. Miller, IA
    SGT Kyle R. Miller, MN
    CPT Lowell T. Miller II, MI
    SPC Marco L. Miller, FL
    PFC Mykel F. Miller, AZ
    SFC Troy L. Miranda, AR
    SGT Ryan J. Montgomery, KY
    SPC Samson A. Mora, GU
    SGT Carl J. Morgain, PA
    SPC Dennis B. Morgan, NE
    SGT Steve Morin Jr., TX
    SGT Shawna M. Morrison, IL
    SPC Clifford L. Moxley, PA
    LTC Charles E. Munier, WY
    SPC Warren A. Murphy, LA
    SGT David J. Murray, LA
    SPC Nathan W. Nakis, OR
    SPC Creig L. Nelson, LA
    SGT Paul C. Neubauer, CA
    SPC Joshua M. Neusche, MO
    SGT Long N. Nguyen, OR
    SPC Paul A. Nicholas, CA
    SFC Scott E. Nisely, IA
    SGT William J. Normandy, VT
    PFC Francis C. Obaji, NY
    SGT John B. Ogburn III, OR
    SGT Nicholas J. Olivier, LA
    SSG Todd D. Olson, WI
    1LT Robert C. Oneto-Sikorski, MS
    1SG Julio C. Ordonez, TX
    SPC Richard P. Orengo, PR
    SSG Billy Joe Orton, AR
    SGT Timothy R. Osbey, MS
    SSG Ryan S. Ostrom, PA
    SSG Michael C. Ottolini, CA
    SSG Paul S. Pabla, IN
    SGT Mark C. Palmateer, NY
    PFC Kristian E. Parker, LA
    SGT Richard K. Parker, ME
    SSG Saburant Parker, MS
    SGT Lawrence L. Parrish, MO
    SSG Michael C. Parrott, CO
    SPC Gennaro Pellegrini Jr., PA
    SGT Theodore L. Perreault, MA
    SSG David S. Perry, CA
    SGT Jacob L. Pfingsten, MN
    SSG Joseph E. Phaneuf, CT
    PFC Sammie E. Phillips, KY
    SGT Edward O. Philpot, SC
    SGT Ivory L. Phipps, IL
    SSG Emanuel Pickett, NC
    CW2 Paul J. Pillen, SD
    PFC Derek J. Plowman, AR
    SGT Foster Pinkston, GA
    SGT Darrin K. Potter, KY
    SGT Christopher S. Potts, RI
    SGT Lynn R. Poulin Sr., ME
    SFC Daniel J. Pratt, OH
    SFC James D. Priestap, MI
    2LT Mark J. Procopio, VT
    SGT Joseph E. Proctor, IN
    SPC Robert S. Pugh, MS
    SFC George A. Pugliese, PA
    SPC Joseph A. Rahaim, MS
    SPC Eric U. Ramirez, CA
    PFC Brandon Ramsey, IL
    SPC Christopher J. Ramsey, LA
    SSG Jose C. Rangel, CA
    SGT Thomas C. Ray II, NC
    SSG Johnathan R. Reed, LA
    SSG Aaron T. Reese, OH
    SGT Gary L. Reese Jr., TN
    SGT Luis R. Reyes, CO
    SPC Jeremy L. Ridlen, IL
    SPC James D. Riekena, WA
    SGT Greg N. Riewer, MN
    PFC Hernando Rios, NY
    SSG Milton Rivera-Vargas, PR
    CPL John T. Rivero, FL
    SSG William T. Robbins, AR
    SSG Christopher L. Robinson, MS
    CPL Jeremiah W. Robinson, AZ
    SGT Nelson D. Rodriguez Ramirez, MA
    SSG Alan L. Rogers, UT
    SFC Daniel Romero, CO
    SGT Brian M. Romines, IL
    SFC Robert E. Rooney, NH
    SPC David L. Roustum, NY
    SGT Roger D. Rowe, TN
    CW3 Brady J. Rudolf, OK
    SGT David A. Ruhren, VA
    CW4 William Ruth, MD
    SPC Lyle W. Rymer II, AR
    SPC Corey J. Rystad, MN
    SFC Rudy A. Salcido, CA
    SGT Paul A. Saylor, GA
    SSG Daniel R. Scheile, CA
    SPC Ronald A. Schmidt, KS
    SFC Richard L. Schild, SD
    SGT Jacob S. Schmuecker, NE
    SPC Jeremiah W. Schmunk, WA
    PFC Benjamin C. Schuster, NY
    SGT Andrew Seabrooks, NY
    SPC Dennis L. Sellen, CA
    SGT Bernard L. Sembly, LA
    SPC Daniel L. Sesker, IA
    SGT Jeffrey R. Shaver, WA
    SGT Kevin Sheehan, VT
    SGT Ronnie L. Shelley Sr., GA
    SGT James A. Sherrill, KY
    1LT Andrew C. Shields, SC
    SPC Bradley N. Shilling, MI
    PFC Ashley Sietsema, IL
    SGT Alfred B. Siler, TN
    SGT Alfredo B. Silva, CA
    SGT Isiah J. Sinclair, LA
    SPC Roshan (Sean) R. Singh, NY
    SPC Channing G. Singletary, GA
    SPC Aaron J. Sissel, IA
    SSG Bradley J. Skelton, MO
    1LT Brian D. Slavenas, IL
    SGT Eric W. Slebodnik, PA
    SPC Erich S. Smallwood, AR
    SGT Keith Smette, ND
    CW4 Bruce A. Smith, IA
    CPL Darrell L. Smith, IN
    SGT Michael A. Smith, AR
    SPC Norman K. Snyder, IN
    SGT Mike T. Sonoda Jr., CA
    Lt Col Kevin H. Sonnenberg, OH
    SGT Matthew R. Soper, MI
    SGT Kampha B. Sourivong, IA
    SFC Theodore A. Spatol, WY
    SFC William C. Spillers, MS
    SPC David S. Stelmat, NH
    SGT Patrick D. Stewart, NV
    SGT Jonnie L. Stiles, CO
    SGT Michael J. Stokely, GA
    Maj Gregory Stone, ID
    MSG John T. Stone, VT
    SPC Brandon L. Stout, MI
    SPC Chrystal G. Stout, SC
    2LT Matthew R. Stoval, MS
    SGT Francis J. Straub Jr., PA
    SGT Matthew F. Straughter, MO
    SGT Thomas J. Strickland, GA
    WO1 Adrian B. Stump, OR
    SSG Daniel A. Suplee, FL
    SSG Michael Sutter, IL
    SGT Robert W. Sweeney III, LA
    SGT Deforest L. Talbert, WV
    SFC Linda A. Tarango-Griess, NE
    SPC Christopher M. Taylor, AL
    SPC Deon L. Taylor, NY
    CPT Michael V. Taylor, AR
    SGT Shannon D. Taylor, TN
    SGT Joshua A. Terando, IL
    MSG Thomas R. Thigpen Sr., GA
    SGT John F. Thomas, GA
    MSG Sean M. Thomas, PA
    SGT Paul W. Thomason III, TN
    CPL Michael E. Thompson, OK
    1LT Jason G. Timmerman, MN
    SGT Humberto F. Timoteo, NJ
    SPC Eric L. Toth, KY
    SSG Robin L. Towns Sr., MD
    SPC Seth R. Trahan, LA
    SPC Quoc Binh Tran, CA
    SSG Philip L. Travis, GA
    CW4 Chester W. Troxel, AK
    SGT Robert W. Tucker, TN
    SGT Gregory L. Tull, IA
    SPC Nicholas D. Turcotte, MN
    1LT Andre D. Tyson, CA
    SPC Daniel P. Unger, CA
    PFC Wilfredo F. Urbina, NY
    SGT Michael A. Uvanni, NY
    1LT Robert Vallejo II, TX
    SGT Gene Vance Jr., WV
    SGT Travis A. Vanzoest, ND
    SGT Daniel R. Varnado, MS
    SSG Jason A. Vazquez, IL
    1LT Michael W. Vega, CA
    SSG David M. Veverka, PA
    SPC Anthony M. K. Vinnedge, OH
    SPC Chad J. Vollmer, MI
    PFC Kenneth Gri Vonronn, NY
    SPC Jason E. von Zerneck, NY
    SSG Michael S. Voss, NC
    PFC Brandon J. Wadman, FL
    SSG Gregory A. Wagner, SD
    SGT Andrew P. Wallace, WI
    SGT Daniel W. Wallace, KY
    SFC Charles H. Warren, GA
    1SG William T. Warren, AR
    SFC Mark C. Warren, OR
    SPC Glenn J. Watkins, CA
    MSG Davy N. Weaver, GA
    SGT Matthew A. Webber, MI
    SFC Kyle B. Wehrly, IL
    SSG David J. Weisenburg, OR
    SPC Michael J. Wendling, WI
    SPC Cody Lee L. Wentz, ND
    SPC Jeffrey M. Wershow, FL
    SGT Marshall A. Westbrook, NM
    SPC Lee A. Wiegand, PA
    LTC James L. Wiley, OR
    1LT Charles L. Wilkins III, OH
    SGT David B. Williams, NC
    SPC Michael L. Williams, NY
    SFC Christopher R. Willoughby, AL
    SSG Clinton L. Wisdom, KS
    SPC Robert A. Wise, FL
    SPC Michelle M. Witmer, WI
    SSG Delmar White, KY
    SGT Elijah Tai Wah Wong, AZ
    SPC John E. Wood, KS
    SFC Ronald T. Wood, UT
    SGT Roy A. Wood, FL
    SSG James Wosika, MN
    SPC Brian A. Wright, IL
    SGT Thomas G. Wright, MI
    SGT Joshua V. Youmans, MI
    SPC Christopher D. Young, CA

        \1\ American Samoa.

        Chairman Inouye. General Wyatt.
    STATEMENT OF LIEUTENANT GENERAL HARRY M. WYATT, III,
                DIRECTOR, AIR NATIONAL GUARD
        General Wyatt. Thank you, Mr. Chairman, Mr. Vice Chairman,
    Senator Leahy. Thank you for the opportunity to appear before
    the subcommittee today and allowing me to testify on behalf of
    the men and women of the Air National Guard (ANG), authorized
    end strength of 106,756 gallant airmen nationwide, and for the
    first time since 2002, our end strength is approaching 108,500.
        As we meet today, your Air National Guard is protecting the
    skies of the United States of America at 16 of the 18 air
    sovereignty alert sites covering the United States of America.
        We are forward-deployed in over 3,300 locations in our
    States. Our airmen are responding to disasters like hurricanes,
    tornadoes, and fires, and currently today we have airmen
    deployed in South Dakota and Minnesota fighting the floods in
    that region and snowstorms in Montana.
        Our airmen continue to volunteer at unprecedented rates to
    support overseas contingency operations, and we cannot forget
    the backbone of our force, the traditional Guard members who
    provide the efficiencies and the search capacity that make the
    Air National Guard a valued member of the Nation's defense.
        The Air National Guard has three primary themes, three
    primary concerns, as we appear before you today. The first is
    modernizing and recapitalizing the aging fleet of aircraft, to
    bridge the gap in mid-term Air Force capability. Second, we
    intend to leverage the inherent ANG efficiencies that I
    mentioned before and take on additional Air Force missions as
    appropriate. And we seek to maximize the use of associations of
    several different kinds, using the association construct and
    community basing to better support the air force mission.
        I stand ready to answer your questions, sir. Thank you.
        Chairman Inouye. Thank you very much, General.
        If I may, I would like to call upon General Vaughn first.
    The Army Guard is currently at 366,500 end strength. This is
    13,900 more than authorized and exceeds the entire end strength
    growth planned for the Guard. Can you tell us why the Guard has
    exceeded the authorized strength so significantly? And how do
    you plan to pay for the additional guardsmen?
        General Vaughn. Thank you, Mr. Chairman.
        Number one, a couple of years ago, we were tremendously
    under strength, and there were a lot of doubting Thomases that
    we could make end strength; however, we did that, we put
    together a great program. The States worked it hard; I take
    tremendous pride in our forces throughout the Nation.
        The authorization for us and the money for the Army
    National Guard in the supplemental is at 358,200. In fact, we
    are, actually--you know this thing continues to climb in spite
    of putting the levers in place to stop it. And we are 10,000
    over the authorized number.
        Next year, to grow the Army piece, we were supposed to be
    at 358,200. The statutory appropriations, as you outline, is
    exactly on the mark, 352,600. So, long story short, we have to
    reduce by 10,000 soldiers between now and the end of the year
    to get to the authorized level. We will do that.
        The way we will do that is that we will change our system.
    We had an albatross of a system. We had a dinosaur of a system.
    We take youngsters in that want to be in our formations and
    swear them in on the first day, and then they sit in our
    formations for a long time before they ship off to basic
    training. So in order to overcome that and to keep from cross-
    leveling like we had to do, we over-drove our end strength with
    a goal toward correcting that deficiency and pulling it down by
    the end of the fiscal year, while at the same time growing
    readiness. We have a plan in place. I have briefed it to
    General McKinley, and there are three phases to this plan. We
    have been discussing that with the staff members, and we have
    discussed it with the Army, and the Army is confident in what
    we are going to do. But our eyes are on readiness, and I want
    to assure you that we will be at a level where we have been
    authorized to be at the end of the year.
        Chairman Inouye. I can assure you that the subcommittee and
    I support you on this, but just for the record, we wanted your
    explanation, sir.
        If I may ask General Wyatt. The Air Guard has announced
    plans to grow by 7,000 in fiscal year 2010. Active duty Air
    Force and Reserve announced similar plans last year to grow
    their end strength levels. They argued that these increases
    were necessary to restore cuts. The Guard was not part of the
    reductions. So why are these additional personnel required?
        General Wyatt. Mr. Chairman, you are correct in that the
    Air National Guard did not take personnel cuts when we were
    asked to respond to a PBD previously. We took those cuts in
    flying hours, took a little risk in their flying hour program.
        To answer your question, sir, if we take a look at the
    missions right now that the Air Force has asked the Air
    National Guard to perform--current authorized end strength of
    106,756--if we look at the validated manpower requirements for
    those missions which we currently have accepted from the Air
    Force, we would need 2,228 additional military positions to
    fully man the missions that the Air Force has assigned the Air
    National Guard.
        We also have a need to populate our joint force
    headquarters which is really the tool that the Adjutants
    General use to execute the missions for the Governors, but also
    to assist in our mobilization and deployments for the Federal
    warfight and to administer a lot of the airmen care programs
    that you mentioned in your opening comments.
        We also understand that the appetite for Air Force
    capability exceeds the authorizations at this point for
    manpower. We are poised with our current upward vector in
    recruiting. We are poised to answer the call should the Air
    Force need our assistance in manning some of these additional
    responsibilities if, again, our senior leaders determine that
    the Air National Guard should play a part in that. So we stand
    ready to answer that call, and those are the reasons why we
    would be looking at a possible increase in manpower if the Air
    Force would so request.
        Chairman Inouye. General, I thank you for your leadership.
    I think you are on the right track.
        General Vaughn, if I recall, in fiscal year 2006, you were
    just about 40 percent of your equipment needs, and now you are
    over 75 percent. How has this affected readiness?
        General Vaughn. Well, Mr. Chairman, it affects readiness in
    a significant way, and the actions, again, that this
    subcommittee has taken has enabled us to have the kind of
    world-class capability that we have today. The Army is making
    good on the promises. I have to tell you that with the pressure
    that has been on this particular issue--and the amount of money
    in it is a substantial amount of money, and our view of this is
    that we are getting better every day at equipping.
        The thing about the Guard, and like the other Reserve
    components back here, it is all about people. And we are moving
    so fast to having a great personnel readiness force that it
    deserves to have its equipment. It is not a hollow force
    anymore. At one time, that was true, but this 75 and 76 percent
    across the board right now--you know, there is a lot of
    turbulence and there is equipment that has been left behind, so
    forth and so on. We are not crying over that. The fact of it is
    that we are now seeing equipment delivered. After we got into
    this thing in 2006, we are now seeing in 2008--and we will see
    more of it in 2009. We are seeing it delivered into our force,
    and what it does for readiness, in a short answer, is
    substantial.

                                  AGING FLEET

        Chairman Inouye. Thank you very much. I believe you made a
    statement saying that about 85 percent of your F-16s will reach
    the end of their lives in about 8 years. What are you doing to
    meet this shortfall?
        General Wyatt. Thank you very much, Chairman Inouye, for
    your question.
        That is one of the primary concerns that I have, the
    recapitalization of the Air National Guard. It is not just a
    problem that the Air National Guard faces. It is an issue that
    the entire Air Force faces, active duty, Guard, and Reserve.
        A large percentage of the Air Force F-16 fleet resides
    within the Air National Guard, and because of that fact and
    because of the aging aircraft, the Air National Guard is the
    component that faces the most risk for any delays in
    recapitalization of the United States Air Force. If you take a
    look at the air sovereignty alert (ASA) locations that I
    mentioned in my opening statement, those 16 ASA sites, that the
    Air National Guard mans, 11 of those are manned by F-16 units;
    the rest, F-15 units in the Air National Guard. Because of the
    service life of our jets, we face the very real projection of
    losing 80 percent of those aircraft, beginning in 2010, over
    the next 8 years. That would take the number of F-16 wings,
    squadron equivalents, if you would, in the Air National Guard
    from about 19 down to about 4.
        It is a very serious problem that we have. We are working
    with the United States Air Force, as they address their
    recapitalization issues, and we have received great support
    from Air Combat Command. But those are some decisions, as far
    as the degree of recapitalization, what type of platforms we
    are talking about, and how many, that obviously will be
    answered by our Nation's leaders.
        The Air National Guard stands ready to work with the United
    States Air Force. I have likened our position to flying close
    formation with the Air Force, but doing so cautiously because
    we know there are fiscal pressures to recapitalization entirely
    in fifth generation fighters, and we are preserving our
    options, depending upon the decisions that are made by our
    national leaders, but also by the United States Air Force as
    they address the issue of recapitalizing, not only their own
    fleet but our fleet.
        Talking about F-22s, we, the Air National Guard, need to be
    a part of that, if there are additional acquisitions of F-22s.
    Our position is that the number one mission and the one that
    the Air National Guard is most involved in is the air
    sovereignty alert, and we feel that the best airplane in the
    world needs to be defending the best country in the world.

                                     F-35S

        The question is when and how many. Regardless of the
    number, we need to be with our United States Air Force and Air
    Force Reserve brothers and sisters in a proportional and
    concurrent fielding of that platform. But it also goes to any
    other platforms that may be acquired, depending upon the fiscal
    situation. We need to be concurrently and proportionately
    fielded with the United States Air Force.
        Chairman Inouye. General, we are all sensitive to what is
    happening in our economy, but I believe I speak for the
    subcommittee when I say we will do our very best to make
    certain that replacements for your fighter units would be
    available--the funding.
        General Wyatt. Thank you, Mr. Chairman.
        Chairman Inouye. Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you very much.
        General Vaughn, over the past few years, new programs have
    been implemented to assess the health condition of soldiers
    after they have been deployed overseas, and particular
    attention is being placed, I think, in a review of the Guard
    forces. With a large number of guardsmen and men and women who
    have been deployed or alerted for deployment--many of them are
    in my State, as you know--I am concerned about this ability to
    provide a continuum of medical care and attention for those who
    need to have their medical situation addressed.
        Could you give us a reaction of whether or not there has
    been similar reactions to the stresses of deployments in the
    Guard and Reserve forces as there have been with regular active
    duty forces? And how is the Bureau working with the Department
    of Defense to deal with this challenge?

                                 MENTAL HEALTH

        General Vaughn. Mr. Vice Chairman, there have been similar
    things happen to our soldiers. Whether they are active duty
    soldiers or Guard soldiers that come back that transition back
    into the civilian world, there have been several things that
    have happened.
        The chairman mentioned, for instance, suicides. Our suicide
    rate is up in alarming fashion. I mean, if we look at what it
    has been over the last couple years--now, this is on active
    duty and this is off active duty. The great majority of them
    are off active duty when they come back. Now, at the same time,
    a substantial number--the greatest number, have never deployed.
        So you are looking at friction across the whole system in
    the United States of America, our suicides are about 140 to 150
    percent right now in the Army Guard. We are attacking this
    along with the United States Army. General Chiarelli has been
    over and testified. We are embedded in that. You know, the
    Yellow Ribbon, an integration piece that the chairman talked
    about on the front end--we are engaged in that.
        We think we have helped lead the way in something called a
    ``blast tracker'' for those soldiers that were involved in
    events down range, explosive events, and they were not hurt
    substantially enough, and nowhere does it appear on the record.
    We are involved in that.
        The sidebar question, are we getting better medically? I
    think we are. I think a number of the problems that are out
    there, last year in 2008, 92 percent of our soldiers went to
    the MOB station in good shape. That is a record. We are better
    than that. There is a program and I think we need to take our
    nondeployables and fix them before they go. I mean, if you had
    a car, you would put the right repair part on and fix them, and
    when do you fix them? Do you fix them a year out? That is
    probably a pretty good tack to take on that.
        But I think overall, what you championed is exactly right.
    We do not need to have two or three levels of citizens. These
    are wonderful citizens that we have defending us and doing the
    things we ask of them. So anything we can do, in terms of
    healthcare and getting this right for this country, we have got
    to do.
        Now, I rambled around on several things, and I think that
    you were getting at two or three of those things when you asked
    that question. So thanks for that question.
        Senator Cochran. General Wyatt, what is your reaction to
    that question?
        General Wyatt. We share the same concerns that General
    Vaughn does. If we look at our statistics, we pretty much
    mirror the United States Air Force in our experience rate as
    far as suicides. Our difficulty is, until recently, we have had
    difficulty tracking the off-duty suicides because we have no
    legal authority to compel investigators to get into the cause
    of a particular death. You cannot tell in an automobile
    accident, for example, if it is accidental or intentional. So
    we have those problems that we are working through. But because
    of the close relationships that the Air National Guard has with
    the local communities, we feel pretty confident that our data
    is correct.
        We have similar programs that the Army National Guard has.
    We are taking steps, through General McKinley's leadership at
    the National Guard Bureau, to integrate our activities with the
    Army National Guard so that our combatant commanders in the
    States, our Adjutants General, when they administer these
    programs to a guardsman, whether it be Army or Air, that they
    efficiently maximize the use of the resources available to
    them.
        And I think what we have got to remember is that the
    Adjutants General on their own--having been one, I have been
    there, and I know that the Adjutants General go to great
    lengths in working with their State resources provided by their
    Governors to help facilitate some of the Federal programs. And
    a lot of the work that is being done at the joint force
    headquarters--I mentioned the need earlier for Air National
    Guard infusion in manpower into our joint force headquarters.
    That would help us facilitate a couple of things, not only
    working with the Army National Guard to make our programs more
    joint and more efficient, but also merging the capabilities
    that the Adjutants General bring in through State health
    departments, mental health programs that may be available in
    the States. And there are some great private programs out there
    too that the Adjutants General know about.

                              JOINT CARGO AIRCRAFT

        The key is that one size does not fit all, as the chairman
    indicated, on some of our programs. We need to allow
    flexibility to the Adjutants General because the needs vary
    from State to State, the programs vary in their availability
    from State to State.
        Senator Cochran. General Wyatt, our subcommittee has
    provided funding for purchasing the Air Force joint cargo
    aircraft, and I wonder if you could tell us what your reaction
    is to the need in the Air National Guard for this aircraft and
    whether or not we have funding that is available for you to
    begin meeting that new requirement.
        General Wyatt. Senator Cochran, thank you for the question.
        That airplane is critical to the Air National Guard not
    just because it addresses some of the States that lost flying
    missions because of BRAC, but because of the capability that it
    provides the United States Air Force and the Joint Warfighter.
        To answer your question about is there a funding stream
    sufficient to acquire the airplane, based upon the data from
    last year, I do not believe so. That is one of the acquisitions
    that I will be talking to the United States Air Force about.
        The need for the airplane, I believe, is there. The way
    that the airplane is operated differs a little bit between the
    Air Force and the United States Army, but I think if you talk
    to the leadership in the United States Air Force, they will
    tell you that they recognize the need of making that aircraft
    available to the land component commander to face the issues
    that the land component commander has. And we stand ready,
    should the President and Congress see fit to fund acquisitions,
    to field those in the Air National Guard and would relish the
    opportunity to do that, sir.
        Senator Cochran. Thank you.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Leahy.
        Senator Leahy. Well, thank you, Mr. Chairman. I am glad you
    and Senator Cochran are having this hearing. Senator Bond, of
    course, and I co-chair the National Guard Caucus, and I think
    that is the reason for everybody up here.
        And I am trying to wear two hats at the same time. We also
    have a hearing in the Judiciary Committee with Director Mueller
    of the Federal Bureau of Investigation, and I will be going
    back there.
        General Wyatt, I am glad to see you here at your first
    meeting before this panel, and I appreciate the time you spent
    with me yesterday afternoon in going over some of the issues of
    the Air National Guard.
        General Vaughn, this may be your last appearance before
    this subcommittee, and I want to take the opportunity to
    publicly applaud you for the superb job you have done. I think
    the Army Guard is going to be better equipped, better trained,
    and in a better position because of your service. And I think
    that is service that has been also complemented by the brave
    men and women in the Guard. So, General Vaughn, I compliment
    you, sir.
        General Vaughn, also Senator Bond and I have written to the
    Secretary of Defense and the Chairman of the Joint Chiefs a
    number of times about the issue of transparency in budgeting
    for equipment for the Reserve components. We approve here in
    Congress budget requests based on justification documents that
    say a certain amount of gear will go to the Guard and Reserves,
    but then when it starts going, we do not find where that
    reference is as the actual distribution goes about. And no one
    can actually certify the equipment slated for the Guard and
    Reserve actually made it to the Guard and Reserve.
        How do we fix this? I mean, there ought to be some
    transparent way that we can say, okay, we wanted x amount of
    equipment to go there. It either did or it did not, and if it
    did not, well, then what was the reason? It may have been a
    national emergency. It may have been an international
    emergency. But at least have some reason other than as it is
    now. Senator Bond and I--we talk to the Guard Caucus. We have
    to kind of guess at what happened.
        General Vaughn. Senator Leahy, thanks for your leadership
    and Senator Bond's on this particular issue. A lot of people
    have had their shoulder over the wheel, you know, on this one
    for a long time and I think is making a lot of difference. I
    have a lot of friends inside of the Army, and we are able to
    argue about things and still come back and be comrades in arms.
    And I will tell you that I think that the Army is finally
    making great strides on this, and I have confidence that they
    are trying to deliver the equipment.
        As I stated very early on, we made some assumptions. First
    of all, we went out and tried to get a dollar value of
    everything that we had received lately. And then we made a
    guess as to which appropriations it probably came out of. And
    then we took--together with the G-8 of the Army, we took a
    range of 18 to 24 months and said it is likely that it would
    take this long for this equipment to appear. Now, if the
    assumptions, as you well know, are somewhere near right, it
    appears like we probably got about what we were supposed to
    get.
        The problem is it is not auditable, and Steve Speakes--I am
    sure he will testify later. There will have to be an auditable
    system in place rather than something that takes a battalion of
    folks to come up with some kind of an answer 2 or 3 years
    later.
        Senator Leahy. So should we do something different in the
    appropriation process itself to make it easier?
        General Vaughn. Sir, the appropriations process itself--if
    we knew how complex it would be to have separate appropriations
    for equipment for the Guard and Reserve, I could probably give
    you a pretty good answer. The first thing that has got to be
    sorted out, if you had a separate appropriations that went
    directly toward the Guard or Reserve for this, what else goes
    with it? There may be so much burden in that.
        The first thing I would say is that the Army is on the
    right track now. They finally got this thing teed up, got
    everybody's attention, and they are getting at it. It has to be
    a ``push-of-a-button'' of some kind to give you and us the
    auditable results of what happened with the appropriations and
    the equipment.
        Senator Leahy. I may have my staff work with your staff to
    follow up on that. And I appreciate what you are saying about
    the equipment. I mean, that is our ultimate goal because we
    want to make sure that happens.
        General Wyatt, you and I talked about--just if I can brag
    for just a moment, not that any parochialism ever appears in
    this subcommittee on our different things. But the 158th
    Fighter Wing from Vermont Air National Guard has carried out
    some tremendous air defense missions. I mentioned that right
    after 9/11, they did the air cover over New York City.

                             AIR SOVEREIGNTY ALERT

        But Senator Bond and I recently released a Government
    Accountability Office (GAO) report we commissioned on the
    management of the air defense mission. It says, more than 7
    years after 9/11, the Air Force has yet to budget for the air
    defense mission even though we see some significant areas where
    we need that in the foreseeable future. It mentions what has
    already been mentioned here, about concerns over the Air
    Guard's ability to carry out the mission because of aging
    aircraft. Some of them are flying some of the oldest aircraft
    in the Air Force, particularly the F-16s. They are going to be
    retired before we even see the follow-on.
        What can you suggest to us in that area?
        General Wyatt. Thank you for the question. And if I may
    take a little liberty here to explain where I believe the Air
    National Guard is in response to your question.
        Modernization of the fleet is one thing. Recapitalization
    of the fleet is another. For years, we have embarked upon
    modernization, and thanks to the great support of this
    subcommittee, through the National Guard Reserve Equipment
    Account (NGREA) and some congressional adds, the Air National
    Guard has been able to modernize its fleet, not to the level
    that we need, but when the combatant commanders request a
    certain capability, they expect the Air National Guard to
    answer with that capability.
        We have a process through our Weapons and Tactics Center
    that we run with the Air Force Reserve that identifies fleet-
    wide, not just the fighter force, but the lift force,
    intelligence, surveillance, and reconnaissance (ISR) force, all
    the platforms inside the Air National Guard, Air Force Reserve,
    and the Air Force that could use some modernization. And we put
    together a bottom-up driven process that identifies the
    capabilities that we need to modernize, and this subcommittee
    has been very supportive with NGREA accounts that help us
    modernize the force.
        As the GAO report indicates and some of the recent articles
    that I have seen in the Air Force Times indicate and our own
    data indicates that we are at that point in time where we have
    got to start looking toward recapitalization.
        Think of this in contextual themes, if you would, one of
    those being the GAO report that you just mentioned that
    recognizes the resourcing issues that the Air Force has and its
    reluctance to fully fund and fully support the air sovereignty
    alert mission. It is still not into the fight if it is not in
    the budget line. It is handled on a 2-year-by-2-year basis.
    That is one problem.
        The other problem is recapitalization not just of the air
    sovereignty alert (ASA) fleet. We have got to remember that the
    air sovereignty alert fleet, when it is not flying air
    sovereignty alert, is participating in air and space
    expeditionary forces rotations. So it is not a specialized
    fleet. They have a specialized capability, but they can use
    that in AEF rotations and they do. Thirty-six percent of the
    combat sorties flown in Iraq and Afghanistan last year were
    flown by the Air National Guard.
        Senator Leahy. With aging equipment.
        General Wyatt. With aging equipment, yes, sir.
        Think about the comments that General Renuart, the NORTHCOM
    commander, issued just a few days ago. Our ASA posture is a
    non-negotiable in the upcoming quadrennial defense review
    (QDR). I see short- to medium-term risk in our ASA force
    structure due to the legacy age-out issue. That is what you are
    talking about.
        Secretary Donley a couple of weeks ago made the comment: I
    look forward to TFI, total force integration, part 2. He
    recognizes the need to leverage the inherent strengths of the
    three components of the Air Force to efficiently provide the
    capability that we need in the future.
        General Schwartz has said with declining resources and
    increasing demands, we must remember that innovation is still
    free.
        Part of the problem is recapitalizing, but part of the
    problem is also thinking about a force structure and a way for
    the three components to work together that maximizes those
    precious resources that the taxpayer pays for.
        Senator Leahy. General, I think we are going to probably,
    in the coming year, have a lot of conversations on this.
        Thank you, Mr. Chairman.
        I am also going to put into the record a couple of other
    questions. One, General Vaughn refers to our Mountain Division.
    Colonel Roy in Vermont has handled that very well, but with the
    upcoming deployment to Afghanistan--this is more of a personal
    nature--I wish you would take a look at that question. Thank
    you.
        Mr. Chairman, I am going back to the Director.
        Chairman Inouye. Senator Durbin.
        Senator Durbin. Thank you, Mr. Chairman.
        I would like to thank the witnesses.
        Eight years ago, I took up an issue. It was an issue
    related to Guard and Reserve activation and the fact that many
    private employers across the United States make good on the
    income and salary of these Guard and Reserve activated soldiers
    and airmen and others. It turned out that the largest employer
    of the Guard and Reserve activated did not. The largest
    employer, of course, is the Federal Government. If a member of
    the Federal workforce was a member of the Guard and Reserve and
    activated, there was no guarantee or protection that their
    salary would not diminish, and in some instances, it did.
        We have talked a lot about the stress of deployment. In
    these times, we can understand the economic stress.
        Well, I offered this for 8 years and lost it every time. I
    would pass it in the Senate, big votes, and it would disappear
    in conference committee. Or there would be some opposition here
    and there.
        Well, lo and behold, I guess perseverance pays off, and in
    the omnibus bill, it finally passed. So now the Federal
    Government is going to make good on the salaries of activated
    Federal employees in the Guard and Reserve.
        I would like to know if you are aware of this and if you
    are involved in helping it work.
        General Vaughn. I am aware, and it was a great action,
    Senator Durbin. You know, the great capability of the Guard and
    Reserve is really warehoused on the back of the employers of
    the Nation, and when they start to let our soldiers and airmen
    and sailors and marines down, then we have really got a
    problem. At the back we think almost all of the really tragic
    circumstances surrounding suicides and so forth and so on--you
    know, failed relationships, and the key driver, it appears,
    happens to be the ability to take care of their families
    through a lost job or an opportunity.
        And so at every turn--and in fact, in the next panel, the
    champion of something across the Nation for the Reserve is Jack
    Stultz. His program we believe in totally, and we are working
    that program, but it is going to take everyone to have the
    employers--to pat them on the back and guide them in the right
    way and keep this great capability warehoused.
        So thank you very much. I am very, very much aware of that.
        Senator Durbin. Good.
        General Wyatt. Senator, likewise. I had the privilege about
    1 week ago to appear before General Schwartz who was involved
    with the Air Force/Navy warfighter talks, to appear on his
    behalf in Fairbanks, Alaska, for the Chamber of Commerce
    military appreciation night, attended by approximately 500
    Fairbanksans. I learned a new term while I was there. One of
    the comments that I made referenced the Omnibus Appropriations
    Act of 2009 that you sponsored, and the relief that that
    provided our civilian workers.
        The reaction of the crowd was one that you would be proud
    of. Several employers came up afterward and said it is nice to
    know that some of the things that we as private employers have
    been doing have now been validated by the United States
    Government and they have seen fit to follow our lead. So they
    felt like they were out there.
        They obviously did not know how hard you had worked to get
    that passed, but it is a huge thing that you did for the Guard.
        Senator Durbin. I kept telling my colleagues for 8 years it
    was a good idea, finally we do have it. Can I ask you about the
    Individual Ready Reserve (IRR) program? Last week, the
    Department of Defense announced that it was going to end the
    practice of stop loss, and since 2001, 120,000 servicemembers
    have been held past their service obligations in that program.
    Even today, 13,000 servicemembers who have done their duty,
    completed their enlistment, are prevented from moving on with
    their lives. Secretary Gates says the stop loss practice
    ``breaks faith,'' with our troops. The Army still uses IRR
    soldiers, Individual Ready Reserve, to fill National Guard
    units that are not at full strength. IRR soldiers have
    fulfilled their enlistment requirements but have time remaining
    on their military service obligations. They are not paid and do
    not train while in the IRR and have moved on with their
    civilian lives without expectation that they are going be
    recalled to active duty except in the most dire situations like
    world war III, God forbid. We have had briefings from the Army
    and believe that the IRR system really needs a close look at
    this point.
        Do you believe the end of the stop loss program, General
    Vaughn, will affect the rate of call-ups from the Individual
    Ready Reserve?
        General Vaughn. Senator Durbin, I do not. I think the end
    of stop loss is a great thing. I do not want to get out too far
    in front of releasing how we are going to execute this program.
    As you know, my buddy Jack Stultz in the Army Reserve is
    supposed to move into that August 1. We move in on September 1.
    We gladly said we are going to move into it September 1. Stop
    loss for the Guard--and I will let Jack talk to the Army
    Reserve piece, obviously, but around 72 percent of our soldiers
    reenlist down range; whereas, on the active side, it is a much
    different figure.
        There will be a bonus that goes with this to stabilize our
    formations, which is what we need. The very best thing to
    stabilize your formations is stop loss for personnel, for
    families and whatnot, maybe that is a very tough thing.
    Unfortunately, we had to cross-level a lot when we first
    started. We have made enormous changes. We do not have to
    cross-level as much now as we did. We think the use of the IRR
    in a sense in our formations is not a good thing. It is not a
    good thing. And so in order to keep from doing that, that is
    why we went to battle on lowering our force structure, taking
    our end strength way up over. The chairman asked me a question
    earlier about the end strength piece. That is why we did it, is
    to keep the stop loss thing from happening.
        So I hope that gets at those two elements of your questions
    sufficiently. Thank you.
        Senator Durbin. So do you anticipate using IRR? I mean, we
    are having to draw down the force in Iraq. And I am trying to
    get to the bottom line here as to whether or not you think that
    we are going to make up the difference by discontinuing stop
    loss and drawing down in Iraq by going to the Individual Ready
    Reserve more.
        General Vaughn. I think what is going to happen with us--
    and the economy has probably got something to do with this. One
    year out, we're going to look at all those soldiers whose time
    of service is coming up, and we are going to give them a high
    unit retention bonus if they stay with us. And so we will know
    at 6 months whether or not they are going to stay with us. And
    we think the cross-leveling piece from within our Guard units,
    because this bonus opportunity and the chance to get them in
    the retention window, and our improved strength posture is
    going to keep us from having to go as deep in the IRR. There
    are, as you know, functional areas in the IRR that we are all
    having trouble with, military intelligence being one of those.
    And so there is always going to some number--I'm telling you
    from the Director of the Army Guard, I would like to minimize
    that to nothing.
        Senator Durbin. Thank you. Thank you both for your service
    and for being here today.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Bond.
        Senator Bond. Thank you very much, Mr. Chairman, and
    Senator Cochran.
        I would like to begin by welcoming back General Vaughn and
    welcoming for the first time General Wyatt. It is good to see
    an Adjutant General assume this very important position, and I
    look forward to working with you on addressing the issues which
    you have already mentioned.
        But first, I have to join with my colleague, Senator Leahy,
    in noting that this is likely General Vaughn's last appearance
    before the subcommittee. And I would be remiss if I did not
    recognize and thank General Vaughn for the exceptional
    leadership and strategic vision he has provided as the Director
    of the Army National Guard. He has put the Army Guard in a
    position of strength and relevance not seen at any time since
    World War II. From his very successful recruitment program, the
    G-RAP, to the visionary agricultural development teams that he
    and I worked on, to filling the critical equipment shortfalls
    that we had after Katrina, General Vaughn's leadership has been
    second to none. We are grateful, General, for your service and
    in your debt.
        And I look forward to working with Senator Leahy and the
    subcommittee to address the equipment shortfalls and ensuring
    transparency, as you mentioned. We must do the latter to ensure
    the equipment this subcommittee provides, especially for dual-
    mission homeland defense, is in fact directed to the Guard for
    that very purpose.
        But now, speaking about equipment, regarding the Air
    National Guard, as General Wyatt has already discussed, I think
    we can all agree that tactical fighters are a paramount piece
    of equipment for the Air Guard to fulfill its mission. From
    defending the territorial air sovereignty of the United States
    in Operation Noble Eagle to taking out terrorists in Iraq like
    Abu Musab Al Zarqawi that the Guard got, the Air National Guard
    provides a paramount mission for our country and at a fraction
    of the cost to the taxpayer.
        But, unfortunately, as I have stated in this subcommittee
    for several years, the senior Air Force leaders continue to
    pursue plan A, a fifth-generation-only fighter strategy, a
    strategy in my view that not only ignores the current budget
    constraints but will disproportionately eviscerate the Air
    Guard force structure if left unchanged. This would, in turn,
    atrophy the Nation's aerospace industrial base, diminish the
    Air Guard's ability to perform missions abroad, and put the air
    sovereignty alert mission at significant risk.
        Senator Leahy and General Wyatt both cited the GAO study on
    the air sovereignty alert. They concluded, ``Given the
    importance of the capability to deter, detect, and destroy
    airborne threats to the United States, it is important that the
    Air Force address current and future requirements of the ASA
    mission to ensure its long-term sustainability. Further, the
    Air Force should ensure that it has fighter aircraft available
    to conduct ASA operations since the F-15s and the F-16s used
    for these operations are beginning to reach the end of their
    useful lives.''
        Now, we all know that the bottom line is that the Air Force
    has stated the defense of the homeland is their most important
    mission, but it has not done much to demonstrate that it
    realizes it is an important mission. As the GAO report stated,
    the ASA mission must be established as a steady state mission
    and then put the necessary resources toward fulfilling the
    mission.
        While I believe, as General McKinley does--and I discussed
    it with him yesterday--that regardless of what happens with the
    Joint Strike Fighter (JSF), the Air Guard needs an interim
    bridge to ensure that the Air Guard does not become a hollow
    force.
        The Air Guard cannot rely on the F-35 program to provide a
    sufficient, if any, number of aircraft to address its
    shortfalls in a timely manner. Last week, the GAO released
    another report providing an assessment of the F-35 JSF program.
    Highlights of the program: Program costs have increased by $23
    billion since last year alone. Operating costs, which were
    projected at $346 billion a few years ago, are now estimated at
    $650 billion. GAO's auditors expect development and procurement
    costs to increase substantially and schedule pressures to
    worsen based on performance to date.
        The report says, ``The contractor has extended
    manufacturing schedules several times, but test aircraft
    delivery dates continue to slip. The flight test program has
    barely begun, but faces substantial risks as design and
    manufacturing problems continue to cause delays. If we continue
    to ignore them and rely on the continued Air Force strategy,
    the Air Guard will be eviscerated.'' As a high-ranking official
    told me yesterday, you could buy three F/A-18s for the current
    price, which can only go up, of one F-35.
        Now, General Wyatt, what is your assessment of the future
    of the Air Guard facing these equipment shortfalls?
        General Wyatt. Senator, thank you for the question. I share
    your concerns. I think in answering some of the questions of
    previous members of the subcommittee, we have laid out the
    perilous position that the Air National Guard fighter fleet is
    in.
        We have a plan. I do not call it necessarily a plan B. I
    call it the Air National Guard plan. It is a strategic plan
    that is based upon a matrix of decisions, some of which will be
    made at levels much higher than me, when we talk about the
    national security strategy, defense strategy, military
    strategy, the Air Force's role, QDR decisions that come down,
    budget decisions that we will hope to learn of in the future.
        As you pointed out, the Air Force is on a recapitalization
    vector that relies entirely on fifth-generation fighters. We
    have worked very well with the Air Combat Command (ACC) in
    bringing to their attention that the force most at risk for
    recapitalization is the Air National Guard fleet and
    specifically the ASA fleet that protects the United States of
    America. We think that is job one, and we think that is where
    most of the recapitalization attention should be applied.
        We are making progress in promoting our position to ACC,
    and they have written us in earlier into the fielding plans of
    the F-35. The F-22--obviously, we would need to get into that.
        But I likened this earlier to flying in close formation
    with the United States Air Force, but there are going to be
    some decisions that they will not be able to make. We are
    preserving our options to include a fourth-generation buy. I
    have not ruled that out. Obviously, there are some decisions
    that will be made at a much higher level that may require not
    just the Air National Guard, but also the United States Air
    Force to consider a fourth-generation buy or a 4.5-generation
    buy. That is one of the issues, the platform, the expense.
        The other is, regardless of the platform, whether it is F-
    22, F-35, F-15, F-16, fourth-generation, 4.5-generation buys,
    we still need to consider what structure we use. This is the
    other one-half of the plan, is we have to take a look at the
    structure of the United States Air Force. Associations are the
    coin of the realm. It maximizes the efficiencies that all three
    components bring to the Air Force. It minimizes, and in some
    cases eliminates, the weak points that those components bring.
    When we talk about associations and we talk about platforms, we
    have got to merge the thought processes together to provide the
    most capability for the United States, whether that be fifth
    generation or fourth generation.
        Senator Bond. Well, thank you very much, General Wyatt. I
    know you were gratified to hear, as I was, the chairman say
    that within the budget constraints, we will work to make sure
    that we have the aircraft necessary for the Guard and its vital
    missions.
        Mr. Chairman, I appreciate your indulgence. I have a lot
    more to say about this that I will submit for the record, for
    anybody who missed my initial comments. Thank you, sir.
        Chairman Inouye. Thank you.
        Senator Murray.
        Senator Murray. Thanks very much, Mr. Chairman, Senator
    Cochran.
        Thank you both for your service and also to the men and
    women who serve under you. We really appreciate all they are
    doing today.
        General Vaughn, I want to start with you. Since our last
    hearing, I understand that the National Guard has implemented
    the new blast tracking system. You mentioned it a few moments
    ago. That is a system that I know is meant to help us track and
    link soldiers to situations where they might have been exposed
    to an adverse situation like an IED explosion.
        I really want to commend you on this effort. I appreciate
    what you are doing with this, and I think that efforts like
    that are going to help us collect the data so that we make sure
    we have the resources we need to fully address those men and
    women who have traumatic brain injury (TBI) exposure or post-
    traumatic stress disorder (PTSD). And I wanted you to share
    with this subcommittee a little bit more about the blast
    tracking system and how it works.
        General Vaughn. Thank you, Senator Murray. To go back to
    the last of your question that you graciously asked about
    this--and as I explain this, when I finished--you know, we had
    a soldier behind me say, sir, you know, that is me. They do not
    have the record of the five explosions that I was in. That is
    me. So I wish I had had him testify. It would have been a lot
    better than me doing it.
        Our issue is this. About 1\1/2\ years ago, we looked at
    this and said, you know, we have got all these soldiers that
    are coming back that are not on active duty and they do not
    have in their medical records a substantial annotated injury.
    They have been returned to duty. But, yet, is this an
    accumulation of effects, I mean, all the questions that are
    being asked of this--there was no tracking mechanism. So simply
    what we wanted to do was put into place a tracking mechanism
    that if a soldier--for instance, the unit that I was watching
    was a route clearance outfit that in--their daily business is
    explosions. And I saw some really tragic ones at the end of
    this, but also I talked to a lot of soldiers that had been
    returned to duty with it.
        And so, I looked at this closely and said, wow. All of
    these are coming back. All of these soldiers will get off
    active duty, and they will be wards of the State. Now, I do not
    mean wards like indigent--I mean the State will end up having
    to deal with them.
        Now, as you know, my sister ran the Head Injury Council in
    Missouri for many years. So I was just battered with all the
    head injury stuff. It has always been in my mind. I thought,
    you know, what is our role? What is the missing link in all
    this? And our role was to help get them on the path if they
    needed treatment or recovery. In other words, are they going to
    come in 5 days, 5 months, 5 years, 15 years, and where are they
    going to come to? Are they going to come to the armory? And if
    they are not, how do we route them into the right State agency?
    And when we do, is there a stigma behind this that prevents
    them from, you know, from doing this, or do they have to
    explain everything?
        And the way we envisioned this was an automated database
    system that was operational in nature that when it happened, it
    was a commander's responsibility to note that this individual
    was in an incident, and, oh, by the way, if he or she was hurt
    badly, they were already in the medical health system, but if
    we noted in such a way and they came back to the State at some
    point, then you would have a mechanism to be able to channel
    them back onto active duty for treatment or into the Veterans
    Administration (VA) with a record behind them, and, oh, by the
    way, you would be able to do research on all the data.
        What we did is we took about $500,000 and sent a team down
    range, and we put together an automated database that was
    already there, the Army system. The greatness of this system
    is--as you well know, you have got to have an LOD, a line-of-
    duty investigation, you know, before you can get into the
    system.
        And so where is an LOD 5 or 10 years from now going to be?
    This automated system is the LOD. It will always track with
    them.
        Now, where are we? If we commanded and control everything
    down range through the Adjutants General, this would not be
    hard. But once they go overseas in an active duty environment,
    it gets a little bit tough because most folks are going to come
    back on active duty; whereas, most of ours are not going to
    come back on active duty. So we met with all the personnel
    officers and the Adjutants General and those that we command
    and control--they are doing this. And I think we have 1,700 and
    some odd soldiers today. We will get the precise numbers for
    you.
        Senator Murray. Okay.
        General Vaughn. Are we reaching everybody? No. I met with
    the Surgeon General of the Army and the G-1, and they said, we
    are going to do this. We are not going to wait on everybody to
    cut an order. We have already told them, you know, because we
    are different, the Guard and the Reserve. Again, they are not
    on active duty. And if we do not get this right, we are going
    to have families that are indigent out here looking for care
    and they are still trying to prove what happened to them.
        Senator Murray. Right.
        General Vaughn. It is an emotional issue I think for all of
    us, and I think that we are probably on the right track with
    this, and it will get better and better and better. But I think
    that we need to get this thing--I am getting ready to retire
    here, but we need to push this thing over the goal line and
    have all Army, Navy, Air Force, and marines doing this because,
    again, if they get off of active duty, they are coming back to
    the State, and we have got to figure out then that inter-
    linkage, and it is easy because at the State inter-agency level
    between the Adjutant General working for the Governor, there
    has to be someone in the interagency over there on the social
    services side and most head injury councils or MTBI councils or
    whatnot--that this data and this linkage will happen
    seamlessly.
        And so that's a long answer I know. We have done what I
    think that you asked us to do.
        Senator Murray. I really commend you. I think you have made
    a lot of progress with that, and it is so important because
    many soldiers I have talked to do not even remember that they
    were close to a blast. And we also know that the symptoms can
    appear in a vast timeframe, sometimes a few days after
    exposure, sometimes as long as 18 months later. So oftentimes
    people do not link the event with the adverse effect. So that
    is really important, which leads me to my next question, about
    the transferability of the data that you are collecting to the
    VA so that when soldiers leave active duty, the data follows
    them.
        Are you ensuring that that does go into the system as part
    of the seamless transition, or how are you doing that?
        General Vaughn. A great question, and the one that needs
    the work because you know it is not protected. It is not locked
    down. It is an operational tool. And my thoughts were that we
    needed an organization at the interagency level, again, head
    injury council, that in consultation with the Adjutants
    General, so that you had military view of this, we knew which
    way to move it. This was not competition between VA and Army,
    Navy, Air Force, Marine Corps medical care. It is getting them
    back on the right track. I think this record is open to VA. I
    think it is open to the military healthcare systems. Yet to be
    worked out, but again, somebody has got to do that because
    folks like me are not going to be operating a system. We will
    have to get them over to the right people and do it in a very
    caring manner.
        Senator Murray. Are you talking to the VA about the system
    now and making sure it is being transferred, or where is the
    conversation happening?
        General Vaughn. I have folks working with me that I feel
    are talking to the VA. As you know, we having--there is a
    council on this, this afternoon, where it is being discussed
    again, and those--you know, we are in the process now of
    bringing the data back and getting to the next stage. Any
    suggestions as we go forward on this--there needs to be
    everybody involved in it. It is not us coming up with some
    bright idea. I mean, this just needs to be done. And the Army
    is solidly behind this. Secretary Geren is a tremendous
    supporter, as well as the Vice Chief of Staff of the Army. I
    have seen it. He is all over it. He has got it.
        Senator Murray. Okay, good. Well, this is something we will
    continue to follow with you. I really appreciate your work on
    it.
        I also have a continuing concern about the backlog of
    claims for VA disability benefits. And one of the ways that we
    tried to speed up the delivery of the VA benefits has been
    through the benefits delivery discharge, or BDD, program, which
    allows claims to be filed within 180 days of discharge, with a
    goal of providing benefits within 60 days after release or
    discharge from active duty.
        Unfortunately, members of our National Guard and Reserve
    have little or no access to the BDD program and are not able to
    expedite the processing of their VA claims. Can either of you
    talk to me about what members are doing to make sure that the
    VA does get them benefits more quickly?
        General Vaughn. Senator, you know, early on we put liaison
    officers and general officer over there to work these type of
    activities. I think we are getting better. You know, when we
    started out down this track, I mean it was like, you know, we
    were out in left field, you know, on the whole thing. The
    report that I get says that there is progress on this, but this
    is a continuing education piece that kind of goes in line with
    this blast tracking thing. Well, all systems were not set up to
    be advantageous for anyone, you know, that had an injury or
    follow-on care. And, you know, when they talk about the
    seamlessness between the services, you know, and whatnot, it is
    just not true. The benefits in the way we fly into the various
    healthcare systems is the primary bugaboo in all this. And
    again, you know, I'm stumbling around on the answer, but I will
    tell you we have people engaged, you know, with you, with VA,
    and you have heard my answer on the blast tracker. They are key
    to what we are going to do.
        Senator Murray. Yes. General Wyatt.
        General Wyatt. Senator Murray, I echo the comments of
    General Vaughn. The problem on the Air National Guard side is
    that we are kind of late to the game as far as the blast
    tracker and the information that we have.
        I know that--and I am going to relate back to my experience
    as the Adjutant General in Oklahoma. I deployed the 45th
    Infantry Brigade combat team to Iraq in 2007, and we did not
    have such a program. I was not smart enough to figure out that
    we needed the program, but the University of Oklahoma was. And
    they came forward with an offer out of their pockets to fund
    baseline studies of our soldiers. We could not make them do
    that, but we offered that service to them that provided a
    baseline so that if something happened in theater, at least we
    would have a baseline to operate from to measure the degree of
    injury.

                                 BLAST TRACKER

        The advantage of the blast tracker is that it does that,
    but it also operationalizes the reporting, which I think is key
    to the whole situation. When we try to tie that to Veterans
    Affairs benefits, when the soldier, airman, sailor, or marine
    comes home, we still have problems in that at the joint force
    headquarters of our various States, some of them are resourced
    rather well to facilitate the integration of those services
    into not only post-mobilization briefings and Yellow Ribbon
    reintegration programs, but also before they deploy.
        And that is one of the reasons that the Air National Guard
    needs to get more in tune with what the Army National Guard is
    doing and to follow their lead, integrate with their program
    because the Adjutants General, whether they wear blue, green,
    whatever color uniform, are responsible for all of the soldiers
    and airmen in their formations. And what I am hearing from the
    Adjutants General is that they need the flexibility to
    administer the program within their States, but they need
    access to the VA. And it needs to rely upon the strength of the
    national VA, not necessarily the strength of the State VA
    programs.
        We have a very strong State VA program in Oklahoma, but I
    am advised that that is not true in a lot of States.
        Senator Murray. Right.
        General Wyatt. And soldiers and airmen should not have to
    rely upon the inequities----
        Senator Murray. Wherever they live. Yes.
        General Wyatt [continuing]. In the State VA systems to
    acquire the care that they need.
        Senator Murray. So we have made some progress, but there is
    lots of work left to do, so don't take our eye off the ball,
    right? Okay.
        General Vaughn, I did want to ask you one other question.
    Since our last hearing, I am excited that you established a
    National Guard Youth Challenge Program in the State of
    Washington. I had the opportunity to meet a couple of cadets
    from the program, and I think it is great. If you can just give
    us a quick update on what is happening with that.
        General Vaughn. You know, a tremendous program. And as you
    know--you mentioned being excited about it. I think 34 States
    that we are up to now. There is always a struggle for
    resources, and so I think that there is probably some language
    that has to do with making it a little bit easier for the
    States right now to be involved in this.
        I would recommend everybody support that to the maximum
    they can. You know, when we look at the great crises that we
    have, one of them is the left-behind, left-out youth of
    America, we really feel good about what we have been able to
    do. The States with Youth Challenge and STARBASE programs for
    the left-out and left-behind--you know, we run one of the
    Nation's largest GED-plus programs to get their GEDs, and then
    ship them on to active duty, and whether they come back to the
    Guard or Reserve or active Army, we care less. We just want to
    turn them around.
        I think there is another piece to this. I think there is a
    high school piece that we need to be involved in, and I think
    this goes to the dropout piece. I think you link great
    programs, Youth Challenge, STARBASE, but in order to get a high
    school degree with those folks who have dropped out, you know,
    after their sophomore year, and you look at the Youth Challenge
    statistics--I mean, the number just jumps day after day about
    all those that make the tragic mistakes and cannot carry on
    with a great life and end up averaging us like $750,000 apiece
    for incarceration for the rest of their lives. And the
    percentage is huge. So it is a staggering problem, and there is
    great talent out there.
        I am not saying we should run social programs necessarily
    in the Army Guard, but we have got such an outreach here that
    the loyalty that you see from, for instance, those folks that
    go through the GED-plus program and Youth Challenge toward our
    Nation and giving everybody a second chance, I think it is the
    way we recruit. I think it is a big piece of the educational
    benefits. I think it is an education piece that we ought to be
    jumping after.
        So am I for big-time Youth Challenge? Absolutely. And you
    have seen the tear-jerking things that I have. We have had
    folks testify that, you know, if you had not given us a
    turnaround, I would not be a surgeon today. We actually had
    that happen 2 years ago, you know. And so we all need to watch
    it, and I know that the question is loaded.
        Senator Murray. I think that is absolutely great.
        General Vaughn. I really appreciate you asking about that.
        Senator Murray. It is a great program, and I want to
    commend you for doing that. We are following it and hoping that
    we can keep it going as long as we have kids out there who need
    a second chance, which I think will be a long time. So thank
    you.
        One last quick question. In December, I sent a letter to
    the National Guard Bureau signed by the whole congressional
    delegation of Washington State requesting to have the HAMMER
    Training Center be named the Western Regional Training Center
    for National Guard Support Teams and Related Training. HAMMER
    is a fantastic facility that trains people on everything from
    weapons of mass destruction to all kinds of other important
    skills. And I wondered if you could give the subcommittee or
    me, if you do not have it today, a written update on HAMMER's
    designation as a national training site.
        General Vaughn. No, I will have to follow up because, you
    know, the way it is broken out, the joint homeland piece comes
    under General McKinley on this. And I'm not pushing--you know
    me. I am candid enough to try to answer the question. But,
    unfortunately, I do not have the data. We will get it to you
    quickly.
        Senator Murray. If you can get it to me, that would be
    great. I appreciate it.
        Thank you very much, Mr. Chairman.
        [The information follows:]

        The Hammer Training Center has provided strong support and
    excellent services to our National Guard Civil Support Teams
    since 2001. The National Guard Bureau has conducted site visits
    to the Hammer Training Center and concurs that the training and
    facilities available for Chemical, Biological, Radiological,
    Nuclear, and high Explosive (CBRNE) training are excellent. At
    present, the number of facilities necessary to meet the
    Nation's CBRNE collective training requirements has not been
    determined and a national training plan for this type of
    mission has not been finalized. We are currently developing a
    capabilities gap analysis and will work in conjunction with
    Northern Command (NORTHCOM) to ascertain the appropriate set of
    CBRNE training facilities. The Army will include the Hammer
    Training Center in its considerations prior to any decisions
    regarding regional training sites.

                         ADDITIONAL COMMITTEE QUESTIONS

        Chairman Inouye. I thank you very much. General Vaughn and
    General Wyatt, on behalf of the subcommittee, I thank you for
    your testimony. And may we, through you, thank the men and
    women of the Air and Army Guards for their service to our
    country? We thank you very much.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
           Questions Submitted to Lieutenant General Clyde A. Vaughn
                Questions Submitted by Chairman Daniel K. Inouye
                            light utility helicopter
        Question. General Vaughn, in the fiscal year 2009 Defense
    Appropriations Act, the Vice Chairman of the subcommittee, Senator
    Cochran, provided the leadership to accelerate the production of Light
    Utility Helicopters. A majority of these helicopters are to be provided
    to the National Guard to meet important MEDEVAC, homeland security, and
    general support missions.
        Could you describe how the accelerated production of the Light
    Utility Helicopter will benefit the Army National Guard?
        Answer. The Army National Guard (ARNG) will begin to see
    significant and positive benefits from the Light Utility Helicopter
    (LUH) production acceleration beginning in fiscal year 2011 and
    subsequent fiscal years. The ARNG Light Utility Helicopter fielding,
    prior to this acceleration, would not have been complete until fiscal
    year 2017. The ARNG, with this acceleration, will now complete fielding
    of its 200 aircraft in fiscal year 2015 which will enhance our ability
    to meet mission readiness in support of our domestic and overseas
    operations. Additionally, this acceleration allows the ARNG to divest
    OH-58 aircraft which the light utility helicopter replaces, over a
    shorter timeframe.
        Question. General Vaughn, approximately three-quarters of the Light
    Utility Helicopters intended for the National Guard are to be equipped
    to support homeland security missions, while the rest are to be
    equipped as MEDEVAC helicopters.
        Is this the right mix of mission equipment to meet the National
    Guard's missions?
        Answer. The Army National Guard (ARNG) and the Army consider
    MEDEVAC Light Utility Helicopters as part of the support capability to
    meet Homeland Security aviation requirements. The MEDEVAC Light Utility
    Helicopter will be an element of the ARNG Security and Support Light
    Utility Helicopter Battalions, one eight ship MEDEVAC company per each
    of the six Security and Support Light Utility Helicopter Battalions.
    The ARNG in coordination with the Army in 2006 developed this mix of
    MEDEVAC and non MEDEVAC Light Utility Helicopters to meet requirements
    for Homeland Security, Domestic Support to Civil Authorities, Training
    and ARNG Post, Camp and Station requirements. We have preliminarily
    indicated to the Army leadership that we believe there are still some
    light utility helicopter capability gaps within the ARNG and that we
    would pursue options to define those gaps and requirements within the
    very near future.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
                             military construction
        Question. In your prehearing testimony, you stated: ``Many of our
    aging facilities are in need of repair or replacement. The continued
    strong support of the Congress for Army National Guard military
    construction and facilities sustainment, restoration, and maintenance
    funding is crucial to our readiness.''
        a. Is the Army sufficiently attentive to the Army National Guard's
    Military Construction needs to ensure the Army National Guard can meet
    its state and federal obligations?
        b. What is the impact of these ``aging facilities'' on the Army
    National Guard's ability to perform its dual state/federal missions?
        Answer. a. Yes. The Army established a Reserve Component Military
    Construction General Officer Steering Committee (MILCON GOSC). The
    MILCON GOSC is a forum in which General Officers from the HQDA Staff
    and ten General Officers from the National Guard and U.S. Army Reserve
    meet every 6 months to discuss priorities and programs of the National
    Guard and Reserve Components.
        Total Long Range Plan requirement for military construction is over
    $13 billion and our current average budgeted level around $500 million.
        b. With the increased demand on the Army National Guard, there is
    an increased risk to carry on in functionally obsolete and energy
    inefficient facilities. There are cases where work functions are spread
    over several buildings or locations, resulting in spending time
    traveling rather than training. Our aging facilities are showing the
    wear with leaky windows, limited insulation and worn our mechanical
    equipment.
        We continue to make strides to improve our facilities and you can
    be assured that the Guard continues to achieve a high performance level
    in support of our dual state/federal missions in spite of aging
    facilities.
                            family readiness levels
        Question. A recent RAND study noted concerns about the readiness
    level for families of deploying members of the Guard and Reserve. Only
    60 percent of spouses surveyed felt their family was ready for the
    deployment. Almost 80 percent reported some type of deployment-related
    problem.
        How does the Army National Guard support families before, during,
    and after their servicemember's deployment? Is the Army Guard pushing
    the right information to families at the specific time it is needed?
        These problems are particularly acute when the servicemember
    deploys with a different unit (such as when an Illinois reservist and
    deploys with a California unit).
        Answer. The National Guard Yellow Ribbon Reintegration Program and
    supporting initiatives are the key instruments to support our families
    before, during and after their Soldier's deployment. The Yellow Ribbon
    Program consists of events at seven critical points during the
    deployment cycle: (1) Alert, (2) Pre-Deployment, (3) During
    Deployment--within 90 day of Soldier's departure, (4) During
    Deployment--within 90 days of Soldier's return, (5) Reintegration--
    about 30 days after return from Active Duty (REFRAD), (6)
    Reintegration--about 60 days after REFRAD, and (7) Reintegration--about
    90 days after REFRAD. Events 2-6 are primarily for providing Families
    with information, resources, points-of-contact, and similar information
    to support them before, during and after their Soldier's deployment.
    They will receive briefings on how their benefits will change, where
    they can go if they need information or financial assistance while
    their Soldier is gone, information regarding childcare, respite and
    youth programs designed to support their children and increase their
    resiliency. They will receive Family Program and Family Readiness Group
    points-of-contact, as well as resources within their community. During
    deployment events focus on financial readiness, stress management,
    preparing for the Soldier's return, Battlemind Training, and other
    resiliency-building and life skills seminars. Reintegration events
    include resources that support the Soldier's transition back to
    civilian life and provide information and resources to address the
    potential stresses that may arise during that transition--Job Fairs,
    Strong Bonds Marriage and Single Soldier Relationship Enrichment
    Seminars, Strong Bonds Family Seminars. Local points-of-contact from
    the Department of Labor, Veteran's Affairs, Law Enforcement, and other
    community partners also participate in these events and provide
    information about the programs that support Veterans and their
    families.
        The National Guard Yellow Ribbon Reintegration Program policy
    memorandum outlines the events and resources that should be provided.
        In addition, the Soldiers, Families Support Services Division
    publishes a bimonthly magazine, called The National Guard Soldier &
    Family Foundations. It is distributed to the homes of 350,000 Soldiers.
    The magazine provides information about support programs and resources
    and highlights feature stories about the Soldiers and their families.
    The National Guard Soldier & Family Foundations magazine has been well-
    received and reaches even those families that opt not to attend Yellow
    Ribbon events.
        Question. How does the Army National Guard provide family support
    when a servicemember cross-levels with another unit?
        Answer. The family support process may vary by state/territory, but
    in general, when a Soldier is mobilized, his/her information is pulled
    from Standard Installation Division Personnel System (SIDPERS) database
    and downloaded to the Guard Family Management System. The State Family
    Program Director (SFPD) from the Soldier's home state will contact the
    Program Director from the gaining state. When the Soldier goes through
    the Soldier Readiness Process (SRP) at the unit, prior to going to the
    mobilization site, Family contact and location information is gathered.
    The SFPD then distributes this family information to the Family
    Assistance Center closest to where the family lives. For example, if
    Soldiers are cross-leveling from the state of California (CA) to a unit
    in the state of Indiana (IN), the CA SFPD may contact the IN SFPD to
    establish contact and a flow of information regarding the unit to these
    families and vice versa. Once the Soldiers go through SRP, the Family
    Assistance Center located nearest their home will be reached and
    provided their families' contact information. The Family Assistance
    Center Coordinators are responsible for checking in with families of
    deployed Soldiers on a monthly basis to ensure they have the support
    and assistance they need while their Soldier is deployed.
        The deploying unit's commander can establish a Virtual Family
    Readiness Group (VFRG) page as well where family support information
    can be made available to unit families regardless of their geographical
    location.
        Some of our main challenges that we are facing are: Soldiers
    providing incorrect contact information or no contact information for
    their families; families move during the deployment and do not provide
    forwarding information; and families opting not to be contacted.
                             deployment challenges
        Question. Before 9/11, it was uncommon for large units of a
    particular state Guard to deploy as a large group (such as an entire
    brigade). For example, the current Illinois deployment is the largest
    deployment of state Guard members since WWII. Other states have
    likewise had large groups of their civilian populations called to
    active duty to deploy with National Guard units.
        How has the Army Guard managed the administrative challenges of
    deploying so many members from one location at one time?
        Answer. The Army National Guard (ARNG) has developed several
    Information Technology solutions to assist the States and Territories'
    mobilize Soldiers more efficiently. We created ``e-mob'' to leverage
    the interactive Personnel Electronic Records Management System (iPERMS)
    records of individual Soldiers to be accessed anywhere via the WEB. The
    use of the RCAS application of the Mobilization Personnel Data viewer
    and the ability to load records into the Active Components Deployment
    and Reconstitution Tracking Software (DARTS) application has helped to
    process personnel in a more expeditious manner. The Line of Duty (LOD)
    Investigation Module developed into the Army's Medical Operational Data
    System (MODS) has greatly enhanced the processing and documenting of
    injuries incurred during mobilization from approval that used to be
    almost a year down to approval in days from submission. The ARNG
    administers the TRICARE Early Eligibility Program to transition
    Guardsmen and their families to DOD's Healthcare system before
    deployment.
        Today most of our States and Territories Joint Forces Headquarters
    field ``White Cell'' teams consisting of administrative personnel who
    meet the redeploying unit and work with the various Power Projection
    Platforms during the Demob process to ensure Soldiers have completed
    Line of Duty, Evaluations, awards and try to convince Soldiers injured
    and ill while deployed to stay on active duty through the Medical
    Retention Process (MRP) or at least be examined through the MRP-E
    (Examination) program to rule out long term injury that would be better
    treated at a Military Medical Treatment Facility. This effort is an
    unfunded requirement often taken out of other programmed requirements
    in order to better take care of our Soldiers.
        Question. What steps are the Army Guard taking to make sure it is
    ready to deal with the reintegration of so many soldiers of one
    community?
        Answer. The ARNG has implemented the Yellow Ribbon Combat Veteran
    Reintegration program in accordance with the joint guidance issued by
    National Guard Bureau and with funding allocated for this purpose. The
    objective of the Yellow Ribbon program is to facilitate the post-
    mobilization reintegration process and reconnect the Service member
    with his or her Family, employer, and community while providing
    information and access to national, state and local resources. Over the
    past few years, the ARNG has established a framework for successful
    Yellow Ribbon events in support of large unit reintegration involving
    Soldiers and units that are dispersed over a multi-state area:
      --Timely and accurate information dissemination at all levels.
      --Emphasis on Family Readiness Group outreach programs including e-
            mails, newsletters, and communication from all levels in the
            chain of command.
      --Utilization and coordination of resources at the local level to
            minimize logistical challenges and limit the need for extensive
            Soldier and Family Member travel.
      --Utilizing the newly fielded Joint Services Support (JSS) portal to
            coordinate and disseminate Yellow Ribbon events and ensure
            maximum Soldier and Family Member participation.
      --Providing Yellow Ribbon contractors beginning fiscal year 2009 to
            augment state efforts; these contractors assist in all phases
            of the event to provide training, briefings, and activities
            that support Service Members and their Families while ensuring
            effective information flow at all levels.
                         individual ready reserve (irr)
        Question. In the last year, how many Individuals Ready Reserve
    (IRR) soldiers has the Army National Guard requested to help fill its
    deploying units? Of that number, how many were involuntarily mobilized?
    Of the number of IRR soldiers requested, how many ultimately mobilized
    and deployed with the Army National Guard?
        Answer. The requirements were for 2,312 Soldiers.
        Mobilized Soldiers--97 were voluntary and 5,671 were involuntary
    for a total 5768.
        The 1,368 Soldiers joined units between July 15, 2008 through July
    15, 2009.
        Question. At the hearing, you stated that the Army National Guard
    will continue to fill certain Military Occupational Specialties with
    IRR soldiers.
        Please provide me with a list of these specialties.
        Answer. Top Military Occupational Skills (MOS) and grade:
      --11B E4 (Infantry)
      --11B E5 (Infantry)
      --11B E3 (Infantry)
      --88M E4 (Transportation)
      --31B E4 (Military Police)
      --88M E3 (Transportation)
      --68W E4 (Health Care Specialist)
      --92F E4 (Fuel Handler Specialist)
      --63B E4 (Mechanic)
      --31B E3 (Military Police)
        Question. As described at the hearing, family support and
    reintegration can be difficult for soldiers and their families when the
    soldier is cross-leveled.
        What changes in procedure are necessary for Army National Guard
    units to be able to cross-level IRR soldiers who already live near the
    unit?
        Answer. The Army National Guard (ARNG) supports drawing IRR
    Soldiers from the same State as the mobilizing unit they will join when
    such is feasible. This could be accomplished via a two-step process for
    filling IRRs that would garner IRR fillers from the same State as the
    mobilizing unit where possible.
        Under the current practice, the ARNG sends a request for IRR
    Soldiers through channels to HQDA G1. The G1 has a contractor (ASM
    Research) run a database query, identify the population of suitable IRR
    Soldiers to fill the requisition, and order them to duty (plus an
    appropriate overage to account for expected attrition). The process as
    currently conducted does not take the Soldier's geographical location
    into account.
        Our proposal would be to add an intermediate step: When ASM
    Research received our IRR requisition, they would identify all
    qualified candidates for fill. From this population, they would first
    apply any qualified IRRs living in the same State as the mobilizing
    unit, and then turn to the national population to fill any shortfall
    not covered by IRR residents of that State (to include the overage
    required to offset attrition at the re-training or ``re-greening''
    station).
        This modified approach would have at least four benefits:
        First, it would provide a recruiting opportunity for the ARNG.
    Currently we have little opportunity to retain IRR Soldiers that serve
    with our units as they usually live in another geographical area
    outside commuting distance. By filling with IRRs residing in the same
    State first, however, it gives us the opportunity to capture and retain
    IRR Soldiers serving with our units who become bonded with their
    colleagues during the deployment, as there is a greater chance that the
    Soldiers would reside close enough to commute to drill with the
    Soldiers they bonded with in combat.
        Second, it would help the Soldier by enabling the unit to include
    the Soldier's family in all support group activities and family support
    while the Soldier is deployed, which is difficult now as the families
    usually do not live in the same geographical area as the unit.
        Third, by affiliating with the local-area deploying ARNG unit prior
    to attending re-training (as required of all IRR Soldiers) the IRR
    Soldier is now affording the opportunity to prepare for remedial
    training and has a familiar chain of command to assist with any
    personal, family, or administrative issues through the home station
    ARNG unit while at training.
        Fourth, it would facilitate accomplishment of all required
    reintegration activities by the Soldier with the unit he or she
    deployed with--again, difficult now as the Soldier does not reside in
    the same geographical area and may not live near a military
    installation.
                                   personnel
        Question. The fiscal year 2009 Omnibus contained the provision to
    help federal employees in the National Guard and Reserves avoid a loss
    of income when they are called the active duty.
        What efforts will the Army National Guard undertake to quickly
    implement this new provision?
        Answer. How quickly the Army National Guard implements any new
    authority/program is dependent upon DOD publishing an Instruction or
    Directive, then the Army must publish guidance to their Components.
        Question. Can you provide the number of current Army Guard members
    who are federal government employees?
        Answer. The Army National Guard has 32,927 Non-AGR personnel who
    are federal government employees.
        Question. Of that number, how many have served at least one tour in
    Operation Enduring Freedom or Operation Iraqi Freedom? How many are
    currently deployed?
        Answer. Of the 32,927 Soldiers who are federal government
    employees; 4,312 are currently mobilized for Operation Iraqi Freedom
    and Operation Enduring Freedom, and are receiving Hostile Fire Pay.
        Since September 11, 2001, there have been 20,688 Army National
    Guard federal government employees (identified by unique social
    security numbers) from the list who have received Hostile Fire Pay for
    Operation Iraqi Freedom or Operation Enduring Freedom.
                                     ______

                   Question Submitted by Senator Patty Murray
                                     hammer
        Question. In December, I sent a letter to the National Guard Bureau
    signed by all the members of the Washington State Congressional
    delegation requested to have HAMMER training center be named the
    western regional training center for National Guard Civil Support Teams
    and related training. In the case of events with weapons of mass
    destruction, National Guardsmen trained there can identify the type of
    agent used to help support police, firefighters and other emergency
    workers who would be the first to respond to the problem. ``HAMMER has
    established a reputation as a premier training site because of its
    excellent chemical, biological, radiological, nuclear and explosive . .
    . facilities and skilled on-site Department of Energy radiation and
    nuclear professionals''. HAMMER had 39 Civil Support Teams conduct
    training on its campus in 2007 and 2008 and already has 12 STEP
    training programs scheduled for fiscal 2009, which started in October.
        General Vaughn, can you provide me any update on HAMMER's
    designation as a regional training site?
        Answer. The HAMMER Training Center has provided strong support and
    excellent services to our National Guard Civil Support Teams since
    2001. The National Guard Bureau has conducted site visits to the HAMMER
    Training Center and concurs that the training and facilities available
    for Chemical, Biological, Radiological, Nuclear, and high Explosive
    (CBRNE) training are excellent. At present, the number of facilities
    necessary to meet the Nation's CBRNE collective training requirements
    has not been determined and a national training plan for this type of
    mission has not been finalized. We are currently developing a
    capabilities gap analysis and will work in conjunction with Northern
    Command (NORTHCOM) to ascertain the appropriate set of CBRNE training
    facilities. The Army will include the HAMMER Training Center in its
    considerations prior to any decisions regarding regional training
    sites.
                                     ______

                 Question Submitted by Senator Byron L. Dorgan
                                  end strength
        Question. With increased operational demands placed on the reserve
    component for the past several years, signs of stress and strain are
    showing. All reserve component services are facing increased challenges
    retaining experienced, mid-grade career service members, precisely
    those eligible for retirement after having served 20-years of service.
    I am concerned we are not maintaining a balanced force, retaining
    enough of the very individuals who have gained the benefit of
    experience these past years of increased operations. I'm considering
    introducing legislation that would enhance retention of those
    experienced career servicemembers, providing an incentive to serve
    beyond 20-years, initial retirement eligibility, to continue to serve
    in the reserve component in exchange for lowering the age at which they
    will be eligible to receive retired pay. For example, if a member
    commits to serving 2 years beyond 20, the age for which they are
    eligible to receive retired pay would be lowered by one year.
        What is your opinion of this idea?
        Answer. The Army National Guard (ARNG) agrees, a 1 year reduction
    in retirement eligibility for each additional 2 years spent over 20
    years of service would improve retention and keep experienced mid-grade
    Officers and Non Commissioned Officers (NCO) in our ranks longer.
                                     ______

                   Question Submitted by Senator Thad Cochran
                          monticello readiness center
        Question. General Vaughn, the Monticello Readiness Center in
    Monticello, Mississippi is a 55-year-old facility that is undersized,
    significantly deteriorated, and does not meet Army requirements for
    fire, safety, health codes and force protection. Congress has provided
    planning and design funding for this project and a new facility which
    has been a top concern for the Mississippi Adjutant General for the
    past 6 years; yet it has never been included in the Army's Future Years
    Defense program budget plan. I don't understand how this can be the top
    priority for the State Adjutant General for years and still not be
    included somewhere in the budget.
        In light of the high priority assigned this readiness center by the
    State Adjutant General, I hope you will look into this request and
    ensure this facility and other similar facilities are carefully
    evaluated as a candidate for the Army's construction plans.
        Can you please comment on this?
        Answer. The Readiness Center in Monticello, Mississippi is in poor
    condition and should be replaced. The National Guard Bureau has granted
    design authority funds to the Army National Guard of Mississippi for
    planning and design of the Readiness Center in Monticello.
    Unfortunately, there are insufficient funds available to include this
    project in the Future Years Defense Plan (FYDP).
        The Readiness Center in Monticello, Mississippi is not the only
    Adjutants General top priority project that has not made it to the
    FYDP. These projects compete with other Army priorities for limited
    funds.
                                     ______

         Questions Submitted to Lieutenant General Harry M. Wyatt, III
                 Questions Submitted by Senator Byron L. Dorgan
                            reserve component stress
        Question. With increased operational demands placed on the Reserve
    component for the past several years, signs of stress and strain are
    showing. All Reserve component Services are facing increased challenges
    retaining experienced, mid-grade career servicemembers, precisely those
    eligible for retirement after having served 20 years of service. I am
    concerned we are not maintaining a balanced force, retaining enough of
    the very individuals who have gained the benefit of experience these
    past years of increased operations. I'm considering introducing
    legislation that would enhance retention of those experienced career
    servicemembers, providing an incentive to serve beyond 20 years,
    initial retirement eligibility, to continue to serve in the reserve
    component in exchange for lowering the age at which they will be
    eligible to receive retired pay. For example, if a member commits to
    serving 2 years beyond 20, the age for which they are eligible to
    receive retired pay would be lowered by 1 year.
        What is your opinion of this idea?
        Answer. The Air National Guard is not facing the same challenges as
    our Air Force Reserve counterpart in retaining members past 20 years
    service. Out of 106,635 members assigned 25,378 (23.8 percent) are
    retirement eligible with over 20 years of service, 7,400 (6.94 percent)
    are within 18-20 years service, and 73,857 (69.26 percent) have not
    reached retirement eligibility.
        We agree that legislation to reduce the retirement age for service
    beyond 20 years would be of benefit in retaining members past the 20
    year mark. With the evolution of the increased operational demands we
    believe this incentive would enhance our overall retention.
                          119th wing, hector field, nd
        Question. With the recent increase in the number of Air National
    Guard personnel authorized to provide direct support for contingency
    operations, are there plans to increase the number of authorized and
    assigned personnel in the North Dakota Air National Guard 119th Wing,
    Hector Field, Fargo, North Dakota, providing MQ-1 Predator/MQ-9 Reaper
    unmanned aircraft systems operations?
        Answer. The Program of Record for the 119th Wing, North Dakota Air
    National Guard, is to provide one steady-state Combatant Command
    (COCOM) Combat Air Patrol (CAP) with a surge capability to two CAPs
    utilizing authorized manning through volunteerism and/or mobilization.
    The wings current manning document reflects the necessary manning to
    meet this Program of Record. Currently, the 119th Wing is operating
    under surge conditions, providing two COCOM CAPs utilizing all Air
    Combat Command assigned equipment. Should Air Force requirements change
    to dictate an increase in COCOM CAPs for ANG units, as a steady state
    requirement, the National Guard Bureau will work with to ensure proper
    resourcing, manning and equipping for those units.
        Question. What is the Air National Guard's plan for maintaining
    current C-21 flying mission at the 119th Wing, Hector Field, North
    Dakota? How long will the Air National Guard continue to support this
    mission at its current level of funding, personnel, and equipment?
        Answer. The current C-21 flying mission at the 119th Wing, Hector
    Field, North Dakota is intended to bridge the gap between the loss of
    their F-16s and the establishment of a follow on mission. The National
    Guard Bureau is committed to support the C-21 flying mission at the
    119th Wing until it's follow on mission is in place.
        Question. What is the Air National Guard's plan for procurement,
    assignment and basing the Joint Cargo (C-27) at the 119th Wing, Hector
    Field, Fargo, North Dakota? When will the Air Force procure these
    aircraft, when will they begin to arrive in Fargo, and how many
    aircraft will be permanently assigned to the 119th Wing?
        Answer. The Air National Guard stands ready to support the Air
    Force's commitment and requirement for the C-27 program. The delivery
    schedule and aircraft numbers are dependent upon the Air Force's C-27
    procurement action. The Chief, National Guard Bureau, has announced
    that Hector Field will be one of our units that operate the C-27.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
                    air national guard military construction
        Question. In Lieutenant General Vaughn's prehearing testimony, he
    stated: ``Many of our aging facilities are in need of repair or
    replacement. The continued strong support of the Congress for Army
    National Guard military construction and facilities sustainment,
    restoration, and maintenance funding is crucial to our readiness.''
        Is the Air Force sufficiently attentive to the Air National Guard's
    Military Construction needs to ensure the Air National Guard can meet
    its state and federal obligations? What is the impact of these ``aging
    facilities'' on the Air National Guard's ability to perform its dual
    state/federal missions?
        Answer. Air National Guard (ANG) facilities are constructed to
    support the operational and training requirements for federal missions
    assigned to various ANG locations. As the Air Force accepts ``risk in
    infrastructure'' and limits the availability of current mission
    military construction (MILCON) funding, some facilities will continue
    to age beyond the planned replacement timeline previously expected.
    This will require continued investment with operations and maintenance
    (O&M) funding to keep facilities sustained, restored, modernized, and
    operable until they can be recapitalized. In the case of new mission
    beddowns, some MILCON funding has been provided later than the mission
    dictated, causing additional reliance upon O&M funding for mission/
    facility workarounds. In all cases the missions have been beddown on an
    initial operational capability basis to provide equipment and
    facilities to being training ANG members until permanent full
    operational capability MILCON investments can be addressed.
        State mission capabilities are assumed to be contingent upon the
    existing equipment and infrastructure being available at the local
    bases. As a community based force, the ANG is responsive to community
    needs in the event of local disasters or acts of nature that would
    require the capabilities in place at ANG bases. Thus, the impact of
    ``aging facilities'' on the ANG's ability to perform the State mission
    is judged to be limited and tolerable at the current budget funding
    level.
                       air national guard family support
        Question. A recent RAND study noted concerns about the readiness
    level for families of deploying members of the Guard and Reserve. Only
    60 percent of spouses surveyed felt their family was ready for the
    deployment. Almost 80 percent reported some type of deployment-related
    problem. These problems are particularly acute when the service member
    deploys with a different unit (such as when an Illinois reservist and
    deploys with a California unit).
        How does the Air National Guard support families before, during,
    and after their service member's deployment? Is the Air National Guard
    pushing the right information to the families at the specific time it
    is needed? How does the Air Guard provide family support when a service
    member cross-levels with another unit?
        Answer. The key is to ensure there are effective communications.
    Wing Family Program Coordinators (WFPCs) are trained and are in place
    to assist families and to include them in activities or meetings held
    on base. If there are problems concerning the military member, WFPCs
    work the issue and, as a minimum, they conduct 30 day (monthly) welfare
    calls to maintain regular contact with families to identify issues
    before they become overwhelming.
        During the pre-deployment process, military members fill out a
    family readiness pre-deployment checklist and indicate if the Family
    Readiness Group may contact their loved ones. WFPCs take care of a
    military member's loved ones regardless of location. If they should
    need assistance in a locality other than their home area, WFPCs contact
    the Air National Guard unit that can best provide the services that the
    families are in need of.
        Air National Guard units typically do not deploy all unit members
    at the same time, which is more characteristic of Army National Guard
    units. If there are notional taskings, remaining unit members are
    usually engaged at some level with a deployed member's family (i.e.,
    phone calls, e-mails or visits). There are many personnel who tag on or
    fill in other unit line numbers. Rarely do families relocate as a
    result of a deployment situation. So from that standpoint families are
    supported from their Air National Guard unit similar to when a full
    scale deployment occurs.
        The Department of Defense Yellow Ribbon Reintegration Program
    (YRRP) will help the flow of information between units and service
    member families. With the five phases of deployment identified, the Air
    National Guard's Defense Department YRRP contractor and/or WFPCs will
    have more opportunities to communicate with individual members and
    their families. They will identify their needs and assist them as
    needed. This program will also increase pressure on unit commanders to
    provide assistance to and/or contact service member families.
        Prior to the Yellow Ribbon Program, WFPC conducted a pre-deployment
    briefing for Airmen and their families but family members rarely
    attended. The presentation included but was not limited to the
    following topics: Air National Guard at home for impacted family
    members, healthy/unhealthy coping strategies, readiness planning issues
    (i.e., bill paying, power of attorney, wills, organizing vital
    documents, household/seasonal maintenance activities, etc.) as well as
    resources available to assist families. WFPCs distributed a variety of
    handouts such as Military OneSource information, Military Family Life
    Consultant business cards, Family Services contact information,
    personal organizers, and a guide to Family Readiness.
              federal employees in the national guard and reserves
        Question. The fiscal year 2009 Omnibus contained the provision to
    help federal employees in the National Guard and Reserves avoid a loss
    of income when they are called to active duty.
        What efforts will the Air National Guard undertake to quickly
    implement this new provision?
        Answer. The Office of the Assistant Secretary of Defense for
    Reserve Affairs, Manpower and Personnel, and the Office of Personnel
    Management, in coordination with the Department of Defense, will
    implement the federal employee provision for income replacement. The
    Air National Guard will follow those implementation guidelines when
    published.
        Question. Can you provide the number of current Air Guard members
    who are federal government employees? Of that number, how many have
    served at least one tour in Operation Enduring Freedom or Operation
    Iraqi Freedom? How many are currently deployed?
        Answer. Currently, there are 27,603 members of the Air National
    Guard who are federal government employees. Of that number, 18,878 have
    served at least one tour of duty supporting Operations Enduring Freedom
    or Iraqi Freedom. 1,300 of the 27,603 are presently deployed supporting
    a named contingency operation.
                                     ______

                  Questions Submitted by Senator Thad Cochran
                             f-15 aesa radar system
        Question. General Wyatt, I understand the Air Force previously
    upgraded some of the Air National Guard's F-15s with next-generation
    Active Electronically Scanned Array radar systems, but it has not
    budgeted to complete retrofits on the entire fleet.
        General, can you describe for the Subcommittee the importance of
    the capabilities provided by the next general radars, and provide an
    update on the status of funding for retrofitting the entire Air
    National Guard F-15 fleet?
        Answer. The F-15's air-to-air advantage remains in the Beyond-
    Visual-Range arena. Beyond-Visual-Range requires the ability to detect
    current and future generation airborne threats in order to retain the
    first shot, first kill advantage, which is essential to effective
    employment. The APG-63(v)3 AESA radar provides the Air National Guard
    with the capability to detect, track, and kill asymmetric threats, such
    as cruise missiles and drones, which is paramount in both the Homeland
    Defense and wartime roles. This state-of-the-art AESA radar is flexible
    enough to be continuously upgraded, allowing the Air National Guard F-
    15s to meet future threats and new mission sets that were not
    previously possible. The APG-63(v)3 is performing very well in flight
    test and is months from operational fielding.
        The Air National Guard's minimum requirement is for 48 AESA-
    equipped F-15s. This allows Air National Guard units to provide
    constant 24/7 homeland defense vigilance with AESA radars, while
    simultaneously providing the Air National Guard the ability to deploy
    AESA-equipped F-15s in the Air and Space Expeditionary Force construct
    to meet wartime and combatant commander taskings.
        In fiscal year 2006, Congress appropriated $52.2 million to
    ``procure six AESA systems for the Air National Guard.'' In fiscal year
    2007, Congress appropriated $72 million for ``procurement of AESA
    radars only for the Air National Guard F-15C fleet'' which provided
    eight AESA radars. In the fiscal year 2008/fiscal year 2009 Emergency
    Bridge Supplemental, Congress appropriated $34 million for ``Air
    National Guard AESA,'' providing four AESA radars. The current fielding
    plan for these funded AESA radars is six at Jacksonville, Florida
    (installs beginning in January 2010), six at Portland, Oregon (installs
    beginning in October 2010), and six at New Orleans, Louisiana (installs
    beginning in July 2011).
        Our immediate need is $62.5 million to procure and install
    approximately eight APG-63(v)3 AESA radar systems, six at Barnes,
    Massachusetts and two at Great Falls, Montana. Our preferred option
    would be for $110 million to procure approximately 12 APG-63(v)3 AESA
    radar systems for the Air National Guard. Six of these would be
    installed at Barnes, Massachusetts (104th Fighter Wing) and six would
    be installed at Great Falls, Montana (120th Fighter Wing). This would
    bring the total to 30, leaving an additional 18 to meet the Air
    National Guard's 48 minimum requirement.
                            186th air refueling wing
        Question. General Wyatt, the 186th Air Refueling Wing currently
    flies KC-135 tanker aircraft out of Key Field in Meridian, Mississippi.
    Due to a 2005 Base Realignment and Closure decision, all of their
    aircraft will be reassigned by 2011. The Air Force has talked about
    replacing the tankers with Joint Cargo Aircraft, but I'm told those
    planes won't be available for Meridian until 2015. That creates a 4
    year gap without a flying mission. At last year's hearing, General Blum
    said the Guard Bureau was committed to arranging a mission to bridge
    the flying gap at Key Field.
        General, would you provide us an update on the progress you are
    making in assigning a ``bridge'' flying mission to Key Field.
        Answer. The National Guard Bureau is working with the Air Force to
    identify a ``bridge'' to the future C-27 mission at Key Field,
    Meridian, Mississippi. Following the 2005 BRAC, the Air Force
    identified a Component Numbered Air Force augmentation unit as the
    replacement for the KC-135 air refueling mission and the National Guard
    Bureau announced that Meridian, MS would also receive the C-27 (JCA).
        Due to their experience in the RC-26, the 186th Air Refueling Wing
    at Key Field was selected and is currently conducting mission
    qualification training in the MC-12W. The MC-12W is a manned-
    intelligence, surveillance, and reconnaissance capability which the Air
    Combat Command is fielding to support overseas contingency operations
    in the U.S. Central Command. While this training mission is currently
    considered to be temporary, there is the possibility that it could be
    an enduring mission depending on Air Force established requirements.
    Should the Air Force determine it to be a long-term requirement,
    Meridian would likely be a strong contender for that mission.
                 guard presence on united states/mexican border
        Question. General Wyatt, your testimony outlined some of the
    successes the Guard achieved in assisting the Border Patrol as part of
    Operation Jump Start.
        What presence do we currently have on our southern border?
        Answer. Currently, all Air National Guard personnel on the
    Southwest Border are involved with Counterdrug operations through the
    Joint Force Headquarters of the bordering states of Mexico. The
    missions the Air National Guard participates in include: Incident
    Awareness and Assessment, Linguist support, Aviation Refueling, and
    Innovative Readiness Training (Civil Engineering). Each state controls
    their border operation. The National Guard, both Army and Air, have a
    total of 681 personnel assigned to the counterdrug effort.
        Question. With the recent escalation in violence on the southern
    border, and the plan announced yesterday by the Administration for more
    federal agents, do you see a need for the continued presence of the
    National Guard on the United States/Mexican border?
        Answer. The National Guard involvement in Operation Jump Start
    provides highly effective cross-functional capabilities to the
    Southwest border. If called upon, we stand ready to fulfill any future
    requirements.
                                    Reserves

    STATEMENT OF LIEUTENANT GENERAL JACK C. STULTZ, CHIEF,
                ARMY RESERVE
        Chairman Inouye. And now we call upon General Stultz, Vice
    Admiral Debbink, Lieutenant General Bergman, and General
    Stenner to come forward to present their testimony on the
    Reserve component.
        Gentlemen, thank you for joining us this morning, and may I
    assure you that your full statement will be made part of the
    record? May I now call upon General Stultz.
        General Stultz. Yes, sir. Mr. Chairman, Mr. Vice Chairman,
    and Senator Murray, it is an honor to be here.
        Senator Inouye, I would like to report to you first--go for
    broke--that 100th of the 442d, I just visited them recently in
    theater. They are doing very, very well. It is their second
    deployment out of the Pacific. And I also sent a task force
    just recently out to the Pacific to visit their families to
    make sure we are taking care of them. They were in Guam,
    Saipan, and Samoa, and so the 442d is doing well, your old
    regiment, and proud to serve this Nation.
        Thank you, first of all, from the 204,000-plus Army Reserve
    soldiers that I represent here today for what you have done for
    us in terms of your support, things like the National Guard and
    Reserve equipment account and other appropriations, and what
    your staffers have done for us, working very diligently with us
    to maintain support for our Nation through the Army Reserve.
        I have submitted my statement for the record, so I do not
    want to take up any time there, but I do want to highlight one
    thing.
        The theme that you will see in the Army Reserve posture
    statement and us going forward this year is return on
    investment. And what we are trying to highlight is what a great
    return on investment your Army Reserve is for this Nation. The
    dollars that we are given to operate with we value, and we
    invest them very, very carefully to make sure that we are
    getting all for our Nation.
        As you well know, 2009 for the Army is the Year of the
    Noncommissioned Officer, and today I have got three
    noncommissioned officers (NCOs) with me, and I would just ask
    them to stand. And it really is to highlight the Year of the
    Noncommissioned Officer, but for the Army Reserve, it really
    highlights return on investment, return on this investment that
    we get for this Nation. I will give you just a couple of
    tidbits here.
        Sergeant Jason Ford is here with me. Sergeant Ford is a
    drill sergeant. He goes and trains basic trainees at Fort
    Leonard Wood, Missouri. He also deployed for this Nation and
    trained the Iraqi army. While on patrol, leading 25 Iraqis--and
    he was the only American in charge--he came under attack and
    suffered wounds and was awarded the Purple Heart, along with
    the Bronze Star. But when Sergeant Ford finishes his tour in
    Iraq, he comes back home to Brockton, Massachusetts, where he
    is a policeman. That is a return on investment for this Nation.
    That is taking capability that we are building that we provide
    for our military in uniform; but, we bring back to the
    communities of America and put it back into our communities.
        Sergeant Henry Farve from California. He is a diesel
    mechanic, works for the Government, also deployed to Iraq, and
    while there, his son, who happened to be part of 32 Stryker
    from Fort Lewis, was wounded. Sergeant Farve maintained his
    mission even though he had the concerns about his own son, and
    then comes back to America and goes back to work for this
    Government as a diesel mechanic. What a great investment we
    have got.
        We have got to do all we can to retain these great NCOs.
    This is the corps. This is what distinguishes the American Army
    from any other army in the world, our noncommissioned officer
    corps.
        So, I look forward to your questions. I thank you for your
    support. It is because of what you do for us that we are able
    to man America's Army with great NCOs like these individuals,
    as well as bring them back to America's communities. I look
    forward to your questions, sir.
        [The statement follows:]
            Prepared Statement of Lieutenant General Jack C. Stultz
        The annual Army Reserve Posture Statement is an unclassified
    summary of Army Reserve roles, missions, accomplishments, plans, and
    programs. The 2009 Army Reserve Posture Statement also addresses the
    support required in fiscal year 2010 to continue the Army Reserve
    transition to a fully operational force.
        Unless otherwise noted, all statistics and facts are current
    through March 20, 2009. This document is available on the Army Reserve
    Web site at: www.armyreserve.army.mil.

                                                          Winter, 2009.
              the army reserve--a positive investment for america
        After 7 years of war, the most compelling evidence of Army Reserve
    success is the confidence deployed commanders have in the quality and
    ability of our Soldiers. The men and women of the Army Reserve-Warrior-
    Citizens are full-time patriots who put their civilian careers on hold
    to protect American interests at home and abroad.
        Army Reserve Warrior-Citizens represent America's best and
    brightest. The Soldiers' and their Families' commitment and willingness
    to sacrifice at home, or by carrying the fight to the enemy on desolate
    battlefields, allow Americans to pursue their dreams and live free from
    fear. In this document, we highlight the remarkable quality of the
    people on the Army Reserve team: men like the Harvard-trained physician
    who, after age 50, applied his medical expertise to saving lives on the
    battlefield; or the commercial airline pilot who put his civilian
    career on hold to serve as a trainer with the Army Reserve; or the
    lawyer with an MBA and a successful professional career, serving as an
    aviation mechanic in the Army Reserve. Men and women like these, and
    countless others, add immeasurable value to the Nation.
        The contribution of Citizen-Soldiers, their Families, and prudent
    investments over the course of this decade, have allowed the Army
    Reserve to evolve from a strategic reserve to an indispensable
    operational force. In this environment of persistent conflict,
    turbulent markets, and tight competition for scarce resources, we must
    continue to invest our national treasure wisely. As an operational
    force, the Army Reserve is one of the best returns American taxpayers
    get for their money. To continue to succeed, the Army Reserve requires
    your support.
        The Army Reserve leverages your investment to attract and develop
    talent. The expertise we nurture is employed on the battlefield and in
    the boardroom. Army Reserve Soldiers bring cutting-edge ideas from the
    marketplace to the military, enabling the Army to accomplish missions
    with maximum impact and minimum risk. In turn, Army Reserve Soldiers
    bring the skills and values they acquire in uniform-leadership skills,
    decision-making ability, confidence, and discipline-back to American
    industry to build stronger businesses and stronger communities.
        To maximize Americans' return on investment, we have streamlined
    our command and control structure, standing down non-deployable support
    commands and establishing in their places operational and functional
    commands. Reducing the number of support headquarters and developing
    more deployable commands is generating more specialized capabilities in
    our core competencies: medicine, transportation, supply, civil affairs,
    military police, engineers, intelligence, and chemical, among others.
        We are aggressively refining our training strategy to reduce post-
    mobilization training time and maximize Boots on the Ground
    contributions of our fighting units. Following the dictates of the Base
    Realignment and Closure (BRAC) Commission we are disposing of outdated
    facilities and replacing them with state-of-the-art centers to optimize
    training and support. Our training strategy, along with new facilities,
    will better prepare our Soldiers for the challenges ahead. Continuing
    to refine these efforts requires resources to complete BRAC mandates,
    develop and employ advanced training techniques, and to acquire
    technology enablers: communications and information systems, training
    simulators, and cutting-edge medical processes.
        We continue to improve readiness at all echelons. During our
    transition from a strategic to an operational force, we have recognized
    the need and advantage of having leaders and staff working full-time to
    support and prepare units in advance of their deployment. We continue
    to seek, and have commissioned research to determine, the optimum
    amount of full-time support to build and sustain readiness. We will be
    working with Congress closely this year to achieve this objective.
        The Army Reserve provides capability the Army could ill afford to
    maintain on active duty. The unique skill sets of Warrior-Citizens have
    proven, over the course of a century, to be cost effective and cost
    efficient. We are further striving to improve our value by striking up
    strategic partnerships with industry. Our way ahead is to build
    America's premiere skill-rich organization by teaming with civilian
    employer partners to produce a human capital strategy model for the
    21st century. Our efforts to create a public-private partnership to
    find, develop, and share talent will leverage the creativity and
    responsiveness of the civilian sector with the organizational skills,
    discipline, and leadership talent of the military. Working with
    industry, we develop our greatest asset--people. At the same time, we
    ensure the security of a system to realize peace and prosperity,
    keeping America shining as a beacon of hope for a troubled world.
        Over the history of the grand American democratic experiment, our
    Nation has risen to greatness because of the character of ordinary
    citizens and their willingness to defend freedom. The Warrior-Citizens
    of the Army Reserve and their Families embody that lasting commitment
    to serve. Since September 11, 2001, more than 170 Army Reserve Soldiers
    have sacrificed their lives in the fight against tyranny. Today,
    thousands stand in harms way, while tens of thousands more stand ready
    to answer the call. America can make no better investment.
        Thank you for your untiring support of the Warrior-Citizens of the
    Army Reserve.

                             Lieutenant General Jack C. Stultz,
                                              Chief, U.S. Army Reserve.
                            Command Sergeant Major Leon Caffie,
                             Command Sergeant Major, U.S. Army Reserve.
                     fiscal year 2008 return on investment
        As America remains a Nation at war, the Army Reserve continues to
    be a cost-effective force. In fiscal year 2008, the $6.9 billion Army
    Reserve appropriation represented only 4 percent of the total Army
    budget, yet we achieved remarkable accomplishments:
        Personnel.--In 2008, we recruited 44,455 Soldiers and reenlisted
    16,523 (111 percent of our annual goal), yielding a net gain of 7,142
    in our ranks. Sustaining momentum to build personnel strength is the
    most important priority for the Army Reserve. Due to significant gains
    in end strength for fiscal year 2008, the Army Reserve is on schedule
    to meet its 2010 end strength objective of 206,000 Soldiers. The Army
    Reserve continues to implement a series of programs to attract skill-
    rich professionals. Future strategic recruiting initiatives target
    shortage specialties, mission-critical skill sets, and mid-grade
    officer shortages. Through our Employer Partnership Initiative, we
    produce a human capital strategy. Businesses and the Army Reserve now
    share in the training and development of quality individuals who
    contribute to both our Nation's defense and the economy. Our
    collaboration with industry in recruiting eliminates the unnecessary
    expenditure of resources when recruiting in competition with each
    other.
        Readiness.--In 2008, we mobilized more than 27,000 Warrior-Citizens
    in support of the Global War on Terror. We developed Regional and
    Combat Support Training Centers (CSTC) to enhance unit readiness,
    increasing the time our units are available to combatant commanders.
    Our civilian-related skills and highly experienced Soldiers afford our
    Army its extended stability operations capacity. We increased the Boots
    on the Ground time for: Combat Support Hospital units by 45 days,
    Military Police Battalions by 37 days, and Combat Engineer Companies by
    31 days by streamlining pre- and post-mobilization training schedules
    and eliminating all unnecessary and duplicate activities. As a federal
    force with personnel and equipment nationwide, we provide a unique
    capability as a Department of Defense ``first responder'' in times of
    domestic emergencies.
        Materiel.--We attained or exceeded the Army standard of 90 percent
    availability for reportable equipment that requires maintenance. All
    redeployed equipment not inducted into national level maintenance was
    recovered, repaired, and serviced. In light of acknowledged shortages,
    this equipment was then immediately transferred to ``next deployers''
    or critical training locations in order to sustain pre-mobilization and
    pre-deployment training.
        Services and Infrastructure.--We strengthened programs to improve
    the well-being of our Soldiers and their Families. The development of
    the ``virtual installation,'' which afford Soldiers and Families ready
    access to services and pre/post-mobilization transition assistance, is
    the cornerstone of this effort.
                            army reserve priorities
        Continue to provide the best trained, best lead, best equipped
    Soldiers and units to combatant commanders to achieve U.S. objectives
    and ensure national security.
        Recruit and retain the best and brightest Warrior-Citizens to
    sustain a robust and capable operational Army Reserve.
        Transform the Army Reserve (operational structure, support
    services, and training and equipping paradigms) to optimize the
    efficiency and effectiveness of a fully operational force.
        Provide Warrior-Citizens and their Families with the training,
    support, and recognition to sustain a cohesive, effective fighting
    force.
        Build and maintain a partnership with industry to facilitate the
    Warrior-Citizens' contribution to both a prosperous economy and a
    skilled, experienced, and capable Army.
        To advance these priorities, the Army Reserve must obtain from
    Congress full support and necessary authorities.
        The President's budget requestwill allow the Army Reserve to: Grow
    and maintain Army Reserve end strength; continue Army Reserve
    transformation; improve medical and dental readiness; equip units and
    soldiers to train and fight; provide quality services and support to
    soldiers and their families; and sustain Army Reserve installations and
    facilities.
                               strategic context
        In accordance with Title 10 of the U.S. Code, the United States
    Army Reserve ``provides trained units and qualified persons available
    for active duty in time of war or national emergency.'' Since the
    September 2001 attacks on America, the Army Reserve continues to
    deliver on its Title 10 obligation by serving in a prolonged
    operational capacity for which it was originally neither designed nor
    equipped, but for which it is currently being transformed. Each day,
    Army Reserve Soldiers and their Families make unprecedented sacrifices
    in response to lengthy and repeated deployments. The Army Reserve is an
    operational force providing critical combat, logistics, and stability
    support capabilities for homeland defense, overseas contingencies, and
    war. The demands of today's conflict, coupled with the existing and
    foreseeable stresses on our force, have redefined the way this
    institution, the Army, and the Nation views the Army Reserve.
        The Army Reserve defines itself as a community-based, federal
    operational force of skill-rich Warrior-Citizens, that provides
    integral capabilities for full spectrum operations. The basis of this
    definition is reflected in the fact that today Army Reserve forces
    mobilize almost continuously. The Army Reserve has supported nine major
    operations and several lesser contingencies since 1990. This legacy of
    service and our most recent contributions set the conditions necessary
    to embrace the future for the Army Reserve.
        One way to view this future is to look at the Army Reserve as an
    enterprise organization: a conceptual model applying a holistic
    approach to strategic leadership to improve organizational
    efficiencies. The enterprise approach is fundamentally about seeing the
    entire organization--its relationships among its people, processes,
    functions, and organizational parts.

        In this document, we present the Army Reserve enterprise across
    four core management areas: Personnel, Readiness, Materiel, and
    Services and Infrastructure.
        To optimize Army Reserve performance we must:
      --Attract and retain the very best Warrior-Citizens to serve our
            Nation (Personnel);
      --Prepare, train, organize, and equip Soldiers and units (Readiness);
      --Provide Soldiers with the latest, mission-ready, modular force
            weapons and equipment (Materiel); and
      --Provide for the well-being of our Soldiers, Families, Army
            Civilians, and employers while providing state-of-the-art
            training capabilities, unit facilities, and secure, redundant
            communications (Services and Infrastructure).
        The following sections of this document highlight our
    accomplishments and discuss the challenges and needs for strengthening
    the organization across these core functions (Personnel, Readiness,
    Materiel, and Services and Infrastructure). The Army Reserve will
    continue to generate a positive return on investment building,
    sustaining, and maintaining warfighting and support capability for
    America.
    Personnel
        Today's Army Reserve Soldiers are patriotic men and women who have
    a vision for their lives, have roots in a civilian community, and have
    a desire to serve their country. Their commitment translates into our
    success.
        The Army Reserve exceeded its fiscal year 2008 recruiting and
    retention objectives by accessing 44,455 new recruits and retaining
    16,523 Soldiers. Yet, recruiting an all-volunteer force in a time of
    war presents challenges. The Army and the Nation face significant
    hurdles--from a lower propensity of young people to enlist, to a
    shrinking pool of fully qualified prospects, to an increasing trend of
    mid-grade Soldiers leaving the service.
        One initiative the Army Reserve is advocating to combat the loss in
    mid-grade ranks is a ``continuum of service'' for a fully integrated
    force--active and reserve. By presenting options, the Army Reserve
    hopes to create an environment for Soldiers to move back and forth
    among components as their personal lives and civilian careers dictate.
    We have taken this continuum concept a step further with our Employer
    Partnership Initiative by developing a human capital strategy model to
    leverage the skill sets of volunteers, the innovations of industry, and
    the human development capacity of the Army.
                Increasing Army Reserve End Strength
        During fiscal year 2008, the Army Reserve increased end strength by
    7,142 Soldiers. A successful community-based recruiting effort;
    targeted programs and incentives; and personnel policies to control
    unanticipated losses resulted in this substantial net gain.

        ----------------------------------------------------------------

                                 Critical Needs
        Obtain from Congress full support and necessary authorities.
      --Sustaining recruiting and retention incentives for Army Reserve
            Soldiers, with specific emphasis on mid-grade commissioned and
            noncommissioned officers;
      --Developing and sustaining adequate full-time support (FTS) to train
            and administer a fully functioning, robust, and capable
            operational force, and to ensure Soldier and Family readiness;
            and
      --Enhancing employer partnerships to optimize the development of
            human capital for the mutual benefit of industry and national
            security.

        ----------------------------------------------------------------

        In fiscal year 2008, the Army Reserve achieved 106 percent of its
    accessions goal and 111 percent of its reenlistment mission. Three
    critical initiatives contributed to this progress. Command emphasis and
    guidance provided the greatest impact focusing energy and effort on
    filling the ranks. The Army Reserve Recruiting Assistance Program (AR-
    RAP) brought a tangible reward to Soldiers for finding other patriots
    to serve. This innovative recruiting assistance program produced 3,751
    accessions this past fiscal year. Finally, the Critical Skills
    Retention Bonus, Army Reserve (CSRB-AR), allowed us to address specific
    skill-set and grade shortfalls and retain much-needed talent and
    expertise in our ranks. These targeted financial incentives for
    continued service in critical specialties ensured 809 captains and 128
    experienced staff sergeants and sergeants first class stayed in
    uniform.
        As we gain momentum, building to a strength of more than 206,000
    Soldiers, and while the Army Reserve is within the congressionally
    mandated end strength window, we recognize a significant gap in
    capability. Overall, the Army Reserve is short on the order of 10,000
    officers in the grades of captain and major. In the enlisted ranks, we
    are challenged to develop and retain senior mid-grade noncommissioned
    officers (staff sergeants and sergeants first class). We are working
    aggressively to grow and shape the force to overcome these challenges.
    Continued re-sourcing of recruiting and retention incentives will
    maintain our manning momentum.
                Full-Time Support for an Operational Reserve
        We now have a strategy to guide the transformation of Full-Time
    Support (FTS) in the Army Reserve in order to better support our
    operational force in this era of persistent conflict and global
    engagement. In 2008, we developed an initial strategy called FTS 2017,
    which envisioned a culture shift in how we support the readiness and
    mobilization of Army Reserve units on a continual basis. This strategy
    defines and directs the effort to transform all aspects of Army Reserve
    full-time support. The strategy improves operational capability by
    providing a more dynamic, responsive, and flexible system to support
    global operations.
        Completing the transition from a strategic to a fully operational
    force requires more than having the right-sized full-time support
    force. The current full-time support model remains a strategic reserve
    legacy. Key legislative and policy modifications may be required to
    change personnel support processes. Evolving the full-time support
    program requires addressing: active-reserve Soldier staffing (AGRs);
    Army civilians; contractors; and unit members on orders beyond their
    statutory 39 training days per year.
        Currently three studies are under way to quantify full-time support
    issues and inform policy-makers. One study is determining the adequacy
    of full-time support billets across the Army Reserve and Army National
    Guard. Another study is providing a ``capabilities and competencies''
    analysis of full-time support across the Army Reserve. The third is
    examining the use of dual-status military technicians within the Army
    Reserve. These studies will lead to the development of a capabilities-
    based full-time support solution for the operational demands of the
    Army Force Generation (ARFORGEN) unit training and employment
    construct. We anticipate initial study recommendations by early fall
    2009. At that time, working with Congress, we will determine the
    optimum full-time support strategy and identify additional actions
    required to appropriately staff the organization to sustain the Army
    Reserve as an ARFORGEN-enabled operational force.
                Employer Partnerships
        The Army Reserve is implementing leading-edge employer relations
    programs that promote a continuum of service, sustain Soldiers' well-
    being during mobilization periods, and provide career-enhancing
    employment opportunities. The Army Reserve's Employer Partnership
    Initiative benefits employers by referring highly qualified, competent,
    disciplined Soldiers to work within their communities. By collaborating
    with employers, the Army Reserve can augment existing Soldier
    proficiencies while simultaneously building new capabilities to
    complement civilian job and military skills. By aligning military and
    civilian credentialing and licensing requirements, the Army Reserve and
    partner employers optimize a shared workforce. As employers are
    critical for sustaining the Army Reserve, sharing the same talent pool
    of Soldier-employees builds mutually beneficial relationships.
    Developing and maintaining effective partnerships allows the Army
    Reserve and employers to capitalize on particular strengths while
    minimizing weaknesses.
        Our way ahead is to build a skill-rich organization by working
    closely with civilian employer partners. From an individual's
    perspective, we see it working this way: a local hospital struggles to
    find quality, skilled personnel to fill technical positions. The Army
    Reserve becomes a personnel source for this hospital through our
    Employer Partnership Initiative. We recruit an individual seeking to be
    a radiology technician. We train that individual as a Soldier and
    certify him or her as a radiology technician. After finishing advanced
    training, the Soldier walks into a civilian job with that local
    hospital where that Soldier continues to develop and refine his or her
    skills. Through our cooperative efforts, the hospital and the Army gain
    a more competent, more experienced, and more capable Soldier-employee.
        We see other advantages of partnering with employers. A major
    trucking company--our civilian partner--uses a state-of-the-art
    training center complete with truck driving simulators. Our Army
    Reserve Soldiers--employees of this trucking company--use the
    simulators to confront an array of driving hazards. The drivers train
    and work daily operating trucks safely on the road. When these Soldiers
    get in the cab of one of our military trucks, they are better, more
    experienced drivers. The training and experience they gain from our
    industry partner benefits the Army Reserve. America gets a better, more
    disciplined, service-oriented employee, a more skilled and capable
    truck driver, and a stronger Soldier.
        Over time, our Employer Partnership Initiative will become more
    than a key human capital strategy. It could well serve as the
    foundation of our identity. Two entities share and enhance the skills
    of one individual who contributes both to the defense of our Nation and
    to sustaining a robust national economy. We are building human capital
    in the Army Reserve and the private sector with highly skilled, career-
    oriented Warrior-Citizens.
    Readiness
        Our military success in the Global War on Terror depends on our
    ability to train and equip Army Reserve Soldiers and fully cohesive
    units for current and future operations. Training units for full
    spectrum operations is directly linked to resourcing. The Army Reserve
    applies a sophisticated training strategy to ensure Army Reserve
    warfighting unit readiness. Fully funding the Army Reserve integrated
    training strategy will ensure trained and ready Army Reserve units and
    individual Soldiers are available to meet the operational needs of the
    United States Army.
                Building an Effective, Fully Operational Force
        Army Reserve support of the fiscal year 2008 Grow the Army plan
    began with the realignment of 16,000-plus spaces from generating force
    structure to critically needed operating force structure. As the
    planned end-strength objective is to grow the Army Reserve by 1,000 to
    206,000 Soldiers, we are investing an additional 1,000 spaces to
    increase operating force structure. Together this translates to a total
    17,000-plus spaces of capability. In addition, the Army Reserve
    continues to rebalance and right size by employing new operating force
    modular command and control structure and reducing generating force
    command, control, and support structure. Streamlining command and
    control maximizes available forces to support Army operational
    requirements.
        Army Reserve units are now aligned to headquarters in the same way
    they are aligned on the battlefield. The Army Reserve streamlined its
    institutional force by replacing seven institutional training divisions
    with three training commands to provide initial entry, military skill
    reclassification, and professional and leader development. We harvested
    additional structure as four two-star regional support commands assumed
    the base support operations functions for more than 900 Army Reserve
    centers across the country. These four support commands relieve
    operational commands of facility and garrison-type service functions
    allowing the operational commands to focus on unit readiness and
    training. The Army Reserve continues to explore innovative structuring
    options to maximize the number of warfighting units available to
    support operations.

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                                 Critical Needs
        Obtain from Congress full support and necessary authorities.
      --Continuing transformation of Army Reserve support command structure
            and the building of operational and functional commands,
            properly organizing Soldiers and units to develop capability
            for diverse national security missions;
      --Implementing the Army Reserve Training Strategy (ARTS) to develop
            Soldiers and build cohesive, capable, and effective units while
            maximizing Boots on the Ground and optimizing the Warrior-
            Citizens' impact and contribution to mission success;
      --Implementation of the training strategy involves three primary
            elements:
        --Army School System Training Centers--for developing individuals
        --Regional Training Centers--for unit pre-mobilization training
        --Combat Support Training Centers--for rigorous mission-focused
                training
      --Support for training man-days to sustain the Army Force Generation
            (ARFORGEN) process and maintain the Army Reserve as a fully
            operational force.

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                Improving Medical and Dental Readiness
        Soldier medical and dental conditions have proven to be one of our
    greatest mobilization challenges. More than half of our Soldiers not in
    a mobilization or alert window are not ready to deploy. In 2008, the
    Army Reserve moved aggressively to improve medical and dental readiness
    by addressing a number of Soldier and Family health concerns. The Army
    Reserve Surgeon working with members of the Office of the Surgeon
    General, the U.S. Army Medical Command, U.S. Army Dental Command, the
    Army National Guard, Department of the Army G-3, the Chaplains Office
    and other agencies developed and implemented three paradigm-shifting
    initiatives to improve Soldier and Family readiness:
      --A comprehensive Reserve Component Soldier dental readiness program;
      --A Whole-Life Fitness program to improve the physical, emotional,
            spiritual, social, family, finance, and career facets of
            Soldier wellness;
      --A partnership with civilian medical and nursing schools to educate
            and develop medical professionals for military service.
        Additionally the team identified medical readiness barriers and
    implemented measures to mitigate each obstruction.
        To ensure unit commanders know the status of their Soldiers'
    medical conditions, the Department of Veterans Affairs and the
    Department of Defense must effectively interface. The Reserve Health
    Readiness Program (RHRP) provides the platform for commanders and
    Soldiers to meet medical and dental readiness now. One significant
    advance for the Army Reserve is to develop and adopt automated
    information systems that interface with current medical data systems:
    Medical Protection System (MEDPROS), and eventually Veterans Health
    Information Systems and Technology Architecture (VISTA). The Army
    Reserve adapted a paperless dental record--DENCLASS--and is in the
    process of converting Soldiers' paper treatment records to the
    electronic health readiness records.
        Improving what we know about the status of Army Reserve Soldiers'
    health has set the conditions for the Army Reserve to implement two
    comprehensive treatment programs: Dental Readiness and Whole-Life
    Fitness. Working across agencies and leveraging civilian health care,
    we are treating dental problems and addressing holistically the well-
    being of Soldiers and Families. This effort includes a mental health
    component and is appropriately linked with our Yellow Ribbon
    Reintegration Program efforts.
        We are supporting and promoting these medical and dental readiness
    initiatives with a multimedia communication outreach effort to all
    Soldiers and Families. Our communications efforts and these new
    programs coupled with TRICARE and TRICARE Reserve Select have allowed
    us to address in significant ways our medical and dental readiness
    challenges.
                Focus on Training Readiness
        The Army Reserve is committed to providing trained platoons,
    companies, and battle staffs to combatant commands. To fulfill this
    commitment the Army Reserve must be resourced as an operational force.
    While the mobilization training centers provide the finishing touch,
    the Army Reserve is responsible to develop and sustain the following,
    prior to mobilization: Adaptive, competent, and broadly skilled
    Soldiers prepared for changing operational environments; agile,
    adaptive, and culturally astute leaders; and rapidly deployable and
    employable, trained, ready, and cohesive units.
        We develop readiness through the execution of a progressive Army
    Reserve Training Strategy (ARTS). The training strategy uses the
    ARFORGEN model as the ``means'' to meeting mission commitments.
    Further, the strategy uses three training domains--Soldier, Leader
    Development, and Unit--as the ways of achieving desired training end-
    states. The ``Soldier'' domain concentrates on completing individual,
    functional, warrior task, tactical and low-level collective training.
    The ``leader development'' domain entails completing professional
    military education and preparing leaders and battle staffs to execute
    full-spectrum operations and directed missions. The ``unit'' domain
    requires, through a progression of collective training events,
    achieving unit technical and tactical proficiency for collective tasks
    in full-spectrum and directed mission environments.

                Preparing Army Reserve Forces for Future Missions
        Army Reserve forces are arrayed across the Army Force Generation
    (ARFORGEN) training and employment cycle. The duration of the entire
    cycle is 5 years. Our objective is for a unit to train for 4 years in
    preparation for an ``available'' year where the unit could mobilize and
    deploy. Army Reserve units flow through this cycle aligned within Army
    force pools to meet global mission demands. Units are to spend 1 year
    in the Reset pool, 3 years in Train/Ready pool, and 1 year in the
    Available pool. Army Reserve units can expect to deploy to meet theater
    commander requirements in the available year. Upon returning from a
    deployment, a unit begins the cycle anew.
                Army Reserve Training Centers
        Success in operationalizing the Army Reserve has hinged on our
    ability to reduce post-mobilization training in order to maximize in
    theater Boots on the Ground. In 2008, the Army Reserve stood up three
    regional training centers to execute theater-specific required tasks.
    These tasks are those perishable individual, crew, and leader warrior
    tasks and battle drills that Soldiers must complete to standard prior
    to arriving in theater. The regional training center initiative reduced
    the average amount of training time for Army Reserve units in mobilized
    status from 70 to 40 days, adding 30 days to Boots on the Ground time
    in theater. Currently, regional training centers are ad hoc training
    facilities supported by mobilized personnel and resourced with
    supplemental funds. When regional training centers are resourced we are
    able to leverage this success and ensure an enduring, pre-mobilization
    training capability.
        To further enhance readiness, one of the Army Reserve's key
    training efforts has been establishing a major collective training
    exercise capability--Combat Support Training Centers (CSTC). This
    exercise capability provides support forces a realistic collective
    training experience to assess tactical proficiency under rigorous
    conditions. A combat support training event tailors the environment and
    integrates extensive exercise support capabilities to include opposing
    forces and observer/controllers. The event provides opportunities for
    support brigades and their subordinate units to train on directed
    mission-essential tasks. The CSTC program leverages training readiness
    platforms to provide Army Reserve commanders an array of institutional
    and collective training capabilities to meet training requirements. The
    Army Reserve will conduct a CSTC proof of principle exercise at Fort
    McCoy in July 2009.
                Capabilities-based Army Reserve Centers
        To minimize turbulence for Soldiers and their Families caused by
    training demands during the first 2 years of ARFORGEN, the Army Reserve
    initiated an effort to create capabilities-based reserve centers to
    support full-spectrum individual-crew-squad-team training requirements.
    We are outfitting reserve centers with digital training capabilities
    and weapon simulator training rooms. This effort provides an array of
    targeted training enablers to meet the training needs of units. During
    2008, the Army Reserve established 53 digital training facility
    locations and three weapons simulator training rooms. The Army Reserve
    is working with the Army Training and Doctrine Command to determine the
    way ahead to field additional training enablers to make these state-of-
    the-art facilities. The Army Reserve is also working to integrate these
    training capabilities into new facilities.
                Training Resources
        We are succeeding in managing unit readiness, with the new paradigm
    for training an operational Army Reserve force. Adequate funding allows
    the Army Reserve to execute pre-mobilization training man-days, develop
    infrastructure, and acquire the latest technology and equipment to meet
    pre-mobilization readiness objectives. We lack, however, the ability to
    fully train Army Reserve Soldiers on the same equipment the Army uses
    in the field.
                Reset Pilot Program
        The Army has established several recent key force readiness
    initiatives to prepare units for future missions. One of these
    initiatives is the Reset Pilot Program. Currently the Army Reserve has
    three pilot units for fiscal year 2008 and three for fiscal year 2009.
    In phase one of the program, units complete inventories in theater,
    report combat losses, direct equipment for reset, reserve quotas in the
    Army School System for unit Soldiers, and prepare for home station
    activities. Upon redeployment, the units move to phase two. The units
    conduct a Welcome Home Warrior-Citizen ceremony, focusing on Soldier,
    Family, and employer reintegration and reconstitution of the unit. If
    successful, this reset program will serve as a model to ensure
    redeploying unit readiness.
                Ready Response Reserve Unit (R\3\U) Pilot Program
        The R\3\U Pilot Program is a Department of the Army-directed
    initiative to test the feasibility of nontraditional access and
    employment of Army Reserve units. This pilot will test our ability to
    man, equip, train, and employ units in three specific capability
    categories: short or no-notice employment; support to known basic
    training surge requirements; and sustainment of dental readiness in the
    Army Reserve force. The pilot units being assessed in each category,
    respectively, are a platoon of a biological detection company, a
    company of drill sergeants, and a dental detachment. After bringing
    these units up to the highest levels of readiness during fiscal year
    2008 we will evaluate their readiness during fiscal year 2009. Key
    tenets of an R\3\U are that they are manned with all volunteers, that
    they sustain a high level of readiness, and that they are used outside
    of the traditional ``one weekend a month, 2 weeks annual training''
    concept of reserve duty. For example, the drill sergeant company will
    conduct a complete 10-week basic combat training cycle at Fort Jackson,
    South Carolina, during fiscal year 2009. Usually, it takes five drill
    sergeant companies 2 weeks each to accomplish that one cycle. The R\3\U
    Pilot will test the Army Reserve's ability to sustain nontraditional
    units like this and provide non-mobilized, enhanced capabilities to
    meet specific Army requirements.
                Meeting Homeland Defense and Disaster Relief Missions
        The Army Reserve can be a federal first-responder to support civil
    authorities during domestic emergencies. As such, the Army Reserve is
    an important element of the current DOD ``Lead, Support, Enable''
    strategy for homeland defense and civil support. U.S. military forces
    organize, train, and equip to operate in contaminated environments, as
    well as manage the consequences of chemical, biological, radiological,
    or nuclear explosion incidents. The Army Reserve was recently tasked to
    provide increased support as a federal responder for man-made or
    natural disaster situations.
    Materiel
        Patriotic men and women who join the Army Reserve today know that
    mobilization and deployment are a reality, not a possibility. Our
    Nation expects much from our Warrior-Citizens, their Families, and
    their employers.
        When preparing to perform a dangerous mission, our Soldiers must
    have modern equipment and state-of-the-art training facilities. The
    Army Reserve is working hard to make these requirements a reality.
    During fiscal year 2008, we continued to refine our sustainment concept
    supporting the Army Reserve Training Strategy (ARTS) and the ARFORGEN
    model. We fielded new equipment; repaired, reset, and reconstituted
    unit equipment; adjusted equipment sets at regional training centers;
    redeployed support assets (manpower, tools, and support equipment) to
    sustain those sets; and continued to field aviation capability in
    accordance with the Army Campaign Plan. As we develop more competent
    and capable Soldiers and unit teams, we seek to provide those teams
    with the best tools available to accomplish diverse and challenging
    national security missions.
                Unit Equipment
        The Army Reserve has been successful meeting expeditionary demands
    primarily by falling in on stay-behind equipment or receiving new
    equipment in theater. We have managed our domestic contingency response
    and training missions by aggressively managing equipment on hand,
    authorized substitutes, and training sets. Looked at holistically,
    however, today the Army Reserve faces momentous equipping challenges.
        The Army Reserve has 73 percent of its required equipment on hand.
    Under currently programmed funding, the Army Reserve should reach 85
    percent equipment on hand by fiscal year 2016 with the goal of 100
    percent on hand by fiscal year 2019.

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                                 Critical Needs
        Obtain from Congress full support and necessary authorities.
      --Equipping Army Reserve units with the latest, fully integrated,
            modular force equipment to develop Soldier skills and unit
            equipment mastery through realistic training in years two and
            three of the ARFORGEN cycle;
      --Equipping Soldiers and units with all the latest required and
            authorized, fully integrated, modular force equipment to
            accomplish deployment and contingency standby missions in
            accordance with the ARFORGEN construct and national security
            mission demands of the ARFORGEN employment cycle; and
      --Resetting and reestablishing unit readiness, replacing lost,
            damaged, and committed (theater stay-behind) equipment
            expeditiously to ensure optimum training and mission readiness
            sustaining the world-class operational Army Reserve.

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                Army Reserve Aviation
        The Army Reserve currently has a fleet of more than 130 aircraft--
    fixed and rotary wing for combat and support operations. In addition to
    sustaining current capability, the Army Campaign Plan identifies growth
    of three aviation medical evacuation companies within the Army Reserve.
    The first company is standing-up in Clearwater, Florida. Congress
    initially approved $1.6 million to lease and modify existing hangar
    space for the aviation company over the next 5 years. As the Army
    Reserve aviation capability grows, Department of the Army has agreed to
    replace 10 King Air 350 aircraft the Army Reserve provided for
    operations in Iraq. The Army Reserve needs these aircraft to ensure the
    readiness of fixed wing aviation warfighting formations. Continued,
    previously funded, multi-year procurement and replacement of aircraft
    transferred to theater and associated aviation support infrastructure
    are essential to optimizing the Army Reserve's aviation capability.
                Depot Maintenance
        In fiscal year 2008, the Army Reserve executed $130 million in
    programmed depot maintenance funds to overhaul 3,256 major end items at
    Army depots or by commercial facilities. The Army Reserve depot
    maintenance program allows the Army Reserve to extend equipment service
    life, reduce life cycle costs, and maintain safe operation of older
    pieces of equipment. Through maintenance and restoration programs, the
    Army Reserve is able to restore and maintain older items to sustain
    unit capabilities while we wait for the fielding of modern modular
    force equipment.
    Services and Infrastructure
        Our Warrior-Citizens are the lifeblood of the Army Reserve. They
    live and work in civilian communities across the country while
    volunteering to serve the Nation. They all serve at a time when the
    stakes for our national security are high and the demands they and
    their Families face are significant. America owes them the best quality
    of life and health care possible.
        The Services and Infrastructure element of the enterprise approach
    encompasses those programs, facilities, and systems that improve the
    well-being of Soldiers and their Families, and supports key management
    processes to ensure readiness and promote Army Reserve institutional
    transformation.
                Yellow Ribbon Reintegration Program
        The Army Reserve Yellow Ribbon Reintegration Program provides
    information, services, referral, and proactive outreach programs to
    Army Reserve Soldiers and their Families through all phases of the
    deployment cycle. The goal of the Yellow Ribbon Reintegration Program
    is to prepare Soldiers and Families for mobilization, sustain Families
    during mobilization, and reintegrate Soldiers with their Families,
    communities, and employers upon release from active duty. The program
    includes information on current benefits and resources available to
    help overcome the challenges of reintegration. The program is comprised
    of seven events through all four phases of the deployment cycle.
    Soldiers are required, and Families highly encouraged, to attend a 1-
    day event at alert and again at pre-deployment to help ensure the
    Soldier and Family are prepared for an extended deployment. During the
    separation, commands provide two 1-day events to help sustain Families
    mentally, spiritually, and emotionally. For the local events, we
    leverage local resources as necessary. Upon redeployment, the Soldier
    is required, and Family members highly encouraged, to attend a 30- and
    60-day reintegration weekend. We conduct a ``Soldiers only'' weekend
    event 90 days post-deployment to perform Post Deployment Health Re-
    Assessments (PDHRA). During this weekend, Soldiers also participate in
    small group discussions to explore and resolve any lingering deployment
    issues.

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                              Critical Challenges
        Obtain from Congress full support and necessary authorities.
      --Developing, improving, and sustaining Soldier and Family programs
            to achieve comprehensive Soldier and Family well-being across
            relationship, spiritual, health, and fitness dimensions;
      --Sustain a robust and appropriately integrated secure communications
            and information technology to connect Army Reserve Soldiers and
            units across the Army enterprise ensuring the Army Reserve
            remains an effective, contributing operational component of the
            total force;
      --Providing the facilities to train and sustain the Army Reserve as
            an active, integrated, robust, and capable operational force.
            The Army Reserve is managing facilities and infrastructure
            transformation through three main efforts:
        --Base Realignment and Closure (BRAC) to consolidate and modernize;
        --Accommodating ``Grow the Army'' and emerging mission set facility
                and training center requirements to optimize unit
                disposition, training, and readiness;
        --Improving maintenance facilities and storage capacity to ensure
                unit readiness and maximize equipment service life.

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                Spiritual Care
        Army Reserve Soldiers, Families, and Army civilians deserve the
    best religious support and spiritual care available. In addition to
    providing pastoral support and direct ministry, unit ministry teams
    (chaplains and chaplain assistants) provide training and education in a
    variety of fields: Strong Bonds, Basic Human Interaction, Suicide
    Intervention and Prevention, Clinical Pastoral Education, Traumatic
    Event Management, and Family Life Chaplain Skills. All these services
    aid in providing this spiritual care to the Army Reserve Family.
        Over 200 Strong Bonds events were conducted by Army Reserve
    commands throughout the country and territories during fiscal year
    2008, enhancing Soldier and Family communication and relationship
    skills. The Army Reserve provided specialized training for couples,
    Families and single Soldiers during pre- and post-deployment. This
    training helps Soldiers and Families relieve stress and address
    relationship issues during every phase of deployment.
        Army chaplains are key enablers of Soldier well-being. Today there
    is a critical shortage of chaplains in the grades of captain and major.
    To address this issue, the chaplain corps partners with religious
    organization endorsers to help recruit and retain high-quality
    chaplains, chaplain assistants, and civilians committed to a
    professional Army chaplaincy.
                Army Reserve Warrior and Family Assistance Center (AR-WFAC)
        The Army Reserve Warrior and Family Assistance Center ensures that
    Warrior-Citizens receive appropriate support under the Army Medical
    Action Plan. This center provides a sponsor to each Army Reserve
    Soldier and Family currently assigned to a Warrior Transition Unit
    (WTU), Community Based Health Care Organization (CBHCO), or Veterans
    Affairs PolyTrauma Center. It also manages a toll-free hotline (1-866-
    436-6290) and Web site (www.arfp.org/wfac) to provide Army Reserve
    Soldiers, Families, and Retirees with assistance in areas such as
    medical, financial, administrative, and pastoral issues.
                Family Programs and Services
        The Army Reserve Family Programs (ARFP) is committed to fostering
    Army Strong Families. We continue to develop and evolve to meet Soldier
    and Family needs. ARFP capabilities include program management,
    marketing, information, follow-up and referral, mobilization,
    deployment and reintegration, partnerships, outreach, training and
    development, crisis management, and command consultation. Our vision is
    to have a Family Programs ``face'' at every battalion or equivalent
    formation to promote resilient Soldiers, Families, and volunteers.
        Army Family Covenant.--The Army Family Covenant recognizes the
    commitment and strength of Soldiers and Families, while committing to a
    supportive environment and a partnership with Army Families. Together,
    we must make the Army Family Covenant a reality, focusing on the five
    deliverables: Family Programs and Services; health care; Soldier and
    Family housing; excellent schools, youth services, and childcare; and
    expanded employment and education opportunities for Family members.
        Family Readiness Groups.--Army Reserve Families participate in
    Virtual Family Readiness Groups (VFRG) utilizing information and
    resources provided by the Army's integrated Family support network, now
    called Army One Source. We have begun hiring 127 Department of the Army
    civilian Family Readiness Support Assistants (FRSA) to provide
    administrative and logistical support to volunteer Family readiness
    group leaders. Taking the administrative burden off volunteers enables
    Family readiness group leaders to concentrate on outreach to Soldiers
    and Families in the command.
        Outreach.--Family Programs published its third issue of ``Family
    Strong''--a full-color quarterly publication providing Family Readiness
    information to all Army Reserve households of deployed Soldiers. The
    entire Army Reserve population will receive future issues of this
    publication. Family Programs continues to enhance its online
    information portal, www.arfp.org, to meet the needs of Soldiers and
    their Families 24 hours a day, 7 days a week. The Family Programs
    outreach and support office is available to Soldiers, Families, and
    civilian employees at 1-866-345-8248.
        Welcome Home Warrior-Citizen Award Program (WHWCAP).--This welcome
    home program publicly recognizes the sacrifices Army Reserve Soldiers
    and their Families make on behalf of the Nation. Since the program's
    inception in fiscal year 2004, 124,887 Soldiers, their Families, and
    employers have received special awards honoring their service and
    support.
        Child, Youth, and School Services (CYSS).--Child, Youth and School
    Services supports readiness and well-being of geographically dispersed
    families by reducing the conflict between parental responsibilities and
    mission requirements. CYSS has 21 full-time staff members dedicated to
    ensuring children of our Warrior-Citizens have support in their
    communities throughout the deployment of their loved ones. Programs and
    initiatives meet the needs of children from youth to young adult and
    include childcare, youth development, and school support services.
        Reserve Enrichment Camps.--Enrichment camps provide youth an
    opportunity to learn new skills, develop relationships, and learn more
    about the Army Reserve. In 2007, we conducted the first two Army
    Reserve Enrichment Camps in North Carolina and Wisconsin, serving 100
    Army Reserve youth. In 2008, we expanded the program to include five
    more campsites that served an additional 250 Army Reserve children.
                Support to Families of Our Fallen Soldiers
        The Army Reserve has lost 170 Warrior-Citizens to date in
    Operations Enduring Freedom and Iraqi Freedom. We recognize the
    ultimate sacrifice these Soldiers and their Families have made for the
    cause of freedom, and we proudly honor our fallen comrades in
    ceremonies and with personal tributes. By remembering the distinguished
    service of our fallen, their selfless acts of bravery and leadership,
    the Army Reserve remains Army Strong. As part of our commitment to the
    Families of the fallen, the Army Reserve conducts memorial services to
    honor their loved ones' sacrifices, offers chaplain support if
    requested, as well as ongoing support to help the Families through the
    difficult time. Soldier Outreach Services currently falls under Army
    Reserve Family Programs and is coordinated through the Chaplains'
    Office in the Warrior and Family Assistance Center.
                Communication (Information Technology)
        The Army Reserve is implementing a 5-year secure communications
    project that includes secure data, voice, and video to the battalion
    level. Secure communications capabilities are essential to unit
    preparation and training. As units move through the ARFORGEN cycle,
    secure communications connectivity will reduce time required for pre-
    mobilization by allowing access to classified information and ``real
    world'' data not currently available through unclassified means.
        Supporting Army information technology enterprise operations, the
    Army Reserve is leading the way to consolidating network management and
    data center services. Consolidation of services generates efficiencies
    and supports the Army's Global Network Enterprise Construct (GNEC). The
    return on investment will support future information technology
    improvements to increase Army Reserve unit readiness.
        The Army Reserve must have highly integrated information technology
    capabilities from the tactical to strategic level--technologies that
    are both modular and scalable. In order to provide these integrated
    capabilities, the Army Reserve must move toward network-managed
    services to reduce overall operating costs, while maintaining
    acceptable service levels nationwide. Sustaining Army Reserve
    information technology capabilities is essential to a fully operational
    Army Reserve.
                Army Reserve Facilities and Base Realignment and Closure
                        (BRAC)
        In the midst of the ongoing war and transformation efforts to grow,
    restation, and modernize the Army, the Army Reserve is building new
    capability. The Army Reserve is disposing of obsolete facilities and
    constructing new state-of-the-art training, maintenance, and
    administrative facilities. In fiscal year 2009, the Army Reserve will
    initiate 12 ``Grow the Army'' projects, 21 BRAC projects, and eight
    Military Construction Army Reserve (MCAR) projects. We are working
    aggressively to address all our facilities and infrastructure
    requirements to ensure Soldiers receive the best training and support
    possible, and that we adequately support and maintain on-hand and
    inbound modular force equipment to ensure unit readiness.
        The initial BRAC 2005 assessment underestimated the facility
    requirements of the number of units and Soldiers in facilities
    identified for closure. This impacts force readiness. To mitigate some
    of these BRAC costs, the Army Reserve, through our Transformation
    Integration Office, provides detailed planning and systematic follow-
    through for each BRAC action. We manage from land acquisition, from
    coordination with local redevelopment authorities, to final property
    closure and disposal. This level of attention to specific BRAC mandates
    enables our commanders to plan unit relocation while minimizing impact
    on operational missions.
        Through our construction efforts, we intend to provide a facilities
    support framework to support and sustain Army Reserve transformation.
    We will maximize the utilization of Army Reserve installations and
    facilities at Fort Dix, Fort McCoy, Fort Buchanan, Fort Hunter Liggett,
    and the Combat Support Training Center at Camp Parks to support
    ARFORGEN. We have embraced a ``retool mindset'' and are thinking
    jointly with other components and services wherever possible. We will
    maintain our community-based presence, and provide flexible, multiuse,
    complete facilities for our units. By reducing our footprint where
    possible, we seek to optimize the return on investment. The Army
    Reserve is building readiness.
                Business Transformation
        The Army Reserve is constantly looking for ways to streamline
    operations, improve unit readiness, develop greater efficiencies--in
    short, increase the rate of return on investment Americans make in the
    Army Reserve.
        One example of the success of our efforts is our increasing the
    Boots on the Ground time for Army Reserve units through restructuring
    pre- and post-mobilization training processes. The goal was to reduce
    training time for mobilized units to no more than 45 days, to maximize
    potential ``boots on the ground'' for a 1-year deployment. We
    approached the challenge deliberately identifying three unit elements
    requiring very different training regimens: combat support hospitals,
    military police companies, and engineer companies. By streamlining the
    pre- and post-mobilization training schedules and eliminating
    unnecessary and duplicate activities, we reduced training time by an
    average of 38 days. This resulted in post-mobilization cost savings
    ranging from $768,000 to $5.6 million per unit deployed. Intangible
    benefits identified include compliance with the Train-Alert-Deploy
    foundation of ARFORGEN, reducing rotational span, and realigning pre-
    and post-mobilization training. While these projects focused on
    specific types of units, the results and findings are universally
    applicable to Army Reserve units.
        Through other business transformation initiatives, we improved the
    Army Reserve's active component to reserve component transition rate.
    We achieved the highest transition rate in the program's history, with
    a projected cost avoidance of approximately $13 million in training
    dollars for fiscal year 2008. Through our business process
    transformation efforts we further decreased the processing time for
    incapacitation pay from 79 to 45 days. The Army Reserve is a forward-
    looking, progressive organization. We will continue to seek to maximize
    America's return on investment.
                  army reserve generating return on investment
        The Army Reserve today is undoubtedly a strong return on investment
    for America. We are an effective, cost efficient organization that
    complements the needs of the Army. The Army Reserve delivers combat
    support and combat service support capability to the Army for America's
    defense. Our value to America goes beyond providing military
    capability. Working with our civilian partners, we are building a human
    capital strategy where both employer and military share and enhance the
    skills of one individual, who contributes both to the defense of our
    Nation and to sustaining a strong national economy. Bottom line, the
    Army Reserve gets a better Soldier; the employer gets a better
    employee. That is a good investment for America.
        The values and talents that are a part of our skill-rich
    organization benefit this nation beyond the traditional role of
    defense. This is the legacy of our Warrior Citizens. When we produce
    truck drivers for America's trucking industry, medical technologists
    for America's medical community, law enforcement officers for America's
    law enforcement agencies, among other specialties, it is a good value
    for America.
        Transitioning the Army Reserve from a strategic reserve to an
    operational force is also good value for this nation. It is difficult
    and complex to operationalize the reserve component, especially in a
    wartime environment; however, we are making it happen. We are moving
    away from a legacy structure that served us well as a strategic reserve
    to a leaner organization that accommodates command and control of an
    operational force. Using the Base Realignment and Closure (BRAC)
    Commission mandate, we are also restructuring to add capability for the
    future. This is the capability we need to support new Army missions,
    such as Stability Operations. We are supporting the requirements of
    this expanding new mission by adding civil affairs professionals,
    transportation specialists, engineers, and military police as part of
    our internal reorganization while adding about 16,000 operational
    spaces of capability for the future. The Army Reserve is doing the
    right thing internally while transforming externally.
        Our success in current and future military operations is dependent
    on our ability to man, equip, train, and prepare Army Reserve Soldiers
    as full cohesive units for current and future operations. Our force of
    Warrior Citizens serves the Nation as an operational force for which
    they are not designed nor resourced; as a result, our primary focus is
    on the demands of current operations. With sufficient means, we cannot
    only grow and transform the force, but we can also train Soldiers and
    units during an era of persistent conflict. We, however, risk failure
    if faced with a rate of change that exceeds our capability to respond.
        We take our commitments to our Nation, to our Army, and to our
    Soldiers, Families, and our Employer Partners seriously. We are
    effective stewards of our Nation's resources. We serve with an
    unwavering pride that the America's sons and daughters willingly answer
    the call to duty in a time of war or national emergency. As we position
    ourselves as an essential provider of combat support and combat service
    support to the United States Army, we look to Congress and our fellow
    citizens for strength and support as our partners in building an
    operational Army Reserve for the 21st century.
                                special honorees
                            award of the silver star
        Sergeant Gregory S. Ruske is the fourth Army Reserve Soldier to
    receive the Silver Star for heroism.
        Sergeant Gregory S. Ruske of Colorado Springs, Colorado, earned the
    Silver Star for placing himself in the line of enemy fire while he
    planned and led the rescue of an Afghan National Police officer felled
    in a firefight. While assigned to Combined Joint Task Force 101,
    operating in Afghanistan's Kapisa province, he and his fellow Soldiers
    from 3rd Platoon, ``A'' Company, Task Force Gladiator, were on a patrol
    in a remote area when Taliban operatives attacked them with heavy
    grenade, machine-gun and rifle fire.
        Trapped with his unit out in the open, Sergeant Ruske returned fire
    so most of the platoon could move to protective cover. After taking a
    bullet to the hip, Sergeant Ruske repositioned himself to a rooftop and
    continued laying fire.
        At that point, Sergeant Ruske realized that two Afghan National
    Police officers were pinned down in the open, taking fire from their
    Taliban attackers. One ran for cover, but the other officer--one
    Sergeant Ruske had worked with at vehicle checkpoints and chatted with
    through an interpreter--had been shot and was trying to crawl to safety
    through a hail of bullets.
        Sergeant Ruske said he did not take time to think about his own
    safety, but simply reacted using the training the Army Reserve gave him
    in preparation for combat.
        Sergeant Ruske credited his mentor during his 3 years of active
    duty, Sergeant First Class Glen Boucher, with instilling the discipline
    and skills that he drew on while under fire.
        ``I don't consider myself a hero,'' he said. ``I was just an
    ordinary guy put in an extraordinary situation. I reacted based on my
    upbringing, training, and compassion, and thankfully, it worked out in
    the end.''
            first army reserve soldier wins army soldier of the year
        ``Best Warrior is a tremendous honor; however, the real `Best
    Warriors' are those who serve, those who have served, and those who
    desire to do so. To represent the United States Army Reserve Command at
    the Department of the Army level means I have a responsibility to bring
    due-credit to the Army Reserve training and leadership of which I am a
    product,'' said Army Soldier of the Year, Specialist David Obray.
        Specialist David Obray is a Construction Equipment Repair
    Specialist with the U.S. Army Reserve, 492nd Engineer Company, 414th
    Engineer Command, Mankato, Minnesota.
        With 3 years experience in the U.S. Army Reserve, Specialist Obray
    is the first Reserve Soldier to win the prestigious Army title.
        A native of Fairmont, Minnesota, Specialist Obray attends Winona
    State University where he is president of the Student Association and
    pursuing a bachelor's degree in Law & Society and Business Law. His
    plans include obtaining a Juris Doctorate and Master of Business
    Administration degree, retiring from the Army Reserve as a Command
    Sergeant Major, and pursuing his dream of becoming a United States
    Senator.
        For Specialist Obray, service to country is a family business. His
    sister and brother currently serve in the Army, and his grandfather and
    great-grandfather served in World War II and World War I respectively.
        Specialist Obray's Army goals include becoming a fire team and
    squad leader and a Battalion Command Sergeant Major. Weighing 300
    pounds at age 16, Specialist Obray credits military discipline with
    giving him the courage and ability to become physically and mentally
    fit. He is proud to represent the U.S. Army as ``Soldier of the Year.''
    ``The Best Warrior is the personified Strength of the Nation,'' says
    Specialist David Obray. ``The title represents the entire United States
    Army and shows the proficiency of all Soldiers and Noncommissioned
    Officers. It is a great honor to be selected.''

                             army reserve snapshot
        Vision.--A community-based federal operational force of skill-rich
    Warrior-Citizens providing complementary capabilities for joint
    expeditionary and domestic operations.
        Mission.--To provide trained and ready Soldiers and units with the
    critical combat service support and combat support capabilities
    necessary to support national strategy during peacetime, contingencies
    and war.
        Desired End State.--An Army Reserve with a culture that embraces
    continuous transformation, is capable of predictably and perpetually
    providing relevant operational forces to Combatant Commanders, and
    maintains strong mutually supporting Warrior-Citizen relationships
    among Soldiers, Families, Army Reserve Civilians, Employers, and the
    Army.
    Key Leaders
        Secretary of the Army: The Honorable Pete Geren
        Army Chief of Staff: General George W. Casey, Jr.
        Chief, Army Reserve and Commanding General, U.S. Army Reserve:
    Lieutenant General Jack C. Stultz
        Deputy Commanding General, U.S. Army Reserve Command: Major General
    Alan D. Bell
        Deputy Chief Army Reserve: Major General Mari K. Eder
        U.S. Army Reserve Command Chief of Staff: Colonel Charles E.
    Phillips, Jr.
        Deputy Chief Army Reserve: Brigadier General Julia A. Kraus
        Director for Resource Management: Mr. John C. Lawkowski
        Chief Executive Officer: Mr. Kenneth N. Williamson
        Command Chief Warrant Officer: Chief Warrant Officer 5 James E.
    Thompson
        Command Sergeant Major: Command Sergeant Major Leon Caffie
    Army Reserve Basics
        Established: April 23,1908
        Designated Direct Reporting Unit to Army: October 1, 2007
        2010 Authorized End Strength: 206,000
        Selective Reserve Strength: 202,500
        Accessions for Fiscal Year 2008: 44,455
        Reenlistments for Fiscal Year 2008: 16,523 (111 percent of annual
    goal)
        Accessions Goal for Fiscal Year 2009: 43,154
        Soldiers Currently Deployed: >27,000
        Soldiers Mobilized Since September 11, 2001: >170,000
        Number of Army Reserve Centers: 1,136
    Distinctive Capabilities
        The Army Reserve contributes to the Army's Total Force by providing
    100 percent of the:

    Chemical Brigades

    Internment Brigades

    Judge Advocate General Unit

    Medical Groups

    Railway Units

    Training & Exercise Divisions

    Water Supply Battalions

        . . . more than two-thirds of the Army's:

    Civil Affairs Units

    Psychological Operations Units

    Transportation Groups

    Motor Battalions

    Chemical Battalions

    Hospitals

    Medical Brigades

    Theater Signal Commands

        . . . and nearly half of the Army's:

    Petroleum Battalions

    Adjutant General Units

    Petroleum Groups

    Transportation Command

    Terminal Battalions

    Public Affairs Units

    Army Reserve Demographics

    ------------------------------------------------------------------------
                                                                    No.
    ------------------------------------------------------------------------
    Ethnicity (in percent):
        Caucasian...........................................            59.7
        Black...............................................            22.0
        Hispanic............................................            12.3
        Asian...............................................             3.4
        Pacific Isl.........................................             1.0
        Native Amer.........................................             0.7
    Average Age.............................................            38.8
        Officers............................................            30.6
        Enlisted............................................            41.8
        Warrant.............................................            44.1
    Married (in percent)....................................            44.5
        Officers............................................            63.1
        Enlisted............................................            39.6
        Warrant.............................................            73.0
    Gender (in percent):
        Male................................................            76.1
        Female..............................................            23.9
    ------------------------------------------------------------------------

    Army Reserve Budget Figures

    ------------------------------------------------------------------------
                                               Total fiscal    Total fiscal
                                                 year 2009       year 2010
                                               budget: $7.5B  program: $7.9B
    ------------------------------------------------------------------------
    Operations and Maintenance..............           $2.6B           $3.1B
    Military Personnel......................           $4.6B           $4.4B
    Military Construction...................           $282M           $381M
    ------------------------------------------------------------------------

    Army Reserve Installations
        Fort Buchanan, Puerto Rico
        Fort McCoy, Wisconsin
        Devens, Massachusetts
        Fort Hunter Ligget, California
        Fort Dix, New Jersey
        Camp Parks, California

        Chairman Inouye. May I now call upon Admiral Dirk Debbink?
    STATEMENT OF VICE ADMIRAL DIRK J. DEBBINK, CHIEF, NAVY
                RESERVE
        Admiral Debbink. Chairman Inouye, Vice Chairman Cochran,
    pleasure to be with you this morning. Thank you for the
    opportunity to testify before you. As you know, this is my
    first testimony before the subcommittee. I would like to begin
    by thanking you for your terrific support of the 67,217 sailors
    and their families that comprise your Navy Reserve.
        I would like to communicate three things to you in my
    testimony today. First and foremost, my written testimony goes
    into some length describing what we are doing for our Navy
    today and, by extension, our Nation. As I testify this morning,
    Navy Reserve sailors are operating in every corner of the
    world, and you see our sailors in the news, but you do not see
    the caption that reads ``Reserve'' because we are part of the
    total force, and seeking to optimize the way we operate as a
    total force Navy. From certifying strike groups at home before
    they deploy overseas, to our naval special warfare teams in
    Iraq, Afghanistan, and around the world, our sailors are making
    significant contributions across the full spectrum of both
    naval and joint operations. And we are very closely linked with
    the active component and our civilians to constitute the total
    force our Navy depends on every day to execute our maritime
    strategy and our national tasking.
        Second, I would like to tell you more about the outstanding
    sailors who are actually doing the work of our Navy Reserve.
    Following a strength reduction of nearly 25 percent since 2003,
    our central focus of our manpower strategy is now to establish
    a true continuum of service culture. This is a culture that
    offers our sailors the opportunity to truly be a sailor for
    life, providing a life/work balance that accommodates
    individual circumstances while also sustaining the inventory of
    skilled and experienced professionals we need for our total
    force missions.
        And finally, I would like to bridge from the what we are
    doing and who is doing it to communicate what I believe is a
    real value proposition of the Navy Reserve. We are proud of
    what we bring to the fight today. We are also acutely aware of
    the necessity of our long-term contribution to our Navy and our
    Nation, and I believe we are demonstrating that daily by the
    incredible return on investment that your Navy Reserve
    represents. Today's Navy Reserve, from civil affairs to Navy
    SEALs, are integral to total force; and we stand shoulder to
    shoulder with our active component executing full-spectrum
    operations that represent every facet of Navy's global maritime
    strategy for the 21st century. We have proven ourselves to be a
    ready, responsive, and adaptive operational force while
    maintaining our strategic depth. This is an important and, I
    think, very meaningful time for all of us to be serving our
    Nation's defense and particularly, I would assert, as a
    reservist.
        I thank you for your continued support and I look forward
    to your questions, sir.
        Chairman Inouye. I thank you very much, Admiral.
        [The statement follows:]
               Prepared Statement of Vice Admiral Dirk J. Debbink
                                  introduction
        Chairman Inouye, Senator Cochran, and distinguished members of the
    Defense Subcommittee, thank you for the opportunity to speak with you
    today about the capabilities, capacity, and readiness of the dedicated
    men and women who serve in our Navy's Reserve Component (RC). I offer
    my heartfelt thanks for all of the support you have provided these
    great Sailors.
        On July 22 last year I had the distinct honor of reporting to the
    Chief of Naval Operations (CNO), Admiral Gary Roughead, as the 12th
    Chief of Navy Reserve. In that capacity, I have the privilege of
    working for over 67,000 Sailors in our Navy's RC. I take to heart that
    each of them has promised to support and defend the Constitution of the
    United States, against all enemies, foreign and domestic. That promise
    is their covenant to our Nation, and my covenant back to these Sailors
    is to do everything I can to make their service truly meaningful,
    significant, and rewarding; these Sailors form an incredibly capable
    and motivated force, and they deserve nothing less. I find myself
    amazed and truly in awe of the daily sacrifices our RC Sailors are
    making for our Nation and our Navy.
        My predecessor, Vice Admiral John Cotton, laid a strong foundation
    during the past 5 years for a more responsive and operational force;
    and we are a better Navy because of his leadership. We remain steady on
    course and we will look to increase speed where able by improving upon
    our strengths and efficiencies to further advance our ``Support to the
    Fleet . . . Ready and Fully Integrated.'' We are also working on new
    initiatives in order to more fully implement the Navy Reserve's vision
    of: ``Ready Now. Anytime, Anywhere.''
        The Navy Reserve is an integral component of our Total Force--
    inextricably linked with the Active Component (AC), civil servants, and
    contractor personnel. Our focus is on strategic objectives and specific
    initiatives that will enable us to optimize our support for the CNO's
    priorities: (1) Build the Future Force, (2) Maintain Warfighting
    Readiness, and (3) Develop and Support our Sailors, Navy Civilians, and
    Families. Within this framework, I would like to take this opportunity
    to update you on the operational contributions, support to the Sailor
    and family, and the people policies and programs of the Navy Reserve.
                           operational contributions
        The Navy's RC contributions are directed when and where they make
    the most operational and cost-effective sense--the right Sailor, in the
    right assignment, at the right time, and importantly, at the right
    cost. Leveraging valuable military and civilian skill-sets and
    capabilities--when possible and consistent with volunteerism--Navy
    Reservists operate in all corners of the world. RC Sailors are on the
    ground in Iraq and Afghanistan; they help project power from the
    Arabian Gulf; and they aid in providing a stabilizing influence in the
    Eastern Mediterranean. They patrol waters off the Horn of Africa and
    deliver humanitarian assistance and disaster relief throughout the
    world.
        To meet global requirements, the Navy continues to mobilize
    thousands of Selected Reserve (SELRES) RC personnel. These mobilized
    SELRES personnel provide a growing spectrum of capabilities to
    prosecute our current fights by integrating seamlessly into a multitude
    of augmentation missions, in addition to mobilizing as Navy units. We
    are called to execute missions well beyond core requirements with new
    capability missions (Civil Affairs Units, Mobile Training Teams, and
    Provincial Reconstruction Teams, in particular) and mission-unique
    training such as Detainee Operations and Customs Inspection battalions.
    One-third of Navy augmentees currently serve in non-traditional
    missions that involve new capabilities or require unique training.
    Mobilized SELRES Sailors have sustained their largest footprints in
    Iraq (1,018 Sailors), Kuwait (796 Sailors), and Afghanistan (277
    Sailors). At the Landstuhl Regional Medical Center (LRMC), more than 90
    percent of the expeditionary medical support personnel are RC
    augmentees. Navy RC medical augmentees are generally activated for
    mobilization employment periods from 3 months to 1 year from various
    Operational Health Support Units to form the highly valued Navy
    Expeditionary Medical Units (NEMUs). Over 380 RC medical personnel
    served in our NEMUs in 2008, and 294 are expected to serve in 2009 and
    2010.
        In addition to the contributions of mobilized SELRES and those
    conducting Active Duty Operational Support in fiscal year 2008, an
    additional 21,803 Navy Reservists provided 385,291 man-days of Fleet
    Operational Support above the traditional 39 days each SELRES provides
    under current law. The Navy Expeditionary Combat Command (NECC) sets
    the example of RC's operational contributions. Led by Rear Admiral
    Carol Pottenger--a Full Time Support (FTS) Officer of the RC (the Navy
    RC equivalent of Active Guard and Reserve (AGR)), its expeditionary
    forces deployed across five continents and 12 countries in 2008, and
    continue fighting the war on terror and supporting the Global Maritime
    Strategy. With 48 percent of the NECC force comprised of RC members,
    NECC's global support to the Navy Component Commanders (NCCs) and
    unified Combatant Commanders (COCOMs) is only executable with integral
    contributions from the RC. In 2008 alone, nearly 2,300 RC members from
    17 NECC units deployed globally, with more than 95 percent of the
    deployed units and personnel supporting Operation Iraqi Freedom (OIF)
    and Operation Enduring Freedom (OEF) in the Central Command (CENTCOM)
    Area of Responsibility (AOR). NECC RC forces continue to support
    operations that include: construction/engineering operations with the
    Naval Construction Forces (e.g., Construction Battalions, or SEABEEs),
    maritime expeditionary landward and seaward security with Maritime
    Expeditionary Security Forces (MESF), Customs Inspections and port/
    cargo operations with Navy Expeditionary Logistics Support Group
    (NAVELSG), warfighting documentation with Combat Camera, document and
    electronic media exploitation with Navy Expeditionary Intelligence
    Command, and Anti-Terrorism/Force Protection (AT/FP) training with the
    Expeditionary Training Command.
        The Navy's RC has been the driver behind an enormous success story
    Navy-wide through its lead role in the critical Customs Inspection
    mission, currently providing virtually the entire deployed footprint
    with more than 500 RC Sailors on Individual Augmentee (IA) assignments.
    The Navy is projected to sustain this footprint in 2009 with planned
    Customs rotations throughout the year. The mobilized Customs Inspectors
    include police officers, corrections officers, state police/sheriffs,
    full-time students, engineers, and small business owners. Others
    include teachers, postal clerks, carpenters, nurses, emergency medical
    technicians, auto technicians, and fire fighters. The most recent
    rotation of RC Sailors to deploy for an 8-month Customs/Ports tour of
    duty in Iraq and Kuwait departed in November. These Customs personnel
    are drawn from 96 Navy Operational Support Centers (NOSCs) representing
    38 states and territories, including Puerto Rico and Guam.
        RC Sailors are also found in the Navy Special Warfare (NSW),
    Maritime Expeditionary Security, and Explosive Ordnance Disposal (EOD)
    communities. Reservists comprise 17 percent of the NSW community,
    including SEALs and Special Warfare Combatant-Craft Crewmen (SWCC). As
    a CNO initiative to relieve stress on the AC EOD force, the RC EOD
    force was established in 2007. In 2008, RC EOD units deployed to
    support two OIF/OEF/Global Naval Force Presence Posture (GNFPP)
    requirements. Through Maritime Expeditionary Security units, the Navy's
    RC also directly augments the Maritime Expeditionary Security mission.
        The RC aviation community is equally involved in Total Force
    operational support. Electronic Attack Squadron 209 (VAQ 209)
    mobilized, deploying 188 FTS and SELRES personnel to Bagram Air Base,
    Afghanistan in support of Coalition operations from January 14th thru
    March 14th in 2008. Helicopter Sea Combat Squadron 84 (HSC 84)
    continues its deployment to Balad Air Base, Iraq to conduct air assault
    combat missions in support of CENTCOM Joint Special Operations. RC
    members of Helicopter Sea Combat Squadron 85 (HSC 85) are deployed to
    Kuwait to support the 2515th Naval Air Ambulance mission, while RC
    members of Helicopter Mine Countermeasures Squadron 15 (HM 15) are
    deployed alongside the AC to the CENTCOM AOR for Fifth Fleet and Navy
    tasking by the U.S. Central Command. Eight RC Sailors from HM 14 are
    also deployed to Korea, conducting Airborne Mine Countermeasures and
    Vertical Onboard Delivery (VOD) missions.
        A detachment from Carrier Airborne Early Warning Squadron 77(VAW
    77), consisting of more than 30 FTS/SELRES personnel and 25 maintenance
    contractors completed 4 month deployments in 2008 to various sites in
    the Southern Command (SOUTHCOM) AOR for counter-narcotics operations,
    directly assisting in the capture of cocaine and heroin with an
    approximate street value of $700 million. A 25-person detachment from
    Helicopter Antisubmarine (Light) Squadron 60 (HSL 60) deployed aboard
    the USS Dewert (FFG 45) last year to support SOUTHCOM and Fourth Fleet
    counter-narcotics operations, assisting in the interdiction of cocaine
    that was valued at $350 million. Currently, HSL 60 has another 25-
    person detachment onboard USS Samuel B. Roberts, seizing seven metric-
    tons of narcotics to date. The Navy Air Logistics Office scheduled
    aircraft and forward-deployed detachments from all 15 Fleet Logistics
    Support Wing (VR) squadrons, enabling the efficient and effective
    transport of more than 127,000 personnel and 21.7 million pounds of
    cargo to/from various overseas locations in support of COCOM and
    theater-validated requirements. The VR Wing routinely fulfills three
    CENTCOM Deployment Orders, and in excess of 160 RC personnel from the
    VR Wing are deployed to Japan, Italy, Qatar, and Bahrain each day.
        The VR Wing also enables the Fleet Readiness Training Plan (FRTP)
    by transporting personnel and cargo throughout the Continental United
    States in support of FRTP airlift requirements for Carrier Air Wings
    (CVWs), Carrier Strike Groups, Fleet Replacement Squadron (FRS)
    detachments, and NSW training requirements. Fighter Squadron Composite
    12 (VFC 12), Fighter Squadron Composite 13 (VFC 13), Fighter Squadron
    Composite 111 (VFC 111), and Strike Fighter Squadron 204 (VFA 204) also
    enable FRTP initiatives by executing adversary sorties for multiple CVW
    and FRS detachments. The Squadron Augmentation Units (SAUs) from
    Commander, Naval Air Training Command (CNATRA) flew 20 percent of all
    sorties conducted in support of student Pilot/Naval Flight Officer
    (NFO) production during 2008, while the FRS SAUs flew nearly 10 percent
    of the syllabus flight events in support of Pilot/NFO and aircrew
    production.
                           equipping the navy reserve
        For Navy Reservists to continue providing superior operational
    support to the Navy through the competencies they have acquired both in
    the Fleet and in their civilian careers, the Navy must also have
    interoperability between all elements of the Total Force. The
    acquisition of AC and RC equipment, enhancements and upgrades to
    programs, and equipment redistribution (AC to RC, as well as RC to AC)
    have virtually eliminated capability and compatibility gaps between AC,
    RC, and Joint forces. Current and future RC equipment requirements that
    are vital to our combat forces include aircraft and NECC equipment.
        The aircraft needed to recapitalize the RC and ensure complete
    alignment with the AC are: the EA-18G ``Growler'' for Electronic
    Attack, the P-8A ``Poseidon'' Multi-Mission Aircraft, the KC-130J
    ``Hercules'' for over- and out-sized cargo intra-theatre transport, and
    the C-40A ``Clipper'' for intra-theatre cargo and passenger transport.
    In addition to RC operators, the AC will also have aircrew personnel
    who will operate the EA-18G, P-8A, and the KC-130J (USMC AC). The C-40A
    is unique among these aircraft as it is only operated by RC aircrew
    personnel--the AC does not have any ``Clipper'' operators. Further, the
    C-40A is essential to providing flexible, time-critical, and intra-
    theater logistics support, serving as a connector between strategic
    airlift points of delivery to Carrier Onboard Delivery and VOD
    locations. The C-40A is the replacement for aging DC-9/C-9B and C-20G
    aircraft, and it can simultaneously transport cargo and passengers. The
    Clipper has twice the range, payload, and days of availability of the
    C-9 models, and it has twice the availability and eight times the
    payload of the C-20G. The C-40A is an outstanding asset and has
    provided enormous operational support, while facilitating the FRTP,
    since its arrival in 2001.
        NECC provides equipment for its subordinate commands, such as
    SEABEE, MESF, EOD, and NAVELSG units. The equipment utilized by these
    type commands include counter-IED (Improvised Explosive Device)
    equipment, tactical vehicles, construction and maintenance equipment,
    material handling equipment, communications gear, boats, and
    expeditionary camp equipment. Like NECC's mission, the equipment it
    operates is both dynamic and diverse.
        The Navy has trimmed the RC force structure to the appropriate
    capacity and capability required to sustain the operational Reserve
    Force. The perceived value and the return on investment that the RC
    delivers in personnel and equipment to the Total Force are measured on
    a daily basis. Critical recapitalization continues to be a priority,
    and budgetary dynamics make us ever reliant on a combination of the
    service priority and the direct appropriation for these aging and
    depreciating assets. Some of these requirements have been mitigated by
    your continued support through the National Guard and Reserve Equipment
    Appropriation.
                        supporting the sailor and family
        As we continue supporting the Fleet, we proactively extend our
    support to individual Sailors and their families. Our Sailors will do
    almost anything we ask of them, and we see evidence of their dedicated
    service everyday, especially in Iraq and Afghanistan. Their expectation
    that we will support their families while they are away from home is
    both fair and reasonable.
        With so many RC Sailors filling IA and mobilization requirements,
    the July 2008 release of the RC IA Business Rules (Navy Administrative
    message 235/08) directly addressed how we care for our RC Sailors. In
    particular, these business rules authorized RC Sailors who volunteer
    for unit mobilization to combat zones inside their 1:5 ``Dwell Time,''
    to reset their ``Dwell Clock'' and receive Post-Deployment/Mobilization
    Respite Absence (administrative leave).
        To ensure that our Reserve Force was ready to deploy at any time,
    the Navy's RC introduced the Medical Readiness Reporting System (MRRS)
    to address Individual Medical Readiness. MRRS use was expanded in
    fiscal year 2008, and is now used by the Navy's AC and RC, as well as
    the Coast Guard and Marine Corps. In addition, MRRS was recently
    enhanced to allow more accurate tracking of those Sailors at risk due
    to combat operational stress, and to ensure they receive the
    appropriate attention during Post Deployment Health Re-assessments
    (PDHRAs) conducted 90-180 days after demobilization.
        To facilitate a continuum of readiness, given the stress that
    oftentimes results from operational deployments overseas, funding was
    approved in 2008 to establish the Navy Reserve Psychological Health
    Outreach Program. This program provides outreach services to Reservists
    returning from deployment, both during the reintegration process and
    beyond. It ensures early identification and timely clinical assessments
    of Navy Reservists at risk for stress injuries. The Program
    Coordinators facilitate access to psychological health support
    resources for the service members and their families, and serve as
    Facilitators at Psychological Health/Traumatic Brain Injury seminars
    and Returning Warrior Workshops.
        The Navy Reserve continues to make exceptional progress in
    advancing a standardized, world-class Continuum of Care for SELRES
    Sailors, FTS Sailors, and their families through all phases of the
    mobilization deployment cycle. United States Fleet Forces (USFF), as
    executive agent for IA and IA Family Support, was vital to the
    evolution of a Total Force Continuum of Care in 2008 by standing up the
    IA and IA Family Cross Functional Team and Executive Steering
    Committee. The Navy Reserve is a lead stakeholder supporting USFF in
    this initiative, and is well-aligned with the Total Force in developing
    and implementing deployment support and reintegration programs for
    deploying IA personnel and units throughout all phases of the
    mobilization cycle.
        The Returning Warrior Workshop (RWW) is now available to RC and AC
    Sailors, Marines, and their spouses throughout the country. The RWW
    serves as a model in the development of a broad spectrum of additional
    ``Continuum of Care'' programs and events. The workshops epitomize
    Sailors taking care of Sailors; they reflect the Navy's dedication to
    supporting, educating, and honoring our Sailors and families, and they
    communicate a strong message that the Navy values their service and
    sacrifice.
        RWWs are ``five-star events'' conducted on weekends and attended by
    up to 200 Sailors, Marines, and spouses. Attending participants have
    the opportunity to address personal, family, or professional situations
    experienced during deployment and receive readjustment and
    reintegration support and resources from a network of counselors,
    psychological health outreach coordinators, chaplains, and Fleet and
    Family Support Center representatives. Throughout the weekend,
    participants benefit greatly from considerable counseling opportunities
    to educate and support the Navy Family and assist Sailors in re-
    acclimating with their families and to civilian lives.
        The future for RWWs is bright given the unprecedented success of
    the workshops completed in 2008 and those already completed in 2009.
    The recent event in Albuquerque, New Mexico was the 21st successful
    event since the inception of the program by Navy Region Southwest
    Reserve Component Command (at Navy Operational Support Center, Phoenix)
    in late 2007. Looking ahead, 29 additional workshops are contracted and
    funded through July 2010.
        Our Return-Reunion-Reintegration team is placing strong emphasis on
    the development, implementation, and enhancement of several other
    transformational programs and events. These high profile initiatives
    include: Full implementation of DOD's Yellow Ribbon Reintegration
    Program by Navy; modification of the Chaplain's Religious Enrichment
    Development Operation (CREDO) retreats to provide a ``One-Day Up-
    Check'' for returning Sailors as an alternative to the RWW; and
    development of comprehensive roles and responsibilities for
    Psychological Health Outreach Coordinators assigned to each region.
                          people policies and programs
        A central component of Navy's Total Force strategy is the
    establishment of a culture of a ``Continuum of Service'' to provide
    opportunities for Sailors to transition in and out of active service at
    different stages of their careers. The Continuum of Service represents
    a new operating paradigm which can be summarized by the phrase:
    ``Recruit once, Retain for life.'' Last year, the Navy's accession and
    retention bonuses for RC Sailors increased to $108 million, enhancing
    our ability to recruit and retain the right people for the right job.
    For fiscal year 2008, Navy Recruiting Command achieved 100 percent of
    the RC enlisted accession goal, and 105 percent of RC General Officer
    goal. As recently stated by our Chief of Naval Personnel, VADM Mark E.
    Ferguson, we believe we are on track to repeat this success in fiscal
    year 2009. Once we recruit, train, and lead these Sailors through their
    initial tours of duty, our imperative is to give them opportunities to
    transition between the Active and Reserve Components, allowing them to
    find the life/work balance that's right for them. This will strengthen
    the focus on retention and reduce the burden on recruiting.
        In addition to achieving the Navy's recruiting goals, the retention
    and attrition for RC personnel have been just as successful. Improved
    retention and lower attrition rates are attributed to a slowing economy
    and an effective recruiting campaign through our ``Stay Navy''
    initiatives. These efforts target affiliation and retention bonuses on
    skill sets we need the most. In fiscal year 2009, we continue to target
    high-demand/low-supply communities and critical skill sets with
    competitive monetary incentives.
        Navy Reserve end strength has declined by approximately 20,000
    Sailors from 2003 through 2008 (88,156 RC Sailors in 2003 to 68,136 RC
    Sailors in 2008). The anticipated steady state end strength is
    approximately 66,000 in fiscal year 2013. During fiscal year 2008, to
    provide for a stable RC inventory, we implemented several force shaping
    measures that included a reduction in prior service accessions, as well
    as proactive management of Transient Personnel Units (TPUs), overmanned
    designators, and Sailors reaching High Year Tenure. These measures
    proved to be effective, as the Navy ended fiscal year 2008 with 68,136
    RC personnel (approximately 0.5 percent above our statutory end
    strength authorization of 67,800).
        In fiscal year 2009, we already see higher retention and fewer
    losses than planned in the enlisted and officer populations. To
    mitigate this over-execution, we continue to enforce current policies
    and adjust enlisted prior service accessions. Our goal is to finish
    fiscal year 2009 with a more stable, balanced inventory of Sailors that
    positions our Reserve force for continued Total Force support.
        Vice Admiral Ferguson and I are identifying legislative, financial,
    technological, and policy barriers impeding a Continuum of Service and
    developing management practices to quickly and efficiently transition
    Sailors between components to meet changing workforce demands. One of
    our key initiatives is to implement a process that transitions Sailors
    between the AC and RC within 72 hours. As we provide opportunities to
    transition seamlessly between active and reserve statuses, Navy's Total
    Force will capitalize on the spirit of volunteerism to encourage a
    Sailor's lifetime of service to the Nation.
        The Navy needs Total Force systems that will reduce administrative
    impediments to a Continuum of Service. The administrative
    inefficiencies created by multiple electronic pay and manpower systems
    create waste and unnecessary burdens on Sailors, and they also hinder
    Force readiness. A common AC/RC pay and personnel system is crucial to
    building seamless transitions and the success of our Sailor for Life
    and Continuum of Service initiatives. In the future, manpower
    transactions will ideally be accomplished with the click of a mouse,
    and records will be shared through a common data repository within all
    DOD enterprises. Navy fully supports this vision of an integrated set
    of processes to manage all pay and personnel needs for service members,
    concurrently providing necessary levels of personnel visibility to
    support joint warfighter requirements. Manpower management tools must
    facilitate audits of personnel costs, and support accurate, agile
    decision-making at all levels of DOD.
        One constraint to seamless transitions is the multiple RC funding
    categories. We are working closely with the Office of the Secretary of
    Defense to reduce the number of duty types, aiming to improve
    efficiency while retaining the flexibility Navy Reservists need to
    manage their careers and personal lives. Coupled with a well-developed,
    web-enabled personnel management system, this initiative will enable RC
    Sailors to rapidly surge to support validated requirements. The
    consolidation of most RC order writing to the Navy Reserve Order
    Writing System (NROWS) has been a significant evolution in Navy's
    effort to integrate its Total Force capabilities by aligning funding
    sources and accurately resourcing operational support accounts.
        The Honorable Secretary of the Navy Donald C. Winter recently
    approved the Navy's request to transition to a community management-
    based promotion policy for the RC Officer community--both SELRES and
    FTS. As a result, the Navy has implemented a policy change to
    ``decouple'' its Reserve Officer promotion zones from the AC Officer
    promotion zones, as was the current practice under the Running Mate
    System (RMS). In place since 1947, the RMS linked RC and AC promotion
    zones without consideration of RC community needs. Under the Navy Total
    Force construct, Officer Community Managers (OCMs) now have the
    flexibility to develop promotion plans and policies that meet
    individual community and component needs, especially for SELRES
    Officers.
        For Navy Reservists who look to further their professional
    development, the Navy has recently obtained Joint and Combined
    Warfighting class quotas for RC personnel (both FTS and SELRES) at the
    Joint Forces Staff College. These new class quotas complement the
    Advanced Joint Professional Military Education course that is already
    in place. The Navy is also in the early stages of establishing an RC
    Foreign Area Officer (FAO) program. RC FAOs will be part of a cadre of
    Officers aligned with the AC who have the skills required to manage and
    analyze politico-military activities overseas.
                                   conclusion
        Since 9/11, nearly 53,000 contingency activation requirements have
    been filled by SELRES personnel, along with an additional 4,300
    contingency requirements filled by FTS Sailors in support of on-going
    conflicts in Iraq, Afghanistan, and the Horn of Africa. On any given
    day, more than 18,000 Navy Reservists, or about 26 percent of the
    Force, are on some type of orders that provide support to global
    operation requirements of Fleet Commanders and COCOMs. Our more than
    67,000 Sailors serving in the RC are forward deployed in support of
    Coalition forces, at their supported commands around the world, or in
    strategic reserve, ready to surge 24/7 each day if more Navy Total
    Force requirements arise.
        I am proud to be a Navy Reservist, and I am humbled by the
    commitment of the men and women of our Navy Reserve. It is very
    rewarding and fulfilling to stand shoulder to shoulder with the Navy's
    AC as we meet our Nation's requirements. Although I readily admit my
    bias, there has never been a more meaningful time to be part of the
    Navy-Marine Corps team, and our Navy Reserve is clearly an integral
    part of the this hard-working, high-spirited and amazingly capable
    force.
        The Navy's ability to be present in support of any operation, in
    war and peace, without permanent infrastructure in the area of
    operations, is a key advantage that will become even more important in
    the future. Our Navy remains the preeminent maritime power, providing
    our Nation with a global naval expeditionary force that is committed to
    global security, while defending our homeland as well as our vital
    interests around the world. The Navy Reserve's flexibility,
    responsiveness, and ability to serve across a wide spectrum of
    operations clearly enhances the Navy Total Force, acts as a true force
    multiplier, and provides unique skill sets towards fulfilling Navy's
    requirements in an increasingly uncertain world.
        On behalf of the Sailors, civilians, and contract personnel of our
    Navy Reserve, we thank you for the continued support within Congress
    and your commitment to the Navy Reserve and our Navy's Total Force.

        Chairman Inouye. Now may I call upon General Bergman?
    STATEMENT OF LIEUTENANT GENERAL JACK W. BERGMAN,
                COMMANDER, MARINE FORCES RESERVE, UNITED
                STATES MARINE CORPS
        General Bergman. Good morning, Chairman Inouye, Vice
    Chairman Cochran. First, thank you, to you and all the members
    of the subcommittee, for your continued support, your continued
    strong support because, without it, the Marine Corps Reserve's
    ability to sustain capability, warfighting capability, in the
    longest call-up of Reserve and Guard units in the history of
    the Nation, it has made a big difference. Your support has made
    the Marine Corps Reserve the ready and relevant fighting force
    that it is today.
        During the past several years, a basic underlying change
    has occurred. Instead of being a strategic reserve, we are now
    largely in the Marine Corps as an operational reserve. About 80
    percent of our drilling reservists are unit-based, and that
    makes up our operational reserve. As that unit-based force, we
    have implemented the force generation model. This model creates
    maximum predictability, predictability for everyone,
    predictability for the marines, for their families, for their
    employers, and for our active component as we work on the ever-
    complex issues of force flow and who goes in what rotation,
    predictability for manning, equipping, training, all of which
    are tied to budgeting. The force generation model is now just
    beginning to allow us to plan for a 5-year well-budgeted,
    highly effective training/dwell time for our units.
        I would suggest to you that there is nothing more adaptable
    than a marine in the fight. Our force generation model has
    enabled us to transition to that highly adaptable operational
    reserve.
        However, because of recent Marine Corps focus on building
    the active component to 202,000, which we have successfully
    done and will be 2 years ahead of schedule here by the end of
    this fiscal year, some of the manpower planning and policies
    that were focused on the active component are just now
    beginning to be refocused to ensure that this transition from
    the strategic to the operational Reserve is effectively planned
    for and effectively implemented.
        I look forward to your questions.
        Chairman Inouye. Thank you very much.
        [The statement follows:]
            Prepared Statement of Lieutenant General Jack W. Bergman
        Chairman Inouye, Senator Cochran, and distinguished Members of the
    Subcommittee, it is my honor to report to you on the state of your
    Marine Corps Reserve.
        I am pleased to report that your Marine Corps Reserve continues to
    equip and train the best and brightest of our Nation's sons and
    daughters. In an environment where the Marine Corps continues to
    rapidly adapt to broad strategic conditions and wide-ranging threats,
    your Marine Corps Reserve--a primarily Operational Reserve--continues
    to meet all challenges and commitments. Whether in Iraq today,
    Afghanistan tomorrow or in subsequent campaigns, your Marine Corps
    Reserve continues to answer the clarion call to arms in defense of this
    great Nation.
        On behalf of all our Marines, sailors and their families, I would
    like to take this opportunity to thank the Subcommittee for its
    continuing support. The support of Congress and the American people
    reveal both a commitment to ensure the common defense and a genuine
    concern for the welfare of our Marines, sailors and their families.
                          today's marine corps reserve
        Your Marine Corps Reserve continues to be fully capable of war
    fighting excellence. As a vested partner in the Total Force Marine
    Corps, we faithfully continue our steadfast commitment to provide
    Reserve units and personnel who stand shoulder-to-shoulder with their
    Active Component counterparts in all contingencies, operations and
    exercises.
        As of March 3, 2009, 52,369 Reserve Marines and approximately 99
    percent of U.S. Marine Corps Reserve units were activated since 9/11--
    98 percent of our activated units deployed to the U.S. Central Command
    area of responsibility.
        Today's Marine Corps Reserve is characterized by a strong resolve
    that enables us to sustain the current operational pace during the
    longest mobilization period in our Nation's history. However, to
    continue this unprecedented pace will require adequate funding. Without
    the total funding, currently provided through baseline and supplemental
    processes, we would be unable to maintain a truly Operational Reserve.
        The Force Generation Model, implemented in October 2006, continues
    to provide predictability of future activation and deployment schedules
    for our Marines and sailors. The predictability the Model provides has
    been well received by our Marines, sailors and employers. The Model
    provides our Reservists the opportunity to effectively plan their lives
    throughout their Reserve contractual agreement, enabling them to
    creatively strike a successful balance between family, civilian career
    and service to community, country and Corps. I am happy to report that
    we recently activated the fifth rotation based upon the Model to
    Operations Iraqi and Enduring Freedom (OIF and OEF) with 5,500 Marines
    being activated and deployed during fiscal year 2008. Additionally, we
    have activated approximately 2,500 more Marines during the timeframe
    November 2008 to February 2009.
        The Force Generation Model continues to assist Service and Joint
    Force planners in maintaining a consistent flow of fully capable Marine
    Corps Reserve units. This steady flow of Reserve units is essential in
    enabling our Active Component to reach a 1:2 dwell time. The Model,
    based on 1-year activation to 4-plus years in a non-activated status,
    continues to be both supportable and sustainable. Predictable
    activation dates permit unit commanders to focus training on core
    mission capabilities early in the dwell period; and then train to
    specific OIF and OEF mission tasks once the unit is within 12 to 18
    months of activation. Additionally, the amount of cross-leveling has
    been significantly reduced. With each subsequent rotation, the
    requirement to cross-level continues to decrease. For example, the
    upcoming activation of the St. Louis, Missouri-based 3rd Battalion,
    24th Marine Regiment, will require minimal cross-leveling of enlisted
    personnel.
        We believe the full benefit of the Force Generation Model will
    begin to be realized once we have completed a full cycle of nine
    rotations and the Active Component reaches the authorized end strength
    of 202,000. A very important byproduct of the Force Generation Model
    will be our emerging ability to more accurately budget for training and
    equipment requirements during the 5 year dwell time.
        In addition to the 5,500 Marines activated and deployed during
    fiscal year 2008 in support of OIF and OEF, we deployed an additional
    3,300 Marines worldwide in support of joint and/or combined Theater
    Security Cooperation Exercises. In each of the past 3 years, between
    OIF, OEF, Theater Security Cooperation Exercises, and recently emerging
    security cooperation mobile training teams that conduct Phase-0
    operations, nearly one-third of our force has deployed outside the
    continental United States both in an activated and non-activated
    status.
        During this past year, more than 3,300 Marines from Fourth Marine
    Division have served in Iraq. Included are two infantry battalions, as
    well as armor, reconnaissance, combat engineer, military police, and
    truck units. Of particular note, the El Paso, Texas-based Battery D,
    2nd Battalion, 14th Marine Regiment, became the second Marine Corps
    High Mobility Artillery Rocket System (HIMARS) unit to be deployed.
    Another highlight was the success of New Orleans, Louisiana-based 3rd
    Battalion, 23rd Marine Regiment, in al-Anbar Province. This infantry
    battalion, with companies in Louisiana and Texas, played a key role in
    the redevelopment of the Haditha K3 Oil Refinery and transport of crude
    oil in al-Anbar Province. Their efforts, spurred primarily by several
    of the battalion's Marines who are consultants and executives within
    the U.S. oil and energy industry, resulted in the successful rail
    transport of crude oil into Anbar and restart of the oil refinery by
    July 2008, several years after the refinery and rail system had ceased
    to operate. Also of note was the ability and flexibility of the
    Division units to train for and conduct ``in lieu of'' or provisional
    missions due to changing operational requirements in OIF/OEF.
        Fourth Marine Division also deployed two of its regimental
    headquarters in the role of Marine Air Ground Task Forces (MAGTF)
    command elements. Kansas City, Missouri-based 24th Marine Regiment
    deployed as a Special Purpose MAGTF to U.S. Southern Command to support
    the new Partnership of the Americas series of small combined Theater
    Security Cooperation Exercises in South America. The San Bruno,
    California-based 23rd Marine Regiment led a combined joint regimental
    headquarters in support of exercise African Lion in Morocco as well as
    a combined joint battalion headquarters in support of Exercise Shared
    Accord in Ghana. These three exercises alone incorporated the
    deployment of more than 1,100 Marines from across Marine Forces
    Reserve. Fourth Marine Division also conducted training to assist our
    allies in foreign militaries from Korea to the Republic of Georgia.
    Calendar Year 2009 will be a busy year for the Division as they conduct
    training in Benin, Brunei, Ukraine, the Dominican Republic, the
    Bahamas, Brazil, Guatemala and Guyana. Returning to exercises in
    Morocco and Australia and supporting the 50th anniversary of UNITAS
    Gold with a command element from 24th Marine Regiment will be key
    engagements. From May through August 2009, an activated Reserve
    reinforced rifle company from the 24th Marine Regiment and a composite
    platoon of Marines from the 4th Amphibious Armored Battalion, in
    partnership with the U.S. Navy, will conduct training and exercises in
    Brunei, Singapore, Malaysia, Indonesia, Thailand and the Philippines
    during exercise Cooperation and Readiness Afloat Training (CARAT).
        Fourth Marine Aircraft Wing has continued to provide essential
    exercise support and pre-deployment training normally provided by
    Active Component squadrons. The Marine Corps' premier pre-deployment
    training exercise, Mojave Viper, received a majority of air support
    from our fixed wing and helicopter squadrons. Fourth Marine Aircraft
    Wing deployed Mount Clemens, Michigan-based, Marine Wing Support
    Squadron 471 as a Provisional Security Company to Camp Lemonier,
    Djibouti, in the Horn of Africa, provided a truck platoon to support
    combat operations for the Active Component's 3rd Battalion, 7th Marine
    Regiment in Iraq, and sourced multiple Marine Air Control detachments
    from Chicago, Illinois-based Marine Air Control Group 48. Marine
    Transport Squadron Belle Chasse (Louisiana) Detachment is currently in
    theater with the UC-35 Citation Encore aircraft providing critical
    Operational Support Airlift capability to U.S. Central Command.
        Additionally, Fourth Marine Aircraft Wing has participated in
    multiple combined, bilateral and joint exercises in Africa, Asia,
    Europe, and South America. Humanitarian Assistance construction
    projects were conducted in Trinidad-Tobago, Peru, and Honduras.
    Participation in these exercises includes support of U.S. and Marine
    Corps forces and facilitates training and interoperability with our
    allies. For example, African Lion participation enabled the Moroccan
    Air Force to develop better close air support and aerial refueling
    techniques.
        Fourth Marine Aircraft Wing continues to be an integral partner in
    the Marine Corps Aviation Transition Strategy. In the near term,
    transition from legacy to leap-ahead aviation capabilities (i.e. MV-22,
    UH-1Y, AH-1Z and JSF) in the Active Component required a transfer of
    certain Reserve Component aviation manpower, airframes and support
    structure to the Active Component Marine Corps. As a result, two
    Reserve Fighter/Attack F/A-18 squadrons were placed in cadre status and
    a Light Attack UH-1N/AH-1W helicopter squadron, a Heavy Lift CH-53E
    helicopter squadron, an Aviation Logistics Squadron and two of four
    Marine Aircraft Group Headquarters were decommissioned. A second Heavy
    Lift CH-53E helicopter squadron has been reduced in size. As the Active
    Component transitions to the new airframes, Fourth Marine Aircraft Wing
    has assumed the Fleet Replacement Squadron role for the legacy model
    KC-130s, UH-1s, and AH-1s. Additionally, as part of the Aviation
    Transition Strategy, two Tactical Air Command Center Augmentation Units
    were commissioned. To complete the Aviation Transition Plan, beginning
    in 2014, Fourth Marine Aircraft Wing will begin transitioning to the
    new airframes and Command and Control (C\2\) capabilities.
        Fourth Marine Logistics Group continues to provide fully capable
    units, detachments and individuals prepared to deliver sustained
    tactical logistics support. In the past year, Fourth Marine Logistics
    Group provided approximately 1,300 Marines and sailors from across the
    spectrum of combat service support to augment the Active Component's
    1st and 2nd Marine Logistics Groups engaged in OIF. In addition to the
    requirements of the Force Generation Model, Fourth Marine Logistics
    Group provided additional support to OIF by sourcing 265 Marines to
    staff the al-Taqauddam Security Force and to OEF by sourcing 279
    Marines from the Portland, Oregon-based 6th Engineer Support Battalion
    to staff Provisional Security Company 8 at Camp Lemonier, Djibouti, in
    the Horn of Africa.
        Increased augmentation in support of OIF/OEF will include a
    complete Combat Logistics Battalion (CLB-46) formed with more than 800
    Marines and sailors from across Fourth Marine Logistics Group's nine
    battalions. Combat Logistics Battalion 46 will provide tactical level
    logistics support to a Marine Regimental Combat Team in al-Anbar
    Province, Iraq. This will be the first CLB formed and deployed by
    Fourth Marine Logistics Group.
        Continuing to aggressively support overseas joint and combined
    exercises, training, and other events in support of the Combatant
    Commanders' Phase-0 operations, Fourth Marine Logistics Group
    participated in 29 overseas events spread across all of the Unified
    Commands, ranging in size from exercises involving 75 Marines down to
    3-person Traveling Country Teams that conducted engagement with foreign
    militaries. Olympic Thrust in June 2008 began the preparation of Fourth
    Marine Logistics Group's battalions' staffs to form the nucleus of a
    CLB headquarters. Exercise Javelin Thrust (June 2009) will be a
    capstone preparation event for CLB-46.
        Fourth Marine Logistics Group has taken the lead on coordinating
    Marine Forces Reserve's participation in Innovative Readiness Training
    (IRT) program events. The purpose of the IRT program is to provide
    civic assistance projects in the United States, possessions and
    territories while simultaneously improving military readiness. Fourth
    Marine Logistics Group has initiated and conducted IRT planning during
    the last year and will execute two events in Alaska and one event in
    the Marianas Islands during 2009. These events will focus on
    infrastructure improvements and medical/dental assistance projects.
        In addition to ground, aviation, and logistic elements, Marine
    Forces Reserve has provided civil affairs capabilities since the start
    of OIF. Air-Naval Gunfire Liaison Detachments from Marine Forces
    Reserve have augmented the supported Marine Air Ground Task Forces and
    adjacent commands with air/ground fires liaison elements. Marine Forces
    Reserve also continues to provide intelligence augmentation, to include
    Human Exploitation Teams, Sensor Employment Teams, and Intelligence
    Production Teams.
        The trend in recent years toward increased participation of Marines
    in the Individual Ready Reserve (IRR) continued in fiscal year 2008.
    During the fiscal year, the Marine Corps Mobilization Command (MOBCOM)
    mustered more than 1,500 Marines from the IRR to screen and prepare
    them for activation. More than 1,500 sets of mobilization orders were
    issued with a total of 1,002 IRR Marines reporting for activation
    during fiscal year 2008. MOBCOM also processed more than 8,100 sets of
    shorter duration active duty orders for IRR Marines during fiscal year
    2008. We have expanded our family programs to reach out to the families
    of our deployed IRR Marines, using local Peacetime/Wartime Support
    Teams as well as MOBCOM assets. With the advent of Yellow Ribbon
    Legislation, we continue to develop programs to better support our
    deploying and returning Marines and their families.
        MOBCOM modified its IRR muster program during 2008, from large
    scale metropolitan musters to a combination of large scale musters and
    smaller, more personalized musters at Reserve sites. We completed the
    fiscal year screening of approximately 11,000 of the 55,000 Marines in
    our IRR population. Our screening effectiveness continues to rise as we
    continue to develop better communication methods with our IRR
    population. For example, MOBCOM contacted and engaged the IRR Marines
    through email, letter correspondence and telephone calls. Higher
    quality communications keeps our Marines better informed and prolongs
    their connection with each other and our Corps. We believe that these
    longer-term connections will be critical as we truly seek to create the
    Continuum of Service necessary to support a sustainable Operational
    Reserve.
        The Marine Corps Reserve's continuing augmentation and
    reinforcement of the Active Component is not without cost. Continuing
    activations and high Reserve operational tempo highlight personnel
    challenges in select military occupational specialties and significant
    strain on Reserve equipment.
                                   personnel
        The Selected Marine Corps Reserve is comprised of Reserve unit
    Marines, Active Reserve Marines, Individual Mobilization Augmentees,
    and Reserve Marines in the training pipeline, which when added
    together, form the inventory of the end strength in the Selected Marine
    Corps Reserve.
    End Strength
        Although we continue to benefit from strong volunteerism of our
    Reserve Marines, a degradation in our ability to achieve authorized end
    strength has occurred. Fiscal years 2002 to 2005 had percentages of
    authorized end strength above 100 percent and fiscal year 2006
    percentage of authorized end strength at 99.71 percent. Fiscal years
    2007 and 2008 percentages of authorized end strength were at 97.36 and
    94.76 percent--shortfalls of 1,044 and 2,077 Marines respectively. This
    resulted in the only fiscal years since 9/11 that the Selected Marine
    Corps Reserve fell below the Title 10 allowable 3 percent variance from
    authorization.
        As previously stated in my testimonies before the House and Senate
    Appropriations Committees' Subcommittees on Defense during 2008, we
    anticipated an adverse affect on meeting an acceptable percentage of
    authorized Marine Corps Selected Reserve end strength as greater
    numbers of Reserve Component Marines volunteered for full-time active
    duty due to the Marine Corps' accelerated build to a 202,000 Active
    Component Marine Corps.
        During the past fiscal year, we accepted the short-term risk in our
    ability to obtain our Selected Marine Corps Reserve Component end
    strength of 39,600 as the Reserve accession plans were adjusted and our
    experienced and combat tested Reserve Marines were encouraged to
    transition back to active duty to support the build effort, and they
    responded in force: From 2007 to present, approximately 1,946 Reserve
    Marines returned to, or are awaiting return to, active duty.
        The fact is that the Active Component Marine Corps will continue to
    rely heavily upon augmentation and reinforcement provided by our
    Reserve Marines. I firmly believe our authorized end strength of 39,600
    is still highly relevant and appropriate, and will consequently drive
    recruiting and retention. This number provides us with the Marines we
    require to support the Force and to achieve our goal of a 1:5
    deployment-to-dwell ratio in the Selected Marine Corps Reserve.
        Additionally, it is worth noting, the Marine Corps is on pace to
    reach an active duty end strength of 202,000 by the end of fiscal year
    2009, which will enable the Marine Corps to refocus the Reserve
    recruiting and retention efforts to achieve the expected percentage of
    authorized Selected Marine Corps Reserve Component end strength. The
    bonuses and incentives for recruiting and retention provided by the
    Congress are essential tools for helping us accomplish this goal and I
    thank you for your continued support.
    Recruiting
        The Marine Corps is unique in that all recruiting efforts (officer,
    enlisted, regular, Reserve, and prior-service) fall under the direction
    of the Marine Corps Recruiting Command. Operationally, this provides
    the Marine Corps with tremendous flexibility and unity of command in
    order to annually meet Total Force Marine Corps objectives.
        Like the Active Component, Marine Corps Reserve units primarily
    rely upon a first term enlisted force. Currently, the Marine Corps
    Reserve continues to recruit and retain quality men and women willing
    to manage commitments to their families, their communities, their
    civilian careers, and their Corps. Despite high operational tempo, the
    morale and patriotic spirit of Reserve Marines, their families, and
    employers remains extraordinarily high.
        The Marine Corps Recruiting Command achieved 100 percent of its
    recruiting goal for non-prior service recruiting (5,287) and exceeded
    its goal for enlisted prior service recruiting (2,672) during fiscal
    year 2007; and achieved 100 percent of its recruiting goal for non-
    prior service recruiting (4,235) and prior service recruiting (4,501)
    in fiscal year 2008. As of February 1, 2009, 1,756 non-prior service
    and 1,227 enlisted prior service Marines have been accessed, which
    reflects 48 percent of the annual enlisted recruiting mission for the
    Selected Marine Corps Reserve. We fully expect to meet our Selected
    Marine Corps Reserve recruiting goals again this year.
        An initiative implemented during June 2006 at Marine Forces Reserve
    to enhance recruiting efforts of prior service Marines was the Selected
    Marine Corps Reserve Affiliation Involuntary Activation Deferment
    policy. Realizing that deployments take a toll on Active Component
    Marines, causing some to transition from active duty because of high
    personnel tempo, we continue to offer this program. This program allows
    a Marine who has recently deployed an option for a 2-year deferment
    from involuntary activation if they join a Selected Marine Corps
    Reserve unit after transitioning from active duty. The intent of the 2-
    year involuntary deferment is to allow transitioning Marines the
    opportunity to participate in the Selected Marine Corps Reserve without
    sacrificing the ability to build a new civilian career.
        Junior officer recruiting and consequently meeting our Reserve
    company grade requirement remains the most challenging area.
    Historically, the Active Component Marine Corps has been the source of
    company grade officers to the Selected Marine Corps Reserve, due to
    initial active duty contractual requirements of all Reserve-
    commissioned officers. There are, however, three programs in place now
    that enable Reserve officer accessions without the typical 3 to 4-year
    active duty obligation: the Reserve Enlisted Commissioning Program
    (RECP), the Meritorious Commissioning Program--Reserve (MCP-R) and the
    Officer Candidate Course--Reserve (OCC-R).
        These programs strive to increase the number and quality of company
    grade officers within deploying Reserve units while addressing our
    overall shortage of junior officers in our Reserve units. The three
    programs combined to access 108 Reserve officers during fiscal years
    2007 and 2008, and are an essential tool to help mitigate company grade
    officer shortages in the Selected Marine Corps Reserve.
        Eligibility for the RECP was expanded to qualified Active Duty
    enlisted Marines. The MCP-R was established for qualified enlisted
    Marines, Reserve and Active, who possess an Associates Degree or
    equivalent number of semester hours. The third program, the OCC-R, has
    proven to be the most successful as 93 candidates have been
    commissioned second lieutenants in the Marine Corps Reserve during
    fiscals years 2007 and 2008. We anticipate commissioning between 50 and
    75 more second lieutenants through the OCC-R this fiscal year.
        The OCC-R focuses on ground-related billets, with an emphasis on
    ground combat and combat service support within Reserve units that are
    scheduled for mobilization. The priority to recruit candidates is tied
    to the Marine Forces Reserve Force Generation Model. Refinement of the
    OCC-R program to target geographic company grade officer shortfalls is
    a logical next step.
    Retention
        All subordinate commanders and senior enlisted leaders at each
    echelon of command are required to retain quality Marines. On a monthly
    basis, these leaders identify Marines who either have to re-enlist or
    extend. Identified Marines are counseled concerning the opportunity for
    their retention in the Selected Marine Corps Reserve.
        Enlisted retention trends remain a concern and are being monitored
    very closely, but were obviously affected by the Active Component
    202,000 build. The good news is that the Active Component Marine Corps
    is no longer making a concerted effort to draw personnel from the
    Selected Marine Corps Reserve to active duty.
        For fiscal year 2008, Reserve officer retention remained at the
    same level as during the previous fiscal year, which was above historic
    levels.
        We continue to offer retention incentives for enlisted Marines in
    the Selected Marine Corps Reserve, to include the maximum allowable
    $15,000 Selected Marine Corps Reserve Affiliation Bonus for an initial
    3-year commitment. We also offer a $10,000 Selected Marine Corps
    Reserve Officer Affiliation Bonus for those officers who affiliate with
    a Selected Marine Corps Reserve unit and agree to participate for 3
    years. I greatly appreciate the continuance of the increased
    reenlistment incentive, which was initially provided in the fiscal year
    2008 National Defense Authorization Act.
        These incentives are necessary tools to help us retain quality
    Marines and consequently assist us in achieving an acceptable
    percentage of authorized Selected Reserve end strength.
        I read with interest the Memorandum of July 24, 2008, by Secretary
    Gates concerning the recommendations of the Commission on the National
    Guard and Reserves. I am pleased to see the strong emphasis on study of
    the various recommendations that pertain to the Continuum of Service
    personnel management construct. As the Continuum of Service concept is
    refined, it should facilitate the affiliation of prior service Marines
    into the Selected Marine Corps Reserve as well as retain those good
    Marines already serving.
                                   equipment
        The Marine Corps Reserve, like the Active Component, has two
    primary equipping priorities: first--equipping individual deploying
    Marines and sailors, and second--equipping our units to conduct home
    station training. We will continue to provide every deploying Marine
    and sailor with the latest generation of individual combat and
    protective equipment. Our unit equipping efforts include the full
    complement of equipment to support training efforts across the MAGTF.
    This complement includes essential communications; crew-served weapon
    systems such as Light Armored Vehicles (LAVs), Assault Amphibian
    Vehicles (AAVs), Tanks, and Artillery; ground mobility; and ground
    support equipment, which requires continued adequate funding of our
    Operations and Maintenance accounts. Your continued support in this
    area has enabled us to adequately sustain home station training and
    pre-deployment operations.
        As with all we do, our focus will continue to be on the individual
    Marine and sailor. Ongoing efforts to equip and train this most valued
    resource have resulted in obtaining the latest generation individual
    combat and protective equipment: M16A4 service rifles, M4 carbines,
    Rifle Combat Optic scopes, improved helmet pad suspension systems,
    enhanced Small Arms Protective Insert plates, Modular Tactical Vests,
    and the latest generation AN/PVS-14 Night Vision Devices, to name a
    few. Every member of Marine Forces Reserve has deployed fully equipped
    with the most current authorized Individual Combat Clothing and
    Equipment to include Personal Protective Equipment.
        Marine Forces Reserve's unit equipping priority is to obtain the
    principal end items necessary to establish or replenish the appropriate
    inventory of equipment to the level dictated by our Training Allowance
    (TA). Training Allowance is the amount of equipment needed by each unit
    to conduct home station training. Our Reserve units should train with
    the equipment necessary for Marine Forces Reserve to effectively
    augment and reinforce the Active Component.
        Currently, our equipping focus is on mitigating the short-term
    impact of reduced supply of certain principal end items, e.g.; seven
    LAV variants, Digital Terrain Analysis Mapping Systems, and the Theater
    Provide Equipment Sensors. We employ adaptive resourcing and training
    management approaches to ensure our Reserve units can adequately train.
    The inherent latency in procurement timelines and competing priorities
    for resources continue to challenge the training and equipping of our
    Operational Reserve. Since the Marine Corps procures and fields
    equipment as a Total Force, equipment modernization efforts of the
    Marine Corps Reserve are synchronized with the efforts of the Active
    Component. The approved $37.3 million fiscal year 2009 NGREA will
    provide Marine Forces Reserve the funds to procure much needed Tactical
    Laptop Computer Packages (Ruggedized Laptops and General Purpose
    Laptops), Supporting Arms upgrade to Digital Virtual Training
    Environment (DVTE), Bright Star FLIR, Light Armored Vehicle 25 A2
    Variant (LAV-25A2), and a Tactical Remote Sensor Suite (TRSS).
        To maintain an inventory of current equipment necessary to conduct
    home station training, Marine Forces Reserves utilizes several
    resources and programs. Routine preventive and corrective maintenance
    are still performed throughout the country by our Marines. However,
    ground equipment maintenance efforts have expanded over the past few
    years, leveraging contracted services and depot-level capabilities.
    Marine Corps Logistics Command (LOGCOM), through mobile maintenance
    teams, provides preventive and corrective maintenance support to our
    Reserve units. Marine Forces Reserve is actively involved in the Marine
    Corps Depot Level Maintenance Program (DLMP) to support the continued
    operation of principal end items. Marine Corps Logistics Command
    continues to uniquely provide Marine Forces Reserve a ``Repair and
    Return'' (R&R) program which enables us to request additional
    maintenance support when requirements exceed the Marine Forces Reserve
    maintenance capacity.
        Another key maintenance program utilized by Marine Forces Reserve
    is the Corrosion Prevention and Control (CPAC) program which extends
    the useful life of all Marine Corps tactical ground and ground support
    equipment. This program reduces significant maintenance requirements
    and associated costs due to corrosion through the application of
    corrosion-resistant compounds, establishing environmentally-safe wash-
    down racks, and providing climate controlled storage. Additionally, the
    program identifies, classifies, and effects repair, or recommends
    replacement of equipment that has already succumbed to the elements.
        Marine Corps Reserve ground equipment readiness rates are currently
    above 90 percent (Maintenance--97 percent and Supply--92 percent as of
    March 9, 2009), based on our Reserve equipment Training Allowance. The
    Marine Corps Reserve equipment investment overseas MAGTF operations
    since 2004 is approximately 5 percent of our overall equipment and
    includes various communications, motor transport, engineer, and
    ordnance equipment, as well as several modern weapons systems such as
    the new HIMARS artillery system and the latest generation Light Armored
    Vehicle. This investment has presented challenges for our home station
    training requirements yet greatly adds to the war fighting capability
    of the Marine Corps. Deliberate planning at the Service level is
    currently underway to reset the Total Force, to include resourcing the
    Reserve equipment. This resourcing will enable the Marine Corps Reserve
    to remain ready, relevant, and responsive to the demands of our Corps.
        Marine Corps Reserve equipment requirements are captured as part of
    Marine Corps Total Force submissions. Priority Reserve equipment
    requirements that cannot be timely met with these vehicles are
    identified in the Commandant's Unfunded Programs List and/or my NGREA
    Request.
        We especially appreciate Congress' support of the Marine Corps
    Reserve through NGREA. It would be impossible for me to overstate the
    importance of NGREA and in particular, the consistency of these
    appropriations. Since 2002, NGREA has provided more than $240 million
    for equipment procurements. The stability of NGREA funding has
    significantly increased our ability to forecast meeting priority
    equipment requirements. The NGREA provides immediate flexibility,
    allowing procurement of items necessary to meet specific combat
    capability, training, and support requirements.
        In the last 3 years, we have been able to close the gap on combat
    equipment requirements necessary to effectively train our Marines and
    sailors. Examples of high-priority combat equipment purchases we have
    made or will make through fiscal years 2007, 2008 and 2009 NGREA
    funding are: the LITENING II Targeting Pod; the AN/ARC-210 (V) Multi-
    Modal Radio system for our KC-130 aircraft; the UC-12+ aircraft;
    multiple C\2\ systems component; and as previously stated, the BRITE
    STAR FLIR; the Tactical Remote Sensor System; and the LAV-25A2. Through
    consistent NGREA funding, we have been able to completely eliminate
    some deficiencies.
        Additionally, with NGREA, we have been able to establish a robust
    ground combat modeling and simulation program, our NGREA-procured
    Virtual Combat Convoy Trainers (VCCTs), Combat Vehicle Training
    Simulators (CVTSs), Medium Tactical Vehicle Replacement--Training
    Systems (MTVR-TS), HMMWV Egress Trainer, and Digital Virtual Training
    Environments (DVTEs) enable us to overcome many resource and time-
    related challenges while increasing the individual and unit's combat
    readiness. Our fiscal year 2009 NGREA plan includes Supporting Arms-
    Helmet Mounted Displays (SA-HMDs) for our DVTEs, giving our Marines the
    ability to enhance Forward Air Control and Indirect Fire Control
    proficiency without leaving the Reserve Training Center. It is accurate
    to say that we could not have provided some critical capabilities
    without these NGREA funds.
                                    training
        The collective lessons wrought from our unit and individual combat
    experiences, Theater Security Cooperation Exercises and other Active
    Component operational tempo relief deployments have helped improve
    nearly all facets of our current Reserve Component training. In this
    regard, one of the most exciting areas where we are continuing to
    transform the depth and scope of our training remains the cutting-edge
    arena of Modeling and Simulations Technology.
        Rapid advancement in modeling and simulation software, hardware and
    network technologies are providing new and increasingly realistic
    training capabilities. Marine Forces Reserve is training with and
    continuing to field several complex digital video-based training
    systems which literally immerse our Reserve Component Marines into
    ``virtual'' combat environments, complete with the sights, sounds and
    chaos of today's battlefield environment in any climate or place, day
    or night, spanning the full continuum of warfare from high-intensity
    conventional warfare to low-intensity urban conflict.
        One new capability that we are fielding to support our Reserve
    Marines is the Indoor Simulated Marksmanship Trainer-XP. This
    interactive audio/video weapons simulator provides enhanced
    marksmanship, weapons employment and tactical decision making training
    for a variety of small arms. The system consists of infantry weapons
    instrumented with lasers that enable Marines to simulate engaging
    multiple target types.
        Another system addressed in lasts year's testimony that continues
    to prove invaluable in the pre-deployment training of our tactical
    drivers is the Virtual Combat Convoy Trainer-Reconfigurable Vehicle
    System. This is an advanced, full-scale vehicle simulator that trains
    Marines in both basic and advanced combat convoy skills using variable
    terrain and roads in a variety of weather, visibility and vehicle
    conditions. The simulator is a mobile, trailer-configured platform that
    utilizes a HMMWV mock-up, small arms, crew-served weapons, 360-degree
    visual display with after-action review/instant replay capability.
    Marine Forces Reserve was the lead agency for initial procurement,
    training and evaluation of this revolutionary training system, which is
    now being used throughout the Marine Corps. We are now preparing to
    accept the fourth generation of this invaluable training system at Camp
    Wilson aboard the Marine Air Ground Combat Center in Twenty Nine Palms,
    California. Upon installation, student throughput capability for combat
    convoy training will double.
        It is important to recognize the key role that Congress has played
    in the fielding of all four generations of the VCCT. Procurement of the
    VCCT resulted directly from NGREA. Of all the training packages our
    deploying units complete, returning combat veterans have consistently
    praised the invaluable benefits of having had the opportunity to train
    in tactics, techniques and procedures using this advanced simulation
    system.
        Beginning this summer, Marine Forces Reserve will field the newly
    developed Deployable Virtual Training Environment (DVTE). This
    advanced, first-person, immersive, simulation-based training system,
    made up of 16 laptops and peripherals packaged in ruggedized deployable
    cases, is capable of emulating and simulating a wide variety of weapons
    systems and generating hi-fidelity, relevant terrain databases. The
    DVTE also provides small-unit echelons with the opportunity to
    continuously review and rehearse Command and Control procedures and
    battlefield concepts in a virtual environment. The system consists of
    two components, the Combined Arms Network, which provides integrated
    first person combat skills, and Tactical Decision Simulations, which
    provides individual, fire team, squad and platoon-level training
    associated with patrolling, ambushes and convoy operations. Additional
    features include combat engineer training, small-unit tactics training,
    tactical foreign language training and event-driven, ethics-based,
    decision-making training.
        One of our newest and rapidly advancing training initiatives
    involves the collocation of a select number of the previously cited
    training systems aboard Camp Upshur at Marine Corps Base Quantico,
    Virginia. Our intent is to provide an advanced, unit-level training
    capability within easy access of the I-95 corridor. When fully
    established this summer, the Camp Upshur training capabilities will
    include eight mobile VCCT trailers, two mobile HMMWV egress trainers, a
    mobile multi-platform tactical vehicle operator simulation system,
    three Indoor Simulated Marksmanship Trainers that are networked for
    combined arms training, and 80 DVTE terminals. These resources, in
    combination with the billeting, training ranges and facilities
    available aboard MCB Quantico, will provide the opportunity for
    reinforced battalions to conduct training and force-on-force exercises
    using combinations of live, virtual and constructive training systems
    and resources. This initiative provides state-of-the-art training
    support to units while revitalizing long-established Camp Upshur into a
    cost effective, vital and dynamic training resource for Marine Forces
    Reserve and other agencies. In addition to facilitating training at
    Camp Upshur, the numerous mobile training systems will remain available
    for movement and redeployment anywhere in the lower 48 states in
    support of training Reserve Marines.
        All of these advanced training systems have been rapidly acquired
    and fielded with vital Supplemental and NGREA funding. These critical
    funding resources are not only providing a near-term training
    capability in support of combat deployments, but are also providing a
    solid foundation for the transformation of our training environment
    from legacy static training methods to more realistic virtual combat
    training environments designed to prepare our Marines and sailors to
    succeed on future battlefields.
                                   facilities
        Marine Forces Reserve is comprised of 185 locations in 48 states,
    the District of Columbia, and Puerto Rico. These facilities are
    comprised of 32 owned and 153 tenant locations. In contrast to Active
    Duty installations that are normally closed to the general public, our
    Reserve sites are openly located within civilian communities. This
    arrangement requires close partnering with state and local entities
    nationwide. Thus, the condition and appearance of our facilities may
    directly influence the American people's perception of the Marine Corps
    and the Armed Forces as well as possibly impacting our recruiting and
    retention efforts.
        Marine Forces Reserve Facilities Sustainment, Restoration, and
    Modernization (FSRM) program funding levels continue to address
    immediate maintenance requirements and longer-term improvements to our
    older facilities. Sustainment funding has allowed us to maintain our
    current level of facility readiness without further facility
    degradation. Your continued support for both the Military Construction
    Navy Reserve (MCNR) program and a strong FSRM program are essential to
    addressing the aging infrastructure of the Marine Corps Reserve. With
    more than 57 percent of our Reserve Centers being more than 30 years
    old and 44 percent being more than 50 years old, the continued need for
    support of both MCNR and FSRM cannot be overstated.
        The Base Realignment and Closure (BRAC) 2005 continues to move
    forward and the Marine Corps Reserve will begin relocating many Reserve
    units to new consolidated Reserve centers during fiscal year 2009. Like
    other BRAC Business Plans, the Marine Corps Reserve BRAC program is
    tightly linked to other service's business plans for our shared reserve
    centers. Of the 25 BRAC actions for the Marine Corps Reserve, 21 are in
    conjunction with Army and Navy military construction projects.
        In September 2008, the Department of the Navy and the State of
    Louisiana signed a lease for a new Federal City in New Orleans, which
    will provide a new headquarters compound for Marine Forces Reserve. The
    state of Louisiana is providing construction dollars for the new
    headquarters facility and saving the federal government more than $130
    million.
        Our Marine Forces Reserve Environmental Program promotes accepted
    stewardship principles as well as compliance with all regulatory
    requirements in support of training both on site and outside the fence
    line. We employ the Environmental Management System (EMS), which uses a
    systematic approach ensuring that environmental activities are well
    managed and continuously improving. Additionally, Marine Forces Reserve
    has initiated a nationwide program to reduce waste production and
    ensure proper disposal at our centers. We have also executed several
    major projects to protect the nation's waterways near our Reserve
    centers.
                                health services
        Military healthcare support (medical prevention and treatment)
    programs have grown exponentially over the past few years--fiscal year
    2008 being one of the most significant. A myriad of programs are now
    provided to our Marines, sailors, and their families during pre-
    deployment, deployment and post deployment.
        Our Health Services priorities are: (1) maximize education and
    awareness of TRICARE support for Reservists; (2) attain DOD/DON
    Individual Medical Readiness (IMR) goals; and (3) ensure general
    awareness of all health service programs in support of our service
    members.
        TRICARE remains the foundation of our medical support programs,
    providing the full spectrum of medical, dental and behavioral health
    services. As a result of the 2009 Defense Authorization Act analysis of
    TRICARE Reserve Select costs, monthly premiums for TRICARE Reserve
    Select dropped by 42 percent for individual coverage and by 29 percent
    for family coverage on January 1, 2009. Reservists now pay $47.51 a
    month for single coverage, down from $81, while the cost for families
    is down from $253 to $180.17 a month. Reservists and their family
    members are eligible for different TRICARE benefits depending on their
    status: as a member of the Select Reserve, a Reservist may qualify for
    and purchase TRICARE Reserve Select; on military duty for 30 days or
    less a Reservist is covered under Line of Duty care; when activated he
    and his family are covered by TRICARE Prime; and when deactivated a
    Reservist is eligible for transitional health plan options.
        All deploying service members are now required to complete a
    Baseline Pre-Deployment Neuro-Cognitive Functional Assessment. The tool
    used to complete this assessment is called the Automated Neuro-
    Psychological Assessment Metric (ANAM). Results from the ANAM will
    assist leaders and medical providers with evaluating service members
    who screen positive and require necessary medical treatment. The intent
    is that ANAM results and implementation of the Psychological Health
    Outreach Program will provide standardized guidance for providers who
    follow up on identified issues and concerns from results of the Post-
    Deployment Health Assessments, to include development of protocols and
    creation and implementation of an information/benefits tracking system.
    Our Commanders and staff are coordinating with the Navy's Bureau of
    Medicine (BUMED) in order to ensure that deploying Marines and sailors
    are properly evaluated prior to deployment.
        Efforts to assess health post deployment have also increased
    significantly over the past year. In addition to completing a Post
    Deployment Health Assessment prior to returning to the United States,
    our Marines and sailors now complete a Post Deployment Health
    Reassessment (PDHRA) 3 to 6 months after returning from deployment. The
    PDHRA is crucial in identifying and addressing health concerns with
    specific emphasis on mental health issues which may have emerged since
    returning from deployment. Active tracking of this process ensures that
    we meet the post-deployment health care needs of our Marines and
    sailors.
        The Psychological Health Outreach Program, introduced by BUMED, is
    another specialty program which addresses post deployment behavioral
    health concerns. This program is designed to provide early
    identification and clinical assessment of our Reserve Marines and
    sailors who return from deployment at risk for not having stress-
    related injuries identified and treated in an expeditious manner. This
    program, funded by supplemental Defense Health Program appropriations,
    provides outreach and educational activities to improve the overall
    psychological health of our Reservists and identifies long-term
    strategies to improve psychological health support services for the
    Reserve community. We are currently developing our concept and
    implementation strategy to best support the Force.
        Individual medical and dental readiness for our Marines and sailors
    remains a top priority. To improve current readiness of our Reservists,
    which is 64 percent and 73 percent as of March 1, 2009 respectively, we
    continue to utilize the Reserve Health Readiness Program (RHRP). This
    program funds medical and dental contracted specialists to provide
    health care services to units specifically to increase individual
    medical and dental readiness. During fiscal year 2008, this service
    provided more than 3,020 Preventive Health Assessments; 4,013 Dental
    examinations, 402 Dental Panoramic x-rays; 529 Blood Draws; 803
    Immunizations; and 3,149 PDHRAs for our Marines and sailors.
        The Armed Forces Health Longitudinal Technology Application
    (AHLTA), which provides electronic health records for the entire U.S.
    Armed Forces, is currently being rolled out to all Reserve Components
    to include Marine Forces Reserve. The transition to electronic medical
    records will enable optimal health services to our Marines and sailors
    with the end result being increased individual and unit medical
    readiness.
                                quality of life
        We continue to aggressively institute new Family Readiness
    Programs, revitalize services, and proactively reach out to our
    Reservists and their families to ensure our programs and services meet
    the needs and expectations of our Marines and their families.
        As part of widespread Marine Corps reforms to enhance family
    support, we are placing full-time Family Readiness Officers (FROs),
    staffed by either civilians or Active Duty Marines, at the battalion/
    squadron level and above to support the Commander's family readiness
    mission. Modern communication technologies, procedures and processes
    are being expanded to better inform and empower family members
    including spouses, children and parents of single Marines.
        The Marine Forces Reserve Lifelong Learning Program continues to
    provide educational information to service members, families, retirees,
    and civilian employees. More than 1,200 Marine Forces Reserve personnel
    (Active and Reserve) enjoyed the benefit of Tuition Assistance,
    utilizing more than $2.4 million that funded more than 4,000 courses
    during fiscal year 2008. Tuition Assistance greatly eases the financial
    burden of education for our service members while enabling them to
    maintain progress toward their education goals.
        The Marine Corps' partnership with the Boys and Girls Clubs of
    America (BGCA) and the National Association for Child Care Resources
    and Referral Agencies (NACCRRA) continues to provide a great resource
    for service members and their families in selecting child care, before,
    during, and after a deployment in support of overseas contingency
    operations. The Boys and Girls Clubs of America provide outstanding
    programs for our Reserve Marines' children between the ages of 6 and 18
    after school and on the weekends. Under our agreement with BGCA,
    Reserve families can participate in more than 40 programs at no cost.
    With NACCRRA, we help families of our Reservists locate affordable
    child care that is comparable to high-quality, on-base, military-
    operated programs. The NACCRRA provides child care subsidies at quality
    child care providers for our Reservists who are deployed in support of
    overseas contingency operations and for those Active Duty Marines who
    are stationed in regions that are geographically separated from
    military installations. We also partnered with the Early Head Start
    National Resource Center Zero to Three to expand services for family
    members of our Reservists who reside in isolated and geographically-
    separated areas. Additionally, our Marine families (on active duty 30
    or more days) enrolled in the Exceptional Family Member Program are
    offered up to 40 hours of free respite care per month for each
    exceptional family member. This allows our families the comfort that
    their family member will be taken care of when they are in need of
    assistance.
        We fully recognize the strategic role our families have in mission
    readiness, particularly mobilization preparedness. We prepare our
    families for day-to-day military life and the deployment cycle (Pre-
    Deployment, Deployment, Post-Deployment, and Follow-On) by providing
    educational opportunities at unit Family Days, Pre-Deployment Briefs,
    Return and Reunion Briefs, and Post-Deployment Briefs. This is
    accomplished through unit level Family Readiness programs that are the
    responsibility of the Commanding Officer managed by the full-time, non-
    deploying FRO and supported by trained volunteers and Force level
    programs such as Lifestyle Insights, Networking, Knowledge, and Skills
    (L.I.N.K.S.).
        Every Marine Corps Reserve unit throughout the country has a Family
    Readiness program that serves as the link between the command and
    family members--providing official communication, information, and
    referrals. The FRO proactively educates families on the military
    lifestyle and benefits, provides answers for individual questions and
    areas of concerns, and enhances the sense of community and camaraderie
    within the unit. The L.I.N.K.S. program is a training and mentoring
    program designed by Marine spouses to help new spouses thrive in the
    military lifestyle and adapt to challenges--including those brought
    about by deployments. This program has recently been expanded to
    support the extended family of a Marine--children and parents. Online
    and CD-ROM versions of L.I.N.K.S. make this valuable tool more readily
    accessible to families of Reserve Marines who are not located near
    Marine Corps installations.
        To better prepare our Marines and their families for activation,
    Marine Forces Reserve is fully engaged with OSD to implement the Yellow
    Ribbon Reintegration Program, much of which we have had in place for
    quite some time. We continue to implement an interactive approach that
    provides numerous resources and services throughout the deployment
    cycle. Available resources include, but are not limited to, family-
    related publications, online volunteer training opportunities, and a
    family readiness/mobilization support toll free number. Family
    readiness educational materials have been updated to reflect the
    current deployment environment. Specifically, deployment guide
    templates that are easily adapted to be unit-specific were distributed
    to unit commanders and family readiness personnel, as well as Marine
    Corps families, and are currently available on our Web site. Services
    such as pastoral care, Military OneSource, and various mental health
    services are readily available to our Reserve Marines' families. Also,
    through the DOD contract with the Armed Services YMCA, the families of
    our deployed Reserve Marines are enjoying complimentary fitness
    memberships at participating YMCA's throughout the United States and
    Puerto Rico. Our Active Duty Marines and their families located at
    Independent Duty Stations have the ability to access these services as
    well.
        Managed Health Network (MHN) is an OSD-contracted support resource
    that provides surge augmentation counselors for our base counseling
    centers and primary support at sites around the country to address
    catastrophic requirements. This unique program is designed to bring
    counselors on-site at Reserve Training Centers to support all phases of
    the deployment cycle. Marine Forces Reserve has incorporated this
    resource into post-demobilization drill periods, Family Days, Pre-
    Deployment Briefs, and Return and Reunion Briefs. Follow-up services
    are scheduled after Marines return from combat at various intervals to
    facilitate on-site individual and group counseling. Additionally, we
    are utilizing these counselors to conduct post-demobilization
    telephonic contact with IRR Marines in order to assess their needs and
    connect them to services.
        The Peacetime/Wartime Support Team and the support structure within
    the Inspector-Instructor staffs at our Reserve sites provides families
    of activated and deployed Marines with assistance in developing
    proactive, prevention-oriented steps such as family care plans, powers
    of attorney, family financial planning, and enrollment in the Dependent
    Eligibility and Enrollment Reporting System. During their homecoming,
    our Marines who have deployed consistently cite the positive importance
    of family support programs.
        To strengthen family support programs, we will continue to enhance,
    market, and sustain outreach capabilities. The current OSD-level
    oversight, sponsorship, and funding of family support programs properly
    corresponds to current requirements. We are particularly supportive of
    Military OneSource, which provides our Reservists and their families
    with an around-the-clock information and referral service via toll-free
    telephone and Internet access on a variety of subjects such as
    parenting, childcare, education, finances, legal issues, elder care,
    health, wellness, deployment, crisis support, and relocation.
        Marines and their families, who sacrifice so much for our Nation's
    defense, should not be asked to sacrifice quality of life. We will
    continue to be a forceful advocate for these programs and services. We
    will continue to evolve and adapt to the changing needs and
    environments in order to ensure that quality support programs and
    services are provided to our Marines and their families.
                casualty assistance and military funeral honors
        One of the most significant responsibilities of the Reserve site
    support staff is that of casualty assistance. It is at the darkest hour
    for our Marine families that our support is most needed. By virtue of
    our dispersed composition, Marine Forces Reserve site support staffs
    are uniquely positioned to accomplish the vast majority of all Marine
    Corps casualty notifications and are trained to provide assistance to
    the family. Historically, Marine Forces Reserve personnel have been
    involved in approximately 90 percent of all notifications and follow-on
    assistance to the next of kin. There is no duty to our families that we
    treat with more importance, and the responsibilities of our Casualty
    Assistance Officers continue well beyond notification. We ensure that
    our Casualty Assistance Officers are adequately trained, equipped, and
    supported by all levels of command. Once a Casualty Assistance Officer
    is designated, he or she assists the family members in every possible
    way, from planning the return and final rest of their Marine to
    counseling them on benefits and entitlements to providing a strong
    shoulder to lean on when needed. The Casualty Assistance Officer is the
    family's central point of contact and support; available to serve as a
    representative or liaison with the media, funeral home, government
    agencies, or any other agency that may become involved.
        Additionally, Marine Forces Reserve units provide significant
    support for military funeral honors for our veterans. The active duty
    site support staff members, with augmentation from their Reserve
    Marines, performed more than 12,000 military funeral honors in 2008 (91
    percent of the Marine Corps total) and we anticipate supporting nearly
    13,000 during 2009. The authorization and funding to bring Reserve
    Marines on active duty to assist in the performance of military funeral
    honors has greatly assisted us at sites such as Bridgeton, Missouri,
    Chicago, and Fort Devens, Massachusetts, where we frequently perform
    more than 10 funerals each week. As with Casualty Assistance, we place
    enormous emphasis on providing military funeral honor support.
                                   conclusion
        The Marine Corps Reserve--your Operational Reserve--continues to
    shoulder the war fighting burden with our Active Component
    counterparts. Operations Enduring and Iraqi Freedom, as well as support
    to Combatant Commanders' Theater Support Cooperation Exercises, have
    required continuous activations of Selected Marine Corps Reserve
    forces. We will continue to focus upon the future challenges to the
    Total Force and corresponding requirements of modernization, training
    and personnel readiness to ensure that the Marine Corps Reserve remains
    on equal footing with our Active Component. Your consistent and
    steadfast support of our Marines, sailors and their families directly
    contributes to our ability to do so. Semper Fidelis!

        Chairman Inouye. General Stenner.
    STATEMENT OF LIEUTENANT GENERAL CHARLES E. STENNER,
                JR., CHIEF, AIR FORCE RESERVE
        General Stenner. Chairman Inouye and Vice Chairman Cochran,
    Senator Murray, I am very, very happy to be here today on
    behalf of the Air Force Reserve and the Air Force Reserve
    Command.
        Before I go any farther, I would like to tell you that I am
    joined today by my command chief, Chief Master Sergeant Troy
    MacIntosh, who is the senior ranking enlisted member of that
    very, very powerful and strong backbone that we have as an Air
    Force Reserve, the enlisted force. And I am pleased that he has
    been around to help me as we move through the transitions that
    we have been making and keep us strong in that regard. So thank
    you very much, Chief, for being here.
        I also have to say thank you, as have the rest of my
    compatriots, for all of the things that this Appropriations
    Committee has done for the Air Force Reserve. The fact that we
    are, in fact, able to provide 14 percent of this Nation's total
    air force for just a little over 5 percent of the military
    personnel budget is a very cost-effective way to deliver the
    capability that the combatant commanders need.
        I believe that we are, in fact, funded appropriately to be
    that tier-one force that can join our two component partners in
    the Guard and the active duty regular Air Force, to seamlessly
    provide that capability as we are showing on a daily basis,
    whether it is deployed or whether it is in place at home
    station. And the capability we provide from home station is
    sometimes a little bit unnoticed as well because we do fight in
    place with our mobility forces and our space forces and our
    cyber forces, our intercontinental ballistic missile (ICBM)
    forces, et cetera, all of which play a part in a three-
    component Air Force.
        I will also tell you that the modernization has happened.
    Our Air Force is modernizing and recapitalizing, and the NGREA
    dollars have been well used to take the equipment that we have
    and get it into the fight earlier, quicker, along with our
    Guard and active component partners.
        My priorities--and I am on the record as to how we are
    about to do business and continue to do business--are to be
    cognizant of the fact that we are, first and foremost, a
    strategic reserve, which I believe we are leveraging on a daily
    basis to provide an operational capability and be that
    operational force around the world. And we will continue to do
    that and retain and recruit the best and the brightest. And as
    a Reserve, we are able to be everywhere we need to be and move
    folks to and from, growing into the new capabilities, and then
    adjust what we need to do in that capability, both in the unit
    world and in that very unique individual mobilization augmentee
    world that we have as well, bringing again a dramatic
    capability to the Air Force.
        The military construction that is required and the manpower
    that we will need to do the new mission sets that are coming
    in, the unmanned aerial systems, the intelligence,
    surveillance, reconnaissance and with our nuclear fleet of
    bombers--all of these things are part and parcel of what we as
    an Air Force Reserve do as part of that three-component Air
    Force. And we are very, very proud of the 67,400 men and women
    that are deployed around the world today doing what the Nation
    needs us to do, and we look forward to your questions about how
    we can do that better.
        Thank you, sir.
        Chairman Inouye. Thank you very much.
        [The statement follows:]
        Prepared Statement of Lieutenant General Charles E. Stenner, Jr.
        Mr. Chairman and distinguished members of the committee, I
    appreciate the opportunity to appear before you today and discuss the
    state of the Air Force Reserve.
        The Air Force Reserve is a powerful manifestation of the finest
    American qualities; pursuit of happiness and dedication to our Nation.
    It is an organization of ordinary working people, wedded to the fabric
    of our great Nation through their individual pursuits. Reserve Airmen
    are linguists, utility technicians, police, railway engineers,
    entomologists, school teachers, salespeople, analysts, aviators, and
    nurses, to name just a few. All are dedicated to the greater purpose of
    serving our Nation; all are essential.
        The Air Force Reserve provides these dedicated individuals the
    opportunity to be a citizen and an Airman. Like the Reserve Components
    from our sister services, we perform the essential task of bringing
    citizens to service. In doing so we gain from them their civilian
    skills, capabilities and experience; alternative approaches to solving
    problems; and expertise and judgment. Civilian employers benefit from
    Air Force Reservists who are instilled with the enduring values of the
    Air Force--integrity, service before self, and excellence in all we do.
        Secretary of Defense Robert Gates recently remarked that if we are
    to meet the myriad of challenges facing our Nation, we must strengthen
    and fully integrate other important elements of national power; that
    military success is not sufficient to win in conflict; that we must
    urgently devote time, energy and thought to how we better organize
    ourselves to meet these challenges.
        The Air Force is already recognizing the benefits of using all of
    its resources from the Reserve, Guard, and Regular Components as it
    increasingly relies on Reservists to support operational missions
    throughout the world. Moreover, the Air Force is encouraging the
    Reserve and Guard to integrate more fully with the Regular Air Force in
    a whole host of missions, adding tremendous value to the forces the Air
    Force provides to the joint warfighter.
        As the Nation looks for ways to strengthen its organizations and
    integrate all of the untapped resources it will need in facing the
    challenges of the 21st Century, we submit that a model by which
    ordinary people, dedicated to serving their country in a way that meets
    both their needs and the needs of the Nation, is already manifest in
    the U.S. Air Force everyday--in the extraordinary Americans of the Air
    Force Reserve.
        I'm proud to serve along side these great Airmen and as Chief and
    Commander of the Air Force Reserve, I have made a promise to them that
    I will advocate on their behalf for resources and legislation that will
    allow them to serve more flexibly in peace and war with minimum impact
    to their civilian career and employer. I will work to eliminate
    barriers of service, so that they can more easily serve in the status
    that meets their needs and those of the Air Force. And, I will work to
    efficiently and effectively manage our Air Force Reserve to meet the
    requirements of the Joint warfighter and the Nation.
                            recruiting and retention
        Over the last 8 years, the Air Force Reserve has exceeded its
    recruiting goals. Our success in great part has been due to the
    accessions of experienced Regular Air Force members upon completion of
    their active duty commitments. Indeed, recruiting highly trained
    individuals is essential to lowering training costs for the Air Force
    Reserve. For the past couple of years we have been able to recruit
    experienced Airmen from the Regular Air Force as a result of force
    structure changes and internal Departmental decisions.
        We no longer have the luxury of large numbers of experienced Airmen
    leaving Regular service. As both the Regular Air Force and the Air
    Force Reserve once again build end strength, we expect we will face
    some recruiting challenges in the near future: not only will the Air
    Force Reserve have access to fewer prior service members, but we will
    be competing with all other services for non-prior recruits.
        We are also facing challenges with retention. The Air Force Reserve
    continued to execute force structure changes in fiscal year 2008, to
    include BRAC and Total Force Initiatives, which prompted a reduction of
    over 7,000 positions. As a result, we again missed our historical
    officer and enlisted retention targets but met end strength
    requirements. Second term reenlistments and extensions fell slightly
    for the third straight year--we also attribute this to the large
    population of Airmen affected by the Air Force drawdown over the past
    few years. There is, however, a bright spot: in fiscal year 2008, for
    the first time in 3 years, we saw a dramatic upswing in reenlistments/
    extensions for first-termers and a modest gain for career Airmen.
        Nevertheless, our forecast models indicate that we will continue to
    face challenges. Accordingly, as outlined in our Air Force Reserve
    priorities discussed below in greater detail, we are striving to
    improve Reserve Airmen awareness of benefits, incentives and policies
    affecting deployments; we are emphasizing the importance of the
    Employer Support of the Guard and Reserve (ESGR) program and the Yellow
    Ribbon Reintegration Program (YRRP); and we are striving to better
    understand this very complicated dynamic by surveying the attitudes and
    beliefs of our Airmen on the array of policies, benefits and incentives
    that affect them to determine what appropriate adjustments can be made
    to improve our retention outlook. The Department of Defense and the Air
    Force have improved our ability to make deployments more predictable.
    And as I discuss below, I believe we need to take a hard look at the
    number of Airmen held in Reserve.
        I am confident that as we act on not only our Air Force Reserve
    priorities, but those of the Air Force and the Department of Defense,
    and with the continued support of this committee and Congress, we will
    be able to continue to meet the needs of combatant commanders and the
    Nation with a viable operational and strategic Air Force Reserve.
     preserving, leveraging and improving air force reserve value and our
                                   priorities
        The Air Force Reserve is a repository of experience and expertise
    for the Air Force. Air Force Reserve Airmen are among the most
    experienced Airmen in the Air Force. Air Force Reserve officers average
    roughly 15 years of experience, and enlisted members average 14 years
    of experience, compared to 11 years and 9 years for Regular Air Force
    officers and enlisted respectively. In fact, roughly 64 percent of Air
    Force Reserve Airmen have prior military experience.
        Airmen of the Selected Reserve remain mission-ready, training to
    the same standards and maintaining the same currencies as those in the
    Regular Air Force, and are capable of deploying within 72 hours of
    notification. These Airmen provide the insurance policy the Air Force
    and the Nation need: a surge capability in times of national crises.
        Reserve Airmen are a cost-effective force provider, comprising
    nearly 14 percent of the total Air Force authorized end-strength at
    only 5.3 percent of the military personnel budget. Put differently, Air
    Force Reserve Airmen cost per capita is 27.7 percent of that of Regular
    Air Force Airmen, or roughly 3.5 Reserve Airman to one Regular
    Airman.\1\
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        \1\ Fiscal year 2008 President's Budget request, figures derived
    from ABIDES (Automated Budget Interactive Data Environment System), the
    budget system currently in use by the Air Force and recognized as the
    official Air Force position with respect to the Planning, Programming
    and Budget Execution (PPBE) system. Inflation data used for any
    constant dollar calculations were based on average Consumer Price Index
    for All Urban Consumers (CPI-U) rates for the past 10 years: roughly
    2.6 percent average annual rate of inflation. Medicare Eligible
    Retirement Health Care (MERHC) is an accrual account used to pay for
    health care of Medicare-eligible retirees (age 65 and beyond). Cost per
    capita figures were derived dividing cost of Selected Reserve program
    by Selected Reserve end-strength. When MERHC figures are included, the
    cost of Air Force Reserve Airmen to Regular Air Force Airmen increases
    to 30.4 percent.
    ---------------------------------------------------------------------------
        The Air Force leverages the inherent value of the Air Force Reserve
    in furtherance of its priorities, which are to: reinvigorate the Air
    Force nuclear enterprise; partner with the joint and coalition team to
    win today's fight; develop and care for Airmen and their families;
    modernize our air and space inventories, organizations and training;
    and recapture acquisition excellence.
        Preserving, utilizing and improving this value in pursuit of Air
    Force priorities underlie each of our Air Force Reserve priorities. We
    must provide an operational, combat ready force while maintaining a
    strategic reserve. We must preserve the viability of the triad of the
    relationships Reservists must sustain with their families, the Air
    Force Reserve and their employers. We must broaden Total Force
    Initiatives. And we must modernize our equipment and facilities. Each
    of these priorities is vital to preserving our value and sustaining our
    forces as we meet the needs of the Nation.
     operational, combat ready force while maintaining a strategic reserve
        The Air Force Reserve is first and foremost a strategic reserve,
    providing the Air Force with a surge capacity in times of national
    crisis. Over time, the Reserve has become a mission-ready reserve force
    capable of serving operationally throughout the world. Since OPERATION
    DESERT STORM, Air Force Reserve Airmen have been continuously engaged
    around the world supporting ongoing contingencies, serving side by side
    with the joint team.\2\
    ---------------------------------------------------------------------------
        \2\ Airmen of the Selected Reserve are mission-ready, capable of
    performing ongoing operations. Collectively, they have met the
    operational needs of the Air Force for decades--largely through
    volunteerism, but also through full-time mobilization. For example,
    Reserve and Guard Airmen have continuously supported Operation Coronet
    Oak in Southern Command year-round, 24/7, since 1977. Between 1991 and
    2003, Reservists supported the no-fly areas of Operations Northern and
    Southern Watch. Since the attacks on September 11, 2001, 54,000
    Reservists have been mobilized to participate in Operations Enduring
    Freedom, Noble Eagle and Operation Iraqi Freedom--6,000 remain on
    active duty status today. It is a fact that the Air Force, more than
    any other time, now relies on members of the Reserve and Guard to meet
    its operational requirements around the globe.
        Our Reserve community continues to answer our Nation's call to duty
    with large numbers of volunteer Reservists providing essential support
    to Combatant Commanders. Forty-six percent of the Air Force's strategic
    airlift mission and 23 percent of its tanker mission capability are
    provided by Reserve Airmen. We currently have over 450 C-17, C-5, KC-
    135 and KC-10 personnel on active duty orders supporting the air
    refueling and airlift requirements.
        In Operations Enduring and Iraqi Freedom, Reserve C-130 crews flew
    over 6,000 hours in 2008; Reserve F-16 and A-10 crews flew over 3,700
    hours. The Air Force Reserve provides 24 crews and 12 fighter aircraft
    to USCENTCOM in their regularly scheduled rotations for the close air
    support mission.
        The Air Force Reserve maintains 60 percent of the Air Force's total
    Aeromedical Evacuation (AE) capability. Reserve AE crews and operations
    teams provide a critical lifeline home for our injured warfighters. Our
    highly trained AE personnel fill 39 percent of each AEF rotation and
    fulfill 12 Tanker Airlift Control Center tasked AE channel missions
    each quarter--all on a volunteer basis. On the home front in 2008, the
    Air Force Reserve provided 21 of 24 AE crews, 88 percent of the mission
    requirement, for the response to Hurricane's Ike and Gustav.
    Additionally, the Reserve provided 4 standby crews, 100 percent of the
    mission requirement, in support the Democratic and Republican National
    Conventions.
        In 2008, the men and women of our Combat Search and Rescue forces
    have been heavily engaged in life saving operations at home and abroad.
    Since February, Airmen of the 920th Rescue Wing at Patrick Air Force
    Base, Florida, and their sister units in Arizona and Oregon, flew over
    745 hours and saved more than 300 U.S. troops on HH-60 helicopter
    missions in support of U.S. Army medical evacuation operations in Iraq
    and Afghanistan. While mobilized for 14 months in support of combat
    missions abroad, the 920th continued to provide humanitarian relief in
    response to natural disasters at home, as well as provide search and
    rescue support for NASA shuttle and rocket launches.
        The Reserve made use of its organic ISR and firefighting
    capabilities to protect the lives and property of our citizens
    threatened by an especially severe fire season. Defense Support to
    Civilian Authorities engagement started with planning and directing
    exploitation and analysis of the first Global Hawk imagery to support
    Incident Analysis and Assessments. In fact, the first Distributed
    Ground System Mission Commander was an Air Force Reserve Officer that
    directed analysis of the areas devastated and movement of the fire
    lines. Aircrews in the 302nd Air Expeditionary Group (AEG) flew more
    than 980 airdrops and delivered in excess of 1.3 million gallons of
    fire retardant to help firefighters on the ground and mitigate further
    damage and destruction. The AEG is a Joint unit made up of eight C-130
    Hercules aircraft equipped with the Air Force Modular Airborne Fire
    Fighting System, six Marine Corps helicopters, and two Navy Reserve
    helicopters. Two of the C-130s belong to the Air Force Reserve's 302nd
    Airlift Wing at Peterson Air Force Base, Colorado. Reserve and Guard
    personnel helped fight the more than 2,000 fires that ravaged the
    California wilderness this past summer.
        The Air Force Reserve provides 100 percent of the airborne weather
    (hurricane hunting) capability for the Department of Defense. This past
    hurricane season tied as the fourth most active with 16 named storms
    and five major hurricanes. Throughout the year, Air Force Reserve
    ``Hurricane Hunters'', C-130J aircraft flown by citizen Airmen of the
    403rd Wing at Keesler Air Force Base, Mississippi flew over 1,000
    hours, collecting life-saving data that was sent directly to the
    National Hurricane Center in Miami, Florida, contributing to better
    forecasts and landfall predictions. Following the end of the hurricane
    season in the Caribbean, the 403rd deployed 2 aircraft and 4 crews to
    the Pacific region to continue its support of storm research.
        In addition to our hurricane mission, the Air Force Reserve
    provides 100 percent of the aerial spray mission in support of the
    Federal Emergency Management Agency, the Centers for Disease Control,
    and state public health officials. Air Force Reserve aircrews and C-
    130s from the 910th Airlift Wing, Youngstown Air Reserve Station, Ohio,
    sprayed more than a million storm ravaged acres of land with pesticides
    to control the spread of disease.
        Our intelligence, surveillance and reconnaissance professionals are
    providing critical information as they answer the Nation's call to
    service. In 2008, 192 intelligence personnel deployed in support of
    world-wide contingency missions to include Afghanistan and Iraq. For
    the foreseeable future, Reserve intelligence professionals will
    continue to be deployed throughout the Combatant Command theaters,
    engaged in operations ranging from intelligence support to fighter,
    airlift, and tanker missions to ISR operations in Combined Air
    Operations Centers and Combined/Joint Task Forces.
        These are but a few examples of the dedication and contributions
    our Air Force Reserve Airmen have made and will continue to make around
    the clock, around the world, each and every day.
    ---------------------------------------------------------------------------
        Using Reservists in operational missions makes sense: it leverages
    the experience and comparatively lower costs of a predominantly part-
    time force. Moreover, it improves relationships between Regular Air
    Force and Air Force Reserve members--it gives Airmen of each component
    an opportunity to demonstrate their capability and relevancy to each
    other, as well as Sister Services and coalition forces; it provides
    Airmen of each component the opportunity to lead each other. Equally
    important, operational duty provides Reserve Airmen the benefit of
    operating as a member of the joint team in diverse environments.
    Operational taskings also improve unit morale and enhance unit pride--
    important factors in achieving and sustaining high performance.
        Yet, for all of our operational capability and contributions, we
    must not lose sight that we--along with our Air National Guard brothers
    and sisters--are also a strategic reserve that must be available to
    surge in times of national emergency. For us to serve as both an
    operational and strategic reserve, it is critical that we find the
    right balance between the two. Too few Reserve Airmen means a higher
    operational tempo for all Airmen--Regular or Reserve; it means less
    capacity to surge in times of national emergency; it means exhausting
    our people and jeopardizing the cornerstone of Air Force Reserve
    service.
        We are now 18 years in continuous combat operations, and in our
    eighth year of OPERATION ENDURING FREEDOM; soon to be in our sixth year
    of OPERATION IRAQI FREEDOM. By any measure, our Airmen are performing
    admirably. But, our retention rates are dropping, our experience levels
    are dropping, indeed the Air Force is ``going deep'' into the Inactive
    Ready Reserve and Retired Reserve with its Limited Pilot Recall
    Program. Are these anomalies that can each be explained; or are they
    the signposts of a more serious problem? My concern and challenge,
    indeed our collective challenge, is to ensure we are able to refocus,
    reconstitute and recapitalize while remaining engaged in the full
    spectrum of operations--in a word, our efforts must be ``sustainable''
    over the long run.
        Volunteerism is vital to the overall capability of not just the Air
    Force Reserve, but the entire Air Force--today we meet roughly 80
    percent of our taskings through volunteerism. Without it, I do not
    believe we can sustain this level of commitment indefinitely. From this
    essential fact flow all of my other priorities.
       preserving the viability of the reserve triad (family, air force
                             reserve and employer)
        Air Force Reserve Airmen must strike a balance between their
    commitments to the Air Force, their families and their civilian
    employers, i.e., their main source of income. We must be ever mindful
    of these commitments and the balancing act our Reservists undertake to
    sustain these relationships. We must strive to preserve these
    relationships through open communication with each of these essential
    partners. And, we must strive to provide predictability in deployments,
    and parity with benefits. Doing so is critically important in ensuring
    we provide ready and capable Reserve Airmen to the Nation.
        This past year, the Air Force Reserve has endeavored to improve
    communication with Reservists by rolling out awareness campaigns
    concerning the differences in benefits Congress has provided over the
    past few years, and how these accrue for those who voluntarily deploy
    and those who are mobilized. We have also put a spotlight on other
    important benefits such as reduced eligibility age for retirement pay,
    improved availability of health benefits, and lower premiums for
    TRICARE Reserve Select. We have begun surveying focus groups within the
    Air Force Reserve to better understand the needs of our Reservists and
    whether we are meeting these needs. And I personally send e-mails to
    all of our Selected Reserve members to highlight important issues
    concerning their service. In the coming months, as we learn more, we
    will be rolling out an awareness campaign on the Post 9/11 Montgomery
    GI Bill and how it works vis-a-vis other education benefits.
        We have worked with the Small Business Association to provide
    Reservists and Employers awareness of improved access to increased,
    uncollateralized, low interest loans that Congress authorized last
    year. We have made it a point to educate our Airmen about the
    importance of the ESGR program, and we have asked that they nominate
    their employers for ESGR recognition and take time to accurately fill
    out employer data in the DOD employer database. I am pleased to report
    that we have increased our nominations by 149 percent this past year.
        We are moving ahead with implementation of the YRRP to support
    Reserve members and their families throughout the entire deployment
    cycle. Prior to the enactment of this program, Air Force Reserve Wings
    dedicated time and a notable level of effort to support their deploying
    Airmen and families, as evidenced by the number of deployment support
    and reintegration activities in the past. In 2008, the Air Force
    Reserve hosted 58 YRRP events that served over 1,250 Airmen and 500
    family members.
        In addition, the Air Force Reserve Command has formed a Yellow
    Ribbon Reintegration Office. This multi-functional team has begun
    identifying challenges, assessing strategic, operational and fiscal
    gaps, and evaluating effective and implementable options. We're working
    towards full implementation of Department of Defense directives.
        In the future, the Air Force Reserve will publish an overarching
    YRRP strategy that optimizes benefits to service members and their
    families. A key component of this strategy will be to support and unify
    the current independent efforts, and identify the successes of those
    efforts.
        As a Total Force, we continue to work through continuum of service
    (CoS) challenges to better enable varying degrees of service commitment
    that members can provide as their life circumstances change throughout
    their career. The Air Force and the Air Reserve Components are taking a
    coordinated approach to identifying the issues that make reserve
    component members disinclined to frequently volunteer for active duty
    tours. We're identifying barriers and options for reducing or removing
    impediments to service. These impediments range from financial,
    cultural, technological to policy and legislative. Through this program
    the services have thus far identified dozens of impediments, three of
    which were mitigated by improving policies concerning enlisted
    promotion, chaplain service age waiver, and security clearances.
    Although still in its formative stage, the Air Force developed a CoS
    Tracking Tool which is gaining wider DOD acceptance and we hope will
    continue to gain momentum as all Services look to act on this important
    reform initiative.
        The fiscal year 2008 National Defense Authorization Act included
    legislation to authorize reimbursement of travel expenses not to exceed
    $300 for certain Selected Reserve members who travel outside the normal
    commuting distance because they are assigned to a unit with a critical
    manpower shortage, or assigned to a unit or position that is
    disestablished or relocated as a result of defense base closure,
    realignment or another force structure reallocation. Because of this
    authorization, the Air Force Reserve has been able to retain trained
    and qualified personnel, rather than having to recruit and train new
    personnel.
                        broaden total force initiatives
        The Air Force leverages the value of its reserve components through
    association constructs. The basic model is an associate wing in which a
    unit of one component has primary responsibility for operating and
    maintaining equipment (such as aircraft), while a unit of another
    component (Air Force Reserve, Air National Guard, or Regular Air Force)
    also operates and maintains that equipment.\3\ This arrangement
    effectively places more people against a piece of equipment, thereby
    gaining more utility from each piece of equipment, and the ability to
    surge as needed, and pull back when not.
    ---------------------------------------------------------------------------
        \3\ The Air Force uses three types of associations to leverage the
    combined resources and experience levels of all three components:
    ``Classic Association'', ``Active Association'', and ``Air Reserve
    Component Association''.
        Under the ``Classic'' model, so-called because it is the first to
    be used, a Regular Air Force unit is the host unit and retains primary
    responsibility for the weapon system, and a Reserve or Guard unit is
    the tenant. This model has flourished in the Military Airlift and Air
    Mobility Commands for over 40 years. We are now beginning to use it in
    the Combat Air Forces (CAF): our first fighter aircraft ``Classic''
    association at Hill Air Force Base, Utah, attained Initial Operational
    Capability in June 2008. This association combined the Regular Air
    Force's 388th Fighter Wing, the Air Force's largest F-16 fleet, with
    the Air Force Reserve's 419th Fighter Wing, becoming the benchmark and
    lens through which the Air Force will look at every new mission. The
    477th Fighter Group, an F-22 unit in Elmendorf, Alaska, continues to
    mature as the first F-22A associate unit. This unit also achieved
    Initial Operating Capability in 2008 and will eventually grow into a
    two-squadron association with the Regular Air Force.
        The Air Force Reserve also established its first Intelligence
    Squadron Association with the 50th Intelligence Squadron at Beale Air
    Force Base, California. This unit of Reserve and Regular Airmen
    delivers real-time, tailored intelligence to combat forces engaged in
    missions in Iraq and Afghanistan, with data derived from theater
    Predator/Reapers, Global Hawks and U-2s, in partnership with the Total
    Force team. The Air Force is considering additional associate
    intelligence units for Beale and Langley Air Force Bases. These new
    capabilities create a strategic reserve force ready to respond to the
    call of our Nation, capable of being leveraged as operational crews
    ready and willing to support the Regular Air Force in everyday missions
    around the world. This model has proven itself and is the basis for the
    growth of associations over the last 5 years.
        Under the ``Active'' model, the Air Force Reserve or Guard unit is
    host and has primary responsibility for the weapon system while the
    Regular Air Force provides additional aircrews to the unit. The 932nd
    Airlift Wing is the first ever Operational Support Airlift Wing in the
    Air Force Reserve with 3 C-9Cs and 3 C-40s. Additionally, the Air Force
    Reserve will take delivery of an additional C-40 in fiscal year 2011,
    appropriated in the fiscal year 2009 Consolidated Security, Disaster
    Assistance and Continuing Appropriations Act. This additional C-40 will
    help to replace the 3 C-9Cs, which are costly to maintain and fly. To
    better utilize the current fleet of C-40s at the 932nd, the Air Force
    created an Active Association. We also are benefiting from our first C-
    130 Active Association with the 440th AW at Pope AFB.
        Under the ``Air Reserve Component (ARC)'' model, now resident at
    Niagara Falls Air Reserve Station (ARS) in New York, the Air Force
    Reserve has primary responsibility for the equipment while the Guard
    shares in the operation of the equipment and works side by side with
    the Reserve to maintain the equipment. The Air National Guard has
    transitioned from the KC-135 air refueling tanker to the C-130,
    associating with the 914th Reserve Airlift Wing. The 914th added four
    additional C-130s, resulting in 12 C-130s at Niagara ARS. This ARC
    Association model provides a strategic and operational force for the
    Regular Air Force while capitalizing on the strengths of the Air
    National Guard and Air Force Reserve. Additionally, in this case it
    provides the State of New York with the needed capability to respond to
    state emergencies.
        The Air Force Reserve has 9 host units and is the tenant at 53
    locations. There are currently more than 100 integration initiatives
    being undertaken by the Air Force and Air Reserve Components.
    ---------------------------------------------------------------------------
        Beyond fiscal efficiencies, however, associations use the inherent
    values that each component brings to the mix. For example, less
    experienced Airmen from Regular Air Force can be more favorably
    balanced against higher experienced Reserve Component Airmen. Moreover,
    these constructs can foster mutual respect among components, and can
    lead to a cross flow of ideas. Regular Air Force Airmen can bring a
    wider perspective of Air Force operations to an associate unit based on
    their ability to change assignments on a regular basis. For their part,
    Reserve Airmen lend stability and continuity to the organization and
    the mission. The ultimate goal is to provide the Air Force and
    combatant commanders the best possible capabilities with fewer physical
    resources by leveraging the combined resources of the Regular Air
    Force, Air National Guard, and Air Force Reserve.
        The Air Force has been using associations modestly, with varying
    degrees of success, since 1968, primarily in the air mobility missions.
    However, during the last 5 years we have aggressively pursued
    fundamental change to maintain our war fighting capabilities. Our
    central strategy is to use integration/association initiatives to
    leverage the strengths of all three components to make one strong Air
    Force in many mission areas. Failing to consider the Air Force
    holistically risks unbalancing the contributions of each component,
    which are central to the success of the efficient and effective
    delivery of combat capability to the war fighter.
        Associations also present new challenges in the way we develop
    plans to meet the needs of combatant commanders. It used to be, and in
    some cases still is, that our mobilization plans were developed for a
    unit and its equipment to deploy together in support of a given
    operations plan. Associations now must be worked into those plans. We
    have made progress in developing war mobilization plans that deploy
    equipment separately from the units that deploy. But we will
    undoubtedly encounter difficulties in the execution of these plans. We
    still will have to find the sweet spot in the Regular Air Force/Air
    Reserve Component (ARC) manpower mix when allocating our people against
    various missions within the Air and Space Expeditionary Force
    construct. We will have to determine how long and how best to access
    ARC personnel--i.e., mobilize or volunteer--to meet that mix so that we
    can give combatant commanders the most effective force. And we should
    consider measuring taskings by associations instead of wings.
        If it is to succeed, the Air Force must educate Airmen about the
    unique challenges of associations--at all levels, within and among each
    of the components. Advancement within each Service is premised upon
    joint education and experience; advancement should also be premised on
    joint component education and experience. Candidates for leadership in
    associations should be screened and selected based on their experience
    and abilities to lead and work well with other components.
        Force integration is not a process unto itself; it has a purpose,
    an end state. Properly understood, an integrated force is a unified,
    harmonious, effective entity. We are merely at the beginning of this
    process; it will take many, many years before we approach the end
    state. We must look beyond the fiscal efficiencies touted as the basis
    for our undertaking, roll up our sleeves, and get to the hard work
    needed to make us a more effective combat force. Should we do so, we
    will some day look about us and recognize a truly integrated Air Force.
                       modernize equipment and facilities
        The Department of Defense's goal is to fully equip Reserve
    Component units, thereby providing a trained and ready force at every
    stage of the service's force rotation plan. The Air Reserve Components,
    along with the Regular Air Force, face significant modernization and
    recapitalization challenges, for both our aircraft and infrastructure.
    Some Air Force Reserve platforms remain out of the fight due to lack of
    defensive and countermeasure systems needed in the USCENTCOM Area of
    Responsibility, including some of our C-5A, A-10 and C-130 aircraft. In
    addition, as with the Regular Air Force, we are facing unpredictable
    fatigue, corrosion, and structural component availability concerns on
    platforms that even our superior maintainers cannot correct forever, as
    we have seen in our C-5, KC-135 and A-10 fleets. While we continue to
    meet the requirements of the Air Force and the Joint team, the current
    high operations tempo has led to our current reality--the increasing
    uncertainty of our long-term fleet viability. Similarly, continued risk
    in the Air Force Military Construction (MILCON) program has caused a
    significant growth in the Air Force Reserve Command's facility project
    backlog. Timely modernization is critical to remaining a relevant and
    capable combat ready Reserve force.
    National Guard Reserve Equipment Account (NGREA)
        The NGREA appropriation has resulted in an increase in readiness
    and combat capability for both the Reserve and the Guard. For fiscal
    year 2009, we received $37.5 million in NGREA appropriations which
    resulted in the Air Force Reserve Command's ability to purchase
    additional upgrades for Reserve owned equipment. Some of the items that
    we purchased using NGREA funding include: Defensive Systems for C-5s,
    Line of Sight/Beyond Line of Sight capability and new upgraded radar
    for our C-130 aircraft, and an upgrade to the F-16 Commercial Fire
    Control Computer. Many of these new capabilities are directly tied to
    better air support for our Soldiers and Marines in Iraq and
    Afghanistan. NGREA funding has helped the Air Force Reserve to remain
    relevant in today's fight as well as the ability to remain ready and
    capable in future conflicts. We thank you for your support with this
    critical program.
    Milcon and Facilities Modernization
        Along with challenges in modernizing our equipment, we face
    challenges modernizing our facilities. During the fiscal year 2008
    budget formulation, both the Regular Air Force and the Air Force
    Reserve took risk in MILCON appropriation in order to fund higher
    priorities. This reduction coupled with past shortfall funding in
    MILCON has resulted in a backlog nearing $1 billion for the Air Force
    Reserve.
        We will continue to work within the fiscal constraints and mitigate
    risk where possible to ensure our equipment and facilities are
    modernized to provide a safe and adequate working environment for all
    of our Airmen.
                                   conclusion
        Mr. Chairman and Members of this Committee, I am excited to have
    been able to take on this role as Chief of the Air Force Reserve and
    Commander of Air Force Reserve Command. I take pride in the fact that
    when our Nation calls on the Air Force Reserve, we are trained and
    ready to go to the fight. Over 67,000 strong, we are a mission-ready
    reserve force capable of serving operationally throughout the world
    with little or no notice.
        The rapidly changing security and economic environment will cause
    Congress, the Department of Defense, and the Air Force to make some
    difficult choices in the year ahead. The Air Force Reserve is highly
    experienced, cost-effective force provider well-suited for this
    challenge. I submit it is a hedge against the uncertainties we are
    facing for which you pay a relatively small premium. I firmly believe
    paying this premium will enable the Air Force to achieve its force
    integration goals and address not only its priorities, but also help
    Congress address the more pressing issues we will face as a nation in
    the years to come.
        I appreciate the support of this committee for the appropriations
    it provides to fund our readiness and combat capability. I look forward
    to working with each of you in the future on the challenges facing the
    Air Force Reserve, the Air Force, and the Nation.

                      YELLOW RIBBON REINTEGRATION PROGRAM

        Chairman Inouye. I would like to begin asking a question.
    In the fiscal year 2008 Defense Authorization Act, the Defense
    Department was directed to establish a centralized office for
    the Yellow Ribbon Reintegration Program. Now, some have
    questioned the wisdom of this. I would like to get your
    thoughts on this. General Stultz.
        General Stultz. Yes, sir. I think my candid assessment on
    that, it probably slowed down the process for us to implement
    the Yellow Ribbon Program because anytime we try to bring all
    the services together and gain some kind of consensus of how we
    are going to implement something, it takes a long time. And I
    think what we came to agreement on is we cannot apply a cookie-
    cutter approach. Each service is different in terms of the way
    we mobilize and deploy soldiers, in terms of the length of time
    we deploy them, and to what they are exposed to during those
    deployments. And so at the end of the day, we came back and
    said--you know, let each service sort of design its own
    implementation plan. So I think we have slowed down part of the
    implementation by going through that process.
        At the same time, I will say when you do raise it to that
    level, to the OSD level, you get buy-in as a Department that
    this is not just a program we are going to throw to the
    services and say you figure it out. It is something that
    Congress has mandated this to us, and as the OSD level, we are
    going to fund it, we are going to buy into it, fund it, and
    make sure it gets implemented properly.
        From the Army Reserve's perspective, we have already
    conducted 70 of the programmed events this year. We are well on
    our way. We have got another 70 or so already scheduled. The
    challenge we are finding with the Yellow Ribbon Program is the
    difficulty in trying to bring a dispersed force back together.
    Unlike an active duty force where everybody comes back home to
    Fort Hood and you can go through a reintegration process there
    at Fort Hood, with the Army Reserve, because our units are
    geographically dispersed, you may have a soldier who lives
    three States away from the unit and he is willing to travel, a
    lot of times at his own expense, to be part of that unit, but
    when we come back for a Yellow Ribbon event and we try to
    engage the families, it makes it tough.
        One approach that was developed was to say, okay, let us
    have a regional approach. Let us have geographic events, and
    that way soldiers can choose where to go to the reintegration
    event based on their geography. I have an issue with that, and
    I have told my commanders that because I think it is imperative
    that we bring soldiers back together as a unit and we look the
    soldiers in the eye and put them through that reintegration
    together as a unit. If you took me and said you go somewhere
    off to an event that is not part of your unit and I go sit in
    the corner and sit there and nobody else knows who I am there,
    they are going to say, well, he's just a quiet guy. If I go and
    do the same thing with my unit, they are going to say something
    is wrong with Jack. He needs help because he is not himself.
    And so it is imperative, if we implement a Yellow Ribbon
    Program properly, it is a unit-based program and the exceptions
    are where we have to disperse geographically. We will always
    have the exceptions.
        Of particular concern to me on Yellow Ribbon is the IRR,
    the Individual Ready Reserve. We do not really have a Yellow
    Ribbon Program for them, in my opinion. I get occasionally, not
    very often, an IRR soldier that is assigned to the Army
    Reserve. It is my, I think, obligation to take care of that
    soldier and his family with the Yellow Ribbon Program. Even
    though the unit may be from Pennsylvania and he goes back to
    Texas, I have got to figure out how to get him the
    reintegration he needs back in Texas. But I just get a very
    small piece of the IRR.
        Most of the IRR are filling active duty units, and when
    that unit comes back to Fort Hood and that soldier goes back to
    Pennsylvania, nobody looks out for him. I have raised this at
    the Vice Chief and the Chief of Staff level to say we have got
    to figure out to do Yellow Ribbon for our IRR soldiers, as well
    as my active Reserve soldiers.
        I think it is a great program, sir, and I appreciate the
    funding we have gotten for that. I think we are still learning
    as to the best way to implement it, and we have been a little
    bit slow to get there.
        Chairman Inouye. Admiral, any thoughts on this?
        Admiral Debbink. Yes, sir, Chairman. The Yellow Ribbon
    Program has been instrumental in the Navy Reserve to helping us
    really propel our Returning Warrior Workshop, as our main
    program, forward with the funding that came with it. It has
    been a very successful program. They're done on weekends not
    because it is a Reserve program, but because that is when we
    can get the spouses there too, which is also very important to
    us because it is a reintegration event. You want to bring the
    members back together who served, as well as the families.
        The other thing we have done is employed the funds from
    Yellow Ribbon to deploy psychological health outreach
    coordinators to each of our regions, and they have been
    instrumental as well, staying in touch with our sailors,
    particularly those who might be at risk for psychological
    health reasons. And I have had a couple of great new stories of
    interventions of possible suicides. So we have been very
    pleased with the funding. It has been very instrumental to our
    programs.
        Chairman Inouye. Thank you.
        General Bergman.
        General Bergman. Yes, sir. General Stultz articulated it
    very, very well. I will just add to the fact that the unit-
    based approach is important because the marines in the unit
    know the other marines. They know who is in distress quicker
    than if you just show up at an individual event by yourself.
    That has paid dividends.
        Number two, Mobilization Command, which is the Marine
    Corps' element in charge of managing the IRR, has been a great
    asset in ensuring that, at least to the 80 percent level, we
    maintain some level of in-touch capability with those IRR
    members. Regardless of whether they went to an active component
    unit or whether they came to a reserve unit, they are included.
        And as Admiral Debbink said, the Marine Corps also utilizes
    a psychological health outreach program that has been
    established for us. We are in the process of building the 32
    teams across the country which will be comprised of about four
    mental health professionals each that will allow us to ensure
    that we dig a little deeper each time. So we appreciate the
    continued funding and support.
        Chairman Inouye. Thank you.
        General Stenner.
        General Stenner. Mr. Chairman, thanks. I do agree with just
    about everything that has been said as far as units are
    concerned. We would love to be able to deploy as a unit. We
    would love to be able to reintegrate and take a look at
    everybody as they come home at the 30-, 90-, 180-day point as a
    unit. We are, however, also involved with our individual
    mobilization augmentees (IMA) who do regularly deploy. So we
    are reintegrating them as well.
        Some of the things the program has done, regardless of the
    implementation, has certainly raised the awareness of what is
    out there, what is necessary, and how we might go about doing
    this. As an example, I was at Youngstown, Ohio, a couple of
    weeks ago, and they had a wonderful Yellow Ribbon Program event
    that brought a security forces squadron back together with
    their families, and it was a wonderful time for all.
        Across the river in Pennsylvania at Pittsburgh 2 weeks
    earlier they had had a similar event, their first. Those two
    units, being in proximity, have in fact generated some great
    discussion, and they are going to share assets, will be able to
    share resources, will be able to, as an example, use the time
    that they are having at one location to have other folks come
    over, if they cannot make it somewhere else.
        We are looking at all those kinds of locations to put our
    IMAs, who also need to be understood and taken care of as well,
    as well as the Individual Ready Reserve. And I think that one
    of the best things that we can do right now is we can get a
    database that shows where these things are. It is up to each of
    us as commanders and unit-equipped members to figure out how
    best to monitor and watch and get all of our folks, regardless
    of unit, IMA, IRR, reintegrated appropriately and monitored
    carefully. So we are working together with our service partners
    to do that as well.
        Thank you, sir.
        Chairman Inouye. Thank you.
        General Stultz, you have implemented an Employer
    Partnership Program. How is that working?
        General Stultz. Yes, sir. It has probably been about 1\1/2\
    years ago, we started really looking seriously. If we are going
    to sustain the up tempo we have with our Army Reserve force, we
    have got to have the employers. I have got to have soldiers who
    have the confidence that they can have a civilian career and be
    in the Army Reserve. And that led us into some discussions with
    employers to sit down and talk about how we are going to work
    together, make sure we have got their support.
        What we found is that the employers of America have the
    same challenge we have in the military, and that is finding the
    talent--not the workers, the talent--that they need to run good
    corporations or good industry in America. And so rather than
    having the discussion about what is going to happen when I take
    workers away from those employers to be soldiers for me, I said
    we ought to be having a discussion--let me bring soldiers to
    you to be workers for you because I have got great talent in my
    ranks. These three individuals that I introduced earlier
    represent that.
        And what we found is there is a natural synergy where we
    have in the Army Reserve, because we are a combat support,
    service support, the same skill sets in our ranks that American
    industry is looking for. We have truck drivers. The American
    Truckers Association said they were desperately short of long-
    haul truck drivers in America. We have medical technologists.
    America's medical centers said that we are desperately short of
    medical technologists, respiratory, x-ray, surgical, ER. Law
    enforcement. We have military police. A lot of law enforcement
    agencies, to include right here in the District of Columbia,
    said we are desperately short of law enforcement. And it goes
    on and on and on.
        So we started this initiative called the Employer
    Partnership where we basically said let the Army Reserve become
    a reservoir of talent to help populate America's industry. Let
    us develop a human capital strategy where I can go recruit a
    soldier to be a medical technologist for me in one of my Army
    Reserve hospitals on the battlefield in Bilad. But when they
    come home, they will come to work for you here at Inova Health
    Care Center in Northern Virginia.
        And so we started signing agreements where we said we will
    go help you. We will find the talent. And as word got out, it
    just kind of snowballed. To date, we have 225 companies that
    have come to us and said we want to sign up with the Army
    Reserve to be partners with you. We have got probably another
    100 that are on a waiting list.
        The recognition is when we bring an Army Reserve--and I
    would just say not Army Reserve. It is Navy Reserve, Marine
    Corps Reserve, National Guard, Air Reserve, whatever--that
    comes to work for us, these industries tell us it is a
    different individual, different work ethic. They understand
    leadership. They understand team work. They understand
    responsibility. They are drug-free. They are physically fit.
    They have an aptitude. And so it is very, very positive.
        I was just a few weeks ago in Kosovo visiting one of my
    units, and a sergeant came up and said, sir, I was not sure
    what I was going to do when I got home, but I went on the Army
    Reserve Employer Partnership website and I have three offers
    now for a job when I get home. So it is very, very encouraging.
        We are still in the infant stages of how we properly
    implement this to match the talent and then expand it across
    all the services that are represented here. But it is very,
    very successful to date, and we have got companies, everything
    from Joe's garage in Slidell, Louisiana, to General Electric,
    which has 300,000 employees around the world, and Wal-Mart or
    somebody like that. So it spans the spectrum in terms of
    employers that really are reaching out and saying we want to
    engage with the talent that you bring us.
        Chairman Inouye. Congratulations.
        General Stultz. Thank you, sir.
        Chairman Inouye. Do the other Reserve components have
    similar programs?
        General Stenner. Sir, I will tell you that one of the most
    valuable resources that we deal with, as far as an Air Force
    Reserve, is the rated crew member that generally has a civilian
    job as an airline participant one way or the other, whether as
    a pilot or in some other kind of other capacity. So right now,
    to share that resource, to understand how we use them, and
    where we can, leverage the talents that come from the Air Force
    Reserve, we are working with the Airline Transport Association
    to see how we can, in fact, deploy our folks, get them back,
    and get that talent where it needs to be. And we bring in folks
    that the airlines would like to have for exactly the same
    reasons that General Stultz is talking about, and I think that
    we are leveraging that, at least in that capacity right now.
    And I will emulate his program. It sounds like it is a good
    one.
        Thank you, sir.
        Chairman Inouye. Admiral.
        Admiral Debbink. Mr. Chairman, I would offer that we are
    terrifically excited about the program that the Army Reserve
    has put in place, and the four of us, plus the National Guard
    Chiefs as well, get together on a monthly basis and share these
    stories. And so we are eager, as this program continues, to see
    how we can piggyback on it.
        In the meantime, we think one of the very important
    programs that we are all very supportive of that has been a
    longstanding program in a similar vein is the employer support
    of the Guard and Reserve and using that as a very important
    outreach to the employers that really are the third leg of the
    stool that we all rely upon, the servicemember, the family, and
    the employer.
        Chairman Inouye. General Bergman.
        General Bergman. Sir, back when General Jones was
    Commandant in around the 1999-2000 timeframe, the Marine Corps
    implemented the Marine for Life Program which put drilling
    marine reservists, some on active duty, some on the drilling
    reserve status, around the country to facilitate reintegration
    into the communities for the marines coming back, whether it be
    through helping them find jobs, connect with employers, or just
    in general reassimilating back into their community.
        Our program is not anywhere near as evolved as the Army's,
    but nonetheless, for the last 8-plus years, it has been serving
    on a smaller level. So I applaud the Army Reserve and General
    Stultz for what they have done because they really have become
    the model for all of us.
        Chairman Inouye. Thank you very much.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I just wanted to raise one
    issue. I noticed in the Army's report, it talks about meeting
    homeland defense and disaster relief missions and how you need
    to maintain a training level and equipment status in order to
    make that kind of contribution. I was just curious to know
    whether in Hurricane Katrina you had experiences in helping to
    provide assistance to the victims of that terrible tragedy?
        General Stultz. Yes, sir, very much so. A lot of those CH-
    47 helicopters you saw picking people up off the roofs or
    dropping sandbags into the dikes were Army Reserve helicopters
    that we sent down there. A lot of the trucks that you saw
    bringing in bottled water and other medical supplies and
    everything were Army Reserve trucks that we dispatched down
    there to that location. Some of the engineers that were down
    there working hand in hand with the Guard folks were Army
    Reserve engineers.
        The challenge we have got is I had no authority to do that
    because it had not been declared a Federal disaster at that
    point. Knowing that my counterparts in the National Guard and
    all, as well as my own soldiers and their families who lived in
    Mississippi, Louisiana, and that area, were suffering, we said
    we cannot wait. We have got to go ahead and get the help down
    there.
        You know, we went through this in Hurricane Andrew when I
    was in Florida, and the question from some of the Guard folks
    was, how come we are driving past Army Reserve equipment that
    could be helping us? And we said, we do not have the authority
    yet to put that equipment into the operation.
        What I did is I put them on annual training. You know, I am
    authorized to do annual training every year, and so I said,
    okay, this is going to be a training exercise for you guys. Get
    down to Louisiana and get those helicopters down there, get
    everything down there, and eventually we will get you into a
    proper status, but we cannot wait.
        What we have said--and the Office of the Secretary of
    Defense has taken it on as far as legislative initiative--we
    need to put some kind authority in place for call-ups of title
    10 forces for homeland emergencies other than just the one we
    have now, which is for weapons of mass destruction. But we have
    a lot of resources populated around America that are ideal for
    these homeland type missions, but again, because of the way the
    laws are written and the title 32 status for the National Guard
    being responsive but it is still a State response, even though
    I have got units sitting there available, they cannot be
    utilized. That is what I am pushing for. We have got to change
    the law to be able to say let us be able to utilize the Marine
    Corps Reserve, the Navy Reserve, the Army Reserve, the Air
    Reserve in homeland missions and give us the authority to put
    these people on orders on short notice.
        Senator Cochran. I wonder if any of the other services have
    had similar experiences, maybe not with Hurricane Katrina.
    General Stenner.
        General Stenner. Yes, sir. Thank you very much for that
    question because it is, in fact germane, I think to all of the
    services here, as our title 10 reserve status puts us in that
    predicament.
        But our combat search and rescue helicopters have been very
    much involved in almost every one of these kind of disasters.
    We know that our spray mission at Youngstown, Ohio is going to
    be called upon almost immediately afterward to start making
    sure that we do not have those infestations that we have had in
    the past with bugs and disease. We know that our lift capacity
    is going to be just as essential as anything else that is in
    there as the supplies continue to get to where they need to be.
        So all of those things that--we have gone out of our way to
    make sure they are positioned as far as we can take them before
    we have the authorities to get them into the fight. So we will
    bring them from all over the country, preposition and prestige
    with our component Air Force. We will coordinate in-house as
    far as we can to the point of what General Stultz said and put
    them on an appropriate order to get the job done until we can
    get the rest of the authorities in place.
        So I have the same issues. I have the same, I think,
    requirements and what we can do as four services would be
    wonderful.
        Senator Cochran. Thank you.
        General Bergman.
        General Bergman. Yes, sir. Well, as I am sure you are very
    well aware, our amphibious assault vehicles, headquartered in
    Gulfport, were out swimming literally before Katrina had moved
    all the way through doing lifesaving kinds of missions and
    continued to do that throughout as necessary.
        We had also in advance, from both the east and the west,
    prepositioned some long-haul vehicles to a point, let us say,
    somewhere between their station of assignment and the central
    gulf coast area in anticipation of a potential event. We were
    as prepared as we could be.
        But more importantly, the lesson learned from that that I
    think paid dividends, let us say, in Hurricane Ike was the fact
    that, for example, the advance coordination between the local
    community and the local governments with our Reserve unit there
    in Galveston allowed for a clearer understanding of who was
    going to do what, who had the capabilities to do what. In other
    words, do not count on us because we are probably going to be
    evacuated. We will be coming back from a different direction.
        In echoing what General Stultz has said, the need for
    ongoing dialogue to understand in our region of the country--
    and I would suggest to you every region, but we just happen to
    have a defined hurricane season every year that allows us to
    preplan for--the lesson learned from Katrina and from follow-on
    hurricanes has helped us become better prepared.
        Senator Cochran. Admiral Debbink.
        Admiral Debbink. Mr. Vice Chairman, I'd offer our example
    would be the California wildfires last year where HSC-85, a
    Reserve helicopter squadron, worked through our regional
    organization there, Navy Region Southwest, to provide support.
    Using this total force look at things, one of our Navy
    reservist's home was threatened by the fire, and Navy Region
    Southwest, the active component, relocated that sailor. So the
    way we see it is employing it through our total force, and it
    is working pretty well for us.
        Senator Cochran. Well, thank you very much for the
    contributions you have made to not only our national security
    interests in terms of traditional military activities, but some
    of these other events that are just as important and can be
    just as deadly. But thank you very much for your service.

                         ADDITIONAL COMMITTEE QUESTIONS

        Chairman Inouye. General Stultz, Admiral Debbink, General
    Bergman, General Stenner, we thank you very much for your
    testimony and for your vision and your wisdom. And through you,
    may we thank the men and women in your Reserve components for
    their service to our country.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
            Questions Submitted to Lieutenant General Jack S. Stultz
                 Question Submitted by Senator Byron L. Dorgan
                                  end strength
        Question. With increased operational demands placed on the reserve
    component for the past several years, signs of stress and strain are
    showing. All reserve component services are facing increased challenges
    retaining experienced, mid-grade career service members, precisely
    those eligible for retirement after having served 20-years of service.
    I am concerned we are not maintaining a balanced force, retaining
    enough of the very individuals who have gained the benefit of
    experience these past years of increased operations. I'm considering
    introducing legislation that would enhance retention of those
    experienced career service members, providing an incentive to serve
    beyond 20-years, initial retirement eligibility, to continue to serve
    in the reserve component in exchange for lowering the age at which they
    will be eligible to receive retired pay. For example, if a member
    commits to serving 2 years beyond 20, the age for which they are
    eligible to receive retired pay would be lowered by one year.
        What is your opinion of this idea?
        Answer. The Army Reserve continues to seek to shape the force
    ensuring we keep the right talent, expertise and experience to sustain
    a superior level of operational performance. Benefits and incentives
    are among the tools the Army Reserve can utilize to shape the force. We
    are looking at other targeted incentives to retain the right talent as
    well. There is no evidence that a reduced retirement age would serve as
    an incentive to retention. RAND studies and current information does
    not support this assertion. Furthermore, reduced retirement would
    create expensive entitlements with no demonstrated improvements in
    force management. It does little to improve the compensation and
    benefits for those who are bearing the burden of mobilization and
    deployment.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
                         individual ready reserve (irr)
        Question. As the Army Reserves have transitioned from a strategic
    force to an operational force, what is your opinion on whether the
    Individual Ready Reserve has kept pace with that transformation? What,
    if any, role do you see for the Army Reserves to manage the Individual
    Ready Reserve?
        Answer. With the creation of the Army Human Resources Command (HRC)
    in 2003, the Individual Ready Reserve (IRR) was moved from the command
    and control of the Chief, Army Reserve and placed under the command of
    the Commanding General, HRC. In 2006, the Secretary of the Army
    approved the IRR Transformation Plan, which was an integrated and
    systemic approach to reset and reinvigorate the IRR. Since
    implementation, the IRR, along with the rest of the Army Reserve, has
    undergone major transformation from a strategic to an operational force
    and made significant progress towards creating a viable pool of
    trained, ready and deployable Soldiers to meet the needs of today's
    Army.
        However, this transformation and the recent operational pace have
    also caused the IRR to evolve away from its traditional role as a place
    where Soldiers can ``take a knee.'' No longer can Soldiers simply wait
    in the IRR while catching up on military education or choosing to focus
    on family and civilian work after a deployment--they are subject to
    mobilization in the IRR. Some active component Soldiers are even
    choosing to be discharged rather than opt to serve in the IRR upon
    transitioning out of the Active Component.
        I believe the Army Reserve needs a place for Soldiers to disengage
    from traditional unit affiliation or possible mobilization in the IRR
    and provide them with a short-term, transitional status. Additionally,
    I think that the Army Reserve would benefit from a program that
    affiliates IRR Soldiers with Army Reserve Units to serve as a ``force
    in reserve'' for contingency operations. This would also benefit the
    IRR Soldiers by providing a home unit for training and support
    requirements.
        Management of the IRR must continue to be a coordinated effort
    between both the Active Army and Army Reserve since the IRR plays an
    integral part in the readiness of the Total Force. I see a role for the
    Chief, Army Reserve in the management of programs that would affiliate
    IRR Soldiers with Troop Program Units and provide a respite for
    Soldiers in transition.
                                   personnel
        Question. The fiscal year 2009 Omnibus contained the provision to
    help federal employees in the National Guard and Reserves avoid a loss
    of income when they are called the active duty.
        What efforts will the Army Reserve undertake to quickly implement
    this new provision?
        Answer. At this point, we are coordinating with the relevant
    agencies within the Army to develop the appropriate policies to
    implement these initiatives. It doesn't appear that legislation is
    necessary, but if that viewpoint changes, we will inform the Committee
    promptly.
        Question. Can you provide the number of current Army Reserve
    members who are federal government employees?
        Answer. The Army does not maintain a central data base that allows
    us to garner the data for all Army Reserve Soldiers who are employed by
    the Federal Government.
        Currently we are able to provide information on the Dual Status
    Military Technicians. There are 8,180 Army Reserve Soldiers employed as
    Military Technicians.
        Question. Of that number, how many have served at least one tour in
    Operation Enduring Freedom or Operation Iraqi Freedom? How many are
    currently deployed?
        Answer. Of the Dual Status Military Technician population:
      --There are 894 currently mobilized; 375 for OEF, 516 for OIF. Of the
            894 currently mobilized, 667 have past mobilizations.
      --There are 4,723 not currently mobilized that have past
            mobilization.
      --There are 2,563 with no mobilization (current or past).
        Source is FTS provided file of employee SSN and DFAS pay files
    (mid-month July 2009) using APC directly correlating to OIF and OEF
    only.
                                     ______

                  Questions Submitted by Senator Patty Murray
                                    tricare
        Question. Is there a need to find a way to extend TRICARE service
    to cover the ``gray area'' between the end of affiliation with the
    Reserves and the start of retirement benefits?
        Answer. Expanding TRICARE coverage to ``gray area'' retirees must
    be weighed against costs and the ultimate impact to overall force
    readiness--an effort to be undertaken by the Army Surgeon General and
    Program Analysis. Study and validation of cost estimates and cost
    sharing is required. Expanding TRICARE coverage (authority to utilize
    TRICARE Reserve Select) similar to the fee based enrollment offered to
    members of the National Guard and Army Reserve in the National Defense
    Authorization Act of Fiscal Year 2007, offers potential benefits to the
    force, which would become clearer once cost study analysis is
    furthered. Expanding TRICARE coverage as a benefit for ``gray area''
    retirees could be used as a retention/force management tool, through
    appropriate qualifying criteria, to retain or release select
    populations of service members--advancing a ``continuum of service'' to
    more effectively manage the total force.
                                  end strength
        Question. Gentlemen, each of you has a full time support entity
    within your organization. With the increase in usage of the Reserve
    component, do you feel you have the full time end strength to fulfill
    your obligations to each of your active duty components requirements?
        Answer. The increased demand and resultant operational tempo since
    September 11, 2001 caused the Army to integrate and employ the Army
    Reserve as an operational force. The Army Reserve has realigned the
    force in accordance with the Army Force Generation (ARFORGEN) unit
    deployment construct and changed its training paradigm from a
    ``mobilize, train, deploy'' to a ``train, mobilize, deploy'' process.
    To sustain the Army Reserve as a truly operational force requires
    increased readiness best achieved by evolving and improving full time
    support (FTS) manning and processes.
        While we have commissioned studies (to be completed by September
    2009) to determine the optimum strength and balance of FTS staffing
    (Active Guard and Reserve (AGR), full time equivalents (FTE), military
    technicians, civilians) we have recognized we must increase FTS to
    support the unit deployment model. FTS provides both steady-state
    support for generating ready forces but also must be flexible enough
    (potentially through FTEs) to meet dynamic, evolving Army Reserve
    mission requirements. A unit in a reset posture may require current
    ``strategic reserve'' staffing (12 percent), however, as the unit moves
    through progressives years of training in preparation for deployment
    FTS must increase until ultimately the entire unit is mobilized on to
    active duty (100 percent). Our preliminary estimates suggest, at a
    minimum, Army Reserve FTS must increase as a percent of total strength
    of between 3 to 6 percent (bringing FTS/FTE to approximately 15
    percent). Appropriately building FTS capability is required for the
    Army Reserve to continue to fulfill obligations to the Army.
        Question. If you do not have the end strength numbers, what
    increase would each of you like to see if there was an acceleration
    plan for your projected future growth?
        Answer. The Army Reserve has reached its fiscal year 2013 end-
    strength objective of 206,000. We are postured to continue to grow.
    However, we have select grade and skill set shortages that will require
    us to continue to shape the force so we have the highest quality force
    available. Further growth of the Army Reserve will be determined by the
    needs of the total force and future mission demands.
                                     ______

              Questions Submitted to Vice Admiral Dirk J. Debbink
                Questions Submitted by Chairman Daniel K. Inouye
        Question. Admiral Debbink, the Navy Reserve is initiating a
    Continuum of Service program to make it easier for sailors to
    transition between the active and reserve components.
        What is the timeline for implementing this program?
        Answer. The Navy's Continuum of Service is a personnel management
    strategy, to include a series of policy initiatives, enhancements and
    management actions designed to simplify the processes used by Sailors
    to move between Active and Reserve Components. Opportunities for this
    type of movement have always existed; the Navy's current focus is to
    remove barriers and establish or revise policies and programs to
    streamline the process. The Navy needs to better integrate both HR
    business processes between the Components and develop a single Navy pay
    and personnel system to streamline a Sailor's transition between
    Components.
        I am working closely with the Chief of Naval Personnel, VADM Mark
    Ferguson, on the many moving parts involved in the Continuum of
    Service. The timeline for implementing initiatives to develop career
    and workforce flexibilities that encourage volunteerism, increase
    options to ``Stay Navy,'' and promote a lifetime of service to the Navy
    Total Force is 2012. Efforts are underway to make seamless transitions
    a reality sooner than our overall 2012 objective.
        Question. Given the current economic situation, are you concerned
    that these initiatives could temporarily hurt Navy Reserve retention as
    reservists transition to full time active duty positions?
        Answer. We do not expect Active or Reserve retention to be
    negatively affected by the Continuum of Service. Opportunities for
    Reservists to transition to the Active Component will be managed
    closely to maximize FIT and health of officer and enlisted communities
    within fiscal and end strength controls for both the Reserve and Active
    Components.
        Question. Admiral Debbink, with the active duty Navy currently well
    over its authorized end strength, do you expect that there will be
    active duty slots available for reservists to fill? How will the active
    component afford to pay for these additional personnel given the
    budgetary constraints that the Navy is currently under?
        Answer. Movement between the Active and Reserve Components is built
    into annual officer and enlisted strength plans, and funding is
    programmed accordingly. Plans are monitored and adjusted continuously
    through the fiscal year to ensure the Navy remains within fiscal and
    end strength controls established by Congress.
                                     ______

                 Question Submitted by Senator Byron L. Dorgan
        Question. With increased operational demands placed on the reserve
    component for the past several years, signs of stress and strain are
    showing. All reserve component services are facing increased challenges
    retaining experienced, mid-grade career servicemembers, precisely those
    eligible for retirement after having served 20 years of service. I am
    concerned we are not maintaining a balanced force, retaining enough of
    the very individuals who have gained the benefit of experience these
    past years of increased operations. I'm considering introducing
    legislation that would enhance retention of those experienced career
    servicemembers, providing an incentive to serve beyond 20 years,
    initial retirement eligibility, to continue to serve in the reserve
    component in exchange for lowering the age at which they will be
    eligible to receive retired pay. For example, if a member commits to
    serving 2 years beyond 20, the age for which they are eligible to
    receive retired pay would be lowered by 1 year. What is your opinion of
    this idea?
        Answer. Current Navy manpower policies provide the necessary
    incentives for the individuals the Navy Reserve needs to deliver its
    required capabilities, including career personnel.
        Bonus payment plans for retention strategically targeted at
    specific year groups (to include those service members with 20 years of
    qualifying service) and critical wartime specialties. These bonuses
    enhance the Navy's ability to recruit and retain the right people for
    the right job. The Reserve bonuses also target the ``right type'' of
    Sailor and focus on undermanned ratings and critical skills. Congress
    has been generous with the authorization of these bonus plans, and I
    appreciate the Congress' foresight and concern for retention of our
    Reserve servicemembers.
        Another key aspect that enables high RC retention, at all pay-
    grades, is to provide the Sailors with real and meaningful work. Having
    recently visited the Central Command Area of Responsibility, I met with
    many RC Sailors in-theatre and know that their motivation is high and
    that their desire to continue serving is remarkable. My job as the
    Chief of Navy Reserve is to ensure that RC Sailors are provided the
    opportunities for such real and meaningful work--I intend to do that.
        For amplification, Enlisted and Officer Reserve retention rates
    remain high, and attrition rates remain at historic lows. The fiscal
    year 2008 Enlisted attrition rate was 25 percent, and the fiscal year
    2008 Officer attrition rate was 15 percent, down from the 3-year
    rolling averages of 29 percent and 19 percent, respectively. As a
    result, the Navy Reserve Officer corps is actually ``over-manned'' in
    the ranks that are tied to 20 years of qualifying service. In addition,
    we continue to enforce policies to shape the Force and maximize
    ``Fit,'' while targeting the optimal number of prior service Enlisted
    accessions to ensure we remain within budgetary limits and strength
    controls.
        Our goal remains to finish fiscal year 2009 with a stable, balanced
    inventory of Sailors that positions our Reserve Force for continued,
    outstanding Total Force support, now and well into the future.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
        Question. The fiscal year 2009 Omnibus contained the provision to
    help federal employees in the National Guard and Reserves avoid a loss
    of income when they are called the active duty.
        What efforts will the Navy Reserve undertake to quickly implement
    this new provision?
        Answer. The Navy Reserve, in coordination with the Employer Support
    of the Guard and Reserve (ESGR), is planning an informational campaign
    aimed at highlighting Section 751 benefits to Reservists throughout the
    country. The specifics of this program will be discussed at ESGR
    presentations and annual pre-deployment briefings at Navy Operational
    Support Centers (NOSCs) and other Navy Reserve Activities (NRAs).
        Question. Can you provide the number of current Navy Reserve
    members who are federal government employees?
        Answer. There are currently 4,720 current Navy Reservists who are
    federal government employees.
        Question. Of that number, how many have served at least one tour in
    Operation Enduring Freedom or Operation Iraqi Freedom? How many are
    currently deployed?
        Answer. Of the 4,720 Navy Reservists that are federal government
    employees, 2,014 have been mobilized during OEF/OIF operations.
    Currently, there are six such Reservists who are deployed, plus another
    89 Reservists from this group who have been identified for deployment
    in the next 3 months.
                                     ______

                  Questions Submitted by Senator Patty Murray
        Question. Gentlemen, each of you has a full time support entity
    within your organization. With the increase in usage of the Reserve
    component, do you feel you have the full time end strength to fulfill
    your obligations to each of your active duty components requirements?
    If you do not have the end strength numbers, what increase would each
    of you like to see if there was an acceleration plan for your projected
    future growth?
        Answer. I do feel that Navy has the Full Time Support end strength
    required to fulfill obligations.
        Since 2004 the Navy has conducted two extensive and comprehensive
    Flag Pole studies of the Reserve Component (RC) Full Time Support (FTS)
    community. These studies included all aspects of Selected Reserve
    (SELRES) training and administration as well as FTS community health
    and career progression. The studies also focused on ways to further
    optimize active-reserve integration (ARI) and maximize operational
    support.
        During the second Flag Pole study, several management options were
    analyzed and the one chosen allowed each Warfare Enterprise (Air,
    Surface, Sub, etc.) to determine what percentage of their Total Force
    (AD, FTS, SELRES, CIV, and Contractor) would provide full-time support
    to the Reserve component. This was essential due to the significant
    operational differences between the various warfare communities. In the
    end, senior leadership concluded that a rigid ``one size fits all''
    approach was not the optimum solution for Navy. At the completion of
    the study, Warfare Enterprises implemented changes as part of their PR-
    09 and POM-10 budget submissions.
        As the Navy continues to institutionalize its operational and
    strategic reserve, the training, administration and overall management
    of manpower requirements will be continually reevaluated by each of the
    Warfare Enterprises. The size of each component of the Navy's Total
    Force (AD, FTS, SELRES, CIV, and Contractor) required to support the
    Reserve component will be adjusted as needed in the annual POM/PR
    process.
        Question. Is there a need to find a way to extend TRICARE service
    to cover the ``gray area'' between the end of affiliation with the
    Reserves and the start of retirement benefits?
        Answer. With changes to the frequency and duration of service for
    activated Guard and Reserve components since 1991, and recognizing the
    tremendous sacrifice of those members and their families, we need to
    carefully balance the benefit structure supporting both active and
    reserve components without adversely affecting our ability to attract,
    recruit and retain in both programs while at the same time recognizing
    potential healthcare implications.
        Extending TRICARE benefits for the ``gray area'', the period
    between retirement under official orders from the selected Guard or
    Reserve component after satisfactorily completing 20 or more years of
    service and eligible for retired pay at age 60 should strongly be
    considered. Currently, ``gray area'' reserve members may purchase the
    TRICARE Retiree Dental Program even before they draw retirement pay. A
    similar program could be shaped to provide healthcare benefits under
    the TRICARE Reserve Select Program, a premium-based health plan which
    requires a monthly premium and offers coverage similar to TRICARE
    Standard and Extra. This option should be carefully reviewed to ensure
    it has its desired affects on personnel programs as well as addressing
    potential access and monetary challenges associated with delivering the
    expanded healthcare benefit.
        The implications of an individual going without healthcare coverage
    during the ``gray period'' are profound. During this period, routine
    healthcare preventive measures that should be incorporated may not be,
    and may result in undiagnosed, treatable disease(s). This failure to
    monitor age appropriate conditions could possibly lead to increased
    disease morbidity as well as increases in the severity of the
    disease(s) when there is delay in detection. An increase in undiagnosed
    diseases could result in cost increases for healthcare at age 60.
                                     ______

           Questions Submitted to Lieutenant General Jack W. Bergman
                 Question Submitted by Senator Byron L. Dorgan
        Question. With increased operational demands placed on the Reserve
    Component for the past several years, signs of stress and strain are
    showing. All Reserve Component services are facing increased challenges
    retaining experienced, mid-grade career servicemembers, precisely those
    eligible for retirement after having served 20 years of service. I am
    concerned we are not maintaining a balanced force, retaining enough of
    the very individuals who have gained the benefit of experience these
    past years of increased operations. I'm considering introducing
    legislation that would enhance retention of those experienced career
    servicemembers, providing an incentive to serve beyond 20 years,
    initial retirement eligibility, to continue to serve in the reserve
    component in exchange for lowering the age at which they will be
    eligible to receive retired pay. For example, if a member commits to
    serving 2 years beyond 20, the age for which they are eligible to
    receive retired pay would be lowered by 1 year. What is your opinion of
    this idea?
        Answer. Although incentives designed to encourage continued service
    in the Reserve Component can be an important tool for maintaining a
    healthy force, they must be implemented carefully to ensure that second
    and third order effects do not manifest unintended consequences such as
    stagnating promotions or exceeding controlled grade strength limits.
    Therefore, while Marine Forces, Reserve (MARFORRES) is always
    interested in exploring new ideas to promote the overall readiness of
    the Reserve force, and consequently the Total Force, we are reluctant
    to take a firm stance one way or the other, absent details that can be
    subject to a thorough manpower analysis. However, as we strive to
    define and implement the Continuum of Service concept, any legislation
    or program that enhances the ability to lengthen the careers of highly
    performing Marines will be a distinct benefit.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
        Question. The fiscal year 2009 Omnibus contained the provision to
    help federal employees in the National Guard and Reserves avoid a loss
    of income when they are called to active duty.
        What efforts will the Marine Forces Reserve undertake to quickly
    implement this new provision?
        Answer. The Marine Corps is preparing information for dissemination
    to Reserve members who are slated to mobilize, or currently mobilized,
    to ensure all members who are civilian federal employees are notified
    of this provision. Additionally, the Marine Corps will publish
    administrative guidance on command and member responsibilities to
    ensure federal government agencies receive accurate information on the
    military compensation, and any income differential, of mobilized
    Reserve members.
        Question. Can you provide the number of current Marine Forces
    Reserve members who are federal government employees?
        Answer. The Marine Corps attempted to access this information
    through the Defense Manpower Data Center (DMDC). However, DMDC is
    unable to provide a macro-level report on the total number of Reserve
    members who are federal government employees, as the data entry fields
    in the Guard and Reserve Portal list employers individually. In
    September and October, the Department of Defense expects to receive
    reports from all agencies of the federal government on civilian federal
    employees who are Reservists, as part of initiatives pertaining to
    Tricare Reserve Select, and the Marine Corps will validate these
    reports in an effort to answer this question.
        Question. Of that number, how many have served at least one tour in
    Operation Enduring Freedom or Operation Iraqi Freedom? How many are
    currently deployed?
        Answer. Once the actions described in the above answer are complete
    the Marine Corps will be able to respond to this question.
                                     ______

                  Questions Submitted by Senator Patty Murray
        Question. Gentlemen, each of you has a full time support entity
    within your organization. With the increase in usage of the Reserve
    component, do you feel you have the full time end strength to fulfill
    your obligations to each of your active duty components requirements?
        Answer. The Marine Corps deems the end strength of the Reserve
    Component is adequate. Our full time support program, called our Active
    Reserve (AR), has been under review as required by the NDAA of 2009.
    That review is not yet complete. If we require growth in the AR
    program, however, it will likely be limited and designed to address
    specific grades and specialties affected by the increased operational
    tempo for the Reserves.
        Question. If you do not have the end strength numbers, what
    increase would each of you like to see if there was an acceleration
    plan for your projected future growth?
        Answer. The analysis of the Marine Corps Active Reserve (AR)
    program (full-time support) is a part of the review of full-time
    support requirements identified in the response to Senator Murray's
    question concerning full-time support end strength. We cannot evaluate
    the AR program except in the context of the full-time support
    requirement. The Marine Corps expects to be able to address the need
    for changes to AR strengths and ``composition'' as we go through our
    review of full-time support requirements.
        Question. Does the Marine Corps have a need to extend TRICARE
    service to cover the ``gray area'' between the end of affiliation with
    the Reserves and the start of retirement benefits?
        Answer. If an additional TRICARE Retiree Medical Benefit can be
    offered that covers this ``gray area'' without raising the cost of
    existing programs for the Service or Reservists or otherwise detracting
    from coverage already available, the Marine Corps would be inclined to
    support such a program.
                                     ______

                 Questions Submitted to Charles E. Stenner, Jr.
                Questions Submitted by Chairman Daniel K. Inouye
                               force realignment
        Question. General Stenner, for several years now the Air Force
    Reserve has implemented force structure realignments as part of the
    Total Force Integration and base closure initiatives. The resulting
    closures and mission realignments have hurt retention levels. At the
    same time, the Reserve now plans to grow its end strength by 7,000
    airmen.
        Do you think the Air Force Reserve will be able to recruit and
    retain these additional personnel given the instability of the ongoing
    realignments?
        Answer. Yes. We have completed all of our programmed manpower
    realignments and are now stable and growing. The Air Force and Air
    Force Reserve (AFR) have identified additional mission requirements and
    the AFR needs to grow proportionately to the regular component to meet
    these requirements. Recruiting for the AFR is strong--having exceeded
    recruiting goals for 8 consecutive years. Nevertheless we are bringing
    on additional recruiters to ensure that we meet any additions to our
    end strength.
        On the retention side, losses realized over the last 3 to 5 years
    were a direct result of programmed force structure changes and
    realignments. Now that this era is behind us, we are confident that we
    will be able to retain the appropriate number of personnel to stay
    within Department of Defense mandated end strength limits. Measures
    recently enacted by Congress such as expanded TRICARE Reserve Select,
    Reduced Eligibility Age for Retirement Pay, the Post 9/11 GI Bill, and
    authorized travel entitlements for certain Selected Reserve members who
    serve outside the normal commuting distance have generated much
    interest. We have undertaken great efforts to make our members aware of
    these benefits. We believe these benefits and our efforts to improve
    awareness will greatly improve our ability to retain our members as we
    go forward.
        Question. General Stenner, with personnel and mission adjustments,
    the Air Force Reserve will have to train and retrain a large number of
    personnel.
        Have you been provided the training slots and funding needed to
    meet your training requirements?
        Answer. Ensuring the Air Force Reserve maintains individual and
    unit readiness standards to support all aspects of the Air Force's
    missions remains a top priority. The help we received from your
    Committee in moving funding into our training program has allowed us to
    keep pace with the increasing demands resulting from changing missions
    and demographics.
        In terms of formal classroom training, we work closely with
    Headquarters Air Education and Training Command (AETC) in projecting
    and securing the appropriate number of quotas to provide our reservists
    with the required training to meet basic requirements. While there are
    limits to the number of class seats AETC has to offer, we have not had
    any notable issues obtaining quotas for our people in the past and do
    not anticipate any in the future.
        While classroom training is vital, it is our ``seasoning training
    program'' that gives our members the hands-on training needed to become
    fully mission capable. When members return from formal school, they
    must still complete several requirements to become fully proficient in
    their assigned mission. The Air Force Reserve has implemented the
    ``seasoning training program'' to bring members back to their units in
    a paid status so that they can more quickly receive the required
    training needed to become fully mission capable in their specialty.
    This program has enabled to us to more readily meet increased demands
    for reserve members needed to augment active duty to prosecute our
    national security objectives.
        Due to the outstanding results we've experienced with this program,
    we would like to expand its reach and scope, but our limited funding
    and inability to tradeoff and reallocate dollars in the year of
    execution inhibits expansion.
        The Air Force Reserve will continue pursue all the avenues
    necessary to ensure we are providing the best trained, combat ready
    force available to meet mission requirements.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
              federal employees in the national guard and reserves
        Question. The fiscal year 2009 Omnibus contained the provision to
    help federal employees in the National Guard and Reserves avoid a loss
    of income when they are called to active duty.
        What efforts will the Air Force Reserve undertake to quickly
    implement this new provision?
        Answer. The provision is directed to the federal agencies rather
    than to the Reserve Components. Section 751 of the Omnibus
    Appropriations Act, 2009 (Public Law 111-8, March 11, 2009) amends
    Title 5, United States Code, Section 5538, to require federal agencies
    to pay a supplemental payment to eligible civilian employees who are
    absent from their civilian employment while on active duty in support
    of a contingency operation under specific paragraphs of Title 10 of the
    United States Code.
        For each covered biweekly pay period, eligible civilian employees
    will receive a supplemental payment equal to the amount by which
    civilian basic pay exceeds (if at all) military pay and allowances
    allowable to the given period. Civilian employees are not eligible for
    this supplemental payment in pay periods during which they use any
    other form of paid leave from the civilian position.
        Question. Can you provide the number of current Air Force Reserve
    members who are federal government employees? Of that number, how many
    have served at least one tour in Operation Enduring Freedom or
    Operation Iraqi Freedom? How many are currently deployed?
        Answer. A total of 14,016 out of 66,871 Air Force Reservists in the
    Selected Reserve are DOD federal employees. A total of 8,729 of the
    14,016 federal employees have been activated in support of Operations
    Enduring Freedom or Iraqi Freedom. Currently, 403 of the 14,016 federal
    employees are activated in support of a named contingency operation.
                                     ______

                  Questions Submitted by Senator Patty Murray
                                    tricare
        Question. Is there a need to find a way to extend TRICARE service
    to cover the ``gray area'' between the end of affiliation with the
    Reserves and the start of retirement benefits?
        Answer. Yes. Extending TRICARE service to cover the ``gray area''
    between retirement from the reserves and the start of retirement health
    benefits would improve our ability to care for reserve members and
    their families, and could serve as an effective recruitment/retention
    tool.
        Such a benefit directly addresses my concerns about caring for our
    people and recognizing the increased service of our reserve forces due
    to higher operations tempo and more frequent deployments: it provides
    ``gray area'' reservists--who might have difficulty securing or may
    otherwise not be able to secure health care coverage--the opportunity
    to purchase affordable health care coverage.
        Congress recently dramatically improved TRICARE for Reserve
    component members to mitigate switching back and forth between civilian
    health plans and the military TRICARE system, by offering TRICARE
    Reserve Select as a full time option to our part-time members at a
    reduced cost. An unintended consequence of subscribing to this offering
    is the member could be without any health coverage upon retirement from
    the reserve. A newly retired reservist with ongoing personal or family
    health issues would have difficulty re-engaging in the civilian
    healthcare insurance market.
        As a recruiting tool, this would be an added benefit for recruiting
    new members into the Reserve components. Increased civilian healthcare
    costs, increased co-payments, and employers eliminating plans make
    healthcare issues a topic of concern for individuals, families, and as
    a nation.
        As a retention tool, TRICARE Reserve Select has provided an
    incentive for continued Reserve component participation. Continued
    service by our Reserve component members reduces training costs,
    retains experience, and strengthens our nation.
        I am always concerned about the effects on our overall bottom line:
    such a benefit must be affordable over the long run. A benefit in which
    the ``gray area'' retiree pays 100 percent of the premium cost for
    TRICARE Reserve Select would minimize the impact to our bottom.
    Moreover, the cost differential between reduced premiums for those
    still in service and the full premiums for ``gray area'' retirees would
    also serve as an incentive to stay in service longer. Lastly, although
    the premiums would be greater to them, ``gray area'' retirees would
    have relatively affordable, continued healthcare coverage available to
    them.
        This benefit would provide for the care of our people who have done
    so much for our nation.
                         reserve full time end strength
        Question. Gentlemen, each of you has a full time support
    requirement with your organization.
        With the increase in usage of the Reserve component, do you feel
    you have the full time strength to fulfill your obligations to each of
    your active duty components requirements?
        Answer. The Air Force Reserve is first and foremost a strategic
    reserve. Our full time support is meant to provide trained and equipped
    Airmen to the active component. In that capacity, we have sufficient
    full time strength to meet our active duty component requirements.
    However, the strategic reserve is a Cold War paradigm that was designed
    for short term high intensity warfare. The conflicts in Iraq and
    Afghanistan are low intensity wars of unknown duration requiring the
    Reserve to continuously provide trained and ready Airmen. Consequently,
    this demand for Airmen requires that we send a portion of our full time
    support away from home station to support operations, thus reducing our
    ability to train and equip Airmen at home station. If the Air Force
    Reserve is to be used operationally, we will need more full time
    strength to support active component requirements.
        Question. If you do not have the end strength numbers, what
    increase would each of you like to see if there was an acceleration
    plan for your projected future growth?
        Answer. The Air Force Reserve's workforce is currently 80 percent
    traditional (part time) citizen Airmen. Our full time support program
    ensures these traditional Airmen are trained and ready to meet the
    requirements of a strategic reserve. For 18 years we've operated at
    higher operations tempo than during peacetime, yet we continued to
    program as if next year this operations tempo will subside and
    peacetime strategic reserve tempo will return. To manage our force and
    sufficiently meet requirements of this new steady state, an increase in
    full time support is needed. We know that certain careers fields like
    security forces and combat search and rescue are enduing higher than
    normal operations tempo and would greatly benefit from an increase in
    full time support end strength. Although we cannot determine an exact
    figure at this time, we will continue to analyze our data to establish
    the right level to ensure our traditional reservist continue to receive
    the proper training.
                     changes in reserve personnel policies
        Question. With increased operational demands placed on the Reserve
    component for the past several years, signs of stress and strain are
    showing. All Reserve component Services are facing increased challenges
    retaining experienced, mid-grade career service members, precisely
    those eligible for retirement after having served 20 years of service.
    I am concerned we are not maintaining a balanced force, retaining
    enough of the very individuals who have gained the benefit of
    experience these past years of increased operations. I'm considering
    introducing legislation that would enhance retention of those
    experienced career service members, providing an incentive to serve
    beyond 20 years, initial retirement eligibility, to continue to serve
    in the reserve component in exchange for lowering the age at which they
    will be eligible to receive retired pay. For example, if a member
    commits to serving 2 years beyond 20, the age for which they are
    eligible to receive retired pay would be lowered by 1 year.
        What is your opinion of this idea?
        Answer. This proposal would be a huge benefit to reserve members
    and anything that helps with recruiting and increased retention is most
    welcomed. However, we recently did some analysis to determine if
    reservist were leaving earlier after reaching retirement age than they
    have historically. The analysis determined that we have not seen
    significant increases through the era of Base Realignment and Closure,
    Total Force Integration or with the increased operations tempo.
    However, in recognition of the contributions our members are making to
    the nation's security, the fiscal year 2008 National Defense
    Authorization Act authorized a similar benefit for members who serve at
    least 90 aggregate days on most active duty and reserve tours. For each
    90 aggregate days served per fiscal year, on most active duty and
    reserve tours, member's retirement will be reduced by 3 months up to
    age 50. This proposal would serve as additional recognition for those
    reservists that continue to serve beyond retirement age. A legitimate
    concern may be the potential impact this proposal will have on the Air
    Force's retirement account. Given that people are living longer now, we
    must be sure that we are able to sustain this initiative over the long
    run. Bottom line: the proposal would likely encourage members to
    continue to serve beyond retirement age and therefore positively impact
    retention.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The Defense Subcommittee will meet next on
    Tuesday, April 22, at 10:30 a.m., at which time we will receive
    testimony from Secretary Michael Donley and General Norton
    Schwartz on the United States Air Force fiscal year 2010 budget
    request. Until then, we will stand in recess.
        [Whereupon, at 11:59 a.m., Wednesday, March 25, the
    subcommittee was recessed, to reconvene at 10:30 a.m., Tuesday,
    April 22.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                             TUESDAY, MAY 12, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:30 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Leahy, Cochran, and Bond.

                             DEPARTMENT OF DEFENSE

                             DEPARTMENT OF THE ARMY

                            Office of the Secretary

    STATEMENTS OF:
            HON. PETE GEREN, SECRETARY OF THE ARMY
            GENERAL GEORGE W. CASEY, JR., CHIEF OF STAFF

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning we welcome the Honorable Pete
    Geren, Secretary of the Army, and General George Casey, the
    Army's Chief of Staff.
        Gentlemen, thank you for being with us today as the
    subcommittee reviews the Army's budget request for fiscal year
    2010.
        The Army's fiscal year budget request is $142 billion, an
    increase of almost $2 billion over last year's inactive budget
    excluding the funding appropriated to the Army in the fiscal
    year 2009 supplemental. The Army has also requested $83.1
    billion for overseas contingencies for fiscal year 2010.
        As we review the request, we are mindful of the fact that
    in this era of persistent conflict, the Army and its soldiers
    remain a constant in any strategy to ensure our national
    security. The Army remains highly engaged in overseas
    contingency operations, while continuing to transform itself.
        But fighting in today's security environment while
    continuing to rebuild and reset has stretched the service and
    the Army has to balance decisions among the strains of meeting
    the high demand of the forces maintaining a debt of forces
    needed to be prepared for other contingencies and managing the
    limited time between deployments.
        At the end of the fiscal year, the active duty Army and the
    Reserve components will have reached its final end strength
    goals, and I wish to congratulate achieving this goal several
    years ahead of schedule, and I hope that these additional
    soldiers will help relieve the current strain on the force.
        There's no question that the continuous hard pace of
    operations has taken a toll on both Army personnel and
    equipment, yet as we address current urgent needs, we cannot
    lose sight of the future.
        The Secretary recently made it clear that the Department of
    Defense is not going to move forward into the future with a
    business-as-usual approach, and last month, Secretary Gates
    held a press conference announcing sweeping cuts and other
    major changes to the budget, including changing the ways the
    Pentagon buys weapons.
        This decision was fueled by outrage over programs that
    exceed cost estimates, and often do not meet operational needs.
        Secretary Gates also acknowledged that major structural
    changes are needed to place the Defense Department on a
    fiscally sustainable path, especially regarding personal
    accounts.
        Facing this new fiscal environment, I think the Army must
    rethink its modernization approach to reflect an increased
    focus on cost, as well as a need to integrate lessons learned
    from ongoing operations. Procurement dollars, as you can
    imagine, will be tighter as the Army faces higher personnel
    costs.
        The subcommittee expects that many of the hard decisions
    facing the Army will be reflected, both in the upcoming
    Quadrennial Defense Review (QDR), and overall modernization
    planning, and it is our hope that this morning's hearing will
    help answer some of these questions, and eliminate how the
    Army's fiscal year 2010 request addresses these challenges in a
    responsible manner.
        Gentlemen, we sincerely appreciate your service to our
    Nation, and the dedication and sacrifice made daily by men and
    women in our Army. We could not be more grateful for what those
    who wear our Nation's uniform do for our country, each and
    every day.
        And, as always, your full statements will be made part of
    the record, and I wish to turn to my vice chairman, Senator
    Cochran, at this time for his opening statement.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you for your
    leadership of this subcommittee, and in the Senate, generally.
    And we welcome our witnesses today to review the request for
    funding for the Department of the Army.
        I first want to commend you for your leadership and your
    success in managing the resources of the United States Army,
    our men and women in uniform, and their families, who are
    performing services that are very important for the safety and
    security of our country and for stability in the world, and for
    that, we're very grateful.
        We want to thank you, too, for the definition of your
    priorities, in terms of funding for programs and activities,
    procurement, resetting the force, all of the things that are
    under your responsibility, and we appreciate your giving us a
    statement and an outline of your thoughts on these subjects. It
    will be very helpful to us as we proceed to consider the budget
    request.
        We welcome you to the subcommittee and look forward to your
    comments.
        Chairman Inouye. I recognize Secretary Geren.
        Secretary Geren. Thank you, Mr. Chairman, Mr. Vice
    Chairman.
        It's an honor for General Casey and me to appear before you
    to discuss our United States Army. An Army that's built on a
    partnership between soldiers and the Congress, it's a
    partnership that pre-dates the independence of our Nation.
        We have provided the subcommittee the full posture
    statement, I ask that it be included in the record.
        Chairman Inouye. Without objection.
        [The statement follows:]
     Prepared Statement of the Honorable Pete Geren and General George W.
                                   Casey, Jr.
    2009 army posture statement--america's army: the strength of the nation
                                                   May 5, 2009.

        Our Nation is in its eighth year of war, a war in which our Army--
    Active, Guard, and Reserve--is fully engaged. The Army has grown to
    more than 1 million Soldiers, with 710,000 currently serving on active
    duty and more than 255,000 deployed to nearly 80 countries worldwide.
    Our Soldiers and Army Civilians have performed magnificently, not only
    in Afghanistan and Iraq, but also in defense of the homeland and in
    support to civil authorities in responding to domestic emergencies.
        Much of this success is due to our Noncommissioned Officers. This
    year, we specifically recognize their professionalism and commitment.
    To honor their sacrifices, celebrate their contributions, and enhance
    their professional development, we have designated 2009 as the ``Year
    of the Army NCO.'' Our NCO Corps is the glue holding our Army together
    in these challenging times.
        Today, we are fighting a global war against violent extremist
    movements that threaten our freedom. Violent extremist groups such as
    Al Qaeda, as well as Iran-backed factions, consider themselves at war
    with western democracies and even certain Muslim states. Looking ahead,
    we see an era of persistent conflict--protracted confrontation among
    state, non-state, and individual actors that are increasingly willing
    to use violence to achieve their political and ideological ends. In
    this era, the Army will continue to have a central role in providing
    full spectrum forces necessary to ensure our security.
        The Army remains the best led, best trained, and best equipped Army
    in the world, but it also remains out of balance. The demand for our
    forces over the last several years has exceeded the sustainable supply.
    It has stretched our Soldiers and their Families and has limited our
    flexibility in meeting other contingencies. In 2007, our Army initiated
    a plan based on four imperatives: Sustain our Soldiers and Families;
    Prepare our forces for success in the current conflicts; Reset
    returning units to rebuild readiness; and Transform to meet the demands
    of the 21st Century. We have made progress in all of these and are on
    track to meet the two critical challenges we face: restoring balance
    and setting conditions for the future.
        Our Army is the Strength of this Nation, and this strength comes
    from our values, our ethos, and our people--our Soldiers and the
    Families and Army Civilians who support them. We remain dedicated to
    improving their quality of life. We are committed to providing the best
    care and support to our wounded, ill, and injured Soldiers--along with
    their Families. And our commitment extends to the Families who have
    lost a Soldier in service to our Nation. We will never forget our moral
    obligation to them.
        We would not be able to take these steps were it not for the
    support and resources we have received from the President, Secretary of
    Defense, Congress, and the American people. We are grateful. With
    challenging years ahead, the Soldiers, Families, and Civilians of the
    United States Army require the full level of support requested in this
    year's base budget and Overseas Contingency Operations funding request.
    Together, we will fight and win the wars in Afghanistan and Iraq,
    restore balance, and transform to meet the evolving challenges of the
    21st Century. Thank you for your support.
                                           George W. Casey, Jr.
                            General, United States Army Chief of Staff.
                                                    Pete Geren,
                                                 Secretary of the Army.

        ----------------------------------------------------------------

        ``As we consider the road that unfolds before us, we remember with
    humble gratitude those brave Americans who, at this very hour, patrol
    far-off deserts and distant mountains. They have something to tell us,
    just as the fallen heroes who lie in Arlington whisper through the
    ages. We honor them not only because they are guardians of our liberty,
    but because they embody the spirit of service; a willingness to find
    meaning in something greater than themselves. And yet, at this moment--
    a moment that will define a generation--it is precisely this spirit
    that must inhabit us all.''----President Barack Obama Inaugural
    Address, January 2009.

        ----------------------------------------------------------------

                                  introduction
        Our combat-seasoned Army, although stressed by 7 years of war, is a
    resilient and professional force--the best in the world. The Army--
    Active, National Guard, and Army Reserve--continues to protect our
    Nation, defend our national interests and allies, and provide support
    to civil authorities in response to domestic emergencies.
        The Army is in the midst of a long war, the third longest in our
    Nation's history and the longest ever fought by our All-Volunteer
    Force. More than 1 million of our country's men and women have deployed
    to combat; more than 4,500 have sacrificed their lives, and more than
    31,000 have been wounded. Our Army continues to be the leader in this
    war, protecting our national interests while helping others to secure
    their freedom. After 7 years of continuous combat, our Army remains out
    of balance, straining our ability to sustain the All-Volunteer Force
    and maintain strategic depth. The stress on our force will not ease in
    2009 as the demand on our forces will remain high. In 2008, the Army
    made significant progress to restore balance, but we still have several
    challenging years ahead to achieve this vital goal.
        As we remain committed to our Nation's security and the challenge
    of restoring balance, we remember that the Army's most precious
    resources are our dedicated Soldiers, their Families, and the Army
    Civilians who support them. They are the strength of the Army--an Army
    that is the Strength of the Nation.
                               strategic context
    An Era of Persistent Conflict
        The global security environment is more ambiguous and unpredictable
    than in the past. Many national security and intelligence experts share
    the Army's assessment that the next several decades will be
    characterized by persistent conflict--protracted confrontation among
    state, non-state, and individual actors that are increasingly willing
    to use violence to achieve their political and ideological ends. We
    live in a world where global terrorism and extremist ideologies,
    including extremist movements such as Al Qaeda, threaten our personal
    freedom and our national interests. We face adept and ruthless
    adversaries who exploit technological, informational, and cultural
    differences to call the disaffected to their cause. Future operations
    in this dynamic environment will likely span the spectrum of conflict
    from peacekeeping operations to counterinsurgency to major combat.
    Global Trends
        Several global trends are evident in this evolving security
    environment. Globalization has increased interdependence and prosperity
    in many parts of the world. It also has led to greater disparities in
    wealth which set conditions that can foster conflict. The current
    global recession will further increase the likelihood of social,
    political, and economic tensions.
        Technology, which has enabled globalization and benefited people
    all over the world, also is exploited by extremists to manipulate
    perceptions, export terror, and recruit people who feel disenfranchised
    or threatened.
        Population growth increases the likelihood of instability with the
    vast majority of growth occurring in urban areas of the poorest regions
    in the world. The limited resources in these areas make young,
    unemployed males especially vulnerable to antigovernment and radical
    ideologies. The inability of governments to meet the challenges of
    rapid population growth fuels local and regional conflicts with
    potential global ramifications.
        Increasing demand for resources, such as energy, water, and food,
    especially in developing economies, will increase competition and the
    likelihood of conflict. Climate change and natural disasters further
    strain already limited resources, increasing the potential for
    humanitarian crises and population migrations.
        The proliferation of weapons of mass destruction (WMD) remains a
    vital concern. Growing access to technology increases the potential for
    highly disruptive or even catastrophic events involving nuclear,
    radiological, chemical, and biological weapons or materials. Many
    terrorist groups are actively seeking WMD. Failed or failing states,
    lacking the capacity or will to maintain territorial control, can
    provide safe havens for terrorist groups to plan and export operations,
    which could include the use of WMD.
        These global trends, fueled by local, regional, and religious
    tensions, create a volatile security environment with increased
    potential for conflict. As these global trends contribute to an era of
    persistent conflict, the character of conflict in the 21st Century is
    changing.
    The Evolving Character of Conflict
        Although the fundamental nature of conflict is timeless, its ever-
    evolving character reflects the unique conditions of each era. Current
    global trends include a diverse range of complex operational challenges
    that alter the manner and timing of conflict emergence, change the
    attributes and processes of conflict, require new techniques of
    conflict resolution, and demand much greater integration of all
    elements of national power. The following specific characteristics of
    conflict in the 21st Century are especially important.
        Diverse actors, especially non-state actors, frequently operate
    covertly or as proxies for states. They are not bound by
    internationally recognized norms of behavior, and they are resistant to
    traditional means of deterrence.
        Hybrid threats are dynamic combinations of conventional, irregular,
    terrorist, and criminal capabilities. They make pursuit of singular
    approaches ineffective, necessitating innovative solutions that
    integrate new combinations of all elements of national power.
        Conflicts are increasingly waged among the people instead of around
    the people. Foes seeking to mitigate our conventional advantages
    operate among the people to avoid detection, deter counterstrikes, and
    secure popular support or acquiescence. To secure lasting stability,
    the allegiance of indigenous populations becomes the very object of the
    conflict.
        Conflicts are becoming more unpredictable. They arise suddenly,
    expand rapidly, and continue for uncertain durations in unanticipated,
    austere locations. They are expanding to areas historically outside the
    realm of conflict such as cyberspace and space. Our nation must be able
    to rapidly adapt its capabilities in order to respond to the
    increasingly unpredictable nature of conflict.
        Indigenous governments and forces frequently lack the capability to
    resolve or prevent conflicts. Therefore, our Army must be able to work
    with these governments, to create favorable conditions for security and
    assist them in building their own military and civil capacity.
        Interagency partnerships are essential to avoid and resolve
    conflicts that result from deeply rooted social, economic, and cultural
    conditions. Military forces alone cannot establish the conditions for
    lasting stability.
        Images of conflicts spread rapidly across communication, social,
    and cyber networks by way of 24-hour global media and increased access
    to information through satellite and fiber-optic communications add to
    the complexity of conflict. Worldwide media coverage highlights the
    social, economic, and political consequences of local conflicts and
    increases potential for spillover, creating regional and global
    destabilizing effects.
        Despite its evolving character, conflict continues to be primarily
    conducted on land; therefore, landpower--the ability to achieve
    decisive results on land--remains central to any national security
    strategy. Landpower secures the outcome of conflict through an
    integrated application of civil and military capabilities, even when
    landpower is not the decisive instrument. The Army, capable of full
    spectrum operations as part of the Joint Force, continues to transform
    itself to provide the prompt, sustainable, and dominant effects
    necessary to ensure our Nation's security in the 21st Century.
                               global commitments
        In this era of persistent conflict, the Army remains essential to
    our Nation's security as a campaign capable, expeditionary force able
    to operate effectively with Joint, interagency, and multinational
    partners across the full spectrum of conflict. Today, the Army has
    243,000 Soldiers deployed in nearly 80 countries around the world, with
    140,000 Soldiers in active combat theaters. To fulfill the requirements
    of today's missions, including defending the homeland and supporting
    civil authorities, the Army has over 710,000 Soldiers on active duty
    from all components. Additionally, 258,000 Army Civilians are
    performing critical missions in support of the Army. More than 4,100 of
    our Civilians and more than 33,000 U.S. contractors are forward-
    deployed, performing vital missions abroad.
        The Army's primary focus continues to be combined counter-
    insurgency operations in Iraq and Afghanistan, while training each
    nation's indigenous forces and building their ability to establish
    peace and maintain stability. Our Army is also preparing ready and
    capable forces for other national security requirements, though at a
    reduced rate. These forces support combatant commanders in a wide
    variety of military missions across the entire spectrum of conflict.
    Examples of Army capabilities and recent or ongoing missions other than
    combat include:
        Responding to domestic incidents by organizing, training, and
    exercising brigade-sized Chemical, Biological, Radiological, Nuclear,
    and high yield Explosive Consequence Management Reaction Forces--the
    first in 2008, the second in 2009, and the third in 2010.
        Supporting the defense of South Korea, Japan, and many other
    friends, allies, and partners.
        Conducting peacekeeping operations in the Sinai Peninsula and the
    Balkans.
        Supporting the establishment of Africa Command, headquartered in
    Germany, and its Army component, U.S. Army Africa, headquartered in and
    Italy.
        Providing military observers and staff officers to U.N.
    peacekeeping missions in Haiti, Iraq, Liberia, the Republic of Georgia,
    Israel, Egypt, Afghanistan, and Chad.
        Conducting multinational exercises that reflect our longstanding
    commitments to our allies and alliances.
        Supporting interagency and multinational partnerships with
    technical expertise, providing critical support after natural
    disasters.
        Continuing engagements with foreign militaries to build
    partnerships and preserve coalitions by training and advising their
    military forces.
        Supporting civil authorities in responding to domestic emergencies.
        Participating, most notably by the Army National Guard, in securing
    our borders and conducting operations to counter the flow of illegal
    drugs.
        Supporting operations to protect against WMD and prevent their
    proliferation.
        Protecting and eliminating chemical munitions.
        Current combat operations, combined with other significant demands
    placed on our forces, have stressed our Army, our Soldiers, and their
    Families. While we remain committed to providing properly manned,
    trained, and equipped forces to meet the diverse needs of our combatant
    commanders, we face two critical challenges.

                            two critical challenges
        While fully supporting the demands of our Nation at war, our Army
    faces two major challenges--restoring balance to a force experiencing
    the cumulative effects of 7 years of war and setting conditions for the
    future to fulfill our strategic role as an integral part of the Joint
    Force.
        The Army is out of balance. The current demand for our forces in
    Iraq and Afghanistan exceeds the sustainable supply and limits our
    ability to provide ready forces for other contingencies. Even as the
    demand for our forces in Iraq decreases, the mission in Afghanistan and
    other requirements will continue to place a high demand on our Army for
    years to come. Current operational requirements for forces and
    insufficient time between deployments require a focus on
    counterinsurgency training and equipping to the detriment of
    preparedness for the full range of military missions. Soldiers,
    Families, support systems, and equipment are stressed due to lengthy
    and repeated deployments. Overall, we are consuming readiness as fast
    as we can build it. These conditions must change. Institutional and
    operational risks are accumulating over time and must be reduced in the
    coming years.
        While restoring balance, we must simultaneously set conditions for
    the future. Our Army's future readiness will require that we continue
    to modernize, adapt our institutions, and transform Soldier and leader
    development in order to sustain an expeditionary and campaign capable
    force for the rest of this Century.
        Modernization efforts are essential to ensure technological
    superiority over a diverse array of potential adversaries. Our Army
    must adapt its institutions to more effectively and efficiently provide
    trained and ready forces for combatant commanders. We will continue to
    transform how we train Soldiers and how we develop agile and adaptive
    leaders who can overcome the challenges of full spectrum operations in
    complex and dynamic operating environments. We also must continue the
    transformation of our Reserve Components to an operational force to
    achieve the strategic depth necessary to successfully sustain
    operations in an era of persistent conflict.
        Through the dedicated efforts of our Soldiers, their Families, and
    Army Civilians, combined with continued support from Congressional and
    national leadership, we are making substantial progress toward these
    goals. Our continued emphasis on the Army's four imperatives--Sustain,
    Prepare, Reset, and Transform--has focused our efforts. We recognize,
    however, that more remains to be done in order to restore balance and
    set conditions for the future.
    Restoring Balance: The Army's Four Imperatives
                Sustain
        We must sustain the quality of our All-Volunteer Force. Through
    meaningful programs, the Army is committed to providing the quality of
    life deserved by those who serve our Nation. To sustain the force, we
    are focused on recruitment and retention; care of Soldiers, Families,
    and Civilians; care for our wounded Warriors; and support for the
    Families of our fallen Soldiers.
                    Recruit and Retain
        Goal.--Recruit quality men and women through dynamic incentives.
    Retain quality Soldiers and Civilians in the force by providing
    improved quality of life and incentives.
        Progress.--In 2008, nearly 300,000 men and women enlisted or
    reenlisted in our All-Volunteer Army. In addition, the Army created the
    Army Preparatory School to offer incoming recruits the opportunity to
    earn a GED in order to begin initial entry training. All Army
    components are exceeding the 90 percent Tier 1 Education Credential
    (high school diploma or above) standard for new recruits. In addition,
    our captain retention incentive program contributed to a nearly 90
    percent retention rate for keeping experienced young officers in the
    Army.
                    Care of Soldiers, Families, and Civilians
        Goal.--Improve the quality of life for Soldiers, Families, and
    Civilians through the implementation of the Soldier and Family Action
    Plan and the Army Family Covenant. Garner support of community groups
    and volunteers through execution of Army Community Covenants.
        Progress.--The Army hired more than 1,000 new Family Readiness
    Support Assistants to provide additional support to Families with
    deployed Soldiers. We doubled the funding to Family programs and
    services in 2008. We began construction on 72 Child Development Centers
    and 11 new Youth Centers and fostered community partnerships by signing
    80 Army Community Covenants. Our Army initiated the ``Shoulder to
    Shoulder, No Soldier Stands Alone'' program to increase suicide
    awareness and prevention.
        The Army also committed to a 5-year, $50 million study by the
    National Institute for Mental Health for practical interventions for
    mitigating suicides and enhancing Soldier resiliency. In addition, the
    Army implemented the Intervene, Act, Motivate (I A.M. Strong) Campaign
    with a goal of eliminating sexual harassment and sexual assault in the
    Army. To enhance the investigation and prosecution of criminal
    behavior, the Army's Criminal Investigation Command and Office of the
    Judge Advocate General have taken new measures to support victims,
    investigate crimes and hold offenders accountable. The Army also has
    provided better access to quality healthcare, enhanced dental readiness
    programs focused on Reserve Component Soldiers, improved Soldier and
    Family housing, increased access to child care, and increased
    educational opportunities for Soldiers, children, and spouses.
                    Warrior Care and Transition
        Goal.--Provide world-class care for our wounded, ill, and injured
    Warriors through properly resourced Warrior Transition Units (WTUs),
    enabling these Soldiers to remain in our Army or transition to
    meaningful civilian employment consistent with their desires and
    abilities.
        Progress.--The Army established 36 fully operational WTUs and 9
    community-based healthcare organizations to help our wounded, ill, and
    injured Soldiers focus on their treatment, rehabilitation, and
    transition through in-patient and out-patient treatment. We initiated
    programs to better diagnose and treat Post-Traumatic Stress Disorder,
    Traumatic Brain Injury and other injuries through advanced medical
    research. We also have made investments in upgrading our clinics and
    hospitals including a $1.4 billion investment in new hospitals at Forts
    Riley, Benning, and Hood.
                    Support Families of Fallen Comrades
        Goal.--Assist the Families of our fallen comrades and honor the
    service of their Soldiers.
        Progress.--The Army is developing and fielding Survivor Outreach
    Services, a multi-agency effort to care for the Families of our
    Soldiers who made the ultimate sacrifice. This program includes benefit
    specialists who serve as subject matter experts on benefits and
    entitlements, support coordinators who provide long-term advocacy, and
    financial counselors who assist in budget planning.
                Prepare
        We must prepare our force by readying Soldiers, units, and
    equipment to succeed in the current conflicts, especially in Iraq and
    Afghanistan. We continue to adapt institutional, collective, and
    individual training to enable Soldiers to succeed in combat and prevail
    against adaptive and intelligent adversaries. We are equally committed
    to ensuring Soldiers have the best available equipment to both protect
    themselves and maintain a technological advantage over our adversaries.
    To prepare our force, we continue to focus on growing the Army,
    training, equipping, and better supporting the Army Force Generation
    (ARFORGEN) process.
                    Grow the Army
        Goal.--Accelerate the end strength growth of the Army so that by
    2010 the Active Component has 547,400 Soldiers and the National Guard
    has 358,200 Soldiers. Grow the Army Reserve to 206,000 Soldiers by 2012
    even as the Army Reserve works an initiative to accelerate that growth
    to 2010. Grow the Army's forces to 73 Brigade Combat Teams (BCTs) and
    approximately 227 Support Brigades with enabling combat support and
    combat service support structure by 2011. Simultaneously develop the
    additional facilities and infrastructure to station these forces.
        Progress.--With national leadership support, our Army has achieved
    our manpower growth in all components during 2009. The Army grew 32
    Modular Brigades in 2008 (7 Active Component Brigades and 25 Brigades
    in the Reserve Component). This growth in the force, combined with
    reduced operational deployments from 15 months to 12 months, eased some
    of the strain on Soldiers and Families.
                    Training
        Goal.--Improve the Army's individual, operational, and
    institutional training for full spectrum operations. Develop the tools
    and technologies that enable more effective and efficient training
    through live, immersive, and adaptable venues that prepare Soldiers and
    leaders to excel in the complex and challenging operational
    environment.
        Progress.--The Army improved training facilities at home stations
    and combat training centers, increasing realism in challenging
    irregular warfare scenarios. Army Mobile Training Teams offered career
    training to Soldiers at their home station, preventing them from having
    to move away for schooling and providing more time for them with their
    Families. Our Army continues to improve cultural and foreign language
    skills.
                    Equipment
        Goal.--Provide Soldiers effective, sustainable, and timely
    equipment through fully integrated research and development,
    acquisition, and logistical sustainment. Continue modernization efforts
    such as the Rapid Fielding Initiative and the Rapid Equipping Force,
    using a robust test and evaluation process to ensure the effectiveness
    of fielded equipment.
        Progress.--In 2008, the Army fielded more than 1 million items of
    equipment including over 7,000 Mine-Resistant, Ambush-Protected (MRAP)
    vehicles, providing Soldiers fighting in Iraq and Afghanistan the best
    equipment available.
                    Army Force Generation (ARFORGEN) Process
        Goal.--Improve the ARFORGEN process to generate trained, ready, and
    cohesive units for combatant commanders on a rotational basis to meet
    current and future strategic demands. Achieve a degree of balance by
    reaching a ratio of 1 year deployed to 2 years at home station for
    Active Component units, and 1 year deployed to 4 years at home for
    Reserve Component units by 2011.
        Progress.--Recent refinements in the ARFORGEN process have
    increased predictability for Soldiers and their Families. When combined
    with the announced drawdown in Iraq, this will substantially increase
    the time our Soldiers have at home.
                Reset
        In order to prepare Soldiers, their Families, and units for future
    deployments and contingencies, we must reset the force to rebuild the
    readiness that has been consumed in operations. Reset restores deployed
    units to a level of personnel and equipment readiness necessary for
    future missions. The Army is using a standard reset model and is
    continuing a reset pilot program to further improve the effectiveness
    and efficiency of the ARFORGEN process. To reset our force, we are
    revitalizing Soldiers and Families; repairing, replacing, and
    recapitalizing equipment; and retraining Soldiers.
                    Revitalize Soldiers and Families
        Goal.--Increase the time our Soldiers and Families have together to
    reestablish and strengthen relationships following deployments.
        Progress.--In the reset pilot program, units have no readiness
    requirements or Army-directed training during the reset period (6
    months for the Active Component and 12 months for the Reserve
    Components). This period allows units to focus on Soldier professional
    and personal education, property accountability, and equipment
    maintenance, and also provides quality time for Soldiers and their
    Families.
                    Repair, Replace, and Recapitalize Equipment
        Goal.--Fully implement an Army-wide program that replaces equipment
    that has been destroyed in combat and repairs or recapitalizes
    equipment that has been rapidly worn out due to harsh conditions and
    excessive use. As units return, the Army will reset equipment during
    the same reconstitution period we dedicate to Soldier and Family
    reintegration.
        Progress.--The Army reset more than 125,000 pieces of equipment in
    2008. The maintenance activities and capacity at Army depots increased
    to their highest levels in the past 35 years.
                    Retrain Soldiers, Leaders, and Units
        Goal.--Provide our Soldiers with the critical specialty training
    and professional military education necessary to accomplish the full
    spectrum of missions required in today's strategic environment.
        Progress.--The Army is executing a Training and Leader Development
    Strategy to prepare Soldiers and units for full spectrum operations.
    The Army is 60 percent complete in efforts to rebalance job skills
    required to meet the challenges of the 21st Century.
                    Reset Pilot Program
        Goal.--Provide lessons learned that identify institutional
    improvements that standardize the reset process for both the Active and
    Reserve Components and determine timing, scope, and resource
    implications.
        Progress.--In 2008, the Army initiated a 6-month pilot reset
    program for 13 units (8 Active Component and 5 Reserve Components). The
    Army has learned many significant lessons and is applying them to all
    redeploying units to allow units more time to accomplish reset
    objectives at their home stations.
    Transform
        We must transform our force to provide the combatant commanders
    dominant, strategically responsive forces capable of meeting diverse
    challenges across the entire spectrum of 21st Century conflict. To
    transform our force, we are adopting modular organizations,
    accelerating delivery of advanced technologies, operationalizing the
    Reserve Components, restationing our forces, and transforming leader
    development.
                Modular Reorganization
        Goal.--Reorganize the Active and Reserve Components into
    standardized modular organizations, thereby increasing the number of
    BCTs and support brigades to meet operational requirements and creating
    a more deployable, adaptable, and versatile force.
        Progress.--In addition to the 32 newly activated modular brigades,
    the Army converted 14 brigades from a legacy structure to a modular
    structure in 2008 (5 Active Component and 9 Reserve Component
    Brigades). The Army has transformed 83 percent of our units to modular
    formations--the largest organizational change since World War II.
                Advanced Technologies
        Goal.--Modernize and transform the Army to remain a globally
    responsive force and ensure our Soldiers retain their technological
    edge for the current and future fights.
        Progress.--The Army will accelerate delivery of advanced
    technologies to Infantry BCTs fighting in combat today through ``Spin-
    outs'' from our Future Combat Systems program. This aggressive fielding
    schedule, coupled with a tailored test and evaluation strategy, ensures
    Soldiers receive reliable, proven equipment that will give them a
    decisive advantage over any enemy.
                Operationalize the Reserve Components
        Goal.--Complete the transformation of the Reserve Components to an
    operational force by changing the way we train, equip, resource, and
    mobilize Reserve Component units by 2012.
        Progress.--The Army continued efforts to systematically build and
    sustain readiness and to increase predictability of deployments for
    Soldiers, their Families, employers, and communities by integrating the
    ARFORGEN process.
                Restationing Forces
        Goal.--Restation forces and families around the globe based on the
    Department of Defense's (DOD) Global Defense Posture and Realignment
    initiatives, Base Realignment and Closure (BRAC) statutes, and the
    expansion of the Army directed by the President in January 2007.
        Progress.--To date, in support of BRAC, our Army has obligated 95
    percent of the $8.5 billion received. Of more than 300 major
    construction projects in the BRAC program, 9 have been completed and
    another 139 awarded. The Army has also completed 77 National
    Environmental Policy Act actions, closed 1 active installation and 15
    U.S. Army Reserve Centers, terminated 9 leases, and turned over 1,133
    excess acres from BRAC 2005 properties. The Army is on track to
    complete BRAC by 2011.
                Soldier and Leader Development
        Goal.--Develop agile and adaptive military and Civilian leaders who
    can operate effectively in Joint, interagency, intergovernmental, and
    multinational environments.
        Progress.--The Army published Field Manual (FM) 3-0, Operations,
    which includes a new operational concept for full spectrum operations
    where commanders simultaneously apply offensive, defensive, and
    stability operations to achieve decisive results. Additionally, the
    Army published FM 3-07, Stability Operations and FM 7-0, Training for
    Full Spectrum Operations and is finalizing FM 4-0, Sustainment. The
    doctrine reflected in these new manuals provides concepts and
    principles that will develop adaptive leaders to train and sustain our
    Soldiers in an era of persistent conflict.
     setting conditions for the future: six essential qualities of our army
        In an era of persistent conflict, our Army is the primary enabling
    and integrating element of landpower. The Army's transformation focuses
    on distinct qualities that land forces must possess to succeed in the
    evolving security environment. In order to face the security challenges
    ahead, the Army will continue to transform into a land force that is
    versatile, expeditionary, agile, lethal, sustainable, and
    interoperable.
        Versatile forces are multipurpose and can accomplish a broad range
    of tasks, moving easily across the spectrum of conflict as the
    situation demands. Our versatility in military operations--made
    possible by full spectrum training, adaptable equipment, and scalable
    force packages--will enable us to defeat a wide range of unpredictable
    threats.
        Our Army must remain an expeditionary force--organized, trained,
    and equipped to go anywhere in the world on short notice, against any
    adversary, to accomplish the assigned mission, including the ability to
    conduct forcible entry operations in remote, non-permissive
    environments. Working in concert with our force projection partners,
    the United States Transportation Command and sister services, we will
    enhance our expeditionary force projection and distribution capability
    to provide rapid, credible, and sustainable global response options for
    the Joint Force.
        Agile forces adapt quickly to exploit opportunities in complex
    environments. Our Army is developing agile Soldiers and institutions
    that adapt and work effectively in such environments.
        A core competency of land forces is to effectively, efficiently,
    and appropriately apply lethal force. The lethal nature of our forces
    enables our ability to deter, dissuade, and, when required, defeat our
    enemies. Because conflicts will increasingly take place among the
    people, the Army will continue to pursue technological and intelligence
    capabilities to provide lethal force with precision to minimize
    civilian casualties and collateral damage.
        Our Army must be organized, trained, and equipped to ensure it is
    capable of sustainable operations for as long as necessary to achieve
    national objectives. In addition, we will continue to improve our
    ability to guarantee the logistical capacity to conduct long-term
    operations while presenting a minimal footprint to reduce exposure of
    support forces.
        The extensive planning and organizing capabilities and experience
    of U.S. land forces are national assets. These capabilities are
    essential to preparing and assisting interagency, multinational, and
    host nation partners to execute their roles in conflict prevention and
    resolution. Our force needs to be increasingly interoperable to
    effectively support and integrate the efforts of Joint, interagency,
    intergovernmental, multinational, and indigenous elements to achieve
    national goals.
        As we look to the future, our Army is modernizing and transforming
    to build a force that exhibits these six essential qualities in order
    to meet the challenges of the security environment of the 21st Century.
    The Army's adoption of a modular, scalable brigade-based organization
    provides a broad range of capabilities that are inherently more
    versatile, adaptable, and able to conduct operations over extended
    periods.
        Another critical transformation initiative to enhance the Army's
    capabilities is the modernization of our global information network
    capabilities through integration of the Global Network Enterprise
    Construct (GNEC). The GNEC will enable network warfighting
    capabilities, dramatically improve and protect the LandWarNet, improve
    both efficiency and effectiveness of the network, and ensure Army
    interoperability across DOD.
        As part of our transformation, the Army is adapting as an
    institution principally in three areas: streamlining the Army Force
    Generation (ARFORGEN) process, implementing an enterprise approach, and
    establishing a more effective requirements process. A streamlined
    ARFORGEN process more efficiently mans, equips, and trains units to
    strengthen our expeditionary capability. The enterprise approach--a
    holistic method to improve the effectiveness and efficiency of the
    Army's policies and processes--will make our institutions more
    efficient and more responsive to the needs of the combatant commanders.
    An improved requirements process will provide more timely and flexible
    responses to meet the needs of our Soldiers. In transforming our
    training and leader development model, we produce more agile Soldiers
    and Civilians who are capable of operating in complex and volatile
    environments.
        The Army's modernization efforts are specifically designed to
    enhance these six essential land force qualities by empowering Soldiers
    with the decisive advantage across the continuum of full spectrum
    operations. Modernization is providing our Soldiers and leaders with
    leading-edge technology and capabilities to fight the wars we are in
    today while simultaneously preparing for future complex, dynamic
    threats. The Army is improving capabilities in intelligence,
    surveillance, and reconnaissance; information sharing; and Soldier
    protection to give our Soldiers an unparalleled awareness of their
    operational environment, increased precision and lethality, and
    enhanced survivability.
        The Army also is addressing the capability gaps in our current
    force by accelerating delivery of advanced technologies to Soldiers in
    Infantry BCTs. For example, more than 5,000 robots are currently in
    Iraq and Afghanistan, including an early version of the Small Unmanned
    Ground Vehicle (SUGV). Soldiers are using the SUGV prototype to clear
    caves and bunkers, search buildings, and defuse improvised explosive
    devices. In addition, an early version of the Class I Unmanned Aerial
    Vehicle (UAV) is currently supporting Soldiers in Iraq with
    reconnaissance, surveillance, and target acquisition. The Class I UAV
    operates in open, rolling, complex, and urban terrain and can take off
    and land vertically without a runway. It is part of the information
    network, providing real time information that increases Soldier agility
    and lethality while enhancing Soldier protection.
        Overall, Army modernization efforts provide a technological edge
    for our Soldiers in today's fight and are essential to the Army's
    efforts to empower Soldiers with the land force qualities needed in the
    21st Century.
                            stewardship/innovations
        The Nation's Army remains committed to being the best possible
    steward of the resources provided by the American people through the
    Congress. We continue to develop and implement initiatives designed to
    conserve resources and to reduce waste and inefficiencies wherever
    possible.
        The recent establishment of two organizations highlights the Army's
    commitment to improving efficiencies. In 2008, the Secretary of the
    Army established the Senior Energy Council to develop an Army
    Enterprise Energy Security Strategy. The Senior Energy Council is
    implementing a plan that reduces energy consumption and utilizes
    innovative technologies for alternative and renewable energy, including
    harvesting wind, solar and geothermal energy, while leveraging energy
    partnerships with private sector expertise. The Army is replacing 4,000
    petroleum-fueled vehicles with electric vehicles. We also are underway
    in our 6-year biomass waste-to-fuel technology demonstrations at six of
    our installations.
        As part of the Army's efforts in adapting institutions, we also
    established the Enterprise Task Force to optimize the ARFORGEN process
    for effectively and efficiently delivering trained and ready forces to
    the combatant commanders.
        In addition, in order to increase logistical efficiencies and
    readiness, the Army is developing 360 Degree Logistics Readiness--an
    initiative that proactively synchronizes logistics support capability
    and unit readiness. This new approach will allow the Army to see,
    assess, and synchronize enterprise assets in support of our operational
    forces. The 360 Degree Logistics Readiness bridges the information
    system gaps between selected legacy logistics automation systems and
    the Single Army Logistics Enterprise. It will improve visibility,
    accountability, fidelity, and timeliness of information to facilitate
    better decisions at every managerial level.
        Finally, the Army is committed to reforming our acquisition,
    procurement, and contracting processes to more efficiently and
    responsively meet the needs of our Soldiers. A streamlined requirements
    process based on reasonable requirements with adequately mature
    technology will produce a system with greater urgency and agility and
    guard against ``requirements creep.'' The Army also will continue to
    grow its acquisition workforce and provide disciplined oversight to its
    acquisition programs.
                                accomplishments
        The Army has been fully engaged over the past year. We remain
    focused on prevailing in Iraq and Afghanistan, while concurrently
    working to restore balance and transforming to set the conditions for
    success in the future. Despite the high global operational tempo and
    our continuing efforts to restore balance and prepare for future
    contingencies, we have accomplished much in the last year:
    Army Accomplishments
        Manned, trained, equipped, and deployed 15 combat brigades, 34
    support brigades, and 369 military and police transition teams in
    support of Iraq and Afghanistan.
        Deployed more than 293,000 Soldiers into or out of combat in Iraq
    and Afghanistan.
        Repaired more than 100,000 pieces of Army equipment through the
    efforts at the Army's depot facilities.
        Invested in the psychological health of the Army by investing over
    $500 million in additional psychological health providers, new
    facilities, and world-class research.
        Reduced the on-duty Soldier accident rate by 46 percent in 2008
    through Soldier and leader emphasis on Army safety measures.
        Reduced the Army's ground accidents by 50 percent and the Army's
    major aviation accidents by 38 percent in 2008 through leader
    application of the Army's Composite Risk Management model.
        Implemented Family Covenants throughout the Army and committed more
    than $1.5 billion to Army Family programs and services.
        Improved on-post housing by privatizing more than 80,000 homes,
    building 17,000 homes, and renovating 13,000 homes since 2000 at 39
    different installations through the Residential Communities Initiative.
        Reduced energy consumption in Army facilities by 10.4 percent since
    2003 through the implementation of the Army's energy strategy.
        Won six Shingo Public Sector Awards for implementing best business
    practices.
        Destroyed more than 2,100 tons of chemical agents, disposed of
    70,000 tons of obsolete or unserviceable conventional ammunition, and
    removed 163,000 missiles or missile components from the Army's arsenal.
        Fostered partnerships with allies by training more than 10,000
    foreign students in stateside Army schools and by executing over $14.5
    billion in new foreign military sales to include $6.2 billion in
    support of Iraq and Afghanistan.
        Saved $41 million by in-sourcing more than 900 core governmental
    functions to Army Civilians.
        Improved Soldier quality of life by constructing or modernizing
    29,000 barracks spaces.
                   america's army--the strength of the nation
        The Army's All-Volunteer Force is a national treasure. Less than 1
    percent of Americans wear the uniform of our Nation's military; they
    and their Families carry the lion's share of the burden of a Nation at
    war. Despite these burdens, our Soldiers continue to perform
    magnificently across the globe and at home, and their Families remain
    steadfast in their support. Our Civilians remain equally dedicated to
    the Army's current and long-term success. They all deserve the best the
    Nation has to offer.
        America's Army has always served the Nation by defending its
    national interests and providing support to civil authorities for
    domestic emergencies. Seven years of combat have taken a great toll on
    the Army, our Soldiers, and their Families. To meet the continuing
    challenges of an era of persistent conflict, our Army must restore
    balance and set the conditions for the future while sustaining our All-
    Volunteer Force. We must ensure our Soldiers have the best training,
    equipment, and leadership we can provide them. Our Army has made
    significant progress over the last year, but has several tough years
    ahead. With the support of Congress, the Army will continue to protect
    America's national security interests while we transform ourselves to
    meet the challenges of today and the future.
                         addendum a--information papers
    360 Degree Logistics Readiness
    Accelerate Army Growth
    Active Component Reserve Component (ACRC) Rebalance
    Adaptive Logistics
    Add-on Armor for Tactical Wheeled Vehicles
    Africa Command (AFRICOM)
    Armed Forces Recreation Centers
    Army Asymmetric Warfare Office (AAWO)
    Army Career and Alumni Program (ACAP)
    Army Career Tracker (ACT) Program
    Army Civilian University (ACU)
    Army Community Service (ACS) Family Programs
    Army Community Service (ACS) Family Readiness Programs
    Army Energy Plan (AEP)
    Army Environmental Programs
    Army Evaluation Task Force (AETF)
    Army Family Action Plan (AFAP)
    Army Force Generation (ARFORGEN)
    Army Geospatial Enterprise (AGE)
    Army Integrated Logistics Architecture (AILA)
    Army Leader Development Program (ALDP)
    Army Modernization Strategy
    Army Onesource
    Army Physical Fitness Research Institute
    Army Physical Readiness Training (FM 3-22.02)
    Army Preparatory School
    Army Prepositioned Stocks (APS)
    Army Reserve Employer Relations (ARER) Program
    Army Reserve Voluntary Education Services
    Army Reserve Voluntary Selective Continuation
    Army Spouse Employment Partnership (ASEP) Program
    Army Strong
    Army Suicide Prevention Program (ASPP)
    Army Values
    Army Volunteer Program
    ARNG Active First Program
    ARNG Agribusiness Development Team
    ARNG Community Based Warrior Transition Units
    ARNG Critical Skills Retention Bonus
    ARNG Education Support Center
    ARNG Environmental Programs
    ARNG Every Soldier a Recruiter
    ARNG Exportable Combat Training Capability
    ARNG Family Assistance Centers
    ARNG Freedom Salute Campaign
    ARNG GED Plus Program
    ARNG Muscatatuck Army Urban Training Center
    ARNG Operational Support Airlift Agency
    ARNG Periodic Health Assessment (PHA)
    ARNG Post Deployment Health Reassessment (PDHRA)
    ARNG Recruit Sustainment Program
    ARNG Recruiting Assistance Program (G-RAP)
    ARNG Strong Bonds
    ARNG Western Army Aviation Training Site (WAATS)
    Asymmetric Warfare Group
    Base Realignment and Closure (BRAC) Program
    Basic and Advanced NCO Courses
    Basic Officer Leader Course (BOLC)
    Behavioral Health
    Better Opportunity for Single Soldiers (BOSS)
    Biometrics
    Broad Career Groups
    Building Partnership Capacity Through Security Cooperation
    Campaign Capable Force
    Capabilities Development for Rapid Transition (CDRT)
    Career Intern Fellows Program
    CBRNE Consequence Management Reaction Force (CCMRF)
    CENTCOM Rest and Recuperation (R&R) Leave Program
    Changing the Culture
    Chemical Demilitarization Program
    Child and Youth Services School Support
    Child Care Program
    Civil Works
    Civilian Corps Creed
    Civilian Education System
    College of the American Soldier
    Combat Casualty Care
    Combat Training Center (CTC) Program
    Combating Weapons of Mass Destruction (WMD)
    Commander's Appreciation and Campaign Design (CACD)
    Common Levels of Support
    Common Logistics Operating Environment (CLOE)
    Community Covenant
    Comprehensive Soldier Fitness Program
    Concept Development and Experimentation
    Condition-Based Maintenance Plus (CBM+)
    Construction and Demolition Recycling Program
    Continuum of Service
    Contractor-Acquired Government Owned (CAGO) Equipment
    Cultural and Foreign Language Capabilities
    Cyber Operations
    Defense Integrated Military Human Resources System (DIMHRS)
    Defense Support to Civil Authorities (DSCA)
    Defense Support to Civil Authorities--Defense Coordinating Officer
    Defense Support to Civil Authorities--Special Events
    Deployment Cycle Support
    Depot Maintenance Initiatives
    Digital Training Management System (DTMS)
    Distributed Common Ground System--Army (DCGS-A)
    Diversity
    Document and Media Exploitation (DOMEX)
    Enhanced Use Leasing
    Enlistment Incentives
    Enlistment Incentives Program Enhancements
    Equal Opportunity and Prevention of Sexual Harassment (EO/POSH)
    Equipment Reset
    Equipping Enterprise and Reuse Conference
    Equipping the Reserve Components
    Exceptional Family Member Program (EFMP)
    Expanding Intelligence Training
    Expeditionary Basing
    Expeditionary Capabilities
    Expeditionary Contracting
    Expeditionary Theater Opening
    Family Advocacy Program (FAP)
    Family Covenant
    Family Housing Program
    Foreign Military Sales
    FORSCOM Mission Support Elements (MSE)
    Freedom Team Salute
    Freedrop Packaging Concept Project (FPCP)
    Full Replacement Value (FRV) and Defense Property System (DPS)
    Full Spectrum Operations in Army Capstone Doctrine (FM 3-0)
    Funds Control Module
    Future Force Integration Directorate
    General Fund Enterprise Business System
    Generating Force Support for Operations
    Global Force Posture
    Global Network Enterprise Construct (GNEC)
    Helicopter, Black Hawk Utility Helicopter (UH-60)
    Helicopter, Chinook Heavy Lift Helicopter (CH-47)
    Helicopter, Lakota (UH-72)
    Helicopter, Longbow Apache (AH-64D)
    Human Terrain System (HTS)
    HUMINT: Growing Army Human Intelligence (HUMINT) Capabilities
    Information Doctrine
    In-Sourcing
    Installation Planning Board
    Institutional Adaptation
    Institutional Training Under Centers of Excellence (COE)
    Intelligence Transformation
    Interceptor Body Armor (IBA)
    Interpreter/Translator Program
    Irregular Warfare Capabilities
    Joint Basing
    Joint Knowledge Development and Distribution Capstone Program (JKDDC)
    Joint Precision Airdrop System (JPADS)
    Leader Development Assessment Course--Warrior Forge
    Lean Six Sigma: Continuous Process Improvement Initiative
    Lean Six Sigma: G-4 Initiative
    Life Cycle Management Initiative
    Live, Virtual, Constructive Integrated Training Environment
    Manpower Personnel Integration Program (MANPRINT)
    March 2 Success
    Medical and Dental Readiness
    Military Construction (MILCON) Program
    Military Construction (MILCON) Transformation
    Military Family Life Consultants (MFLC) Program
    Military Intelligence Capacity
    Mine-Resistant, Ambush-Protected (MRAP) Vehicles
    Mobile Training Teams (MTT) for Warrior Leader Course (WLC)
    Mobilization Tiger Team
    Modular Force Conversion
    Morale Welfare and Recreation (MWR)
    Multinational Exercises
    Multi-Source Assessment and Feedback (MSAF) Program
    National Guard CBRNE Enhanced Response Force Package (CERFP)
    National Guard Counterdrug Program
    National Guard Public Affairs Rapid Response Team (PARRT)
    National Guard State Partnership Program
    National Guard Weapons of Mass Destruction Civil Support Teams (WMD-
    CSTs)
    National Guard Yellow Ribbon Program
    National Guard Youth ChalleNGe
    National Security Personnel System (NSPS)
    Next Generation Wireless Communications (NGWC)
    Officer Education System (OES)
    Officer Education System--Warrant Officers
    Officer Retention
    Pandemic Influenza Preparation
    Partnership for Youth Success Programs (PaYS)
    Persistent Air and Ground Surveillance to Counter IED
    Persistent Conflict
    Physical Disability Evaluation System (PDES)
    Post Deployment Health Reassessment (PDHRA)
    Power Projection Platform
    Privatization of Army Lodging
    Property Accountability
    Rapid Equipping Force (REF)
    Rapid Fielding Initiative (RFI)
    Real-Estate Disposal
    Red Team Education and Training
    Redeployment Process Improvements
    Referral Bonus Pilot Program
    Reset
    Residential Communities Initiative (RCI)
    Restructuring Army Aviation
    Retained Issue OCIE
    Retention Program
    Retiree Pre-Tax Healthcare
    Retirement Services
    Retrograde
    Risk Management
    Robotics
    Safety and Occupational Training
    Safety Center Online Tools and Initiatives
    Science and Technology
    Sexual Harassment/Assault Response and Prevention (SHARP) Program
    Single Army Logistics Enterprise (SALE)
    Soldier and Family Action Plan (SFAP)
    Soldier and Family Assistance Center Program and Warrior in Transition
    Units
    Soldier as a System
    Soldier's Creed
    Stability Operations (FM 3-07)
    Strong Bonds
    Structured Self Development
    Survivor Outreach Services
    Sustainability
    Sustainable Range Program
    The Army Distributed Learning Program (TADLP)
    The Human Dimension: The Concept and Capabilities Development
    Training Counter-IED Operations Integration Center (TCOIC)
    Training for Full Spectrum Operations (FM 7-0)
    Training Support System (TSS)
    Transferability of GI Bill Benefits to Family Members
    Transforming the Reserve Components to an Operational Force
    Traumatic Brain Injury (TBI)
    Unaccompanied Personnel Housing
    Unit Combined Arms Training Strategies
    Unmanned Aircraft, Raven Small System
    Unmanned Aircraft, Shadow System
    Unmanned Aircraft, Sky Warrior System
    Up-Armored High Mobility Multipurpose Wheeled Vehicle (HMMWV)
    War Reserve Secondary Items
    Warfighter's Forums (WfF)
    Warrior Ethos
    Warrior in Transition
    Warrior Tasks and Battle Drills
    Warrior University
    Western Hemisphere Institute for Security Cooperation (WHINSEC)
    Wounded Warrior Program Youth Programs
                              addendum b--websites
    Headquarters, Department of the Army and other Commands
        This site has links for information regarding the Headquarters,
    Department of the Army (HQDA), Army Command Structure, Army Service
    Component Commands (ASCC), and Direct Reporting Units (DRU).
        http://www.army.mil/institution/organization/
    The Army Homepage
        This site is the most visited military website in the world,
    averaging about 7 million visitors per month or approximately 250 hits
    per second. It provides news, features, imagery, and references.
        http://www.army.mil/
    The Army Modernization Strategy
        http://www.g8.army.mil/G8site_redesign/modStrat.html
    The Army Posture Statement
        This site provides access to archived Army Posture Statements from
    1997 to 2008.
        http://www.army.mil/aps
    The Army Staff
                Personnel: G-1
        http://www.armyg1.army.mil/
                Intelligence: G-2
        http://www.dami.army.pentagon.mil/
                Operations, Plans, and Policy: G-3/5/7
        https://www.g357extranet.army.pentagon.mil
                Logistics: G-4
        http://www.hqda.army.mil/logweb/
                Programs: G-8
        This site provides information on material integration and
    management.
        http://www.army.mil/institution/organization/unitsandcommands/dcs/
    g-8/
    Installation Management
        This site provides information about policy formulation, strategy
    development, enterprise integration, program analysis and integration,
    requirements and resource determination, and best business practices
    for services, programs, and installation support to Soldiers, their
    Families, and Army Civilians.
        http://www.acsim.army.mil/
    Army Commands (ACOMs)
        Army Forces Command (FORSCOM)
        http://www.forscom.army.mil/
        Army Training and Doctrine Command (TRADOC)
        http://www.tradoc.army.mil/
        Army Materiel Command (AMC)
        http://www.army.mil/institution/organization/unitsandcommands/
    commandstructure/amc/
    Reserve Components
                Army Reserve
        http://www.armyreserve.army.mil
                Army National Guard
        http://www.arng.army.mil
    Other informative websites
                Army Wounded Warrior Program
        This site provides information on the Army's Wounded Warrior
    Program which provides support to severely wounded Soldiers and their
    Families.
        https://www.aw2.army.mil
                My ArmyLifeToo Web Portal
        This site serves as an entry point to the Army Integrated Family
    Network and Army OneSource.
        http://www.myarmylifetoo.com
                              addendum c--acronyms
        AC--Active Component
        ACOM--Army Command
        ACP--Army Campaign Plan
        AETF--Army Evaluation Task Force
        ARFORGEN--Army Force Generation
        AFRICOM--Africa Command
        AMAP--Army Medical Action Plan
        AMC--Army Material Command
        APS--Army Prepositioned Stocks
        AR--Army Regulation
        ARCIC--Army Capabilities Integration Center
        ARNG--Army National Guard
        ASC--Army Sustainment Command
        ASCC--Army Service Component Command
        AWG--Asymmetric Warfare Group
        AWO--Asymmetric Warfare Office
        AW2--Army Wounded Warrior Program
        BCT--Brigade Combat Team
        BCTP--Battle Command Training Program
        BOLC--Basic Officer Leader Course
        BRAC--Base Realignment and Closure
        CBRN--Chemical, Biological, Radiological, and Nuclear
        CBRNE--Chemical, Biological, Radiological, Nuclear, and (High-
    Yield) Explosives
        CCDR--Combatant Commander
        CCMRF--CBRNE Consequence Management Reaction Force
        CES--Civilian Education System
        C4ISR--Command, Control, Communications, Computer, Intelligence,
    Surveillance and Reconnaissance
        CMETL--Core Mission Essential Task List
        CMTC--Combat Maneuver Training Center
        COCOM--Combatant Command
        COE--Center of Excellence; Common Operating Environment;
    Contemporary Operating Environment
        COIN--Counterinsurgency
        COTS--Commercial Off-The-Shelf
        CS--Combat Support
        CSS--Combat Service Support
        CT--Counter Terrorism
        CTC--Combat Training Center
        DA--Department of the Army
        DA PAM--Department of the Army Pamphlet
        DCGS-A--Distributed Common Ground System--Army
        DMDC--Defense Manpower Data Center
        DMETL--Directed Mission Essential Task List
        DoD--Department of Defense
        DOTMLPF--Doctrine, Organization, Training, Material, Leadership and
    Education, Personnel, and Facilities
        EBCT--Evaluation Brigade Combat Team
        EOD--Explosive Ordnance Disposal
        ES2--Every Soldier a Sensor
        ETF--Enterprise Task Force
        FCS--Future Combat Systems
        FM--Field Manual
        FORSCOM FY--Forces Command Fiscal Year
        GBIAD--Global Based Integrated Air Defense
        GCSS-A--Global Combat Service Support-Army
        GDPR--Global Defense Posture Realignment
        GNEC--Global Network Enterprise Construct
        HBCT HMMWV--Heavy Brigade Combat Team High Mobility Multipurpose
    Wheeled Vehicle
        HUMINT--Human Intelligence
        IBA--Improved Body Armor
        IBCT--Infantry Brigade Combat Team
        IED--Improvised Explosive Device
        ISR--Intelligence, Surveillance, and Reconnaissance
        IT--Information Technology
        JIEDDO--Joint Improvised Explosive Device Defeat Organization
        JIIM--Joint, Interagency, Intergovernmental, and Multinational
        JRTC--Joint Readiness Training Center
        JTF--Joint Task Force
        LMP--Logistics Modernization Program
        LSS--Lean Six Sigma
        MI--Military Intelligence
        METL--Mission Essential Task List
        MOUT--Military Operations in Urban Terrain
        MRAP--Mine-Resistant, Ambush-Protected
        MRE--Mission Readiness Exercise
        MRX--Mission Rehearsal Exercise
        MTOE--Modified Table of Organization and Equipment
        MTT--Mobile Training Teams
        NBC--Nuclear, Biological, Chemical
        NEPA--National Environmental Protection Act
        NET--New Equipment Training
        NCO--Noncommissioned Officer
        NDAA--National Defense Authorization Act
        NDS--National Defense Strategy
        NLOS-C--Non Line of Sight-Cannon
        NMS--National Military Strategy
        NSPS--National Security Personnel System
        NSS--National Security Strategy
        NTC--National Training Center
        OCO--Overseas Contingency Operations
        OEF--Operation Enduring Freedom
        OIF--Operation Iraqi Freedom
        OPTEMPO--Operational Tempo
        O&M--Operations and Maintenance
        POM--Program Objective Memorandum
        PSYOP--Psychological Operations
        PTSD--Post-Traumatic Stress Disorder
        QDR--Quadrennial Defense Review
        QOL--Quality of Life
        RC--Reserve Components
        RCI--Residential Communities Initiative
        REF--Rapid Equipping Force
        RFI--Rapid Fielding Initiative
        SALE--Single Army Logistics Enterprise
        SBCT--Stryker Brigade Combat Team
        SFAP--Soldier and Family Action Plan
        SHARP--Sexual Harassment/Assault Response and Prevention (SHARP)
    Program
        SIGINT--Signal Intelligence
        SOF--Special Operations Forces
        SOS--Survivor Outreach Services
        TBI--Traumatic Brain Injury
        TDA--Table of Distribution and Allowances
        TRADOC--Training and Doctrine Command
        TTP--Tactics, Techniques, and Procedures
        UAH--Up-Armored HMMWV
        UAS--Unmanned Aircraft System
        UAV--Unmanned Aerial Vehicle
        UGV--Unmanned Ground Vehicle
        USAR--United States Army Reserve
        VBIED--Vehicle Borne Improvised Explosive Device
        WMD--Weapons of Mass Destruction
        WO--Warrant Officer
        WTBD--Warrior Tasks and Battle Drills
        WTU--Warrior Transition Units

        Secretary Geren. The President's budget for fiscal year
    2010 is now before the Congress. It includes $142 billion for
    the United States Army.
        The Army budget is mostly about people, and the operations
    and maintenance (O&M) to support those people. Our personnel
    and O&M accounts make up two-thirds of the Army budget,
    reflecting General Abrams' axiom that people are not in the
    Army, people are the Army.
        The Army is stretched by the demands of this long war, but
    it remains the best-led, best-trained, and best-equipped Army
    we have ever fielded, and this subcommittee's ongoing support
    has a lot to do with that, and we thank you for that.
        Mr. Chairman, we've designated 2009 as the year of the
    noncommissioned officer (NCO), and I've asked that three
    noncommissioned officers join us today, and with the permission
    of the chairman, I'd like to introduce them to the
    subcommittee.
        Chairman Inouye. Please do.
        Secretary Geren. We have Sergeant First Class, Chairman
    Wiles. He's a Platoon Sergeant from the 3d Infantry Old Guard.
    He deployed to Operation Iraqi Freedom/Operation Enduring
    Freedom (OIF/OEF). He's married with four children, he's from
    Louisburg, Tennessee. Appreciate his being here.
        Sergeant Aron Aus, he's a light-wheel vehicle mechanic with
    the 3d Infantry Old Guard at Fort Meyer. He's been forward
    stationed for 15 months in Korea, and he's married with one
    child.
        Sergeant Dulashti is a wounded warrior from Cincinnati,
    Ohio. He was with 82d Airborne Division, was assigned to their
    sniper platoon, graduated at the top of his class from AIT
    Infantry Sniper School, and he was deployed to Afghanistan with
    the 82d forward-deployed along the Pakistani border.
        He was wounded during the recon and sniper mission, was
    caught in an ambush, and was shot through his left knee, right
    knee, and stomach. He is a distinguished soldier, he received a
    Purple Heart, Army Commendation Medal with a V-Device. Also has
    a combat infantry badge, and a parachutist badge.
        I want to thank all three of these outstanding
    noncommissioned officers for joining us today. Thank you for
    your service.
        General Casey. I just want you to know, Mr. Chairman, that
    I feel a heck of a lot better with them sitting behind me than
    I usually do.
        Secretary Geren. As you know, at the front of every Army
    mission, here or overseas, you'll find a noncommissioned
    officer. NCOs lead the way in education, training, and
    discipline, and they share their strength of character with
    every soldier they lead, every officer they support, and every
    civilian with whom they serve.
        Our NCOs are empowered and entrusted like no other NCOs in
    the world, and the most advanced armies in the world today are
    going to school on our model.
        This year, the Year of the NCO, we're giving special
    recognition to them, and we're redoubling our commitment to
    enhance their professional development.
        Mr. Chairman, as a former NCO, this year we honor you and
    all noncommissioned officers, past and present. Thank you for
    your service, and thank you for the men and women who are our
    noncommissioned officers, who are the glue that hold us
    together during these challenging times.
        Currently, our Army has 710,000 soldiers serving on active
    duty, with 243,000 deployed in 80 countries around the world--
    140,000 are deployed to Iraq and Afghanistan, and additionally
    there are 250,000 Army civilians who are providing critical
    support to our soldiers around the world.
        Our National Guard and our Reserves continue to shoulder a
    heavy burden for our Nation. Since 9/11, our Nation has
    activated over 400,000 reservists and guardsman in support of
    OIF and OEF.
        Our Reserve component soldiers also have answered the call
    at home for domestic emergencies--hurricanes, floods, forest
    fires, and support along our borders.
        Today, we truly are one Army--active, Guard, and Reserves,
    and our Guard and Reserves are transitioning from the strategic
    Reserve, to an operational force. And I would like to discuss
    some of the progress we've made in that regard.
        Go back to 2001, and we spent about $1 billion a year
    equipping the National Guard. We're now spending about $4
    billion a year, and that continues under this budget.
        As a result, we anticipate that the last Huey helicopter,
    the venerable work horse of the Vietnam era, will leave Guard
    service by the end of this fiscal year. At that time, the Guard
    will have 40 light utility helicopters, and nearly 800
    Blackhawk helicopters.
        Over 8,000 new trucks have been provided to our Guard, the
    famous Deuce and a half truck is planned to disappear in fiscal
    year 2011. This hurricane season will be the first since 2004
    in which the Guard will not have to borrow from the active
    component to meet its operational and equipment needs.
        We've also made substantial progress in implementing the
    recommendations of the Commission on National Guard and
    Reserves. Of the 19 Army-led implementation plans, 14 are
    completed. Among them, ensuring that members are provided with
    a 2-year notice of mobilization, with orders at least 1 year
    out--major change, major improvement for our soldiers, and for
    the operation of our Reserve component.
        Furthermore, although not an Army lead, we are supporting
    DOD improvements to increase transparency of RC-component
    equipment funding. Soldiers are our most valuable assets. The
    strength of our soldiers depends on the strength of Army
    families and as Admiral Mullen said recently, if we don't get
    the people part of our budget right, nothing else matters.
        This Army budget, and this DOD budget has taken care of
    people as the top priority. From fiscal year 2007-2009, with
    your support, we have more than doubled funding for Army family
    programs. In this budget that we bring to you today, we include
    $1.7 billion in the base budget for family programs.
        In fiscal year 2009, we started a new program, we hired 279
    military family-life consultants to work with our families on
    installations to work with the soldiers. Under this budget we
    will grow that to nearly 300. And we've provided full-time
    family support personnel, down to the battalion level,
    providing support and help to those volunteer spouses who carry
    so much of the load for deployments.
        We've provided expanded childcare for families of deployed
    soldiers with 16 hours, per child, per month, at no cost, along
    with free recreational and instructional classes. In this
    budget, we sustain loss and SRM at levels that will ensure we
    continue to provide our families a quality of life equal to the
    quality of their service.
        This budget continues improvement in the case of our
    wounded, ill, and injured soldiers. Your support has enabled us
    to add needed medical personnel, provide better healthcare for
    our wounded warriors and meet the needs of family members who
    are supporting their loved ones, and we've initiated programs
    to better diagnosis and treat the invisible wounds of war--
    post-traumatic stress disorder (PTSD) and traumatic brain
    injury (TBI).
        With your leadership, we are investing unprecedented
    amounts in brain injury research. This fiscal year 2010 budget
    will let us advance these initiatives, address personnel
    shortages, improve facilities, expand research, and work toward
    the long-term goal of providing seamless transition from the
    Department of Defense to the Veterans Affairs for those
    soldiers who choose to return to private life.
        With 7 plus years of war in an all-volunteer force, we are
    in uncharted waters for our soldiers and their families. Our
    soldiers and families are carrying a heavy burden for our
    Nation, and we are working to reduce the stress on our force,
    and on those families.
        We are working to reverse the tragic rise in soldier
    suicides--it's a top priority throughout our Army, with the
    Vice Chief of Staff of our Army serving as the lead.
        We've partnered with the National Institute of Mental
    Health on a 5-year, $50 million groundbreaking study, to
    leverage their world-renowned expertise in suicide prevention
    in bringing that wisdom, that knowledge, and that experience
    into our Army.
        We're educating all soldiers in new, innovative ways of
    suicide risk identification and reduction, including
    intervention and prevention.
        Every NCO in this Army knows how to recognize the onset of
    heat stroke, and knows what to do about it. Our goal for
    suicide prevention is that every soldier in our Army be able to
    identify the signs of potential suicide, and know what to do
    about it.
        We also have launched new initiatives to attack the problem
    of sexual assault and harassment, with our Sexual Harassment
    Response and Prevention Program, focusing on intervention and
    prevention. As we work to prevent sexual harassment and sexual
    assault, our goal also is to become the Nation's best in the
    investigation and prosecution of this heinous crime. Sexual
    assault and sexual harassment has no place in the United States
    Army.
        We are hiring national experts, with a highly qualified
    expert authority that Congress has given us to bring their
    expertise into the United States Army, hiring top notch
    investigators, and training our prosecutors. We want to be the
    Nation's model for the prevention, investigation and
    prosecution of sexual assault crimes.
        And whether the problem is PTSD, suicidal ideation, the
    trauma of sexual assault, or dealing with any emotional or
    mental health issue, we're working hard to remove the stigma
    that has caused some soldiers to decline help.
        We also are improving our business processes, and have
    instituted major reforms for our contracting and acquisition
    processes, while continuing to provide world-class equipment
    and support to more than a quarter of a million soldiers
    scattered around the world.
        We have set up a two-start contracting command and enhanced
    training and career opportunities for contracting officers.
    Last year, we thanked Congress for authorizing five new
    contracting general officers, help us build the bench that had
    been depleted over the last 20 years.
        We're adding nearly 600 military, and over 1,000 civilians
    over the next 3 years for our contracting workforce, also
    reversing a trend that began in the early nineties of depleting
    the contracting workforce. We're turning away from contractors,
    and turning toward in-sourcing and hiring as civil service, and
    training those civil service.
        Being a good steward is more than just money. Our goal,
    also, is to lead the Department of Defense and the entire
    Federal Government in protecting the environment and saving
    energy. And I'm pleased to report that the Army has won several
    awards in recognition of our environmental efforts.
        The Army's energy security strategy reduces energy
    consumption and carbon dioxide emissions by using innovative
    technologies for alternative and renewable energy, including
    wind, solar, and geothermal.
        At Fort Carson, we've recently completed a 2 megawatt solar
    project that covers 12 acres. We have solar projects now at 28
    locations, and geothermal projects at many others. We are in
    the planning stages for a 500 megawatt solar farm at Fort Irwin
    in California, bigger than any solar project in the country
    today.
        This year we've begun--and we'll complete it over the next
    2 years--we are acquiring 4,000 electrical vehicles to use on
    installations. You can see some of those today at Fort Meyer;
    these 4,000 electric cars will cut the Army's fuel consumption
    by 11.5 million gallons, and reduce carbon dioxide emissions by
    115,000 tons per year. And our plan is to invest over $54
    billion in green buildings by 2012, leading the Department in
    the investment in this new technology. It will help us save
    over 30 percent in energy consumption on our building program.
        In theater, our investment of the filming of tents slashes
    the energy use at our FOBs and reduces the number of convoys
    taking fuel over dangerous routes to remote locations.
        And I'm pleased to report that we are on track to finish
    the base realignment and closure (BRAC) by September 2011.
        Mr. Chairman, in summary, we are a busy, stretched, and
    stressed Army, with soldiers, civilians and Army families doing
    the extraordinary as the ordinary every single day. Our
    Nation's finest young men and women are ready to respond to
    whatever our Nation's leaders demand, around the world, and
    here at home.
        In 2008, in this time of war, nearly 300,000 men and women
    are reenlisted in our United States Army. They're volunteer
    soldiers and volunteer families. They're proud of what they do,
    and they're proud of who they are.
        For the past 7\1/2\ years, we've watched soldiers go off to
    war, and watched their families stand with them, and watched
    our Congress stand alongside them every step of the way.
        Mr. Chairman, and members of the subcommittee, thank you
    for your support of our soldiers and their families, and for
    the resources and support you provide them, every year. Thank
    you very much.
        Chairman Inouye. I thank you very much, Mr. Secretary, for
    your very comprehensive report, and a very hopeful one.
        May I now recognize General Casey?

                                  ARMY POSTURE

        General Casey. Thank you, Mr. Chairman, Senator Cochran,
    Senator Bond. Great to have the opportunity here today to
    update you on the 2010 budget, and really, where we are as an
    Army.
        And I'd like to give you a little progress report about
    what we've accomplished here over the last year, and then talk
    a little bit about the way ahead.
        You may recall that last year when I talked to you, I said
    the Army was out of balance. I said that we were so weighed
    down by current commitments that we couldn't do the things we
    knew we needed to do to sustain this all-volunteer force for
    the long haul, and to restore a strategic flexibility, to
    prepare to do other things.
        I can tell you that we have made progress in getting
    ourselves back in balance, but we are not out of the woods,
    yet.
        In 2007, we developed a plan based on four imperatives, the
    four most important things we said we needed to do to put this
    Army in balance--sustain our soldiers and families, continue to
    prepare our soldiers for success in the current conflict, reset
    them effectively when they return, and continue to transform
    for an uncertain future. And I'd like to give you an update
    just on the--where we are on our six major objectives, here.
        Our first objective was to finish the growth. And as you
    said in your opening statement, Mr. Chairman, we're actually
    doing a little better than that. We were originally scheduled
    to complete our growth in 2012, with the Secretary of Defense's
    support, we moved it forward to 2010, and as of this month, all
    of our components--active, Guard and Reserve--have met the end
    strength targets that they were originally to meet in 2012, and
    that's a big lift for us.
        Now, we still have to put those people in units, and match
    them with the equipment and the training, and there's about
    20,000 spaces to do that, but that's a very positive step
    forward, here.
        A positive step forward from a couple of perspectives--one,
    it allows us to begin coming off of stop-loss this year. And
    the Reserves will begin coming off in August, the Guard in
    September, and the active force in 2010, and we will--what that
    means is we will begin deploying units without stop loss on
    those dates.
        This has always been our goal, as we have built our modular
    organizations and put them on a rotational cycle, and we're on
    track to meet that goal by 2011.
        Our second key objective was to increase the amount of time
    that our soldiers spend at home between deployments. And over
    the past 2 years, I have come to realize that this is the
    single-most important element of putting our forces back in
    balance.
        And it's important from three perspectives: one, so that
    our soldiers have time to recover from these repeated combat
    deployments. Second, it gives them a more stable preparation
    time for their next mission. When they're home just for 12
    months, they have to start going to the field shortly after
    they get back, and that doesn't give them the time that they
    need to recover.
        And last, it gives them time to prepare to do other things,
    besides Iraq and Afghanistan. I will tell you that originally
    in 2007, I thought we would get not quite to 1 year out, 2
    years back, by 2011. But the President's drawdown plan in Iraq,
    if it's executed according to plan--and I have no reason to
    doubt that it will be--we will get--we will do slightly better
    than that. And that's very important for us, because we must
    increase the time our soldiers spend at home if we are going to
    get ourselves back in balance.
        The third thing, element of balance, Mr. Chairman, is we
    are moving away from our cold war formations, to formations
    that are far more relevant today. And in 2004 we began
    converting to modular organizations. We're 85 percent done.
    That's about 300 brigades who will convert--have converted or
    will convert--between now and 2011.
        We're also two-thirds of the way through re-balancing the
    force--taking soldiers who were in skills we needed more in the
    cold war, and putting them into skills more relevant today.
    That's about 150,000 people that will change jobs.
        Let me give you an example--since 2004, we have stood down
    about 200 tank companies, artillery batteries, and air defense
    batteries, and we have stood up an equivalent number of
    military police companies, engineers, special forces, and civil
    affairs companies, the skills that you hear that we need every
    day.
        So, put together, that's the largest organizational
    transformation of the Army since World War II and we have done
    it while we were deploying 150,000, or 140,000 over and back to
    Iraq and Afghanistan every year. A huge accomplishment for us.
        Fourth, we're moving to put the whole Army on a rotational
    cycle much like the Navy and the Marine Corps have been on for
    years, and we believe that is the only way that we can one,
    field trained and ready forces regularly for our combat
    commanders, but two, to give our soldiers and families a
    predictable deployment tempo, and we're well on our way to
    being able to do that.
        Fifth, as the Secretary mentioned, we're about halfway
    through our rebasing effort. With the base realignment and
    closure reposturing, modular conversions, and growth of the
    Army, we will actually restation about 380,000 soldiers,
    families, and civilians between now and the end of 2011. That's
    a huge accomplishment, but it is resulting in a great
    improvement in the quality of the facilities for our soldiers
    and families.
        And our last objective, Chairman, is to restore strategic
    flexibility--the ability for our soldiers to quickly do other
    things. And again, that's a function of the time they spend at
    home, and what I've told our soldiers is, that if you're home
    for 18 months or less, stay focused on your current mission. If
    you're home for 18 months or more, begin rekindling the skills
    that may have atrophied during your time in Iraq and
    Afghanistan. And as we progressively have more time at home, we
    will progressively rekindle those skills.
        So, to wrap up, we have made progress, but we are not out
    of the woods, yet. And the next 12 to 18 months are going to
    continue to be difficult for us, because we will actually
    increase the numbers of forces we've had deployed as we make
    the shift from Iraq to Afghanistan before the Iraq drawdown
    starts. So, we get through the next 12 to 18 months, Mr.
    Chairman, I think we'll be in fairly good shape.
        Now, let me just say just a couple of words, if I might,
    about each of the imperatives and what this budget does for
    those imperatives.
        First of all, sustaining our soldiers and families is, as
    the Secretary said, our first priority, and this is where the
    budget makes a difference. Housing, barracks, child care
    centers, youth care centers, warrior transition units,
    operational facilities, all of that is in there, and all of
    that is critical. We are continuing to work hard to deliver on
    our soldier-family action plan, and we have more than $1.7
    billion in this budget for soldiers and families--that's about
    double what it was 2 years ago.
        I can tell you, I've just finished--in the last 7 weeks--
    visiting five of our installations in the United States,
    visiting soldiers in Djibouti and Afghanistan. My feedback to
    you, Chairman, is the families continue to be the most
    stretched and stressed part of the force, which is why we're
    taking--paying so close attention to improving what we're doing
    for them.
        On the prepare side, probably the most significant
    accomplishment in the last year is the fielding of about 10,000
    mine-resistant, ambush-protected (MRAPs) to our soldiers in
    theater, and they have made a huge difference. And I talked to
    some of the crews in Afghanistan, and they said, ``Well,
    sometimes it was harder to drive off-road,'' but anybody that
    had been hit by an improvised explosive device (IED) can
    survive, spoke glowingly of it, and so it's made a huge
    difference.
        Third, on reset--we are putting the whole Army on a 6-month
    reset model. This is a work in progress, but the money that is
    in the base and the OCO budget, here, about $11 million for
    reset is essential to our ability to continue to deploy our
    forces for combat in Iraq and Afghanistan.
        Last, transforming. And you mentioned an era of persistent
    conflict, Mr. Chairman, I could not agree with you more. And I
    believe that to see that--for us, for our country--to succeed
    in an era of persistent conflict, I believe that we need land
    forces that can, one, prevail in a global counterinsurgency
    campaign; two, engage to help others to build the capacity to
    deny their country to terrorists; three, to provide support to
    civil authorities both at home and abroad; and four, deter and
    defeat hybrid threats and hostile state actors around the
    world. And we are building an Army to do that.
        It's an Army that has a versatile mix of tailorable
    organizations, and that's organized on a rotational cycle, so
    we can provide a sustained flow of trained and ready forces to
    combatant commanders and against unexpected contingencies. The
    budget will help us continue on a path to building that force.
        And Mr. Chairman, Secretary Geren mentioned the Year of the
    Non-Commissioned Officer. Thank you for your service as an Army
    noncommissioned officer and I recognize these three great
    noncommissioned officers here.
        I'll close with a story about Staff Sergeant Christopher
    Wayers, who received the Distinguished Service Cross for
    actions in Baghdad in April 2007. He was riding on a Stryker
    vehicle in a patrol when a Bradley fighting vehicle in front of
    him struck an IED. The Bradley burst into flames. He realized
    that the crew was still inside, he left his Stryker, fought his
    way to the Bradley, dragged out the driver and one of the
    crewman back 100 yards to his Stryker, provided aid to them,
    when he realized there was still another soldier left in the
    vehicle.
        Again, fighting his way across 100 yards of open space back
    to the Bradley vehicle, he went inside, the ammunition was
    cooking off, and he realized that the soldier inside was dead.
    He went back to his vehicle, got a body bag, went back and
    recovered the fallen soldier out of the vehicle. That's the
    kind of men and women that you have in your Armed Forces today,
    and that's why our noncommissioned officers are the best in the
    world at what they do.
        Mr. Chairman, Senators, thank you for your attention, and
    the Secretary and I look forward to handling your questions.
        Chairman Inouye. I thank you very much, General.
        And through you, we thank all of the men and women of the
    Army, and those three men there--thank you very much. We
    appreciate your service to our Nation.

                                 GROW THE ARMY

        General, in January 2007, a decision was made to build up
    to 48 active combat brigades. Recently, Secretary Gates
    announced that it will be stopped at 45. Now, will this have an
    impact on the Army? If so, what will it be?
        General Casey. Chairman, I would tell you that it will have
    a negligible impact on our ability to put ourselves back in
    balance by 2011. All of those brigades were scheduled to just
    start being built in 2011, and we actually had already had to
    slip two of their starts, one 6 months, and once a year. So, it
    will not have any kind of a significant impact on our plan to
    get ourselves back in balance.
        It will also--not building those brigades--will actually
    have a positive impact on our ability to fill the rest of the
    units that we are building and deploying, with an increased
    level of manpower. Our manpower is probably our most--our
    personnel system is probably our most--stretch system. And we
    have a good number of soldiers who are unavailable to us to put
    in units, because they're already deployed on a transition
    team, or in headquarters. They're in a warrior transition unit,
    or running a warrior transition unit, or they have some type of
    nondeployable, disabling injury. And so, this helps us--gives
    us a little edge, here, to fill those forces.
        And the last thing I'd tell you, Mr. Chairman, is that the
    Secretary of Defense has left the door open that if conditions
    don't abate as is our plan in Iraq, and he's left the door open
    for us to continue to grow those, if we still feel them
    necessary. So, I am comfortable with that decision.
        Chairman Inouye. So, you're saying, then, it won't have an
    impact on dwell time, either?
        General Casey. The number of brigades--a month or two. On
    overall drill, overall dwell. So it is not, as I said, a
    significant impact on us.
        Chairman Inouye. Thank you very much.

                                    STRYKER

        Secretary, in order to maintain the industrial base of the
    Stryker, we have to purchase 200 deployed. I notice that we're
    planning to do much less than that. Is there anything we can
    do?
        Secretary Geren. We are constantly weighing our needs for
    the Strykers and Stryker replacement. As far as examining the
    industrial base issue, it's not something that, at the Army
    level, we have focused on, and what I'd like to do is get back
    with you on that, if I could.
        And I know the Office of the Secretary of Defense (OSD) has
    been focused on the industrial base issue for many of the
    manned ground vehicles, as well as many of the other systems,
    so to give you a full answer as to the impact on the industrial
    base, I'd like to get back to you for the record, if I could,
    Mr. Chairman.
        [The information follows:]

        The contractor for the Stryker Family of Vehicles, General
    Dynamics Land Systems (GDLS), has stated that a yearly
    production of 240 Stryker vehicles is the minimum sustainment
    rate to maintain the production facilities at Anniston Army
    Depot, Alabama, and London, Ontario (Canada). At the time of
    the hearing, the projected fiscal year 2009 production was 82
    Stryker vehicles. To mitigate the risk of not maintaining the
    minimum sustainment rate (MSR) in fiscal year 2009, the Army
    laid the groundwork for adjusting the fiscal year 2008 Stryker
    delivery schedule over a longer period of time to maintain the
    MSR while allowing the Army time to complete the Quadrennial
    Defense Review that will assess force structure and force mix.
    Subsequently, Congress has increased the Stryker program's
    fiscal year 2009 Overseas Contingency Operations (OCO) funding
    by $200 million in addition to the original $112 million
    request from the fiscal year 2009 OCO. An additional $238
    million became available as a result of vehicle contract
    definitization. Stryker vehicle procurement in fiscal year 2009
    is now projected at 353 Stryker vehicles (271 Strykers above
    the original 82 projected).

        Chairman Inouye. And do you have plans to continue getting
    something equivalent to the Stryker, if that base runs out?
        Secretary Geren. We expect to have the Strykers in our--as
    part of the inventory of our Army many years into the future.
    I've seen nothing that would project that we would be phasing
    them out.
        We do have plans, we've got a partnership with the marines
    to come up with another joint vehicle. We're also looking at--
    as we develop the new manned ground vehicle, after we made
    the--after the Secretary made the decision to start the future
    combat system, manned ground vehicle system. So, we are looking
    at all of our--the future of all our vehicles, going forward--
    looking at them as they relate to each other, but I know the
    Stryker is certainly an important part of our future.
        Chairman Inouye. Do we have any plans to acquire Stryker
    ambulances?
        Secretary Geren. At this point, our requirement for Stryker
    ambulances has been addressed. I know it's an issue that has
    been raised, and we're going to study it further, the House
    Appropriations Subcommittee on Defense has put additional
    ambulances, MEVs, in their appropriations bill, and we're going
    back and looking at our requirements in that regard. At the
    present time, we believed that the requirements that we had had
    been met with our budget, but that issue has been raised with
    Chairman Murtha's subcommittee, and we're going back and
    revisiting that issue.
        Chairman Inouye. Thank you.
        May I recognize the vice chairman?
        Senator Cochran. Mr. Chairman, thank you.

                               HELICOPTER PILOTS

        One of the priorities that has been announced by the
    Secretary of Defense for the Army would be to increase the
    number of helicopter units that are deployable and can be
    deployed to the theater where they're needed.
        A recent article stated that there was a shortage of
    pilots--up to 300 personnel--to meet the needs for Army
    helicopter crews.
        Mr. Secretary, we understand that there has been a new
    initiative begun, to recruit and train more helicopter
    personnel. Could you give us a status report on how that is
    going, and what your outlook is?
        Secretary Geren. Well, this budget includes an additional
    $500 million over the original proposed budget for 2010 to
    recruit and train helicopter pilots. Secretary Gates recently
    went to Fort Rucker and met with the leadership down there, and
    has tasked the Army to look at the infrastructure, look at our
    capabilities to support the training requirements.
        We have helicopters in the inventory that are not being
    used to the maximum extent, and this additional $500 million
    will allow us to bring additional trained pilots and crew into
    the Army, and allow us to better utilize those existing assets.
    But we are looking at what the future requires for development
    of that capability down at Fort Rucker, and are putting
    together a proposal to enhance the infrastructure and the
    resources down there.
        Senator Cochran. How many total personnel will be needed to
    meet the shortfall of helicopter personnel? If we provide the
    $500 million, as requested, when do you expect you'd be able to
    have the personnel trained and assigned to deployable units?
        Secretary Geren. I don't have the insight on--the Chief, if
    you could get--I'd like to get back to the record on that. I
    don't have the answer with me, but I'll certainly let you know.
    We're working to identify the resources that we'll need, the
    infrastructure that we'll need, and lay out a game plan for
    applying those funds.
        [The information follows:]

                              Helicopter Training

        Currently, the Army trains an annual student load of 1,200
    with 442 instructor personnel (includes 228 instructor pilots).
    We will increase student output in a phased approach over 2 to
    4 years. In fiscal years 2010 and fiscal year 2011, the annual
    student load will increase to 1,375 with an increase of the
    instructor staff to 568 (includes 312 instructor pilots). Army
    will reach its training requirement of 1,498 between fiscal
    year 2012-14. Increasing from 1,375 to 1,498 is dependent on
    the delivery of additional aviation motion simulators. New
    simulators that are needed are three TH-67 Instrument Flight
    Trainers, one CH-47D Operator Flight Trainer, one Longbow Crew
    Trainer, and to convert three UH60A/L Instrument Flight
    Trainers to Operator Flight Trainers. Delivery and conversions
    of the above simulators are projected in fiscal year 2011-14. A
    total of 624 instructors (includes 334 instructor pilots) will
    be required to support the 1,498 sustained training requirement
    for fiscal year 2014 and beyond. Finally, the effect of
    increased trained pilot output will be evident immediately in
    fiscal year 2010, when deploying units in all three Army
    Components will start receiving a greater number of initial
    rotary wing trained pilots. The number of trained pilots will
    increase by 12.7 percent (1,375) in fiscal year 2010 and will
    increase by 20 percent between fiscal year 2012 and 14 (1,498)
    over the current fiscal year 2009 (1,200) output.

                                 FIRE SCOUT UAS

        Senator Cochran. Another program--deployment program and
    procurement--involves the unmanned aerial systems (UAS), a
    tactical, vertical takeoff capability, the Fire Scout unmanned
    aerial system is the description given of the unit to be built.
    How soon do you think an operational Fire Scout--will be able
    to be delivered to the Army for evaluation?
        General Casey. Senator, that Fire Scout is currently part
    of our--the spinout program of the future combat system--and it
    is moving forward in its development. I do not recall when the
    first unit will be delivered to us for testing, but I would
    say, it's in the next 3 to 4 years.
        [The information follows:]

        Class IV Unmanned Aerial System, XM-157 (Fire Scout) will
    begin testing on April 29, 2011 under the current System
    Development and Demonstration program schedule.

                               ARMY END STRENGTH

        Senator Cochran. General, I understand the Army is over the
    end strength by 1,500 personnel. Do you think the goal can be
    attained by the end of the fiscal year? Or, what is the outlook
    for dealing with that?
        General Casey. In this town, there's always good news and
    bad news, isn't it, Senator? The good news is, we've met our
    end strength targets early, the bad news is we have to pay for
    it for the rest of this year.
        But I do believe, to answer your question, that we will be
    able to get down and meet our end strength targets at the end
    of this year.
        Senator Cochran. That's good. Well, we wish you well, and
    we want to be sure that the bill that we recommend provides the
    funds that are needed to meet those goals.
        Chairman Inouye. Thank you very much.
        Senator Bond.
        Senator Bond. Thank you very much, Mr. Chairman.
        And welcome, Secretary Geren, General Casey. Thank you for
    being here today. Special thanks to Secretary Geren for your
    steadfast service on behalf of the Army. You've been a great
    champion for our Nation's most vital asset--our assets, our
    troops and their families, and a very capable Secretary. I
    particularly applaud your talking about fully resourcing the
    Guard, which is where we've made great progress--and it's been
    needed in the last few years.
        The electric vehicles that you're talking about, we will be
    making some light-duty electric trucks and vans in Missouri
    that we hope will be competing for some of those--for some of
    that opportunity.

                             MANNED GROUND VEHICLES

        General Casey, we look forward to working with you, and
    thank you for leading the Army. You referenced the future
    combat systems (FCS), of course, we all know it took a big hit,
    the manned ground vehicles. And what is the way forward the
    Army plans to do for bringing into the FCS system manned ground
    vehicles?
        General Casey. Thank you, Senator. And for giving me the
    opportunity to comment on that.
        First of all, it's only the manned ground vehicle element
    of the FCS program that will be stopped. All of the other
    elements of it--the network and the spinouts--are not only
    going to go forward, but they will be fielded to all 73 brigade
    combat teams.
        What we plan to do--there's a meeting going on this week--
    it's called the System of Systems Design Review. And when that
    is over we, with the Department of Defense, will issue an
    acquisition decision memorandum that will halt the future
    combat systems program as we know it today. And we will then
    work with the contractor to split out the manned ground vehicle
    from the other systems so that the--and attempt to do that in a
    way that does not slow the development and fielding of the
    spinout.
        We have already begun and given direction to our training
    and doctrine command to build a development document for a new
    ground combat vehicle. And as we went through the discussions
    on this program with the Secretary of Defense, I could not
    convince him that we had sufficiently integrated the lessons
    from the current fight----
        Senator Bond. That would be incorporating the v-shape to
    the MRAP, as well as the IEP protection on the sides? Is that--
    --
        General Casey. Exactly, those kinds of systems.
        And the good thing is, what we've gotten from the future
    combat system program, is we know the state of technology for
    those type of protective systems. I mean, we're at the limits
    of it, right now. And so, we will work to include both lessons
    from the current fight, and what we've learned from technology,
    and build a better vehicle. And build a better vehicle with the
    support of the Secretary and the Department of Defense, which I
    think will significantly help us move this forward.
        We--our goal is to come forward after Labor Day--with a new
    concept, design for the new manned ground vehicle, so that we
    can move forward, and our attempt will be to get a new vehicle
    in 5 to 7 years, and so we don't stretch this process out, any
    longer than it is.
        Secretary Geren. Let me add one thing, if I might, Senator.
        Senator Bond. Sure.
        Secretary Geren. Just so there's no misunderstanding on
    this one. The Secretary made the decision to terminate the
    manned ground vehicle, he included within that the non-line of
    sight cannon. It's actually a separate program under the
    authorization bill, but there's been some question about
    whether or not that was included in the Secretary's decision.
    He's made it clear that it covers the manned ground vehicles,
    and the non-line of sight cannon. So, just for the record, I
    wanted to----

                        ARMY NATIONAL GUARD END STRENGTH

        Senator Bond. Mr. Secretary, turning to the Army National
    Guard, I'm concerned about some of the personnel readiness. The
    Guard has over 73,000 troops activated in support of OIF and
    OEF, and they had over 300,000 call-ups since 9/11.
        And there's no question they're doing a tremendous job,
    whether it's fighting insurgency, assisting local Afghanis in
    agriculture development, but as the Army expands to 547 active
    duty, or whatever the number will be--I'm concerned that the
    Guard force will be stretched thin. The Guard has stated that
    the current operational environment requires a 371,000 soldier
    end strength. Does the Army have a--Guard have enough troops to
    fulfill its mission, both at home and abroad? With an end
    strength of the 358,000 outlined in the current budget?
        Secretary Geren. What the Secretary of Defense has directed
    us, the current end strength holds for active Guard and Reserve
    are set for this year, but he has left the door open to
    reconsider that issue, as we get into the future, if
    circumstances require additional end strength.
        But, with the Guard, as the Guard has transformed from a
    strategic Reserve to an operational force, many of the changes
    that they have underway are allowing them to better utilize
    their--the resources and the personnel.
        The Guard is going toward the R-4 Gen model, with the goal
    of 1 year deployed, 4 years at home. As you know, modularity,
    as well, with this additional equipping--we're doing a better
    job in the, frankly, with--much of this came from congressional
    leadership on the medical and dental readiness, so we've got a
    much higher percent today--almost double the medical-dental
    readiness that we had just 4 years ago.
        So, the transformation that the Guard is going through,
    with extraordinary leadership that's coming out of these Guard
    officers and NCOs that have had the experience of these last 7
    years, is they're transforming building a new Guard.
        Is the end strength number exactly right? It is set for
    this year, and they're having to reduce the numbers to get to
    that end strength total by the end of the year--I'm confident
    that they will. But I--for the time being, we're set at that
    end strength. We're working to make sure that the personnel in
    the Guard is assigned to the right MOSs, has the proper
    training, and is properly equipped and is ready, from a medical
    standpoint.
        So, I think we're where we need to be for the moment, and
    as the situation changes over the coming years, we'll see what
    the demand signal is, and have a better sense of whether that's
    the right number, long term.

                         ARMY NATIONAL GUARD EQUIPPING

        Senator Bond. Mr. Secretary, I'll have several other
    questions for the record, but about--on the equipment issues,
    as you indicated, you've made great progress in the way you
    track equipment procurement and distribution. The current
    tracking procedures are very labor-intensive, but if the Army
    can institutionalize and automate them, the Army National Guard
    should have the full visibility of resources intended for it by
    Congress. But how would you suggest the Army increase the
    transparency in the allocation of equipment to the Army
    National Guard, in light of the emerging threats that require a
    host of contingencies, both at home and abroad?
        Secretary Geren. One of the most important initiatives from
    the Ponarous Commission, we're working with OSD on it, OSD is
    working across all of the services on this issue, coming up
    with a system and approach that will allow us to have the kind
    of transparency that we'll be able to track the procurement and
    follow the equipment to the Guard unit, and keep track of it
    there.
        It's--as we've learned, as we've dug into it over the last
    7 or 8 months, and it's easier said than done, but we're
    building systems to enable us to do that. It's partly a
    technical challenge, but partly just a commitment to get it
    done. It's an area that I think it really had suffered from
    some neglect over the years. There was not a commitment to
    ensure that we could track it.
        Dr. Gates has made it a priority for all of the services,
    OSD really has the lead on it, but we're working with them to
    ensure that we accomplish that. It's a very high priority for
    us.
        Senator Bond. Thank you very much, Mr. Secretary, General.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.

                              STRESS ON THE FORCE

        Gentlemen, I'd like to submit my questions for the record,
    but I want one other question, Mr. Secretary, General.
        In recent years, divorce and suicide rates have sharply
    increased, and the day before yesterday, five men were killed
    by a stressed out patient, I believe, stressed. This was at a
    stress clinic. Do you believe that the initiatives that we are
    taking to address these problems is sufficient, sir?
        Secretary Geren. Mr. Chairman, I think the initiatives that
    we have underway are steps in the right direction. But this is
    a very stressed force, and as General Casey noted, our families
    are perhaps the most stressed component of our all-volunteer
    force.
        The investments that we're making are going to help better
    support families. Long term, I think the most important thing
    we can do is increase the dwell time, move it beyond the--
    currently 1 to--about 1.3 that it is today, and get to the R-4
    Gen model of 1 year deployed to 2 years at home--ultimate goal,
    3 years at home. I don't think there's any substitute for
    giving these soldiers and these families time together.
        These investments we're making, we believe, will better
    support the families, but there's no substitute for the
    families being together--the family unit being together, and
    being able to support each other.
        So, long term, the most important initiative is to get the
    demand in line with our ability to provide forces, and ensure
    that our soldiers have the time to be home, be with their
    families, regenerate, reconnect with their families.
        You mentioned this, the tragedy of suicide. As we attempt
    to better understand suicides, we see in these suicides that we
    can determine the cause, it's the same issues that cause people
    to commit suicide on the outside.
        Mostly, at the top of the list, it's problems with
    relationships--failed relationships--divorce, some type of
    failure of a very significant relationship, either with a
    husband and a wife, or a parent and a child.
        And when you have the kind of separation that our soldiers
    are experiencing from their families, some soldiers on their
    third, fourth, and fifth deployment, it's obvious that that's
    going to put a relationship under strain. And in some cases,
    push a family to the breaking point.
        So, we are investing--the Chief and I spend a lot of time
    listening to spouses, and talking to children, figuring out
    what we can do to help them. But long term, ultimately, there's
    no substitute for soldiers having time with their families. And
    the most important initiative in relieving the stress on this
    force is going to be get on this R-4 Gen model, and have the
    soldiers be able to spend more time at home.
        Chairman Inouye. General.
        General Casey. Could I add to that, Mr. Chairman? Because
    you asked, are we doing enough.

                     COMPREHENSIVE SOLDIER FITNESS PROGRAM

        We are putting the finishing touches on a program called
    the Comprehensive Soldier Fitness Program, and I expect to
    initiate it this summer. And the intent of that program is to
    raise the attention that we give to mental fitness, to the same
    level that we give to physical fitness. And to give all
    soldiers the skills they need to be resilient, and to succeed
    in combat.
        Now, a lot of people think that everybody that goes to
    combat gets post-traumatic stress, and you know that's not
    true. In fact, the vast majority of the people that go to
    combat have a growth experience, because they're exposed to
    something very, very difficult, and they succeed.
        And so we're trying to give the skills to all soldiers, so
    that more people have a growth experience when they go.
        We, actually, this week have our first group of
    noncommissioned officers going to the University of
    Pennsylvania to become master resilience trainers, to get the
    skills they need to go back to their unit to help them develop
    effective programs.
        Now, we're modeling that after a program we have for master
    fitness trainers--we have guys that can teach you how to do
    good pushups. This is going to be the same type of thing for
    mental fitness.
        We're also developing a self-diagnostic test that can be
    taken--and will be taken--at various times during a soldier's
    career, and results will be reported to them. And it will give
    them an assessment of where they are in several areas, and then
    we'll connect them to several self-help modules, so that they
    can get the personal assistance there, in building their
    resilience.
        And I look to roll both of those out here, probably in the
    fall. But we had to get beyond just being reactive. And so this
    program is designed to give our soldiers the skills that they
    need to enhance their performance across the board.
        Chairman Inouye. Thank you very much.
        Senator Leahy.
        Senator Leahy. Thank you, both.
        General Casey, and Secretary Geren, so good to see you
    both. I know you both know the 86th Mountain Brigade, that's
    upward of 1,800 very proud citizen soldiers from the Vermont
    Army National Guard are going to begin a deployment, either end
    of this year or early next year, to Afghanistan. They're going
    to make up the bulk of Task Force Phoenix, to carry out the
    training of Afghan troops, and I've been glad to work with both
    of your offices to make sure the National Guard, and also the
    Army National Guard, to make sure they, the brigade has the
    equipment it needs, as well as the vehicle and body armor.

                   MINE-RESISTANT, AMBUSH PROTECTED VEHICLES

        What I have been concerned about are the increased use of
    roadside bombs. I mean, not just--obviously not just for the
    Vermonters--but for all of our service people that are over
    there. The MRAP, which is the best protection against that
    has--requires paved roads, is fairly heavy--you know better
    than I--it doesn't work well in undeveloped Afghanistan.
        I understand the overseas contingency operations, a portion
    of the budget includes a request pending for the so-called MRAP
    all-terrain vehicle (ATV). I talked with Secretary Gates about
    this, when he was here before this subcommittee. I sent him a
    personal note about it. Will that remain a priority? I would
    like very much to see that, get it into operation, I know we
    have testing, and so on, but can I just kind of raise that up
    into the level of you two gentlemen?
        Secretary Geren. Very high priority--the same type of
    priority emphasis that led to the very rapid development and
    fielding of the original MRAPs, once the decision was made to
    go forward--that same type of commitment is behind bringing
    the--this MRAP ATV, or some are calling it ``MRAP Light,'' but
    a lighter version that would be more suitable for the Afghani
    terrain. A top priority for the Department, I can assure you.
        Senator Leahy. General Casey.
        General Casey. I was just going to say, Senator, I was
    there about 10 days ago, and heard, basically, the same thing
    that you said about--that there are off-road challenges with
    some of the larger MRAPs. But, what the soldiers do, is when
    they go on patrol, they figure out where they're going, and
    then they tailor the mix of vehicles that they take with them
    for that mission, and they vary the mix of up-armored RVs and
    MRAPs, depending on where they're going. And so they're quite
    agile at doing that. But as the Secretary said, this lighter
    MRAP is, indeed, a priority, and we will continue to work that.
        I will also tell you that we are working to integrate the
    MRAP into the design of all of our units. And, you know,
    those--the MRAPs have been procured by the supplemental budgets
    for the forces in the field. But we, I'm sure, like you believe
    that the improvised explosive device is going to be part of any
    battlefield that we deal with in our lifetime. And so those
    need to become an integral part of our force.
        Senator Leahy. And I would add, again, Secretary and
    General, that I don't raise this just out of a parochial
    concern for the 1,800 from Vermont, but for obviously, for
    everybody who is there. And for the flexibility that you might
    have in being able to train Afghans take over something.
        And I realize, also, that as you say about planning where
    you're going, but of course we also have times when the
    deployment is on very, very short notice--there's been an
    ambush, there's been other things that you see probably too
    often in the reports from there.

                        ARMY NATIONAL GUARD END STRENGTH

        And I also noticed, Mr. Secretary, the Army Guard has
    planned to get to 100 percent readiness, fully manned units, no
    more cross-leveling. When it deploys, it would not have to raid
    other units for people. To get that plan in place--which I
    think is a good plan--you have to ensure every unit in the
    Guard's force structure has all of the people it needs, the end
    strength of the National Guard to have to get to 371,000, I'm
    told, and a special holding account for those awaiting for
    training.
        I understand the Army's approved the holding account, but
    not the formal increase in the size of the force. Am I correct
    on that? Is that just being--is that just a monetary issue--or
    will we get to that?
        General Casey. Senator, we're working with them to reduce
    their training backlog of new recruits, because the challenge
    the Guard has is they recruit for a position, and until that
    soldier has been through basic training and advanced training,
    they're not qualified in their skills, so the unit cannot count
    them as a ready soldier, and we're working with them to reduce
    the backlog.
        We have not increased the end strength beyond the 5--
    358,000 that was their target for fiscal year 2011.
        Senator Leahy. Will it be increased?
        General Casey. I do not--I don't see it. We're going to
    continue to work closely with the Guard on this, Senator, but I
    do not see an end strength increase for the Guard in the near
    future.
        Senator Leahy. I'm not quite sure how I see you doing
    this--how you get away from no more cross-leveling, and the
    rating.
        General Casey. We spoke--the Secretary and I both spoke in
    our opening statements about putting the Army on a rotational
    model--it's not just the active Army. It's also the Guard and
    Reserve. And our goal by 2011, is to have the Guard and Reserve
    on a 1 year out, 4 year back model.
        And what happens is, their readiness--both personnel and
    equipment--improves as they get closer to deployment. And just
    as--this is the same model that we will use for the active
    force. And that is the method that we are using to decrease
    cross-leveling.
        We're never going to get completely away from cross-
    leveling. But it's this rotational model that gives us much
    better flexibility to build capability.
        So, in the first year, availability, they have every piece
    of equipment and all that the active force has, and they're
    manned for the mission. In the second year, they're manned at a
    little slightly lower level for their training, on the third
    year, slightly lower than that.
        Senator Leahy. And I'll close with this, on having the
    equipment, Senator Bond and I, we're co-chairs of the Guard
    Caucus, which both Members--both parties--belong to, here.

                                   EQUIPPING

        We've written to you on the question of more transparency
    of where equipment goes--we appropriate the money for it, and
    we kind of lose sight as it comes off the assembly line, where
    it goes. I would just kind of give you a heads up that you're
    going to, kind of, follow-up question on that, because I really
    would like to see more transparency--which is actually to your
    advantage. Because if you have the transparency, you also have
    the ability to have some flexibility.
        If there's a concern here that it's not being done the way
    we want it, you're going to have these scriptures written into
    the appropriations law, which actually doesn't help you, and
    ultimately it doesn't help us.
        Secretary Geren. No, we're working--it's one of the most
    significant initiatives under the Punaro Commission, this
    transparency, and something we're working with OSD on, for
    the--all of the services Reserve component--this transparency
    has been a struggle for us. We're working to put together a
    system so that we will be able to track that equipment. Dr.
    Gates has made it a high priority, we certainly, in the Army,
    embrace it. It's a very high priority, and we'll--and are
    working hard to develop the processes and procedures to enable
    us to do that.
        And just the fact that it's become a very high priority for
    the Department--Congress, you all have made your intentions
    well-known in that regard. It may have taken us a little while
    to get the message, but we've gotten it, and we're working it
    very hard. We understand the importance of it to the Reserve
    component, we understand the importance of it for us as we try
    to manage all of our forces.
        I'll mention one other initiative that is significant as
    far as reducing the amount of cross-leveling. For the Guard
    units that are deploying next summer, they already have their
    orders--I mean, summer 2010, not summer 2009. We are now giving
    notice of mobilization 2 years out, and actually orders 1 year
    out. So, this allows every Guard unit the opportunity to manage
    their force, and determine who's going to stay, and start
    filling the holes, 1 year plus out, and much better able to
    manage their force.
        Senator Leahy. Thank you.
        Chairman Inouye. Thank you.
        Senator Cochran.

                         ARMY HELICOPTER MODERNIZATION

        Senator Cochran. Mr. Chairman, I have just one other
    question--there have been two efforts made to modernize the
    armed helicopter capability for the Army, and there have been
    problems in both instances. I wonder whether consideration can
    now be given to modifying an existing platform to provide these
    capabilities? We've suggested in a letter to the Secretary of
    Defense that be considered. What is the status of that
    situation, and is there an interest in moving forward to select
    some alternative that's workable and affordable?
        Secretary Geren. There is, Senator. In fact, after we went
    through the--worked through what happened with the armed
    reconnaissance helicopter, after the Nunn-McCurdy breach, and
    the decision to terminate the program, we went and studied what
    the--we felt our options were, and concluded that our best step
    would be to do a full analysis of all alternatives. And we're
    going to begin this summer, we're going to look at all options,
    including what's available in modifying commercial, off-the-
    shelf platforms.
        So, we've got the aperture wide open--it's an analysis of
    all of the alternatives, and then we're going to move ahead,
    and produce the helicopter that serves the needs of our Army,
    but we're starting over, really, with a blank slate and looking
    at all of the options that are out there.
        Chairman Inouye. General Casey, Secretary, I thank you very
    much on behalf of the subcommittee. We thank you for your
    testimony and your service to our Nation.

                         ADDITIONAL COMMITTEE QUESTIONS

        And we'd like to thank the three gallant men sitting before
    us, here. Thank you for your service, Sergeants.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
                Questions Submitted by Chairman Daniel K. Inouye
                           future combat system (fcs)
        Question. Secretary Geren, the fiscal year 2010 defense budget
    drastically changes the Future Combat System, which has long been
    touted as the Army's modernization program. I believe this is the
    fourth major restructure to the FCS program since its inception. We
    have spent almost $18 billion on FCS since 2003, including at least
    $4.2 billion on efforts to develop a new class of manned ground
    vehicles that are now being terminated, and while we have started
    fielding some spin out technologies, they are not delivering the
    capabilities envisioned by the original FCS.
        Tell us Mr. Secretary, what lessons have you learned from the FCS
    program history to ensure the Army is developing a program that
    addresses the needs of the warfighter?
        Answer. Army challenges to modernization remain consistent in a
    complex operational environment against adaptive enemies. The Army is
    adapting using the hard won lessons learned over 7 years of war, which
    highlight the demand for greater versatility, lethality, and
    interoperability across the entire Army.
        The Army is transitioning elements of the Future Combat Systems
    (FCS) (such as sensors, unmanned ground and aerial vehicles, and
    network development) to the new Brigade Combat Team (BCT) Modernization
    program in compliance with the anticipated Acquisition Decision
    Memorandum from the Milestone Decision Authority. This proposed
    transition completes a shift in the Army's modernization strategy--
    moving from equipping only 15 BCTs with all of the FCS equipment to
    holistic modernizing of all Army BCTs.
        The Training and Doctrine Command established a task force to work
    over the course of the summer to develop an affordable, incremental BCT
    Modernization plan. They will reexamine force design, analyze and
    determine the appropriate mix of systems to field in capability
    packages, develop incremental network capability packages to support
    them, and refine requirements for a new ground combat vehicle. This
    work will be informed by views and perspectives from a broad spectrum
    of thought including individuals from think tanks, retired officers,
    currently serving officers and civilian leaders, senior non-
    commissioned officers, and program managers.
        We have learned much from the FCS program in the past decade and
    appreciate the commitment of industry to provide our Soldiers the best
    available equipment. We will work closely with the Office of the
    Secretary of Defense, Congress and FCS contractors/subcontractors in
    the days ahead to capture what we have learned, to implement program
    change decisions, to maintain the momentum of the spin-outs, and to
    move forward expeditiously with a ground combat vehicle.
                              joint cargo aircraft
        Question. General Casey, the budget before the Congress proposes to
    restructure the Joint Cargo Aircraft program by fielding the aircraft
    only to the Air Force, and reducing the total program from 78 airplanes
    to 38. One of the major reasons for the Army's participation in the
    Joint Cargo Aircraft has been the need to provide airlift for the
    ``last tactical mile'' to support soldiers serving on the front lines.
        Will the proposals to transfer the program to the Air Force or to
    reduce the number of aircraft have an impact on supporting our forward-
    deployed troops?
        Answer. It is Air Force's intent that the transfer of JCA have no
    negative impact on the forward deployed Soldier. The Army and Air Force
    have partnered since July 2005 to shape complementary capability
    requirements for the Joint Cargo Aircraft (JCA) program. The Army
    requires the JCA to focus on responsive, direct support transportation
    of Time-Sensitive Mission-Critical (TS/MC) resupply and key personnel
    transport at the tactical level (``the last tactical mile''). The Army
    will continue to provide time-sensitive, mission-critical, direct
    support with a combination of contract air, Sherpas, and CH-47s until
    the USAF begins performing that mission in the summer of fiscal year
    2010. To mitigate the reduced number of airframes procured, the Air
    Force is studying the feasibility of using other cargo aircraft to
    supplement the C-27J. A valid requirement remains with the Army for the
    replacement of the C-23B/B+ Sherpa Cargo Airplane as operational and
    sustainment costs are exceedingly high. The Army, Air Force, Joint
    Staff, and Office of the Secretary of Defense are working closely
    together to develop operational procedures and measures to meet the
    Army's mission needs and to determine the final procurement quantity of
    Joint Cargo Aircraft. This analysis will include the potential use of
    C-130s to meet a portion of the Army's requirement. If a determination
    is made to procure more JCAs, there is still time to do that.
                                     ______

                Questions Submitted by Senator Patrick J. Leahy
              integrated vehicle health management system (ivhms)
        Question. General Casey, I understand that the Integrated Vehicle
    Health Management System (IVHMS) is providing significant maintenance,
    safety, and operational benefits on the UH-60 fleet.
        Could you highlight some of those benefits and cost savings?
        Answer. The Integrated Vehicle Health Management System (IVHMS)
    provides early detection of impending aircraft component failures and
    eliminates guesswork when performing maintenance actions. The IVHMS
    also provides the ability to automate preventative and recurring
    maintenance checks. Through the automation of regular maintenance
    checks such as the 120-hour vibration check, the Army will potentially
    realize a savings in scheduled maintenance man-hours. The IVHMS also
    allows insight into the health of the aircraft, which is changing the
    way aviation maintenance operations are planned and conducted. For
    example during a recent deployment to Iraq, 22 IVHMS equipped UH-60
    aircraft indicated a high engine temperature and/or an excessive speed
    condition. These conditions normally require engine replacement for
    analysis. Due to the IVHMS health monitoring abilities, 21 of the 22
    UH-60 engine replacements were not required, avoiding $9.7 million in
    unscheduled maintenance cost. It is anticipated that IVHMS, which is an
    enabler of Condition Based Maintenance, will allow the Army to avoid
    unnecessary component removal in the future due to data collected
    through health monitoring systems.
        Question. Further, can you provide an update on the status of fully
    outfitting the UH-60 fleet with the IVHMS?
        Answer. As of June 8, 2009, 542 Army H-60 aircraft are equipped
    with Integrated Vehicle Health and Usage Management System (IVHMS) in
    the field (including 98 UH-60Ms that are delivered from the factory
    with IVHMS installed). In addition, 344 IVHMS kits were funded and are
    on contract for installation on the legacy fleet of H-60A/Ls, for an
    IVHMS equipped total of 886 (542+344). Therefore, 46 percent of the
    1,931 H-60 objective fleet either has IVHMS installed or is funded to
    be installed.
        Question. Is current funding adequate to outfit all of the UH-60
    aircraft currently scheduled to deploy to Iraq and Afghanistan so they
    continue to realize the benefits of IVHMS?
        If not, how much is needed by the Army to do so?
        Answer. For the fiscal year 2010-11 rotation being prepared
    currently, only 10 aircraft will not be equipped with IVHMS kits. The
    cost to procure and install 10 additional kits is estimated to be
    approximately $2.9 million, subject to operational availability of
    individual aircraft as they near their deployment date.
                                     ______

                   Question Submitted by Senator Thad Cochran
                              joint cargo aircraft
        Question. General Casey, the budget proposes transferring Joint
    Cargo Aircraft purchased by the Army and the mission associated with
    those aircraft to the Air Force. In the past, the Army has maintained
    that they must maintain a role in this program to fulfill a service-
    unique requirement to provide time sensitive, mission critical supplies
    such food, water, repair parts and ammunition directly to Army units?
    Do you support transferring this mission to the Air Force and do you
    see any change in requirements for the Department?
        Answer. I support transferring this mission to the Air Force. The
    Air Force can and will support the end-to-end distribution of time
    sensitive, mission critical (TS/MC) equipment, personnel, and supplies
    to the forward deployed Army forces. There has been no change in this
    requirement. It is just a matter of which Service operates and
    maintains the aircraft to conduct the TS/MC mission. Currently, the
    Army and Air Force are determining the concepts of operations and
    employment and preparing the transfer of the Joint Cargo Aircraft (JCA)
    program from the Army to the Air Force.
                                     ______

               Questions Submitted by Senator Christopher S. Bond
                         individual ready reserve force
        Question. My final question is about the Individual Ready Reserve
    Force, or IRR. General Casey and Secretary Geren, I know you both
    advocate for the movement away from calling on our IRR forces if we can
    prevent it. However, the realities abroad and within our armed forces
    present serious challenges--namely that we are fighting with men and
    woman who, at one point or another, believed they had completed their
    service obligation to their country.
        Unfortunately, maintaining a robust IRR force is necessary to
    protect our country's interests. However, these call ups are designed
    for full-scale mobilization emergencies, not as manning solutions for
    today's multifaceted counter-insurgency. Grasping the complexities of
    today's battlefield is an exhaustive training process for our active
    duty ranks that takes months and even years.
        How do you tell a 23 year old who has been out of the service for 2
    years that he must re-learn the subtleties and nuances of the Afghan
    terrain and culture?
        Now imagine he's married with two kids, maintaining a full-time
    job, and has never been to Afghanistan?
        Answer. An IRR Soldier being called to active duty goes through a
    medical screening and participates in military occupational specialty
    refresher training, and in unit collective training. These measures
    reintegrate the Soldier into the force and prepare the Soldier for the
    upcoming deployment, just like any other Soldier who has been out of a
    theater of operations for any significant period of time. IRR Soldiers
    who have family care issues, medical issues, or other issues that would
    prevent them from being called to active duty in accordance with their
    orders, may request a delay or an exemption through the Army's Delay
    and Exemption Request Process. Historically, more than two-thirds of
    exemption requests and nearly nine-tenths of the delay requests have
    been approved.
        Question. Clearly, many former war fighters find difficulty in
    summoning the requisite will, training, and discipline to carry out the
    full spectrum operations occurring today in Iraq and Afghanistan
    because they have fundamentally moved on. Many times, our deployed IRR
    soldiers only know how to pursue a strategy that does not center on
    winning, but purely how to survive, not lose, and get back home to a
    normal life again, before it was interrupted.
        Are the odds of getting called up increasing among the IRR force?
        Answer. The odds of an IRR Soldier being called to active duty
    depend more on his or her military occupational specialty (MOS) than on
    the overall population of Soldiers in the IRR. Soldiers with low-
    density/high-demand MOSs (e.g., Civil Affairs, Engineers, Signal Corps,
    and mechanics) have a higher probability of being mobilized than other
    IRR Soldiers.
        Question. Do you believe that filling units with IRR soldiers is an
    effective manning solution for operations characterized by full-
    spectrum conflict and irregular warfare?
        Answer. IRR Soldiers began their Army careers in an active status,
    whether it was with the Regular Army or the Reserves. They are
    experienced and trained Soldiers who either elect to stay in the Army
    past their Military Service Obligation (MSO), or are in the IRR
    completing their MSO. IRR Soldiers are called to active duty to fill
    unit vacancies in units that have been notified of their pending
    mobilization. Once they are assigned to a unit, IRR Soldiers are
    integrated into the unit and participate in their collective training
    prior to their deployment in theater.
                                     ______

                    Question Submitted by Senator Judd Gregg
     third generation extended cold weather clothing system (gen iii ecwcs)
        Question. I would like to commend the Army for its hard work and
    initiative in developing the Third Generation Extended Cold Weather
    Clothing System (GEN III ECWCS). I feel strongly that the system
    ensures the safety and health of our soldiers while bolstering mission
    readiness and combat capability. I understand that GEN III ECWCS has
    proven to be a combat advantage for our troops, but I remain concerned
    about the Army's present and future plans to fully field and fund the
    GEN III ECWCS.
        What is the Army's requirement for GEN III ECWCS, and in the
    absence of supplemental funding, how does the Army plan to fund the
    deployment of GEN III in future years?
        Answer. The Army requirement to provide its Soldiers effective
    protection from the environment without hindering their performance is
    documented in our Core Soldier System Capability Production Document
    (CPD). The Third Generation Extended Cold Weather Clothing System (GEN
    III ECWCS) supports this requirement as a product improvement over
    previously fielded Soldier items. At this time, one set of GEN III
    ECWCS is fielded per deploying Soldier as part of our Rapid Fielding
    Initiative issue process. The Army's future requirement for GEN III
    ECWCS is currently being staffed as part of an update to the Core
    Soldier System CPD, and will likely be one set per Soldier.
        Current GEN III ECWCS fielding is supported primarily with
    supplemental funding; however, there is limited sustainment funding for
    select layers as part of Army Clothing Bag and Central Issue Facility
    support. For future years the Army Staff is in the process of
    developing fielding and sustainment processes that will be integrated
    into the Equipping and Sustainment Program Objective Memorandum
    requests for fiscal years 2012 and beyond.
                                     ______

                Questions Submitted by Senator Robert F. Bennett
        dugway proving ground--u.s. army unmanned aerial vehicle testing
        Question. The Utah delegation was pleased to announce last week
    that Dugway Proving Ground in Utah's west desert has been chosen to
    integrate systems and conduct testing on the U.S. Army's Hunter, Shadow
    and Sky Warrior Unmanned Aerial Vehicles (UAVs).
        The Army's decision to establish the Rapid Integration and
    Acceptance Center at Dugway could bring as many as several hundred
    good-paying jobs to Utah within 2 years and provide a welcome economic
    boost to the state. The center's primary missions will be to
    consolidate all acceptance testing of the Shadow, Hunter and Sky
    Warrior UAVs and to help the Army streamline the introduction of new
    UAV technology to combat units.
        I consider the Utah Test and Training Range and Dugway Proving
    Grounds to be national assets and would welcome any plans for future
    expansion of the mission. It's clear in the budget materials that I
    have seen that the overall use of unmanned aerial systems (UAS) is
    increasing. In an unclassified setting could you tell me more about the
    U.S. Army's plans for expanding the use of UAS's and how we can support
    it?
        Answer. Much of the Army UAS work at Dugway Proving Ground (DPG)
    will be related to acceptance test procedure (ATP) flights for the
    Shadow, Hunter and Extended Range Multi-Purpose (ERMP) aircraft. During
    ATP flights, the government formally accepts aircraft delivered by the
    prime contractors. Up to this point, these ATP flights have taken place
    at three separate locations. To streamline the ATP as well as other
    airframe integration activities, Program Manager (PM) UAS consolidated
    his assets and established a Rapid Integration Acceptance Center (RIAC)
    which is currently being moved to DPG.
        Several other critical activities will take place at the RIAC. To
    better meet Warfighter needs, PM UAS will conduct rapid integration,
    flight assessment, and deployment of new UAS technologies from the RIAC
    into theater. At the RIAC, PM UAS will conduct rapid integration of new
    technologies to support not only Army priorities, but Marine Corps and
    Special Operations Command requirements (or other Service needs, as
    required). By consolidating all Army UAS aircraft and ancillary
    equipment at Dugway, we will have all the assets necessary in one place
    to accelerate and achieve true interoperability between aircraft, the
    Universal Ground Control Station (UGCS) and the One System Remote Video
    Terminal (OSRVT).
        The RIAC infrastructure will allow a great opportunity to include
    academic experimentation. Many universities are working various
    technologies to include payloads, sense and avoid technologies, etc.
    However, they are limited as far as platform availability to validate
    these technologies. Having this capability at the RIAC will allow
    academia to bring the best of breed technologies to fruition for
    potential follow-on efforts and will provide better enabling
    technologies to the Warfighter.
        The Army Reserve recently selected DPG to consolidate Reserve UAS
    units with PM UAS facilities. This will allow synergy for training,
    shared resources, etc. Additionally, the Utah National Guard (at a
    minimum), as well as other National Guard units across the United
    States, will be able to leverage the infrastructure being established
    for the RIAC, as well as the available airspace over DPG property.
        As noted earlier, having all the assets necessary in one place
    allows the PM to accelerate and achieve true interoperability between
    the various aircraft and systems, the UGCS and OSRVT. Additionally, if
    the Army is truly to achieve the capability to have a universal
    operator, it is critical to be able to validate the technology and
    procedures in one location flying more than one type aircraft from one
    UGCS.
        To truly establish a first-class facility, funds will be required
    to purchase hangars, office space and bonded storage. DPG has all the
    runway capability (near and long-term) and some temporary hangar
    capabilities for the near-term; however, with an influx of several
    systems and possibly more than 200 personnel, additional space is
    needed for office and hangar space over what DPG currently offers. The
    PM UAS staff is finalizing the facility requirements and expects to
    have a rough estimate of funds required in the next month.
        The timeline for arrival of Shadow, Hunter and Warrior on site is
    staggered. Shadow is already on site at DPG for some engineering
    flights, to include the re-wing effort and additional laser designator
    payload testing. Shadow ATP will be fully transitioned from Fort
    Huachuca by February 2010. Hunter will have its initial flight assets
    at DPG by late October, early November 2009, with additional test
    assets on site by February 2010. Warrior-A and Block-0 will also be on
    site around November 2009. The ERMP program will start arriving on site
    during 4th Quarter, fiscal year 2010 and is expected to be fully
    operational with its ATP process established by 1st Quarter, fiscal
    year 2011. Other RIAC efforts will be integrated into the schedule as
    they become available and approved/funded for integration and testing.
        Critical to the entire success of the RIAC effort, along with other
    associated activities for the Army noted above, is the availability of
    the restricted airspace above DPG land property for the Army to fly
    with impunity. Recently, there have been concerns noted by the 388th
    Range Squadron at Hill Air Force Base (AFB) that they want to retain
    control of scheduling of the restricted airspace over DPG. However,
    with the changing mission at DPG for aircraft testing, mostly unmanned,
    it is imperative that the Army (DPG specifically) retain that priority
    for use and scheduling over its airspace. Any additional airspace
    needed in the Utah Test and Training Range area would be coordinated
    per standard procedures already in place with Hill AFB, to include
    long-range data link testing and weapons firing during certain flight
    profiles.
                    national guard state partnership program
        Question. I'm sure you are both familiar with the National Guard
    State Partnership Program. The Utah National Guard has been very
    pleased with their experience to date in partnering with Morocco and I
    am pleased to report that things are going well.
        I recently cosponsored S. 775, which would formalize the
    relationship at an institutional level if passed into law.
        What can you tell me about the Army's view of this program, its
    effectiveness and impact on military-to-military relationships around
    the globe?
        Answer. Senate Bill 775 would provide the National Guard with the
    clear, unambiguous authority needed to continue strengthening its State
    Partnership Program and, consequently, will ensure that the National
    Guard SPP continues its very effective contribution to our national
    security. While it does not call for any additional funds for the
    program, which operates with a modest budget of about $8 million in
    fiscal year 2009 (drawn from both the Air Force and Army), it would
    codify the authority for the National Guard to continue expending funds
    for international activities under the SPP program, in support of our
    national security strategy.
        The SPP plays a critical role in building capacities in strategic
    nations and regions throughout the world. SPP develops unique,
    sustainable, cooperative partnerships between individual U.S. States
    and Territories paired up with foreign partner countries. Today, SPP
    consists of 53 U.S. States and Territories partnered with 61 countries
    around the world.
        The SPP builds partner capacity by allowing Army and Air Guardsmen
    to share both civilian and military experiences at the individual and
    unit levels. The focus of SPP remains to develop military to civilian
    contacts and activities that promote defense and security-related
    cooperation in critical areas such as emergency management and disaster
    response, border and port security, leadership and NCO development,
    medical capacities, economic security, natural resource protection,
    peacekeeping operations, counter trafficking, counter proliferation and
    counter and anti-terrorism. Additionally, SPP encourages Guardsmen to
    facilitate civilian, state, and local government relationships
    strengthen and develop broad spectrum civil security cooperation
    between our nation and the SPP partner.
        The SPP supports military to military contacts and activities
    between the United States and those nations partnering with us in the
    SPP program. All SPP activities support the Combatant Commanders, as
    well as the individual mission plans of the U.S. Ambassadors.
        The SPP can be measured by the support Combatant Commanders and
    U.S. missions around the world continue to give to the SPP, and the
    growing demands for SPP expansion to include more countries. The
    ambiguous regulatory authorities currently in place inhibit mission
    flexibility and resourcing necessary for the program to achieve its
    full potential. S. 775 will ensure that SPP can continue building
    strong, lasting bilateral relationships and support to key nations
    whose stability will in turn promote regional and, ultimately, global
    security.
                                 camp williams
        Question. Camp Williams is one of the finest training sites in the
    country, offering a wide variety of training opportunities to soldiers.
    In addition to Utah Guard units, many regular Army, Army Reserve,
    Marine Corps and Air Force units utilize the facilities, both at Camp
    Williams and at the licensed facilities at Dugway Proving Ground. Camp
    Williams facilities are also used by the FBI, law enforcement agencies
    from across the state, and other state agencies for training and
    leadership conferences. It has also become a regular training area for
    many youth groups. To keep up with demand, the Camp is continually
    improving its facilities, both in the cantonment area and in its range
    areas.
        Despite the high value the area offers for national security and
    law enforcement training, one of the growing issues its leadership must
    face is that of the expanding local communities physically encroaching
    the fence line and seeking to place legal restrictions on training and
    operations there due to issues such as noise complaints, hiking
    requests and spreading wildfires. These seemingly small issues have the
    possibility of incrementally disabling its mission that supports our
    national security. Will you discuss what Army efforts have been made to
    address encroachment issues in general and any efforts specific to Camp
    Williams?
        Answer. Camp Williams and the National Guard Bureau (NGB) are
    responding to this issue through a variety of means. First, the Utah
    Army National Guard (UTARNG) applied for participation in the Joint
    Land Use Study (JLUS) program of the DOD Office of Economic Adjustment.
    Camp Williams made it through the nomination process, and on May 7,
    2009, held a kick off meeting with a JLUS project manager from DOD.
        Second, UTARNG regularly participates in the planning commission
    meetings of all communities in their vicinity. This helps them partner
    with the communities, develop relationships and a presence, and express
    their issues and concerns. NGB provided UTARNG with information on and
    examples of local ordinances and legislation that could protect their
    training mission from encroachment.
        Third, we are developing an Army Compatible Use Buffer (ACUB)
    proposal. A group of installation and headquarters staff met with state
    and local government officials and potential partners to explain the
    ACUB program as a possible solution. There is considerable interest in
    the program from the local communities. The cost of property is
    extremely high adjacent to Camp Williams: a prior appraisal assessed an
    approximately 3,400-acre parcel at $39 million. A concern is that the
    ACUB proposal would depend upon significant partner contributions as
    the program is currently not funded. Camp Williams is currently working
    on aligning willing partners and developing their proposal.
        Finally, UTARNG is working with staff from the NGB to address
    unexploded ordnance on property along and beyond the northern boundary
    of the Camp Williams under the Military Munitions Response Program. As
    part of this effort, UTARNG will be conducting Public Safety Awareness
    training to educate the surrounding community about safety issues
    related to munitions releases that occurred in the past, beyond the
    facility boundaries. This effort should assist in raising community
    awareness of the Camp Williams' mission and the importance of
    maintaining a buffer around this valuable military facility.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The subcommittee will reconvene on
    Thursday, May 14, at 10:30 in the morning. At that time we'll
    have a closed hearing to receive testimony on classified
    information.
        And now, we'll stand in recess.
        [Whereupon, at 11:38 a.m., Tuesday, May 12, the
    subcommittee was recessed, to reconvene subject to the call of
    the Chair.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                             TUESDAY, JUNE 2, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:29 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Cochran, and Bond.

                             DEPARTMENT OF DEFENSE

                             DEPARTMENT OF THE NAVY

                            Office of the Secretary

    STATEMENT OF HON. RAYMOND MABUS, SECRETARY OF THE NAVY

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning the subcommittee meets to
    receive testimony on the fiscal year 2010 budget request from
    the Secretary of the Navy, the Honorable Raymond Mabus; the
    Chief of Naval Operations, Admiral Gary Roughead; and the
    Commandant of the Marine Corps, General James Conway. I'd like
    to welcome each of you and extend special greetings to the
    Secretary. This is your first appearance before us.
        For fiscal year 2010, the President has requested $156.4
    billion for the Navy and the Marine Corps, plus an additional
    $15.3 billion in supplemental wartime costs. Although the
    Secretary of Defense has proposed a number of terminations and
    delays in major weapons systems, relatively few of these
    decisions would have an immediate impact on the Navy or Marine
    Corps. In fact, the $9 billion in growth in the Navy budget is
    50 percent greater than the growth in the Army and the Air
    Force combined.
        The budget supports many Department of Navy priorities,
    including truncating the DDG 1000 in favor of additional DDG 51
    destroyers, continuing production and test of the Joint Strike
    Fighter (JSF), accelerating the production of Virginia class
    submarines next year, and completing the growth of the Marine
    Corps to 202,100 personnel.
        Despite the growth in the budget, there is bound to be
    controversy over other investment decisions. Funds for
    shipbuilding are not sufficient to achieve our 313 ship Navy,
    our carrier fleet would be reduced to 10 by year 2040, and it
    will be very difficult to purchase more littoral combat ships
    within the statutory cost cap.
        While plans for sea basing and amphibious warfare are
    getting additional scrutiny, the Expeditionary Fighting Vehicle
    Program continues unchanged. Many have questioned the
    cancellation of the VH-71 Presidential helicopter and others
    are asking whether enough F-18s are being bought to close the
    strike fighter shortfall.
        These are but some of the controversies before us this
    year. It is also clear that next year will be even more
    challenging, as the administration has warned that the 2011
    budget will have additional spending constraints. Future
    decisions will be guided by the results of the Quadrennial
    Defense Review (QDR) and the Nuclear Posture Review (NPR) which
    are now under development. Yet there has already been a shift
    in balancing the demands of the current fight with the
    preparations for future threats. Today's fight involves
    supporting the surge in Afghanistan, managing the drawdown from
    Iraq, meeting irregular threats such as terrorism, drug
    smuggling, and piracy. Each of these missions require different
    capabilities, some of which have been funded in base budgets
    and others were loaded into supplemental appropriation
    requests.
        For the first time, the administration has submitted both
    pieces of the DOD budget at the same time. This will give
    Congress a clearer view of what is needed to support our
    warfighters, and the subcommittee welcomes the testimony of our
    witnesses on these matters, in addition to their views on the
    fiscal year 2010 base budget request.
        The full statements of each of the witnesses will be
    included in the record in total and I'd like to now turn to the
    vice chairman for any remarks he wishes to make.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, I'm pleased to join you in
    welcoming this distinguished panel of witnesses to our
    subcommittee hearing to review the Department of the Navy's
    budget request.
        Mr. Secretary, it is a special pleasure to welcome you in
    your new capacity as Secretary of the Navy. We look forward to
    working with you closely to respond to the challenges facing
    the Department of the Navy. As everyone knows, this new
    Secretary served as the Governor of our State of Mississippi
    with great distinction, and we appreciate his public service.
        The Navy and Marine Corps team has been a very important
    part of our national security organization and throughout
    history they have performed their missions in a very impressive
    fashion, and continue to contribute to the safety and security
    of all Americans. We need to be sure we provide them with the
    funding needed to continue to carry out their missions in the
    way they have in the past.
        The Department has performed with a high degree of
    professional distinction and we congratulate the individual
    members of the panel on the roles they have played and will
    continue to play in carrying out our national security
    responsibilities.
        Thank you.
        Chairman Inouye. Thank you very much.
        Senator Bond, would you wish to say something?

                    STATEMENT OF SENATOR CHRISTOPHER S. BOND

        Senator Bond. Thank you very much, Mr. Chairman. Yes, on
    this subject I do have a lot to say. But I appreciate your
    holding the hearing and I welcome good friends, the Secretary,
    the Admiral, and the General. This is very important. I will
    ask some questions and, Admiral Roughead, you know where I'm
    coming from. In the Navy Posture Review, you stated:

        Navy and Marine Corps carrier-based F/A-18 aircraft are
    providing precision strike in support of the forces on the
    ground in Iraq and Afghanistan. The F/A-18E/F is the aviation
    backbone of our Navy's ability to project power ashore without
    bases that infringe on a foreign nation's sovereign territory.
    At the rate we are operating these aircraft, the number of our
    carrier-capable strike fighters will decrease between 2016 and
    2020, which will affect our air wing capacity and
    effectiveness.

        Admiral, I couldn't agree with you more, which is why I'm
    baffled and concerned and stunned about the budget
    recommendation to underfund the Super Hornet. The inventory of
    strike fighters currently falls short of the number that we
    have heard you say in the past is required to support fully the
    requirement of the Navy air wings and the Marine Corps air
    wings. In March of this year it was projected, if no action is
    taken, the Navy strike fighter shortfall will increase to 243
    aircraft in the next decade.
        But instead of dealing with that, we saw a recommendation
    for $4.4 billion in the long delayed, overbudget, and so far
    unavailable F-35 Joint Strike Fighter, the JSF, which at best,
    as the cost continues to escalate past $150 million, you could
    buy three F/A-18s for every one F-35 or JSF, save hundreds of
    millions of dollars, and get a multiyear which would bring the
    price down.
        We have seen that in the past, that we can't afford to make
    these sacrifices and short fund the operations that we know are
    needed. So I will be asking questions about that, and I thank
    you, Mr. Chairman.
        Chairman Inouye. I thank you, sir.
        Now may I call upon the Secretary.

                           STATEMENT OF RAYMOND MABUS

        Mr. Mabus. Mr. Chairman, my distinguished home State
    Senator, Senator Cochran, and members of the subcommittee: It's
    an honor to be here before you with Admiral Roughead and
    General Conway on behalf of our sailors, marines, civilians,
    and their families.
        Two weeks ago, 2 weeks ago today, I assumed the
    responsibilities as Secretary of the Navy. In this very short
    period of time, it's been my privilege to gain first-hand
    insight into our Nation's exceptional Navy and Marine Corps.
    This naval force serves today around the world, providing a
    wide range of missions in support of our Nation's interests.
        I'm here today to discuss with you, as the chairman pointed
    out, the fiscal year 2010 budget, the various missions of the
    Navy and Marine Corps, and some priorities of the Department.
    The Department's fiscal year 2010 budget reflects commitment to
    our people, shaping our force, providing adequate
    infrastructure, and sustaining and developing the right
    capabilities for the future. The ongoing Quadrennial Defense
    Review will also aid in shaping the Department's contribution
    to the national effort in the future.
        As I have taken on these new duties, my first priority is
    to ensure that we take care of our people--sailors, marines,
    civilians, and their families. Thousands of brave marines and
    sailors are currently engaged in Iraq and Afghanistan.
    Thousands more carry out other hazardous duties around the
    globe. These inspirational Americans volunteered to serve and
    they are protecting us and our way of life with unwavering
    commitment. We must show them the same level of commitment when
    providing for their health and welfare and that of their
    families.
        Last week I made a visit to the National Naval Medical
    Center in Bethesda and visited with our wounded. It was both a
    humbling and inspirational experience. It reinforced the
    enduring commitment we owe them in terms of treatment,
    transition, and support. Programs such as the Marine Corps
    Wounded Warrior Regiment, the Navy's Safe Harbor Program,
    advances in treatment of traumatic brain injuries, and programs
    that offer training and support in stress control must continue
    to be our priorities.
        Today our sailors and marines are serving and responding to
    a wide variety of missions, from combat operations to
    humanitarian assistance and maritime interdiction. The Navy has
    13,000 sailors ashore and 9,500 sailors at sea in Central
    Command's area of responsibility. More than 25,000 marines are
    deployed in Iraq and Afghanistan. Our civilian force is also
    heavily engaged in supporting these operational efforts.
        We have to ensure that the Department of the Navy will
    continue to meet these missions while investing to provide the
    right naval force for future challenges.
        Real acquisition reform too has to be a priority. The
    Department of the Navy has begun to implement the Weapons
    Systems Acquisition Reform Act and is ready to use this act and
    other tools to try to ensure that we get the right capabilities
    on time and at an affordable cost.

                               PREPARED STATEMENT

        I look forward to working together with you in our shared
    commitment to our Nation and the marines, the sailors, the
    civilians, and their families. On behalf of all of them, thank
    you for your commitment and your support, and I look forward to
    your questions.
        Senator Durbin. Thank you very much, Mr. Secretary.
        [The statement follows:]
                        Prepared Statement of Ray Mabus
        Chairman Inouye, Senator Cochran, and Members of the Committee,
    thank you for the opportunity to appear before you today as the 75th
    Secretary of the Navy. It is my great honor to serve with and represent
    the over 800,000 men and women of the United States Navy and Marine
    Corps--active, reserve, and civilian and their families. I am committed
    to ensuring that the Naval Force remains the preeminent sea power,
    ready to meet both current and future challenges.
        I assumed my duties as Secretary of the Navy very recently. So
    please allow me to begin by expressing my gratitude to the members of
    the Senate for the trust that has been placed in me. I am humbled by
    and proud of the responsibility of representing the wonderful men and
    women of our Navy and Marine Corps.
        Our enduring seapower has been essential to furthering America's
    interests worldwide. Its importance cannot be overstated, over 70
    percent of the planet is covered by water, 80 percent of the world's
    inhabitants live near the oceans, and 90 percent of global commerce is
    transported by sea. By maintaining U.S. maritime dominance, our Sailors
    and Marines promote security, stability, and trust around the world.
    Together, we provide a persistent forward presence, power projection
    abroad, and protection of the world's sea lanes. Our Sailors and
    Marines, in cooperation with our foreign partners and allies, continue
    to provide training, deliver humanitarian aid, disaster relief and
    other assistance throughout the globe.
        Our naval forces are uniquely postured to deter aggression and
    prevent escalations. Should deterrence fail, we stand ready to fight
    America's wars and defeat our adversaries. In times of crisis, Navy and
    Marine Corps units are often already on the scene or the first U.S.
    assets to arrive in force. And they accomplish this all as a seaborne
    force with a minimum footprint.
        To ensure and sustain an effective Navy and Marine Corps in an
    increasingly complex security environment, we must emphasize and
    promote a number of essential priorities.
        First, we must ensure the proper care for our forces and their
    families. America's greatest military assets are the dedicated men and
    women who wear the uniform. Thousands of brave Sailors and Marines are
    currently engaged in Iraq and Afghanistan; thousands more carry out
    hazardous duties around the globe. Every one of these incredible
    Americans volunteered to serve, and they are protecting us and our way
    of life with unwavering commitment. As we drawdown in Iraq and increase
    our strength in Afghanistan, they once again stand ready to answer our
    Nation's call. We must show them the same level of commitment when
    providing for their health and welfare and that of their families.
        Second, we must ensure that the Department of the Navy continues to
    meet our many missions of today, while preparing for the unknowable but
    inevitably complex challenges of tomorrow.
        Third, we must continue to balance the Department of the Navy's
    programs, choosing to maintain or establish only those that are
    achievable, affordable, and responsive to our Nation's needs. We are
    committed to refining fiscal and budgetary discipline, tackling waste
    and cost overruns, and building our acquisition workforce. I look
    forward to working with you to make sure that the Department of the
    Navy does not shortchange our Sailors, Marines or our taxpayers.
            take care of our sailors and marines and their families
        The Department continues to shape the force to balance today's
    missions and to provide flexibility for the future. The Marine Corps
    has accomplished its goal of growing the force to 202,000 Marines. This
    will help to provide our Marines greater dwell time and will provide
    the opportunity to address other training and missions that have not
    been accomplished in our recent history. The Navy force has stabilized.
    Both the Navy and Marine Corps are meeting their recruiting goals both
    in numbers and quality. Our reserves continue to play a key role as
    part of the Total Force and our civilians are a bedrock providing
    support around the globe to our warfighters and to our naval
    capabilities. Together, we thank you for your support in sustaining the
    people who stand in our ranks--military and civilian.
        We must support and strive to find ways to improve the initiatives
    that provide for their physical and mental welfare. The following
    programs exemplify some of the actions we are taking.
    Wounded Warrior Medical Care
        We as a Nation have no higher obligation than to care for our
    wounded heroes who have sacrificed so much to serve our Nation. We have
    a solemn duty to ensure that when our forces go into harm's way, there
    is an excellent, comprehensive and sustainable plan for the care of our
    wounded, ill, or injured. The budget request reflects the Department of
    the Navy's commitment to this highest priority, providing exceptional,
    individually tailored assistance to our wounded warriors, with a
    comprehensive approach designed to optimize their recovery,
    rehabilitation, and reintegration. The Navy Safe Harbor Program and the
    Marine Corps Wounded Warrior Regiment extend this assistance to the
    wounded, ill, and injured warriors and their families. The Navy
    Department is also collaborating with the Department of Defense (DOD)
    and the Department of Veterans Affairs (VA) to foster continuity of
    care across all systems and facilitate efficient and effective
    transitions.
    Traumatic Brain Injury
        Traumatic Brain Injury is the defining wound of Operation Iraqi
    Freedom. The National Naval Medical Center Bethesda has a new state-of-
    the-art Unit to treat Traumatic Brain Injury. I recently had the
    opportunity to visit this unit and was deeply impressed both by the
    staff and the facilities. This clinic provides unsurpassed inpatient
    care for polytrauma patients with TBI, serving all blast-exposed or
    head-injured casualties medically evacuated from theater. The medical
    professionals are highly trained and actively manage symptomatic
    patients and evaluate complex cases to fashion appropriate, individual
    treatment and rehabilitation plans.
        To increase TBI detection during deployments, the Department of the
    Navy has implemented a strategy of lowering the index of suspicion for
    TBI symptoms and improving screening, detection, and treatment
    coordination between line and medical leaders.
        The Department of the Navy has also expanded TBI research. Navy
    Medical Research Command is using new techniques to identify
    transmissibility of blast-wave energy into the brain, focusing on the
    nexus between the blast-wave energy transmission and the resulting
    brain pathology.
    Psychological Health
        To address Post Traumatic Stress Disorder (PTSD) and other
    psychological conditions that effect more and more of our force, the
    Navy and the Marine Corps continue to improve their Operational Stress
    Control (OSC) programs. This comprehensive approach seeks to not only
    promote psychological resilience, but also a culture of psychological
    health among Sailors and Marines and their families. I am committed to
    removing any stigma associated with seeking help for mental health. To
    address this, the Bureau of Medicine and Surgery has established a
    centralized and comprehensive OSC program to indoctrinate psychological
    health-stigma reduction into the broader Navy-Marine Corps culture.
    This includes training and tools that line leadership can use from the
    newest accessions to flag and general officers. OSC is targeting
    perceptions within individuals and command leadership, as well as
    working to help care-givers overcome barriers to psychological health
    care.
        Navy Medicine has established 17 Deployment Health Clinics as
    portals of care for service members, staffed with primary-care medical
    and psychological health providers who support early recognition and
    treatment of deployment-related psychological health issues within the
    primary care setting. These examples are not all inclusive. Thank you
    for your continued support of these programs that are so vital to the
    overall strength of the Department.
    Housing and Child Care
        The world's finest naval force deserves the world's finest family
    support programs, including community and health care services and
    access to quality, affordable child care. The budget request
    demonstrates a commitment to our Navy and Marine Corps families by
    investing in family programs, housing, and infrastructure.
                         meeting the missions of today
        While naval forces are conducting combat and combat-support
    missions in Iraq and Afghanistan, the Navy and the Marine Corps also
    stand ready to answer our Nation's call across the full spectrum of
    military operations. Despite a high operational tempo, our naval forces
    remain resilient and motivated, and they are performing superbly around
    the globe. We will work to continue their proud tradition of readiness
    and to ensure that they are fully trained and equipped for their
    assigned missions.
        Today our Marines and Sailors are undertaking a myriad of missions,
    from combat operations in the mountains of Afghanistan, to humanitarian
    assistance in Africa. The Navy has over 9,900 Individual Augmentees and
    more then 6,600 reservists deployed on the ground around the world in
    support of Overseas Contingency Operations. Nearly half of the combat
    air missions over Afghanistan are flown by naval air forces. There are
    283 active ships in service--76 percent of these ships, including four
    aircraft carriers and two large-deck amphibious ships, are underway.
    Over 50 percent of our attack submarines are underway, with nearly
    forty percent of our submarine force on deployment.
        More than 25,000 Marines are deployed in support of Operations
    IRAQI FREEDOM (OIF) and ENDURING FREEDOM (OEF). The large majority are
    in Iraq; however, the process has begun drawing down those forces and
    increasing the number of Marines in Afghanistan. Nearly 5,700 Marines
    are deployed to various regions throughout Afghanistan--either as part
    of the Special Purpose Marine Air Ground Task Force, Afghanistan, or in
    the 2d Marine Expeditionary Brigade, Marine Special Operations
    Companies, Embedded Training Teams, or Individual Augments.
        One of the most significant readiness challenges facing the Navy
    and the Marine Corps is balancing their current obligations to overseas
    contingency operations with other anticipated readiness requirements.
    To address these concerns, the Department of the Navy is working to
    expand our engagements with other nations in order to meet our common
    challenges.
        Fostering trust and cooperative relationships with foreign partners
    is critical to national security, but trust cannot be simply summoned
    in moments of crisis. It must be developed over time. To revitalize
    existing relationships and create new ones, we need to show long-term
    commitment.
        Our Naval Forces contribute significantly to cooperative security
    operations through forward presence and sustained, routine engagement
    with foreign partners and allies. We are committed to sustaining this
    core capability of the Maritime Strategy and ask for your continued
    support.
        Additionally, in order to meet our readiness challenges, the
    Department is working to develop greater energy independence and
    conservation ashore and afloat. Energy costs siphon resources away from
    vital areas. The potential for disruption and the possible
    vulnerability of energy supplies could threaten our ability to perform
    on the battlefield.
        The Department of the Navy has made good progress in increasing
    energy efficiency, reducing energy consumption, and capitalizing on
    renewable energy sources. We are the Department of Defense lead for
    solar, geothermal, and ocean energy, and today, 17 percent of our total
    energy requirements are provided through alternative or renewable
    sources.
        The Navy and Marine Corps can, and should, do more. As we continue
    to increase conservation and develop alternative energy options, the
    Department of the Navy can mitigate the impact of energy volatility,
    use energy as a strategic resource for operational advantage, and
    become a leader in environmental stewardship.
              building and balancing the naval force of the future
        The Department of the Navy will continue to meet America's current
    commitments worldwide, while simultaneously developing a force capable
    of meeting the challenges of the future. We will focus on irregular
    warfare and hybrid campaigns, while continuing those more conventional
    capabilities where our technology gives us a strategic advantage. The
    fiscal year 2010 budget request puts us on the path towards the goal of
    balancing near-term requirements with those of the next decade and
    beyond.
        The budget request provides balanced support for deployed and non-
    deployed steaming days, associated flight hours, and related ship and
    aircraft maintenance. It works to bolster our naval forces'
    independence and flexibility by building on their unique ability to
    operate at great distance with long staying power. This budget would
    also fund the critical ``eyes and ears'' of our forces with increases
    to Intelligence, Reconnaissance, and Surveillance programs and Command,
    Control, Communications, Computers programs. The budget shows
    commitment to maintain key capabilities such as power projection, sea
    control, interdiction, deterrence, and humanitarian assistance.
        In an effort to continue to shape our future contributions to the
    joint force and our country, I look forward to engaging in the
    Quadrennial Defense Review, which strives to define the best, most
    affordable collective military force to defend our national interests
    at home and abroad.
        Changes to how equipment is acquired are essential to building our
    forces for the future. We are committed to pursuing acquisition reform
    and cost control measures and look forward to implementing
    Congressional acquisition reform, as well as working with you to
    continue to find ways to produce the best results out of our
    acquisition process.
        Our Sailors and Marines are a superb fighting force which can be
    lethal or compassionate, patient or quick, as situations dictate. They
    are well-trained, proud warriors that continue to deserve the
    appreciation of a grateful Nation. As their new Secretary, I look
    forward to working together with you to continue to enhance a
    relationship built on trust and commitment to our Nation, and the
    Sailors, Marines, civilians and their families who sacrifice for its
    cause.
        On behalf of the more then 800,000 dedicated men and women of the
    United States Navy and Marine Corps, I express our grateful
    appreciation to Congress for its continuing and unflagging support.

        Senator Durbin. May I call upon the Chief of Naval
    Operations, Admiral Roughead.
    STATEMENT OF ADMIRAL GARY ROUGHEAD, CHIEF OF NAVAL
                OPERATIONS, DEPARTMENT OF THE NAVY
        Admiral Roughead. Thank you, Mr. Chairman. Chairman Inouye,
    Senator Cochran, distinguished members of the subcommittee: On
    behalf of the 600,000 sailors, Navy civilians, and their
    families, thank you for your continued support and for the
    opportunity and the honor to represent our Navy alongside
    Secretary Mabus and General Conway.
        Today we have 40,000 sailors on station making a difference
    around the world. We are more versatile and agile than we have
    ever been, with approximately 13,000 sailors on the ground in
    Central Command, to include SEALs, explosive ordnance disposal
    technicians, Seebees, and many individual augmentees.
        The 2010 budget balances the needs of those sailors around
    the world, our current operations, and the needs for our future
    fleet, in accordance with our maritime strategy. However, we
    are progressing at an adjusted pace. Our risk is moderate
    today, trending toward significant because of challenges posed
    by our fleet capacity, operational requirements, manpower,
    maintenance, and infrastructure costs. Our Navy is operating at
    its highest levels in recent years and, while we remain ready
    and capable, we are stretched in our ability to meet additional
    operational demands while balancing our obligation to our
    people and to building the future fleet.
        We require additional capacity to meet combatant commander
    demands and to maintain our operational tempo. A fleet of at
    least 313 ships is needed, along with the capabilities that
    include more ballistic missile defense, irregular warfare, and
    open ocean anti-submarine warfare capabilities. These needs
    drove the decision to truncate the DDG 1000 and restart DDG 51
    with its blue water anti-submarine warfare capability and
    integrated air and missile defense, and also to procure three
    littoral combat ships this year.
        As I articulated last year, our Navy must have a stable
    shipbuilding program that provides the right capability and
    capacity while preserving our Nation's industrial base. The
    balance among capability, capacity, affordability, and
    executability in our procurement plans, however, is not
    optimal. I continue to focus on the control of requirements,
    integration of total ownership costs into our decisionmaking,
    maturing new ship designs before production, and pursuing
    proven designs, the use of common hull forms and components,
    and longer production runs to control costs as we build the
    future fleet.
        To best maintain the ships we have, we've reinstituted an
    engineering-based approach to maintenance for our surface ships
    through the surface ship life cycle management activity.
    Meanwhile, our board of inspection and survey teams will
    continue to use our internal INSURV process to conduct rigorous
    self-assessments on the condition of our ships and submarines.
        All that we do is made possible by our dedicated sailors
    and Navy civilians. I am committed to providing the necessary
    resources and shaping our personnel policies to ensure our
    people and their families are properly supported. We are
    stabilizing our force this year by seeking authorization and
    funding for an end strength of 328,800 sailors, including
    overseas contingency operations funding for 4,400 individual
    augmentees who are in today's fight.
        We continue to provide a continuum of care that governs all
    aspects of individual medical, physical, psychological, and
    family readiness to our returning warriors and sailors. In 2008
    we added 170 care managers to our military treatment facilities
    and ambulatory care clinics for our 1,800 wounded warriors and
    their families. In addition, we continue to move mental health
    providers closer to the battlefield and are actively working
    against the stigma of post traumatic stress disorder (PTSD).
        Achieving the right balance within and across my three
    priorities of the future fleet, current operations, and people
    is critical today and for the future. I ask Congress to fully
    support our 2010 budget and identified priorities.

                               PREPARED STATEMENT

        Thank you for all you do and your continued support and
    commitment to our Navy. I look forward to your questions today.
    Thank you very much.
        Chairman Inouye. Thank you, Admiral.
        [The statement follows:]
                  Prepared Statement of Admiral Gary Roughead
        Chairman Inouye, Senator Cochran, and members of the Committee, it
    is an honor to appear before you today representing the more than
    600,000 Sailors and civilians of the U.S. Navy. We are making a
    difference around the world. We are globally deployed, persistently
    forward, and actively engaged. I greatly appreciate your continued
    support as our Navy defends our Nation and our national interests.
        Last year, I came before you to lay out my priorities for our Navy,
    which were to build tomorrow's Navy, remain ready to fight today, and
    develop and support our Sailors, Navy civilians, and families. We made
    great progress on those priorities this past year. Sustaining our
    Navy's maritime dominance requires the right balance of capability and
    capacity for the challenges of today and those we are likely to face in
    the future. It demands our Navy remain agile and ready.
        Our Maritime Strategy, issued by the Navy, Marine Corps, and Coast
    Guard over a year ago, continues to guide our efforts. The strategy
    recognizes the importance of naval partnerships, elevates the
    importance of preventing war to the ability to fight and win, and
    identifies six core capabilities: forward presence, deterrence, sea
    control, power projection, maritime security, and humanitarian
    assistance and disaster response (HA/DR). We have increased the breadth
    and depth of our global maritime partnerships. We have engaged, more
    than ever, in stability operations and theater security cooperation.
    Moreover, we are performing each of our six core capabilities as part
    of the joint force in Operation Enduring Freedom (OEF) and Operation
    Iraqi Freedom (OIF), and across the globe.
        We continue to build tomorrow's Navy. As I articulated last year,
    our Navy needs a stable shipbuilding program that provides the right
    capability and capacity for our Fleet while preserving our Nation's
    industrial base. Since I came before you last year, 10 new ships have
    joined our Fleet. Among them, is U.S.S. Freedom (LCS 1), an important
    addition that addresses critical warfighting gaps. We have increased
    oversight and are working closely with industry to lower LCS costs and
    meet program milestones. I am pleased to announce we have awarded fixed
    price, incentive fee contracts for the third and fourth LCS ship. We
    are aggressively working to ensure LCS is a successful and affordable
    program. The introduction of U.S.S. George W. Bush (CVN 77) earlier
    this year also re-affirmed the strength and power of the American
    shipbuilder and our industrial base. I remain committed to a carrier
    force of 11 for the next three decades. In our drive to build the
    future Fleet, I continue to demand that we accurately articulate
    requirements and remain disciplined in our processes. As I testified
    last year, effective procurement requires affordable and realistic
    programs to deliver a balanced future Fleet.
        We reached several key milestones in Navy aviation over the last
    year. Recently, the first P-8A Poseidon aircraft successfully completed
    its first flight. The P-8A will replace our aging P-3 Orion maritime
    patrol aircraft, which we have adapted to the fight we are in by
    providing critical Intelligence, Surveillance, and Reconnaissance
    capabilities to current operations in Iraq and Afghanistan. We also
    issued our first contract for the Broad Area Maritime Surveillance
    aircraft, which will provide capability to meet the challenges we are
    likely to face in the future. As I identified last year, we continue to
    expect a decrease in the number of our strike fighters between 2016 and
    2020 which will affect the capacity and effectiveness of our carrier
    air wings. The timely delivery of the F-35 Joint Strike Fighter is
    critical to meeting our strike fighter needs.
        While we have been building our Navy for tomorrow, we have also
    been focused intensely on today's fight. Our Sailors are fully engaged
    on the ground, in the air, and at sea in support of operations in Iraq
    and Afghanistan. On the ground, our Navy has more than 13,000 active
    and reserve Sailors in Central Command supporting Navy, Joint Force,
    and Combatant Commander requirements. Navy Commanders are leading six
    of the 12 U.S.-led Provincial Reconstruction Teams in Afghanistan. Our
    elite teams of Navy SEALs are heavily engaged in combat operations.
    Navy Explosive Ordnance Disposal platoons are defusing Improvised
    Explosive Devices (IEDs) and landmines. Our SEABEE construction
    battalions are rebuilding schools and restoring critical
    infrastructure. Navy sealift is delivering the majority of heavy war
    equipment to Iraq, while Navy logisticians are ensuring materiel
    arrives on time. Our Navy doctors are providing medical assistance in
    the field and at forward operating bases. In addition, I am thankful
    for the support of Congress for Navy Individual Augmentees who are
    providing combat support and combat service support for Army and Marine
    Corps personnel in Iraq and Afghanistan. On the water, Navy
    Expeditionary Combat Command Riverine forces are working closely with
    the Iraqi Navy to safeguard Iraqi infrastructure and provide maritime
    security in key waterways. Navy forces are also intercepting smugglers
    and insurgents and protecting Iraqi and partner nation oil and gas
    infrastructure. We know the sea lanes must remain open for the transit
    of oil, the lifeblood of the Iraqi economy, and our ships and Sailors
    are making that happen.
        Beyond the fight in Iraq and Afghanistan, however, we remain an
    expeditionary force, engaged around the world. As the dramatic capture
    of Maersk Alabama and subsequent rescue of Captain Richard Phillips
    demonstrated, we do not have the luxury to be otherwise. We are engaged
    in missions from the Horn of Africa, to the Caribbean and the
    Philippines. Our operations range from tracking attempted ballistic
    missile launches from North Korea, to interacting with international
    partners at sea, to providing medical and humanitarian assistance from
    the sea. Our Sailors continue to be ambassadors for our Nation. This
    past October marked the first visit ever of a U.S. nuclear-powered
    ship, U.S.S. Theodore Roosevelt, to South Africa, the first year Navy
    ships were engaged in operations on both the East and West Coasts of
    Africa, and the first visit ever of a U.S. CNO to South Africa.
    Additionally, my recent visit to China continued a dialogue with the
    PLA(N) that will enhance our military-to-military relationships. In
    total, we have more than 50,000 Sailors deployed and more than 10,500
    in direct support of global Requests for Forces and Joint manning
    requirements.
        My commitment to developing and supporting our Sailors and Navy
    civilians in their global operations endures. We have met overall
    officer and enlisted (active and reserve) recruiting goals for 2008 and
    are on track for success in 2009. We are also improving the diversity
    of our Navy through significant outreach and mentorship. We continue to
    provide, support, and encourage training and education for our
    warfighters in the form of Joint Professional Military Education,
    Language Regional Expertise and Cultural programs, and top-notch
    technical schoolhouses. In addition, to help our Sailors balance
    between their service to the Nation and their lives at home and with
    their families, we have expanded access to childcare, and improved
    housing for families and bachelors through Public Private Ventures
    (PPV). We also continue to address the physical and mental needs of our
    Wounded and Returning Warriors and their families, as well as the needs
    of all our Sailors who deploy. I appreciate the support of Congress for
    these incredible men and women.
        My focus as CNO is to ensure we are properly balanced to answer the
    call now and in the decades to come. As I indicated last year, the
    balance among capability, capacity, affordability, and executability in
    our procurement plans is not optimal. This imbalance has increased our
    warfighting, personnel, and force structure risk in the future. Our
    risk is moderate today trending toward significant in the future
    because of challenges associated with Fleet capacity, increasing
    operational requirements, and growing manpower, maintenance, and
    infrastructure costs.
        We remain a ready and capable Navy today, but the stress on our
    platforms and equipment is increasing. We can meet operational demands
    today but we are stretched in our ability to meet additional
    operational demands while taking care of our people, conducting
    essential platform maintenance to ensure our Fleet reaches its full
    service life, and modernizing and procuring the Navy for tomorrow. Our
    fiscal year 2010 budget aligns with the path our Maritime Strategy has
    set; however, we are progressing at an adjusted pace. Our budget
    increases our baseline funding, yet our Navy continues to rely on
    contingency funding to meet current operational requirements and remain
    the Nation's strategic reserve across the entire spectrum of conflict.
        Achieving the right balance within and across my priorities will be
    critical as we meet the challenges of today and prepare for those of
    tomorrow. I request your full support of our fiscal year 2010 budget
    request and its associated capabilities, readiness, and personnel
    initiatives highlighted below.
                             build tomorrow's navy
        To support our Nation's global interests and responsibilities, our
    Navy must have the right balance of capability and capacity, across
    multiple regions of the world, to prevent and win in conflict today
    while providing a hedge against the challenges we are most likely to
    face tomorrow. You have provided us with a Fleet that possesses the
    capabilities Combatant Commanders demand. Our budget request for fiscal
    year 2010 increases the capacity of our Fleet to respond to those
    demands.
        We are addressing our aviation capability and capacity by investing
    in both new and proven technologies. Our E/A-18G aircraft utilize the
    same airframe as the F/A-18F, which improves construction costs and
    efficiencies, but it is equipped for airborne electronic attack, rather
    than strike missions. The E/A-18G will complete operational testing
    this year and eventually replace our existing EA-6B Fleet. Our budget
    includes procurement and RDT&E funding for this aircraft and for our P-
    8A Multi-mission Maritime Aircraft, which will replace our aging P-3
    Orion Fleet. In addition to manned aviation, our Navy is investing in
    unmanned aircraft, such as Firescout, which is more affordable, can be
    built in larger numbers, and can do the missions needed in the small
    wars and counterinsurgencies we are likely to face in the near to mid-
    term. We are also investing in the Broad Area Maritime Surveillance
    System (BAMS), which is the only unmanned aircraft that can provide
    long-range intelligence, surveillance, and reconnaissance in the
    maritime environment. Our aviation programs increased by more than $4.2
    billion from fiscal year 2009 to fiscal year 2010 to achieve the right
    balance of capability and capacity.
        Our Navy's operational tempo over the past year reaffirms our need
    for a minimum of 313 ships. The mix of those ships has evolved in
    response to the changing security environment and our investments in
    fiscal year 2010 support growing Combatant Commander demands for
    ballistic missile defense, irregular warfare, and open ocean anti-
    submarine warfare. We are also addressing demands for high speed and
    intra-theater lift, as well as a variety of missions in the littoral.
    Specifically, our fiscal year 2010 budget funds eight ships: the 12th
    Virginia class submarine, three Littoral Combat Ships (LCS), two T-AKE
    Dry Cargo and Ammunition Ships, a second Joint High Speed Vessel (JHSV)
    for the Navy, and an advanced Arleigh Burke Class Destroyer that will
    restart the DDG 51 program. The budget also funds the balance of LPD 26
    and DDG 1002 construction, and provides third-year funding for CVN 78.
        American shipbuilding is not broken, but improvements are needed.
    Since becoming CNO, I have focused on our need to address and control
    procurement and total ownership costs. Shipbuilding costs have been
    increasing as a result of reductions in number of ships procured,
    overtime costs, and challenges associated with the introduction of new
    technologies and sophisticated systems. We are addressing these costs
    by maturing new ship designs to adequate levels before commencing
    production, and by pursuing common hull forms, common components,
    proven designs, and repeat builds of ships and aircraft to permit
    longer production runs and lower construction costs. Additionally, our
    shipbuilding plans incorporate open architecture for hardware and
    software systems and increasingly use system modularity. These
    initiatives reduce costs from inception to decommissioning and allow
    ease of modernization in response to evolving threats.
        In 2008, we introduced a more comprehensive acquisition governance
    process to better link requirements and costs throughout the
    procurement process. I will work closely with the Secretary of the Navy
    to grow our acquisition workforce and enhance our ability to properly
    staff and manage our acquisition programs. I also enthusiastically
    support reviewing the overall acquisition and procurement processes to
    determine how the Services can best address costs and accountability.
        A solid and viable industrial base is essential to national
    security and our future Navy, and is a significant contributor to
    economic prosperity. Shipbuilding alone is a capital investment that
    directly supports more than 97,000 American jobs and indirectly
    supports thousands more in almost every U.S. State. Similarly, aircraft
    manufacturing provides extraordinary and unique employment
    opportunities for American workers. Like the manufacturing base in
    other sectors of our economy, the shipbuilding and aircraft industries
    depend upon stable and predictable workloads to stabilize their
    workforce and maximize efficiencies. Level loading of ship and aircraft
    procurements helps retain critical skills and promotes a healthy U.S.
    shipbuilding and aircraft industrial base.
        I seek your support for the following initiatives and programs:
    Aircraft Carrier Force Structure
        The Navy remains committed to a force of 11 carriers for the next
    three decades that can respond to national crises and provide options
    when access is not assured. Our carrier force provides the Nation the
    unique ability to overcome political and geographic barriers to access
    critical areas and project power ashore without the need for host
    nation ports or airfields.
        The 11-carrier requirement is based on a combined need for world-
    wide presence requirements, surge availability, training and exercises,
    and maintenance. During the period between the planned 2012
    inactivation of U.S.S. Enterprise (CVN 65) and the 2015 delivery of
    Gerald R. Ford (CVN 78), however, legislative relief is needed to
    temporarily reduce the operational carrier force to 10. Extending
    Enterprise beyond 2012 involves significant technical risk, challenges
    manpower and the industrial base, and requires expenditures in excess
    of $2.8 billion with a minimal operational return on this significant
    investment. Extending Enterprise would result in only a minor gain in
    carrier operational availability and adversely impact carrier
    maintenance periods and operational availability of the force in the
    future. The temporary reduction to 10 carriers can be mitigated by
    adjustments to deployments and maintenance availabilities. I request
    your approval of this legislative proposal.
    F/A-18 and Joint Strike Fighter (JSF)
        Navy and Marine Corps carrier-based F/A-18 aircraft are providing
    precision strike in support of forces on the ground in Iraq and
    Afghanistan. The F/A-18 E/F is the aviation backbone of our Navy's
    ability to project power ashore without bases that infringe on a
    foreign nation's sovereign territory. At the rate we are operating
    these aircraft, the number of our carrier-capable strike fighters will
    decrease between 2016 and 2020, which will affect our air wing capacity
    and effectiveness. The F-35 Joint Strike Fighter (JSF) is essential to
    addressing the Navy's strike fighter needs. Stable funding of JSF will
    facilitate the on-time and within budget delivery of the aircraft to
    our Fleet. I also appreciate the support of Congress for our fiscal
    year 10 request that continues to fund F/A-18 E/F production while
    transitioning to JSF.
    Littoral Combat Ship (LCS)
        LCS is a fast, agile, and networked surface combatant with
    capabilities optimized to support naval and joint force operations in
    littoral regions. LCS fills warfighting gaps in support of maintaining
    dominance in the littorals and strategic choke points around the world.
    It will operate with focused-mission packages, which will include
    manned and unmanned vehicles, to execute a variety of missions,
    primarily anti-submarine warfare (ASW), anti-surface warfare (SUW), and
    mine countermeasures (MCM).
        LCS' inherent characteristics of speed, agility, shallow draft,
    payload capacity, reconfigurable mission spaces, and air/water craft
    capabilities, combined with its core Command, Control, Communications,
    Computers and Intelligence, sensors, and weapons systems, make it an
    ideal platform for engaging in irregular warfare and maritime security
    operations, to include counter-piracy missions.
        I am pleased to report that U.S.S. Freedom (LCS 1) is at sea and
    Independence (LCS 2) will deliver later this year. We have issued
    fixed-price incentive fee contracts for construction of the next two
    LCS ships based on a limited competition between the current LCS
    seaframe prime contractors.
        The Navy is aggressively pursuing cost reduction measures to ensure
    delivery of future ships on a schedule that affordably paces evolving
    threats. We are applying lessons learned from the construction and test
    and evaluation periods of the current ships, and we are matching
    required capabilities to a review of warfighting requirements. I am
    committed to procuring 55 LCS, however legislative relief may be
    required regarding the LCS cost-cap until manufacturing efficiencies
    can be achieved. Our fiscal year 2010 budget includes funding for three
    additional LCS seaframes.
    DDG 1000/DDG 51
        Ballistic missile capability is rapidly proliferating and, since
    1990, the pace of that proliferation has increased markedly. Non-state
    actors are also acquiring advanced weapons, as demonstrated in 2006
    when Hezbollah launched a sophisticated anti-ship missile against an
    Israeli ship. In addition, while DDG 1000 has been optimized for
    littoral anti-submarine warfare, the number of capable submarines
    worldwide does not allow us to diminish our deep-water capabilities.
    The world has changed significantly since we began the march to DDG
    1000 in the early 1990's and, today, Combatant Commander demands are
    for Ballistic Missile Defense, Integrated Air and Missile Defense, and
    Anti-Submarine Warfare.
        To align our surface combatant investment strategy to meet these
    demands, we are truncating the DDG 1000 program at three ships and
    appropriately restarting the DDG 51 production line. The technologies
    resident in the DDG 51 provide extended range air defense now, and when
    coupled with open architecture initiatives, will best bridge the
    transition to the enhanced ballistic missile defense and integrated air
    and missile defense capability envisioned in the next generation
    cruiser. In our revised plan, we are addressing the changing security
    environment and the dynamic capability requirements of the Fleet, while
    providing maximum stability for the industrial base.
        Our fiscal year 2010 budget requests $1.084 billion to provide the
    balance of incremental funding for the third ship of the DDG 1000 class
    authorized in 2009. In addition, $2.241 billion is requested to re-
    start the DDG 51 program. The SWAP II Memorandum of Agreement (MOA)
    will align construction responsibilities to ensure shipyard workload
    stability, stabilize and minimize cost risk for the DDG 1000 program,
    and efficiently re-start DDG 51 construction. Research, development,
    test and evaluation efforts for the DDG 1000 program, will continue in
    order to deliver the necessary technology to complete the DDG 1000
    class ships and support the CVN 78 Class.
    Ballistic Missile Defense
        The increasing development and proliferation of ballistic missiles
    threatens our homeland, our allies, and our military operations.
    Current trends indicate adversary ballistic missile systems are
    becoming more flexible, mobile, survivable, reliable, accurate, and
    possess greater range. Threats posed by ballistic missile delivery are
    likely to increase and become more complex over the next decade.
        Our Navy is on station today performing ballistic missile defense
    (BMD) as a core mission. Maritime BMD is a joint warfighting enabler.
    Aegis BMD contributes to homeland defense through long range
    surveillance and tracking and Aegis BMD ships can conduct organic
    midcourse engagements of short and medium range ballistic missiles in
    support of regional and theater defense. Our Navy and partner nation
    Aegis BMD capability, proven and deployed around the world, has an
    impressive record of success: 18 of 22 direct hits on target, of which
    3 of 3 were successful engagements within the earth's endo-atmosphere.
        Today, Navy Aegis BMD capability is currently installed on 18
    ships: three guided missile cruisers and 15 guided missile destroyers.
    In response to an urgent Combatant Commander demand, the Defense
    Department budget requests $200 million to fund conversion of six
    additional Aegis ships to provide BMD capability. Ultimately, our plan
    is to equip the entire Aegis Fleet with BMD capability, to provide
    Joint Commanders an in-stride BMD capability with regularly deploying
    surface combatants. While development and procurement funding is
    covered under the Missile Defense Agency budget, Navy has committed
    $14.5 million in fiscal year 2010 for operations and sustainment of
    Aegis BMD systems and missiles that have transferred to the Navy.
    Modernizing Cruisers and Destroyers
        Our Cruiser and Destroyer modernization programs provide vital mid-
    life upgrades to the combat systems and hull, mechanical, and
    engineering systems. These upgrades complement our engineered ship
    life-cycle maintenance efforts, which are necessary to ensure our ships
    maintain their full service life. Combat systems upgrades, in
    particular, reduce technology risk for future surface combatants and
    provide a rapid and affordable capability insertion process.
    Maintaining the stability of the Cruiser and Destroyer modernization
    programs will be critical to our future Navy capability and capacity.
    Our fiscal year 2010 budget includes funds to modernize two Cruisers
    and two Destroyers.
    Joint High Speed Vessel (JHSV)
        Intra-theater lift is key to enabling the United States to rapidly
    project, maneuver, and sustain military forces in distant, anti-access
    or area-denial environments. The Joint High Speed Vessel (JHSV) program
    is an Army and Navy joint program to deliver a high-speed, shallow
    draft surface ship capable of rapid transport of medium payloads of
    cargo and personnel within a theater to austere ports without reliance
    on port infrastructure for load/offload. The detail design and lead
    ship construction contract was awarded to Austal USA on November 13,
    2008, and includes contract options for nine additional ships for the
    Army and Navy. Delivery of the first vessel will be to the Army and is
    expected in 2011. Our fiscal year 2010 budget includes $178 million for
    the construction of the Navy's second JHSV. Navy will oversee
    procurement of the second Army funded vessel.
    LPD 17 Class Amphibious Warfare Ship
        The LPD 17 Class of amphibious warfare ships represents the Navy's
    commitment to a modern expeditionary power projection Fleet that will
    enable our naval force to operate across the spectrum of warfare. The
    class will have a 40-year expected service life and serve as the
    replacement for four classes of older ships: the LKA, LST, LSD 36, and
    the LPD 4. San Antonio Class ships will play a key role in supporting
    ongoing overseas operations by forwardly deploying Marines and their
    equipment to respond to global crises. U.S.S. Green Bay (LPD 20) was
    commissioned in January 2009 and U.S.S. New Orleans (LPD 18) deployed
    the same month. New York (LPD 21) is planned to deliver this fall. LPDs
    22-25 are in various stages of construction. Our fiscal year 2010
    budget requests $872 million for the balance of the funding for LPD 26,
    which was authorized in 2009. Further, we request $185 million of
    advance procurement for LPD 27 to leverage production efficiencies of
    the existing LPD 17 class production line. Amphibious lift will have my
    highest attention as we address it in the ongoing Quadrennial Defense
    Review.
    P-3 Orion and P-8 Multi-mission Maritime Aircraft
        Your continued support of the P-3 and P-8A force remains essential.
    The legacy P-3 Orion, is providing critical intelligence, surveillance
    and reconnaissance (ISR) to the current fight and it is a key enabler
    in the execution of our Maritime Strategy. An airframe in very high
    demand, the P-3 supports the joint warfighter with time-critical ISR,
    contributes directly to our maritime domain awareness across the globe,
    and is our Nation's pre-eminent airborne deterrent to an increasing
    submarine threat. Thirty-nine P-3s were grounded in December 2007 due
    to airframe fatigue. I thank Congress for providing $289.3 million to
    our Navy in the fiscal year 2008 Supplemental to fund the initial phase
    of the recovery program.
        Boeing has resolved labor issues with their workforce and is
    implementing a recovery plan for the P-8A within fiscal resources that
    will restore the program schedule from delays caused by last year's
    strike.
        The P-8A Poseidon will start to fill the P-3 capability in 2013. I
    am pleased to report the program reached a critical milestone this
    April when the first P-8A test aircraft successfully completed its
    first flight. I request your support of our fiscal year 2010 budget
    request for six P-8A aircraft.
    E-2D Advanced Hawkeye
        The E-2D Advanced Hawkeye aircraft replaces the E-2C Hawkeye
    aircraft. The aircraft's APY-9 radar is a two-generation leap in
    airborne surveillance radar capability, significantly improving
    detection and tracking of small targets in the overland and littoral
    environment when compared to the E-2C. The E-2D improves nearly every
    facet of tactical air operations, maintains open ocean capability, and
    adds overland and littoral surveillance to support Theater Air and
    Missile Defense capabilities against air threats in high clutter,
    electro-magnetic interference, and jamming environments. I ask Congress
    to support our fiscal year 2010 budget request for two E-2D Hawkeye
    aircraft.
    Unmanned Aerial Systems
        We are investing in unmanned systems to enhance our capacity to
    meet increasing global demands for Intelligence, Surveillance and
    Reconnaissance (ISR) capability. The Broad Area Maritime Surveillance
    (BAMS) UAS enhances situational awareness of the operational
    environment and shortens the sensor-to-shooter kill chain by providing
    persistent, multiple-sensor ISR to Fleet commanders and coalition and
    joint forces. Our fiscal year 2010 budget requests funding for
    continued research and development of BAMS. We are also requesting
    funding for the procurement of five MQ-8 Vertical Takeoff and Landing
    Tactical UAVs (VTUAV). The MQ-8 supports LCS core mission areas of ASW,
    Mine Warfare, and SUW. It can operate from all air-capable ships and
    carry modular mission payloads to provide day and night real time
    reconnaissance, surveillance and target acquisition capabilities. VTUAV
    began operational testing this March aboard U.S.S. McInerny (FFG 8).
    MH-60R/S Multi-Mission Helicopter
        The MH-60R multi-mission helicopter program will replace the
    surface combatant-based SH-60B and carrier-based SH-60F with a newly
    manufactured airframe and enhanced mission systems. The MH-60R provides
    forward-deployed capabilities, including Surface Warfare, and Anti-
    Submarine Warfare, to defeat area-denial strategies, which will enhance
    the ability of the joint force to project and sustain power. MH-60R
    deployed for the first time in January 2009 with the U.S.S. John C.
    Stennis. Our fiscal year 2010 budget requests funding to procure 24 MH-
    60R helicopters.
        The MH-60S will support deployed forces with combat logistics,
    search and rescue, air ambulance, vertical replenishment, anti-surface
    warfare, airborne mine counter-measures, and naval special warfare
    mission areas. Our fiscal year 2010 budget requests funding to procure
    18 MH-60S helicopters.
    Virginia Class SSN
        The Virginia Class submarine is a multi-mission submarine that
    dominates in the littorals and open oceans. Now in its 10th year of
    construction, the Virginia program is demonstrating that this critical
    undersea capability can be delivered affordably and on time. We have
    aggressively reduced construction costs of the Virginia Class to $2
    billion per submarine, as measured in fiscal year 2005 dollars, through
    construction performance improvements, redesign for affordability, and
    a multi-year procurement contract, which provides an assured build rate
    for shipyards and vendors and offers incentives for cost, schedule, and
    capital expenditure for facility improvements. Not only are these
    submarines coming in within budget and ahead of schedule, their
    performance is exceeding expectations and continues to improve with
    each ship delivered. I consider Virginia Class cost reduction efforts a
    model for all our ships, submarines, and aircraft.
    SSBN
        Our Navy supports the Nation's nuclear deterrence capability with a
    credible and survivable Fleet of 14 Ohio Class ballistic missile
    submarines (SSBN). Originally designed for a 30-year service life, this
    class will start retiring in 2027 after over 40 years of service life.
        As long as we live in a world with nuclear weapons, the United
    States will need a reliable and survivable sea-based strategic
    deterrent. Our fiscal year 2010 budget requests research and
    development funds for the Ohio Class Replacement, to enable the start
    of construction of the first ship in fiscal year 2019. The United
    States will achieve significant program benefits by aligning our
    efforts with those of the United Kingdom's Vanguard SSBN replacement
    program. The United States and United Kingdom are finalizing a cost
    sharing agreement.
    Foreign Military Sales
        Our Navy also supports the development of partner capability and
    capacity through a robust Foreign Military Sales (FMS) program. FMS is
    an important aspect of security cooperation programs designed to
    improve interoperability, military-to-military relations, and global
    security. Navy uses the FMS program to help build partner nation
    maritime security capabilities through transfers of ships, weapon
    systems, communication equipment, and a variety of training programs.
    Sales and follow-on support opportunities may also result in production
    line efficiencies and economies of scale to help reduce USN costs. In
    the past year, Navy FMS has worked with over 147 nations and
    international organizations, coordinating 2 ship transfers and 25 ship
    transfer requests, providing military training to over 12,000
    international military members, with total foreign military sales of
    roughly $6.8 billion. Congressional support is key to the successful
    transfer of U.S. equipment to our partners. I thank you for your
    continued support in this area.
    Next Generation Enterprise Network (NGEN)
        To pace the complex and adaptive techniques of potential
    adversaries, we need survivable and persistent network communications
    that enable secure and robust means to command and control our assets,
    and to use, manage, and exploit the information they provide. These
    functions come together in cyberspace, a communication and warfighting
    domain that includes fiber optic cables on the ocean floor, wireless
    networks, satellite communications, computer systems, databases,
    Internet, and most importantly, properly trained cyber personnel to
    execute cyberspace effects. Cyberspace presents enormous challenges and
    unprecedented opportunities to shape and control the battlespace.
    Recent activities, such as the cyber attacks on Georgia and Estonia
    last year, highlight the complex and dynamic nature of cyber threats.
        Our Navy has provided cyber capabilities to the joint force for
    more than 11 years and we continue to make security and operations in
    the cyberspace domain a warfighting priority. The challenge we face
    today is balancing our need to collect and share information with our
    need to protect against 21st century cyber threats. We are taking steps
    to effectively organize, man, train, and equip our Navy for cyber
    warfare, network operations, and information assurance. We are also
    working closely with Joint and interagency partners to develop
    offensive and defensive cyberspace capabilities, infrastructure,
    experience, and access, rather than developing independent, Navy-only
    capabilities.
        As we move from the Navy-Marine Corps Intranet (NMCI) to the Next
    Generation Enterprise Network (NGEN), the sophistication, speed, and
    persistence of cyber threats we observe today makes it imperative that
    we continually improve our network capabilities, improve our
    flexibility to adapt to changing environment, and maintain complete
    operational control of the network. NGEN Block 1 is the follow-on to
    the existing NMCI contract that expires 30 September 2010. It replaces
    the services currently provided by NMCI and takes advantage of lessons
    learned from that network. Future NGEN Blocks will upgrade services
    provided by NMCI and the OCONUS Navy Enterprise Network. NGEN will also
    integrate with shipboard and Marine Corps networks to form a globally
    integrated, Naval Network Environment to support network operations.
    NGEN will leverage the Global Information Grid (GIG) and, where
    possible, utilize DOD enterprise services. A comprehensive transition
    strategy is currently being developed to detail the approach for
    transition from NMCI to NGEN. I appreciate the support of Congress as
    we execute a Continuity of Services Contract to assist in this
    transition.
                          remain ready to fight today
        Our Navy is operating at its highest levels in recent years. As I
    testified last year, even as our Nation shifts its focus from Iraq to
    Afghanistan, our Navy's posture, positioning, and frequency of
    deployment remain high. Combatant Commanders recognize the value of
    Navy forces to the current fight and to operations world-wide. We are
    meeting new needs for ballistic missile defense in Europe and the
    Pacific, counter-piracy and maritime security in Africa and South
    America, and humanitarian assistance in the Caribbean and Southeast
    Asia. Many of these demands started as one-time sourcing requests and
    have evolved into enduring requirements for Navy forces. As a result,
    we have experienced a significant difference between our budgeted and
    actual Fleet operations from year to year, as well as an increase in
    maintenance requirements for our Fleet as a result of its increased
    operational tempo.
        We have been able to meet these requirements by relying on a
    combination of base budget and contingency funding and the continuous
    readiness of our force generated by the Fleet Response Plan (FRP). FRP
    allows us to provide continuous availability of Navy forces that are
    physically well-maintained, properly manned, and appropriately trained
    to deploy for ongoing and surge missions. Any future funding reductions
    or increased restrictions limit our Navy's ability to respond with as
    much flexibility to increased Combatant Commander demands world-wide.
        Our bases and infrastructure enable our operational and combat
    readiness and are essential to the quality of life of our Sailors, Navy
    civilians, and their families. I appreciate greatly your enthusiastic
    support and confidence in the Navy through the inclusion of Navy
    projects in the American Reinvestment and Recovery Act. The funding
    provided through the Recovery Act addresses some of our most pressing
    needs for Child Development Centers, barracks, and energy improvements.
    Our projects are prioritized to make the greatest impact on mission
    requirements and quality of life. All of our Recovery Act projects meet
    Congress' intent to create jobs in the local economy and address
    critical requirements. These projects are being quickly and prudently
    executed to inject capital into local communities while improving
    mission readiness and quality of work and life for our Sailors and
    families.
        I appreciate your support for the following initiatives:
    Training Readiness
        The proliferation of advanced, stealthy, nuclear and non-nuclear
    submarines, equipped with anti-ship weapons of increasing range and
    lethality, challenge our Navy's ability to guarantee the access and
    safety of joint forces. Effective Anti-Submarine Warfare (ASW) remains
    a remarkably and increasingly complex, high-risk warfare area that will
    require continued investment in research and development to counter the
    capabilities of current and future adversaries.
        Active sonar systems, particularly medium frequency active (MFA)
    sonar, are key enablers of our ability to conduct effective ASW. MFA
    sonar is the Navy's most effective tool for locating and tracking
    submarines at distances that preclude effective attack on our ships. We
    must conduct extensive integrated training, to include the use of
    active sonar, which mirrors the intricate operating environment present
    in hostile waters, particularly the littorals. This is of the highest
    importance to our national security and the safety of our Sailors and
    Marines.
        Over the past 5 years, Navy has expended significant effort and
    resources preparing comprehensive environmental planning documentation
    for our at sea training and combat certification activities. The Navy
    remains a world leader in marine mammal research, and we will continue
    our robust investment in this research in fiscal year 2010 and beyond.
    Through such efforts, and in full consultation and cooperation with our
    sister federal agencies, Navy has developed effective measures that
    safely protect marine mammals and the ocean environment from adverse
    impacts of MFA sonar while not impeding vital naval training.
        In overruling attempts to unduly restrain Navy's use of MFA sonar
    in Southern California training ranges, the Supreme Court cited
    President Teddy Roosevelt's quote ``the only way in which a navy can
    ever be made efficient is by practice at sea, under all conditions
    which would have to be met if war existed.'' We can and do balance our
    responsibility to prepare naval forces for deployment and combat
    operations with our responsibility to be good stewards of the marine
    environment.
    Depot Level Maintenance
        Optimum employment of our depot level maintenance capability and
    capacity is essential to our ships and aircraft reaching their expected
    service life. Depot maintenance is critical to the safety of our
    Sailors and it reduces risk caused by extension of ships and aircraft
    past their engineered maintenance periodicity. Effective and timely
    depot level maintenance allows each ship and aircraft to reach its
    Expected Service Life, preserving our existing force structure and
    enabling us to achieve our required capacity.
        I have taken steps to enhance the state of maintenance of our
    surface combatants. In addition to our rigorous self-assessment
    processes that identify maintenance and readiness issues before our
    ships and aircraft deploy, I directed the Commander, Naval Sea Systems
    Command to reinstate an engineered approach to surface combatant
    maintenance strategies and class maintenance plans with the goal of
    improving the overall condition of these ships. Our Surface Ship Life
    Cycle Maintenance Activity will provide the same type of planning to
    address surface ship maintenance as we currently have for carriers and
    submarines.
        Consistent, long term agreements and stable workload in both the
    public and private sector are necessary for the efficient utilization
    of depots, and it is the most cost effective way to keep our ships and
    aircraft at the highest possible state of readiness. Consistent with my
    intent to drive our Navy to better articulate requirements and costs in
    all we do, we have rigorously updated the quantitative models we use to
    develop our maintenance budgets, increasing their overall fidelity.
    These initial editions of the revised maintenance plans have resulted
    in increased maintenance requirements and additional costs. Our
    combined fiscal year 2010 budget funds 96 percent of the projected
    depot ship maintenance requirements necessary to sustain our Navy's
    global presence. Our budget funds aviation depot maintenance at 100
    percent for deployed squadrons and at 87 percent for aviation
    maintenance requirements overall. I request the support of Congress to
    fully support our baseline and contingency funding requests for our
    operations and maintenance to ensure the safety of our Sailors and the
    longevity of our existing ships and aircraft.
    Shore Readiness
        Our shore infrastructure enables our operational and combat
    readiness and is essential to the quality of life and quality of work
    for our Sailors, Navy civilians, and their families. For years,
    increased operational demand, rising manpower costs, and an aging Fleet
    have led our Navy to underfund shore readiness and, instead, invest in
    our people, afloat readiness, and future force structure. As a result,
    maintenance and recapitalization requirements have grown and the cost
    of ownership for our shore infrastructure has increased. At current
    investment levels, our future shore readiness, particularly
    recapitalization of our facilities infrastructure, is at risk.
        In an effort to mitigate this risk in a constrained fiscal
    environment, we are executing a Shore Investment Strategy that uses
    informed, capabilities-based investment decisions to target our shore
    investments where they will have the greatest impact to our strategic
    and operational objectives. I appreciate the enthusiastic support and
    confidence of Congress in the Navy through the inclusion of Navy
    projects in the American Reinvestment and Recovery Act. Through the
    Recovery Act, you allowed our Navy to address some of our most pressing
    needs for Child Development Centers, barracks, dry dock repairs, and
    energy improvements. These Navy projects are located in 22 states and
    territories and fully support the President's objectives of rapid and
    pervasive stimulus efforts in local economies. I am committed to
    further improvements in our shore infrastructure but our Navy must
    balance this need against our priorities of sustaining force structure
    and manpower levels.
    Energy
        Our Navy is actively pursuing ways to reduce our energy consumption
    and improve energy efficiency in our operations and at our shore
    installations. Our emerging Navy Energy Strategy spans three key areas,
    afloat and on shore: (1) an energy security strategy to make certain of
    an adequate, reliable, and sustainable supply; (2) a robust investment
    strategy in alternative renewable sources of energy and energy
    conservation technologies; and (3) policy and doctrine changes that are
    aimed at changing behavior to reduce consumption.
        I will be proposing goals to the Secretary of the Navy to increase
    energy independence in our shore installations, increase use of
    alternative fuels afloat and reduce tactical petroleum consumption, and
    to reduce our carbon footprint and green house gas emissions. We are
    leveraging available investment dollars and current technological
    advances to employ technology that reduces energy demand and increases
    our ability to use alternative and renewable forms of energy for shore
    facilities and in our logistics processes. This technology improves
    energy options for our Navy today and in the future. Our initial
    interactions with industry and academic institutions in public symposia
    over the past few months have generated an enthusiastic response to our
    emerging strategy.
    United Nations Convention on the Law of the Sea
        The Law of the Sea Convention codifies navigation and overflight
    rights and high seas freedoms that are essential for the global
    mobility of our armed forces. It directly supports our national
    security interests. Our current non-party status constrains efforts to
    develop enduring maritime partnerships, inhibits efforts to expand the
    Proliferation Security Initiative, and elevates the level of risk for
    our Sailors as they undertake operations to preserve navigation rights
    and freedoms, particularly in areas such as the Strait of Hormuz and
    Arabian Gulf, and the East and South China Seas. Accession to the Law
    of the Sea Convention remains a priority for our Navy.
               develop and support our sailors and navy civilians
        Our talented and dedicated Sailors and Navy civilians are the
    critical component to the Navy's Maritime Strategy. I am committed to
    providing the necessary resources and shaping our personnel policies to
    ensure our people are personally and professionally supported in their
    service to our Nation.
        Since 2003, the Navy's end strength has declined by approximately
    10,000 per year aiming for a target of 322,000 Active Component (AC)
    and 66,700 Reserve Component (RC) Sailors. While end strength declined,
    we have increased operational availability through the Fleet Response
    Plan, supported new missions for the joint force, and introduced the
    Maritime Strategy. This increased demand includes maritime
    interdiction, riverine warfare, irregular and cyber warfare,
    humanitarian and disaster relief, an extended individual augmentee
    requirement in support of the joint force, and now, counter-piracy.
        To meet increased demands, maintain required Fleet manning levels
    with minimal risk, and minimize stress on the force, we have
    transitioned from a posture of reducing end strength to one of
    stabilizing the force. We anticipate that we will finish this fiscal
    year within two percent above our authorized level.
        The fiscal year 2010 budget request supports an active component
    end strength of 328,800. This includes 324,400 in the baseline budget
    to support Fleet requirements, as well as increased capacity to support
    the individual augmentee missions. The budget also supports the
    reversal of the Defense Health Program military-to-civilian conversions
    as directed by the Congress. The fiscal year 2010 budget also requests
    contingency funding for individual augmentees supporting the joint
    force in non-traditional Navy missions. To maintain Fleet readiness,
    support Combatant Commanders, and to minimize the stress on the force,
    our Navy must be appropriately resourced to support this operational
    demand.
        I urge Congress to support the following manpower and personnel
    initiatives:
    Recruiting and Retention
        Navy has been successful in attracting, recruiting, and retaining a
    highly-skilled workforce this fiscal year. The fiscal year 2010 budget
    positions us to continue that success through fiscal year 2010. We
    expect to meet our overall officer and enlisted recruiting and
    retention goals, though we remain focused on critical skills sets, such
    as health professionals and nuclear operators.
        As demand for a professional and technically-trained workforce
    increases in the private sector, Navy must remain competitive in the
    marketplace through monetary and non-monetary incentives. Within the
    health professions, Navy increased several special and incentives pays,
    and implemented others, targeting critical specialties, including
    clinical psychology, social work, physician assistant, and mental
    health nurse practitioners. We are also offering mobilization
    deferments for officers who immediately transition from active to
    reserve status. We have increased bonuses and other incentives for
    nuclear trained personnel to address an increasing demand for these
    highly-trained and specialized professionals in the private sector.
        We continually assess our recruiting and retention initiatives,
    taking a targeted investment approach, to attract and retain high-
    performing Sailors. We appreciate Congressional support for the Post-9/
    11 GI Bill. Navy's goal is to maintain a balanced force, in which
    seniority, experience, and skills are matched to requirements.
    Total Force Integration
        Navy continues to invest in Navy Reserve recruiting, retention and
    training while achieving Total Force integration between active and
    reserve components. The Navy Reserve Force provides mission capable
    units and individuals to the Navy and Marine Corps team through a full
    range of operations. Navy's goal is to become a better aligned Total
    Force in keeping with Department of Defense and Department of the Navy
    strategic guidance, while providing fully integrated operational
    support to the Fleet. Navy continues to validate new mission
    requirements and an associated Reserve Force billet structure to meet
    future capability requirements. Navy has leveraged incentives to best
    recruit Sailors within the Total Force and is developing and improving
    programs and policies that promote a continuum of service through Navy
    Reserve affiliation upon separating from the active component. Navy is
    removing barriers to ease transition between active and reserve
    components and is developing flexible service options and levels of
    participation to meet individual Sailor ability to serve the Navy
    throughout a lifetime of service.
    Sailor and Family Continuum of Care
        Navy continues to provide support to Sailors and their families,
    through a ``continuum of care'' that covers all aspects of individual
    medical, physical, psychological, and family readiness. Through an
    integrated effort between Navy Medicine and Personnel headquarters
    activities and through the chain of command, our goal is reintegrating
    the individual Sailor with his or her command, family, and community.
        Our Navy and Coast Guard recently signed a memorandum of agreement
    for the Coast Guard to share the services provided by the Navy Safe
    Harbor Program. The program is currently comprised of approximately 375
    lifetime enrollees and 217 individuals receiving personally-tailored
    care management. It provides recovery coordination and advocacy for
    seriously wounded, ill, and injured Sailors and Coast Guardsmen, as
    well as a support network for their families. We have established a
    headquarters support element comprised of subject matter expert teams
    of non-medical care managers and recovery care coordinators, and
    Reserve surge support to supplement field teams in mass casualty
    situations.
        We have also developed the Anchor Program, which leverages the
    volunteer services of Navy Reserve members and retirees who assist
    Sailors in reintegrating with family and community. Navy recently
    institutionalized our Operational Stress Control (OSC) Program which
    provides an array of initiatives designed to proactively promote
    psychological resilience and sustain a culture of psychological health
    among Sailors and their families. We are developing a formal curriculum
    which will be integrated into the career training continuum for all
    Sailors throughout their Navy careers.
    Active and Reserve Wounded, Ill and Injured
        Navy Medicine continues to assess the needs of wounded, ill and
    injured service members and their families. In 2008, Navy Medicine
    consolidated all wounded, ill and injured warrior healthcare support
    with the goal of offering comprehensive implementation guidance, the
    highest quality and most compassionate care to service members and
    their families. As of October 2008, 170 additional clinical care
    managers were assigned to military treatment facilities (MTFs) and
    ambulatory care clinics caring for approximately 1,800 OIF/OEF
    casualties. Over 150 clinical medical case managers at Navy MTFs
    advocate on behalf of wounded warriors and their family members by
    working directly with the multi-disciplinary medical team caring for
    the patient.
        The Navy recognizes the unique medical and administrative
    challenges faced by our Reserve Wounded Sailors when they return from
    deployment, and we know their care cannot end at the Military Treatment
    Facility (MTF). In 2008, we established two Medical Hold Units
    responsible for managing all aspects of care for Reserve Sailors in a
    Medical Hold (MEDHOLD) status. Co-located with MTFs in Norfolk and San
    Diego, these units are led by Line Officers with Senior Medical
    Officers supporting for medical issues. Under their leadership, case
    managers serve as advocates who proactively handle each Sailor's
    individualized plan of care until all medical and non-medical issues
    are resolved. We have reduced the numbers of Sailors in the MEDHOLD
    process and the length of time required to resolve their cases. The RC
    MEDHOLD program has become the single, overarching program for
    providing prompt, appropriate care for our Reserve Wounded Sailors.
    Traumatic Brain Injury (TBI)
        TBI represents the defining wound of OIF/OEF due to the
    proliferation of improvised explosive devices (IED). The Department of
    the Navy has implemented a three-pronged strategy to increase detection
    of TBI throughout the deployment span, which includes mental health
    stigma reduction efforts, lowering the index of suspicion for TBI
    symptoms and improving seamless coordination of screening, detection
    and treatment among line and medical leaders. Navy Medicine continues
    to expand its efforts to identify, diagnosis and treat TBI. The
    traumatic stress and brain injury programs at National Naval Medical
    Center (NNMC) Bethesda, Naval Medical Center San Diego (NMCSD), Naval
    Hospital (NH) Camp Pendleton, and NH Camp Lejeune are collaborating to
    identify and treat service members who have had blast exposure.
    Furthermore, Navy Medicine has partnered with the Line community to
    identify specific populations at risk for brain injury such as front
    line units, SEALS, and Navy Explosive Ordinance disposal units.
    Psychological Health
        The number of new cases of Post Traumatic Stress Disorder (PTSD) in
    the Navy has increased in the last year, from 1,618 in fiscal year 2007
    to 1,788 in fiscal year 2008 and we have expanded our efforts to reach
    out to service members. We continue to move mental health providers
    closer to the battlefield and remain supportive of the Psychologist-at
    Sea program. Incentives for military mental health providers have also
    increased to ensure the right providers are available. We are actively
    working to reduce the stigma associated with seeking help for mental
    health. Our recently established Operational Stress Control (OSC)
    program implements training and tools that line leadership can use to
    address stigma. Since inception, OSC Awareness Training, which included
    mental health stigma reduction, has been provided to over 900 non-
    mental health care givers and 16,000 Sailors including over 1,395 at
    Navy's Command Leadership School and Senior Enlisted Academy.
    Diversity
        We have had great success in increasing our diversity outreach and
    improving diversity accessions in our ranks. We are committed to a Navy
    that reflects the diversity of the Nation in all specialties and ranks
    by 2037. Through our outreach efforts, we have observed an increase in
    NROTC applications and have increased diverse NROTC scholarship offers
    by 28 percent. The NROTC class of 2012 is the most diverse class in
    history and, with your help through nominations, the U.S. Naval Academy
    class of 2012 is the Academy's most diverse class in history. Our Navy
    is engaging diversity affinity groups such as the National Society of
    Black Engineers, Thurgood Marshall College Fund, Society of Hispanic
    Professional Engineers, American Indian Science and Engineering
    Society, Mexican American Engineering Society, and the Asian Pacific
    Islander American Scholarship Fund to increase awareness of the
    opportunities for service in the Navy. Our engagement includes Flag
    attendance, junior officer participation, recruiting assets such as the
    Blue Angels, direct Fleet interaction. We have also established
    Regional Outreach Coordinators in Atlanta, Chicago, Houston, Los
    Angeles, and Miami to build Navy awareness in diverse markets.
        As we continue to meet the challenges of a new generation, the Navy
    is already being recognized for our efforts through receipt of the Work
    Life Legacy Award (Families and Work Institute), the Work Life
    Excellence Award (Working Mother Media), Most Admired Employer (U.S.
    Black Engineer and Hispanic Engineer Magazine), and Best Diversity
    Company (Diversity/Careers in Engineering and IT).
    Life-Work Integration
        Thank you for your support of our Navy's efforts to balance work
    and life for our Sailors and their families. You included two important
    life-work integration initiatives in the fiscal year 2009 National
    Defense Authorization Act (NDAA) in which our Sailors have consistently
    expressed strong interest. The NDAA authorized 10 days of paternity
    leave for a married, active duty Sailor whose wife gives birth to a
    child, establishing a benefit similar to that available for mothers who
    receive maternity leave and for parents who adopt a child. The NDAA
    also included a career intermission pilot program, allowing
    participating Sailors to leave active duty for up to three years to
    pursue personal and professional needs, while maintaining eligibility
    for certain medical, dental, commissary, travel and transportation
    benefits and a portion of basic pay. In addition to these new
    authorities, Navy is also exploring other life-work integration
    initiatives, such as flexible work schedules and telework in non-
    operational billets through use of available technologies such as
    Outlook Web Access for e-mail, Defense Connect Online, and Defense
    Knowledge Online for document storage and virtual meetings. The Virtual
    Command Pilot, implemented within the Total Force Domain for an initial
    group of officers, will allow individuals to remain in their current
    geographic locations while working for parent commands located
    elsewhere within the United States.
    Education
        We recognize the importance both to the individual and to our
    mission of providing a life-long continuum of learning and development.
    Education remains a critical component of this continuum. The Navy's
    Professional Military Education Continuum, with an embedded Joint
    Professional Military Education (JPME) component, produces leaders
    skilled in maritime and joint planning. Additionally, we offer several
    college-focused incentives. Tuition assistance provides funds to
    individuals to pay for college while serving. The Navy College Fund
    provides money for college whenever the Sailor decides to end his or
    her Navy career. The Navy College Program Afloat College Education
    (NCPACE) provides educational opportunities for Sailors while deployed.
    Furthermore, officers are afforded the opportunity to pursue advanced
    education through the Naval Postgraduate School (NPS), NPS distance
    learning programs, the Naval War College, and several Navy fellowship
    programs. In addition, our Loan Repayment Program allows us to offer
    debt relief up to $65,000 to recruits who enlist after already earning
    an advanced degree. The Advanced Education Voucher (AEV) program
    provides undergraduate and graduate off-duty education opportunities to
    selected senior enlisted personnel as they pursue Navy-relevant
    degrees. The Accelerate to Excellence (A2E) program, currently in the
    second year of a three-year pilot, combines two semesters of education
    completed while in the Delayed Entry Program, one semester of full-time
    education taken after boot camp, and college credit earned upon
    completion of ``A'' school to complete an Associates Degree. The Navy
    Credentialing Opportunities Online (COOL) program matches rate training
    and experience with civilian credentials, and funds the costs of
    credentialing and licensing exams. As of the end of March 2009, there
    have been more than 35 million visits to the COOL web site, with more
    than 13,000 certification exams funded and approximately 8,500 civilian
    certifications attained.
                                   conclusion
        Despite the challenges we face, I remain optimistic about the
    future. The men and women, active and reserve, Sailor and civilian, of
    our Navy are extraordinarily capable, motivated, and dedicated to
    preserving our national security and prosperity. We are fully committed
    to the current fight and to ensuring continued U.S. global leadership
    in a cooperative world. We look forward to the upcoming Quadrennial
    Defense Review, which will address how we can best use our military
    forces to meet the complex and dynamic challenges our Nation faces
    today and will face in the future. We have seen more challenging times
    and emerged prosperous, secure, and free. I ask Congress to fully
    support our fiscal year 2010 budget and identified priorities. Thank
    you for your continued support and commitment to our Navy, and for all
    you do to make the U.S. Navy a force for good today and in the future.

        Chairman Inouye. Now may I call upon the Commandant of the
    Marine Corps, General Conway.
    STATEMENT OF GENERAL JAMES T. CONWAY, COMMANDANT,
                UNITED STATES MARINE CORPS, DEPARTMENT OF
                THE NAVY
        General Conway. Mr. Chairman, Senator Cochran, Senator
    Bond: Thank you, sirs, for the opportunity to report to you on
    your Marine Corps. My pledge, as always, is to provide you with
    a candid and honest assessment, and I appear before you in that
    spirit today.
        Our number one priority remains your marines in combat.
    Since testimony before your subcommittee last year, progress in
    the Anbar Province of Iraq continues to be significant. Indeed,
    our marines are in the early stages of the most long-awaited
    phase of operations, the reset of our equipment and the
    redeployment of the force. Having recently returned from a trip
    to theater, I'm pleased to report to you that the magnificent
    performance of our marines and sailors in al-Anbar continues
    across a whole spectrum of tasks and responsibilities.
        In Afghanistan, we have substantially another story, as
    thus far in 2009 the Taliban have increased their activity. The
    2d Marine Expeditionary Brigade, an air-ground task force
    numbering more than 10,000 marines and sailors, has just
    assumed responsibility for its battle space under Regional
    Command South. They're operating primarily in the Helmand
    Province, where 93 percent of the country's opium is harvested
    and where the Taliban have been most active.
        We are maintaining an effort to get every marine to the
    fight and today more than 70 percent of your Marine Corps has
    done so. Yet our force remains resilient, in spite of an
    average deployment-to-dwell that is slightly better than one to
    one in most occupational specialties.
        We believe retention is a great indicator of the morale of
    the force and the support of our families. By the halfway point
    of this fiscal year, we had already met our reenlistment goals
    for first term marines and for our career force.
        Our growth in the active component by 27,000 marines has
    proceeded and 2\1/2\ years now ahead of schedule, with no
    change to our standards. We have reached the level of 202,100
    marines and have found it necessary to throttle back our
    recruiting efforts. We attribute our accelerated growth to four
    factors: quality recruiting, exceptional retention levels,
    reduced attrition, and, not least, a great young generation of
    Americans who wish to serve their country in wartime.
        Our Corps is deeply committed to the care and welfare of
    our wounded and their families. Our Wounded Warrior Regiment
    reflects this commitment. We seek through all phases of
    recovery to assist in the rehabilitation and transition of our
    wounded, injured or ill, and their families. I would also like
    to thank those of you on the subcommittee who have set aside
    your personal time to visit with our wounded warriors.
        Secretary Gates seeks to create a balanced U.S. military
    through the efforts of the Quadrennial Defense Review. We have
    always believed that the Marine Corps has to be able to play
    both ways, to be a two-fisted fighter. Our equipment and major
    programs reflect our commitment to be flexible in the face of
    uncertainty. That is to say that 100 percent of United States
    Marine Corps (USMC) procurement can be employed either in a
    hybrid conflict or in major combat.
        Moreover, we seek to remain good stewards of the resources
    provided by Congress through innovative adaptation of our
    equipment. The tilt rotor technology of the M-22 Osprey is
    indicative of this commitment. We are pleased to report that
    this airframe has continued to exceed our expectations through
    three successful combat deployments to Iraq and now a fourth
    aboard ship. Beginning this fall, there will be at least one
    Osprey squadron in Afghanistan for as long as we have marines
    deployed there.
        The future posture of our Corps includes a realignment of
    marine forces in the Pacific. As part of the agreement between
    Tokyo and Washington, we are planning the movement of 8,000
    marines off Okinawa to Guam. We support this move. However, we
    believe the development of training areas and ranges on Guam
    and the adjoining islands in the Marianas are key prerequisites
    for the realignment of our forces. We are actively working
    within the Department of Defense to align USMC requirements
    with ongoing environmental assessments and political
    agreements.
        Finally, on behalf of your Marine Corps I extend my
    gratitude for the support that we have received to date. Our
    great young patriots have performed magnificently and have
    written their own page in history. They know as they go into
    harm's way that their fellow Americans are behind them. On
    their behalf, I thank you for your enduring support. We pledge
    to spend wisely every dollar you generously provide in ways
    that contribute to the defense of this great land.

                               PREPARED STATEMENT

        Thank you once again for the opportunity to report to you
    today and I look forward, sir, to your questions.
        Chairman Inouye. Thank you very much, Commandant.
        [The statement follows:]
                     Prepared Statement of James T. Conway
                                  introduction
        Chairman Inouye, Senator Cochran, and distinguished Members of the
    Committee, my pledge to you remains the same--to always provide my
    forthright and honest assessment of your Marine Corps. The following
    pages detail my assessment of the current state of our Corps and my
    vision for its future.
        First and foremost, on behalf of all Marines, I extend deep
    appreciation for your magnificent support of the Marine Corps and our
    families--especially those warriors currently engaged in Iraq and
    Afghanistan. Extremists started this war just over 25 years ago in
    Beirut, Lebanon. Since then, our country has been attacked and
    surprised repeatedly, at home and abroad, by murderers following an
    extreme and violent ideology. I am convinced, given the chance, they
    will continue to kill innocent Americans at every opportunity. Make no
    mistake, your Marines are honored and committed to stand between this
    great Nation and any enemy today and in the future. Whether through
    soft or hard power, we will continue to fight the enemy on their land,
    in their safe havens, or wherever they choose to hide.
        A selfless generation, today's Marines have raised the bar in
    sacrifice and quality. They know they will repeatedly go into harm's
    way, and despite this, they have joined and reenlisted at exceptional
    rates. Exceeding both the Department of Defense and our own high school
    graduate standards, more than 96 percent of our enlistees in fiscal
    year 2008 had earned their high school diploma. Furthermore, based on a
    recent study from the Center for Naval Analyses, we are also retaining
    higher quality Marines.
        The success in Al Anbar directly relates to the quality of our
    Marines. Several years ago, few would have thought that the conditions
    we see in Al Anbar today were possible, but rotation after rotation of
    Marines, Sailors, Soldiers, and Airmen practiced patience,
    perseverance, and trigger control until the Sunni leadership realized
    that we were not the enemy. Now, the vast majority of our actions in Al
    Anbar deal with political and economic issues--the Corps looks forward
    to successfully completing our part in this initial battle of the Long
    War.
        However, our Marines are professionals and understand there is
    still much work to be done. As we increase our strength in Afghanistan,
    Marines and their families are resolved to answer their Nation's call.
    There are many challenges and hardships that lie ahead, but our Marines
    embrace the chance to make a difference. For that, we owe them the full
    resources required to complete the tasks ahead--to fight today's
    battles, prepare for tomorrow's challenges, and fulfill our commitment
    to our Marine families.
        Our Marines and Sailors in combat remain my number one priority.--
    The resiliency of our Marines is absolutely amazing. Their performance
    this past year in Iraq and Afghanistan has been magnificent, and we
    could not be more proud of their willingness to serve our great Nation
    at such a critical time. Our concerns are with our families; they are
    the brittle part of the equation, yet through it all, they have
    continued to support their loved ones with the quiet strength for which
    we are so grateful.
        To fulfill the Marine Corps' commitment to the defense of this
    Nation, and always mindful of the sacrifices of our Marines and their
    families that make it possible, our priorities will remain steadfast.
    These priorities will guide the Corps through the battles of today and
    the certain challenges and crises in our Nation's future. Our budget
    request is designed to support the following priorities:
      --Right-size the Marine Corps for today's conflict and tomorrow's
            uncertainty
      --Reset the force and prepare for the next contingency
      --Modernize for tomorrow to be ``the most ready when the Nation is
            least ready''
      --Provide our Nation a naval force fully prepared for employment as a
            Marine Air Ground Task Force across the spectrum of conflict
      --Take care of our Marines and their families
      --Posture the Marine Corps for the future
        Your support is critical as we continue to reset the force for
    today and adapt for tomorrow. As prudent stewards of the Nation's
    resources, we are committed to providing the American taxpayer the
    largest return on investment. The future is uncertain and invariably
    full of surprises, but continued support by Congress will ensure a
    balanced Marine Corps--increasingly agile and capable--ready to meet
    the needs of our Nation and a broadening set of missions. From
    humanitarian assistance to large-scale conventional operations, your
    Marines have never failed this great Nation, and thanks to your
    steadfast support, they never will.
                       our marines and sailors in combat
        Our Corps' most sacred resource is the individual Marine. It is
    imperative to the long-term success of the institution that we keep
    their well being as our number one priority. Over the past several
    years, sustained deployments in Iraq, Afghanistan, and across the globe
    have kept many Marines and Sailors in the operating forces deployed as
    much as they have been at home station. They have shouldered our
    Nation's burden and done so with amazing resiliency. Marines understand
    what is required of the Nation's elite warrior class--to stand up and
    be counted when the Nation needs them the most. For this, we owe them
    our unending gratitude.
        Marines and their families know that their sacrifices are making a
    difference, that they are part of something much larger than
    themselves, and that their Nation stands behind them. Thanks to the
    continued support of Congress, your Marines will stay resolved to fight
    and defeat any foe today or in the future.
    USMC Operational Commitments
        The Marine Corps is fully engaged in a generational, multi-faceted
    Long War that cannot be won in one battle, in one country, or by one
    method. Our commitment to the Long War is characterized by campaigns in
    Iraq and Afghanistan as well as diverse and persistent engagements
    around the globe. As of 6 May 2009, there are more than 25,000 Marines
    deployed to the U.S. Central Command's Area of Responsibility in
    support of Operations IRAQI FREEDOM (OIF) and ENDURING FREEDOM (OEF).
    The vast majority are in Iraq; however, we are in the process of
    drawing down those forces and increasing the number of Marines in
    Afghanistan.
        In Afghanistan, we face an enemy and operating environment that is
    different than that in Iraq. We are adapting accordingly. Nearly 5,700
    Marines are deployed to various regions throughout Afghanistan--either
    as part of Special Purpose Marine Air Ground Task Force (SPMAGTF)--
    Afghanistan, 2d Marine Expeditionary Brigade, Marine Special Operations
    Companies, Embedded Training Teams, or Individual Augments and those
    numbers will grow substantially. The Embedded Training Teams live and
    work with the Afghan National Army and continue to increase the Afghan
    National Army's capabilities as they grow capacity. Other missions
    outside Afghanistan are primarily in the broader Middle East area, with
    nearly 2,800 Marines, to include the 13th Marine Expeditionary Unit.
        While we recognize the heavy demand in Iraq and Afghanistan, the
    Marine Corps is very conscious of the need for deployed forces
    throughout the rest of the globe. As of 6 May 2009, there are roughly
    2,800 Marines deployed in the U.S. Pacific Command's Area of
    Responsibility alone, to include the 31st Marine Expeditionary Unit and
    a 62-man detachment in the Philippines. More than 100 Marines are
    deployed in support of Combined Joint Task Force--Horn of Africa in
    Djibouti. Additionally, the Marine Corps has participated in more than
    200 Theater Security Cooperation events, ranging from small mobile
    training teams to MAGTF exercises in Latin America, Africa, Eastern
    Europe, and the Pacific.
                          right-size the marine corps
        The needs of a Nation at war demanded the growth of our active
    component by 27,000 Marines. We have had great success and will reach
    our goal of 202,000 Marines during fiscal year 2009--more than 2 years
    earlier than originally forecasted. Solid planning and your continued
    support will ensure we meet the training, infrastructure, and equipment
    requirements resulting from this growth. This growth will significantly
    improve the ability of your Corps to train to the full range of
    military operations. It will also increase our capacity to deploy
    forces in response to contingencies and to support security cooperation
    with our partners, ultimately reducing operational risk and posturing
    the Corps for continued success in the future.
        Before we were funded to grow our force, we were forced into an
    almost singular focus on preparing units for future rotations and
    counterinsurgency operations. This narrowed focus and the intense
    deployment rate of many units weakened our ability to maintain
    traditional skills, such as amphibious operations, combined-arms
    maneuver, and mountain warfare. Congressionally-mandated to be ``the
    most ready when the Nation is least ready,'' this growth is an
    essential factor to improve our current deployment-to-dwell ratio and
    allow our Corps to maintain the sophisticated skills-sets required for
    today and the future.
        In fiscal year 2008, we activated another infantry battalion and
    increased capacity in our artillery, reconnaissance, engineer, military
    police, civil affairs, intelligence, and multiple other key units that
    have seen a significantly high deployment tempo. With your continued
    support, we will continue to build capacity according to our planned
    growth.
        Improving the deployment-to-dwell ratio for our operating forces
    will also reduce stress on our Marines and their families. Achieving
    our goal of a 1:2 deployment-to-dwell ratio for active duty and a 1:5
    ratio for Reserves is crucial to the health of our force and our
    families during this Long War. Our peacetime goal for active duty
    remains a 1:3 deployment-to-dwell ratio.
    Achieving and Sustaining a Marine Corps of 202,000
        The Marine Corps grew by more than 12,000 Marines in fiscal year
    2008 and is on pace to reach an active duty end strength of 202,000 by
    the end of fiscal year 2009--more than 2 years ahead of schedule. We
    attribute our accelerated growth to four factors: quality recruiting,
    exceptional retention levels, reduced attrition, and--not least--an
    incredible generation of young Americans who welcome the opportunity to
    fight for their country. Our standards remain high, and we are
    currently ahead of our fiscal year 2009 goal in first term enlistments
    and are on track with our career reenlistments. Attrition levels are
    projected to remain at or below fiscal year 2008 rates.
                Recruiting
        Recruiting is the strategic first step in making Marines and
    growing the Corps. With first-term enlistments accounting for more than
    70 percent of our end strength increase, our recruiting efforts must
    not only focus on our overall growth, but also on attracting young men
    and women with the right character, commitment, and drive to become
    Marines.
        We continue to exceed Department of Defense quality standards and
    recruit the best of America into our ranks. The Marine Corps achieved
    over 100 percent of the Active Component accession goal for both
    officer and enlisted in fiscal year 2008. We also achieved 100 percent
    of our Reserve component recruiting goals.
                Retention
        Retention is a vital complement to recruiting and an indicator of
    the resiliency of our force. In fiscal year 2008, the Marine Corps
    achieved an unprecedented number of reenlistments with both the First
    Term and Career Force. We established the most aggressive retention
    goals in our history, and our achievement was exceptional. Our 16,696
    reenlistments equated to a first-term retention rate of almost 36
    percent and a Career Marine retention rate of 77 percent. Through 17
    March 2009:
      --7,453 first-term Marines reenlisted, meeting 101.6 percent of our
            goal. This represents the fastest attainment of a fiscal year
            first-term reenlistment goal in our history and equates to a
            retention rate of 31.4 percent retention rate; traditional
            reenlistments average 6,000 or a retention rate of 24 percent.
      --7,329 Marines who have completed at least two enlistment contracts
            chose to reenlist again. This number represents 98.2 percent of
            our goal of 7,464 reenlistments, and a 72.2 percent retention
            rate among the eligible population.
        Our retention success may be attributed to several important
    enduring themes. First, Marines are motivated to ``stay Marine''
    because they are doing what they signed up to do--fighting for and
    protecting our Nation. Second, they understand that the Marine Corps
    culture is one that rewards proven performance. Third, our reenlistment
    incentives are designed to retain top quality Marines with the most
    relevant skill sets. The continued support of Congress will ensure
    continued success.
                The Marine Corps Reserve
        Our Reserves continue to make essential contributions to our Total
    Force efforts in The Long War, particularly in Iraq and Afghanistan. As
    we accelerated our build to 202,000 Active Component Marines, we
    understood that we would take some risk in regards to obtaining our
    Reserve Component end strength of 39,600. During the 202,000 build-up,
    we adjusted our accession plans and encouraged our experienced and
    combat-tested Reserve Marines to transition back to active duty in
    support of these efforts. They responded in force, and as a result, we
    came in under our authorized Reserve Component end strength limit by
    2,077. As a Total Force Marine Corps, we rely heavily upon the
    essential augmentation and reinforcement provided by our Reserve
    Marines. We believe our authorized end strength of 39,600 is
    appropriate and provides us with the Marines we require to support the
    force and to achieve our goal of a 1:5 deployment-to-dwell ratio. With
    the achievement of the 202,000 active duty force, we will refocus our
    recruiting and retention efforts to achieve our authorized Reserve
    Component end strength. The bonus and incentives provided by Congress,
    specifically the authorization to reimburse travel expenses to select
    members attending drill, will be key tools in helping us accomplish
    this goal.
    Infrastructure
        The Marine Corps remains on track with installation development in
    support of our personnel growth. With the continued support of
    Congress, we will ensure sufficient temporary facilities or other
    solutions are in place until permanent construction can be completed.
                Military Construction: Bachelor Housing
        Due to previous fiscal constraints, the Marine Corps has routinely
    focused on critical operational concerns, and therefore we have not
    built barracks. With your support, we have recently been able to expand
    our construction efforts and have established a program that will
    provide adequate bachelor housing for our entire force by 2014.
    Additional support is required for our fiscal year 2010 program to
    provide 3,000 new barracks spaces and meet our 2014 goal. We are also
    committed to funding the replacement of barracks' furnishings on a 7-
    year cycle as well as the repair and maintenance of existing barracks
    to improve the quality of life of our Marines.
        We are constructing our barracks to a two-person room configuration
    and assigning our junior personnel (pay grades E1-E3) at two Marines
    per room. We are a young Service; the majority of our junior Marines
    are 18-21 years old, and assigning them at two per room helps
    assimilate them into the Marine Corps culture, while fostering
    camaraderie and building unit cohesion. As Marines progress to
    noncommissioned officer rank and take on the added responsibilities of
    corporal (E4) and sergeant (E5), our intent is to assign them one per
    room.
                Public Private Venture (PPV) Housing
        The Marine Corps supports the privatization of family housing. To
    date, the Public Private Venture (PPV) program has been a success
    story. We have benefited from the construction of quality homes and
    community support facilities, as well the vast improvement in
    maintenance services. PPV has had a positive impact on the quality of
    life for our Marines and families. The feedback we have received has
    been overwhelmingly positive.
        PPV has been integral to accommodating existing requirements and
    the additional family housing requirements associated with the growth
    of our force. By the end of fiscal year 2007, with the support of
    Congress, the Marine Corps privatized 96 percent of its worldwide
    family housing inventory. By the end of fiscal year 2010, we expect to
    complete our plan to privatize 97 percent of our existing worldwide
    family housing inventory.
        We again thank the Congress for its generous support in this area.
    In fiscal years 2008 and 2009, you provided the funding to construct or
    acquire nearly 3,000 additional homes and two related Department of
    Defense Dependent Schools through this program; and by 2014, PPV will
    result in all of our families being able to vacate inadequate family
    housing.
                                reset the force
        Operations in Iraq and Afghanistan have placed an unprecedented
    demand on ground weapons systems, aviation assets, and support
    equipment. These assets have experienced accelerated wear and tear due
    to the harsh operating environments and have far exceeded the planned
    peacetime usage rates. Additionally, many equipment items have been
    destroyed or damaged beyond economical repair. High rates of degraded
    material condition require the Marine Corps to undergo significant
    equipment reset for our operational forces and our prepositioning
    programs. Reset will involve all actions required to repair, replace,
    or modernize the equipment and weapons systems that will ensure the
    Nation's expeditionary force in readiness is well prepared for future
    missions. We appreciate the generous support of Congress to ensure that
    Marines have the equipment and maintenance resources they need to meet
    mission requirements. It is our pledge to be good stewards of the
    resources you so generously provide.
    Reset Costs
        Costs categorized as ``reset'' meet one of the following criteria:
    maintenance and supply activities that restore and enhance combat
    capability to unit and prepositioned equipment; replace or repair
    equipment destroyed, damaged, stressed, or worn out beyond economic
    repair; or enhance capabilities, where applicable, with the most up-to-
    date technology.
        Congressional support has been outstanding. Thus far, you have
    provided more than $12 billion toward reset. We thank you for this
    funding; it will help ensure that Marines have the equipment they need
    to properly train for and conduct combat operations.
    Equipment Readiness
        Sustained operations have subjected our equipment to more than a
    lifetime's worth of wear and tear stemming from mileage, operating
    hours, and harsh environmental conditions. The additional weight
    associated with armor plating further exacerbates the challenge of
    maintaining high equipment readiness. Current Marine Corps policy
    dictates that as forces rotate in and out of theater, their equipment
    remains in place. This policy action was accompanied by an increased
    maintenance presence in theater and has paid great dividends as our
    deployed ground force readiness remains above 90 percent. While we have
    witnessed a decrease in supply readiness rates for home station units,
    the delivery of supplemental procurements is beginning to bear fruit
    and we expect our readiness rates in supply to rise steadily.
    Aviation Equipment and Readiness
        Marine Corps Aviation supports our Marines in combat today while
    continuing to plan for crisis and contingency operations of tomorrow.
    Our legacy aircraft are aging, and we face the challenge of maintaining
    current airframes that have been subjected to heavy use in harsh,
    austere environments while we transition to new aircraft. Our aircraft
    have been flying at rates well above those for which they were
    designed; however, despite the challenge of operating in two theaters,
    our maintenance and support personnel have sustained a 74.5 percent
    aviation mission-capable rate for all Marine aircraft over the past 12
    months. We must continue to overuse these aging airplanes in harsh
    environments as we transition forces from Iraq to Afghanistan.
        To maintain sufficient numbers of aircraft in squadrons deployed
    overseas, our non-deployed squadrons have taken significant cuts in
    available aircraft and parts. Reset and supplemental funding have
    partially alleviated this strain, but we need steady funding for our
    legacy airframes as age, attrition, and wartime losses take their toll
    on our aircraft inventory.
    Prepositioning Programs
        Comprised of three Maritime Prepositioning Ships Squadrons (MPSRON)
    and other strategic reserves, the Marine Corps' prepositioning programs
    are a critical part of our ability to respond to current and future
    contingency operations and mitigate risk for the Nation. Each MPSRON,
    when married with a fly in echelon, provides the equipment and
    sustainment of a 17,000-man Marine Expeditionary Brigade for employment
    across the full range of military operations. Withdrawal of equipment
    from our strategic programs has been a key element in supporting combat
    operations, growth of the Marine Corps, and other operational
    priorities. Generous support from the Congress has enabled long-term
    equipment solutions, and as a result, shortfalls within our strategic
    programs will be reset as equipment becomes available from industry.
                Maritime Prepositioning Squadrons (MPSRON)
        Our MPSRONs will be reset with the most capable equipment possible,
    and we have begun loading them with capabilities that support lower
    spectrum operations while still maintaining the ability to generate
    Marine Expeditionary Brigades capable of conducting major combat
    operations. The MPSRONs are currently rotating through Maritime
    Prepositioning Force Maintenance Cycle-9. MPSRON-1 completed MPF
    Maintenance Cycle-9 in September 2008 and is currently at 86 percent of
    its full equipment set. As I addressed in my 2008 report, equipment
    from MPSRON-1 was required to outfit new units standing up in fiscal
    year 2007 and fiscal year 2008 as part of our end strength increase to
    202,000. MPSRON-1 is expected to be fully reset at the completion of
    its next maintenance cycle in 2011.
        MPSRON-2 is currently undergoing its rotation through MPF
    Maintenance Cycle-9. Equipment from MPSRON-2 was offloaded to support
    Operation IRAQI FREEDOM and much of that equipment remains committed to
    forward operations today. With projected deliveries from industry,
    MPSRON-2 will complete MPF Maintenance Cycle-9 in June 2009 with
    approximately 90 percent of its planned equipment set. Our intent is to
    finish the reset of MPSRON-2 when it completes MPF Maintenance Cycle-10
    in fiscal year 2012. MPSRON-3 was reset to 100 percent of its equipment
    set during MPF Maintenance Cycle-8 in March 2007 and remains fully
    capable.
        We are currently in the process of replacing the aging, leased
    vessels in the Maritime Prepositioning Force with newer, larger, and
    more flexible government owned ships from the Military Sealift Command
    fleet. Two decades of equipment growth and recent armor initiatives
    have strained the capability and capacity of our present fleet--that
    was designed to lift a Naval Force developed in the early 1980s. As we
    reset MPF, these changes are necessary to ensure we incorporate hard
    fought lessons from recent combat operations.
        Five of the original 13, leased Maritime Prepositioning Ships will
    be returned to Military Sealift Command by July 2009. In their place,
    we are integrating 3 of Military Sealift Command's 19 large, medium-
    speed, roll-on/roll-off ships (LMSR), a fuel tanker and a container
    ship into the MPF Program. One LMSR was integrated in September 2008
    and two more are planned for January 2010 and January 2011. The fuel
    tanker and container ship will be incorporated in June 2009. These
    vessels will significantly expand MPF's capacity and flexibility and
    will allow us to reset and optimize to meet current and emerging
    requirements. When paired with our amphibious ships and landing craft,
    the LMSRs provide us with platforms from which we can develop advanced
    seabasing doctrine and tactics, techniques, and procedures for
    utilization by the Maritime Prepositioning Force (Future) program.
                Marine Corps Prepositioning Program: Norway
        The Marine Corps Prepositioning Program--Norway (MCPP-N) was also
    used to source equipment in support of current operations in both
    Operations Iraqi and Enduring Freedom and to provide humanitarian
    assistance in Georgia. The Marine Corps continues to reset MCPP-N in
    accordance with our operational priorities while also exploring other
    locations for geographic prepositioning that will enable combat and
    theater security cooperation operations in support of forward deployed
    Naval Forces.
                             modernize for tomorrow
        Surprise is inevitable; however, its potentially disastrous effects
    can be mitigated by a well-trained, well-equipped, and disciplined
    force--always prepared for the crises that will arise. To that end and
    taking into account the changing security environment and hard lessons
    learned from 7 years of combat, the Marine Corps recently completed an
    initial review of its Operating Forces' ground equipment requirements.
    Recognizing that our unit Tables of Equipment (T/E) did not reflect the
    challenges and realities of the 21st century battlefield, the Corps
    adopted new T/Es for our operating units. This review was synchronized
    with our modernization plans and programs, and provided for enhanced
    mobility, lethality, sustainment, and command and control across the
    MAGTF. They reflect the capabilities required not only for the Corps'
    current mission, but for its future employment across the range of
    military operations, against a variety of threats, and in diverse
    terrain and conditions. The MAGTF T/E review is an integral part of the
    critical work being done to reset, reconstitute, and revitalize the
    Marine Corps.
        Additionally, we recently published the Marine Corps Vision and
    Strategy 2025, which guides our development efforts over the next two
    decades. Programs such as the Expeditionary Fighting Vehicle and the
    Joint Strike Fighter are critical to our future preparedness.
    Congressionally-mandated to be ``the most ready when the Nation is
    least ready,'' your multi-capable Corps will be where the Nation needs
    us, when the Nation needs us, and will prevail over whatever challenge
    we face.
    Urgent Needs Process
        The Marine Corps Urgent Needs Process synchronizes abbreviated
    requirements, resourcing, and acquisition processes in order to
    distribute mission-critical warfighting capabilities on accelerated
    timelines. Operating forces use the Urgent Universal Need Statement to
    identify mission-critical capability gaps and request interim
    warfighting solutions to these gaps. Subject to statutes and
    regulations, the abbreviated process is optimized for speed and
    involves a certain degree of risk with regard to doctrine,
    organization, training, materiel, leadership and education, personnel,
    and facilities integration and sustainment, along with other deliberate
    process considerations. A Web-based system expedites processing;
    enables stakeholder visibility and collaboration from submission
    through resolution; and automates staff action, documentation, and
    approval. This Web-based system is one of a series of process
    improvements that, reduced average time from receipt through Marine
    Requirements Oversight Council decision from 142 days (December 2005
    through October 2006) to 85 days (November 2006 through October 2008).
    Enhancing Individual Survivability
        We are providing Marines the latest in Personal Protection
    Equipment (PPE)--such as the Scalable Plate Carrier, Modular Tactical
    Vest, Lightweight Helmet, and Flame Resistant Organizational Gear
    (FROG). The Scalable Plate Carrier features a smaller area of coverage
    to reduce weight, bulk, and heat load for operations at higher
    elevations like those encountered in Afghanistan. Coupled with the
    Modular Tactical Vest, the Scalable Plate Carrier provides commanders
    options to address various mission/threat requirements. Both vests use
    Enhanced Small Arms Protective Inserts (E-SAPI) and Side SAPI plates
    and provide the best protection available against a wide variety of
    small arms threats--including 7.62 mm ammunition.
        The current Lightweight Helmet provides a high degree of protection
    against fragmentation threats and 9 mm bullets, and we continue to
    challenge industry to develop a lightweight helmet that will stop the
    7.62 mm round. The lifesaving ensemble of Flame-Resistant
    Organizational Gear (FROG) clothing items help to mitigate potential
    heat and flame injuries to our Marines from improvised explosive
    devices.
        We are also upgrading our Counter Radio-controlled Electronic
    Warfare (CREW) systems to meet evolving threats. Our Explosive Ordnance
    Disposal (EOD) equipment has been reconfigured and modernized to be
    used with CREW systems and has provided EOD technicians the capability
    of remotely disabling IEDs.
    Marine Aviation Plan
        The fiscal year 2009 Marine Aviation Plan provides the way ahead
    for Marine Aviation through fiscal year 2018, with the ultimate long-
    range goal of fielding an all-short-takeoff/vertical landing aviation
    force by 2025. We will continue to transition from our 12 legacy
    aircraft models to six new airframes and expand from 64 to 69 flying
    squadrons while adding 565 officers and more than 4,400 enlisted
    Marines.
                Joint Strike Fighter (JSF)
        The F-35 Lightning II, Joint Strike Fighter, will provide the
    Marine Corps with an affordable, stealthy, high performance, multi-role
    jet aircraft to operate in the expeditionary campaigns of the future.
    The JSF acquisition program was developed using the concept of cost as
    an independent variable (CAIV), which demands affordability, aggressive
    management, and preservation of the warfighting requirement. The F-
    35B's cutting edge technology and STOVL design offer greater safety,
    reliability, and lethality than today's tactical aircraft.
        This aircraft will be the centerpiece of Marine Aviation. Our
    program of record is to procure 420 aircraft (F-35B, STOVL). Our first
    flight of the STOVL variant was conducted in the summer of 2008, and
    the manufacture of the first 19 test aircraft is well under way, with
    assembly times better than planned. We will reach initial operational
    capability in 2012, with a standing squadron ready to deploy.
                MV-22 Osprey
        The MV-22 is the vanguard of revolutionary assault support
    capability and is currently replacing our aged CH-46E aircraft. In
    September 2005, the MV-22 Defense Acquisition Board approved Full Rate
    Production, and MV-22 Initial Operational Capability was declared on 1
    June 2007, with a planned transition of two CH-46E squadrons per year
    thereafter. We have 90 operational aircraft, a quarter of our planned
    total of 360. These airframes are based at Marine Corps Air Station New
    River, North Carolina; and Pawtuxet River, Maryland. Recently, we
    welcomed back our third MV-22 squadron from combat. By the end of
    fiscal year 2009, we will have one MV-22 Fleet Replacement Training
    Squadron, one test squadron, and six tactical VMM squadrons.
        The MV-22 program uses a block strategy in its procurement. Block A
    aircraft are training aircraft and Block B are operational aircraft.
    Block C aircraft are operational aircraft with mission enhancements
    that will be procured in fiscal year 2010 and delivered in fiscal year
    2012.
        Teaming with Special Operations Command, we are currently on
    contract with BAE systems for the integration and fielding of a 7.62mm,
    all aspect, crew served, belly mounted weapon system that will provide
    an enhanced defensive suppressive fire capability. Pending successful
    developmental and operational testing we expect to begin fielding
    limited numbers of this system later in 2009.
        This aircraft, which can fly higher, faster, farther, and longer
    than the CH-46, provides dramatically improved support to the MAGTF and
    our Marines in combat. On deployments, the MV-22 is delivering Marines
    to and from the battlefield faster, ultimately saving lives with its
    speed and range. Operating from Al Asad, the MV-22 can cover the entire
    country of Iraq. The Marine Corps asked for a transformational assault
    support aircraft--and Congress answered.
                KC-130J Hercules
        The KC-130J Hercules is the workhorse of Marine aviation, providing
    state-of-the-art, multi-mission capabilities; tactical aerial
    refueling; and fixed-wing assault support. KC-130Js have been deployed
    in support of Operations IRAQI FREEDOM and ENDURING FREEDOM and are in
    heavy use around the world.
        The success of the aerial-refuelable MV-22 in combat is tied to the
    KC-130J, its primary refueler. The forced retirement of the legacy KC-
    130F/R aircraft due to corrosion, fatigue life, and parts obsolescence
    requires an accelerated procurement of the KC-130J. In addition, the
    Marine Corps will replace its 28 reserve component KC-130T aircraft
    with KC-130Js, simplifying the force to one Type/Model/Series. The
    Marine Corps is continuing to plan for a total of 79 aircraft, of which
    34 have been delivered.
        In response to urgent requests from Marines currently engaged in
    combat in Afghanistan, additional capabilities are being rapidly
    fielded utilizing existing platforms and proven systems to enhance
    intelligence, surveillance, and reconnaissance (ISR) as well as fire
    support capability. The ISR/Weapon Mission Kit being developed for use
    onboard the KC-130J will enable the MAGTF commander to take advantage
    of the Hercules' extended endurance to provide persistent over-watch of
    ground units in a low-threat environment. A targeting sensor coupled
    with a 30mm cannon, Hellfire missiles, and/or standoff precision guided
    munitions will provide ISR coverage with a sting. Additionally, this
    added capability will not restrict or limit the refueling capability of
    the KC-130J. The USMC is rapidly pursuing fielding of the first two
    kits to support operations in Afghanistan in 2009.
                H-1 Upgrade
        The H-1 Upgrade Program (UH-1Y/AH-1Z) resolves existing operational
    UH-1N power margin and AH-1W aircrew workload issues while
    significantly enhancing the tactical capability, operational
    effectiveness, and sustainability of our attack and utility helicopter
    fleet. Our Vietnam-era UH-1N Hueys are reaching the end of their useful
    life. Due to airframe and engine fatigue, Hueys routinely take off at
    their maximum gross weight with no margin for error. Rapidly fielding
    the UH-1Y remains a Marine Corps aviation priority and was the driving
    force behind the decision to focus on UH-1Y fielding ahead of the AH-
    1Z. Three UH-1Ys deployed aboard ship with a Marine Expeditionary Unit
    in January of 2009.
        Twenty production H-1 aircraft (14 Yankee and 6 Zulu) have been
    delivered. Operation and Evaluation Phase II commenced in February
    2008, and as expected, showcased the strengths of the upgraded
    aircraft. Full rate production of the UH-1Y was approved during the
    fourth quarter fiscal year 2008 at the Defense Acquisition Board (DAB)
    with additional Low Rate Initial Production (LRIP) aircraft approved to
    support the scheduled fleet introduction of the AH-1Z in the first
    quarter of fiscal year 2011.
                CH-53K
        The CH-53K is a critical ship-to-objective maneuver and seabasing
    enabler; it will replace our CH-53E, which has been fulfilling our
    heavy lift requirements for over 20 years. The CH-53K will be able to
    transport 27,000 pounds externally to a range of 110 nautical miles,
    more than doubling the CH-53E lift capability under similar
    environmental conditions while maintaining the same shipboard
    footprint. Maintainability and reliability enhancements of the CH-53K
    will significantly decrease recurring operating costs and will
    radically improve aircraft efficiency and operational effectiveness
    over the current CH-53E. Additionally, survivability and force
    protection enhancements will dramatically increase protection for
    aircrew and passengers; thereby broadening the depth and breadth of
    heavy lift operational support to the joint task force commander.
    Initial Operational Capability for the CH-53K is scheduled for fiscal
    year 2015. Until then, we will upgrade and maintain our inventory of
    CH-53Es to provide heavy lift capability in support of our warfighters.
                Unmanned Aerial Systems (UAS)
        When fully fielded, the Corps' Unmanned Aerial Systems will be
    networked through a robust and interoperable command and control system
    that provides commanders an enhanced capability applicable across the
    spectrum of military operations. Revolutionary systems, such as those
    built into the Joint Strike Fighter, will mesh with these UAS to give a
    complete, integrated picture of the battlefield to ground commanders.
        Our Marine Expeditionary Forces have transitioned our Unmanned
    Aerial Vehicle Squadrons (VMU) to the RQ-7B Shadow; reorganized the
    squadrons' force structure to support detachment-based flexibility
    (operating three systems versus one for each squadron); and are
    preparing to stand up our fourth active component VMU squadron. The
    addition of a fourth VMU squadron is critical to sustaining operations
    by decreasing our deployment-to-dwell ratio--currently at 1:1--to a
    sustainable 1:2 ratio. This rapid transition and reorganization, begun
    in January 2007, will be complete by the middle of fiscal year 2010.
        In Iraq and Afghanistan, the Marine Corps is currently using an ISR
    Services contract to provide Scan Eagle systems to our forces, but we
    anticipate fielding Small Tactical UAS (STUAS), a combined Marine Corps
    and Navy program, in fiscal year 2011 to fill that void at the regiment
    and Marine Expeditionary Unit (MEU) level. In support of battalion-and-
    below operations, the Marine Corps is transitioning from the Dragon Eye
    to the joint Raven-B program.
                Airborne Electronic Attack (AEA)
        The EA-6B remains the premier electronic warfare platform within
    the Department of Defense. The Marine Corps is fully committed to the
    Prowler. While the Prowler continues to maintain a high deployment
    tempo, supporting operations against new and diverse irregular warfare
    threats, ongoing structural improvements and the planned Improved
    Capabilities III upgrades will enable us to extend the aircraft's
    service life through 2018.
        Beyond the Prowler, the future of electronic warfare for the Marine
    Corps will be comprised of a networked system-of-systems. The
    constituent components of this network include the F-35B Joint Strike
    Fighter, Unmanned Aerial Systems, Intelligence, Surveillance, and
    Reconnaissance pods and payloads, the Next Generation Jammer (NGJ), and
    ground systems already fielded or under development. Our future vision
    is to use the entire array of electronic warfare capabilities
    accessible as part of the distributed electronic warfare network. This
    critical and important distinction promises to make Marine Corps
    electronic warfare capabilities accessible, available, and applicable
    to all MAGTF and joint force commanders.
    Ground Tactical Mobility Strategy
        The Army and Marine Corps are leading the Services in developing
    the right tactical wheeled vehicle fleets for the joint force. Through
    a combination of resetting and replacing current systems and developing
    several new vehicles, our work will provide the joint force with
    vehicles of appropriate expeditionary mobility, protection level,
    payload, transportability, and sustainability. As we develop new
    vehicles, it is imperative that our ground tactical vehicles provide
    adequate protection while still being sized appropriately for an
    expeditionary force.
                Expeditionary Fighting Vehicle (EFV)
        The EFV is the cornerstone of the Nation's forcible entry
    capability and the Marine Corps is in a period of critical risk until
    the EFV is fielded. Based on current and future threats, amphibious
    operations must be conducted from over the horizon and at least 25
    nautical miles at sea. The EFV is the sole sea-based, surface oriented
    vehicle that can project combat power from the assault echelon over the
    horizon to the objective. EFVs are specifically suited to maneuver
    operations from the sea and sustained operations ashore. It will
    replace the aging Assault Amphibious Vehicle, which has been in service
    since 1972. Complementary to our modernized fleet of tactical vehicles,
    the EFV's amphibious mobility, day and night lethality, enhanced force
    protection capabilities, and robust communications will substantially
    improve joint force capabilities.
        During the program's Nunn-McCurdy restructure in June 2007, the EFV
    was certified to Congress as essential to National security. EFV System
    Development and Demonstration was extended 4\1/2\ years to allow for
    design reliability. The EFV program successfully released a Critical
    Design Review in the first quarter of fiscal year 2009 during a
    capstone event that assessed the EFV design as mature with a predicted
    reliability estimate of 61 hours mean time between operational mission
    failures greatly exceeding the exit criteria of 43.5 hours. These
    improvements will be demonstrated during the Developmental Test and
    Operational Test phases starting second quarter fiscal year 2010 on the
    seven new EFV prototypes currently being manufactured at the Joint
    Services Manufacturing Center in Lima, Ohio. The Low Rate Initial
    Production decision is programmed for fiscal year 2012. The current
    acquisition objective is to produce 573 EFVs. Initial Operational
    Capability is scheduled for 2015 and Full Operational Capability is
    scheduled for 2025.
                Mine Resistant Ambush Protected (MRAP) Vehicles
        The Marine Corps is executing this joint urgent requirement to
    provide as many highly survivable vehicles to theater as quickly as
    possible. In November 2008, the Joint Requirements Oversight Council
    established a new 16,238-vehicle requirement for all Services and
    SOCOM. The current Marine Corps requirement of 2,627 vehicles supports
    our in-theater operations and home station training and was satisfied
    in June 2008. We are currently developing modifications that will
    provide for greater off-road mobility and utility in an Afghan
    environment in those vehicles that have been procured.
    Vehicle Armoring
        The evolving threat environment requires proactive management of
    tactical wheeled vehicle programs in order to provide Marine
    warfighters with the most well protected, safest vehicles possible
    given technological limitations. Force protection has always been a
    priority for the Marine Corps. We have fielded a Medium Tactical
    Vehicle Replacement (MTVR) Armor System for the MTVR; Fragmentation
    Armor Kits for the High Mobility Multipurpose Wheeled Vehicles (HMMWV);
    Marine Armor Kits (MAK) armor for the Logistics Vehicle System (LVS);
    and the Mine Resistant Ambush Protected (MRAP) vehicles. We have
    developed increased force protection upgrades to the MTVR Armor System,
    safety upgrades for the HMMWVs, and are developing improved armor for
    the Logistics Vehicle System. We will continue to work with the Science
    & Technology community and with our sister Services to develop and
    apply technology as required to address force protection. Congressional
    support for our force protection efforts has been overwhelming, and we
    ask that Congress continue their life-saving support in the coming
    years.
    Marine Air Ground Task Force (MAGTF) Fires
        In 2007, we initiated ``The MAGTF Fires Study.'' This study
    examined the current organic fire support of the MAGTF to determine the
    adequacy, integration, and modernization requirements for ground,
    aviation, and naval surface fires. The study concluded that the MAGTF/
    Amphibious Task Force did not possess an adequate capability to engage
    moving armored targets and to achieve a volume of fires in all weather
    conditions around the clock. This deficiency is especially acute during
    Joint Forcible Entry Operations. We are currently conducting a study
    with the Navy to analyze alternatives for meeting our need for naval
    surface fires during this phase. Additionally, we performed a
    supplemental historical study using Operation IRAQI FREEDOM data to
    examine MAGTF Fires across the range of military operations. These
    studies reconfirmed the requirement for a mix of air, naval surface,
    and ground-based fires as well as the development of the Triad of
    Ground Indirect Fires.
                Triad of Ground Indirect Fires
        The Triad of Ground Indirect Fires provides for complementary,
    discriminating, and non-discriminating fires that facilitate maneuver
    during combat operations. The Triad requires three distinct systems to
    address varying range and volume requirements. Offering improved
    capabilities and mobility, the M777 is a medium-caliber artillery piece
    that is currently replacing the heavy and aged M198 Howitzer. The High
    Mobility Artillery Rocket System is an extended range, ground-based
    rocket capability that provides precision and volume fires. The
    Expeditionary Fire Support System (EFSS) is a towed 120mm mortar. It
    will be the principal indirect fire support system for heli-borne and
    tilt rotor-borne forces executing Ship-to-Objective Maneuver. When
    paired with an Internally Transportable Vehicle, the EFSS can be
    transported aboard MV-22 Osprey and CH-53E aircraft. EFSS-equipped
    units will have immediately responsive, organic indirect fires at
    ranges beyond those of current infantry battalion mortars. Initial
    operational capability is planned in 2009 with full operational
    capability expected for fiscal year 2012.
                Naval Surface Fire Support
        In the last year, the Naval Services have focused on reinvigorating
    our strategy for building naval surface fire support capable of
    engaging targets at ranges consistent with our Ship-to-Objective
    Maneuver concept. In March 2008, the Extended Range Guided Munition
    development effort, which was designed to provide naval gunfire at
    ranges up to 53 nautical miles, was cancelled due to numerous technical
    and design flaws. The DDG 1000 program, which provides for an Advanced
    Gun System firing the Long Range Land Attack Projectile 70 nautical
    miles as well as for the Dual Band RADAR counter-fire detection
    capability, was truncated as priorities shifted to countering an
    emerging ballistic missile threat. As a result, the Marine Corps and
    Navy are committed to re-evaluating methods for providing required
    naval fires.
                Aviation Fires
        Marine aviation is a critical part of the MAGTF fires capability.
    The Joint Strike Fighter will upgrade missile and bomb delivery,
    combining a fifth-generation pilot-aircraft interface, a 360-degree
    view of the battlefield, and a new generation of more lethal air-
    delivered ordnance coming online through 2025. Systems, such as
    Strikelink, will mesh forward air controllers with pilots and infantry
    officers at all levels. Laser and global positioning systems will
    provide terminal phase precision to less-accurate legacy bombs,
    missiles and rockets, providing more-lethal, all-weather aviation
    fires.
    Infantry Weapons
        We are also developing infantry weapons systems based on our combat
    experience and supporting studies. These systems not only support the
    current fight, but also posture Marines to respond across the full
    spectrum of war. Our goals include increased lethality and combat
    effectiveness, reduced weight, improved modularity, and integration
    with other combat equipment. The Marine Corps and Army are co-leading a
    joint Service capabilities analysis in support of future developments.
        The M16A4 and the M4 carbine are collectively referred to as the
    Modular Service Weapon. While both weapons have proven effective and
    reliable in combat operations, we must continually seek ways of
    improving the weapons with which we equip our warriors. With that in
    mind, we are re-evaluating current capabilities and determining
    priorities for a possible future service rifle and pistol.
        We are in the process of acquiring the Infantry Automatic Rifle,
    which is shorter and lighter than the M249 Squad Automatic Weapon and
    will enable the automatic rifleman to keep pace with the fire team
    while retaining the capability to deliver accurate and sustained
    automatic fire in all tactical environments. The Infantry Automatic
    Rifle will increase the lethality of our rifle squads while reducing
    logistical burden.
        The Marine Corps is also upgrading its aging Shoulder-launched
    Multipurpose Assault Weapon (SMAW) with a lighter launcher and enhanced
    targeting and fire control. In concert with this, we are developing a
    ``fire from enclosure'' rocket that will enable Marines to fire the
    SMAW from within a confined space.
                Non-lethal Weapons
        Our joint forces will continue to operate in complex security
    environments where unintended casualties and infrastructure damage will
    work against our strategic goals. Therefore, our warfighters must have
    the capability to respond using both lethal and non-lethal force. As
    the Executive Agent for the Department of Defense Non-Lethal Weapons
    Program, the Marine Corps oversees and supports joint Service
    operational requirements for non-lethal weapons and their development
    to meet identified capability gaps. Our efforts extend across the
    globe, as reflected by the Department of Defense's engagement with the
    North Atlantic Treaty Organization in identifying emerging non-lethal
    capabilities. Directed-energy technology is proving to hold much
    promise for the development of longer-range, more effective non-lethal
    weapons. Non-lethal weapon applications will provide new options for
    engaging personnel, combating small boat threats, and stopping
    vehicles, and are critical to our success against today's hybrid
    threats.
    Command and Control
        The Marine Corps' Command and Control Harmonization Strategy
    articulates our goal of delivering seamless support to Marines. We are
    taking the best of emerging technologies to build an integrated set of
    capabilities that includes the Common Aviation Command and Control
    System (CAC2S), Joint Tactical Radio System, Very Small Aperture
    Terminal, the Combat Operations Center (COC), Joint Tactical COP
    Workstation, and Blue Force tracking system.
                Combat Operations Center (COC)
        By 2010, the MAGTF Combat Operations Center capability will
    integrate air and ground tactical situations into one common picture.
    The COC program has a current Authorized Acquisition Objective of 260
    systems, of which 242 are COCs supporting regimental/group-size and
    battalion/squadron-size operating forces. As of 1 May 2009, 22 COCs
    have been deployed overseas in support of units participating in
    Operation IRAQI FREEDOM; 16 COCs are deployed in support of Operation
    ENDURING FREEDOM. COC systems will eventually support the warfighter
    from the Marine Expeditionary Force-level to the company-level and
    below.
    Marine Corps Enterprise Network (MCEN)
        The Marine Corps Enterprise Network (MCEN) enables the Marine
    Corps' warfighters and business domains to interface with joint forces,
    combatant commands, and the other Services on our classified and
    unclassified networks.
        To meet the growing demands for a modern, networked force, the
    Marine Corps, as part of a Department of Navy-led effort, is
    transitioning its Non-Secure Internet Protocol Routing Network
    (NIPRNET) from the contract owned and contract operated Navy-Marine
    Corps Intranet (NMCI) to a government owned and government operated
    Next Generation Enterprise Network (NGEN). This transition will provide
    the Marine Corps unclassified networks increased security, control, and
    flexibility.
        The Marine Corps continues to invest in the expansion and
    enhancement of our Secret Internet Protocol Routing Network (SIPRNET)
    to ensure a highly secure and trusted classified network that meets our
    operational and intelligence requirements.
        The Marine Corps has enhanced its security posture with a defense-
    in-depth strategy to respond to cyber threats while maintaining network
    accessibility and responsiveness. This layered approach, aligned with
    Department of Defense standards, provides the Marine Corps networks
    that support our warfighting and business operations while protecting
    the personal information of our Marines, Sailors, and their families.
    Intelligence, Surveillance, and Reconnaissance (ISR)
        We continue to improve the quality, timeliness, and availability of
    actionable intelligence through implementation of the Marine Corps
    Intelligence, Surveillance, and Reconnaissance Enterprise (MCISR-E).
    This approach incorporates Marine Corps ISR capabilities into a
    flexible framework that enables us to collect, analyze, and rapidly
    exchange information necessary to facilitate increased operational
    tempo and effectiveness. Through development of the Distributed Common
    Ground System--Marine Corps (DCGS-MC), the enterprise will employ fully
    integrated systems architecture compliant with joint standards. This
    will allow our units to take advantage of joint, national, interagency,
    and coalition resources and capabilities, while making our intelligence
    and combat information available to the same. MCISR-E will integrate
    data from our ground and aerial sensors as well as from non-traditional
    intelligence assets, such as from battlefield video surveillance
    systems, Joint Strike Fighter sensors, and unit combat reports. This
    will enhance multi-discipline collection and all-source analytic
    collaboration. Additionally, MCISR-E will improve interoperability with
    our command and control systems and facilitate operational reach-back
    to the Marine Corps Intelligence Activity and other organizations.
        Recent growth in intelligence personnel permitted us to establish
    company-level intelligence cells, equipped with the tools and training
    to enable every Marine to be an intelligence collector and consumer.
    This capability has improved small unit combat reporting and enhanced
    operational effectiveness at all levels. Collectively, these efforts
    provide an adaptive enterprise that supports Marine Air-Ground Task
    Force intelligence requirements across the full range of military
    operations.
    Improved Total Life Cycle Management
        To assure effective warfighting capabilities, we are improving the
    Total Life Cycle Management of ground equipment and weapons systems.
    Overall mission readiness will be enhanced through the integration of
    the Total Life Cycle Management value stream with clear aligned roles,
    responsibilities, and relationships that maximize the visibility,
    supportability, availability, and accountability of ground equipment
    and weapons systems.
        This will be accomplished through the integration of activities
    across the life cycle of procuring, fielding, sustaining, and disposing
    of weapon systems and equipment. Some of the expected benefits include:
      --``Cradle to grave'' material life cycle management capability
      --Clearly defined roles and responsibilities for life cycle
            management across the enterprise
      --Availability of reliable fact-based information for decision making
      --Full cost visibility
      --Full asset visibility
      --Standardized processes and performance metrics across the
            enterprise
      --Improved internal management controls
    Water and Energy Conservation
        The Marine Corps believes in good stewardship of water and energy
    resources aboard our installations. In April 2009, we published our
    Facilities Energy & Water Management Campaign Plan, which includes the
    steps we are taking to reduce greenhouse gas emissions and our
    dependence on foreign oil. In our day-to-day operations and long-term
    programs, we intend to reduce the rate of energy use in existing
    facilities, increase energy efficiency in new construction and
    renovations, expand the use of renewable resources, reduce usage rates
    of water on our installations, and improve the security and reliability
    of energy and water systems.
                    a naval force, for employment as a magtf
        Your Corps provides the Nation a multi-capable naval force that
    operates across the full range of military operations. The Navy, Marine
    Corps, and Coast Guard will soon publish the Naval Operations Concept
    2009 (NOC 09). This publication describes how, when, and possibly where
    U.S. naval forces will prevent conflict--and/or prevail in war--as part
    of a maritime strategy. In this era of strategic uncertainty, forward
    deployed naval forces are routinely positioned to support our national
    interests. The ability to overcome diplomatic, geographic, and anti-
    access impediments anywhere on the globe is a capability unique to
    naval forces. Our strategies and concepts address the following
    requirements: The ability to maintain open and secure sea lines of
    communication for this maritime nation; the ability to maneuver over
    and project power from the sea; the ability to work with partner
    nations and allies to conduct humanitarian relief or non-combatant
    evacuation operations; and the ability to conduct sustained littoral
    operations along any coastline in the world. These strategies and
    concepts highlight the value of naval forces to the Nation and
    emphasize the value of our Marine Corps-Navy team.
    Seabasing
        The ability to operate independently from the sea is a core
    capability of the Navy and Marine Corps. Seabasing is our vision of
    future joint operations from the sea. Seabasing is the establishment of
    a port, an airfield, and a replenishment capability at sea through the
    physical coupling and interconnecting of ships beyond the missile range
    of the enemy. We believe sea-based logistics, sea-based fire support,
    and the use of the ocean as a medium for tactical and operational
    movement will permit our expeditionary forces to move directly from
    their ships to the objectives--on the shoreline or far inland. From
    that base at sea--with no footprint ashore--we will be able to conduct
    the full range of operations, from forcible entry to disaster relief or
    humanitarian assistance.
    Forcible Entry
        Naval forces afford the Nation's only sustainable forcible entry
    capability. Two Marine Expeditionary Brigades (MEBs) constitute the
    assault echelon of a sea-based Marine Expeditionary Force. Each MEB
    assault echelon requires 17 amphibious warfare ships--resulting in an
    overall ship requirement of 34 operationally available amphibious
    warfare ships. In order to meet a 34-ship availability rate based on a
    Chief of Naval Operations approved maintenance factor of 10 percent
    (not available for deployment), this calls for an inventory of 38
    amphibious ships. This amphibious fleet must be composed of not less
    than 11 amphibious assault ships (LHA/LHD), 11 amphibious transport
    dock ships (LPD-17 class), and 12 dock landing ships (LSD), with 4
    additional amphibious ships, which could be either LPDs or LSDs. This
    arrangement accepts a degree of risk but is feasible if the assault
    echelons can be rapidly reinforced by the Maritime Prepositioning Force
    (future). The Navy and Marine Corps agreed to this requirement for 38
    amphibious warfare ships.
                LPD-17
        The recent deployment of the first of the San Antonio-class
    amphibious warfare ship demonstrates the Navy's commitment to a modern
    expeditionary power projection fleet that will enable our naval force
    to operate across the spectrum of conflict. It is imperative that, at a
    minimum, 11 of these ships be built to support the 2.0 MEB assault
    echelon amphibious lift requirement. Procurement of the 10th and 11th
    LPD remains one of our highest priorities. The Marine Corps recognizes
    and appreciates the support Congress has provided in meeting the
    requirement for 11 LPD-17 ships.
        To assist the Navy in transitioning to an optimum number and types
    of common hull forms, the LPD-17 remains the leading candidate for
    replacing the dock landing ships (LSD). Constructing new amphibious
    ships based on the incremental refinement of common hull forms will
    greatly enhance our ability to meet evolving MAGTF lift requirements.
    Critical to this strategy is the development of a shipbuilding schedule
    that will provide a smooth transition from legacy ship decommissioning
    to new ship delivery, minimizing operational risk while driving costs
    down.
        Today and in the future, LPD-17 class ships will play a key role by
    forward deploying Marines and their equipment to execute global
    commitments throughout all phases of engagement. The ship's flexible,
    open-architecture design will facilitate expanded force coverage and
    decrease reaction times of forward deployed Marine Expeditionary Units.
    It will also offer the capacity to maintain a robust surface assault
    and rapid off-load capability in support of combatant commander forward
    presence and warfighting requirements.
                LHA(R)/LH(X)
        A holistic amphibious shipbuilding strategy must ensure that our
    future warfighting capabilities from the sea are fully optimized for
    both vertical and surface maneuver capabilities. The MV-22 and Joint
    Strike Fighter, combined with CH-53 K and the UH-1 Y/Z, will provide an
    unparalled warfighting capacity for the combatant commanders. Two
    Amphibious Assault (Replacement) (LHA(R)) ships with enhanced aviation
    capabilities will replace two of the retiring Amphibious Assault (LHA)
    class ships and join the eight LHD class amphibious assault ships. The
    LHA(R) design traded surface warfare capabilities to provide enhanced
    aviation hangar and maintenance spaces to support aviation maintenance,
    increase jet fuel storage and aviation ordnance magazines, and increase
    aviation sortie generation rates.
        Operational lessons learned and changes in future operational
    concepts have caused changes in MAGTF equipment size and weight and
    have reinforced the requirement for amphibious ships with flexible
    surface interface capabilities. The Marine Corps remains committed to
    meeting the long-standing requirement for simultaneous vertical and
    surface maneuver capabilities from the seabase. Toward that end,
    follow-on big deck amphibious ship construction to replace LHAs will
    incorporate surface interface capabilities while retaining significant
    aviation enhancements of the LHA Replacement ship.
    Maritime Prepositioning Force (Future)
        The Maritime Prepositioning Force (Future) (MPF(F)) is a key
    Seabasing enabler and will build on the success of the legacy Maritime
    Prepositioning Force program. MPF(F) will provide support to a wide
    range of military operations, from humanitarian assistance to major
    combat operations, with improved capabilities such as at-sea arrival
    and assembly; selective offload of mission sets; persistent, long-term,
    sea-based sustainment; and at-sea reconstitution. The squadron is
    designed to provide combatant commanders a highly flexible operational
    and logistics support capability to meet widely varied expeditionary
    missions ranging from reinforcing and supporting the assault echelon
    during Joint Forcible Entry Operations to conducting independent
    operations throughout the remaining range of military operations. The
    squadron will preposition a single MEB's critical equipment and
    sustainment capability for delivery from the sea base without the need
    for established infrastructure ashore.
        The Acting Secretary of the Navy, the Chief of Naval Operations,
    and the Commandant of the Marine Corps approved MPF(F) squadron
    capabilities and ship composition in May 2005, as documented in the
    MPF(F) Report to Congress on 6 June 2005. Those required capabilities
    and ship composition remain fully valid today in meeting the full range
    of combatant commander mission requirements. The MPF(F) squadron is
    designed to be comprised of three aviation-capable ships, three
    modified Large Medium-Speed Roll-on/roll-off ships (LMSR), three Dry
    Cargo/Ammunition (T-AKE) supply ships, three Mobile Landing Platforms,
    and two legacy dense-packed (T-AK) ships.
                MPF(F) Aviation Capable Ships: ``An Airfield Afloat''
        MPF(F) aviation-capable ships are the key Seabasing enablers that
    set it apart from legacy prepositioning programs. These ships are
    multifaceted enablers that are vital to the projection of forces from
    the seabase, offering a new level of operational flexibility and reach.
    MPF(F) aviation capable ships contain the MEB's command and control
    nodes as well as medical capabilities, vehicle stowage, and berthing
    for the MEB. They serve as a base for rotary wing/tilt-rotor aircraft,
    thus supporting the vertical employment of forces to objectives up to
    110 nautical miles from the sea base as well as surface reinforcement
    via the LHD well deck. These ships allow for the stowage, operation,
    arming, control, and maintenance of aircraft in the seabase, which
    directly allows for the vertical and surface employment, projection,
    and sustainment of forces ashore.
        Without these ships, the MPF(F) squadron would have to compensate
    for the necessary operational capabilities and lift capacities,
    increasing the number of ships, modifying the remaining platforms in
    the squadron, and/or accepting significant additional operational risk
    in areas such as vertical maneuver, command and control, and medical.
                Mobile Landing Platform (MLP): ``A Pier in the Ocean''
        The Mobile Landing Platform (MLP) is perhaps the most flexible
    platform in the MPF(F) squadron. MLP will provide at-sea vehicle,
    equipment, and personnel transfer capabilities from the Large Medium
    Speed Roll-on/Roll-off ship (LMSR) to air-cushioned landing craft via
    the MLP's vehicle transfer system currently under development. The MLP
    also provides organizational and intermediate maintenance that enables
    the surface employment of combat ready forces from over the horizon. In
    short, the MLP is a highly flexible, multi-purpose intermodal
    capability that will be a key interface between wide varieties of
    seabased platforms. Instead of ships and lighters going to a terminal
    on shore, they will conduct at-sea transfers of combat-ready personnel,
    vehicles, and equipment to and from the MPF(F).
        Beyond its critical role within the MPF(F) squadron, the MLP also
    serves as the crucial joint interface platform with other Services and
    coalition partners. The MLP will possess an enhanced container-handling
    capability, allowing it to transfer containerized sustainment from
    military and commercial ships to forces ashore.
                Dry Cargo/Ammunition Ship (T-AKE): ``A Warehouse Afloat''
        The Dry Cargo/Ammunition Ship (T-AKE) is a selectively off-
    loadable, afloat warehouse ship that is designed to carry dry, frozen,
    and chilled cargo, ammunition, and limited cargo fuel. It is a
    versatile supply platform with robust underway replenishment
    capabilities for both dry and wet cargo that can re-supply other ships
    in the squadron and ground forces as required. Key holds are
    reconfigurable for additional flexibility. It has a day/night capable
    flight deck. The squadron's three T-AKEs will have sufficient dry cargo
    and ammunition capacities to provide persistent sustainment to the
    Marine Expeditionary Brigade operating ashore. The cargo fuel--in
    excess of a million gallons--will greatly contribute to sustaining the
    forces ashore. These ships can support the dry cargo and compatible
    ammunition requirements of joint forces and are the same ship class as
    the Combat Logistics Force T-AKE ships.
                Large Medium-Speed Roll-on/Roll-off (LMSR) Ship: ``Assembly
                        at Sea''
        A Large Medium Speed Roll on/Roll off ship (LMSR) platform will
    preposition MEB assets and will enable at-sea arrival and assembly
    operations and selective offload operations. Expansive vehicle decks
    and converted cargo holds will provide sufficient capacity to stow the
    MEB's vehicles, equipment, and supplies in an accessible configuration.
    This, combined with selective offload via the MLP's vehicle transfer
    system, will permit at-sea arrival and assembly operations within the
    ship. The LMSR will have sufficient berthing for assembly and
    integration of MEB personnel and associated vehicles and equipment.
    LMSR modifications will include two aviation operating spots, underway
    replenishment equipment, a controlled assembly area, and ordnance
    magazines and elevators. Specific modifications, such as the side port
    hatch design and inclusion of anti-roll tanks, will facilitate
    employing the MLP's vehicle transfer system with the MPF(F) LMSR during
    seabased operations. The LMSR will also have dedicated maintenance
    areas capable of supporting organizational intermediate maintenance
    activities for all ground combat equipment.
                            our marines and families
        While our deployed Marines never question the need or ability to
    live in an expeditionary environment and harsh climates, they have
    reasonable expectations that their living quarters at home station will
    be clean and comfortable. Those who are married want their families to
    enjoy quality housing, schools, and family support. It is a moral
    responsibility for us to support them in these key areas. A quality of
    life survey we conducted in late 2007 reflected that despite the
    current high operational tempo, Marines and spouses were satisfied with
    the support they receive from the Marine Corps. Marines make an
    enduring commitment to the Corps when they earn the title Marine. In
    turn, the Corps will continue its commitment to Marines and their
    families. We extend our sincere appreciation for Congress' commitment
    to this Nation's wounded warriors and their direction for the
    establishment of Centers of Excellence within the Department of Defense
    that address Traumatic Brain Injury, Post-traumatic Stress Disorder,
    eye injuries, hearing loss, and a joint Department of Defense/
    Department of Veterans Affairs Center addressing loss of limbs.
    Family Readiness Programs
        Last year, we initiated a multi-year plan of action to put our
    family support programs on a wartime footing. We listened to our
    families and heard their concerns. We saw that our commanders needed
    additional resources, and we identified underfunded programs operating
    largely on the strength and perseverance of hard-working staff and
    volunteers.
        To address the above concerns, we have established full-time Family
    Readiness Officer billets in more than 400 units and have also acted to
    expand the depth and breadth of our family readiness training programs.
    The Family Readiness Officer is supported in this mission by the Marine
    Corps Community Services Program. For the families communication with
    their deployed Marines is their number one quality of life requirement.
    With the Family Readiness Officer serving as the focal point, we have
    used information technology tools to expand the communication between
    Marines and their families.
        These initiatives and others demonstrate the commitment of the
    Marine Corps to our families and underscore the significance of family
    readiness to mission readiness. We thank Congress for the supplemental
    funding during fiscal years 2008 and 2009 that enabled initial start-
    up. Beginning in fiscal year 2010, the funding required to maintain
    these critical programs will be part of our baseline budget.
    Casualty Assistance
        Our casualty assistance program is committed to ensuring that
    families of our fallen Marines are treated with the utmost compassion,
    dignity, and honor. We have taken steps to correct the unacceptable
    deficiencies in our casualty reporting process that were identified in
    congressional hearings and subsequent internal reviews.
        Marine Corps commands now report the initiation, status, and
    findings of casualty investigations to the Headquarters Casualty
    Section in Quantico, which has the responsibility to ensure the next of
    kin receive timely notification of these investigations from their
    assigned Casualty Assistance Calls Officer.
        The Headquarters Casualty Section is a 24-hour-per-day operation
    manned by Marines trained in casualty reporting, notification, and
    casualty assistance procedures. These Marines have also taken on the
    additional responsibility of notifying the next of kin of wounded,
    injured, and ill Marines.
        In October 2008, we implemented a mandatory training program for
    Casualty Assistance Calls Officers that includes a Web-based capability
    to expand the reach of the course. This training covers notification
    procedures, benefits and entitlements, mortuary affairs, and grief and
    bereavement issues. We will continue to monitor the effectiveness of
    these changes and make adjustments where warranted.
    Wounded Warrior Regiment
        The Marine Corps is very proud of the positive and meaningful
    impact that the Wounded Warrior Regiment is having on wounded, ill, and
    injured Marines, Sailors, and their families. Just over 18 months ago,
    we instituted a comprehensive and integrated approach to Wounded
    Warrior care and unified it under one command. The establishment of the
    Wounded Warrior Regiment reflects our deep commitment to the welfare of
    our wounded, ill, and injured, and their families throughout all phases
    of recovery. Our single process provides active duty, reserve, and
    separated Marines with non-medical case management, benefit information
    and assistance, resources and referrals, and transition support. The
    nerve center of our Wounded Warrior Regiment is our Wounded Warrior
    Operations Center--where no Marine is turned away.
        The Regiment strives to ensure programs and processes adequately
    meet the needs of our wounded, ill, and injured and that they remain
    flexible to preclude a one-size-fits-all approach to that care. For
    example, we have transferred auditing authority for pay and
    entitlements from the Defense Finance and Accounting Service in
    Cleveland directly to the Wounded Warrior Regiment, where there is a
    comprehensive awareness of each wounded Marine's individual situation.
    We have also designed and implemented a Marine Corps Wounded, Ill, and
    Injured Tracking System to maintain accountability and case management
    for the Marine Corps Comprehensive Recovery Plan. To ensure effective
    family advocacy, we have added Family Readiness Officers at the
    Regiment and our two battalions to support the families of our wounded,
    ill, and injured Marines.
        While the Marine Corps is aggressively attacking the stigma and
    lack of information that sometimes prevents Marines from asking for
    help, we are also proactively reaching out to those Marines and Marine
    veterans who may need assistance. Our Sergeant Merlin German Wounded
    Warrior Call Center not only receives calls from active duty and former
    Marines, but also conducts important outreach calls. In the past year,
    the Marine Corps added Battalion contact cells that make periodic
    outreach to Marines who have returned to duty in order to ensure their
    recovery needs are being addressed and that they receive information on
    any new benefits. The Call centers between them have made over 40,000
    calls to those Marines injured since September 2001 to assess how they
    are doing and offer our assistance.
        To enhance reintegration, our Job Transition Cell, manned by
    Marines and representatives of the Departments of Labor and Veterans
    Affairs, has been proactively reaching out to identify and coordinate
    with employers and job training programs to help our wounded warriors
    obtain positions in which they are most likely to succeed and enjoy
    promising careers. One example is our collaboration with the U.S. House
    of Representatives to establish their Wounded Warrior Fellowship
    Program for hiring disabled veterans to work in congressional offices.
        The Marine Corps also recognizes that the needs of our wounded,
    ill, and injured Marines and their families are constantly evolving. We
    must ensure our wounded Marines and their families are equipped for
    success in today's environment and in the future.
        As we continue to improve the care and management of our Nation's
    wounded, the Marine Corps is grateful to have the support of Congress.
    In addition to the support provided in the fiscal year 2009 National
    Defense Authorization Act, I would like to thank you for your personal
    visits to our Wounded Warriors in the hospital wards where they are
    recovering and on the bases where they live. The Marine Corps looks
    forward to continuing to work with Congress in ensuring that our
    wounded, ill, and injured Marines receive the best care, resources, and
    opportunities possible.
    Traumatic Brain Injury (TBI)
        With 2,700 new cases of Marines with TBI entered into the
    Department of Defense and Veteran's Brain Injury Center (DVBIC) in
    calendar year 2008, we continue to see TBI as a significant challenge
    that we are confronting. Many of these new cases represent older
    injuries that are just now being diagnosed, and our expectation is
    that, with the institution of the Automated Neuropsychological
    Assessment Metrics (ANAM) for all Marines, we will discover mild
    Traumatic Brain Injuries more promptly post-deployment. While the
    Marine Corps is providing leadership and resources to deal with this
    problem, we cannot solve all the issues on our own.
        The Marine Corps continues to work closely with Military Medicine,
    notably DOD's Center of Excellence for Psychological Health and
    Traumatic Brain Injury, to advance our understanding of TBI and improve
    care for all Marines. We are grateful for your continued support in
    this area.
    Psychological Health Care
        Marine Corps commanders are fully engaged in promoting the
    psychological health of our Marines, Sailors, and family members. The
    message to our Marines is to look out for each other and to know that
    it is okay to get help. While culture change is hard to measure, we
    feel that the efforts we have made to reduce the stigma of combat
    stress are working.
        The Marine Corps Combat and Operational Stress Control Program
    encompasses a set of policies, training, and tools to enable leaders,
    individuals, and families to prepare for and manage the stress of
    operational deployment cycles. Our training emphasizes ways in which to
    recognize stress reactions, injuries, and illnesses early and manage
    them more effectively within operational units. Our assessments of
    stress responses and outcomes are rated on a continuum: unaffected;
    temporarily or mildly affected; more severely impaired but likely to
    recover; or persistently distressed or disabled. Combat stress deserves
    the same attention and care as any physical wound of war, and our
    leaders receive extensive training on how to establish an environment
    where it is okay to ask for help.
        To assist leaders with prevention, rapid identification, and early
    treatment of combat operational stress, we are expanding our program of
    embedding mental health professionals in operational units--the
    Operational Stress Control and Readiness (OSCAR) program--to provide
    direct support to all active and reserve ground combat elements. This
    will be achieved over the next 3 years through realignment of existing
    Navy structure supporting the operating forces, and increases in Navy
    mental health provider inventory. Our ultimate intent is to expand
    OSCAR to all elements of the Marine Air-Ground Task Force. In the
    interim, OSCAR teams are filled to the extent possible on an ad hoc
    basis with assets from Navy Medicine.
    Exceptional Family Member Program (EFMP)
        Last year, I reported on our intent to establish a continuum of
    care for our EFMP families. We are actively helping more than 6,000
    families in the Exceptional Family Member Program gain access to
    medical, educational, and financial care services that may be limited
    or restricted at certain duty stations. We have assigned case managers
    to all of our enrolled EFMP families, obtained the help of the Bureau
    of Medicine and Surgery and TRICARE to resolve health care concerns at
    several bases, and directed legal counsel to advise the EFMP and our
    families on State and Federal entitlements and processes. Additionally,
    we are developing assignment policies that will further facilitate the
    continuum of care.
        While no family should have to endure interruptions in care,
    gaining access to services can be most challenging to families who have
    Autism Spectrum Disorder (ASD). We sincerely appreciate the support of
    Congress for our ASD families and others who are entitled to the
    TRICARE Extended Care Health Option (ECHO) program. For fiscal year
    2009, you have increased the monthly reimbursement rate for Applied
    Behavioral Analysis (ABA)--a specific therapy that our Marine families
    value.
        However, there is still more to do. While appropriate TRICARE
    reimbursement rates are important, the highly specialized services
    these families require are not always available. We are evaluating how
    we can partner with other organizations to increase the availability of
    these specialized services in areas where resources are currently
    lacking.
    Water Contamination at Camp Lejeune
        Past water contamination at Camp Lejeune has been, and continues to
    be, a very important issue for the Marine Corps. Using good science,
    our goal is to determine whether past exposure to the contaminated
    water at Camp Lejeune resulted in any adverse health effects for our
    Marines, their families, or our civilian workers.
        The Marine Corps continues to support the Agency for Toxic
    Substances and Disease Registry (ATSDR) in their health study, which is
    estimated to be completed in late 2009. With the help of Congress, the
    National Academy of Sciences is assisting us in developing a way ahead
    on this difficult issue.
        The Marine Corps continues to make progress notifying former
    residents and workers. We have established a call center and registry
    where the public can provide contact information so that we can notify
    them when these health studies are complete.
        Our outreach efforts include a range of communication venues to
    include letters to individuals located from Department of Defense
    databases, paid print and broadcast advertising, publications in
    military magazines, press releases, and a fully staffed call center. As
    of 22 March 2009, we have had 131,000 total registrations and mailed
    more than 200,000 direct notifications.
    Sexual Assault Prevention and Response
        Sexual assault is a crime, and we take every reported incident very
    seriously. The impact on its victims and the corrosive effect on unit
    and individual readiness are matters of great concern. A recent
    Government Accountability Office study reported several shortcomings in
    our program. To address these findings, we are refreshing our training
    program and assessing the requirement to hire full-time Sexual Assault
    Prevention and Response Program coordinators at installations with
    large troop populations. We have trained more than 3,200 victim
    advocates to provide assistance upon the request. All Marines receive
    sexual assault prevention and awareness training upon entry and are
    required to receive refresher training at least annually. We have also
    incorporated sexual assault prevention into officer and noncommissioned
    officer professional development courses and key senior leader
    conferences and working groups. At the request of our field commanders,
    we have also increased the number of Marine Corps judge advocates who
    attend specialized training on prosecution of these crimes and have
    assembled a mobile training team to teach our prosecutors how to better
    manage these cases.
    Suicide Prevention
        With 42 Marine suicides in 2008, we experienced our highest suicide
    rate since the start of Operation Enduring Freedom and Operation Iraqi
    Freedom. The number of confirmed Marine suicides has increased from 25
    in Calendar Year 2006, to 33 in 2007, to 42 in 2008. Through March
    2009, we have 8 presumed suicides this year, which place us on a
    trajectory for 32 this calendar year. Our numbers are disturbing; we
    will not accept them, or stand idle while our Marines and families
    suffer.
        Our studies have found that regardless of duty station, deployment,
    or duty status, the primary stressors associated with Marine suicides
    are problems in romantic relationships, physical health, work-related
    issues such as poor performance and job dissatisfaction, and pending
    legal or administrative action. This is consistent with other Services
    and civilian findings. Multiple stressors are usually present in
    suicide.
        In November 2008, we reviewed our suicide awareness and prevention
    program and directed the development of a leadership training program
    targeted at noncommissioned officers. As in combat, we will rely upon
    our corporals and sergeants to chart the course and apply their
    leadership skills to the challenge at hand. This program includes high-
    impact, engaging videos, and a Web-ready resource library to provide
    additional tools for identifying their Marines who appear at risk for
    suicide. Further, during March 2009, we required all of our commanders
    to conduct suicide prevention training for 100 percent of the Marines
    under their charge. This training educated Marines on the current
    situation in our Corps; it taught them how to identify the warning
    signs; it reinforced their responsibility as leaders; and it informed
    them of the resources available locally for support.
        The Marine Corps will continue to pursue initiatives to prevent
    suicides, to include reevaluating existing programs designed to reduce
    the stressors most correlated with suicidal behavior; developing and
    distributing new prevention programs; and refreshing and expanding
    training materials.
    Child Development Programs
        To ensure Children, Youth, and Teen Programs continue to transition
    to meet the needs of our families, a Functionality Assessment was
    conducted in June 2008 to identify program improvements, such as the
    development of staffing models to improve service delivery, as well as
    recommendations to explore and re-define services to meet the unique
    and changing needs of Marines and their families living both on and off
    our installations. In addition, the Marine Corps has expanded
    partnerships to provide long- and short-term support for geographically
    dispersed Marines. We can now provide 16 hours of reimbursed respite
    care per month for families with a deployed Marine. We are expanding
    our care capacity in many ways, including extended hours as well as
    through partnerships with Resource and Referral agencies, off-base
    family childcare, and Child Development Home spaces.
        We are currently providing 11,757 childcare spaces and meeting 63.6
    percent of the calculated total need. It is important to note that the
    Marine Corps has initiated rigorous data collection and analysis
    improvements. As a result, it will be necessary to correct the 2007
    annual summary due to identified reporting errors. Our reported rate of
    71 percent of potential need last year is more accurately stated as
    59.1 percent. We are not satisfied with our progress to date, and have
    planned for 10 Child Development Center Military Construction projects
    in Program Years 2008 through 2013. Two of those projects were executed
    in fiscal year 2008, and one is approved for fiscal year 2009. These
    approved projects will provide an additional 915 spaces.
        We also are considering additional modular Child Development
    Centers, subject to more detailed planning and availability of funds.
    Planned MILCON and modular centers would add approximately 2,600
    spaces, and although our need is expanding, based on our current
    calculations, this expansion would bring us much closer to the
    Department of Defense goal. Continued Congressional support will help
    us provide these needed facilities. As the needs of our families
    change, our program is committed to grow and adapt to meet these
    developments.
    School Liaison Program
        The education of more than 51,000 school-age children of Marine
    parents has been identified as a readiness and retention issue of great
    concern. Our Marine children, who are often as mobile as their military
    parent, face additional stress and challenges associated with frequent
    moves between schools with differing educational systems and standards.
    Exacerbating this is the varying degree of satisfaction Marines and
    their spouses have with the quality and sufficiency of local education
    systems. The Marine Corps is addressing this issue by establishing
    national, regional, and installation level School Liaison capability.
    The School Liaison will help parents and commanders interact with local
    schools, districts, and State governments to help resolve educational
    issues. The increased family readiness funding has allowed us to
    establish a School Liaison position at each Marine Corps installation.
    Complementing our local effort, the Marine Corps is working with the
    Department of Defense to establish an ``Education Compact'' with States
    to enable reciprocal acceptance of entrance, subject, testing, and
    graduation requirements. The Education Compact has been enacted in
    North Carolina and Arizona, and is under varying stages of
    consideration in the other States with Marine Corps installations.
                    posture the marine corps for the future
        As we prepare for an unpredictable future, we must continue to
    assess the potential future security environments and the challenges of
    tomorrow's battlefields. Our solid belief is that a forward deployed
    expeditionary force, consistently engaged and postured for rapid
    response, is as critical for national security in the future as it is
    today. The Marine Corps, with its inherent advantages as an
    expeditionary force, can be rapidly employed in key areas of the globe
    despite challenges to U.S. access. Our sea-based posture will allow us
    to continue conducting security cooperation activities with a variety
    of allies and partners around the world to mitigate sources of
    discontent and deter conflict. We must increase our capacity to conduct
    security cooperation operations without compromising our ability to
    engage in a major regional conflict.
    Realignment in the Pacific: Defense Policy Review Initiative (DPRI)
        The Defense Policy Review Initiative was established in 2002 by the
    United States and Japan as a means to review each nation's security and
    defense issues. One of the key outcomes of this process was an
    agreement to move approximately 8,000 Marines from Okinawa to Guam. The
    movement of these forces will address encroachment issues facing
    Marines on Okinawa. Moreover, the relocation will afford new
    opportunities to engage with our partners in Asia, conduct multilateral
    training on American soil, and be better positioned to support a broad
    range of contingencies that may confront the region. Furthermore, the
    political agreements brokered by the Office of the Secretary of Defense
    provide for a long term presence of Marines on Okinawa as well as
    substantial financial support by the Government of Japan.
        As can be expected with an effort of this scale and complexity,
    there are a number of challenges. Developing training areas and ranges
    on Guam and the Commonwealth of Northern Mariana Islands is a key pre-
    requisite for moving Marine forces to Guam. We also seek a contiguous
    base design on Guam where housing, operations, and quality of life
    facilities can be collocated. This will reduce the road traffic on Guam
    and provide for a better security posture. We have also found that
    collocated facilities--where Marines live and work--tend to be used
    more often, and serve to unify the military community.
        We continue to work within the Department of Defense to align our
    training and installation requirements with ongoing environmental
    assessments and political agreements. Planned and executed properly,
    this relocation to Guam will result in Marine forces that are combat
    ready, forward postured, and value-added to U.S. interests in the
    Pacific for the next 50 years.
    Security Cooperation MAGTF
        The Security Cooperation Marine Air Ground Task Force (SC MAGTF)
    provides geographic combatant commanders with a security cooperation
    capability for employment in remote, austere locations across the
    globe. SC MAGTFs will be organized based upon the specific requirements
    of each training event or operation they are requested to support and
    will enhance the combatant commander's ability to alleviate the
    conditions that cause instability to proliferate.
    Training and Education
        Our training and education systems, from recruit training to top-
    level Professional Military Education schools, rigorously instill in
    our Marines the physical and mental toughness and intellectual agility
    required to successfully operate in today's and tomorrow's complex
    environments. Marine Corps forces are organized, trained, equipped, and
    deployed with the expectation of operating under inhospitable
    conditions against committed and competent foes. Our forces are heavy
    enough to sustain major combat operations against conventional and
    hybrid threats but light enough to facilitate rapid deployment.
    Capability enhancements across the board are supported by a vigorous
    application of lessons learned from current operations.
                Operation ENDURING FREEDOM Pre-deployment Training Program
        The Afghanistan Pre-deployment Training Plan provides well-trained
    individuals and units that are prepared to operate in the austere and
    challenging environment of Afghanistan. While similar to the current
    Iraq Pre-Deployment Training Program, the Afghanistan Pre-deployment
    Training Program emphasizes the inherent capability of the MAGTF to
    conduct combined arms operations within a joint, multinational, and
    interagency framework. The capstone event of the Afghanistan Pre-
    Deployment Training Program incorporates all elements of the MAGTF.
                Combined Arms Training, Large Scale Exercises, and
                        Amphibious Operations
        Our training programs must prepare Marines to support current
    commitments and maintain MAGTF proficiency in core warfighting
    capabilities. We are developing a program of nested training exercises
    that focus on interagency and coalition operations to support the
    current fight and prepare the Marine Corps for the Long War.
        The Combined Arms Exercise-Next is a service-level, live-fire
    training exercise that develops the core capability of combined arms
    maneuver from the individual Marine to the regimental-sized unit level.
    This exercise focuses on the integration of functions within and
    between the MAGTF elements. The MAGTF Large Scale Exercise is a
    service-level training exercise that develops the MAGTF's capability to
    conduct amphibious power projection and sustained operations ashore in
    a joint and inter-agency environment.
        Amphibious operations are a hallmark of the Marine Corps. Through a
    combination of amphibious-focused professional military education,
    classroom training, and naval exercises, we will ensure MAGTFs are
    capable of fulfilling Maritime Strategy amphibious requirements,
    combatant commanders' operational plans, and future national security
    requirements.
                Training and Simulation Systems
        Cost-effective training requires a combination of live, virtual,
    and constructive training to attain the requisite level of combat
    readiness. We have leveraged technologies and simulations to augment,
    support, and create training environments for Marines to train at the
    individual, squad, and platoon levels. Virtual and constructive
    simulations support the pre-deployment training continuum, while live
    training systems create a training environment that replicates
    battlefield effects and conditions. Our long-range effort for infantry
    skills simulation training is the Squad Immersive Training Environment.
    This provides realistic training for our infantry squads. Over the past
    year, we have increased our efficiency and provided greater training
    opportunities for the individual Marine up to the MAGTF and joint level
    to satisfy Title 10 and joint training readiness standards.
                Training Range Modernization--Twentynine Palms Land
                        Expansion
        Our facilities at Twentynine Palms are critical to the pre-
    deployment training of our deploying Marine units. These facilities
    support the integration of fires and maneuver of new and emerging
    weapons systems, which cannot be accomplished within current boundaries
    of other Marine Corps bases. The Corps believes that to meet
    obligations to the Nation's defense, we must conduct live-fire and
    maneuver exercises at the Marine Expeditionary Brigade level.
        The Marine Corps' Mission Capable Ranges Initiative guides Marine
    Corps range planning and investment. A key to this initiative is the
    proposed expansion of the Marine Air-Ground Task Force Training
    Command's range complex at Marine Corps Base Twentynine Palms,
    California. This 507,000-acre installation, established in the 1950s,
    requires expansion to meet today's training requirements. We have begun
    the National Environmental Policy Act-required environmental studies to
    guide decisions during the acquisition process, and we expect
    acquisition to commence in 2012.
                Core Values and Ethics
        In an effort to improve values-based training and address the
    difficult ethical dilemmas faced by Marines, the John A. Lejeune
    Leadership Institute implemented several initiatives and publications
    to strengthen core values training. Publications include the
    Leadership, Ethics, and Law of War Discussion Guide. These guides offer
    15 contemporary case studies with suggested topics for discussion group
    leaders. We have also published a primer on the Law of War and
    Escalation of Force, a discussion aid on moral development, and Issues
    of Battlefield Ethics and Leadership--a series of brief, fictionalized
    case studies to develop Small Unit Leaders. These are used in our
    schools, beginning with recruit training at boot camp and continuing
    into MOS training and PME schools.
        Two video versions of case studies were created to sharpen the
    focus of our semiannual Commandant's Commanders' Program on the
    commander's role in setting a climate of positive battlefield ethics,
    accountability, and responsibility. In addition, the John A. Lejeune
    Leadership Institute held the first Russell Leadership Conference since
    2002 with 230 first-line leaders from across the Corps. The conference
    broadened and reinforced our leaders' understanding of the role they
    fill as ethical decision-makers, mentors, and critical thinkers.
                Marine Corps University
        The Marine Corps University established a Middle East Institute in
    2007 to research, publish, and promote regional awareness. A highly
    successful Iran Conference clearly demonstrated the utility of the
    institute. The new Marine Corps University Press was a successful step
    in our outreach program that includes publishing a professional
    journal. These initiatives were all part of Marine Corps University's
    health assessment and are an integral part of the University Strategic
    Plan.
                                   conclusion
        Marines take extreme pride in the comment attributed to journalist
    Richard Harding Davis, ``The Marines have landed, and the situation is
    well in hand.'' Our history has repeatedly validated that statement.
    Our training and organization ensures our fellow Americans that they
    should never doubt the outcome when her Marines are sent to do the
    Nation's work. Our confidence comes from the selfless sacrifices we
    witness every day by courageous young Marines. They responded
    magnificently after 9/11--took the fight to the Taliban and Al Qaeda,
    conducted a lightening-fast offensive campaign in Iraq, and turned the
    tide in the volatile Al Anbar province. Now, we are ready to get back
    to the fight in Afghanistan--or wherever else our Nation calls.
        Your Marine Corps is grateful for your support and the support of
    the American people. Our great young patriots have performed
    magnificently and written their own page in history. They have proven
    their courage in combat. Their resiliency, dedication, and sense of
    self-sacrifice are a tribute to this great Nation. They go into harm's
    way knowing their country is behind them. On their behalf, I thank you
    for your enduring support. We pledge to be good stewards of the
    resources you most generously provide and remain committed to the
    defense of this great land. Thank you again for the opportunity to
    report to you today.

                                   SHIP COUNT

        Chairman Inouye. Mr. Secretary, the events of recent days
    have been of much concern to many of us. For example, in North
    Korea there's a lot of saber-rattling and a lot of promise-
    breaking. We've had tests notwithstanding our complaints and
    our sanctions. They seem to ignore everything and continue on,
    and now testing a missile that has a capability of reaching
    Alaska.
        On the other side of the world in Iran, similar rattling
    goes on. Notwithstanding the United Nations, notwithstanding
    the pleas of Europeans and Americans and such, the Iranians
    seem to move merrily along with their testing.
        Taking these and events such as piracy into consideration,
    do you believe that we have enough ships to do the job? I ask
    this because I've been on this subcommittee long enough to
    recall that it wasn't too long ago when the goal was 600. Then
    it became 500-something, came down to 400. Now it's 313 and I
    believe we have about 280.
        What are your thoughts, Mr. Secretary, as you come in just
    2 weeks old? I'd like to hear your thoughts.
        Mr. Mabus. Thank you, Mr. Chairman. As you just pointed
    out, the number 313 came out of the last Quadrennial Defense
    Review and that number was supported by the CNO at the time,
    who is now Chairman of the Joint Chiefs, Admiral Mullen. It's
    supported by Admiral Roughead, the current CNO, who put it in
    his statement.
        You're correct in that we have about 284 ships today in the
    active fleet. We do need a fleet of 313 ships, and it points
    out the need to take some strong steps in acquisition reform.
    If we continue to build ever more exotic, ever more expensive,
    but ever fewer numbers of ships, we simply won't have the
    numbers that we need. At some point, even though these ships
    are far more capable than the ships in the 600 ship Navy, for
    example, the individual capabilities--you can't put two ships
    at the same place, at the same time.
        So if we're going to have a forward deployed Navy, which I
    believe we should, if we're going to have a Navy which can
    respond to whatever crises or whatever events it needs to
    respond to, then we have an obligation to make sure that we get
    enough ships into this fleet and to do so to bring down the
    cost of these ships, to make the schedule stay on time, and to
    make sure that we have sufficient ships to meet any eventuality
    that we may face.
        Chairman Inouye. Admiral Roughead, do you have any
    additional comments to make?
        Admiral Roughead. Yes, sir. As you know, Mr. Chairman, I've
    maintained for some time that 313 is the floor with regard to
    fleet capacity. But I would also submit that this budget that
    is before you really begins to address the direction where we
    have to go. The truncation of the DDG 1000, which we began some
    months ago, and the restart of the DDG 51 line, which has
    terrific ballistic missile defense capability, and we're seeing
    those types of missiles being tested by Korea, by Iran, and
    they proliferate globally, that is exactly the direction where
    we have to go.
        The three littoral combat ships that we have in the budget
    are able to operate with our high-end forces, but I would
    submit they're ideally suited to the maritime security missions
    that we see in the counter-piracy operations.
        So our budget really does begin to take us there. The start
    of the Joint High Speed Vessel line is also important to us and
    to the combatant commanders so that we can get at some of these
    challenges.
        But I would also say that in order to get to the 313, it's
    not just about the acquisition that's represented in this
    budget, but it's also in our ability to take the ships that we
    have today and allow them to achieve their full service life,
    because most of the ships that we have in service today will be
    in service in 2020. So maintaining that force is also equally
    important.

                                   SHIPYARDS

        Chairman Inouye. Mr. Secretary, another question. In order
    to maintain these ships, do you believe that our depots, our
    shipyards, are up to par and prepared?
        Mr. Mabus. Yes, sir, I do. I think they will continue to be
    as long as we work with them to ensure a stable industrial
    base, to make sure that we have a trained, skilled workforce in
    place, by making sure that our shipbuilding requirements are
    made known to them, that they are able to invest in the
    equipment and the people that we will need, and to give them
    the stability that they need to provide this incredibly vital
    service.
        Chairman Inouye. Admiral, have you got any thoughts on
    that?
        Admiral Roughead. As I mentioned, Senator, I think the
    maintenance of our fleet is what also allows us to achieve the
    313 level. The public shipyards that we have that are so much a
    part of maintaining our very high-end forces, our nuclear
    submarines and our aircraft carriers, absolutely key. Then the
    involvement of the private sector that we call on throughout
    the country is extraordinarily important and allows us to
    achieve that force level and readiness that's so important to
    the Navy today.

                            MARINE CORPS FORCE SIZE

        Chairman Inouye. Commandant, at this moment South Korean
    troops are on alert. The alert status for that peninsula is
    four, I believe, just one less than the top. Taking those
    things in consideration, do you believe that the projected
    number in our force is sufficient?
        General Conway. Yes, sir, I do. There are plans that we
    can't talk about in an open hearing that would provide for our
    ability to respond to an additional major contingency, such as
    Korea would represent. Although there is a level of risk
    associated with our ability to I think conduct and complete
    those war plans, we think that our forces that are present
    today would be able to do that. There would be issues, sir. We
    have equipment that would have to be moved all over the globe
    in order to be able to satisfy those demands. The force
    structure would not be as organic as we would like. There would
    have to be a level of ad hoc conglomeration of forces, if you
    will. But in the end I am convinced we would prevail.
        Chairman Inouye. I thank you, sir.
        Senator Cochran.
        Senator Cochran. Thank you, Mr. Chairman.

                        SECNAV NAVAL OFFICER EXPERIENCE

        Mr. Secretary, we are grateful that you are a person who's
    had experience personally in the Navy and now assuming
    responsibilities as Secretary of the Navy. I wonder what
    experiences you've had as a naval officer do you think will be
    important to you in carrying out your responsibilities as
    Secretary?
        Mr. Mabus. Well, Senator, I do think that time that I spent
    in the Navy was some of the most profound times that I've spent
    in my life. The Navy has changed a lot in the nearly 40 years
    since I was a surface warfare officer on board the U.S.S.
    Little Rock, and it's changed almost totally for the better.
    The training level, the caliber of recruits that are coming
    into the Navy, into our forces, the education that they are
    getting once in, the commitment that they have to the Navy and
    to the country, the deployment tempo, which is much higher and
    more flexible than when I was in, allowing us to get ships to
    places faster and better equipped. The thing the CNO talked
    about, about maintaining our fleet, has improved so
    dramatically since that time.
        But I think the thing that my experience in the Navy--I
    hope I brought with me, is the importance of the sailors, that
    it doesn't matter in the end how capable our equipment is if
    our sailors cannot match that equipment. In today's Navy, I'm
    happy to say that I think we have as fine a trained force as
    the world has ever seen.
        Senator Cochran. Thank you. I think that's an eloquent and
    important assessment for all of us to understand. I think the
    leadership we have in the military today is so much more
    sophisticated and impressive in terms of intellectual and
    educational fitness for these hugely important jobs. I think
    we're very fortunate to have the benefit of that kind of
    leadership in the Navy and the Marine Corps and at the civilian
    posts that are important to the management of these important
    assets.

                         JOINT COMMAND SHIP REPLACEMENT

        General Conway, I notice the Department of the Navy is
    looking at the LPD 17 amphibious ships and the T-AKE dry cargo
    ship hull forms for joint command ship replacement
    responsibilities. What in your opinion are the key factors in
    determining which hull form is suitable, and do you believe
    that survivability is a critical factor?
        General Conway. Sir, we have examined it and made
    recommendations to the CNO and ultimately to the Secretary of
    the Navy on the value associated with a consistent hull form,
    both for purposes of the research and development (R&D)
    associated with what would otherwise be new hull forms and with
    regard to the sustainability and the maintenance factors that
    exist with a single hull form.
        We have been a proponent of maintaining the LPD 17 form
    throughout the near term with regard to additional command and
    control ships. We think that that would be beneficial for the
    shipyards. We think it would be beneficial for the ultimate
    product that's produced there, and we think it would help to
    provide for the numbers of amphibious ships that we need both
    for forcible entry--and it was interesting that the chairman's
    question referenced at least two areas where forcible entry
    could be necessary--but also for purposes of day to day
    requirements that we see on the part of our combatant
    commanders.
        Interestingly, the numbers come together to be about the
    same for both of those types of requirements. It will be
    discussed in the Quadrennial Defense Review and we see it I
    think as our collective mission to make sure that there's a
    clear understanding that amphibs are not just high-end
    capability. They have very much a role in the low-end scheme of
    things on a day to day basis in support of combatant
    commanders.
        Senator Cochran. Thank you.

                              CNO PRIOR EXPERIENCE

        Admiral Roughead, we first met down at Pascagoula,
    Mississippi, when you were assuming command of one of the new
    ships being built there at Ingalls. What personal experiences
    did you have as a result of that responsibility that have
    shaped your views about shipbuilding and the efficiencies and
    the importance of taking advantage of new technologies in
    helping ensure that we can protect our naval interests around
    the world?
        Admiral Roughead. Yes, sir. Thank you, sir. I would say the
    first thing that I took away was that the strength and the
    viability of our Navy depends on the American shipbuilder. No
    one builds ships as capable or as tough as the American
    shipbuilder. That was my first take away and I have not lost
    that sentiment ever since that time.
        I would also say that it's important that we get production
    runs as consistent and as long running as we can, that we
    should look at every opportunity to take advantage of designed
    hull forms and adapt them to other uses, as you mentioned with
    regard to command ships. Command ships have to be survivable.
    We have to make sure that they have the capacity for the type
    of function that will be performed on them and that they also
    can be modified at the least cost to fulfill those missions.
        But I think it's extremely important that we get as much
    commonality as we can in our fleet. It reduces operating costs.
    It will reduce maintenance costs and logistics costs, and I
    believe we need to continue down that path.

                                  NAVY RESERVE

        Senator Cochran. I had the pleasure of spending several
    years as a Reserve officer following active duty in the Navy. I
    enjoyed the opportunities of going back to Newport, Rhode
    Island, for example and being on the staff of the faculty at
    Officer Candidate School, continuing to be involved. Do you
    still have a strong reserve program utilizing the experience
    and talents of former active duty officers in the reserve
    activities? Is that a wise investment? What is your impression
    of the Navy Reserve mission today and how it complements the
    active duty forces?
        Admiral Roughead. Senator, we are one force today. The
    integration of our active component and our Reserve component
    is as close as it has ever been. In fact, most of the
    individual augmentees that have gone into the Central Command
    area of operation over the past 8 years are Reserve sailors and
    officers.
        We cannot be the Navy we are today without our Reserve
    component. The way that they move into our active force after
    having served in an active capacity is absolutely seamless. The
    importance that we place on our Reserve programs is extremely
    high, and the Navy that the Secretary was referring to as being
    as professional and as competent and as agile as it is today is
    a function of that active-Reserve integration that has taken
    place.
        Senator Cochran [presiding]. Senator Bond.
        Senator Bond. Thank you very much, Senator Cochran.
        To the Commandant, congratulations on the excellent job
    that you have done in al-Anbar. We had a CODEL over there in
    May 2007 and saw not only were they clearing the area, but the
    hold and build, which is the new wave of the smart power use of
    our military, was working so well. That is a great credit to
    the leadership up and down the line, as well as to the marines
    who did it. It is a great story that has convinced many people,
    as they now see how it resolves.
        Mr. Secretary and Admiral, again I congratulate you on the
    support you're providing to the sailors, the SEALs, and the
    marines in the field, and particularly for what you're doing to
    the wounded warriors. I've had some opportunities, not by
    planning, but to spend some time at Bethesda, and I have
    visited the wounded warriors there and seen the great care.
    This is truly outstanding. Your reference to dealing with the
    PTSD and the traumatic brain injury (TBI), which is so
    important, is something we're going to have to continue to
    address because it really sneaked up on us.

                              JOINT STRIKE FIGHTER

        But I need to go back to the point I made in my opening
    statement, cutting production of the one effective carrier-
    based aircraft, the F/A-18 that we have, from 45 to 30, and
    only 9 of those are going to be combat aircraft. The rest are
    Growlers. Right now the Joint Strike Fighter is behind
    schedule, way over budget. It's only 2 percent flight tested.
    Under your most optimistic circumstances, what kind of
    contribution can the JSF make to that shortfall on the carrier
    decks in 2016 through 2020, Admiral?
        Admiral Roughead. Senator, we have just in this budget put
    in the money for the first carrier variants of JSF. JSF is
    extraordinarily important to where we are going with naval
    aviation, because we can never in my opinion have all of one
    type of an airplane on our carrier deck. There should always be
    a generational movement taking place, so that in the event
    there's a problem in any particular airframe or type of
    airplane we don't ground an entire wing. So we have to get to
    JSF.
        We are the last service to take delivery of JSF and that
    begins in 2015. As we looked at our 2010 budget, what we did
    with what I'll call the 18 line--that includes both the Growler
    and the E's and F's--was to put in the budget what we needed
    for electronic attack and then also, as we balanced across our
    programs, to put in place the nine E's and F's, because, as you
    know, in the Quadrennial Defense Review all of the services
    that fly tactical aviation are going to be conducting the
    review. We will look at where we are collectively and where we
    must go in order to continue to provide the capability and
    capacity in our air wings.
        That may be through life extension programs, but that's
    what we're going to examine in the QDR.
        Senator Bond. Well, very respectfully, Admiral, you are
    deciding to cut that, cut off the E and F production, before
    you have even proven that this JSF, called by some the ``Joint
    Strike Failure.'' If you read the Government Accountability
    Office (GAO) reports, it's been so far behind schedule, it's
    been over production costs, and it is now only 2 percent flight
    tested, and you haven't even thought about seeing whether it
    can land on an aircraft carrier.
        To me it looks like you've made a bad bet if you have not
    proven something that can take its place and you're cutting it
    off. To me, the first rule of digging is if you dig yourself
    into a hole, stop digging, because this is a bad decision, made
    a number of years previously, to put all of the production of
    the JSF into one company. Unfortunately, that line is not
    producing.
        I cannot believe that you can ignore reality and say, until
    we know that we have a follow-on plane, we ought to keep the
    plane that is working. As I recall, there was a requirement in
    the law that you produce by March 1 of this year a report on
    the costs and benefits of a multiyear procurement of the F/A-
    18. You can get at least three for what one JSF would cost you.
        When is that report coming out? And is anybody looking
    seriously at the need to keep something until and unless the
    JSF can land on a carrier?
        Admiral Roughead. What we have done, Senator, with the 18
    line, to include both the Growler and the E's and F's, is that
    we in the 2010 budget have more than what is the sustaining
    rate for that 18 production line. So as we go into the QDR we
    have not stopped in 2010 the 18s. We still are working on that
    second multiyear that allows the production to continue. When
    we get into the QDR discussions on tactical air wings, I
    believe that we will be making the decisions we have to make
    while we've preserved the manufacturing of the F-18s.

                                INDUSTRIAL BASE

        Senator Bond. Well, as a final question for the Secretary,
    I certainly appreciate your speaking about the need to protect
    the defense industrial base, because if we go down the same
    path that our fine ally Great Britain has gone, their
    industrial base was allowed to atrophy, so they can no longer
    build aircraft and they're struggling to build ships. We are--
    unless somebody rethinks the tragic decision that was made to
    go with only one tac air producer, unless that decision is made
    in the QDR, we're going to find ourselves in a real hole.
        Why is it acceptable in your view to have only one
    production line for a tac air fighter, a tac airplane?
        Mr. Mabus. Senator, I will echo what the CNO just said in
    terms of making sure that the E and F production line in the
    fiscal year 2010 budget is at a level that can sustain that
    production and sustain that workforce and sustain that
    industrial base through fiscal year 2010 as we go through the
    Quadrennial Defense Review to see what our tactical air
    requirements are, just as the CNO has pointed out.
        So I think that you do have that capacity maintained
    through the industrial base and through the trained workforce
    by this purchase of F-18s, both the Growlers and the E and F's.
        Senator Bond. Well, thank you, Mr. Secretary. I hope in the
    QDR there's some realism that strikes and that you do take a
    look at the costs. We'd still like to see that report due March
    1 of this year on the 18, because you can't continue to make
    good sound investments unless and until you prove that you do
    have an alternative. I hope you will take that into serious
    consideration.
        Mr. Chairman, I've filibustered long enough and I'll let
    you take on. Thank you.
        Senator Inouye [presiding]. You did a good job.
        Mr. Secretary, there's a vote on, so that's why we're
    moving in and out.

                                      GUAM

        Commandant, by the year 2014 your 8,000 marines and 9,000
    dependents are supposed to be out of Okinawa into Guam.
    However, we're concerned with the relocation of Futenma.
    Apparently the prefectural government is against the location.
    Is the time 2014 going to be kept or do we have to extend that?
        General Conway. Sir, we hope so. At this point the Futenma
    replacement facility, which the Japanese are at least on
    schedule to build for us off Camp Schwab, which is near the
    middle of the island, is very much a keystone to the 2014 date.
    There are some preliminary efforts that are underway, but if
    you have seen that space--and I think you have--it will require
    a tremendous amount of fill into the sea, into some fairly deep
    water in the sea, at some I think fairly significant expense to
    the Japanese Government. So we watch and encourage their
    efforts very closely, because again that sort of kicks off the
    game for other things that will take place associated with the
    move.
        So I think that will be the primary determinant as to
    whether or not we're able to maintain the 2014 date.
        Chairman Inouye. The estimated costs of movement, if I
    recall, was about $10 billion. Now it's been estimated to go up
    to $15 billion; is that correct?
        General Conway. Sir, I haven't seen the $15 billion figure.
    In the initial negotiations with the Japanese Government it was
    on the order of about $6 billion plus for the Japanese
    Government and $4 billion plus for the United States
    Government. Our independent estimates, if you will, for all of
    the required training, infrastructure, family, quality of life
    issues associated with that move, would put it closer to about
    $12 billion from our perspective.
        We have floated those figures past the folks in the Office
    of the Secretary of Defense. They are taking them under
    advisement. We're looking at how the Department of the Navy
    might be able to afford that kind of money in the out-years.
    The discussion I think is on table as to whether or not that
    ought to be a corporate bill for the Department of Defense as
    opposed to a Navy-Marine Corps bill.
        But we think that the cost estimates are significantly
    greater than initially estimated, but I have not heard a figure
    of $15 billion to date.
        Chairman Inouye. Do you believe Guam is a better place than
    Okinawa for your troops?
        General Conway. Sir, Guam has advantages for us. It is U.S.
    soil, and to the degree that we have a level of certainty in
    terms of U.S. forces' presence in the Pacific for 50, 75 years
    assurance, I think it is very positive in that regard. In some
    ways it moves us farther away from some critical engagements,
    but in some ways it puts us closer to some other engagements in
    the South Pacific Basin.
        So we support the move and we're at this point trying to
    make sure that it does happen along the time line that's been
    suggested and that the training requirements associated with
    putting 8,000 marines in Guam are necessarily taken care of in
    advance of the move. So we're engaging, sir, but at least at
    this point we're trying not to spend a lot of money until such
    time as, again, we see that Futenma replacement facility start
    to give us relief and move out of Futenma.

                                     PIRACY

        Chairman Inouye. Admiral, one thing that very few of us
    anticipated was piracy, and now it's a new job description for
    you. How are we coping with pirates?
        Admiral Roughead. Yes, sir. We've kind of come full circle
    since our origins as a Navy, and I give great credit to our
    sailors who are performing the counter-piracy mission. The
    rescue that they performed on Maersk Alabama and the return of
    Captain Phillips I think speaks volumes about the value and the
    quality of training and the contributions that are made every
    day by our sailors in that part of the world.
        I'm pleased that since the May 7 there have been no
    successful piracy actions in the area around Somalia. I also
    believe that our counter-piracy effort has drawn navies of the
    world more closely together in a meaningful way than ever
    before. Not only do we have the North Atlantic Treaty
    Organization (NATO) that is contributing, the European Union is
    contributing, but we have Indian ships, Chinese ships,
    Malaysian ships, and Turkish ships. In fact, the commander of
    Task Force 151, our counter-piracy task force, is a Turkish
    admiral.
        So it has really brought the focus in. That said, the real
    solution to piracy, as we saw in Southeast Asia, is a solution
    that must include the maritime dimension, to be sure, what
    we're doing today, but piracy will not be eradicated unless
    there is the ability to provide for some governance ashore, for
    legal action to be taken against those who commit piracy and
    those who finance piracy. So there must be a two-pronged
    approach: the maritime piece that we're doing today; but there
    must be an effort to get some form of lawful behavior ashore in
    Somalia and to go after where the networks are operating from.
        Chairman Inouye. Is Somalia cooperating?
        Admiral Roughead. Somalia in my opinion, Senator, right now
    does not have the capacity or the capability to cooperate. The
    lack of governance there is going to be a problem for some
    time.
        Chairman Inouye. Mr. Secretary, do you have any final
    thoughts? Because I'd like to submit all of my questions for
    your perusal and response.
        Mr. Mabus. I look forward to getting those questions, Mr.
    Chairman. My final thought is just to once again express our
    deep appreciation to you and to this subcommittee for the
    support that you have given our sailors and our marines over
    the years and that you continue to give to them and to their
    families as they go in harm's way for all of us.
        Thank you.

                         ADDITIONAL COMMITTEE QUESTIONS

        Chairman Inouye. I thank you very much, Mr. Secretary.
    Thank you very much, Admiral Roughead. Thank you very much,
    General Conway.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subject to the
    hearing:]
                        Questions Submitted to Ray Mabus
                Questions Submitted by Chairman Daniel K. Inouye
                         vh-71 sustainment of aircraft
        Question. Secretary Mabus, the Department's plan for presidential
    helicopters, in the absence of the VH-71 program, is not well
    understood. In particular, the choice to pay substantial termination
    costs and not field any of the Increment 1 helicopters has been
    questioned.
        Two weeks ago, the cost of terminating the VH-71 contract was
    estimated to be $555 million. Critics could say that figure is more
    than the cost of finishing testing on the five existing Increment 1
    helicopters. This, on the surface, appears problematic.
        Unfortunately, the budget submission does not shed any light on how
    much the decisions made today will cost the taxpayer in the future.
    Secretary Mabus, what further information can you share with the
    Subcommittee to inform our decisions on whether the termination of the
    VH-71 is the right course? Could you provide Congress the detailed
    budget estimates of the impact of the decisions proposed by the
    Department?
        Answer. On January 28, 2009, the Secretary of the Navy notified
    Congress that the cost growth in the VH-71 Presidential Helicopter
    program had breached the critical Nunn-McCurdy threshold. As a result
    of this, as well as the subsequent review of the program in building
    the President's fiscal year 2010 budget submission, the decision was
    made to cancel the VH-71 program.
        The President's fiscal year 2010 budget requests funding to extend
    the service lives of the VH-3D and VH-60N. In total, the service life
    extension is currently estimated to cost about $500 million over the
    life of the program. The cost of terminating the VH-71 prime contract
    is being developed by the VH-71 prime contractor and will be negotiated
    with the contracting officer over the coming year. This total is
    significantly less than the amount that would have been needed to
    complete development of Increment 1, procure additional Increment 1
    aircraft and logistics support, and develop configuration improvements
    required for long term operation. Accordingly, the contracting officer
    has prudently implemented the cancellation decision by issuing a notice
    of termination.
        Because there remains the need to replace the current fleet of
    Presidential helicopters, the Navy is preparing a plan to develop
    options for a Presidential helicopter replacement program. The
    President's fiscal year 2010 budget requests $30 million for efforts
    associated with the new program. Part of that plan will include
    evaluation of technologies developed under the VH-71 program to
    identify potential benefit to other programs.
                           vh-71 impact of decisions
        Question. With cancellation of the VH-71 program, how is Navy
    addressing sustainment for the existing aircraft? Are sufficient funds
    in the fiscal year 2010 budget to invest in the reliability of the
    current systems?
        Answer. The Navy received RDT&E funding in fiscal year 2009 to
    conduct a Service Life Assessment on both the VH-3D and VH-60N. The
    President's fiscal year 2010 budget requests funding to extend the
    service lives of the VH-3D and VH-60N. As submitted, the Department of
    the Navy's budget supports the requirements of the VH-3D and VH-60N for
    fiscal year 2010.
                            strike fighter shortfall
        Question. Secretary Mabus, a recent Congressional Research Service
    report states that the Department of the Navy is facing a shortage of
    strike fighters that peaks at 243 aircraft in 2018. This is almost
    double the 125 aircraft shortfall projected at this time last year. The
    report says that shortages will begin this year and continue through
    2025. What is your plan to address this problem and what are the risks
    involved with the plan?
        Answer. The Department has four primary avenues for addressing its
    strike fighter inventory requirements within current force structure
    and force scheduling requirements. These include:
      --Maintaining wholeness of the JSF program: 2012 F-35B Initial
            Operating Capability (IOC), 2015 F-35C IOC with targeted
            procurement ramp to 50 aircraft per year;
      --Service life extension of F/A-18A-D Hornets from 8,600 flight hours
            to 10,000 flight hours service life;
      --Continued sustainment of legacy aircraft; and
      --Further procurement of F/A-18E/F Super Hornet.
        The challenge that Navy leadership is undertaking during the
    Quadrennial Defense Review and upcoming budget year, is to determine
    the necessary balance of these options in terms of force requirements
    as they become evident over this summer's review.
        Question. Secretary Mabus, it would appear that buying more of the
    lower cost aircraft is a way to mitigate the risks of the shortfall.
    Why is the Navy reducing procurement of F/A-18s now?
        Answer. The Navy presently has the necessary tactical strike
    fighter aircraft--F/A-18A/C and F/A 18E/F--to properly resource its
    force structure requirements in support of its current Maritime
    Strategy and Fleet Response Plan (FRP) scheduling for 10 carrier air
    wings (CVW) of 44 strike fighters each and one unit deployment program
    (UDP) F/A-18C squadron in support of DoN TACAIR Integration (TAI).
        Fiscal year 2010, represented in PB10, reflects a reduction of nine
    F/A-18E/F from PB09 fiscal year 2010 planning. While this is a present
    reduction in F/A-18E/F procurement for a single year, there is no
    immediate detrimental affect to the Navy's near-term (out to 2013)
    strike fighter inventory with this decision. PB10 represents balanced
    funding that meets DOD's requirements.
        Continued procurement of F/A-18E/F is one of four areas that Navy--
    and DON as a whole--will continue to assess through this summer's
    Quadrennial Defense Review (QDR) and into the following year's budget
    submission. The DON has four inter-related avenues for addressing its
    strike fighter inventory requirements to meet current force structure
    requirements:
      --Maintaining wholeness of the JSF program: 2012F-35 Initial
            Operating Capability (IOC), 2015 F-35C IOC with targeted
            procurement ramp to 50 aircraft per year;
      --Service life extension of F/A-18A-D Hornets from 8,600 flight hours
            to 10,000 flight hours service life;
      --Continued sustainment of legacy aircraft;
      --Further procurement of F/A-18E/F Super Hornet.
        The challenge that Navy leadership is undertaking during the QDR
    and upcoming budget year, is to determine the necessary balance of
    these options in terms of force requirements as they become evident
    over this summer's review.
               nuclear aircraft carrier move to mayport, florida
        Question. Secretary Mabus, in January, the Navy formally endorsed
    plans to relocate a nuclear-powered aircraft carrier to Florida's
    Mayport Naval Station. This announcement came after a lengthy process
    of studying the benefits and risks of dispersing East Coast carriers.
    Please share with the Committee how this decision supports the Navy's
    mission and our national security interests.
        Answer. Secretary Gates decided that the larger issue of whether
    Mayport will be upgraded to enable it to serve as a homeport for CVNs
    should be objectively evaluated during the Department's Quadrennial
    Defense Review (QDR). We believe that the QDR will provide the best
    forum to assess the costs and benefits associated with a strategic move
    of this scale.
        Strategic dispersal and CVN homeporting are important and
    complicated issues that deserve serious consideration. The Secretary
    and I are committed to arriving at decisions that are in the best
    interests of the nation, the Department, and the U.S. Navy.
        Question. Secretary Mabus, some argue that relocating a nuclear-
    powered aircraft carrier is cost-prohibitive, especially since the
    infrastructure already exists in Norfolk. How much did the cost of this
    relocation weigh into deliberations of whether or not to move an
    aircraft carrier to Mayport Naval Station?
        Answer. Secretary Gates recently testified that he is troubled by
    the idea of having only one port capable of providing maintenance
    support for East Coast CVNs. Any large magnitude event, a Katrina-like
    hurricane, a terrorist attack, or an accident that blocks the Norfolk
    shipping channel, could have the effect of rendering East Coast carrier
    operations ineffective. Therefore, Secretary Gates has taken the
    prudent step of seeking funding for the dredging of the Mayport channel
    within the fiscal year 2010 budget to provide an alternative port to
    dock East Coast carriers in the event of a disaster.
                                     ______

              Questions Submitted by Senator Kay Bailey Hutchison
                     naval aviation training in south texas
        Question. Aviation training performed in South Texas is important
    for our Navy and for the local community. Are there any plans to
    upgrade these squadrons?
        Answer. The six training squadrons based in South Texas are
    undergoing numerous upgrades.
        Training Squadrons Twenty One and Twenty Two at NAS Kingsville.--
    VT-21 and VT-22 will receive the last five production T-45C aircraft
    from Boeing this year while their inventory of T-45A aircraft is being
    upgraded to the T-45C configuration as part of the Required Avionics
    Modernization Program (RAMP). 15 T-45A aircraft have been upgraded to
    the T-45C with 56 aircraft remaining to be completed by mid 2014 at the
    rate of 12 per year. The Navy has submitted a Request for Proposal
    (RFP) for accelerating RAMP production to 18 aircraft per year in order
    to complete the transition by early 2013.
        T-45 simulators are also being upgraded to the T-45C digital
    cockpit configuration. A new Jet Engine Test Cell facility (P-278;
    $12.675 million) is currently under construction at NAS Kingsville.
        Training Squadrons Twenty Seven and Twenty Eight at NAS Corpus
    Christi.--VT-27 and VT-28 will transition from the T-34C primary
    trainer to the T-6B starting in March 2012. The transition will begin
    with the delivery of two simulators in March 2012 with three additional
    simulators to be delivered over the following 2 years. The T-6B
    aircraft will be delivered starting in July 2012 at a rate of three to
    four aircraft per month finishing by August 2015 with a total of 110 T-
    6Bs. A new Trainer Facility (P-353; $14.290 million) is currently under
    construction at NAS Corpus.
        Training Squadrons Thirty One and Thirty Five at NAS Corpus
    Christi.--VT-31 and VT-35 are transitioning multi-engine pilot training
    to the upgraded T-44C. 20 T-44A aircraft have been upgraded to the T-
    44C configuration with 34 aircraft remaining to be completed by mid
    2013 at the rate of nine per year. Four T-44 simulators are also being
    upgraded to the T-44C digital cockpit configuration.
        Question. What is the plan for equitable sustainment funding for
    South Texas?
        Answer. The sustainment requirement for the Navy is determined by
    the Facility Sustainment Model (FSM) according to OSD policy. The model
    determines the equitable distribution to installations based on the
    total Navy inventory. Commander Navy Region Southeast (CNRSE) received
    $13 million for fiscal year 2009 in support of NAS Corpus Christi and
    NAS Kingsville sustainment efforts.
        Additionally, the following special projects were approved for
    execution in South Texas.
        Fiscal year 2009 Approved CNRSE SRM Projects ($K) NAS Kingsville RM
    002-05 Repair Runway 13L and 31L $6,100.
        Fiscal year 2009 Approved CNRSE ARRA Projects ($K) NAS Corpus
    Christi RM004-04 Repair Various Taxiways $3,283.
                           t-6 operational facilities
        Question. Currently, there are funds in the base budget for
    ``operational facilities for T-6. I have been advised that these funds
    will be used for the acquisition of an Outlaying Landing Field (OLF)
    called Goliad at NAS Kingsville, Texas. What is the timeline for this
    acquisition?
        Answer. The Navy is considering acquisition of the Goliad County
    Industrial Airpark (GCIA) to support training requirements of the T-6
    Joint Primary Aircraft Training System that is scheduled to arrive at
    NAS Corpus Christi in July 2012. MILCON P437 ($19.764 million) would
    provide funds for acquiring the GCIA (1,136 acres) and constructing
    supporting facilities. An Environmental Assessment is currently
    underway and is scheduled for completion in September 2009. Assuming a
    subsequent Finding of No Significant Impact, appraisal and title work
    will begin and is projected to be complete by October 31, 2009.
    Negotiations and land acquisition would then occur between November
    2009 and February 2010. Award of the construction contract for
    supporting facilities at Goliad is anticipated in June 2010, with
    completion in June 2012 to support the July arrival of the T-6
    aircraft.
        Goliad County Industrial Airpark (GCIA) is approximately 77 miles
    north of Naval Air Station (NAS) Kingsville and 66 miles north-
    northwest of NAS Corpus Christi.
                        aviation support nas fort worth
        Question. What is the plan to provide aircraft and support to the
    units at the Naval Air Station at Fort Worth?
        Answer. There are currently seven Navy Reserve aircraft assigned to
    units at NAS JRB Fort Worth (3 C-40s, 3 C-9s, and 1 C-12). This number
    of aircraft represents the planned inventory for permanent Navy Reserve
    aircraft at that base.
        Two Navy construction projects are underway on the base. The first
    project is part of the Base Closure and Realignment (BRAC) legislation
    in 2005 that moved a Navy Air Forces Reserve squadron to Fort Worth
    from NAS Atlanta, Georgia. This project will upgrade a hangar to
    provide additional space necessary to protect the aircraft that
    completed the BRAC move. The second project, the construction of a
    maintenance facility that will support Navy, Marine Corps, and Texas
    Air National Guard aircraft, is 99 percent complete. A third project,
    designed to upgrade a hangar that Navy Reserve units share with other
    services, is approved and pending contract award.
                            strike fighter shortfall
        Question. There is common knowledge in the Navy that there will be
    a significant fighter shortfall in the future if the Joint Strike
    Fighter program isn't kept on track or accelerated. What would the
    impact be on the Navy and Marine Corps if procurement was reduced or
    slowed? If the decisions are made to procure a second engine for the
    Joint Strike Fighter, will this result in delays in overall production
    or result in reductions in other programs?
        Answer. One of the primary avenues for addressing strike fighter
    inventory requirements within current force structure and force
    scheduling requirements is maintaining wholeness of the JSF program
    (2012 F-35B IOC, 2015 F-35 IOC with PB10 procurement ramp to 50
    aircraft per year for a DON total procurement of 680 JSF). It is
    foundational to Naval Aviation's future force structure and a central
    assumption in current strike fighter inventory predictions. Delaying or
    reducing DON JSF procurement would exacerbate Naval Aviation's
    predicted strike fighter trend.
        The Department has not funded the JSF alternate engine effort in
    the fiscal year 2010 President's budget. The various studies that have
    been done by the OSD CAIG, GAO, and IDA are mixed in terms of the
    likelihood the Department would ever recover such an investment. While
    there are many intangible benefits associated with competition and a
    second source engine, the Department continues to maintain that the
    benefits do not outweigh the significant investment to develop,
    procure, and maintain two JSF engines.
        The cost impact of procuring F-136 across the FYDP is estimated at
    $4.7 billion (DOD).
                                     ______

                Question Submitted by Senator Robert F. Bennett
                          demands of irregular warfare
        Question. I am intrigued by the growing significance that
    ``irregular warfare'' and so-called ``hybrid campaigns'' play in our
    national defense strategy. In your prepared remarks, you mentioned the
    need to achieve balanced growth through a focus on these new elements,
    as well as continuing to promote more conventional capabilities. How
    specifically do you plan to focus the Navy on the future demands
    imposed by Irregular Warfare? Given what I imagine to be the ever-
    evolving nature of these challenges, how effectively is the Navy
    changing and developing its strategies to meet these threats? In what
    ways can Congress help support the Navy in addressing future concerns?
        Answer. As demonstrated by past and ongoing efforts in the
    irregular arena, the Navy is uniquely equipped and postured to have an
    enduring effect in this complex security environment. Today, the Navy
    provides one-half of the combat air sorties in Iraq and Afghanistan,
    protecting our ground troops in an irregular fight. The Navy is
    building partner capacity and sustainable regional maritime security
    force capability as shown in the ongoing Africa Partnership Station
    initiative. The goal of these efforts is to help countries at risk
    become net contributors to maritime security and good governance as
    part of a whole-of-government approach to diminish and counter violent
    extremism and other Irregular Warfare threats. We continue to evaluate
    opportunities in this environment, orient our force, and develop new
    means for applying the general purpose forces to meet irregular
    challenges.
        Two prime examples are the Littoral Combat Ship (LCS) and the Joint
    High-Speed Vessel (JHSV). LCS's inherent speed, agility, shallow draft,
    payload capacity, reconfigurable mission spaces, and air/water craft
    capabilities, combined with its core Command, Control, Communications,
    Computers and Intelligence, sensors, and weapons systems, make it an
    ideal platform for Irregular Warfare and maritime security operations,
    to include counter-piracy missions. JHSV also has some of the same
    characteristics as LCS (i.e. speed, agility, shallow draft, payload
    capacity, reconfigurable mission spaces, and air/water craft
    capabilities). JHSV is built to commercial American Bureau of Shipping
    (ABS) standards with minor military modification. The vessel can be
    operated with a core crew of civilian mariners as a non-combatant. It
    is less robust than LCS in terms of C\4\I system, sensors, and weapons
    systems (.50 cal only). Its ability to offload Army and Marine Corps
    equipment and personnel in austere or degraded ports can contribute to
    Irregular Warfare operations.
        Consistent with the ``Cooperative Strategy for 21st Century
    Seapower'', the Navy is at the front end of aligning its organizations
    and processes to be more adaptive across a broad range of challenges.
    In conjunction with DOD Directive (3000.07), tasking the Services to
    increase their proficiency in Irregular Warfare, and lessons learned
    through operations, the Navy is developing its vision and an
    operational concept for becoming a fundamental enabler to whole of
    government efforts to confront irregular challenges through balanced
    diplomacy, development, and defense.
        As the Navy continues to refine the capabilities and capacities to
    address irregular challenges, Congress can advocate for the Navy's
    employment in preventive maritime security and remain responsive to
    resource requirements that expand the Navy's ability to address future
    concerns. The Navy remains postured to deter near-peer competitors, but
    with 70 percent of the world's population living within 100 miles of
    the coast, irregular challenges will grow in the maritime domain and
    the Navy's role in Irregular Warfare will be pivotal to addressing
    those challenges. As the Navy expands its aperture for Irregular
    Warfare, continued funding will be needed to equip our sailors with the
    training, resources, and equipment they need to carry out Irregular
    Warfare missions.
                                     ______

                  Questions Submitted to Admiral Gary Roughead
                Questions Submitted by Chairman Daniel K. Inouye
                           future of testing at pmrf
        Question. The Missile Defense Agency (MDA) together with the Navy
    has conducted Aegis Ballistic Missile Defense (BMD) tests at the
    Pacific Missile Range Facility (PMRF) for years. However, the future of
    that testing at PMRF is in jeopardy since MDA plans to move both Aegis
    and Terminal High Altitude Area Defense (THAAD) tests to the Reagan
    Test Site in Kwajalein, which will be expensive and cause delays in the
    test program.
        What are the costs associated with moving Aegis ballistic missile
    defense tests out of the Pacific Missile Range Facility to the Reagan
    Test Site in Kwajalein? How will the delay in testing caused by moving
    to Kwajalein impact the Aegis BMD program?
        Answer. The Navy has not yet assessed the impact to the program or
    costs associated with moving Aegis BMD tests to the Reagan site;
    however, I anticipate there will be increased logistics and support
    costs for Aegis ships operating in the vicinity of Kwajalein for BMD
    tests.
        While some MDA Aegis BMD tests may require support from the Reagan
    Test Site or the Kodiak Launch Center because the tests require more
    complex, longer-range targets, the future MDA flight test program will
    continue to leverage the significant capabilities of PMRF. The
    communications architecture, data collection assets, logistics
    infrastructure, and ability to draw on an experienced and technically
    superb cadre of test planning and execution professionals have and
    continue to enable Aegis BMD to conduct a progressively more robust and
    realistic flight test program since 1995.
        Question. What is the MDA's rationale for moving the Aegis BMD and
    THAAD tests out of PMRF?
        Answer. Certain tests, such as the upcoming Aegis BMD-THAAD Flight
    Test Mission (FTM-15), may be moved to the Reagan Test Site in
    Kwajalein where MDA can conduct increasingly complex tests with longer-
    range targets, and higher engagement altitudes and velocities. Debris
    patterns from tests such as these produce larger debris patterns than
    previous Aegis BMD tests. If conducted at PMRF, these tests could
    result in debris that impacts the Hawaiian Islands in violation of the
    1998 PMRF Enhanced Capability Environmental Impact Statement.
        While MDA may require the use of the Reagan site to conduct BMD
    tests in certain threat-realistic regimes, MDA will continue to use
    PMRF for BMD and THAAD testing. Test plans indicate the majority of
    Aegis BMD testing will take place at PMRF and MDA will conduct more
    tests at PMRF than any other test range.
        Question. What do the Navy and MDA need to do in order to continue
    Aegis and THAAD tests, including the future long range tests, at PMRF?
        Answer. According to developed test plans, Aegis and THAAD testing
    at PMRF will continue and MDA will conduct more tests at PMRF than any
    other test range. However, selected future tests with longer-range
    targets, and higher engagement altitudes and velocities may result in
    debris patterns that could impact the Hawaiian Islands. These tests
    will be considered for the Reagan Test Site.
        Question. What are the potential environmental hazards and risks
    for the Hawaiian Islands if the Navy and MDA continued to do more
    complex testing at PMRF?
        Answer. More complex testing at PMRF may result in debris falling
    on the Hawaiian Islands. PMRF has consistently interpreted the 1998
    PMRF Enhanced Capability Environmental Impact Statement (EIS), as
    allowing ``no debris on island.'' Further EIS analysis of potential
    environmental impacts and safety risk analysis will be required to
    determine the feasibility of more complex tests.
                             ship depot maintenance
        Question. Admiral Roughead, on May 14, 2009, the Committee received
    a letter responding to an authorization requirement certifying that the
    Navy has fully funded the 2010 requirements for ship steaming days and
    projected depot maintenance for ships and aircraft.
        Less than a week after that letter was sent, on May 19, the
    Committee received the Navy's fiscal year 2010 Unfunded Programs List.
    The only items on that list are depot maintenance for aircraft and
    ships in the amount of $395 million. Please explain how there are
    unfunded requirements for depot maintenance if the Committee has a
    letter certifying that sufficient funding has been requested to meet
    mission requirements in fiscal year 2010.
        Answer. The fiscal year 2010 Department of the Navy Assessment of
    Ship Steaming Days, Ship Depot Maintenance and Air Depot Maintenance
    Workload delivered with the May 14, 2009 letter to the Committee
    reported that ship depot maintenance was funded to 96 percent of the
    requirement, accepting some risk in deferred ship maintenance. It also
    reported that aircraft depot maintenance was funded at 100 percent for
    deployed squadrons, 97 percent for non-deployed squadrons, and 67
    percent for engine maintenance. The Navy's fiscal year 2010 Unfunded
    Programs List is consistent with this report. Funding levels for
    maintenance represent the best balance of risk across the entire Navy
    program. The Navy remains committed to funding ship and aviation depot
    maintenance accounts within acceptable risk levels and meeting expected
    service life for our platforms.
        Question. Admiral Roughead, what kind of actions is the Navy
    undertaking to reduce the reliance on supplemental funding for ship and
    aircraft depot maintenance?
        Answer. The Navy is committed to accurately programming and
    budgeting costs into our baseline budget and reducing our reliance on
    supplemental funding. To that end, we continue to refine our
    performance models to better predict future maintenance requirements
    and operating costs for ships and aircraft. These performance models
    undergo a rigorous review process and are validated by an independent
    assessor. In addition to modeling, our Fleet Maintenance Board of
    Directors (FMBOD) provide additional oversight of the requirements
    definition phase for ship depot maintenance to ensure that hull-unique
    requirements are factored into our baseline. The Navy does not budget
    for unanticipated maintenance requirements; we address these emergent
    requirements in the year of execution.
                        aegis ballistic missile defense
        Question. Admiral Roughead, in last year's testimony before this
    Committee, you told us that it was the appropriate time to consider
    migrating the ``fielding wedge'' of Aegis ballistic missile defense
    from the Missile Defense Agency to the Navy. Can you elaborate on what
    the ``fielding wedge'' entails and the status of that migration?
        Answer. The ``fielding wedge'' is the common term MDA had used for
    the Department of Defense-wide account that provided funding for
    fielding Ballistic Missile Defense System assets, such as SM-3 missiles
    and additional Aegis BMD installations. Currently, procurement of SM-3
    missiles is an MDA program and funds in the ``fielding wedge'' have
    been allocated to MDA.
        When the SM-3 procurement program is transitioned to the Navy in
    the future, it may be appropriate for SM-3 procurement funding to
    migrate to the Navy.
        The SM-3 missile used for exo-atmospheric (in space) intercepts is
    launched from our Aegis BMD capable cruisers and destroyers. Over the
    last 5 years MDA and the Navy developed and installed this capability
    in 3 cruisers and 15 destroyers for a total of 18 ships. In the fall of
    2008, due to an increasing demand for BMD capable ships, MDA and the
    Navy collaborated in co-funding the installation of Aegis BMD
    capability in three additional East Coast Aegis ships in 2009 and 2010,
    increasing the Aegis BMD fleet to 21 ships. In the President's budget
    for fiscal year 2010, the Department added $200 million across the FYDP
    to install the Aegis BMD capability on six additional Aegis ships.
                               surface combatants
        Question. Admiral Roughead, last year this committee supported
    continued funding for the DDG 1000 program and provided $200 million in
    advance procurement funding to restart the DDG 51 program. We
    understand that the Navy has made decisions on how to proceed with
    these programs and has reached an agreement with shipyards on a
    construction plan. Would you explain the agreement and explain how this
    approach will benefit the Navy?
        Answer. After extensive discussions with General Dynamics
    Corporation Bath Iron Works (BIW) and Northrop Grumman Shipbuilding
    (NGSB), the Navy will build all three DDG 1000 Class ships at BIW and
    the first three DDG 51 Class ships under the restarted program at NGSB.
    This agreement will ensure workload stability at both shipyards,
    leverage learning, stabilize and minimize cost risk for the DDG 1000
    program, efficiently re-start DDG 51 construction, facilitate
    performance improvement opportunities at both shipyards, and maintain
    two sources of supply for future Navy surface combatant shipbuilding
    programs.
        This plan most affordably meets the requirements for surface
    combatants, commences the transition to improved missile defense
    capability in new construction, and provides significant stability for
    the industrial base.
        Question. Admiral Roughead, will the DDG 1000 be the precursor to
    the future cruiser?
        Answer. Future surface combatant requirements are being studied.
    Capabilities and technologies inherent in both the DDG 51 class and DDG
    1000 class will inform this study and help us better approach future
    combatant requirements definition and designs.
        Question. Admiral Roughead, how do you plan to employ the three DDG
    1000s once they are delivered to the Navy?
        Answer. The three DDG 1000 ships will be employed globally as U.S.
    Navy Fleet assets in traditional destroyer roles, as well as integral
    members of joint and combined expeditionary forces. The DDG 1000 will
    provide forward presence, deterrence, and support to ground forces
    through all-weather precision gun fire and inland strikes and littoral
    anti-submarine warfare.
                          advance seal delivery system
        Question. Last November, the Advanced SEAL Delivery System suffered
    a catastrophic fire which brought into question whether a repair was
    feasible. It now appears that the ASDS could be repaired, although the
    repair could take several years and cost several hundreds of millions
    of dollars.
        Admiral Roughead, do you have firm estimates on what it would take
    to repair the ASDS? Has Special Operations Command and the Navy
    developed a proposal for how to pay that bill?
        Answer. The current ASDS repair estimate is approximately $250
    million. The program cost estimates have been reviewed by cost
    engineers and are considered reasonable for the anticipated repairs,
    however, the Naval Sea Systems Command Program Office will continue to
    refine the cost estimate. USSOCOM is pursuing various options to obtain
    funding to effect the repairs.
        Question. Admiral Roughead, SOCOM is planning to build a new ASDS-
    like submarine, with research and development funds requested in this
    budget. Do you believe there is an urgent case to repair the ASDS,
    considering that a new capability is expected to be available soon
    after the ASDS repairs would be completed?
        Answer. The estimated repair timeline would return ASDS to service
    in fiscal year 2012. The acquisition plan for the Joint Multi-Mission
    Submersible has the first vehicle achieving Initial Operational
    Capability in fiscal year 2016. SOCOM has validated numerous missions
    for this capability in the near term. Failure to repair ASDS-1 would
    result a capability gap for four years and, therefore, delay such
    missions.
                                amphibious ships
        Question. Admiral Roughead, what is the current status of the
    seabasing concept?
        Answer. Seabasing concept supports our Maritime Strategy. Seabasing
    enables operational commanders to project capabilities ashore whether
    access is opposed, infrastructure (air and sea ports) are non-existent,
    or a large footprint ashore is politically undesirable.
        In recent years we have expanded upon the seabasing concept.
    Examples of seabasing include: U.S. Fifth Fleet's Combined Task Force
    151 counter-piracy operations, U.S. Pacific Fleet's Pacific Partnership
    humanitarian civic assistance missions, Naval Forces Africa's/Naval
    Forces Europe's Africa Partnership Station initiative to improve
    maritime safety and security in West and Central Africa, U.S. Fourth
    Fleet's Continuing Promise humanitarian civic assistance operation in
    U.S. Southern Command's area of responsibility, the 2006 non-combatant
    evacuation operation from Lebanon, the 2005 Pakistan earthquake
    response, and the 2005 Asian tsunami response.
        The ongoing Seabasing Capabilities Based Assessment (CBA) will
    identify and prioritize capability gaps and propose solutions that
    could enhance our ability to meet future requirements.
                          amphibious lift requirement
        Question. Admiral Roughead, would you comment on the 38 ship
    amphibious lift requirement, and the future requirements for seabasing?
        Answer. In the January 2009 Report to Congress on Naval Amphibious
    Force Structure, the Commandant of the Marine Corps and I reaffirmed
    that 38 amphibious ships are required to lift the assault echelon of
    2.0 Marine Expeditionary Brigades (MEBs). We agreed to sustain,
    resources permitting, an amphibious force of about 33 total amphibious
    ships in the assault echelon, evenly balanced at 11 aviation capable
    ships, 11 LPD-17 class ships, and 11 LSD 41 class ships. The 33 ship
    force accepts risk in the arrival of combat support and combat service
    support elements of the MEB but has been judged to be adequate in
    meeting the needs of all parties within the limits of today's fiscal
    realities.
        The Navy and Marine Corps continuously evaluate amphibious lift
    capabilities to meet current and projected requirements. In addition to
    our internal reviews, the Quadrennial Defense Review is assessing
    future amphibious force structure requirements.
        Seabasing concept supports our Maritime Strategy. Seabasing enables
    operational commanders to project capabilities ashore whether access is
    opposed, infrastructure (air and sea ports) are non-existent, or a
    large footprint ashore is politically undesirable.
        In recent years we have expanded upon the seabasing concept.
    Examples of seabasing include: U.S. Fifth Fleet's Combined Task Force
    151 counter-piracy operations, U.S. Pacific Fleet's Pacific Partnership
    humanitarian civic assistance missions, Naval Forces Africa's/Naval
    Forces Europe's Africa Partnership Station initiative to improve
    maritime safety and security in West and Central Africa, U.S. Fourth
    Fleet's Continuing Promise humanitarian civic assistance operation in
    U.S. Southern Command's area of responsibility, the 2006 non-combatant
    evacuation operation from Lebanon, the 2005 Pakistan earthquake
    response, and the 2005 Asian tsunami response.
        The ongoing Seabasing Capabilities Based Assessment (CBA) will
    identify and prioritize capability gaps and propose solutions that
    could enhance our ability to meet future requirements.
                      next generation ballistic submarine
        Question. The President announced in April a new series of nuclear
    arms control efforts, including negotiations on an arms reduction
    treaty with Russia and a goal to eventually retire our nuclear arsenal.
    But the budget request includes $387 million to begin development of
    the next generation ballistic missile submarine, which would go into
    production approximately 10 years from now.
        Admiral Roughead, given these new arms control initiatives and the
    upcoming Nuclear Posture Review, why is this the appropriate time to
    begin developing a new platform for our strategic arsenal?
        Answer. The President has reaffirmed the need to maintain a strong
    strategic deterrent for the foreseeable future. To ensure there is no
    gap in strategic coverage when the OHIO class SSBNs begin to retire in
    2027, we need to start concept and system definition for the OHIO class
    replacement in fiscal year 2010. Starting this work now is consistent
    with the 20-year timeline used to develop, build, and test the existing
    OHIO class submarines. There are key technical and schedule drivers
    that require the fiscal year 2010 start so design and technology can
    mature to support a fiscal year 2019 ship construction schedule.
    Additionally, we will achieve significant program benefits by aligning
    our efforts with those of the United Kingdom as they move forward with
    their SSBN replacement program.
        Question. Admiral Roughead, there are significant concerns about
    the cost of a new ballistic missile submarine. Some are saying that it
    could cost as much as an aircraft carrier. Is there a target cost for
    this new submarine to allow it to fit into our long-term shipbuilding
    plan?
        Answer. No cost target has been established for the SSBN
    replacement. The Navy is currently conducting an Analysis of
    Alternatives (AoA) and will develop an estimated Shipbuilding and
    Conversion, Navy (SCN) cost for the new ballistic submarine after the
    completion of the AoA in early 2010.
                        long-term plan for end strength
        Question. Admiral Roughead, this year the Navy decided to halt its
    personnel reductions, believing the current plan cut too deep. The Navy
    now plans to reach an end strength of 328,800 in fiscal year 2010. What
    is the long term plan for the Navy's end strength?
        Answer. The Navy fiscal year 2010 budget requests baseline end
    strength of 324,400 plus Overseas Contingency Operations (OCO) funding
    to support temporary augmentation requirements of up to 4,400
    additional personnel. Navy manpower requirements are determined by the
    Navy's force structure, assigned missions, and job related tasks;
    therefore, Navy's long-term plan for end strength will be shaped by
    decisions from the Quadrennial Defense Review regarding these factors.
    With QDR guidance, Navy will review job tasks and processes, identify
    manpower and training requirements to support new missions or cease
    work that may no longer be required, and recommend improvements to
    training and distribution processes. Navy is committed to size, shape,
    and stabilize the force to fit current and future manpower requirements
    to meet future threats.
                considerations to resource additional personnel
        Question. Admiral, what tradeoffs is the Navy considering to be
    able to resource these additional personnel?
        Answer. The President's budget submitted to the Congress provides
    the necessary funding for the Navy's requested baseline end strength
    requirements. Navy has requested Overseas Contingency Operations (OCO)
    funding to support temporary augmentation requirements of up to 4,400
    in fiscal year 2010.
                                     ______

                  Questions Submitted by Senator Thad Cochran
                               common hull forms
        Question. Admiral Roughead, you are on record as being a strong
    advocate for the use of common hull forms to permit longer production
    runs to help reduce shipbuilding costs. As you have said in the past,
    ``We can no longer design a different ship for every different mission
    that we have.'' We must plan and build ships more efficiently, and I
    agree with your commonality approach as one means to make headway in
    this area.
        With this in mind, do you see any utility in using the LPD-17 hull
    as the future replacement for joint command ships and dock landing
    ships?
        Answer. In general, the Navy's long range vision for shipbuilding
    includes reducing the types and models of ships in the Fleet,
    maximizing the reuse of ship designs and components, and building ship
    variants that leverage existing production lines. Regarding the LPD-17
    hull, we are currently considering this hull, along with the existing
    T-AKE hull in an Analysis of Alternatives for the replacement of our
    two existing LCC ships.
                       fire scout unmanned aerial vehicle
        Question. Admiral Roughead, the Fire Scout unmanned aerial vehicle
    is being developed for deployment aboard Littoral Combat Ships. I have
    been informed the Navy has been testing the Fire Scout at-sea aboard
    frigates and plans to deploy the system aboard the U.S.S. McInerney
    this fall. Could you update the committee on how testing is progressing
    and what operational impact deployment of the system will have for the
    Navy?
        Answer. The Fire Scout is successfully completing developmental
    testing and is on track to deploy in the fall of 2009 on-board the
    U.S.S. McInerney. Three productive ship test periods aboard the U.S.S.
    McInerney have been completed. Systems testing of the Vertical Takeoff
    and Landing Tactical Unmanned Aerial Vehicle (VTUAV) Command and
    Control, Data Links, landing sub-system, flight deck procedures, and
    Ground Control Station were performed during the February 2009 at sea
    period. Dynamic Interface testing was completed in the April 2009 and
    May 2009 at sea periods, clearing an operationally acceptable flight
    envelope.
        During the U.S.S. McInerney deployment, the Fire Scout will enhance
    the ship's war fighting capability by using its sensors and persistence
    to increase battle space awareness. Specifically, during drug
    interdiction operations, the Fire Scout can use its speed and electro-
    optical/infra-red (EO/IR) sensor to maintain visual contact on high
    speed trafficking boats and provide evidence suitable for prosecution.
                            fire scout uav benefits
        Question. Admiral Roughead, do you believe there are benefits to
    deploying Fire Scout aboard all air-capable ships?
        Answer. Fire Scout has capabilities that are applicable to all air-
    capable ships. Presently, the requirement and funding support
    integration on the LCS class and one frigate deployment in support of
    Fire Scout Initial Operational Test and Evaluation. Future plans for
    Fire Scout to be deployed on additional ships will be guided by the
    operational value, other Navy priorities and our budget.
                              littoral combat ship
        Question. Admiral Roughead, the original cost estimate for the
    Littoral Combat Ship was $220 million per ship. The Navy's fiscal year
    2010 budget request includes the procurement of three Littoral Combat
    Ships funded at a congressionally mandated cost cap of $460 million per
    ship. However, current estimates are that the fiscal year 2010 ships
    will cost about $100 million more per ship than you have requested. How
    does the Navy intend to execute the fiscal year 2010 Littoral Combat
    Ship request given this shortfall?
        Answer. Navy is actively engaged with industry to implement cost
    reductions with the intent to procure the fiscal year 2010 ships within
    the $460 million cost cap. We have formalized a cost reduction effort
    that primarily targets cost drivers in design, Navy specifications, and
    program management costs. Until manufacturing efficiencies can be
    achieved for the follow on ships Navy may require some legislative
    relief regarding the fiscal year 2010 LCS cost-cap.
                         joint high speed vessel (jhsv)
        Question. Admiral Roughead, the Administration's budget proposal
    requests two Joint High Speed Vessels, one funded by the Navy and one
    funded by the Army. Would you describe to the committee the
    Department's procurement plans for these vessels? In addition, please
    explain the capability strengths and weaknesses of the Joint High Speed
    Vessel and the sea state limitations?
        Answer. The current requirement for the Joint High Speed Vessel
    (JHSV) program is 20 ships: 15 ships to be operated by the Navy and 5
    ships to be operated by the Army. The Detail Design and Construction
    contract for the first vessel, funded in fiscal year 2008 for the Army,
    was awarded to Austal USA on November 13, 2008. Funding for the second
    and third ships (one Navy and one Army) was provided in the fiscal year
    2009 Defense Appropriations Act. Funding for fourth and fifth ships
    (one Navy and one Army) is included in the fiscal year 2010 budget
    request. Delivery of the first Army JHSV is expected in 2011. Delivery
    of the first Navy ship is expected in 2012.
        JHSV will be a high-speed, shallow-draft surface ship that will be
    able to rapidly transport medium payloads of cargo and personnel in-
    theater, reconfigure and rearrange loads when missions change and
    access to port facilities that are too austere or shallow for other
    larger auxiliary ships. JHSV, while performing a variety of lift and
    support missions, will be a non-combatant ship that will operate in
    permissive environments or in higher threat environments under the
    protection of combatant vessels and other Joint forces. JHSV is a
    commercial-design and does not require the development of any new
    technology. JHSV is being built to American Bureau of Shipping (ABS)
    High Speed Naval Craft Code. It has no combat system capability.
        JHSV capabilities include:
      --High speed transits of 35 knots.
      --Open architecture and rapid reconfigurability for Command, Control,
            Communications, Computers, and Intelligence (C\4\I).
      --High payload fraction and large, rapidly reconfigurable, payload
            volume.
      --Shallow 13-foot draft.
      --Support for helicopter operations; and at-sea replenishment of fuel
            and cargo extended range transits of greater than 3,000 nm in
            up to Sea State 3.
                                     ______

                Question Submitted by Senator Robert F. Bennett
                     f/a-18 e/f's retire and jsf shortfall
        Question. Admiral Roughead, considering the numerous challenges
    currently facing the Navy, I am impressed by the variety of tasks that
    you undertake, particularly the sizable portion of missions flown by
    Navy airmen over Afghanistan. I am concerned by the drop in the number
    of airframes that will be available to the Navy due to battle-worn F/A-
    18 E/F's having to be retired sooner than anticipated. While I
    understand the fundamental role that the new F-35 Joint Strike Fighter
    (JSF) will play in addressing this shortfall, how do you plan to
    maintain the Navy's ability to carry out its air operations should the
    JSF program become significantly delayed? What actions are currently
    being taken to address this problem? How can the Congress assist you in
    meeting this responsibility?
        Answer. The Navy is experiencing a decrease in strike fighter
    capacity due to the continued high pace of operating our older F/A-18
    A-D aircraft. The timely delivery of the Joint Strike Fighter is
    critical to our ability to meet operational demands for expeditionary
    strike and maintain a mix of strike fighter aircraft on our carrier
    decks.
        Until JSF reaches initial operating capability in 2015, we are
    managing our existing strike fighter inventory by extending service
    life of our F/A-18A-D Hornets beyond their originally-designed 6,000-
    hour service life to 8,000 flight hours. There is also the potential to
    extend the service lives of some of our A-D Hornets further, to 10,000
    hours.
        The Quadrennial Defense Review (QDR) will review TACAIR
    requirements across all the Services to include the required number of
    carrier-capable strike fighters our nation needs. Navy will then do a
    cost-benefit analysis to determine the best option for buying
    additional life in our strike fighter inventory: through service life
    extensions of existing aircraft, through procurement of new aircraft,
    or through a combination of these two options. The fiscal year 2010
    budget contains appropriate funding to continue development and
    procurement of JSF and buy an adequate number of F/A-18 aircraft to
    keep that production line open until QDR completes its review.
                                     ______

                 Questions Submitted to General John T. Conway
                Questions Submitted by Chairman Daniel K. Inouye
                           marine corps end strength
        Question. General Conway, as the Army and Marine Corps complete
    their planned end strength growth, there has been discussion about
    whether the Army should continue to grow to sustain the current
    operational tempo. Has the Marine Corps undertaken a similar analysis?
    Do you think the Marine Corps has reached an end strength that is large
    enough to sustain operations and relieve the strain on the force?
        General, what does the increased commitment to Afghanistan mean for
    the end strength of the Marine Corps? How will this affect the Marine
    Corps ability to sustain its current commitments?
        Answer. The Marine Corps has undertaken similar analysis by
    conducting the Uncompensated Review Board (URB) for the last 2 years.
    The URB conducts an annual review and validation of the Marine Corps'
    capabilities to assess new active duty uncompensated force structure
    requirements and prioritize these adjustments against my approved force
    structure plan. If analysis supports, the URB will recommend that the
    end strength of the Marine Corps be increased. Following the URB, a
    standing DOTMLPF (Doctrine, Organization, Training, Materiel,
    Leadership and Education, Personnel and Facilities) Working Group is
    overseeing the implementation and synchronization of this plan. This
    working group consists of a cross section of my staff and the Marine
    Forces Commanders.
        The Marine Corps has reached an end strength that is large enough
    to sustain operations and relieve the strain on the force. I continue
    to stress that the growth to 202,000 active-duty Marines will enable
    the Corps to meet current and future challenges in an increasingly
    demanding operational environment. Growth to 202,000 gives the Marine
    Corps the capacity to deploy forces in response to contingencies and to
    support security cooperation efforts with our partners across all
    theaters, Our forces are multi-capable, transitioning seamlessly from
    fighting conventional and hybrid threats to promoting stability and
    mitigating conditions that lead to conflict. By building to 202,000, we
    improve training, upgrade readiness, and enhance the quality of life
    for all our Marines and their families by allowing them more recovery
    time between deployments.
                     marine corps suicide and divorce rates
        Question. General Conway, the Marine Corps' suicide and divorce
    rate have risen sharply this past year. It appears that the strain of
    frequent deployments is beginning to show in the emotional health of
    our Marines. What more can the Marine Corps do to support Marines and
    their families?
        General, the Marine Corps what additional support could the
    Committee provide to help alleviate the strain on the force?
        Answer. There is no question that continued OPTEMPO puts stress on
    the force, not just for deploying Marines, but for those who remain
    behind and face increased workloads. There were year on year increases
    for 2008 in suicide incidents and divorces.
        Health of the Force.--Marine Corps commanders are fully engaged in
    promoting the psychological health of our Marines, Sailors, and family
    members. To enable leaders, individuals, and families to prepare for
    and manage the stress of operational deployment cycles, the Combat and
    Operational Stress Control (COSC) Program provides a set of policies,
    training, and tools to prepare for the upcoming deployment, recognize
    stress reactions early and manage them more effectively within
    operational units. Marine leaders are assisted by mental health
    professionals, chaplains, and COSC regional training coordinators in
    the operating forces, to detect stress problems in warfighters as early
    as possible, and are provided the resources to effectively manage these
    stress problems in theater or at home base. Resources are also provided
    for the family members left behind to provide support, communications,
    and information flow.
        This training is being incorporated in formal Professional Military
    Education schools for both officer and enlisted Marines, such as the
    Expeditionary Warfare School and the Staff Non-commissioned Officer
    Advanced Course. We have staffed full-time COSC training coordinators
    at each of our Marine Expeditionary Force headquarters.
        To assist with prevention, rapid identification, and effective
    treatment of combat operational stress, we are expanding the
    Operational Stress Control and Readiness (OSCAR) Program--our program
    of embedding mental health professionals in operational units--to
    directly support all active and reserve ground combat elements. This
    year, we begin placing mental health professionals organic to the
    active Divisions and Marine Forces Reserve. By fiscal year 2011, full
    OSCAR teams will be fielded to the Infantry Regiment level. OSCAR will
    eventually be expanded to all deployed elements of the Marine Air-
    Ground Task Force.
        Our Marine Operational Stress Training (MOST) program was developed
    with Tri-Marine Expeditionary Force (TRI MEF) Commanders based on the
    USMC COSC stress continuum model, now adopted by OSD. Our program
    supports the full deployment cycle by focusing on Leaders, Marines and
    families from pre-deployment through post-deployment, providing
    information on what's to come, what to look for, and what to do when
    stress reactions appear. COSC concepts have also been incorporated in
    family readiness training.
        Suicide.--We are taking proactive action to address the issue of
    suicide. The Sergeant Major hand-selected a senior enlisted Marine
    leader to add unique insight to our efforts in suicide prevention, and
    the Assistant Commandant (ACMC), through the Executive Safety Board, is
    directing a series of initiatives which are currently in accelerated
    development:
      --Training.--Since 90 percent of suicides have tended to occur in the
            ranks of E1-E5 Marines, a half-day, high impact, relevant
            workshop has been designed to reach the NCO/FMF Sailor
            community and facilitate their work with junior enlisted
            Marines. This training is expected to be ready by this summer.
            In March, I directed that an all-hands training on suicide
            prevention be conducted throughout the Corps.
      --Leadership Suicide Prevention Video Messages.--All O6 and higher
            commanding officers have been directed to produce videos
            focusing on leadership and suicide prevention to set the tone
            for stigma reduction and an imperative of prevention.
      --Integration of Suicide Prevention and the Marine Corps Martial Arts
            Program (MCMAP).--A prevention message was incorporated in the
            MCMAP program in a manner appropriate and engaging to reach all
            Marines.
      --Relationship Distress Hotline.--Relationship problems, both
            romantic and marital, remain the number one associated stressor
            related to suicidal behavior. Suicide is complex and while this
            is not the only problem, it is the most common. A hotline by
            phone, email and live internet chat that is marketed
            specifically to assist with relationship distress and questions
            may reduce risk of suicide related behaviors that result from
            this type of stress. In the interim, we have partnered with The
            Outreach Call Center of the Defense Center of Excellence on
            Psychological Health and Traumatic Brain Injury, and Military
            OneSource to strategically market their relationship building
            resources to Marines and family members.
        We will continue to aggressively pursue suicide prevention
    initiatives; reevaluate existing programs designed to reduce the
    stressors most correlated with suicidal behavior; develop and
    distribute new prevention programs; and refresh and expand training
    materials.
        Divorce.--Relationship problems leading to distress may result from
    difficulties in communication, parenting, sexual intimacy, finances or
    immaturity. The average age of married enlisted Marines is 27 and the
    average age of Marine Corps spouses is 28, the youngest of all the four
    military services. Coupling this young age with the demands of a
    military lifestyle can result in significant challenges for Marine
    couples.
        The Marine Corps takes a proactive stance in supporting healthy
    marital relationships. Most leaders are keenly aware of how
    relationships can impact mission readiness. When Marines are confident
    that their relationships are in good standing and their spouses are
    supported, they are able to focus on the mission at hand.
        Leaders encourage participation in such marital support programs
    as:
      --Marriage Enrichment Workshops.--The chaplain and Marine Corps
            Family Team Building offer this workshop which is built on the
            very successful Personal Relationship Enhancement Program
            (PREP). This program focuses on skill building in a fun and
            relaxed environment.
      --Face to Face Counseling Support.--Services of MCCS One Source
            supplement the existing support system for Marines and their
            families by providing assistance 24 hours a day, 7 days a week
            via toll free telephone and Internet access. In addition, MCCS
            One Source supports geographically dispersed Marines and their
            families (recruiters, Inspector and Instructor staffs, and
            mobilized reservists) who do not have traditional services
            available. Military OneSource provides counseling support, 24/
            7, 7 days a week, for anyone seeking to learn more about
            building a strong relationship that lasts. One Source can
            provide assistance through referrals to military and community
            resources, online articles, newsletters, and workshops, prepaid
            booklets and audio recordings.
      --Couples Counseling.--The Counseling Center at Marine and Family
            Services provides individual, marriage, and family counseling
            as needed. Services are intended to be solution-focused on
            well-defined problem areas amenable to brief intervention and
            rehabilitation, such as adult adjustment issues, crisis
            intervention, academic and occupational problems, parent-child
            communication, grief and loss issues, and nonviolent marital
            problems. Licensed clinical providers assist clients to
            identify and clarify the nature and extent of problems based on
            an initial assessment, and to develop a collaborative plan for
            solving problems; and
      --Spouse Support.--These programs are aimed at reducing the social
            isolation many young spouses experience and help to establish
            more realistic expectations of what marriage in the Marine
            Corps is all about. Some of these programs include:
        --L.I.N.K.S.--A Marine Corps Family Team Building program that
                offers an orientation to the Marine lifestyle for all
                spouses. The orientation includes spouse-to-spouse
                mentorship and small group discussion, and provides a
                positive, supportive environment for spouses of all ages to
                learn to manage the demands of Marine Corps life and to
                work together as team;
        --Key Volunteer Network--This program is an integral part of the
                commander's official family readiness program and is the
                primary communication link between the Commanding Officer
                and unit families for the enhancement of mission readiness.
                The Network supports families on the home front when
                Marines are deployed. Not only does the Network provide
                information on local programs and services but also
                provides support through unit based activities;
        --Spouse Learning Series.--One-day seminar provided by MCCS and
                hosted by Marine Corps Family Team Building to equip
                spouses with techniques and skills that help to develop
                leadership skills.
                                amphibious ships
        Question. General Conway, the ability to operate independently from
    the sea is a core capability of the Navy and the Marine Corps. The
    Marine Corps is developing new tactical vehicles and aviation systems
    for future warfighting capability. Are you concerned about these
    systems making the Marine Corps is too heavy, and that our amphibious
    lift capability may be inadequate to allow the Marine Corps to continue
    to operate as units from ships?
        Answer. Yes, I'm concerned that we are getting heavier. As a result
    of our current operations in Iraq and Afghanistan, much of the
    equipment we have has gotten heavier because of our efforts to provide
    more protection for our Marines and Sailors. This increased weight,
    coupled with increased dimensions, affects how we are able to embark on
    amphibious ships as well as prepositioning ships and other strategic
    sealift platforms and how we tactically move ashore. Our requirement
    for square foot vehicle stowage on Assault Echelon amphibious ships has
    grown, along with the weight of the vehicles; consequently, we are
    working to find the right balance between protection and
    transportability for our future forces. Further, we are examining how
    tactical movement ashore (assault) times have been affected because of
    weight for the vertical landing and by both weight and vehicle square
    for surface landings.
              mine resistant all terrain vehicles for afghanistan
        Question. General Conway, Mine Resistant Ambush Protected Vehicles,
    referred to as ``MRAPs'' in short, have saved thousands of lives in
    Iraq. To address the complex terrain in Afghanistan, the Department
    will purchase a lighter version of the MRAP vehicle, known as the ``M-
    ATV''. But we are hearing that the Marine Corps is opting to upgrade
    its MRAPs instead of purchasing the lighter M-ATV for troops deploying
    to Afghanistan. Can you tell us the advantages of this strategy?
        Answer. We are upgrading current Mine Resistant Ambush Protected
    (MRAPs) vehicles with a modified independent suspension system that is
    being used on the highly reliable Medium Tactical Vehicle Replacement
    (MTVR) vehicles. This will significantly increase the vehicles' off
    road mobility while retaining crew survivability. The MRAP All Terrain
    Vehicle (M-ATV) will be used to complement the other tactical vehicles
    that are already in the theater of operations. We anticipate awarding
    M-ATV contracts by the end of June 2009.
        Question. General Conway, can you assure the Committee that
    upgraded MRAPs will provide the same level of force protection for our
    troops as the newer, lighter M-ATVs?
        Answer. Yes. Survivability is always a priority in our ongoing
    spiral development efforts. All MRAPs undergo rigorous testing and
    evaluation to ensure the greatest survivability capabilities are
    available to our forces to meet the warfighters' requirements.
        Question. General Conway, the original MRAP program was managed
    through the Marine Corps. The M-ATV program is being managed through
    the Army. What caused this transition and how is it affecting the
    Program Office's ability to move forward on the program?
        Answer. The MRAP program continues to be managed by the Marine
    Corps. The Office of the Secretary of Defense (OSD) determined the M-
    ATV is within the MRAP family of vehicles. MRAP Joint Program Office
    (JPO) personnel are leveraging the resources of the U.S. Army Tank-
    automotive and Armaments Command (TACOM) Contracting Center to conduct
    the competitive acquisition and award the contract.
                     marine corps move from okinawa to guam
        Question. General Conway, the original plan to move Marines from
    Okinawa to Guam included moving 8,000 and 9,000 dependants. Are those
    numbers still accurate or has the size of the move been reexamined.
        Answer. The relocation of Marine units to Guam alleviates growing
    encroachment issues on Okinawa and creates a long-term, enduring force
    posture in the Pacific. The Agreed Implementation Plans (AIPs) calls
    for approximately 8,000 Marines to relocate to Guam and approximately
    10,000 Marines to remain on Okinawa.
        Many things have changed since the planning and development of the
    2006 Roadmap and associated AIPs. These changes have forced planners to
    re-evaluate what is the proper force lay down in the Pacific,
    specifically the appropriate array of MAGTF units to properly support
    the PACOM commander's operational requirements. While the Marine Corps
    is executing strictly toward the AIP force laydown, it looks forward to
    opportunities that may re-examine the force posture, such as the
    Quadrennial Defense Review and the Deputy Secretary of Defense Guam
    Oversight.
                                     ______

                  Questions Submitted by Senator Thad Cochran
                          amphibious ship requirements
        Question. General Conway, based on current major contingency plans
    what is the requirement for amphibious ships, and how can these plans
    be conducted with the current number of amphibious ships?
        Answer. The Marine Corps' contribution to the Nation's forcible
    entry requirement is a single, simultaneously-employed two Marine
    Expeditionary Brigade (MEB) assault capability--as part of a seabased
    Marine Expeditionary Force (MEF). Although not a part of the MEF
    Assault Echelon (AE), a third reinforcing MEB is required and will be
    provided through MPF(F) shipping. Each MEB AE requires seventeen
    amphibious warfare ships--resulting in an overall ship requirement for
    thirty-four amphibious warfare ships. To make thirty-four operationally
    available amphibious ships based on a CNO approved maintenance factor
    of 10 percent, four additional ships are required for an inventory of
    thirty-eight amphibious ships which also covers our forward presence
    requirement. The Navy and Marine Corps have agreed to this requirement
    in a January 7, 2009 letter to members of the House Appropriations
    Committee which also states that: ``Understanding this requirement, and
    in light of the fiscal constraints with which the Navy is faced, the
    Department of the Navy will sustain a minimum of 33 total amphibious
    ships in the assault echelon. This 33 ship force accepts risk in the
    arrival of combat support and combat service support elements of the
    MEB, but has been adjudged to be adequate in meeting the needs of the
    naval service within today's fiscal limitations.''
        Again, this arrangement accepts some degree of risk but is feasible
    with the assault echelons being rapidly reinforced by Maritime
    Prepositioning Force Future (MPF-F).
        Question. General Conway, what is the current readiness status of
    amphibious ships particularly with crew manning and material readiness?
        Answer. This question is more appropriately aimed at the CNO and
    his staff to answer the details; however, I will say that amphibious
    class ships are among the ships with the highest Operational tempo
    (OPTEMPO) in the Surface Fleet.
        Question. General Conway, how does the move of Marines from Okinawa
    to Guam change or shape the requirement for amphibious ships either in
    their homeport lay down and/or numbers?
        Answer. The Pacific realignment will result in a disaggregation of
    III MEF forces on Okinawa, Guam, and Hawaii. This disaggregation
    creates inherent challenges in sustaining MAGTF core competencies and
    rapidly responding to contingencies in the theater. The realignment
    highlights the need for increased theater mobility, which is provided
    by a combination of tactical airlift, high-speed vessels, amphibious
    ships, black-bottom shipping (MSC), and strategic airlift. The quantity
    and mix of theater mobility assets, some of which may be sourced
    globally, will be reviewed as the force laydown, training requirements,
    Theater Security Cooperation plans, and OPLANS are refined as we
    progress with Pacific realignment planning. Currently, amphibious
    shipping is home stationed in Sasebo, Japan, and Honolulu, Hawaii, to
    support Marines on Okinawa and Hawaii, and could be used to support
    Marines on Guam with additional transit time. A review of amphibious
    shipping support for Marine forces based on Guam has not been initiated
    as key issues, such as force laydown and training, are still being
    studied within the Quadrennial Defense Review.
        Question. General Conway, does the Army or Special Operations
    Command have any requirement for amphibious ships? If not, why not? And
    if yes, how are their requirements factored into the overall program?
        Answer. According to our research, the U.S. Army and USSOCOM
    currently have no requirement for amphibious ships. The U.S. Marine
    Corps provides the nation's ``forcible entry from the sea,'' it is our
    core competency.
        Question. General Conway, we have seen amphibious ships used for
    non-traditional functions such as disaster relief and humanitarian-
    assistance. What other missions or requirements exist for amphibious
    ships; could they be used for, mine counter measure ships, Afloat
    Forward Staging Bases for Special Operations Forces, Theater Security
    Cooperation Platforms, and Marine Air-Ground Task Force. Would these
    missions or requirements change the overall requirement for amphibious
    ships?
        Answer. Broadly stated, there are three competing demands for
    amphibious ships. The first two, maintaining persistent forward
    presence and episodically aggregating sufficient numbers to deliver the
    assault echelon in a joint forcible entry operation, are both tied to
    lifting Marine air-ground task forces. The third demand is tied to key
    joint enablers.
      --Forward Presence.--Amphibious forces in general, and Amphibious
            Ready Groups with embarked Marine Expeditionary Units (ARG/MEU)
            in particular, have proven themselves invaluable for regional
            deterrence and crisis response. In recent years amphibious
            ships have also demonstrated their utility for missions such as
            security cooperation and civil support to include humanitarian
            assistance and disaster relief. They allow the United States to
            discretely interact with partner nations without the unintended
            consequences often generated by a large footprint ashore in
            politically sensitive areas. As a result, in this era of
            declining overseas access the geographic combatant commanders'
            (GCC) have an increased demand for forward-postured amphibious
            forces. The cumulative GCC demand for forward-postured
            amphibious forces can be met with an inventory of 38 ships.
      --Assault Echelon.--An amphibious inventory of 38 ships will also
            support Marine Corps forcible entry requirements. The assault
            echelon of a Marine Expeditionary Force can be accommodated on
            34 ships. Our challenge is one of aggregating those 34 ships
            from an inventory of 38. Essentially, that means we can have no
            more than four ships--10 percent of the inventory--in
            maintenance at any one time and that the United States is
            willing to sail the remaining 34 ships away from all other
            global commitments.
      --Joint Enablers.--Extant operation plans and recent experience prove
            the need for amphibious ships specifically dedicated to support
            Special Operations Forces (SOF) and Mine Countermeasure (MCM)
            forces. Inasmuch as SOF and MCM support are critical enablers
            for forcible entry, these requirements must be supported either
            by the acquisition of additional amphibious ships--over and
            above the 38 needed to satisfy Marine Corps forward presence/
            assault echelon requirements--or the provision of other
            suitable platforms.
                     medevac mission support in afghanistan
        Question. General Conway, the issue of providing timely medical
    care for our service members in combat is of great concern to us all. A
    major contributor to being able to providing timely care is associated
    with having full medical evacuation capabilities in Theater. Have you
    seen any improvement in lowering the response time in Afghanistan for
    medical evacuations? If so, do these efforts meet your expectations for
    providing support to the additional personnel being stationed in
    Afghanistan and what other improvements are planned to support the
    medical needs of additional ground forces?
        Answer. I am very pleased with the procedures initiated by CENTCOM
    to monitor the Secretary of Defense's directed 60-minute MEDEVAC
    standard. We have to give the newly arriving forces time on the ground
    to become Fully Operational Capable (FOC) before improvements can be
    measured. When the units are declared FOC and start conducting
    missions, CENTCOM will analyze their progress and conduct reassessments
    on capabilities including MEDEVAC. I am of the belief that the initial
    medical and MEDEVAC forces requested by USFOR-A and CENTCOM as well as
    the additional Forward Surgical Teams and MEDEVAC recommended by the
    Joint Staff and approved by the Secretary of Defense are capable of
    providing care to the additional force structure and will meet the
    directed 60-minute MEDEVAC standard. The standard is measured from
    ``point of injury'' to ``surgical intervention.''
                 marine corps cargo unmanned air systems (uas)
        Question. General Conway, I have been informed that the Marine
    Corps is interested in an unmanned aerial system for cargo operations
    for troop resupply in Afghanistan and that you hope to have this
    capability by February of next year. Could you please discuss the
    Marine Corps' immediate need for this unmanned air cargo system in
    Afghanistan? We would also like to hear more about the requirements and
    potential solutions for this capability.
        Answer. The objective of the Marine Corps Warfighting Lab's (MCWL)
    effort is to find a technology capable of removing, in whole or in
    part, the need to move supplies to Forward Operating Bases (FOBs) by
    ground transportation. The focus is ``getting trucks off the road'' as
    soon as possible in Afghanistan to reduce the vulnerability of supply
    lines. In general, the capability need is for an unmanned air vehicle
    to be able to deliver 10,000-20,000 pounds of cargo in a 24 hour period
    to a round-trip distance of 150 nautical miles and hover in ground
    effect/hover out of ground effect (HIGE/HOGE) at 12,000 feet density
    altitude (DA) but fly at 15,000 feet DA with a full cargo load.
        In the next 6 months we hope to demonstrate currently available
    technologies that may be operationally relevant. We will then
    transition the successful technologies to the appropriate acquisition
    command immediately thereafter for future operational deployment. The
    Naval Research Enterprise is also investigating longer term technology
    candidates for future capabilities.
        MCWL is currently in the process of conducting a source selection
    to select vendor(s) capable of demonstrating the capability of
    providing an immediate cargo unmanned aerial systems. For the
    demonstration, a single airframe must deliver at least 2,500 lbs of
    cargo in a 6 hour period to a location 75NM from the starting point
    (which is a representation of 10,000 lbs in a 24 hour period with a
    round-trip distance of 150 nautical miles), Beyond Line Of Sight (BLOS)
    from origination. The System shall be able to terminally control the
    vehicle from a destination location which is BLOS from the launch
    location with a remote controller. Terminal control will consist of the
    following options at the destination location: Deliver at programmed
    location, abort delivery, and return to launch location with original
    load. The smallest element in a cargo package shall be equivalent to at
    least a standard wood pallet (48 by 40 in. Stack  67 in.) of cubic
    volume.
        It is anticipated that a contract(s) will be awarded on or about 17
    July 2009.
                         joint high speed vessel (jhsv)
        Question. General Conway, given the sea state limitations of the
    Joint High Speed Vessel, what is the impact or potential impact on
    Marine operations and training.
        Answer. According to the JHSV Capability Development Document, it
    is designed for a speed of 35 knots in a sea state 3 (SS3) carrying the
    threshold payload of 600 short tons. The high speed of the vessel
    allows it to maneuver and change course to mitigate forecasted higher
    sea conditions allowing it to maintain the mission profile. The HSV-2
    Swift supported humanitarian assistance operations in Beirut, Lebanon
    in 2006 as part of a record breaking 2-year deployment period (2005-
    2007) in which Swift successfully completed various missions in support
    of EUCOM, CENTCOM, PACOM, and SOUTHCOM. Further, the WestPac Express
    continues to provide critical intra-theater sealift support to III MEF,
    so there is no impact on our operations and training.
                                     ______

                Question Submitted by Senator Robert F. Bennett
                                      v-22
        Question. General Conway, in your efforts to ``modernize for
    tomorrow,'' I am interested in the progress being made on a tactical
    vehicle that readily fits inside the V-22. What is the status of
    identifying and procuring an effective vehicle that meets Marine
    requirements? What assistance can Congress provide to ensure that our
    V-22 transported assault forces have the mobility that they need to
    carry out their mission?
        Answer. The Internally Transported Vehicle (ITV) is a family of
    vehicles developed and procured by the Marine Corps to provide a
    deployed Marine Air Ground Task Force (MAGTF) with a ground vehicle
    that is internally transportable in the MV-22 and CV-22 tilt-rotor
    aircraft, CH-53, and MH-47 aircraft. The vehicle serves primarily as a
    high mobility weapons-capable platform to support a variety of
    operations (reconnaissance, raids, etc.) and to provide ground units
    greater mobility, thereby enhancing their mission performance and
    survivability. The ITV was judged Operationally Effective and
    Operationally Suitable during Operational Testing in early 2008, and
    met all Key Performance Parameters and critical requirements. Full Rate
    Production (FRP) for the Light Strike Variant (LSV) of the ITV was
    granted by the Milestone Decision Authority (MDA) on July 10, 2008.
        To date a total of 21 LSVs have been fielded to the following east
    coast units; MarSoc (10), 2nd Marines (6), and 1/10 (5). Currently
    another 15 LSVs are being fielded to 1/9. New Equipment Training with
    1/9 will be completed on June 25, at which point Initial Operational
    Capability (IOC) will have been achieved for the ITV (LSV). IOC is
    achieved when, ``one Infantry Battalion assigned to a MEU is fully
    equipped with the ITV, the assigned mechanics and operators have
    received initial training, and sufficient repair parts are in place to
    support operations,'' as defined by the vehicle's requirement document.
    Fielding will begin to I MEF units in late September/early October with
    the exact date being determined at the upcoming I MEF Fielding
    Conference.
        The goal of the fielding effort for the first year is to establish
    a foundation in the operating forces to be able to support East and
    West Coast MEU deployments, the MarSoc requirement, and 1st and 2nd
    Recon Battalion's operational requirements. Fielding of LSVs will then
    continue to III MEF units. At this point the program is on track to
    purchase and field about 80-100 vehicles per year. Our current
    requirement (Approved Acquisition Allowance-AAO) is 729 vehicles.
        I ask for your continued support for all current and future funding
    requests that allow us to field this vehicle to our active and reserve
    units as quickly as possible.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The subcommittee will stand in recess
    until Thursday, June 4, and at that time we'll hear from the
    Secretary of the Air Force and the Chief of Staff of the Air
    Force on the fiscal year 2010 budget request. With that, thank
    you very much.
        [Whereupon, at 11:25 a.m., Tuesday, June 2, the
    subcommittee was recessed, to reconvene at 10:30 a.m.,
    Thursday, June 4.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                             THURSDAY, JUNE 4, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:30 a.m., in room SD-138, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Dorgan, Murray, Cochran, Bond,
    Shelby, and Bennett.

                             DEPARTMENT OF DEFENSE

                          DEPARTMENT OF THE AIR FORCE

                            Office of the Secretary

    STATEMENTS OF:
            HON. MICHAEL B. DONLEY, SECRETARY OF THE AIR FORCE
            GENERAL NORTON A. SCHWARTZ, CHIEF OF STAFF, UNITED STATES AIR
                FORCE

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning, the subcommittee convenes to
    hear testimony from the Air Force on its budget request for
    fiscal year 2010, and I am pleased to welcome the Secretary of
    the Air Force, the Honorable Michael Donley, and the Chief of
    Staff of the Air Force, General Norton Schwartz.
        Gentlemen, welcome. And I realize this is your first time
    here, but I can assure you that we are looking forward to
    working with you in the coming years because we believe that
    the Air Force is a very important part not just of the defense
    community, but of the United States.
        So let me begin by commending you both for the measures
    taken to strengthen stewardship of the Air Force's nuclear
    arsenal. The fiscal year 2010 budget includes several key
    improvements, including an increase in personnel for the
    nuclear mission and the establishment of the Global Strike
    Command. Your leadership has been essential, and we look
    forward to continued progress.
        For fiscal year 2010, the Air Force is requesting $160.5
    billion in the base budget and $16 billion in the overseas
    contingency operations budget. This budget submission is
    notable in a number of ways.
        First, it funds a more robust active duty end strength
    level of 331,000 personnel rather than continuing the drawdown
    that we have witnessed up until now. It is important to
    stabilize the Air Force manpower levels, especially now when
    mission demands are increasing.
        More personnel will help to meet the needs of irregular
    warfare, aerial surveillance support, cyberspace and
    acquisition excellence, and in restoring the nuclear
    enterprise. The subcommittee will be interested in how the Air
    Force plans to allocate personnel across these critical
    missions.
        It is noteworthy that this budget supports the continued
    emphasis on irregular warfare and building up the intelligence,
    surveillance, and reconnaissance assets needed in today's
    fight. It will increase the Predator and the Reaper unmanned
    aerial vehicle (UAV) coverage to 43 combat air patrols. The
    budget also supports the training and operation of the MC-12
    Liberty ISR aircraft. The Air Force has made great strides in
    improving its posture in this mission area.
        Third, this budget reflects the hard and controversial
    decisions that the Department is making on future investments.
    In this request, the F-22 Raptor, the C-17 airlifter, and the
    transformational communications satellite programs are
    terminated. The joint cargo aircraft program is reduced from 78
    to 38 aircraft and is no longer a joint program with the Army.
        The request restructures the combat air forces and retires
    249 fighter aircraft. The subcommittee will be interested in
    understanding both the risks and benefits of these choices.
        Gentlemen, I remain concerned about the aging aircraft
    fleet, especially the tanker fleet. The average aircraft age is
    now over 24 years. The average age of the KC-135 fleet is close
    to 50 years. The tanker aircraft must be replaced, and I have
    several questions on this program and many others today.
        And I look forward to hearing your testimony this morning.
    Your full statements will be made part of the record, but
    first, I would like to turn it over to the vice chairman of
    this subcommittee, Senator Cochran of Mississippi, for any
    opening remarks he may wish to make.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, it is a pleasure to work
    with you on this important subcommittee and to join you in
    welcoming our distinguished witnesses before the subcommittee
    today.
        The Air Force is playing a unique and important role in the
    defense of our Nation. We respect all of you who are involved
    in that. We thank you for your dedicated service and bringing
    to the challenge the expertise and results of the training and
    experience you have had in the defense of our Nation.
        The aircraft and forces of the Air Force have been
    protecting our Nation's interests in a very remarkable and
    praiseworthy way. We especially appreciate the dangers that are
    faced in Iraq, Afghanistan, and other areas around the world
    where the Air Force is playing a very important and active role
    in helping ensure that our Nation's policies succeed in those
    areas.
        We look forward to hearing your testimony to help us
    determine how best to allocate the resources that are available
    to this subcommittee for the Air Force in carrying out your
    missions.
        Thank you very much.
        Chairman Inouye. Thank you very much.
        Senator Bond.

                    STATEMENT OF SENATOR CHRISTOPHER S. BOND

        Senator Bond. Thank you very much, Mr. Chairman.
        And I join with the chairman in congratulating you on the
    good work you are doing to restore the reliability and
    assurance of our Nation's nuclear mission, and we welcome
    Secretary Donley. We thank both of you for your distinguished
    service.
        Gentlemen, as you know, we have had discussions about
    concerns over the tactical fighter's air shortfalls and, as the
    chair mentioned, 24 years age on the Air Force fleet. Last
    year, before the Airland Subcommittee of SASC, the Air Force
    testified it was facing a shortfall of 800 plus aircraft Air
    Force wide. And the Air National Guard testified that over the
    next 8 to 9 years, Air Guard is facing a fighter shortfall that
    will result in 80 percent of the aircraft used to defend the
    skies of the United States, the Air Sovereignty Alert mission,
    being retired.
        And it is clear from what the Government Accountability
    Office (GAO) has told us that accelerating the Joint Strike
    Fighter (JSF) will not prevent the fighter gap. In March of
    this year, GAO concluded it would cost $33 billion to
    accelerate the JSF program and said, ``Accelerating procurement
    in a cost reimbursement contract environment, where
    uncertainties in contract performance do not permit costs to be
    estimated with sufficient accuracy to use any type of fixed-
    price contract, places very significant financial risk on the
    Government.''
        My view, now is not the time to be placing significant
    financial risk on the Government, and it is never time to place
    the country at a security risk. But it is my view that is what
    the present budget is proposing.
        I know a lot of people will talk about the Quadrennial
    Defense Review (QDR), but as in years past, we have seen that.
    We have got the T-shirt. I know that it will be an attempt to
    justify the budget reductions by saying we don't need as many
    fighters. It is a massive budget drill. But none of that
    analysis--I will review that when it comes out--will be
    available in time for this budget session.
        So I remain convinced and we will discuss whether it is
    time to rethink the plan. JSF is too big to fail. So we are not
    going to let it go, but is it time to look at an 85 percent
    solution at one-half to two-thirds of the cost, giving the Air
    Force the proven platforms that will bridge us to the time, if
    and when, the JSF can complete its mission?
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Shelby.

                     STATEMENT OF SENATOR RICHARD C. SHELBY

        Senator Shelby. And I just want to say welcome to Secretary
    Donley and General Schwartz, and I look forward to their
    testimony. And of course, I have some questions, especially, as
    the chairman mentioned, in dealing with the tanker competition.
    And also, Mr. Secretary, with the UAVs and so forth. We will
    get into that after your testimony.
        Thank you.
        Chairman Inouye. Mr. Secretary?

                  SUMMARY STATEMENT OF HON. MICHAEL B. DONLEY

        Mr. Donley. Thank you, Mr. Chairman, Senator Cochran,
    members of the subcommittee.
        It is, indeed, a privilege to be with you today to testify
    on the fiscal year 2010 budget and Air Force's future plans.
        It has been almost a year since General Schwartz and I took
    on these roles, and I will tell you that it has been both a
    pleasure and a privilege to work with General Schwartz in this
    effort. He has been an outstanding partner and wingman in our
    work together over the last year.
        In recent months, Secretary Gates and Admiral Mullen led a
    constructive dialogue about necessary changes in our national
    defense priorities and areas of emphasis. Our discussions
    emphasized taking care of our most important asset, which is
    our people; rebalancing our capabilities to fight and win the
    current and most likely conflicts in front of us, while also
    hedging against other risks and contingencies; and reforming
    how and what we buy.
        We have contributed our analysis and judgment to these
    discussions throughout. With OSD and our sister services and
    interagency partners, we have undertaken several strategic
    reviews of the Air Force in the last year.

                         AIR FORCE STRATEGIC PRIORITIES

        Last fall, we refined the Air Force mission statement,
    articulated our five strategic priorities, and refined the core
    functions of the Air Force to more clearly articulate our role
    in the defense and national security establishment. We also
    made progress in areas that required focused attention in the
    near term, such as strengthening the Air Force's nuclear
    enterprise, preparing to stand up our cyber numbered air force,
    articulating our strategy for irregular warfare and
    counterinsurgency operations, consolidating our approach in the
    Air Force for global partnerships, and advancing stewardship of
    our energy program.
        Our reviews were guided by the concept of strategic
    balance, which has several meanings for us. As Secretary Gates
    and Admiral Mullen have described, balance means prevailing in
    today's fight while also being able to respond across the
    spectrum of conflict to emerging hybrid threats.
        Balance also means allocating investment across our 12
    diverse, but complementary core functions, and balance also
    means organizing training and equipping across the Air Force
    components--active, Guard, Reserve, and our civilian workforce
    as well.

                              AIR FORCE PERSONNEL

        Our budget proposal recognizes that our people are the
    heart and soul of America's Air Force, and without them, our
    organizations and equipment would simply grind to a halt. In
    fiscal year 2010, we are reversing previously planned
    reductions in Air Force active duty end strength with
    commensurate adjustments in the Reserve components as well. We
    will also grow our civilian cadre, with focused attention on
    the acquisition workforce.
        At the same time, we will continue to reshape our skill
    sets, with particular emphasis on stressed career fields and
    missions that need our attention now, such as intelligence,
    surveillance, and reconnaissance (ISR); acquisition;
    maintenance; cyber operations; and nuclear matters.
        For fiscal year 2010, we are also driving more balance into
    our force structure. In theater, the demand for ISR and special
    operations capabilities continues to increase. So we will
    increase unmanned aerial system combat air patrols, as the
    chairman mentioned, from 34 today to 43 by the end of fiscal
    year 2010, as well as increase our special operations forces
    end strength by about 550 personnel.

                          AIR FORCE COMBAT CAPABILITY

        We also took a broader strategic look at the total combat
    Air Force capability, and there is a general view in the
    Department's leadership that the United States has enough
    tactical air capability. With that in mind, we determined that
    this was a prudent opportunity to accelerate the retirement of
    older aircraft, as we have done in this budget.
        As a result, we will reshape the portfolio of the fighter
    force by retiring about 250 of our oldest tactical fighters. We
    will complete the production of the F-22 fighter at 187
    aircraft and continue our planned modernization of the F-22
    going forward. And we are readying another fifth generation
    fighter, the F-35 Joint Strike Fighter, to become the workhorse
    of our new fighter fleet in the future.
        We will ensure balance for joint airlift needs by
    completing the C-17 production, subject to continued
    congressional action in that area, continuing to modernize our
    C-5s, reinitiating the C-130J production line, and
    transitioning the C-27J program office from the Army to the Air
    Force.
        In particular, the Department made a judgment that the 316
    strategic airlift tails in the program of record is adequate to
    meet our needs. We also conducted a business case analysis that
    identified alternatives to improve our current strategic
    airlift fleet at less cost than simply buying more C-17s. We
    know that is an issue with Congress, and we look forward to
    further discussions with you on that subject.
        Our plan is to enhance the stability and remove risk in our
    military satellite communications (SATCOM) programs by
    extending our advanced extremely high frequency (AEHF) and
    wideband global SATCOM (WGS) inventories and continuing our
    partnerships with commercial providers.
        While AEHF does not give us all the capabilities projected
    for the transformational satellite (TSAT) program, additional
    AEHF and WGS satellites provide additional SATCOM capability
    until we can gain confidence about the affordability and the
    requirements for TSAT-like capabilities in the future.

                             AIR FORCE ACQUISITION

        We have also placed additional emphasis on Air Force
    acquisition. We recently published an acquisition improvement
    plan to focus our efforts in several key areas. First,
    revitalizing the Air Force acquisition workforce. Second,
    improving our requirements generation process. Third,
    instilling more budget and financial discipline in our work.
    Fourth, improving Air Force major system source selections in
    the Air Force. And last, establishing clear lines of authority
    and accountability within our acquisition organizations.
        We will continue to work on these issues going forward with
    Secretary Gates and Dr. Carter.
        Over the coming months, we will, of course, participate in
    several major reviews underway in the Department--the QDR, the
    nuclear and space posture reviews. And from these analyses, we
    will better understand the needs, the requirements, and
    available technologies for long-range strike, as well as our
    requirements and potential joint solutions for personnel
    recovery.

                               PREPARED STATEMENT

        Mr. Chairman, stewardship of the United States Air Force is
    a responsibility that we take very seriously, and we know this
    subcommittee does as well. We thank you for your support for
    our airmen and for our national security in general, and we
    look forward to the continued support of this subcommittee and
    working with you in the future.
        Thank you.
        Chairman Inouye. I thank you very much, Mr. Secretary.
        [The statement follows:]
       Prepared Statement of the Honorable Michael B. Donley and General
                               Norton A. Schwartz
        The 2009 Air Force Posture Statement articulates our vision of an
    Air Force ready to fulfill the commitments of today and face the
    challenges of tomorrow through strong stewardship, continued precision
    and reliability, and dedication to persistent Global Vigilance, Reach
    and Power for the Nation.
                                  introduction
        Today, the United States faces a spectrum of challenges to our
    national security and global interests. As an integral member of the
    Joint team, America's Air Force provides the critical capabilities of
    Global Vigilance, Global Reach, and Global Power. The U.S. Air Force is
    ``All In'' today's Joint fight. At the same time, our investments in
    new capabilities will ensure we are ready for tomorrow's challenges.
    The mission of the U.S. Air Force is to ``fly, fight, and win . . . in
    air, space and cyberspace''--as an integral member of the Joint team
    that ensures our Nation's freedom and security.
                              a balanced approach
        Today's uncertain international security environment requires a
    balance-driven approach to prevail in today's operations, and prepare
    for tomorrow's challenges by identifying and investing in new
    capabilities and force structure. This balanced approach postures the
    Air Force to provide an array of capabilities to Combatant Commanders
    across the spectrum of conflict--from building partnership capacity to
    ensuring the readiness of strategic deterrence forces.
                            air force core functions
        Our Air Force's foremost responsibility is to organize, train, and
    equip Airmen to meet the needs of our national leadership and Combatant
    Commanders. Our fiscal year 2010 budget proposal reflects a commitment
    to the 12 Air Force Core Functions, which provide the framework for
    investment and training.
    Air Force Core Functions
    Nuclear Deterrence Operations
    Air Superiority
    Space Superiority
    Cyberspace Superiority
    Global Precision Attack
    Rapid Global Mobility
    Special Operations
    Global Integrated ISR
    Command and Control
    Personnel Recovery
    Building Partnerships
    Agile Combat Support

        The Air Force fiscal year 2010 budget proposal reflects a
    commitment to our Core Functions that will be informed by numerous
    reviews of the overall defense-planning construct. Through the
    Quadrennial Defense Review (QDR), the Nuclear Posture Review (NPR), the
    Space Posture Review (SPR) and internal mid-term reviews, we will
    continue to sharpen and institutionalize our Core Functions. These
    capabilities, combined with the extraordinary commitment and dedication
    of our Airmen, provide our Nation with truly exceptional air, space,
    and cyber power.
                         nuclear deterrence operations
        For more than 60 years, the Air Force has proudly served as
    stewards of a large portion of our Nation's nuclear arsenal. We
    operate, maintain and secure these nuclear forces to deter potential
    adversaries and to prevail if deterrence fails. Recent incidents and
    assessments have highlighted performance shortfalls, and we are
    diligently working to ensure the safety, security, and reliability
    demanded for this vital capability.
        Our fiscal year 2010 budget proposal addresses many of the
    recommendations provided by the various assessments of the Air Force
    nuclear enterprise. Our overall investment in nuclear deterrence
    operations in fiscal year 2010 is $4.9 billion, which includes
    increasing nuclear related personnel by 2,500 and adding a fourth B-52
    squadron. The fiscal year 2010 budget proposal places additional
    emphasis on nuclear weapons security, committing $72 million to
    strengthen the physical integrity of our Weapon Storage Areas.
        Through a back-to-basics approach, the Air Force is re-emphasizing
    accountability, compliance, and precision in the nuclear enterprise. We
    are reorganizing our nuclear forces in a manner that reduces
    fragmentation of authority and establishes clear chains of supervision
    for nuclear sustainment, surety and operations. These changes include:
    (1) consolidating all nuclear sustainment matters under the Air Force
    Nuclear Weapons Center; (2) establishing a new Air Staff nuclear
    directorate responsible for policy oversight and integration of our
    nuclear enterprise activities; and (3) standing up Air Force Global
    Strike Command, which is already operating in a provisional status at
    an interim location. Global Strike Command will consolidate Air Force
    Intercontinental Ballistic Missiles and nuclear-capable bombers under a
    single command, and is on track to activate later this year.
                  air superiority and global precision attack
        Air Superiority and Global Precision Attack remain the foundations
    of our ability to deliver Global Power. In fiscal year 2010, we are
    investing $21 billion into these Core Functions.
        New and unprecedented challenges to our Nation's Air Superiority
    continue to emerge, and threaten to remove the technological advantage
    enjoyed by our Air Force. Our adversaries continue to invest in highly
    capable surface-to-air missile technology, which threatens even our
    most advanced combat aircraft. Likewise, emerging adversaries may now
    pose a significant air threat by leveraging inexpensive technology to
    modify existing airframes with improved radars, sensors, jammers, and
    weapons.
        To meet these challenges and assure freedom of movement for the
    Joint team, the Air Force continues to invest in weapons and platforms
    for Global Precision Attack. The Joint Air Surface Standoff Missile--
    Extended Range, will enable our aircrews to attack targets precisely
    while negating or avoiding surface threats. Similarly, the Laser Joint
    Direct Attack Munition will enhance our capability to strike moving or
    static targets efficiently and precisely.
        The F-22 and F-35 are key components of the Air Force's future Air
    Superiority and Global Precision Attack Core Functions. Given their
    low-observable characteristics and ability to fuse information from
    multiple sensors--key components of their 5th Generation designs--these
    aircraft are far more survivable and lethal than our current 4th
    Generation force. While the F-35 is optimal for Global Precision
    Attack, it also serves as a complementary capability to the F-22, which
    is optimal for Air Superiority. Together, they form the backbone of a
    fighter force that will ensure the United States maintains a decisive
    edge in an increasingly lethal threat environment. We support the
    current investment strategy that ends F-22 production at 187 aircraft.
    The Air Force will invest $4.1 billion in fiscal year 2010 to procure
    10 F-35s as part of the Department of Defense's strategy to ramp up
    production. By accelerating the procurement ramp, we can lower unit
    procurement costs while also making the platform more cost competitive
    for our Coalition partners.
        Our fiscal year 2010 budget proposal accelerates the integration of
    our Guard and Reserve components into new and emerging mission sets,
    including unmanned aerial systems, F-22 and F-35 missions. By
    considering Air National Guard and Air Force Reserve Command for
    inclusion in emerging mission areas and basing strategies, we
    capitalize on the experience and unique skill sets that our Air Reserve
    Components contribute to the Total Force.
        We are also modernizing our existing bomber force to increase its
    effectiveness and survivability against emerging threats, while meeting
    the requirements of today's Joint Force Commanders. We have fielded a
    state-of-the-art infrared, electro-optical targeting pod on the B-1 to
    provide an additional, persistent sensor on the battlefield to self-
    target weapons, or provide real-time streaming video to ground forces.
    We are also modernizing our B-2 fleet by improving the radar,
    integrating the Link-16 data link and adding extremely high frequency
    satellite communication capabilities for nuclear command and control.
    In addition, investments in low observable maintenance improvements
    will decrease sustainment costs and reduce aircraft downtime. In
    accordance with the Secretary of Defense's budget guidance, we will not
    pursue the development of the Next Generation Bomber until we have a
    better understanding of the requirements, technologies, and concept of
    operations for this capability--all of which are expected to be
    addressed in the QDR.
    Restructuring Our Combat Air Forces
        This year, the Department of Defense provided guidance for the
    military to eliminate excessive overmatch in our tactical fighter force
    and consider alternatives in our capabilities. Acting on this guidance,
    the Air Force examined emerging, advanced threats and then analyzed our
    Combat Air Forces' capabilities against them. Our intent was to ensure
    the proper mix of platforms that meet requirements while minimizing
    excess inventory and deriving the most capability from our limited
    resources.
        After a comprehensive review of alternatives, the Air Force saw an
    opportunity to reshape our aging fighter force via an accelerated
    retirement of our oldest legacy fighters. The review weighed the
    benefits of retiring aircraft nearing their expected service life,
    against near-term risk. The analysis also considered the ``game-
    changing'' capabilities of low observable platforms like the B-2, F-22,
    and F-35 that possess the ability to access areas defended by advanced
    surface-to-air missile systems.
        Once the size and scope of the reduction was determined, the Air
    Force presented its implementation plan to the Combatant Commanders,
    Joint Staff and the Office of the Secretary of Defense. Accelerating
    the retirement of roughly 250 legacy F-15s, F-16s, and A-10s enables us
    to redistribute over $3.5 billion in the next 6 years to modernize our
    Combat Air Forces into a smaller, but more capable force--one that is
    balanced across our Active and Reserve Components and meets our
    commitments at home and abroad. This restructuring also facilitates the
    movement of approximately 4,000 manpower positions that will be
    realigned to support growth in priority missions such as manned and
    unmanned aerial surveillance systems, ISR support, and the nuclear
    enterprise.
        Our current fleet of legacy and 5th Generation aircraft represent
    our readiness to fulfill today's commitments, while our fiscal year
    2010 budget proposal invests in a future force mix to meet tomorrow's
    challenges.
                             rapid global mobility
        Global Reach ensures our Joint team can deploy, maneuver and
    sustain large forces on a global scale. In Iraq and Afghanistan, Air
    Force air mobility assets are central to sustaining the Joint and
    Coalition team. On any given day, Air Force C-5s deliver life-saving
    Mine Resistant Ambush Protected vehicles into theater; C-17s airdrop
    critical supplies to forward-based ground forces via the revolutionary
    GPS-aided Joint Precision Airdrop System; and C-130s provide tactical
    airlift to move theater-based personnel and equipment. Highly skilled
    aeromedical transport teams swiftly evacuate combat casualties,
    ensuring our wounded warriors receive the best possible medical care.
    And Air Force air refueling aircraft continue to play a vital, daily
    role in extending the range and persistence of almost all other
    aircraft of the Joint force. The fiscal year 2010 budget proposal
    reflects our commitment to sustaining and modernizing these critical
    national capabilities.
        Replacing the aging KC-135 fleet remains the Air Force's top
    acquisition priority. The fiscal year 2010 budget proposal supports the
    release of a request for proposal in summer 2009 with a contract award
    early in fiscal year 2010.
        The fiscal year 2010 budget proposal continues efforts for
    modernization and includes funding to begin the shut down of the C-17
    production with a fleet of 205 aircraft. Modernization of our C-5 fleet
    continues through the Avionics Modernization Program and Reliability
    Enhancement and Re-engining Programs, and during fiscal year 2010 we
    will continue recapitalizing our intra-theater airlift capability by
    re-initiating the C-130J production line following one year procurement
    gap and procuring three C-130J aircraft for $394 million.
        The Air Force will also begin procuring C-27J in fiscal year 2010
    to provide mission-critical/time-sensitive airlift in direct support of
    our Joint partners. The fiscal year 2010 budget proposal procures 8 C-
    27Js, as the first step toward a total procurement of 38 C-27Js. The
    Air Force continues to work closely with the U.S. Army to accept full
    management of the Joint Cargo Aircraft (JCA) program and the direct
    support airlift mission.
                               special operations
        Air Force special operations capabilities are playing an
    increasingly vital role in supporting U.S. Special Operations Command
    (USSOCOM) and geographical Combatant Commanders. We are also responding
    to significant growth in the requirements for Irregular Warfare (IW)
    capabilities with major investments in special operations airlift,
    close air support and Intelligence, Surveillance and Reconnaissance
    (ISR).
        Our fiscal year 2010 budget proposal reflects the Air Force's
    commitment to special operations capabilities, and includes $862.6
    million for the procurement of 4 MC-130Js and 5 CV-22s. AFSOC will
    expand its special operations ISR force structure by activating a
    squadron of MQ-9 Reapers, in addition to the already operational MQ-1
    Predator squadron. Additionally, we are recapitalizing our MC-130E/P
    fleet with newer, more capable MC-130Js for low-level air refueling,
    infiltration, exfiltration and resupply of special operations forces.
    At the same time, we will convert 8 MC-130Ws to AC-130 gunships, and
    procure additional CV-22s.
                             global integrated isr
        Operations in Iraq and Afghanistan have highlighted the increasing
    need for timely, fused data from all available sources. To meet this
    need, we are greatly expanding our airborne ISR force structure of
    manned and unmanned ISR assets. In fiscal year 2009, we will field the
    MC-12W to provide increased full-motion video and signals intelligence.
    Additionally, our fiscal year 2010 budget proposal continues major
    investments in unmanned aircraft, transitioning from the MQ-1 Predator
    to the MQ-9 Reaper, with $489 million for 24 additional MQ-9s to
    increase our total UAS combat air patrols from 34 CAPs today to our
    goal of 50 CAPs by the end of fiscal year 2011. We are also investing
    $84 million to integrate the Wide Area Airborne Surveillance (WAAS)
    onto existing and new MQ-9s, providing 12 times the number of streaming
    video spots per aircraft. Our fiscal year 2010 budget proposal also
    contains funding for five RQ-4 Global Hawk UAVs, which provide
    persistent ISR from high-altitude orbits. We are also balancing our ISR
    personnel requirements by re-examining our training programs for
    intelligence professionals, creating new duty specialty codes, and
    establishing trial programs to develop ISR operators.
                              command and control
        The Air Force has established Air and Space Operations Centers
    (AOCs) aligned with each geographical Combatant Commander to integrate
    air, space, cyber, and missile defense capabilities into Joint
    operations. We have also improved our Tactical Air Control System
    (TACS) to account for increasingly distributed air-ground operations in
    Iraq and Afghanistan. Our restructured Air Liaison Officer program
    offers these Airmen a viable career path. We are also training
    additional terminal air controllers and equipping them with
    increasingly capable, portable and flexible air strike control systems
    like Remote Operated Video Receiver (ROVER) version 5.
                               space superiority
        America's ability to operate effectively across the spectrum of
    conflict rests heavily on our space capabilities. Recognizing this
    importance, our fiscal year 2010 budget proposal includes $4.4 billion
    for procurement of space and related support systems.
        The Joint force depends upon space capabilities provided by the Air
    Force, which fall into five key areas: Early Warning; Space Situational
    Awareness; Military Satellite Communications; Positioning, Navigation
    and Timing; and Weather capabilities. We will field several new
    satellites, including the Global Positioning System Block IIF, Advanced
    Extremely High Frequency (AEHF), Space Based Surveillance System
    (SBSS), and the Space Based Infrared System--Geostationary (SBIRS-
    Geo)--recapitalization programs that are important to both the United
    States and its Allies. The fiscal year 2010 budget proposal
    discontinues the Transformational Satellite (TSAT) program and supports
    procurement of additional AEHF and Wideband Global SATCOM (WGS)
    satellites.
                             cyberspace superiority
        Operating within the cyber domain has become an increasingly
    critical requirement for our networked force. In order to develop and
    institutionalize cyberspace capabilities, and to better integrate them
    into the Joint cyberspace structure, we are consolidating many Air
    Force cyberspace operations into a new 24th Air Force under Air Force
    Space Command. The Air Force is firmly committed to developing the
    necessary capabilities to defend the cyber domain, and our fiscal year
    2010 budget proposal includes $2.3 billion to grow this important Core
    Function.
                               personnel recovery
        Personnel Recovery (PR) remains an imperative, fulfilling our
    promise to never leave an American behind. Air Force PR forces are
    fully engaged in Iraq and Afghanistan, accomplishing crucial missions
    that include command and control, intelligence, CSAR, convoy support,
    hostage recovery, and reintegration.
        The fiscal year 2010 budget proposal terminates the current CSAR-X
    program to allow for additional discussion on platform requirements and
    quantities across the Joint force. We will continue to sustain our HH-
    60 helicopter fleet, while exploring Joint solutions to ensure
    sufficient PR capabilities in the coming years. We are continuing to
    extend our current capabilities by recapitalizing our HC-130P/N fleet
    with newer, more capable HC-130Js to provide low-level air refueling,
    infiltration, exfiltration, and resupply of CSAR forces. In fiscal year
    2010, we will invest $605 million to procure an additional five HC-
    130Js.
                             building partnerships
        The Air Force continues to seek opportunities to develop our
    partnerships around the world, and to enhance our long-term
    capabilities through security cooperation. For example, in the Central
    Command AOR, deployed Airmen are working with our Afghan and Iraqi
    partners to build a new Afghan National Army Air Corps and the Iraqi
    Air Force. We are also working to further partnerships with more
    established allies, with programs like the Joint Strike Fighter, where
    our allies have committed $4.5 billion in research and development
    funding. Australia's commitment to fund a communications satellite in
    the WGS constellation is another example of the value and synergy of
    lasting partnerships.
        In the recently released Global Partnership Strategy, we outlined a
    path to cultivate these key partnerships, nurturing the global
    relations, fortifying our geographic access, safety and security around
    the world. The strategy seeks to develop partners who are able to
    defend their respective territories while ensuring the interoperability
    and integration necessary for Coalition operations.
                              agile combat support
        Underpinning the work of all Air Force Core Functions are the
    capabilities included in Agile Combat Support. As part of our fiscal
    year 2010 budget proposal initiatives, Agile Combat Support accounts
    for efforts affecting our entire Air Force, from the development and
    training of our Airmen to revitalizing our processes in the acquisition
    enterprise. Agile Combat Support reflects a large portion of the Air
    Force budget proposal, totaling approximately $42 billion.
    Developing and Caring for Airmen and Their Families
        The Air Force remains committed to recruiting and retaining the
    world's highest quality force, while meeting the needs of their
    families. Our fiscal year 2010 budget proposal enables us to recruit,
    train, educate, and retain the right number and mix of personnel, and
    to provide Quality of Service worthy of our Airmen's commitment to
    serve in the Armed Forces of the United States and supports an end
    strength of 331,700 active duty personnel.
                Sharpening Our Skills
        Our fiscal year 2010 budget proposal enables us to train Airmen to
    fulfill both our Core Functions and the Combatant Commander's
    requirements. These changes span the vast array of skill sets, from
    improving language and cultural instruction to accelerated training for
    network operators. In fiscal year 2010, we will also enhance
    foundational training received by all enlisted personnel entering the
    Air Force by constructing a $32 million state-of-the-art training
    facility at Lackland Air Force Base.
                Quality of Service
        The Air Force leadership is committed not only to the quality of
    life of our Airmen and families, but also to their Quality of Service--
    ensuring each Airman is able to perform consistently meaningful work
    and make a daily impact on the Air Force mission.
        We also understand the burdens placed on the families of our
    Airmen. To meet the needs of our Airmen and their families, our fiscal
    year 2010 budget proposal funds a range of needed Quality of Life
    initiatives, including expanded legal assistance, advanced educational
    opportunities and new family housing. For example, our fiscal year 2010
    budget proposal invests $20 million to build two new Child Development
    Centers, as well as $66 million to improve and modernize military
    family housing overseas. The Air Force is also continuing to execute
    its Family Housing Master Plan, which synchronizes the military
    construction, operations and maintenance, and privatization efforts
    necessary to improve our family housing. By fiscal year 2010, we will
    have all the funds necessary to award the privatization and MILCON
    projects needed to eliminate all of our inadequate homes, both in the
    United States and abroad--with all projects scheduled to be completed
    by fiscal year 2015. To this end, we are on track to award contracts to
    privatize 100 percent of Military Family Housing in the CONUS, Hawaii,
    Alaska, and Guam by the end of fiscal year 2010. For Airmen concerned
    about foreclosure, we provide assistance at the Airmen and Family
    Readiness Center at each Air Force installation. Additionally, we are
    working with the Department of Defense as it expands the Homeowners
    Assistance Program to wounded warriors/civilians, surviving spouses,
    and eligible military members affected by permanent changes of station.
                Shaping the Force
        America's Air Force draws its strength from its outstanding Airmen,
    with over 660,000 members of our Regular, Reserve, Guard, and Civilian
    personnel dedicated to the mission of the Air Force. In accordance with
    the Secretary of Defense's guidance, we will halt active duty manpower
    reductions at 331,700 for fiscal year 2010. We will also make
    commensurate adjustments in the Reserve Components, with 69,500 Airmen
    in the Air Force Reserve and 106,700 Airmen in the Air National Guard.
    We will also grow our Civilian cadre to 179,152, which includes 4,200
    contractor-to-civilian conversions.
        Retaining quality Airmen with critical skill sets remains a top
    priority. For fiscal year 2010, we have proposed $641.4 million for
    retention bonuses and recruiting, which includes a $88.3 million
    increase for recruiting and retaining health professionals. In
    addition, we will retrain Airmen to fill undermanned career fields to
    balance and shape our force in accordance with emerging requirements.
    Further efforts to shape our force will also include diversity
    initiatives designed to leverage the unique qualities of all Airmen to
    achieve mission excellence.
                Warrior Care
        As part of our commitment to Airmen, we, in collaboration with the
    rest of the Department of Defense, are strengthening our focus on
    wounded warrior care. The importance of ensuring that our wounded
    warriors receive the service and support they need throughout the
    recovery process cannot be overstated. Through specific budget proposal
    items, such as increased funding to bolster the size of our Recovery
    Care Coordinators cadre, our wounded care programs will continue to
    provide our Airmen the best medical and professional support possible.
        Other advances in wounded warrior care are also underway including
    work with Interagency and local partners to create the necessary
    support networks to ensure success in continued military service or in
    the transition to civilian life. We are also reinforcing our commitment
    to our Air Force wounded warrior families through support programs
    specifically designed to help allay their burdens and honor their
    sacrifices.
    Recapturing Acquisition Excellence
        To most effectively meet the demands of our warfighters, the Air
    Force has made Recapturing Acquisition Excellence a top priority. We
    recognize the profound importance of this capability, which enables us
    to acquire and recapitalize platforms that provide Global Vigilance,
    Reach, and Power. As stewards of the taxpayer's resources, the Air
    Force will solidify an Acquisition system that delivers the right
    capabilities to the warfighter in the field--on-time and within budget.
        To accomplish this we have published an Acquisition Improvement
    Plan (AIP) that outlines the steps we will take to improve Air Force
    Acquisition, informed by a series of internal and external reviews.
    This plan focuses on five initiatives that: revitalize the Air Force
    acquisition workforce; improve the requirements generation process;
    instill budget and financial discipline; improve Air Force major
    systems source selection; and establish clear lines of authority and
    accountability within acquisition organizations.
        Through this plan, the Air Force will focus on better developing
    our acquisition workforce to ensure that it is appropriately sized to
    perform essential, inherently governmental functions and flexible
    enough to meet continuously evolving demands. We will also work to
    develop requirements that meet the users' needs while, at the same
    time, ensuring that they can be incorporated into effective acquisition
    strategies that maximize competition and allow for a fair and open
    source selection process.
        Our reviews also emphasized that establishing adequate and stable
    budgets continues to be critical for program success. Therefore, the
    AIP emphasizes realistic budgeting based on comprehensive program cost
    estimates. Once budget baselines are established, achieving program
    stability and cost control will be given the same priority as technical
    performance and schedule.
        We also found some weaknesses in our procedures for large system
    acquisition source selections and shortages in the skill sets required
    to conduct major source selections. So we are going back to the basics;
    building processes to ensure that our personnel have the experience and
    training required to conduct source selections and, where necessary,
    revising our processes and policies and increasing our use of multi-
    functional independent review teams (MIRTs). We are also reassessing
    our Program Executive Officer (PEO) and wing/group/squadron
    organizations to determine if they are properly structured, and
    identifying specific actions that could be taken to improve them.
                            readiness and resourcing
        In the past year, we have continued to see stresses on our Air
    Force, both in our people and in our platforms. The Air force has
    conducted nearly 61,000 sorties in Operation Iraqi Freedom and over
    37,000 sorties supporting Operation Enduring Freedom, delivering over 2
    million passengers and 700,000 tons of cargo. In doing so, Airmen
    averaged nearly 265 sorties per day. Tens of thousands of America's
    Airmen are deployed to locations across the globe, including 63
    locations in the Middle East. To support the efforts of our Airmen and
    provide for the recruiting and retention of the highest quality Air
    Force, our fiscal year 2010 budget proposal includes $28.6 billion in
    Military Personnel funding. It provides for an across the board 2.9
    percent pay increase, a Basic Allowance for Housing increase of 5.6
    percent--resulting in zero out-of-pocket housing expenses for our
    Airmen--and a Basic Allowance for Subsistence increase of 5 percent.
    Additionally it halts the end strength drawdown which allows for
    rebalancing of the total force to cover new and emerging missions and
    stabilizes the active component end strength at 331,700; Reserve
    Component end strength at 69,500 Airmen and Air National Guard end
    strength at 106,700 Airmen. It also funds recruiting and retention
    bonuses targeted at critical wartime skills, including key specialties
    such as command and control, public affairs, contracting, pararescue,
    security forces, civil engineering, explosive ordnance disposal, and
    special investigations.
        This high operations tempo requires focused attention on readiness.
    We use aircraft availability as our enterprise-level metric for
    monitoring fleet health, and the fiscal year 2010 budget proposal
    provides $43.4 billion in Operations and Maintenance funding, a $1.3
    billion increase over our fiscal year 2009 appropriation, to mitigate
    the stresses of continuous combat operations on our aircraft. The
    fiscal year 2010 Operations and Maintenance appropriation funds pay and
    benefits for 179,000 civilian personnel, including 4,200 contractor to
    civilian conversions, an increase of 200 civilian acquisition
    professionals and a 2 percent pay raise. It fully funds 1.4 million
    flying hours, produces 1,200 pilots and sustains over 5,400 aircraft
    while accelerating the retirement of roughly 250 aged aircraft,
    producing a smaller, more capable fighting force.
        Our aging air and space fleet requires focused attention. For
    example, we have grounded our F-15, F-16, A-10, C-130, and T-6 fleets
    for limited periods during the past 2 years. The skill and
    determination of our maintainers have ensured that we return aircraft
    to service as quickly as possible, but 2 percent of the fleet remains
    grounded and many aircraft fly restricted profiles. To ensure stable
    aircraft availability and mission capable rates, we continue to
    integrate Fleet Viability Boards into our normal life-cycle sustainment
    processes and strengthen centralized asset management.
        Additionally, in fiscal year 2010 O&M funds will be used to rebuild
    the nuclear infrastructure by fortifying operations, developing people
    and sustaining 76 B-52s for global strike capability. The AF is also
    increasing MQ-1 and MQ-9 ISR capability to 43 unmanned Command Air
    Patrols. The O&M budget request honors the AF commitment to our Airmen
    and their families by increasing child care availability and special
    programs for children of deployed parents, providing for both legal
    assistance and advanced educational opportunities. Dollars are also
    committed to dormitory initiatives, unaccompanied housing, active
    Warfighter/Family Support Centers and Fitness Centers while still
    providing for the operating expenses of 83 major installations
    including two space lift ranges.
        Our $19.4 billion fiscal year 2010 Budget proposal for Research,
    Development, Test and Evaluation (RDT&E) is an increase of $600 million
    from fiscal year 2009. This request funds requirements for next
    generation weapons and platforms by maturing technologies essential to
    equipping our Nation to defeat near-term and forecasted threats. We
    continue to develop and invest in future systems such as the KC-X
    Tanker program, F-35 Joint Strike Fighter, and the next enhancement of
    the Global Positioning System. Science and technology efforts advance
    propulsion, space-based airborne and ground sensors, directed energy,
    and command and control for both air and space. Modernizing our current
    fleet initiatives will provide upgrades to legacy fighters, bombers,
    strategic radar, and mobility requirements. Systems and technologies
    designed to improve space situational awareness are also critical
    elements of this Budget Request. Additionally we are rebalancing the
    portfolio towards procurement of proven and multi-role platforms.
        We are committed to supporting today's warfighter while building
    tomorrow's weapon systems capability. The fiscal year 2010 procurement
    budget request provides $21.7 billion to deliver immediate and future
    capabilities through investments made across four specific procurement
    appropriations: aircraft, missiles, ammunition, and other. The fiscal
    year 2010 Budget Request supports the Irregular Warfare Mission by
    increasing ISR platforms while modifying the existing fleet, provides
    joint warfighter support funding and balances investment in advanced
    aircraft platforms and legacy aircraft modifications. These funds will
    allow for the acquisition and modification of manned and unmanned
    aircraft, missiles, munitions, vehicles, electronic and
    telecommunications equipment, satellites and launch vehicles, and
    support equipment.
        Funding critical infrastructure projects while meeting the needs of
    the Air Family are critical to our mission. The $2.4 billion budget
    request for military construction, military family housing and base
    realignment and closure supports a $300 million increase in military
    construction from fiscal year 2009. Projects will be focused on
    supporting the rebalance of AF and DOD priorities. Additionally the
    budget request continues our emphasis on providing quality housing for
    Airmen and their families. Finally, the AF is on target to deliver 17
    BRAC 2005 projects on time while continuing the environmental clean-up
    of legacy BRAC locations.
        To ensure proper stewardship of our resourcing, we have designated
    a Deputy, Chief Management Officer (DCMO) in line with the Department
    of Defense Strategic Management Plan. The DCMO is responsible for
    continuing our momentum in refining internal processes for reducing
    workloads or eliminating unnecessary work. Through a culture of
    continuous improvement, we are further improving warfighter
    effectiveness through integrated processes and systems, process
    improvement, and technology investments aligned with our priorities.
                                    summary
        We believe the Air Force's total proposed fiscal year 2010 budget
    of $160.5 billion--which includes $115.6 billion for Air Force managed
    programs, $28.9 billion in other funded programs such as the National
    Foreign Intelligence, Special Operation Forces, and the Defense Health
    Programs, and $16 billion in Overseas Contingency Operations provides
    the balance necessary to ensure support of today's commitments, while
    posturing the Air Force for success against tomorrow's challenges.

        Chairman Inouye. Now may I call upon General Schwartz?

                SUMMARY STATEMENT OF GENERAL NORTON A. SCHWARTZ

        General Schwartz. Mr. Chairman, Senator Cochran, and other
    members of the subcommittee, I am proud to be here with
    Secretary Donley, representing your Air Force.

                             AIR FORCE CORE VALUES

        The United States Air Force is committed to effective
    stewardship of the resources the American people place in our
    trust, a commitment founded on our core values of integrity
    first, service before self, and excellence in all we do. Guided
    by our core values, American airmen are all-in, working
    courageously every day with precision and reliability.
        I recently had a chance to take a trip and visit with some
    of our airmen performing at several locations around the world,
    and they are providing game-changing capabilities for the
    combatant commanders in the air and on the ground.
        Last year, American airmen conducted 61,000 sorties in
    Operation Iraqi Freedom (OIF), some 37,000 sorties in Operation
    Enduring Freedom (OEF), and that is about 265 sorties a day.
    Airmen also serve in convoys and in coalition operations
    centers and deliver 2 million passengers and some 700,000 tons
    of cargo in the United States Central Command (USCENTCOM) area
    of responsibility.
        And dedicated airmen directly support USCENTCOM operations
    from right here in the United States by providing command and
    control of unmanned aerial systems, while our nuclear
    operations professionals support the umbrella of deterrence for
    the Nation and our allies across the globe. And our space
    professionals are providing truly amazing capabilities, ranging
    from early warning to precise global positioning navigation and
    timing.

               BALANCING AIR FORCE PRIORITIES TO MEET CHALLENGES

        Through Secretary Donley's guidance and his leadership, we
    have set the course to provide even greater capabilities for
    America and to balance our priorities across and to meet the
    spectrum of challenges. The top priority is to reinvigorate the
    nuclear enterprise as outlined in our nuclear roadmap.
        We are fielding capabilities that allow us to innovate
    partnerships with joint and coalition teammates to win today's
    fight by expanding intelligence, surveillance, and
    reconnaissance with the procurement of 24 MQ-9 Reaper unmanned
    aerial systems.
        And at the same time, we will continue to support our most
    precious asset, our people. We are focused on providing
    programs that develop and care for our airmen and their
    families with world-class quality of service and honor our
    commitments that we all have made to our wounded warriors.
        Part of ensuring support for our airmen means providing the
    tools they need to do their jobs effectively. Therefore, we are
    modernizing our air and space inventories, organizations, and
    training with the right, if difficult, choices.
        In addition to the programs that Secretary Donley just
    mentioned, we are committed to providing a robust air refueling
    capability. We also intend to increase efficiency by retiring
    aging aircraft, and we will complete production of the F-22 at
    187 aircraft and the C-17 at 205 aircraft, subject to
    congressional approval.
        In recent testimony, Admiral Mullen stated that we are what
    we buy. Following his lead, we intend to maintain stewardship
    of America's resources for our warfighters in the field and our
    taxpayers at home by recapturing acquisition excellence and
    fielding the right capabilities for our Nation on time and
    within budget.
        Mr. Chairman, with our core values guiding us, the Air
    Force will continue to provide the best military advice and
    stewardship, delivering global vigilance, reach, and power for
    America.
        Thank you for your continued support of the United States
    Air Force, and particularly for our airmen and their families.
        Sir, I look forward to your questions.
        Chairman Inouye. I thank you very much.
        As both of you are well aware, this subcommittee has been
    deeply involved in recent weeks in what we call the
    supplemental appropriations process. It seems likely that this
    week, we will close the shop and sign the bill. And hopefully,
    we will have this matter sent to the White House.
        In all likelihood, this measure will include eight
    additional C-17s. It will have five additional C-130s and
    several other items. But I will leave those matters up to my
    colleagues who are experts in this area. But I would like to
    touch upon other items that may not be touched upon by my
    colleagues.

                               IRREGULAR WARFARE

        Secretary Gates has been speaking of irregular warfare as
    being just as important as traditional warfare. And in your
    proposal, you have requested funds to build this capability to
    carry out your mission in this irregular warfare.
        For the record, because many of my colleagues who are not
    on this subcommittee may not be familiar with what irregular
    warfare is all about, can you tell us what it is? And second,
    how you hope to build up the capability to involve yourself in
    this? General?
        General Schwartz. Mr. Chairman, irregular warfare is--I
    would describe it as something different than the traditional
    confrontation of major maneuver units on the battlefield.
        It is a distributed battle. It involves high concentrations
    of civilian populations. It involves having to exert governance
    and control in the battlespace in a way that might not
    typically be the case in more conventional employment of our
    forces. And significantly, I think it requires a level of
    precision that perhaps is, again, not as needed in sort of
    traditional force-on-force engagements.
        Now our basic approach to this is, again, not just for the
    Air Force, but rather recognition that this kind of employment
    requires a joint team that is very well integrated and can
    employ forces across the spectrum.
        So that includes, for us, things all the way from lift and
    transportation to strike, very precision strike, and just as
    importantly as intelligence, surveillance, and reconnaissance
    capability because that is--intelligence is a key factor in
    success in this domain. And likewise, a whole range of skills
    that are required to build partner capacity.
        So, for example, while the traditional aspect of training
    others depend on aircrew skills, it is much, much broader than
    that now and includes how do you run an airfield? How do you
    operate a safety shop? How do you maintain a runway? How do you
    maintain a budget?
        These are things that are necessary for nascent air forces
    to achieve a capability to serve their nations well and
    effectively. And typically, they are not as sophisticated as we
    are and certainly don't have the benefit of the resources that
    you all put at our disposal.
        And so, it means in terms of equipage perhaps having things
    that allow us to train others on that is something that they
    might be able to employ. It is not so sophisticated it can't be
    maintained or so sophisticated that perhaps it is beyond the
    natural ability of a growing, maturing Air Force.
        I guess I would finally conclude, sir, by indicating that
    this is an area that requires skills that, as I was growing up,
    were not sufficiently appreciated--language and the capacity to
    interact with other cultures and appreciate that how we sit,
    how we present ourselves, how we interact with elders matters a
    lot in terms of our ultimate success. That is how I would
    capture it for you, sir.
        Chairman Inouye. Mr. Secretary, do you have anything to add
    to that?

            EFFECTIVE USE OF FORCES ACROSS THE SPECTRUM OF CONFLICT

        Mr. Donley. I think the chief has captured it very well. I
    would also add I think, as we have approached our role in
    helping to train the emerging Afghan and Iraqi air forces, we
    are learning some good lessons along the way.
        I think the Secretary's challenge to us is not just to
    improve our irregular warfare (IW) capability in specialized
    areas that we are all familiar with in the special operations
    forces (SOF). And we have additional resources put against our
    SOF forces, additional investments that are well understood by
    the subcommittee. The CV-22 is coming online, MC-130s. These
    kinds of capabilities will continue to be improved.
        But what the Secretary is asking us to do is to think about
    how to use our general purpose forces more effectively in the
    irregular warfare part of the conflict spectrum. He has not
    asked us to fundamentally overhaul the capabilities of the
    United States Air Force or the other services, which are
    required to meet the full range of potential contingencies
    across the conflict spectrum, all the way from irregular, all
    the way up through high-intensity operations. And of course, we
    have the nuclear deterrent mission as well in the Air Force.
        He is asking us to figure out ways to use the bulk of our
    forces, which are deployed across this conflict spectrum,
    figure out ways to be able to tailor those capabilities more
    effectively for IW work. So, as the chief has, I think, laid
    out pretty well, our issues are focused on how do we use our
    education and training system and our support for other nations
    to build up their capabilities more effectively?
        And we are seeing that come through in a couple of
    different areas. One is, for example, the JCA, the C-27, which
    our Department has been working on. That mission, as you know,
    is transferring from the Army to the Air Force.
        But a light mobility aircraft such as this is of interest
    and is of use potentially to partners like Iraq and Afghanistan
    that may or may not have a C-130 kind of capability. Or if they
    do, it will be fairly circumscribed. They certainly won't be in
    the C-17 business, for example.
        So we think having a capability like this in the United
    States Air Force makes us better teachers for potential
    partners who are not going to be buying JSFs or C-17s, the
    high-end capabilities that we will produce. So we see that in
    mobility, in the C-27. We see it also in the intelligence,
    surveillance, and reconnaissance (ISR) platforms, in the MC-12
    capability that we are building that might, in the future, have
    some applicability.
        That small, twin-engine airframe has applicability for
    partners who cannot afford and will not be in the unmanned
    aerial systems business and will not have thousands of
    personnel in their intelligence, surveillance, and
    reconnaissance systems. But, yes, they may be able to operate
    that MC-12-like capability going forward to give them an ISR
    capability.

                               TRAINING AIRCRAFT

        And the third area is in our trainers, which, consistent
    with past practice, are often able to evolve from a training
    aircraft to a light attack aircraft, and there are different
    options for how to do this.
        So certainly in our T-6 trainer programs, there are
    opportunities going forward to make T-6 and/or Super Tucano or
    propeller-driven airplanes of this class into light attack
    aircraft that could be utilized by partners again who are not
    going to be able to and do not have a need to operate at that
    higher end of the conflict spectrum. They can't afford to do
    that.
        So having these capabilities inside our force structure we
    think will help us be better teachers and better partners and
    help us build up the security capabilities of partners facing
    counterterrorist operations, counterinsurgency operations whom
    we have an interest in building up to be not only better
    partners for us internationally, but to be good regional
    partners and able to take care of their own neighborhoods.
        I apologize for the lengthy answer, but this is a good
    question.

                             24TH AIR FORCE MISSION

        Chairman Inouye. Well, the Secretary said, it is just as
    important as traditional warfare. Your 24th Air Force is going
    to be a focal point for cyber warfare. Can you tell us what you
    have in mind to carry out this mission, Mr. Secretary?
        Mr. Donley. Well, sir, I will let the chief discuss it in
    more detail, but in general, we have information operation
    wings and network warfare wings and network operations
    capabilities that are responsible for taking care of Air Force
    networks, for defending them against cyber threats, which are
    growing and are at increasing risk. And so, we are growing this
    capability in the Air Force.
        We made a decision last fall to put those capabilities
    under a numbered Air Force, which is our operational level
    inside the Air Force, to more effectively manage and oversee
    this work.
        Chairman Inouye. General?
        General Schwartz. Mr. Chairman, just to emphasize, the
    thrust here is on two basic themes within what really is
    emerging as a contested domain. And that is, one, as the
    Secretary mentioned, to defend ourselves, to defend our nets
    because, increasingly, these networks are not just
    administrative conveniences, but they are, in fact, the way
    that we bring the integration of the magnitude of all of our
    capabilities to bear and command and control them in real time.
        So defending our nets is vital to our combat capability,
    and that is a major function for the 24th Air Force. As well,
    there are more offensive kinds of capabilities here. For
    example, one can envision that it might be prudent to disable
    an integrated air defense array that we might want to penetrate
    by use of cyber rather than kinetic means, or some mix of the
    two. And advancing our capabilities in this regard will also be
    within the portfolio of the 24th Air Force.
        I would conclude, sir, by indicating that, as you know, the
    President announced a cyber initiative last week. As part of
    that, there will likely be an organizational realignment within
    the Department of Defense. And the 24th will be the Air Force
    contribution to that larger enterprise for the entire
    Department.
        Chairman Inouye. Thank you.
        Senator Cochran.

         AIR FORCE NONTRADITIONAL SUPPORT TO ARMY AND COALITION FORCES

        Senator Cochran. Mr. Chairman, thank you.
        General Schwartz, I understand that the Air Force has
    established as one of its top priorities greater support for
    the Army and coalition forces overseas in nontraditional Air
    Force missions on the ground. Could you give us some examples
    of this activity and the impact that that may be having in
    terms of your overall end strength?
        Is it going to require you to reorganize or ask for more
    authority from the Congress to continue to carry out this
    mission?
        General Schwartz. Sir, the proposal, which is embedded
    within this fiscal year 2010 program proposal at 331,700 active
    duty end strength, is where we need to be, and I don't see us
    climbing much higher than that, if at all.
        With regard to the so-called nontraditional tasks, our
    sense is and the leadership of our Air Force acknowledges,
    recognizes the country is at war, and that there are needs at
    this time that need to be fulfilled. They are requirements that
    the joint team needs to have accomplished.
        And if your Air Force can do this, if we can make a
    contribution, that is what we are going to do. We will do
    whatever is required, wherever it is needed, for however long
    it is needed, provided that our youngsters are properly
    trained. That is our obligation.
        And so, sir, we have folks that are doing convoy duty in
    Iraq. I visited with some at Arifjan a couple of months ago,
    and believe me, these folks do not see what they are doing as
    peripheral or not worthy. They know very well how important the
    work they are doing is.
        And that is true whether it is medics or transportation
    folks or security forces operating outside the fence, whatever
    the discipline. It is needed. It is part of the joint effort,
    and our Air Force is proud to do it, sir.
        Senator Cochran. Well, I compliment you for the initiative
    and showing flexibility of responding to something that is
    clearly needed and in our national interest. And we hope we
    will be able to provide the resources that you need to carry
    out these important activities.

             HIRING OF GOVERNMENT CIVILIANS TO REPLACE CONTRACTORS

        Secretary Donley, I understand the Air Force intends to
    reduce its reliance on contracted workers by hiring several
    thousand Government civilians to replace contractors. Has the
    Air Force identified what positions or functions it intends to
    resource from within your organization, and what savings, if
    any, do you anticipate through this initiative?
        Mr. Donley. Sir, this is a DOD wide initiative, and a very
    important one. I believe there is a strong consensus in the
    Department and I believe also here in Congress that the
    reliance of the Department on contractors to do some work that
    was previously done within the Government has probably run its
    course, and the pendulum is starting to swing back the other
    way.
        We are much more sensitized at this point to the need to
    bring back into the organic Government capability some of those
    functions that have been contracted out. And our target for
    fiscal year 2010, as I recall it, is about 4,000 of these
    conversions.
        Almost about 2,000, about one-half of that is targeted for
    us on our acquisition workforce and growing our acquisition
    workforce in some critical areas that need reinforcement--
    contracting, systems engineering, and cost estimating. These
    are examples of capabilities we plan to beef up by relying less
    on contractor support and bringing those capabilities in-house.
        Senator Cochran. As you know, we have a very large training
    facility on the Mississippi gulf coast at Keesler Air Force
    Base and very proud of the role that they have played over the
    years in our national defense. They are currently hosting the
    81st Training Wing. I think it is the largest technical
    training unit and is a so-called ``center of excellence'' for
    computer and electronics training.
        Anyway, I am going to put in the record some facts and
    figures that I understand are currently reflected in the hiring
    and the activities there. But they are being tasked now with
    developing infrastructure capacity to potentially host a new
    mission, the undergraduate cyber training mission for the Air
    Force.

              COMMUNICATIONS AND ELECTRONICS CENTER OF EXCELLENCE

        I wonder, General, if you have taken a role in this or have
    any information that you can give us about this possibility of
    a new center of excellence for electronics and computer-related
    training at Keesler?
        General Schwartz. Sir, as you know, Keesler Air Force Base
    has been for decades the center of excellence for training our
    entry-level communications and electronics specialists. And a
    natural extension of that could very well be the training of
    the workforce that 24th Air Force will employ in this
    increasingly digital and cyber era.
        That decision has not been formally taken where that
    element will go, but clearly, Keesler Air Force Base is a very
    strong candidate, and we will have a range of courses from
    entry level on the cyber side to, obviously, what we call 5 and
    7 level courses, increasingly more demanding courses, so that
    our people have the breadth and background required to do this
    work.
        That is an important piece of the 24th, too. My focus
    naturally was on operations, but you have to make sure that the
    workforce has the skills necessary to do this. And that is the
    task that we are focused on, sir.
        Senator Cochran. Well, thank you very much. And thank you
    for your excellent leadership in the roles that you have. We
    appreciate it.
        Chairman Inouye. Thank you.
        Senator Bond.

                        NEXT GENERATION FIGHTER AIRCRAFT

        Senator Bond. Thank you very much, Mr. Chairman.
        As I mentioned earlier, General Schwartz, I have some very
    real concerns about the intermediate term plans and, to be
    honest, what I see as a lack of intermediate plans.
        I said that right now we have available proven platforms
    that have about an 85 percent solution. They are not fifth
    generation, but they are 4.8, 4.9, and you, yourself, mentioned
    the ability of externalities to enable some of those fourth
    generations to do things that one would have expected we could
    only achieve with the fifth generation. We won't go into that
    here, but we have discussed that previously.
        And so, I am asking if you and the Secretary would be
    willing to take a look at the outstanding shortfall in the Air
    National Guard and the Air Sovereignty Alert mission, as well
    as the other needs in the Air Force? To determine whether there
    are fourth-plus generations of planes that will be needed that
    are affordable and that will be available unless and until the
    JSF or the F-35 is able to get online, which, at this point,
    having only completed, as I understand, 2 percent of its flight
    tests, may be some time.
        General Schwartz. Senator, as we have exchanged in the
    past, there is nothing off the table. I certainly am willing to
    revisit the formula and our positions that we have developed,
    as new information comes in. It would be foolish to do
    otherwise. And in fact, we met as recently as yesterday on this
    issue with Lieutenant General Harry (Bud) Wyatt from the Air
    National Guard and others.
        Senator Bond. I understand. I am well aware of that, well
    aware of those discussions. I am not going to bring out the
    chart or anything like that because I know the discussions.
        General Schwartz. Right. Yes, sir. But I think that is what
    I would like to do, it is still my view that the high
    confidence path for us is to make the leap to the F-35. That
    is--it will populate the preponderance of our force as we go
    forward.
        And the vital thing here is that in order for the F-35 to
    do the work that is required not just for us, but for the
    Marine Corps, for the Navy, and importantly, international
    partners, the F-35 needs to be produced at rates which will
    help us manage our fleet aging issue that you mentioned, not
    less than 80 and probably higher, maybe as high as 110 a year.
        And the other not insignificant benefit is to keep the
    average unit cost down for F-35 so that it can compete
    internationally.
        Senator Bond. As we know, it is already--our international
    partners have already made the decision. The other broader
    question that needs to be considered is the aircraft industrial
    base.
        Earlier this week, Secretary Mabus said they need to
    maintain a competitive shipbuilding base. Right now, we know we
    have gone from five or six primary aircraft producers down to
    two. And this budget annihilates one of those two. If this
    budget were carried out, we would be down to one.
        And quite frankly, I ask you to look at the performance,
    the timeliness, the performance and the cost to see whether you
    would be comfortable going down to one, and I think there is a
    very good argument not to go down to one. And I just ask you to
    look at that.
        General Schwartz. You have my commitment to do so, sir.

                             NEXT-GENERATION BOMBER

        Senator Bond. Next-generation bomber is part of that.
    Actually, the next-generation bomber and the sixth generation
    fighter have to be competed. They have to bring in these
    others, and the next-generation bomber was designed to force
    our adversaries to invest in their own defensive weapons.
        Current bombers are having increasing access challenges.
    The warfighters analysis of alternatives completed in 2006 said
    that they were very comfortable with the NGB. The Center for
    Strategic and Budgetary Analysis replied to a question on NGB
    saying we have studied the NGB issue to death. The need, the
    requirement, and the technology are in hand and reasonably well
    understand.
        And I believe Secretary Gates last week said, ``My personal
    view is that we probably do need a follow-on bomber.''
        I would ask you, Mr. Secretary and General, whether it is
    time to be moving forward, looking at the industrial base as
    well as the need for the NGB?
        Mr. Donley. Well, Senator, I think there is pretty good
    consensus that our national defense capabilities need to
    include more long-range strike and that we need to start
    modernizing that part of our force structure.
        My sense is that the Secretary's decision in this regard
    earlier this year was based on the fact that we did not quite
    have all of the parameters of this capability locked down. I
    will let the chief talk to those in more detail.
        So we made a decision to cancel the program that we had
    laid in. I do think we will need to return to this issue in the
    QDR. I do think there needs to be a good, thorough discussion
    about the attributes of the long-range strike capability we
    need. Its relationship to the Nuclear Posture Review is going
    to be very important. Obviously, that had not played out yet
    earlier this year.
        So I think the Secretary, as he has indicated, will be open
    to further discussion.

                         RETIRING OBSOLESCENT AIRCRAFT

        Senator Bond. Well, we will look forward to discussing that
    with you. I won't take up the time of my colleagues here.
        One final question. You are talking about the C-5. General
    Schwartz, you mentioned retiring obsolescent aircraft. I know
    you are constrained by congressional mandate not to retire
    those C-5s, some of which, not all of which, may be a very
    uneconomical way. Modernization isn't going to cut the mustard.
        Should we be revisiting that to give the Air Force more
    flexibility to save costs by retiring inefficient, outmoded
    aircraft that will not meet the current needs so you can put it
    into other areas?
        General Schwartz. Senator Bond, too much aluminum is almost
    as bad as not enough. And as the Secretary indicated earlier,
    316 tails is about the sweet spot right now. And if it is the
    decision to have the Air Force take on additional C-17s, it
    makes sense to begin to alter the fleet mix in a way that
    maintains that top line. So, yes, retiring older, less reliable
    C-5As certainly makes sense in the context if we go above 205
    C-17s.
        And sir, if I may take one minute perhaps of your privilege
    just to address the bomber briefly, your earlier question? This
    is important. Long-range strike is an essential capability for
    the Nation.
        As the Secretary indicated, we weren't quite together with
    the Secretary of Defense on how we define this thing. What is
    the range? What is the payload? Is it supersonic? Is it
    subsonic? Is it manned? Is it unmanned? Is it nuclear, non-
    nuclear? Is it low observable, very low observable? These are
    the parameters we need to get together with the Secretary on.
        There is an unfunded request that we have come forward with
    that addresses this to keep a concept development activity
    going so that we can answer these questions, as well as to keep
    certain technology efforts underway that apply regardless of
    how we define the platform. These are antennas, low observable
    antennas. These are data links. These are radars. Stuff like
    that.
        Senator Bond. These have application to others across the
    fleet, not just long strike?
        General Schwartz. They do. Yes, sir. Thank you, sir.
        Senator Bond. Thank you very much.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Thank you, Mr. Chairman.

                               TANKER ACQUISITION

        It has been my long-held belief that our military should
    procure the most capable tanker possible for our airmen using a
    fair, open, and transparent acquisition process. In separate
    discussions with both Defense Secretary Robert Gates and
    Acquisition Chief Dr. Ashton Carter, they assured me that this
    would be the case. Do you both agree?
        Mr. Donley. We do, sir.
        Senator Shelby. Okay. This process, I believe, should also
    utilize a best value method that does not contain an option
    based purely on lowest cost. I will closely follow, as this
    subcommittee will, the procurement process to ensure that our
    men and women in uniform receive the best equipment possible.
        Secretary Donley, the Air Force tanker competition is
    scheduled to begin later this summer with the release of the
    request for proposal. There has been some discussion that a
    lowest price technically acceptable process could be utilized
    in the competition. I have concerns with this acquisition
    method because it clearly would not reach everyone's stated
    objective, that is, that the Air Force procures the best tanker
    for our warfighters.
        Mr. Secretary, is it your belief that our pilots should fly
    the best, most capable tanker possible and not just the
    cheapest?
        Mr. Donley. Sir, we always--we always balance capability
    and cost----
        Senator Shelby. Right.
        Mr. Donley [continuing]. In our acquisition process.
        Senator Shelby. You have got to balance it.
        Mr. Donley. We will continue to do that going forward. We
    are working on the acquisition strategy for KC-X right now at
    the senior levels in the Department, and we are committed to
    sharing with the Congress the results of our work when the
    Secretary has made a decision exactly how to proceed.
        Senator Shelby. General Schwartz, I know there has been
    some concerns about protecting, and should be, about the
    industrial base as the tanker competition moves forward. We are
    all concerned about jobs in the United States.
        I believe any assertion that the Northrop Grumman tanker
    program steals jobs from American aerospace workers and sends
    them overseas is factually incorrect. By assembling the
    Northrop tanker in a new aircraft assembly and militarization
    facility, this proposal would create almost 50,000 new jobs in
    50 States and comply with all current procurement laws in the
    Buy American Act.
        Do you agree that given the vast quantity of jobs that
    would be created in selecting either Northrop Grumman or Boeing
    as the winner, it would have a positive impact on our Nation's
    industrial base? Either one.
        General Schwartz. Senator, as you are well aware, my role
    is to define requirements----
        Senator Shelby. That is right.
        General Schwartz [continuing]. And so on. Clearly, as
    others have suggested, what we want is to get the best possible
    airplane as quickly as we possibly can. And so, I, frankly, am
    agnostic about how this exactly gets done, provided we get on
    with it. And that is what I certainly have offered my
    Secretary, as well as the Secretary of Defense, is my best
    advice.
        Senator Shelby. Thank you.

                            UNMANNED AERIAL VEHICLES

        Mr. Secretary, if I could do a little transition to the
    UAVs. I know you are working with the Army and the other
    services to develop a UAV acquisition roadmap. While I
    understand the benefits for the services to work together on
    this vital issue--I think it is important to do so--I have
    stated the importance of the Army retaining tactical control of
    their UAVs.
        Do you feel that you can continue to work together with the
    Army, Navy, and Marine Corps to allow them continued control of
    the tactical assets that are so critically important to our
    troops on the ground and commanders in the field, especially as
    we move forward through the QDR?
        Mr. Donley. Senator, these are very important capabilities
    that are being developed for our defense establishment. I will
    let the chief address the operational piece of this, but let me
    just say at the DOD level, we do cross-level and look very
    carefully at production capacity and how that is spread across
    different platforms, Predators versus Reapers, and other
    classes of UAVs.
        And that is well balanced at the DOD level in terms of who
    is investing how much where to get the best balance across the
    services when we put together the budget.
        Senator Shelby. General Schwartz, do you have any comment?
        General Schwartz. Yes, sir. Senator Shelby, what General
    George Casey, the Army Chief of Staff, and I want is what works
    best, and whatever the division of labor is, is a very
    pragmatic call. And there is no emphasis within the Air Force
    of trying to assert ownership. This is a question of how one
    can best employ the fleet.
        Now the reality is, is that, for example, unmanned systems,
    you have to take account for them in the airspace. You don't
    want airplanes running together, so on and so forth. If you
    have an air defense situation, you have got to know who is
    friendly and who is not. So there is a need for a level of
    coordination that must continue, regardless of who is operating
    the platform.
        Senator Shelby. Absolutely.
        General Schwartz. But the bottom line is that you should
    have little concern about whether the Army and the Air Force
    can collaborate on this. We can, and we are.
        Senator Shelby. And the marines and Navy, too?
        General Schwartz. Of course. Yes, sir.
        Senator Shelby. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Dorgan.
        Senator Dorgan. Mr. Chairman, thank you very much.
        I have been at a markup of the Energy Committee. So I am
    sorry I have been delayed.
        General Schwartz and Secretary Donley, welcome.
        I want to ask about the UAV and UAS issues. My
    understanding is that you plan to go from 34 Predator/Reaper
    combat air patrols to about 50 by the end of 2011. Have you
    decided where you might assign additional units of personnel to
    operate that many additional combat air patrol units?
        General Schwartz. Senator, we have not done specific
    assignment of those assets, which will be coming on down the
    road. Those which are coming on in fiscal year 2010, we have a
    much firmer idea. Those beyond are not quite as firm at this
    time.

                           C-27 JOINT CARGO AIRCRAFT

        Senator Dorgan. All right. What is the status of the C-27
    joint cargo aircraft program?
        General Schwartz. Sir, let me start big on that, if I may,
    and then get small. At the strategic level, what this is is a
    question about who will do the direct support mission for the
    ground forces in the United States Army in particular? The Air
    Force traditionally does general support very well. As the
    Secretary of Defense has commented, it is sort of like running
    an airline, and you do it to both accomplish the tasks
    assigned, but to do it as efficiently as possible.
        On the other hand, there is a different model which is a
    direct support model, which means that certain assets are
    dedicated to certain commanders or maneuver units, maybe not
    quite as efficient, but improves the reliability of that
    service to that particular organization or commander.
        And what General George Casey, the Chief of Staff of the
    Army, and I have agreed is that the United States Air Force, if
    the decision is that the C-27 should migrate to the United
    States Air Force, we will do the direct support mission of the
    United States Army the way they think it needs to be done. And
    that is a commitment.
        Now with respect to the program, the Secretary of Defense
    made a decision. It is not an instantaneous change. The Army is
    currently in charge of the program, has a program office. We
    have Air Force people assigned there. We will increase that
    number of Air Force people assigned or attached. And so, there
    will be a migration of the program management responsibility
    over about a year's time from the Army to the Air Force.
        And a significant mark on the wall is the deployment of
    four aircraft to United States Central Command later in fiscal
    year 2010. That is driving us in terms of how we make the
    transition to make sure that we have got aircrews and
    maintainers and so on who can operate these aircraft forward.
        Frankly, it might be a mix of Army and Air Force for that
    first deployment. That is not a problem, I don't think. But
    ultimately, we will incorporate the C-27 mission into the Air
    Force and provide the capabilities to the Army that they need
    and want.

                           RECRUITMENT AND RETENTION

        Senator Dorgan. What kind of experience are you having with
    recruitment and retention?
        General Schwartz. Senator, we actually are in pretty good
    shape. Arguably, the economy is an asset in this regard in
    terms of recruiting, and retention has been good. In the
    noncommissioned officer (NCO) ranks, there is a little bit of
    softness, not something to be alarmed about. But a little bit
    of softness in the middle-grade NCOs, and we are watching that
    carefully.
        In both officer and NCO recruitment and retention, we have
    difficulty in the medical career fields. There is keen
    competition for medical professionals, nurses, physicians, and
    so on. And that is an area where we have increased bonuses up
    to I think $88 million in the 2010 program in order to try to
    compete better to bring medical professionals into our Air
    Force.

              B-52 SQUADRON AT MINOT AIR FORCE BASE, NORTH DAKOTA

        Senator Dorgan. Just two other questions, if I still have
    time? What is your status with respect to standing up the new
    B-52 squadron at Minot Air Force Base?
        General Schwartz. On track, sir. And that is part of our
    nuclear roadmap to do that, and it is on schedule, on track.

             AIR FORCE ACTIVITY IN USCENTCOM AREA OF RESPONSIBILITY

        Senator Dorgan. And could you just give the subcommittee a
    general description of the Air Force presence and activities in
    the war theaters of Iraq and Afghanistan so we get a sense of
    assets and personnel and so on?
        General Schwartz. Yes, sir. Of the 38,000 roughly folks
    that we have deployed overseas, about 30,000 of those personnel
    are in Iraq and Afghanistan or in the adjacent spaces. Of that,
    about 8,000 are Reservists, 5,000 Air National Guard, 3,000 Air
    Force Reserve. And they are performing a range of missions,
    certainly from lift to strike to intelligence, surveillance,
    and reconnaissance.
        We run the hospitals at both Bagram Air Base and Balad Air
    Base on behalf of the joint team. We have, as I mentioned
    earlier, some of our youngsters performing convoy duties from
    Kuwait into Iraq, security forces, engineers, the whole array.
    It is a significant commitment.
        We will grow in Afghanistan from about 5,000 today to maybe
    6,500 total Air Force personnel as the numbers increase in
    theater. It is a significant commitment and one we do proudly.
        Senator Dorgan. Well, let me thank you, Secretary Donley,
    and you, General Schwartz, for your willingness to be always
    available to us. And I would like to send you some additional
    questions on the C-27 and the combat air patrol future. So I
    will submit those questions.
        And again, let me thank both of you for the work you do. I
    am very pleased.
        Chairman Inouye. Thank you very much.
        Senator Bennett.
        Senator Bennett. Thank you, Mr. Chairman.

           HILL AIR FORCE BASE AND ICBM SOLID ROCKET INDUSTRIAL BASE

        And I want to say to our two witnesses thank you for coming
    to Utah and for the experience you had. I hope the weather was
    good enough for you and the hospitality, et cetera. We
    appreciated your being there. They were there for the Air Force
    Association meetings last week.
        I trust I can be forgiven for being a little parochial and
    discuss some of the issues relating to Hill Air Force Base and
    also the intercontinental ballistic missile (ICBM) solid rocket
    industrial base. On that latter issue, let me thank you for the
    news that I have received that the Air Force is going to
    maintain the solid rocket motor industrial base that supports
    the Minuteman III. What is the status of your request to
    reprogram fiscal 2009 funds?
        Mr. Donley. Yes, sir. We do intend to request reprogramming
    just to beef up this program. The Department is looking at the
    reprogramming right now, awaiting first the results of the
    overseas contingency operations (OCO) work that the chairman
    referred to earlier. So once we have seen the results of the
    OCO, then the Department will proceed with its reprogramming
    work.
        Senator Bennett. Do you have any idea how many solid rocket
    motors you are planning to buy?
        Mr. Donley. Off the top of my head, I do not have that
    information. But we will get you that for the record.
        Senator Bennett. Okay. Thank you. Thank you very much.
        [The information follows:]

        The intent of the warm line is to exercise industry's
    Minuteman III-unique solid rocket motor production
    capabilities. Identifying a specific number of solid rocket
    motors is not an accurate measure of the ability to maintain
    this industrial base. Our fiscal year 2010 effort will initiate
    a low-rate production of the Minuteman solid rocket motors
    which will maintain design-unique material availability, sub-
    tier material supplier viability, touch labor currency, and
    design engineering personnel continuity unique to the Minuteman
    weapon system. In addition, our fiscal year 2010 effort will
    maintain systems engineering assessment capability and utilize
    independent verification of production processes. However, the
    actual production quantities are unknown until the contract is
    finalized.

                  F-16 REDUCTIONS AT HILL AIR FORCE BASE, UTAH

        Senator Bennett. Now I want to talk about what appears to
    be something of a donut hole on the fighter situation.
    Naturally, we are disappointed to learn that Hill is going to
    lose one of its three F-16 fighter squadrons as a part of the
    restructuring, and I understand the restructuring has to go
    forward and that there are logical reasons for it. But as I
    look at the locations where the F-16s are going to be removed
    around the country, they seem to be focused primarily in bases
    in the intermountain and southwest regions, and that will be
    geographically the area where you will see most of the F-16s
    withdrawn. And yet the Utah Test and Training Range (UTTR) is
    most accessible to those regions, and it seems to me that it
    would make most sense to take the aircraft away from something
    that is farther away from the Utah Test and Training Range.
        I know Senator Cochran is very proud of the training range
    in Mississippi, but UTTR is the biggest land-based training
    range we have and, I think, a major, major asset to the Air
    Force. So has any thought been given to the fact that it might
    make more sense to keep the airplanes closer to the training
    range and take the reductions perhaps someplace else?
        General Schwartz. Senator Bennett, we have given thought to
    an array of considerations. The model of aircraft, their age,
    the proximity to training opportunities, the arrangements
    related to total force initiatives, and so on and so forth at
    various locations. Just to give you a sense, the rough
    reductions were predominantly in the training area. Air Combat
    Command took substantially less reductions than did our Air
    Education and Training Command.
        The bottom line is that we have looked at that. It is true
    that Hill Air Force Base is a candidate to lose 24 F-16s. That
    is--from a people point of view, sir, that is 591 spaces. We
    know that is not trivial.
        But we have looked at this as a package. And yes, Tucson
    will lose some airplanes, largely training platforms. Hill Air
    Force Base will take some down. There are roughly--the split is
    some overseas, some in Europe, some in the Pacific, a number
    here in the continental United States.
        But I think the key thing here is that we have done this
    from a fleet management point of view, from a construct which
    suggests that if we do this now, it will allow us to leap to F-
    35 more rapidly and that we need to look to the future and less
    to the past.
        Senator Bennett. All right. That brings up the donut hole I
    am talking about because you are going to combine the 388th and
    the 419th, merge them as a prototype for further efforts to mix
    active and Reserve fighters, and that is an effort that has
    seen good results so far.
        But the impact on the depot is that they are going to see
    not just the 500 people you are talking about, but you are
    going to see a significant drop in depot work. And it is fine
    to say, well, the F-35 will come in at some particular point,
    but if that particular point is stretched out, you then lose--
    we are back to the question of manufacturing base. Only in this
    case, it is maintenance base. You lose the expertise that is
    there that could be maintained if there were some way to deal
    with the question of the F-16s.

                                  F-35 BASING

        Now it has been over 1\1/2\ years, the other side of the
    donut hole, stretching it out, that I have been told that Hill
    would be one of the first Air Force bases to receive an
    operational F-35 squadron. And now I understand that there is
    some backing away from that commitment, at least on the timing.
        So do you still say that Hill is going to receive one of
    the first two operational F-35 squadrons? And if so, can you
    give me some hope that it will come sooner rather than later so
    that the donut hole can be filled with work?
        General Schwartz. Senator, I can't. I can't tell you it
    will be the first. We haven't made that decision yet. And one
    thing that the Secretary and I have tried very hard to do is
    not to make promises we can't keep. And so, I am being
    straight.
        Senator Bennett. Sure. Obviously, we prefer that.
        General Schwartz. Understood, sir. I think, just to give
    you a sense of what is at play here, there are multiple demands
    on the new system, as you can well imagine. There are--our
    commander in the Pacific Air Forces and certainly Admiral
    Keating at United States Pacific Command (USPACOM) has levied a
    demand signal for modernization in the Pacific with regard to
    potential threats on the Asia-Pacific rim.
        Likewise, General John Craddock and the United States
    European Command has indicated that because the allies will
    gain F-35s in Europe, there will be a need for us to have F-35
    presence or we will be out of sync with our allies on the
    European continent. And likewise, we know very well that we
    have needs--donut holes, if you will--in the United States.
        So there are a lot of moving parts on this. The bottom line
    is that, and I am not saying anything that I don't think
    anybody believes, Hill Air Force Base is a great place to fly
    airplanes. And that is well known, and that certainly will be
    factored into basing decisions as we sort of integrate all of
    these demand signals.
        Senator Bennett. Well, I thank you for that. And it is not
    just a great place to fly airplanes. It is a great place to
    repair airplanes. And my concern is that if we see the
    workforce on the repair side, on the depot side drop down
    because of the action with respect to the F-16 and then a delay
    in bringing in the F-35, we wake up to discover that the
    capacity that we have always identified with Hill suddenly
    isn't there. Well, not suddenly isn't there, but isn't there.
        So I would ask you to take a look at that and say is there
    any way we can kind of nudge both of these, that is, nudge the
    F-16 in one way to close that end of the donut hole and nudge
    the F-35 in the other way to close that end of the donut hole?
    Yes, it is parochial on my part, but I also think it makes
    sense for the Air Force's capability to service the F-35 when
    the time comes.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Murray.
        Senator Murray. Mr. Chairman, thank you very much for
    having this hearing.
        General Schwartz, Secretary Donley, thank you to both of
    you. It is good to see you again. Let me just start by saying
    thank you to all the work you and the men and women serving in
    the Air Force do today to successfully perform the very
    critical missions that they are doing to safeguard our country.

                     TANKER COMPETITION AND INDUSTRIAL BASE

        It is really important to me that our airmen have
    everything they need to fight our wars overseas, both today and
    in the future. So I am going to start my questions today with a
    shocker. What can you tell me about tankers?
        But before I do that, let me just frame that question about
    the upcoming tanker competition from the standpoint of our
    domestic industrial base. Mr. Chairman, I am very worried about
    our domestic industrial base. I am worried about its long-term
    ability to provide our military forces with what they need to
    accomplish their national security missions.
        During last year's KC-X competition, everybody had real
    high hopes that it was going to be the best and brightest
    example of how the acquisition process could function and
    provide for the needs of our warfighters. Here we are today
    without a much-needed replacement of our aging fleet of
    refueling tankers.
        Now I applaud the work of Chairman Levin and Senator
    McCain. They have championed efforts here to move acquisition
    reform through Congress. As part of that, I included a
    provision that requires DOD to report on the effects that
    canceling an acquisition program would have on our Nation's
    industrial base.
        I have talked with both Secretary Gates and Secretary
    Carter about this issue. I want to make sure that we maintain a
    domestic industrial base that can respond to the ongoing need
    of our warfighters.
        This is of particular concern to me as a Senator from a
    State that represents really the entire spectrum of
    constituencies on this issue. One end of the scale, we have end
    users who are the servicemembers at many military facilities in
    Washington State. We have two outstanding Air Force bases,
    Fairchild and McChord, who rely on the goods and services this
    industry produces. At the other end, we have the hard-working
    men and women of the industry, including the smallest supplier
    companies to the major manufacturers that tirelessly work to
    support our servicemembers.
        So how we move forward with this acquisition is very
    important to me and to everyone I represent. General Schwartz,
    so I would like to ask you today how you are taking into
    account the health and longevity of our domestic industrial
    base as you tackle acquisition reform in the Air Force?
        General Schwartz. Ma'am, the basic approach, the mandate
    for doing this is clear to our Air Force. The way it has
    traditionally been done, and I, frankly, think it is
    appropriate, is that industrial base considerations are
    typically not considered within specific source selection
    activity on specific programs.
        The acquisition technology and the logistics organization
    in OSD has the role to do that at particular milestones in the
    acquisition process. So they have the more global perspective,
    if you will, not just whether it is a tanker or a fighter or a
    lift platform or a satellite, but rather, the broader
    implications for industrial base.
        And so, again, not completely in my lane, but the way that
    is currently being done makes sense to me. And it is clear that
    the civilian leadership understands the mandate.
        Senator Murray. Secretary Donley, do you want to add
    anything?
        Mr. Donley. No question that the Department has an interest
    in tracking how industrial base issues get affected by
    Departmental-level decisions and making sure those are taken
    into account as we go forward.
        Senator Murray. We have to think about the future while we
    are thinking about today.
        Well, let me talk about the timeframe for the tanker
    competition. Secretary Gates said that he needed a full team in
    place before this competition could be restarted. Now,
    Secretary Donley and General Schwartz, you are here.
    Secretaries Lynn and Carter, they have been confirmed and are
    in place. I have been told that we are going to begin work on
    this competition process this summer.

                     TIMING OF TANKER REQUEST FOR PROPOSAL

        That is a couple weeks away from now. Can you provide an
    update on the timing for the request for proposal (RFP) and how
    this process will follow that?
        Mr. Donley. Ma'am, we have been working on this issue for a
    couple of months now fairly intensively with Deputy Secretary
    Lynn, Secretary Carter, and other members of the acquisition
    team, and we are in the process of carrying forward the results
    of that work to the Secretary for his consideration. And we
    still do hope to get an RFP out this summer on the street.
        Senator Murray. Hope to is not a definite timeframe.
        Mr. Donley. No, this is our intent. And we have pledged,
    Secretary Gates has and I would certainly echo it, that when we
    have completed the results of our internal work and we are
    ready to go out, we will be briefing the Congress on the way
    forward.
        Senator Murray. Okay. So we are still in the timeframe of
    summer?
        Mr. Donley. Yes, ma'am.
        Senator Murray. Can you tell me what measures are being
    taken to prevent the claims of an unfair evaluation or scales
    being tipped to one side or the other?
        Mr. Donley. Well, we are committed from the get-go to a
    fair and open competition. There is no doubt of that.
        We have taken measures inside the Air Force to strengthen
    our source selection process. We have, since the events of last
    summer, increased our focused training on lessons learned from
    the two protests that were sustained last year, the KC-X and
    the CSAR-X, to get those lessons learned into our source
    selection process.
        With respect to the KC-X program in particular, we have put
    a few more senior people into that program office. We have
    moved contract approval authority up to the Secretary of the
    Air Force level, and we are undertaking other measures to
    strengthen the KC-X team and our source selection process as we
    lead into this RFP process going forward.
        Senator Murray. Well, this is a difficult process, and all
    of us want the best aircraft as soon as possible. But I think I
    share with everyone on this subcommittee, we want to make sure
    that this is a fair and transparent competition. We are really
    urging you to make sure that that is very clear.
        We want it to be good for the warfighter and good for the
    taxpayer, which leads me to the question of whether a dual buy
    is a viable option?
        Mr. Donley. Well, we share the Secretary's view that a dual
    buy would be more expensive for the taxpayer in at least three
    dimensions. It would require the development of two airplanes
    instead of one. We would end up with two logistics and two sort
    of depot infrastructure processes in support of that effort
    instead of one. And in the near term especially, we are
    concerned about the impact on the Air Force's budget and the
    Department of Defense's budget generally by going to a dual
    track approach.
        Our program has been structured around a buy of about 15
    airplanes per year. To accommodate a dual award strategy, where
    you are buying airplanes from two providers, probably the
    minimum order quantity for each is 12 aircraft. So that means
    instead of buying 15 per year, we would need to be buying about
    24 per year.
        Senator Murray. And we do not have the budget capacity for
    that?
        Mr. Donley. Well, this would eat significantly into our
    procurement program going forward. It potentially would almost
    double the tanker piece of the Air Force's procurement program
    within the FYDP going forward.
        Senator Murray. Which means other things would be left off
    the table?
        Mr. Donley. At the same time, we are trying to ramp up JSF,
    et cetera. So this is a concern to us, and this is basically
    the reason why we think the dual award would not make sense.

         FAIRCHILD AIR FORCE BASE, WASHINGTON--AERIAL REFUELING MISSION

        Senator Murray. Okay. I appreciate that, and I want this
    tanker competition done. You, of course, know I am hoping one
    plane company wins it. Just as high on the list for me is
    making sure that we protect our taxpayers in this process. So I
    appreciate your answer to that question.
        Beyond the tanker competition, you are simultaneously
    working on tanker beddown. So I want to talk about Fairchild
    Air Force Base in my home State and how it is uniquely
    positioned to support the KC-X beddown.
        We have two air wings who have a very proud refueling
    history there. I have seen them in action. They are incredible.
    We have a large runway and a strategic location for the
    execution of global reach mission, which is important.
        I recently met with the wing commander at Fairchild, and we
    talked about the excellent relationship that Fairchild has with
    the Spokane community, as well as some of the challenges that
    they have faced of late. I am sure you are aware that last
    winter one of Fairchild's key training facilities had its roof
    collapse during a major snowstorm there. Even though its runway
    is the right size, it is due as well for some very important
    maintenance and continued upkeep so it is ready for KC-X.
        Can you confirm for me that we are doing everything we can
    to make sure that Fairchild is ready for the KC-X when the time
    comes?
        General Schwartz. Again, ma'am, I don't want to suggest
    that, again, promises--not a promise. But certainly Fairchild
    Air Force Base is an obvious candidate for early beddown. There
    are others in the country, too, and we will see sort of what
    the production rate allows us to do. But Fairchild Air Force
    Base certainly is in the long-term plan.

       FUTURE OF 36TH RESCUE FLIGHT--FAIRCHILD AIR FORCE BASE, WASHINGTON

        Senator Murray. Okay. Well, I stand ready to help you do
    whatever we need to do there to make sure we are ready for that
    as well.
        In addition to supporting the refueling mission, Fairchild
    is also home to the 36th Rescue Flight. They are very
    important. They support the 336th Training Group and Air Force
    Survival School. We know that these helicopters evacuate and
    help locate students who become lost during their survival
    training. They are very important.
        It also supports civilian search and rescue operations.
    They have actually saved about 600 people during recent
    missions in a variety of States, not only mine, but Idaho,
    Oregon, and Montana. They are just extraordinary. Their
    crewmembers are unbelievable, and everybody just is amazed at
    their capability. So, first of all, my thanks to them.
        But I wanted to make sure that you all were committed to
    work with us on the future of that 36th Rescue Flight. This is
    so that we can maintain that very critical training in
    emergency rescue operations that they have.
        General Schwartz. Yes, ma'am. And I would also indicate
    that that is related to the decision to discontinue the CSAR-X
    program. And the Secretary made a call on that particular
    program, but clearly, the mission remains important for the
    Department of Defense, and that unit is part of that tapestry.
        Senator Murray. Okay. Well, they are very important to us.
    I know they are important to you, and I will work with you to
    make sure we have what we need within the budget process on
    that.
        So thank you very much.
        And thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Shelby, do you have any questions?
        Senator Shelby. I have no further questions.
        Chairman Inouye. Then Mr. Secretary, General Schwartz, I
    would like to thank both of you for your testimony today.

                         ADDITIONAL COMMITTEE QUESTIONS

        I will be submitting questions on the tanker fleet. I am
    concerned personally because of the age factor. And I will also
    inquire into your thoughts further on dual purchase because I
    have received a report suggesting that there may be massive
    savings if you had two sources, but I will leave it up to you.
        I am also asking questions on the possibility of developing
    an export version of the F-22. I have had inquiries from our
    friends and allies abroad indicating strong interest in
    acquiring such aircraft.
        And so, with that, I would like to thank you once again.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
                 Questions Submitted to Hon. Michael B. Donley
                Questions Submitted by Chairman Daniel K. Inouye
                             tanker contract award
        Question. Secretary Donley, will the tanker replacement program
    request for proposals go out to industry this summer? Is the Department
    on track to make a contract award for the tanker replacement in early
    fiscal year 2010?
        Answer. We expect to release the draft request for proposal in late
    September 2009, with a planned contract award in summer 2010.
        Question. Secretary Donley, why is the Department confident that
    the upcoming tanker contract award will not result in a protest to the
    Government Accountability Office? What is the Department's plan if
    another protest is lodged and upheld?
        Answer. Protests are the prerogative of industry afforded by law.
    The Air Force cannot guarantee that the losing bidder will not file a
    protest with the Government Accountability Office. However, the Air
    Force has worked closely with the Office of the Secretary of Defense to
    ensure that the source selection strategy we implement will withstand
    outside scrutiny. If a protest is lodged and upheld, the Air Force will
    take the Government Accountability Office recommendation into
    consideration, and evaluate the next steps to recapitalize our tanker
    fleet.
                            tanker dual buy strategy
        Question. Secretary Donley, what are the pros and cons of the
    Department of Defense awarding a split buy of tankers between the two
    industry competitors? What are the costs associated with this
    acquisition strategy for the full tanker replacement program?
        Answer. The pros and cons of the Department of Defense awarding a
    split buy of tankers are as follows:
        Pros:
      --Will likely expand U.S. wide-body aircraft manufacturer industrial
            base; and
      --Lowers risk of protest.
        Cons:
      --Doubles development cost from approximately $3.5 billion to $7
            billion;
      --To produce the minimum Economic Order Quantity of 12 aircraft per
            year per competitor would increase average annual production
            costs from approximately $3.6 billion per year to $6.2 billion
            per year;
      --Magnifies training, operations, logistics, and support costs by
            introducing two new and different airframes at the same time;
            and
      --Would result in a significantly increased cost per aircraft if we
            pursued a split buy at the current funding level, due to
            production inefficiencies.
        Note: If additional production funds were available to support the
    procurement of 24 aircraft per year, there would be a faster
    recapitalization of our tanker fleet; but, we could achieve at least
    equal benefit from buying 24 aircraft per year from a single offeror
        OSD (AT&L) estimates the costs associated with a dual award
    strategy for the whole KC-X program would be between $11-$14 billion
    (Net Present Value).
                      structural repairs of kc-135 tankers
        Question. Secretary Donley, based on the current tanker replacement
    program, it will take over 30 years to recapitalize the KC-135 fleet.
        Can you elaborate on the cost of the structural repairs that will
    need to be done on the KC-135 fleet during the acquisition of the
    replacement tankers? Can these costs be avoided if the fleet is
    replaced sooner?
        Answer.
    Discussion of Approach
        Skin replacements are the major structural repairs that occur on
    the KC-135 over and above the existing Programmed Depot Maintenance
    (PDM) scheduled maintenance. To date, these skin replacements have been
    manageable. Replacements in PDM have been limited, and there is a
    reasonable amount of rework that can be accomplished before most of the
    structures require replacement. However, the lack of a methodology
    accounting for the interaction of corrosion with fatigue generates
    uncertainty in our ability to accurately predict structure degradation.
        The following assumptions were made to determine the cost and
    schedule for replacing the skins:
      --The dates we have forecast for replacement were selected to gain
            the most benefit from the work that will be accomplished,
            therefore the initiation date was schedule and not technically
            driven.
      --To minimize the impact to aircraft availability, it was assumed
            that no more than 12 aircraft would be down at any one time,
            and the tasks were grouped to be accomplished concurrently.
      --Each estimate uses current year (fiscal year 2009) dollars and is
            per aircraft; then year dollars will be more.
        The information below can be compared with the proposed adjusted
    schedule for the KC-X. For example, the crown and center wing (wing
    box) upper skins (see below) would not require replacement until fiscal
    year 2026. Acquisition of KC-X would eliminate the requirement to
    modify 230 of the KC-135 aircraft.
                Aft Body Skins
        Replacement of these skins is already programmed to be done as part
    of PDM fiscal year 2012-fiscal year 2017.
        Estimated cost per airplane: $0.3 million.
        Schedule: Fiscal year 2012-fiscal year 2017, 416 aircraft.
        Estimated total cost: $124.8 million.
        Maximum aircraft down: N/A--concurrent with PDM.
                Upper Wing and Horizontal Stabilizer Skins
        These would be done concurrently, separate from PDM, in a speed
    line, and include replacement of substructure components that are
    important to continued use of the aircraft and accessible when the
    skins are removed.
        Estimated cost per airplane: $6.7 million.
        Schedule: Fiscal year 2016-fiscal year 2034, 416 aircraft.
        Estimated total cost: $2.8 billion.
        Maximum aircraft down: 12 (at any one time).
                Crown and Center Wing (wing box) Upper Skins
        This replacement is planned further in the future since recent
    experience has not indicated significant problems with corrosion or
    cracking. They are planned to be done concurrently in a speed line and
    separate from PDM. We have accounted for planned retirements in this
    increment.
        Estimated cost per airplane: $4.6 million.
        Schedule: Fiscal year 2026-fiscal year 2034, 230 aircraft.
        Estimated total cost: $1.1 billion.
        Maximum aircraft down: 12 (at any one time).
        Due to the materials and the assembly techniques used when the KC-
    135 aircraft was originally procured, occurrences of corrosion and
    stress corrosion cracking will continue to be a primary area of
    concern. These materials are susceptible to corrosion or stress
    corrosion cracking. Corrosion is aggravated by the assembly techniques
    that did not use modern methods of corrosion prevention during
    assembly. Continued inspections, repairs, and preventive maintenance
    are required to ensure a viable fleet.
        Can these costs be avoided if the fleet is replaced sooner? Yes, as
    indicated in the answers above, some of the costs could be avoided,
    depending on timing of KC-X replacement and retirement schedule for the
    KC-135.
                                  end strength
        Question. Secretary Donley, we understand that the Air Force will
    be allocating personnel to new or growing mission areas such as cyber
    security, the nuclear enterprise, intelligence, surveillance and
    reconnaissance and other air support activities.
        What tradeoffs are you considering that will enable the Air Force
    to dedicate more people to these missions?
        Answer. In the fiscal year 2010 President's budget, we source these
    new and emerging missions primarily through the proposed Combat Air
    Forces (CAF) restructuring plan. This effort accelerates the retirement
    of approximately 250 of our oldest fighters, funding a smaller but more
    capable, flexible, and lethal force, and redistributing manpower to
    emerging high priority missions.
        Implementation of the CAF restructure allows the Air Force to
    realign approximately 4,000 manpower authorizations to emerging and
    priority missions such as manned and unmanned surveillance operations
    and nuclear deterrence operations. This restructure is a major step,
    and was proposed only after a careful assessment of the current threat
    environment and our current capabilities. In addition to being a
    significant investment in bridge capabilities to our fifth generation-
    enabled capability, this action shifts manpower to capabilities needed
    now for operations across the entire spectrum of conflict.
        Question. Secretary Donley, how do you see the roles and missions
    of the Air National Guard and Air Force Reserve changing in the future?
        Answer. As the Air Force moves forward, we must capitalize on the
    tremendous talent the Air National Guard and Air Force Reserve
    contribute to the Total Force, as both a strategic and operational
    resource. It is critical to build on the success of Total Force
    Integration to drive even greater gains in effectiveness and
    efficiency, and expanding integration initiatives across the force
    maximizes our capabilities across the spectrum of conflict--from
    building partnerships and irregular warfare to conventional operations
    and strategic deterrence. The Air Force will need to expand
    associations, both classic and active, as part of our broad effort to
    modernize our organizations into a more capable Air Force. This
    expansion also includes examining new mission areas, such as unmanned
    aerial systems, space and cyber, for Air Reserve component units as
    appropriate.
                                  c-17 program
        Question. Secretary Donley, there are some critics of the
    Department's plan to terminate production of the C-17 strategic airlift
    aircraft in fiscal year 2010. The next mobility capabilities and
    requirements study which will inform a decision has not been completed
    and C-17 is the only warm production line we have for strategic lift
    aircraft.
        What are your views about the adequacy of planned strategic
    airlift?
        Answer. The Air Force's planned fleet of 324 strategic airlift
    aircraft (213 C-17s, 52 C-5Ms and 59 C-5As) is more than sufficient to
    meet the current National Military Strategy. The C-5 RERP Nunn-McCurdy
    review of the 2005 Mobility Capabilities Study established a strategic
    airlift capability requirement of 33.95 million ton-miles per day, and
    the Air Force's strategic airlift program of record meets this
    requirement. The ongoing Mobility Capabilities and Requirements Study
    2016, expected in December 2009, will help establish the future
    strategic airlift requirement.
                          air force nuclear enterprise
        Question. Last fall, the Air Force published a strategic plan on
    ``Reinvigorating the Air Force Nuclear Enterprise.''
        Secretary Donley, please walk us through the Air Force's plan to
    restore credibility in delivering secure and reliable nuclear
    deterrence capabilities to the American people.
        Answer. The Air Force has undertaken major efforts to reinvigorate
    our Nuclear Enterprise, to include a major step by activating a new
    major air command, Air Force Global Strike Command (AFGSC), at
    Barksdale AFB, Louisiana. The AFGSC organizational construct clearly
    aligns nuclear missile and nuclear capable bomber units under a single
    command and demonstrates a visible commitment to the nuclear deterrence
    mission. AFGSC will now foster a robust strategic deterrence enterprise
    and standardized self-assessment culture.
        Additionally, we realigned and consolidated nuclear sustainment
    under the Nuclear Weapons Center in Air Force Materiel Command. The
    Nuclear Weapons Center is now the focal point for nuclear weapons life
    cycle management and positive inventory control for nuclear weapons
    related material.
        The Air Force has also established a new directorate on the Air
    Staff responsible for Strategic Deterrence and Nuclear Integration
    under the leadership of a major general. These actions represent the
    largest reorganization the Air Force has undertaken since the early
    1990s, and provides the leadership and focus necessary to accomplish
    this critical mission with the precision and reliability it demands in
    today's environment and into the future.
        In addition to this significant reorganization effort we have also
    instituted changes to the Air Force corporate process by adding the
    Nuclear Panel for specific focus on nuclear issues and charged the
    Under Secretary of the Air Force to be responsible for broad nuclear
    policy and oversight. We also founded the Nuclear Issues Resolution and
    Integration Board and the Nuclear Oversight Board. These boards meet
    quarterly to ensure Air Force senior leaders involvement and
    notification on recent events occurring in the nuclear enterprise. The
    Nuclear Oversight Board is made up of major command commanders with
    equity in the enterprise and chaired by General Schwartz and me.
        We have also examined our inspection and self-assessment culture
    across the nuclear enterprise and have made improvements there as well.
    The Air Force Inspection Agency will have oversight of every nuclear-
    related inspection. Inspection teams will consist of approximately 20
    ``core'' team members who have undergone a standardized training and
    certification process to ensure consistent rigor. We have implemented a
    root cause analysis methodology to determine why mistakes were made and
    if they are a symptom of a larger problem.
        Finally, we have undertaken initiatives to deliberately develop
    leaders in the nuclear enterprise. We have reviewed every Air Force
    professional military education course from basic training to senior
    developmental education to ensure every Airman knows and understands
    the United States' policy and strategy for nuclear weapons.
    Additionally, we have established a process to track nuclear experience
    and developed new courses to prepare leaders to fill key nuclear
    billets. These processes will help ensure we place the right person,
    with the right skill set, in the right job, and at the right time.
        Question. Secretary Donley, how do you plan to rebuild the Air
    Force's culture and institutions so that each Airman understands the
    importance of the nuclear deterrence mission?
        Answer. The Air Force has conducted a review of the curriculum in
    every professional military education course from basic training
    through senior development education to ensure Airman are taught Air
    Force nuclear policy and strategy at key points throughout their
    careers.
        We have also refocused our nuclear inspection mindset. Instead of
    inspection teams identifying errors and the units simply fixing
    identified problems, we now do an extensive root cause analysis to
    determine why the mistake occurred, and if it is the symptom of a
    larger problem. This encourages our organizations to take a look at
    their entire processes to find ways to improve instead of just fixing
    what is broken. This new process strengthens self-assessment
    capabilities and instills a ``culture of excellence'' mentality.
                              joint cargo aircraft
        Question. Secretary Donley, the Joint Cargo Aircraft program is now
    an Air Force responsibility rather than a joint Army-Air Force program.
    In addition, the validated requirement of 78 aircraft appears to have
    dropped to 38 aircraft.
        Why has the Air Force assumed responsibility for this program and
    what has changed to reduce the requirement?
        Answer. The transfer of Army Time Sensitive/Mission Critical
    airlift support to the Air Force intends to capitalize on efficiencies
    gained by operating the tactical airlift fleet under a single service.
    The Department of Defense is now engaged in an overall look to leverage
    existing intra-theater airlift capability to maximize effectiveness and
    minimize expenditure of taxpayer dollars. The changes reflected in the
    fiscal year 2010 President's budget request balance the C-27J
    capabilities with the existing capabilities in the Department. The Air
    Force will continue to evaluate the entire intra-theater fleet as
    mission needs develop.
                       fighters in the air national guard
        Question. Secretary Donley, the Committee recently received
    testimony from the Air National Guard alerting us to the fact that 80
    percent of their F-16 fighter inventory will face retirement beginning
    in 2017. Retiring these aircraft will almost eliminate the fighter
    aircraft that the Air National Guard has dedicated to the Combat
    Aviation and Air Sovereignty Alert missions.
        What steps are you taking to ensure that the Air National Guard is
    properly equipped for its important homeland security mission over the
    United States?
        Answer. Homeland Defense is the Department of Defense's first
    priority and we are committed to the Operation NOBLE EAGLE mission
    through the long term. Recapitalization of the fighter and tanker fleet
    will require many years, and within the available funding, we will
    maximize the life of existing aircraft.
        We continue shaping our force structure to meet the threat with the
    best mix of capabilities. To do this, we are acting swiftly to remedy
    our potential capability gaps, based on accurate service life and fleet
    health projections over the next 5-15 years. The Quadrennial Defense
    Review will also take a close look at Homeland Defense requirements and
    provide us further insight on the force structure required to meet our
    Nation's air defense needs.
        Question. Secretary Donley, is the Air Force looking at new
    missions for the Air National Guard? Are additional association
    relationships with active Air Force units planned?
        Answer. The Air Force continues to examine opportunities for
    integration with the Air National Guard and all existing and emerging
    mission areas are considered for Total Force Integration initiatives.
    Currently, there are additional fighter associations planned for the
    Air National Guard. The Air Force recognizes the significant
    contributions that experienced Air National Guard Airmen bring to Total
    Force Integration associations and expects those benefits to continue
    in legacy and next generation missions.
        Question. Secretary Donley, if delays in the F-35 Joint Strike
    Fighter program keep the Air Force from filling the empty fighter spots
    in the Air National Guard with the new aircraft, will you consider
    buying 4th generation F-15s and F-16s, which provide improved
    capability over the aircraft being flown today?
        Answer. The United States Air Force has invested heavily in the F-
    35 program, and we are closely tracking developments in order to ensure
    that it stays on track. The Chief of Staff of the Air Force, General
    Schwartz, has stated on many occasions that the key to the Air Force's
    fighter recapitalization is the F-35, and any initiatives to procure
    fighter weapons systems other than the F-35 would require buying fewer
    F-35s. Subsequently, delays in F-35 procurement would also cause an
    increase in cost and further delay the F-35 for the Air Force, Navy,
    and Marine Corps.
        After the Quadrennial Defense Review is completed, we expect to
    have a more accurate picture of what the Nation's and Air Force's
    requirement will be for fighter force structure. If there is going to
    be a gap in capabilities, this could be addressed by extending the
    service life of the F-15s and F-16s. We are currently conducting
    fatigue testing on the F-15 and F-16 fleets to provide a scope and
    focus on the structural modifications that might be necessary. Once
    these structural tests are complete, we will have a sense of whether or
    not we will need a Service Life Extension Program. Beyond this, we have
    no plans to procure additional 4th generation F-15s and F-16s.
                 intelligence, surveillance and reconnaissance
        Question. Secretary Donley, what is the status of discussions to
    bring the C-12 programs together, possibly under the Air Force, and
    avoid duplicative efforts in areas such as sensor development and
    training programs? What are the disadvantages of a joint approach here?
        Answer. The C-12 class of aircraft is made up of over 26 different
    aircraft variations, and the numerous sensor configurations easily
    triple the number of overall configurations in separate Services.
    Consolidation of these converted civilian platforms under one program
    would be extremely challenging and time-consuming. A few discussions
    have occurred with regard to merging the C-12 class aircraft under one
    Service; however, to satisfy urgent warfighter needs, the Air Force's
    focus has been on producing, modifying, and fielding aircraft as
    rapidly as possible. Due to the numerous variations and capabilities of
    currently fielded C-12 systems, separate management is the most rapid
    way forward for today's needs. To determine the full range of
    advantages and disadvantages for a common future platform, further
    discussion and in-depth analysis will be required.
                           export version of the f-22
        Question. Secretary Donley, I believe the Department should
    consider an export program for the F-22 Raptor fighter aircraft. Under
    the rules for such a program, the costs for developing an export
    variant is borne by the interested nation, not the United States. This
    would enable us to provide advanced fighter capabilities to our close
    friends and allies.
        Secretary Donley, what is your view of an export program for an F-
    22 variant?
        Answer. The Obey amendment to the fiscal year 1998 Defense
    Appropriations Act, reenacted annually in every subsequent
    appropriations act, prohibits foreign military sales of the F-22A
    Raptor. However, I believe the F-35 is the aircraft of the future, for
    both the United States military and our partner nations. It would be
    very expensive for Japan, Australia, or other nations to buy an export
    model of the F-22, and this funding is potentially better spent on
    collectively developing the F-35 and the interoperability that enables
    us to work together in future joint and coalition operations around the
    world.
        Question. Secretary Donley, could you give the Committee a rough
    order of magnitude estimate on the cost and schedule to develop an
    export version of the F-22?
        Answer. The rough order of magnitude cost and schedule estimate to
    develop an export version of the F-22 is estimated at $2.3 billion for
    non-recurring development and manufacturing, with the first delivery of
    an operational aircraft 6.5 years from the Engineering Manufacturing
    and Development contract.
        These figures came from a recent study which was reported to SAC-D
    staff and Senator Inouye in May 2009. The study also identified an
    additional cost estimate of $9.3 billion for the production of 40
    aircraft, resulting in a total estimated cost of $11.6 billion (average
    aircraft cost of $290 million). A Letter of Agreement signed in early
    2010 would result in the first operational aircraft delivery no sooner
    than 2017.
        The cost and schedule estimates above only include the air vehicle
    (aircraft, engines, and avionics). The study did not include recurring
    or non-recurring costs for support and training systems, initial
    spares, base stand-up, interim contractor support, U.S. government
    program offices, foreign military sales surcharges or production
    shutdown.
        Question. Secretary Donley, do you think the availability of an
    export version of the F-22 would change the international market for
    the F-35 Joint Strike Fighter?
        Answer. Introducing the F-22 into the export market as another
    available fifth generation fighter would have a pronounced effect in
    reducing international interest in acquiring the F-35. Reduced foreign
    sales of the F-35 would cause an attendant increase in unit cost to the
    United States--Air Force, Navy, and Marine Corps--and would have the
    same effect on those international partners dependant on the F-35 for
    their future airpower capabilities; potentially decreasing
    international sales, resulting in even greater unit cost increase.
        The benefit of interoperability to the U.S. warfighter is another
    major concern. The Air Force will maintain a small fleet of F-22s,
    while acquiring F-35s. The Air Force, Navy, and Marine Corps will have
    much greater interoperability with partner air forces employing the F-
    35 than with the F-22.
        Finally, non-recurring engineering costs associated with hardware
    and software re-design to produce an exportable version will be
    substantial--well over $2 billion. The result would be an airframe
    different in many respects from the Air Force F-22, complicating the
    training of international pilots and adversely affecting
    interoperability even beyond considerations of fleet size.
    Additionally, Air Force personnel and technical resources required to
    develop and oversee such a program would detract from resources needed
    to properly manage our own acquisition programs.
                               the cyber command
        Question. Secretary Donley, the 24th Air Force, which will stand-up
    this year at Lackland Air Force Base, Texas, is the Air Force's focal
    organization for dealing with cyber operations and network warfare. The
    mission is new and success will depend on developing a highly skilled
    workforce drawn from a number of Air Force career fields.
        What are your plans for identifying and managing the cyber warrior
    career force?
        Answer. The Air Force is committed to establishing dedicated
    officer, enlisted and civilian career fields to meet the emerging
    demand and address recruiting, training and retention challenges. Air
    Force Space Command, as the lead command for cyber, and the Air Staff
    are collaborating to identify personnel and positions that are
    performing or will perform cyber duties. So far, the enlisted Network
    Warfare Operations (1B4) and officer Cyber Operations (17D) career
    fields were approved on April 15, 2008, to be established not later
    than October 2010. No date has been established for civilian career
    field solutions, as we are still in the early stages of investigation
    and development.
        Question. Secretary Donley, since the cyber field is relatively
    new, this is an opportunity to optimize a DOD-wide approach to training
    and operations.
        How is the Air Force working with the other Services to develop
    joint training, joint certifications or shared facilities?
        Answer. Joint cyber training standards and certification remain a
    work in progress. The Office of the Secretary of Defense and Joint
    Staff are leading the Department of Defense effort in collaboration
    with the Services, U.S. Strategic Command, and Joint Forces Command.
    The Air Staff and Air Force Space Command, as lead command for cyber
    operations, are heading Air Force efforts. Current Joint and Service
    efforts focus on enhancing existing training programs to further mature
    and professionalize the force. A robust cyber training enterprise has
    emerged, composed of Service, Joint, academic and commercial solutions.
    This initial effort should be complete by spring 2010.
                                     ______

                 Questions Submitted by Senator Robert C. Byrd
                                  c-5 aircraft
        Question. Mr. Secretary, I believe premature repeal of Section 132
    of the fiscal year 2004 National Defense Authorization Act (NDAA) that
    pertains to the retirement of C-5A strategic lift aircraft language
    could result in the U.S. Air Force's (USAF) making uninformed force
    structure decisions, just as the Army and Marine Corps are growing in
    size and lift requirements. Section 132 was enacted to ensure the USAF
    does not prematurely retire C-5A aircraft without having the objective
    data from the C-5 Reliability Enhancement and Re-Engining Program
    (RERP) Operational Test and Evaluation (OT&E) and a report submitted to
    the Congressional defense committees.
        Should Section 132 be repealed and will the USAF undertake a
    thorough review of the C-5 OT&E data, which is expected to be available
    this year, prior to issuing any decisions to retire any C-5 aircraft?
        Answer. The United States Air Force will fully consider all
    information at its disposal, to include the IDA study, prior to making
    any programmatic decisions.
        Question. Mr. Secretary, the fiscal year 2008 NDAA-directed
    Institute for Defense Analysis (IDA) Study on Size and Mix of Airlift
    Force (February 2009) affirmed the value of C-5s and their
    modernization programs. IDA considered 36 alternative mixes and sizes
    and compared them against the current program of record (316 strategic
    airlifters). The study found; ``that retiring C-5As to release funds to
    buy and operate more C-17s is not cost-effective''. Additionally,
    ``virtually all the C-5s and C-17s have lifetimes beyond 2040''.
        Will the IDA study's overall conclusion that C-5A RERP is
    preferable to additional C-17s be fully considered by the USAF prior to
    moving forward with any plans to retire any C-5A aircraft?
        Answer. The United States Air Force fully considers all information
    at its disposal prior to any programmatic decisions and will fully
    consider the IDA study if there is a proposal to retire C-5A aircraft.
        Question. Mr. Secretary, I do not support repeal of Section 132 of
    the fiscal year 2004 NDAA. I believe the Office of the Secretary of
    Defense and the Congress should consider all objective data in support
    of future fact-based force structure decisions. It is my hope that
    Section 132 be allowed to expire in the February/March 2010 timeframe
    following submission, and proper consideration of the C-5 RERP OT&E
    report to Congress.
        Should Section 132 be repealed and a decision made to prematurely
    retire a portion of, or the entire, C-5A fleet, what would be the
    impact on the 167th Airlift Wing of the West Virginia Air National
    Guard, which was just officially designated as a fully operational C-5A
    unit on April 1, 2009?
        Answer. Repeal of Section 132 of the fiscal year 2004 National
    Defense Authorization Act would provide the Air Force maximum
    flexibility in managing its strategic airlift fleet. We value the
    information that reports such as the Reliability Enhancement and Re-
    engining Program Operational Test and Evaluation provide and weigh them
    accordingly in our analysis. In addition, we are awaiting the Mobility
    Capabilities and Requirement Study 2016 final report, expected in late
    2009, to make an updated, fact-based analysis of our strategic airlift
    fleet. Any future decision to alter the force structure will be based
    on a detailed evaluation of factors.
        Question. Mr. Secretary, at a February 21, 2007, Senate
    Appropriations Defense Subcommittee hearing on the USAF's fiscal year
    2008 budget request, I asked your predecessor, Secretary Wynne to
    respond to comments made by then-USAF Chief of Staff General Moseley
    that the USAF would like to retire 25-30 of the worst performing C-5
    aircraft. My specific question was, ``Under what timeline is the USAF
    planning to act and to inform Congress and the impacted bases of such
    retirements?'' His response was: ``If relieved of legislative
    restrictions, the USAF would be able to effectively manage the mix of
    various aircraft fleets. Preliminary options under review include
    replacing retiring strategic airlift aircraft with newer C-17s or
    backfilling with newer C-5Bs from within the USAF. No new units are
    anticipated. Likewise, closures of existing units are not planned. The
    USAF will be open and transparent with regard to basing plans.
        If relieved of legislative restrictions regarding the C-5A aircraft
    in the near future, do you and General Schwartz intend to replace
    retiring strategic airlift aircraft with newer C-17s or backfill with
    newer C-5Bs from within the USAF? You may be assured that I will be
    following up with you in this regard in the near future.
        Answer. The United States Air Force will fully consider all
    information at its disposal, to include the IDA study, prior to making
    any programmatic decisions.
                                     ______

                 Questions Submitted by Senator Byron L. Dorgan
                              joint cargo aircraft
        Question. C-27 Joint Cargo Aircraft (JCA): the Defense Department
    recently realigned executive agency of the C-27 Joint Cargo Aircraft
    (JCA) from the U.S. Army to the U.S. Air Force. Concurrent with this
    action, the total planned procurement of the C-27 aircraft was reduced
    from 78 to 38. Originally, the Air Force was to procure and assign 24
    aircraft to the Air National Guard. Now the plan is for the Air Force
    to operate all 38 JCAs.
        What is the Air Force plan for basing these aircraft?
        Answer. Given recent Department of Defense decisions regarding the
    JCA program, the Air Force is working with the National Guard Bureau
    and the Army to determine how to best meet domestic requirements and
    the strong demand for direct support airlift in overseas contingency
    operations. Similarly, the Air Force is working closely with the
    National Guard Bureau and the Air National Guard to determine the
    basing plans for the C-27J. Final basing decisions for this system are
    still pending.
        Question. When and how many C-27 aircraft will be assigned to the
    119th Air Guard Wing in Fargo, ND?
        Answer. Given recent Department of Defense decisions regarding the
    JCA program, the Air Force is working with the National Guard Bureau
    and the Army to determine how to best meet domestic requirements and
    the strong demand for direct support airlift in overseas contingency
    operations. Similarly, the Air Force is working closely with the
    National Guard Bureau and the Air National Guard to determine the
    basing plans for the C-27J. Final basing decisions for this system are
    still pending.
                             next generation bomber
        Question. Next Generation Bomber (NGB): in the fiscal year 2010
    budget, the Air Force is no longer funding continued development of a
    new long range strike aircraft, the Next Generation Bomber (NGB).
    Previous Air Force budget submissions indicated a need to obtain an
    initial capability by the year 2018.
        Explain why the Air Force cancelled the NGB program and outline its
    plans for addressing this need and fulfilling the requirement for a new
    long range strike platform.
        Answer. The decision to cancel the Next Generation Bomber was
    directed by the Secretary of Defense in the fiscal year 2010
    President's budget submission. The Air Force supports the Quadrennial
    Defense Review and Nuclear Posture Review to assess future strategic
    requirements.
        Question. If the Service is not continuing the new NGB, what steps
    are being taken to modernize and keep our legacy bomber fleet healthy
    and viable until a follow-on bomber is fielded?
        Answer. The Air Force plans to maintain the current bomber force
    (B-1s, B-2s, and B-52s) and continue with planned sustainment and
    modernization programs. The B-1 has five sustainment programs to
    prevent grounding and one developmental program, which adds data link
    capability. The B-2 also has robust sustainment and modernization
    programs. These programs have been in previous budget requests and
    continue in the fiscal year 2010 President's budget request.
                                     ______

                   Question Submitted by Senator Thad Cochran
                       reductions to contractor workforce
        Question. Secretary Donley, will efforts to reduce your reliance on
    contractors and hire additional civilian government workers mean an end
    to ``Public-Private'' competitions conducted under the Office of
    Management and Budget A-76 Circular process?
        Answer. The Air Force views in-sourcing as one of many efficiency
    tools that comprise our overall human capital strategy. We do not view
    it as necessarily being mutually exclusive from reasoned and strategic
    application of public-private competitions. Presently, the Air Force
    has no new public-private competitions identified for the remainder of
    this fiscal year due to the moratorium established by the fiscal year
    2009 Omnibus Appropriations Act.
                                     ______

              Questions Submitted by Senator Kay Bailey Hutchison
                           additional f-22 purchases
        Question. Does the Air Force plan to purchase additional F-22
    aircraft to fill the gap if and when F-22 attrition occurs?
        Answer. The Air Force does not plan to purchase additional F-22s.
    The fiscal year 2010 President's budget request completes the F-22
    program of record at 187 aircraft and the last aircraft will be
    delivered in March 2012. No further procurement is planned or
    programmed beyond the program of record. Air Force fleet management
    actions will ensure the long-term viability and combat capability of
    the F-22.
                            f-35 technical training
        Question. F-35 technical training is currently conducted in several
    locations. Follow-on technical training for F-15s, F-16s, and A-10s
    (Air Force legacy platforms that the F-35 is set to replace) is
    completed at four additional locations. I believe that there are many
    benefits to consolidate training at a valued Air Force installation
    such as Sheppard Air Force Base in Wichita Falls, Texas. This may
    include reduced costs, experience with allied and international
    training, expertise and core competencies in fifth-generation fighter
    technical training, strong positive community support, and reduced
    permanent change of station and temporary duty moves for our airmen and
    women.
        Please share your thoughts on consolidation of F-35 technical
    training as well as possible timelines for this to become a reality.
        Answer. All F-35 maintenance technicians will receive their initial
    skills training at Sheppard Air Force Base, Texas. Crew chief, avionics
    and armament specialists will receive follow-on specialized F-35
    training at Eglin Air Force Base, Florida. This arrangement will
    provide our Airmen with the skills needed.
        Beginning in 2013, F-35 maintenance technicians will complete basic
    military training at Lackland Air Force Base, Texas and then proceed to
    Sheppard Air Force Base, Texas for maintenance fundamentals training.
    Thereafter, crew chief, avionics and armament specialists will receive
    F-35-unique apprentice training at Eglin Air Force Base, Florida. All
    other Air Force F-35 maintenance technicians will receive initial
    skills training at Sheppard Air Force Base and F-35-unique hands-on
    training at a field training detachment at their first operational
    base.
              support to states--potential mobility capability gap
        Question. Currently The Texas National Guard Sherpa (C-23) are
    scheduled to deploy to support overseas operations. The extreme demands
    of intra-theater cargo airlift will pose significant stress on an
    already aging airframe.
        How does the Air Force plan to provide adequate replacement support
    to the States to sustain high maintenance and potential replacement of
    aircraft attrition if the anticipated and validated C-27 Joint Cargo
    Aircraft program is not moved forward?
        Answer. In accordance with Chapter 1011 of Title 10, the National
    Guard Bureau is the channel of communication between the States and the
    Air Force on all matters pertaining to the National Guard. In
    stationing and allocating Air National Guard capabilities across the
    States, the National Guard Bureau has historically endeavored to
    disperse capabilities geographically in such as way as to facilitate
    access by States when needed. This practice is expected to continue.
        Given recent Department of Defense decisions regarding the JCA
    program, the Air Force is working with the National Guard Bureau and
    the Army to determine how to best meet domestic requirements and the
    strong demand for direct support airlift in overseas contingency
    operations. Similarly, the Air Force is working closely with the
    National Guard Bureau and Air National Guard to determine the basing
    plans for the C-27J. Final basing decisions for this system are still
    pending.
                              joint cargo aircraft
        Question. The Joint Cargo Aircraft (JCA) mission was validated at
    the Joint Capabilities Integration Development Systems (JCIDS) process
    and approved by the Joint Requirements Oversight Council. The 2009
    Quadrennial Roles and Missions Review report found that Service
    Capabilities were appropriately assigned.
        What new information has over-ridden the extensive validation of
    this thoroughly vetted program?
        Answer. The adjustments made to the fiscal year 2010 President's
    budget request will maximize the robust capabilities resident in our
    current airlift fleet and ensure all intra-theater requirements are
    met. The transfer of Army Time Sensitive/Mission Critical airlift
    support is intended to capitalize on efficiencies gained by operating
    the tactical airlift fleet under a single Service. The Department of
    Defense is now engaged in an overall look to leverage existing intra-
    theater airlift capability as we look to maximize effectiveness and
    minimize expenditure of taxpayer dollars.
        While the requirement for Joint Cargo Aircraft capability remains,
    the Air Force will, whenever possible, apply existing capability to
    fill a requirement before procuring additional hardware. Determining
    the extent to which we can apply our current fleet to this mission area
    is the task at hand and the Mobility Capability Requirements Study 2016
    will help resolve this question.
                          test and evaluation support
        Question. The new Administration's budget request cuts PE 0605807F
    almost $50 million when compared to the fiscal year 2009 budget and by
    almost $60 million compared to the first fiscal year 2010 budget
    request submitted in January. A portion of the cut is just that, a cut.
    The second element of the cut is based upon the assertion that there
    will be a savings realized when 750 contractor positions are converted
    to civil service solutions.
        What analysis has been done to identify what the workforce mix of
    contractor and civil service should be?
        Answer. The Service components received Office of the Secretary of
    Defense-directed contractor to Department of Defense civilian
    conversion targets which begin in fiscal year 2010. While currently
    there is no analysis, the Air Force is in the process of identifying
    specific in-sourcing candidates to comply with the requirement.
                       contractor to civilian conversions
        Question. The new Administration's budget request cuts PE 0605807F
    almost $50 million when compared to the fiscal year 2009 budget and by
    almost $60 million compared to the first fiscal year 2010 budget
    request submitted in Jan. A portion of the cut is just that, a cut. The
    second element of the cut is based upon the assertion that there will
    be a savings realized when 750 contractor positions are converted to
    civil service solutions.
        What analysis has been done showing the savings that will result
    from the conversion of contractor positions to civil services
    positions? Did the analysis include fully burdened costs of civil
    service positions similar to costs clearly visible for contractor
    support (i.e., overhead, G&A, material & handling, etc.)?
        Answer. The Service components received Office of the Secretary of
    Defense-directed contractor to Department of Defense civilian
    conversion targets which begin in fiscal year 2010. The associated
    funding reductions were based on the Office of the Secretary of
    Defense's estimate of 40 percent savings. While currently there is no
    analysis, the Air Force is in the process of identifying specific in-
    sourcing candidates to satisfy the requirement.
        Question. What is the hiring ramp-up schedule for achieving the
    contractor to civil service conversions? What analysis has been done to
    verify that OPM and AF offices can achieve the ramp-up schedule?
        Answer. The Service components received Office of the Secretary of
    Defense-directed contractor to Department of Defense civilian
    conversion targets which begin in fiscal year 2010. The associated
    funding reductions were based on the Office of the Secretary of
    Defense's estimate of 40 percent savings.
        Question. What assessments of disruption to programs (operational
    readiness perspective) have been completed?
        Answer. The Service components received Office of the Secretary of
    Defense-directed contractor to Department of Defense civilian
    conversion targets which begin in fiscal year 2010. The associated
    funding reductions were based on the Office of the Secretary of
    Defense's estimate of 40 percent savings.
                         major range and test facility
        Question. Defense Test Resource Management Center (DTRMC) is
    required by law to do an independent scrub of Major Range & Test
    Facility Base (MRTFB) budgets of the Services. That was accomplished
    when the fiscal year 2010 President's budget request was delivered to
    Congress in January of this year which exceeded the current funding
    level by $60 million. No such assessment has been, nor is intended, for
    the new Administration's budget.
        What is the Department's plan to avoid circumventing the law and
    Congress?
        Answer. The Defense Test Resource Management Center has issued an
    addendum to its previous certification of the fiscal year 2010
    President's budget request. This addendum addresses the new
    Administration's budget request.
                                     ______

                Questions Submitted by Senator Robert F. Bennett
                                 minuteman iii
        Question. I deeply appreciate the news I received that the Air
    Force is going to maintain the solid rocket motor industrial base that
    supports the Minuteman III land-based portion of our nation's strategic
    missile defense and nuclear deterrence. Only the prompt transfer of
    funds will prevent further disruptions in production and provide a
    desirable continuity of employment for the highly sought after
    engineers and workers of the solid rocket industrial base.
        What is the status of the Air Force's request to the Department of
    Defense to reprogram fiscal year 2009 funds?
        Answer. As part of Department of Defense's fiscal year 2009 Omnibus
    Reprogramming request, the Air Force has submitted a new start request
    to initiate an ICBM solid rocket motor warm line. Once new start
    authority is granted by the Congressional Defense Committees and
    propulsion replacement program contract close-out finalization is
    completed, the Air Force intends to internally reprogram available
    funding from within the Minuteman squadrons program element to fund
    initial warm line activities as a bridge to fiscal year 2010. The
    fiscal year 2010 President's budget request includes $43 million for
    the ICBM solid rocket motor warm line.
        Question. How many solid rocket motors is the Air Force planning to
    buy? If this is not an accurate measure of the ability to maintain a
    warm line, please explain the rationale that is driving the budget
    numbers we have seen.
        Answer. The number of solid rocket motors is not an accurate
    measure of the ability to maintain an industrial base. We believe the
    ability to maintain the industrial base is captured in the fiscal year
    2010 effort which is structured to maintain design-unique material
    availability; sub-tier material supplier viability; touch labor
    currency; and design engineering personnel continuity unique to the
    Minuteman weapon system. In addition, the fiscal year 2010 effort is
    designed to maintain systems engineering assessment capability and
    utilize independent verification of production processes.
        Actual production quantities will not be known until the contract
    is finalized.
                              force restructuring
        Question. I was disappointed to learn that Hill will lose one of
    its three F-16 fighter squadrons as a part of the recently announced
    force-wide restructuring. However, upon reviewing the list of locations
    from which the Air Force plans to remove F-16s, I noticed bases in the
    intermountain and southwest regions appear to bear the brunt of F-16
    force reductions. I find this puzzling due to the tremendous training
    opportunities afforded by ranges in these regions.
        If the Air Force is seeking cost reductions, is it not more
    efficient to station aircraft near the ranges, like the Utah Test and
    Training Range, which affords the most effective training environments?
        Answer. Proximity to training ranges is one of many criteria the
    Air Force uses to make basing decisions. The Combat Air Forces fighter
    force restructuring plan will provide the United States with a smaller,
    but more flexible, capable, and lethal force as we bridge to our
    ultimate goal of a 5th generation-enabled force. As we developed this
    plan over the last year, we focused on balancing planned force
    reductions across active duty, Guard, and Reserve components, as well
    as overseas and U.S. locations. We carefully analyzed the missions
    across our units in all the Air Force components to achieve the force
    mix that made the most strategic sense. The changes in this plan were
    closely coordinated with our Air National Guard and Air Force Reserve
    partners, as well as our major commands and affected regional combatant
    commanders.
        Question. I also wanted to ask about the confusing signals I've
    received regarding the restructuring that could take place at Hill.
    Under the total force integration concept, the 388th and 419th fighter
    wings were merged together as a prototype for further efforts to mix
    active and reserve fighters, an effort that has seen great results so
    far. Despite this the restructuring calls for one full squadron of F-
    16s to be removed from that combined wing.
        Can you explain to me how the Air Force came to this decision, and
    what you have determined are the real impacts on the total force
    integration program?
        Answer. The fiscal year 2010 Combat Air Forces fighter force
    restructuring plan offers the Air Force an opportunity to reap
    significant savings in funds and manpower by accelerating the
    retirement of approximately 250 of our oldest fighters, reinvest in
    critical modifications to our combat forces fleet, procure preferred
    air-to-air and air-to-ground munitions and critical Air Force and Joint
    enabling technologies, and redistribute manpower to national priority
    missions.
        These actions will provide the United States with a smaller, but
    more flexible, capable, and lethal force as a capability-based bridge
    from our legacy-dominated force to our ultimate goal of a 5th
    generation-enabled force. The proposed Hill Air Force Base, Utah
    changes are part of a global resource allocation process that makes
    strategic sense.
        As we developed this plan over the last year, we were successful in
    balancing planned force reductions across our active duty, Guard, and
    Reserve components, as well as in the States and overseas locations. We
    carefully analyzed the missions across our units in all the Air Force
    components to achieve the force mix that made the most strategic sense.
    The changes in this plan were closely coordinated with our Air National
    Guard and Air Force Reserve partners, as well as our major commands and
    affected regional combatant commanders.
        The partnership between the active duty and Air Force Reserve
    components at Hill Air Force Base, Utah was one of the first Total
    Force Integration (TFI) initiatives. The classic association with the
    Air Force Reserve regarding F-16s at Hill Air Force Base, Utah has a
    proven record of success and it has yielded valuable lessons learned
    for other TFI associations. This association with the Air Force Reserve
    at Hill Air Force Base will continue to meet the needs of the combatant
    commanders during and after any force structure changes. The Air Force
    will continue to assess the impact of force structure changes on
    associate units in order to maintain an efficient and effective combat
    air force.
                           f-35 squadron at hill afb
        Question. It has been over a year and half since I was informed
    that Hill is to be one of the first two Air Forces Bases in the
    continental United States to receive an operational F-35 squadron. Now,
    I understand that Hill is only ``on track'' to receive the F-35. Why is
    the Air Force stepping back from the commitment it made?
        Is Hill going to receive one of the first two operational F-35
    squadrons in the continental United States?
        Answer. A corporate, across the Air Force, review was not used in
    developing the previous ``roadmap.'' To ensure the Air Force did not
    considered all potential basing opportunities to support basing, I
    directed the current ``Enterprise-Wide Look'' (EWL), which will include
    Hill Air Force Base, Utah. The basing process prior to Fall 2008 was
    de-centrally executed by our major commands. Basing decisions are now
    at the Headquarters Air Force level. Bringing the basing decision to
    this level improves the decision making process to meet corporate Air
    Force requirements and the EWL planning process will assist in defining
    a measured, transparent and repeatable process; allowing for a
    narrowing of the list of potential F-35 basing locations. Upon
    completion of its internal review, the Air Force will release the
    results of the EWL and its content consistent with requests for
    information from the public. It would be premature at this time to
    presuppose the results of the EWL, but we expect to finalize the
    initial candidate list for the first increment of operational bases by
    October 2009.
                             f-35 software workload
        Question. I understand 22 percent of the depot maintenance for the
    F-35 is software. Hill's Software Maintenance Group is ranked as one of
    the top software engineering corporations in the world with a Level 5
    Carnegie Mellon Software Capability Maturity rating. The additions to
    Hill's Software Center will be completed shortly.
        How is Hill's performance rated in the competition for the F-35
    software workload?
        Answer. The F-35 depot source of repair decision process for
    software is not complete, and we are several years away from any
    selection process involving the organic depots. There are ongoing
    discussions between the F-35 Program Office, the Services, and the
    prime contractor on the most cost effective method to transition
    software maintenance from the developing contractors to organic depots.
    Specifics for the timing of depot activation are dependent on
    completion of software development, results of flight test, and the
    maturation of software through the end of the system development and
    demonstration program. The F-35 Program Office will perform a study
    during 2011 on the activation costs associated with standing up organic
    software capability through the Future Years Defense Program. The depot
    source of repair decision for F-35 software is currently scheduled to
    be completed by the end of 2014.
                                     ______

               Questions Submitted to General Norton A. Schwartz
                Questions Submitted by Chairman Daniel K. Inouye
                         age and health of tanker fleet
        Question. General Schwartz, I am concerned about the aging Air
    Force tanker fleet and the health and age of the KC-135 tankers by the
    time they are replaced.
        Can you update the Committee on the status of the Air Force tanker
    fleet, including the age of the fleet and any current safety and flight
    concerns?
        Answer. The Air Force tanker force structure includes 415 KC-135 R
    and T models, and 59 KC-10A aircraft with average fleet ages of 48
    years and 24 years, respectively. Upon retirement of the last KC-135
    planned for 2040, this tanker will have reached 80 years of service.
    The KC-10 will have achieved 60 years of service upon its planned
    retirement. Investment programs for both airframes focus on safety of
    flight and obsolescence issues. The KC-135 aircraft has six ongoing
    fleet-wide modification programs:
      --Control Column Actuated Brake.--Modification preventing an unsafe
            stabilizer trim wheel runaway condition--fleet modification
            complete in fiscal year 2010.
      --VOR/ILS Antennae Replacement.--Replaces the obsolescent antennae
            used for navigation and precision instrument landing systems--
            this is an fiscal year 2010 New Start program.
      --Block 45 Upgrade.--Cockpit avionics modernization replacing
            obsolescent Autopilot, Flight Director, Radar Altimeter, and
            Engine Instruments--contract award late fiscal year 2009.
      --Global Air Traffic Management.--Updates and replaces Communication
            Navigation Surveillance/Air Traffic Management (CNS/ATM)
            equipment to meet restricted airspace requirements worldwide;
            modification complete in fiscal year 2011.
      --Enhanced Surveillance.--Replaces APX-110 transponder with APX-119,
            providing enhanced aircraft tracking and Identify Friend or Foe
            Mode 5 capability (complete by fiscal year 2010).
      --Mode 5.--DOD-mandated upgrade to the IFF system used for aircraft
            identification in Air Defense Operations (fiscal year 2010 to
            fiscal year 2012).
        The KC-10, a commercial derivative of the McDonnell Douglas DC-10-
    30 delivered in 1981, provides both strategic air refueling and airlift
    for deployment, employment, redeployment and Joint/Combined support
    operations. In its current configuration, the KC-10 does not meet
    future Federal Aviation Administration/International Civil Aviation
    Organization (ICAO) CNS/ATM requirements for 2015 airspace
    restrictions. To mitigate operational risk, two modification programs
    exist for the KC-10:
      --CNS/ATM Modification.--Addresses near-term issues required to keep
            aircraft operational within 2015 air traffic mandates/
            restrictions.
      --Boom Control Unit Replacement.--Replaces unsustainable Boom Control
            Unit (complete 2012).
                                  end strength
        Question. General Schwartz, how do you see Air Force missions
    changing as operations draw down in Iraq and increase in Afghanistan?
        Answer. The Air Force will continue to provide critical air, space
    and cyberspace capabilities to the warfighter in both Joint Operating
    Areas--Iraq and Afghanistan. Continued improvement in Iraqi security
    will permit the Air Force to move from a ``combat'' posture toward one
    more aligned with ``advise and assist,'' to include shifting focus
    toward training the Iraqi Air Force.
        In Afghanistan, the Air Force continues to provide unique
    capabilities to the Commander International Security Assistance Force
    and U.S. Forces Afghanistan. Since January 2009, the Air Force has
    increased its efforts in airlift, intelligence, surveillance and
    reconnaissance, space support, electronic warfare, close air support,
    engineering and logistics to improve the security environment in
    preparation for the Afghanistan national elections. In addition, the
    U.S. Air Force component of U.S. Central Command will increase its
    theater engagement efforts across the area of responsibility as a long-
    term and enduring measure to enhance regional security and stability.
                               irregular warfare
        Question. General Schwartz, Secretary Gates has made it clear that
    irregular warfare is of equal strategic importance as the more
    traditional methods of warfare.
        Can you tell us how the Air Force plans to build its irregular
    warfare capability and how these initiatives are reflected in the Air
    Force's fiscal year 2010 budget request?
        Answer. The Air Force recognizes the important need to rebalance
    our forces with additional irregular warfare capabilities, and we have
    prioritized investments to continue growing these capabilities.
    Operations in Iraq and Afghanistan have also increased the requirement
    for low-density/high-demand personnel and platforms, and we expect this
    high demand to continue as we prosecute counterterrorism and irregular
    warfare missions. As such, we have invested additional resources in our
    Airmen and force structure to ensure that we are able to meet the
    Combatant Commander's needs, both today and in the future.
        Specifically, for the fiscal year 2010 President's budget request:
      --The Air Force gained the Direct Support airlift mission from the
            U.S. Army. The Service will use 38 C-27J aircraft to support
            the Time Sensitive/Mission Critical cargo requirements of the
            U.S. Army to support irregular warfare operations. These
            aircraft are well suited for the small fields often associated
            with irregular warfare type missions.
      --The Air Force will support USSOCOM's equipping of 8 MC-130Ws with
            Precision Strike packages to augment the current AC-130 fleet.
            This will provide more aircraft for armed overwatch of ground
            forces engaging in dispersed irregular warfare operations.
      --The Air Force will also establish in fiscal year 2010 a formal air
            advisor training unit at a base that is yet to be determined to
            build our international partners' ability to train partner Air
            Forces.
      --The Air Force will be adding an additional 52 (fiscal year 2010)/
            437 (FYDP) Joint Terminal Attack Controllers and Tactical Air
            Control Party personnel in support of Army Modularity and their
            growth to 45 Active Duty Brigade Combat Teams. To ensure that
            training requirements will be met, the Air Force has also
            invested in 42 Joint Tactical Controller Training Rehearsal
            Systems that provide high-fidelity simulator training.
      --The Air Force will also be providing dedicated liaison support
            aligned at the Army Division level by growing from six to
            eleven Air Support Operations Centers (ASOCs). These ASOCs will
            add 51 (fiscal year 2010)/201 (FYDP) personnel and five
            communications, vehicle, and battlefield equipment packages
            that will ultimately allow the Air Force and Army airspace
            control elements to merge into one joint organization.
      --Additional air liaison manpower (21 fiscal year 2010/91 FYDP) will
            be added at the Army division and corps level to bolster Air
            Force leadership and expertise of key enablers in intelligence,
            surveillance, and reconnaissance; air mobility; space; and
            electronic warfare.
      --The irregular campaigns we are waging in Iraq and Afghanistan are
            ISR driven. For the foreseeable future we expect this
            insatiable demand for ISR to continue, but in an effort to meet
            this demand, the Air Force has surged unmanned aerial systems
            (UASs) into the fight achieving 36 combat air patrols orbiting
            24 hours a day, 365 days a year. The Air Force has also
            increased investment to expand to a total of 50 UAS combat air
            patrols by fiscal year 2011. We are also adding manpower, as
            the number of personnel that operate and maintain these
            systems, and process, exploit, and disseminate the intelligence
            they gather has dramatically increased.
                           fifth generation aircraft
        Question. General Schwartz, the Air Force has gained a great deal
    of experience in building fifth generation aircraft. The F-22 aircraft
    still has a substantial maintenance burden to sustain its stealth
    characteristics.
        Will the F-35 have a more sustainable stealth profile, or will we
    be facing the time-consuming maintenance issues that the F-22 demands?
        Answer. The F-35 Program is applying low observable maintainability
    lessons learned across the spectrum, centered on designed-in
    maintainability (materials, design, repair), assessment and
    verification, and training. The low observable coating material for the
    F-35 is different than that of the F-22, and the techniques required to
    repair the F-35 coatings are different than those required for the F-
    22. With the lessons learned from the F-22 program, we expect the F-35
    low observable coatings to be easier to maintain and support.
                              joint cargo aircraft
        Question. General Schwartz, we recently heard that the Air National
    Guard was expecting to receive about 48 of these aircraft with more
    going to Army Guard units.
        With a buy of just 38 aircraft, what is the basing plan?
        Answer. The fiscal year 2010 President's budget request provides
    funding for 8 C-27J aircraft for the Air Force to perform direct
    support missions. The Office of the Secretary of Defense, Joint Staff,
    National Guard Bureau, Army, and Air Force are working to develop a
    joint implementation plan which will include basing recommendations.
        The first 6 locations for 24 aircraft have been previously
    announced. They are Martin State, MD; Mansfield, OH; Bradley, CT;
    Battle Creek, MI; Fargo, ND, and Meridian, MS. Each location will
    receive four aircraft.
        The remaining 14 aircraft will be based in accordance with the Air
    Force Strategic Basing Process. The National Guard Bureau, the lead
    agency, will present the C-27J basing criteria to the Strategic Basing/
    Executive Steering Group in October 2009. The recommended criteria will
    then be presented to the Secretary and Chief of Staff for final
    approval.
                       fighters in the air national guard
        Question. General Schwartz, the Air Force is focusing its fighter
    acquisition on fifth generation, or low observable, aircraft. Is
    stealth required for the Air Sovereignty mission?
        Answer. Homeland Defense is the Department of Defense's first
    priority and we are committed to the Operation NOBLE EAGLE mission
    through the long term. Stealth technology is not required to protect
    aircraft fulfilling this mission under any currently projected threat
    scenario. However, these Operation NOBLE EAGLE fighter aircraft are not
    dedicated solely to air defense and should be capable to support the
    full spectrum of combat operations.
                 intelligence, surveillance and reconnaissance
        Question. General Schwartz, the Army and the Air Force have
    invested in C-12 airplanes to provide full motion video and other
    capabilities to our troops in Iraq and Afghanistan.
        Do you believe that greater efficiencies could be gained through
    common management of these programs, and if so, what might those be?
        Answer. Multiple Service acquisition entities have been tasked to
    develop and field unique, quick reaction capabilities to meet the
    increasing and urgent need for full motion video (FMV) in current
    overseas contingency operations. In response to this urgent need, the
    Air Force has already fielded 8 MC-12W Project Liberty aircraft that
    incorporate a combination of sensors (to include FMV) and are proving
    their worth in combat on each mission. The Air Force will continue this
    effort to provide a total of 37 Project Liberty aircraft. At this time,
    potential increased efficiencies of C-12 class aircraft management may
    not be possible due the wide variety and combination of C-12 aircraft
    in separate Services. These aircraft have varying sensor combinations
    assembled under quick reaction timelines required by the warfighter.
    Additionally, numerous aircrew manning and training requirements may
    preclude potential efficiencies gained through a common approach at
    this time.
        Question. General Schwartz, we have recently been informed that
    there are delays in delivering some of the Project Liberty aircraft.
        What do these delays mean for fielding the capability, and do you
    have a plan in place to fix the problems?
        Answer. The Secretary of Defense tasked the Air Force to get him a
    70 percent solution to the fight as rapidly as possible. The Air Force
    delivered an 80 percent solution to the warfighters in less than 9
    months and is now following up with an aggressive plan to add the
    remaining 20 percent through a quick reaction block upgrade program.
    The initial scope of this development effort was estimated at 8 months;
    actual results were a 7 month delivery date for aircraft numbers 1-7.
    We are now implementing lessons learned from the modification of
    aircraft tails numbers 1-7 to improve the modification process for the
    remaining deliveries. These include opening additional integration and
    kit production lines on a 24/7 schedule and improvements to the
    manufacturing and quality control processes. The first Phase II
    aircraft (tail #8) has been successfully tested in all aspects of
    mission performance and is the baseline for tails numbers 9-37.
    Lessons-learned from the development of tail #8 have been applied to
    the production line for aircraft numbers 9-37 to prevent any further
    delivery and deployment delays similar to the ones already experienced.
    No delays in the remaining aircraft deliveries are anticipated.
                           export version of the f-22
        Question. Secretary Donley, I believe the Department should
    consider an export program for the F-22 Raptor fighter aircraft. Under
    the rules for such a program, the costs for developing an export
    variant is borne by the interested nation, not the United States. This
    would enable us to provide advanced fighter capabilities to our close
    friends and allies.
        General Schwartz, how could the export of F-22 to U.S. allies in
    the Pacific Rim region affect our international relationships there?
    Would this be beneficial?
        Answer. Due to legal restrictions on discussing F-22 exports, and
    the overriding technology transfer issues involved, the Air Force does
    not have a well vetted position on this subject. However, I believe the
    export of F-22 aircraft to partner air forces would likely have a net
    negative effect on U.S. international relationships in the Pacific.
        An F-22 export program can be expected to shift focus away from F-
    35 exports, likely driving undesirable price and schedule changes to
    the F-35 program. For instance, the manufacturer would divert
    engineering and management resources away from the F-35 to developing
    an F-22 export variant. Any perturbations in our close allies' F-35
    programs, induced by a mid-course U.S. Government policy modification,
    could tend to disrupt our current stable relationships.
        Finally, the exorbitant costs (well over $2 billion) associated
    with development of an export variant could well become a point of
    contention with our partners. The resulting airframe, likely different
    in many respects from the Air Force F-22 because of technology transfer
    issues, would also reduce interoperability and lessen partner
    satisfaction. Although F-22 export could also provide another avenue
    for security assistance activities, the size of the Air Force F-22
    inventory, unlike the F-15 and F-16, will prevent its development into
    a robust instrument of security cooperation. In contrast, the planned
    F-35 fleet size translates into much greater security cooperation
    opportunities which F-22 purchasers would forego. For these reasons, I
    believe F-22 export would likely have an overall negative effect.
                               irregular warfare
        Question. General Schwartz, in this time of fiscal challenge, how
    will the Air Force ensure it maintains its existing conventional
    superiority while investing in these new capabilities? Where do you
    envision trade-offs?
        Answer. The fiscal year 2010 President's budget request reflects
    tough, thoughtful decisions aimed at properly resourcing capabilities
    that enable ongoing operations, while maintaining our superiority in
    conventional capabilities. We have taken aggressive measures to balance
    our portion of the fiscal year 2010 President's budget request in a
    fiscally-constrained environment, amidst the challenges of continuing
    high operations tempo and rising operating costs. To meet the demands
    of an uncertain and dynamic international security environment, the
    fiscal year 2010 President's budget request reflects strategic balance
    across these diverse mission sets and functions.
        Question. General Schwartz, if these new initiatives are
    implemented, how will you ensure that they complement, and do not
    unnecessarily duplicate, the capabilities of existing Air Force Special
    Operations Command air advisory units?
        Answer. The Air Force strives to be a good steward of taxpayer
    dollars. Changes in doctrine, organization, training, materiel,
    leadership and education, personnel, and facilities are evaluated
    before a material solution is funded. For example, the establishment of
    the Air Advisor Schoolhouse is a foundational step towards expanding
    the Building Partner Capacity and Security Force Assistance structure
    resident in the general purpose forces of our Air Force. They will
    definitely complement the Aviation Foreign Internal Defense roles of AF
    Special Operations Squadron units, primarily the 6th Special Operations
    Squadron. The 6th Special Operations Squadron is considered the ``gold
    standard'' for aviation advising, and the time, talent, and treasure
    invested in this capability result in a graduate-level capability with
    expertise focused at regions around the globe. However, the demand
    signal for advising partner nations in aviation far exceeds what
    Special Operations Squadron units can support. But just as important, a
    large percentage of these engagement efforts do not require the
    graduate-level of expertise that a Special Operations Squadron
    provides. By developing tiered levels of expertise within the general
    purpose forces, we can work with ambassadors and country teams for a
    tailored engagement approach that complements Special Operations
    Squadron activities.
                                     ______

                  Questions Submitted by Senator Thad Cochran
                              joint cargo aircraft
        Question. General Schwartz, you may know that the 186th Air
    Refueling Wing currently flies KC-135 tanker aircraft out of Key Field
    in Meridian, MS. Due to a 2005 Base Realignment and Closure decision,
    all of their aircraft will be reassigned and they are scheduled to be
    replaced with Joint Cargo Aircraft. Given this direct impact on my
    State, you are probably not surprised when I tell you that I have been
    watching the Joint Cargo Aircraft program over the last few years. With
    this budget, the Department of Defense announced its decision to
    transfer the Joint Cargo Aircraft mission from the Army to the Air
    Force.
        Is it the Department's intent that only the Air Force operates the
    Joint Cargo Aircraft? If so, can you explain to the committee what
    steps you are taking to ensure the Army's logistics requirements will
    be meant in a timely manner?
        Answer. While the C-27J has been transferred exclusively to the Air
    Force, aircraft manning and basing are still being worked. As for
    ensuring we meet the Army's logistical needs, the Air Force, in
    conjunction with the Army, is rapidly developing a Concept of
    Employment (CONEMP) for the Time-Sensitive/Mission Critical (TS/MC)
    Direct Support airlift mission closely mirroring the Army's current
    operational construct. In addition, 25 percent of the crew force in the
    initial C-27J deployment in 2010 will consist of Army personnel to
    ensure an experienced core cadre to facilitate initial Air Force
    operations. Close coordination with the Army throughout the program
    transfer and into the first deployment of the C-27J in the fall of 2010
    will be the cornerstone to ensuring mission success.
                              f-15 radar upgrades
        Question. General Schwartz, I noticed funding for five additional
    Active Electronically Scanned Array radars for F-15C aircraft is number
    eight on your Unfunded Priority List. I understand this type of radar
    is being used on a number of other fighters as well and that it
    significantly enhances the capability of these aircraft in detecting
    and engaging enemy threats.
        General Schwartz, could you elaborate on the importance of the
    Active Electronically Scanned Array radar system and also tell us about
    the need for these five additional systems?
        Answer. Active Electronically Scanned Array radar on the remaining
    long-term F-15 C/Ds in the Air Force inventory adds significant
    capability ensuring their viability and utility. Among the advantages
    are significantly improved performance against cruise missiles; a near
    doubling of improvement in target acquisition and combat identification
    range; a baseline capability for digital radio frequency memory
    protection; the ability to detect and track multiple targets, and
    connectivity with on-board and off-board sensors.
        We will also obtain a smaller deployment footprint (nine to one
    pallets) and greatly improve the meantime between failures.
        Question. If funded, would these systems be installed on Active
    Duty or Air National Guard F-15C aircraft?
        Answer. Eighteen APG-63v3 Active Electronically Scanned Array
    (AESA) radars have already been funded by the Congress for the Air
    National Guard. The first 14 radars will be installed in the first
    quarter of calendar year 2010. The remaining four radars are being
    procured. Only long-term F-15s (Golden Eagles) are slated for APG-63v3
    AESA installation. The five AESA radars noted above for active duty F-
    15s will be installed at the same time as the ANG radars.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. And this subcommittee will meet next
    Tuesday, June 9 at 10:30 a.m. At that time, we will receive
    testimony from the Secretary of Defense, the Honorable Robert
    Gates, and from the Chairman of the Joint Chiefs of Staff,
    Admiral Michael Mullen.
        And with that, we would like to thank the men and women of
    the Air Force for their service to our country. Thank you very
    much, sir.
        General Schwartz. Thank you, Mr. Chairman, for your
    support.
        [Whereupon, at 12 noon, Thursday, June 4, the subcommittee
    was recessed, to reconvene at 10:30 a.m., Tuesday, June 9.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                             TUESDAY, JUNE 9, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:28 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Leahy, Feinstein, Murray,
    Specter, Cochran, Bond, and Shelby.

                             DEPARTMENT OF DEFENSE

                            Office of the Secretary

    STATEMENTS OF:
            HON. ROBERT M. GATES, SECRETARY OF DEFENSE
            ADMIRAL MICHAEL G. MULLEN, U.S. NAVY, CHAIRMAN, JOINT CHIEFS OF
                STAFF
    ACCOMPANIED BY HON. ROBERT F. HALE, UNDER SECRETARY OF DEFENSE
                (COMPTROLLER)

                     STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning the subcommittee is pleased
    to welcome Dr. Robert Gates, Secretary of Defense, and Admiral
    Mike Mullen, the Chairman of the Joint Chiefs of Staff, to
    testify on the administration's budget for fiscal year 2010.
    Mr. Secretary, while the full Senate Appropriations Committee
    has already had the pleasure of meeting with you earlier this
    year regarding the so-called supplemental bill, let me extend a
    warm welcome to you on behalf of the Defense Subcommittee.
        Your continued willingness to put your Nation's needs ahead
    of your personal interests demonstrates your unwavering
    commitment to public service and your dedication to the men and
    women in our military, and our Nation owes you a great debt of
    gratitude.
        The administration has requested $534 billion for the base
    budget of the Department of Defense, an increase of $21 billion
    over the amount enacted in the last fiscal year. Additionally,
    the administration has requested $130 billion in supplemental
    nonemergency funding for overseas contingency operations in the
    next fiscal year.
        Mr. Secretary, you have called this a reform budget and in
    recent months you have given several keynote speeches
    emphasizing in particular the need for greater balance in our
    force structure between competing requirements for irregular
    warfare and conventional warfare and for changing the way the
    Defense Department does business. This budget request before us
    reflects these priorities and, as you're well aware, it will
    raise a few questions.
        A key theme you have emphasized in recent months is the
    need to improve an institutional home in the Department of
    Defense for the warfighter engaged in the current irregular
    fight. Much of the critical force protection equipment that is
    used with great success in the theater today has been funded
    outside the regular defense budget process and is being managed
    by newly created ad hoc organizations that appear to be
    temporary in nature.
        For example, since 2005 the Department has procured over
    16,000 mine-resistant ambush-protected vehicles, funded
    entirely with supplemental appropriations. Yet even after 5
    years, the role of these vehicles in our force structure and
    the future role of the office that manages this program within
    the Department are undefined.
        Another example is the ISR Task Force, which is to
    accelerate the fielding of critical intelligence, surveillance,
    and reconnaissance assets into the theater. You have made it a
    point to emphasize these capabilities by adding $2 billion to
    the base budget for the ISR capabilities. Yet the role of this
    task force within the Department's institutional chain of
    command remains ad hoc and the future is undetermined.
        There's no question that these capabilities will be needed
    in the future. So we hope today you can illustrate to the
    subcommittee how we can institutionalize the lessons learned
    with respect to equipping our warfighter and permanently
    address the warfighter's requirements in the DOD bureaucracy
    without continuously adding bureaucratic layers.
        At the same time, Mr. Secretary, conventional threats to
    our national security remain. While irregular warfare is and
    will presumably continue to be the preferred tactic of non-
    state actors, we cannot lose sight of threats from traditional
    nation states such as North Korea, Iran, and others. So as we
    consider the many adjustments your budget proposes to modernize
    programs designed to address conventional threats, it is
    important that we understand the strategic underpinnings and
    consequences of curtailing or terminating programs such as the
    F-22, the C-17 transport, or future combat systems manned
    ground vehicles.
        Now, there's no question, Mr. Secretary, that the
    requirements to winning irregular conflicts have been neglected
    too long. But I believe we must ensure that we strike the right
    balance between preparing for both irregular and regular wars,
    and we look forward to hearing your thoughts on that matter.
        Finally, Mr. Secretary, your budget emphasizes our Nation's
    greatest military asset, the All Volunteer Force, by fully
    funding end strength growth, providing for increased medical
    research, and increased funding for warfighter families. These
    programs have long been funded through supplemental
    appropriations and we welcome your commitment to our
    servicemembers and their families by institutionalizing these
    programs in the base budget.
        On the other hand, the rising military personnel and
    healthcare costs are creating budget pressures on our
    acquisition programs, calling into question the affordability
    of many high-priced platforms designed to meet specific
    military requirements.
        So, gentlemen, we have much to discuss this morning. We
    very much appreciate your being here with us today and we look
    forward to your testimony. However, before proceeding with your
    opening statements, may I call upon the vice chairman of the
    subcommittee, Senator Cochran, for comments.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you. I'm pleased to
    join you in welcoming the distinguished panel to review the
    budget request of the Department of Defense.
        Mr. Secretary, Admiral Mullen, and Comptroller Hale, we
    appreciate the hard work you're doing and the challenges you
    face, and we want to be sure that what we do will help deal
    with the problems that we face in the national security arena,
    and we thank you for your distinguished service.
        Chairman Inouye. Senator Leahy.

                     STATEMENT OF SENATOR PATRICK J. LEAHY

        Senator Leahy. Just very briefly, Mr. Chairman. I am glad
    to see the Secretary and Admiral Mullen. I've had many
    conversations with them and I appreciate their help, as well as
    Mr. Hale's assistant. I just had an opportunity to lead a
    Senate delegation on a trip to Iraq and Pakistan and
    Afghanistan. You've made some visits of your own there, which I
    think is of significance to the troops, although I think
    they're probably more excited to see Steven Colbert than they
    were to see me.
        But we did see some extremely hard-working men and women in
    uniform in each of the places we went. We also saw our
    coalition forces, especially in Afghanistan, working diligently
    and taking a large number of casualties. Canada, our neighbor
    to the North, has had many, as have other coalition nations,
    and yet they're working very, very hard.
        I wanted to be there because, as I've mentioned before, Mr.
    Secretary, the end of the year we'll see 1,800 members, up to
    1,800 members, of the 86th Infantry Brigade Combat Team from
    the Vermont National Guard going there. They're one of the only
    units with mountain skills. They train both summertime and in
    20 degree below zero weather in Vermont in the wintertime. They
    are training very hard.
        I will, Mr. Chairman, ask some questions on that. Of
    course, I'm very proud of these men and women that are going.
    But this is the largest deployment we've ever had. I see
    Senator Feinstein here. It would be the equivalent on a per
    capita basis of about 100,000 people going from California.
        Mr. Secretary, I appreciate your response and your
    willingness to work with us on some of the special situations
    the Guard will have.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Mr. Chairman, I just want to welcome
    Secretary Gates here, Admiral Mullen, and Comptroller Hale.
    Thank you.
        Chairman Inouye. Thank you, Senator Shelby.Senator
    Feinstein.
        Senator Feinstein. No opening statement, Mr. Chairman. I
    just welcome Secretary Gates and Admiral Mullen.
        Chairman Inouye. Senator Bond.

                    STATEMENT OF SENATOR CHRISTOPHER S. BOND

        Senator Bond. Thank you very much, Mr. Chairman.
        Welcome, Secretary Gates, Admiral Mullen. We congratulate
    you on the progress you're making in Afghanistan and Pakistan.
    It's not easy, but I think you have a way ahead with the
    counterinsurgency strategy. I will be back to ask some
    questions, but two points I want to raise with you.
        First, you have said we need to shift away from the 99
    percent exquisite, service-centric platforms that are so costly
    and so complex that they take forever to build, deploy in
    limited quantities, and we must look more to the 80 percent
    multiservice solutions that can be produced on time, on budget,
    and in significant numbers. Mr. Secretary, I'd like to know how
    that fits with the recommendation in the overhead area to go
    with the NGEO when there are a number of less expensive
    solutions that can provide a multitude of opportunities for
    getting the overhead collection we need. Chair Feinstein and I
    on the Intelligence Committee have been looking at that very
    intensely and we would like to continue the discussions with
    you on that.
        The second thing, Admiral Roughead recently stated the F/A-
    18E and F is the aviation backbone of our Navy's ability to
    project power ashore, and the way the numbers of carrier-
    capable strike fighters will decrease between 2016 and 2020 to
    affect our air wing capacity effectiveness. We had asked last
    year and actually set in law a requirement that there be a
    report on the multiyear procurement of the F/A-18. I believe
    that was due in March. We think that is a very important
    element to consider, particularly with the delays in time, the
    budget being exceeded, and the failure to meet operational
    standards of the plane forecast to take its place to date.
        So I will look forward to asking more about those and may
    have some questions for the record. I have another meeting I
    have to go to, but I will come back for the questions. I thank
    the chairman and the members of the subcommittee for the
    indulgence.
        Chairman Inouye. Thank you.
        Now, Mr. Secretary.
        Secretary Gates. Mr. Chairman, Senator Cochran, members of
    the subcommittee: Thank you for inviting us to discuss the
    details of the President's fiscal year 2010 defense budget.
    There is a tremendous amount of material here and I know that
    there are a number of questions, so I'll keep my opening
    remarks brief and focus on the strategy and thinking behind
    many of these recommendations. My submitted testimony has more
    detailed information on specific programmatic decisions.
        First and foremost, as you suggested and commented on, Mr.
    Chairman, this is a reform budget, reflecting lessons learned
    in Iraq and Afghanistan, yet also addressing the range of other
    potential threats around the world now and in the future. I
    visited Afghanistan last month and as we increase our presence
    there and refocus our efforts with a new strategy, I wanted to
    get a sense from the ground level of the challenges and needs
    so we can give our troops the equipment and the support to be
    successful and come home safely.
        Indeed, listening to our troops and commanders unvarnished
    and unscripted has from the moment I took this job been the
    greatest single source for ideas on what this Department needs
    to do, both operationally and institutionally. As I told a
    group of soldiers in Afghanistan, they have done their job; now
    it is time for us in Washington to do ours.
        In many respects this budget builds on all the meetings I
    have had with troops and commanders and everything that I have
    learned over the past 2\1/2\ years, all underpinning this
    budget's three principal objectives: First, to reaffirm our
    commitment to take care of the All Volunteer Force, which in my
    view represents America's greatest strategic asset. As Admiral
    Mullen says, if we don't get the people part of this business
    right, none of the other decisions will matter.
        Second, to rebalance this Department's programs in order to
    institutionalize and enhance our capabilities to fight the wars
    we are in and the scenarios we are most likely to face in the
    years ahead, while at the same time providing a hedge against
    other risks and contingencies.
        Third, in order to do this we must reform how and what we
    buy, making a fundamental overhaul of our approach to
    procurement, acquisition, and contracting.
        From these priorities flow a number of strategic
    considerations, more of which are included in my submitted
    testimony. The base budget request is for $533.8 billion for
    fiscal year 2010, a 4 percent increase over the fiscal year
    2009 enacted level. After inflation, that is 2.1 percent real
    growth. In addition, the Department's budget request includes
    $130 billion to support overseas contingency operations,
    principally in Iraq and Afghanistan.
        I know that there has been discussion about whether this is
    in fact sufficient to maintain our defense posture, especially
    during a time of war. I believe that it is. Indeed, I have
    warned in the past that our Nation must not do what we have
    done after various previous times of conflict on so many
    occasions and slash defense spending. I can assure you that I
    will do everything in my power to prevent that from happening
    on my watch.
        This budget is intended to help steer the Department of
    Defense toward an acquisition and procurement strategy that is
    sustainable over the long term, that matches real requirements
    to needed and feasible capabilities.
        As you know, this year we have funded the costs of the war
    through the regular budgeting process, as opposed to emergency
    supplementals. By presenting this budget together, we hope to
    give a more accurate picture of the costs of the wars and also
    create a more unified budget process to decrease some of the
    churn usually associated with funding for this Department.
        This budget aims to alter many programs and many of the
    fundamental ways that the Department of Defense runs its
    budgeting, acquisition, and procurement processes. In this
    respect, three points come to mind about the strategic thinking
    behind these decisions. First, sustainability. By that I mean
    sustainability in light of current and potential fiscal
    constraints. It simply is not reasonable to expect the defense
    budget to continue increasing at the same rate it has over the
    last number of years. We should be able to secure our Nation
    with a base budget of more than half a trillion dollars, and I
    believe this budget focuses money where it can most effectively
    do that.
        I also mean sustainability of individual programs.
    Acquisition priorities have changed from defense secretary to
    defense secretary, administration to administration, and
    Congress to Congress. Eliminating waste and ending requirements
    creep, terminating programs that go too far outside the line,
    and bringing annual costs for individual programs down to a
    more reasonable level will reduce this friction.
        Second, balance. We have to be prepared for the wars we are
    most likely to fight, not just the ones we have been
    traditionally best suited to fight or threats we conjure up
    from potential adversaries, who in the real world also have
    finite resources. As I've said before, even when considering
    challenges from nation states with modern militaries, the
    answer is not necessarily buying more technologically advanced
    versions of what we built on land, at sea, and in the air to
    stop the Soviets during the cold war.
        At the same time, this budget robustly funds many
    modernization programs that will sustain our significant
    advantages for potential future conflict. Where certain
    modernization programs have been cancelled because of
    acquisition, technological or requirements issues, such as FCS
    vehicles, it is our intention to re-launch those modernization
    programs on a much sounder and more sustainable basis after
    completion of the Quadrennial Defense Review (QDR), the nuclear
    posture review, the ballistic missile defense review, and the
    space policy review later this year.
        Finally, there are all the lessons learned from the last 8
    years, on the battlefield and, perhaps just as importantly,
    institutionally at the Pentagon. The responsibility of this
    Department first and foremost is to fight and win the Nation's
    wars, not just constantly prepare for them. We have to do
    better. In that respect, the conflicts we are in have revealed
    numerous problems that I am working to improve and this budget
    makes real headway in that respect.
        At the end of the day, this budget is less about numbers
    than it is about how the military thinks about the nature of
    war and prepares for the future, about how we take care of our
    people and institutionalize support for the warfighter in the
    long term, about the role of the services in how we can buy
    weapons as jointly as we fight, about reforming our
    requirements and acquisition processes.
        I know that some will take issue with individual decisions.
    I would ask, however, that you look beyond specific programs
    and instead at the full range of what we are trying to do, the
    totality of the decisions and how they will change the way we
    prepare for and fight wars in the future.
        As you consider this budget and specific programs, I would
    caution that each program decision is zero sum. A dollar spent
    for capabilities excess to our real needs is a dollar taken
    from capability we do need, often to sustain our men and women
    in combat and bring them home safely.

                               PREPARED STATEMENT

        Once again, I thank you for this subcommittee's ongoing
    support of our men and women in uniform, and we look forward to
    your questions.
        Chairman Inouye. Thank you very much, Mr. Secretary.
        [The statement follows:]
                     Prepared Statement of Robert M. Gates
                                  introduction
        Mr. Chairman, Senator Cochran, members of the committee, thank you
    for inviting me to discuss the details of the President's fiscal year
    2010 defense budget. First and foremost, this is a reform budget--
    reflecting lessons learned in Iraq and Afghanistan, yet also addressing
    the range of other potential threats around the world, now and in the
    future.
        I was in Afghanistan last month. As we increase our presence
    there--and refocus our efforts with a new strategy--I wanted to get a
    sense from the ground level of what the challenges and needs are so
    that we can give our troops the equipment and support to be successful
    and come home safely. Indeed, listening to our troops and commanders--
    unvarnished and unscripted--has from the moment I took this job been
    the single greatest source for ideas on what the Department needs to do
    both operationally and institutionally. As I told a group of soldiers
    in Afghanistan, they have done their job. Now it is time for us in
    Washington to do ours. In many respects, this budget builds on all the
    meetings I have had with service members, and all that I have learned
    over the past 2\1/2\ years--all underpinning this budget's three
    principal objectives:
      --First, to reaffirm our commitment to take care of the all-volunteer
            force, which, in my view represents America's greatest
            strategic asset; as Admiral Mullen says, if we don't get the
            people part of our business right, none of the other decisions
            will matter;
      --Second, to rebalance this department's programs in order to
            institutionalize and enhance our capabilities to fight the wars
            we are in and the scenarios we are most likely to face in the
            years ahead, while at the same time providing a hedge against
            other risks and contingencies; and
      --Third, in order to do all this, we must reform how and what we buy,
            meaning a fundamental overhaul of our approach to procurement,
            acquisition, and contracting.
        From these priorities flow a number of strategic considerations,
    which I will discuss as I go through the different parts of the budget.
        The base budget request is for $533.8 billion for fiscal year
    2010--a 4 percent increase over the fiscal year 2009 enacted level.
    After inflation, that is 2.1 percent real growth. In addition, the
    Department's budget request includes $130 billion to support overseas
    contingency operations, primarily in Iraq and Afghanistan. I know there
    has been some discussion about whether this is, in fact, sufficient to
    maintain our defense posture--especially during a time of war. I
    believe it is. Indeed, I have warned in the past that our Nation must
    not do what we have done after previous times of conflict and slash
    defense spending. I can assure you that I will do everything in my
    power to prevent that from happening on my watch. This budget is
    intended to help steer the Department of Defense toward an acquisition
    and procurement strategy that is sustainable over the long term--that
    matches real requirements to needed and feasible capabilities.
        I will break this down into three sections: our people, today's
    warfighter, and the related topics of acquisition reform and
    modernization.
                                   our people
        Starting with the roll-out of the Iraq surge, my overriding
    priority has been getting troops at the front everything they need to
    fight, to win, and to survive while making sure that they and their
    families are properly cared for when they return. So, the top-priority
    recommendation I made to the President was to move programs that
    support the warfighters and their families into the services' base
    budgets, where they can acquire a bureaucratic constituency and long-
    term funding. To take care of people, this budget request includes,
    among other priorities:
      --$136 billion to fully protect and properly fund military personnel
            costs--an increase of nearly $11 billion over the fiscal year
            2009 budget level. This means completing the growth in the Army
            and Marines while halting reductions in the Air Force and Navy.
            The Marine Corps and Army will meet their respective end-
            strengths of 202,100 and 547,400 by the end of this fiscal
            year, so this money will be for sustaining those force levels
            in fiscal year 2010 and beyond;
      --$47.4 billion to fund military health care;
      --$3.3 billion for wounded, ill and injured, traumatic brain injury,
            and psychological health programs, including $400 million for
            research and development. We have recognized the critical and
            permanent nature of these programs by institutionalizing and
            properly funding these efforts in the base budget; and
      --$9.2 billion for improvements in child care, spousal support,
            lodging, and education, some of which was previously funded in
            the bridge and supplemental budgets.
        We must move away from ad hoc funding of long-term commitments.
    Overall, we have shifted $8 billion for items or programs recently
    funded in war-related appropriations into the base budget.
                               today's warfighter
        As I told the Congress in January, our struggles to put the defense
    bureaucracies on a war footing these past few years have revealed
    underlying flaws in the priorities, cultural preferences, and reward
    structures of America's defense establishment--a set of institutions
    largely arranged to prepare for conflicts against other modern armies,
    navies, and air forces. Our contemporary wartime needs must receive
    steady long-term funding and must have a bureaucratic constituency
    similar to conventional modernization programs and similar to what I
    have tried to do with programs to support our troops. The fiscal year
    2010 budget reflects this thinking:
        First, we will increase intelligence, surveillance and
    reconnaissance (ISR) support for the warfighter in the base budget by
    some $2 billion. This will include:
      --Fielding and sustaining 50 Predator-class unmanned aerial vehicle
            orbits by fiscal year 2011 and maximizing their production.
            This capability, which has been in such high demand in both
            Iraq and Afghanistan, will now be permanently funded in the
            base budget. It will represent a 62 percent increase in
            capability over the current level and 127 percent from over a
            year ago;
      --Increasing manned ISR capabilities such as the turbo-prop aircraft
            deployed so successfully as part of ``Task Force Odin'' in
            Iraq; and
      --Initiating research and development on a number of ISR enhancements
            and experimental platforms optimized for today's battlefield.
        Second, we will also spend $500 million more in the base budget
    than last year to boost our capacity to field and sustain more
    helicopters--an urgent demand in Afghanistan right now. Today, the
    primary limitation on helicopter capacity is not airframes but
    shortages of maintenance crews and pilots. So our focus will be on
    recruiting and training more Army helicopter crews.
        Third, to strengthen global partnership efforts, we will fund $550
    million for key initiatives. These include training and equipping
    foreign militaries to undertake counterterrorism and stability
    operations.
        Fourth, to grow our special operations capabilities, we will
    increase personnel by more than 2,400--or 4 percent--and will buy more
    aircraft for special operations forces. We will also increase the buy
    of Littoral Combat Ships (LCS)--a key capability for presence,
    stability, and counterinsurgency operations in coastal regions--from
    two to three ships in fiscal year 2010.
        Fifth, to improve our intra-theater lift capacity, we will increase
    the charter of Joint High Speed Vessels (JHSV) from two to four until
    our own production program begins deliveries in 2011.
        And, finally, we will stop the growth of Army Brigade Combat Teams
    (BCTs) at 45 versus the previously planned 48, while maintaining the
    planned increase in end strength to 547,400. This will ensure that we
    have better-manned units ready to deploy, and help put an end to the
    routine use of stop loss--which often occurs because certain
    specialties are in high demand. This step will also lower the risk of
    hollowing the force.
                       acquisition reform and insourcing
        In today's environment, maintaining our technological and
    conventional edge requires a dramatic change in the way we acquire
    military equipment. I welcome legislative initiatives in the Congress
    to help address some of these issues and look forward to working with
    lawmakers in this regard. This budget will support these goals by:
      --Reducing the number of support service contractors from our current
            39 percent of the workforce to the pre-2001 level of 26 percent
            and replacing them with full-time government employees. Our
            goal is to hire as many as 13,800 new civil servants in fiscal
            year 2010 to replace contractors and up to 33,600 new civil
            servants in place of contractors over the next 5 years;
      --Increasing the size of the defense acquisition workforce,
            converting 10,000 contractors, and hiring an additional 10,000
            government acquisition professionals by 2015--beginning with
            4,080 in fiscal year 2010; and
      --Terminating and delaying programs whose costs are out of hand,
            whose technologies are immature, or whose requirements are
            questionable--for example, the VH-71 presidential helicopter.
                                 modernization
        We must be prepared for the future--prepared for challenges we can
    see on the horizon and ones that we may not even have imagined. I know
    that some people may think I am too consumed by the current wars to
    give adequate consideration to our long-term acquisition needs. This
    budget provides $186 billion for modernization, which belies that
    claim.
        As I went through the budget deliberations process, a number of
    principles guided my decisions:
        The first was to halt or delay production on systems that relied on
    promising, but as yet unproven, technologies, while continuing to
    produce--and, as necessary, upgrade--systems that are best in class and
    that we know work. This was a factor in my decisions to cancel the
    Transformational Satellite (TSAT) program and instead build more
    Advanced Extremely High Frequency (AEHF) satellites.
        Second, where different modernization programs within services
    existed to counter roughly the same threat, or accomplish roughly the
    same mission, we must look more to capabilities available across the
    services. While the military has made great strides in operating
    jointly over the past two decades, procurement remains overwhelmingly
    service-centric. The Combat Search and Rescue helicopter, for example,
    had major development and cost problems to be sure. But what cemented
    my decision to cancel this program was the fact that we were on the
    verge of launching yet another single-service platform for a mission
    that in the real world is truly joint. This is a question we must
    consider for all of the services' modernization portfolios.
        Third, I looked at whether modernization programs had incorporated
    the experiences of combat operations since September 11th. This was
    particularly important to the ground services, which will be in the
    lead for irregular and hybrid campaigns of the future. The Future
    Combat Systems' ground vehicle component was particularly problematic
    in this regard.
        Fourth, I concluded we needed to shift away from the 99 percent
    ``exquisite'' service-centric platforms that are so costly and so
    complex that they take forever to build, then are deployed in very
    limited quantities. With the pace of technological and geopolitical
    change, and the range of possible contingencies, we must look more to
    the 80 percent multi-service solution that can be produced on time, on
    budget, and in significant numbers.
        This relates to a final guiding principle: the need for balance--to
    think about future conflicts in a different way--to recognize that the
    black and white distinction between irregular war and conventional war
    is an outdated model. We must understand that we face a more complex
    future than that, a future where all conflict will range across a broad
    spectrum of operations and lethality. Where near-peers will use
    irregular or asymmetric tactics that target our traditional strengths.
    And where non-state actors may have weapons of mass destruction or
    sophisticated missiles. This kind of warfare will require capabilities
    with the maximum possible flexibility to deal with the widest possible
    range of conflict.
        Overall, we have to consider the right mix of weapons and platforms
    to deal with the span of threats we will likely face. The goal of our
    procurement should be to develop a portfolio--a mixture of capabilities
    whose flexibility allows us to respond to a spectrum of contingencies.
    It is my hope that the Quadrennial Defense Review will give us a more
    rigorous analytical framework for dealing with a number of these
    issues. That is one reason I delayed a number of decisions on programs
    such as the follow-on manned bomber, the next generation cruiser, as
    well as overall maritime capabilities. But where the trend of future
    conflict is clear, I have made specific recommendations.
                                air capabilities
        This budget demonstrates a serious commitment to maintaining U.S.
    air supremacy, the sine qua non of American military strength for more
    than six decades. The key points of this budget as it relates to air
    capabilities are:
      --An increase in funding from $6.8 to $10.4 billion for the fifth-
            generation F-35, which reflects a purchase of 30 planes for
            fiscal year 2010 compared to 14 in fiscal year 2009. This money
            will also accelerate the development and testing regime to fix
            the remaining problems and avoid the development issues that
            arose in the early stages of the F-22 program. More than 500 F-
            35s will be produced over the next 5 years, with more than
            2,400 total for all the services. Russia is probably 6 years
            away from Initial Operating Capability of a fifth-generation
            fighter and the Chinese are 10 to 12 years away. By then we
            expect to have more than 1,000 fifth-generation fighters in our
            inventory;
      --This budget completes the purchase of 187 F-22 fighters--
            representing 183 planes plus the four funded in the fiscal year
            2009 supplemental to replace one F-15 and three F-16s
            classified as combat losses;
      --We will complete production of the C-17 airlifter program this
            fiscal year. Our analysis concludes that we have enough C-17s
            with the 205 already in the force and currently in production
            to meet current and future needs;
      --To replace the Air Force's aging tanker fleet, we will maintain the
            KC-X aerial refueling tanker schedule and funding, with the
            intent to solicit bids this summer. Our aging tankers, the
            lifeblood of any expeditionary force, are in serious need of
            replacement;
      --We will retire approximately 250 of the oldest Air Force tactical
            fighter aircraft in fiscal year 2010; and
      --Before continuing with a program for a next-generation manned
            bomber, we should first assess the requirements and what other
            capabilities we might have for this mission--and wait for the
            outcome of the Quadrennial Defense Review, the Nuclear Posture
            Review, and the outcome of post-START arms-control
            negotiations.
                             maritime capabilities
        The United States must not take its current maritime dominance for
    granted and needs to invest in programs, platforms, and personnel to
    ensure that dominance in the future. But rather than go forward under
    the same assumptions that guided our shipbuilding during the Cold War,
    I believe we need to reconsider a number of assumptions--a process that
    will, as I mentioned, be greatly helped by the QDR.
        We must examine our blue-water fleet and the overall strategy
    behind the kinds of ships we are buying. We cannot allow more ships to
    go the way of the DDG-1000: since its inception the projected buy has
    dwindled from 32 to three as costs per ship have more than doubled.
        The healthy margin of dominance at sea provided by America's
    existing battle fleet makes it possible and prudent to slow production
    of several shipbuilding programs. This budget will:
      --Shift the Navy Aircraft Carrier program to a 5-year build cycle,
            placing it on a more fiscally sustainable path. This will
            result in a fleet of 10 carriers after 2040;
      --Delay the Navy CG-X next generation cruiser program to revisit both
            the requirements and acquisition strategy; and
      --Delay amphibious ship and sea-basing programs such as the 11th
            Landing Platform Dock (LPD) ship and the Mobile Landing
            Platform (MLP) ship to fiscal year 2011 in order to assess
            costs and analyze the amount of these capabilities the Nation
            needs.
        The Department will continue to invest in areas where the need and
    capability are proven by:
      --Accelerating the buy of the Littoral Combat Ship, which, despite
            its development problems, is a versatile ship that can be
            produced in quantity and go to places that are either too
            shallow or too dangerous for the Navy's big, blue-water surface
            combatants;
      --Adding $200 million to fund conversion of six additional Aegis
            ships to provide ballistic missile defense capabilities;
      --Beginning the replacement program for the Ohio class ballistic
            missile submarine; and
      --Using fiscal year 2010 funds to complete the third DDG-1000
            Destroyer and build one DDG-51 Destroyer. The three DDG-1000
            class ships will be built at Bath Iron Works in Maine and the
            DDG-51 Aegis Destroyer program will be restarted at Northrop
            Grumman's Ingalls shipyard in Mississippi.
                               land capabilities
        As we have seen these last few years, our land forces will continue
    to bear the burdens of the wars we are in--and also the types of
    conflicts we may face in the future, even if not on the same scale. As
    I said earlier, we are on track with the expansion of the ground
    forces, and have added money for numerous programs that directly
    support warfighters and their families.
        Since 1999, the Army has been pursuing its Future Combat Systems--
    an effort to simultaneously modernize most of its platforms, from the
    way individual soldiers communicate to the way mechanized divisions
    move. Parts of the FCS program have already demonstrated their
    adaptability and relevance to today's conflicts. For example, the
    connectivity of the Warfighter Information Network will dramatically
    increase the agility and situational awareness of the Army's combat
    formations.
        But the FCS vehicle program is, despite some adjustments, based on
    the same assumptions as when FCS was first conceived. The premise
    behind the design of these vehicles is that lower weight, greater fuel
    efficiency, and, above all, near-total situational awareness,
    compensate for less heavy armor--a premise that I believe was belied by
    the close-quarters combat, urban warfare, and increasingly lethal forms
    of ambush that we've seen in both Iraq and Afghanistan. I would also
    note that the current vehicle program does not include a role for our
    recent $25 billion investment in the MRAP vehicles being used to good
    effect in today's conflicts.
        With that in mind:
      --We have canceled the existing FCS ground vehicle program, and will
            reevaluate the requirements, technology, and approach and then
            relaunch a new Army vehicle modernization program, including a
            competitive bidding process;
      --The FCS budget in fiscal year 2010 is $3 billion. I have directed
            that the new FCS program be fully funded in the out-years; and
      --We will accelerate FCS's Warfighter Information Network development
            and field it, along with proven FCS spin-off capabilities,
            across the entire Army.
                                missile defense
        The United States has made great technological progress on missile
    defense in the last two decades, but a number of questions remain about
    certain technologies and the balance between research and development
    on one hand, and procurement on the other. This is one area where I
    believe the overall sustainability of the program depends on our
    striking a better balance. To this end, this budget will:
      --Restructure the program to focus on the rogue state and theater
            missile threat. We will not increase the number of current
            ground-based interceptors in Alaska as had been planned. But we
            will continue to robustly fund research and development to
            improve the capability we already have to defend against long-
            range rogue missile threats--threats that North Korea's missile
            launch reminds us are real;
      --Cancel the second airborne laser (ABL) prototype aircraft. We will
            keep the existing aircraft and shift the program to an R&D
            effort. The ABL program has significant affordability and
            technology problems and the program's proposed operational role
            is highly questionable;
      --Terminate the Multiple Kill Vehicle (MKV) program because of its
            significant technical challenges and the need to take a fresh
            look at the requirement. Overall, the Missile Defense Agency
            program will be reduced by $1.2 billion; and
      --Increase by $700 million funding for our most capable theater
            missile defense systems like the THAAD and SM-3 programs.
                                 cyber security
        To improve cyberspace capabilities, this budget:
      --Increases funding for a broad range of Information Assurance
            capabilities to improve the security of our information as it
            is generated, stored, processed, and transported across our IT
            systems;
      --Increases the number of cyber experts this department can train
            from 80 students per year to 250 per year by fiscal year 2011;
            and
      --Establishes a cyber test range.
        There is no doubt that the integrity and security of our computer
    and information systems will be challenged on an increasing basis in
    the future. Keeping our cyber infrastructure safe is one of our most
    important national-security challenges. While information technology
    has dramatically improved our military capabilities, our reliance on
    data networks has at the same time left us more vulnerable. Our
    networks are targets for exploitation, and potentially disruption or
    destruction, by a growing number of entities that include foreign
    governments, non-state actors, and criminal elements.
                        overseas contingency operations
        As you know, this year we have funded the costs of the wars through
    the regular budgeting process--as opposed to emergency supplementals.
    By presenting this budget together, we hope to give a more accurate
    picture of the costs of the wars and also create a more unified budget
    process to decrease some of the churn usually associated with funding
    for the Department of Defense.
        We are asking for $130 billion to directly support the missions in
    Iraq and Afghanistan. This is less than the $141.7 billion we asked for
    last year through the bridge fund and the remaining supplemental
    request--which in part reflects shifting some programs into the base
    budget.
        The OCO request includes $74.1 billion to maintain our forces in
    Afghanistan and Iraq--from pre-deployment training, to transportation
    to or from theater, to the operations themselves.
      --In Afghanistan, this will support an average of 68,000 military
            members and six Brigade Combat Team (BCT) equivalents--plus
            support personnel; and
      --In Iraq, this will fund an average of 100,000 military members, but
            also reflects the President's decision to cut force levels to
            six Advisory and Assistance Brigades by August 31, 2010.
            Compared to the fiscal year 2008 enacted levels for Operation
            Iraqi Freedom, we are asking for less than half.
        Aside from supporting direct operations, the OCO funding also
    includes, among other programs:
      --$17.6 billion to replace and repair equipment that has been worn-
            out, damaged, or destroyed in theater. The major items include
            helicopters, fixed-wing aircraft, trucks, Humvees, Bradleys,
            Strykers, other tactical vehicles, munitions, radios, and
            various combat support equipment;
      --$15.2 billion for force protection, which includes $5.5 billion for
            MRAPs--$1.5 billion to procure 1,080 new MRAP All Terrain
            Vehicles (ATV) for Afghanistan and $4 billion for sustainment,
            upgrades, and other costs for MRAPs already fielded or being
            fielded.
      --$7.5 billion for the Afghan National Security Forces (ANSF).
            Ultimately, the Afghan people will shoulder the responsibility
            for their own security, so we must accelerate our training of
            their security forces in order to get more Afghans into the
            fight;
      --$1.5 billion for the Commander's Emergency Response Fund (CERP)--a
            program that has been very successful in allowing commanders on
            the ground to make immediate, positive impacts in their areas
            of operation. It will continue to play a pivotal role as we
            increase operations in Afghanistan and focus on providing the
            population with security and opportunities for a better life. I
            should note that the Department has taken a number of steps to
            ensure the proper use of this critical combat-enhancing
            capability;
      --$1.4 billion for military construction--most of which will go
            toward infrastructure improvements in Afghanistan to support
            our increased troop levels; and
      --$700 million for the Pakistan Counterinsurgency Capability Fund
            (PCCF). This program will be carried out with the concurrence
            of the Secretary of State and will complement existing and
            planned State Department efforts by allowing the CENTCOM
            commander to work with Pakistan's military to build
            counterinsurgency capability. I know there is some question
            about funding both the PCCF and the Foreign Military Financing
            program, but we are asking for this authority for the unique
            and urgent circumstances we face in Pakistan--for dealing with
            a challenge that simultaneously requires military and civilian
            capabilities. This is a vital element of the President's new
            Afghanistan-Pakistan strategy.
                                   conclusion
        Let me close with a few final thoughts.
        This budget aims to alter many programs, and many of the
    fundamental ways that the Department of Defense runs its budgeting,
    acquisition, and procurement processes. In this respect, three key
    points come to mind about the strategic thinking behind these
    decisions.
        First of all, sustainability. By that, I mean sustainability in
    light of current and potential fiscal constraints. It is simply not
    reasonable to expect the defense budget to continue increasing at the
    same rate it has over the last number of years. We should be able to
    secure our Nation with a base budget of more than half a trillion
    dollars--and I believe this budget focuses money where it can more
    effectively do just that.
        I also mean sustainability of individual programs. Acquisition
    priorities have changed from defense secretary to defense secretary,
    administration to administration, and congress to congress. Eliminating
    waste, ending ``requirements creep,'' terminating programs that go too
    far outside the line, and bringing annual costs for individual programs
    down to more reasonable levels will reduce this friction.
        Second of all, balance. We have to be prepared for the wars we are
    most likely to fight--not just the wars we have traditionally been best
    suited to fight, or threats we conjure up from potential adversaries
    who, in the real world, also have finite resources. As I've said
    before, even when considering challenges from nation-states with modern
    militaries, the answer is not necessarily buying more technologically
    advanced versions of what we built--on land, at sea, or in the air--to
    stop the Soviets during the Cold War.
        Finally, there are all the lessons learned from the last 8 years--
    on the battlefield and, perhaps just as important, institutionally back
    at the Pentagon. The responsibility of this department first and
    foremost is to fight and win wars--not just constantly prepare for
    them. In that respect, the conflicts we are in have revealed numerous
    problems that I am working to improve; this budget makes real headway
    in that respect.
        At the end of the day, this budget is less about numbers than it is
    about how the military thinks about the nature of warfare and prepares
    for the future. About how we take care of our people and
    institutionalize support for the warfighter for the long term. About
    the role of the services and how we can buy weapons as jointly as we
    fight. About reforming our requirements and acquisition processes.
        I know that some of you will take issue with individual decisions.
    I would, however, ask you to look beyond specific programs, and instead
    at the full range of what we are trying to do--at the totality of the
    decisions and how they will change the way we prepare for and fight
    wars in the future.
        Once again, I thank you for your ongoing support of our men and
    women in uniform. I look forward to your questions.

        Chairman Inouye. Admiral Mullen.

                     STATEMENT OF ADMIRAL MICHAEL G. MULLEN

        Admiral Mullen. Mr. Chairman, Senator Cochran,
    distinguished members of this subcommittee: Thank you for the
    opportunity to appear before you today.
        Let me start by saying I fully support not only the
    President's fiscal year 2010 budget submission for this
    Department, but more specifically the manner in which Secretary
    Gates developed it. He presided over a comprehensive and
    collaborative process the likes of which, quite frankly, I've
    not seen in more than a decade of doing this sort of work in
    the Pentagon.
        Over the course of several months and a long series of
    meetings and debates, every service chief and every combatant
    commander had a voice and every one of them used it. Normally,
    as you know, budget proposals are worked from the bottom up,
    with each service making the case for specific programs and
    then fighting it out at the end to preserve those that are most
    important to them. This proposal was done from the top down.
    Secretary Gates gave us broad guidance, his overall vision, and
    then gave us the opportunity to meet it.
        Everything was given a fresh look and everything had to be
    justified. Decisions to curtain or eliminate a program were
    based solely on its relevance and on its execution. The same
    can be said for those we decided to keep. If we are why we buy,
    I believe the force we are asking you to help us buy today is
    the right one, both for the world we're living in and the world
    we may find ourselves living in 20 to 30 years down the road.
        This submission before you is just as much a strategy as it
    is a reform budget. First and foremost, it makes people our top
    strategic priority. I've said many times and I remain
    convinced, the best way to guarantee our future security is to
    support our troops and their families. It is the recruit and
    the retain choices of our families and, quite frankly, American
    citizens writ large, that will make or break the All Volunteer
    Force. They will be less inclined to make those decisions
    should we not be able to offer them viable career options,
    adequate healthcare, suitable housing, advanced education, and
    the promise of a prosperous life long after they've taken off
    the uniform.
        This budget devotes more than one-third of the total
    request to what I would call the people account, with the great
    majority of that figure, nearly $164 billion, going to pay
    military pay and healthcare. I am particularly proud of the
    funds we've dedicated to caring for our wounded. There is in my
    view no higher duty for this Nation or for those of us in
    leadership positions than to care for those who sacrificed so
    much and who must now face lives forever changed by wounds both
    seen and unseen.
        I know you share that feeling, and thank you for the work
    you've done in this subcommittee and throughout the Congress to
    pay attention to these needs and to the needs of the families
    of our fallen. Our commitment to all of them must be for the
    remainder of their lives.
        That's why this budget allocates funds to complete the
    construction of additional wounded warrior complexes, expands
    the pilot program designed to expedite the processing of
    injured troops through the disability evaluation system,
    increases the number of mental health professionals assigned to
    deployed units, and devotes more resources to the study and
    treatment of post-traumatic stress and traumatic brain
    injuries.
        After nearly 8 years of war, we are the most capable and
    combat experienced military we've ever been, certainly without
    question the world's best counterinsurgency force. Yet, for all
    this success, we are pressed and still lack a proper balance
    between OPTEMPO and home tempo, between unconventional and
    conventional capabilities, between readiness today and
    readiness tomorrow.
        That, Mr. Chairman, is the second reason this budget of
    ours acts as a strategy for the future. It seeks balance. By
    investing more heavily in critical enablers, such as aviation,
    special forces, cyber operations, civil affairs, language
    skills, it rightly makes winning the wars we are in our top
    operational priority. By adjusting active army BCT growth to
    45, it helps ensure our ability to impact the fight sooner,
    increase dwell time, and reduce our overall demand on
    equipment. By authorizing Secretary Gates to transfer money to
    the Secretary of State for reconstruction, security, or
    stabilization, it puts more civilian professionals alongside
    warfighters in more places like Iraq and Afghanistan.
        I said it before, but it bears repeating: More boots on the
    ground are important, but they will never be completely
    sufficient. We need people with graphing tablets and shovels
    and teaching degrees. We need bankers and farmers and law
    enforcement experts.
        As we draw down responsibly in Iraq and shift the main
    effort to Afghanistan, we need a more concerted effort to build
    up the capacity of our partners. The same can be said of
    Pakistan, where boots on the ground aren't even an option.
        Some will argue this budget devotes too much money to these
    sorts of low intensity needs, that it tilts dangerously away
    from conventional capabilities. In my view it does not. A full
    35 percent of this submission is set aside for modernization
    and much of that will go to what we typically consider
    conventional requirements. We know there are global risks and
    threats out there not tied directly to the fight against Al
    Qaeda and other extremist groups, threats like those we awoke
    to on this past Memorial Day, when the stability of an entire
    region was shaken by the increasing belligerence of North
    Korea.
        The work of defending this Nation does not fit nicely into
    any one bucket. It spans the entire spectrum of conflict. We
    must be ready to deter and win all wars, big and small, near
    and far. With this budget submission, the Nation is getting the
    military it needs for that challenge. It's getting a strategy
    for the future.

                               PREPARED STATEMENT

        Thank you all for your continued support and for all you do
    to support the men and women of the United States military and
    their families.
        Chairman Inouye. Thank you very much, Admiral Mullen.
        [The statement follows:]
                Prepared Statement of Admiral Michael G. Mullen
        Chairman Inouye, Senator Cochran, distinguished members of the
    Committee, it is my privilege to report on the posture of the United
    States Armed Forces.
        First, I would like to thank our Service men and women and their
    families. Those who defend this Nation and the families who support
    them remain our most valuable national assets and deserve continued
    gratitude. I want especially to honor the sacrifices of our wounded,
    their families, and the families of the fallen. We are redefining our
    duty to them as a Nation, a duty which I believe lasts for life. I
    thank everyone in this distinguished body for their continued efforts
    in support of this cause.
        Your Armed Forces stand as the most combat experienced in this
    Nation's history. Deeply experienced from decades of deployments in
    harm's way and from 7\1/2\ years of war, they have remained resilient
    beyond every possible expectation. They make me, and every American,
    very proud.
        I am grateful for your understanding of the stress our Armed Forces
    and their families are under. Your recognition of their burdens and
    uncertainties has been a vital constant throughout these challenging
    times. Thank you for your support of initiatives such as transferring
    G.I. Bill benefits to military spouses and children, military spouse
    employment support, expanded childcare and youth programs, homeowner's
    assistance programs, and, most importantly, long-term comprehensive
    support of Wounded Warrior families.
        This testimony comes after a notable transition of administration,
    the first during wartime since 1968 and the first since the 9/11
    attacks on the homeland. Conducted in the face of threats and continued
    wartime missions overseas, the transition was marked by courtesy and
    concern for the mission and our forces from start to finish. Transition
    obviously means change, but in this case, it also meant continuity in
    providing for the common defense. Continuity has been and is
    particularly important at this juncture as we implement the key
    strategic changes underway that end the war in Iraq through a
    transition to full Iraqi responsibility and reinforce a whole of
    government effort in Afghanistan and Pakistan.
        While several key developments have emerged since I last testified,
    in particular the global economic crisis, the three strategic
    priorities for our military that I outlined last year remain valid.
    First, we must continue to improve stability and defend our vital
    national interests in the broader Middle East and South Central Asia.
    Second, we must continue efforts to reset, reconstitute, and revitalize
    our Armed Forces. Third, we must continue to balance global strategic
    risks in a manner that enables us to deter conflict and be prepared for
    future conflicts. The three strategic priorities are underpinned by the
    concept of persistent engagement, which supports allies and partners
    through programs abroad and at home and which must be led by and
    conducted hand-in-hand with our interagency partners to achieve
    sustainable results.
                                key developments
        Over the past year your Armed Forces continued to shoulder a heavy
    burden worldwide, particularly in the Middle East and South Central
    Asia. Our emphasis has rightfully remained on the ongoing wars in
    Afghanistan and Iraq and against al-Qaeda extremists, though we remain
    ready to face other global challenges.
        Per the President's guidance on February 27th, we will end our
    combat mission in Iraq by August 31, 2010. The Joint Chiefs and I
    believe this is a prudent course given the sustained security gains we
    have seen to date and Iraq's positive trajectory. This current plan
    preserves flexibility through early 2010 by conducting the majority of
    the drawdown after the Iraqi election period. In the meantime, our
    troops are on course to be out of Iraqi cities by June of this year and
    two more brigades will return to the United States without replacement
    by the end of September. Drawing down in Iraq is not without risks.
    Lingering political tensions remain and violence could flare from time
    to time. Assuming no major surprises, however, we will successfully
    transition fully to the advise and assist mission over the next 16
    months and lay the groundwork for a continued partnership with Iraq
    that promotes security in the region.
        In Afghanistan and Pakistan we are providing additional resources
    to address the increase in violence. The strategic goal as outlined by
    the President on March 27, 2009, is to disrupt, dismantle, and defeat
    al-Qaeda and its extremist allies in Pakistan and Afghanistan and to
    prevent their return to either country. As that strategy was being
    developed, we began responding to conditions on the ground by
    reinforcing the International Security and Assistance Force commander
    with some 17,700 troops, the majority of which will arrive by this
    summer. Our aim in Afghanistan is to check the momentum of the
    insurgency, train additional forces, and ensure security for the Afghan
    national elections in August, while in Pakistan we will work with the
    Pakistani military to further develop their counterinsurgency skills
    and build stronger relationships with Pakistani leaders at all levels.
        We will shift the main effort from Iraq to Afghanistan in the
    coming year, though our residual footprint in Iraq will remain larger
    than in Afghanistan until well into 2010. The strategic environment we
    face beyond these ongoing conflicts is uncertain and complex. In the
    near term, we will maintain focus on threats to our vital national
    interests and our forces directly in harm's way. Increasingly, the
    greatest mid-term military threats will come from transnational
    concerns--the proliferation of nuclear weapons and missile technology,
    transnational terrorism, competition over energy, water, and other
    vital resources, natural disasters and pandemics, climate change, and
    space vulnerabilities.
        A prominent aspect of this shifting strategic environment is the
    disturbing trend in cyber attacks, where we face both state and non-
    State actors. Cyberspace is a borderless domain wherein we operate
    simultaneously with other U.S. Government agencies, allies, and
    adversaries. Effectiveness is increasingly defined by how well we share
    information, leverage technology, and capitalize on the strength of
    others. When appropriate, DOD will lead. Likewise, when appropriate,
    DOD will provide support and ensure collective success. Our national
    security and that of our allies is paramount.
        A critical new challenge has been added to the strategic
    environment--the global economic crisis. Although we do not fully
    understand the impact or depth of this worldwide recession, dire
    economic conditions increase the pressures for protectionism. They also
    staunch the flow of remittances, which provide enormous benefits to
    developing nations. Prolonged downturns can generate internal strife,
    authoritarian rule, virulent nationalism, manufactured crises, and
    state conflict. Decreased energy prices have also affected the global
    economy, on one hand reducing the resources available to some malicious
    actors, but on the other hand hurting some key allies. Any conflict
    involving a major energy producer, however, could escalate prices
    rapidly, which would undoubtedly hamper prospects for a quicker global
    recovery. Economic concerns will increasingly be the lens through which
    we--and our partners and competitors--filter security considerations.
    Many nations may decrease expenditures on defense and foreign
    assistance, thus making smaller the pool of collective resources with
    which we have to address challenges. We will work through our routine
    military-to-military contacts to address this tendency directly and
    help to coordinate priorities, emphasizing that we are all bound
    together in this global economy.
        Winning our Nation's current and future wars requires concurrent
    efforts to restore the vitality of the Armed Forces and balance global
    risk. I am grateful for Congress's continued support of the programs
    designed to return our units to the desired levels of readiness and for
    the honest debate engendered in these chambers to ascertain national
    interests and determine the best mix of capabilities and programs to
    protect those interests. The ability to debate these national choices--
    openly and transparently--is just one of the attractive features of our
    Republic that others seek to emulate.
        Our military remains capable of protecting our vital national
    interests. At the same time, the strain on our people and equipment
    from more than 7 years of war has been tremendous. There is no tangible
    ``peace dividend'' on the horizon given the global commitments of the
    United States. We still face elevated levels of military risk
    associated with generating additional ground forces for another
    contingency should one arise. I do not expect the stress on our people
    to ease significantly in the near-term given operations in the Middle
    East, the strategic risk associated with continued regional instability
    in South Central Asia, and the uncertainty that exists globally. Over
    the next 2 years the number of forces deployed will remain high. The
    numbers will reduce, but at a gradual pace. The drawdown in Iraq is
    weighted in 2010, with the bulk of the combat brigades coming out after
    the Iraqi elections. At the same time, through the course of 2009 and
    into 2010, we will be reinforcing the effort in Afghanistan. Only in
    2011 can we expect to see marked improvements in the dwell time of our
    ground forces.
        We cannot--and do not--face these global challenges alone. We
    benefit greatly from networks of partners and allies. Despite the
    economic downturn, the bulk of the world's wealth and the majority of
    the world's most capable militaries are found in those nations we call
    friends. Persistent engagement maintains these partnerships and lays
    the foundation upon which to build effective, collective action in
    times of security and economic crisis. In the coming years we must be
    careful not to shunt aside the steady work required to sustain these
    ties. By maintaining regional security partnerships, developing and
    expanding effective information sharing networks, and continuing
    military-to-military outreach, we improve the ability to monitor the
    drivers of conflict and help position our Nation for engagement rather
    than reaction. Such engagement also propels us toward the common good,
    relieves some of the burden on our forces, improves the protection of
    the homeland, and helps secure U.S. vital national interests.
     defend vital national interests in the broader middle east and south
                                  central asia
        Given its strategic importance and our vital national interests,
    the United States will continue to engage in the broader Middle East
    and South Central Asia--as a commitment to friends and allies, as a
    catalyst for cooperative action against violent extremism, as a
    deterrent against state aggression, as an honest broker in conflict
    resolution, and as a guarantor of access to natural resources. Yet we
    recognize that our presence in these regions can be more productive
    with a lower profile. The Iraq drawdown is the first step on the path
    to that end.
        Attaining our goals in these critical regions requires time,
    resources, and endurance. Most of the challenges in the region are not
    military in nature and can only be met successfully from within. Our
    role remains one essentially of consistent, transparent partnership
    building. These actions send an unmistakable message to all that the
    United States remains committed to the common good, while steadily
    expanding the sets of partnerships available to address future
    challenges.
        Central to these efforts in the Middle East and South Central Asia
    will be the relentless pressure we maintain on al-Qaeda and its senior
    leadership. Al-Qaeda's narrative will increasingly be exposed as
    corrupt and self-limiting. Though too many disaffected young men still
    fall prey to al-Qaeda's exploitation, I believe the populations in the
    region will ultimately reject what al-Qaeda offers. Our priority effort
    will remain against al-Qaeda, but we will also take preventative
    measures against the spread of like-minded violent extremist
    organizations and their ideologies to neighboring regions such as the
    Horn of Africa and the Sahel. The U.S. military's task is to partner
    with affected nations to combat terrorism, counter violent extremism,
    and build their capacity to shoulder this same burden.
        Afghanistan and Pakistan are central fronts in the fight against
    al-Qaeda and militant global extremism and must be understood in
    relation to each other. Afghanistan requires additional resources to
    counter a growing insurgency partially fed by safe havens and support
    networks located within Pakistan. Additional U.S. troops will conduct
    counterinsurgency operations to enhance population security against the
    Taliban in south/southwest Afghanistan and to accelerate and improve
    training and mentoring of Afghan security forces. As in Iraq, our
    troops will live among the population. We must make every effort to
    eliminate civilian casualties, not only because this is the right thing
    to do but also because it deprives the Taliban of a propaganda tool
    that exploits Afghan casualties and calls into question U.S./NATO
    endurance and effectiveness in providing security. Although we must
    expect higher Alliance casualties as we go after the insurgents, their
    sanctuaries, and their sources of support, our extended security
    presence must--and will--ultimately protect the Afghan people and limit
    both civilian and military casualties. Our troops will integrate
    closely with Afghan forces, with the objective of building Afghan
    security forces that are capable of assuming responsibility for their
    country's security.
        We expect the reinforcements to have the most pronounced effect
    over the next 12-24 months. Security gains can only be assured when
    complemented by development and governance programs designed to build
    greater self sufficiency over time. Our commanders in the field can lay
    some of this groundwork through the proven Commanders Emergency
    Response Program to start smaller projects quickly, but these projects
    can not compensate for the larger, enduring programs required. A
    temporary boost in security that is not matched with commensurate
    political and economic development will not only fail to generate faith
    in the Afghan government and fail to convince Afghans of our
    commitment, but also fail to accomplish our objectives. Over time,
    these objectives will be met more through civilian agencies and non-
    governmental organizations, with a lighter military presence. Getting
    to that point, however, requires that military forces generate the
    security required for political and economic initiatives to take root.
        Pakistan is crucial to our success in Afghanistan. In my nine trips
    to Pakistan, I've developed a deeper understanding of how important it
    is that we, as a Nation, make and demonstrate a long term commitment to
    sustaining this partnership. We are taking multiple approaches to
    rebuild and strengthen relationships and address threats common to both
    of our nations. One key approach in the near term is to help Pakistan's
    military to improve its overall--and specifically its
    counterinsurgency--capabilities. Beyond the trainers we will continue
    to provide, the Pakistani Counterinsurgency Capability Fund and
    Coalition Support Funds provide us the means to address this issue
    directly, and I ask the Congress to support these initiatives and
    provide the flexibility to accelerate their implementation. We are
    committed to comprehensive accountability measures to ensure that these
    funds go exactly where they are intended to go and do not compromise
    other USG humanitarian assistance objectives. These programs will help
    the Pakistanis take continued action to combat extremist threats in
    western Pakistani territories which will complement the reinforcement
    of troops and special operations efforts in Afghanistan to maintain
    pressure on al-Qaeda and Taliban leadership. In addition to these
    initiatives, steady support of the Foreign Military Sales and Foreign
    Military Financing programs will help us to address the needs expressed
    by Pakistan's leaders and validated by our civil-military leadership.
    We will also be well served by the substantially larger request for
    International Military Education and Training exchanges with Pakistan,
    to help reconnect our institutions and forge lasting relationships.
    Military programs must also be supplemented by non-military investment
    and continued engagement, which further confirm our Nation's long term
    commitment.
        In all, we must recognize the limits of what can be accomplished at
    what price and at what pace in both countries. This will be a long
    campaign. We are committed to providing sustained, substantial
    commitment to Afghanistan and Pakistan. Progress in Afghanistan and
    Pakistan will be halting and gradual, but we can steadily reduce the
    threats to our Nation that emanate from conditions in those countries.
        In Iraq, we are on the path to stability and long-term partnership
    as codified in the Security Agreement. Political, ethnic, and sectarian
    tensions may continue to surface in sporadic bouts of violence. But we
    also expect that Iraq's Security Forces will continue to improve,
    malign Iranian influence will not escalate, and, although resilient,
    al-Qaeda in Iraq will not be able to regroup and reestablish the
    control it once had. I am heartened by the conduct of Iraq's provincial
    elections in January and the election of a new Speaker of the Council
    of Representatives and expect additional political progress in the
    coming year.
        The drawdown in Iraq carries inherent risks. But the plan that is
    underway provides sufficient flexibility for the ground commander to
    adjust to Iraqi political and security developments and to deal with
    the unexpected. We are currently working with Multi-National Force-
    Iraq, CENTCOM, SOCOM, TRANSCOM, and the Services on the mechanics of
    the drawdown and the composition of the roughly 35,000- to 50,000-
    strong transition force provided for in the Status of Forces Agreement
    that will remain in Iraq after August 31, 2010, to advise and assist
    the Iraqi Security Forces, conduct counter terrorism operations, and
    provide force protection to civilian agencies.
        The Iranian government's sponsorship of violent surrogates and
    failure to improve the confidence of the international community in the
    intent of its nuclear program, contribute to instability in the broader
    Middle East. Iran's Islamic Revolutionary Guard Corps--Qods Force
    orchestrates the activities of its proxies in Iraq and Afghanistan,
    across the Levant, and beyond. Through these proxies, Iran inserts
    itself into the Israeli-Palestinian situation and Lebanese internal
    politics by its direct support of Hamas and Hizballah. Iran's continued
    failure to comply with U.N. Security Council resolutions and cooperate
    fully with the IAEA cast doubt on the exclusively peaceful nature of
    its nuclear program. Our allies in the region share our deep concerns
    about Iran's nuclear policies, which if unchecked could lead to further
    regional proliferation as other States would seek nuclear weapons as a
    hedge--an outcome that would serve neither Iran nor the region. Iran
    could be an immensely constructive actor in the region, and its choices
    in the near term will have far reaching consequences. As the
    administration pursues diplomacy with Iran to address these serious
    concerns, we will continue to work with the international community to
    convince Iran to comply with its international obligations under U.N.
    Security Council resolutions.
        Al-Qaeda has expressed the desire for WMD and its intent to strike
    the homeland is undisputed. Al-Qaeda would also likely use WMD against
    populations in the broader Middle East. Consequently, the nexus between
    violent extremism and the proliferation of WMD remains a grave threat
    to the United States and our vital national interests. The defeat of
    al-Qaeda would significantly diminish the threat from this nexus, but
    does not fully remove it given the conceptual blueprint already
    established for other extremists. We will continue to support national
    efforts to counter, limit, and contain WMD proliferation from both
    hostile state and non-State actors. We will also team with partners
    inside and outside the broader Middle East to reduce vulnerabilities
    and strengthen regional governments' confidence that we can address the
    WMD threat. But we must recognize that this threat requires vigilance
    for the duration, given the magnitude of damage that can be wrought by
    even a single incident.
        The Israeli-Palestinian conflict, in particular the violence in
    Gaza in from Operation Cast Lead in the Gaza Strip in late December
    2008 and January 2009, continues to cast a pall across the region. The
    Peace Process is primarily a diplomatic endeavor, but one we support
    fully through such initiatives as the training and advising of
    legitimate Palestinian security forces, exchanges with Israeli
    counterparts, and cooperation with Arab military partners. These
    initiatives support broader national endeavors aimed at a reduction in
    violence, greater stability, and peaceful co-existence in this critical
    region.
              reset, reconstitute, and revitalize the armed forces
        Protecting our Nation's interests in recent years has required the
    significant commitment of U.S. military forces. Indeed, extensive
    security tasks remain before us as we pursue the stated objectives in
    Iraq, Afghanistan and Pakistan, defeat the al-Qaeda network, prevent
    the spread of WMD, deter conflict, preserve our ability to project and
    sustain military power at global distances, and maintain persistent
    engagement with allies and partners around the globe. At the core of
    our ability to accomplish all of these tasks are the talented, trained,
    and well-equipped members of the Armed Forces. I remain convinced that
    investment in our people is the best investment you make on behalf of
    our citizens.
        The pace of current commitments has prevented our forces from fully
    training for the entire spectrum of operations. Consequently, readiness
    to address the range of threats that might emerge has declined. The
    demands we have put on our people and equipment over the past 7 years
    are unsustainable over the long-term. As we continue to
    institutionalize proficiency in irregular warfare, we must also restore
    the balance and strategic depth required to ensure national security.
    Continued operations that are not matched with appropriate national
    resources will further degrade equipment, platforms, and, most
    importantly, our people.
        Our Nation's service members and their families are at the core of
    my efforts to reset, reconstitute, and revitalize our forces. Every
    decision I make takes into consideration their well-being. The All-
    Volunteer Force has accomplished every mission it has been given, but
    at a high price. I do not take their service for granted and recognize
    the limits of their endurance. I remain extremely concerned about the
    toll the current pace of operations is taking on them and on our
    ability to respond to crises and contingencies beyond ongoing
    operations in Iraq and Afghanistan.
        The dwell time of units is one key metric we watch closely for the
    Army and Marine Corps. Dwell time remains at approximately 1:1 for
    ground units, meaning 1 year deployed and 1 year at home for the Army,
    7 months deployed/7 months at home for the Marine Corps, and similar
    cycles for the Airmen and Sailors serving in joint expeditionary
    taskings. Dwell time will improve, but we cannot expect it to return to
    an interim 1:2 or the desired 1:3 or better for several years given the
    number of ground forces still tasked with re-posturing to Afghanistan,
    the advise and assist mission in Iraq after drawdown, and other global
    commitments. Special Operations Forces (SOF) face similar deployment
    cycles but improvements in their dwell time will lag the Army and
    Marine Corps given the demand for SOF expertise in the irregular
    warfare environment we face. A key part of the effort to improve dwell
    time is the continued commitment to the size of the Army, Marine Corps,
    and Special Operations Forces as reflected in the 2010 budget.
    Institution of the ``Grow the Force'' initiative is an indispensable
    element of the long-term plan to restore readiness.
        Our recruiters met the missions of their military departments for
    fiscal year 2008 and are well on track for fiscal year 2009. The
    Services have been able to reduce the number of conduct waivers issued
    and the Army in the recruiting year to date has seen a marked increase
    in the number of high school graduates joining its ranks, exceeding the
    Department of Defense Tier 1 Educational Credential Standard of 90
    percent for all three Army components--Active, Army National Guard, and
    Army Reserve. Retaining combat-proven leaders and the people with the
    skills we need is just as important. The Services have benefited from
    the full range of authorities given to them by Congress as retention
    incentives. I ask for your continued support of these programs, in
    particular the bonuses used by the Services to retain key mid-career
    active duty officers and enlisted. I also ask for your continued
    support of incentives for Reserve and National Guard service to provide
    flexibility and enhanced retirement benefits. We have made important
    strides in the past year in equipping these vital members of the Total
    Force, and their performance over the past 7 years of war has been
    superb. Economic conditions will ameliorate some of the recruiting and
    retention pressure in the coming year, but we must recognize that
    personnel costs will continue to grow as we debate the national level
    of investment in defense.
        As Chairman of the Joint Chiefs of Staff, I have spent the last 18
    months meeting with Soldiers, Sailors, Airmen, Marines, Coast
    Guardsmen, and civilian public servants. In them I recognize the
    differences in our generations, with the younger ones ever more
    comfortable with social networking and technology. Yet I recognize in
    all of them a strong thread of continuity that stretches back to the
    Nation's beginnings. That thread is a keen awareness of how they and
    their influencers--parents, teachers, coaches, and peers--perceive the
    manner in which today's veterans are treated. Service members know that
    the American people stand fully behind them, regardless of varying
    opinions over American policy. The All-Volunteer Force has earned this
    trust and confidence. This contract must be renewed every day with the
    American people, who can never doubt that we will be good stewards of
    their most precious investment in their armed forces--the sons and
    daughters who serve our Nation.
        Emblematic of that stewardship is the way we treat returning
    Wounded Warriors and the parents, spouses and family members who
    support them. As a Nation, we have an enduring obligation to those who
    have shouldered the load and who bear the visible and invisible scars
    of war, some of whom we unfortunately find in the ranks of the
    homeless. As leaders, we must ensure that all Wounded Warriors and
    their families receive the care, training, and financial support they
    need to become self-sufficient and lead as normal a life as possible--a
    continuum of care that lasts for life. This continuum extends
    especially to the families of the fallen. Our focus must be more on
    commitment rather than compensations, and on transition and ability
    rather than disability. To the degree that we fail to care for them and
    their families, and enable their return to as normal a life as
    possible, we undermine the trust and confidence of the American people.
        One other area that has been particularly troubling since I last
    testified is the rise in the number of service member suicides. The
    Army in particular has been hit hard by a troubling increase over the
    past 4 years and an already disturbing number of suicides in 2009. We
    do not know precisely why this is occurring, though the increased
    stress of wartime is certainly a factor. All Service leaders are
    looking hard at the problem, to include ensuring that we make a service
    member's ability to seek mental health care both unimpeded and stigma
    free. This approach requires a cultural change in all of the Services
    that will take time to inculcate, but the seeds are planted and taking
    root. The program at Fort Hood, Texas, is just one example of how a
    commander-empowered that understands the problem as a result of stress
    rather than weakness and incorporates families can sharply reduce the
    number of suicides in a specific community.
        The Department and the Services have also continued to expand
    comprehensive programs designed to prevent sexual abuse in the
    military. Such abuse is intolerable and an unacceptable betrayal of
    trust. We will continue work towards the goal of eliminating this crime
    from our ranks.
        Although the strain on our people is most acute, the strain on
    equipment and platforms is likewise significant. Through the
    reconstitution effort over the next decade, we will repair, rebuild,
    and replace the equipment that has been destroyed, damaged, stressed,
    and worn out beyond repair after years of combat operations. As
    Congress is well aware, Service equipment has been used at higher rates
    under harsher conditions than anticipated. The drawdown in Iraq through
    the end of next summer will provide us even greater first-hand insight
    into the state of ground force equipment as we retrograde multiple
    brigade combat team and enabler sets.
        Beyond the wear and tear experienced by ground vehicles in Iraq and
    Afghanistan, our airframes are aging beyond their intended service
    lives. Indeed since Desert Storm, 18 years ago, the U.S. Air Force and
    U.S. Navy have flown near continuous combat missions over the Middle
    East and the Balkans with the F-15s, F-16s, and F-18s that were
    designed in the 1960s and 1970s and which, with upgrades, have proven
    their worth repeatedly over time. We have struggled with a wide variety
    of airframes, as seen in the fleet-wide groundings of all major fighter
    weapons systems at various times over the past 5 years, the strains on
    30-year-old P-3 Orion reconnaissance aircraft, and ongoing efforts to
    retire some of our C-130 Hercules and KC-135 Strato-tankers.
    Maintaining and acquiring sufficiently robust air and naval forces
    remain pressing requirements as these assets are central to ensuring
    the command of the sea and air that enables all operations. To help pay
    for these pressing requirements we must continue to look towards
    acquisition transformation that supports accelerated fielding of
    equipment before the speed of technology eclipses its value. We also
    need to reduce stove-piped Information Technology service solutions and
    replace them wherever possible with joint enterprise solutions and
    capabilities that are more effective at reduced costs.
        Our forces have relied upon the funds appropriated in the fiscal
    year 2009 budget request to accomplish equipment reset and to address
    readiness shortfalls. Congress's continued support is necessary for the
    predictable, adequate funding required for the repair and replacement
    of both operational and training equipment. I ask for your continued
    support for the upcoming fiscal year 2010 funding request. I fully
    support the vision Secretary Gates has laid out--and which the
    President has endorsed and forwarded--for the Department and the joint
    force. This vision and its program decisions emphasize our people
    first. Our advanced technology, superior weapons systems, and proven
    doctrine won't produce effective organizations absent quality men and
    women. These decisions also balance our efforts by addressing the
    fights we are in and most likely to encounter again without sacrificing
    conventional capability. That balance helps to check programs that have
    exceeded their original design, improve efficiency, and steward the
    resources taxpayers provide us for the common defense. The holistic
    changes we are making work in combination with one another and span the
    joint force. I am confident that they not only preserve our war
    fighting edge but also inject the flexibility required to address
    today's most relevant challenges.
        An area of particular interest is energy--which is essential to
    military operations. Our in-theater fuel demand has the potential to
    constrain our operational flexibility and increase the vulnerability of
    our forces. Thus your Armed Forces continue to seek innovative ways to
    enhance operational effectiveness by reducing total force energy
    demands. We are also looking to improve energy security by
    institutionalizing energy considerations in our business processes,
    establishing energy efficiency and sustainability metrics, and
    increasing the availability of alternative sources.
        The ongoing revitalization of the joint force makes our
    conventional deterrent more credible, which helps prevent future wars
    while winning the wars we are now fighting. Restoring our forces is an
    investment in security--one which is hard in tough economic times--but
    one that is required in an exceedingly uncertain and complex security
    environment. Understanding that environment and having forces capable
    of the full range of military operations is central to balancing global
    strategic risk.
                        balancing global strategic risk
        My third priority of balancing global strategic risk is aimed at
    the core functions of our military--to protect the homeland, deter
    conflict, and be prepared to defeat enemies. Each function is tied to
    today's conflicts and each requires continuous attention. Successful
    campaigns in Iraq and Afghanistan and improved partnership with
    Pakistan will take us far in the fight against al-Qaeda, although the
    network has spread tentacles across Asia, Africa, and Europe that we
    will continue to attack. These campaigns have two functions: first,
    deterring future conflict, and second, staying prepared by building
    networks of capable partners who help us see conflict brewing and are
    ready to stand with us if prevention fails. These functions help to
    protect and secure the global commons: sea, air, space, and cyberspace.
    Increasingly, we are encountering more security challenges to these
    nodes and networks of global commerce. In cyberspace, we are continuing
    proactive steps to pursue effective organizational constructs and to
    reshape attitudes, roles, and responsibilities; we must increasingly
    see our information systems as war fighting tools equal in necessity to
    tanks, aircraft, ships, and other weapon systems. The Nation must work
    to increase the security of all vital government and commercial
    internet domains and improve coordination between all U.S. Government
    agencies and appropriate private sectors. One related step in
    strengthening the military's operations in the commons that I continue
    to support is the United States' accession to the Law of the Sea
    Convention. This Convention provides a stable legal regime by
    reaffirming the sovereign immunity of our warships, preserving the
    right to conduct military activities in exclusive economic zones,
    ensuring unimpeded transit passage through international straits, and
    providing a framework to counter excessive claims of other States.
        We must be sized, shaped, and postured globally to detect, deter,
    and confront the threats of the future. At the same time we must
    leverage the opportunities for international cooperation while building
    the capacity of partners for stability. These capacity building efforts
    are investments, with small amounts of manpower and resources, which
    can, over time, reduce the need to commit U.S. forces. I recognize, as
    do the Combatant Commanders, that our ability to do so is constrained
    by ongoing operations, but that does not make building partner capacity
    any less important. We can magnify the peaceful effects we seek by
    helping emerging powers become constructive actors in the international
    system. Fostering closer international cooperation, particularly in
    today's distressed economic climate, is one method of preventing
    nations from turning inward or spiraling into conflict and disorder.
        The wars we are fighting limit our capacity to respond to future
    contingencies and preclude robust global partnership building programs.
    While necessary, our focus on the current mission also offers potential
    adversaries, both state and non-State, incentives to act. We must not
    allow today's technological and organizational arrangements to impede
    our preparation for tomorrow's challenges, which include irregular,
    traditional and cyber warfare. In cyberspace, one often overlooked
    challenge is the need for military forces to maintain access to and
    freedom of action in this global domain. Our command and control and
    most sensitive information are constantly threatened by intrusion,
    interruption, and exploitation efforts. We must understand these risks
    in the context of the combined arms fight and carefully weigh their
    effects on our national security and global missions. This is true for
    the military as well as our Nation's public and private sector
    cyberspace. In all, we continue to mitigate the risk we face in the
    ability to respond rapidly to other contingencies through a variety of
    measures. Restoring balance to our forces, however, remains the
    principal mitigation necessary for the long-term.
        Enduring alliances and partnerships extend our reach. In each
    relationship we remain wedded to this Nation's principles which respect
    human rights and adhere to the rule of law. The 28-nation North
    Atlantic Treaty Organization, designed for a far different mission
    decades ago, has proven adaptive to the times and now leads the
    security and stability mission in Afghanistan. Australia, New Zealand,
    South Korea, and Japan have made key contributions to operations in
    Afghanistan and Iraq. India has emerged as an increasingly important
    strategic partner. We seek to mature this partnership and address
    common security challenges globally as well as within the region.
    Singapore, Indonesia, Australia, New Zealand, and the Philippines
    continue to work with us to counter international terrorist threats in
    Southeast Asia while Thailand remains a significant partner in
    supporting humanitarian assistance and disaster response in South and
    Southeast Asia. The Trans-Sahara Counterterrorism Partnership has
    worked to counter transnational terrorist threats in north and west
    Africa, and cooperative efforts with the Gulf of Guinea nations has
    generated improvements in maritime security against piracy, illegal
    trafficking, and overfishing off Africa's west coast. Multinational
    efforts in the Gulf of Aden are helping stem the unwanted scourge of
    piracy emanating from Somalia, though much work remains to be done.
    Colombia continues a successful counterinsurgency campaign in the
    Andean Ridge that reflects the patient, steady partnership between our
    nations, and we are particularly grateful for the Colombian Armed
    Forces' impressive rescue of three Americans held in FARC captivity
    last July. Military-to-military relationships with Mexico and Canada
    help to improve homeland security. In the coming year, in coordination
    with the Department of Homeland Security, we will work to improve
    cooperation with Mexico via training, resources, and intelligence
    sharing as Mexico takes on increased drug-related violence. The
    examples above represent far broader efforts and partially illuminate
    how enhancing teamwork with allies and partners helps to protect our
    shared interests. The interdependency of nations should not be allowed
    to unravel under economic duress, and these security focused programs
    are one way of reinforcing beneficial ties that bind.
        We also seek to further cooperation with States not in our formal
    alliances. We have established relationships with the nations in the
    Caucasus and Central Asia to build a transportation network in support
    of our efforts in Afghanistan. We recognize the key role Russia plays
    and are encouraged by Russian assistance with this project. There is
    more we can do together to bring peace and security to the people of
    Afghanistan. At the same time, we are troubled by the Russian-Georgian
    conflict last August and while we acknowledge Russia's security
    concerns, its actions created a more difficult international situation
    and damaged its relationship with NATO and the United States. We look
    forward to resuming military-to-military engagement, as part of our
    broader relationship, in a manner that builds confidence, enhances
    transparency, and rights the path towards cooperation.
        We likewise seek to continue improved relations with China, which
    is each year becoming a more important trading partner of the United
    States. We acknowledge the positive trends in our bilateral relations
    with China even as we maintain our capabilities to meet commitments in
    the region, given the security and stability that credible U.S. power
    has promoted in the western Pacific for over 60 years. We seek common
    understanding on issues of mutual concern but must recognize China's
    unmistakable and growing strength in technological, naval, and air
    capabilities, and this growth's effect on China's neighbors. While we
    are concerned over events such as the confrontation between U.S.N.S.
    Impeccable and Chinese vessels, we support China's growing role as a
    regional and global partner. I believe both governments can synchronize
    common interests in the Pacific. Key among these interests are
    continued joint efforts aimed at reducing the chance of conflict on the
    Korean peninsula and the return of North Korea to the Six Party Talks.
    This is particularly true given North Korea's recent nuclear test and
    continued testing of intercontinental ballistic missiles in the face of
    United Nations Security Council Resolutions demanding that it halt
    nuclear tests or launch of ballistic missiles.
        Rebalancing strategic risk also means addressing capability gaps.
    Our Nation's cyber vulnerabilities could have devastating ramifications
    to our national security interests. Interruption of access to
    cyberspace, whether in the public or private sectors, has the potential
    to substantively damage national security. We cannot conduct effective
    military operations without freedom of action in cyberspace. Addressing
    this threat, the President's budget for fiscal year 2010 includes funds
    to reduce cyber vulnerabilities and to close some of the operational
    and policy seams between military, government, and commercial Internet
    domains. Likewise, and related to maintaining a secure global
    information grid, freedom of action in Space remains vital to our
    economic, civil, and military well-being. We need to ensure access to
    cyberspace and Space as surely as we must have access to the sea and
    air lanes of the global commons. We must also balance the needs of the
    Combatant Commanders in Intelligence Surveillance and Reconnaissance
    sensors and processing infrastructure that are proving ever more
    crucial in missions that span the globe.
        Fighting and winning wars will always be the military's most
    visible mission. Preventing wars through deterrence, however, is
    preferable. In our strategic deterrence mission, deterring nuclear
    threats is most crucial. Our Nation remains engaged in many vital
    efforts to counter nuclear proliferation and reduce global stockpiles
    through international agreements and support activities. Still, many
    States and non-State actors have or actively seek these weapons. To
    preserve a credible deterrent we will need safe, secure, and reliable
    nuclear weapons, an effective infrastructure to sustain that
    enterprise, and skilled people to support it. In addition, as our
    strategic deterrence calculus expands to address new and varied
    threats, proven missile defense capabilities will remain essential as
    tools to deter, dissuade and assure in an environment of WMD and
    ballistic missile proliferation.
                             persistent engagement
        Our vital national interests call for a wise, long-term investment
    in global persistent engagement. For military forces, persistent
    engagement requires successfully conducting ongoing stability
    operations and building capacity with allies and partners. These
    efforts range from advising defense ministries to training host nation
    forces to conducting joint exercises to sharing intelligence to
    exchanging professional students. Over time, such actions help to
    provide the basic level of security from which economic development,
    representative political institutions, and diplomatic initiatives can
    take permanent root. Persistent engagement demonstrates enduring U.S.
    commitment, though, importantly, this commitment must be tempered with
    humility and a realistic assessment of the limits of our influence. The
    goal is always to empower partners, who are ultimately the only ones
    who can achieve lasting results.
        During my travels, I've developed a more comprehensive appreciation
    of the value that personal relationships, fostered over time, bring to
    our security endeavors. At the senior level, these relationships
    provide insight and alert us to signals we might have otherwise missed,
    as such, providing us warning of conflict which can then be used to
    head off a brewing storm in some cases. These relationships should not
    be limited to just senior leaders. Rather, they should be developed
    throughout the careers of our officers and their partner nation
    colleagues. Such sustained cooperation builds a network of military-to-
    military contacts that ultimately provides avenues to defuse crises,
    assure access, institutionalize cooperation, and address common
    threats.
        As I noted in particular with Pakistan, the criticality of ``mil-
    to-mil'' exchanges, combined exercises, schoolhouse visits,
    professional education collaboration, and many other programs are all
    part of the robust outreach we require. In particular, I ask that the
    Congress fully fund the Department of State's Foreign Military
    Financing (FMF) and International Military Education and Training
    (IMET) programs and Global Train and Equip Programs, which the
    Departments of State and Defense jointly manage. While many militaries
    around the world clamor to train with us, we reap far more than the
    costs of these programs in terms of personal, sustained relationships.
    These relationships help us bridge difficult political situations by
    tapping into trust developed over the course of years. I cannot
    overemphasize the importance of these programs. They require only small
    amounts of funding and time for long term return on investment that
    broadly benefits the United States.
        I endorse a similar approach for and with our interagency partners,
    and I fully support the building of a Civilian Response Corps.
    Achieving the objectives of any campaign requires increased emphasis
    not only on fully developing and resourcing the capacity of other U.S.
    agencies (State, USAID, Agriculture, Treasury, and Commerce and so
    forth), but also on increasing our Nation's ability to build similar
    interagency capacities with foreign partners.
                                   conclusion
        In providing my best military advice over the past 18 months, one
    important point I have made, consonant with Secretary Gates, is that
    our military activities must support rather than lead our Nation's
    foreign policy. Our war fighting ability will never be in doubt. But we
    have learned from the past 7 years of war that we serve this Nation
    best when we are part of a comprehensive, integrated approach that
    employs all elements of power to achieve the policy goals set by our
    civilian leaders. To this end, I believe we should fully fund the State
    Department as the lead agent of U.S. diplomacy and development, an
    action that would undoubtedly resonate globally. This approach
    obviously requires the backing of a robust military and a strong
    economy. As we win the wars we are fighting and restore the health of
    our Armed Forces, the military's approach will increasingly support our
    diplomatic counterparts through the persistent engagement required to
    build networks of capable partners. By operating globally, hand-in-hand
    with partners and integrated with the interagency and non-governmental
    organizations, we will more successfully protect the citizens of this
    Nation.
        On behalf of our service members, I would like to thank Congress
    for the sustained investment in them and for your unwavering support in
    time of war.

                               ACQUISITION REFORM

        Chairman Inouye. Mr. Under Secretary?
        If I may now begin my questioning. Mr. Secretary, our
    troops entered Afghanistan in 2001 and our troops entered Iraq
    in 2003 and we soon learned that it wasn't what we expected and
    in some ways we weren't quite prepared. So we rapidly developed
    platforms like the MRAP and the anti-improvised explosive
    device (IED) mines. Now, why was it necessary to go outside the
    regular DOD acquisition process to get these things? And how
    can we institutionalize these activities instead of continually
    adding layers of new bureaucracy?
        Secretary Gates. We've had to go outside the regular
    bureaucracy, I think, in four major areas, one before I became
    Secretary and three subsequently. The first, that was formed
    before I became Secretary, was the effort to counter the IEDs,
    as you suggest. The subsequent ones have been for dealing with
    wounded warriors, for building the MRAPs, and for greater
    intelligence, surveillance and reconnaissance needs.
        The problem is that there were too few people that came to
    work in the Pentagon every day asking, what can I do today to
    help our warfighters succeed and come home safely. So we needed
    to go outside the regular procurement processes, because
    frankly without the top-down direction from the Secretary of
    Defense these efforts would not have been successful.
        In the case of the MRAPs, it required using a number of
    authorities provided by law only to the Secretary of Defense in
    terms of acquisition of materials and priorities and so on. But
    in other cases the solution was across multiple services and
    outside the normal bureaucratic structure.
        I believe that the services are changing the way they do
    business. For example, the Air Force just in the last year or
    so under General Schwartz's leadership has taken on board the
    significance of the ISR challenge and the need to have
    significantly larger numbers of pilots who can pilot, who can
    run these UAVs and so on. So the services I think are beginning
    to embrace the needs of the current warfighter and provide for
    them.
        Frankly, the reason for my putting a number of these things
    into the base budget is because that's where the services draw
    the resources to be able to go ahead and pursue these programs.
    For example, the ISR Task Force, my anticipation is that it
    will disappear, and one of the challenges that I've had is
    keeping it focused on what can we do in the next 2 or 3 months
    to help get more ISR capabilities into the field. The natural
    bureaucratic propensity has been to try and squeeze, because
    I'm paying attention to that task force, to try and squeeze all
    kinds of new long-term programs that'll take years and so on
    into it. So we've had to be very disciplined about keeping it
    focused on the near term while the longer term issues are taken
    care of in the regular bureaucracy.
        But I'm satisfied enough with the progress that the Air
    Force and the Army are making in the ISR area that I believe
    this task force can go away. The truth of the matter is, in the
    case of the MRAPs, had it not been for the generosity of the
    Congress and the American people, we never could have built the
    MRAPs. As you suggest, Mr. Chairman, we built and deployed some
    16,000 of these. We are now developing a new kind of MRAP for
    Afghanistan. But the total cost of that program to date has
    been about $26 billion. If we had tried to carve $26 billion
    out of the current Pentagon budget, there would have been a
    real blood-letting. So the only way we were able to do the
    MRAPs was through the special funding from the Congress.
        What I am trying to do is to bring about a change in the
    culture of the Pentagon so we can, as I described it in another
    hearing, walk and chew gum at the same time, so that we can
    energetically and with a sense of urgency deal with the wars we
    are in and at the same time plan for the future wars, which, as
    you rightfully suggested, we have to be prepared to fight.
        Chairman Inouye. Thank you.
        Admiral Mullen, many have described the acquisition process
    in DOD to be cumbersome and inflexible because we tend to seek
    the perfect solution. It takes many years to do this. But for
    the wars in Iraq and Afghanistan, we, as the Secretary pointed
    out, we have expedited the process, maybe not seeking 100
    percent, but going for 75. My question to you as a leader of
    troops: Do you believe that we are meeting the needs of
    warfighters?
        Admiral Mullen. Yes, sir. If I were to use the task force
    analogy just briefly, because I've been in this building, in
    and out, but in certainly in the last decade or so for a long
    time, I just think it takes the kind of leadership focus that
    has been offered in those to create the sense of urgency, to
    constantly update the guidance so the system does not take off
    by itself.
        It is really in those areas that the Secretary and you have
    talked--in addition, the equipment, the personal equipment for
    our warfighters, which all of us have taken a great interest
    in, and service chiefs certainly lead that as well. So from an
    equipment standpoint, absolutely. That doesn't mean that we
    won't continue to advance in some of these areas, because we
    still need more capability in terms of capacity. ISR would be a
    great example.
        I also, having participated in this acquisition for a long
    period of time, think we don't move swiftly, with the sense of
    urgency and the speed, and we do look too far out to meet the
    current needs. I've seen the kind of focus that these task
    forces have created and the leadership that's on top of them be
    able to do that. I just don't believe our system could have
    done that.
        I do think they need to at some point in time sunset, have
    a sunset clause, set the criteria out there to be absorbed in
    the system. As the Secretary has indicated, that's the case for
    the ISR Task Force.
        So I am confident we have the equipment we need. We also
    need to stay focused as the enemy changes to ensure that we
    stay ahead of the enemy as he changes his tactics.
        Secretary Gates. Mr. Chairman, let me add one more example
    of, frankly, where we, the Chairman and I, have to fight the
    inertia of the Department on a daily basis. One of the things
    that we've been trying to do this spring--this goes to Senator
    Leahy's point about his troops going to Afghanistan--is drive
    the medevac time, the time required for medevac, from 2 hours
    down to the same golden hour that exists in Iraq.
        We've made some substantial headway in this. We're now on
    average at about 68 minutes and many are much faster. I sent a
    number of additional resources forward from the Air Force and
    the Army earlier this spring, including three additional field
    hospitals. But the sad reality is that without the Chairman and
    I paying attention to this almost daily, getting it done and
    getting it done in a timely manner is just a real challenge.

                                BUDGET RATIONALE

        So at the end of the day I'm not sure that there is a
    permanent bureaucratic fix, but what it does take is the focus
    of the leadership on what's important. And that priority in my
    view, when we are at war is taking care of those who are at
    war.
        Chairman Inouye. Mr. Secretary, you suggested about 10
    percent of this budget will be for irregular warfare, about 50
    percent for conventional, strategic, traditional warfare, and
    40 percent for dual use. How did you divide it up in that
    fashion?
        Secretary Gates. Well, actually those numbers came after
    the fact, Mr. Chairman. I made the decisions on each of the
    program areas independently and in the context of each other
    from a strategic standpoint and capabilities standpoint. It was
    only after I had made all the decisions that, frankly, the guys
    who manage the money told me that that was about how the
    breakout of the percentages worked. So it basically was a
    recognition of a reality that was formed by the decisions that
    had already been made. I didn't go into it with the goal of
    shifting x dollars.
        Chairman Inouye. Thank you.
        Senator Cochran.
        Senator Cochran. Mr. Chairman.

                                 MRAP VEHICLES

        I appreciate your mentioning the MRAP vehicles, the
    vehicles that have been used in Afghanistan. I wonder about
    whether the budget requests funding for the new all-terrain
    vehicle (ATV) as well, the M-ATV as it's now referred to. Will
    that be useful in Afghanistan or do you foresee other uses of
    those vehicles besides in our efforts to deal with the
    challenges in Afghanistan?
        Secretary Gates. They're primarily being designed for use
    in Afghanistan, where the extraordinary weight of the regular
    MRAPs we've designed for Iraq sometimes limits their usefulness
    off road. So what we have done in the all-terrain MRAP is to
    try and provide essentially the same level of protection, but
    with a different design that will give it more capability off
    road. There is money in the budget, both in the overseas
    contingency operation funds and also in the base budget, that
    will fund most of the requirement for the all-terrain vehicles.
    The requirement has been growing since we submitted the budget,
    and so I don't think that there's enough money in the budget to
    buy all of those needed to meet the requirement, but a
    substantial number. In fact, Mr. Hale can give you the exact
    numbers.
        Mr. Hale. We have 1,000 MRAP ATVs in the 2009 remaining
    supplemental and 1,080 in the fiscal 2010 OCOA. I believe
    Congress is adding some to the fiscal 2009 supplemental.
        Senator Cochran. In connection with ship requirements,
    we've noticed the increase in the amphibious ship fleet needs
    that go beyond traditional military missions. The tsunamis, the
    hurricanes in the Gulf of Mexico, led the military to
    contribute ships, some aircraft carrier capabilities, for
    humanitarian relief and providing food and medical supplies to
    these areas that were hard-hit.
        Do you see a continuing need for shipbuilding in the
    amphibious area because of the willingness to use those vessels
    for nontraditional missions?

                                  NAVAL ISSUES

        Secretary Gates. This is one of the issues where I did not
    make any significant decisions, because I didn't feel that I
    had the analytical basis to do so. So one of the subjects that
    the Quadrennial Defense Review is addressing is the role of
    amphibious capability going forward, and not whether we need
    it, but how much we need. So that will be one of the areas of
    the QDR where I will be looking for some analytical guidance.
        But it's clear that those capabilities range far beyond the
    kind of armed intrusiveness or the armed intervention that was
    the original design purpose.

                                MISSILE DEFENSE

        Senator Cochran. The activity we've noticed with concern in
    North Korea in the recent short-range missile testing has led
    to concerns about whether or not we are moving fast enough with
    a ground-based interceptor production line. What is the
    impression that you have about the request in this budget as it
    relates to our capacity to defend ourselves against what looks
    to be an emerging and a continuing threat from North Korea and
    maybe others?
        Secretary Gates. The ground-based interceptors in Alaska
    and California clearly are an important element of defense
    against rogue state launches, and I would say in particular
    North Korea. I think the judgment and the advice that I got was
    that the 30 silos that we have now or are under construction
    are fully adequate to protect us against the North Korean
    threat for a number of years.
        Now, the reality is that if that threat were to begin to
    develop more quickly than anybody anticipates or in a way that
    people haven't anticipated, where the 30 interceptors would not
    look like they were sufficient, it would be very easy to resume
    this program and expand the number of silos.
        I was just in Fort Greeley last week and it's an immensely
    capable system, and one of the things that I think is important
    to remember is it is still a developmental system. It has real
    capabilities and I have confidence that if North Korea launched
    a long-range missile in the direction of the United States that
    we would have a high probability of being able to defend
    ourselves against it.
        But one of the things this budget does is robustly fund
    further development and testing of the interceptors at Fort
    Greeley and at Vandenberg, so that as new interceptors with new
    capabilities and that are more sophisticated are developed we
    will put those into the silos and take the old interceptors
    out. So the idea is this is not just a static system up in Fort
    Greeley, but something that is undergoing continuing
    improvement. If the circumstances should change in a way that
    leads people to believe that we need more interceptors than the
    30, then there's plenty of room at Fort Greeley to expand.
        Senator Cochran. Well, we thank you and Admiral Mullen and
    the Department and the soldiers and sailors who carry out your
    decisions well and continued success as we protect our Nation.
        Thank you.
        Chairman Inouye. Thank you very much.
        Senator Leahy.
        Senator Leahy. Thank you, Mr. Chairman.

                                    MRAP ATV

        Secretary Gates, I was going to ask some questions about
    the MRAP ATV, but Senator Cochran and others have. Chairman
    Inouye has been very helpful on funding on that critical
    program.
        Mr. Hale, you had mentioned the money for it. In the 2009
    supplemental budget, we doubled it here in the Senate. We're
    now in negotiations with the other body of that. I have a
    particular interest in this. Everybody I've talked with when I
    was in Afghanistan told me how much they need this for the same
    reasons that the Secretary described. I heard from the
    commanding generals to the coalition forces and others.
        You know this terrain probably far better than I, but you
    just look at the terrain--coming from a rural mountainous area
    myself, I can easily understand why the MRAPs, as great as they
    are, with their weight, when they go off road, they're just
    going to tip over. So I hope it will happen.

                                  AFGHANISTAN

        Incidentally, when we were there we visited the Kabul
    Military Training Center, Senator Whitehouse, Senator Warner--
    at that sprawling former Soviet base, where the Afghan National
    Army go through a kind of basic training. I went to the
    training courses and saw what they do. The extraordinary high
    rate of illiteracy among the recruits there has to be a cause
    of concern. I saw so many of the training things where they
    were written in their language, but also almost like a comic
    book showing diagrams of people doing things.
        Then I read the article, which I'm sure you've seen, the
    C.J. Chivers article from the New York Times about the
    failures, especially in the police force, in the training of
    the police force, and then in the military and on patrol. One
    of the things that struck me is when one Afghan insulted the
    other and they started into a fistfight in the middle of
    patrol, when you're out in an area where you have to depend on
    everybody being on their highest level.
        That's on the bad side. On the good side, I heard from so
    many there how they don't see us as occupiers; they see us as
    people trying to help. They see a country, unlike some of its
    neighbors, a country probably with the potential of pulling
    this out, with our help. Our help means a lot of money and,
    unfortunately, a lot of casualties.
        How do you feel? Are we going to have a cohesive, trained
    Afghan National Army and police force? Because I don't see how
    we leave until there is one. I mean, you just look at this all
    the time, Mr. Secretary.
        Secretary Gates. Let me start and then ask Admiral Mullen
    to add in. I think our commanders are very optimistic about
    particularly the Afghan National Army. It is I think at this
    point perhaps the strongest national institution that exists in
    Afghanistan, and we are on a path to increase the size from
    about 82,000 to 134,000.
        I think a lot of the problems with the police are being
    addressed. Part of that problem is the lack of sufficient
    trainers, and part of the added forces that we're sending in
    will in fact be for training the police. We have a program
    where we're going back into districts, pulling the police force
    out, retraining them, giving them new equipment, and then
    putting them back in with police mentors. The experience with
    that program so far has been encouraging. It's still pretty
    small scale and it needs to be expanded and accelerated, and I
    hope that the addition of our trainers will be able to do that.
        But there's no question but that our ticket out of
    Afghanistan is the ability of the Afghans to maintain their own
    security. I think our commanders feel that we're on the right
    track.
        But let me ask Admiral Mullen.
        Admiral Mullen. I would only echo that, Senator Leahy, from
    the point of view that these are warriors. They are a warrior
    nation and they have been in many cases at war over the last 30
    years. We share the concern about illiteracy. That said, in my
    many visits this kind of issue has never routinely raised its
    head as something that we can't take into account and move
    forward with.
        Senator Leahy. Would you agree that there is a significant
    difference between the police and the Army.
        Admiral Mullen. Yes, sir, actually not unlike Iraq. In Iraq
    the army came quicker. It's the same thing in Afghanistan.
        Senator Leahy. But the average person is going to see the
    police before they're going to see the army in many, many
    instances in their day to day life.
        Admiral Mullen. Yes, sir.
        Senator Leahy. And if they see bribery and corruption and
    all that, that's the face of the government. I mean, it's the
    same in our country. The difference is that we've evolved so
    most of our police forces are extraordinarily well trained.
        Do you feel confident we can turn that around?
        Admiral Mullen. Yes, sir. I think it's actually Minister of
    Interior Otmar, and I don't know if you met him.
        Senator Leahy. I did.
        Admiral Mullen. He's a very impressive guy. He understands
    the problems he has and he's addressing them. It's going to
    take some time.
        This program the Secretary mentioned, which is this focused
    district development, where they go off to school for 8 or 9
    weeks and then return with mentors, is another significant step
    in the right direction. But it's going to take time, and the
    police are not going to come as fast as the army is. But it is
    the way out.
        Senator Leahy. And if your staff could keep me posted, both
    of you, on how that's going, because I'm one who wants to see
    it work, and I know a number of our Vermonters are going to be
    involved in helping to train. I think the potential is there. I
    think it's a real uphill battle.
        Thank you.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Thank you, Mr. Chairman.

                   AIR FORCE/ARMY AIRCRAFT ACQUISITION ISSUES

        Secretary Gates, I believe that we must have a fair, open,
    and honest Air Force tanker acquisition process that ensures
    that our men and women in uniform receive the best possible
    aircraft. It's also my belief that the upcoming request for
    proposals should utilize the best value process so that we're
    procuring the most capable tanker for our warfighters.
        We've talked about this earlier this year and it's my
    understanding that you stated that you believe the process
    should be fair, open, transparent. With regard to the process,
    who will be the acquisition authority for the upcoming tanker
    competition? Would it be the Office of the Secretary of Defense
    or the Air Force? Also, do you believe that the draft RFP will
    be released this month?
        Secretary Gates. I don't know that it will be released this
    month, and I'm in the process, the final decision process in
    terms of the acquisition authority and the structure we're
    going to put into place to ensure that it is a fair, open, and
    transparent process.
        I would expect to make the decision on the acquisition
    process within the next week or 10 days. All I have heard is
    that their hope is to put the RFP out this summer, perhaps next
    month. I'm not entirely sure about that. And we will fulfill
    the commitment that we have made to you to share the draft RFP
    here in the Congress as part of being a transparent process.
        Senator Shelby. Mr. Secretary, shifting to Army aviation,
    your proposed budget calls for an additional $500 million over
    last year's funding level to field and sustain helicopters. As
    stated in your testimony, this is an urgent demand in
    Afghanistan right now, and I support this initiative.
        I understand you've indicated the focus will be on
    recruiting and training more Army helicopter crews. Could you
    provide additional details regarding how this money would be
    spent, either now or for the record?
        Secretary Gates. I'd be pleased to do that for the record.
        [The information follows:]

        As you noted, we have an urgent need to train more
    helicopter pilots and crews. The budget request includes
    procurement to buy additional helicopters and expand operation
    and maintenance for the training. More specifically, as the
    Army developed their fiscal year 2010 budget they planned for
    an increase of $70 million for 22 light utility helicopters
    above the quantities approved for fiscal year 2009. During the
    final review of the budget, we increased the Army's aircraft
    account for the UH-60 by $156 million to bring the total
    quantity to 95 or an increase of 26 airframes above the fiscal
    year 2009 level. I am satisfied that this provides for a
    balanced increase in these various airframes.
        To meet the near-term demand for more trained pilots and
    crews, we also increased funding by $276 million for aviation
    training at Fort Rucker. This level of funding allows the Army
    to support the goal of increasing pilot throughput to 1,375 per
    year in fiscal year 2010.

        Senator Shelby. Okay.
        Secretary Gates. But let me just say that, having visited
    Fort Rucker, it's clear that the schoolhouse needs to be
    expanded and modernized.
        Senator Shelby. Thank you.

                               NAVAL SHIP ISSUES

        Admiral Mullen, the LCS, littoral combat ships. The
    Department's 2010 budget provides an increase in purchase in
    the littoral combat ship from two to three ships. Do you
    believe that this program will play a vital role in our Navy's
    future fleet, and could you tell us here the advantages that
    the Navy will gain once the service begins to utilize the LCS
    around the world?
        Admiral Mullen. I need LCS at sea deployed today. The
    urgency of that requirement has been there for a number of
    years, which is why we started this program, and that urgency
    hasn't gone away. I'll be very specific about its need in
    places like the Persian Gulf. It offers unique characteristics
    in terms of speed and mobility.
        Senator Shelby. Also firepower.
        Admiral Mullen. And firepower. It certainly provides--back
    to helicopters, if I'm short one thing sort of across the
    Department, helicopter qualifies for being at the top.
        The LCS also has a small crew. It has flexibility in its
    mission. It has the modules, depending on where you're going to
    apply it, where you're going to deploy it, whether it's mine
    warfare or anti-submarine warfare or surface warfare.
        So it's a very adaptable platform. I need them out and I
    need them in numbers as rapidly as we can get them out.
        Senator Shelby. You need them now, too, if you can.
        Admiral Mullen. Yes, sir.
        Senator Shelby. Thank you, Admiral.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Feinstein.

                            INTELLIGENCE/SATELLITES

        Senator Feinstein. Thank you very much, Mr. Chairman.
        Mr. Secretary, I'd like to put on my Intelligence hat for a
    minute. I note Senator Bond has come back. Without getting into
    details or classified matters, I wanted to ask you about the
    overhead architecture program. I think it's fair to say that
    both sides of the aisle on the Intelligence Committee are very
    concerned about matters dealing with this program, particularly
    the huge investment in electrical-optical satellites.
        Senator Bond mentioned your statement that you would not
    necessarily favor a 99 percent solution, but a lesser solution.
    So my question is, can the Department's imagery needs be met
    with a larger number of lower resolution systems?
        Secretary Gates. I have agreed with Admiral Blair on the
    architecture that is before you and before this subcommittee. I
    would say first of all that I think that the primary need for
    the very high resolution of the upper tier of capabilities is
    needed above all by the intelligence community. We have had
    those kinds of satellites--obviously, the new ones are much
    more sophisticated than when I was last in the intelligence
    business. But we have always needed that kind of resolution and
    multimission capability.
        My view, the reason that I supported going with the lower
    tier satellites, frankly is because there is some schedule and
    technology risk associated with the upper tier. I felt very
    strongly about having a capability that was proven technology
    and that we would have high confidence would work and meet,
    with the upper tier, the needs of the military.
        I would have to get back to you for the record in terms of
    what military needs are satisfied by the higher resolution
    capability.
        [The information follows:]

        Classified response was sent directly from the SECDEF's
    office to the subcommittee on August 11, 2009.

        Senator Feinstein. Well, if you would, I think both Senator
    Bond and I would appreciate it.
        We have extraordinarily serious concern involving the waste
    of many, many dollars over a period of years and are rather
    determined that that not happen again. We also have information
    that the so-called lesser tiered satellites can be just as
    effective and have a stealth capability. So if you would get
    back to us on that point, we hope to sit down with Senator
    Inouye and Senator Cochran and our staff and talk very
    seriously on this issue, because you know, to make a mistake
    once or twice is all right, but to continue that mistake
    doesn't make sense, I think, to the vice chairman or to myself
    or to other members of the subcommittee or to our technical
    advisory group who has looked at this as well.
        So if you would, I would appreciate it very much.

                                      IRAN

        Let me move on to another thing. There has been a lot of
    discussion in the public press about the possibility of Israel
    attacking Iran. I think we asked you the last time you were
    before us: In the last year, do you believe that the chances of
    that happening have gone up or down?
        Secretary Gates. Well, I'd hesitate to speculate about the
    decisions of another government. But I would say that our
    concern about the nature of the Iran problem has continued to
    rise as they continue to make further progress in enriching
    uranium and particularly in their public statements and also as
    they have enjoyed some success in their missile field.
        So I would say that our concerns with Iran's programs--and
    I believe I can say also Israel's--has continued to grow, given
    the unwillingness of the Iranians to slow, stop, or even
    indicate a willingness to talk about their programs.
        Senator Feinstein. Thank you very much.

                            AFGHANISTAN TROOP LEVELS

        A final question if I may, Mr. Chairman. It's on the
    subject of Afghanistan. We have slipped into this very easily,
    very quickly. I believe there are about 68,000 men and women
    either due to Afghanistan or already there. Is that a correct
    figure?
        Secretary Gates. Yes, ma'am.
        Senator Feinstein. And you look back at 48 years of
    history, and let me just give you one quote from a recent
    Government Accountability Office report. It said: ``Some
    progress has occurred in areas such as economic growth,
    infrastructure development, and training of the Afghan national
    security forces. But the overall security situation in
    Afghanistan has not improved after more than 7 years of United
    States and international efforts.''
        I'm one that has deep concern as to how you turn this
    country around after 40 years into a much more secure area. I
    know you're making changes and maybe they work and maybe they
    don't work. I don't know. But could you share with us how you
    see this going, because this is a large commitment over a
    substantial unknown period of time, with no known benchmarks,
    no known exit strategy at this time, but just a continuation of
    beefing up troops and changing commanders.
        So if you could give us some idea of what benchmarks you
    would hold, how you would evaluate success, where you would
    look for it, and within what timeframe, I think it would be
    very helpful.
        Secretary Gates. Let me open and then ask Admiral Mullen to
    add his thoughts. First of all, I think that the
    administration's new strategy gives us some opportunities that
    we have not had before, and I think the strategy brings a focus
    to our efforts that we may not have had before.

                                  AFGHANISTAN

        The reality is the situation in Afghanistan went along okay
    after 2002 until about 2006, and it coincided to a considerable
    degree to--the beginning of greater Taliban activity in
    Afghanistan began as Pakistan began to do these peace
    agreements with various insurgent and extremist groups on their
    western border, which then freed the Taliban to come across the
    border because they had no pressure from the Pakistani army.
        That situation has continued to worsen, and it is a
    combination of the Taliban, which are the heart of the problem
    we face, but not the only piece of it--the Hakkani network, Al
    Qaeda, and Gulbaddin Hekmatyar and these others. So as this
    problem became worse in terms of the violence caused by the
    Taliban coming across the border from Pakistan, I think that
    it's self-evident that we were underresourced to deal with it.
    We did not have the military capabilities or the civilian
    capabilities in terms of counterinsurgency to be able to deal
    with it.
        I think under the administration's new strategy we'll have
    both the military and the civilian capacity to be able to make
    headway with the Afghans. I think the key here is the
    strengthening of the Afghan National Army and police that we
    talked about earlier. It is the strengthening of other
    institutions in Afghanistan.
        I think one of the things that's important to remember
    about Afghanistan is that we have 40 some other nations there
    as our allies. This is not just the United States carrying this
    by ourselves. Now, do we wish they had more troops? Do we wish
    they spent more money? Absolutely. But the fact is our allies
    have 32,000 troops in Afghanistan. This is not a trivial
    commitment on their part. As I think Senator Leahy pointed out,
    the Canadians, the British, the Australians, the Danes, and
    others have been in the fight and have lost a lot of people.
        So I think that the new strategy and now the newest
    development which gives me more hope than I've had in quite a
    while--the newest development of the Pakistani army taking on
    these extremists in Swat and elsewhere I think is an extremely
    important development, and the possibility of the Afghans, the
    Pakistanis, ourselves, and our allies together working against
    this problem has given me more optimism about the future than
    I've had in a long time in Afghanistan.
        I will say we have developed in the inter-agency benchmarks
    for success. I've pressed very hard for these because I said
    the last administration had benchmarks forced upon it; let's
    volunteer them. Let's say, here's what we think we need to
    achieve and here's how we can measure ourselves against this.
        My own view is it's very important for us to be able to
    show the American people that we are moving forward by the end
    of the year or a year from now, to show some shift in momentum.
    This is a long-term commitment, but I think the American people
    will be willing to sustain this endeavor if they believe it's
    not just a stalemate and that we're sacrificing lives and not
    making any headway. So I think the benchmarks are important and
    I think making an evaluation a year from now of where we are is
    important.
        The last point I'd make before turning it over to Admiral
    Mullen is I'm very sensitive about the number of troops we put
    into Afghanistan. I'm too familiar with the Soviets having had
    110,000 troops there and still losing. If you don't have the
    right strategy and if you don't have the Afghan people on your
    side, you will not win in Afghanistan because, as the Admiral
    said, they are a warrior nation.
        So I think that we have to be very cautious about
    significantly further expanding the American military footprint
    in Afghanistan, in my view.
        Admiral.
        Admiral Mullen. Ma'am, I'm encouraged there is a strategy
    and it's a regional strategy. It's not just Afghanistan or
    Pakistan, because I think they're inextricably linked and we've
    got to approach it in that, with that in mind.
        Second, I recognize that it has changed a lot since 2002
    and the resources we're putting in there now meet a need that
    we've had for some time. Our lessons learned from Iraq, the
    counterinsurgency force that we are, the civilian-military
    approach that we now have, obviously with Ambassador Holbrooke,
    who has focused this effort and does so full time--I believe we
    know what we need to do. I too am concerned about time and
    think that with these forces we're putting in there now we've
    got to reverse the trend of violence over the next 12 to 18
    months.
        I think it's possible. So I think we have the strategy
    right. We're resourcing it right. But I do not underestimate
    the difficulty of the challenge here, the benchmarks, not only
    in security, which are important, but also in governance and
    improvement in whether local tribal leaders, local district,
    sub-district leaders are providing for their people, and that
    we make the Afghan people the center of gravity here.
        We've been through some difficult times with civilian
    casualties. We can't keep doing that. The more we do that, the
    more we back up, and it hurts our strategy. So I am actually
    optimistic, more than I was, but I think the next 12 to 18
    months will really tell the tale.
        Secretary Gates. We heard two statistics on a
    teleconference, videoconference, with Kabul this morning from
    one of our commanders. They believe this year will be the first
    year in 30 years that Afghanistan will not need to import
    wheat, that the wheat crop is sufficiently robust that they
    won't need to import.
        And just as important, it's at basically price parity with
    poppies, and in some districts even higher value than poppies.
    So maybe I'm grasping at straws, but I thought that was pretty
    interesting.
        Senator Feinstein. It's a good one to grasp.
        Thank you very much.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Bond.
        Senator Bond. Thank you, Mr. Chairman.
        With respect to Afghanistan and Pakistan, I agree with what
    you've said. I believe the counterinsurgency strategy is
    important. I think we have to realize that, while our North
    Atlantic Treaty Organization (NATO) allies had many people over
    there, they very often didn't get into the fight. They were
    restrained in the compounds. They traveled around in armored
    tanks and went back home at night, and the Taliban works at
    night. We did not have an effective force.
        The Admiral has said we have to have an Afghan face. We've
    got to do that. The counterinsurgency strategy is essential. I
    know the commanders emergency response, the CERP funds, were
    used to buy wheat, at least in Nangahar Province, and that kind
    of rebuilding of agriculture I think is a critical key.
        But I would just ask you: Is it reasonable to expect the
    counterinsurgency to pacify the whole country in 12 or 18 or
    even 24 months? It seems to me we have to be realistic and we
    have to say, yes, we're seeing signs of progress. Nangahar
    Province for example is an area that I know about and poppy
    production has dropped almost to nothing. But still, does it
    not take some time to get the full benefits of the
    counterinsurgency strategy? Should we be looking at a slightly
    longer timeframe?
        Secretary Gates. Absolutely, Senator. What I was referring
    to and I think what Admiral Mullen was referring to is hoping
    to see a shift in the momentum over the course of the next year
    to 18 months. This problem will not be over in 18 months. This
    problem will not be over in 2 years. This is, let's be honest,
    a long-term commitment that we are involved in in Afghanistan
    if we are to ultimately be successful.
        I think what we are saying simply is that we think that the
    strategy needs to show some signs that it's working, not that
    it has been totally successful a year or 18 months from now.
        Senator Bond. I think you can cite Nangahar as one little
    province that's working. With the marines going into Helmand, I
    think that you'll see some changes there.
        I would mention, following up on what my good friend from
    California said, the kinds of overhead requirements you have. I
    was talking with Admiral Blair earlier this morning about
    intelligence needs in Afghanistan for the PRTs and others. He
    needed some overhead. That's the kind of thing that we think
    can very well be supplied in terms of military needs by the
    smaller, cheaper, more flexible alternatives that we would like
    to see with NGEO. We would welcome the opportunity to talk and
    we will look forward to talking with the chairman, the ranking
    member, and other members of the subcommittee in a classified
    setting about some of the problems and some of the
    opportunities.
        I hope that we will be able to continue to talk with you
    about that, because we feel very strongly about the overhead.

                              JOINT STRIKE FIGHTER

        I want to ask one other point. I agree with Admiral Mullen
    on so many things. At breakfast last week you said: ``We're all
    concerned about the industrial base. I have been for a period
    of time. The competition for who is going to build the Joint
    Strike Fighter (JSF) was done years ago, essentially moving
    down to one contractor, and that's where we are. What I worry
    about, you want as much competition for as long as you can.
    That said, we years ago got down to a minimum number of
    competitors. I'm concerned about how I do not have a lot of
    other choices about where to go to build. I think it's an
    important consideration. We need to pay attention to it.''
        I would agree with those statements and I think that
    maintaining the F/A-18 as a bridge, moving forward on the C-17,
    and the next generation bomber, which you, Mr. Secretary, you
    indicated you wish to pursue, are all parts of that strategy. I
    happen to think that, no matter who won the competition, giving
    the entire purchase was a tragic mistake on the tac air. I
    would like to hear your comments, both Secretary and Admiral,
    on the defense industrial base.
        Secretary Gates. Well, it is a concern and, frankly, the
    last time I was in Government in 1993 we had a lot of choices,
    and when we wanted to build satellites we had multiple choices
    as well. So I think that, with respect to the F/A-18, we have
    31 in the budget for fiscal year 2010. We will probably buy
    more in 2011. One of the subjects that the Quadrennial Defense
    Review is examining is the right balance for our tactical air,
    and I look forward to the conclusions of the QDR on that.

                                AIRCRAFT ISSUES

        Admiral Mullen. Senator Bond, it's a great airplane. It's
    actually at a great price. You've certainly dealt with the
    multiyear aspect of this. One of the reasons it is at a great
    price is because it has been under multiyear a number of times.
        That said, we're at a point in time where we're trying to
    figure out how long the program goes on, how many more years.
    That's really the analysis that's at the heart of this.
        As I said the other day, although I'm amazed you got
    absolutely every word I said very accurately----
        Senator Bond. My other business is intel.
        Admiral Mullen. And I do have a concern about the
    industrial base, in airplanes, in ships, in satellites. We
    dramatically brought the defense contractors together in the
    90s and that, by virtue of that, eliminated an awful lot of
    competition.
        So I don't have the answer with how we go ahead here,
    except I think we do have to pay attention to it over the long
    run and make some strategic decisions. I think the ``we'' there
    is the Department, the services, the industry itself, as well
    as here in Congress. It's that strategic relationship which I
    think is important, which says this is how much of America's
    industrial base we are going to make sure is in good shape for
    the future. The requirements of that obviously drive that
    continuation.
        As I said before and would only repeat, it was years ago
    this decision was made about the JSF and at that point in time
    it's my view we made a national decision to go down to,
    essentially to go down to one contractor for the future, and
    we're living with the results of that now.
        Senator Bond. I think that's a tragedy. I've made my point
    time and time again at these hearings year after year. I have
    an answer for you. If you ever want to call me some time, I'll
    be happy to share it with you. But I'm not the witness today,
    Mr. Secretary.
        Secretary Gates. You know, I used to be in intelligence and
    I think I know the answer.
        Senator Bond. I'll bet you do. We'll see if we can
    communicate by mental telepathy.
        But can we expect the study assessing the cost-benefits of
    an F/A-18 multiyear any time soon? I think it was requested in
    law to be delivered a couple of months ago.
        Secretary Gates. We can certainly provide a response,
    Senator. I think that what we are hoping to do is be able to
    give you a meaningful response after the QDR. If the decision,
    for example, were made to continue the F/A-18 line, then a
    multiyear contract would make all the sense in the world, for
    exactly the reasons you and Admiral Mullen have been talking
    about.
        We can provide you an interim response if you would like.
        Senator Bond. I just think that was required in law, and
    the QDR, I know everybody hypes it, but if it's just a
    justification of what you put in the budget--I hope there will
    be some thinking on that, broader thinking along the lines that
    maybe Admiral Mullen suggested and your intelligence suggests.
        So thank you, Mr. Chairman. I appreciate the opportunity.
        Chairman Inouye. Senator Specter.
        Senator Specter. Thank you, Mr. Chairman.

                                MISSILE DEFENSE

        Mr. Secretary, I was intrigued with one of the points you
    made in testifying before the Appropriations Committee on the
    war supplement, where you said that it would be useful in our
    dealings with Iran to have a missile defense that is aimed only
    at Iran, and that played into the relationship that we have
    with Russia; and it is generally recognized that if we're to be
    successful in dealing with Iran we're going to have to have
    cooperation of other countries, perhaps mostly Russia.
        We've talked before about the issue of having Russia enrich
    Iran's uranium, which Russia has offered to do and Iran has
    declined, as a way of being sure that Iran is not moving toward
    the use of enriched uranium for military purposes.
        A two-part question. No. 1: Is any progress being made on
    publicizing Russia's offer, which I think has gotten scant
    little attention, and the Iranian refusal really shows--raises
    the inference of potential bad faith? Second, where do we stand
    on efforts to pick up your suggestion that missile defense be
    aimed only at Iran and not at Russia, which has given so many
    political problems?
        Secretary Gates. First, I think that, although it's
    certainly not been a secret, it has not been I think widely
    enough publicized, Russia's offer and Iran's turn-down of it. I
    think equally not publicized was the fact that the United
    States indicated that we thought that was a pretty good idea
    and would be supportive.
        With respect to the missile defense, I still have hope that
    we can get the Russians to partner with us on missile defense
    directed against Iran.
        Senator Specter. Have we made that offer, suggesting that
    missile defense would not be aimed at Russia?
        Secretary Gates. Oh, yes. And I've made it myself to then-
    President Putin and I've made it to President Medvedev. We've
    made a number of offers in terms of how to partner, and I think
    there are still some opportunities, for example perhaps putting
    radars in Russia, having data exchange centers in Russia.
        So I think the administration is very interested in
    continuing to pursue this prospect with the Russians, and it
    may be that our chances are somewhat improved or making
    progress because I think the Russians--when I first met with
    President Putin and talked about this, he basically dismissed
    the idea that the Iranians would have a missile that would have
    the range to reach much of Western Europe and much of Russia
    before 2020 or so, and he showed me a map that his intelligence
    guys had prepared. And I told him he needed a new intelligence
    service.
        The fact of the matter is the Russians have come back to us
    and acknowledged that we were right in terms of the nearness of
    the Iranian missile threat. So my hope is--and that they had
    been wrong. So my hope is we can build on that and perhaps,
    perhaps at the President's summit meeting with President
    Medvedev, perhaps begin to make some steps where they will
    partner with us and Poland and the Czech Republic in going
    forward with missile defense in this third site.
        I would say, although I took the money out of the 2010
    budget for the third site, the reason I did that is because we
    have enough money in the budget from 2009 that would enable us
    to do anything in the way of construction necessary.
        Senator Specter. Mr. Chairman, how much time do I have
    remaining? There's no clock here.

                                     SYRIA

        I'm pleased to see the announcement of the joint military
    operations or sending military commanders to Syria. It appears
    to be part of a general change in U.S. policy which I believe
    is long overdue in trying to at least explore with Syria the
    possibilities of having them stop destabilizing Lebanon and
    stop supplying Hamas and moving toward negotiations, which have
    been brokered so long now by Turkey, with Israel.
        What do you say for the opportunities to improve
    relationships with Syria along those lines?
        Secretary Gates. Well, I guess my attitude would be that
    there's no harm in trying. The CENTCOM representatives who will
    be going to Syria--I think their mandate is focused on the
    security of the border between Syria and Iraq, and particularly
    to try and enlist Syria's support in stopping the foreign
    fighters from crossing that border into Iraq and attacking us
    and the Iraqis.
        Senator Specter. I have one more question. There may be
    good news in the offing with what is happening along a number
    of fronts. The election results in Lebanon with Hezbollah
    losing and the dominance of U.S.-backed interests is certainly
    encouraging. There's speculation that President Obama's speech
    in Cairo may have had some effect on that. The political
    campaign in Iran by all press accounts is about as much of a
    political brawl as you see, I'm about to pick south
    Philadelphia as an illustration.
        The question that is in my mind, I'm interested in your
    views as to whether the change in policy toward Lebanon and
    Syria and the speech that President Obama has made--is there
    any intelligence that that is having an impact on the
    forthcoming Iranian elections and whether it has had any impact
    on the elections in Lebanon?
        Secretary Gates. I have not seen any intelligence
    specifically relating to either Lebanon or Iran on that.
        Senator Specter. Thank you very much, Mr. Secretary.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Murray.
        Senator Murray. Thank you very much, Mr. Chairman.
        Secretary Gates and Admiral Mullen, thank you all for being
    here and for what you do for all of our men and women who serve
    this country. I really do appreciate it.
        I apologize for my voice. I was out in Seattle this week
    and it was warm weather and the allergy season went crazy.
    Secretary Gates, you're going to be out there, I believe, to
    speak to the University of Washington, so be prepared. But I
    apologize for my voice.

                                  ACQUISITION

        I understand I missed some questions from Senator Shelby on
    the tanker competition and your statement that you expected
    some kind of decision on how to move forward in the next 7 to
    10 days. I wanted to ask you, is that discussion going to
    include who will lead the process, whether it's you or the Air
    Force?
        Secretary Gates. The period 7 to 10 days was how we will
    structure the acquisition and who the acquisition authority
    will be. I'm in the process of making those decisions right
    now, but have not made final decisions. I don't know with
    specificity, but, as I told Senator Shelby, our hope is to
    probably try and get the RFP out mid-summer, and we will
    fulfill our commitment to bring the draft up for you to look
    at.
        Senator Murray. I really appreciate that.
        I just wanted to ask you if you're thinking about what kind
    of measures you're going to take to make sure that we don't
    have claims of unfair evaluation or the scales being tipped one
    way or the other as we move through this.
        Secretary Gates. Well, part of the process I'm going
    through right now is to try and structure this in a way that
    puts the best people on this program and that provides a
    supervisory role; and right now, tentatively thinking, I'm
    going to clearly ask the Deputy Secretary to take a very close
    interest in this process.
        Senator Murray. Clearly this is a real challenge. We all
    want the best aircraft at the end of the day. We all want fair
    and transparent competition. Everybody's saying that and I
    think that's clear. We all want the best for the warfighter. We
    also want what's best for the taxpayer as well.
        You have been a strong proponent of the winner-take-all
    competition. Is that still your opinion at this point?
        Secretary Gates. Yes, ma'am.
        Senator Murray. Thank you very much.

                               ACQUISITION REFORM

        Secretary Gates, let me ask you. You've referred to your
    budget as a reform budget, reforming how and what we buy. I'm
    really worried about how we are balancing this acquisition
    reform effort in relation to our domestic industrial base. I'm
    worried about the long-term ability of our domestic industrial
    base to provide our military forces what they need to
    accomplish their national security missions.
        Since we talked last April, I have worked with Chairman
    Levin on the acquisition reform bill and included language to
    require a report regarding the effects that cancelling a major
    acquisition program would have on the Nation's industrial base.
    I wanted to ask you today if you can tell me how you are taking
    into account the health and longevity of our domestic
    industrial base, including our suppliers, design engineers,
    manufacturers, as you tackle acquisition reform in the DOD?
        Secretary Gates. Well, I think so far, in terms of the
    decisions that I've made, most of the decisions have not been
    taken with a view to the industrial base, but rather
    acquisition programs that had been extremely badly managed, in
    substantial measure by the Department of Defense. So I would
    say that, in all honesty, not very many of the decisions that I
    have made were made with the industrial base being as an
    important consideration, but rather as acquisition programs
    gone badly awry.
        But as we go forward, as Admiral Mullen talked about a few
    minutes ago, clearly we have concerns about the industrial
    base. But to be perfectly honest, decisions made a long time
    ago have limited our options in this respect. The best example,
    as he cited, is the Joint Strike Fighter. So we are where we
    are, and----
        Senator Murray. We are where we are, but if we keep going
    down this road then 10 years from now have to ask, oh my gosh,
    what happened? If we don't start thinking about it now, we're
    going to be in a bad place. So I agree with you, we've looked
    at acquisition reform in terms of contracts gone bad. I do
    think we have to start talking about acquisition reform in
    terms of our industrial base as well. I hope we can work with
    you on that.
        Admiral Mullen.
        Admiral Mullen. If I could just offer one other thing, and
    I spoke to this earlier. But the other thing that I have found
    which keeps primes very focused as well as subs is
    predictability. We can't keep changing the program, whatever it
    is, whoever ``we'' is, because we all do this, year after year
    after year, because they just won't plan. They won't invest in
    the industrial base if there is great uncertainty and great
    risk associated with that.
        So as we come to grips with this whole issue of
    acquisition, which I think we need to do and which this budget
    really attempts to do and the acquisition reform legislation is
    critical to that, is that is a key piece, is can we get
    programs into some level of predictability and stability.
        Senator Murray. I think that's really important. So thank
    you with that.

                              MILITARY HEALTHCARE

        Secretary Gates, I wanted to applaud the budget plan in
    terms of military healthcare. I really think it goes a long
    ways toward ensuring that all our servicemembers and their
    eligible family members have access to and get the best medical
    care possible. I just want to say, I am still, as I think all
    of you are, still very concerned about the psychological health
    of our servicemembers. We continue to see reports--and Admiral
    Mullen, I know combat-related stress is a great concern for
    you. If you can just address that for a minute here and tell us
    what you're doing systemwide to continue to focus on that?
        Admiral Mullen. Again, this budget puts a lot more money in
    that direction and that's key. We, leadership throughout the
    Department and clearly the military leadership, is very focused
    on making more capability and capacity, more mental health
    providers available. I won't rest on the fact that we're short
    nationally. If I do that, then I just accept that we're going
    to be short, and I'm not going to do that until I have no other
    choice, and I just don't believe we've wrung it out.
        We've taken some steps in the stigma issue, but that's
    still a huge issue. I don't think we really remove that until
    we get to a point where everybody receives an effective
    screening and it's not voluntary--you must do it--and create
    again opportunities to both understand when somebody is
    suffering, as so many are right now, which is pretty normal and
    pretty human.
        So leadership will continue to focus on this. In fact, it
    was at Fort Lewis--I was there maybe 18 months ago now--that
    really--Madigan has really got some very innovative staff
    personnel, medical personnel there. We're trying to pay
    attention to them and to spread those kinds of best practices.
        But we're not there yet. As long as we've been at this,
    it's still early.
        Secretary Gates. Let me just add two things. First of all,
    the Admiral mentioned money. This budget, we budgeted $428
    million just for psychological health in 2009, fiscal year
    2009. The fiscal year 2010 budget will have $750 million in it,
    so a substantial increase focused strictly on psychological
    health.

                               MENTAL HEALTHCARE

        Second, one of the things that I'd like to explore with the
    Congress and it goes to the issue of the availability of mental
    healthcare providers. The truth is there are a lot of places in
    this country where we are trying to hire them and they aren't
    available. We have hired a lot, but not as many as we would
    like.
        One of the things that I'd like to explore with the
    Congress is expanding the military medical education program so
    that it goes beyond just physicians and includes mental
    healthcare professionals, whether it's people getting master's
    degrees--and I'm not talking necessarily about funding somebody
    to become a psychiatrist, but somebody who can do counseling
    and somebody who is the first-line provider for mental
    healthcare, and to pay for that education for someone in
    exchange for a commitment to the military, and then frankly we
    will have done the country a service because then they can go
    out into the broader population.
        Senator Murray. Mr. Secretary, I think that's exactly what
    we need to be doing because, as the Admiral mentioned, this
    isn't just a DOD problem; it's a problem for everyone. And we
    can't just say we hope that they come through the other system.
    I think if the military really focuses on that and promotes and
    sustains a program within itself, it will help the military. It
    will also help the rest of us. So I think it's a great idea and
    I really would like to work with you on making that happen.
        Thank you very much, Mr. Chairman.
        Mr. Secretary, I look forward to seeing you out in Seattle
    at the Husky graduation.

                                AIRCRAFT ISSUES

        Chairman Inouye. Mr. Secretary, Admiral Mullen, as we close
    this session I'd like to make a couple of observations if I
    may. Your decision to terminate the acquisition of the C-17s,
    the F-22s, the DDG 1000, and the future combat system vehicles,
    we have concerns that it may send the wrong signal to our
    friends and our potential aggressors that we are reducing our
    capability. It may also have a long-term impact on our defense
    industrial base. It may diminish our capacity to provide
    deterrence and reduce our strength that we provide to our
    allies. We hope that this is not the consequence, but some have
    the concern.

                           VETERAN HEALTH/MENTAL CARE

        The second observation is that in that ancient war in which
    I involved myself about 65 years ago, the casualties were high,
    but the survival rate was not as good as the ones we have
    today. For example, in my regiment, which in 1 year's time we
    went through, from 5,000 men, 12,000 because of replacements,
    we had no double amputee survivor. None of those survived. Yet
    if you go to Walter Reed today, double amputations are
    commonplace.
        We had no brain injury survivors. As a result, as I look
    back, we had very little psychological concerns. But today we
    have survival rates so well because of high technology that
    double amputees, triple amputees are surviving, brain injuries
    are surviving. As we can anticipate, as Senator Murray pointed
    out, psychological problems become commonplace. I just hope
    that we are preparing ourselves to cope with all of these
    problems.

                         ADDITIONAL COMMITTEE QUESTIONS

        With that, I'd like to thank you, Mr. Secretary, Admiral
    Mullen, Secretary Hale, for your contributions today. We hope
    that we can continue our discussions because we will be
    submitting to you, if we may, questions for your concern and
    response.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
                     Questions Submitted to Robert M. Gates
                Questions Submitted by Chairman Daniel K. Inouye
               institutionalizing irregular warfare capabilities
        Question. Secretary Gates, our troops entered Afghanistan in 2001
    and Iraq in 2003. We soon realized that the threat environment for our
    military operations was quite different than what we were prepared and
    equipped for. We responded by rapidly developing and fielding thousands
    of anti-IED jammers, more than 16,000 mine resistant ambush protective
    vehicles and countless intelligence, surveillance and reconnaissance
    assets. All of these programs have saved American lives, yet none of
    them are Programs of Record and they are all managed outside of the
    traditional Defense Department bureaucracy. Why was it necessary to go
    outside of the regular Department of Defense acquisition process? And
    how can we institutionalize these capabilities instead of continuously
    adding more layers to the bureaucracy?
        Answer. Force protection has always been a priority for our troops.
    The enemy we face and the tactics and technology we have employed have
    been truly remarkable. The evolving threat environment requires
    continued, proactive management of anti-IED programs to keep
    warfighters protected and as safe as possible given technological
    limitations. We learn from each innovation and that knowledge will be
    reflected in all our IED-related acquisition programs. I am very
    interested in applying these lessons to Afghanistan and to our future
    programs.
        Question. One of the reasons our acquisition system is so
    cumbersome and inflexible lies in requirements that often demand gold-
    plated solutions that can take years to develop. Many of the rapid
    fielding capabilities we're now sending to theater may only represent a
    75 percent solution, but collectively, they seem to get the job done.
    What is your assessment of the new equipment we've been sending into
    theater? Are we addressing our warfighters' needs?
        Answer. In general, the new equipment fielded has had a huge impact
    in theater, especially in Iraq. The Department is capitalizing on the
    wartime procurement lessons learned so that Afghanistan can benefit
    from these experiences. Much of the rapidly, urgently fielded ISR, C2,
    UAS, force protection, and Counter-IED capabilities are typically low-
    cost, commercial-off-the-shelf (COTS) or slightly modified-COTS
    solutions. The short, time-certain need period is a determinant factor.
    The speed of development and production is increasingly important. Our
    focus is to improve our ability to anticipate requirements and
    therefore minimize the need for partial solutions.
                               irregular warfare
        Question. Secretary Gates, roughly 6 months ago, your office issued
    guidance declaring irregular warfare to be as ``strategically important
    as traditional warfare''. You state that the fiscal year 2010 budget
    rebalances capabilities and provides roughly 10 percent for irregular
    warfare, 50 percent for traditional, strategic and conventional
    conflict, and 40 percent for dual-use capabilities. However, with no
    outyear budget data and no movement by the military services to
    significantly adapt doctrine and training, how can the Committee be
    assured that ``irregular warfare'' is not just a convenient way to cut
    programs or justify new programs?
        Answer. You cannot be assured that the Department of Defense is
    genuinely increasing its emphasis on irregular warfare until we
    complete our Quadrennial Defense Review and send you our fiscal year
    2011 budget and outyear plans reflecting the results of that Review. My
    decisions for the fiscal year 2010 budget were only a beginning. We
    still have to make some tough decisions and then explain how our new
    emphasis on irregular warfare is not just a convenient way to cut
    programs and justify new ones.
        Question. How will you ensure that the military services will not
    scale back their full spectrum readiness training too much, so that we
    can continue to dominate and prevail in major combat operations?
        Answer. We will ensure that prudent readiness is maintained the
    same way we traditionally do--by insisting on sufficient funding for
    readiness requirements and by having our military and civilian leaders
    checking on readiness in the field.
                        acquisition reform--requirements
        Question. Secretary Gates, as we look at improving the acquisition
    system due to massive cost overruns and schedule delays, perhaps we
    should think about the way that weapon system requirements are
    generated and validated. It appears that too often, ``requirements
    creep'', or reaching for immature technologies makes programs too
    costly and off-schedule. How can the Department better manage
    requirements, and perhaps change the service cultures, so that
    acquisition programs are more likely to provide needed capabilities on
    time and on cost?
        Answer. The Department has established a number of important new
    policies to improve requirements formulation, establish more effective
    program technical foundations, and control ``requirements creep'':
      --To reduce technical risk and refine program requirements, our
            practice will be to conduct competitive prototyping and
            complete Preliminary Design Reviews before we initiate a
            program,
      --We will employ independent technical reviews to certify the
            maturity of program technologies before we permit a program to
            proceed to the costly final phases of development and finally,
      --We have established Configuration Steering Boards (CSBs) with broad
            executive membership to review all requirements changes and
            significant technical configuration changes that have the
            potential to result in cost and schedule impacts to the
            program.
        The intent is to prevent ``requirements creep'' and defer any
    changes to future program increments. We believe these actions,
    complemented by those directed in the Weapons System Acquisition Reform
    Act, will ensure that our requirements and acquisition approach are
    tightly related, and that this disciplined approach will result in
    significantly improved program outcomes.
        Question. Do you believe that your staff has the analytic support,
    such as modeling and simulation tools, for objective analysis to help
    prioritize requirements?
        Answer. The procedures established in the Joint Capabilities
    Integration and Development System (JCIDS) support the Chairman of the
    Joint Chiefs of Staff (CJCS) and the Joint Requirements Oversight
    Council (JROC) in identifying, assessing, and prioritizing joint
    military capability needs/requirements.
        Models and simulations are an important part of the process to
    identify capability gaps and potential materiel and non-materiel
    solutions. These are used to support the analytical process by
    objectively considering a range of operating, maintenance, sustainment,
    and acquisition approaches through the incorporation of innovative
    practices. Specifically, as new requirements are identified, models and
    simulations are used in an analysis of alternatives process to
    determine if the new requirements can be satisfied through changes in
    tactics, techniques, procedures, doctrine, training, or leadership. If
    the analysis of alternatives does not identify alternate solutions to
    the need, then models and simulations play an important role in concept
    exploration to identify costs and benefits to potential materiel
    solutions.
        Modeling and simulation tools are available and adequate for
    objective analysis; through outreach and education, we are continuing
    to improve the knowledge and expertise of the DOD modeling and
    simulation workforce.
        Question. What improvements or changes would you recommend in order
    to better manage requirements?
        Answer. We are continuously evaluating methods to streamline the
    management of requirements. To that end, we have made recent changes in
    the requirements development and management process.
      --We are limiting the number of documents that must go through joint
            review and oversight to those that impact joint operations.
      --We have provided guidance to better scope the analysis done in the
            capability gap assessment process. This will reduce time and
            resources required while presenting an appropriately defined
            requirements gap to the Joint Requirements Oversight Council
            (JROC) for validation. This will allow the Department to move
            more quickly from the requirements process into the acquisition
            process.
      --We have recognized that information technology systems need to have
            a more flexible requirements management process than
            traditional hardware programs. To address this, we have better
            tailored the requirements process as it applies to information
            technology systems. Once the JROC approves the initial
            performance requirements and provides overarching cost and
            schedule constraints, it will delegate requirements management
            and oversight to an appropriate Flag level body that has the
            time and flexibility to effectively manage the development of
            these systems.
        We are also working on future improvements to the requirements
    management process:
      --We are developing an information technology data management tool
            which will allow us to structure the data in requirements
            documents to make the information more readily available and
            visible for comparison and analysis.
      --We are developing a similar tool for managing joint urgent needs to
            allow for more rapid information sharing so that we can make
            decisions more rapidly and get solutions into the hands of the
            warfighter more quickly.
        We will continue to identify opportunities to improve the
    requirements management process to ensure we provide the correct level
    of oversight balanced with the ability to respond efficiently to the
    warfighter's needs.
                 strategic implications of program terminations
        Question. Secretary Gates, we understand that the fiscal year 2010
    budget is a step towards rebalancing resources to build irregular
    warfare capacity applicable to the current fight. But we still face
    threats from traditional nation states such as North Korea and
    potentially Iran or others. How do program terminations such as the F-
    22, C-17 and Future Combat System Manned Ground Vehicle affect our
    ability to respond to traditional threats? Are we swinging the pendulum
    too far the other way?
        Answer. Although the proposed fiscal year 2010 defense budget
    reflects some shifts in emphasis, it is important for the United States
    to maintain its capabilities for conventional warfare dominance. All of
    the Military Departments are challenged to find the right balance
    between making the changes necessary to win the wars we are in and to
    be prepared for likely future threats. With this budget, I have tried
    to make a holistic assessment of the capabilities, requirements, risks
    and needs across the Military Departments.
                      de-militarizing u.s. foreign policy
        Question. Secretary Gates, you have repeatedly made statements
    about the need to improve the coordination and collaboration of efforts
    among the Department of Defense, the State Department, the U.S. Agency
    for International Development and non-governmental organizations. Mr.
    Secretary, you have even taken the highly unusual step for a Defense
    Secretary to support an increased budget for the State Department. Can
    you give the Committee some examples of where this inter-agency effort
    is currently being employed and how it could be expanded?
        Answer. There are many examples of where interagency work is
    ongoing and could be expanded. What follows are a few examples of such
    cooperation:
      --Strategic Planning.--Civilian agencies have participated in DOD's
            strategic planning processes, including the development of
            DOD's strategic guidance for employing its forces, Combatant
            Command Theater Campaign Plans, and the Quadrennial Defense
            Review. DOD participates in a range of planning activities led
            by the Department of State, U.S. Agency for International
            Development (USAID), and Department of Homeland Security.
      --Building Partner Capacity.--Innovative ``dual key'' tools like
            Section 1206 allow DOD and the Department of State to address
            security challenges that are the shared responsibility of both
            Departments. The Secretary of Defense, with Secretary of State
            concurrence, has leveraged the expertise resident in both
            departments to execute over $700 million in train and equip
            programs in over 40 countries. Separately, DOD, the Department
            of State, and USAID have published guidance on security sector
            reform to better integrate train-and-equip programs with
            efforts that build partner institutions to sustain long-term
            security.
      --Reconstruction and Stabilization.--DOD has worked closely with the
            Department of State's Coordinator for Reconstruction and
            Stabilization in developing an Interagency Management System
            (IMS) to provide reconstruction and stabilization expertise and
            whole-of-government planning support for complex contingencies.
            Realization of the full potential of IMS requires full funding
            of the Department of State's Civilian Stabilization Initiative.
      --Humanitarian Assistance.--DOD's humanitarian assistance guidance
            ensures that projects align with wider foreign policy
            objectives and do not duplicate or replace the work of civilian
            organizations. DOD is formalizing a USAID role in the clearance
            process.
      --Military-Non-Governmental Organization (NGO) Relations.--DOD and
            InterAction--the umbrella for many U.S.-based NGOs--jointly
            developed guidelines for how the U.S. Armed Forces and NGOs
            should relate to one another in hostile environments. We
            continue to educate both communities about the guidelines,
            foster dialogue, and develop NGO-military liaison arrangements.
        Effective interagency coordination and collaboration also depend on
    giving our civilian partners greater capacity. When our civilian
    departments and agencies are more robust and engaged with DOD, military
    risk is reduced and deployments are minimized. For these reasons, I
    strongly urge you to support the President's fiscal year 2010 foreign
    affairs and foreign assistance requests. We also need your help in
    fully funding and authorizing Section 1207 ``Security and Stabilization
    Assistance'' for fiscal year 2010. The President requested $200 million
    for this important program for fiscal year 2010. Unfortunately, the
    House Armed Services Committee reduced Section 1207 spending authority
    from $100 million to $25 million in its National Defense Authorization
    Act mark-up. Section 1207 allows DOD to help the Department of State
    and USAID address security challenges and defuse crises that might
    otherwise require a U.S. military response, and it has catalyzed
    interagency collaboration on Country Teams and in Washington.
               ground-based missile defense (alaska interceptors)
        Question. Secretary Gates, the budget request would effectively
    stop the emplacement of ground-based interceptors in Fort Greely,
    Alaska. Has the ballistic missile threat to the U.S. homeland changed
    to warrant curtailing this program?
        Answer. The Ground-Based Interceptor (GBI) is designed to defeat
    the relatively small number of unsophisticated missiles that could be
    launched by a rogue nation against U.S. territory. The rogue country
    ICBM threat has not evolved as rapidly as was originally projected in
    2002. I am confident that deployment of 26 interceptors in Alaska and 4
    in California with four spare missiles plus additional missiles for
    testing gives the Nation a robust capability. The modified program
    would retain all previously planned reliability upgrades to the GBIs
    and maintain the planned number of Ground-Based Missile Defense flight
    tests. We will close the older, prototype Missile Field One and move
    those missiles into the newly constructed Missile Field Two resulting
    in an overall higher reliability rate for those missiles. If the threat
    were to expand, the United States has time to build additional
    interceptors.
      national polar-orbiting operational environmental satellite system
                                    (npoess)
        Question. Secretary Gates, as you know, the Department has had a
    troubled history with its satellite programs. One of the programs that
    continue to be plagued with cost growth and schedule problems is
    NPOESS. Who in the Department of Defense is in charge of making
    decisions on this program, and what is the plan for the future of the
    satellite system?
        Answer. The May 1994 Presidential Decision Directive/NSTC-2
    directed the merging of the DOD and DOC operational weather satellite
    systems with the objective of reducing the cost of space based data
    collection for weather prediction. The PDD/NSTC-2 and the December 2008
    Amendment to the Tri-agency Memorandum of Agreement (MOA) outline the
    roles and responsibilities of each agency. DOD is named as the lead
    agency for systems acquisition. As such, the Under Secretary of Defense
    for Acquisition, Technology, and Logistics (USD(AT&L)), as Milestone
    Decision Authority (MDA), makes the final acquisition decisions for
    NPOESS.
        Since NPOESS is such a large portion of the NOAA budget, NOAA has
    dedicated several senior executives to management and oversight of
    NPOESS. A significant part of the continued cost growth on NPOESS stems
    from the growing acknowledgment of climate data as critical to our
    national interest. The program was not initially set up, nor was it set
    up after the Nunn-McCurdy restructure, to provide the complex
    instrumentation desired for climate assessment.
        Senior DOD and DOC officials have engaged in discussions concerning
    management of NPOESS. The DOD and DOC are reviewing a number of courses
    of action to help alleviate the friction. Options range from enforcing
    the current MOA to single agency management of the program to a split
    management strategy. DOD and DOC are also engaged with the Office of
    Science and Technology Policy to help craft a path forward to benefit
    all parties involved. The importance of NPOESS and the need to avoid a
    continuity gap is understood by DOD, DOC, and NASA.
        Question. Secretary Gates, there are too many people within the
    Department of Defense that believe they are in charge of satellite
    acquisition. With no one actually empowered to make decisions on
    satellite programs, we continue to see large cost growth and schedule
    delays in these systems. Do you have a plan to fix this chronic problem
    or will it be addressed in the ongoing Quadrennial Defense Review?
        Answer. Ensuring future space systems are delivered within promised
    cost and schedule targets requires the proper checks and balances
    necessary to appropriate management and oversight of the Nation's
    acquisition programs. In June 2008, the DOD established the Space and
    Intelligence Capabilities Organization, reporting directly to the Under
    Secretary of Defense for Acquisition, Technology, and Logistics
    (USD(AT&L)), to perform and be accountable for all acquisition
    oversight and related matters concerning DOD Space and Intelligence
    programs. A wide range of space related issues are being addressed in
    the Space Posture Review.
            fiscal year 2010 overseas contingency operations request
        Question. Secretary Gates, the fiscal year 2010 budget request
    includes $130 billion in non-emergency spending for overseas
    contingency operations. In the past, the administration has had
    difficulty predicting the full year costs of these operations. For
    example, in fiscal year 2008, the administration submitted along with
    the regular budget request a full-year supplemental request for
    operations in Iraq and Afghanistan. But within 8 months, the
    administration submitted two budget amendments to this supplemental
    request. How confident are you in the fiscal year 2010 overseas
    contingency operations request that you've submitted to the Congress?
        Answer. I am very confident about the $130 billion war-funding
    request the President sent to Congress on May 7, just over a month ago.
    However, I acknowledge that as the months go by security situations in
    Iraq, Afghanistan, and Pakistan can change, and that might mean that
    there might be changes in what exactly needs to be funded in fiscal
    year 2010.
        Question. How will you ensure that urgent, unforeseen warfighter
    requirements are addressed in the fiscal year 2010 overseas contingency
    operations budget? Can you assure us that the Committee will be
    informed of any necessary adjustments?
        Answer. Yes, I can assure you that my staff and I will keep
    Congress informed of any needed adjustments in our fiscal year 2010
    request, and that is how both Congress and the Department of Defense
    can address unforeseen warfighter needs.
                              strain on the force
        Question. Secretary Gates, the Army's and Marine Corps' suicide and
    divorce rates have risen sharply this past year. It appears that the
    strain of frequent deployments is affecting the emotional health of our
    soldiers and Marines. Do you believe the Department is doing enough to
    support service members and their families? What more could we do?
        Answer. The health and wellbeing of our service members and their
    families is one of the Department's top priorities and we are
    addressing suicide prevention and the psychological health of our
    service members in many ways. The military is the pre-eminent example
    in suicide prevention, targeting its members with a frequency and
    number of efforts unparalleled by any other organization.
        We are engaged in comprehensive preventive education initiatives.
    Within the Military Health System (MHS), there are many programs for
    service members that include the family when providing care and
    services, especially those deployed or returning from theater.
    Dedicated resources are focused on identifying the unique problems of
    military families and establishing or enhancing programs that
    specifically address the needs of the family. The Defense Centers of
    Excellence (DCoE) for Psychological Health and Traumatic Brain Injury
    (TBI) was established in November of 2007 and assesses, validates,
    oversees, and facilitates prevention, resilience, identification,
    treatment, outreach, rehabilitation, and reintegration programs for
    psychological health to ensure the Department meets the needs of the
    Nation's military communities, service members, and families. We have
    made significant contributions in support of the service members and
    their families with psychological health and TBI concerns. Furthermore,
    the services have a forum to discuss their current suicide prevention
    programs and best practices through the Department of Defense (DOD)
    Suicide Prevention and Risk Reduction Committee. The Army has
    specifically been taking multiple proactive steps to address the issue
    of suicide within its ranks, including the creation of a suicide
    prevention task force. The task force was developed as part of a month-
    long ``stand down'' to address soldier suicides.
    Access to Care
        Lack of access to mental health professionals is a particular
    problem in the MHS due to a shortage of providers and an increased
    demand for services. The services established an effort to aggressively
    recruit and retain mental health providers to ensure better access for
    service members and their families. In the past 2 years, we have placed
    1,700 mental health professionals in primary care clinics to increase
    access and reduce the stigma associated with visiting a mental health
    facility. In addition, the TRICARE Network has added 10,000 mental
    health providers, including child psychiatrists and psychologists.
    Quality of Care
        Research continues to help DOD better understand the mental health
    status of military families by providing data to develop programs
    specifically targeted to current needs. Evolving evidence has been used
    to develop psychological health (including post-traumatic stress
    disorder) clinical practice guidelines and training materials to ensure
    service members and families receive the best possible care. In
    addition to providing additional training to the MHS providers and
    staff, we are sharing military psychological health resources and
    clinical guidelines with local and community organizations and
    providers throughout the country who are often the first line in
    treating Reserve Component beneficiaries. Training is also offered to
    TRICARE network providers to continually improve their skills.
    Resilience, Protection, Prevention
        As with many conditions, prevention and early diagnosis are
    critical for those who are in need of psychological healthcare. The
    services and DOD have recognized that family, friends, and others in
    the military member's support system need to be aware of the signs that
    psychological health or TBI treatment may be necessary, and have
    instituted programs to inform and train them. The Battlemind Transition
    Office runs the Army's Resiliency Program, a preventive approach
    intended to strengthen individual service members, their families,
    their units, and communities and enhance their ability to cope with
    stress.
    Research
        DOD funded research is underway to more precisely identify the
    effects of war on service members, their families, and especially their
    children. We are also conducting research to compare the effect on
    family members of service members who return from deployment wounded
    versus non-injured. The National Child Traumatic Stress Network Center,
    based at the Uniformed Services University of the Health Science's
    Center for the Study of Traumatic Stress, develops knowledge related to
    military childhood experiences, develops effective public education
    materials, and expands and studies effective intervention strategies.
    We also have an ongoing Family Program Assessment to identify the
    antecedents and consequences of different levels of family readiness by
    collecting longitudinal data from Army families across the deployment
    cycle. This study will identify potential predictors of divorce in
    military families. This information will then be used to design
    programs to reduce the rate of divorce in military families. The
    possibility of expanding this study to all services is being actively
    considered.
    Non-Medical Approaches
        Six years of deployments and multiple deployments prompted the
    Department to rethink methods and strategies to deliver family support.
    Now, Military OneSource provides support services 24 hours per day, 7
    days per week to Active Duty, National Guard, and Reserve component
    service members and their families worldwide. Toll-free confidential
    telephonic support and a website, www.militaryonesource.com, provide
    interactive tools, educational materials, discussion boards, links to
    military and community resources, and tax filing services, among other
    services. Outreach non-medical counseling offer service members and
    their family members confidential, short term, situational, problem
    solving assistance that is instrumental for coping with normal
    reactions to the stressful situations created by deployments, family
    separations, and reintegration. Military OneSource offers confidential
    face-to-face, telephonic, and online counseling up to 12 sessions. The
    Military and Family Life Consultant program provides professional,
    confidential, and flexible service delivery on a 30-90 day rotational
    basis on military installations to meet surge support requirements and
    to support National Guard and Reserve events. Child and youth
    behavioral health specialists work with families and educators to
    identify and help struggling children and families. Additionally,
    financial counseling is available to assist with the financial concerns
    of military members and their families during all stages of the
    deployment cycle.
        These are just some of the initiatives we have underway, but we are
    always looking at the conditions and indicators to determine if there
    are other actions that can benefit our service members and their
    families work through their difficult problems.
        Question. Do you believe that the Army and Marine Corps force
    structure is large enough to relieve the operational strain on the
    force?
        Answer. Yes, but I will be reviewing the conclusion of the
    Quadrennial Defense Review on ground forces before making a final
    assessment.
        Question. Secretary Gates, you recently returned from a trip to
    Afghanistan. What is your assessment of how our troops are holding up
    under the continued high operational tempo?
        Answer. The troops I had an honor to meet with displayed a high
    level of morale. It was inspiring to see their level of commitment and
    positive demeanor in light of all we are asking them to do.
                         age and health of tanker fleet
        Question. Secretary Gates, I am concerned about the aging Air Force
    tanker fleet and the health and age of the KC-135 tankers by the time
    they are replaced. Can you update the Committee on the status of the
    Air Force tanker fleet, including the age of the fleet and any present
    safety and flight concerns with the current fleet?
        Answer. The USAF tanker force structure includes 415 KC-135 R and T
    models and 59 KC-10A aircraft with average fleet ages of 48 years and
    24 years, respectively. Upon retirement of the last KC-135 planned for
    2040, this tanker will have reached 80 years of service. The KC-10 will
    have achieved 60 years of service upon its planned retirement. Per the
    fiscal year 2010 Annual Planning and Program Guidance (APPG) and to
    maintain fleet viability, investment programs for these airframes are
    focused on safety of flight and obsolescence issues. To this extent,
    the KC-135 aircraft has six and the KC-10 has two on-going fleet-wide
    modification programs. Regarding safety of flight issues, the CCAB
    program addresses the only known ``safety of flight'' issue for the KC-
    135. There are no KC-10 safety of flight issues at this time.
        The six KC-135 programs consist of the following:
      --Control Column Actuated Brake (CCAB).--Modification preventing an
            unsafe stabilizer trim wheel runaway condition--fleet
            modification complete in fiscal year 2010;
      --VOR/ILS Antennae Replacement.--Replaces the obsolescent antennae
            used for navigation and precision instrument landing systems--
            this is an fiscal year 2010 New Start program;
      --Block 45 Upgrade.--Cockpit avionics modernization replacing
            obsolescent Autopilot, Flight Director, Radar Altimeter, and
            Engine Instruments--contract award late fiscal year 2009;
      --Global Air Traffic Management (GATM).--Updates and replaces
            Communication Navigation Surveillance/Air Traffic Management
            (CNS/ATM) equipment to meet restricted airspace requirements
            worldwide; modification complete in fiscal year 2011;
      --Enhanced Surveillance (EHS).--Replaces APX-110 transponder with
            APX-119 providing enhanced aircraft tracking and IFF Mode 5
            capability (complete by fiscal year 2010);
      --Mode 5.--DOD-mandated upgrade to the Identify Friend or Foe (IFF)
            system used for aircraft identification in Air Defense
            Operations (fiscal year 2010 to fiscal year 2012).
        The KC-10 provides both strategic air refueling and airlift for
    deployment, employment, redeployment and Joint/Combined support
    operations. This aircraft is a commercial derivative of the McDonnell
    Douglas DC-10-30 and since its first delivery in 1981, no major
    avionics upgrades have been completed. As such, in its current
    configuration, the KC-10 does not meet future Federal Aviation
    Administration (FAA)/International Civil Aviation Organization (ICAO)
    CNS/ATM requirements for 2015 airspace restrictions. To mitigate
    operational risk, two modification programs exist for the KC-10:
      --CNS/ATM Modification: addresses near term issues required to keep
            aircraft operational within 2015 air traffic mandates/
            restrictions;
      --Boom Control Unit Replacement: replaces unsustainable Boom Control
            Unit (complete 2012).
                fiscal year 2010 tanker contract award schedule
        Question. Secretary Gates, will the tanker replacement program
    request for proposals go out to industry this summer? Is the Department
    on track to make a contract award for the tanker replacement in early
    fiscal year 2010?
        Answer. Yes. The Department anticipates being able to issue a draft
    solicitation this summer with award of a contract by late spring 2010.
                          tanker contract competition
        Question. Secretary Gates, do you have confidence that the upcoming
    tanker contract award will not result in another protest to the
    Government Accountability Office (GAO)? What is your plan if another
    protest is upheld by the GAO?
        Answer. Contractors have the right to protest any contract award.
    There is no guarantee there will not be a protest in the upcoming
    tanker competition. I am confident the Department has a process in
    place to address the original GAO protest decision findings and to
    ensure a fair competition. If another protest is upheld by the GAO, we
    will address it at that time.
                      structural repairs of kc-135 tankers
        Question. Secretary Gates, based on the current tanker replacement
    program, it will take over 30 years to recapitalize the KC-135 fleet.
    Can you elaborate on the cost of the structural repairs that will need
    to be done on the KC-135 fleet during the acquisition of the
    replacement tankers? Can these costs be avoided if the fleet is
    replaced sooner?
        Answer. Skin replacements are the major structural repairs that
    occur on the KC-135 when the skins exceed reparable limits. To date,
    the number of skins needing replacement has been manageable and have
    not greatly affected Program Depot Maintenance (PDM) flow and overall
    aircraft availability. There is a reasonable amount of rework that can
    be accomplished before most of the structures require replacement. Over
    time, however, the skins will need to be replaced.
        The Air Force is planning for three structural repairs to the KC-
    135 fleet: replacement of Aft Body Skins, replacement of Upper Wing and
    Horizontal Stabilizer Skins, and replacement of Crown and Center Wing
    (wing box) Upper Skins. The KC-X recapitalization rate will influence
    the number of aircraft requiring each structural repair. The
    calculations below assume 416 KC-135s require replacement of Aft Body
    and Upper Wing and Horizontal Stabilizer Skins, but that only 230 KC-
    135s will require replacement of Crown and Center Wing (wing box) Upper
    Skins (see below). The dates used in the forecasts were selected to
    gain the most benefit from the work that will be accomplished. Each
    estimate uses current year, fiscal year 2009, dollars and is per
    aircraft. Then year dollars would be more.
    Aft Body Skins
        Replacement of these skins is already programmed to begin in the
    current FYDP.
        Estimated cost per airplane: $0.3 million.
        Estimated total cost: $124.8 million (416 aircraft).
        Max aircraft down: N/A--concurrent with PDM. (Note: Air Force
    programming this work into the fiscal year 2012 PDM work package
    reduces potential delays from unscheduled ``over and above'' work.)
    Upper Wing and Horizontal Stabilizer Skins
        These would be done concurrently, separate from PDM, in a ``speed
    line,'' and would include replacement of substructure components that
    are important to continued use of the aircraft and accessible when the
    skins are removed. (Note: The ``speed line'' will be a stand alone
    repair line dedicated solely to the upper wing and horizontal
    stabilizer skin replacement work.)
        Estimated cost per airplane: $6.7 million.
        Estimated total cost: $2.8 billion (416 aircraft).
        Max aircraft down: 12 (at any one time).
    Crown and Center Wing (Wing Box) Upper Skins
        This replacement is planned further in the future since recent
    experience has not indicated significant problems with corrosion or
    cracking. They are planned to be done concurrently in a speed line and
    separate from PDM. We have accounted for planned retirements in this
    increment.
        Estimated cost per airplane: $4.6 million.
        Estimated total cost: $1.1 billion (230 aircraft).
        Max aircraft down: 12 (at any one time).
        Due to the materials and the assembly techniques used when the KC-
    135 aircraft was originally procured, occurrences of corrosion will
    continue to be a primary area of concern. Continued inspections,
    repairs, and preventive maintenance are required to ensure a viable
    fleet.
        Question. Can these costs be avoided if the fleet is replaced
    sooner?
        Answer. Yes; as indicated in the answers above, some of the costs
    could be avoided, depending on timing of KC-X replacement and
    retirement schedule for the KC-135.
                            tanker dual buy strategy
        Question. Secretary Gates, I understand that you are strongly
    opposed to awarding contracts to two tanker manufacturers. Can you
    elaborate on the pros and cons of this dual buy approach and the costs
    associated with this type of acquisition strategy?
        Answer. The Department's analysis and experience convinces us that
    dual sourcing of the KC-X tanker would be costly and ineffective. We
    oppose the introduction of two separate training, maintenance and
    logistics requirements simultaneously into the fleet. Developing two
    tankers at once would require approximately $14 billion over The FYDP
    10-15. Over the life cycle of KC-X we estimate that dual sourcing would
    cost the taxpayers $7-8 billion when compared to a single source.
    Doubling the number of tanker platforms complicates the Air Force's
    mission. The Air Force will have to increase its allocation of limited
    financial and human capital to support the logistics, maintenance and
    training needs of two tanker platforms over the lifecycle of these
    aircraft. These lifecycle inefficiencies and complications are
    unnecessary, and can be avoided by selecting a single tanker platform.
                       special operations command (socom)
        Question. Secretary Gates, the Commander of the Special Operations
    Command, Admiral Olson, recently stated that escalating requirements
    for capabilities provided by Special Operations Forces have outpaced
    SOCOM's ability to train new personnel and develop critical enablers in
    the areas of aviation, intelligence, and communications. To mitigate
    these shortfalls, Admiral Olson has requested that the military
    services provide Special Operations Command with additional assistance
    and manpower in these critical support areas. Are the services able to
    meet these additional requirements? How will this plan be managed, and
    to what degree has it been incorporated in the fiscal year 2010 budget
    request?
        Answer. USSOCOM is working with the Military Departments to
    leverage capabilities to address Special Operations Forces (SOF)
    shortages in critical mission areas. USSOCOM is currently coordinating
    with the Military Departments to address critical support areas. Of
    note, the Military Departments are opening their recruiting and
    training aperture to increase the number of students at their training
    centers, including aviation training, to support SOF requirements. The
    Military Departments are also assisting with providing a mix of organic
    and dedicated intelligence, surveillance, reconnaissance and
    communications support for USSOCOM.
        The demand for SOF capabilities will continue to increase for the
    foreseeable future. One of the major focus areas for the Quadrennial
    Defense Review (QDR) is to balance the force for irregular warfare
    capabilities, which includes addressing the support of the Military
    Departments to Special Operations Forces.
        Question. Secretary Gates, funding for Special Operations Command
    has grown from $2.1 billion in 2001 to nearly $8.6 billion, including
    supplemental funding, in fiscal year 2010. During this same time period
    Special Operations Command's mission has grown exponentially, as
    evidenced most recently by its designation as the DOD Proponent for
    Security Force Assistance (SFA). Given this rapid growth in both budget
    and responsibility, how are you ensuring programmatic and fiscal
    accountability within Special Operations Command?
        Answer. The resources requested and executed by the U.S. Special
    Operations Command (USSOCOM) are scrutinized and justified throughout
    the Department's rigorous planning, programming, budgeting and
    execution process. The discipline of our department-wide processes
    along with additional actions that USSOCOM has taken internally help
    ensure that they maintain programmatic and fiscal accountability for
    the funds allocated to them. Specifically, USSOCOM has implemented
    several organizational changes and processes to ensure effective
    stewardship of appropriated funding. The Command has doubled the size
    of the Financial Management workforce to ensure the appropriate checks
    and balances are in place, establishing separate Directorates within
    the Comptroller organization that provide the Command Program and
    Budget, Policy and fiscal oversight across the enterprise. Also, the
    Comptroller is now a stand-alone center with direct reporting to the
    Commander, USSOCOM. on all fiscal matters. Further, USSOCOM complies
    with the full complement of regulatory and legislative requirements,
    such as the Federal Managers' Financial Integrity Act (FMFIA) of 1982,
    and the DOD Managers' Internal Control Program (MICP), as well as the
    Chief Financial Officers' Act of 1990, as amended. Finally, there are a
    broad range of accounting tools and processes to provide an additional
    layer of visibility over the use of MFP-11 funds and help identify any
    potential abnormalities during execution.
                           export version of the f-22
        Question. Secretary Gates, I believe the Department should consider
    an export program for the F-22 Raptor fighter aircraft. Under the rules
    for such a program, the costs for developing an export variant is borne
    by the interested nation, not the United States. This would enable us
    to provide advanced fighter capabilities to our close friends and
    allies. Secretary Gates, what is your view of an export program for an
    F-22 variant?
        Answer. The Department of Defense does not plan to promote the sale
    of an exportable variant of the F-22. The F-22 was designed and
    developed solely to meet U.S. requirements and, based on a recent
    analysis by the Department, would require over $2 billion of non-
    recurring investment by a purchasing nation to meet United States
    Government (USG) exportability requirements. We will continue to
    implement our longstanding plans to offer the F-35 Lightning II to
    selected allied and friendly nations through Foreign Military Sales
    (FMS) channels based on the USG's evaluation of our foreign policy and
    national security interests in relation to the potential purchasing
    nation. The F-35 program, which already has eight cooperative partner
    nations and two potential FMS purchasers, was developed with
    exportability in mind. The USG consults closely with our friends and
    allies on the capability requirements for the current and emerging
    security environment. The F-35 incorporates coalition warfighting
    capability and interoperability features in a highly capable,
    affordable, and supportable 5th generation strike fighter that was
    designed from its inception to meet the requirements of both the United
    States and international partners.
                        military personnel compensation
        Question. Secretary Gates, in the last 10 years, active duty
    military personnel compensation costs have increased by 91 percent. Do
    you believe that these costs are sustainable? How are these rising
    costs affecting the Department's ability to adequately fund your
    acquisition priorities?
        Answer. All rising costs, not just military compensation, diminish
    our ability to fund acquisition adequately.
        Whether or not these rising costs are sustainable will depend on
    several factors, most notably:
      --Our progress in moderating the escalating cost of military
            healthcare.
      --Our overhaul of acquisition programs and our ability to control
            costs in acquisition programs that continue.
      --Cooperation with Congress on minimizing non-essential funding in
            DOD appropriations.
                                     ______

                Questions Submitted by Senator Patrick J. Leahy
        Question. Secretary Gates, in your testimony, you highlighted the
    need to have the right programs in place for the future to meet our
    shifting defense requirements.
        A few years ago, DOD and NSA developed the Trusted Foundry Program
    to ensure government access to computer chips for a diverse range of
    mission critical programs and to slow the erosion of the domestic
    supply base. At that time, the government faced challenges producing
    required chips itself and was having trouble maintaining pace with the
    rapid advances in chip technology.
        The Trusted Foundry Program has been successful in providing our
    government with access to domestically produced chips and cutting edge
    microelectronic technologies and processes. In fact, I understand that
    under the Trusted Foundry Program the access to new technologies in a
    ``trusted'' environment, has led to an increase in government demand
    for more advanced domestically produced semiconductors.
        Do you agree that demand for the services provided by the Trusted
    Foundry Program has met and/or exceeded expectations? What do you
    foresee to be the role of the Trusted Foundry Program and its network
    of more than 10 foundries over the next 3-5 fiscal years?
        Answer. Yes, demand for the Trusted Foundry has exceeded our
    expectations. The role of the Trusted Foundry Program and its network
    of suppliers over the next 3-5 years will be expanded to cover the full
    defense-wide requirements for trusted microelectronics for Defense
    systems and weapons.
                                trusted foundry
        Question. Does the demand for the chips and services from the
    Trusted Foundry currently exceed the contracted services provided for
    in the fiscal year 2009 budget?
        Answer. Yes, current demand has exceeded the services contracted
    directly through the Trusted Access Program Office. Several programs
    like JTRS and GPS have used their program funds to purchase trusted
    microelectronics through the TAPO when the resources needed by those
    programs exceeded the capabilities provided within the Trusted Foundry
    Program.
        Question. Does the current budget request fiscal year 2010 support
    the majority of pending projects that are proposed to use Trusted
    Foundry services?
        Answer. No. Recent estimates are that the DOD purchases about $3-5
    billion in integrated circuits per year. Based on the cyber-threats and
    direct threats to our systems from counterfeit and tampered parts, we
    believe that all of those should be trusted. The current 2010 budget
    request is based on the projected needs for the few programs that have
    requested support for obtaining trusted parts. The majority of programs
    are not yet in full compliance with the Secretary's directive-type memo
    that calls for full scale implementation of trusted components for our
    systems. The Trusted Foundry Program is making a concerted effort to
    align program offices and services with the ability to obtain trusted
    components from trusted sources.
        Question. If Congress were to provide additional funding for the
    Trusted Foundry Program above the President's fiscal year 2009 request,
    what additional capacity or services would be your highest priority?
        Answer. The priorities of an expanded program are to establish
    direct contracts with all of the trusted foundries and suppliers to
    provide trusted parts, drive new leading-edge technologies into the
    Trusted Foundry, and provide additional fabrication runs for defense
    programs.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
        Question. How, if at all, has the Department of Defense turned to
    the interagency process to provide rule-of-law training in Afghanistan?
        Answer. Working to reduce corruption in Afghanistan has been a U.S.
    Government objective from the beginning. The principal Department of
    Defense efforts to reduce corruption include the Department's training
    and mentoring of Afghan National Security Forces and personnel of the
    associated Afghan ministries. These efforts support and are supported
    by other U.S. Government agency efforts to reduce corruption. For
    example, USAID anti-corruption efforts include training Afghan judges
    and judicial staff and restructuring personnel and pay structures in
    the Afghan court system.
        Question. Please provide the following: The total number of lawyers
    (military and civilian) whose primary responsibility is to provide
    rule-of-law training in Afghanistan on behalf of the Department of
    Defense; the offices within the Department of Defense (or United States
    Government) or organization to which these individuals are assigned;
    the total number of Afghanis who have received rule-of-law training
    from these individuals; an estimate of the total number of Afghanis for
    which the Department of Defense anticipates it will provide rule-of-law
    training.
        Answer. The lead U.S. agency for rule-of-law and other governance
    development initiatives is the Department of State. There are no
    military or civilian lawyers providing rule-of-law training as a
    primary duty on behalf of the Department of Defense.
        Question. The President's policy towards Afghanistan notes that
    part of our counter-insurgency strategy must include building effective
    local governance.
        What is the Department of Defense's plan for combating corruption
    in the Afghan government entities with which it works on a regular
    basis, including the Afghan National Army and Afghan National Police?
        Answer. The Department works to reduce corruption in Afghanistan
    principally through training, mentoring, and partnering with the Afghan
    National Security Forces and the associated Afghan ministries. The
    training and mentoring programs ensure that Afghan National Army
    soldiers and officers, Afghan National Police (ANP) officers, and
    ministry staff understand the potential impact that corrupt practices
    could have on the population. Partnering with ANP units that have
    completed the Focused District Development program conducted by
    International Security Assistance Force units, U.S. and Coalition
    personnel seek to ensure that ANP officers do not return to corrupt
    practices. Indirectly, counternarcotics efforts by the Department of
    Defense and other U.S. Government agencies will help reduce corruption
    by removing a source of funding for corrupt practices.
        Question. What office or offices within the Department of Defense
    are responsible for anti-corruption policies that the Department of
    Defense will apply when working with Afghan government entities?
        Answer. The Department of State is responsible for rule-of-law and
    anti-corruption policies at the national level. The Combined Security
    Transition Command--Afghanistan develops training and mentoring
    programs and curricula for the Afghan National Security Forces and the
    relevant ministries in support of U.S. rule-of-law and anti-corruption
    policies.
                                     ______

                Questions Submitted by Senator Dianne Feinstein
             conflicts between the military mission and wind power
        Question. Earlier this year, my Senate colleagues and I wrote to
    you to request a more coordinated response to conflicts between the
    military mission and wind power. Please let me know when we can expect
    an answer to our request.
        Answer. The Office of the Secretary of Defense tasked the Under
    Secretary of Defense for Acquisition, Technology and Logistics
    (USD(AT&L)) with responding to the Senator's letter. The response
    required extensive coordination within the Department because mapping
    areas feasible for energy development impacts DOD missions and
    training. It is not simply an issue of the Department's obtaining or
    using energy. The USD(AT&L) response, which is attached, was finalized
    and sent on August 13, 2009.
                                The Under Secretary of Defense,
                                       Washington, DC, August 13, 2009.
    Hon. Dianne Feinstein,
    U.S. Senate,
    Washington, DC.
        Dear Senator Feinstein: Thank you for your May 14 letter to the
    Secretary of Defense requesting the Department of Defense (DOD)
    establish clear policy to support renewable energy development projects
    while maintaining necessary protections for military airspace. I am
    responding on behalf of the Secretary.
        The Department has set ambitious goals for the use of renewable
    energy and is aggressively pursuing efforts on military bases across
    the Nation. By 2025, the Department plans to procure or produce the
    equivalent of 25 percent of the electricity it consumes from renewable
    sources. The national security challenges posed by reliance on foreign
    sources of energy are clear, and the transition to renewable sources is
    a key element of the DOD strategy to respond.
        As you know, the Department must balance goals to increase
    renewable energy with maintenance of critical testing, training and
    homeland defense capabilities. Some renewable energy projects on or
    near military installations or surveillance radars can have substantial
    adverse effects on DOD test and training ranges, training routes,
    special use airspace, and our air defense and border surveillance
    assets.
        You offered suggestions in two broad areas, one of which being the
    process by which proposals for renewable energy projects get reviewed.
    For the very reasons you cited, the Department must evaluate each
    proposed project on an individual, site-specific basis. The
    Department's red-yellow-green maps are intended to serve merely as
    guides. In practice, each proposal must be assessed on the basis of the
    specific factors such as the physical characteristics of the proposed
    construction, training, test and surveillance needs, and the local
    geography. For this reason, it is not feasible to fully centralize
    decision making on wind development projects. However, my staff will
    work with other offices in the Department to review the current,
    decentralized decision process and recommend ways to expedite it and
    improve transparency.
        You also suggested that better technology can help mitigate the
    limitations on placement of wind energy projects. The Department is
    conducting flight trials and analytic studies to develop tools to
    improve prediction of impacts and explore possible mitigations. My
    staff will explore how we might accelerate development of technical
    mitigation approaches.
        I appreciate your suggestions for ways in which the Department can
    improve the prospects for the development of wind energy in particular.
    I share your view that the U.S. Government needs to take the steps
    necessary to allow our country to exploit the benefits of wind energy
    generation without compromising national security.
        A similar letter has been sent to the other signatories of your
    letter. I look forward to working with you to address this challenge.
                Sincerely,
                                                      Ashton B. Carter.

        Question. As you know, there is a great deal of potential and
    interest in producing significant amounts of solar electricity on
    military bases in southern California. At least three bases are
    considering significant projects, which could make the bases
    independent of the power grid, combat global warming, and increase our
    energy security. These efforts are often the result of serious
    initiative by good base commanders and other people in uniform. (1)
    What is the Pentagon doing to facilitate the use of solar power on
    military bases in Southern California? (2) What resources and personnel
    have you dedicated to this effort? (3) What coordination is occurring
    between services? (4) Would you consider setting a goal that Southern
    California bases should attempt to produce enough solar power on base
    that they are able to meet or exceed all of their net energy needs?
        Answer. What is the Pentagon doing to facilitate the use of solar
    power on military bases in Southern California? The abundance of
    available solar energy presents opportunities for the Department of
    Defense (DOD) to increase the energy security of military bases in
    California. DOD is employing photovoltaic technologies at many
    installations in California using Energy Conservation Investment
    Program (ECIP) funding. Using 2008 and 2009 funds (including funds
    appropriated in the ARRA), DOD is designing and constructing more than
    30 solar projects, including thermal systems for domestic hot water,
    heating pools, and photovoltaics on roofs to provide building power for
    a variety of operational needs. In addition to carrying out solar
    technology applications tailored toward specific buildings, DOD is
    exploring large, utility-scale solar energy plants in partnership with
    utility companies and energy developers. For example, the Army recently
    selected its commercial partners for a project at Fort Irwin that could
    ultimately provide 500 MW of solar power. Finally, DOD envisions
    military installations can serve as testbeds for renewable energy
    technologies that are not yet commercially feasible, including, but not
    limited to, solar technologies, and we are talking with the Department
    of Energy (DOE) about potential opportunities.
        Note, however, that some proposed large-scale commercial solar
    development projects, including projects that would be located on land
    adjacent to military installations, may be incompatible with the
    military's mission. For example, solar towers can obstruct flight
    operations and interfere with radar. Photovoltaic arrays can also
    impact testing and training by degrading habitat for threatened and
    endangered species. Thus, we must carefully evaluate the impact of
    these proposed projects. Still, we are committed to transparency
    wherever possible, and we will try to provide information to
    stakeholders as early in the process as possible.
        What resources and personnel have you dedicated to this effort?
    Each installation has an energy manager, and many installations have a
    Resource Efficiency Manager (REM) who works with the installation's
    engineering and operations staffs to determine which renewable energy
    technologies can be employed to satisfy installation energy
    requirements. In addition, the installation-level staff relies on the
    energy subject matter experts at major commands and field-operating
    agencies to verify the technical solutions and then authorize a
    contracting method to implement those solutions. Finally, the military
    services work closely with the Department of Energy Federal Energy
    Management Program (FEMP). Drawing on the vast expertise of the DOE's
    many laboratories, FEMP provides technical assistance to individual
    installations. FEMP also provides enterprise-wide solutions in areas
    like utility contracting, power purchase agreements, and utility-scale
    renewable energy development.
        What coordination is occurring between services? Installation-
    energy issues are coordinated through the Defense Energy Working Group
    (DEWG), which is chaired by the Deputy Under Secretary of Defense for
    Installations and Environment (DUSD(I&E)), Dr. Dorothy Robyn. Members
    of the DEWG include the senior military service officials responsible
    for installations and energy and the services' chief engineers. The
    DEWG has met monthly since November 2008, and it has proved to be an
    invaluable forum. Among other things, the DEWG is trying to identify
    and reduce key impediments to expanded development of renewable energy
    at military installations. Complementing the DEWG (and with many of the
    same members) is the Energy Infrastructure Compatibility Working Group,
    which focuses on potential encroachment issues, particularly on the
    ranges used for military training and testing. For example, this group
    worked with Interior's Bureau of Land Management to draft a Wind Energy
    Protocol that defines a process for DOD evaluation of proposed wind
    projects on BLM lands. DOD and Interior are exploring the expansion of
    the protocol to include solar energy.
        Would you consider setting a goal that Southern California bases
    should attempt to produce enough solar power on base that they are able
    to meet or exceed all of their net energy needs? For a variety of
    reasons, it would be premature to set a solar or renewable energy goal
    for Southern California bases beyond those established in law today. To
    review, the Energy Policy Act of 2005 establishes as a goal that
    Federal agencies produce or purchase 3 percent of their electricity
    from renewable sources by 2007-2009, 5 percent by 2010-2012, and 7.5
    percent by 2013. Moreover, in November 2005, DOD established as an
    internal goal that it would produce or procure 25 percent of its
    facilities energy from renewable sources by 2025. This 25-percent goal
    was included in the National Defense Authorization Act for fiscal year
    2007. Nevertheless, even these goals represent a challenge, because key
    technologies are not yet commercially mature or cost-competitive, and,
    in some cases, mission needs may preclude their use at a particular
    military installation. In sum, while we plan to be aggressive in
    pursuing opportunities for greater reliance on renewable energy, we
    want to be cost effective and consistent with mission needs.
        Question. It is my understanding that there are fuel cell
    technologies that may meet the emerging requirements of the military.
    Solid oxide fuel cell systems generate clean, cost-effective, onsite
    electricity that (1) eliminates dependence on the power grid, (2) uses
    significantly less fuel than traditional generators, and (3) would
    improve our overall security posture through reliance on domestic fuel
    sources.
        Have you considered including these options to our military energy
    portfolio as a way to increase energy security?
        Answer. Yes. The Army's Research, Development and Engineering
    Command, along with DARPA and DOE, is evaluating solid oxide fuel cell
    (SOFC) technology for military uses. Specifically, they are looking at
    how SOFC systems can be used at installations and forward operating
    locations in conjunction with other fuel cell technologies (e.g.,
    reformed methanol and direct methanol) to deliver power to a 250 W
    battery charger fueled by JP-8. However, in spite of the promising
    advances in recent years, the successful development of a militarized
    SOFC for a battery charger is probably some years away.
                                     ______

                  Questions Submitted by Senator Thad Cochran
        Question. Secretary Gates, I understand the Department intends to
    reduce its reliance on contracted workers by hiring more than 13,000
    government civilians to replace contractors. Has the Department
    identified what positions or functions it intends to in-source, and
    what savings do you anticipate achieving through this initiative?
        Answer. The Department is currently working to identify the
    specific positions that will be insourced. This identification is not
    constrained to specific functional communities although the Department
    does have a focus on the acquisition workforce and functions that have
    been determined to be inherently governmental, closely associated with
    inherently governmental, or will increase government oversight. The
    Department has budgeted for 40 percent savings efficiency from the
    conversion of these support contractors to civil servants.
        Question. Secretary Gates, the cost of providing contracted
    healthcare for our military beneficiaries and their families has
    increased substantially in the past 5 years, and shows no sign of
    decreasing in the near future. As the Department looks to in-source
    throughout the Department, is there consideration for increasing
    capacity for care in military clinics and hospitals to reduce the need
    and the associated cost of contracted care?
        Answer. While the cost of providing care for military beneficiaries
    has certainly escalated in the past several years, it is important to
    point out the cost increase has been across the Military Health System
    (MHS) and not just in the Purchased Care Sector. Much of the increase
    in cost can be attributed to a significant increase in the total number
    of beneficiaries within the MHS and an expansion of the TRICARE
    benefit. Having said this, however, most of the cost and workload
    increase has indeed been seen in the Purchased Care Sector. This has
    been well recognized by MHS leadership and broad-based efforts are
    underway to both optimize access to military treatment facilities
    (MTFs) and the Direct Care Sector and to improve the efficiency and
    quality of the healthcare experience within facilities. Each of the
    services has addressed the issue head on.
        The Army's ``Access To Care Initiative,'' the Navy's ``Patient
    Centered Medical Home'' projects at National Naval Medical Center and
    San Diego, and the Air Force's innovative ``Family Health Initiative''
    are all excellent examples of the commitment each of the services have
    made to improving the healthcare experience of beneficiaries and
    maximizing MTF enrollment within existing capacity and budget. So far,
    these initiatives have demonstrated early success and the Department
    hopes to capitalize on these successes to improve performance
    throughout the system. In addition, Health Affairs/TRICARE Management
    Activity has piloted a ``Pay for Performance'' project that has been
    engineered to incentivize individual MTFs to optimize efforts to
    improve healthcare quality, access, continuity, and patient
    satisfaction. Again, the purpose is to stimulate innovation, highlight
    best practices, and promote their adoption across the MHS.
        Question. Secretary Gates, you and Secretary Clinton supported
    transferring the ``Pakistan Counterinsurgency Capability Fund'' to the
    State Department over the next 2 years. What efforts are underway
    within the interagency to implement this initiative, and where would
    you like to see the fiscal year 2010 funding appropriated?
        Answer. For fiscal year 2010, the Pakistan Counterinsurgency
    Capability Fund (PCCF) has been appropriated to the Department of State
    in the Supplemental Appropriations Act, 2009. The Department of Defense
    is working with the Department of State to build its capacity to manage
    a wartime program in support of DOD requirements, and needs to ensure
    that the Department of State has the authorities, resources, and
    processes necessary to provide our commanders the flexibility sought
    under PCCF. DOD and the Department of State will work together over the
    coming months and year to make sure the transfer of management
    responsibility to the Department of State takes place without any
    degradation of the support required by DOD to build Pakistan's
    counterinsurgency capabilities in support of U.S. forces' efforts in
    Afghanistan.
        Question. Admiral Mullen, can you give us your thoughts on how the
    Pakistan Counterinsurgency Capability Fund will help secure Pakistan's
    tribal areas, and what actions may be necessary to improve the
    interagency coordination so these funds are used effectively?
        Answer. The Pakistan Counterinsurgency Capability Fund (PCCF)
    focuses on building enduring capabilities for the Pakistani military to
    conduct counterinsurgency operations in support of U.S. efforts in
    Operation Enduring Freedom (OEF). The funding is designed to accelerate
    development of the Government of Pakistan's capacity to secure its
    borders, including the tribal areas, deny safe haven to extremists, and
    provide security for the indigenous population in the border areas with
    Afghanistan.
        PCCF will fund counterinsurgency requirements such as helicopters,
    soldier equipment, and training. The Department proposed $400 million
    for PCCF in the fiscal year 2009 supplemental and $700 million in the
    fiscal year 2010 overseas contingency operations request. We are
    grateful to Congress for supporting our request for $400 million for
    the Pakistan Counterinsurgency Fund (PCF) in fiscal year 2009.
        For fiscal year 2010, we have requested a clean transfer to DOD of
    the $700 million Congress provided to the Department of State to ensure
    uninterrupted execution of this crucial program while the Departments
    work closely on developing plans for the Department of State to
    implement the program in fiscal year 2011.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
        Question. Recently, it was announced that a heavy armor brigade
    from Europe will not go to White Sands Missile Range in New Mexico, as
    originally planned. Will DOD be giving serious consideration to sending
    that brigade to Fort Knox? If not, why not?
        Answer. Senator, the Army released the Grow the Army Stationing
    Plan in December 2007 after it was approved by the Department of
    Defense and the President. We will adhere to the same plan once the
    Quadrennial Defense Review determines force structure end state in
    Europe. The criteria we would use for a returning Germany brigade would
    be similar to the criteria we used in December 2007.
        Question. What criteria or requirements will be evaluated in order
    to match resources and capabilities of installations with the returning
    heavy armor brigade?
        Answer. The same criteria will be considered in this decision as
    was used in the installation analysis for Grow the Army 2007:
    Maximizing Army installation capabilities; growth capacity; power
    projection; training; and quality of life. The Base Realignment and
    Closure 2005 Military Value Model will also be used for computation.
    Other factors that will be considered include minimizing community
    impact and disruption to the current plan, while maintaining
    flexibility for future force mix decisions. Our final stationing
    decision will reflect the results of analysis and best Military
    Judgment.
        Question. Section 8119 of Public Law 110-116 provides in relevant
    part that: ``(b) REPORT--(1) Not later than December 31, 2007, and
    every 180 days thereafter, the Secretary of Defense shall submit to the
    parties described in paragraph (2) a report on the progress of the
    Department of Defense toward compliance with this section . . . (3)
    Each report submitted under paragraph (1) shall include the updated and
    projected annual funding levels necessary to achieve full compliance
    with this section. The projected funding levels for each report shall
    include a detailed accounting of the complete life-cycle costs for each
    of the chemical disposal projects . . .'' In its latest report to
    Congress, the Department did not include funding totals for the out-
    years for the Blue Grass Army Depot and Pueblo Depot in contravention
    of this provision. It only included the fiscal year 2010 request
    figures.
        Why was this long-term budget information not included? What was
    the Department's legal rationale for not including these funding
    levels? How does this comport with President Obama's promise ``not to
    nullify or undermine Congressional instructions as enacted into law?''
    Please provide all of the info required by Section 8119 of Public Law
    110-116.
        Answer. The Department did not finalize the outyear estimate when
    the fiscal year 2010 Presidents budget plan was formulated. The outyear
    programs and funding will not be settled until completion of
    Quadrennial Defense Review and the follow-on program and budget review
    later this year.
        DOD fully supports President Obama's promise, and doing the
    legislatively-mandated QDR does not ``nullify or undermine
    Congressional instructions as enacted into law.''
        We will provide the information required by Section 8119 as soon as
    we can.
                                     ______

                Questions Submitted by Senator Robert F. Bennett
        Question. Iran's leadership uses despicable rhetoric regarding
    Israel, continues its support for international terrorist groups such
    as Hezbollah and Hamas, and disregards the international community's
    concerns over its efforts to obtaining nuclear power and possibly
    weapons. It seems clear that the regional effect of these actions will
    be destabilizing in an area of the world vital for U.S. strategic
    interests.
        I want to ask your opinion on the possible change in Iran's
    attitude, if any, based on the outcome of last week's presidential
    elections. Do you believe there is any chance that a change in
    leadership would temper their growing sense of regional importance and
    detrimental national pride? Would a second term with Ahmadenijad at the
    helm cause further military concern in the region based on his rhetoric
    and the state's support of terrorist groups in the region?
        Answer. We are watching the events in Iran very closely. Regardless
    of how the current political dispute is resolved, U.S. and
    international concerns about Iran's nuclear program and support for
    terrorism remain unchanged and DOD will continue to focus on steps
    required to safeguard U.S. security interests.
        Question. There has been a great deal of discussion as of late over
    cyber security. May I commend you for the active and engaged role that
    the DOD is taking in recognizing and addressing the very real threats
    posed by cyber security attacks. Having chaired the Senate Special
    Committee on the Year 2000 Technology Problem (Y2K Committee), I am
    convinced that a significant national security threat exists. It is
    clearly short-sighted to suppose that by increasing funding for one
    year that we will solve all current and future problems. Because
    threats will evolve, so must our responses. This then would call in to
    question not so much our individual responses to cyber threats, but the
    system put in place to address them. Can you describe current efforts
    to effectively structure the systems that will determine how to secure
    cyberspace?
        Answer. The Department has taken steps to address risk effectively,
    and ensure our freedom of action in cyberspace. The Department recently
    established USCYBERCOMMAND, a subunified command under USSTRATCOM. As
    part of that effort we are reviewing all cyberspace policy and strategy
    to develop a comprehensive approach to DOD cyberspace operations.
    Additionally, we are currently reviewing how we acquire information
    technology (IT) systems within the Department. The end result of the
    establishment of USCYBERCOMMAND and the policy, strategy and
    acquisition reviews currently underway will determine how the
    Department secures cyberspace for our operations.
        Question. One of the tests of the new administration's cyber
    security policy is whether it can move beyond what some say has been
    outdated or inadequate thinking that had permeated previous debate. Can
    you describe the right balance in determining the proper role of
    government intervention so that it does not impose too much bureaucracy
    on the private sector, but still offers sufficient protection of
    government resources and assets, especially defense assets?
        Answer. An example of creating the right balance is the
    Department's Defense Industrial Base (DIB) Cyber Security and
    Information Assurance (CS/IA) program. The DIB CS/IA program was
    established in September 2007 by the Department to partner with cleared
    defense contractors to secure critical unclassified DOD information
    resident on, or transiting, DIB unclassified systems and networks. This
    DOD-DIB partnering model provides the mechanism to exchange relevant
    cyber threat and vulnerability information in a timely manner, provides
    intelligence and digital forensic analysis on threats, supports damage
    assessments for compromised information, and expands government-to-
    industry cooperation, while ensuring that industry equities and privacy
    are protected.
                                     ______

                Questions Submitted to Admiral Michael G. Mullen
                Questions Submitted by Chairman Daniel K. Inouye
               institutionalizing irregular warfare capabilities
        Question. Admiral Mullen, our troops entered Afghanistan in 2001
    and Iraq in 2003. We soon realized that the threat environment for our
    military operations was quite different than what we were prepared and
    equipped for. We responded by rapidly developing and fielding thousands
    of anti-IED jammers, more than 16,000 mine resistant ambush protective
    vehicles and countless intelligence, surveillance and reconnaissance
    assets. All of these programs have saved American lives, yet none of
    them are Programs of Record and they are all managed outside of the
    traditional Defense Department bureaucracy. Why was it necessary to go
    outside of the regular Department of Defense acquisition process? And
    how can we institutionalize these capabilities instead of continuously
    adding more layers to the bureaucracy?
        Answer. The experiences of MRAP, the rapid fielding of Army's Task
    Force Odin and other ISR capabilities into theater, and the UAS ``max
    capacity'' push (more Predators/Global Hawk Block 10s) were invaluable.
    These exceptional efforts were successful because we prioritized
    requirements and expedited traditional processes to obtain the agility
    and responsiveness required for wartime acquisition. Several of these
    initiatives now are programs of record or transitioning to programs of
    record.
        We are working to institutionalize the procurement of urgently-
    needed resources in wartime to meet current and future requirements. At
    Congressional request, GAO and the Defense Science Board (DSB) are
    currently looking at this problem and we look forward to their
    recommendations for improvement. The rapid acquisition, deployment, and
    sustainment activities must be harmonized. Additionally, the Department
    must balance the need for high-tech and low-tech equipment solutions,
    while institutionalizing processes and procedures that field
    capabilities quickly and efficiently, when and where needed.
        Question. Admiral Mullen, one of the reasons our acquisition system
    is so cumbersome and inflexible lies in requirements that often demand
    gold-plated solutions that can take years to develop. Many of the rapid
    fielding capabilities we're now sending to theater may only represent a
    75 percent solution, but collectively, they seem to get the job done.
    What is your assessment of the new equipment we've been sending into
    theater? Are we addressing our warfighters' needs?
        Answer. In general, the new equipment fielded has had a huge impact
    in theater, especially in Iraq. The Department is capitalizing on the
    wartime procurement lessons learned so that Afghanistan can benefit
    from these experiences. Much of the rapidly, urgently fielded ISR, C2,
    UAS, force protection, and Counter-IED capabilities are typically low-
    cost, commercial-off-the-shelf (COTS) or slightly modified-COTS
    solutions. The short, time-certain need period is a determinant factor.
    The speed of development and production is increasingly important. Our
    focus is to improve our ability to anticipate requirements and
    therefore minimize the need for partial solutions.
                               irregular warfare
        Question. Admiral Mullen, roughly 6 months ago, your office issued
    guidance declaring irregular warfare to be as ``strategically important
    as traditional warfare''. You state that the fiscal year 2010 budget
    rebalances capabilities and provides roughly 10 percent for irregular
    warfare, 50 percent for traditional, strategic and conventional
    conflict, and 40 percent for dual-use capabilities. However, with no
    outyear budget data and no movement by the military services to
    significantly adapt doctrine and training, how can the Committee be
    assured that ``irregular warfare'' is not just a convenient way to cut
    programs or justify new programs?
        Answer. Recent conflicts around the world highlight how irregular
    warfare is increasingly being employed against conventional military
    forces, and I am absolutely certain that irregular warfare will be with
    us in future conflicts. I see joint doctrine, education and training
    adapting accordingly; we have new doctrine in counterinsurgency,
    stability operations, security force assistance (amongst others) on-
    line and coming on-line, near-term. IW has also been a specific
    emphasis area of mine in both joint education and training for a number
    of years. I fully support the balance between conventional, dual-use,
    and irregular capabilities in the fiscal year 2010 President's budget
    request. The program decisions in this budget request emphasize our
    people first, while balance our efforts by addressing the fights we are
    in and most likely to encounter again without sacrificing conventional
    capability. That balance helps to check programs that have exceeded
    their original design, improve efficiency, and steward the resources
    taxpayers provide us for the common defense. I am confident that this
    balance not only preserves our war fighting edge but also inject the
    flexibility required to address today's most relevant challenges.
        Question. How will you ensure that the military services will not
    scale back their full spectrum readiness training too much, so that we
    can continue to dominate and prevail in major combat operations?
        Answer. We acknowledge adjusting joint force combat capabilities
    and capacities to provide greater emphasis on fighting irregular forces
    potentially risks reducing combat capabilities and capacities with
    respect to regular forces, a less likely but potentially more dangerous
    security threat. This risk will be mitigated to the extent that combat
    capabilities and organizations are designed from the outset for maximum
    versatility and specialized capabilities essential for success against
    regular forces or for deterrence are preserved. It can also be
    mitigated by the development and application of training techniques and
    technologies that help leaders and their subordinates master new skills
    more quickly than more traditional training methods. There are
    processes in place for the service chiefs and combatant commanders to
    provide annual comprehensive assessments of their ability to meet Title
    10 and Unified Command Plan responsibilities including the entire range
    of military operations. The Department's readiness reporting processes
    assess readiness to meet the demands of the National Military Strategy
    across the entire set of NMS missions, and are based largely on
    information reported by the services and combatant commands. Decreases
    in preparedness for major combat operations caused by increasing IW
    preparedness would be evident through reporting by the combatant
    commanders and service chiefs, and managed appropriately. Lastly,
    Congress receives the Quarterly Readiness Report produced by OSD in
    conjunction with the Joint Staff and the services.
                        acquisition reform--requirements
        Question. Admiral Mullen, as we look at improving the acquisition
    system due to massive cost overruns and schedule delays, perhaps we
    should think about the way that weapon system requirements are
    generated and validated. It appears that too often, ``requirements
    creep'', or reaching for immature technologies makes programs too
    costly and off-schedule. How can the Department better manage
    requirements, and perhaps change the service cultures, so that
    acquisition programs are more likely to provide needed capabilities on
    time and on cost?
        Answer. The Department is committed to improve systems acquisition
    performance. We must generate greater agility and responsiveness in our
    acquisition system, especially wartime procurements and foreign
    military sales. The Department made a number of key revisions to its
    acquisition policies and procedures. It is important to
    institutionalize these changes with discipline and better measures of
    effectiveness.
        Part of improving the acquisition process is improving the front
    end of the process--our requirements definition. To improve overall
    performance, the Joint Staff has implemented Requirements Management
    training for all those who occupy positions of responsibility in
    defining and vetting requirements documents. The Joint Requirements
    Oversight Council (JROC) has also continued to refine its processes and
    aims to establish well defined, realistic requirements. To improve this
    process, the JROC has focused and streamlined the capabilities-based
    assessment (CBA) to ensure it provides an appropriate definition of
    capability needs to support a decision for a material solution and the
    warfighter defined requirements to be met. In order to provide the
    warfighter an increased role in the requirements process, the JROC has
    begun to experiment with delegation of Joint Capabilities Board (JCB)
    authority to appropriate functional combatant commands (JFCOM for C2
    and SOCOM for special operations related capabilities). The JROC is
    continuing to evaluate this delegation of JCB authorities and will next
    look at delegation to TRANSCOM for logistics capabilities and STRATCOM
    for net-centric and battlespace awareness capabilities. The JROC has
    updated its instruction and procedures to provide additional direction
    delineating capabilities the JROC must approve to ensure they receive
    appropriate oversight without undue delay. Finally, the JROC is working
    to fully implement the provisions and changed enacted in the Weapon
    Systems Acquisition Reform Act of 2009.
        Question. Do you believe that your staff has the analytic support,
    such as modeling and simulation tools, for objective analysis to help
    prioritize requirements?
        Answer. The Joint Staff has adequate analytical support both in
    terms of qualitative methods (human in the loop war gaming
    capabilities) and quantitative methods (modeling and simulation
    capabilities) to validate assumptions and outcomes. These analytic
    tools help frame the front end of the requirements development process
    and feed into Capability Based Assessments which are conducted to
    assess and prioritize specific capability gaps.
        Question. What improvements or changes would you recommend in order
    to better manage requirements?
        Answer. We are continuously evaluating methods to streamline the
    management of requirements. To that end, we have made recent changes in
    the requirements development and management process.
      --We are limiting the number of documents that must go through joint
            review and oversight to those that impact joint operations.
      --We have provided guidance to better scope the analysis done in the
            capability gap assessment process. This will reduce time and
            resources required while presenting an appropriately defined
            requirements gap to the Joint Requirements Oversight Council
            (JROC) for validation. This will allow the Department to move
            more quickly from the requirements process into the acquisition
            process.
      --We have recognized that information technology systems need to have
            a more flexible requirements management process than
            traditional hardware programs. To address this, we have better
            tailored the requirements process as it applies to information
            technology systems. Once the JROC approves the initial
            performance requirements and provides overarching cost and
            schedule constraints, it will delegate requirements management
            and oversight to an appropriate Flag level body that has the
            time and flexibility to effectively manage the development of
            these systems.
        We are also working on future improvements to the requirements
    management process:
      --We are developing an information technology data management tool
            which will allow us to structure the data in requirements
            documents to make the information more readily available and
            visible for comparison and analysis.
      --We are developing a similar tool for managing joint urgent needs to
            allow for more rapid information sharing so that we can make
            decisions more rapidly and get solutions into the hands of the
            warfighter more quickly.
        We will continue to identify opportunities to improve the
    requirements management process to ensure we provide the correct level
    of oversight balanced with the ability to respond efficiently to the
    warfighter's needs.
                 strategic implications of program terminations
        Question. Admiral Mullen, we understand that the fiscal year 2010
    budget is a step towards rebalancing resources to build irregular
    warfare capacity applicable to the current fight. But we still face
    threats from traditional nation states such as North Korea and
    potentially Iran or others. How do program terminations such as the F-
    22, C-17 and Future Combat System Manned Ground Vehicle affect our
    ability to respond to traditional threats? Are we swinging the pendulum
    too far the other way?
        Answer. I don't think the President's fiscal year 2010 budget (PB-
    10) swings the pendulum too far away from traditional threats. PB-10
    provides a rebalancing of the Department's programs in order to enhance
    our capability to fight the wars we are in today and the scenarios we
    are most likely to face in the years ahead. This rebalancing also
    provides a hedge against other risks and contingencies. Last year's
    National Defense Strategy concluded that although U.S. predominance in
    conventional warfare is not unchallenged, it is sustainable for the
    medium term given current trends. PB-10 focused on what programs are
    necessary to deter aggression, project power when necessary, and
    protect our interests and allies around the globe.
                      de-militarizing u.s. foreign policy
        Question. Admiral Mullen, earlier this year, you suggested that the
    military should be ``brave enough not to lead'' when it comes to
    foreign policy. Can you elaborate on that concept for us?
        Answer. We have learned from the past 7 years of war that we serve
    this Nation best when we are part of a comprehensive, integrated
    approach that employs all elements of power to achieve the policy goals
    set forth by our civilian leaders. The lead agent of U.S. diplomacy and
    development should be the State Department, which obviously requires
    the backing of a robust military and a strong economy. As we win the
    wars we are fighting and restore the health of our Armed Forces, the
    military's approach will increasingly support our diplomatic
    counterparts through the persistent engagement required to build
    networks of capable partners. Integrated with these partners and the
    interagency and non-governmental organizations, we will more
    successfully protect the citizens of this Nation.
               ground-based missile defense (alaska interceptors)
        Question. Admiral Mullen, the Department's budget request would
    effectively stop the emplacement of ground-based interceptors in Fort
    Greely, Alaska. Has the ballistic missile threat to the U.S. homeland
    changed to warrant curtailing this program?
        Answer. The threat of long-range ballistic missile attacks by rogue
    states, such as North Korea today and Iran in the near-future, remain a
    threat to the U.S. homeland. The fiscal year 2010 budget adequately
    addresses the current North Korean threat and provides limited
    protection against future threats from the Middle East.
            fiscal year 2010 overseas contingency operations request
        Question. Admiral Mullen, how will you ensure that urgent,
    unforeseen warfighter requirements are addressed in the fiscal year
    2010 overseas contingency operations budget? Can you assure us that the
    Committee will be informed of any necessary adjustments?
        Answer. We built the fiscal year 2010 overseas contingency
    operations budget with the best information available. The new
    administration provided us with the decisions necessary to produce
    estimates reflective of the current policies of the United States for
    the operations in Iraq and Afghanistan for fiscal year 2010.
        However, changing conditions on the ground and the commander's
    assessment of needs to prevail in the operations could drive the
    requirement for changes in force structure or in other areas that would
    compel the Department to make adjustments to the budget. We ask for
    your support of legislative proposals that would increase our
    flexibility for responding to these types of adjustments. Legislative
    proposals such as raising the threshold level for urgent minor
    construction, expanding or continuing train/equip authorities, and
    continuing or expanding authority for the transfer of equipment to the
    Iraqi/Afghan security forces increase our flexibility and are essential
    to the successful conduct of the operations. Should we experience
    significant urgent, unforeseen requirements we cannot resolve on our
    own, we will work with the administration to inform the committee as
    appropriate.
                              strain on the force
        Question. Admiral Mullen, the Army's and Marine Corps' suicide and
    divorce rates have risen sharply this past year. It appears that the
    strain of frequent deployments is affecting the emotional health of our
    soldiers and Marines. Do you believe the Department is doing enough to
    support service members and their families? What more could we do?
        Answer. The high suicide rates are a sobering gauge of challenges
    currently facing all the services. Failed relationships, alcohol abuse,
    legal, financial and occupational difficulties all remain established
    risk factors for suicide. We know that high mission tempo associated
    with the wars in Iraq and Afghanistan, increased deployment lengths,
    repeated deployments and limited downtime between deployments are all
    associated with increased mental health issues. We believe that combat
    deployments, combat stress and suicide rates are all very much related,
    although analytical data citing this direct correlation is not yet
    available.
        In response to this belief, we are actively engaged in efforts to
    reduce the stress on the force and their families by increasing dwell
    time at home between deployments. Over the next 18-24 months, we
    anticipate a move toward 2 years at home for every 1 year deployed for
    our active duty forces and 5 years at home for every one year deployed
    for our reserve component forces.
        Meanwhile, the services are actively engaged in educating service
    members and leaders at all levels on suicide prevention, and programs
    targeting risk factors and incorporating protective factors have been
    instituted. Joint initiatives, such as the establishment of the Defense
    Centers of Excellence for Psychological Health and Traumatic Brain
    Injury and the DOD Suicide Prevention and Risk Reduction Committee
    provide infrastructure to assess, validate, oversee and facilitate best
    practice prevention, resilience, identification, treatment, outreach,
    rehabilitation and reintegration programs to ensure we meet the needs
    of the Nation's military communities.
        The military has made large strides to provide improved and
    increased mental health support for service members and families. Each
    service has been addressing this issue since 2003, most actively since
    2007. DOD has made sufficient funding available to meet the
    psychological health requirements as currently established by OSD(HA)
    and the services through 2010. We have increased military/civilian
    mental health provider numbers by 75 percent and network mental health
    providers by 25 percent since 2001.
        Despite these overall increases in mental health provider staffing
    to support our military communities, shortfalls remain. Although the
    services are funded, a shortfall of nearly 1,000 additional mental
    health providers is reported across the services this year.
    Complicating this shortfall is the similar overall shortage of
    providers in the civilian sector, as well as difficulty hiring
    clinicians for the relatively remote locations of the posts, camps, and
    installations where service members and their families reside. Numerous
    mental health recruitment and retention staffing initiatives continue
    in order to try to fill this gap, including direct hire authority of
    civilians, scholarships, critical skills retention bonuses and loan
    repayment programs. However, dedicated efforts to address our military
    health system's current distribution/utilization of mental health
    personnel, staffing models, standard of care and practice issues and
    manpower accounting capabilities must be further examined and modified
    where required.
        Senator Inouye, your sponsorship of significant telemedicine
    legislation and research is greatly appreciated. We are striving to
    leverage these assets.
        Because of the nature of the problem and the number of service
    members affected, the medical community alone will not succeed without
    increased leadership emphasis targeting prevention and cultural change.
    A continued concerted effort is required to first identify and then
    successfully reverse the root causes of the complex issues we confront
    as well as fighting the mental health stigma at every level. I do not
    consider the elimination of mental health stigma to be a heath issue,
    but a leadership issue. I am determined to change our culture and
    assure you this is a top priority.
        Question. The Army and Marine Corps have now both completed their
    planned end strength growth. Do you believe that the Army and Marine
    Corps force structure is large enough to relieve the operational strain
    on the force?
        Answer. The Army and Marine Corps force structure will be large
    enough to relieve the operational strain on the force when, in the
    Army's case, the 22,000 personnel are fully accessed and trained. With
    respect to the Marine Corps, the authorized 202,000 active duty end
    strength is sufficient to meet 1:2 Active Duty dwell and 1:5 Reserve
    Force dwell in the mid-term.
        The Army sought and received a temporary increase of up to 22,000
    personnel in end strength to alleviate the continued pressure of global
    demands. This increase will serve to relieve the strain on the force by
    improving the Army's ability to fill deploying units (both BCTs and
    enablers) in order to offset increasing non-deployable rates (13
    percent in 2009, primarily medical conditions) and the elimination of
    the Stop Loss program.
        Additionally, when fully implemented, the temporary increase will
    improve the strength of units in RESET by achieving over 100 percent
    authorized strength for TRAIN/READY units to provide more units with
    deployable strength at or above 93 percent.
        Up to 2,000 of the 22,000 will be focused on officer increases
    (through retiree recalls) and NCO increases (retention actions and
    retiree recalls) with the priority for the retiree recalls to fill/
    offset Worldwide Individual Augmentation System (WIAS) requirements.
        The Army's decision to seek the full 22,000 temporary increase will
    be based on detailed analysis of the demand assumptions projected for
    summer 2010 and the impact on readiness of the first 15,000 of the
    temporary end-strength increase which will be complete by September,
    2010.
        With respect to force readiness, the improvement in readiness will
    be incremental as we bring increasing numbers of the 22,000 into the
    force. The first priority is to increase deployer fill. We have
    determined the priority Military Occupational Specialties (MOS) and
    training base capacity allowing us to impact those units with goal of
    bringing the first 5,000 on by the end of the fiscal year.
        The transition to the Afghanistan-focused CENTCOM theater campaign
    plan before a sufficiently reduced demand for forces in Iraq impacted
    the overall demand for Army forces. Of the 43 Active Component Brigade
    Combat Teams (BCT), all are either committed to global operations, in
    transit to those operations, in Army force regeneration, RESET, or
    training phases with a Boots-On-Ground (BOG) to dwell ratio of 1:1.4.
    The Army's manning guidance for deploying BCTs is to man to 105 percent
    assigned strength in order to attain 95 percent deployed strength. U.S.
    Army in coordination with CENTCOM guidance deploys all combat arms
    forces at or above 90 percent deployed strength. Deploying units that
    do not achieve a manning level of 90 percent at Latest Arrival Date
    (LAD) plus 30 days must ``deploy by exception'' as approved by the
    Chief of Staff of the Army.
                         age and health of tanker fleet
        Question. Admiral Mullen, I am concerned about the aging Air Force
    tanker fleet and the health and age of the KC-135 tankers by the time
    they are replaced. Can you update the Committee on the status of the
    Air Force tanker fleet, including the age of the fleet and any present
    safety and flight concerns with the current fleet?
        Answer. Our current Air Force tanker fleet has been operating
    without readiness issues, but with the age of KC-135s averaging 48
    years, future operational availability will depend on flight hours and
    usage patterns.
                       special operations command (socom)
        Question. Admiral Mullen, the Commander of the Special Operations
    Command, Admiral Olson, recently stated that escalating requirements
    for capabilities provided by Special Operations Forces have outpaced
    SOCOM's ability to train new personnel and develop critical enablers in
    the areas of aviation, intelligence, and communications. To mitigate
    these shortfalls, Admiral Olson has requested that the military
    services provide Special Operations Command with additional assistance
    and manpower in these critical support areas. Are the services able to
    meet these additional requirements? How will this plan be managed, and
    to what degree has it been incorporated in the fiscal year 2010 budget
    request?
        Answer. Through the generous support of Congress, the services have
    been able to meet the additional requirements for conventional support
    to special operations. In limited situations, the services have
    supported special operations requests with ``ad hoc'' solutions and by
    detailing ``in lieu of'' manpower or assets to assist. Looking forward,
    achieving the Grow the Force Initiatives in the Army and Marine Corps
    and the significant increases in ISR and rotary wing aviation training
    requested in the fiscal year 2010 President's budget will ensure
    critical conventional force enablers to special operations forces are
    provided to support current conflicts and prepare for future
    challenges.
        Question. Funding for Special Operations Command has grown from
    $2.1 billion in 2001 to nearly $8.6 billion, including supplemental
    funding, in fiscal year 2010. During this same time period Special
    Operations Command's mission has grown exponentially, as evidenced most
    recently by its designation as the DOD Proponent for Security Force
    Assistance (SFA). Given this rapid growth in both budget and
    responsibility, how are you ensuring programmatic and fiscal
    accountability within Special Operations Command?
        Answer. Special Operations Command (SOCOM) has developed rigorous
    strategic planning, programming, budgeting and execution processes. The
    command submits its program for Special Operations Forces (SOF)-
    peculiar requirements, funded through defense-wide appropriations
    lines, directly to the Department, in much the same way the services
    do. While the four component commands work their SOF-peculiar
    requirements through SOCOM's processes, they must also work through
    their individual parent services to ensure the approval and resourcing
    of service-common requirements.
        Commander, SOCOM has taken several steps since 2001 to help ensure
    effective stewardship of appropriated funding. SOCOM has not only
    increased the number of military and civilian financial management
    personnel who execute and oversee resources, and in June 2008, the
    commander made the financial management function a stand-alone center,
    and the Comptroller reports directly to him.
        Specifically, there are several programs and processes in place to
    help command financial managers maintain visibility over the command's
    SOF-peculiar Major Force Program (MFP)-11 funding. The command
    established a quarterly resourcing process, the Joint Resources
    Management Program (JRMP) with the Deputy Commander as the final
    decision-making authority. Further, the component command and the
    Theater Special Operations Command (TSOC) comptrollers participate in
    the allocation of SOCOM's funding. The JRMP oversees all MFP-11
    resources; this year, the process was more closely aligned with the
    command's Center for Acquisition and Logistics, and includes quarterly
    execution reviews of all procurement and RDTE programs.
        The command has established controls to reasonably ensure that
    obligations and costs are in compliance with any applicable laws; its
    funds, property, and other assets are safeguarded against waste, loss,
    unauthorized use or misappropriation; and they properly record and
    account for revenues and expenditures.
        Finally, SOCOM uses accounting processes and tools to provide
    additional visibility over the use of MFP-11 funds, and to help
    identify potential abnormalities during execution. These include: the
    analysis of the monthly Appropriation Status FY Programs and
    Subaccounts Report (AR(M)1002); Tri-Annual Reviews (TARs), which
    require financial analysts to formally review all open documents to
    determine validity of funds obligated and committed, and de-obligates
    for other purposes those that are not valid; electronic databases such
    as the Financial Information System that provide command personnel with
    real-time fund status; and the Defense Departmental Reporting System,
    which provides SOCOM's official financial reports and Auditable
    Financial Statements.
                                     ______

                Questions Submitted by Senator Richard J. Durbin
        Question. In 2008, the Department of Defense's Defense Institute
    for International Legal Studies (DIILS) began its ``Afghan National
    Army Legal Development Program'' in response to a request for rule-of-
    law training from the Combined Security Transition Command--
    Afghanistan. Approximately eight Afghanis were trained to be the
    trainers for future Afghan Legal Advisor training programs. In March
    2009, the first course, taught by these trainers trained 50 Afghan
    National Army and Afghan Ministry of Defense legal advisors on various
    aspects of the ``rule of law.''
        What is the Department of Defense's comprehensive plan to ensure
    that its rule-of-law training in Afghanistan is conducted in a
    consistent, systematic, and integrated manner?
        Answer. Defense Institute for International Legal Studies (DIILS)
    has been active in Afghanistan since February 2004. DIILS was part of a
    Legal Development Training Team (LDTT) engaged in the development of a
    Comprehensive Legal Officer Training Plan (CLOTP) for the Afghan
    National Army (ANA). The CLOTP entailed working with eight experienced
    ANA legal personnel to develop a curriculum and instructional materials
    for a formal course of instruction for ANA legal officers. The LDTT and
    the Afghan legal personnel co-authored, co-produced, and implemented
    the training program and provided the training to a mix of 50 officers
    from the ANA and the MOD. The goal of this course is that every Afghan
    legal officer be able to participate and attend this course over the
    next 1-2 years. This program is under the overall oversight of the
    Staff Judge Advocate (SJA) for CSTC-A. The SJA is responsible for the
    conduct of this course and will continue to encourage the cadre of
    Afghan instructors to implement this program of instruction.
        Question. What is the Department of Defense's plan to monitor
    adherence to rule-of-law principles within the Afghan National Army,
    Afghan National Police, and Afghan Ministry of Defense and provide
    follow-up training?
        Answer. The Department of State is the department responsible for
    rule-of-law and other governance and development initiatives. Please
    also see the answer to the previous question.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
        Question. Admiral Mullen recently predicted that in 2009 the Army
    would see a record number of suicides. So far this year, the highest
    reported number of suicides on an Army installation has been at Fort
    Campbell in my home State of Kentucky, with 11 suicides. I find this
    deeply troubling. What immediate action is being taken at Fort Campbell
    to prevent further suicides among soldiers?
        Answer. In April 2009, the Army published Annex D of the Army
    Campaign Plan for Health Promotion, Risk Reduction and Suicide
    Prevention which was distributed to Commanders throughout the Army.
    This was followed by an All-Army Action (ALARACT) from VCSA GEN Peter
    W. Chiarelli encouraging Commanders to utilize the guidance provided in
    Annex D. Annex D directs Installation, Garrison and Military Treatment
    Facility Commanders to optimize efforts of already existing programs by
    ensuring their coordination, integration, evaluation and marketing.
    There were specific steps and tasks to be completed in preparation for
    further ongoing programmatic changes initiated by the group of subject
    matter experts.
        In addition, those experts have worked closely with command
    elements at Fort Campbell and the Army's Office of the Surgeon General
    to address the unique needs of the military community at that
    installation. Consequently, Fort Campbell developed a concept of
    ``resilience teams'' which will supplement current medical assets. The
    resilience team is placed into each Brigade and works closely with unit
    leaders, soldiers and families to identify high risk individuals.
    Medical personnel have also been ``surged'' to Fort Campbell from other
    installations to supplement existing assets while Fort Campbell works
    to expeditiously fill vacancies.
        Fort Campbell has redistributed its behavioral health assets to
    maximize access to care among its supported Soldier population, to
    include relocating some behavioral health assets to fill brigade-level
    behavioral science officer positions.
        In addition, the Army's Center for Health Promotion and Preventive
    Medicine (CHPPM) sent a team to assess whether leadership turnover and
    training were contributing factors. A senior psychiatrist from the Army
    Surgeon General's office performed a staff assistance visit in June and
    will conduct a follow up visit in July.
        Question. What mental health and counseling resources are currently
    available to soldiers and their families at Fort Campbell?
        Answer. Blanchfield Army Community Hospital (BACH) supports a
    military population of 78,222 eligible beneficiaries with an average of
    8,000 claims per month for mental healthcare in the BACH network area.
    The current staffing picture for services provided by the Community
    Counseling Center, Adult Behavior Health Unit, Child and Adolescent
    Psychiatry Unit, Social Work Service and the Family Advocacy Program
    includes a total of 201 behavioral health providers (military, civilian
    and contractors). Twenty-five additional positions have been recently
    funded and filled, and recruiting actions are underway for another 15
    positions which are funded, but unfilled. (Information provided by U.S.
    Army Office of the Surgeon General on July 27, 2009.)
        In addition to the services listed in the previous paragraph, the
    Substance Abuse Program currently has eight available counselors and
    two counselor vacancies. BACH is actively engaged in recruitment
    efforts to increase the total number of substance abuse counselors to
    15. All soldiers are seen on a walk-in basis; however, rehabilitation
    team meetings are not meeting the 7-day completion standard due to the
    staffing shortfalls. Group treatment settings are provided for all
    participating soldiers; however, group participation is limited to
    generic pre-treatment groups for the first 4-5 weeks, until which time
    space in specific treatment groups becomes available.
        Office of the Secretary of Defense (OSD) Military OneSource (MOS)
    supplements existing Fort Campbell Army Family programs by providing a
    24-hour toll-free information and referral telephone line and Internet/
    web based service. MOS has received a total of 3,802 calls for
    counseling with 11 of those resulting in telephonic counseling, 1,455
    in-person counseling and 1,200 referrals to in-person counseling.
    Seventy percent of these contacts were from service members and 30
    percent for family members. The top five reasons for in person
    counseling includes relationship, stress management, depression,
    personal growth and returning from deployment. All soldiers and their
    families have access to Military OneSource which provides up to 12
    counseling sessions free of charge with providers from the local
    community.
        Each battalion at Fort Campbell has a chaplain who is available for
    soldiers and family members and there are additional chaplains
    integrated throughout the installation.
        As of June 23, 2009 the U.S. Army OTSG Headquarters reports 2,735
    behavioral health providers in the U.S. Army staffing inventory with a
    current shortfall of 336. This is an increase of 156 providers since
    the last update provided June 9, 2009 with March 2009 numbers. Funding
    is available for the shortage of 336 mental health providers. The Army
    is using a number of incentives with continuous positive outcomes shown
    in an increase in positions being filled. There continues to be work in
    the area of determining the correct staffing model and numbers to meet
    the needs of all locations of the military population.
        Question. Are these resources going to be increased in light of the
    rise in the suicide rate? If not, why not?
        Answer. Yes, the Army Medical Command (MEDCOM) has sent 31
    additional behavioral health specialists to support Fort Campbell's
    soldiers and families. Specifically, it doubled the number of Army
    Substance Abuse Counselors from 8 to 16; it sent 3 additional
    psychiatrists, 6 additional clinical psychologists, and 3 additional
    licensed clinical social workers. These personnel will stay in place at
    Fort Campbell until permanent military, civilian, and contract
    personnel arrive at Fort Campbell.
        There is a very active and robust recruiting effort at Fort
    Campbell which aims to fill vacant behavioral health positions while
    maintaining standards to ensure the highest quality of care for our
    soldiers and families.
        In the interim, Fort Campbell developed a concept of ``resilience
    teams'' which will supplement the already existing medical assets at
    Fort Campbell by placing these teams into each Brigade. These teams
    will work closely with unit leaders, soldiers and families to identify
    high risk individuals. Medical personnel have been ``surged'' to Fort
    Campbell from other installations to supplement existing assets while
    Fort Campbell works to expeditiously fill vacancies. In addition, the
    Army Office of the Surgeon General and MEDCOM are actively reviewing
    the Automated Staffing Assessment Model to evaluate the necessity of
    modifying the required number of behavioral health and primary care
    providers given the effects of protracted conflict on the soldiers,
    families and the military health system.
        Question. More broadly, what is the Army doing across the board to
    address this deeply troubling trend?
        Answer. The Army is focusing, but not limiting, its efforts through
    the Army Campaign Plan for Health Promotion, Risk Reduction and Suicide
    Prevention. This plan was developed through a group of subject matter
    experts convened by the VCSA GEN Peter W. Chiarelli. The experts
    developed approximately 250 tasks which span the entire Policy,
    Doctrine, Organization, Training, Materiel, Leadership, Personnel,
    Facilities and Resource (P-DOTMLPeF-R) spectrum and incorporated those
    tasks in a synchronization matrix. This matrix is a working document
    and has been staffed with the Army Suicide Prevention Council which is
    made up of senior representatives from across the Army Staff. The tasks
    are designed to approach suicide prevention from a holistic perspective
    with the belief that if we address areas which contribute to suicide,
    the rate of suicide will decline.
        The Army also completed Phase I of Suicide Prevention Training
    during an unprecedented stand down from February 15 to March 15. The
    Army is currently executing Phase II of suicide prevention training
    (March 16 to July 16). Phase III will follow and will consist of
    ongoing efforts that are developed and modified to address the evolving
    needs of the Army.
        Question. Does the military need greater authority or resources in
    this area? If so, what are they?
        Answer. DOD recognizes the need for comprehensive mental health
    programs to support our soldiers, sailors, airmen, marines and their
    families. The services currently have an estimated staffing need for
    4,935 mental health professionals (3,072 Army, 1,011 Air Force and 852
    Navy); 479 (9.7 percent) of these positions are unfilled (337 Army, 100
    Air Force and 42 Navy). DOD has budgeted over $1.7 billion and $1.8
    billion for fiscal years 2009-2010 respectively to pay for these
    shortfalls; significant hiring initiatives and overall progress
    continue to be made across the services, although challenges remain. We
    continue to refine our staffing models (accounting for increased
    deployments, occupational issues, risks for combat-related illness and
    injuries and cumulative stress on servicemembers and families) in order
    to best define numbers and types of staffing necessary to most
    effectively meet our goals of building resilience, reducing stigma and
    providing timely access to preventive and therapeutic mental healthcare
    while maintaining servicemember and family satisfaction. Requirements
    will continue to evolve and additional authorities and resources may be
    required in the future.
        The Nation's overall shortage and maldistribution of mental health
    providers is a significant impediment to filling our currently funded,
    yet empty mental health provider billets. According to experts from the
    U.S. Department of Health and Human Services' Health Resources and
    Services Administration, a shortage of over 5,000 mental health
    practitioners exists in the civilian mental health provider communities
    serving United States underserved areas. This shortage is likely to
    grow, as witnessed by recent media attention to increased demand for
    mental health services by the U.S. civilian population as well. The
    national shortage compounds our problem of attracting non-uniformed
    providers to the rural areas in which many military installations are
    located, negatively impacting both military and TRICARE network
    staffing. Greater authority and resourcing to provide scholarships to
    civilians-in-training in exchange for medical service within our
    military health system would benefit DOD mental health professional
    recruitment efforts.
        In an effort to find alternative solutions to the ongoing national
    mental health professional shortage, Internet technologies are being
    explored within the military and network health communities. We believe
    telehealth technologies could be utilized to expand services to
    military members and their families in these underserved areas. TRICARE
    Management Activity has recently modified the managed care support
    contracts to allow Employee Assistance Program level consultations at
    home. A study protocol for in-home psychiatric consultation capability
    using these modalities is also being developed. Legislative change
    providing relief for healthcare provider State licensure requirements
    and restrictions during telemedicine has the potential to foster
    greater telemedicine access and would help military families and the
    Nation as a whole.
        Finally, we believe that non-medical factors such as recruitment,
    retention, training, leadership and stigma are critical aspects of the
    larger, complex problem which must continue to be closely examined if
    we are to effectively deal with the issues facing our servicemembers
    and their families.
                                     ______

                Questions Submitted by Senator Robert F. Bennett
        Question. I understand the State Department is considering placing
    North Korea back on its list of state sponsors of terrorism. The recent
    missile tests, nuclear detonation and farcical trial of two American
    journalists are only the most recent examples of the North Korean
    regime's intentionally bellicose actions intended to antagonize the
    international community and provide diplomatic maneuvering from which
    to blackmail the rest of the world. The new administration's view of
    missile defense focuses on rogue state and theater missile threats. It
    seems especially pertinent at this time to look at the missile defense
    system in Alaska that has been targeted for reduction.
        Is it wise at this point to reduce the number of ground-based
    interceptors and await the result of the Quadrennial Defense Review and
    the Nuclear Posture Review to determine the best capabilities to defend
    against threats from an obvious rogue state whose missile are already
    capable of striking our northern-most state?
        Answer. The interceptors in place (to include programmed
    improvements), plus those planned for in the fiscal year 2010 budget,
    are sufficient to defend against the North Korean ballistic missile
    threat capable of striking U.S. homeland. Given the current shot
    doctrine, 30 operational GBIs provide sufficient fire power to protect
    the United States from ICBMs given the number of ICBM launch complexes
    and the long development time required for additional ICBM launch
    complexes in North Korea and Iran. The U.S. inventory of operational
    GBIs may be expanded in the future should the threat grow.
        Question. The United States has an obvious and immediate interest
    in the future of Pakistan, a nuclear-armed state with a history of
    military coups, ethnic and religious instability that contains lawless,
    drug-filled hinterlands that harbor international terrorists. With this
    explosive mix geographically adjacent to our troops in Afghanistan and
    cross-border cooperation between drug cartels, Al-Qaeda and the Taliban
    I am very concerned about our future military plans for the region. I
    understand the budget request for $700 million for the Pakistan
    Counterinsurgency Capabilities Fund will compliment Department of State
    efforts and be coupled with the Foreign Military Financing Program
    underway.
        Can you describe in an unclassified setting the contingency plans
    we may have with regard to the Pakistani military, its nuclear weapons
    and stability in the region should the Pakistani government fail or be
    overthrown by Islamic militants?
        Answer. The Department of Defense routinely plans for a variety of
    contingencies around the world. For security reasons, we cannot comment
    further.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. Our next hearing will be held on June 19
    at 10:30, at which time we'll listen to public witnesses.
        Mr. Secretary, Admiral Mullen, Mr. Hale, we thank you very
    much for your service to our country and, through you, we thank
    the men and women of our uniformed services. Thank you very
    much.
        [Whereupon, at 12:09 p.m., Tuesday, June 9, the
    subcommittee was recessed, to reconvene at 10:30 a.m., Friday,
    June 19.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010

                                  ----------

                            THURSDAY, JUNE 18, 2009

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:30 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye and Cochran.

                           NONDEPARTMENTAL WITNESSES

    STATEMENT OF ALEC PETKOFF, DEPUTY DIRECTOR, NATIONAL
                SECURITY COMMISSION, THE AMERICAN LEGION

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. I'm pleased to welcome all of you to this
    hearing, where we'll receive public testimony pertaining to
    various issues related to the fiscal year 2010 Defense
    appropriations request.
        Because we have so many witnesses who wish to present
    testimony, I'd like to remind each witness that, unfortunately,
    they'll have to be limited to 3 minutes. Like to have this all
    day, but I have a supplemental appropriations pending on the
    floor.
        So at this point, I'd like to recognize the first witness,
    Mr. Alec Petkoff, deputy director of the--national security of
    The American Legion.
        Mr. Petkoff. Thank you, Mr. Chairman.
        Mr. Chairman, I want to thank you for inviting The American
    Legion to share its views on defense appropriations for fiscal
    year 2010.
        Since its founding in 1919, The American Legion remains
    steadfast in support of a strong national defense. The United
    States is a Nation at war, still battling against extremist
    Islamists all over the world. The United States also must be
    prepared for any number of threats to our national security,
    whether they arise from powerful nation states, rogue nation
    states, nonstate violent extremists, natural disasters, or
    instability resulting from economic downturns in the world
    economy.
        Our need for a ready and robust military is clear. Now is
    not the time to slow down or reduce the level of spending
    required to keep our country safe from this spectrum of
    threats. From quality-of-life issues, to force structure, to
    military healthcare, to procurement, none of these areas should
    be neglected at the expense of the other. With this in mind, we
    would like to briefly highlight some vital areas of concern.
        The first area of concern is the size of the active duty
    force. For decades, The American Legion has advocated for an
    active duty force of at least 2.1 million members. Since
    September 11, 2001, we have seen the results of having a force
    that is too small in relation to our national security needs.
    The results have been dramatically bad for our military
    servicemembers. These results are multiple deployments without
    adequate dwell time, straining military servicemembers, and
    likewise their families, to the breaking point; the required
    implementation of stop-loss, and the dramatic transformation of
    the National Guard from a strategic force to an operational
    force, which has increased our risk and reduced our strategic
    freedom of action. These results have had negative impacts on
    readiness and quality of life.
        Three years ago, Congress decided to increase the size of
    the force, adding 65,000 soldiers to the Army. This initiative
    has been a success. The Army reached its increased recruiting
    goal earlier this year, 2 years ahead of schedule. The Grow the
    Force Initiative has been successful, but that does not mean it
    should end.
        This is reinforced by Defense Secretary Robert Gates, who
    said, in testimony before the Senate Armed Services Committee
    last month, that despite the success of the Grow the Force
    Initiative, he remains concerned by the limited dwell time that
    our soldiers have between deployments. Therefore, The American
    Legion recommends further funding to significantly increase the
    size of the force beyond the original Grow the Force
    Initiative.
        The American Legion also has the following recommendations
    for the subcommittee:
        In military personnel, The American Legion supports a
    military pay raise from the suggested 2.9 percent to 3.9
    percent, to help close the civilian-military pay gap, and
    additional funds for Reserve Officer Training Corps.
        In operation and maintenance, with respect to defense
    health programs, The American Legion supports the full funding
    of TRICARE for retirees, dependents, and all Reserve forces.
    The American Legion also supports wounded warrior care
    improvements, to include outreach and treatment for traumatic
    brain injury and all mental and combat-stress related
    illnesses. And finally, funding for a standalone DOD research
    program into blood cancers, through the congressionally
    directed medical research program.
        In procurement, the Army should obtain necessary equipment
    to man the full complement of 48 brigade combat teams, as
    opposed to the proposed cutback to 45, and continue to refit
    and update the equipment of our Reserve forces, and timely
    procurement of advanced Air Force and Navy weapons systems,
    aircraft, and ships.
        In research, development, testing and evaluation, increases
    in missile defense, electronic warfare technology, and weapons
    technology are needed. Cuts to missile defense seem unwise.
        And finally, military construction--construction
    improvements to base medical facilities, commissaries,
    exchanges, and other facilities. And we urge that whenever a
    base realignment and closure is conducted, that certain base
    facilities, such as medical facilities, commissaries,
    exchanges, and other facilities, be preserved for use by active
    duty, reservists, retired military, veterans, and their
    families.
        The American Legion, again, thanks the chairman for having
    this important hearing, and for inviting us to present our
    views. I look forward to continue working with this
    subcommittee on these important issues of national defense.
        Chairman Inouye. Thank you very much. I would welcome any
    written material you may have.
        Mr. Petkoff. I would like to submit our written testimony
    for the record at this time, Mr. Chairman.
        Chairman Inouye. Thank you.
        [The statement follows:]
                       Prepared Statement of Alec Petkoff
        Mr. Chairman and members of the Subcommittee, thank you for
    inviting The American Legion to share its views on defense
    appropriations for fiscal year 2010. Since its founding in 1919, The
    American Legion remains steadfast in its support of a strong national
    defense which is reflected in the Preamble to The American Legion
    Constitution, namely, ``To uphold and defend the Constitution of the
    United States of America,'' and ``to inculcate a sense of individual
    obligation to the community, state and nation.''
        The United States is a Nation at war still battling against
    extremist Islamists all over the world. The United States also must be
    prepared for any number of threats to our national security whether
    they arise from powerful nation-states like Russia or China; rogue
    nation-states like Iran, North Korea or Somalia; natural disasters; or
    instability resulting from economic downturns in the world economy. Our
    need for a robust military is clear. Now is not the time to slow down
    or reduce the level of spending required to keep our country safe. With
    this in mind, The American Legion offers the following recommendations
    with a brief summary of explanation followed by a more complete
    rendering of The American Legion's views and recommendations:

     APPROPRIATIONS PROPOSALS FOR SELECTED GENERAL DISCRETIONARY PROGRAMS FOR DEPARTMENT OF DEFENSE FOR FISCAL YEAR
                                                         2010\1\
                                                      [In Billions]
    ----------------------------------------------------------------------------------------------------------------
                                                                                        Proposed
                                                                       Funding for       defense       The American
                                                                       fiscal year     funding for   Legion's fiscal
                                                                          2009         fiscal year      year 2010
                                                                                          2010       recommendations
    ----------------------------------------------------------------------------------------------------------------
    Total Defense Spending.........................................          $654.7          $663.7           $728.2
    Military Personnel.............................................          $142.7          $149.6             $150
    Operation and Maintenance......................................          $273.5          $276.2           $315.7
    Defense Health Programs (Operation and Maintenance)............           $25.7           $26.9        \2\ $63.2
    Procurement....................................................          $133.2          $131.2           $136.2
    Research, Development, Test and Evaluation.....................           $81.7           $78.9             $100
    Military Construction..........................................             $28           $22.9           $26.3
    ----------------------------------------------------------------------------------------------------------------
     \1\ Includes Overseas Contingency Operations or OCO funding.
     \2\ Increase already included in Operation and Maintenance.

        Military Personnel.--Military pay raise from 2.9 to 3.4 percent to
    help close the civilian/military pay gap. Additional funds for Reserve
    Officer Training Corps (ROTC).
        Operation and Maintenance.--The Administration's overall modest
    increase in operations and maintenance is found mostly in the line
    item, ``Administration and Servicewide Activities'' while the line item
    ``Operation Forces'' actually gets a decrease. While one can only
    assume the decrease is predicated on a drawdown of forces in Iraq, The
    American Legion recommends that more funds be allocated in case the
    plans for withdrawal are found to be premature by either the Iraqi
    government or more importantly our commanders on the ground.
        Defense Health Programs.--Fully fund TRICARE for retirees,
    dependents and all reserve forces; Stand alone fund for blood cancers;
    Wounded Warrior Care improvements.
        Procurement--Army.--Obtain necessary equipment to man the full
    complement of 48 BCTs, Navy--Oppose shifting the Navy Aircraft Carrier
    program to a 5-year build cycle. Longer cycles only mean larger costs
    and a weakened force. Air Force--Continue to purchase more F-22 Raptors
    and to hasten purchase and building of the aerial refueling tankers.
    Reserve Forces--Continue to refit and update equipment.
        Research, Development, Test and Evaluation.--Increases in missile
    defense, electronic warfare technology, and weapons technology needed.
    Cuts to missile defense are unwise.
        Military Construction.--Construction and improvements to base
    medical facilities, commissaries, exchanges and other facilities.
        The American Legion upholds the following national security
    principles as fundamental to the best interests of the United States:
      --The National Security Strategy needs to be reassessed so that
            missions and resources are more closely aligned, particularly
            during the upcoming Quadrennial Defense Review.
      --The credibility of the United States in an unstable world needs to
            be maintained by retaining requisite military capabilities to
            deal with actual and potential threats.
      --Such a strategy requires that the Armed Forces be more fully
            structured, equipped and budgeted to achieve this strategy.
      --Active and reserve military end strengths should be increased to an
            absolute minimum of 2.1 million for the foreseeable future.
      --At least 12 full-strength Army Divisions, 11 deployable Navy
            aircraft carrier battle groups, three or more Marine Corps
            Expeditionary Forces, and 13 or more active Air Force fighter
            wing equivalents should be retained, as the minimum needed
            baseline force.
      --Defense budgets should be funded at least 4 percent of Gross
            Domestic Product (GDP) during time of peace, and at 5 percent
            or more during time of war to fund both people and weapons
            requirements.
      --The National Guard and Reserves must be realistically manned,
            structured, equipped, trained, fully deployable and maintained
            at high readiness levels, and not over-utilized in order to
            accomplish their increasing and indispensable missions and
            roles in the national defense.
      --Peacetime Selective Service registration should be retained so as
            to maintain a viable capability to rapidly reconstitute forces
            in the event of emergencies or war.
      --Force modernization for the Armed Forces needs to be realistically
            funded, and not further delayed, or the United States is likely
            to unnecessarily risk American lives in the years ahead.
            Production of airlift and sealift assets needs to be expedited.
      --The American people expect that whenever Armed Forces are
            committed, that they will be committed only when America's
            vital national interests are threatened and only as a last
            resort after all reasonable alternatives have been explored and
            tried.
      --Peacekeeping, peace enforcement, peace-making and humanitarian
            operations detract from military readiness to conduct combat
            operations across the full spectrum of potential conflicts.
            Such operations should be limited, congressionally approved and
            separately appropriated on a case-by-case basis.
      --The honorable nature of military service should be upheld, as it
            not only represents fulfillment of American patriotic
            obligation, but is also a privilege and responsibility of
            citizenship that embodies the highest form of service to the
            Nation.
      --The United States Government must honor its obligations to all
            service members, veterans, military retirees and their families
            with equitable earned benefits, lasting military retirement
            compensation and other appropriate incentives, such as timely
            access to quality health care for all beneficiaries.
      --Major incentives for military service should include an enhanced GI
            Bill for education and training, improved quality-of-life
            features, and a reduced operational tempo in order to recruit
            and retain a high-quality and fully manned, professionally led
            force.
      --The United States Government is urged to retain the necessary
            deployed forces worldwide to accomplish short-term as well as
            long-term commitments and contingencies.
        The American Legion would like to thank Subcommittee Members for
    their hard work on previous legislation to improve the quality-of-life
    for America's Total Force military, retirees, and their families.
        This portion of the statement will contain issues on the following
    subject areas:
      --Quality-of-Life;
      --Force Structure;
      --Manpower and Weapons Systems;
      --POW/MIA.
                                quality-of-life
        It is with particular purpose that The American Legion address
    quality-of-life issues before the issues of ``force structure'' and
    ``manpower and weapons systems'' as concerns our national defense.
    Maintaining a high quality-of-life for our service members has to be
    the first priority of any nation that seeks to defend its interests at
    home or abroad. Whether it be the infantryman, the pilot, the mechanic,
    or the cook, America needs to be able to attract and retain the best
    and brightest our Nation has to offer. Without such Americans to answer
    the call to service, all other money spent on defense will be in vain.
    And so it is with good reason that The American Legion is first
    concerned with the enhancement of quality-of-life issues for active-
    duty service members, Reservists, the wounded and disabled, military
    retirees, and their families. If we are to win the war on terror, and
    prepare for the wars of tomorrow--in this decade and beyond--we must
    take care of the DOD's (Department of Defense) greatest assets; namely,
    its men and women in uniform.
        The United States must honor its obligations to all service members
    (past, present and future) and their families. The American Legion
    urges the Congress and DOD to support and fund quality-of-life features
    for Active-Duty, National Guard and Reservists as well as military
    retirees, veterans and their dependents, and military survivors. This
    is including but not limited to, the following:
      --Military pay comparability for the Armed Forces and regular
            increases in the Basic Allowances for Quarters; renovation and
            construction of military quarters and increased funding for
            child day care centers are direly needed. Pay raises must be
            competitive with the private sector;
      --Adequate medical, mental and dental health services; morale,
            welfare and recreational facilities; and non-privatized
            exchanges and commissary facilities. The Defense Commissary
            Agency (DECA) and its functions should be retained and not
            relegated to the military services;
      --Preserving an attractive retirement system for the active and
            Reserve components and annual cost-of-living adjustments
            (COLAs) paid at the same rate and concurrently with other
            Federal retiree COLAs; oppose any changes to the military
            retirement system, whether prospective or retroactive, that
            would violate contracts made with military retirees and
            undermine morale and readiness;
      --Requiring that the Services perform mandatory physical
            examinations, without waivers, for all separating veterans;
      --Fully funding the concurrent receipt of military retirement pay,
            military separation pays, and Department of Veterans Affairs
            (VA) disability compensation as well as Special Compensation
            pays for disabled military retirees;
      --That the Survivor Benefit Plan and Dependency and Indemnity
            Compensation (SBP/DIC) offset be eliminated;
      --TRICARE for Life and the TRICARE Senior Pharmacy program for
            Medicare-eligible military retirees, their dependents and
            military survivors, should be adequately funded; and regular
            cost-of-living adjustments to military retirement deployment
            pay, capital gains tax exclusions, tax-free and increased death
            gratuity payments, and combat zone tax exclusions for service
            in South Korea;
      --Congressional re-enactment of Impact Aid to fund the local public
            school education of military dependents;
      --Adequately protecting the American public and the Armed Forces from
            the actual or potentially harmful effects of friendly and
            hostile chemical, biological and nuclear agents or munitions;
      --Urging the Congress to extend and improve additional quality-of-
            life benefits, allowances and privileges to the National Guard
            and Reserves involved in homeland security and other missions
            so as to more closely approximate those of the active force.
            Military retirement pay and TRICARE healthcare for members of
            the Reserve Components should be authorized before age 60.
            Hazardous duty and incentive pays for Reservists should be the
            same as active duty; tax credits to private businesses that pay
            the difference between military and civilian salaries to
            mobilized Reservists and restore travel exemptions for Reserve
            and Guard members for expenses associated with attending
            drills;
      --Military health care should also be provided to members of the
            Reserve Components and their dependents, who become injured
            while on active duty status regardless of the number of days
            served on active duty, to the same degree as active duty
            members under the same circumstances;
      --Whenever a Base Realignment and Closure (BRAC) is conducted, The
            American Legion will urge that certain base facilities such as
            base medical facilities, commissaries, exchanges and other
            facilities be preserved for use by active duty and Reservist
            personnel and military retired veterans and their families;
      --Walter Reed Army Medical Center not be closed until after Overseas
            Contingency Operations have ended;
      --That the numerous, recurring and serious pay problems experienced
            by the Active and Reserve Components be immediately resolved;
            and
      --Traumatic Brain Injury and Combat Stress Disorders be diagnosed and
            effectively treated in the military.
    Wounded Warrior Care
        The respective branches of the military often like to pontificate
    on how they all ``take care of their own.'' Nowhere is this statement
    put more to the test than when dealing with the combat and severely
    wounded. Since the Building 18 episode at Walter Reed Army Medical
    Center, a well-deserved spotlight was put on the whole transition
    process for outgoing military personnel. The resulting findings were
    somewhat surprising in that it was not the quality of medical care that
    was in question, but rather it was everything else. Some of those
    issues included electronic transference of medical records; scheduling
    of appointments; housing; family support issues; the Physical
    Evaluation Board (PEB) and Medical Evaluation Board (MEB) process;
    applying for VA benefits and receiving them without a gap in pay upon
    discharge from the military; endless forms, paperwork and tests.
        The American Legion supports many of the reforms, most of which are
    still in the form of pilot programs, that address these issues. Warrior
    Transition Units (WTUs) need to be fully funded and fully staffed. PEB/
    MEB process needs to be overhauled. Great strides have been made since
    2007, but the progress made (particularly in the area of the WTUs) not
    only needs to be maintained but expanded.
        The American Legion supports some of the recommendations of the
    President's Commission on Care for America's Returning Wounded Warriors
    (the Dole/Shalala Commission). Under the Commission's proposal, service
    members found unfit for military duty (a determination made by DOD
    based on a joint VA/DOD collaborative examination process) would be
    awarded a lifetime annuity payment by DOD based on years of service and
    rank. The purpose of this annuity is to compensate for the loss of the
    service member's military career.
        As these reforms are instituted, the new rating system and
    compensation should be made retroactive to correct those past egregious
    disability decisions and call for the re-rating and reevaluation of
    immediate past military disability retired personnel.
        Since Operations Enduring Freedom and Iraqi Freedom began, over
    5,000 Americans have given their lives in our operations in Iraq and
    Afghanistan and over 34,000 have been wounded in action. Of those
    wounded, over 15,700 did not return to duty. Caring for our military
    and ensuring good quality-of-life for the service member and the family
    is part of the ongoing cost of war and national security.
        The fiscal year 2009 budget has $3 billion to improve army
    barracks, military hospitals, and other facilities. The American Legion
    recommends a minimum of $3.4 billion for fiscal year 2010 in order to
    ensure that there are no delays in construction and improvement of
    living quarters and medical facilities.
        The fiscal year 2009 budget has $25.8 billion, $2.4 billion above
    2008, for medical care. This includes $300 million for traumatic brain
    injury (TBI) and psychological health. The American Legion applauds
    Congress for this increase and recommends that funding for fiscal year
    2010 be $28 billion in order to sustain current costs and to improve
    treatment for TBI and psychological health professionals, particularly
    for the Reserve force that may live in rural areas.
    Force Health Protection
        The American Legion continues to actively monitor the DOD's
    implementation of Force Health Protection policies and urges continual
    congressional oversight to ensure that all Force Health Protection laws
    and policies, including thorough pre- and post-deployment physical and
    mental examinations, are being properly implemented in a consistent
    manner by all military branches.
        The American Legion also urges DOD to actively track and follow-up,
    with proper medical care, adverse reactions to vaccinations as well as
    any and all health-related complaints associated with the ingestion of
    controversial drugs such as pyridostigmine bromide and Lariamand. In
    addition, The American Legion urges DOD to continually improve its
    treatment of service personnel who have been diagnosed with post-
    traumatic stress disorder and/or traumatic brain injury.
    Concurrent Receipt of Military Retired and Severance Pays and
            Disability Compensation and Their Dependents
        Military retired pay and disability compensation have been
    erroneously equated in one form or another for too long. One pay is
    earned through service and the other is compensation for debilitating
    injuries that were acquired while in service (on the job, so to speak).
    To offset one against the other is clearly unfair.
        The American Legion expresses its gratitude to the Congress for the
    authorization of both Combat-Related Special Compensation (CRSC) and
    partial concurrent receipt for over 200,000 disabled military retirees
    but urges the Congress to authorize and fund full concurrent receipt
    for all disabled military retirees to include those rated at 40 percent
    and below and to authorize the CRSC payment of military disability
    retiree pay and VA disability compensation for those disabled military
    retirees.
        Additionally, The American Legion urges Congress to eliminate the
    phase-in of provisions in Public Law 108-136 so as to accelerate
    restored retired pay in less than 10 years and to authorize the
    concurrent receipt of military severance pay for less than 30 percent
    disabled service members and VA disability compensation.
    TRICARE
        The American Legion has a longstanding position that it should
    prevail upon any Administration and DOD to reconsider any proposals to
    implement any increases in the military retirees' TRICARE enrollment
    fees, deductibles, or premiums. The American Legion urges Congress to
    fully fund military and VA healthcare programs for beneficiaries as
    well as a permanent TRICARE program for Guardsmen and Reservists. The
    American Legion recommends that the following guidelines be
    incorporated as part of the DOD healthcare package for military
    retirees, dependents and military survivors:
      --Administrative barriers to an effective TRICARE system to include
            raising TRICARE provider reimbursements; program portability
            between TRICARE regions; reducing delays in claim payments; and
            increasing electronic claims processing need to be removed.
            Improve TRICARE enrollment procedures, beneficiary education,
            decrease administrative burdens, eliminate non-availability
            requirements and eliminate unnecessary reporting requirements;
      --TRICARE programs to include the TRICARE for Life and the TRICARE
            Senior Pharmacy programs which are used by 1.3 million
            Medicare-eligible military retirees and their dependents should
            be fully funded annually;
      --Restore TRICARE reimbursement policy to pay up to what TRICARE
            would have paid had there been no other health insurance as was
            the policy before 1993;
      --Dual eligible disabled retirees continue to receive health care
            from both military treatment facilities and VA medical centers.
            TRICARE Prime Remote should be included for military retirees,
            dependents and military survivors;
      --All military beneficiaries should be authorized to receive dental
            and visual care at military treatment facilities;
      --Retired Reservists and their dependents should be eligible for
            TRICARE coverage when they become eligible to receive
            retirement pay; The American Legion urges that all discharging
            service members, active and Reservists be required to have
            discharge and retirement physical examinations; physicals
            should not be optional or abbreviated;
      --Adequate military medical personnel, to include graduates of the
            Uniformed Services University of Health Sciences and members of
            the Commissioned Officer Corps of the Public Health Service,
            should be retained on active duty to provide health care for
            active duty and retired military personnel and their
            dependents;
      --The Federal Employee Health Benefits Plan (FEHBP) should be
            authorized as an alternative to TRICARE for those military
            retirees and dependents who can afford such premiums;
      --TRICARE fees should not be increased except as authorized by
            Congress, not by DOD;
      --Military construction funding should be authorized for the
            construction of Walter Reed Military Medical Center and the
            Fort Belvoir Army Community Center;
      --If Congress increases TRICARE fees, the increases should be at a
            rate no larger than the rate of pay increases for Active,
            Reserve, National Guard, military and medical retirees, and
            military survivors.
    Quality-of-Life for National Guard and Reserve Forces
        The American Legion urges Congress and DOD to pass legislation and
    create policy that addresses all the needs of the Reserve forces to
    include:
      --Full range of active duty retention bonuses and recruiting
            incentives, pay promotions and health care quality-of-life be
            applicably activated to the National Guard and Reserve;
      --Qualified Reservists should be authorized to receive Military
            retirement pay and TRICARE healthcare before age 60;
      --Hazardous duty and incentive pays for Reservists set the same as
            active-duty;
      --Creating tax credits to private businesses paying the difference
            between military and civilian salaries to mobilized Reservists;
      --Restoring travel exemptions for Reserve and Guard members for
            expenses associated with attending drills;
      --Military health care provided to members of the Reserve Components
            and their dependents, who become injured while on active duty
            status regardless of the number of days served on active duty;
      --Retired Reservists and their dependents should be eligible for
            TRICARE coverage when they become eligible to receive
            retirement pay;
      --All discharging Reservists should be required to have complete
            discharge and/or retirement physical examinations to the same
            standard as the active-duty force.
    General Quality-of-Life Issues
                Armed Forces Retirement Homes
        The American Legion urges the Congress to support and fund those
    measures, to include annual Congressional appropriations, which will
    provide for the long-term solvency and viability of the Armed Forces
    Retirement Home--Washington. The American Legion also strongly supports
    the rebuilding of the Armed Forces Retirement Home at Gulfport,
    Mississippi.
                Support for the Selective Service Registration Program
        The American Legion supports the retention of the Selective Service
    Registration Program as being in the best interests of all Americans,
    and its maintenance is a proven cost-effective, essential, and rapid
    means of reconstituting the required forces to protect our national
    security interests.
                Reforming the Military Absentee Voting System
        The American Legion urges that appropriate laws and guidelines be
    developed at Federal, State and local levels with the intent that all
    military absentee voters and their families will have their votes
    counted in every election. The American Legion also recommends that the
    sending and receiving of blank and completed military absentee ballots
    be accomplished electronically as much as possible.
                Military Commissaries
        The American Legion urges DOD and the Congress to continue full
    Federal funding of the military commissary system and to retain this
    vital non-pay compensation benefit system. This quality-of-life benefit
    is essential to the morale and readiness of the dedicated men and women
    who have served, and continue to serve, the national security interests
    of the United States. The American Legion opposes any efforts to
    institute ``variable pricing'' or to privatize the military commissary
    system or to dismantle or downsize the Defense Commissary Agency.
                Military Funeral Honors
        The American Legion reaffirms that the Congress should mandate and
    appropriately fund DOD and the Military Services, to include
    reimbursing the National Guard, so as to provide military honors upon
    request at veterans' funerals in coordination with Veterans' Service
    Organizations such as The American Legion at local levels. The
    Department of Defense should implement equitable and expedient
    reimbursement procedures for members of the veterans' service
    organizations who participate in military funeral honors.
        The American Legion also recommends that an action be taken to
    change the wordage, as currently written in Section 578 Public Law 106-
    65 to: That any and all funeral directors performing services for any
    veteran of The United States armed forces shall be required to ask the
    veteran's family member or other interested party if military honors
    are requested, at no expense to the family, rather than placing the
    burden upon the veteran's family at this time of bereavement.
                                force structure
        The current active-duty personnel level has been funded to maintain
    just under 1.37 million active-duty service members. Military leaders
    had been making up manpower shortages by increasing the OPTEMPO,
    increasing rotations to combat zones, and by over-utilizing the Reserve
    Components. American military personnel are deployed to over 150
    countries worldwide. Many of these personnel are from the Reserve
    Components. Multiple deployments, particularly to combat zones, are
    often the core element of the recruitment and retention challenges that
    have confronted the Army. While all the services have met or exceeded
    their recruitment goals for 2008, this is due in large part to the
    uncertainty in the economy and to the great successes our forces are
    having in Iraq. All of the services could find themselves in
    recruitment difficulties again if the economy recovers quickly or if
    casualties begin to rise again either in Iraq, Afghanistan or some
    other area of the world where our national security is threatened. We
    applaud Congress for funding the requested end strength increases of
    7,000 for the Army, 5,000 for the Marine Corps, and 1,300 for the Army
    Guard for fiscal year 2009. However, The American Legion insists that
    these nominal increases are not enough to adequately provide for the
    needs of a strong national security posture. The active force combined
    with the reserve force still only totals under 1.75 million. As stated
    previously, The American Legion urges an active and reserve force of
    2.1 million.
        Modernization of weapons systems is vital to properly equip the
    armed forces, but is totally ineffective without adequate personnel to
    effectively operate state-of-the-art weaponry. No military personnel
    should go into battle with unarmed or under-armored vehicles or without
    body armor or with vehicles and helicopters that are approaching or
    exceeding their service lives. America stands to lose its service
    members on the battlefield and during training exercises due to aging
    equipment. The current practice of trading off force structures and
    active-duty personnel levels to recoup or bolster modernization or
    transformation resources must be discontinued. The Army and the Marine
    Corps need to be immediately funded to reset their combat forces so as
    to maintain their readiness.
        The American Legion recommends restoring former military force
    structures and increasing active-duty end strengths so as to improve
    military readiness and to more adequately pursue the Overseas
    Contingency Operations (OCO). The American Legion seeks to improve
    alignment of service levels with missions to ease deployment rates and
    improve quality-of-life features. Ensuring readiness also requires
    retaining the peacetime Selective Service System to register young men
    for possible military service in case of a national emergency. Military
    history repeatedly demonstrates that it is far better to err on the
    side of preserving robust forces to protect America's interests than to
    suffer the consequences of an inadequate force structure or military
    non-readiness, especially during time of war.
        America needs a more realistic strategy with appropriate force
    structure, weaponry, and equipment with increased active-duty and
    Reserve components and readiness levels to achieve its national
    security objectives.
    Other Force Structure Issues and Recommendations
                Support for the Non-Federal Roles of the National Guard
        The active-duty force must be able to better accomplish its
    operational objectives around the globe without relying so heavily on
    the National Guard. The Guard must go back to its primary roles in
    homeland security and used as a mainly strategic asset and not as an
    operational one. The American Legion urges the Congress to retain
    National Guard units at reasonable readiness levels so that in addition
    to their active duty missions they may continue to provide civil
    disturbance and natural and man-made disaster assistance; perform civil
    defense and drug interdictions functions as well as other essential
    State or Federal roles as required to include border security.
                Uniformed Services University of the Health Sciences (USU)
        The American Legion urges the Congress to: continue its
    demonstrated commitment to USU, as a national asset, for the continued
    provision of uniquely educated and trained uniformed physicians,
    advanced practice nurses, and scientists dedicated to careers of
    service in the Army, Navy, Air Force, and the United States Public
    Health Service; support timely construction at the USU campus during
    fiscal years 2009-2010; continue funding the University's collaborative
    effort for sharing its chemical, radiological and biological, nuclear
    and high yield explosive (CBRNE) expertise and training; support
    development of the USU Immersive, Wide Area Virtual Environment (WAVE)
    Simulation for CBRNE/WMD Medical Readiness Training; support funding
    for the Graduate School of Nursing Teaching/Educational Programs; and,
    encourage continued close collaboration and progress towards the OSD-
    proposed Joint Medical Command and WRNMMC with USU as the core academic
    health center.
                Aeronautical and Space Exploration
        The American Legion deems it imperative that the United States, in
    the face of increasing competition, maintain its hard-won status as the
    world leader in aeronautics and aircraft production and in space
    exploration and research. To realize this goal, we urge the Congress to
    provide:
      --Adequate funding for the Nation's civilian and military aerospace
            research and development programs to maintain U.S.
            technological leadership.
      --Adequate funding to build, upgrade and enhance the Nation's
            civilian and military aerospace research facilities and wind
            tunnels.
      --A renewed national commitment to education involving academia in
            aeronautical and aerospace engineering research and
            technologies insuring a state-of-the art educated work force.
      --Over-watch and investigate functions and related activities with
            respect to the transfer of American aerospace technology
            abroad.
                Combating Cyberspace Threats
        The American Legion urges the Congress to appropriate the necessary
    funding and resources to combat the continuing cyberspace and other
    threats to the United States in the 21st Century.
                National Missile Defense System
        The American Legion urges the United States Government to develop
    and continue to deploy a national missile defense system which is in
    the national interest of the United States and the American people and
    an essential ingredient of our homeland security.
        Considering the growing threats of rocket and missile attacks by
    Iran and North Korea, proposed cuts to missile defense seem unwise.
    Even if cuts are being made in systems that are not deemed successful,
    those monies should be reallocated to those defense systems that are
    working.
                          manpower and weapons systems
        The President's fiscal year 2010 Defense budget request should
    require continued funding to sustain current Overseas Contingency
    Operations (OCO) while maintaining the war-fighting capabilities of the
    Armed Forces. For years, the increased Operations Tempo (OPTEMPO), OCO,
    and budgetary shortfalls have had a devastating impact on military
    readiness, modernization, and personnel.
        The American Legion recommends that the fiscal year 2010 Defense
    appropriations bill should include higher military pay raises and
    allowances as well as recruitment bonuses and incentives. The Defense
    Health Program, to include the TRICARE health care system, needs to be
    fully funded without new or increased TRICARE fees. Authorizations for
    continued higher spending on modernization must include: the resetting,
    repairing and procuring of Army weapons systems and equipment;
    continued spending for development of, and fielding, Joint Strike
    Fighters for the Air Force and Navy; and, procurement of more F-22A
    Raptor fighter jets and aerial refueling tankers for the Air Force.
        The American Legion urges Congress to increase defense spending to
    levels that represent at least 5 percent of GDP. This represents not
    only ongoing needs, but also the shared burden of the American people
    during a time of war.
        Defense budgets, military manpower and force structures are
    currently one-third of their 1986 peacetime levels. Military
    capabilities are at significantly lower levels than the Persian Gulf
    War in 1991. With only 10 active Army divisions in the inventory, it is
    little wonder that thousands of Reservists and Guardsmen have been
    called to active-duty to bolster homeland security and in fighting the
    wars in Iraq and Afghanistan. The current plan to cap the Brigade
    Combat Team numbers to 45, as opposed to the recommended 48, is a
    terrible case of robbing Peter to pay Paul. While the size of the force
    will still increase, the actual size of combat ready ground forces will
    still be inadequate. If our national security needs require more
    administrators and trainers, then so be it, but it should not come at a
    cost of a reduction in combat ready forces.
        The American Legion, along with its previous quality-of-life and
    force structure recommendations, further recommends the following as
    regards the purchasing of weapons systems and armaments in general:
    Rebuilding America's Defense Industrial Base
        The American Legion urges the new administration and the Congress
    to rebuild America's industrial base by continuing to adequately fund
    research, development and acquisition budgets to assure that our
    military production can meet national requirements especially when U.S.
    military power is committed. Rebuilding America's industrial base
    could, and perhaps should, be part of the administration's plan to
    reinvigorate the economy.
        We encourage the new Administration and the Congress in the
    rebuilding of America's defense industrial base by having a proper
    balance of policies that:
      --Increase and then sustain domestic production at levels that
            maintain a robust and internationally competitive defense
            industry.
      --Keep the arms industry internationally competitive.
      --Ensure that the United States is not putting itself at risk by
            having our armaments produced offshore.
                Buy American
        The American Legion urges Congress to require Government
    contractors to utilize American-made components and subsystems in
    construction of their equipment over those made by foreign
    subcontractors for use by the United States military services to ensure
    the defense of the country, as well as the continued employment of
    Americans and veterans at subcontractor facilities.
                Foreign Investments in the American Defense Industry
        The American Legion urges the U.S. Government to ensure that
    foreign entities are not permitted to own critical industries,
    especially those involved in producing defense items. The American
    Legion further opposes the transfer and sales of sensitive technologies
    which may endanger our national security and economic interests.
                Commercial Shipbuilding for Defense
        The American Legion urges the Congress to vigorously act to stop
    the further erosion of our vital maritime capability by boosting naval
    budgets, promoting commercial shipbuilding, expanding the use of U.S.
    flagships in world commerce, and resisting foreign actions that would
    further damage America's defense industrial base.
                Procurement of Sufficient F-22 Aircraft
        The American Legion advocates that the procurement of F-22 Raptor
    aircraft should be approved and funded by Congress for the stated USAF
    requirement of 381 and that such procurement be funded through
    additional appropriations even if that should result in an increase in
    the overall National Defense Budget.
                             military construction
        Military Construction is directly related to the quality-of-life of
    the service member and their dependants. As such, Military Construction
    must be funded to a level that meets the immediate and future needs of
    DOD. The cornerstone to a strong national defense is not based on
    weapon systems purchased or the way the force structure is organized,
    but rather, the way military service members and their families are
    treated and cared for on military installations within the continental
    United States and overseas. In today's All-Volunteer Armed Forces,
    maintaining the highest quality-of-life standards is the least we
    should do in the interest of national security and as the thanks of a
    grateful Nation to those who serve.
    Military Construction
        The $26.3 billion recommendation is based of the current force
    structure of 1.75 million. This recommendation also accounts for the
    modest upcoming authorized increases in the sizes of the Army and
    Marine Corps.
        In fiscal year 2009, $25 billion, ($4.4 billion above fiscal year
    2008) was appropriated for Military Construction. The large increase is
    mostly due to the costs of implementing Base Realignment and Closure
    (BRAC) and plans to increase the size of the Army and Marine Corps. It
    should be noted that The American Legion recommends a 2.1 million man
    force structure as opposed to the current force size. As such, if
    authorization and funding for the expansion of the active-duty and
    reserve force increased by an additional 50,000 service members for
    fiscal year 2010 (in order to get closer to The American Legion's
    recommended force structure level), The American Legion would recommend
    $31.3 billion for Military Construction funding for the construction
    associated with such an expansion of forces.
    Quality-of-Life and BRAC
        A quality-of-life concern that must be considered is the welfare of
    our retired military. Often, when a service member retires from
    service, whether medically of by longevity, they choose to live in
    close proximity to a military installation. They choose this in order
    to have access to the benefits they earned from honorable service.
    Those benefits include access to base medical facilities, commissaries,
    exchanges and other facilities.
        Whenever a Base Realignment and Closure (BRAC) is conducted, The
    American Legion will urge that certain base facilities (such as base
    medical facilities, commissaries, exchanges and other facilities) be
    preserved for use by active-duty and Reservist personnel and military
    retired veterans and their families.
        One key element of quality of life for service members and their
    families is the quality of their housing, whether it is supplied by the
    military in the form of on-base housing, or the availability and
    quality of off-base housing. Long standing policy of DOD has been to
    rely on local community housing. This policy comes into conflict with
    reality where there is a localized influx of military families, whether
    from BRAC or ``Grow the Army''-like programs.
        Currently, roughly 63 percent of all military families reside in
    off-base, private sector housing. A further 26 percent reside in
    residences built under the Military Housing Privatization authorities.
    Of the remaining 11 percent, 8 percent live in Government-owned housing
    and 3 percent in (primarily overseas) leased housing. However, the
    transience of forces may cause localized market problems in the coming
    years, as changes occur resulting from BRAC, Grow the Force
    initiatives, global re-posturing and joint basing. Some installations
    may suddenly find they have a surplus of housing as a result, while in
    other areas housing availability may be in deficit. Ensuring that
    service members and their families have access to safe, affordable and
    sufficient housing must remain a priority in order to address the
    quality of life for these families.
        One initiative which has received excellent reviews from the
    services has been the Military Housing Privatization Initiative (MHPI)
    which encourages high quality construction, sustainment, and renovation
    of military housing by leveraging capital and expertise from the
    private sector. Under this initiative, 94 projects have been awarded,
    allowing the DOD to eliminate nearly all inadequate domestic family
    housing. This program should be continued and expanded with additional
    resources.
        Numerous media reports surfaced last year of troops returning from
    OCO to barracks that were unsatisfactory. In one case, a distraught
    father of a soldier with the 82nd Airborne at Fort Bragg, NC went so
    far as film the living conditions and to publicize it through social
    networking sites. Following this renewed interest, the Army in
    particular began a sweeping inspection of all its living facilities and
    barracks to ascertain the level of need that many of them required in
    terms of maintenance and repair. The reforms resulted in the First
    Sergeants Barracks Initiative (FSBI) where the barracks are continually
    monitored for needed repairs, and ``ownership'' of barracks for
    deployed troops is transferred to post control for the duration of the
    deployment. This successful innovation should be adequately funded to
    accomplish these needed renovations.
        In October of 2007, Secretary of the Army Pete Geren initiated a
    program entitled the ``Army Family Covenant.'' At the time he stated:
        The Health of our all-volunteer force, our Soldier-volunteers, our
    Family-volunteers, depends on the health of the Family. The readiness
    of our all-volunteer force depends on the health of the Families. I can
    assure you that your Army leadership understands the important
    contribution each and every one of you makes. We need to make sure we
    step up and provide the support families need so the army stays healthy
    and ready.
        This covenant addressed various ways to improve family readiness
    by:
      --Standardizing and funding existing family programs and services;
      --Increasing accessibility and quality of healthcare;
      --Improving Soldier and Family Housing;
      --Ensuring excellence in schools, youth services, and child care; and
      --Expanding education and employment opportunities for family
            members.
        While we enlist soldiers, airmen, marines and navy personnel, we
    also re-enlist families. Issues of the covenant from which funding
    comes under the rubric of the Military Construction appropriations
    should be funded fully to ensure that we maintain a high level of
    quality of life, and thereby ensure a higher rate of reenlistment for
    the Armed Forces.
        The commitment to this program by the Army was demonstrated by the
    testimony of Keith Easton, Assistant Secretary of the Army for
    Installations on March 12. He noted that the Army Family Covenant
    Program has shown significant progress in meeting its' goals since it
    came into existence. The program itself shows a commitment and
    understanding of the importance of family in our force structure and
    maintaining readiness and force levels. This program is another which
    should be expanded through adequate funding, to ensure the well being
    of service members and demonstrate the national commitment towards
    helping them individually and collectively prosper and reach their
    potential.
        Increased spending in the area of military construction not only
    serves the strategic needs of the armed forces but also the needs of
    the service members. It takes approximately 8 years to build a senior
    Non-Commissioned Officer. To lose a member of the armed forces like
    that to the civilian world, because they feel they can have a better
    quality of life for them and their family outside of the services, is a
    cost that can not be recouped.
        The American Legion fully supports the Army Family Covenant Program
    and engages all of its 14,000+ local American Legion posts to become
    involved.
    Wounded Warrior Care
        All branches of the armed forces ascribe to the ethic that they
    ``take care of their own.'' Nowhere is this statement put more to the
    test than when dealing with the combat and severely wounded. Since the
    Building 18 episode at Walter Reed Army Medical Center, a well-deserved
    spotlight was put on the whole transition process for outgoing military
    personnel. The fiscal year 2009 budget has $3 billion to improve army
    barracks, military hospitals, and other facilities. The American Legion
    recommends a minimum of $3.4 billion for fiscal year 2010 in order to
    ensure that there are no delays in construction and improvement of
    living quarters and medical facilities.
        Further, The American Legion advocates that Walter Reed Army
    Medical Center should not be closed until after the wars in Iraq and
    Afghanistan have ended. As such Walter Reed Army Medical Center needs
    to be funded at levels high enough to meet and exceed the high
    standards of care our service members deserve.
    Uniformed Services University of the Health Sciences
        The American Legion has supported the Uniformed Services University
    of the Health Sciences (USU), since its establishment in 1972 as the
    Nation's Federal Academic Health Center. USU is dedicated to providing
    uniquely educated and trained uniformed officers for the United States
    Army, Navy, Air Force and Public Health Service. USU alumni are
    currently serving over 20-year careers and thus providing continuity
    and leadership for the Military Health System (MHS) as physicians,
    advanced practice nurses and scientists. USU F. Edward Heert School of
    Medicine has a year-round, 4-year curriculum that is nearly 700 hours
    longer than found at other U.S. medical schools. These extra hours
    focus on epidemiology, health promotion, disease prevention, tropical
    medicine, leadership and field exercises. Doctoral and Masters degrees
    in the biomedical sciences and public health are awarded by
    interdisciplinary and department-based graduate programs within the
    School of Medicine. Programs include infectious disease, neuroscience,
    and preventive medicine research.
        USU Graduate School of Nursing offers a Master of Science in
    Nursing degree in Nurse Anesthesia, Family Nurse Practitioner,
    Perioperative Clinical Nursing, Psychiatric Mental Health Nurse
    Practitioner, and a full and part-time program for a Ph.D. degree in
    Nursing Science. The university's continuing education program is
    unique and extensive, serving and sustaining the professional and
    readiness requirements of the Defense Department's worldwide military
    healthcare community.
        The university's nationally ranked military and civilian faculty
    conduct cutting edge research in the biomedical sciences and in areas
    specific to the DOD health care mission such as combat casualty care,
    infectious diseases and radiation biology. The university specializes
    in military and public health medicine, focusing on keeping people
    healthy, disease prevention, and diagnosis and treatment. USU faculty
    offer significant expertise in tropical medicine and hygiene,
    parasitology, epidemiologic methods and preventive medicine.
        The Department of Defense and the United States Congress have
    recognized that the extensive military-unique and preventive health
    care education provided in the multi-service environment of USU ensures
    Medical Readiness and Force Health Protection for the MHS. USU is
    recognized as the place where students receive thorough preparation to
    deal with the medical aspects of Weapons of Mass Destruction, including
    chemical, radiological and biological, nuclear and high yield explosive
    (CBRNE) terrorism or other catastrophe. USU has developed similar
    training for civilian first responders, medical professionals and
    emergency planners. USU is also uniquely qualified and experienced in
    simulation technology, education and training.
        With the establishment by the Office of the Secretary of Defense
    (OSD) of a Joint Medical Command in fiscal year 2008, the role of USU
    will expand. Plans to establish the Walter Reed National Military
    Medical Center (WRNMMC) by 2011 has created close collaboration between
    the Armed Services Flag Officers and the President of USU to create a
    world-class military academic health center, expanding the role of USU.
        As stated previously, The American Legion urges the Subcommittee
    to: continue its demonstrated commitment to USU, as a national asset,
    for the continued provision of uniquely educated and trained uniformed
    physicians, advanced practice nurses, and scientists dedicated to
    careers of service in the Army, Navy, Air Force, and the United States
    Public Health Service; support timely construction at the USU campus
    during fiscal years 2009-2010; continue funding the University's
    collaborative effort for sharing its chemical, radiological and
    biological, nuclear and high yield explosive (CBRNE) expertise and
    training; support development of the USU Immersive, Wide Area Virtual
    Environment (WAVE) Simulation for CBRNE/WMD Medical Readiness Training;
    support funding for the Graduate School of Nursing Teaching/Educational
    Programs; and, encourage continued close collaboration and progress
    towards the OSD-proposed Joint Medical Command and WRNMMC with USU as
    the core academic health center.
    Armed Forces Retirement Homes
        The United States Soldiers' and Airmen's Home (USSAH) and the
    United States Naval Home (USNH), jointly called the Armed Forces
    Retirement Home (AFRH), are continuing care facilities which were
    created more than 150 years ago to offer retirement homes for
    distinguished veterans who had served as soldiers, sailors, airmen and
    Marines in our Nation's conflicts. The AFRH system, which is available
    to retiree veterans from all the Armed Services whose active duty was
    at least 50 percent enlisted or warrant officer, has been supported by
    a trust fund resourced by 50 cents a month withheld from active duty
    enlisted and warrant officer paychecks as well as from fines and
    forfeitures from disciplinary actions, resident fees and interest
    income. The extensive downsizing of the Armed Forces has resulted in a
    39 percent decrease in that revenue and, coupled with rising nursing
    home care costs, the Homes have been operating at an $8-10 million
    annual deficit which would reportedly require both Homes to close their
    doors.
        The American Legion urges the Subcommittee to support measures
    which will provide for the long-term solvency and viability of the
    Armed Forces Retirement Home--Washington, DC. The American Legion also
    strongly supports the rebuilding of the Armed Forces Retirement Home at
    Gulfport, Mississippi which was destroyed by Hurricane Katrina.
    American Battle Monuments Commission
        The American Battle Monuments Commission (ABMC) was established by
    law in 1923, as an independent agency of the Executive Branch of the
    United States Government. The Commission's commemorative mission
    includes:
      --Designing, constructing, operating and maintaining permanent
            American cemeteries in foreign countries.
      --Establishing and maintaining U.S. military memorials, monuments and
            markers where American armed forces have served overseas since
            April 6, 1917, and within the United States when directed by
            public law.
      --Controlling the design and construction of permanent U.S. military
            monuments and markers by other U.S. citizens and organizations,
            both public and private, and encouraging their maintenance.
        The resulting United States Military Cemeteries have been
    established throughout the world and are hallowed grounds for America's
    war dead. United States Military Cemeteries existing in foreign
    countries today are in need of adequate funding for repair,
    maintenance, additional manpower and other necessities to preserve the
    integrity of all monuments and cemeteries which are realizing increased
    numbers of visitors annually.
        Adequate funding and human resources to the American Battle
    Monuments Commission must be provided in order to properly maintain and
    preserve these hallowed, final resting places for America's war dead
    located on foreign soil. In fiscal year 2009, $59.5 million, $15
    million above fiscal year 2008 was provided for the care and operation
    of our military monuments and cemeteries around the world. The American
    Legion applauded this increased funding and supports the continued full
    funding for the needs of the American Battle Monuments Commission.
    Funding for Joint POW/MIA Accounting Command
        The American Legion has long been deeply committed to achieving the
    fullest possible accounting for U.S. personnel still held captive,
    missing and unaccounted for from all of our Nation's wars. The level of
    personnel and funding for the Joint POW/MIA Accounting Command (JPAC)
    has not been increased at a level commensurate with the expanded
    requirement to obtain answers on Americans unaccounted from wars and
    conflicts prior to the Vietnam War. It is the responsibility of the
    U.S. Government to account as fully as possible for America's missing
    veterans, including--if confirmed deceased--the recovery of their
    remains when possible. The Congress has a duty and obligation to
    appropriate funds necessary for all Government agencies involved in
    carrying out strategies, programs and operations to solve this issue
    and obtain answers for the POW/MIA families and our Nation's veterans.
    This accounting effort should not be considered complete until all
    reasonable actions have been taken to achieve the fullest possible
    accounting. The American Legion calls on Congress to provide increases
    in personnel and full funding for the efforts of JPAC, the Defense POW/
    Missing Personnel Office (DPMO), the Life Sciences Equipment
    Laboratory, and the Armed Forces DNA Laboratory, including specific
    authorization to augment assigned personnel when additional assets and
    resources are necessary. The American Legion remains steadfast in our
    commitment to the goal of achieving the fullest possible accounting for
    all U.S. military and designated civilian personnel missing from our
    Nation's wars.
        JPAC was forced to reduce field operations in pursuit of missing
    U.S. personnel in early 2006 due to a failure of DOD to provide
    adequate funding. The mission of JPAC has been expanded by Congress to
    include investigation and recovery operations dating back to and
    including unaccounted for WWII personnel, while funding levels have not
    increased to meet this requirement. The headquarters currently utilized
    by JPAC is no longer capable of housing neither the expanded command
    nor the expanded laboratory requirements for forensic identifications.
    The American Legion calls on the Congress to ensure that JPAC has at
    least $62 million per year in operation funds and an additional $64
    million per year for fiscal year 2010 through fiscal year 2011 for JPAC
    military construction funds as part of the budget for the Department of
    Defense in connection with JPAC. The American Legion calls on the
    Congress to ensure that such funds be approved and restricted for use
    for no purpose other than those included in the mission statement of
    the Joint POW/MIA Accounting Command, Hickam AFB, Hawaii.
        The American Legion commends Admiral Timothy Keating, Commander,
    U.S. Pacific Command, for his commitment to seek U.S. Navy funding in
    the amount of $105 million to begin construction of a new JPAC
    headquarters, including a state-of-the-art laboratory in fiscal year
    2010, to be completed in fiscal year 2011. Furthermore, The American
    Legion urges the Congress to fully fund this U.S. Navy military
    construction project to ensure that those who serve our Nation--past,
    present, and future--are returned and accounted for as fully as
    possible.
                                   conclusion
        The United States continues to fight in OCO and defend our vital
    national interests. While America may be safer and has not suffered
    another tragic event on our soil since the tragic day of 9/11/01, the
    world is still not a safe place. The American Legion thanks the
    Subcommittee for inviting The American Legion to this hearing and looks
    forward to working with Congress and the administration on the many
    issues in National Defense facing our country.

        Chairman Inouye. And now the deputy director of the
    National Military Family Association, Ms. Kelly Hruska.
    STATEMENT OF KELLY B. HRUSKA, GOVERNMENT RELATIONS,
                DEPUTY DIRECTOR, NATIONAL MILITARY FAMILY
                ASSOCIATION
        Ms. Hruska. Thank you, Mr. Chairman, for the opportunity to
    highlight the National Military Family Association's belief
    that policies and programs should provide a firm foundation for
    families buffeted by the uncertainties of deployment and
    transformation. It is imperative full funding for these
    programs be included in the regular budget process, not merely
    added on as a part of supplemental funding. Programs must
    expand and grow to adapt to the changing needs of
    servicemembers and families as they cope with multiple
    deployments and react to separations, reintegration, and the
    situation of those returning with both visible and invisible
    wounds.
        Standardization in delivery, accessibility, and funding are
    essential. Programs should provide for families in all stages
    of deployment, and reach out to them in all geographic
    locations. Families should be given the tools to take greater
    responsibility for their own readiness. We appreciate your help
    over the past years in addressing many of these important
    issues.
        The increased access to resources and programs by the Joint
    Family Support Assistance Program, now offered in all States
    and territories, allows families to receive added help when
    they need it, during all cycles of deployment. The Military
    Family Readiness Council held its first informal meeting in
    December. We feel this will be an effective tool in identifying
    programs that work, and in helping to eliminate overlapping or
    redundant programs, as the council reviews existing resources
    for military families. In an effort to make their efforts more
    credible, our association would like to see more funding set
    aside to be used for pilot programs that may come out of the
    council's recommendations, or allows DOD to replicate best
    practices, as necessary. This seed funding would streamline the
    bureaucracy and get the pilot programs out to families faster.
        Huge strides have been made in the building of brick-and-
    mortar child development centers on military installations.
    Within the next year or two, thousands of spaces will become
    available for our military families. But, the need for more
    spaces will still exist. Innovative strategies are needed to
    address the non-availability of after-hours childcare and
    respite care. We applaud the partnership between the services
    and the National Association of Childcare Resources and
    Referral Agencies that provides subsidized childcare to
    families who cannot access installation-base child development
    centers. Including National Guard and Reserve families.
    Families often find it difficult to obtain affordable, quality
    care, especially during hard-to-fill hours and on weekends.
        Both the Navy and the Air Force have piloted 24/7 programs.
    These innovative programs must be expanded to provide care to
    more families at the same high standard as the services'
    traditional child development programs.
        The Army, as part of the funding attached to the Army
    Family Covenant, has rolled out more resources for respite care
    of families of deployed services. Respite care is needed across
    the board for families of the deployed, and the wounded, ill,
    and injured. We are pleased the services have rolled out more
    respite care for special-needs families, but since the programs
    are new we are unsure of the impact it will have on families.
    We appreciate the recent increase to the special survivor
    indemnity allowance, for surviving spouses, but the elimination
    of the dependency and indemnity compensation offset to the
    survivor benefit plan annuity should still remain a high
    priority.
        Our association recognizes and appreciates the many
    resources and programs that support our military families
    during this time of war. The need will not go away the day the
    war ends. We believe it is imperative these programs be
    included in the regular budget process.
        In our written statement we have identified other ways to
    assist military families, and will be glad to expand on those
    suggestions, should you have any questions.
        Military families--one size does not fit all, but they are
    united in their sacrifices in support of their servicemembers
    and our Nation. We ask you to help the Nation sustain and
    support them.
        Thank you, sir.
        Chairman Inouye. I thank you very much, Ms. Hruska.
        And to all the witnesses, if you have supporting documents
    and memos, please feel free to submit them, because I can
    assure you we'll read them.
        [The statement follows:]
                     Prepared Statement of Kelly B. Hruska
        Chairman Inouye and Distinguished Members of this Subcommittee, the
    National Military Family Association would like to thank you for the
    opportunity to present testimony on the quality of life of military
    families--the Nation's families. You recognize the sacrifices made by
    today's service members and their families by focusing on the many
    elements of their quality of life package: access to quality health
    care, robust military pay and benefits, support for families dealing
    with deployment, and special care for the families of the wounded, ill
    and injured and those who have made the greatest sacrifice.
        In this statement, our Association will expand on several issues of
    importance to military families: Family Readiness; Family Health;
    Family Transitions.
                                family readiness
        The National Military Family Association believes policies and
    programs should provide a firm foundation for families buffeted by the
    uncertainties of deployment and transformation. It is imperative full
    funding for these programs be included in the regular budget process
    and not merely added on as part of supplemental funding. We promote
    programs that expand and grow to adapt to the changing needs of service
    members and families as they cope with multiple deployments and react
    to separations, reintegration, and the situation of those returning
    with both visible and invisible wounds. Standardization in delivery,
    accessibility, and funding are essential. Programs should provide for
    families in all stages of deployment and reach out to them in all
    geographic locations. Families should be given the tools to take
    greater responsibility for their own readiness.
        We appreciate provisions in the National Defense Authorization Acts
    of the past several years that recognized many of these important
    issues. The increased access to resources and programs provided by the
    Joint Family Support Assistance Program (JFSAP), now offered in all
    States and territories, allows families to receive added help when they
    need it during all cycles of deployment. The Military Family Readiness
    Council held its first informal meeting in December. We feel this will
    be an effective tool in identifying programs that work and in helping
    to eliminate overlapping or redundant programs as the Council reviews
    existing resources for military families. Our Association is proud to
    represent military families as a member of the Council.
        Our Association believes that it is imperative full funding for
    family readiness programs be included in the regular budget process and
    not merely added on as part of supplemental funding.
    Child Care
        The Services--and families--continue to tell us more child care is
    needed to fill the ever growing demand, including hourly, drop-in,
    respite, and after-hour child care. We've heard stories like this:

        Child care facilities on base are beyond compare--for spouses and
    military members who work nine to five. In our increasingly service-
    oriented economy, the job I have has me working until at least seven
    most days, and usually as late as midnight 1 to 2 days a week. When my
    husband deploys or has a stint on second shift, I run out of options
    quickly. I have been unable to get another, more conventional job in
    the 2 years I have been in this area . . . there are minimum
    requirements as to what shifts I need to work to maintain full-time
    employment at my current workplace, and I cannot have those waived for
    an entire deployment.

        Innovative strategies are needed to address the non-availability of
    after-hour child care (before 6 a.m. and after 6 p.m.) and respite
    care. We applaud the partnership between the Services and the National
    Association of Child Care Resource and Referral Agencies (NACCRRA) that
    provides subsidized childcare to families who cannot access
    installation based child development centers. Families often find it
    difficult to obtain affordable, quality care especially during hard-to-
    fill hours and on weekends. Both the Navy and the Air Force have
    programs that provide 24/7 care. These innovative programs must be
    expanded to provide care to more families at the same high standard as
    the Services' traditional child development programs. The Army, as part
    of the funding attached to its Army Family Covenant, has rolled out
    more space for respite care for families of deployed soldiers. Respite
    care is needed across the board for the families of the deployed and
    the wounded, ill, and injured. We are pleased that the Services have
    rolled out more respite care for special needs families, but since the
    programs are new we are unsure of the impact it will have on families.
        At our Operation Purple Healing Adventures camp for families of
    the wounded, ill and injured, we were told there is a tremendous need
    for access to adequate child care on or near military treatment
    facilities. Families need the availability of child care in order to
    attend medical appointments, especially mental health appointments. Our
    Association encourages the creation of drop-in child care for medical
    appointments on the DOD or VA premises or partnerships with other
    organizations to provide this valuable service.
        Our Association urges Congress to ensure resources are available to
    meet the child care needs of military families to include hourly, drop-
    in and increased respite care for families of deployed service members
    and the wounded, ill and injured.
    Working with Youth
        Older children and teens must not be overlooked. School personnel
    need to be educated on issues affecting military students and be
    sensitive to their needs. To achieve this goal, schools need tools.
    Parents need tools, too. Military parents constantly seek more
    resources to assist their children in coping with military life,
    especially the challenges and stress of frequent deployments. Parents
    tell us repeatedly they want resources to ``help them help their
    children.'' Support for parents in their efforts to help children of
    all ages is increasing, but continues to be fragmented. New Federal,
    public-private initiatives, increased awareness, and support by DOD and
    civilian schools educating military children have been developed.
    However, many military parents are either not aware such programs exist
    or find the programs do not always meet their needs.
        Our Association is working to meet this pressing need through our
    Operation Purple summer camps. Unique in its ability to reach out and
    gather military children of different age groups, Services, and
    components, Operation Purple provides a safe and fun environment in
    which military children feel immediately supported and understood. Last
    year, with the support of private donors, we achieved our goal of
    sending 10,000 military children to camp. We also were successful in
    expanding the camp experience to families of the wounded and bereaved.
    This year, we expect to maintain those numbers by offering 95 weeks of
    camp in 37 States and territories, as well as conducting several pilot
    family reintegration retreats in the National Parks.
        Through our Operation Purple camps, our Association has begun to
    identify the cumulative effects multiple deployments are having on the
    emotional growth and well being of military children and the challenges
    posed to the relationship between deployed parent, caregiver, and
    children in this stressful environment. Understanding a need for
    qualitative analysis of this information, we contracted with the RAND
    Corporation in 2007 to conduct a pilot study aimed at the current
    functioning and wellness of military children attending Operation
    Purple camps and assessing the potential benefits of the OPC program in
    this environment of multiple and extended deployments. The results of
    the pilot study were published last spring and confirmed much of what
    we have heard from individual families. They also highlighted gaps in
    our current knowledge, including how family relationships are affected
    by deployment and reintegration. The study looked at differences in
    child and caregiver experiences based on Service component, such as how
    life is different during deployment for families from the Active
    Component compared to those in the Guard or Reserve.
        In May 2008, we embarked on phase two of the project--a
    longitudinal study on the experience of 1,507 families, which is a much
    larger and more diverse sample than included in our pilot study. RAND
    is following these families for 1 year, and interviewing the non-
    deployed caregiver/parent and one child per family between 11 and 17
    years of age at three time points over that year. Recruitment of
    participants has been extremely successful because families are eager
    to share their experiences. RAND is currently gathering information
    from these families for the 6-month follow-up survey. Preliminary
    findings from the first round of surveys provide additional support for
    the pilot study results and identify new areas to investigate. This
    includes examining the relationship between the total months of
    deployment that a family experiences and its association with non-
    deployed caregiver's mental health and child's well-being at school and
    at home. In addition, RAND is assessing the impact of reintegration on
    the families and how this varies by a service member's rank and Service
    component.
        This study will provide valuable data to inform the future creation
    and implementation of services for children and families. More
    specifically, we hope this study will provide more detailed and clearer
    understanding of the impact of multiple and extended deployments on
    military children and their families. We expect to present the final
    study results in Spring 2010.
    National Guard and Reserve
        Our Association would like to thank Congress for authorizing many
    provisions that affect our Reserve Component families, who have
    sacrificed greatly in support of our Nation. We continue to ask
    Congress to fully fund these programs so vital to the quality of life
    of our National Guard and Reserve families.
        The National Military Family Association has long realized the
    unique challenges our Reserve Component families face and their need
    for additional support. This need was highlighted in the final report
    from the Commission on the National Guard and Reserves, which confirmed
    what we had always asserted: ``Reserve Component family members face
    special challenges because they are often at a considerable distance
    from military facilities and lack the on-base infrastructure and
    assistance available to active duty families.'' While citing a robust
    volunteer network as crucial, the report also stated that family
    readiness suffers when there are too few paid staff professionals
    supporting the volunteers.
        Our Association would also like to thank Congress for the
    provisions which allowed for the implementation of the Yellow Ribbon
    Reintegration program which is so crucial to the well-being of our
    Reserve Component families. We urge Congress to make the funding for
    this program permanent. We also believe that family members should be
    paid a travel allowance to attend these important reintegration
    programs. Furthermore, DOD and service providers need to move away from
    the one-size fits all approach to reintegration which does not work for
    all the Reserve Components due to the specific nature of each mission
    and the varying length of deployments.
        Our Association asks Congress to fully fund the Yellow Ribbon
    Reintegration program and other provisions affecting our Reserve
    Component families and to move away from the one-size fits all approach
    to reintegration.
    Military Housing
        Privatized housing is a welcome change for military families and we
    are pleased the fiscal year 2009 NDAA called for an annual report that
    addresses the best practices for executing privatized housing
    contracts. With our depressed economy, increased oversight is critical
    to ensure timely completion of these important projects. Project delays
    negatively impact the quality of life of our families.
        Commanders must be held accountable for the quality of housing and
    customer service in privatized communities. Housing areas remain the
    responsibility of the installation Commander even when managed by a
    private company. Services members who are wounded and must move to a
    handicap accessible home or break their lease provisions due to short-
    notice PCS orders should not be penalized. Service members should not
    languish on wait lists while civilians occupy housing. While
    privatization contracts permit other non-military occupants for vacant
    units, Commanders must ensure that privatized housing is first and
    foremost meeting the needs of the active duty population of the
    installation. In some cases, this will require modification or
    renegotiation of contracts.
        Our Association feels there needs to be a review of BAH standards.
    While families who live on the installation are better off, families
    living off the installation are forced to absorb more out-of-pocket
    expenses in order to live in a home that will meet their needs. BAH
    standards are based on an outdated concept of what would constitute a
    reasonable dwelling. For example, in order to receive BAH for a single
    family dwelling a service member must be an E9. However, if that same
    service member lived in military housing, he or she would likely have a
    single family home at the rank of E6 or E7. BAH standards should mirror
    the type of dwelling a service member would occupy if government
    quarters were available.
        Our Association believes that BAH standards should be reviewed and
    should better reflect the type of dwelling the service member would
    occupy if government quarters were available.
    Commissaries and Exchanges
        The commissary is a key element of the total compensation package
    for service members and retirees and is valued by them, their families,
    and survivors. Not only do our surveys indicate that military families
    consider the commissary one of their most important benefits, during
    this economic downturn, many families are returning to the commissary
    to help them reduce their grocery budget. In addition to providing
    average savings of more than 30 percent over local supermarkets,
    commissaries provide an important tie to the military community.
    Commissary shoppers get more than groceries at the commissary. They
    gain an opportunity to connect with other military family members and
    to get information on installation programs and activities through
    bulletin boards and installation publications. Finally, commissary
    shoppers receive nutrition information and education through commissary
    promotions and educational campaigns contributing to the overall health
    of the entire beneficiary population.
        Our Association appreciates the provision included in the fiscal
    year 2009 NDAA allowing the use of proceeds from surcharges collected
    at remote case lot sales for Reserve Component members to help defray
    the cost of those case lot sales. This inclusion helps family members,
    not located near an installation partake in the valuable commissary
    benefit.
        Our Association is concerned there will not be enough commissaries
    to serve areas experiencing substantial growth, including those
    locations with service members and families relocated by BRAC. The
    surcharge was never intended to pay for DOD and Service transformation.
    Additional funding is needed to ensure commissaries are built or
    expanded in areas that are gaining personnel as a result of these
    programs.
        The military exchange system serves as a community hub, in addition
    to providing valuable cost savings to members of the military
    community. Equally important is the fact that exchange system profits
    are reinvested in important Morale, Welfare and Recreation (MWR)
    programs, resulting in quality of life improvements for the entire
    community. We believe that every effort must be made to ensure that
    this important benefit and the MWR revenue is preserved, especially as
    facilities are down-sized or closed overseas. Exchanges must also
    continue to be responsive to the needs of deployed service members in
    combat zones and have the right mix of goods at the right prices for
    the full range of beneficiaries.
    Family Care Plans
        We have heard from single parent and dual military families about
    the expenses incurred when they have to relocate their children to
    another location when they are activated for deployment. This issue was
    raised within the Army Family Action Plan process. Service members
    requiring activation of Family Care Plans are not compensated for the
    travel of dependents and shipment of the dependent's household goods.
    Some items such as infant equipment, computers and toys are necessary
    for the emotional and physical well-being of the children in their new
    environment during an already stressful time. Implementation of the
    Family Care Plan should not create additional financial hardship and
    emotional stress on the service member and family.
        We recommend that changes be made to the DOD Joint Travel
    Regulations to provide for travel and shipment of household goods to
    fulfill the needs of a deploying service member's Family Care Plan.
                                 family health
        Family readiness calls for access to quality health care and mental
    health services. Families need to know the various elements of their
    military health system are coordinated and working as a synergistic
    system. Our Association is concerned the DOD military health care
    system may not have all the resources it needs to meet both the
    military medical readiness mission and provide access to health care
    for all beneficiaries. It must be funded sufficiently, so the direct
    care system of military treatment facilities (MTF) and the purchased
    care segment of civilian providers can work in tandem to meet the
    responsibilities given under the TRICARE contracts, meet readiness
    needs, and ensure access for all military beneficiaries.
    Military Health System
                Improving Access to Care
        In an interview with syndicated Military Update columnist Tom
    Philpott in December of 2008, MG (Dr.) Elder Granger, deputy director
    of TRICARE, gave the Military Health System (MHS) an overall grade of
    ``C-plus or B-minus''. His discussion focused on access issues in the
    direct care system--our military hospitals and clinics--reinforcing
    what our Association has observed for years. We have consistently heard
    from families that their greatest health care challenge has been
    getting timely care from their local military hospital or clinic. In
    previous testimony before this subcommittee we have noted the failure
    of MTFs to meet TRICARE Prime access standards and to be held
    accountable in the same way as the TRICARE contractors are for meeting
    those standards in the purchased care arena.
        In discussions with families the main issues are: access to their
    Primary Care Managers (PCM); getting appointments; getting someone to
    answer the phone at central appointments; having appointments available
    when they finally got through to central appointments; after hours
    care; getting a referral for specialty care; being able to see the same
    provider or PCM; and having appointments available 60, 90, and 120 days
    out in our MTFs. Families familiar with how the MHS referral system
    works seem better able to navigate the system. Those families who are
    unfamiliar experienced delays in receiving treatment or decide to give
    up on the referral process and never obtain a specialty appointment.
        Case management for military beneficiaries with special needs is
    not consistent across the MHS, whether within the MTFs or in the
    purchased care arena. Thus, military families end up managing their own
    care. The shortage of available health care providers only adds to the
    dilemma. Beneficiaries try to obtain an appointment and then find
    themselves getting partial health care within the MTF, while other
    health care is referred out into the purchased care network. Meanwhile,
    the coordination of the military family's care is being done by a non-
    synergistic health care system. Incongruence in the case management
    process becomes more apparent when military family members transfer
    from one TRICARE region to another and is further exasperated when a
    special needs family member is involved. Each TRICARE Managed Care
    Contractor has created different case management processes. There needs
    to be a seamless transition and a warm handoff between TRICARE regions
    for these families and the establishment of a universal case management
    process across the MHS.
        Our wounded, ill, and injured service members, veterans, and their
    families are assigned case managers. In fact, there are many different
    case managers: Federal Recovery Coordinators (FRC), Recovery Care
    Coordinators, each branch of Service, TBI care coordinators, VA
    liaisons, etc. The goal is for a seamless transition of care between
    and within the two governmental agencies: DOD and the VA. However, with
    so many to choose from, families often wonder which one is the
    ``right'' case manager. We often hear from families, some who have long
    since been medically retired with a 100 percent disability rating or
    others with less than 1 year out from date-of-injury, who have not yet
    been assigned a FRC. We need to look at whether the multiple, layered
    case managers have streamlined the process, or have only aggravated it.
    Our Association still finds these families alone trying to navigate a
    variety of complex health care systems trying to find the right
    combination of care. Many qualify for and use Medicare, VA, DOD's
    TRICARE direct and purchased care, private health insurance, and State
    agencies. Does this population really need all of these different
    systems of receiving health care? Why can't the process be streamlined?
                TRICARE
        While Congress temporarily forestalled increases over the past 2
    years, we believe DOD officials will continue to support large
    increased retiree enrollment fees for TRICARE Prime combined with a
    tiered system of enrollment fees, the institution of a TRICARE standard
    enrollment fee and increased TRICARE Standard deductibles. Two reports,
    the Task Force on the Future of the Military Health Care and The Tenth
    Quadrennial Review of Military Compensation Volume II, recently
    recommended the same.
        We acknowledge the annual Prime enrollment fee has not increased in
    more than 10 years and that it may be reasonable to have a mechanism to
    increase fees. With this in mind, we have presented an alternative to
    DOD's proposal should Congress deem some cost increase necessary. The
    most important feature of our proposal is that any fee increase be no
    greater than the percentage increase in the retiree cost of living
    adjustment (COLA). If DOD thought $230/$460 was a fair fee for all in
    1995, then it would appear that raising the fees simply by the
    percentage increase in retiree pay is also fair. We also suggest it
    would be reasonable to adjust the TRICARE Standard deductibles by tying
    increases to the percentage of the retiree annual COLA. We stand ready
    to provide more information on this issue if needed.
                Support for Special Needs Families
        We applaud Congress and DOD's desire to create a robust health care
    and educational service for special needs children. But, these robust
    services do not follow them when they retire. We encourage the Services
    to allow these military families the opportunity to have their final
    duty station be in an area of their choice. We suggest the Extended
    Care Health Option (ECHO) be extended for 1 year after retirement for
    those already enrolled in ECHO prior to retirement.
        There was discussion last year by Congress and military families
    regarding the ECHO program. The fiscal year 2009 NDAA included a
    provision to increase the cap on certain benefits under the ECHO
    program to $36,000 per year for training, rehabilitation, special
    education, assistive technology devices, institutional care and under
    certain circumstances, transportation to and from institutions or
    facilities, because certain beneficiaries bump up against it. The ECHO
    program was originally designed to allow military families with special
    needs to receive additional services to offset their lack of
    eligibility for State or federally provided services impacted by
    frequent moves. We suggest that before making any more adjustments to
    the ECHO program, Congress should direct DOD to certify if the ECHO
    program is working as it was originally designed and has been effective
    in addressing the needs of this population. We need to make the right
    fixes so we can be assured we apply the correct solutions.
                National Guard and Reserve Member Family Health Care
        National Guard and Reserve families need increased education about
    their health care benefits. We also believe that paying a stipend to a
    mobilized National Guard or Reserve member for their family's coverage
    under their employer-sponsored insurance plan may prove to be more
    cost-effective for the government than subsidizing 72 percent of the
    costs of TRICARE Reserve Select for National Guard or Reserve members
    not on active duty.
                TRICARE Reimbursement
        Our Association is concerned that continuing pressure to lower
    Medicare reimbursement rates will create a hollow benefit for TRICARE
    beneficiaries. As the 111th Congress takes up Medicare legislation, we
    request consideration of how this legislation will impact military
    families' health care, especially access to mental health services.
        National provider shortages in the psychological health field,
    especially in child and adolescent psychology, are exacerbated in many
    cases by low TRICARE reimbursement rates, TRICARE rules, or military-
    unique geographic challenges--for example large populations in rural or
    traditionally underserved areas. Many psychological health providers
    are willing to see military beneficiaries on a voluntary status.
    However, these providers often tell us they will not participate in
    TRICARE because of what they believe are time-consuming requirements
    and low reimbursement rates. More must be done to persuade these
    providers to participate in TRICARE and become a resource for the
    entire system, even if that means DOD must raise reimbursement rates.
        We have heard the main reason for the VA not providing health care
    and psychological health care services is because they cannot be
    reimbursed for care rendered to a family member. However, the VA is a
    qualified TRICARE provider. This allows the VA to bill for services
    rendered in their facilities to a TRICARE beneficiary. There may be a
    way to bill other health insurance companies as well. The VA needs to
    look at the possibility for other methods of payments.
                Pharmacy
        We caution DOD about generalizing findings of certain beneficiary
    pharmacy behaviors and automatically applying them to our Nation's
    unique military population. We encourage Congress to require DOD to
    utilize peer-reviewed research involving beneficiaries and prescription
    drug benefit options, along with performing additional research
    involving military beneficiaries, before making any recommendations on
    prescription drug benefit changes, such as co-payment and tier
    structure changes for military service members, retirees, their
    families, and survivors.
        We appreciate the inclusion of Federal pricing for the TRICARE
    retail pharmacies in the fiscal year 2008 NDAA. However, we need to
    examine its effect on the cost of medications for both beneficiaries
    and DOD. Also, we will need to see how this potentially impacts the
    overall negotiation of future drug prices by Medicare and civilian
    private insurance programs.
        We believe it is imperative that all medications available through
    TRICARE Retail Pharmacy (TRRx) should also be available through TRICARE
    Mail Order Pharmacy (TMOP). Medications treating chronic conditions,
    such as asthma, diabetes, and hypertension should be made available at
    the lowest level of co-payment regardless of brand or generic status.
    We agree with the recommendations of The Task Force on the Future of
    Military Health Care that OTC drugs be a covered pharmacy benefit and
    there be a zero co-pay for TMOP Tier 1 medications.
                National Health Care Proposal
        Our Association is cautious about current rhetoric by the
    Administration and Congress regarding the establishment of a National
    health care insurance program. As the 111th Congress takes up a
    National health care insurance proposal, we request consideration of
    how this legislation will also impact TRICARE, military families'
    access to health care, and especially recruitment and retention of our
    service members at a time of war.
                DOD Must Look for Savings
        We ask Congress to establish better oversight for DOD's
    accountability in becoming more cost-efficient. We recommend:
      --Requiring the Comptroller General to audit MTFs on a random basis
            until all have been examined for their ability to provide
            quality health care in a cost-effective manner;
      --Creating an oversight committee, similar in nature to the Medicare
            Payment Advisory Commission, which provides oversight to the
            Medicare program and makes annual recommendations to Congress.
            The Task Force on the Future of Military Health Care often
            stated it was unable to address certain issues not within their
            charter or the timeframe in which they were commissioned to
            examine the issues. This Commission would have the time to
            examine every issue in an unbiased manner;
      --Establishing a Unified ``Joint'' Medical Command structure, which
            was recommended by the Defense Health Board in 2006.
        Our Association does not support the recommendation of the Task
    Force on the Future of Military Health Care to carve out one regional
    TRICARE contractor to provide both the pharmacy and health care
    benefit. We agree a link between pharmacy and disease management is
    necessary, but feel this pilot would only further erode DOD's ability
    to maximize potential savings through TMOP. We were also disappointed
    to find no mention of disease management or a requirement for
    coordination between the pharmacy contractor and Managed Care Support
    Contractors in the Request for Proposals for the new TRICARE pharmacy
    contract. The ability certainly exists for them to share information
    bi-directionally and should be established.
        Our Association believes optimizing the capabilities of the
    facilities of the direct care system through timely replacement of
    facilities, increased funding allocations, and innovative staffing
    would allow more beneficiaries to be cared for in the MTFs, which DOD
    asserts is the most cost effective. The Task Force made recommendations
    to make the DOD MHS more cost-efficient which we support. They conclude
    the MHS must be appropriately sized, resourced, and stabilized; and
    make changes in its business and health care practices.
        Our Association suggests this Subcommittee DOD reassess the
    resource sharing program used prior to the implementation of the T-Nex
    contracts and take the steps necessary to ensure Military Treatment
    Facilities (MTF) meet access standards with high quality health care
    providers.
        We also suggest this Subcommittee direct the Department to make
    case management services more consistent across the direct and
    purchased care segments of the MHS.
        Our Association recommends a 1-year transitional active duty ECHO
    benefit for the family members of service members who retire.
        We believe tying increases in TRICARE enrollment fees to the
    percentage increase in the Retiree Cost of Living Adjustment (COLA) is
    a fair way to increase beneficiary cost shares should Congress deem an
    increase necessary.
        We oppose DOD's proposal to institute a TRICARE Standard enrollment
    fee and believe Congress should reject this proposal because it changes
    beneficiaries' entitlement to health care under TRICARE Standard to
    just another insurance plan.
        Our Association strongly believes an enrollment fee for TFL is not
    appropriate.
        We believe that Reserve Component families should be given the
    choice of a stipend to continue their employer provided care during
    deployment.
    Behavioral Health Care
        Our Nation must help returning service members and their families
    cope with the aftermaths of war. DOD, VA, and State agencies must
    partner in order to address behavioral health issues early in the
    process and provide transitional mental health programs. Partnering
    will also capture the National Guard and Reserve member population, who
    often straddle these agencies' health care systems.
                Full Spectrum of Care
        As the war continues, families' need for a full spectrum of
    behavioral health services--from preventative care to stress reduction
    techniques, to individual or family counseling, to medical mental
    health services--continues to grow. The military offers a variety of
    psychological health services, both preventative and treatment, across
    many agencies and programs. However, as service members and families
    experience numerous lengthy and dangerous deployments, we believe the
    need for confidential, preventative psychological health services will
    continue to rise. It will also remain high for some time even after
    military operations scale down.
                Access to Behavioral Health Care
        Our Association is concerned about the overall shortage of
    psychological health providers in TRICARE's direct and purchased care
    network. DOD's Task Force on Mental Health stated timely access to the
    proper psychological health provider remains one of the greatest
    barriers to quality mental health services for service members and
    their families. While families are pleased more psychological health
    providers are available in theater to assist their service members,
    they are disappointed with the resulting limited access to providers at
    home. Families are reporting increased difficulty in obtaining
    appointments with social workers, psychologists, and psychiatrists at
    their MTFs and clinics. The military fuels the shortage by deploying
    some of its child and adolescent psychology providers to combat zones.
    Providers remaining at home report they are overwhelmed by treating
    active duty members and are unable to fit family members into their
    schedules. This can lead to compassion fatigue, creating burnout and
    exacerbating the provider shortage problem.
        We have seen an increase in the number of psychological health
    providers joining the purchased care side of the TRICARE network.
    However, the access standard is 7 days. We hear from military families
    after accessing the psychological health provider list on the
    contractor's websites that the provider is full and no longer taking
    patients. The list must be up-to-date in order to handle real time
    demands by families. We need to continue to recruit more psychological
    health providers to join the TRICARE network and we need to make sure
    we specifically add those in specialty behavioral health care areas,
    such as child and adolescence psychology and psychiatrists.
        Families must be included in mental health counseling and treatment
    programs for service members. Family members are a key component to a
    service member's psychological well-being. We recommend an extended
    outreach program to service members, veterans, and their families of
    available psychological health resources, such as DOD, VA, and State
    agencies. Families want to be able to access care with a psychological
    health provider who understands or is sympathetic to the issues they
    face.
        Frequent and lengthy deployments create a sharp need in
    psychological health services by family members and service members as
    they get ready to deploy and after their return. There is also an
    increase in demand in the wake of natural disasters, such as hurricanes
    and fires. We need to maintain a flexible pool of psychological health
    providers who can increase or decrease rapidly in numbers depending on
    demand on the MHS side. Currently, Military Family Life Consultants and
    Military OneSource counseling are providing this type of service for
    military families on the family support side. We need to make the
    Services, along with military family members, more aware of resources
    along the continuum. We need the flexibility of support in both the MHS
    and family support arenas.
                Availability of Treatment
        Do DOD, VA and State agencies have adequate psychological health
    providers, programs, outreach, and funding? Better yet, where will the
    veteran's spouse and children go for help? Many will be left alone to
    care for their loved one's invisible wounds resulting from frequent and
    long combat deployments. Who will care for them when they are no longer
    part of the DOD health care system?
        The Army's Mental Health Advisory Team (MHAT) IV report links
    reducing family issues to reducing stress on deployed service members.
    The team found the top non-combat stressors were deployment length and
    family separation. They noted soldiers serving a repeat deployment
    reported higher acute stress than those on their first deployment and
    the level of combat was the major contribution for their psychological
    health status upon return. These reports demonstrate the amount of
    stress being placed on our troops and their families.
        Our Association is especially concerned with the scarcity of
    services available to the families as they leave the military following
    the end of their activation or enlistment. Due to the service member's
    separation, the families find themselves ineligible for TRICARE, and
    are very rarely eligible for healthcare through the VA. Many will
    choose to locate in rural areas lacking available psychological health
    providers. We need to address the distance issues families face in
    finding psychological health resources and obtaining appropriate care.
    Isolated service members, veterans, and their families do not have the
    benefit of the safety net of services and programs provided by MTFs, VA
    facilities, Community-Based Outpatient Centers and Vet Centers. We
    recommend:
      --using alternative treatment methods, such as telemental health;
      --modifying licensing requirements in order to remove geographic
            practice barriers that prevent psychological health providers
            from participating in telemental health services outside of a
            VA facility; and
      --educating civilian network psychological health providers about our
            military culture as the VA incorporates Project Hero.
                National Guard and Reserve Members
        The National Military Family Association is especially concerned
    about fewer mental health care services available for the families of
    returning National Guard and Reserve members as well as service members
    who leave the military following the end of their enlistment. They are
    eligible for TRICARE Reserve Select, but as we know, National Guard and
    Reserve members are often located in rural areas where there may be no
    mental health providers available. Policy makers need to address the
    distance issues that families face in linking with military mental
    health resources and obtaining appropriate care. Isolated National
    Guard and Reserve families do not have the benefit of the safety net of
    services provided by MTFs and installation family support programs.
    Families want to be able to access care with a provider who understands
    or is sympathetic to the issues they face. We recommend the use of
    alternative treatment methods, such as telemental health; increasing
    mental health reimbursement rates for rural areas; modifying licensing
    requirements in order to remove geographic practice barriers that
    prevent mental health providers from participating in telemental health
    services; and educating civilian network mental health providers about
    our military culture.
                Wounded, Ill, and Injured Families
        When designing support for the wounded, ill, and injured in today's
    conflict, our Association believes the government, especially DOD, VA,
    and State agencies, must take a more inclusive view of military and
    veterans' families. Those who have the responsibility to care for the
    wounded service member must also consider the needs of the spouse,
    children, parents of single service members, siblings, and other
    caregivers. Family members are an integral part of the health care team
    and recovery process.
        Caregivers need to be recognized for the important role they play
    in the care of their loved one. Without them, the quality of life of
    the wounded service members and veterans, such as physical, psycho-
    social, and mental health, would be significantly compromised. They are
    viewed as an invaluable resource to DOD and VA health care providers
    because they tend to the needs of the service members and the veterans
    on a regular basis. And, their daily involvement saves DOD, VA, and
    State agency health care dollars in the long run. Their long-term
    psychological care needs must be addressed. Caregivers of the severely
    wounded, ill, and injured services members who are now veterans have a
    long road ahead of them. In order to perform their job well, they will
    require access to mental health services.
        The Vet Centers are an available resource for veterans' families
    providing adjustment, vocational, and family and marriage counseling.
    The VA health care facilities and the community-based outpatient
    clinics (CBOCs) have a ready supply of mental health providers, yet
    regulations restrict their ability to provide mental health care to
    veterans' families unless they meet strict standards. Unfortunately,
    this provision hits the veteran's caregiver the hardest. We recommend
    DOD partner with the VA to allow military families access to mental
    health services. We also believe Congress should require the VA,
    through its Vet Centers and health care facilities to develop a
    holistic approach to care by including families when providing mental
    health counseling and programs to the wounded, ill, or injured service
    member or veteran.
        The Defense Health Board has recommended DOD include military
    families in its mental health studies. We agree. We encourage Congress
    to direct DOD to include families in its Psychological Health Support
    survey; perform a pre and post-deployment mental health screening on
    family members (similar to the PDHA and PDHRA currently being done for
    service members); and sponsor a longitudinal study, similar to DOD's
    Millennium Cohort Study, in order to get a better understanding of the
    long-term effects of war on our military families.
                Children
        Our Association is concerned about the impact deployment and/or the
    injury of the service member is having on our most vulnerable
    population, children of our military and veterans. Multiple deployments
    are creating layers of stressors, which families are experiencing at
    different stages. Teens especially carry a burden of care they are
    reluctant to share with the non-deployed parent in order to not ``rock
    the boat.'' They are often encumbered by the feeling of trying to keep
    the family going, along with anger over changes in their schedules,
    increased responsibility, and fear for their deployed parent. Children
    of the National Guard and Reserve members face unique challenges since
    there are no military installations for them to utilize. They find
    themselves ``suddenly military'' without resources to support them.
    School systems are generally unaware of this change in focus within
    these family units and are ill prepared to lookout for potential
    problems caused by these deployments or when an injury occurs. Also
    vulnerable, are children who have disabilities that are further
    complicated by deployment and subsequent injury of the service members.
    Their families find stress can be overwhelming, but are afraid to reach
    out for assistance for fear of retribution to the service member's
    career. They often choose not to seek care for themselves or their
    families.
        The impact of the wounded, ill, and injured on children is often
    overlooked and underestimated. Military children experience a
    metaphorical death of the parent they once knew and must make many
    adjustments as their parent recovers. Many families relocate to be near
    the treating Military Treatment Facility (MTF) or the VA Polytrauma
    Center in order to make the rehabilitation process more successful. As
    the spouse focuses on the rehabilitation and recovery, older children
    take on new roles. They may become the caregivers for other siblings,
    as well as for the wounded parent. Many spouses send their children to
    stay with neighbors or extended family members, as they tend to their
    wounded, ill, and injured spouse. Children get shuffled from place to
    place until they can be reunited with their parents. Once reunited,
    they must adapt to the parent's new injury and living with the ``new
    normal.''
        We encourage partnerships between government agencies, DOD, VA and
    State agencies and recommend they reach out to those private and non-
    governmental organizations who are experts on children and adolescents.
    They could identify and incorporate best practices in the prevention
    and treatment of mental health issues affecting our military children.
    We must remember to focus on preventative care upstream, while still in
    the active duty phase, in order to have a solid family unit as they
    head into the veteran phase of their lives. School systems must become
    more involved in establishing and providing supportive services for our
    Nation's children.
                Caregivers
        In the 7th year of the Global War on Terror, care for the
    caregivers must become a priority. Our Association hears from the
    senior officer and enlisted spouses who are so often called upon to be
    the strength for others. We hear from the health care providers,
    educators, rear detachment staff, chaplains, and counselors who are
    working long hours to assist service members and their families. They
    tell us they are overburdened, burnt out, and need time to recharge so
    they can continue to serve these families. These caregivers must be
    afforded respite care; given emotional support through their command
    structure; and, be provided effective family programs.
                Education
        The DOD, VA, and State agencies must educate their health care and
    mental health professionals of the effects of mild Traumatic Brain
    Injury (mTBI) in order to help accurately diagnose and treat the
    service member's condition. They must be able to deal with polytrauma--
    Post-Traumatic Stress Disorder (PTSD) in combination with multiple
    physical injuries. We need more education for civilian health care
    providers on how to identify signs and symptoms of mild TBI and PTSD.
        The families of service members and veterans must be educated about
    the effects of mTBI and PTSD in order to help accurately diagnose and
    treat the service member/veteran's condition. These families are on the
    ``sharp end of the spear'' and are more likely to pick up on changes
    attributed to either condition and relay this information to their
    health care providers.
                Reintegration Programs
        Reintegration programs become a key ingredient in the family's
    success. Our Association believes we need to focus on treating the
    whole family with programs offering readjustment information; education
    on identifying mental health, substance abuse, suicide, and traumatic
    brain injury; and encouraging them to seek assistance when having
    financial, relationship, legal, and occupational difficulties.
        Successful return and reunion programs will require attention over
    the long term, as well as a strong partnership at all levels between
    the various mental health arms of DOD, VA, and State agencies.
        DOD and VA need to provide family and individual counseling to
    address these unique issues. Opportunities for the entire family and
    for the couple to reconnect and bond must also be provided. Our
    Association has recognized this need and is piloting two family
    retreats in the National Parks to promote family reintegration
    following deployment.
        We recommend an extended outreach program to service members,
    veterans, and their families of available psychological health
    resources, such as DOD, VA, and State agencies.
        We encourage Congress to request DOD to include families in its
    Psychological Health Support survey; perform a pre and post-deployment
    mental health screening on family members (similar to the PDHA and
    PDHRA currently being done for service members); and sponsor a
    longitudinal study, similar to DOD's Millennium Cohort Study, in order
    to get a better understanding of the long-term effects of war on our
    military families.
        We recommend the use of alternative treatment methods, such as
    telemental health; increasing mental health reimbursement rates for
    rural areas; modifying licensing requirements in order to remove
    geographic practice barriers that prevent mental health providers from
    participating in telemental health services; and educating civilian
    network mental health providers about our military culture.
        Caregivers must be afforded respite care; given emotional support
    through their command structure; and, be provided effective family
    programs.
    Wounded Service Members Have Wounded Families
        Our Association asserts that behind every wounded service member
    and veteran is a wounded family. It is our belief the government,
    especially the DOD and VA, must take a more inclusive view of military
    and veterans' families. Those who have the responsibility to care for
    the wounded, ill, and injured service member must also consider the
    needs of the spouse, children, parents of single service members and
    their siblings, and the caregivers. We appreciate the inclusion in the
    fiscal year 2008 NDAA Wounded Warrior provision for health care
    services to be provided by the DOD and VA for family members. DOD and
    VA need to think proactively as a team and one system, rather than
    separately; and addressing problems and implementing initiatives
    upstream while the service member is still on active duty status.
        Reintegration programs become a key ingredient in the family's
    success. In the spring of 2008, our Association held a focus group
    composed of wounded service members and their families to learn more
    about issues affecting them. Families find themselves having to
    redefine their roles following the injury of the service member. They
    must learn how to parent and become a spouse/lover with an injury. Each
    member needs to understand the unique aspects the injury brings to the
    family unit. Parenting from a wheelchair brings a whole new challenge,
    especially when dealing with teenagers. Parents need opportunities to
    get together with other parents who are in similar situations and share
    their experiences and successful coping methods. Our Association
    believes we need to focus on treating the whole family with programs
    offering skill based training for coping, intervention, resiliency, and
    overcoming adversities. Injury interrupts the normal cycle of
    deployment and the reintegration process. We must provide opportunities
    for the entire family and for the couple to reconnect and bond,
    especially during the rehabilitation and recovery phases. We piloted a
    Operation Purple Healing Adventures camp to help wounded service
    members and their families learn to play again as a family and plan one
    more in the summer of 2009.
        Brooke Army Medical Center (BAMC) has recognized a need to support
    these families by expanding in terms of guesthouses co-located within
    the hospital grounds and a family reintegration program for their
    Warrior Transition Unit. The on-base school system is also sensitive to
    issues surrounding these children. A warm, welcoming family support
    center located in guest housing serves as a sanctuary for family
    members. The DOD and VA could benefit from looking at successful
    programs like BAMC's which has found a way to embrace the family unit
    during this difficult time.
                Transitioning for the Wounded and Their Families
        Transitions can be especially problematic for wounded, ill, and
    injured service members, veterans, and their families. The DOD and the
    VA health care systems, along with State agency involvement, should
    alleviate, not heighten these concerns. They should provide for
    coordination of care, starting when the family is notified that the
    service member has been wounded and ending with the DOD, VA, and State
    agencies working together, creating a seamless transition, as the
    wounded service member transfers between the two agencies' health care
    systems and, eventually, from active duty status to veteran status.
        Transition of health care coverage for our wounded, ill, and
    injured and their family members is a concern of our Association. These
    service members and families desperately need a health care bridge as
    they deal with the after effects of the injury and possible reduction
    in their family income. We have created two proposals. Service members
    who are medically retired and their families should be treated as
    active duty for TRICARE fee and eligibility purposes for 3 years
    following medical retirement. This proposal will allow the family not
    to pay premiums and be eligible for certain programs offered to active
    duty, such as ECHO for 3 years. Following that period, they would pay
    TRICARE premiums at the rate for retirees. Service members medically
    discharged from service and their family members should be allowed to
    continue for 1 year as active duty for TRICARE and then start the
    Continued Health Care Benefit Program (CHCBP) if needed.
                Caregivers
        Caregivers need to be recognized for the important role they play
    in the care of their loved one. The VA has made a strong effort in
    supporting veterans' caregivers. The DOD should follow suit and expand
    their definition. Caregivers of the severely wounded, ill, and injured
    services members have a long road ahead of them. In order to perform
    their job well, they must be given the skills to be successful. This
    will require the caregiver to be trained through a standardized,
    certified program, and appropriately compensated for the care they
    provide. The time to implement these programs is while the service
    member is still on active duty status.
        Our Association proposes that new types of financial compensation
    be established for caregivers of injured service members and veterans
    that could begin while the hospitalized service member is still on
    active duty and continue throughout the transition to care under the
    VA. This compensation should recognize the types of medical and non-
    medical care services provided by the caregiver, travel to appointments
    and coordinating with providers, and the severity of injury. It should
    also take into account the changing levels of service provided by the
    caregiver as the veteran's condition improves or diminishes or needs
    for medical treatment changes. These needs would have to be assessed
    quickly with little time delay in order to provide the correct amount
    of compensation. The caregiver should be paid directly for their
    services, but the compensation should be linked to training and
    certification paid for by the VA and transferable to employment in the
    civilian sector if the care is no longer needed by the service member.
    Our Association looks forward to discussing details of implementing
    such a plan with Members of this Subcommittee.
        Consideration should also be given to creating innovative ways to
    meet the health care and insurance needs of the caregiver, with an
    option to include their family. Perhaps, caregivers of severely injured
    service members or veterans can be given the option of buying health
    insurance through the Federal Employees Health Benefit Program or
    through enrollment in CHAMPVA. A mechanism should also be established
    to assist caregivers who are forced out of the work force to save for
    their retirements, for example, through the Federal Thrift Savings
    Plan.
        There must be a provision for transition for the caregiver if the
    caregiver's services are no longer needed, chooses to no longer
    participate, or is asked by the veteran to no longer provide services.
    The caregiver should still be able to maintain health care coverage for
    1 year. Compensation would discontinue following the end of services/
    care provided by the caregiver.
        The VA currently has eight caregiver assistance pilot programs to
    expand and improve health care education and provide needed training
    and resources for caregivers who assist disabled and aging veterans in
    their homes. DOD should evaluate these pilot programs to determine
    whether to adopt them for themselves. Caregivers' responsibilities
    start while the service member is still on active duty.
                Relocation Allowance
        Active Duty service members and their spouses qualify through the
    DOD for military orders to move their household goods (known as a
    Permanent Change of Station (PCS)) when they leave the military
    service. Medically retired service members are given a final PCS move.
    Medically retired married service members are allowed to move their
    family; however, medically retired single service members only qualify
    for moving their own personal goods.
        The National Military Family Association is requesting the ability
    for medically retired single service members to be allowed the
    opportunity to have their caregiver's household goods moved as a part
    of the medical retired single service member's PCS move. This should be
    allowed for the qualified caregiver of the wounded service member and
    the caregiver's family (if warranted), such as a sibling who is married
    with children or mom and dad. This would allow for the entire
    caregiver's family to move, not just the caregiver. The reason for the
    move is to allow the medically retired single service member the
    opportunity to relocate with their caregiver to an area offering the
    best medical care, rather than the current option that only allows for
    the medically retired single service member to move their belongings to
    where the caregiver currently resides. The current option may not be
    ideal because the area in which the caregiver lives may not be able to
    provide all the health care services required for treating and caring
    for the medically retired service member. Instead of trying to create
    the services in the area, a better solution may be to allow the
    medically retired service member, their caregiver, and the caregiver's
    family to relocate to an area where services already exist.
        The decision on where to relocate for optimum care should be made
    with the Federal Recovery Coordinator (case manager), the service
    member's medical physician, the service member, and the caregiver. All
    aspects of care for the medically retired service member and their
    caregiver shall be considered. These include a holistic examination of
    the medically retired service member, the caregiver, and the
    caregiver's family for, but not limited to, their needs and
    opportunities for health care, employment, transportation, and
    education. The priority for the relocation should be where the best
    quality of services is readily available for the medically retired
    service member and his/her caregiver.
        The consideration for a temporary partial shipment of caregiver's
    household goods may also be allowed, if deemed necessary by the case
    management team.
        Provide transitioning wounded, ill and injured service members and
    their families a bridge of extended active duty TRICARE eligibility for
    3 years, comparable to the benefit for surviving spouses.
        Caregivers of the wounded, ill and injured must be provided with
    opportunities for training, compensation and other support programs
    because of the important role they play in the successful
    rehabilitation and care of the service member.
        Service members medically discharged from service and their family
    members shall be allowed to continue for 1 year as active duty for
    TRICARE and then start the Continued Health Care Benefit Program
    (CHCBP) if needed.
                Senior Oversight Committee
        Our Association is appreciative of the provision in the fiscal year
    2009 NDAA continuing the DOD/VA Senior Oversight Committee (SOC) for an
    additional year. We understand a permanent structure is in the process
    of being established and manned. We urge Congress to put a mechanism in
    place to continue to monitor DOD and VA's partnership initiatives for
    our wounded, ill, and injured service members and their families, while
    this organization is being created.
        The National Military Family Association encourages the Armed
    Service Committee along with the Veterans' Affairs Committee to talk on
    these important issues. We can no longer be content on focusing on each
    agency separately because this population moves too frequently between
    the two agencies, especially our wounded, ill, and injured service
    members and their families.
        We would like to thank you again for the opportunity to provide
    information on the health care needs for the service members, veterans,
    and their families. Military families support the Nation's military
    missions. The least their country can do is make sure service members,
    veterans, and their families have consistent access to high quality
    mental health care in the DOD, VA, and within network civilian health
    care systems. Wounded service members and veterans have wounded
    families. The caregiver must be supported by providing access to
    quality health care and mental health services, and assistance in
    navigating the health care systems. The system should provide
    coordination of care with DOD, VA, and State agencies working together
    to create a seamless transition. We ask Congress to assist in meeting
    that responsibility.
                               family transitions
        Our Association will promote policies and access to programs
    providing training and support for families during the many transitions
    they experience.
    Survivors
        In the past year, the Services have been focusing on outreach to
    surviving families. In particular, the Army's SOS (Survivor Outreach
    Services) program makes an effort to remind these families that they
    are not forgotten. DOD and the VA must work together to ensure
    surviving spouses and their children can receive the mental health
    services they need, through all of VA's venues. New legislative
    language governing the TRICARE behavioral health benefit may also be
    needed to allow TRICARE coverage of bereavement or grief counseling.
    The goal is the right care at the right time for optimum treatment
    effect. DOD and the VA need to better coordinate their mental health
    services for survivors and their children.
        We ask that the active duty TRICARE Dental benefit be extended to
    surviving children to mirror the active duty TRICARE medical benefit to
    which they are now eligible. We also ask that eligibility be expanded
    to those Reserve Component family members who had not been enrolled in
    the active duty TRICARE Dental benefit prior to the service member's
    death.
        Our Association recommends that surviving children be allowed to
    remain in the TRICARE Dental Program until they age out of TRICARE
    eligibility and that eligibility be expanded to those Reserve Component
    survivors who had not been enrolled prior to the service member's
    death.. We also recommend that grief counseling be more readily
    available to survivors.
        Our Association still believes the benefit change that will provide
    the most significant long-term advantage to the financial security of
    all surviving families would be to end the Dependency and Indemnity
    Compensation (DIC) offset to the Survivor Benefit Plan (SBP). Ending
    this offset would correct an inequity that has existed for many years.
    Each payment serves a different purpose. The DIC is a special indemnity
    (compensation or insurance) payment paid by the VA to the survivor when
    the service member's service causes his or her death. The SBP annuity,
    paid by DOD, reflects the longevity of the service of the military
    member. It is ordinarily calculated at 55 percent of retired pay.
    Military retirees who elect SBP pay a portion of their retired pay to
    ensure that their family has a guaranteed income should the retiree
    die. If that retiree dies due to a service connected disability, their
    survivor becomes eligible for DIC.
        Surviving active duty spouses can make several choices, dependent
    upon their circumstances and the ages of their children. Because SBP is
    offset by the DIC payment, the spouse may choose to waive this benefit
    and select the ``child only'' option. In this scenario, the spouse
    would receive the DIC payment and the children would receive the full
    SBP amount until each child turns 18 (23 if in college), as well as the
    individual child DIC until each child turns 18 (23 if in college). Once
    the children have left the house, this choice currently leaves the
    spouse with an annual income of $13,848, a significant drop in income
    from what the family had been earning while the service member was
    alive and on active duty. The percentage of loss is even greater for
    survivors whose service members served longer. Those who give their
    lives for their country deserve more fair compensation for their
    surviving spouses.
        We appreciate the establishment of a special survivor indemnity
    allowance as a first step in the process to eliminate the DIC offset to
    SBP.
        We believe several other adjustments could be made to the Survivor
    Benefit Plan. Allowing payment of the SBP benefits into a Special Needs
    Trust in cases of disabled beneficiaries will preserve their
    eligibility for income based support programs. The government should be
    able to switch SBP payments to children if a surviving spouse is
    convicted of complicity in the member's death.
        We ask the DIC offset to SBP be eliminated to recognize the length
    of commitment and service of the career service member and spouse. We
    also request that SBP benefits be allowed to be paid to a Special Needs
    Trust in cases of disabled family members.
    Spouse Employment, Unemployment
        Our Association appreciates the expansion of the Military Spouse
    Career Advancement Accounts. We look forward to the rollout and full
    implementation of the expanded program and hope that the definition of
    ``portable careers'' is broad enough to support the diverse military
    spouse population. To further spouse employment opportunities, we
    recommend an expansion to the Workforce Opportunity Tax Credit for
    employers who hire spouses of active duty and Reserve component service
    members, and to provide tax credits to military spouses to offset the
    expense in obtaining career licenses and certifications when service
    members are relocated to a new duty station within a different State.
    Families on the Move
        Our Association is concerned about the timely implementation of the
    Defense Personal Property Program, formerly titled ``Families First.''
    Worldwide rollout is still incomplete and it is unclear if customer
    satisfaction surveys are incorporated into the carrier ranking process.
    Full Replacement Value has been rolled out, but is handled differently
    by each carrier. Families are confused about how and where to file
    claims. Congressional oversight is needed to press for implementation
    of this program and deliver the best possible service to our families.
        Our Association is grateful for the addition of the weight
    allowance for spousal professional materials. We ask that Congress
    broaden the language to require the Service Secretaries to implement
    this much needed benefit.
        A PCS move to an overseas location can be especially stressful.
    Military families are faced with the prospect of being thousands of
    miles from extended family and living in a foreign culture. At many
    overseas locations, there are insufficient numbers of government
    quarters resulting in the requirement to live on the local economy away
    from the installation. Family members in these situations can feel
    extremely isolated; for some the only connection to anything familiar
    is the local military installation. Unfortunately, current law permits
    the shipment of only one vehicle to an overseas location, including
    Alaska and Hawaii. Since most families today have two vehicles, they
    sell one of the vehicles.
        Upon arriving at the new duty station, the service member requires
    transportation to and from the place of duty leaving the military
    spouse and family members at home without transportation. This lack of
    transportation limits the ability of spouses to secure employment and
    the ability of children to participate in extra curricular activities.
    While the purchase of a second vehicle alleviates these issues, it also
    results in significant expense while the family is already absorbing
    other costs associated with a move. Simply permitting the shipment of a
    second vehicle at government expense could alleviate this expense and
    acknowledge the needs of today's military family.
        Our Association requests that Congress ease the burden of military
    PCS moves on military families by pressing for the full implementation
    of the Defense Personal Property Program and by authorizing the
    shipment of a second vehicle for families assigned to an overseas
    location on accompanied tours.
    Education of Military Children
        While our Association remains appreciative for the additional
    funding you provide to civilian school districts educating large
    numbers of military children, DOD Impact Aid still remains under-
    funded. We urge Congress to increase funding for schools educating
    large numbers of military children to $60 million for fiscal year 2010.
    We also encourage you to make the additional funding for school
    districts experiencing growth available to all school districts
    experiencing significant enrollment increases and not just to those
    districts meeting the current 20 percent enrollment threshold. The
    arrival of several hundred military students can be financially
    devastating to any school district, regardless of how many of those
    students the district already serves. This supplement to Impact Aid is
    vital to school districts that have shouldered the burden of ensuring
    military children receive a quality education despite the stresses of
    military life.
        As increased numbers of military families move into new communities
    due to Global Rebasing and BRAC, their housing needs are being met
    further and further away from the installation. Thus, military children
    may be attending school in districts whose familiarity with the
    military lifestyle may be limited. Educating large numbers of military
    children will put an added burden on schools already hard-pressed to
    meet the needs of their current populations. With over 70,000 military
    families returning to the United States, at the same time the Army is
    moving over one third of its soldiers within the United States, we urge
    Congress to authorize an increase in this level of funding until BRAC
    and Global Rebasing moves are completed.
        Although it does not fall under the purview of this Subcommittee,
    we thank Congress for passing the Higher Education Opportunity Act of
    2008, which contained many new provisions affecting military families.
    Chief among them was a provision to expand in-State tuition eligibility
    for military service members and their families. Under this provision,
    colleges and universities receiving Federal funding under the act will
    be required to offer in-State tuition rates for active duty service
    members and their families and provide continuity of in-State rates if
    the service member receives orders for an assignment out of State.
    However, family members have to be currently enrolled in order to be
    eligible for continuity of in-State tuition. Our Association is
    concerned that this would preclude a senior in high school from
    receiving in-State tuition rates if his or her family PCS's prior to
    matriculation. We urge Congress to amend this provision.
        Our Association congratulates the DOD Office of Personnel and
    Readiness and the Council of State Governments (CSG) for drafting the
    Interstate Compact on Educational Opportunity for Military Children and
    for spearheading the adoption of this important legislation. Designed
    to alleviate many of the transition issues facing military children,
    the Compact has now been adopted in 20 States. In addition, Hawaii has
    a Compact bill awaiting their Governor's signature, and 11 other States
    are working active legislation this year. With 10 States needed to
    enact the Compact, the first meeting of the Interstate Commission on
    Educational Opportunity for Military Children met in October 2008. Our
    Association is pleased to have been a member of both the Advisory Group
    and Drafting Team, and has been working actively to support the
    adoption of this Compact, which will greatly enhance the quality of
    life of our military children and families.
        We ask Congress to increase the DOD supplement to Impact Aid to $60
    million to help districts better meet the additional demands caused by
    large numbers of military children, deployment-related issues, and the
    effects of military programs and policies. We also ask Congress to
    allow all school districts experiencing a significant growth in their
    military student population due to BRAC, Global Rebasing, or
    installation housing changes to be eligible for the additional funding
    currently available only to districts with an enrollment of at least 20
    percent military children.
    Spouse Education
        Since 2004, our Association has been fortunate to sponsor our
    Joanne Holbrook Patton Military Spouse Scholarship Program, with the
    generosity of donors who wish to help military families. In 2007, we
    published Education and the Military Spouse: The Long Road to Success,
    based on spouse scholarship applicant survey responses, identifying
    education issues and barriers specific to military spouses. The entire
    report may be found at www.nmfa.org/education.
        The survey found military spouses, like their service members and
    the military as a whole, value education and set education goals for
    themselves. Yet, military spouses often feel their options are limited.
    Deployments, the shortage of affordable and quality child care,
    frequent moves, the lack of educational benefits and tuition assistance
    for tuition are discouraging. For military spouses, the total cost of
    obtaining a degree can be significantly higher than the cost for
    civilian students. The unique circumstances that accompany the military
    lifestyle have significant negative impacts upon a spouse's ability to
    remain continuously enrolled in an educational program. Military
    spouses often take longer than the expected time to complete their
    degrees. More than one-third of those surveyed have been working toward
    their goal for 5 years or more. The report offers recommendations for
    solutions that Congress could provide:
      --Ensuring installation education centers have the funding necessary
            to support spouse education programs and initiatives;
      --Providing additional child care funding to support child care needs
            of military spouse-scholars;
      --Helping to defray additional costs incurred by military spouses who
            ultimately spend more than civilian counterparts to obtain a
            degree.
        Our Association wishes to thank Congress for passing the Post 9/11
    G.I. Bill for service members and for including transferability of the
    benefit to spouses and children. We will continue to monitor the
    implementation of this benefit, and hope to see the regulations posted
    soon.
    Military Families--Our Nation's Families
        We thank you for your support of our service members and their
    families and we urge you to remember their service as you work to
    resolve the many issues facing our country. Military families are our
    Nation's families. They serve with pride, honor, and quiet dedication.
    Since the beginning of the war, government agencies, concerned citizens
    and private organizations have stepped in to help. This increased
    support has made a difference for many service members and families,
    yet, some of these efforts overlap while others are ineffective. In our
    testimony, we believe we have identified improvements and additions
    that can be made to already successful programs while introducing
    policy or legislative changes that address the ever changing needs of
    our military population. Working together, we can improve the quality
    of life for all these families.

        Chairman Inouye. Our next witness represents the Fleet
    Reserve Association: Mr. John Davis, director of legislative
    programs.
        Mr. Davis.
    STATEMENT OF JOHN R. DAVIS, DIRECTOR, LEGISLATIVE
                PROGRAMS, FLEET RESERVE ASSOCIATION
        Mr. Davis. Good morning, Chairman Inouye. My name is John
    Davis, and I want to thank you for the opportunity to express
    FRA's views today.
        The association also wants to thank the Obama
    administration for adequately funding healthcare without a
    proposed TRICARE fee increase.
        FRA believes that raising TRICARE fees during the war on
    terror would send the wrong message, and that could impact
    recruitment and retention. A recent FRA survey indicates that
    more than 90 percent of all active duty, retired, and veteran
    respondents cited healthcare as their top quality-of-life
    benefit. That is why FRA supports the Military Retirees Health
    Care Protection Act, H.R. 816, that would prohibit increasing
    TRICARE fees unless approved by Congress.
        FRA welcomes the 10-percent increase in funding to provide
    case managers and mental health counselors to heal and
    rehabilitate our wounded warriors. Adequate funding is
    necessary for a seamless transition and quality services for
    wounded warriors, especially those with traumatic brain injury
    (TBI) and post traumatic stress disorder (PTSD).
        FRA is also grateful for the administration calling for
    improvements to concurrent receipt. And it's also mentioned in
    the budget resolution.
        The offset for chapter 61 retirees would be phased out over
    5 years. FRA supports legislation authorizing the immediate
    payment of concurrent receipt of full military retired pay and
    veterans disability compensation for all disabled retirees. And
    this improvement is a big step toward achieving that goal. And
    if authorized, we urge the subcommittee to provide funding.
        FRA strongly supports the funding of the 3.4 percent pay
    increase for active duty pay, which is one-half of 1 percent
    above the administration's request. Pay increases, in recent
    years, have contributed to improved morale, readiness, and
    retention. Better pay reduces family stress, especially for
    junior enlisted. Military pay and benefits must reflect the
    fact that military service is very different from work in the
    private sector. FRA strongly supports the fully funded family
    readiness program and stands foursquare in support of our
    Nation's reservists. Due to the demands of the war on terror,
    Reserve units are now increasingly being mobilized to augment
    active duty components. As a result of these operational
    demands, the Reserve component is no longer a strategic
    reserve, but is now an operational reserve. And that is an
    integral part of the total force. That is why, if authorized,
    FRA supports funding for retroactive eligibility for early
    retirement benefit, to include reservists who have supported
    contingency operations since September 11, 2001.
        The 2008 Defense Authorization Act reduced the Reserve
    retirement age by 3 months for every 90 days of active duty,
    but this only applies to the service after the effective date
    of the legislation, which is January 28, 2008, and leaves out
    more than 600,000 reservists mobilized since 9/11.
        Thank you again for giving me this opportunity to speak.
        Chairman Inouye. Thank you very much, Mr. Davis.
        [The statement follows:]
                      Prepared Statement of John R. Davis
                                    overview
        Mr. Chairman, ensuring that wounded troops, their families and the
    survivors of those killed in action are cared for by a grateful Nation
    remains an overriding priority for the Fleet Reserve Association (FRA).
    The Association thanks you and the entire Subcommittee for your strong
    and continuing support of funding for the Department of Defense (DOD)
    portion of the Wounded Warrior Assistance Program. Another top FRA
    priority is full funding of the Defense Health Program (DHP) to ensure
    quality care for active duty, retirees, Reservists, and their families.
                          the fiscal year 2010 budget
        The DOD request totals $663.8 billion for fiscal year 2010, which
    is a base budget increase of $20.5 billion representing a 4-percent
    increase over fiscal year 2009 (2.1 percent in real growth). It is
    noteworthy that for the first time in 4 years, the proposed budget
    fully funds military health care programs without calling for a TRICARE
    fee increase. FRA appreciates the reluctance of the new administration
    to shift health care costs to beneficiaries, and the inclusion of
    additional money to make improvements in current receipt to expand the
    number of disabled military retirees receiving both their full military
    retired pay and VA disability compensation. The budget also calls for a
    2.9-percent active duty pay increase that equals the Employment Cost
    Index (ECI), $1.1 billion to fund military housing and support programs
    for service members and their families, and $3.3 billion to support
    injured service members in their recovery, rehabilitation, and
    reintegration.
        As Operation Iraqi Freedom ends and troops depart from Iraq, some
    will be urging reductions in spending, despite the need to bolster
    efforts in Afghanistan and other operational commitments around the
    world. FRA understands the budgetary concerns generated by the current
    economic slowdown but advocates that cutting the DOD budget during the
    Global War on Terror would be short sighted and that America needs a
    Defense budget that will provide adequate spending levels for both
    ``benefits and bullets.''
        This statement lists the concerns of our members, keeping in mind
    that the Association's primary goal is to endorse any positive safety
    programs, rewards, quality of life improvements that support members of
    the Uniform Services, particularly those serving in hostile areas, and
    their families, and survivors.
                                wounded warriors
        A two-front war, a lengthy occupation and repeated deployments for
    many service members has put a strain on the DOD/VA medical system that
    treats our wounded warriors. The system is impacted not only by volume
    but by the complexity of injuries and the military has shown that it is
    woefully inadequate in recognizing and treating cases of Traumatic
    Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD).
        In recent years substantial progress has been made in the treatment
    of the Nation's wounded warriors. The fiscal year 2010 budget provides
    $3.3 billion to support injured service members in their recovery and
    rehabilitation and FRA appreciates the $300 million increase over
    fiscal year 2009 for mental health programs which includes additional
    case managers, and mental health counselors. The budget also provides
    for an expedited Disability Evaluation System (DES), and construction
    of 12 additional wounded warrior transition complexes. The budget also
    continues implementation of the Walter Reed National Military Medical
    Center, Bethesda, Maryland, DeWitt Army Community Hospital, Fort
    Belvoir, Virginia, and BRAC projects within the national capitol
    region. More than $400 million is targeted for medical research for
    Traumatic Brain Injury (TBI) and other casualty treatment issues. FRA
    advocates for resources to support an effective delivery system between
    DOD and VA to ensure seamless transition and quality services for
    wounded personnel, particularly those suffering from PTSD and TBI.
        Adequate funding is essential to providing pre- and post-deployment
    screenings for mental and physical injuries, and if authorized
    compensation, training, and health care coverage for family members
    forced into service as full-time caregivers for the severely wounded
    warriors. Further, the War on Terror has seen an increasing percentage
    of women serving in the military (15 percent in 2009 as compared to 4.4
    percent in 1988) and combined with the asymmetrical nature of the
    conflict will undoubtedly cause an increasing number of women
    casualties that will place unique demands upon the military health care
    system requiring additional associated funding.
                                  health care
        Adequately funding health care benefits for all beneficiaries is
    part of the cost of defending our Nation and a recent FRA survey
    indicates that more than 90 percent of all active duty, retired, and
    veteran respondents and most Reserve participants cited health care as
    their top quality-of-life benefit. Accordingly, protecting and/or
    enhancing health care access for all beneficiaries is FRA's top 2009
    legislative priority.
        Health care costs both in the military and throughout society have
    continued to increase faster than the Consumer Price Index (CPI) making
    this a prime target for those wanting to cut the DOD budget. Many
    beneficiaries targeted in recent proposals to drastically increase
    health care fees are those who served prior to enactment of the recent
    and significant pay and benefit enhancements and receive significantly
    less in retired pay than those serving and retiring in the same pay
    grade with the same years of service today. They clearly recall
    promises made to them about the benefit of health care for life in
    return for a career, and many believe they are entitled to ``free''
    health care for life based on the Government's past commitments.
        For these reasons, FRA strongly supports ``The Military Retirees'
    Health Care Protection Act'' (H.R. 816) sponsored by Representatives
    Chet Edwards (TX) and Walter Jones (NC). The legislation would prohibit
    DOD from increasing TRICARE fees, specifying that the authority to
    increase TRICARE fees exists only in Congress.
        DOD must continue to investigate and implement other TRICARE cost-
    saving options as an alternative to shifting costs to retiree
    beneficiaries. FRA notes progress in this area in expanding use of the
    mail order pharmacy program, Federal pricing for prescription drugs and
    a pilot program of preventative care for TRICARE beneficiaries under
    age 65, and elimination of co-pays for certain preventative services.
    The Association believes these efforts will prove beneficial in slowing
    military health care spending in the coming years.
        Our Nation is at war and imposing higher health care costs on
    retirees would send a powerful negative message not only to retirees,
    but to those currently serving about the value of their service. The
    prospect of drastically higher health care fees for retirees is also a
    morale issue with the senior enlisted communities who view this as an
    erosion of their career benefits. Unlike private sector employees,
    military retirees have answered the call to serve, and most have done
    so under extremely difficult circumstances while separated from their
    families to defend the freedoms we enjoy today.
                               concurrent receipt
        FRA appreciates a boost in compensation for benefiting disabled
    retirees in the new Administration's budget. The fiscal year 2010
    budget includes funding for expansion of concurrent receipt of military
    retired pay and VA disability compensation to retirees who were
    medically retired from service (Chapter 61 Retirees). Under current law
    these benefits (CRDP) are offset by the amount of VA disability
    compensation. This offset would be phased-out over 5 years. FRA
    supports legislation authorizing the immediate payment of concurrent
    receipt of full military retired pay and veterans' disability
    compensation for all disabled retirees, and these improvements reflect
    a big step toward achieving this goal.
                           protect personnel programs
        Active Duty Pay.--FRA strongly supports the authorization and
    funding of a 3.4 percent fiscal year 2010 pay increase which is
    consistent with past support of annual active duty pay increases that
    are at least 0.5 percent above the Employment Cost Index (ECI). The
    Association also supports targeted increases, as appropriate for mid-
    career and senior enlisted personnel to help close the remaining 2.9
    percent pay gap between active duty and private sector pay.
        Adequate and targeted pay increases authorized in recent years,
    particularly for middle grade and senior petty and noncommissioned
    officers, have contributed to improved morale, readiness, and
    retention. Better pay reduces family stress, especially for junior
    enlisted and may reduce the need for military personnel use of short-
    term pay day loans unaware of the ruinous long-term impact of excessive
    interest rates. Military pay and benefits must reflect the fact that
    military service is very different from work in the private sector.
        End Strength.--Adequate active duty and Reserves end strengths are
    essential to success in Operations Enduring Freedom (OEF) and Iraqi
    Freedom, and other commitments around the world. The fiscal year 2010
    budget supports additional end strength for the Marine Corps (202,000)
    and halts Navy end strength reductions. The Association supports
    funding to support these proposals and also strongly supports funding
    for bonuses for service members with extended deployments.
                                family readiness
        FRA supports a fully funded, robust family readiness program which
    is crucial to overall readiness of our military, especially with the
    demands of frequent and extended deployments. Resource issues continue
    to plague basic installation support programs at a time when families
    are dealing with increased deployments, and they often are being asked
    to do without in other important areas.
        The availability of child care is especially important when so much
    of the force is deployed and this program, along with other family
    readiness programs must be adequately funded in fiscal year 2010 and
    beyond.
        BRAC and Rebasing.--Adequate resources are required to fund
    essential quality of life programs and services at bases impacted by
    the Base Realignment and Closure (BRAC) and rebasing initiatives. FRA
    is concerned about sustaining commissary access, MWR programs and other
    support for service members and their families particularly at
    installations most impacted by these actions. These include Guam, where
    a significant number of Marines and their families are being relocated
    from Okinawa. The shortage of funds is curtailing or closing some of
    the activities while the costs of participating in others have recently
    increased.
        Family Housing.--The Association welcomes the $200 million more for
    family housing, child care, and other support services over the fiscal
    year 2009 budget. Adequate military housing that's well maintained is
    critical to retention and morale.
        Child and Youth Programs.--MCPON Rick West testified before the
    House Appropriations Subcommittee on Military Construction and Veterans
    Affairs in February 2009 that there is a need for more child care
    facilities since the Navy currently provides for only 72 percent of
    capacity while the goal is 80 percent. Access to child care is
    important and FRA urges Congress to authorize adequate funding for this
    important program.
                                 reserve issues
        FRA stands foursquare in support of the Nation's Reservists. Due to
    the demands of the War on Terror, Reserve units are now increasingly
    being mobilized to augment active duty components. As a result of these
    operational demands, Reserve component is no longer a strategic Reserve
    but is now an operational Reserve that is an integral part of the total
    force. And because of these increasing demands on Reservists to perform
    multiple missions abroad over longer periods of time, it's essential to
    improve compensation and benefits to retain currently serving personnel
    and attract quality recruits.
        Retirement.--If authorized, FRA supports funding retroactive
    eligibility for the early retirement benefit to include Reservists who
    have supported contingency operations since 9/11/2001 (S. 831/S. 644).
    The fiscal year 2008 Defense Authorization Act (H.R. 4986) reduces the
    Reserve retirement age (age 60) by 3 months for each cumulative 90-days
    ordered to active duty. The provision however only applies to service
    after the effective date of the legislation, and leaves out more than
    600,000 Reservists mobilized since 9/11 for Afghanistan and Iraq and to
    respond to natural disasters like Hurricane Katrina. About 142,000 of
    them have been deployed multiple times in the past 6 years.
        Family Support.--FRA supports resources to allow increased outreach
    to connect Reserve families with support programs. This includes
    increased funding for family readiness, especially for those
    geographically dispersed, not readily accessible to military
    installations, and inexperienced with the military. Unlike active duty
    families who often live near military facilities and support services,
    most Reserve families live in civilian communities where information
    and support is not readily available. Congressional hearing witnesses
    have indicated that many of the half million mobilized Guard and
    Reserve personnel have not received transition assistance services they
    and their families need to make a successful transition back to
    civilian life.
                                   conclusion
        FRA is grateful for the opportunity to present the organization's
    views to this distinguished Subcommittee. The Association reiterates
    its profound gratitude for the extraordinary progress this
    Subcommittee, with outstanding staff support, has made in advancing a
    wide range of enhanced benefits and quality-of-life programs for all
    uniformed services personnel, retirees, their families and survivors.
    Thank you.

        Chairman Inouye. I'd like to point out that, at this
    moment, several subcommittees are having their meetings or
    conferences. As a result, you can see that they're busy
    elsewhere. The vice chairman of this subcommittee had to go to
    the Energy Committee subcommittee, because he is the senior
    member there.
        So, if I may, I'd like to call upon him for any remarks he
    may have.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you very much.
        I'm pleased to be able to come by and join you in thanking
    these witnesses for preparing testimony, and giving us the
    benefit of your observations and experience and interest as we
    review the budget for this next fiscal year for the Department
    of Defense and related agencies.
        Because of your experiences and your knowledge, we take
    what you say very seriously, and we will carefully review your
    statements and make sure that the subcommittee considers them
    as we proceed through our appropriations process for this next
    fiscal year.
        Thank you.
        Chairman Inouye. Thank you very much.
        And next, the Chief Executive Officer of the Air Force
    Sergeants Association, Command Master Sergeant John McCauslin,
    of the Air Force.
    STATEMENT OF COMMAND MASTER SERGEANT JOHN R. McCAUSLIN,
                UNITED STATES AIR FORCE (RET.), CHIEF
                EXECUTIVE OFFICER, AIR FORCE SERGEANTS
                ASSOCIATION
        Sergeant McCauslin. Good morning, Chairman Inouye, Senator
    Cochran.
        On behalf of the 125,000 members of the Air Force Sergeants
    Association, I thank you for your continued support of our
    airmen and their families. I appreciate this opportunity to
    present our perspective of six important areas of priority for
    the fiscal year 2010 defense appropriations.
        First, Air Force manpower and equipment. AFSA strongly
    believes the aging fleet of legacy Air Force systems,
    facilities, and equipment needs to be modernized. However, we
    also know the truly most valuable weapon that America has are
    those serving this Nation, especially the men and women wearing
    chevrons.
        Operational demands, including deployments, have greatly
    increased to include intelligence activity, reconnaissance, and
    surveillance resources, the newest combatant command in Africa,
    the new Air Force Cyber Command, increased activity in
    Afghanistan and elsewhere overseas. Therefore, AFSA supports
    General Schwartz's request for more F-35 aircraft to do our job
    of preserving peace through deterrence.
        Quality of life. Our Nation's military should not be
    considered a financial burden, but considered a national
    treasure, as they preserve our national security for all that
    live here. If we expect to retain this precious resource, we
    simply must provide they and their families with decent and
    safe work centers, family housing and dormitories, healthcare,
    childcare, physical fitness centers, and recreational programs
    and facilities. Tremendous strides have been made to improve
    access to quality childcare and fitness centers on our military
    installations, and we're grateful to the Department of Defense
    and Congress for these collective efforts. However, there's
    still much work to be done. I have personally visited over 125
    Air Force installations in the States and overseas these past 3
    years, and I can assure you that the demand for adequate
    childcare and decent, affordable housing is a top priority
    among our airmen and their families' decision to stay or get
    out.
        Veterans Affairs healthcare funding. AFSA believes that the
    healthcare portion of Veterans Affairs (VA) funding should be
    moved to mandatory annual spending. One of the Nation's highest
    obligations is their willingness to fully fund VA healthcare
    facilities and other programs for those who have served in the
    past or are serving today and will serve in the future.
        On a positive note, we're particularly pleased by the
    tremendous support of Congress and this subcommittee to
    implement and fund wounded warrior programs across America.
        The Air Force Sergeants Association applauds the actions of
    this subcommittee, other committees and subcommittees, to
    directly address the issue of unique health challenges faced by
    our women veterans. AFSA urges an increase to the VA budget so
    that they can appropriately care for these female veterans, now
    and in the future.
        Regarding the educational benefits. The post-9/11 GI bill
    was a giant step forward, even though there are still some
    funding shortfalls being currently worked by Senator Webb's
    office, and we urge your subcommittee's support.
        And finally, my final point concerns basic military pay and
    the tremendous pay gap, for these last 15 years, that you've
    helped us close. However, we still have serious problems in the
    junior enlisted. For example, enrollment in food stamps rose 25
    percent in the military this last year alone. Our junior
    enlisted are all volunteers serving our Nation, yet thousands
    remain on food stamps.
        In conclusion, this was a very brief presentation of our
    perspective for you. Our detailed, typed testimony has been
    personally delivered to your subcommittee staff for inclusion
    today.
        Thank you very much.
        Chairman Inouye. I thank you very much, Command Master
    Sergeant.
        [The statement follows:]
                Prepared Statement of John R. ``Doc'' McCauslin
        Mr. Chairman and distinguished committee members, on behalf of the
    125,000 members of the Air Force Sergeants Association, (AFSA), I thank
    you for your continued support of Airmen and their families. I
    appreciate this opportunity to present our perspective on priorities
    for the fiscal year 2010 defense appropriations.
        The Air Force Sergeants Association (AFSA) represents Air Force
    Active Duty, Air National Guard, Air Force Reserve Command, including
    active, retired and veteran enlisted Airmen and their families. We are
    grateful for this subcommittee's efforts, and I cannot overstate the
    importance your work is to those serving this Nation.
        You certainly have a daunting task before you and shoulder the
    tremendous responsibility as you wisely appropriate limited resources
    based on many factors. The degree of difficulty deciding what is funded
    isn't lost on us. It is significant.
                               air force manpower
        AFSA strongly believes the aging fleet of legacy Air Force systems,
    facilities, and equipment needs to be modernized. However, we also know
    the truly most valuable weapon America has are those serving this great
    Nation, especially the men and women wearing chevrons of the enlisted
    grades.
        We are deeply concerned about the recent Air Force drawdown of
    manpower in order to facilitate funding of system modernization and
    recapitalization but we greatly appreciate Congressional support that
    has reinstated some of that lost resource. The impact on Air Force
    ability to maintain the highest level of readiness was felt throughout
    the smaller force and it placed even more stress on our maintainers and
    security forces.
        Although well-intended, that drawdown did not appear to have
    yielded the results envisioned. Some efficiency was gained as Airmen
    exercised innovation and continuous process improvement in order to
    accomplish more. The ole adage ``do more with less'' certainly and
    quickly became a reality.
        Operational demands including deployments have increased over this
    same time--increased intelligence activity, reconnaissance and
    surveillance (ISR) resources, supporting the newest combatant command
    in Africa, the new Air Force Cyber Command based in Louisiana,
    increased activity in Afghanistan, and elsewhere overseas. The Air
    Force has increased its capabilities to ward off threats from the cyber
    domain and accomplishing the expanding workload associated with more
    inspections and maintenance to keep aging airframes mission ready.
        With the appropriate recommendations from the Armed Service
    committees, we need to continue offering enlistment bonuses for those
    career fields that are physically demanding and highly skilled hard to
    fill jobs since 2001. With Congressional assistance, coupled with the
    hard work of our Air Force recruiters, we can continue to meet the
    required annual needs of new Combat Controllers, Para-rescue; Tactical
    Air Control Party; Explosive Ordinance Disposal; Security Forces;
    Linguist and Survival, Evasion, Resistance, and Escape Instructors. The
    amount offered at the initial enlistment ranges from $2,000 to $13,000,
    depending on the career specialty and terms of enlistment. These are
    currently the only fields offering enlistment bonuses for fiscal year
    2009. Congress authorized hazardous duty allowance for all DOD
    firefighters, still today the services have not funded this program.
    The Air Force has over 3,000 firefighters who have been authorized this
    allowance by Congress but not funded.
        AFSA believes a course correction is needed to avert severe
    adverse, long-term consequences that have already begun to affect
    morale, retention and combat readiness. We strongly support increasing
    and fully funding Air Force end strength to 332,800.
                                quality of life
        Our Nation's military should not be considered a financial burden
    but considered a national treasure as they preserve our national
    security for all that live here. If we expect to retain this precious
    resource, we must provide they and their families, with decent and safe
    work centers, family housing and dormitories, health care, child care
    and physical fitness centers, and recreational programs and facilities.
    These areas are a prime recruitment and retention incentive for our
    Airmen and their families. This directly impacts their desire to
    continue serving through multiple deployments and extended separations
    from family and friends.
        This Nation devotes considerable resources to train and equip
    America's sons and daughters--a long term investment--and that same
    level of commitment should be reflected in the facilities and equipment
    they use and in where they live, work, and play.
        We urge extreme caution in deferring these costs, especially at
    installations impacted by base realignment and closure (BRAC) decisions
    and mission-related shifts.
        We applaud congressional support for military housing privatization
    initiatives. This has provided housing at a much faster pace than would
    have been possible through military construction alone.
        AFSA urges Congress to fully fund appropriate accounts to ensure
    our installations eliminate substandard housing and work centers as
    quickly as possible. Those devoted to serving this Nation deserve
    better.
        Tremendous strides have been made to improve access to quality
    child care and fitness centers on military installations, and we are
    grateful to the Department of Defense and Congress for these collective
    efforts. However, there is still much more work to be done. I have
    personally visited over 125 Air Force installations in the states and
    overseas these past three years and I can assure you that the demand
    for adequate child care is a top priority among our Airmen and their
    families. The importance of this is directly reflected in the military
    members' family decision to remain in the service or exit.
                      veterans affairs healthcare funding
        AFSA believes that the healthcare portion of Veterans Affairs (VA)
    funding should be moved to mandatory annual spending. One of this
    Nation's highest obligations is the willingness to fully fund VA health
    care, facilities, and other programs for those who have served in the
    past, are serving today and will serve in the future.
        There are many challenges facing veterans and we are encouraged by
    the initiatives centered on improving access for all veterans
    regardless of their VA designated category. Much more emphasis has to
    be focused on continuity of care and addressing the scars of war, some
    obvious and others not so, such as traumatic brain injuries and post
    traumatic stress disorders. We are particularly pleased by the
    tremendous support of Congress and this Committee to implement and fund
    Wounded Warrior programs across America. The outpouring of support from
    civilian communities and volunteer support has been truly amazing and
    very much appreciated.
                        women veterans healthcare issues
        The Air Force Sergeants Association applauds the actions of this
    committee, other committees and sub-committees to directly address the
    issue of the unique health challenges faced by women veterans. Between
    1990 and 2000, the women veteran population increased by over 33
    percent from 1.2 million to 1.6 million, and women now represent
    approximately 9 percent of the total veteran population. By next year,
    the VA estimates women veterans will comprise well over 10 percent of
    the veteran population. Currently women make up more than 20 percent of
    the active duty Air Force, Air National Guard 19 percent, and
    approximately 26 percent of the Air Force Reserves with thousands
    serving, or having already returned from serving, in Iraq, Afghanistan
    and other places a long way from our shores. AFSA urges an increase to
    the VA budget so they can appropriately care for these veterans now and
    in the future.
                                   impact aid
        Military leaders often use the phrase, ``we recruit the member, but
    we retain the family'' when talking about quality of life and
    retention. Impact Aid is a program at the very core of this premise,
    because it directly affects the quality of educational programs
    provided to the children of military service members. In the Department
    of Defense Dependent Schools, there are over 79,000 children of our
    active duty force scattered all over the globe.
        These children lead unique lives, fraught with challenges
    associated with frequent changes in schools, repeatedly being uprooted
    and having to readjust to new communities and friends. Many of these
    school children are in other countries in either the DODDS system or
    host nation schools that are not affected by Impact Aid funding.
    Worrying about what resources might or might not be available to school
    administrators should not be yet another concern heaped upon them and
    their parents.
        The Impact Aid program provides Federal funding to public school
    districts in the United States with enrollment of students that have a
    parent who is a member of the Armed Forces, living on and/or assigned
    to a military installation.
        The budget proposed by the administration is identical to the
    approved funding in 2009 in spite of increased financial obligations by
    the servicing local school districts. It has a completely detrimental
    effect on the military member and their decision to take that next
    assignment or opt to get out for the good of his or her family. The
    implicit statement in this action is military children are a lower
    priority than others in our Nation. We ask this committee to take the
    steps necessary to show our military men and women that the education
    of their children is as important at the next child.
        AFSA is grateful that Congress funded Impact Aid with 1.265.7
    million this past fiscal year. We strongly urge increased funding of
    this important family quality of life area that has a direct bearing on
    reenlistment rates and military families quality of life. We urge
    Congress restore this program to its rightful full funding.
                               basic military pay
        Tremendous progress has been made over the last 15+ years to close
    the gap between civilian sector and military compensation. AFSA
    appreciates these steady efforts and we encourage further steps. We
    believe linking pay raises to the employment cost index (ECI) is
    essential to recruiting and retaining the very best and brightest
    volunteers. AFSA urges the formula for determining annual pay increases
    to be ECI + 0.5 percent until the gap is completed eliminated. If we
    want to continue having an all volunteer force then we must continue on
    the path to close the aforementioned pay gap. Enrollment in food stamps
    rose 25 percent in the military last year. Our junior enlisted are all
    volunteers serving our Nation, yet they remain on monthly use of food
    stamps.
                         transition assistance programs
        The all-volunteer military force repeatedly answers this Nation's
    call to duty and at the end of their tours of duty, whether a few years
    or after decades of service, all transition to civilian life.
        Section 502 of the National Defense Authorization Act of Fiscal
    Year 1991 codified in sections 1141-1143 and 1144-1150 of title 10,
    United States Code, authorized comprehensive assistance benefits and
    services for separating service members and their spouses.
        From that legislation, grew a valuable partnership between the
    Department of Labor and the Departments of Defense, Veterans Affairs
    and Homeland Security to provide Transition Assistance Program (TAP)
    employment workshops, VA Benefits Briefings and the Disabled Transition
    Assistance Program (DTAP). These programs and briefings provide service
    members valuable job placement assistance, training opportunities, and
    education on veteran benefits so they make informed choices about post-
    service opportunities.
        We urge the committee to continue fully funding transition
    assistance programs at a level that serves our deserving volunteer
    veterans.
        In addition, we ask you to support the initiatives in this Congress
    to pass legislation and fund a program that would create hiring
    preferences across the Federal Government for military spouses. Under
    current law, veterans of America's Armed Forces are entitled to
    preferences over others in competitive hiring positions in Federal
    Government. We believe the sacrifice of family members warrant this
    consideration as well.
                          veterans education benefits
        There's no escaping the fact that college costs are rising. As the
    gap between the cost of an education and value of the MGIB widens, the
    significance of the benefit becomes less apparent. For that reason, the
    Post 9-11 GI Bill was a giant step forward. However, we must make sure
    that the new post 9-11 stays current at all times, so that this benefit
    will not lose its effectiveness when it comes to recruiting this
    Nation's finest young men and women into service. As a member of The
    Military Coalition and the Partnership for Veterans' Education, we
    strongly recommend you make the technical corrections to the Post 9-11
    Veterans GI Bill that need to be done prior to its implementation this
    August 1st.
        When young enlisted men and women opt for military service, they
    should know that this Nation will provide them with a no-cost, complete
    education, as do numerous companies in the private industry. We, as a
    Government, give them a one-time chance to enroll in the MGIB during
    basic training. The Department of Defense charges them $1,200 to enroll
    at a time when they can least afford it. Service-members are even
    offered an opportunity to increase their education benefit by paying an
    additional $600.
        Now that the new Post 9-11 GI bill is coming on board for free,
    those who already paid for but who have not yet utilized the Montgomery
    GI Bill, will now have to wait until their chapter 33 entitlements are
    exhausted before they will be allowed to receive a refund on their
    Montgomery GI bill contributions. Under current law, those who have
    contributed the additional $600, will not have that money returned to
    them at all.
        This is unacceptable.
        In good faith and trusting their Government-funded education will
    be provided in their best interest, service-members now find a program
    that does not require further investment in their education. However
    the Government will withhold the service-member's Montgomery GI Bill
    initial investment and not refund it. Our recommendation is that the
    service-members who chose to enroll in the chapter 33 benefit, and who
    bought the additional benefit for $600, should be given their
    investment back or granted an additional 2 years of chapter 30 benefits
    to roll their $600 education investment into the new education bill.
    The latest shortfall with the new bill is that all active duty will not
    receive the $1,000 book allowance. We urge the appropriate committees
    to make the necessary corrections to ensure those on active duty
    receive this allowance.
        Mr. Chairman, we appreciate your efforts and thank you for this
    opportunity to share our perspective. AFSA realizes the many difficult
    decisions this committee must make and hope the information presented
    today proves helpful. As always, the Air Force Sergeants Association
    remains ready to support you in matters of mutual concern.

        Chairman Inouye. And our next witness represents the
    American Psychological Association, Dr. Gavin O'Shea.
    STATEMENT OF GAVIN O'SHEA, Ph.D., ON BEHALF OF THE
                AMERICAN PSYCHOLOGICAL ASSOCIATION
        Dr. O'Shea. Good morning Mr. Chairman and members of the
    subcommittee. I'm Dr. Gavin O'Shea from HumRRO, the Human
    Resources Research Organization. I'm submitting testimony on
    behalf of the American Psychological Association, or APA, a
    scientific and professional organization of more than 148,000
    psychologists.
        For decades, clinical and research psychologists have used
    their unique and critical expertise to meet the needs of our
    military and its personnel, playing a vital role within the
    Department of Defense. My own military-oriented research and
    consulting focuses on organizational commitment, personnel
    selection, and leadership assessment.
        This morning, I focus on APA's request that Congress
    reverse disturbing administration cuts to DOD's science and
    technology budget and maintain support for important behavioral
    sciences research on counterterrorism and counterintelligence
    operations.
        In terms of the overall DOD S&T budget, the President's
    request for fiscal year 2010 represents a dramatic step
    backward for defense research. Defense S&T would fall from the
    current fiscal year 2009 level of $13.6 billion to $11.6
    billion, with cuts across the board. With very few exceptions,
    all basic and applied research accounts within military labs
    would face cuts, some as high as 50 percent.
        This is not the time to reduce support for research that is
    vital to our Nation's continued security in a global atmosphere
    of uncertainty and asymmetric threats. APA urges the
    subcommittee to reverse this cut to the critical defense
    science program by providing $14 billion for defense S&T in
    fiscal year 2010.
        Finally, APA is also concerned about the potential loss of
    invaluable human-centered research programs related to
    counterintelligence and counterterrorism due to the
    reorganization of the CIFA office into the Defense Intelligence
    Agency (DIA). APA urges the subcommittee to provide ongoing
    funding in fiscal year 2010 for DIA's behavioral research
    programs on cyberdefense, insider threat, credibility
    assessment, detection of deception, and other operational
    challenges.
        As noted in a recent National Research Council report,
    ``People are the heart of all military efforts. People operate
    the available weaponry and technology, and they constitute a
    complex military system composed of teams and groups at
    multiple levels. Scientific research on human behavior is
    crucial to the military, because it provides knowledge about
    how people work together, and use weapons and technology to
    extend and amplify their forces.''
        The defense research programs need your help more than ever
    this year, and we look forward to your support.
        Thank you.
        Chairman Inouye. I thank you very much, Dr. O'Shea.
        [The statement follows:]
                       Prepared Statement of Gavan O'Shea
        The American Psychological Association (APA) is a scientific and
    professional organization of more than 148,000 psychologists and
    affiliates.
        For decades, psychologists have played vital roles within the
    Department of Defense (DOD), as providers of clinical services to
    military personnel and their families, and as scientific researchers
    investigating mission-targeted issues ranging from airplane cockpit
    design to human intelligence-gathering. More than ever before,
    psychologists today bring unique and critical expertise to meeting the
    needs of our military and its personnel. APA's testimony will focus on
    reversing Administration cuts to the overall DOD Science and Technology
    (S&T) budget and maintaining support for important behavioral sciences
    research within DOD.
                                  dod research
        ``People are the heart of all military efforts. People operate the
    available weaponry and technology, and they constitute a complex
    military system composed of teams and groups at multiple levels.
    Scientific research on human behavior is crucial to the military
    because it provides knowledge about how people work together and use
    weapons and technology to extend and amplify their forces.''----Human
    Behavior in Military Contexts, Report of the National Research Council,
    2008.
        Just as a large number of psychologists provide high-quality
    clinical services to our military service members stateside and abroad,
    psychological scientists within DOD conduct cutting-edge, mission-
    specific research critical to national defense.
        In terms of the overall DOD S&T budget, the President's request for
    fiscal year 2010 represents a dramatic step backward for defense
    research. Defense S&T would fall from the estimated fiscal year 2009
    level of $13.6 billion to $11.6 billion with cuts across the board.
    With the exception of a less-than-1-percent increase in Air Force basic
    (6.1) research and an increase in basic research in the Office of the
    Secretary of Defense, all military labs would see cuts to their 6.1,
    6.2 and 6.3 accounts, some as high as 50 percent.
        The President's budget request for basic and applied research at
    DOD in fiscal year 2010 is $11.6 billion, which represents a stunning
    decrease of almost $2 billion or 15 percent from the enacted fiscal
    year 2009 level of $13.6 billion. APA urges the Subcommittee to reverse
    this cut to the critical defense science program by providing a total
    of $14 billion for Defense S&T in fiscal year 2010. This is not the
    time to cut back on research vital to our Nation's continued security
    in a global atmosphere of uncertainty and asymmetric threats.
          behavioral research within the military service labs and dod
        Within DOD, the majority of behavioral, cognitive and social
    science is funded through the Army Research Institute (ARI) and Army
    Research Laboratory (ARL); the Office of Naval Research (ONR); and the
    Air Force Research Laboratory (AFRL), with additional, smaller human
    systems research programs funded through the Office of the Secretary of
    Defense, the Defense Advanced Research Projects Agency (DARPA), and
    DOD's Defense Intelligence Agency (DIA).
        The military service laboratories provide a stable, mission-
    oriented focus for science, conducting and sponsoring basic (6.1),
    applied/exploratory development (6.2) and advanced development (6.3)
    research. These three levels of research are roughly parallel to the
    military's need to win a current war (through products in advanced
    development) while concurrently preparing for the next war (with
    technology ``in the works'') and the war after next (by taking
    advantage of ideas emerging from basic research). All of the services
    fund human-related research in the broad categories of personnel,
    training and leader development; warfighter protection, sustainment and
    physical performance; and system interfaces and cognitive processing.
    National Academies Report Calls for Doubling Behavioral Research
        The 2008 National Academies report on Human Behavior in Military
    Contexts recommended doubling the current budgets for basic and applied
    behavioral and social science research ``across the U.S. military
    research agencies.'' It specifically called for enhanced research in
    six areas:
      --intercultural competence;
      --teams in complex environments;
      --technology-based training;
      --nonverbal behavior;
      --emotion; and
      --behavioral neurophysiology.
        Behavioral and social science research programs eliminated from the
    mission labs due to cuts or flat funding are extremely unlikely to be
    picked up by industry, which focuses on short-term, profit-driven
    product development. Once the expertise is gone, there is absolutely no
    way to ``catch up'' when defense mission needs for critical human-
    oriented research develop. As DOD noted in its own Report to the Senate
    Appropriations Committee: ``Military knowledge needs are not
    sufficiently like the needs of the private sector that retooling
    behavioral, cognitive and social science research carried out for other
    purposes can be expected to substitute for service-supported research,
    development, testing, and evaluation . . . our choice, therefore, is
    between paying for it ourselves and not having it.''
    Defense Science Board Calls for Priority Research in Social and
            Behavioral Sciences: Mapping the Human Terrain
        This emphasis on the importance of social and behavioral research
    within DOD is echoed by the Defense Science Board (DSB), an independent
    group of scientists and defense industry leaders whose charge is to
    advise the Secretary of Defense and the Chairman of the Joint Chiefs of
    Staff on ``scientific, technical, manufacturing, acquisition process,
    and other matters of special interest to the Department of Defense.''
        In its 2007 report on 21st Century Strategic Technology Vectors,
    the DSB identified a set of four operational capabilities and the
    ''enabling technologies'' needed to accomplish major future military
    missions (analogous to winning the Cold War in previous decades). In
    identifying these capabilities, DSB specifically noted that ``the
    report defined technology broadly, to include tools enabled by the
    social sciences as well as the physical and life sciences.'' Of the
    four priority capabilities and corresponding areas of research
    identified by the DSB for priority funding from DOD, the first was
    defined as ``mapping the human terrain.''
             maintaining behavioral research on counterintelligence
        In addition to strengthening the DOD S&T account, and behavioral
    research within the military labs in particular, APA also is concerned
    with maintaining invaluable human-centered research programs formerly
    within DOD's Counterintelligence Field Activity (CIFA) now that staff
    and programming have been transferred to the Defense Intelligence
    Agency. Within this DIA program, psychologists lead intramural and
    extramural research programs on counterintelligence issues ranging from
    models of ``insider threat'' to cybersecurity and detection of
    deception. These psychologists also consult with the three military
    services to translate findings from behavioral research directly into
    enhanced counterintelligence operations on the ground.
        APA urges the Subcommittee to provide ongoing funding in fiscal
    year 2010 for counterintelligence behavioral science research programs
    at DIA in light of their direct support for military intelligence
    operations.
                                    summary
        On behalf of APA, I would like to express my appreciation for this
    opportunity to present testimony before the Subcommittee. Clearly,
    psychological scientists address a broad range of important issues and
    problems vital to our national security, with expertise in modeling
    behavior of individuals and groups, understanding and optimizing
    cognitive functioning, perceptual awareness, complex decision-making,
    stress resilience, recruitment and retention, and human-systems
    interactions. We urge you to support the men and women on the front
    lines by reversing another round of cuts to the overall defense S&T
    account and the human-oriented research projects within the military
    laboratories and CIFA.
        As our Nation rises to meet the challenges of current engagements
    in Iraq and Afghanistan as well as other asymmetric threats and
    increased demand for homeland defense and infrastructure protection,
    enhanced battlespace awareness and warfighter protection are absolutely
    critical. Our ability to both foresee and immediately adapt to changing
    security environments will only become more vital over the next several
    decades. Accordingly, DOD must support basic Science and Technology
    (S&T) research on both the near-term readiness and modernization needs
    of the department and on the long-term future needs of the warfighter.
        Below is suggested appropriations report language for fiscal year
    2010 which would encourage the Department of Defense to fully fund its
    behavioral research programs within the military laboratories and
    protect counterintelligence research:
    Department of Defense
                Research, Development, Test, and Evaluation
        Behavioral Research in the Military Service Laboratories.--The
    Committee notes the increased demands on our military personnel,
    including high operational tempo, leadership and training challenges,
    new and ever-changing stresses on decision-making and cognitive
    readiness, and complex human-technology interactions. To help address
    these issues vital to our national security, the Committee has provided
    increased funding to reverse cuts to psychological research through the
    military research laboratories: the Air Force Office of Scientific
    Research and Air Force Research Laboratory; the Army Research Institute
    and Army Research Laboratory; and the Office of Naval Research.
        Human-Centered Counterintelligence Research.--The Committee urges
    the Department of Defense to continue supporting human-centered
    research, formerly coordinated through the Counterintelligence Field
    Activity, at the Defense Intelligence Agency.

        Chairman Inouye. And now may I call upon the chair of the
    Extremities War Injuries Project Team of the American Academy
    of Orthopaedic Surgeons, Dr. Andrew Pollak.
    STATEMENT OF ANDREW N. POLLAK, M.D., CHAIR, EXTREMITY
                WAR INJURIES AND DISASTER PREPAREDNESS
                PROJECT TEAM, AMERICAN ACADEMY OF
                ORTHOPAEDIC SURGEONS
        Dr. Pollak. Good morning, Senators. I'm Dr. Andy Pollak,
    and I chair the Extremity War Injuries Project Team for the
    American Academy of Orthopaedic Surgeons. During the day, I
    serve as chief of orthopaedic surgery at the Shock Trauma
    Center at the University of Maryland in Baltimore.
        On behalf of military and civilian orthopaedic surgeons and
    researchers throughout the country, I take this opportunity to
    urge the subcommittee to continue to provide significant
    resources for peer-reviewed medical research in the area of
    extremity war injuries, injuries arising from trauma to the
    bones, joints, muscles, and tendons of the arms and legs.
        We thank you for providing the DOD with the funding for
    this purpose since fiscal year 2006, including $117 million
    total in fiscal year 2009, and we urge you to consider
    increasing funding for this program, in fiscal year 2010, to
    $150 million.
        Chairman Inouye, we know of your personal experience
    involving extremity trauma during war, and appreciate the fact
    that you have both personal and professional perspectives from
    which to address this issue.
        We're very grateful for the dedicated work of Senators
    Harkin and Hutchison, both members of the subcommittee. They
    worked together in support of last year's appropriation, and
    have both expressed support for growing this program to $150
    million for fiscal year 2010.
        Mr. Chairman, I've had the privilege of performing surgery
    in military facilities in Balad, Iraq, and Landstuhl, Germany.
    I can assure this subcommittee of the outstanding quality of
    trauma care being delivered by the military health system
    there. The problem facing surgeons emanates from limitations in
    medical knowledge and techniques in the management of these
    horrific injuries. We need your help to advance the state of
    the art. We also need your help to improve our ability to treat
    consequences of severe injury to the extremities, such as
    arthritis, nerve damage, infection, and failure of bones to
    heal properly.
        I'll keep the statistics short. Extremity injury is the
    most common type of injury sustained in battle, affecting over
    80 percent of wounded warriors. Extremity wounds are the
    greatest source of expense related to hospitalization of
    wounded warriors after combat injury. Extremity war wounds are
    the greatest source of war-related disability expense for the
    military, expected to total $1.8 billion, lifetime, for
    payments related to injuries sustained to American warriors in
    Iraq and Afghanistan, exclusive of costs associated with their
    medical care. And conditions analogous to arthritis were the
    most common reason for disability-related retirement from the
    Army in 2008.
        The peer-reviewed orthopaedic research programs were
    designed to help military surgeons find new, limb-sparing
    techniques, with the goals of avoiding amputations, and
    preserving and restoring the function of injured extremities,
    limiting disability and suffering, and, whenever possible,
    allowing our warriors to return to duty as soon as it's safely
    possible.
        The interest and capacity of the U.S. research community is
    very strong. This past year, as a result of funding made
    available in the fiscal year 2008 supplemental appropriation,
    the DOD accepted applications for development of a consortium
    of military and civilian trauma centers to begin work on the
    critically important clinical studies necessary to understand
    the best ways to treat extremity injuries, and to translate
    recent scientific advances in bone growth and tissue
    regeneration to the real world, where these advances can help
    improve the lives of our injured heroes.
        Mr. Chairman, Mr. Vice Chairman, you've recognized the
    urgent need to finance extremity research over the past 4
    years, and we're extremely grateful for that support. Based on
    the level of scientific need, our goal is to see the Defense
    Department programs achieve an operating level of $150 million
    per year.
        Thank you and the entire subcommittee for your vision and
    leadership in responding to this appeal. We strongly urge your
    continued action.
        Chairman Inouye. All right, thank you very much, Dr.
    Pollak.
        [The statement follows:]
                     Prepared Statement of Andrew N. Pollak
        Chairman Inouye, Vice Chairman Cochran, Members of the Senate
    Defense Appropriations Subcommittee, thank you for the opportunity to
    testify today. I am Andrew N. Pollak, M.D., and I speak today on behalf
    of the American Academy of Orthopaedic Surgeons (AAOS), of which I am
    an active member, as well as my military and civilian orthopaedic
    surgery colleagues who are involved in extremity trauma research and
    care.
        I am Chair of the Academy's Extremity War Injuries and Disaster
    Preparedness Project Team, past-chair of its Board of Specialty
    Societies, and a subspecialist in orthopaedic traumatology. I am
    Associate Director of Trauma and Head of the Division of Orthopaedic
    Traumatology at the R Adams Cowley Shock Trauma Center and the
    University of Maryland School of Medicine. My Division at Shock Trauma
    is responsible for providing education and training in orthopaedic
    traumatology to residents from eight separate training programs
    nationally, including the Bethesda Naval, Walter Reed Army and Tripler
    Army military orthopaedic residency programs. In addition, Shock Trauma
    serves as the home for the Air Force Center for the Sustainment of
    Trauma and Readiness Skills (CSTARS) program. I also serve as Second
    Vice President of the Orthopaedic Trauma Association.
        Senators, on behalf of all the military and civilian members of the
    American Academy of Orthopaedic Surgeons, please allow me to take this
    opportunity today to thank you both, as well as the Members of this
    Subcommittee, for your vision and leadership in providing funding in
    fiscal years 2006 through 2009 for the peer reviewed medical research
    program on orthopaedic and extremity war injuries. In particular, we
    thank you for providing $66 million in your fiscal year 2009 Conference
    Bill and for creating the Peer Reviewed Orthopedic Research Program to
    cover the full range of research--from basic to clinical trials.
        We also thank you most sincerely for your consideration of
    providing funding in the fiscal year 2009 Supplemental Appropriations
    Bill. Your commitment to building this research enterprise and enabling
    the Department of Defense to pursue answers to its critical medical
    needs must be recognized. Clearly this effort by the Congress will
    provide medical benefit through improved treatments and procedures to
    help our Wounded Warriors heal better and quicker.
        We are very grateful for the dedicated work of Senators Tom Harkin
    and Kay Bailey Hutchison--both Members of this Subcommittee--in
    sponsoring a ``Dear Colleague'' letter this year supporting the
    ultimate goal of achieving an annual operating level of $150 million
    per year for this critical peer reviewed research program.
        It really cannot be overstated: the level and consistency of
    appropriations you are providing are ``game-changing.'' It provides the
    Department with the ability to move rapidly in developing the full
    research continuum, especially clinical trials--an essential form of
    investigation that has not existed in the extremity injury field
    previously because of a lack of significant and sustained resources.
    Just last month because of your support the U.S. Army's Medical
    Research and Materiel Command accepted applications in response to its
    first ever call for the formation of network for clinical research into
    these challenges. In addition because of this critical funding, in
    April the Command hosted a 2-day scientific conference to further
    examine needs, and prioritize areas for its broadened research agenda.
        Mr. Chairman, our message is straightforward:
      --Extremity trauma and its sequelae represent the single most common
            injury class our wounded warriors suffer, the greatest source
            of inpatient medical care expense for the DOD, the single
            greatest source of injury related disability expense for the
            military, and the most common cause for disability retirement
            from all branches of the armed services;
      --the state of the science must be advanced to provide better
            treatment options for our wounded service members who suffer
            extremity trauma and other injuries to their bone and muscles
            with a goal of limiting the profound long-term disability
            associated with these injuries;
      --the current peer reviewed research program has great potential to
            address a wide range of bone and muscle injuries and conditions
            that are sidelining our troops at increasing rates; and
      --the Defense Department must be convinced to proactively budget for
            research on military-related orthopaedic injuries, including
            extremity trauma, but until that occurs, we believe that the
            Congress has an obligation to ensure--as you have done--that
            the necessary resources are appropriated and directed to the
            task.
        As the Iraq and Afghanistan conflicts enter their seventh year, the
    Nation continues to face a profound need for focused medical research
    to help military surgeons find new limb-sparing techniques with the
    goal of avoiding amputations and preserving and restoring the function
    of injured extremities.
        Chairman Inouye, we know of your experience with extremity trauma
    during war and appreciate the fact that you have both personal and
    professional perspectives from which to address this issue and we honor
    your service as well as that of Vice Chairman Cochran.
        U.S. military researchers have documented that approximately 82
    percent of war injuries suffered fighting the global war on terror
    involve the extremities--often severe and multiple injuries to the arms
    and legs.
        The evidence is also reflected in legislative documents. House
    Report 111-105 accompanying the recent fiscal year 2009 Supplemental
    Appropriations Bill, H.R. 2346, correctly states that ``. . . extremity
    injuries are the most prevalent injury, and amputations following
    battlefield injury now occur as twice the rate as in past wars.
    Understanding how to treat and facilitate rapid recovery from
    orthopedic injuries should be one of the top priorities for the
    Military Health System.''
        The Report accompanying the fiscal year 2009 House Appropriations
    Bill made similar points and added: ``. . . the committee believes that
    every aspect of research shall be considered during a time when unique
    and dynamic research and treatment is necessary to provide the soldiers
    the greatest ability to recover from injuries sustained on the
    battlefield.''
        House Report 110-279 accompanying the fiscal year 2008 Defense
    Appropriations Bill stated that ``Extremity injuries are the number one
    battlefield injury . . . dynamic research and treatment is necessary to
    provide service members the greatest ability to recover from injuries
    sustained on the battlefield.''
        A recent U.S. Army analysis of soldiers injured in Iraq and
    Afghanistan from 2001 through 2005 shows that extremity injuries
    account for the greatest proportion of medical resource utilization and
    cause the greatest number of disabled soldiers. In fact, soldiers with
    extremity injuries had the longest average inpatient stays, accounted
    for 65 percent of total inpatient resource utilization and 64 percent
    of projected disability benefits costs in the future. The projected
    disability cost for extremity injuries sustained in this conflict to
    date--exclusive of ANY short or long-term medical costs--is estimated
    to be approximately $1.2 billion.
        In addition, muscle and bone injuries are sidelining a growing
    number of troops in our current conflicts. Data from the U.S. Army
    reported 257,000 acute orthopaedic injuries in 2007--an increase of
    10,000 over the previous year. Increasing numbers of troops are listed
    as ``non-deployable'' as a result of injuries related to carrying heavy
    combat gear in repeated deployments, and, in the case of Afghanistan,
    carrying those loads in high altitude settings.
        A February 1, 2009 Washington Post article on this challenge stated
    that ``Army leaders and experts say the injuries--linked to the stress
    of bearing heavy loads during repeated 12- or 15-month combat tours--
    have increased the number of soldiers categorized as ``non
    deployable.''
        The article goes on to quote General Peter W. Chiarelli, the Army
    Vice Chief of Staff: ``You can't hump a rucksack at 8,000 to 11,000
    feet for 15 months, even at a young age, and not have that have an
    impact on your body, and we are seeing an increase in muscular-skeletal
    issues.''
                 the peer reviewed orthopaedic research program
        Chairman Inouye, the AAOS and military and civilian orthopaedic
    surgeons and researchers are very grateful for your Subcommittee's
    vision in providing support for Peer Reviewed Orthopedic Research. This
    is the first program created in the Department of Defense dedicated
    exclusively to funding peer-reviewed intramural and extramural
    orthopaedic research. Having the program administered on behalf of the
    Defense Health Program by the U.S. Army Medical Research and Materiel
    Command, Fort Dietrick, ensures that the funding closely follows the
    research priorities established by the Armed Forces. With the
    assistance of the Army's Institute of Surgical Research, MRMC has
    extensive experience administering military-related research grant
    programs. Military orthopaedic surgeons have also had significant input
    into the creation of this program and fully support its goals.
        The design of the program fosters collaboration between civilian
    and military orthopaedic surgeons and researchers and various
    facilities. Civilian researchers have the expertise and resources to
    assist their military colleagues with the growing number of patients
    and musculoskeletal injuries and war wound challenges in building the
    military research program. As can been seen in extensive numbers of
    research applications submitted under each RFP, civilian investigators
    are extremely interested in advancing this research and have responded
    enthusiastically to engage in this important work which will also
    provide wide ranging spin-off benefits to civilian trauma patients.
        The program is growing to encompass the full spectrum of research,
    from basic and translational studies to clinical trials. It focuses on
    targeted, competitively-awarded research where peer reviewers score
    proposals on the degree of (1) military relevance, (2) military impact,
    and (3) scientific merit. Military and civilian orthopaedic surgeons
    are highly involved in defining the research topics and in evaluating
    and scoring the proposals. This unique process ensures that projects
    selected for funding have the highest chance for improving treatment of
    battlefield injuries and deployment related musculoskeletal injuries.
        Significant new funding from the Congress will allow for more
    robust numbers of grants, a broader scope of work and increased multi-
    institutional collaboration. As mentioned earlier, clinical trials and
    more in-depth tracking of long term outcomes are in the planning
    stages--important components in rapidly advancing the state of the
    science.
        By funding the Peer Reviewed Orthopedic Research Program--operated
    on behalf of all services by the Army's Medical Research and Materiel
    Command--your committee is advancing the state of the science in this
    field to the benefit of our current servicemen and women--and those who
    will step forward in the future to defend our Nation. Your action will
    directly result in improved treatments for our Wounded Warriors and
    injured troops now and in future conflicts.
        It is important to point out that unique to the current conflicts
    is a new type of patient, a war fighter with multiple and severely
    mangled extremities who is otherwise free of life-threatening injury to
    the torso or whose life-threatening injuries have been successfully
    addressed because of improvements in protective body armor and the
    excellent care quickly delivered through the echelon treatment system.
    Such injuries are rarely seen in civilian surgical hospitals, even in
    Level 1 trauma centers like my own at Shock Trauma in Baltimore.
    Current challenges that often compound the battlefield injuries include
    serious infections due to the nature of the injuries and the
    environment in which they are sustained, and the need for immediate
    transport for more complex surgery.
        The Academy's interest in this effort began in the very early days
    of Operation Enduring Freedom when our deployed military Academy
    members began to report the great clinical needs that were emerging as
    they went about their work in surgery to save injured servicemen and
    women. Soon studies on the nature of injuries in Iraq and Afghanistan
    documented the high proportion of extremity injuries as well as the
    severity of injuries.
        I have been fortunate to travel to and operate in the U.S. Army
    Hospital in Landstuhl, Germany several times and to the Air Force
    Theater Hospital in Balad, Iraq to initiate the Academy's Distinguished
    Visiting Scholars Program. This program is a joint initiative between
    the AAOS and the Orthopaedic Trauma Association. The activity allows
    civilian orthopaedic trauma specialists with demonstrated clinical
    expertise and national recognition for their teaching abilities to
    volunteer two weeks at a time to be away from their practices
    performing surgery and teaching at Landstuhl Regional Medical Center. I
    also had the privilege of operating in Balad, Iraq as part of a request
    by Air Force Surgeon General James Roudebush to evaluate the trauma
    care being delivered at the Air Force Theater Hospital and to
    investigate the feasibility and value of extending the Distinguished
    Visiting Scholars Program into Iraq and Afghanistan. Based on my
    experiences in Balad, I can assure this committee of the outstanding
    quality of trauma care being delivered there by the military health
    system. I believe the quality of medical care being delivered to our
    injured warriors in Balad is at or above the care being delivered in
    our finest trauma centers within the United States.
        On January 21-23 of this year, the fourth annual Extremity War
    Injuries Scientific Symposium was held in Washington, DC, sponsored by
    our Academy, along with the Society of Military Orthopaedic Surgeons,
    The Orthopaedic Research Society and the Orthopaedic Trauma
    Association. This combined effort of three major associations and the
    United States military began in 2006 in an initiative to examine the
    nature of extremity injuries sustained during Operation Enduring
    Freedom and Operation Iraqi Freedom and to plan for advancing the state
    of the science and treatment of these injuries. Each year the meetings
    are attended by over 175 military and civilian leaders in orthopaedic
    and extremity medical research and treatment from around the world. We
    have been very fortunate to have had many outstanding leaders speak to
    the conference audiences in the past about their perspectives on
    injuries being sustained by our armed forces. These speakers have
    included Joint Chiefs Chairman Adm. Michael Mullen, Senator Tom Harkin,
    Representatives John Murtha, Dutch Ruppersberger, and Tom Latham, and
    the previous Assistant Secretary of Defense for Health Affairs, Ward
    Casscells. This conference series has produced widely referenced
    scientific publications describing the clinical challenges posed by
    extremity war injuries, and a research agenda to guide the scientific
    community and the managers of the Peer Reviewed Orthopedic Research
    Program in planning and executing the program.
    orthopaedic trauma from operation iraqi freedom and operation enduring
                                    freedom
        The likelihood of surviving wounds on the battlefield was 69.7
    percent in WWII and 76.4 percent in Vietnam. Now, thanks in part to the
    use of body armor, ``up-armored'' vehicles, intense training of our
    combat personnel and surgical capability within minutes of the
    battlefield, survivability has increased dramatically to 90.2 percent
    as of February 2007.
        The Armed Forces are attempting to return significantly injured
    warriors to full function or limit their disabilities to a functional
    level in the case of the most severe injuries. The ability to provide
    improved recovery of function moves toward the goal of keeping injured
    warriors part of the military team. Moreover, when they do leave the
    Armed Forces, these rehabilitated warriors have a greater chance of
    finding worthwhile occupations outside of the service to contribute
    positively to society. The military believes that it has a duty and
    obligation to provide the highest level of care and rehabilitation to
    those men and women who have suffered the most while serving the
    country and our Academy fully supports those efforts.
        It comes as no surprise that the vast majority of trauma
    experienced in Iraq and Afghanistan is orthopaedic-related, especially
    upper and lower extremity and spine. A recent article in the Journal of
    Orthopaedic Trauma reports on wounds sustained in Operation Iraqi
    Freedom (OIF) and Operation Enduring Freedom (OEF) based on data from
    the Joint Theater Trauma Registry, a database of medical treatment
    information from theater of combat operations at U.S. Army medical
    treatment facilities. From October, 2001 through January, 2005, of
    1,566 soldiers who were injured by hostile enemy action, 1,281 (82
    percent) had extremity injuries, with each solider sustaining, on
    average, 2.28 extremity wounds. These estimates do not include non-
    American and civilians receiving medical care through U.S. military
    facilities. (Owens, Kragh, Macaitis, Svoboda and Wenke.
    Characterization of Extremity Wounds in Operation Iraqi Freedom and
    Operation Enduring Freedom. J Orthopaedic Trauma. Vol. 21, No. 4, April
    2007. 254-257.)
        An earlier article reported on 256 battle casualties treated at the
    Landstuhl Regional Medical Center in Germany during the first 2 months
    of OIF, finding 68 percent sustained an extremity injury. The reported
    mechanism of injury was explosives in 48 percent, gun-shot wounds in 30
    percent and blunt trauma in 21 percent. As the war has moved from an
    offensive phase to the current counter-insurgency campaign, higher
    rates of injuries from explosives have been experienced. (Johnson BA.
    Carmack D, Neary M, et al. Operation Iraqi Freedom: the Landstuhl
    Regional Medical Center experience. J Foot Ankle Surg. 2005; 44:177-
    183.) According to the JTTR, between 2001 and 2005, explosive
    mechanisms accounted for 78 percent of the war injuries compared to 18
    percent from gun shots.
        While medical and technological advancements, as well as the use of
    fast-moving Forward Surgical Teams, have dramatically decreased the
    lethality of war wounds, wounded soldiers who may have died in previous
    conflicts from their injuries are now surviving and have to learn to
    recover from devastating injuries. While body armor is very effective
    in protecting a soldier's torso, his or her extremities are
    particularly vulnerable during attacks.
    Characteristics of Military Orthopaedic Trauma
        At this point there have been almost 40,000 warriors evacuated to
    Landstuhl Regional Medical Center in the Global War on Terror. Of
    these, almost 16,000 have been wounded in action. As mentioned earlier,
    the vast majority have injuries to their extremities--often severe and
    multiple injuries to the arms and legs. Most wounds are caused by
    exploding ordinance--frequently, improvised explosive devices (IEDs),
    rocket-propelled grenades (RPGs), as well as high-velocity gunshot
    wounds. Military surgeons report an average of 3 wounds per casualty.
        According to the New England Journal of Medicine, blast injuries
    are producing an unprecedented number of ``mangled extremities''--limbs
    with severe soft-tissue and bone injuries. (``Casualties of War--
    Military Care for the Wounded from Iraq and Afghanistan,'' NEJM,
    December 9, 2004). The result of such trauma is open, complex wounds
    with severe bone fragmentation. Often there is nerve damage, as well as
    damage to tendons, muscles, vessels, and soft-tissue. In these types of
    wounds, infection is often a problem. According to the JTTR, 53 percent
    of the extremity wounds are classified as penetrating soft-tissue
    wounds, while fractures compose 26 percent of extremity wounds. Other
    types of extremity wounds composing less than 5 percent each are burns,
    sprains, nerve injuries, abrasions, amputations, contusions,
    dislocations, and vascular injuries.
        The sheer number of extremity injuries represents a staggering
    health burden. Between January 2003, and February 2009, over 15,000
    U.S. Warriors have been wounded-in-action severely enough to require
    evacuation out of theater. In addition, 780 American patients have lost
    at least one limb.
    Military Versus Civilian Orthopaedic Trauma
        While there are similarities between military orthopaedic trauma
    and the types of orthopaedic trauma seen in civilian settings, there
    are several major differences that must be noted.
        With orthopaedic military trauma, there are up to five echelons of
    care, unlike in civilian settings when those injured are most likely to
    receive initial treatment at the highest level center. Instead, wounded
    warriors get passed from one level of care to the next, with physicians
    and other health care providers rendering the most appropriate type of
    care possible in the context of the limitations of a battlefield
    environment in order to ensure the best possible outcome. The surgeon
    in each subsequent level of care must try to recreate what was
    previously done. In addition, a majority of injured soldiers have to be
    ``med-evaced'' to receive care and transportation is often delayed due
    to weather or combat conditions. It has been our experience that over
    65-percent of the trauma is urgent and requires immediate attention.
        Injuries from IEDs and other explosive ordnance in Iraq and
    Afghanistan differ markedly from those of gunshot wounds sustained in
    civilian society. The contamination, infection and soft-tissue injury
    caused by exploding ordnance requires more aggressive treatment and new
    techniques, especially when the wounded warrior was in close proximity
    to the blast radius.
        Warriors are usually in excellent health prior to injury. However,
    through the evacuation process they may not be able to eat due to
    medical considerations resulting in impaired body nitrogen stores and
    decreased ability to heal wounds and fight infections. This presents
    many complicating factors when determining the most appropriate care.
        The setting in which care is initially provided to wounded soldiers
    is less than ideal, to say the least, especially in comparison to a
    sterile hospital setting. The environment, such as that seen in Iraq
    and Afghanistan, is dusty and hot, leading to concerns about secondary
    contamination of wounds in the hospital setting. For example, infection
    from acinetobacter baumanni, a ubiquitous organism found in the desert
    soil of Afghanistan and Iraq, is extremely common. In addition, the
    surgical environment is under constant threat of attack by insurgents.
    Imagine teams of medical specialists working in close quarters to save
    an injured serviceman while mortars or rockets are raining down on the
    hospital. Finally, the forward-deployed surgical team is faced with
    limited resources that make providing the highest level of care
    difficult.
        While, as I have stated, there are many unique characteristics of
    orthopaedic military trauma, there is no doubt that research done on
    orthopaedic military trauma also benefits trauma victims in civilian
    settings. Many of the great advancements in orthopaedic trauma care
    have been made during times of war, including principles of debridement
    of open wounds, utilization of external fixation and use of tourniquets
    for control of hemorrhage which has been used extensively during the
    current conflict.
        Research Needs.--With such strong research interest and capacity,
    and the great need for medical breakthroughs in this field, the
    scientific community believes that a sustained, multi-year program
    funded at $150 million per year is justified. Such significant funding
    is required allow the Defense Department to conduct multi-center
    clinical trials--research projects that would greatly advance the field
    and significantly benefit the battlefield injured warriors. In
    addition, basic and translational research also must be sustained, as
    in any major research undertaking, to provide the underpinnings for
    advancing clinical breakthroughs. Research in the management of
    extremity injuries and other disabling orthopaedic conditions will lead
    to quicker recovery times, improved function of limbs, better response
    rates to infection, and new advances in rehabilitation benefiting both
    military and civilian patients. General areas of research need include
    bone regeneration, improved healing of massive soft tissue damage,
    prevention of wound infection, techniques to improve irrigation and
    debridement of blast injuries, prevention of bone reformation
    abnormalities, and epidemiology of current battle-related injuries.
        Specific areas of research need include:
      --Prevention and treatment of post-traumatic arthritis;
      --Prevention and treatment of infections following high-energy
            extremity war injury;
      --Management of segmental bone defects;
      --Establishment of tissue viability markers--this would assist
            surgeons in better understanding the ideal frequency and
            techniques of debridement wound cleaning);
      --Timing of treatment--early versus late surgical treatment;
      --Prevention and treatment of chronic neck and low back arthritic
            conditions resulting from combat associated stress and overuse
            injury;
      --Treatment of severe muscle, nerve, ligament and other soft-tissue
            injury associated with combat trauma; and
      --Rehabilitation of high-performance warriors after significant
            combat related injury.
    Future Needs of Orthopaedic Research
        As mentioned earlier, an important development in this scientific
    effort has been the convening of the annual Extremity War Injury
    Symposia, which began in January of 2006. These widely attended medical
    conferences in Washington, D.C. bring together leading military and
    civilian clinicians and researchers to focus on the immediate needs of
    personnel sustaining extremity injuries. Discussions at the conferences
    have confirmed that there is tremendous interest and much untapped
    research capacity in the Nation's military and civilian research
    community.
        These extraordinary scientific meetings were a partnership effort
    between organized orthopaedic surgery, military surgeons and
    researchers. They were attended by key military and civilian physicians
    and researchers committed to the care of extremity injuries. The first
    conference addressed current challenges in the management of extremity
    trauma associated with recent combat in Iraq and Afghanistan. The major
    focus was to identify opportunities to improve care for the sons and
    daughters of America who have been injured serving our Nation. The
    second focused on the best way to deliver care within the early
    echelons of treatment. The third explored the wide spectrum of needs in
    definitive reconstruction of injuries. Scientific proceedings from the
    symposia have been published by our Academy and made available to the
    military and civilian research community. Each conference has continued
    to refine the list of prioritized research needs which I will
    summarize:
                Timing of Treatment
        Better data are necessary to establish best practices with regard
    to timing of debridement, timing of temporary stabilization and timing
    of definitive stabilization. Development of animal models of early
    versus late operative treatment of open injuries may be helpful.
    Prospective clinical comparisons of treatment groups will be helpful in
    gaining further understanding of the relative role of surgical timing
    on outcomes.
                Techniques of Debridement
        More information is necessary about effective means of
    demonstrating adequacy of debridement. Current challenges, particularly
    for surgeons with limited experience in wound debridement, exist in
    understanding how to establish long-term tissue viability or lack
    thereof at the time of an index operative debridement. Since patients
    in military settings are typically transferred away from the care of
    the surgeon performing the initial debridement prior to delivery of
    secondary care, opportunities to learn about the efficacy of initial
    procedures are lost. Development of animal models of blast injury could
    help establish tissue viability markers. Additional study is necessary
    to understand ideal frequencies and techniques of debridement.
                Transport Issues
        Clinical experience suggests that current air evacuation techniques
    are associated with development of complications in wound and extremity
    management although the specific role of individual variables in the
    genesis of these complications is unclear. Possible contributing
    factors include altitude, hypothermia and secondary wound
    contamination. Clinical and animal models are necessary to help develop
    an understanding of transport issues.
                Coverage Issues
        Controlled studies defining the role of timing of coverage in
    outcome following high-energy extremity war injuries are lacking. Also
    necessary is more information about markers and indicators to help
    assess the readiness of a wound and host for coverage procedures.
    Additional animal modeling and clinical marker evaluation are necessary
    to develop understanding in this area.
                Antibiotic Treatments
        Emergence of resistant organisms continues to provide challenges in
    the treatment of infection following high-energy extremity war
    injuries. Broader prophylaxis likely encourages development of
    antibiotic resistance. In the context of a dwindling pipeline of new
    antibiotics, particularly those directed toward gram-negative
    organisms, development of new technologies to fight infection is
    necessary. This patient population offers opportunity to assess
    efficacy of vaccination against common pathogens. Partnerships with
    infectious disease researchers currently involved in addressing similar
    questions warrants further development.
                Management of Segmental Bone Defects
        A multitude of different techniques for management of segmental
    bone defects is available. These include bone transport, massive onlay
    grafting with and without use of recombinant proteins, delayed
    allograft reconstruction, and acute shortening. While some techniques
    are more appropriate than others after analysis of other clinical
    variables, controlled trials comparing efficacy between treatment
    methods are lacking. Variables that may affect outcome can be grouped
    according to patient characteristics including co-morbidities, injury
    characteristics including severity of bony and soft-tissue wounds, and
    treatment variables including method of internal fixation selected.
    Evaluation of new technologies for treatment of segmental bone defects
    should include assessment of efficacy with adequate control for
    confounding variables and assessment of cost-effectiveness.
    Partnerships with other military research programs may be particularly
    effective in improving clinical capabilities in this area.
                Development of an Animal Model
        A large animal survival military blast injury model is necessary to
    serve as a platform for multiple research questions including: negative
    pressure wound therapy v. bead pouch v. dressing changes; wound
    debridement strategy; effect of topical antibiotics; modulation of
    inflammatory response; timing of wound closure; and vascular shunt
    utilization.
                Prevention of Post-Traumatic Arthritis
        More research is necessary to better understand how to address
    traumatic injuries to articular cartilage with associated articular
    loss. Current treatment options include artificial joint replacement
    and joint fusion. Regeneration of cartilage and re-growth of joint
    surfaces is poorly understood and warrants further investigation.
    Similarly, the role of cadaver joint surfaces in replacing injured
    joints in soldiers warrants further consideration and investigation.
    Initial research has been exciting in this area, particularly in the
    area of allograft hand transplantation.
                Amputee Issues
        Development and validation of ``best practice'' guidelines for
    multidisciplinary care of the amputee is essential. Treatment protocols
    should be tested clinically. Studies should be designed to allow for
    differentiation between the impacts of the process versus the device on
    outcome. Failure mode analysis as a tool to evaluate efficacy of
    treatment protocols and elucidate shortcomings should be utilized.
    Clinically, studies should focus on defining requirements for the
    residual limb length necessary to achieve success without proceeding to
    higher level amputation. Outcomes based comparisons of amputation
    techniques for similar injuries and similar levels should be performed.
    Use of local tissue lengthening and free tissue transfer techniques
    should be evaluated. In the context of current results and increasing
    levels of expectation for function following amputation, development of
    more sensitive and military appropriate outcomes monitors is necessary.
                Heterotopic Ossification
        This condition, known as ``H.O.'' by the many soldiers who
    experience it, is abnormal and uncontrolled bone growth that often
    occurs following severe bone destruction or fracture. Animal models of
    heterotopic ossification should be utilized to develop early markers
    for heterotopic ossification that could identify opportunities for
    early treatment and prevention. Better information is needed about
    burden of disease including prevalence following amputation for
    civilian versus military trauma and frequency with which symptoms
    develop. Treatment methods such as surgical debridement, while
    effective, necessarily interrupt rehabilitation. Prevention could
    expedite recovery and potentially improve outcome.
                                   conclusion
        With extremity trauma injuries being the most common form of injury
    seen in current military conflicts and musculoskeletal injuries
    becoming an increasing factor in sidelining our troops, it is crucial
    that significant funding be directed specifically to the advancement of
    research. The AAOS has worked closely with the top military orthopaedic
    surgeons and medical leaders, at world-class facilities such as the
    U.S. Army Institute of Surgical Research, Brooke Army Medical Center,
    Bethesda Naval Hospital, Landstuhl Regional Medical Center, the Medical
    Research and Materiel Command and Walter Reed Army Medical Center to
    identify the gaps in research and clinical treatment--and the
    challenges are many.
        Orthopaedic research currently being carried out at those and other
    facilities, and at civilian medical centers, is vital to the health of
    our soldiers and to the Armed Forces' objective to return injured
    soldiers to full function in hopes that they can continue to be
    contributing soldiers and active members of society.
        The 17,000 members of our Academy thank you for sustaining the Peer
    Reviewed Orthopedic Research Program. While Congress funds an extensive
    array of medical research through the Department of Defense, with over
    80 percent of military trauma being extremity-related, I can assure you
    that this type of medical research will greatly benefit our men and
    women serving in the Global War on Terror and in future conflicts.
        Mr. Chairman and Mr. Vice Chairman, the American Academy of
    Orthopaedic Surgeons, as well as the entire orthopaedic trauma
    community, stands ready to work with this Subcommittee to identify and
    prioritize research opportunities for the advancement in the care of
    extremity and orthopaedic injuries. Military and civilian orthopaedic
    surgeons and researchers are committed to pursuing scientific inquiry
    that will benefit the unfortunately high number of soldiers afflicted
    with such conditions and return them to the highest level of function
    possible. This investment to improve treatment for our soldiers will be
    well spent. It is imperative that the Federal Government--when
    establishing its defense health research priorities in the future--
    continues to ensure that research on treating orthopaedic and extremity
    war injuries remains a top priority. We appreciate your consideration
    of our perspective on this critical issue and urge your continued
    action on behalf of our Nation's servicemen and women.

        Chairman Inouye. And we'd like to thank the whole panel and
    now call upon the new panel.
        Thank you very much.
        The next panel consists of Ms. Frances Visco, Ms. Jackie S.
    Rowles, Mr. Rick Jones, Ms. Cara Tenenbaum, Colonel William
    Holahan, and Ms. Elizabeth Cochran.
        I've been advised that Mr. Wicks will be substituting for
    Ms. Jackie Rowles.
        And our next witness is the president of the National
    Breast Cancer Coalition, Ms. Frances Visco.
    STATEMENT OF FRAN VISCO, J.D., PRESIDENT, NATIONAL
                BREAST CANCER COALITION
        Ms. Visco. Thank you, Chairman Inouye, Senator Cochran.
        I'm here as a 22-year breast cancer survivor, a wife, a
    mother, and the president of the National Breast Cancer
    Coalition. As you know, NBCC is a coalition of more than 600
    organizations from across the country whose mission is to end
    breast cancer.
        I want to thank you, as I do every year, for your continued
    support of this program. And I want to report to you that this
    program continues to be incredibly successful. It continues to
    create new models of science, new models of research, through a
    competitive, peer-reviewed process that releases funding to
    scientists around the world.
        This program has funded innovative research, it has filled
    the gaps in the traditional funding mechanisms. It has also
    been copied by the National Institutes of Health, by private
    foundations. The models that this program has launched have now
    changed science in many different areas within the Department
    of Defense, collaborations within the Defense Department, and
    without. It has resulted in bringing many new young scientists
    into the field of research, and biomedical research. And I'm
    very proud to say--very proud of the military--that this
    program has incredibly low administrative costs, so that 90
    percent--more than 90 percent of the appropriations go directly
    to research funding.
        There's an incredibly high return on the investment of
    these funds. And, most importantly, this program is
    transparent, and it is accountable to the taxpayers. It is
    possible to see where every dollar of these funds has gone. And
    the public gets a report of the results of the research that
    has been funded with these dollars.
        It has made an incredible difference to women with breast
    cancer, to their families, but really to all disease research.
    And I want to take my last moments to say how grateful we are
    to the members of the military, to--who administer this
    program. They are passionately committed to this mission, and
    they do an incredible job. And I want to thank you very much
    for continuing and allowing this program to proceed.
        Thank you.
        Chairman Inouye. Thank you very much, Ms. Visco.
        [The statement follows:]
                        Prepared Statement of Fran Visco
        Thank you, Mr. Chairman and members of the Appropriations
    Subcommittee on Defense, for the opportunity to submit testimony today
    about a Program that has made a significant difference in the lives of
    women and their families.
        I am Fran Visco, a 21-year breast cancer survivor, a wife and
    mother, a lawyer, and President of the National Breast Cancer Coalition
    (NBCC). My testimony represents the hundreds of member organizations
    and thousands of individual members of the Coalition. NBCC is a
    grassroots organization dedicated to ending breast cancer through
    action and advocacy. The Coalition's main goals are to increase Federal
    funding for breast cancer research and collaborate with the scientific
    community to implement new models of research; improve access to high
    quality health care and breast cancer clinical trials for all women;
    and expand the influence of breast cancer advocates wherever breast
    cancer decisions are made.
        You and your Committee have shown great determination and
    leadership in funding the Department of Defense (DOD) peer-reviewed
    Breast Cancer Research Program (BCRP) at a level that has brought us
    closer to eradicating this disease. Chairman Inouye and Ranking Member
    Cochran, we appreciate your longstanding personal support for this
    Program. I am hopeful that you and your Committee will continue that
    determination and leadership.
        I know you recognize the importance of this Program to women and
    their families across the country, to the scientific and health care
    communities and to the Department of Defense. Much of the progress in
    the fight against breast cancer has been made possible by the
    Appropriations Committee's investment in breast cancer research through
    the DOD BCRP. This Program has launched new models of biomedical
    research that have benefited other agencies and both public and private
    institutions. It has changed for the better the way research is
    performed and has been replicated by programs focused on other
    diseases, by other countries and states. To support this unprecedented
    progress moving forward, we ask that you support a separate $150
    million appropriation for fiscal year 2010. In order to continue the
    success of the Program, you must ensure that it maintain its integrity
    and separate identity, in addition to the requested level of funding.
    This is important not just for breast cancer, but for all biomedical
    research that has benefited from this incredible government Program. In
    addition, as Institute of Medicine (IOM) reports concluded in 1997 and
    2004, there continues to be excellent science that would go unfunded
    without this Program. It is only through a separate appropriation that
    this Program is able to continue to focus on breast cancer yet impact
    all other research. The separate appropriation of $150 million will
    ensure that this Program can rapidly respond to changes and new
    discoveries in the field and fill the gaps in traditional funding
    mechanisms.
        Since its inception, this Program has matured into a broad-reaching
    influential voice forging new and innovative directions for breast
    cancer research and science. Breast cancer is an extraordinarily
    complex disease. Despite the enormous successes and advancements in
    breast cancer research made through funding from the DOD BCRP, we still
    do not know what causes breast cancer, how to prevent it, or how to
    cure it. It is critical that innovative research through this unique
    Program continues so that we can move forward toward eradicating this
    disease.
               overview of the dod breast cancer research program
        The DOD peer-reviewed Breast Cancer Research Program has
    established itself as a model medical research program, respected
    throughout the cancer and broader medical community for its innovative,
    transparent and accountable approach. The pioneering research performed
    through the Program has the potential to benefit not just breast
    cancer, but all cancers, as well as other diseases. Biomedical research
    is being transformed by the DOD BCRP's success.
        This Program is both innovative and incredibly streamlined. It
    continues to be overseen by an Integration Panel including
    distinguished scientists and advocates, as recommended by the IOM.
    Because there is little bureaucracy, the Program is able to respond
    quickly to what is currently happening in the research community.
    Because of its specific focus on breast cancer, it is able to rapidly
    support innovative proposals that reflect the most recent discoveries
    in the field. It is responsive, not just to the scientific community,
    but also to the public. The flexibility of the Program has allowed the
    Army to administer it with unparalleled efficiency and effectiveness.
        An integral part of this Program has been the inclusion of consumer
    advocates at every level. Breast cancer is not just a problem of
    scientists; it is a problem of people. Advocates bring a necessary
    perspective to the table, ensuring that the science funded by this
    Program is not only meritorious, but it is also meaningful and will
    make a difference in people's lives. The consumer advocates bring
    accountability and transparency to the process. Many of the scientists
    who have participated in the Program have said that working with the
    advocates has changed the way they approach research. Let me quote Dr.
    Michael Diefenbach of Mount Sinai School of Medicine:

        ``I have served as a reviewer for the Department of Defense's
    Breast and Prostate Cancer Review programs and I am a member of the
    behavioral study section for the National Cancer Institute . . . I find
    survivors or advocate reviewers as they are sometimes called bring a
    sense of realism to the review process that is very important to the
    selection and ultimately funding process of important research . . .
    Both sides bring important aspects to the review process and the
    selected projects are ultimately those that can fulfill scientific
    rigor and translatability from the research arena to clinical practice.
    I urge that future review panels include advocate reviewers in the
    review process.''

        Since 1992, nearly 600 breast cancer survivors have served on the
    BCRP peer review panels. As a result of this inclusion of consumers,
    the Program has created an unprecedented working relationship between
    the public, scientists, and the military, and ultimately has led to new
    avenues of research in breast cancer. The vital role of the advocates
    in the success of the BCRP has led to consumer inclusion in other
    biomedical research programs at DOD. This Program now serves as an
    international model.
        It is important to note that the Integration Panel that designs
    this Program has a strategic plan for how best to spend the funds
    appropriated. This plan is based on the state of the science--both what
    scientists know now and the gaps in our knowledge--as well as the needs
    of the public. While this plan is mission driven, and helps ensure that
    the science keeps that mission--eradicating breast cancer--in mind, it
    does not restrict scientific freedom, creativity or innovation. The
    Integration Panel carefully allocates these resources, but it does not
    predetermine the specific research areas to be addressed.
                          unique funding opportunities
        The DOD BCRP research portfolio includes many different types of
    projects, including support for innovative ideas, networks to
    facilitate clinical trials, and training of breast cancer researchers.
        Developments in the past few years have begun to offer breast
    cancer researchers fascinating insights into the biology of breast
    cancer and have brought into sharp focus the areas of research that
    hold promise and will build on the knowledge and investment we have
    made. The Innovative Developmental and Exploratory Awards (IDEA) grants
    of the DOD Program have been critical in the effort to respond to new
    discoveries and to encourage and support innovative, risk-taking
    research. Concept Awards support funding even earlier in the process of
    discovery. These grants have been instrumental in the development of
    promising breast cancer research by allowing scientists to explore
    beyond the realm of traditional research and unleash incredible new
    ideas. IDEA and Concept grants are uniquely designed to dramatically
    advance our knowledge in areas that offer the greatest potential. IDEA
    and Concept grants are precisely the type of grants that rarely receive
    funding through more traditional programs such as the National
    Institutes of Health and private research programs. They therefore
    complement, and do not duplicate, other Federal funding programs. This
    is true of other DOD award mechanisms also.
        Innovator awards invest in world renowned, outstanding individuals
    rather than projects, by providing funding and freedom to pursue highly
    creative, potentially groundbreaking research that could ultimately
    accelerate the eradication of breast cancer. The Era of Hope Scholar
    Award supports the formation of the next generation of leaders in
    breast cancer research, by identifying the best and brightest
    scientists early in their careers and giving them the necessary
    resources to pursue a highly innovative vision of ending breast cancer.
        These are just a few examples of innovative funding opportunities
    at the DOD BCRP that are filling gaps in breast cancer research.
    Scientists have lauded the Program and the importance of these award
    mechanisms. In 2005, Zelton Dave Sharp wrote about the importance of
    the Concept award mechanism:

        ``Our Concept grant has enabled us to obtain necessary data to
    recently apply for a larger grant to support this project. We could
    have never gotten to this stage without the Concept award. Our eventual
    goal is to use the technology we are developing to identify new
    compounds that will be effective in preventing and/or treating breast
    cancer . . . Equally important, however, the DOD BCRP does an
    outstanding job of supporting graduate student trainees in breast
    cancer research, through training grants and pre-doctoral fellowships .
    . . The young people supported by these awards are the lifeblood of
    science, and since they are starting their training on projects
    relevant to breast cancer, there is a high probability they will devote
    their entire careers to finding a cure. These young scientists are by
    far the most important `products' that the DOD BCRP produces.''----
    Zelton Dave Sharp, Associate Professor, Interim Director/Chairman,
    Institute of Biotechnology/Dept. Molecular Medicine, University of
    Texas Health Science Center (August 2005).

        The DOD BCRP also focuses on moving research from the bench to the
    bedside. DOD BCRP awards are designed to fill niches that are not
    addressed by other Federal agencies. The BCRP considers translational
    research to be the application of well-founded laboratory or other pre-
    clinical insight into a clinical trial. To enhance this critical area
    of research, several research opportunities have been offered. Clinical
    Translational Research Awards have been awarded for investigator-
    initiated projects that involve a clinical trial within the lifetime of
    the award. The BCRP has expanded its emphasis on translational research
    by also offering five different types of awards that support work at
    the critical juncture between laboratory research and bedside
    applications.
        The Centers of Excellence award mechanism brings together the
    world's most highly qualified individuals and institutions to address a
    major overarching question in breast cancer research that could make a
    significant contribution towards the eradication of breast cancer. Many
    of these Centers are working on questions that will translate into
    direct clinical applications. These Centers include the expertise of
    basic, epidemiology and clinical researchers, as well as consumer
    advocates.
        Dr. John Niederhuber, now the Director of the National Cancer
    Institute (NCI), said the following about the Program when he was
    Director of the University of Wisconsin Comprehensive Cancer Center in
    April, 1999:

        ``Research projects at our institution funded by the Department of
    Defense are searching for new knowledge in many different fields
    including: identification of risk factors, investigating new therapies
    and their mechanism of action, developing new imaging techniques and
    the development of new models to study [breast cancer] . . . Continued
    availability of this money is critical for continued progress in the
    Nation's battle against this deadly disease.''

        Scientists and consumers agree that it is vital that these grants
    continue to support breast cancer research. To sustain the Program's
    momentum, $150 million for peer-reviewed research is needed in fiscal
    year 2010.
                            scientific achievements
        One of the most promising outcomes of research funded by the DOD
    BCRP was the development of the first monoclonal antibody targeted
    therapy that prolongs the lives of women with a particularly aggressive
    type of advanced breast cancer. This drug could not have been developed
    without first researching and understanding the gene known as HER-2/
    neu, which is involved in the progression of some breast cancers.
    Researchers found that over-expression of HER-2/neu in breast cancer
    cells results in very aggressive biologic behavior. The same
    researchers demonstrated that an antibody directed against HER-2/neu
    could slow the growth of the cancer cells that over-expressed the gene.
    This research, which led to the development of the targeted therapy,
    was made possible in part by a DOD BCRP-funded infrastructure grant.
    Other researchers funded by the DOD BCRP are identifying similar kinds
    of genes that are involved in the initiation and progression of cancer.
        Another example of innovation in the Program is in the area of
    imaging. One DOD BCRP awardee developed a new use for medical
    hyperspectral imaging (MHSI) technology. This work demonstrated the
    usefulness of MHSI as a rapid, noninvasive, and cost-effective
    evaluation of normal and tumor tissue during a real-time operating
    procedure. Application of MHSI to surgical procedures has the potential
    to significantly reduce local recurrence of breast tumors and may
    facilitate early determination of tumor malignancy.
        Studies funded by the DOD BCRP are examining the role of estrogen
    and estrogen signaling in breast cancer. For example, one study
    examined the effects of the two main pathways that produce estrogen.
    Estrogen is often processed by one of two pathways; one yields
    biologically active substances while the other does not. It has been
    suggested that women who process estrogen via the biologically active
    pathway may be at higher risk of developing breast cancer. This
    research will yield insights into the effects of estrogen processing on
    breast cancer risk in women with and without family histories of breast
    cancer.
        Another example of success from the Program is a study of sentinel
    lymph nodes (SLNs). This study confirmed that SLNs are indicators of
    metastatic progression of disease. The resulting knowledge from this
    study and others has led to a new standard of care for lymph node
    biopsies. If the first lymph node is negative for cancer cells, then it
    is unnecessary to remove all the lymph nodes. This helps prevent
    lymphodema which can be painful and have lasting complications.
                            federal money well spent
        The DOD BCRP is as efficient as it is innovative. In fact, 90
    percent of funds go directly to research grants. The flexibility of the
    Program allows the Army to administer it in such a way as to maximize
    its limited resources. The Program is able to quickly respond to
    current scientific advances and fulfills an important niche by focusing
    on research that is traditionally under-funded. This was confirmed and
    reiterated in two separate IOM reports released in 1997 and 2004. The
    areas of focus of the DOD BCRP span a broad spectrum and include basic,
    clinical, behavioral, environmental sciences, and alternative therapy
    studies, to name a few. The BCRP benefits women and their families by
    maximizing resources and filling in the gaps in breast cancer research.
        The Program is responsive to the scientific community and to the
    public. This is evidenced by the inclusion of consumer advocates at
    both the peer and programmatic review levels. The consumer perspective
    helps the scientists understand how the research will affect the
    community and allows for funding decisions based on the concerns and
    needs of patients and the medical community.
        The outcomes of the BCRP-funded research can be gauged, in part, by
    the number of publications, abstracts/presentations, and patents/
    licensures reported by awardees. To date, there have been more than
    12,241 publications in scientific journals, more than 12,000 abstracts
    and nearly 550 patents/licensure applications. The American public can
    truly be proud of its investment in the DOD BCRP. Scientific
    achievements that are the direct result of the DOD BCRP grants are
    undoubtedly moving us closer to eradicating breast cancer.
                   independent assessments of program success
        The success of the DOD peer-reviewed Breast Cancer Research Program
    has been illustrated by several unique assessments of the Program. The
    IOM, which originally recommended the structure for the Program,
    independently re-examined the Program in a report published in 1997.
    They published another report on the Program in 2004. Their findings
    overwhelmingly encouraged the continuation of the Program and offered
    guidance for program implementation improvements.
        The 1997 IOM review of the DOD peer-reviewed Breast Cancer Research
    Program commended the Program, stating, ``the Program fills a unique
    niche among public and private funding sources for cancer research. It
    is not duplicative of other programs and is a promising vehicle for
    forging new ideas and scientific breakthroughs in the Nation's fight
    against breast cancer.'' The 2004 report spoke to the importance of the
    program and the need for its continuation.
                   transparent and accountable to the public
        The DOD peer-reviewed Breast Cancer Research Program not only
    provides a funding mechanism for high-risk, high-return research, but
    also reports the results of this research to the American people every
    2 to 3 years at a public meeting called the Era of Hope. The 1997
    meeting was the first time a federally-funded program reported back to
    the public in detail not only on the funds used, but also on the
    research undertaken, the knowledge gained from that research and future
    directions to be pursued.
        Sixteen hundred and consumers and researchers met for the fifth Era
    of Hope meeting in June, 2008. As MSNBC.com's Bob Bazell wrote, this
    meeting ``brought together many of the most committed breast cancer
    activists with some of the Nation's top cancer scientists. The
    conference's directive is to push researchers to think `out of the box'
    for potential treatments, methods of detection and prevention in
    ways.'' He went on to say ``the program . . . has racked up some
    impressive accomplishments in high-risk research projects . . .''
        One of the topics reported on at the meeting was the development of
    more effective breast imaging methods. An example of the important work
    that is coming out of the DOD BCRP includes a new screening method
    called molecular breast imaging, which helps detect breast cancer in
    women with dense breasts--which can be difficult using a mammogram
    alone. I invite you to log on to NBCC's new website http://
    influence.stopbreastcancer.org/ to learn more about the exciting
    research reported at the 2008 Era of Hope.
        The DOD peer-reviewed Breast Cancer Research Program has attracted
    scientists across a broad spectrum of disciplines, launched new
    mechanisms for research and facilitated new thinking in breast cancer
    research and research in general. A report on all research that has
    been funded through the DOD BCRP is available to the public.
    Individuals can go to the Department of Defense website and look at the
    abstracts for each proposal at http://cdmrp.army.mil/bcrp/.
               commitment of the national breast cancer coalition
        The National Breast Cancer Coalition is strongly committed to the
    DOD BCRP in every aspect, as we truly believe it is one of our best
    chances for finding cures for and ways to prevent breast cancer. The
    Coalition and its members are dedicated to working with you to ensure
    the continuation of funding for this Program at a level that allows
    this research to forge ahead. From 1992, with the launch of our ``300
    Million More Campaign'' that formed the basis of this Program, until
    now, NBCC advocates have appreciated your support.
        Over the years, our members have shown their continuing support for
    this Program through petition campaigns, collecting more than 2.6
    million signatures, and through their advocacy on an almost daily basis
    around the country asking for support of the DOD BCRP.
        There are 3 million women living with breast cancer in this country
    today. This year, more than 40,000 will die of the disease and more
    than 240,000 will be diagnosed. We still do not know how to prevent
    breast cancer, how to diagnose it truly early or how to cure it. It is
    an incredibly complex disease. We simply cannot afford to walk away
    from this program.
        Since the very beginning of this Program in 1992, Congress has
    stood with us in support of this important investment in the fight
    against breast cancer. In the years since, Chairman Inouye and Ranking
    Member Cochran, you and this entire Committee have been leaders in the
    effort to continue this innovative investment in breast cancer
    research.
        NBCC asks you, the Defense Appropriations Subcommittee, to
    recognize the importance of what has been initiated by the
    Appropriations Committee. You have set in motion an innovative and
    highly efficient approach to fighting the breast cancer epidemic. We
    ask you now to continue your leadership and fund the Program at $150
    million and maintain its integrity. This is research that will help us
    win this very real and devastating war against a cruel enemy.
        Thank you again for the opportunity to submit testimony and for
    giving hope to all women and their families, and especially to the 3
    million women in the United States living with breast cancer.

        Chairman Inouye. And now may I call upon Mr. Wicks,
    representing the American Association of Nurse Anesthetists.
    STATEMENT OF TERRY WICKS, PAST PRESIDENT, ON BEHALF OF
                THE AMERICAN ASSOCIATION OF NURSE
                ANESTHETISTS (AANA)
        Mr. Wicks. Chairman Inouye, Senator Cochran, and members of
    the subcommittee, good morning.
        My name is Terry Wicks, and I am a past president of the
    40,000-member American Association of Nurse Anesthetists. The
    quality of healthcare America provides our servicemen and women
    and their dependents has long been this subcommittee's high
    priority. Today, I report to you the contributions that
    certified registered nurse anesthetists, or CRNAs, make toward
    our services' mission. I will also provide you our
    recommendations to further improve military healthcare for
    these challenging times.
        I also ask that--unanimous consent that my written
    statement be entered into the record.
        Chairman Inouye. So ordered.
        Mr. Wicks. America's CRNAs provide some 30 million
    anesthetics annually, in every healthcare setting requiring
    anesthesia care. And we provide that care safely. The Institute
    of Medicine reported, in 2000, that anesthesia care is 50 times
    safer than it was in the early 1980s.
        For the United States Armed Forces, CRNAs are particularly
    critical. In 2005, 493 active duty and 790 reservist nurse
    anesthetists provided anesthesia care indispensable to our
    Armed Forces' current mission. Not long ago one CRNA, Major
    General Gail Pollock, served as Acting Surgeon General of the
    Army.
        Today, CRNAs serve in major military hospitals, in
    educational institutions, aboard ships, and in isolated bases
    abroad and at home, and as members of forward surgical teams,
    and they are as close to the tip of the spear as they can be.
    In most of these environments, CRNAs provide anesthesia
    services, alone, with anesthesiologists, enabling surgeons and
    other clinicians to safely deliver lifesaving care to our
    soldiers.
        In recent years, however, the number of CRNAs needed in the
    Armed Forces has fallen below--the number of CRNAs in the
    services has fallen below the number needed. The private market
    for nurse anesthetists is extremely strong, and the military
    has struggled to compete. The services, this subcommittee, and
    the authorizing committees have responded with increased
    benefits to CRNAs, incentive specialty pay, and the health
    professions loan repayment program, focusing on incentives for
    multiyear agreements.
        The profession of nurse anesthesia has likewise responded.
    Our Council on Certification of Nurse Anesthetists reports
    that, in 2008, our schools produced 2,161 graduates, double the
    number since the year 2000, and 2,100 nurse anesthetists were
    certified. That growth is expected to continue, and the Council
    on Accreditation of Nurse Anesthesia Educational Programs
    projects that nurse anesthesia programs will produce over 2,400
    graduates in 2009.
        These combined actions have helped strengthen the services'
    readiness and the quality of healthcare available to our
    servicemen and women.
        So, our first recommendation to you is to extend and
    strengthen this successful incentive service pay program for
    CRNAs. The authorizing committee has extended the ISP program,
    and we encourage this subcommittee to continue funding ISP
    levels sufficient for the services to recruit and retain CRNAs
    needed for the mission.
        Our second recommendation is for the subcommittee to
    encourage all the services to adopt the joint scope of
    practice. Standard practice across the services enhances
    patient safety and the quality of healthcare of our servicemen
    and women. The Navy, in particular, has made a great deal of
    progress toward adopting the joint scope of practice of
    independent practitioners. We encourage its adoption in all the
    services.
        Like our military CRNAs that serve each and every day, the
    American Association of Nurse Anesthetists stands ready to work
    with Congress to ensure that all our Nation's military men and
    women get the care they need and deserve.
        Thank you, and I'll be happy to answer any question that
    you may have.
        Chairman Inouye. All right. Thank you very much, Mr. Wicks.
        [The statement follows:]
         Prepared Statement of Jackie S. Rowles, CRNA, MBA, MA, FAAPM,
          President, American Association of Nurse Anesthetists (AANA)
        Chairman Inouye, Ranking Member Cochran, and Members of the
    Subcommittee: The American Association of Nurse Anesthetists (AANA) is
    the professional association that represents over 40,000 Certified
    Registered Nurse Anesthetists (CRNAs) across the United States,
    including more than 500 active duty and over 750 reservists in the
    military reported in 2009. The AANA appreciates the opportunity to
    provide testimony regarding CRNAs in the military. We would also like
    to thank this committee for the help it has given us in assisting the
    Department of Defense (DOD) and each of the services to recruit and
    retain CRNAs.
               crnas and the armed forces: a tradition of service
        Let us begin by describing the profession of nurse anesthesia, and
    its history and role with the Armed Forces of the United States.
        In the administration of anesthesia, CRNAs perform the same
    functions as anesthesiologists and work in every setting in which
    anesthesia is delivered including hospital surgical suites and
    obstetrical delivery rooms, ambulatory surgical centers, health
    maintenance organizations, and the offices of dentists, podiatrists,
    ophthalmologists, and plastic surgeons. Today, CRNAs administer some 30
    million anesthetics given to patients each year in the United States.
    Nurse anesthetists are also the sole anesthesia providers in the vast
    majority of rural hospitals, assuring access to surgical, obstetrical
    and other healthcare services for millions of rural Americans.
        Our tradition of service to the military and our Veterans is
    buttressed by our personal, professional commitment to patient safety,
    made evident through research into our practice. In our professional
    association, we state emphatically ``our members' only business is
    patient safety.'' Safety is assured through education, high standards
    of professional practice, and commitment to continuing education.
    Having first practiced as registered nurses, CRNAs are educated to the
    master's degree level, and some to the doctoral level, and meet the
    most stringent continuing education and recertification standards in
    the field. Thanks to this tradition of advanced education and clinical
    practice excellence, we are humbled and honored to note that anesthesia
    is 50 times safer now than in the early 1980s (National Academy of
    Sciences, 2000). Research further demonstrates that the care delivered
    by CRNAs, physician anesthesiologists, or by both working together
    yields similar patient safety outcomes. In addition to studies
    performed by the National Academy of Sciences in 1977, Forrest in 1980,
    Bechtoldt in 1981, the Minnesota Department of Health in 1994, and
    others, Dr. Michael Pine, MD, MBA, recently concluded once again that
    among CRNAs and physician anesthesiologists, ``the type of anesthesia
    provider does not affect inpatient surgical mortality'' (Pine, 2003).
    Thus, the practice of anesthesia is a recognized specialty in nursing
    and medicine. Most recently, a study published in Nursing Research
    confirmed obstetrical anesthesia services are extremely safe, and that
    there is no difference in safety between hospitals that use only CRNAs
    compared with those that use only anesthesiologists (Simonson et al,
    2007). Both CRNAs and anesthesiologists administer anesthesia for all
    types of surgical procedures from the simplest to the most complex,
    either as single providers or together.
                       nurse anesthetists in the military
        Since the mid-19th century, our profession of nurse anesthesia has
    been proud and honored to provide anesthesia care for our past and
    present military personnel and their families. From the Civil War to
    the present day, nurse anesthetists have been the principal anesthesia
    providers in combat areas of every war in which the United States has
    been engaged.
        Military nurse anesthetists have been honored and decorated by the
    U.S. and foreign governments for outstanding achievements, resulting
    from their dedication and commitment to duty and competence in managing
    seriously wounded casualties. In World War II, there were 17 nurse
    anesthetists to every one anesthesiologist. In Vietnam, the ratio of
    CRNAs to physician anesthetists was approximately 3:1. Two nurse
    anesthetists were killed in Vietnam and their names have been engraved
    on the Vietnam Memorial Wall. During the Panama strike, only CRNAs were
    sent with the fighting forces. Nurse anesthetists served with honor
    during Desert Shield and Desert Storm.
        Military CRNAs also provide critical anesthesia support to
    humanitarian missions around the globe in such places as Bosnia and
    Somalia. In May 2003, approximately 364 nurse anesthetists had been
    deployed to the Middle East for the military mission for ``Operation
    Iraqi Freedom'' and ``Operation Enduring Freedom.'' When President
    George W. Bush initiated ``Operation Enduring Freedom,'' CRNAs were
    immediately deployed. With the new special operations environment new
    training was needed to prepare our CRNAs to ensure military medical
    mobilization and readiness. Brigadier General Barbara C. Brannon,
    Assistant Surgeon General, Air Force Nursing Services, testified before
    this Senate Committee on May 8, 2002, to provide an account of CRNAs on
    the job overseas. She stated, ``Lt. Col Beisser, a certified registered
    nurse anesthetist (CRNA) leading a Mobile Forward Surgical Team (MFST),
    recently commended the seamless interoperability he witnessed during
    treatment of trauma victims in Special Forces mass casualty incident.''
        Data gathered from the U.S. Armed Forces anesthesia communities
    reveal that CRNAs have often been the sole anesthesia providers at
    certain facilities, both at home and while forward deployed. For
    decades CRNAs have staffed ships, isolated U.S. Bases, and forward
    surgical teams without physician anesthesia support. The U.S. Army
    Joint Special Operations Command Medical Team and all Army Forward
    Surgical Teams are staffed solely by CRNAs. Military CRNAs have a long
    proud history of providing independent support and quality anesthesia
    care to military men and women, their families and to people from many
    nations who have found themselves in harm's way.
        In the current mission, CRNAs are deployed all over the world, on
    land and at sea. This committee must ensure that we retain and recruit
    CRNAs for now and in the future to serve in these military deployments
    overseas. This committee must ensure that we retain and recruit CRNAs
    now and in the future to serve in these military overseas deployments
    and humanitarian efforts, and to ensure the maximum readiness of
    America's armed services.
    nurse anesthesia provider supply and demand: solutions for recruitment
                                 and retention
        In all of the Services, maintaining adequate numbers of active duty
    CRNAs is of utmost concern. For several years, the number of CRNAs
    serving in active duty fell short of the number authorized by the
    Department of Defense (DOD). This is further complicated by strong
    demand for CRNAs in both the public and private sectors.
        It is essential to understand that while there is strong demand for
    CRNA services in the public and private healthcare sectors, the
    profession of nurse anesthesia is working effectively to meet this
    workforce challenge. The AANA anticipates growing demand for CRNAs. Our
    evidence suggests that while vacancies exist, the demand for anesthesia
    professionals can be met if appropriate actions are taken. As of
    January 2009, there are 108 accredited CRNA schools to support the
    profession of nurse anesthesia. The number of qualified registered
    nurses applying to CRNA schools continues to climb. The growth in the
    number of schools, the number of applicants, and in production
    capacity, has yielded significant growth in the number of nurse
    anesthetists graduating and being certified into the profession, while
    absolutely maintaining and strengthening the quality and competence of
    these clinicians. The Council on Certification of Nurse Anesthetists
    reports that in 2008, our schools produced 2,161 graduates, double the
    number since 2000, and 2,110 nurse anesthetists were certified. The
    growth is expected to continue. The Council on Accreditation of Nurse
    Anesthesia Educational Programs (COA) projects that CRNA schools will
    produce over 2,417 graduates in 2009.
        This Committee can greatly assist in the effort to attract and
    maintain essential numbers of nurse anesthetists in the military by
    their support to increase special pays.
                        incentive special pay for nurses
        According to a March 1994 study requested by the Health Policy
    Directorate of Health Affairs and conducted by DOD, a large pay gap
    existed between annual civilian and military pay in 1992. This study
    concluded, ``this earnings gap is a major reason why the military has
    difficulty retaining CRNAs.'' In order to address this pay gap, in the
    fiscal year 1995 Defense Authorization bill Congress authorized the
    implementation of an increase in the annual Incentive Special Pay (ISP)
    for nurse anesthetists from $6,000 to $15,000 for those CRNAs no longer
    under service obligation to pay back their anesthesia education. Those
    CRNAs who remained obligated receive the $6,000 ISP.
        Both the House and Senate passed the fiscal year 2003 Defense
    Authorization Act Conference report, H. Rept. 107-772, which included
    an ISP increase to $50,000. The report included an increase in ISP for
    nurse anesthetists from $15,000 to $50,000. The AANA is requesting that
    this committee fund the ISP at $50,000 for all the branches of the
    armed services to retain and recruit CRNAs now and into the future. Per
    the testimony provided in 2006 from the three services' Nurse Corps
    leaders, the AANA is aware that there is an active effort with the
    Surgeons General to closely evaluate and adjust ISP rates and policies
    needed to support the recruitment and retention of CRNAs. In 2006,
    Major General Gale Pollock, MBA, MHA, MS, CRNA, FACHE, Deputy Surgeon
    General, Army Nurse Corps of the U.S. Army stated in testimony before
    this Subcommittee, ``I am particularly concerned about the retention of
    our certified registered nurse anesthetists (CRNAs). Our inventory of
    CRNAs is currently at 73 percent. The restructuring of the incentive
    special pay program for CRNAs last year, as well as the 180 (day)-
    deployment rotation policy were good first steps in stemming the loss
    of these highly trained providers. We are working closely with the
    Surgeon General's staff to closely evaluate and adjust rates and
    policies where needed.''
        There have been positive results from the Nurse Corps and Surgeons
    General initiatives to increase incentive special pays for CRNAs. In
    testimony before the House Armed Services Committee in 2007, Gen.
    Pollock stated, ``We have . . . increased the Incentive Special Pay
    (ISP) Certified Registered Nurse Anesthetist, and expanded use of the
    Health Professions Loan Repayment Program (HPLRP). The . . . Nurse
    Anesthetist bonuses have been very successful in retaining these
    providers who are critically important to our mission on the
    battlefield.'' She also stated in that same statement, ``In 2004, we
    increased the multi-year bonuses we offer to Certified Registered Nurse
    Anesthetists with emphasis on incentives for multi-year agreements. A
    year's worth of experience indicates that this increased bonus, 180-day
    deployments, and a revamped Professional Filler system to improve
    deployment equity is helping to retain CRNAs.''
        There still continues to be high demand for CRNAs in the healthcare
    community leading to higher incomes widening the gap in pay for CRNAs
    in the civilian sector compared to the military. However, the ISP and
    other incentives the services are providing CRNAs has helped close that
    gap the past 3 years, according to the most recent AANA membership
    survey data. In civilian practice, all additional skills, experience,
    duties and responsibilities, and hours of work are compensated for
    monetarily. Additionally, training (tuition and continuing education),
    healthcare, retirement, recruitment and retention bonuses, and other
    benefits often equal or exceed those offered in the military.
    Therefore, it is vitally important that the Incentive Special Pay (ISP)
    be supported to ensure retention of CRNAs in the military.
        AANA thanks this Committee for its support of the annual ISP for
    nurse anesthetists. AANA strongly recommends the continuation in the
    annual funding for ISP at $50,000 or more for fiscal year 2010, which
    recognizes the special skills and advanced education that CRNAs bring
    to the DOD healthcare system, and supports the mission of our U.S.
    Armed Forces.
                       board certification pay for nurses
        Included in the fiscal year 1996 Defense Authorization bill was
    language authorizing the implementation of a board certification pay
    for certain clinicians who are not physicians, including advanced
    practice nurses.
        AANA is highly supportive of board certification pay for all
    advanced practice nurses. The establishment of this type of pay for
    nurses recognizes that there are levels of excellence in the profession
    of nursing that should be recognized, just as in the medical
    profession. In addition, this pay may assist in closing the earnings
    gap, which may help with retention of CRNAs.
        While many CRNAs have received board certification pay, some remain
    ineligible. Since certification to practice as a CRNA does not require
    a specific master's degree, many nurse anesthetists have chosen to
    diversify their education by pursuing an advanced degree in other
    related fields. But CRNAs with master's degrees in education,
    administration, or management are not eligible for board certification
    pay since their graduate degree is not in a clinical specialty. Many
    CRNAs who have non-clinical master's degrees either chose or were
    guided by their respective services to pursue a degree other than in a
    clinical specialty. The AANA encourages DOD and the respective services
    to reexamine the issue of restricting board certification pay only to
    CRNAs who have specific clinical master's degrees.
         dod/va resource sharing: u.s. army-va joint program in nurse
                 anesthesia, fort sam houston, san antonio, tx
        The establishment of the joint U.S. Army-VA program in nurse
    anesthesia education at the U.S. Army Graduate Program in Anesthesia
    Nursing, Fort Sam Houston, in San Antonio, TX holds the promise of
    making significant improvements in the VA CRNA workforce, as well as
    improving retention of DOD registered nurses in a cost effective
    manner. The current program utilizes existing resources from both the
    Department of Veterans Affairs Employee Incentive Scholarship Program
    (EISP) and VA hospitals to fund tuition, books, and salary
    reimbursement for student registered nurse anesthetists (SRNAs). This
    joint program also serves the interests of the Army.
        This VA nurse anesthesia program started in June 2004 with three
    openings for VA registered nurses to apply to and earn a Master of
    Science in Nursing (MSN) in anesthesia granted through the University
    of Texas Houston Health Science Center. In the future, the program is
    granting degrees through the Northeastern University Bouve College of
    Health Sciences nurse anesthesia educational program in Boston, Mass.
    At a time of increased deployments in medical military personnel, this
    type of VA-DOD partnership is a cost-effective model to fill these gaps
    in the military healthcare system. At Fort Sam Houston, the VA faculty
    director has covered her Army colleagues' didactic classes when they
    are deployed at a moments notice. This benefits both the VA and the DOD
    to ensure the nurse anesthesia students are trained and certified in a
    timely manner to meet their workforce obligation to the Federal
    Government as anesthesia providers. We are pleased to note that the
    Department of Veterans' Affairs Acting Deputy Under Secretary for
    Health and the U.S. Army Surgeon General approved funding to start this
    VA nurse anesthesia school in 2004. In addition, the VA director has
    been pleased to work under the direction of the Army program director
    LTC Thomas Ceremuga, CRNA, PhD to further the continued success of this
    U.S. Army-VA partnership. With modest levels of additional funding in
    the VA EISP, this joint U.S. Army-VA nurse anesthesia education
    initiative can grow and thrive, and serve as a model for meeting other
    VA workforce needs, particularly in nursing.
                                   conclusion
        In conclusion, the AANA believes that the recruitment and retention
    of CRNAs in the armed services is of critical concern. By Congress
    supporting these efforts to recruit and retain CRNAS, the military is
    able to meet the mission to provide benefit care and deployment care--a
    mission that is unique to the military.
        The AANA would also like to thank the Surgeons General and Nurse
    Corp leadership for their support in meeting the needs of the
    profession within the military workforce. Last, we commend and thank
    this committee for their continued support for CRNAs in the military.

        Chairman Inouye. Our next witness is the legislative
    director of the National Association for Uniformed Services,
    Mr. Rick Jones.
    STATEMENT OF RICHARD A. ``RICK'' JONES, LEGISLATIVE
                DIRECTOR, NATIONAL ASSOCIATION FOR
                UNIFORMED SERVICES
        Mr. Jones. Chairman Inouye, Ranking Member Cochran, it's a
    privilege to be invited before your subcommittee.
        My association is very proud of the job our young
    generation is doing overseas. They risk their lives every day,
    and what we do for them is vital for the debt we owe them and
    the vital job they do for security.
        Mr. Chairman, quality healthcare is a strong incentive for
    a military career. My association asks that you ensure full
    funding is provided to maintain the value of the healthcare
    benefit that has been earned by these men and women who have
    served a career in our military.
        Mr. Chairman, the war on terror is fought by an
    overstretched force. There are signs of wear; simply too many
    missions and too few troops. We must increase troop strength;
    it must be resourced. We ask that you give priority to funding
    operation and maintenance accounts to reset, recapitalize, and
    renew the force.
        My association asks, also, that you maintain the Walter
    Reed facility. Its operations support and medical services
    require an uninterrupted care for those who are
    catastrophically wounded. We request that funds be in place to
    ensure that Walter Reed remain open, fully operational, fully
    functional, until the planned facilities at Bethesda and Fort
    Belvoir are in place and ready to give appropriate care to
    these young servicemen and women.
        Our wounded warriors deserve the Nation's best quality
    treatment. They earned it the hard way. With proper resources,
    we know our Nation will continue to hold the well-being of
    these troops in hand.
        Traumatic brain injury is the signature injury of the war
    overseas. We request that the subcommittee fund a full spectrum
    of traumatic brain injury care. The approach to this problem
    requires resources for hiring doctors, nurses, clinicians,
    general caregivers. And we must meet the needs of these men and
    women and their families. They have given so much for our
    Nation.
        We encourage the subcommittee to ensure funding for the
    Defense Department prosthetic research, to make sure that that
    is adequately funded. We support the Uniformed Service
    University Healthcare. That Federal school has the--provides
    medical instruction to all active duty troops who provide for
    wartime casualties, for national disasters, for emerging
    diseases. And we support the Armed Forces Retirement Home in
    Washington, DC, and in Gulfport, Mississippi.
        Mr. Chairman, regarding the supplemental, NAUS received a
    message from one of our members who wanted us to assure that we
    support a strong, timely action on the emergency supplemental.
    The bill will assure that, as our sons and daughters go into
    harm's way under the flag of the United States, they will have
    the vital wherewithal to carry out their mission. He's
    concerned, however, that when he sees not one dime, one penny,
    nor a shadow of concern is given to our military survivors, yet
    $1 billion will be spent on a program to replace older cars--
    cash for clunkers--he says he's concerned about our survivors.
        Thank you very much for the opportunity to testify.
        Chairman Inouye. Thank you very much, Director Jones.
        [The statement follows:]
                        Prepared Statement of Rick Jones
        Chairman Inouye, Ranking Member Cochran, and members of the
    Subcommittee, it is a pleasure to appear before you today to present
    the views of the National Association for Uniformed Services on the
    fiscal year 2010 Defense Appropriations Bill.
        My name is Richard ``Rick'' Jones, Legislative Director of the
    National Association for Uniformed Services (NAUS). And for the record,
    NAUS has not received any Federal grant or contract during the current
    fiscal year or during the previous 2 years in relation to any of the
    subjects discussed today.
        As you know, the National Association for Uniformed Services,
    founded in 1968, represents all ranks, branches and components of
    uniformed services personnel, their spouses and survivors. The
    Association includes all personnel of the active, retired, Reserve and
    National Guard, disabled veterans, veterans community and their
    families. We love our country, believe in a strong national defense,
    support our troops, and honor their service.
        Mr. Chairman, the first and most important responsibility of our
    government is the protection of our citizens. As we all know, we are at
    war. That is why the defense appropriations bill is so very important.
    It is critical that we provide the resources to those who fight for our
    protection and our way of life. We need to give our courageous men and
    women everything they need to prevail. And we must recognize as well
    that we must provide priority funding to keep the promises made to the
    generations of warriors whose sacrifice has paid for today's freedom.
        At the start, I want to express NAUS concern about the amount of
    our investment in our national defense. At the height of the War on
    Terror, our current defense budget represents only a little more than 4
    percent of the gross national product, as opposed to the average of 5.7
    percent of GNP in the peacetime years between 1940 and 2000.
        We cannot look the other way in a time when we face such serious
    threats. Resources are required to ensure our military is fully
    staffed, trained, and equipped to achieve victory against our enemies.
    Leaders in Congress and the administration need to balance our
    priorities and ensure our defense in a dangerous world.
        Here, I would like to make special mention of the leadership and
    contribution this panel has made in providing the resources and support
    our forces need to complete their mission. Defending the United States
    homeland and the cause of freedom means that the dangers we face must
    be confronted. And it means that the brave men and women who put on the
    uniform must have the very best training, best weapons, best care and
    wherewithal we can give them.
        The members of this important panel have taken every step to give
    our fighting men and women the funds they need, despite allocations we
    view as insufficient for our total defense needs. You have made
    difficult priority decisions that have helped defend America and taken
    special care of one of our greatest assets, namely our men and women in
    uniform.
        And the National Association for Uniformed Services is very proud
    of the job this generation of Americans is doing to defend America.
    Every day they risk their lives, half a world away from loved ones.
    Their daily sacrifice is done in today's voluntary force. What they do
    is vital to our security. And the debt we owe them is enormous.
        Our Association does, however, have some concerns about a number of
    matters. Among the major issues that we will address today is the
    provision of a proper health care for the military community and
    recognition of the funding requirements for TRICARE for retired
    military. Also, we will ask for adequate funding to improve the pay for
    members of our armed forces and to address a number of other challenges
    including TRICARE Reserve Select and the Survivor Benefit Plan.
        We also have a number of related priority concerns such as the
    diagnosis and care of troops returning with Post Traumatic Stress
    Disorder (PTSD) and Traumatic Brain Injury (TBI), the need for enhanced
    priority in the area of prosthetics research, and providing improved
    seamless transition for returning troops between the Department of
    Defense (DOD) and the Department of Veterans Affairs (VA). In addition,
    we would like to ensure that adequate funds are provided to defeat
    injuries from the enemy's use of Improvised Explosive Devices (IEDs).
               tricare and military quality of life: health care
        Quality health care is a strong incentive to make military service
    a career. The provision of quality, timely care is considered one of
    the most important benefits afforded the career military. The TRICARE
    benefit, earned through a career of service in the uniformed services,
    reflects the commitment of a Nation, and it deserves your wholehearted
    support.
        It should also be recognized that discussions have once again begun
    on increasing the retiree-paid costs of TRICARE earned by military
    retirees and their families. We remember the outrageous statement of
    Dr. Gail Wilensky, a co-chair of the Task Force on the Future of
    Military, calling congressional passage of TRICARE for Life ``a big
    mistake.''
        And more recently, we heard Admiral Mike Mullen, the current
    Chairman of Joint Chiefs of Staff, call for an increase in TRICARE
    fees. Mullen said, ``It's a given as far as I'm concerned.''
        Fortunately, President Obama has taken fee increases off the table
    this year in the administration budget recommendation. However, with
    comments like these from those in leadership positions, there is little
    wonder that retirees and active duty personnel are upset.
        Seldom has NAUS seen such a lowing in confidence about the
    direction of those who manage the program. Faith in our leadership
    continues, but it is a weakening faith. And unless something changes,
    it is bound to affect recruiting and retention.
        criminal activity costs medicare and tricare billions of dollars
        Recent testimony and studies from the Government Accountability
    Office (GAO), the investigative arm of the United States Congress,
    shows us that at least $80 billion worth of Medicare money is being
    ripped off every year. Frankly, it demonstrates that criminal activity
    costs Medicare and TRICARE billions of dollars.
        Here are a couple of examples. GAO reports that one company billed
    Medicare for $170 million for HIV drugs. In truth, the company
    dispensed less than a million dollars. In addition, the company billed
    $142 million for nonexistent delivery of supplies and parts and medical
    equipment.
        In another example, fake Medicare providers billed Medicare for
    prosthetic arms on people who already have two arms. The fraud amounted
    to $1.4 billion of bills for people who do not need prosthetics.
        TRICARE is closely tied to Medicare and its operations are not
    immune. According to Rose Sabo, Director of the TRICARE Program
    Integrity Office, the Government Accountability Office says that 10
    percent of all health care expenditures are fraudulent. With a military
    health system annual cost of $47 billion, fraudulent purchase of care
    in the military health system would amount to $4.7 billion.
        Last year a Philippine corporation was ordered to pay back more
    than $100 million following a TRICARE fraud conviction. But despite
    TRICARE efforts to uncover this type of criminal activity, money
    continues to go out the door with insufficient resources dedicated to
    its recovery.
        Regarding TRICARE efforts to uncover fraud problems, it should be
    noted that documents by the Department of Defense Inspector General
    (DODIG) reported the fraud as early as 1998 to TRICARE Management
    Activity (TMA). But it wasn't until 2005 that TMA stopped paying the
    fraudulent claims reported 7 years earlier by DODIG.
        NAUS urges the Subcommittee to challenge DOD and TRICARE
    authorities to put some guts behind efforts to drive fraud down and out
    of the system. If left unchecked, fraud will increasingly strip away
    resources from government programs like TRICARE. And unless Congress
    directs the administration to take action, you know who will be left in
    the breach, holding the bag--the law abiding retiree and family.
        We recently learned of an incident of clear outright healthcare
    fraud involving a Medicare/TRICARE provider. The patient was a member
    of a veterans-related survivor organization and a TRICARE for Life
    beneficiary. She went to visit a doctor for the first time but was not
    content with the provider so she did not see him again. But bills
    against TRICARE continued to roll in for visits and services that were
    never provided. The beneficiary reported this suspicious activity to
    the TRICARE Management Activity. TRICARE officials were reticent to
    talk to the individual when she called them again to report additional
    fraudulent bills. When the individual's survivor organization became
    involved, it was told by TRICARE not to worry about the billings
    because the bogus charges only added up to about $2,500, which fell
    below the level of investigative action. The TMA rational is
    troublesome on many levels. It is, of course, quite possible that the
    same doctor charged TRICARE for the ``care'' of other patients.
        A fair portion of the cost of controlling Medicare and TRICARE
    fraud can be directly attributed to the detection of it. In this
    instance, a beneficiary attempted to perform her civic duty by
    ``sounding the alarm'' only to be ignored by the agency that claims to
    be committed to preventing, identifying, and assisting in the
    prosecution of healthcare fraud, not only to save valuable benefit
    dollars but also to ensure that eligible beneficiaries receive
    appropriate medical care. Deceitful schemes can adversely impact the
    quality of the care received. NAUS believes that criminal activity
    should be identified and prosecuted to the fullest extent of the law,
    whether it is for $2,500 or $250,000.
        America expects its government to move courageously and tackle the
    real problems of issues like fraud in the TRICARE system and the
    Medicare system. The government should direct and resource its
    investigative teams to root out criminal activity, rather than looking
    to take money out of the pockets of military retirees. With hard work
    and honest public service, we are confident Congress will have more
    than enough money to pay for earned benefits like TRICARE.
        The National Association for Uniformed Services urges increased
    funding for the Defense Criminal Investigative Service (DCIS), the
    criminal investigative arm of the DOD Inspector General, and for the
    TRICARE Program Integrity Office, responsible for anti-fraud activity
    in the military health system.
        We urge the Subcommittee to take the actions necessary for honoring
    our obligation to those men and women who have worn the Nation's
    military uniform. Root out the corruption, fraud and waste. And confirm
    America's solemn, moral obligation to support our troops, our military
    retirees, and their families. They have kept their promise to our
    Nation, now it's time for us to keep our promise to them.
                         military quality of life: pay
        For fiscal year 2010, the administration recommends a 2.9 percent
    across-the-board pay increase for members of the Armed Forces. The
    proposal is designed, according to the Pentagon, to keep military pay
    in line with civilian wage growth.
        The National Association for Uniformed Services calls on you to put
    our troops and their families first. Our forces are stretched thin, at
    war, yet getting the job done. We ask you to express the Nation's
    gratitude for their critical service, increase basic pay and drill pay
    one-half percent above the administration's request to 3.4 percent.
        Congress and the administration have done a good job over the
    recent past to narrow the gap between civilian-sector and military pay.
    The differential, which was as great as 14 percent in the late 1990s,
    has been reduced to just under 4 percent with the January 2009 pay
    increase.
        However, we can do better than simply maintaining a rough measure
    of comparability with the civilian wage scale. To help retention of
    experience and entice recruitment, the pay differential is important.
    We have made significant strides. But we are still below the private
    sector.
        In addition, we urge the appropriations panel to never lose sight
    of the fact that our DOD manpower policy needs a compensation package
    that is reasonable and competitive. Bonuses have a role in this area.
    Bonuses for instance can pull people into special jobs that help supply
    our manpower for critical assets, and they can also entice ``old
    hands'' to come back into the game with their skills.
        The National Association for Uniformed Services asks you to do all
    you can to fully compensate these brave men and women for being in
    harm's way, we should clearly recognize the risks they face and make
    every effort to appropriately compensate them for the job they do.
             military quality of life: basic allowance for housing
        The National Association for Uniformed Services strongly supports
    revised housing standards within the Basic Allowance for Housing (BAH).
    We are most grateful for the congressional actions reducing out-of-
    pocket housing expenses for servicemembers over the last several years.
    Despite the many advances made, many enlisted personnel continue to
    face steep challenge in providing themselves and their families with
    affordable off-base housing and utility expenses. BAH provisions must
    ensure that rates keep pace with housing costs in communities where
    military members serve and reside. Efforts to better align actual
    housing rates can reduce unnecessary stress and help those who serve
    better focus on the job at hand, rather than the struggle with meeting
    housing costs for their families.
               military quality of life: family housing accounts
        The National Association for Uniformed Services urges the
    Subcommittee to provide adequate funding for military construction and
    family housing accounts used by DOD to provide our service members and
    their families quality housing. The funds for base allowance and
    housing should ensure that those serving our country are able to afford
    to live in quality housing whether on or off the base. The current
    program to upgrade military housing by privatizing Defense housing
    stock is working well. We encourage continued oversight in this area to
    ensure joint military-developer activity continues to improve housing
    options. Clearly, we need to be particularly alert to this challenge as
    we implement BRAC and related rebasing changes.
        The National Association for Uniformed Services also asks special
    provision be granted the National Guard and Reserve for planning and
    design in the upgrade of facilities. Since the terrorist attacks of
    Sept. 11, 2001, our Guardsmen and reservists have witnessed an upward
    spiral in the rate of deployment and mobilization. The mission has
    clearly changed, and we must recognize they account for an increasing
    role in our national defense and homeland security responsibilities.
    The challenge to help them keep pace is an obligation we owe for their
    vital service.
                         increase force readiness funds
        The readiness of our forces is in decline. The long war fought by
    an overstretched force tells us one thing: there are simply too many
    missions and too few troops. Extended and repeated deployments are
    taking a human toll. Back-to-back deployments means, in practical
    terms, that our troops face unrealistic demands. To sustain the service
    we must recognize that an increase in troop strength is needed and it
    must be resourced.
        In addition, we ask you to give priority to funding for the
    operations and maintenance accounts where money is secured to reset,
    recapitalize and renew the force. The National Guard, for example, has
    virtually depleted its equipment inventory, causing rising concern
    about its capacity to respond to disasters at home or to train for its
    missions abroad.
        The deficiencies in the equipment available for the National Guard
    to respond to such disasters include sufficient levels of trucks,
    tractors, communication, and miscellaneous equipment. If we have
    another overwhelming storm, hurricane or, God forbid, a large-scale
    terrorist attack, our National Guard is not going to have the basic
    level of resources to do the job right.
                        walter reed army medical center
        Another matter of great interest to our members is the plan to
    realign and consolidate military health facilities in the National
    Capital Region. The proposed plan includes the realignment of all
    highly specialized and sophisticated medical services currently located
    at Walter Reed Army Medical Center in Washington, DC, to the National
    Naval Medical Center in Bethesda, MD, and the closing of the existing
    Walter Reed by 2011.
        While we herald the renewed review of the adequacy of our hospital
    facilities and the care and treatment of our wounded warriors that
    result from last year's news reports of deteriorating conditions at
    Walter Reed Army Medical Center, the National Association for Uniformed
    Services believes that Congress must continue to provide adequate
    resources for WRAMC to maintain its base operations' support and
    medical services that are required for uninterrupted care of our
    catastrophically wounded soldiers and marines as they move through this
    premier medical center.
        We request that funds be in place to ensure that Walter Reed
    remains open, fully operational and fully functional, until the planned
    facilities at Bethesda or Fort Belvoir are in place and ready to give
    appropriate care and treatment to the men and women wounded in armed
    service.
        Our wounded warriors deserve our Nation's best, most compassionate
    healthcare and quality treatment system. They earned it the hard way.
    And with application of the proper resources, we know the Nation will
    continue to hold the well-being of soldiers and their families as our
    number one priority.
       department of defense, seamless transition between the dod and va
        The development of electronic medical records remains a major goal.
    It is our view that providing a seamless transition for recently
    discharged military is especially important for servicemembers leaving
    the military for medical reasons related to combat, particularly for
    the most severely injured patients.
        The National Association for Uniformed Services is pleased to
    receive the support of President Obama and the forward movement of
    Secretaries Gates and Shinseki toward this long-supported goal of
    providing a comprehensive e-health record.
        The National Association for Uniformed Services calls on the
    appropriations committee to continue the push for DOD and VA to follow
    through on establishing a bi-directional, interoperable electronic
    medical record. Since 1982, these two departments have been working on
    sharing critical medical records, yet to date neither has effectively
    come together in coordination with the other.
        The time for foot dragging is over. Taking care of soldiers,
    sailors, airmen, and marines is a national obligation, and doing it
    right sends a strong signal to those currently in military service as
    well as to those thinking about joining the military.
        DOD must be directed to adopt electronic architecture including
    software, data standards, and data repositories that are compatible
    with the system used at the Department of Veterans Affairs. It makes
    absolute sense and it would lower costs for both organizations.
        If our seriously wounded troops are to receive the care they
    deserve, the departments must do what is necessary to establish a
    system that allows seamless transition of medical records. It is
    essential if our Nation is to ensure that all troops receive timely,
    quality health care and other benefits earned in military service.
        To improve the DOD/VA exchange, the hand-off should include a
    detailed history of care provided and an assessment of what each
    patient may require in the future, including mental health services. No
    veteran leaving military service should fall through the bureaucratic
    cracks.
                      defense department force protection
        The National Association for Uniformed Services urges the
    Subcommittee to provide adequate funding to rapidly deploy and acquire
    the full range of force protection capabilities for deployed forces.
    This would include resources for up-armored high mobility multipurpose
    wheeled vehicles and add-on ballistic protection to provide force
    protection for soldiers in Iraq and Afghanistan, ensure increased
    activity for joint research and treatment effort to treat combat blast
    injuries resulting from improvised explosive devices (IEDs), rocket
    propelled grenades, and other attacks; and facilitate the early
    deployment of new technology, equipment, and tactics to counter the
    threat of IEDs.
        We ask special consideration be given to counter IEDs, defined as
    makeshift or ``homemade'' bombs, often used by enemy forces to destroy
    military convoys and currently the leading cause of casualties to
    troops deployed in Iraq. These devices are the weapon of choice and,
    unfortunately, a very efficient weapon used by our enemy. The Joint
    Improvised Explosive Device Defeat Organization (JIEDDO) is established
    to coordinate efforts that would help eliminate the threat posed by
    these IEDs. We urge efforts to advance investment in technology to
    counteract radio-controlled devices used to detonate these killers.
    Maintaining support is required to stay ahead of our enemy and to
    decrease casualties caused by IEDs.
                 defense health program--tricare reserve select
        Mr. Chairman, another area that requires attention is reservist
    participation in TRICARE. As we are all aware, National Guard and
    Reserve personnel have seen an upward spiral of mobilization and
    deployment since the terrorist attacks of Sept. 11, 2001. The mission
    has changed and with it our reliance on these forces has risen.
    Congress has recognized these changes and begun to update and upgrade
    protections and benefits for those called away from family, home, and
    employment to active duty. We urge your commitment to these troops to
    ensure that the long overdue changes made in the provision of their
    heath care and related benefits is adequately resourced. We are one
    force, all bearing a critical share of the load.
                   department of defense, prosthetic research
        Clearly, care for our troops with limb loss is a matter of national
    concern. The global war on terrorism in Iraq and Afghanistan has
    produced wounded soldiers with multiple amputations and limb loss who
    in previous conflicts would have died from their injuries. Improved
    body armor and better advances in battlefield medicine reduce the
    number of fatalities, however injured soldiers are coming back
    oftentimes with severe, devastating physical losses.
        In order to help meet the challenge, Defense Department research
    must be adequately funded to continue its critical focus on treatment
    of troops surviving this war with grievous injuries. The research
    program also requires funding for continued development of advanced
    prosthesis that will focus on the use of prosthetics with
    microprocessors that will perform more like the natural limb.
        The National Association for Uniformed Services encourages the
    Subcommittee to ensure that funding for Defense Department's prosthetic
    research is adequate to support the full range of programs needed to
    meet current and future health challenges facing wounded veterans. To
    meet the situation, the Subcommittee needs to focus a substantial,
    dedicated funding stream on Defense Department research to address the
    care needs of a growing number of casualties who require specialized
    treatment and rehabilitation that result from their armed service.
        We would also like to see better coordination between the
    Department of Defense Advanced Research Projects Agency and the
    Department of Veterans Affairs in the development of prosthetics that
    are readily adaptable to aid amputees.
     post traumatic stress disorder (ptsd) and traumatic brain injury (tbi)
        The National Association for Uniformed Services supports a higher
    priority on Defense Department care of troops demonstrating symptoms of
    mental health disorders and traumatic brain injury.
        It is said that Traumatic Brain Injury (TBI) is the signature
    injury of the Iraq war. Blast injuries often cause permanent damage to
    brain tissue. Veterans with severe TBI will require extensive
    rehabilitation and medical and clinical support, including neurological
    and psychiatric services with physical and psycho-social therapies.
        We call on the Subcommittee to fund a full spectrum of TBI care and
    to recognize that care is also needed for patients suffering from mild
    to moderate brain injuries, as well. The approach to this problem
    requires resources for hiring caseworkers, doctors, nurses, clinicians,
    and general caregivers if we are to meet the needs of these men and
    women and their families.
        The mental condition known as Post Traumatic Stress Disorder (PTSD)
    has been well known for over a hundred years under an assortment of
    different names. For example more than 60 years ago, Army psychiatrists
    reported, ``That each moment of combat imposes a strain so great that .
    . . psychiatric casualties are as inevitable as gunshot and shrapnel
    wounds in warfare.''
        PTSD is a serious psychiatric disorder. While the government has
    demonstrated over the past several years a higher level of attention to
    those military personnel who exhibit PTSD symptoms, more should be done
    to assist service members found to be at risk.
        Pre-deployment and post-deployment medicine is very important. Our
    legacy of the Gulf War demonstrates the concept that we need to
    understand the health of our service members as a continuum, from pre-
    to post-deployment.
        The National Association for Uniformed Services applauds the extent
    of help provided by the Defense Department, however we encourage that
    more resources be made available to assist. Early recognition of the
    symptoms and proactive programs are essential to help many of those who
    must deal with the debilitating effects of mental injuries, as
    inevitable in combat as gunshot and shrapnel wounds.
        We encourage the Members of the Subcommittee to provide for these
    funds and to closely monitor their expenditure and to see they are not
    redirected to other areas of defense spending.
                          armed forces retirement home
        The National Association for Uniformed Services encourages the
    Subcommittee's continued interest in providing funds for the Armed
    Forces Retirement Home (AFRH).
        We urge the Subcommittee to continue its help in providing adequate
    funding to alleviate the strains on the Washington home. Also, we
    remain concerned about the future of the Gulfport home, so we urge your
    continued close oversight on its re-construction. And we thank the
    subcommittee for the construction of a new Armed Forces Retirement Home
    at its present location in Gulfport.
        The National Association for Uniformed Services also asks the
    Subcommittee to closely review administration plans to sell great
    portions of the Washington AFRH to developers. The AFRH home is a
    historic national treasure, and we thank Congress for its oversight of
    this gentle program and its work to provide for a world-class quality-
    of-life support system for these deserving veterans.
       improved medicine with less cost at military treatment facilities
        The National Association for Uniformed Services is also seriously
    concerned over the consistent push to have Military Health System
    beneficiaries age of 65 and over moved into the civilian sector from
    military care. That is a very serious problem for the Graduate Medical
    Education (GME) programs in the MHS; the patients over 65 are required
    for sound GME programs, which, in turn, ensure that the military can
    retain the appropriate number of physicians who are board certified in
    their specialties.
        TRICARE/HA policies are pushing out those patients not on active
    duty into the private sector where the cost per patient is at least
    twice as expensive as that provided within Military Treatment
    Facilities (MTFs). We understand that there are many retirees and their
    families who must use the private sector due to the distance from the
    closest MTF; however, where possible, it is best for the patients
    themselves, GME, medical readiness, and the minimizing the cost of
    TRICARE premiums if as many non-active duty beneficiaries are taken
    care of within the MTFs. As more and more MHS beneficiaries are pushed
    into the private sector, the cost of the MHS rises. The MHS can provide
    better medicine, more appreciated service and do it at improved medical
    readiness and less cost to the taxpayers.
              uniformed services university of the health sciences
        As you know, the Uniformed Services University of the Health
    Sciences (USUHS) is the Nation's Federal school of medicine and
    graduate school of nursing. The medical students are all active-duty
    uniformed officers in the Army, Navy, Air Force, and U.S. Public Health
    Service who are being educated to deal with wartime casualties,
    national disasters, emerging diseases, and other public health
    emergencies.
        The National Association for Uniformed Services supports the USUHS
    and requests adequate funding be provided to ensure continued
    accredited training, especially in the area of chemical, biological,
    radiological, and nuclear response. In this regard, it is our
    understanding that USUHS requires funding for training and educational
    focus on biological threats and incidents for military, civilian,
    uniformed first responders, and healthcare providers across the Nation.
                    joint pow/mia accounting command (jpac)
        We also want the fullest accounting of our missing servicemen and
    ask for your support in DOD dedicated efforts to find and identify
    remains. It is a duty we owe to the families of those still missing as
    well as to those who served or who currently serve. And as President
    Bush said, ``It is a signal that those who wear our country's military
    uniform will never be abandoned.''
        In recent years, funding for the Joint POW/MIA Accounting Command
    (JPAC) has fallen short, forcing the agency to scale back and even
    cancel many of its investigative and recovery operations. NAUS supports
    the fullest possible accounting of our missing servicemen. It is a duty
    we owe the families, to ensure that those who wear our country's
    uniform are never abandoned. We request that appropriate funds be
    provided to support the JPAC mission for fiscal year 2010.
                  appreciation for the opportunity to testify
        As a staunch advocate for our uniformed service men and women, the
    National Association for Uniformed Services recognizes that these brave
    men and women did not fail us in their service to country, and we, in
    turn, must not fail them in providing the benefits and services they
    earned through honorable military service.
        Mr. Chairman, the National Association for Uniformed Services
    appreciates the Subcommittee's hard work. We ask that you continue to
    work in good faith to put the dollars where they are most needed: in
    strengthening our national defense, ensuring troop protection,
    compensating those who serve, providing for DOD medical services
    including TRICARE, and building adequate housing for military troops
    and their families, and in the related defense matters discussed today.
    These are some of our Nation's highest priority needs and we ask that
    they be given the level of attention they deserve.
        The National Association for Uniformed Services is confident you
    will take special care of our Nation's greatest assets: the men and
    women who serve and have served in uniform. We are proud of the service
    they give to America every day. They are vital to our defense and
    national security. The price we pay as a Nation for their earned
    benefits is a continuing cost of war, and it will never cost more nor
    equal the value of their service.
        We thank you for your efforts, your hard work. And we look forward
    to working with you to ensure we continue to provide sufficient
    resources to protect the earned benefits for those giving military
    service to America every day.
        Again, the National Association for Uniformed Services deeply
    appreciates the opportunity to present the Association's views on the
    issues before the Defense Appropriations Subcommittee.

        Chairman Inouye. Our next witness represents the Ovarian
    Cancer National Alliance, Ms. Cara Tenenbaum.
    STATEMENT OF CARA TENENBAUM, SENIOR POLICY DIRECTOR,
                OVARIAN CANCER NATIONAL ALLIANCE
        Ms. Tenenbaum. Good morning, Mr. Chairman, Vice Chairman. I
    want to thank you and all the members of the subcommittee for
    the opportunity to testify today. I'm here to talk about the
    Department of Defense's Ovarian Cancer Research Program, one of
    the congressionally directed medical research programs.
        For more than 10 years, the Ovarian Cancer National
    Alliance has worked with you to fund groundbreaking research
    that will help women diagnosed with, and women at high risk
    for, ovarian cancer. The ovarian cancer community is so
    grateful for the money you've appropriated in the past and last
    year, and we respectfully request further funding for this
    year, fiscal year 2010.
        Simply put, the ovarian cancer research program's mission
    is to eliminate ovarian cancer. It's the only Federal research
    program with that mission, conquering the disease. Of course,
    that's a complicated effort. It requires understanding the
    cause of the disease, its development, how the disease spreads,
    and recurrence.
        The Ovarian Cancer Research Program has a two-tiered peer-
    review system that chooses the best potential research. Much of
    this research has been published, patented, granted further
    Federal funding by the National Cancer Institute, and/or gone
    into commercial development.
        Ovarian cancer is rarely diagnosed in early stages, when
    survival is best. There is no reliable early-detection test,
    but the Ovarian Cancer Research Program has made progress on
    this front. There is one early-detection test that's currently
    looking at commercialization--it's a urine biomarker test--and
    another you may have read about in the newspaper, the cancer-
    sniffing dogs.
        The Ovarian Cancer Research Program has also developed two
    working models--animal models of ovarian cancer--for ovarian
    cancer: the mouse model, which is commonly used in research,
    but also the chicken model, which is the only other known
    animal to get ovarian cancer.
        I'm here, not only as an employee of the Ovarian Cancer
    National Alliance, but as someone with a personal interest in
    ovarian cancer. I'm an Ashkenazi Jew, my family is from Eastern
    Europe, and I have a strong family history of cancer. My
    mother, a breast cancer survivor, is here with me. And I know
    that I'm at high risk for both breast cancer and ovarian
    cancer. Because there is no early-detection test, I know that
    I, and so many other women, have to remain vigilant about our
    health.
        I'm here, and I'm honored to be here, on behalf of the
    ovarian cancer community. And I ask, on behalf of all of these
    daughters, mothers, and sisters, like my own--my sister is also
    here--that you continue to support the Ovarian Cancer Research
    Program, so that we all have a better chance at detecting
    ovarian cancer early. We ask you to continue supporting the
    Ovarian Cancer Research Program's mission to eliminate this
    deadly disease.
        Thank you for your time.
        Chairman Inouye. All right. Thank you very much, Ms.
    Tenenbaum.
        [The statement follows:]
                      Prepared Statement of Cara Tenenbaum
        Mr. Chairman, Ranking Member, and Members of the Committee, thank
    you for the opportunity to testify before you today about the
    Department of Defense's Ovarian Cancer Research Program, one of the
    Congressionally Directed Medical Research Programs.
        My name is Cara Tenenbaum, and I'm the Senior Policy Director at
    the Ovarian Cancer National Alliance. For more than 10 years, we have
    worked with you to fund ground breaking research that will help women
    diagnosed with, and women at high risk for, ovarian cancer. The ovarian
    cancer community is so grateful for the $20 million you appropriated to
    the Ovarian Cancer Research Program for fiscal year 2009. This year we
    respectfully request $30 million for this program.
        Simply put, the Ovarian Cancer Research Program's mission is to
    eliminate ovarian cancer. It is the only Federal research program that
    seeks to conquer this disease, rather than explore it. Of course,
    conquering ovarian cancer is a complicated effort that requires
    understanding the causes of the disease, its development, how it
    spreads and recurrence. The Ovarian Cancer Research Program has a two
    tiered peer review system that chooses the best potential research.
    Much of this research has been published, patented, granted further
    Federal funding by the National Cancer Institute and/or gone into
    commercial development.
        Ovarian cancer is rarely diagnosed in the early stages when
    survival is best. There is no reliable early detection test, which is
    an urgent priority for the ovarian cancer community. The Ovarian Cancer
    Research Program has funded two early detection tests that are in
    development: one in progress is the discovery and commercialization of
    a urine biomarker test; the second is a breath test, which you may have
    read about in the popular press under headlines like ``Cancer Sniffing
    Dogs.''
        The Ovarian Cancer Research Program has also developed working
    animal models of ovarian cancer: the mouse model, which is commonly
    used in medical research; and the chicken model, which is the only
    other animal known to get ovarian cancer.
        What makes this program unique is not just its use of ovarian
    cancer survivors as patient reviewers, and its transparency and low
    overhead, but the numerous grant mechanisms that provide a flexible
    model that funds innovative research.
        I am here, not only as an employee of the Ovarian Cancer National
    Alliance, but as someone with a personal interest in ovarian cancer. As
    an Ashkenazi Jew with a strong family history of cancer--my mother, a
    breast cancer survivor is here with me--I know that I am at high risk
    for both breast and ovarian cancer. As there is no reliable early
    detection test for ovarian cancer, I, like so many others, have to rely
    on my own vigilance for early detection of ovarian cancer.
        As a single woman who hopes to have children one day, I'm not ready
    for prophylactic surgery, although many of the patients I speak with
    have urged me to consider it. I am not even interested in genetic
    testing at this point, because without any action steps, I'm left with
    more worry than solutions. And so, on behalf of the millions of
    daughters, mothers, and sisters, like my own who has joined me here, I
    ask that you continue to support funding the Ovarian Cancer Research
    Program so that we all have a better chance of detecting ovarian cancer
    early, fighting it with better treatments and fulfilling the Ovarian
    Cancer Research Program's mission to eliminate this deadly disease.
        I am honored to be here representing the ovarian cancer community
    in respectfully requesting that Congress provide $30 million for the
    Ovarian Cancer Research Program (OCRP) in fiscal year 2010 as part of
    the Federal Government's investment in the Department of Defense's
    Congressionally Directed Medical Research Programs (CDMRP).
                      the ovarian cancer research program
        The Ovarian Cancer Research Program was created in 1997 to address
    a lack of ovarian cancer research, which remains the deadliest
    gynecologic cancer. The program uses a two tier peer review system,
    including patient advocates in both levels of review. Reviews are made
    not only on scientific rigor, but on the impact the proposed research
    will have on the disease and patients.
        To date, accomplishments reported by awardees include 371
    publications, 431 abstracts/presentations, and 15 patents applied for/
    obtained. The Ovarian Cancer Research Program meets each year to
    evaluate the science and determine funding priorities for the upcoming
    year. This flexibility, along with input from patient advocates and
    leading researchers, allows the Ovarian Cancer Research Program to fill
    current research gaps. Much of the research funded by the Ovarian
    Cancer Research Program continues to get larger grants from this seed
    money, including four Ovarian Cancer Specialized Programs of Research
    Excellence (SPORES) funded by the National Cancer Institute.
        The program provides awards in the following categories:
    Collaborative Translational Research Award, Consortium Development
    Award, Idea Development Award, Ovarian Cancer Academy Award, Career
    Development Award, Translational Research Partnership Award,
    Historically Black Colleges and Universities/Minority Institution
    Collaborative Research Awards, Pilot Awards, and the New Investigator
    Research Award. From 1997 to 2009 more than $140 million has been
    awarded through these mechanisms.
        In fiscal year 2009 alone:
      --A New Investigator Award funded a research project using
            immunotherapy, rather than chemotherapy or surgery, to fight
            tumors;
      --An Idea Development award funded a research project on biomarkers,
            including the discovery of a biomarker that is elevated 3 years
            prior to clinical diagnosis of ovarian cancer;
      --An Idea Development award to explore the use of a new drug as a
            single agent and in combination with existing chemotherapy
            regimens to shrink tumors;
      --An Idea Development Award to fund preclinical studies of DNA
            therapies that induce ovarian cancer cell death without any
            toxicity to normal cells;
      --Phase II research in angiogenisis inhibitors, which stop new blood
            vessels from forming in a tumor.
                       ovarian cancer's deadly statistics
        According to the American Cancer Society, in 2009, more than 21,000
    American women will be diagnosed with ovarian cancer, and more than
    15,000 will lose their lives to this terrible disease. Ovarian cancer
    is the fifth leading cause of cancer death in women. Currently, more
    than half of the women diagnosed with ovarian cancer will die within 5
    years. When detected early, the 5-year survival rate increases to more
    than 90 percent, but when detected in the late stages, the 5-year
    survival rate drops to less than 29 percent.
        In the more than 30 years since the War on Cancer was declared,
    ovarian cancer mortality rates have not significantly improved. A valid
    and reliable screening test--a critical tool for improving early
    diagnosis and survival rates--still does not exist for ovarian cancer.
    Behind the sobering statistics are the lost lives of our loved ones,
    colleagues, and community members. While we have been waiting for the
    development of an effective early detection test, thousands of our
    wives, mothers, daughters, and sisters have lost their battle with
    ovarian cancer.
        More than three-quarters of women diagnosed with ovarian cancer
    will have at least one recurrence. These recurrences may indicate that
    the tumor cells are no longer responsive to some therapies, leaving
    women with fewer treatment options. The Ovarian Cancer Research Program
    spends almost 20 percent of its grant money studying recurrence. Almost
    a third is spent on understanding ovarian cancer cell biology,
    genetics, and molecular biology, areas that we hope will lead to a more
    reliable early detection test.
        In 2007, a number of prominent cancer organizations released a
    consensus statement identifying the early warning symptoms of ovarian
    cancer. Without a reliable diagnostic test, we can rely only on this
    set of vague symptoms of a deadly disease, and trust that both women
    and the medical community will identify these symptoms and act promptly
    and quickly. Unfortunately, we know that this does not always happen.
    Too many women are diagnosed late due to the lack of a test; too many
    women and their families endure life-threatening and debilitating
    treatments to kill cancer; too many women are lost to this horrible
    disease.
                                    summary
        The Ovarian Cancer National Alliance has made commitments to work
    with Congress, the Administration, and other policymakers and
    stakeholders to improve the survival rate from ovarian cancer through
    education, public policy, research, and communication. Please know that
    we appreciate and understand that our Nation faces many challenges and
    that Congress has limited resources to allocate; however, we are
    concerned that without increased funding to bolster and expand ovarian
    cancer research efforts, the Nation will continue to see growing
    numbers of women losing their battle with this terrible disease.
        On behalf of the entire ovarian cancer community--patients, family
    members, clinicians, and researchers--we thank you for your leadership
    and support of Federal programs that seek to reduce and prevent
    suffering from ovarian cancer. Thank you in advance for your support of
    $30 million in fiscal year 2010 funding for the Ovarian Cancer Research
    Program.

        Chairman Inouye. You know, I just can't resist this
    temptation but if you'll forgive me, the Ovarian Cancer
    Treatment Program and the Breast Cancer Treatment Program are
    earmarks. They were not suggested by the administration or by
    experts. The Congress did that. And today we're being condemned
    for earmarks. But----
        The next witness represents the Reserve Officers
    Association, Colonel William Holahan.
    STATEMENT OF COLONEL WILLIAM HOLAHAN, UNITED STATES
                MARINE CORPS (RET.), DIRECTOR, MEMBER
                SERVICES, RESERVE OFFICERS ASSOCIATION OF
                THE UNITED STATES
        Colonel Holahan. Mr. Chairman, Senator Cochran, we ask the
    subcommittee that our submitted written testimony, particularly
    with regard to the unfunded equipment and priorities of those
    Reserve components noted therein, be accepted for the record.
        Chairman Inouye. It will be made part of the record.
        Colonel Holahan. Thank you for the opportunity to speak
    once again on the issue of funding for our Nation's Reserve
    components.
        Today the United States cannot conduct extended military
    operations without the augmentation and reinforcement of its
    active component. That reinforcement must come from one of two
    sources: a draft, or the National Guard and Reserve.
        The 700,000 men and women of our Nation's Reserve
    components have provided that reinforcing and augmenting force
    since 2001. They have saved the country from a draft. Every
    indication I see and hear is that they can and will continue to
    do so, if they are properly trained, equipped, and supported.
    The Congress has made great strides in increasing the funding
    for these important needs, but realism demands that we
    recognize the armed services frequently push the needs of their
    Reserve components to a lower priority in times when funding is
    tight.
        The Reserve Officers Association--and I have been
    authorized to speak on this subject for the Reserve Enlisted
    Association, as well--urges this subcommittee to specifically
    identify appropriations for resetting of both the National
    Guard and the Reserve, such that it must be spent to train and
    re-equip the Reserve components for both their homeland defense
    mission and any overseas contingency operations that they may
    be assigned.
        Each Reserve component has shared with ROA that there is a
    continued problem of tracking equipment specifically
    appropriated to the Reserves from manufacturers to a service's
    Reserve component. Frustrations continue with the belief that
    the active component either pushes out Reserve items during
    production, or actually redirects equipment in distribution
    channels before it reaches their reserve.
        At the end of the day, the Nation wants an All-Volunteer
    Force, and it does not want a draft. The only way to achieve
    both of these objectives is to ensure that the Reserve and the
    National Guard continue to be filled with the same type of
    great American patriots who serve, today. To do that, you must
    ensure that they are fully trained, properly re-equipped, and
    that their families are adequately supported. And you ensure
    that your appropriations get where you intend that they go.
        Thank you for your consideration.
        Chairman Inouye. Thank you very much, Colonel Holahan.
        [The statement follows:]
                     Prepared Statement of William Holahan
                                   priorities
        CY 2009 Legislative Priorities are:
        Providing adequate resources and authorities to support the current
    recruiting and retention requirements of the Reserves and National
    Guard.
        Reset the whole force to include fully funding equipment and
    training for the National Guard and Reserves.
        Support citizen warriors, families and survivors.
        Assure that the Reserve and National Guard continue in a key
    national defense role, both at home and abroad.
    Issues To Help Fund, Equip, and Train
        Advocate for adequate funding to maintain National Defense during
    overseas contingency operations.
        Regenerate the Reserve Components (RC) with field compatible
    equipment.
        Fence RC dollars for appropriated Reserve equipment.
        Fully fund Military Pay Appropriation to guarantee a minimum of 48
    drills and 2 weeks training.
        Sustain authorization and appropriation to National Guard and
    Reserve Equipment Account (NGREA) to permit flexibility for Reserve
    Chiefs in support of mission and readiness needs.
        Optimize funding for additional training, preparation and
    operational support.
        Keep Active and Reserve personnel and Operation & Maintenance
    funding separate.
        Equip Reserve Component members with equivalent personnel
    protection as Active Duty.
    Issues To Assist Recruiting and Retention
        Support continued incentives for affiliation, reenlistment,
    retention and continuation in the Reserve Component.
                Pay and Compensation
        Provide permanent differential pay for Federal employees.
        Offer Professional pay for RC medical professionals.
        Eliminate the 1/30th rule for Aviation Career Incentive Pay, Career
    Enlisted Flyers Incentive Pay, Diving Special Duty Pay, and Hazardous
    Duty Incentive Pay.
                Education
        Continued funding for the GI Bill for the 21st Century.
                Health Care
        Provide Medical and Dental Readiness through subsidized preventive
    health care.
        Extend military coverage for restorative dental care for up to 180
    days following deployment.
                Spouse Support
        Repeal the SBP-Dependency Indemnity Clause (DIC) offset.
            national guard & reserve equipment & personnel accounts
        It is important to maintain separate equipment and personnel
    accounts to allow Reserve Component Chiefs the ability to direct
    dollars to needs.
    Key Issues Facing the Armed Forces Concerning Equipment
        Developing the best equipment for troops fighting in overseas
    contingency operations.
        Procuring new equipment for all U.S. Forces.
        Maintaining or upgrading the equipment already in the inventory.
        Replacing the equipment deployed from the homeland to the war.
        Making sure new and renewed equipment gets into the right hands,
    including the Reserve Component.
    Reserve Component Equipping Sources
        Procurement.
        Cascading of equipment from Active Component.
        Cross-leveling.
        Recapitalization and overhaul of legacy (old) equipment.
        Congressional adds.
        National Guard and Reserve Appropriations (NGREA).
        Supplemental appropriation.
                        continued resetting of the force
        Resetting or reconstitution of the force is the process to restore
    people, aircraft and equipment to a high state of readiness following a
    period of higher-than-normal, or surge, operations.
        Some equipment goes through recapitalization: stripping down and
    rebuilding equipment completely. Recapitalization is one of the fastest
    ways to get equipment back to units for use, and on some equipment,
    such as trucks, recapitalization costs only 75 percent of replacement
    costs. A second option is to upgrade equipment, such as adding armor. A
    third option is to simply extend the equipment's service life through a
    maintenance program.
        Theater operations in Iraqi and Afghanistan are consuming the
    Reserve Component force's equipment. Wear and tear is at a rate many
    times higher then planned. Battle damage expends additional resources.
    New equipment suited for mountain warfare will be needed with the shift
    back into Afghanistan.
        In addition to dollars already spent to maintain this well-worn
    equipment for ongoing operations, the Armed Forces will likely incur
    large expenditures in the future to repair or replace (reset) a
    significant amount of equipment when hostilities cease. It is still
    unknown how much equipment will be left in Afghanistan.
                               personnel training
        When Reserve Component personnel participate in an operation they
    are focused on the needs of the particular mission, which may not
    include everything required to maintain qualification status in their
    military occupation specialty (MOS, AFSC, NEC).
      --There are many different aspects of training that are affected:
        --Skills that must be refreshed for specialty;
        --Training needed for upgrade but delayed by mission;
        --Ancillary training missed;
        --Professional military education needed to stay competitive;
        --Professional continuing education requirements for single-managed
                career fields and other certified or licensed specialties
                required annually;
        --Graduate education in business related areas to address force
                transformation and induce officer retention.
      --Loss, training a replacement: There are particular challenges that
            occur to the force when a loss occurs during a mobilization or
            operation and depending on the specialty this can be a
            particularly critical requirement that must be met:
        --Recruiting may require particular attention to enticing certain
                specialties or skills to fill critical billets;
        --Minimum levels of training (84 days basic, plus specialty
                training);
        --Retraining may be required due to force leveling as emphasis is
                shifted within the service to meet emerging requirements.
                                  end strength
        The ROA would like to place a moratorium on reductions to the Guard
    and Reserve manning levels. Manpower numbers need to include not only
    deployable assets, but individuals in the accession pipeline. ROA urges
    this subcommittee to fund to support:
      --Army National Guard of the United States, 358,200.
      --Army Reserve, 206,000.
      --Navy Reserve, 66,700.
      --Marine Corps Reserve, 39,600.
      --Air National Guard of the United States, 106,756.
      --Air Force Reserve, 69,900.
      --Coast Guard Reserve, 10,000.
        In a time of war and the highest OPTEMPO in recent history, it is
    wrong to make cuts to the end strength of the Reserve Components. We
    need to pause to permit force planning and strategy to catch-up with
    budget reductions.
        With the Navy's requested increase by 2,500 sailors, corresponding
    increases need to be made in the Navy Reserve. The Navy Reserve is
    providing most of the individual augmentee support for the Navy in
    overseas operations. Five years ago was the last time the Navy
    evaluated its USNR requirements; such a study needs to be done again.
                                   readiness
        Readiness is a product of many factors, including the quality of
    officers and enlisted, full staffing, extensive training and exercises,
    well-maintained weapons and authorized equipment, efficient procedures,
    and the capacity to operate at a fast tempo.
        The Defense Department does not attempt to keep all Active units at
    the C-1 level. The risk is without resetting the force returning Active
    and Reserve units will be C-4 or lower because of missing equipment,
    and without authorized equipment their training levels will
    deteriorate.
                   nonfunded army reserve component equipment
        The Army National Guard and Army Reserve have made significant
    contributions to ongoing military operations, but equipment shortages
    and personnel challenges continue and if left unattended, may hamper
    the Reserves' preparedness for future overseas and domestic missions.
    To provide deployable units, the Army National Guard and the Army
    Reserve have cross-leveled large quantities of personnel and equipment
    to deploying units, an approach that has resulted in growing shortages
    in nondeployed units.
    Army Reserve Unfunded Requirements
        The 21st Century Army Reserve mobilizes continuously with 12
    percent of its force consistently deployed in support of the current
    contingencies. However, the Army Reserve lacks the ability to fully
    train Army Reserve Soldiers on the same equipment the Army uses in the
    field. To prepare to perform a dangerous mission, soldiers must have
    modern equipment and state-of-the-art training facilities. The Army
    Reserve has 73 percent of its required equipment on hand. Under
    currently programmed funding, the Army Reserve should reach 85 percent
    equipment on hand by fiscal year 2016 with the goal of 100 percent on
    hand by fiscal year 2019.
                C-12 Huran Cargo Transport Airplane (7)--$63 Million
        Replace aircraft permanently transferred to Intelligence,
    Surveillance and Reconnaissance (ISR) mission. Seven below total
    authorized count. Capacity lift 5,185 lbs, distance 1,710 miles.
                Communications Security (COMSEC) AKMS/Computer Sets
                        (3648)--$8.6 Million
        Provide secure communications to (4) companies with AN/GYK-49(V)1
    &AN/PYQ-10(C) sets.
                Cargo Bed, Demountable PLS 8 x20 (5498)--$109.7 Million
        Transportation Support: pacing item for Medium Truck Company, 360
    each.
                Optical Data Entry Reader (115)--$25.5 Million
        Imaging/Reader automation to fix trailer transfer and Inland Cargo
    units.
                Heavy/Medium Trailers (1760)--$115.8 Million
        Cargo--MTV with dropsides (M1095); flatbed--LMTV w/dropsides
    (M1086)
    Army National Guard Unfunded Equipment Requirements
        Army National Guard (ARNG) units deployed overseas have the most
    up-to-date equipment available. However, a significant amount of
    equipment is currently unavailable to the Army National Guard in the
    States due to continuing rotational deployments and emerging
    modernization requirements. Many States have expressed concern about
    the resulting shortfalls of equipment for training as well as for
    domestic emergency response operations.
                Aviation Upgrade Kits--$100.5 Million
        UH-60A to UH-60L Upgrade Kits; LUH-72A S&S Mission Equipment
    Package.
                Homeland Security Command and Control Package--$168.4
                        Million
        Joint Incident Site Communications and Interim Satcom Incident
    Site. (JISC & ISISCS); Wideband Imagery Satellite Terminals, and Full
    Motion Video (FMV) downlink to support state and local leaders during
    natural and manmade disasters.
                M777A2 Lightweight 155mm Howitzer (18)--$54 Million
        To ensure readiness of Army National Guard (ARNG) Fire Support,
    Field Artillery units.
                Transportation--$1.15 Billion
        FMTV/LMTV Cargo Trucks; HMMWV; HTV 8x8 Heavy Trucks; Tactical
    Trailers.
                Force XXI Battlefield Command Brigade and Below (FBCB2)--
                        $179 Million
        To ensure readiness of ARNG Combat Support and Combat Service
    Support (CS/CSS) units.
        Also needed: To organize a second Stryker Brigade Combat Team
    (SBCT)
                air force reserve component equipment priorities
        ROA continues to support military aircraft Multi-Year Procurement
    (MYP) beginning with 15 for more C-17s and 8 more C-130Js for USAir
    Force and its Reserve. Further, ROA supports additional funding for
    continued Research and Development of the next generation bomber.
    Air Force Reserve Unfunded Requirements
        The Air Force Reserve (AFR) mission is to be an integrated member
    of the Total Air Force to support mission requirements of the joint
    warfighter. To achieve interoperability in the future, the Air Force
    Reserve top priorities for nonfunded equipment are:
                C-40 D multi-role airlift (3)--$370 Million
        To replace aging C-9 C's at Scott Air Force Base: mission requests
    exceed aircraft availability.
                KC-130J Aircraft (2)--$148 Million
        These Aircraft are needed to fill the shortfall in Search and
    Rescue refueling capabilities.
                Cyber Systems Defense--$109 Million
        Upgrade Active Duty and AF Reserve network infrastructure to ensure
    overall A.F. mission.
                Helmet Mounted Cueing System--$38 Million
        Upgrade and enhancement to engagement systems.
    Defensive Systems
        Airlift Defensive Systems (16) Install ADS systems onto (16) AFRC
    C-5As at Lackland Air Force Base against IR missile threats.
        Infra-Red Counter Measures (42) Procure and install (42) LAIRCM
    lite systems on AFRC C-5s. Protects high value national assets against
    advanced IR missile threats.
        Missile Warning System (MWS) Upgrade/replacement--Improve and
    integrate the existing Electronic Attack (EA) for A-10 and F-16 and
    Electronic Protection (EP) for A-10, F-16 and HC-130.
    Air National Guard Unfunded Equipment Requirements
        Shortfalls in equipment will impact the Air National Guard's
    ability to support the National Guard's response to disasters and
    terrorist incidents in the homeland. Improved equipping strengthens
    readiness for both overseas and homeland missions and improves the ANG
    capability to train on mission-essential equipment.
                Infra-Red Counter Measures--$240.7 Million
        Procure and install LAIRCM systems on C-5, C-17, C-130, 130, HC-
    130, EC-130, KC-135 a/c.
                Air Defensive Systems--$59.31 Million
        Install ADS systems onto C-5, C-17, F-15 aircraft.
                Missile Warning Systems--$22.48 Million
        Upgrade/replacement--Improve and integrate the existing Electronic
    Attack (EA) and Electronic Protection (EP) for A-10, C-130.
                Rear Aspect Visual Scan Capability/Safire--$57.2 Million
        Increase the field of view on C-5, C-17 transports and add a larger
    window in the C-130 paratroop doors.
                Personal Protective Equipment, M4 Rifles--$34.77 Million
                Force Protection Mobility Bag Upgrades/Replacements--
                        $113.72 Million
                        navy reserve unfunded priorities
        Active Reserve Integration (ARI) aligns Active and Reserve
    component units to achieve unity of command. Navy Reservists are fully
    integrated into their Active component supported commands. Little
    distinction is drawn between Active component and Reserve component
    equipment, but unique missions remain.
                C-40 A Combo Cargo/Passenger Airlift (4)--$402 Million
        The Navy requires a Navy Unique Fleet Essential Airlift Replacement
    Aircraft. The C-40A is able to carry 121 passengers or 40,000 pounds of
    cargo, compared with 90 passengers or 30,000 pounds for the C-9.
                KC-130J Super Hercules Aircraft Tankers (4)--$160 Million
        These Aircraft are needed to fill the shortfall in Navy Unique
    Fleet Essential Airlift (NUFEA). Procurement price close to upgrading
    existing C-130Ts with the benefit of a long life span.
                P-3 Maritime Patrol Aircraft Fixes--$312 Million
        Due to the grounding of 39 airframes in December 2007, there is a
    shortage of maritime patrol and reconnaissance aircraft, which are
    flown in associate Active and Reserve crews. P-3 wing crack kits are
    still needed for fiscal year 2010.
                F-5 Radar/Electronic Attack Block-2--$148.3 Million
        Aircraft used in adversarial training of F-18 pilots. Heightens
    adversary competition conditions.
                C-40 Hangar, Oceana--$31.4 Million
                    marine corps reserve unfunded priorities
        The Marine Corps Reserve faces two primary equipping challenges,
    supporting and sustaining its forward deployed forces in the Long War
    while simultaneous resetting and modernizing the Force to prepare for
    future challenges. Only by equally equipping and maintaining both the
    Active and Reserve forces will an integrated Total Force be seamless.
                KC-130J Super Hercules Aircraft tankers (4)--$160 Million
        These Aircraft are needed to fill the shortfall in Marine Corps
    Essential Airlift. Procurement price close to upgrading existing C-
    130Ts with the benefit of a long life span. Commandant, USMC, has
    testified that acquisition must be accelerated.
                Light Armored Vehicles--LAV (14)--$21 Million
        A shortfall in a USMCR light armor reconnaissance company, the LAV-
    25 is an all-terrain, all-weather vehicle with night capabilities. It
    provides strategic mobility to reach and engage the threat, tactical
    mobility for effective use of fire power.
                Training Allowance (T/A) Shortfalls--$187.7 Million
        Shortfalls consist of over 300 items needed for individual combat
    clothing and equipment, including protective vests, poncho, liner,
    gloves, cold weather clothing, environmental test sets, took kits,
    tents, camouflage netting, communications systems, engineering
    equipment, combat and logistics vehicles and weapon systems.
                MCB Vehicle Maintenance Facility--$10.9 Million
        Additional vehicle storage and maintenance: routine preventive and
    corrective maintenance are still performed throughout the country by
    Marines. Ground equipment maintenance efforts have expanded over the
    past few years, leveraging contracted services and depot-level
    capabilities.
                          transparency of procurement
        Each Reserve Component has shared with ROA that there is a
    continued problem of tracking equipment specifically appropriated to
    the Reserves from manufacturer to a service's Reserve Component.
    Frustrations continue with a belief that the Active Component either
    pushes out Reserve items during production or actual misappropriates
    equipment in distribution before it reaches the Reserve.
               national guard and reserve equipment appropriation
        Much-needed items not funded by the respective service budget are
    frequently purchased through this appropriation. In some cases it is
    used to bring unit equipment readiness to a needed State for
    mobilization. With the war, the Reserve and Guard are faced with
    mounting challenges. Funding levels, rising costs, lack of replacement
    parts for older equipment, etc. have made it difficult for the Reserve
    Components to maintain their aging equipment, not to mention
    modernizing and recapitalizing to support a viable legacy force. The
    Reserve Components benefit greatly from a National Military Resource
    Strategy that includes a National Guard and Reserve Equipment
    Appropriation.
                           cior/ciomr funding request
        The Interallied Confederation of Reserve Officers (CIOR) was
    founded in 1948, and its affiliate organization, The Interallied
    Confederation of Medical Reserve Officers (CIOMR) was founded in 1947.
    The organization is a nonpolitical, independent confederation of
    national reserve associations of the signatory countries of the North
    Atlantic Treaty (NATO). Presently there are 16 member nation
    delegations representing over 800,000 reserve officers. CIOR supports
    four programs to improve professional development and international
    understanding.
        Military Competition.--The CIOR Military Competition is a strenuous
    3-day contest on warfighting skills among Reserve Officers teams from
    member countries. These contests emphasize combined and joint military
    actions relevant to the multinational aspects of current and future
    Alliance operations.
        Language Academy.--The two official languages of NATO are English
    and French. As a non-government body, operating on a limited budget, it
    is not in a position to afford the expense of providing simultaneous
    translation services. The Academy offers intensive courses in English
    and French as specified by NATO Military Agency for Standardization,
    which affords international junior officer members the opportunity to
    become fluent in English as a second language.
        Partnership for Peace (PfP).--Established by CIOR Executive
    Committee in 1994 with the focus of assisting NATO PfP nations with the
    development of Reserve officer and enlisted organizations according to
    democratic principles. CIOR's PfP Committee, fully supports the
    development of civil-military relationships and respect for democratic
    ideals within PfP nations. CIOR PfP Committee also assists in the
    invitation process to participating countries in the Military
    Competition.
        Young Reserve Officers Workshop.--The workshops are arranged
    annually by the NATO International Staff (IS). Selected issues are
    assigned to joint seminars through the CIOR Defense and Security Issues
    (SECDEF) Commission. Junior grade officers work in a joint seminar
    environment to analyze Reserve concerns relevant to NATO.
        Dues do not cover the workshops and individual countries help fund
    the events. The Department of the Army as Executive Agent hasn't been
    funding these programs. Senate leadership support would be beneficial.
                                   conclusion
        DoD is in the middle of executing a war and operations in Iraq and
    Afghanistan. The impact of these operations is affecting the very
    nature of the Guard and Reserve, not just the execution of Roles and
    Missions. Without adequate funding, the Guard and Reserve may be viewed
    as a source to provide funds to the Active Component. It makes sense to
    fully fund the most cost efficient components of the Total Force, its
    Reserve Components.
        At a time of war, we are expending the smallest percentage of GDP
    in history on National Defense. Funding now reflects close to 4 percent
    of GDP including supplemental dollars. ROA has a resolution urging that
    defense spending should be 5 percent to cover both the war and homeland
    security. While these are big dollars, the President and Congress must
    understand that this type of investment is what it will take to equip,
    train and maintain an all-volunteer force for adequate National
    Security.
        The Reserve Officers Association, again, would like to thank the
    sub-committee for the opportunity to present our testimony. We are
    looking forward to working with you, and supporting your efforts in any
    way that we can.

        Chairman Inouye. Our next witness is the Secretary of the
    Associations for America's Defense, Ms. Elizabeth Cochran.
    STATEMENT OF ELIZABETH COCHRAN, SECRETARY, ASSOCIATIONS
                FOR AMERICA'S DEFENSE
        Ms. Cochran. Thank you, Mr. Chairman and Mr. Vice Chairman.
        The Associations for America's Defense is very grateful to
    testify today, and we'd like to submit written testimony at
    this time.
        We would like to thank this subcommittee for its
    stewardship on defense issues and setting an example by its
    nonpartisan leadership. The Associations for America's Defense
    is concerned that U.S. defense policy is sacrificing future
    security for near-term readiness. It's been suggested that the
    United States should focus on wars we're fighting today, not on
    future wars that may not occur. The Pentagon's priorities sound
    like money will be redirected to more immediate needs.
        Erosion in the capability in the force means added risk
    will be faced today and tomorrow. According to the Office of
    Management and Budget, base defense spending, projected at $534
    billion in 2010, will stay relatively flat for the next 5
    years. We disagree with placing such budgetary constraints on
    defense, because it can lead to readiness and effectiveness
    being subtly degraded, which won't be immediately evident. We
    support increasing defense spending to 5 percent of the gross
    domestic product during times of war to cover procurement, and
    prevent unnecessary personnel end-strength cuts.
        The Associations for America's Defense is alarmed about the
    fiscal year 2010 unfunded programs list, submitted by the
    military services, which is 87 percent lower than fiscal year
    2009's request. We're concerned the unfunded requests were
    driven by budgetary factors more than risk assessment, which
    will impact national security.
        As always, our military will do everything to accomplish
    its missions, but response time is measured by equipment
    readiness. Due to the DOD's tactical aircraft acquisition
    programs having been blunted by cost and schedule overruns, the
    Air Force has offered to retire 250 fighter jets in one year,
    which the Secretary of Defense has accepted. Until new systems
    are acquired in sufficient quantities to replace legacy fleets,
    those legacy systems must be sustained. Airlift contributions
    in moving cargo and passengers are indispensable to American
    warfighters. As the military continues to become more
    expeditionary, more airlifts in C-17 and C-130Js will be
    required. Procurement needs to be accelerated and modernized,
    and mobility requirements need to be reported upon.
        The need for air refueling is utilized worldwide in DOD
    operations. But, significant numbers of tankers are old and
    plagued with structural problems. The Air Force would like to
    retire as many as 131 of the Eisenhower-era KC-135E tankers by
    the end of the decade. These aircraft must be replaced.
        Finally, we ask this subcommittee to continue to provide
    appropriations for the National Guard and Reserve equipment
    requirements. The National Guard's goal is to make at least
    one-half the army and air assets available to Governors and
    adjutants general at any given time. Appropriating funds to
    Guard and Reserve equipment provides Reserve chiefs with
    flexibility prioritizing funding.
        Once again, I thank you for your ongoing support for the
    Nation's armed services and the fine men and women who defend
    our country. Please contact us with any questions.
        Thank you.
        Chairman Inouye. Thank you very much, Ms. Cochran.
        And I thank the panel.
        [The statement follows:]
                    Prepared Statement of Elizabeth Cochran
                                  introduction
        Mister Chairman and distinguished members of the Committee, the
    Associations for America's Defense (A4AD) is again very grateful for
    the invitation to testify before you about our views and suggestions
    concerning current and future issues facing the defense appropriations.
        The Association for America's Defense is an adhoc group of 12
    military and veteran associations that have concerns about national
    security issues. Collectively, we represent armed forces members and
    their families, who are serving our Nation, or who have done so in the
    past.
                  current versus future: issues facing defense
        The Associations for America's Defense would like to thank this
    subcommittee for the on-going stewardship that it has demonstrated on
    issues of Defense. At a time of war, its pro-defense and non-partisan
    leadership continues to set the example.
    Emergent Risks
        Members of this group are concerned that U.S. Defense policy is
    sacrificing future security for near term readiness. So focused are our
    efforts to provide security and stabilization in Afghanistan and a
    withdrawal from Iraq, that risk is being accepted as an element in
    future force planning. Force planning is being driven by current
    overseas contingency operations, and to allow for budget limitations.
    Careful study is needed to make the right choice. A4AD is pleased that
    Congress and this subcommittee continue oversight in these decisions.
        What seems to be overlooked is that the United States is involved
    in a Cold War as well as a Hot war. With the United States preoccupied
    with the Middle East, North Korea, China, Russia, and Iran are growing
    areas of risk.
    Korean Peninsula
        Provocatively, North Korea successfully tested a nuclear weapon at
    full yield, unilaterally withdrew from that 1953 armistice, and
    continues to test-fire missiles from both its coasts. The South sent a
    high speed missile patrol boat into Western waters in response to a
    reported amphibious assault training staged by the North. South Korean
    and U.S. troops have been put on the highest alert level in 3 years,
    and the South Korean Coast Guard is escorting its fishing boats.
        North Korea has 1.2 million troops, with the 655,000 South Korean
    soldiers and 30,000 U.S. troops stationed to the South. While not an
    immediate danger to the United States, North Korea is still viewed as a
    threat by its neighbors, and represents a destabilizing factor in Asia.
    Recent events may be mere posturing, but North Korea is still a failed
    state, where misinterpretation clouded by hubris could start a war. The
    North has prepositioned and could fire up to 250,000 rounds of heavy
    artillery in the first 48 hours of war along the border and into Seoul.
    China
        China remains the elephant in the war room. As the United States
    expends resources in the Middle East and continues to restructures the
    military to fight terrorism, China patiently waits for America's
    ability to project force to weaken.
        China's armed forces are the biggest in the world and have
    undergone double-digit increases in military spending since the early
    1990s. The Pentagon has reported that China's actual spending on
    military is up to 250 percent higher than figures reported by the
    Chinese government, and their cost of materials and labor is much
    lower. This year, China chose to increase its defense budget by almost
    15 percent. China's build-up of sea and air military power appears
    aimed at the United States, according to Admiral Michael Mullen, the
    chairman of the U.S. Joint Chiefs of Staff.
        The U.S. military strategy cannot be held hostage by international
    debts. While China is the biggest foreign holder of U.S. Treasuries
    with $768 billion at the end of the first quarter, we can't be lulled
    into a sense of complacency.
    Russia
        Russian President Dmitry Medvedev has called for ``comprehensive
    rearmament.'' Last March, in televised remarks to defense ministry
    officials, Medvedev proclaimed the ``most important task is to re-equip
    the [Russian] armed forces with the newest weapons systems.'' Russia's
    defense budget could jump 30 percent this year, increasing Moscow's
    military might and preserving its arms-export industry, reports Peter
    Brookes of the Heritage Foundation. The country will aim for 70 percent
    of its weaponry to be ``modern'' by 2020, Defense Minister Anatoly
    Serdyukov said, according to RIA-Novosti, the state-run news agency.
        Following an April meeting with President Medvedev, the Obama
    administration is seeking a new start with Russia. Underlying U.S.-
    Russian frictions are issues of NATO military expansion to countries
    like Georgia and Ukraine, and U.S. plans to base a missile defense
    system in Poland and the Czech Republic to defend against attacks from
    countries like Iran. Concerns have been voiced about a European
    military threat to Russian gas and oil fields.
    Iran
        While Iran lobs petulant rhetoric towards the United States, the
    real international tension is between Israel and Iran. Israel views
    Tehran's atomic work as a threat, and would consider military action
    against Iran. If Iran was attacked, it has threatened to ``eliminate
    Israel.'' Israeli leadership has warned Iran that any attack on Israel
    would result in the ``destruction of the Iranian nation.'' Israel is
    believed to have between 75 to 200 nuclear warheads with a megaton
    capacity.
    Force Structure: An Erosion in Capability
        Supporting the National Security Strategy requires that the United
    States to maintain robust and versatile military forces that can
    accomplish a wide variety of missions. The two major theater war (2MTW)
    approach was an innovation at the end of the Cold War. It was based on
    the proposition that the United States should prepare for the
    possibility that two regional conflicts could arise at the same time,
    so that if the United States were engaged in a conflict in one theater,
    an adversary in a second theater could be prevented from gaining his
    objectives in the other. In 1996, the United States adopted the ``win-
    hold-win'' concept--a strategy to fight and win one major regional
    contingency, with enough force to hold another foe at a stalemate until
    the first battle is won, and then to move the forces to the second
    theater.
        The Bush Administration's ``1-4-2-1 strategy'' from the 2001
    Quadrennial Defense Review (QDR) called their new military strategy
    ``1-4-2-1,'' which meant: ``1'' Defend the United States; ``4'' Deter
    aggression in four critical regions: Europe, Northeast Asia, Southwest
    Asia, the Middle East; ``2'' Maintain the capability to combat
    aggression in two of these regions simultaneously; and ``1'' Maintain a
    capability to ``win decisively'' up to and including forcing regime
    change and occupation in one of those two conflicts ``at a time and
    place of our choosing.''
        A top to bottom review in 2005, suggested change to the national
    strategy as to mount one conventional campaign while devoting more
    resources to defending American territory and antiterrorism efforts.
        In a speech announcing the fiscal year 2010 Defense Budget,
    Secretary of Defense Robert Gates stated ``Our conventional
    modernization goals should be tied to the actual and prospective
    capabilities of known future adversaries--not by what might be
    technologically feasible for a potential adversary given unlimited time
    and resources . . .''
        ``This budget is less about numbers than it is about how the
    military thinks about the nature of warfare and prepares for the
    future,'' Secretary of Defense Robert Gates testified before the Senate
    Armed Services Committee on May 14, 2009. Gates says that the United
    States should focus on the wars that we are fighting today, not on
    future wars that may never occur. He also asserts that U.S.
    conventional capabilities will remain superior for another 15 years.
    Anthony Cordesman, a national security expert for the Center for
    Strategic and International Studies, says that Gates' plan should be
    viewed as a set of short-term fixes aimed at helping ``a serious cost
    containment problem,'' not a new national security policy.
        War planners are often accused of planning for the last war.
    Secretary Gates speaks to enhancing the capabilities of fighting
    today's wars. A concern arises on whether the Pentagon's focus should
    be on irregular or conventional warfare, and whether it should be
    preparing for a full scale ``peer'' war. From his priorities, it sounds
    like Secretary Gates will be redirecting money to more immediate needs.
        Each strategy permitted change to resize a force that was
    originally oriented to global war to a smaller force focused on smaller
    regional contingencies. But the erosion in the capability and the force
    means added risks will be faced today and tomorrow than when the 2MTW
    standard was established. ``The danger is in the poverty of
    expectation, a routine obsession with danger that are familiar rather
    than likely,'' wrote Thomas Schelling, in the Forward to: Pearl Harbor:
    Decision and Warning (1962).
    Funding for the Future
        Base defense spending, projected at $534 billion in 2010, will stay
    relatively flat for the next 5 years, counting inflation, according to
    spending outlines by the Office of Management and Budget. ``It is
    simply not reasonable to expect the defense budget to continue
    increasing at the same rate it has over the last number of years,''
    Secretary Gates told the Senate committee. ``We should be able to
    secure our Nation with a base budget of more than half a trillion
    dollars.''
    Hollow Force
        The Associations for America's Defense couldn't disagree more by
    placing such budgetary constraints on the defense. A4AD members
    question the spending priorities of the current administration.
    ``Fiscal restraint for defense and fiscal largesse for everything
    else,'' commented Rep. John McHugh at a HASC hearing on the Defense
    Budget in May.
        The result of such budgetary policy could again lead to a hollow
    force whose readiness and effectiveness has been subtly degraded and
    whose lessened efficiency will not be immediately evident. This process
    which echoes of the past, raises no red flags and sounds no alarms, and
    the damage can go unnoticed and unremedied until a crisis arises that
    highlights just how much readiness has decayed.
    Defense as a Factor of GDP
        Secretary Gates has warned that that each defense budget decision
    is ``zero sum,'' providing money for one program will take money away
    from another. A4AD encourages the appropriations subcommittee on
    defense to scrutinize the recommended spending amount for defense. Each
    member association supports increasing defense spending to 5 percent of
    Gross Domestic Product during times of war to cover procurement and
    prevent unnecessary personnel end strength cuts.
    A Changing Manpower Structure
        Secretary Gates proposed spending an extra $11 billion to finish
    enlarging the Army and the Marine Corps and to halt reductions in the
    Air Force and the Navy. The Navy has asked for an increase in end
    strength of nearly 2,500 to 328,800 sailors. The Navy Reserve (USNR) on
    the other hand would be reduced to 65,506, a cut of 1,194. The Navy
    Reserve continues to be cut, and it is the main contributor to the
    Navy's individual augmentees (IA) force on the ground in Iraq and, now,
    Afghanistan. Of the requested dollars to support 4,400 by the Navy, the
    Navy Reserve supplies 3,000.
        A4AD supports a moratorium on further cuts including the Navy
    Reserve. We further suggest that a Zero Based Review (ZBR) be performed
    to evaluate the manning level of the USNR. The last review was done
    over 5 years ago, and much has changed since.
    Maintaining a Surge Capability
        The armed forces need to provide critical surge capacity for
    homeland security, domestic and expeditionary support to national
    security and defense, and response to domestic disasters, both natural
    and man-made that goes beyond operational forces. A strategic surge
    construct includes manpower, airlift and air refueling, sealift
    inventory, logistics, and communication to provide a surge-to-demand
    operation. This requires funding for training, equipping and
    maintenance of a mission-ready strategic reserve composed of active and
    reserve units. An additional requirement is excess infrastructure which
    would permit the housing of additional forces that are called-up beyond
    the normal operational force.
    Dependence on Foreign Partnership
        Part of the U.S. military strategy is to rely on long-term
    alliances to augment U.S. forces. ``To succeed in any efforts the
    Department must harness and integrate all aspects of national power and
    work closely with a wide range of allies, friends and partners,'' as
    stated in a DOD progress report. ``Our strategy emphasizes the
    capacities of a broad spectrum of partners . . . We must also seek to
    strengthen the resiliency of the international system . . . helping
    others to police themselves and their regions.'' It's been recommended
    in the budget to increase funding of global partnerships efforts by
    $500 million in the fiscal year 2010 base budget proposal, to support
    training and equipping foreign militaries to undertake counter
    terrorism and stability operations. Performances by allies have yet
    proven to be a good return on investment.
        The risk of basing a national security policy on foreign interests
    and good world citizenship is increasingly uncertain because the United
    States does not necessarily control our foreign partners; countries
    whose objectives may differ with from own. This is more an exercise of
    consensus building rather than security integration. Alliances should
    be viewed as a tool and a force multiplier, but not the foundation of
    National Security.
                             unfunded requirements
        The fiscal year 2010 Unfunded Program Lists submitted by the
    military services to Congress was 87 percent less than was requested
    for fiscal year 2009 with requests for only $3.44 billion versus $29.9
    billion the year before. A4AD has concerns that the unfunded requests
    were driven more by budgetary factors than risk assessment which will
    impact national security. The following are lists submitted by A4AD
    including additional non-funded recommendations.
    Tactical Aircraft
        DOD's efforts to recapitalize and modernize its tactical air forces
    have been blunted by cost and schedule overruns in its new tactical
    aircraft acquisition programs. The Air Force has offered a plan to
    retire 250 fighter jets in 1 year alone, which the Secretary of Defense
    has accepted.
        Until new systems are acquired in sufficient quantities to replace
    legacy fleets, legacy systems must be sustained and kept operationally
    relevant. The risk of the older aircraft and their crews and support
    personnel being eliminated before the new aircraft are on line could
    result in a significant security shortfall.
    Airlift
        Hundreds of thousands of hours have been flown, and millions of
    passengers and tons of cargo have been airlifted. Their contributions
    in moving cargo and passengers are absolutely indispensable to American
    warfighters in the Global War on Terrorism. Both Air Force and Naval
    airframes and air crew are being stressed by these lift missions. As
    the U.S. military continues to become more expeditionary, it will
    require more airlift. Procurement needs to be accelerated and
    modernized, and mobility requirements need to be reported upon.
        DOD should buy an additional (35) C-17s above the current 205 to
    ensure an adequate airlift force for the future and allow for
    attrition--C-17s are being worn out at a higher rate than anticipated
    in the Global War on Terrorism. Given the C-5's advanced age, it makes
    more sense to retire the oldest and most worn out of these planes and
    use the upgrade funds to buy more C-17s. DOD should also continue with
    a joint multi-year procurement of C-130Js.
        The Navy and Marine Corps need C-40-A replacements for the C-9B
    aircraft. The Navy requires Navy Unique Fleet Essential Airlift. The C-
    40A, a derivative of the 737-700C a Federal Aviation Administration
    (FAA) certified, while the aging C-9 fleet is not compliant with either
    future global navigation requirements or noise abatement standards that
    restrict flights into European airfields.
    Tankers
        The need for air refueling is reconfirmed on a daily basis in
    worldwide DOD operations. A significant number of tankers are old and
    plagued with structural problems. The Air Force would like to retire as
    many as 131 of the Eisenhower-era KC-135E tankers by the end of the
    decade. DOD and Congress must work together to replace of these
    aircraft.
    NGREA
        A4AD asks this committee to continue to provide appropriations for
    unfunded National Guard and Reserve Equipment Requirements. The
    National Guard's goal is to make at least half of Army and Air assets
    (personnel and equipment) available to the Governors and Adjutants
    General at any given time. To appropriate funds to Guard and Reserve
    equipment provides Reserve Chiefs with a flexibility of prioritizing
    funding.

                         UNFUNDED EQUIPMENT REQUIREMENTS
                [The services are not listed in priority order.]
    ------------------------------------------------------------------------
                                                                  Amount
    ------------------------------------------------------------------------
    Air Force:
        C-17 Globemaster III transport aircraft (15)........    $3.9 billion
        C-130J Super Hercules (5)...........................     395 million
        Battlefield Airborne Communications Node (2) lease     180.2 million
         and operation......................................
        Upgrade kits for the EC-130s/Compass Call                 78 million
         Modifications (4)..................................
        HH-60G Pave Hawk (3) Search and Rescue..............     120 million
        AAQ-29 Forward Looking Infra Red System--FLIR (81)        81 million
         HH-60G.............................................
    Air Force Reserve:
        C-5A Airlift Defense system (ADS) (42)..............    17.3 million
        C-130H LAIRCM--Large Aircraft I/R Counter Measures      56.6 million
         (6)................................................
        C-130J LAIRCM (2)...................................      22 million
        Missile Warning Systems and Electronic Protection, A-   27.9 million
         10, F-16...........................................
        C-5 Structural repair...............................      22 million
    Note: USAFR has a $1 billion MILCON backlog.

    Air National Guard:
        C-40C pax aircraft, procurement (1) and avionics        98.6 million
         upgrade............................................
        C-38 aircraft, replacement program..................     110 million
        Radio, Beyond Line of Sight (BLOS) ADS TACSAT, F-15,   109.7 million
         F-16C..............................................
        Electronic Attack Pod, A-10, F-16C..................      44 million
        Helmet Mounted Cueing System, A -10, F-16C, HH-60G..      38 million
    Note: Air National Guard faces a MILCON backlog of $2
     billion to recapitalize facilities.

    Army:
        Aviation Support Equipment..........................    36.2 million
        Field Feeding.......................................    30.7 million
        Force XXI Battlefield Command Brigade and Below.....     179 million
        Information System Security COMSEC..................    44.8 million
        Liquid Logistics Storage and Distribution...........       2 million
    Army Reserve:
        Palletized Load System (PLS) Trailer................    27.8 million
        Tactical Light Truck (Ambulance HMMWV, Armament        183.8 million
         Carrier HMMWV, Troop/Cargo Carrier HMMWV)..........
        Command Post (FBCB2/TOCS/UYK-128) computer set,        181.4 million
         shelter............................................
        Support (Antenna-OE-361(V)/Loudspeakers tactical)...    13.4 million
        HEMTT (Tactical Heavy wrecker)......................    55.9 million
    Army National Guard:
        CH-47F Chinook helicopters (6) in fiscal year 10....      66 million
        UH-60M Black Hawk medium-lift helicopter (10) in         164 million
         fiscal year 10.....................................
        Warfighter Information Network-Tactical (WIN-T).....     1.2 billion
        Communication Systems (JNN, SINCGARS, HF)...........     1.5 billion
        Stryker combat vehicles, various configurations          1.4 billion
         (549)..............................................
    Note: $280 million/year is the investment necessary to
     effectively recapitalize MILCON.

    Navy:
        P-3 Repair/Recovery Plan, kit installation..........     462 million
        Aviation Depot Maintenance, to fund 86 deferred          195 million
         airframes and 314 engines..........................
        Ship Depot Maintenance, for 20 surface ship              200 million
         availabilities.....................................
        C-130J Super Hercules (1) to replace Blue Angels          64 million
         transport..........................................
    Navy Reserve:
        C-40A Combo cargo/passenger airlift aircraft (4)....     402 million
        KC-130J Super Hercules aircraft (4).................     256 million
        Maritime Expeditionary Warfare Equipment............    35.5 million
        Maritime Prepositioning Force Utility Boats (RHIB)..     6.6 million
        Information Systems Security Program................     5.5 million
    Marine Corps:
        MTVR trailers (buys 352) to cover shortfall.........    28.9 million
        Engineer Equipment for Logistics Support:
            TRAMs, bucket loader (93).......................      21 million
            Forklift, Light Rough Terrain--LRTF (96)........      13 million
            Forklift, Extended Boom (177)...................      24 million
        MV-22 Osprey Aircraft, Improvements, and Upgrades...    17.4 million
        Mountain Terrain Support Vehicles (10)..............    10.2 million
        Tier I UAS (146) Digital Data Link upgrade kits.....    10.5 million
    Note: Military Construction requirements are $70.5
     million.

    Marine Forces Reserves:
        KC-130Js Super Hercules tanker aircraft (2).........     128 million
        Light Armored Vehicles (14).........................      21 million
        Helmet Mounted Displays (SA-HMDs) Systems...........  ..............
        Theater Provided Equipment Sensors..................  ..............
    ------------------------------------------------------------------------

    Conclusion
        A4AD is a working group of military and veteran associations
    looking beyond personnel issues to the broader issues of National
    Defense.
        This testimony is an overview, and expanded data on information
    within this document can be provided upon request.
        Thank you for your ongoing support of the Nation, the Armed
    Services, and the fine young men and women who defend our country.
    Please contact us with any questions.

        Chairman Inouye. Now we have our final panel, consisting of
    Dr. Philip Boudjouk; the president and CEO, Ms. Sandra Raymond,
    Dr. George Zitnay, Captain Ike Puzon, of the Navy, Ms. Mary
    Hesdorffer, Dr. Jonathan Berman, vice president--Mr. George
    Dahlman, and General Michael Dunn.
        Thank you very much.
        Representing the Coalition of EPSCoR/IDeA States, Dr.
    Philip Boudjouk. Is that the correct pronunciation?
        Dr. Boudjouk. Mr. Chairman, ``boo-jock'' is the correct
    pronunciation.
        Chairman Inouye. Boudjouk.
        Dr. Boudjouk. Boudjouk, thank you.
    STATEMENT OF PHILIP BOUDJOUK, Ph.D., VICE PRESIDENT,
                RESEARCH, CREATIVE ACTIVITIES AND
                TECHNOLOGY TRANSFER, NORTH DAKOTA STATE
                UNIVERSITY; CHAIR, COALITION OF EPSCoR/IDeA
                STATES
        Dr. Boudjouk. Chairman Inouye, Ranking Member Cochran,
    members of the subcommittee, thank you for the opportunity to
    testify today on the importance of maintaining and adequately
    funding the Department of Defense DEPSCoR program.
        My name is Philip Boudjouk, and I serve as the vice
    president of research, creative activities, and technology
    transfer at North Dakota State University, and I also serve as
    chair of the Coalition of EPSCoR/IDeA States, a nonprofit
    organization representing the 21 States and two territories
    currently eligible to receive DOD DEPSCoR research awards.
        DEPSCoR was originally authorized by section 257 of the
    National Defense Authorization Act of 1995 to ensure a
    nationwide, multi-State infrastructure to support the 6.1 basic
    research needs of the Department of Defense. In recent years,
    Congress has generously provided funding for DEPSCoR between
    $15 and $17 million, and has affirmatively rejected efforts by
    the previous administration to reduce the size of the program.
        In the fiscal year 2009 National Defense Authorization Act,
    the Senate directed a federally funded Research and Development
    Center assessment of the DEPSCoR program to determine its value
    to the Department and to the American taxpayer. The Institute
    for Defense Analyses concluded that DEPSCoR has strengthened
    the nationwide basic research capacity. More importantly, the
    assessment determined that the DEPSCoR States' share of
    nondefense--non-DEPSCoR DOD science and engineering funding
    increased steadily from inception of the program to today.
        However, the administration's proposed 2010 DOD budget
    recommends no funding for DEPSCoR. The 23 eligible DEPSCoR
    jurisdictions must therefore rely on Congress to ensure the
    DEPSCoR program is adequately funded, at a level that ensures
    our Nation maintains a nationwide infrastructure of DOD
    research capabilities.
        Allowing the DEPSCoR program to go unfunded in fiscal year
    2010 will not only create a critical shortfall in our national
    research infrastructure, but it will, likewise, have dire
    consequences for DEPSCoR States that otherwise may not receive
    an investment of DOD research funding. Therefore, we
    respectfully request that the DEPSCoR program at a minimum of
    $20 million.
        Mr. Chairman, every State has important contributions to
    make to our Nation's research competitiveness, and every State
    has scientists and engineers that can contribute significantly
    to supporting the research needs of DOD.
        Thank you for the opportunity to testify before the
    subcommittee.
        Chairman Inouye. I thank you very much, sir.
        [The statement follows:]
                     Prepared Statement of Philip Boudjouk
        Chairman Inouye, Ranking Member Cochran, Members of the
    Subcommittee: Thank you for the opportunity to testify today on the
    importance of maintaining and adequately funding the Department of
    Defense Experimental Program to Stimulate Competitive Research
    (DEPSCoR) \1\.
    ---------------------------------------------------------------------------
        \1\ Alabama, Alaska, Arkansas, Delaware, Hawaii, Idaho, Kansas,
    Kentucky, Louisiana, Maine, Mississippi, Montana, Nebraska, Nevada, New
    Hampshire, New Mexico, North Dakota, Oklahoma, Puerto Rico, Rhode
    Island, South Carolina, South Dakota, Vermont, Virgin Islands, West
    Virginia, and Wyoming.
        States in bold letters are eligible for the DEPSCoR program. All of
    the States listed above are also eligible for the EPSCoR program.
    ---------------------------------------------------------------------------
        My name is Philip Boudjouk and I serve as the Vice President of
    Research, Creative Activities and Technology Transfer at North Dakota
    State University. I also currently serve as Chair of the Coalition of
    EPSCoR/IDeA States, a non-profit organization representing the 21
    States and 2 territories currently eligible to receive Department of
    Defense DEPSCoR research awards.
        EPSCoR States have a vast reservoir of talent and capacity. They
    represent 20 percent of the U.S. population, 25 percent of the research
    and doctoral universities, and 18 percent of the Nation's scientists
    and engineers. The EPSCoR program is critical to ensuring that we
    maintain a national infrastructure of research and engineering by
    providing much needed funding to these leading universities and
    scientists.
        As you know, DEPSCoR was initially authorized by Section 257 of the
    National Defense Authorization Act of 1995 (Public Law 103-337) to
    ensure a nationwide, multi-State infrastructure to support the 6.1
    basic research needs of the Department of Defense. Today, 21 States and
    two territories participate in DEPSCoR, receiving grants from the
    Department to perform research that directly responds to specific
    priorities identified by the Department and announced under competitive
    solicitations to the eligible DEPSCoR States.
        At the program's peak funding level, DEPSCoR received nearly $25
    million to fund Department of Defense basic research in eligible
    States. In recent years, Congress has generously provided funding for
    DEPSCoR between $15 million and $17 million, and has affirmatively
    rejected efforts by the previous administration to reduce the size of
    the DEPSCoR program.
        Additionally, in the fiscal year 2009 National Defense
    Authorization Act, the Senate directed a federally funded research and
    development center assessment of the DEPSCoR program to determine its
    value to the Department and to the American taxpayer. The Institute for
    Defense Analayses (IDA) was entrusted with the assessment and concluded
    in its study that DEPSCoR has strengthened the nationwide basic
    research capacity in the following areas:
      --DEPSCoR awards have funded first-time investigators in defense-
            related basic research;
      --DEPSCoR awards have contributed to publications and patents;
      --DEPSCoR awards have supported graduate student and postdoctoral
            training;
      --DEPSCoR awards have supported purchase and maintenance of cutting
            edge research equipment; and
      --DEPSCoR awards have supported collaborations among researchers in
            all States.
        Perhaps most importantly, the IDA assessment determined that the
    DEPSCoR States' share of non-DEPSCoR Department of Defense science and
    engineering funding increased steadily from inception of the program to
    today. This finding provides firm evidence that DEPSCoR is a valuable
    use of taxpayer dollars because it demonstrates that DEPSCoR provides a
    return on investment to the Department of Defense that far exceeds the
    funding amount provided for the program each year.
        Mr. Chairman, DEPSCoR is also a valuable use of taxpayer dollars
    because it represents Federal research money well spent. Past DEPSCoR
    research has included:
      --designing helicopter rotors;
      --modeling sea ice predictions to aid ship and submarine navigation;
      --prediction of river currents for Navy operations;
      --securing critical software systems;
      --developing chem.-biodefense agents;
      --enhancing stored energy density for weapons;
      --improving wireless communication for warfighter systems;
      --determining the effect of exposure of military personnel to extreme
            physical and climatic conditions;
      --preventing laser damage to aircraft optical guidance systems;
      --increasing durability of lightweight composite materials; and
      --developing small plastic air-vehicles for the Air Force.
        Despite this important work, and despite the positive assessment
    provided to the Senate by the Institute for Defense Analyses, the
    administration's proposed fiscal year 2010 Department of Defense budget
    recommends no funding for DEPSCoR. The 23 DEPSCoR eligible
    jurisdictions must therefore rely on Congress once again to ensure the
    DEPSCoR program is adequately funded at a level that ensures our Nation
    maintains a nationwide infrastructure of Department of Defense research
    capabilities.
        Mr. Chairman, every State has important contributions to make to
    our Nation's research competitiveness and every State has scientists
    and engineers that can contribute significantly to supporting the
    research needs of the Department of Defense. Accordingly, it is vital
    that we build a Department of Defense research infrastructure that
    leaves no State behind. Allowing the DEPSCoR program to go unfunded in
    fiscal year 2010 will not only create a critical shortfall in our
    national research infrastructure, but it will likewise have dire
    consequences for DEPSCoR States that otherwise may not receive an
    investment of Department of Defense research funding.
        As the Committee considers the President's fiscal year 2010 budget
    proposal for the Department of Defense, the Coalition of EPSCoR/IDeA
    States, representing major research universities and institutions
    across 23 participating jurisdictions, respectfully requests that the
    DEPSCoR program be funded at a minimum of $20 million. Participating
    DEPSCoR institutions continue to advance the basic research priorities
    of the Department of Defense and it is the sincere hope of our
    Coalition that this Subcommittee will consider robustly funding the
    DEPSCoR program in fiscal year 2010.
        The Coalition of EPSCoR/IDeA States is grateful for this
    opportunity to testify before the Subcommittee. We look forward to
    continuing to work with the Senate to ensure the DEPSCoR program fully
    supports our Nation's critical research infrastructure requirements.
        Thank you Mr. Chairman.

        Chairman Inouye. And our next witness is the president and
    chief executive officer of the Lupus Foundation of America, Ms.
    Sandra Raymond.
        Ms. Raymond?
    STATEMENT OF SANDRA C. RAYMOND, PRESIDENT AND CHIEF
                EXECUTIVE OFFICER, LUPUS FOUNDATION OF
                AMERICA, INC.
        Ms. Raymond. Thank you, Chairman Inouye, Ranking Member
    Cochran, and all of the subcommittee members. We thank you for
    the work that you are doing to serve and protect our country
    and the health of our servicemen and women. I'm here today to
    talk with you about a largely undiagnosed health issue of
    concern in the military and in the population at large, and
    that is lupus.
        In April 2003, a 22-year-old female soldier was about to be
    deployed to Iraq. As is the practice, she was given the
    standard battery of vaccines, and soon after she received the
    shots, she died. This soldier had undiagnosed lupus, and the
    live viruses in the vaccine were said, by a panel of medical
    experts, to have caused a fatal reaction.
        In people with compromised immune systems, live viruses and
    other triggers can cause the body to attack its own tissues and
    organs, and this can lead to morbidity and death.
        Lupus is a chronic, life-threatening disease of the immune
    system. It's the prototypical autoimmune disease, and learning
    more about it will provide clues to understanding autoimmune
    diseases that affect 23 million Americans.
        The disease principally affects young women in their
    childbearing years, but men and children also develop lupus. It
    is two to three times more common among African-Americans,
    Hispanics, Asian Americans and Pacific Islanders, and American
    Indians. This health disparity remains unexplained.
        Three issues make lupus directly relevant to the DOD's
    medical research program.
        First, vaccinations given routinely to American servicemen
    and women may trigger fatal reactions, especially since
    military doctors have no way to screen for lupus or underlying
    autoimmune diseases.
        Second, lupus disproportionately affects minority
    populations and young people, those most likely to be in the
    military. Minorities comprise over one-third of the active duty
    military members; and among enlisted women the percentage in
    2004 was almost 40 percent.
        Third, environmental stresses are known to cause lupus. We
    know that genes linked to lupus are triggered by environmental,
    hormonal, and stress factors. These may be exacerbated by
    intense training, foreign deployment, exposure to chemical
    agents, battle, and more.
        But, there is a way to insure that military personnel are
    protected, and that is through identification of biological
    markers that can detect lupus. We all know that measurement of
    blood pressure or cholesterol are biological markers that can
    tell us if we're at risk for cardiovascular disease or stroke.
    In lupus, scientists have now identified a number of biomarkers
    that are prime candidates for validation. And, once validated,
    an early detection test can be developed to screen for lupus.
    With the leadership of military lupus scientists, and academic
    centers across the United States, this research can get off to
    a running start.
        While it's important that lupus remain in the peer-review
    program, we respectfully ask you to consider initiating what we
    call the Lupus Biomarker and Test Development Research Project.
    As part of the defense program, or the clinical investigation
    program of force health protection and readiness, establishing
    this program has the potential to save lives. Start-up costs
    are estimated to be $6 million.
        We thank you for the opportunity to speak today, and we
    look forward to working with you to address this public health
    issue.
        Thank you.
        Chairman Inouye. Thank you very much, Ms. Raymond.
        [The statement follows:]
                    Prepared Statement of Sandra C. Raymond
        Chairman Inouye, Ranking Member Cochran, and Distinguished
    Subcommittee Members, my name is Sandra Claire Raymond and I am the
    President and CEO of the Lupus Foundation of America. I want to take
    this opportunity to thank you for all you are doing to serve and
    protect our country and the health of our servicemen and women.
        In April of 2003, a 22-year-old female soldier about to be deployed
    to Iraq was given the standard battery of vaccines and soon after these
    were administered she died. This soldier had undiagnosed lupus and live
    viruses in the vaccines triggered a fatal reaction. Lupus is a chronic
    and life-threatening disease that causes the immune system to become
    unbalanced, causing inflammation and tissue damage to virtually every
    organ system. It is the prototypical autoimmune disease and learning
    more about lupus will have broad-ranging implications for the estimated
    23 million Americans suffering from autoimmune diseases. Lupus affects
    women, men and children, but, women in their child-bearing years are
    most at risk. The disease is two to three times more common among
    African Americans, Hispanics, Asian Americans and Pacific Islanders and
    American Indians. This health disparity remains unexplained. A recent
    study indicates that lupus annually costs the Nation an estimated $31.4
    billion in direct and indirect expenditures.
        Here are the issues that are directly relevant to the DOD's medical
    research programs:
      --Vaccinations given routinely to American Service men and women may
            trigger fatal reactions. Military physicians have no way to
            screen personnel for lupus or other autoimmune diseases prior
            to administering necessary vaccinations.
      --Lupus disproportionately affects minorities and young people--those
            most likely to be in the military. Minorities comprise over one
            third of the active duty military members. 2004 statistics
            indicate that among active duty enlisted women, the minority
            percentage is even higher: 38.7 percent are minorities. And,
            again the 2004 statistics indicate that African Americans make
            up 18.3 percent of the military but less than 13 percent of the
            general population. African Americans are among those most at
            risk for lupus. Their disease begins earlier in life and is
            generally more severe. More than 90 percent of active duty
            military personnel are age 40 or younger and lupus strikes
            people between the ages of 15 and 44. In 2004, 11,000
            individuals with lupus, active duty personnel and dependents,
            receive care through the DOD healthcare system and that number
            has been increasing in these last 5 years.
      --Environmental stresses are known to cause lupus flares. Genes
            linked to lupus may be triggered by environmental, hormonal and
            stress factors exacerbated by intense training, foreign
            deployment, exposure to unaccustomed environment, chemical
            agents, battle and trauma.
        Chairman Inouye, I want to thank you and the Congress for naming
    lupus as one of the diseases that can be researched under the Peer
    Reviewed Medical Research Program. The research projects that have been
    funded since 2005 have provided valuable insights into this devastating
    disease. However, in order to ensure that military personnel and their
    families are protected, there is an urgent and unmet need to validate
    biomarkers to detect lupus. Scientists have identified a number of
    biomarkers that are now ready for validation and this work will lead to
    an early detection test to screen for lupus. In fact, there is a
    network of academic medical centers across the country interested in
    this project and with leadership and coordination from the military
    lupus scientists, this project can get off to a running start. We ask
    that lupus remain in the congressionally directed Peer Reviewed Medical
    Research Program; however, in addition, we believe that lupus biomarker
    and test development research should originate in the DOD's Defense
    Health Program. With respect, we ask for $6 million to establish this
    program. Thank you for providing me with this opportunity to speak
    today and I look forward to working with all of you to help improve the
    lives of our soldiers living with lupus.

        Chairman Inouye. Our next witness is Dr. Zitnay, co-founder
    of the Defense and Veterans Brain Injury Center.
    STATEMENT OF GEORGE A. ZITNAY, Ph.D., CO-FOUNDER,
                DEFENSE AND VETERANS BRAIN INJURY CENTER
        Dr. Zitnay. Good morning, Mr. Chairman, Vice Chairman
    Cochran. It's a pleasure to be with you today.
        As the chairman stated, I'm the co-founder of the Defense
    and Veterans Brain Injury Center, and I recently retired, so
    I'm here today as a volunteer on behalf of the participants in
    the 2008 International Conference on Behavioral Health and
    Traumatic Brain Injury, convened at the request of the
    Congressional Brain Injury Task Force, chaired by Mr. Bill
    Pascrell and Todd Platts.
        I come before you today to request $370 million in funding
    for brain injury care, research, treatment, and training,
    through the Defense and Veterans Brain Injury Center, an
    affiliate of the Defense Center of Excellence in Psychological
    Health and TBI. As you know, TBI is the signature injury in the
    wars in Iraq and Afghanistan, affecting over 360,000 of our
    troops. Some 300,000 have also been identified as experiencing
    post traumatic stress disorder.
        Blast-related injuries, extended deployments, all
    contribute to the unprecedented number of warriors suffering
    from TBI and psychological conditions such as anxiety,
    depression, PTSD, and, unfortunately, suicide.
        The long-term effects and consequences of TBI and PTSD will
    cost millions unless we start treating now, with available
    technology that is now currently available in the private
    sector.
        In a report to Congress issued earlier this year, the
    experts at the international conference noted that the private
    sector--mostly academic centers of excellence across the
    country, and major clinics--have available the advanced
    technology and treatments that should be made available now to
    our men and women, and our wounded warriors, especially in the
    rural areas. They will benefit from this advanced care through
    the use of telemedicine and rehabilitation.
        For example, new technology, and new advances in brain
    imaging, reveals that even the most severe--the most severe TBI
    patient improves, with brain stimulation. It's electrical
    stimulation applied to the inner brain. This helps the
    individual wake up. And once they wake up we can then provide
    rehabilitation until they gain function. We also know that
    neutraceuticals can also help repair brain tissue.
        Our request includes $50 million for a--DVBIC demonstration
    project, to utilize these advanced techniques to improve the
    standard of care for severe TBI patients. While many with
    severe TBI will never return to active duty, some may, if they
    get this advanced technology. But, most importantly, they will
    be able to live a life worth living.
        DVBIC is a partnership between the DOD and the VA with
    the--trauma centers, and it was created by Congress to ensure
    the optimum care is given.
        Finally, we request $20 million for education and training
    of brain injury specialists. There is confusion between mild
    TBI and PTSD, but they are distinct conditions. TBI can be
    mild, as in concussion, or severe, as in unresponsive states of
    consciousness. Training is particularly needed in our rural
    areas of the country, as some of our young men and women who
    return home never get the chance to seek treatment, because it
    is too far away.
        Thank you for your leadership; thank you for your support
    of the Defense and Veterans Brain Injury; but most of all for
    your care for our wounded warriors.
        Chairman Inouye. Thank you very much, Dr. Zitnay.
        [The statement follows:]
                     Prepared Statement of George A. Zitnay
        Dear Chairman Inouye, Vice Chairman Cochran and Members of the
    Senate Appropriations Subcommittee on Defense: Thank you for this
    opportunity to submit testimony in support of funding brain injury
    programs and initiatives in the Department of Defense. I am George A.
    Zitnay, PhD, a neuropsychologist and co-founder of the Defense and
    Veterans Brain Injury Center (DVBIC).
        I have over 40 years of experience in the fields of brain injury,
    psychology and disability, including serving as the Executive Director
    of the Kennedy Foundation, Assistant Commissioner of Mental Retardation
    in Massachusetts, Commissioner of Mental Health, Mental Retardation and
    Corrections for the State of Maine, and a founder and Chair of the
    International Brain Injury Association and the National Brain Injury
    Research, Treatment and Training Foundation. I have served on the
    Advisory Committees to the Centers for Disease Control and Prevention
    (CDC) and the National Institutes of Health (NIH), was an Expert
    Advisor on Trauma to the Director General of the World Health
    Organization (WHO) and served as Chair of the WHO Neurotrauma
    Committee.
        In 1992, as President of the national Brain Injury Association, I
    worked with Congress and the Administration to establish what was then
    called the Defense and Veterans Head Injury Program (DVHIP) after the
    Gulf War as there was no brain injury program at the time. I have since
    worn many hats, and helped build the civilian partners to DVBIC:
    Virginia NeuroCare, Laurel Highlands and DVBIC-Johnstown. I recently
    retired as an advisor to the Department of Defense (DOD) regarding
    policies to improve the care and rehabilitation of wounded warriors
    sustaining brain injury.
        I am pleased to report that DVBIC continues to be the primary
    leader in DOD for all brain injury issues. DVBIC has come to define
    optimal care for military personnel and veterans with brain injuries.
    Their motto is ``to learn as we treat.''
        The DVBIC has been proactive since its inception, and what began as
    a small research program, the DVBIC now has 19 sites.\1\ In 2007 your
    committee helped move DVBIC funding from under the auspices of the
    Uniformed Services University of the Health Sciences (USUHS) over to
    the Army's Medical and Materiel Command at Fort Detrick. DVBIC is now
    the key operational component for brain injury of Defense Centers of
    Excellence for Psychological Health and Traumatic Brain Injury (DCoE)
    under DOD Health Affairs.
    ---------------------------------------------------------------------------
        \1\ Walter Reed Army Medical Center, Washington, DC; Landstuhl
    Regional Medical Center, Germany; National Naval Medical Center,
    Bethesda, MD; James A. Haley Veterans Hospital, Tampa, FL; Naval
    Medical Center San Diego, San Diego, CA; Camp Pendleton, San Diego, CA;
    Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; Veterans
    Affairs Palo Alto Health Care System, Palo Alto, CA; Fort Bragg, NC;
    Fort Carson, CO; Fort Hood, TX; Camp Lejeune, NC; Fort Campbell,
    Kentucky; Boston VA, Massachusetts; Virginia Neurocare, Inc.,
    Charlottesville, VA; Hunter McGuire Veterans Affairs Medical Center,
    Richmond, VA; Wilford Hall Medical Center, Lackland Air Force Base, TX;
    Brooks Army Medical Center, San Antonio, TX; Laurel Highlands,
    Johnstown, PA; DVBIC-Johnstown, PA.
    ---------------------------------------------------------------------------
        I am here today to ask for your support for $370 million in the
    Defense Appropriations bill for fiscal year 2010 for the DCoE which
    includes $50 million specifically for a consortium of private sector
    entities to partner with DCoE and DVBIC to move the standard of care
    for brain injury forward, as well as $20 million for education and
    training of brain injury specialists.
        As you know, traumatic brain injury (TBI) is the ``signature
    injury'' of the conflicts in Iraq and Afghanistan, affecting some
    360,000 service personnel and some 300,000 have experienced post
    traumatic stress disorder (PTSD). Blast-related injuries and extended
    deployments are contributing to an unprecedented number of warriors
    suffering from traumatic brain injury (ranging from mild, as in
    concussion, to severe, as in unresponsive states of consciousness) and
    psychological conditions such as anxiety, depression, PTSD and suicide.
        The Rand Corporation, DOD, and CDC report that the long term
    effects and consequences of TBI, PTSD, and other psychological health
    issues will cost billions of dollars in care, treatment, and
    rehabilitation unless action is taken. The Rand Report estimates that
    PTSD-related and major depression-related costs could range from a 1-
    year cost of $25,000 in mild cases to $408,000 for severe cases. The
    total cost for TBI-related health issues is in the billions of dollars
    and does not include the lost productivity or the deleterious effects
    to quality of life. In reality, it has been well-established that the
    health care needs of our young service members returning from OIF/OEF
    are not being met and are overwhelming the current veterans' health
    care system that has been primarily designed to care for elderly
    veterans.
        In 2005, the Conemaugh International Symposium, brought together 60
    of the world's finest neuroscientists and physicians from across the
    United States and from 12 other nations, including representatives from
    the National Institutes of Health (NIH), CDC, DOD, Veterans
    Administration (VA), and the National Institute for Disability and
    Rehabilitation Research, resulting in a strong recommendation for
    United States Congressional action to significantly improve outcomes in
    wounded warriors with traumatic brain injury. In addition, the
    Symposium report called for the creation of Seven Centers of Excellence
    in TBI treatment, research and training to be located across the
    Nation.
        A second international meeting on Disorders of Consciousness
    produced the Mohonk Report, in which scientists, ethicists, physicians,
    and family members from across the United States, as well as leading
    neuroscientists from Israel, Europe, and South America, collaborated to
    prepare an action report to Congress that focused on Improving Outcomes
    for Individuals with Disorders of Consciousness. The report called on
    Congress to fund a network of highly specialized centers, utilizing the
    latest technology available, to significantly improve outcomes for
    wounded warriors living in the minimally conscious state.
        A third follow-up meeting of experts, the Symposium on Severe and
    Minimally Conscious Wounded Warriors, occurred in the spring of 2008,
    in Johnstown, Pennsylvania. This meeting rendered a Feasibility Study
    on treating wounded warriors with disorders of consciousness which was
    subsequently delivered to the DVBIC for consideration.
        Based upon the history and results of these international meetings,
    the International Conference on Behavioral Health and Traumatic Brain
    Injury was convened in October 2008, hosted by Congressmen Bill
    Pascrell and Todd Platts, co-chairs of the Congressional Brain Injury
    Task Force, and sponsored by the DOD, DVBIC, and numerous other groups
    to prepare recommendations for action and funding by the United States
    Congress.
        The Executive Report from this meeting of over 100 international
    experts generated critical recommendations in the areas of Research,
    Education, Assessment, Family, and Treatment. The authors of the report
    concluded: ``The over-arching goal is to provide our wounded warriors
    and their families with what they deserve: the best health care and
    support services that our state-of-the-art science and medicine have to
    offer. In doing so, we will create a standard of excellence in military
    health care, research, and training that will serve as an exemplary
    model for the rest of the world.'' The report requested from Congress a
    total of $350 million in funding to achieve that goal.
        On March 12, 2009 representatives of the International Conference
    unveiled a Report to Congress (the Paterson Report) calling for action
    now to improve the care of wounded warriors.
        The Paterson Report noted:
      --new advances in brain imaging are revealing that even those with
            the most severe levels of TBI have preserved brain tissue which
            can be used through deep brain electrical stimulation to help
            the individual wake up and regain function;
      --new advanced technologies can help those wounded warriors with loss
            of sight regain some vision;
      --new cognitive protheses can help those wounded warriors with severe
            memory loss regain the ability to plan and remember;
      --neutraceuticals can help restore parts of damaged brains; and
      --new screening and early automated psychological tools and tests can
            help detect those at risk for PTSD and other psychological
            disorders.
        What we need to do now is to make these advanced technologies and
    treatments that are available in the private sector available to our
    wounded warriors, and we need to offer services and clinics in our
    rural areas through telemedicine and tele-rehabilitation.
                              treat now consortium
        Our funding request includes $50 million specifically for the work
    of a consortium of private sector providers (called TREAT NOW:
    Treatment and Research Excellence Achieved Today: Neuroscientists for
    Our Warriors) who have come together to improve the standard of care of
    wounded warriors as soon as possible.
        For those warriors who have sustained the most severe TBIs, the
    recommendations from the Reports of the Aspen and Mohonk Meetings are
    not being followed. Thus, the current standard of care for these
    warriors is inconsistent, clinically unreliable, and not maximally
    effective. The exact number of these wounded warriors from Operation
    Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) who suffer
    from severe disorders of consciousness (SDOC) is unknown. The DVBIC
    reports that 4 percent of the 15,000 TBI patients examined and/or
    treated by their Center suffer from SDOC. This is an underestimation of
    the true number of warriors because it does not include those seen or
    treated at other military hospitals and programs and the dependents of
    wounded warriors and veterans.
        Serving under the auspices of the DCoE, the Consortium will
    complement, and partner with the DVBIC and the National Intrepid Center
    of Excellence (NICoE) in their vision and commitment to improve the
    current system of medical care and support for troops sustaining severe
    TBIs. The partners include some of the best scientists, researchers and
    rehabilitation specialists from around the United States. While
    geographically diverse, participating members are heavily invested in
    improving tele-health technologies. There is no project like it and DOD
    Health Affairs is interested in moving it forward.
                                  tbi vs. ptsd
        Much has been accomplished by the DCoE in its efforts to improve
    public awareness of TBI and psychological disorders, address the stigma
    associated with such conditions, and help connect family, caregivers
    and wounded warriors with appropriate information, treatment and
    services.
        There are concerns however about an overemphasis on psychological
    disorders that affects the public perception of TBI. Many in the brain
    injury medical and family support community do not want to see TBI
    becoming considered a ``psychological disorder.'' This concern comes
    from the fact that in no other health care system are psychological
    issues and brain injury combined--not in the DVA, NIH, or any
    university medical program. Brain injury specialists and family
    advocates want to be assured that as much focus and funding is being
    put into the science of brain injury rehabilitation and treatment as is
    being put into the psychological effects of combat. Of the 25 programs
    funded under the Congressionally Directed Medical Research Program with
    2007 supplemental funding, only 8 were for brain injury.
        We must not lose sight of the actual cause of subsequent
    psychological problems. TBI can lead to depression and suicide but TBI
    is not itself a psychological disorder. Treatments for TBI and PTSD are
    not only different, but can be contraindicated and make the patient
    worse. In working with the Wounded Warrior Project, I have heard many
    stories of warriors with brain injury not getting the right treatment
    because they were sent to a psychologist instead of a neuropsychologist
    and given drugs for PTSD that exacerbated the effects of TBI.
        There are harmful reports like the USA Today article on April 15,
    2009 \2\, in which Cols. Charles Hoge and Carl Castro argue that the
    DOD and DVA are overemphasizing mild TBI among troops and that the
    focus should be more on the symptoms rather than the cause. Citing the
    Hoge-Castro article in The New England Journal of Medicine, USA Today
    reports that ``symptoms blamed on TBI after troops return home likely
    are due to depression, PTSD or substance abuse . . . and overemphasis
    on mild TBI keeps troops with those conditions from being properly
    treated . . . most troops who suffered a concussion in battle recovered
    within days of the injury.'' This is very damaging to the efforts to
    improve public awareness of TBI.
    ---------------------------------------------------------------------------
        \2\ Zoroya, Gregg, ``Officials: Troops Hurt by Brain Injury
    Focus,'' USA Today, April 15, 2009.
    ---------------------------------------------------------------------------
        A plethora of leading brain injury specialists dispute Hoge and
    Castro's claims and urge caution in making changes to screening
    procedures. David Hovda, PhD, Director of the Brain Injury Research
    Center at UCLA, strongly recommended continuing screening, saying that
    without it, troops may develop long-term neurological problems after
    numerous concussions, similar to former professional football players.
    Research conducted at the Defense Advanced Research Projects Agency
    (DARPA) shows that the most common cause of TBI in combat, blast
    injury, causes a range of injury from mild (concussion) to severe.
        I urge your Committee to recommend that DOD continue its practice
    of screening which is based on the best science available and offers
    troops the best chance at recovery.
        In addition the Paterson Report recommended that the National
    Institutes of Health and the DOD convene a ``Consensus Conference'' to
    clearly define mild TBI and PTSD and establish specific standards for
    treatment. The Report recommended that definitions and treatment
    standards be evidence based and incorporate a thorough review of
    available treatment programs and outcome measures. The Report urged the
    Consensus Conference to strive to equitably involve all stakeholders.
        The confusion has devastating effects when it results in wounded
    warriors not seeking treatment. DVBIC officials have reported that
    troops are now less likely to seek help for mild brain injury if it is
    considered to be a ``psychological disorder.''
        President Obama made a speech last week regarding health care
    reform and urged that we ``fix what's broken and move forward with what
    works.'' The same should be said about improving DOD's health system.
    While the increase in suicides has brought public attention to the
    stresses of combat, the complex issues of TBI should not get lost or
    overlooked. The research and treatment for TBI must remain distinct and
    the focus of the DVBIC must be preserved. DVBIC needs to continue to be
    recognized as the center of excellence in providing brain injury care
    and research.
        $20 million for education and training brain injury specialists
        We recommend an additional $20 million be appropriated specifically
    for training medical students in brain injury diagnosis, treatment and
    rehabilitation. We need more brain injury specialists in the medical
    field. More neurologists, neuropsychologists and physiatrists and
    rehabilitation specialists should be educated by the Uniformed Services
    University for the Health Sciences.
        In summary, we respectfully request $370 million for fiscal year
    2010 to enhance ongoing projects of the DCoE and to develop new
    initiatives to improve the care of wounded warriors and support for
    their families. We need to assure that our brave men and women who are
    injured in the course of duty are given every possible opportunity for
    the best medical care, rehabilitation and community reentry assistance
    that we as a Nation can provide.
        Thank you for your consideration of this request to help improve
    the care of our wounded warriors.

        Chairman Inouye. Our next witness is the director of
    legislation, Association of the United States Navy, Captain Ike
    Puzon.
    STATEMENT OF CAPTAIN IKE PUZON, UNITED STATES NAVY
                (RET.), DIRECTOR OF LEGISLATION,
                ASSOCIATION OF THE UNITED STATES NAVY
        Captain Puzon. Mr. Chairman, Mr. Vice Chairman, and the
    Association of the United States Navy is grateful to have the
    opportunity to testify today.
        Our newly transitioned association is now focused on
    equipment, force structure, policy issues, manpower issues, for
    a total force.
        Your unwavering support for our deployed servicemembers in
    Iraq and Afghanistan and the worldwide fight against terrorism
    is of crucial importance. AUSN would like to highlight three
    areas of importance.
        The C-40--first, the C-40 aircraft originally listed in the
    unfunded list, to replace critically overused C-20G aircraft,
    and to replace overaged and overused C-9 transport, both are
    playing a vital role in Iraq and Afghanistan and worldwide
    contingency operations.
        Second, the EF-18 Growler aircraft for U.S. Navy and U.S.
    Navy Reserves, specifically in the Navy Reserve, to replace
    aged aircraft in a Maryland-based squadron that is currently
    deployed to Iraq and Afghanistan.
        And finally, number three, stabilization of authorized end-
    strength for active Navy and Navy Reserve.
        In recent years, the Pentagon has recommended the repeal of
    separate budget requests for procurement Reserve equipment. A
    combined appropriations for each service does not guarantee
    needed equipment for National Guard and Reserve components. We
    do not agree with the Pentagon's position on this issue, and
    ask that the subcommittee continue to provide separate
    appropriations against National Guard and Reserve equipment.
        For the foreseeable future, we must be realistic about what
    the unintended consequences are for a very high rate of usage
    for active and Reserve components. Our active duty Navy and the
    current Reserve members are pleased to making it--a significant
    contribution to the Navy's defense as operational forces.
    However, the reality of it all is that the added stress on the
    total force could pose long-term consequences for our country
    in terms of recruiting, retention, and family support. The Navy
    has a total of over 10,000 people--personnel deployed in
    Operation Iraqi Freedom (OIF). The Navy Reserve continues to
    mobilize 4,500 sailors for the support of the ongoing global
    war on terror (GWOT). Your Navy is engaged throughout.
        We recognize that there are many issues that need address
    by the subcommittee. We are perplexed by the short Navy
    unfunded program list. History points to a larger list.
    Overwhelmingly, we hear that--discussions and requirements for
    more and better equipment for training total force is
    necessary.
        In summary, we believe the subcommittee needs to address
    the following issues for total force, in the best interest of
    our national security: fund the C-40A for Navy Reserve and
    Navy, per previous supplementals, and we replace the C-9
    transport and the C-20G; fund the E/F-18 Growler; increase
    funding for the National Guard and Reserve equipment; and
    establish end-strength stabilization for the Navy and Navy
    Reserve.
        Thank you for your--opportunity.
        Chairman Inouye. Thank you very much, Captain Puzon.
        [The statement follows:]
                        Prepared Statement of Ike Puzon
        Mister Chairman and distinguished members of the Committee, the
    Association of the United States Navy is very grateful to have the
    opportunity to testify.
        Our newly transitioned association looks at equipment, force
    structure, policy issues, and manpower issues.
        We would like to thank this Committee for the on-going stewardship
    on the important issues of national defense and, especially, the
    reconstitution and transformation of the Navy. At a time of war, non-
    partisan leadership sets the example.
        Your unwavering support for our deployed Service Members in Iraq
    and Afghanistan and the world-wide fight against terrorism and piracy
    is of crucial importance. AUSN would like to highlight some areas of
    emphasis.
      --C-40A Aircraft to replace critically overused C-20G in Hawaii and
            Maryland; and, to replace over aged C-9 transports--both are
            playing a vital role in Iraq and Afghanistan. They are not VIP
            aircraft--but, can be used for such missions.
      --EF/A 18 Growler aircraft for U.S. Navy and U.S. Navy Reserve--
            specifically to replace aged aircraft in a Maryland based
            squadron that is currently deployed to Iraq and Afghanistan.
      --C-130J aircraft--to meet the intra-theater needs of the Geographic
            Commanders and Navy component commanders.
        These issues are in line with all previous years Navy and Navy
    Reserve unfunded list.
        As a Nation, we need to supply our service members (active duty and
    reserve) with the critical equipment and support needed for individual
    training, unit training, and combat.
        In recent years, the Pentagon has recommended the repeal of
    separate budget requests for procuring Reserve Equipment. A combined
    equipment appropriation for each service does not guarantee needed
    equipment for the National Guard and Reserve Components. For the Navy
    Reserve, this is especially true. We do not agree with the Pentagon's
    position on this issue and history has proven the requirements for
    NGREA, and we ask this committee to continue to provide separate
    appropriations against NG and RE requirements.
        In addition to equipment to accomplish assigned missions, AUSN
    believes that the Administration and Congress must make it a high
    priority to maintain, if not increase, the end strengths of already
    overworked, and perhaps even overstretched, military forces. This
    includes the Active Duty Navy & Navy Reserve. The Navy Reserve has
    always proven to be a highly cost-effective and superbly capable
    operational and surge force in times of both peace and war. At a
    minimum, the Navy Reserve should be stabilized since they are deployed
    with active forces in Iraq and Afghanistan.
        For the foreseeable future, we must be realistic about what the
    unintended consequences are from a high rate of usage. History shows
    that a Reserve force is needed for any country to adequately meet its
    defense requirements, and to enable success in offensive operations.
    Our Active Duty Navy and the current Reserve members are pleased to be
    making a significant contribution to the Nation's defense as
    operational forces; however, the reality of it all is that the added
    stress on the Reserve could pose long term consequences for our country
    in recruiting, retention, family and employer support. This issue
    deserves your attention in Family Support Programs, Transition
    Assistance Programs and for the Employer Support for the Guard and
    Reserve programs.
        At the same time, the Navy has a total of over 10,000 personnel
    deployed in OIF/OEF theaters; Navy Reserve continues to mobilize over
    4,500 Sailors in support for the on-going GWOT. Your Navy is engaged
    throughout the world in operations.
        Care must be taken that that tremendous reservoir of operational
    capability be maintained and not capriciously dissipated. Officers,
    Chief Petty Officers, and Petty Officers need to exercise leadership
    and professional competence to maintain their capabilities. There is a
    risk that they will not be able to do so in the present model of
    utilization of Navy Reserve and Active Duty IA utilizations.
        AUSN is perplexed by this year's Navy Unfunded Programs list
    provided by the Chief of Naval Operations. We fully support CNO's
    unfunded list. However, history points at a much larger unfunded list
    and the needs are there.
        Specific Equipment and Funding needs of the Navy Reserve include:
      --C-40 funding to replace dangerously aged C-9s. These are war
            fighting logistic weapons systems. 2 Aircraft were programmed
            for fiscal year 2009 supplemental, and 4 were programmed for
            fiscal year 2009 funding. The Navy did not get these funded. We
            have to replace aging C-9s to maintain Navy and Marine Corps
            engagement in the GWOT.
        First:
      --It is the Navy's only world-wide intra-theater organic airlift,
            operated by the U.S. Navy.
      --Navy currently operates 9 C-40As, in three locations: Fort Worth,
            Jacksonville, San Diego.
      --These aircraft are needed for Hawaii, Maryland, Texas and
            Washington units.
      --A pending CNA study--substantiates the requirements for 31-35 C-
            40As to replace aging C-9s.
        Second:
      --CNO, SECNAV, & DOD have supported the requirement for C-40As.
      --Commander, Naval Air Force 2007 Top Priority List stated the
            requirement for at least 32 aircraft.
        Third:
      --Current average age of remaining C-9s that the C-40 replaces is: 38
            years.
      --There will be no commercial operation of the C-9s or derivates by
            2011.
      --C-9s can not meet the GWOT requirement, due to MC rates, and
            availability of only 171 days in 2006.
      --Modifications required to make C-9s compliant with stage III Noise
            compliance, and worldwide Communications/Navigation/
            Surveillance/Air Traffic Management compliance--are cost
            prohibitive.
      --There are growing concerns about the availability and Mission
            Capability rates of the C-20Gs at Hawaii and Maryland units.
        Fourth:
      --737 Commercial Availability is slipping away, if we do not act now;
            loss of production line positions in fiscal year 2008-09--due
            to commercial demand would slip to 2013, and increase in DOD,
            Service expenditures.
      --C-130J procurement funding for 6 C-130s for the Navy Reserve.
      --E/F-18 Growler procurement to replace aged and retiring EA-6B
            aircraft at Maryland units, and for Active Duty Navy usage.
            Currently the NR EA-6B unit provides 90 continuous detachments
            in support of OIF/OEF.
      --A full range of Navy Expeditionary Command equipment.
        People join the Reserve Components to serve their country and
    operate equipment. Recruiting and retention issues have moved to center
    stage for all services and their reserve components. In all likelihood
    the Navy will not meet its target for new Navy Reservists and the Navy
    Reserve will be challenged to appreciably slow the departure of
    experienced personnel this fiscal year. We've heard that Reserve Chiefs
    are in agreement, expressing concern that senior personnel could leave
    when equipment is not available for training. Besides reenlistment
    bonuses which are needed, we feel that dedicated Navy Reserve equipment
    and Navy Reserve units are a major factor in recruiting and retaining
    qualified personnel in the Navy Reserve.
        Overwhelmingly, we have heard Reserve Chiefs and Senior Enlisted
    Advisors discuss the need and requirement for more and better equipment
    for Reserve Component training. The Navy Reserve is in dire need of
    equipment to keep personnel in the Navy Reserve and to keep them
    trained. We must have equipment and unit cohesion to keep personnel
    trained. This means--Navy Reserve equipment and Navy Reserve specific
    units with equipment.
                     the reserve component as a worker pool
        Issue: The view of the Reserve Component that has been suggested
    within the Pentagon is to consider the Reserve as of a labor pool,
    where Reservists could be brought onto Active Duty at the needs of a
    Service and returned, when the requirement is no longer needed. It has
    also been suggested that an Active Duty member should be able to rotate
    off active duty for a period, spending that tenure as a Reservist,
    returning to active duty when family, or education matters are
    corrected.
        Position: The Guard and Reserve should not be viewed as a
    temporary-hiring agency. Too often the Active Component views the
    recall of a Reservist as a means to fill a gap in existing active duty
    manning.
                              equipment ownership
        Issue: An internal study by the Navy has suggested that Naval
    Reserve equipment should be transferred to the Navy. At first glance,
    the recommendation of transferring Reserve Component hardware back to
    the Active component appears not to be a personnel issue. However,
    nothing could be more of a personnel readiness issue and is ill
    advised. Besides being attempted several times before, this issue needs
    to be addressed if the current National Security Strategy is to
    succeed.
        Position: The overwhelming majority of Reserve members join the RC
    to have hands-on experience on equipment. The training and personnel
    readiness of Reserve members depends on constant hands-on equipment
    exposure. History shows, this can only be accomplished through Reserve
    equipment, since the training cycles of Active Components are rarely if
    ever--synchronized with the training or exercise times of Reserve
    units. Additionally, historical records show that Reserve units with
    hardware maintain equipment at or higher than average material and
    often better training readiness. Current and future war fighting
    requirements will need these highly qualified units when the Combatant
    Commanders require fully ready units.
        Reserve and Guard units have proven their readiness. The personnel
    readiness, retention, and training of Reserve and Guard members will
    depend on them having Reserve equipment that they can utilize,
    maintain, train on, and deploy with when called upon. Depending on
    hardware from the Active Component, has never been successful for many
    functional reasons. The AUSN recommends the Committee strengthen the
    Reserve and Guard equipment appropriation in order to maintain
    optimally qualified and trained Reserve and Guard personnel.
        In summary, we believe the Committee needs to address the following
    issues for Navy and Navy Reservists in the best interest of our
    National Security:
      --Fund C-40A for the Navy Reserve, per the fiscal year 2009
            Supplemental; we must replace the C-9s and replace the C-20Gs
            in Hawaii and Maryland.
      --Fund 6 C-130Js for the Navy Reserve, per the CNO unfunded list.
      --Moratorium on Active Duty end-strength cuts.
      --Establish an End-strength cap of 68,000 as a floor for end strength
            to Navy Reserve manpower--providing for surge-ability and
            operational force.
      --Increase funding for Naval Reserve equipment in NGREA
        --E/F-18 Growler aircraft for Navy and Navy Reserve units,
                especially the NR unit stationed in Maryland.
        --Explosive Ordnance Disposal Equipment
        We thank the committee for consideration of these tools to assist
    the Navy and Navy Reserve in an age of increased sacrifice and
    utilization of these forces.
        Thank you for your ongoing support of the Nation, the Armed
    Services, The United States Navy, The United States Navy Reserve, and
    the fine men and women who defend our country.

        Chairman Inouye. Our next witness represents the
    Mesothelioma Applied Research Foundation, Ms. Mary Hesdorffer.
    STATEMENT OF MARY HESDORFFER, NURSE PRACTITIONER,
                MEDICAL LIAISON, MESOTHELIOMA APPLIED
                RESEARCH FOUNDATION (MARF)
        Ms. Hesdorffer. Good morning, distinguished members of the
    U.S. Senate Defense Appropriations Subcommittee. Thank you for
    the opportunity to address you on a cruel cancer that kills our
    veterans.
        My name is Mary Hesdorffer, I'm a nurse practitioner, and
    I'm the medical liaison to the Mesothelioma Applied Research
    Foundation.
        Your subcommittee has recognized the strong connection
    between mesothelioma and military service. Because asbestos was
    heavily used all over Navy ships, millions of servicemen and
    shipyard workers were exposed. One study found that one-third
    of today's meso victims were exposed on U.S. Navy ships, or
    shipyards, like Pearl Harbor, Puget Sound, and Groton.
        A renowned meso researcher from Lake Forest just shared
    with me, the other night, that the rate of veterans who have
    been exposed to asbestos have a sevenfold increase in
    mesothelioma over the normal population. Dangerous exposures
    continue today, and have been reported among the troops in Iraq
    and Afghanistan, and there's also grave concern for our first
    responders to 9/11. My son just returned from Iraq, and he was
    a responder at 9/11, so I have a deep concern over these
    exposures.
        Asbestos is common in buildings, including the utility
    tunnels right below us. For all those who develop mesothelioma
    as a result, the only hope is that we will develop an effective
    treatment, yet mesothelioma has virtually received no Federal
    funding. Therefore, treatments have not advanced. We only have
    one approved treatment for this disease; it takes a life
    expectancy of between 6 to 9 months to, now, 12.2 months.
        Your subcommittee has recognized the need and has taken the
    lead. For the past 2 years, you have directed DOD to spur
    research for meso by including it in the PR and RP. However,
    your leadership was thwarted this year. Thirty-eight
    mesothelioma research grants were submitted to the--for the
    review year for 2008, which demonstrates a huge interest in
    mesothelioma. But, while other diseases got six grants each,
    DOD is funding only one mesothelioma grant.
        It's critically needed, our research funding. The research
    with--Dr. Courtney Broaddus is one of the world's top meso
    experts, and she told us that, without this grant, she was
    going to have to close her lab. This really has salvaged her
    career.
        Going forward on an award rate of 2.6 percent is still not
    enough to encourage top researchers to apply, or new
    researchers to establish their careers in mesothelioma. The
    research will not advance, effective treatments will not be
    found. We believe that the subcommittee must make clear to DOD
    its intent to spur mesothelioma research by directing DOD to
    establish funding of $67 million to DOD for seven new programs,
    including a peer-reviewed cancer research program that does not
    currently include mesothelioma.
        It's a rapidly fatal, excruciatingly painful cancer,
    directly related to military service. We ask the subcommittee
    to appropriate DOD $5 million for a peer-reviewed cancer
    research program that will boost the long-neglected field of
    mesothelioma research, translating directly to saving lives and
    reducing suffering in veterans.
        Thank you.
        Chairman Inouye. I thank you very much, Ms. Hesdorffer.
        [The statement follows:]
                     Prepared Statement of Mary Hesdorffer
        Distinguished members of the U.S. Senate Defense Appropriations
    Subcommittee: Thank you for this opportunity to address a tragic
    disease that kills our veterans. My name is Mary Hesdorffer. I am a
    nurse practitioner with over a decade's experience in mesothelioma
    treatment and research, and am the Medical Liaison for the Mesothelioma
    Applied Research Foundation.
                             malignant mesothelioma
        Mesothelioma is an aggressive cancer caused by asbestos. It is
    among the most painful and fatal of cancers, as it invades the chest,
    destroys vital organs, and crushes the lungs.
                the ``magic mineral''--exposures were widespread
        From the 1930s through the 1970s asbestos was used all over Navy
    ships. Millions of servicemen and shipyard workers were exposed. Many
    of them are now developing mesothelioma, following the disease's long
    latency period.
                         mesothelioma takes our heroes
        These are the people who served our country's defense. Heroes like
    Admiral Elmo Zumwalt, Jr., Chief Naval Officer during Vietnam,
    Commander Harrison Starn, who served from World War II through Vietnam,
    and thousands of servicemen like USS Kitty Hawk Boilerman Lewis Deets,
    who volunteered for Vietnam at barely 18, all struck down by
    mesothelioma. Last year I testified about mesothelioma patient Bob
    Tregget, who was exposed to asbestos aboard a nuclear submarine from
    1965 to 1972. Following grueling best-available treatment, Bob was
    recurrent and in extreme untreatable pain. But he was hanging on,
    hoping the next treatment advance would come soon enough to help him.
    It didn't and Bob passed away a few months ago.
        Almost 3,000 more Americans like Bob die each year of mesothelioma,
    and one study found that one-third were exposed on U.S. Navy ships or
    shipyards, lost through service to country just as if they had been on
    a battlefield.
        Many more are being exposed now. Asbestos exposures have been
    reported among the troops in Iraq and Afghanistan. There is grave
    concern for the heroic first responders from 9/11, including my son,
    who just returned from service in Iraq. Asbestos is common in
    buildings. The utility tunnels in this very building have dangerous
    levels. Even low-dose, incidental exposures cause mesothelioma.
    Minnesota Congressman Bruce Vento worked near an asbestos-insulated
    boiler in a summer college job. He died of mesothelioma in 2000. His
    wife Sue Vento testified before you in 2007. For all those who will
    develop mesothelioma as a result of these past or ongoing exposures,
    the only hope is that we will develop effective treatment.
                     mesothelioma funding has not kept pace
        Yet mesothelioma research has been overlooked. With the huge
    Federal investment in cancer research through the NCI, and $4.8 billion
    spent in biomedical research through the DOD Congressionally Directed
    Research Program since 1992, we are winning the war on cancer and many
    other diseases. But for mesothelioma, the National Cancer Institute has
    provided virtually no funding, in the range of only $1.7 to $3 million
    annually over the course of the last 6 years, and the DOD has not
    invested in any mesothelioma research despite the military-service
    connection. As a result, advancements in the treatment of mesothelioma
    have lagged far behind other cancers. In fact, for decades, there was
    no approved treatment better than doing nothing at all. Our veterans
    who develop mesothelioma have an average survival of only 4-14 months.
                               new opportunities
        But there is good news. Brilliant researchers are dedicated to
    mesothelioma. The FDA has now approved one drug which has some
    effectiveness, proving that the tumor is not invincible. Biomarkers are
    being identified. Two of the most exciting areas in cancer research--
    gene therapy and anti-angiogenesis--look particularly promising in
    mesothelioma. The Meso Foundation has funded $6 million to support
    research in these and other areas. Now we need the Federal Government's
    partnership, to develop the promising findings into effective
    treatments.
                        committee's leadership thwarted
        Your committee has recognized the need and taken the lead. For the
    past 2 years (fiscal years 2008 and 2009), you have directed DOD to
    spur research for this service-related cancer by including it as an
    area of emphasis in the Peer Reviewed Medical Research Program.
        However, I have to report to you that unfortunately your leadership
    in acting to spur mesothelioma research has been thwarted. DOD just
    announced the results of the PRMRP program for fiscal year 2008.
    Thirty-eight mesothelioma research projects were submitted. This
    demonstrates the huge demand for mesothelioma research funding that we
    testified about and that you directed DOD to address. But while other
    diseases got six grants each, DOD (tentatively) funded only one
    researcher (Courtney Broaddus) for a mesothelioma project. This is a
    successful application rate of just 2.6 percent.
        This is critically-needed funding. Dr. Broaddus is one of the
    world's top mesothelioma researchers. Indeed she was president of the
    International Mesothelioma Interest Group from 1999 through 2002. She
    and her team were surviving on three now concluded grants from the Meso
    Foundation. This DOD grant salvaged career in mesothelioma research.
    (See attached 5/24/09 email from Dr. Broaddus to Meso Foundation
    Executive Director Chris Hahn.) We are extremely grateful that thanks
    to your leadership and the DOD's awarding this one grant this renowned
    researcher will not have to abandon her investment and expertise in
    mesothelioma. But 37 other researchers put in the time, effort and
    expense to gather preliminary data and apply, and then were rejected.
    What happens to them? Going forward, a success rate of just 2.6 percent
    will discourage top researchers from applying in mesothelioma; they
    will direct their effort and expertise into other, better funded
    cancers. Similarly, new researchers will not establish their careers in
    mesothelioma either. Mesothelioma research will not advance, effective
    treatments will not be found, and veterans and current members exposed
    to asbestos through their military service will be left without hope.
                             a dedicated investment
        Since the Committee's intent to spur mesothelioma research is not
    being executed through the PRMRP, we believe the Committee must respond
    by directing DOD to establish a dedicated mesothelioma program. For
    2009, Congress added dedicated funding for all of the following as new
    programs, in addition to the DOD's existing programs for Breast Cancer,
    Prostate Cancer, Ovarian Cancer, Neurofibromatosis, Tuberous Sclerosis
    Complex, and the Peer Reviewed Medical Research Program:
      --Autism Research Program, $8 million;
      --Gulf War Illness Research Program, $8 million;
      --Amyotrophic Lateral Sclerosis Research Program, $5 million;
      --Bone Marrow Failure Research Program, $5 million;
      --Multiple Sclerosis Research Program, $5 million;
      --Peer Reviewed Lung Cancer Research Program, $20 million;
      --Peer Reviewed Cancer Research Program, $16 million, restricted as
            follows: $4 million for research of melanoma and other skin
            cancers as related to deployments of service members to areas
            of high exposure; $2 million for research of pediatric brain
            tumors within the field of childhood cancer research; $8
            million for genetic cancer research and its relation to
            exposure to the various environments that are unique to a
            military lifestyle; and $2 million for non-invasive cancer
            ablation research into non-invasive cancer treatment including
            selective targeting with nano-particles.
        All of these research areas warrant attention, but mesothelioma is
    a rapidly fatal, excruciatingly painful cancer directly related to
    military service. We ask the Committee to appropriate to DOD for fiscal
    year 2010 $5 million for a dedicated Mesothelioma Research Program or
    as a specific restriction within the Peer Reviewed Cancer Research
    Program. This will boost the long-neglected field of mesothelioma
    research, enabling mesothelioma researchers to build a better
    understanding of the disease and develop effective treatments. This
    will translate directly to saving lives and reducing suffering of
    veterans battling mesothelioma.
        We look to the Senate Defense Appropriations Subcommittee to
    provide continued leadership and hope to the servicemen and women and
    veterans who develop this cancer after serving our Nation. Thank you
    for the opportunity to provide testimony before the Subcommittee and we
    hope that we can work together to develop life-saving treatments for
    mesothelioma.

        Chairman Inouye. And now may I call upon the secretary
    treasurer of the American Society of Tropical Medicine and
    Hygiene, Dr. Jonathan Berman.
    STATEMENT OF JONATHAN D. BERMAN, MD, Ph.D., COLONEL,
                UNITED STATES ARMY (RET.), SECRETARY-
                TREASURER, AMERICAN SOCIETY OF TROPICAL
                MEDICINE AND HYGIENE
        Dr. Berman. Mr. Chairman, ranking member, I welcome the
    opportunity to testify before you today on behalf of the
    American Society of Tropical Medicine and Hygiene, ASTMH.
        I commend this subcommittee for its focus on the vital
    issue of military infectious disease research, and the
    important role of that research in protecting troops deployed
    abroad.
        I am Dr. Jonathan Berman, secretary/treasurer of ASTMH, and
    a retired U.S. Army colonel.
        With nearly 3,500 members, ASTMH is the world's largest
    professional membership organization dedicated to the
    prevention and control of tropical diseases. We represent,
    educate, and support tropical medicine's scientists and
    clinicians. I want to talk to you today about the importance of
    funding for the DOD's infectious disease research and
    particularly malaria research.
        Malaria is one of the most serious health threats facing
    U.S. troops serving abroad. The U.S. military has, for decades,
    been on the forefront of global efforts to develop new
    antimalarial drugs and the world's first malaria vaccine. These
    research efforts are appropriately aimed at protecting and
    treating the warfighter, but they have important civilian
    applications, as well. Malaria is one of the greatest
    infectious-disease killers, and countless lives worldwide have
    been saved by antimalarial medicines developed in part or
    primarily by the DOD.
        Unfortunately, the parasite that causes malaria, like all
    microorganisms, is adaptive and develops resistance to drugs
    quickly. Until very recently, the military's first-line malaria
    therapeutic and prophylactic agent was mefloquine, a drug
    developed by military researchers to create a replacement for
    chloroquine, used soon after World War II.
        Mefloquine came into use in the 1980s, but parasites in
    Southeast Asia have already developed resistance to it, and
    resistance is now being identified in West Africa and South
    America, as well. Consequently, the military no longer
    considers mefloquine to be a first-line treatment, and at this
    time the military does not have an ideal malarial prophylactic
    agent. Ensuring that we can protect troops from malaria in
    future deployments means that we must continue to develop new
    drugs and an effective vaccine.
        Military malaria research funding represented approximately
    $23 million in fiscal year 2008, the most recent fiscal year
    for which figures are available. This level is not commensurate
    with the health threat malaria poses to military operations,
    therefore ASTMH respectively requests that the subcommittee
    increase funding for malaria research in fiscal year 2010 to
    $30 million, and provide subsequent annual increases, ending up
    at $77 million in funding in fiscal year 2015.
        Mr. Chairman and ranking member, thank you for providing me
    with the opportunity to speak today on behalf of ASTMH
    regarding this important but often overlooked defense issue.
        Chairman Inouye. Thank you very much, Dr. Berman.
        [The statement follows:]
                    Prepared Statement of Jonathan D. Berman
        Overview: The American Society of Tropical Medicine and Hygiene
    (ASTMH) appreciates the opportunity to submit written testimony to the
    Senate Defense Appropriations Subcommittee. With nearly 3,300 members,
    ASTMH is the world's largest professional membership organization
    dedicated to the prevention and control of tropical diseases. We
    represent, educate, and support tropical medicine scientists,
    physicians, clinicians, researchers, epidemiologists, and other health
    professionals in this field.
        Because the military operates in and deploys to so many tropical
    regions, reducing the risk that tropical diseases present to servicemen
    and women is often critical to mission success. Malaria is a
    particularly important disease in this respect, because it is both one
    of the world's most common and deadly infectious diseases, and the U.S.
    military has a long history of deploying to regions endemic to malaria
    and suffering malaria casualties as a result.
        For this reason, we respectfully request that the Subcommittee
    expand funding for the Department of Defense's longstanding and
    successful efforts to develop new drugs, vaccines, and diagnostics
    designed to protect servicemen and women from malaria while deployed
    abroad. Specifically, we request that in fiscal year 2010, the
    Subcommittee ensure that the Department of Defense spends $30 million
    on malaria research and development. Furthermore, we request that the
    Subcommittee provide annual increases such that total military spending
    on malaria research is $76.5 million in fiscal year 2015. This funding
    will support ongoing efforts by military researchers to develop a
    vaccine against malaria and to develop new anti-malaria drugs to
    replace older drugs that are losing their effectiveness as a result of
    parasite resistance. Increased malaria research will help ensure that
    our soldiers, sailors, airmen, and marines are protected from this
    deadly disease when deployed to tropical regions.
        We very much appreciate the Subcommittee's consideration of our
    views, and we stand ready to work with Subcommittee members and staff
    on these and other important tropical disease matters.
                                     astmh
        ASTMH plays an integral and unique role in the advancement of the
    field of tropical medicine. Its mission is to promote global health by
    preventing and controlling tropical diseases through research and
    education. As such, the Society is the principal membership
    organization representing, educating, and supporting tropical medicine
    scientists, physicians, researchers, and other health professionals
    dedicated to the prevention and control of tropical diseases. Our
    members reside in 46 States and the District of Columbia and work in a
    myriad of public, private, and nonprofit environments, including
    academia, the U.S. military, public institutions, Federal agencies,
    private practice, and industry.
        The Society's long and distinguished history goes back to the early
    20th century. The current organization was formed in 1951 with the
    amalgamation of the National Malaria Society and the American Society
    of Tropical Medicine. Over the years, the Society has counted many
    distinguished scientists among its members, including Nobel laureates.
    ASTMH and its members continue to have a major impact on the tropical
    diseases and parasitology research carried out around the world.
        The central public policy priority of ASTMH is reducing the burden
    of infectious disease in the developing world. To that end, we advocate
    implementation and funding of Federal programs that address the
    prevention and control of infectious diseases that are leading causes
    of death and disability in the developing world, and which pose threat
    to U.S. citizens. Priority diseases include malaria, Dengue fever,
    Leishmaniasis, Ebola, cholera, and tuberculosis.
                        malaria and military operations
        Servicemen and women deployed from the U.S. military comprise a
    majority of the healthy adults traveling each year to malarial regions
    on behalf of the U.S. Government. For this reason, the U.S. military
    has long taken a primary role in the development of anti-malarial
    drugs, and nearly all of the most effective and widely used anti-
    malarials were developed in part by U.S. military researchers. Drugs
    that have saved countless lives throughout the world were originally
    developed by the U.S. military to protect troops serving in tropical
    regions during WWII, the Korean War, and the Vietnam War.
        Fortunately, in recent years the broader international community
    has stepped up its efforts to reduce the impact of malaria in the
    developing world, particularly by reducing childhood malaria mortality,
    and the U.S. military is playing an important role in this broad
    partnership. But military malaria researchers are working practically
    alone in the area most directly related to U.S. national security:
    drugs and vaccines designed to protect or treat healthy adults with no
    developed resistance to malaria who travel to regions endemic to the
    disease. These drugs and vaccines would benefit everyone living or
    traveling in the tropics, but are particularly essential to the United
    States for the protection of forces from disease during deployments.
        Unfortunately, the prophylaxis and therapeutics currently given to
    U.S. servicemen and women are losing their effectiveness. During World
    War II, the Korean War, and Vietnam, the quinine-based anti-malaria
    drug chloroquine was the chemoprophylaxis and therapy of choice for the
    U.S. military. Over time, however, the malaria parasite developed
    widespread resistance to choloroquine, making the drug less effective
    at protecting deployed troops from malaria. Fortunately, military
    researchers at the Walter Reed Army Institute of Research (WRAIR)
    achieved the scientific breakthroughs that led to the development of
    mefloquine, which quickly replaced chloroquine as the military's front-
    line drug against malaria.
        The malaria parasite has consistently demonstrated a notorious
    ability to quickly become resistant to new drugs, and the latest
    generation of medicines is no exception. Malaria parasites in Southeast
    Asia have already developed significant resistance to mefloquine, and
    resistant strains of the parasite have also been identified in West
    Africa and South America. In addition, there are early indications that
    parasite populations in southeast Asia may already be developing
    limited resistance to arteminisin, currently the most powerful anti-
    malarial available. Indeed, the most deadly variant of malaria--
    Plasmodium falciparum--is believed by the World Health Organization to
    have become resistant to ``nearly all antimalarials in current use.''
    This resistance is not yet universal among the global Plasmodium
    falciparum population, with parasites in a given geographic area having
    developed resistance to some drugs and not others. But the sheer speed
    with which the parasite is developing resistance to mefloquine and
    arteminisin--drugs developed in the 1970s and 1980s--reminds us that
    military malaria researchers cannot afford to rest on their laurels.
    Developing new anti-malarials as quickly as the parasite becomes
    resistant to existing ones is an extraordinary challenge, and one that
    requires significant resources. Without new anti-malarials to replace
    existing drugs as they become obsolete, U.S. military operations in
    regions endemic to malaria may be compromised.
        Unfortunately, our limited ability to protect forces from malaria
    infection is not hypothetical: overseas operations are already being
    impacted. A 2007 study by Army researchers found that from 2000 through
    2005, at least 423 U.S. service members contracted malaria while
    deployed overseas, with the vast majority of these cases the result of
    deployments to South Korea (where malaria has recently remerged along
    the demilitarized zone with North Korea), Afghanistan and, to a lesser
    extent, Iraq. Notably, none of these countries are thought of by
    experts as being especially dangerous in terms of malaria, as opposed
    to the many countries in Sub-Saharan Africa and Southeast Asia where
    malaria is much more prevalent, and where more deadly strains of the
    parasite thrive. For example, a 2003 peacekeeping operation in Liberia
    resulted in a 44 percent malaria infection rate among Marines who spent
    at least one night ashore.
        Clearly, U.S. service members are insufficiently protected from
    malaria. The reasons for this are many, and include drug resistance as
    well as ongoing issues with compliance by soldiers who have difficulty
    maintaining a malaria prophylaxis regimen under combat conditions, or
    who have contraindications to the use of mefloquine or other drugs.\1\
    Regardless of the cause for continuing vulnerability to malaria,
    however, the outlook is the same: until a malaria vaccine is finally
    developed, ensuring the safety and health of U.S. troops deploying to 1
    of the more than 100 countries where malaria is endemic will require
    the constant development of new malaria drugs, in a race against the
    parasite's ability to develop drug resistances.
    ---------------------------------------------------------------------------
        \1\ The aforementioned 2007 Army study found that of 11,725 active
    duty Army personnel deployed to Afghanistan during the study period,
    9.6 percent had contraindications to the use of mefloquine, the Army's
    first-line malaria treatment.
    ---------------------------------------------------------------------------
        To ensure that as many American soldiers as possible are protected
    from tropical and other diseases, Congress provides funding each year
    to support Department of Defense programs focused on the development of
    vaccines and drugs for priority infectious diseases. To that end, the
    Walter Reed Army Institute of Research and the Naval Medical Research
    Center coordinate one of the world's premier tropical disease research
    programs. These entities contributed to the development of the gold
    standard for experimental malaria immunization of humans, and the most
    advanced and successful drugs current being deployed around the world.
        The need to develop new and improved malaria prophylaxis and
    treatment for U.S. service members is not yet a crisis, but it could
    quickly become one if the United States were to become involved in a
    large deployment to a country or region where malaria is endemic,
    especially sub-Saharan Africa. Fortunately, a comparatively tiny amount
    of increased support for this program would restore the levels of
    research and development investment required to produce the drugs that
    will safeguard U.S. troops from malaria. In terms of the overall DOD
    budget, that malaria research program's funding is small--approximately
    $23.1 million in fiscal year 2008--but very important. Cutting funding
    for this program would deal a major blow to the military's work to
    reduce the impact of malaria on soldiers and civilians alike, thereby
    undercutting both the safety of troops deployed to tropical climates,
    and the health of civilians in those regions.
                      fiscal year 2010 dod appropriations
        To protect U.S. military personnel, research must continue to
    develop new anti-malarial drugs and better diagnostics, and to identify
    an effective malaria vaccine appropriate for adults with no developed
    resistance to malaria. Much of this important research currently is
    underway at the Department of Defense. Additional funds and a greater
    commitment from the Federal Government are necessary to make progress
    in malaria prevention, treatment, and control.
        In fiscal year 2008, the Department of Defense spent only $23.1
    million on malaria research, despite the fact that malaria historically
    has been a leading cause of troop impairment and continues to be a
    leading cause of death worldwide. As the 2006 Institute of Medicine
    report Battling Malaria: Strengthening the U.S. Military Malaria
    Vaccine Program noted, ``Malaria has affected almost all military
    deployments since the American Civil War and remains a severe and
    ongoing threat.'' ASTMH agrees that malaria remains a severe and
    ongoing threat to U.S. military deployments to countries and regions
    endemic to malaria, and we believe that increased support for efforts
    to reduce this threat is warranted. A more substantial investment will
    help to protect American soldiers and potentially save the lives of
    millions of individuals around the world.
        Therefore, we request that the Subcommittee take support a fiscal
    year 2010 Department of Defense malaria research funding level of $30
    million. Furthermore, we request that the Subcommittee provide annual
    increases to this account such that total military spending on malaria
    research is $76.5 million in fiscal year 2015.
        By way of comparison with this request, in March of 2007 the
    Department of Defense estimated that it would spend $23.1 million on
    malaria research in fiscal year 2008. Unfortunately, neither an
    estimated level of fiscal year 2009 spending nor a fiscal year 2010
    request is available, because the Department of Defense does not
    typically report these numbers. However, recent funding trends suggest
    that military spending on research in this vital area is falling
    steadily.
        The role of infectious disease in the success or failure of
    military operations is often overlooked, but even a cursory review of
    U.S. and world military history underscores the fact that keeping
    military personnel safe from infectious disease is critical to mission
    success. The drugs and prophylaxis used to keep our men and women safe
    from malaria during previous conflicts in tropical regions are no
    longer reliable. Ensuring the safety of those men and women in future
    conflicts and deployments will require research on new anti-malaria
    tools. Thank you for your attention to this matter. We appreciate the
    opportunity to share our views, and please be assured that ASTMH stands
    ready to serve as a resource on this and any other tropical disease
    policy matters.

        Our next witness is the senior vice president for public
    policy of The Leukemia & Lymphoma Society, Mr. George Dahlman.
    STATEMENT OF GEORGE DAHLMAN, SENIOR VICE PRESIDENT FOR
                PUBLIC POLICY, THE LEUKEMIA & LYMPHOMA
                SOCIETY
        Mr. Dahlman. Thank you very much, Mr. Chairman and Senator
    Cochran.
        I am George Dahlman, I'm pleased to appear today on behalf
    of The Leukemia & Lymphoma Society, and all the thousands of
    blood cancer patients we represent.
        As you know, there have been impressive strides in blood
    cancers--that's leukemia, lymphoma, myeloma, and some others--
    but, there is a lot of work to be done, and we believe that the
    public/private partnership that's part of the DOD's
    congressionally directed medical research program is an
    important part of that effort, and should be strengthened.
        The Leukemia & Lymphoma Society, along with its partners,
    believe that this is especially important for the Department of
    Defense to address. First, research in blood-related cancers
    has significant relevance to the Armed Forces because the
    incidence of these cancers is substantially higher among
    individuals with chemical and nuclear exposure. Higher
    incidences of leukemia have been substantiated in extreme
    nuclear incidents in both military and civilian populations,
    and individual exposures to chemical agents, such as Agent
    Orange in the Vietnam war, caused an increased risk of
    contracting lymphoid malignancies.
        And now we're seeing the applicability of blood cancer
    research played out once again in Iraq and Afghanistan as U.S.
    service personnel face consequences of burn pits and the blood
    cancers that have been reported.
        DOD research on blood cancers addresses the importance of
    preparing civilian and military exposure to the weapons being
    developed by several hostile nations, and aid in the research
    of all cancers.
        Mr. Chairman, and members of the subcommittee, with all due
    respect to our colleagues fighting a broad range of
    malignancies that are represented in this program, and
    certainly not to diminish their significance, a cancer research
    program designed for application of military and national
    security needs would invariably begin with a strong blood-
    cancer research foundation. And recognizing that fact and the
    opportunity this research represents, a bipartisan group of 48
    Members of Congress recently requested that the program be
    instated for $25 million, and be expanded to all blood cancers.
        Furthermore, we respectfully request that funding be
    dedicated to a collaborative, public/private effort between the
    United States Military Cancer Institute, The Leukemia &
    Lymphoma Society, and a blue-ribbon panel of scientific
    academicians.
        Chairman Inouye, as the cosponsor of Senate Bill 51, which
    authorizes the U.S. Military Cancer Institute, surely you
    recognize that the USMCI has over 9 million electronic medical
    records detailing the health histories of servicemen and women
    and their families. The military also has serum and tissue
    specimens from these individuals stored, as a routine step in
    their healthcare. These records and samples together provide a
    unique base that can power blood cancer research relevant to
    the military environment and lifestyle in a way that is not
    possible for any other population. A joint effort, tapping the
    expertise of both the USMCI and The Leukemia & Lymphoma Society
    represents a unique opportunity to identify valuable research
    opportunities and state-of-the-art technology that can address
    significant questions on the origins and diagnosis of blood
    cancers.
        And I would just add, Senator Inouye, it seems odd that
    there is this disconnect between the USMCI, on the one hand,
    that studies cancer, and the cancer programs that are done
    through the CDMRP, as part--at Fort Dietrich--these two groups
    do not communicate with one another.
        The Leukemia & Lymphoma Society strongly endorses and
    enthusiastically supports an effort to pursue this project, and
    respectfully urges the subcommittee to include this funding in
    the fiscal year 2010 defense appropriations bill.
        Thank you.
        Chairman Inouye. Thank you very much, Mr. Dahlman.
        [The statement follows:]
                      Prepared Statement of George Dahlman
                                  introduction
        Mr. Chairman and members of the committee, my name is George
    Dahlman, Senior Vice President, Public Policy for The Leukemia &
    Lymphoma Society. I am pleased to appear today and testify on behalf of
    the Society and the more than 900,000 Americans currently living with
    blood cancers and the 135,000 who will be diagnosed with one this
    year--recently some of whom have been right here in the Senate
    Furthermore, every 10 minutes, someone dies from one of these cancers--
    leukemia, lymphoma, Hodgkin's disease and myeloma.
        During its 60-year history, the Society has been dedicated to
    finding a cure for the blood cancers, and improving the quality of life
    of patients and their families. The Society has the distinction of
    being both the nation's second largest private cancer organization and
    the largest private organization dedicated to biomedical research,
    education, patient services and advocacy as they pertain to blood
    cancers.
        Our central contribution to the search for cures for the blood
    cancers is providing a significant amount of the funding for basic,
    translational and clinical research. In 2009, we will provide
    approximately $70 million in research grants. In addition to our
    research funding role, we help educate health care and school
    professionals as needed and provide a wide range of services to
    individuals with a blood cancer, their caregivers, families, and
    friends through our 64 chapters across the country. Finally, we
    advocate responsible public policies that will advance our mission of
    finding cures for the blood cancers and improving the quality of life
    of patients and their families.
        We are pleased to report that impressive progress is being made in
    the effective treatment of many blood cancers, with 5-year survival
    rates doubling and even tripling over the last two decades. More than
    90 percent of children with Hodgkin's disease now survive, and survival
    for children with acute lymphocytic leukemia and non-Hodgkin's lymphoma
    has risen as high as 86 percent.
        Just 7 years ago, in fact, a new therapy was approved for chronic
    myelogenous leukemia, a form of leukemia for which there were
    previously limited treatment options, all with serious side-effects--5-
    year survival rates were just over 50 percent. Let me say that more
    clearly, if 8 years ago your doctor told you that you had CML, you
    would have been informed that there were limited treatment options and
    that you should get your affairs in order. Today, those same patients
    have access to this new therapy, called Gleevec, which is a so-called
    targeted therapy that corrects the molecular defect that causes the
    disease, and does so with few side effects. Now, 5-year survival rates
    are as high as 96 percent for patients newly diagnosed with chronic
    phase CML.
        The Society funded the early research that led to Gleevec's
    approval, as it has contributed to research on a number of new
    therapies. We are pleased that we played a role in the development of
    this life-saving therapy, but we realize that our mission is far from
    realized. Many forms of leukemia, lymphoma and myeloma still present
    daunting treatment challenges. There is much work still to be done, and
    we believe that the research partnership between the public and private
    sectors--as represented in the Department of Defense's Congressionally
    Directed Medical Research Program--is an integral part of that
    important effort and should be further strengthened.
             the grant programs of the leukemia & lymphoma society
        The grant programs of the Society have traditionally been in three
    broad categories: Career Development Program grants, Translational
    Research Program grants, and Specialized Centers of Research Program
    grants. In our Career Development Program, we fund Scholars, Special
    Fellows, and Fellows who are pursuing careers in basic or clinical
    research. In our Translational Research Program, we focus on supporting
    investigators whose objective is to translate basic research
    discoveries into new therapies.
        The work of Dr. Brian Druker, an oncologist at Oregon Health
    Sciences University and the chief investigator responsible for
    Gleevec's development, was supported by a Translational Research
    Program grant from the Society.
        Our Specialized Centers of Research grant program is intended to
    bring investigators together to form new research teams focused on the
    discovery of innovative approaches to treating and/or preventing
    leukemia, lymphoma, and myeloma. The awards go to those groups that can
    demonstrate that their close interaction will create research synergy
    and accelerate our search for new and better treatments.
        Dr. Druker is certainly a star among those supported by the
    Society, but our support in the biomedical field is broad and deep.
    Through the Society's research grant programs, we are currently
    supporting more than 380 investigators at 134 institutions in 34 States
    and 12 other countries.
        Not content with these extensive efforts, the Society has launched
    a new Therapy Acceleration Program intended to proactively invest in
    promising blood cancer therapies that are in early stages of
    development by industry, but which may not have sufficient financial
    support or market potential to justify private sector investment. In
    addition, the Society will use this program to further facilitate the
    advancement of therapies in development by academic researchers who may
    not have the spectrum of resources or expertise to fulfill the
    potential of their discoveries. Directed early phase clinical trial
    support in this funding program will further advance new and better
    treatments for blood cancer treatments.
                        impact of hematological cancers
        Despite enhancements in treating blood cancers, there are still
    significant research challenges and opportunities. Hematological, or
    blood cancers pose a serious health risk to all Americans. These
    cancers are actually a large number of diseases of varied causes and
    molecular make-up, and with different treatments, that strike men and
    women of all ages. In 2009, more than 130,000 Americans will be
    diagnosed with a form of blood-related cancer and almost 65,000 will
    die from these cancers. For some, treatment may lead to long-term
    remission and cure; for others these are chronic diseases that will
    require treatments across a lifetime; and for others treatment options
    are still extremely limited. For many, recurring disease will be a
    continual threat to a productive and secure life.
        A few focused points to put this in perspective:
      --Taken together, the hematological cancers are fifth among cancers
            in incidence and fourth in mortality.
      --Over 900,000 Americans are living with a hematological malignancy
            in 2009.
      --Almost 65,000 people will die from hematological cancers in 2009,
            compared to 160,000 from lung cancer, 41,000 from breast
            cancer, 27,000 from prostate cancer, and 52,000 from colorectal
            cancer.
      --Blood-related cancers still represent serious treatment challenges.
            The improved survival for those diagnosed with all types of
            hematological cancers has been uneven. The 5-year survival
            rates are:
        --Hodgkin's disease, 87 percent;
        --Non-Hodgkin's lymphoma, 64 percent;
        --Leukemias (total), 50 percent;
        --Multiple Myeloma, 33 percent;
        --Acute Myelogenous Leukemia, 21 percent.
      --Individuals who have been treated for leukemia, lymphoma, and
            myeloma may suffer serious adverse consequences of treatment,
            including second malignancies, organ dysfunction (cardiac,
            pulmonary, and endocrine), neuropsychological and psychosocial
            aspects, and poor quality of life.
      --For the period from 1975 to 2005, the incidence rate for non-
            Hodgkin's lymphoma increased by 79 percent (increasing 2.6
            percent/year).
      --Non-Hodgkin's lymphoma and multiple myeloma rank second and fifth,
            respectively, in terms of increased cancer mortality since
            1973.
      --Lymphoma is the third most common childhood cancer and the fifth
            most common cancer among Hispanics of all races. Recent
            statistics indicate both increasing incidence and earlier age
            of onset for multiple myeloma.
      --Multiple myeloma is one of the top 10 leading causes of cancer
            death among African Americans.
      --Hispanic children of all races under the age of 20 have the highest
            rates of childhood leukemias.
      --Despite the significant decline in the leukemia and lymphoma death
            rates for children in the United States, leukemia is still the
            leading cause of death in the United States among children less
            than 20 years of age, in females between the ages of 20 and 39
            and males between the ages of 60-79.
      --Lymphoma is the fourth leading cause of death among males between
            the ages of 20 and 39 and the fifth leading cause of death for
            females older than 80. Overall, cancer is now the leading cause
            of death for U.S. citizens younger than 85 years of age,
            overtaking heart disease as the primary killer.
             possible environmental causes of hematological cancers
        The causes of hematological cancers are varied, and our
    understanding of the etiology of leukemia, lymphoma, and myeloma is
    limited. Extreme radiation exposures are clearly associated with an
    increased incidence of leukemias. Benzene exposures are associated with
    increased incidence of a particular form of leukemia. Chemicals in
    pesticides and herbicides, as well as viruses such as HIV and EBV,
    apparently play a role in some hematological cancers, but for most
    cases, no environmental cause is identified. Researchers have recently
    published a study reporting that the viral footprint for simian virus
    40 (SV40) was found in the tumors of 43 percent of NHL patients. These
    research findings may open avenues for investigation of the detection,
    prevention, and treatment of NHL. There is a pressing need for more
    investigation of the role of infectious agents or environmental toxins
    in the initiation or progression of these diseases.
                    importance to the department of defense
        The Leukemia & Lymphoma Society, along with its partners in the
    American Society of Hematology, Aplastic Anemia & MDS International
    Foundation, International Myeloma Foundation, Lymphoma Research
    Foundation, and Multiple Myeloma Research Foundation, believe
    biomedical research focused on the hematological cancers is
    particularly important to the Department of Defense for a number of
    reasons.
        First, research on blood-related cancers has significant relevance
    to the armed forces, as the incidence of these cancers is substantially
    higher among individuals with chemical and nuclear exposure. Blood
    cancers are linked to members of the military who were exposed to
    ionizing radiation, such as those who occupied Japan after World War II
    and those who participated in atmospheric nuclear tests between 1945-
    1962. Service members who contract multiple myeloma, non-Hodgkin's
    lymphoma, and leukemias other than chronic lymphocytic leukemia are
    presumed to have contracted these diseases as a result of their
    military service; hence, they are eligible to receive benefits from the
    Department of Veterans Affairs (VA).
        Secondly, in-country Vietnam veterans who contract Hodgkin's
    disease, chronic lymphocytic leukemia, multiple myeloma, or non-
    Hodgkin's lymphoma are presumed to have contracted these diseases as a
    result of their military service and the veterans are eligible to
    receive benefits from the VA.
        Thirdly, the Institute of Medicine (IOM) has found that Gulf War
    veterans are at risk for contracting a number of blood cancers. For
    instance, the IOM has found sufficient evidence of a causal
    relationship between exposure to benzene and acute leukemias.
    Additionally, the IOM has found there is sufficient evidence of an
    association between benzene and adult leukemias, and solvents and acute
    leukemias. Finally, the IOM has also found there is also limited or
    suggestive evidence of an association between exposure to
    organophosphorous insecticides to non-Hodgkin's lymphoma and adult
    leukemias; carbamates and Benzene to non-Hodgkin's lymphoma; and
    solvents to multiple myeloma, adult leukemias, and myelodysplastic
    syndromes--a precursor to leukemia.
        Furthermore, research in the blood cancers has traditionally
    pioneered treatments in other malignancies. Cancer treatments that have
    been developed to treat a blood-related cancer are now used or being
    tested as treatments for other forms of cancer. Combination
    chemotherapy and bone marrow transplants are two striking examples of
    treatments first developed for treating blood cancer patients. More
    recently, specific targeted therapies have proven useful for treating
    patients with solid tumors as well as blood cancers.
        From a medical research perspective, it is a particularly promising
    time to build a DOD research effort focused on blood-related cancers.
    That relevance and opportunity were recognized for a 6-year period when
    Congress appropriated $4.5 million annually--for a total of $28
    million--to begin initial research into chronic myelogenous leukemia
    (CML) through the Congressionally Directed Medical Research Program
    (CDMRP). As members of the Subcommittee know, a noteworthy and
    admirable distinction of the CDMRP is its cooperative and collaborative
    process that incorporates the experience and expertise of a broad range
    of patients, researchers and physicians in the field. Since the Chronic
    Myelogenous Leukemia Research Program (CMLRP) was announced, members of
    the Society, individual patient advocates and leading researchers have
    enthusiastically welcomed the opportunity to become a part of this
    program and contribute to the promise of a successful, collaborative
    quest for a cure.
        In spite of the utility and application to individuals who serve in
    the military, the CML program was not included in January's 2007
    Continuing Resolution funding other fiscal year 2007 CDMRP programs.
    This omission, and the program's continued absence seriously
    jeopardizes established and promising research projects that have clear
    and compelling application to our armed forces as well as pioneering
    research for all cancers.
        Recognizing that fact and the opportunity this research represents,
    a bipartisan group of 45 Members of Congress have requested that the
    program be reconstituted at a $25 million level and be expanded to
    include all the blood cancers--the leukemias, lymphomas and myeloma.
    This would provide the research community with the flexibility to build
    on the pioneering tradition that has characterized this field.
        With all due respect to our colleagues fighting a broad range of
    malignancies that are represented in this program--and certainly not to
    diminish their significance--a cancer research program designed for
    application to military and national security needs would invariably
    include a strong blood cancer research foundation. DOD research on
    blood cancers addresses the importance of preparing for civilian and
    military exposure to the weapons being developed by several hostile
    nations and to aid in the march to more effective treatment for all who
    suffer from these diseases. This request clearly has merit for
    inclusion in the fiscal year 2010 legislation.
        Furthermore, we respectfully request that funding be dedicated to a
    collaborative public-private effort between the U.S. Military Cancer
    Institute, The Leukemia & Lyphoma Society and a blue ribbon panel of
    scientific academicians.
        The USMCI has over 9 million electronic medical records detailing
    the health histories of service men and women and their families. The
    military also has serum and tissue specimens from these individuals
    stored as a routine step in their health care. These records and
    samples, together, provide a unique base that can power blood cancer
    research relevant to the military environment and lifestyle in a way
    that is not possible for any other population.
        A joint effort, tapping the expertise of both USMCI and LLS,
    represents a unique opportunity to identify valuable research
    opportunities and state-of-the-art technology that can address
    significant questions on the origins and diagnosis of blood cancers.
    For example:
      --meta-analysis of the existing data may be used to gain insight into
            the exposure risks inherent in the military environment that
            may predispose the war fighter or their dependents to develop
            blood cancer.
      --Gene profiling might be used to gauge the existing genetic risk for
            blood cancer in a given individual and may guide the delivery
            of healthcare and/or deployment decisions.
      --Proteomic analysis of historically preserved serial blood samples
            from a military member diagnosed with blood cancer may reveal
            exposures related to development of the disease and drive
            decisions about safety precautions and protective gear.
        The Leukemia & Lymphoma Society strongly endorses and
    enthusiastically supports this effort and respectfully urges the
    Committee to include this funding in the fiscal year 2010 Defense
    Appropriations bill.
        We believe that building on the foundation Congress initiated over
    a 6-year period should not be abandoned and would both significantly
    strengthen the military's cancer program and accelerate the development
    of all cancer treatments. As history has demonstrated, expanding its
    focus into areas that demonstrate great promise; namely the blood-
    related cancers of leukemia, lymphoma and myeloma, would substantially
    aid the overall cancer research effort and yield great dividends.

        Chairman Inouye. And now may I call upon the president of
    the Air Force Association, Lieutenant General Michael M. Dunn.
    STATEMENT OF LIEUTENANT GENERAL MICHAEL M. DUNN (RET.),
                PRESIDENT/CHIEF EXECUTIVE OFFICER, AIR
                FORCE ASSOCIATION
        General Dunn. Thank you, Mr. Chairman.
        Last but not least. Mr. Chairman, Mr. Vice Chairman, I'm
    honored to be with you today to talk about the fiscal year 2010
    defense budget.
        I represent 120,000 members of the Air Force Association,
    and I need to point out to this subcommittee that we are
    independent of the Air Force, that the Air Force has not made
    any inputs, nor seen my statement or my remarks.
        At this time I request my written statement be included in
    the record.
        Chairman Inouye. Without objection.
        General Dunn. Mr. Chairman, I have to tell this
    subcommittee I'm worried, at this point in history, about the
    future. The average age of Air Force aircraft is the oldest in
    its very short history--25 years old, one-quarter of a century.
    Some types of aircraft are over 50 years old, and, when they
    are eventually replaced, some are going to be over 90 years
    old.
        To begin to replace the fleet, the Air Force has to buy
    about 165 aircraft per year, of all types. The 2010 budget
    request purchases only 81 aircraft, and 29 of them are unmanned
    aerial vehicles, and 13 are for the Air Force Academy.
        This puts the Air Force on a replacement rate of about 100
    years. Obviously, this is not a sustainable path. Costs to keep
    the fleet are rising--fleet ready--are rising, many aircraft
    have been grounded over the past few years, planes are breaking
    in unpredictable ways, and readiness rates are falling. Our men
    and women who serve deserve the very best we, as a Nation, can
    provide to them. We have to turn this around.
        DOD has stated they need to rebalance the force to focus on
    irregular warfare (IW). The sad fact is, they have to do both--
    modernize and recapitalize, as well as focusing on IW.
        I hope DOD is right about the future, that they won't face
    a strong opponent. But, the one thing certain about the future
    is we have been wrong over the type of opponent we will face.
    We did not anticipate the Japanese attacking the Hawaiian
    Islands in World War--to begin World War II for the United
    States; we did not anticipate the Korean War, Vietnam, the fall
    of the Soviet Union, Iraq's attack on Kuwait, 9/11, nor
    Operation Iraqi Freedom. To maintain that all wars in the
    future will be irregular wars is--well--not supported by the
    lessons of the past.
        The decisions made by DOD and this Congress are ones we
    will live with for a long time. They are 30-year decisions.
    When the Nation terminates or delays seven aircraft production
    lines, the impact on our aerospace industry is devastating. And
    this is an industry that adds almost $40 billion per year in
    positive trade balance. Engineers, design teams, and innovation
    will be lost, or hard or expensive to replace; tens of
    thousands of jobs will be lost. And these are high paying
    manufacturing jobs that benefit, not just local communities,
    but the Nation as a whole.
        Mr. Chairman, I think you can see why I'm worried. This is
    not just about one system or another, this is about air power,
    our asymmetric advantage and the reason our past conflicts have
    so spectacular, with some of the lowest friendly casualty rates
    in the history of warfare. We have to nurture this capability
    for the future.
        And thank you for your time, sir.
        Chairman Inouye. Well, thank you very much, General Dunn.
        [The statement follows:]
                     Prepared Statement of Michael M. Dunn
        Ladies and gentleman of the Committee, I am honored to come before
    you today, representing the Air Force Association, to discuss your
    United States Air Force. I would like to begin my remarks by saluting
    our Airmen who strive every day to ensure that America's Air Force is
    second to none. These men and women are true heroes and we salute their
    dedication and determination, while also recognizing the sacrifices
    they make for our Nation.
        To borrow a phrase from General Schwartz, the United States Air
    Force is truly ``all in.'' Whether deterring potential adversaries,
    striking strategic targets, gathering critical intelligence, delivering
    humanitarian relief supplies, evacuating wounded, airlifting cargo
    around the globe, enabling command and control, rescuing personnel
    behind enemy lines, or providing close air support, the Air Force is an
    invaluable national asset. Just looking at operations in Iraq and
    Afghanistan, the Air Force has flown nearly 60,000 sorties this year
    alone. In the real world, this translates into Airmen doing their very
    best 24/7 to fight and win on the front lines along with their joint
    team partners.
        While we are certainly proud of the Air Force's current record,
    this success cannot be taken for granted. The Air Force has spent the
    past two decades engaged in continuous combat operations and is
    utilizing an aircraft fleet that averages nearly a quarter of a century
    in age--with some planes in the inventory dating back to the Eisenhower
    Administration.
        The most obvious problem associated with this aging fleet is that
    old airplanes break more often and eventually are no longer airworthy.
    In the time since Desert Storm the average age of the Air Force fleet
    has increased by nearly a decade and the availability rate has dropped
    in a corresponding fashion. This means that since 1991 the percentage
    of time an aircraft is not broken and can fly a mission has fallen from
    77 percent to 65 percent. Aside from these costly maintenance
    challenges, a number of dramatic airworthiness issues have also
    afflicted the Air Force fleet. In 2000 the service grounded one third
    of its KC-135 air refueling aircraft because of a faulty flight control
    component. In 2004 the Air Force discovered that many of its C-130s had
    major cracks in their wings. In 2007 an F-15 broke in two while on a
    training flight due to structural fatigue, grounding the entire fleet
    for months. In 2008 the entire T-38 fleet was grounded for an extended
    period because of an aging control surface fixture. Most recently, half
    of the A-10 fleet was grounded due to wing cracks and the C-130 fleet
    was also grounded due to a faulty bolt found in the wings of many of
    the aircraft. More problems are certain to arise as the age of the
    fleet continues to increase.
        It is also important to consider that most next generation aircraft
    yield tremendous operational efficiencies that dramatically offset
    their higher per-unit acquisition cost and yield long-term savings.
    This performance increase was clearly demonstrated on the first night
    of Desert Storm when 20 new F-117 stealth fighters took the
    unprecedented step of attacking 28 separate targets. On the same night
    it took a combined force of 41 legacy non-stealth aircraft to strike
    one target--4 F/A-18s to defend against enemy aircraft, 3 drones to
    serve as decoys, 5 EA-6B aircraft to jam enemy radar, along with 4 F-4s
    and 17 F/A-18s to suppress enemy surface-to-air missiles so that 4 A-6s
    and 4 Tornadoes could strike one target. The full spectrum cost imposed
    by these legacy aircraft was tremendous--aircraft development and
    acquisition funding, operations and maintenance expenses, personnel
    bills, base access issues, etc. Viewed from this perspective, the
    encompassing price of new aircraft like the F-22 and F-35 is not so
    high.
        The global threat environment is rapidly evolving and proliferation
    of modern weaponry is negating the survivability of the Air Force's
    legacy fleet. Over 30 nations operate fighter aircraft that equal or
    exceed the capabilities of the F-15 and F-16, whose designs
    respectively date back to the 1960s and 1970s. Nations such as Russia
    and China are also developing 5th generation fighters that will have F-
    22-like capabilities and will be bought in F-35-like quantities . . .
    and sold to other countries. Additionally, dozens of nations operate
    surface-to-air missiles that can easily shoot down aircraft such as the
    B-1, B-52, F-15, F-16, F-18, Predator, Global Hawk, and more. It is
    important to remember that in the final days of Vietnam the Air Force
    lost 15 B-52s in 12 days during Operation Linebacker II. Air defenses
    have advanced markedly since then but 47 percent of the long range
    strike fleet is comprised of these same B-52s. Had the U.S. Air Force
    been called upon to engage in the recent Georgian conflict, the B-2 and
    F-22 were the only aircraft in the U.S. inventory that would have
    survived in the threat environment. U.S. national security demands a
    broader array of effective capabilities than just 20 B-2s and 186 F-
    22s.
        The fiscal year 2010 budget proposal currently under consideration
    by Congress fails to make necessary recapitalization investments and
    actually exacerbates the challenges facing several key mission sets.
    For example, the fiscal year 2010 budget proposal ends production of
    the F-22 at 187 aircraft even though the stated military requirement is
    for 243 airframes. A fleet comprised of 187 airframes yields a force of
    about 100 combat-ready aircraft, no attrition/reserve inventory, and
    too few aircraft to engage/deter in more than one operation at a time.
    All known analysis undertaken to this point has concluded such a
    limited fleet size entails high risk. Air dominance is the precondition
    for all successful U.S. military combat operations--this isn't just
    about the U.S. Air Force--it is essential for the entire joint team.
        This year's budget also discontinues C-17 acquisition at 205
    aircraft even though demand for airlift is so high that the Air Force
    is currently flying its C-17 airframes over 1,000 hours past what was
    originally programmed per year. Additional developments have seen the
    ground component grow by 92,000 Soldiers and Marines, increased
    reliance on airlift, to include leased Russian aircraft, to get
    equipment to Afghanistan and Iraq, and a decision to relocate many
    units back to CONUS. Each one of these developments suggests that the
    need for military airlift will increase. Closing the C-17 production
    line at 205 aircraft risks creating a high-demand low-density mission
    set.
        Even though existing Combat Search and Rescue (CSAR) helicopters
    are rapidly nearing the end of their service lives, the budget cancels
    their replacement program. CSAR is a moral imperative. Our current
    enemies do not take prisoners of war. They welcome the opportunity to
    torture and kill their captives, making CSAR even more critical than
    before. In fact, the Air Force CSAR capabilities are in such high
    demand in Iraq and Afghanistan that the Weapons School has been closed
    so that a maximum number of assets can be surged forward.
        The Next Generation Bomber program was also cancelled even though
    the current long range strike fleet averages over 40 years in age.
    While elements of the force are still capable in certain threat
    environments, the proliferation of advanced anti-access weaponry is
    curtailing when and where many of the legacy assets can successfully
    operate. Twenty B-2s are the only long range strike assets in the Air
    Force inventory that can penetrate high threat environments and
    survive. These aircraft are approaching 20 years in age, have not been
    in production since 1997, and have no viable replacements to backfill
    losses. During the Cold War, bombers were primarily viewed as nuclear
    deterrence assets. However, actual combat operations have demonstrated
    that long range conventional strike is an incredibly important tool.
    Modern long range bombers can penetrate air defense systems, respond
    rapidly to strike fleeting targets, and operate over long distances
    without excessive logistical support. The tactical strike fleet, while
    capable, simply does not have the range and payload capabilities to
    fulfill many of these missions.
        The Airborne Laser (ABL) program was also curtailed even though
    nuclear weapons proliferation, combined with advances in delivery
    system technology, is yielding an increasingly dangerous world.
    Sufficient investment in robust missile defense capabilities is
    essential for the security of United States and its allies.
        Cumulatively, these decisions will also have a tremendous impact on
    the defense industrial base. This sector is an invaluable strategic
    partner for the United States. Whether addressing problems through
    innovation, delivering high-quality products that enable our forces to
    attain victory, or developing solutions for future challenges, the
    industrial base is a critical national security asset. The United
    States is rapidly approaching the point where it will be limited to one
    major heavy aircraft production line (Boeing in Seattle, WA) and one
    advanced fighter production facility (Lockheed Martin in Fort Worth,
    TX). The proposed fiscal year 2010 budget cuts rapidly accelerate the
    decline of this sector. The barriers to entry are extraordinarily high
    within the military aerospace industrial base and once the Nation loses
    certain core competencies, they will be exceedingly difficult and
    costly to regenerate. For example, low observable (stealth) design
    teams are incredibly skilled in a highly nuanced field that does not
    lend itself to dual-use applications within the civilian aerospace
    sector. If projects are not forthcoming to maintain this skill set,
    then the country will face major challenges trying to regenerate such
    capabilities in the future. Additionally, the military aerospace sector
    will have an increasingly difficult time recruiting and retaining
    talent amidst these challenging times. Failing to build a viable and
    competent workforce for the next generation will have a dramatic impact
    on the national security options available to the Nation for the
    foreseeable future.
        Clearly the United States Air Force is at a strategic crossroads.
    The Nation cannot realistically expect Airmen to successfully engage
    and survive in future campaigns if it does not equip them with modern
    and effective equipment. One of the key lessons from history is the
    importance of preparing for the full spectrum of operations. This
    country has failed to anticipate numerous critical events--Pearl
    Harbor, Berlin Blockade, Cuban Missile Crisis, Soviet Invasion of
    Afghanistan, fall of the Shah in Iran, end of the Cold War, Iraq's
    invasion of Kuwait, 9/11, etc. Events in the modern world develop
    rapidly and the country has to respond quickly with the forces on hand.
    The days of WWII-like rapid wartime industrialization are gone. Aside
    from rudimentary supplies, effective weapons systems can no longer be
    developed in a matter of months and events are often decided by the
    time new items are fielded. This demands that the Nation prepare for a
    wide variety of contingencies. Otherwise, the lives of the men and
    women in uniform will be placed at undue risk as they struggle to
    achieve their respective objectives with inadequate tools. While
    airpower can operate with relative impunity in current operations, such
    access must not be taken for granted in the future. Current legacy
    systems will last a few more years, but eventually they will be
    retired. Most of the cuts involved in this budget kill the platforms
    that were intended to replace these legacy systems. The Chief of Staff
    of the Air Force has stated he needs to buy 165 aircraft per year in
    order to keep the average age of the fleet the same as it is now--a
    quarter of a century old. This budget only buys 81 aircraft--13 of
    which are for the Air Force Academy and 29 of which are UAVs. That puts
    the Air Force on a replacement rate of over 100 years. It is important
    that Congress and the American people fully appreciate the full
    ramifications of these decisions. We risk imposing drastic limitations
    on the strategic options available to the country for decades into the
    future.

                         ADDITIONAL SUBMITTED STATEMENT

        Chairman Inouye. The subcommittee has received testimony
    from the National Military and Veterans Alliance and their
    testimony will be made part of the record.
        [The statement follows:]
       Prepared Statement of the National Military and Veterans Alliance
        The Alliance was founded in 1996 as an umbrella organization to be
    utilized by the various military and veteran associations as a means to
    work together towards their common goals. The Alliance member
    organizations are: American Logistics Association; American Military
    Retirees Association; American Military Society; American Retirees
    Association; American World War II Orphans Network; AMVETS (American
    Veterans); Armed Forces Marketing Council; Army and Navy Union;
    Catholic War Veterans; Gold Star Wives of America, Inc.; Japanese
    American Veterans Association; Korean War Veterans Foundation; Legion
    of Valor; Military Order of the Purple Heart; Military Order of the
    World Wars; Military Order of Foreign Wars; National Assoc. for
    Uniformed Services; National Gulf War Resource Center; Naval Enlisted
    Reserve Association; Naval Reserve Association; Paralyzed Veterans of
    America; Reserve Enlisted Association; Reserve Officers Association;
    Society of Military Widows; The Retired Enlisted Association; TREA
    Senior Citizens League; Tragedy Assist. Program for Survivors;
    Uniformed Services Disabled Retirees; Veterans of Foreign Wars; Vietnam
    Veterans of America; Women in Search of Equity.
        These organizations have over three and a half million members who
    are serving our Nation or who have done so in the past, and their
    families.
                                  introduction
        Mister Chairman and distinguished members of the Committee, the
    National Military and Veterans Alliance (NMVA) is very grateful for the
    invitation to testify before you about our views and suggestions
    concerning defense funding issues. The overall goal of the National
    Military and Veterans Alliance is a strong National Defense. In light
    of this overall objective, we would request that the committee examine
    the following proposals.
        While the NMVA highlights the funding of benefits, we do this
    because it supports National Defense. A phrase often quoted ``The
    willingness with which our young people are likely to serve in any war,
    no matter how justified, shall be directly proportional as to how they
    perceive the Veterans of earlier wars were treated and appreciated by
    their country,'' has been frequently attributed to General George
    Washington. Yet today, many of the programs that have been viewed as
    being veteran or retiree are viable programs for the young serving
    members of this war. This phrase can now read ``The willingness with
    which our young people, today, are willing to serve in this war is how
    they perceive the veterans of this war are being treated.''
        This has been brought to the forefront by how quickly an issue such
    as the treatment of wounded warriors suffering from Traumatic Brain
    Injury or Post Traumatic stress Disorder has been brought to the
    national attention.
        In a long war, recruiting and retention becomes paramount. The
    National Military and Veterans Alliance, through this testimony, hopes
    to address funding issues that apply to the veterans of various
    generations.
                            funding national defense
        NMVA is pleased to observe that the Congress continues to discuss
    how much should be spent on National Defense. The Alliance urges the
    President and Congress to increase defense spending to 5 percent of
    Gross Domestic Product during times of war to cover procurement and
    prevent unnecessary personnel end strength cuts.
                              pay and compensation
        Our serving members are patriots willing to accept peril and
    sacrifice to defend the values of this country. All they ask for is
    fair recompense for their actions. At a time of war, compensation
    rarely offsets the risks.
        The NMVA requests funding so that the annual enlisted military pay
    raise exceeds the Employment Cost Index (ECI) by at least half of a
    percent.
        Further, we hope that this committee continues to support targeted
    pay raises for those mid-grade members who have increased
    responsibility in relation to the overall service mission. Pay raises
    need to be sufficient to close the civilian-military pay gap.
        NMVA would apply the same allowance standards to both Active and
    Reserve when it comes to Aviation Career Incentive Pay, Career Enlisted
    Flyers Incentive Pay, Diving Special Duty Pay, Hazardous Duty Incentive
    Pay and other special pays.
        The Service chiefs have admitted one of the biggest retention
    challenges is to recruit and retain medical professionals. NMVA urges
    the inclusion of bonus/cash payments (Incentive Specialty pay IPS) into
    the calculations of Retirement Pay for military health care providers.
    NMVA has received feedback that this would be incentive to many medical
    professionals to stay in longer.
        G-R Bonuses.--Guard and Reserve component members may be eligible
    for one of three bonuses, Prior Enlistment Bonus, Reenlistment Bonus
    and Reserve Affiliation Bonuses for Prior Service Personnel. These
    bonuses are used to keep men and woman in mission critical military
    occupational specialties (MOS) that are experiencing falling numbers or
    are difficult to fill. During their testimony before this committee the
    Reserve Chiefs addressed the positive impact that bonuses have upon
    retention. This point cannot be understated. The operation tempo,
    financial stress and civilian competition for jobs make bonuses a
    necessary tool for the DOD to fill essential positions. The NMVA
    supports expanding and funding bonuses to the Federal Reserve
    Components.
        Reserve/Guard Funding.--NMVA is concerned about ongoing DOD
    initiatives to end ``two days pay for one days work,'' and replace it
    with a plan to provide 1/30 of a Month's pay model, which would include
    both pay and allowances. Even with allowances, pay would be less than
    the current system. When concerns were addressed about this proposal, a
    retention bonus was the suggested solution to keep pay at the current
    levels. Allowances differ between individuals and can be affected by
    commute distances and even zip codes. Certain allowances that are
    unlikely to be paid uniformly include geographic differences, housing
    variables, tuition assistance, travel, and adjustments to compensate
    for missing health care. The NMVA strongly recommends that the reserve
    pay system ``two days pay for one days work,'' be funded and retained,
    as is.
                               educational issues
    MGIB-SR Enhancements
        Practically all active duty and Selected Reserve enlisted
    accessions have a high school diploma or equivalent. A college degree
    is the basic prerequisite for service as a commissioned officer, and is
    now expected of most enlisted as they advance beyond E-6. Officers to
    promote above O-4 are expected to have a post graduate degree. The
    ever-growing complexity of weapons systems and support equipment
    requires a force with far higher education and aptitude than in
    previous years.
        Both political parties are looking at ways of enhancing the GI
    bill. There are suggested features in legislation be suggested by both
    sides. At a minimum, the GI bill needs to be viewed as more than a
    recruiting and retention incentive. Education is a means to help
    reintegrate our returning veterans into society. A recent survey by
    military.com, of returning military veterans, found that 81 percent
    didn't feel fully prepared to enter the work force, and 76 percent of
    these veterans said they were unable translate their military skills
    into civilian proficiencies.
        Transferability of educational benefits to spouses and children are
    another key aspect that should be included in a GI Bill enhancement. In
    addition, for those with existing degrees and outstanding debts, the GI
    Bill stipend, should be allowed to pay-off outstanding student loans.
        No enhancement can be accomplished without funding. This should be
    viewed as an investment rather than an expense. The original GI bill
    provided years of economic stimulus, returning seven dollars for every
    dollar invested in veterans.
        The National Military and Veterans Alliance asks this subcommittee
    to support funding for suggested GI Bill funding.
        The Montgomery G.I. Bill for Selective Reserves (MGIB-SR) will
    continue to be an important recruiting and retention tool. With massive
    troop rotations the Reserve forces can expect to have retention
    shortfalls, unless the government provides enhances these incentives as
    well.
        The problem with the current MGIB-SR is that the Selected Reserve
    MGIB has failed to maintain a creditable rate of benefits with those
    authorized in Title 38, Chapter 30. MGIB-SR has not even been increased
    by cost-of-living increases since 1985. In that year MGIB rates were
    established at 47 percent of active duty benefits. The MGIB-SR rate is
    28 percent of the Chapter 30 benefits. Overall the allowance has inched
    up by only 7 percent since its inception, as the cost of education has
    climbed significantly.
        The NMVA requests appropriations funding to raise the MGIB-SR and
    lock the rate at 50 percent of the active duty benefit. Cost:
    $25,000,000/first year, $1,400,000,000 over 10.
                           force policy and structure
    War Funding
        The Alliance thanks the committee for the war funding amended to
    the Supplemental Appropriations Act 2008, H.R. 2642. While the debate
    on Iraqi policy is important, the Alliance would like to stress that
    resulting legislation should be independent and not included as
    language in any Defense Appropriation bill. Supporting the troops
    includes providing funding for their missions.
        NMVA supports the actions by this subcommittee to put dollars for
    the War back into the Emergency Supplemental.
    End Strength
        The NMVA concurs with funding increases in support of the end
    strength boosts of the Active Duty Component of the Army and Marine
    Corps that have been recommended by Defense Authorizers. New recruits
    need to be found and trained now to start the process so that American
    taxpayer can get a return on this investment. Such growth is not
    instantaneously productive. Yet, the Alliance is concerned with
    continued end strength cuts to the other services: the Air Force and
    the Navy. Trying to pay the bills by premature manpower reductions may
    have consequences.
    Manning Cut Moratorium
        The NMVA would also like to put a freeze on reductions to the Guard
    and Reserve manning levels. A moratorium on reductions to End Strength
    is needed until the impact of an operational reserve structure is
    understood. Many force planners call for continuation of a strategic
    reserve as well. NMVA urges this subcommittee to at least fund to last
    year's levels.
             survivor benefit plan (sbp) and survivor improvements
        The Alliance wishes to deeply thank this Subcommittee for your
    funding of improvements in the myriad of survivor programs.
        However, there is still an issue remaining to deal with: Providing
    funds to end the SBP/DIC offset.
        SBP/DIC Offset affects several groups. The first is the family of a
    retired member of the uniformed services. At this time the SBP annuity
    the servicemember has paid for is offset dollar for dollar for the DIC
    survivor benefits paid through the VA. This puts a disabled retiree in
    a very unfortunate position. If the servicemember is leaving the
    service disabled it is only wise to enroll in the Survivor Benefit Plan
    (perhaps being uninsurable in the private sector). If death is service
    connected then the survivor loses dollar for dollar the compensation
    received under DIC.
        SBP is a purchased annuity, available as an elected earned employee
    benefit. The program provides a guaranteed income payable to survivors
    of retired military upon the member's death. Dependency and Indemnity
    Compensation (DIC) is an indemnity program to compensate a family for
    the loss of a loved one due to a service connected death. They are
    different programs created to fulfill different purposes and needs.
        A second group affected by this dollar for dollar offset is made up
    of families whose service member died on active duty. Recently Congress
    created active duty SBP. These service members never had the chance to
    pay into the SBP program. But clearly Congress intended to give these
    families a benefit. With the present offset in place the vast majority
    of families receive no benefit from this new program, because the vast
    numbers of our losses are young men or women in the lower paying ranks.
    SBP is completely offset by DIC payments.
        Other affected families are service members who have already served
    a substantial time in the military. Their surviving spouse is left in a
    worse financial position that a younger widow. The older widows will
    normally not be receiving benefits for her children from either Social
    Security or the VA and will normally have more substantial financial
    obligations (mortgages, etc). This spouse is very dependent on the SBP
    and DIC payments and should be able to receive both.
        The NMVA respectfully requests this Subcommittee fund the SBP/DIC
    offset.
        current and future issues facing uniformed services health care
        The National Military and Veterans Alliance must once again thank
    this Committee for the great strides that have been made over the last
    few years to improve the health care provided to the active duty
    members, their families, survivors and Medicare eligible retirees of
    all the Uniformed Services. The improvements have been historic.
    TRICARE for Life and the Senior Pharmacy Program have enormously
    improved the life and health of Medicare Eligible Military Retirees
    their families and survivors. It has been a very successful few years.
    Yet there are still many serious problems to be addressed:
    Wounded Warrior Programs
        As the committee is aware, Congress has held a number of hearings
    about the controversy at Walter Reed Army Medical Center. The NMVA will
    not revisit the specifics. With the Independent Review Group and the
    Dole/Shalala Commission recommending the closure of Walter Reed, an
    emphasis needs to be placed on the urgency of upgrades at Bethesda, and
    the new military treatment hospital at Fort Belvoir. NMVA hopes that
    this committee will financially support the studies that measure the
    adequacy of this plan.
        The Alliance supports continued funding for the wounded warriors,
    including monies for research and treatment on Traumatic Brain Injuries
    (TBI), Post Traumatic Stress Disorder, the blinded, and our amputees.
    The Nation owes these heroes an everlasting gratitude and recompense
    that extends beyond their time in the military. These casualties only
    bring a heightened need for a DOD/VA electronic health record accord to
    permit a seamless transition from being in the military to being a
    civilian.
    Full Funding for the Defense Health Program
        The Alliance applauds the Subcommittee's role in providing adequate
    funding for the Defense Health Program (DHP) in the past several budget
    cycles. As the cost of health care has risen throughout the country,
    you have provided adequate increases to the DHP to keep pace with these
    increases.
        Full funding for the defense health program is a top priority for
    the NMVA. With the additional costs that have come with the deployments
    to Southwest Asia, Afghanistan and Iraq, we must all stay vigilant
    against future budgetary shortfalls that would damage the quality and
    availability of health care.
        With the authorizers having postponed the Department of Defenses
    suggested fee increases, the Alliance is concerned that the budget
    saving have already been adjusted out of the President's proposed
    budget. NMVA is confident that this subcommittee will continue to fund
    the DHP so that there will be no budget shortfalls.
        The National Military and Veterans Alliance urges the Subcommittee
    to continue to ensure full funding for the Defense Health Program
    including the full costs of all new programs.
    TRICARE Pharmacy Programs
        NMVA supports the continued expansion of use of the TRICARE Mail
    Order pharmacy.
        To truly motivate beneficiaries to a shift from retail to mail
    order adjustments need to be made to both generic and brand name drugs
    co-payments. NMVA recommends that both generic and brand name mail
    order prescriptions be reduced to zero $$ co-payments to align with
    military clinics.
        Ideally, the NMVA would like to see the reduction in mail order co-
    payments without an increase in co-payments for Retail Pharmacy.
        The National Military and Veterans Alliance urges the Subcommittee
    to adequately fund adjustments to co-payments in support of
    recommendations from Defense Authorizers.
    TRICARE Standard Improvements
        TRICARE Standard grows in importance with every year that the
    Global War on Terrorism continues. A growing population of mobilized
    and demobilized Reservists depends upon TRICARE Standard. A growing
    number of younger retirees are more mobile than those of the past, and
    likely to live outside the TRICARE Prime network.
        An ongoing challenge for TRICARE Standard involves creating
    initiatives to convince health care providers to accept TRICARE
    Standard patients. Health care providers are dissatisfied with TRICARE
    reimbursement rates that are tied to Medicare reimbursement levels. The
    Alliance is pleased by Congress' plan to prevent near-term reductions
    in Medicare reimbursement rates, which will help the TRICARE Program.
        Yet this is not enough. TRICARE Standard is hobbled with a
    reputation and history of low and slow payments as well as what still
    seems like complicated procedures and administrative forms that make it
    harder and harder for beneficiaries to find health care providers that
    will accept TRICARE. Any improvements in the rates paid for Medicare/
    TRICARE should be a great help in this area. Additionally, any further
    steps to simplify the administrative burdens and complications for
    health care providers for TRICARE beneficiaries hopefully will increase
    the number of available providers.
        The Alliance asks the Defense Subcommittee to include language
    encouraging continued increases in TRICARE/Medicare reimbursement
    rates.
    TRICARE Retiree Dental Plan (TRDP)
        The focus of the TRICARE Retiree Dental Plan (TRDP) is to maintain
    the dental health of Uniformed Services retirees and their family
    members. Several years ago we saw the need to modify the TRDP
    legislation to allow the Department of Defense to include some dental
    procedures that had previously not been covered by the program to
    achieve equity with the active duty plan.
        With ever increasing premium costs, NMVA feels that the Department
    should assist retirees in maintaining their dental health by providing
    a government cost-share for the retiree dental plan. With many retirees
    and their families on a fixed income, an effort should be made to help
    ease the financial burden on this population and promote a seamless
    transition from the active duty dental plan to the retiree dental plan
    in cost structure. Additionally, we hope the Congress will enlarge the
    retiree dental plan to include retired beneficiaries who live overseas.
        The NMVA would appreciate this Committee's consideration of both
    proposals.
                     national guard and reserve health care
    Funding Improved TRICARE Reserve Select
        It is being suggested that the TRICARE Reserve Select healthcare
    plan be changed to allow the majority of Selected Reserve participate
    at a 28 percent co-payment level with the balance of the premium being
    paid by the Department of Defense.
        NMVA asks the committee to continue to support funding of the
    TRICARE Reserve Select program.
    Mobilized Health Care--Dental Readiness of Reservists
        The number one problem faced by Reservists being recalled has been
    dental readiness. A model for healthcare would be the TRICARE Dental
    Program, which offers subsidized dental coverage for Selected
    Reservists and self-insurance for SELRES families.
        In an ideal world this would be universal dental coverage. Reality
    is that the services are facing challenges. Premium increases to the
    individual Reservist have caused some junior members to forgo coverage.
    Dental readiness has dropped. The Military services are trying to
    determine how best to motivate their Reserve Component members but feel
    compromised by mandating a premium program if Reservists must pay a
    portion of it.
        Services have been authorized to provide dental treatment as well
    as examination, but without funding to support this service. By the
    time many Guard and Reserve are mobilized, their schedule is so short
    fused that the processing dentists don't have time for extensive
    repair.
        The National Military Veterans Alliance supports funding for
    utilization of Guard and Reserve Dentists to examine and treat
    Guardsmen and Reservists who have substandard dental hygiene. The
    TRICARE Dental Program should be continued, because the Alliance
    believes it has pulled up overall Dental Readiness.
    Demobilized Dental Care
        Under the revised transitional healthcare benefit plan, Guard and
    Reserve who were ordered to active duty for more than 30 days in
    support of a contingency and have 180 days of transition health care
    following their period of active service.
        Similar coverage is not provided for dental restoration. Dental
    hygiene is not a priority on the battlefield, and many Reserve and
    Guard are being discharged with dental readiness levels much lower than
    when they were first recalled. At a minimum, DOD must restore the
    dental state to an acceptable level that would be ready for
    mobilization, or provide some subsidize for 180 days to permit
    restoration from a civilian source.
        Current policy is a 30-day window with dental care being space
    available at a priority less than active duty families.
        NMVA asks the committee for funding to support a DOD's
    demobilization dental care program. Additional funds should be
    appropriated to cover the cost of TRICARE Dental premiums and co-
    payment for the 6 months following demobilization if DOD is unable to
    do the restoration.
                         other guard and reserve issues
        Ensure adequate funding to equip Guard and Reserve at a level that
    allows them to carry out their mission. Do not turn these crucial
    assets over to the active duty force. In the same vein we ask that the
    Congress ensure adequate funding that allows a Guardsman/Reservist to
    complete 48 drills, and 15 annual training days per member, per year.
    DOD has been tempted to expend some of these funds on active duty
    support rather than personnel readiness.
        The NMVA strongly recommends that Reserve Program funding remain at
    sufficient levels to adequately train, equip and support the robust
    reserve force that has been so critical and successful during our
    Nation's recent major conflicts.
        While Defense Authorizers provided an early retirement benefit in
    fiscal year 2008, only those who have served in support of a
    contingency operation since 28 January 2008 are eligible, nearly 6
    years and 4 months after Guard and Reserve members first were mobilized
    to support the active duty force in this conflict. Over 600,000
    Reservists have served during this period and were excluded from
    eligibility. The explanation given was lack of mandatory funding
    offset. To exclude a portion of our warriors is akin to offering the
    original GI Bill to those who served after 1944.
        NMVA hopes that this subcommittee can help identify excess funding
    that would permit an expanded early retirement benefit for those who
    have served.
                         armed forces retirement homes
        Following Hurricane Katrina, Navy/Marine Corps residents from AFRJ-
    Gulfport were evacuated from the hurricane-devastated campus and were
    moved to the AFRH-Washington, D.C. campus. Dormitories were reopened
    that are in need of refurbishing.
        NMVA urges this subcommittee to continue funding upgrades at the
    Washington, D.C. facility, and to continue funding to rebuild the
    Gulfport facility.
                                   conclusion
        Mr. Chairman and distinguished members of the Subcommittee the
    Alliance again wishes to emphasize that we are grateful for and
    delighted with the large steps forward that the Congress has affected
    the last few years. We are aware of the continuing concern all of the
    subcommittee's members have shown for the health and welfare of our
    service personnel and their families. Therefore, we hope that this
    subcommittee can further advance these suggestions in this committee or
    in other positions that the members hold. We are very grateful for the
    opportunity to submit these issues of crucial concern to our collective
    memberships. Thank you.

                             CONCLUSION OF HEARINGS

        Chairman Inouye. I'd like to thank all of you for your
    testimony this morning. The subcommittee will take all issues
    seriously, I can assure you. And if you do have documents to
    support your testimony, please submit them.
        With that, the meeting will stand in recess, subject to the
    call of the Chair.
        Thank you.
        [Whereupon, at 11:40 a.m., Thursday, June 18, the hearings
    were concluded, and the subcommittee was recessed, to reconvene
    subject to the call of the Chair.]

           LIST OF WITNESSES, COMMUNICATIONS, AND PREPARED STATEMENTS

                                  ----------
                                                                       Page
    Aylward, Major General Peter M., Director, Joint Staff, National
      Guard Bureau, Department of Defense, prepared statement........   131

    Bennett, Senator Robert F., U.S. Senator From Utah, Questions
      Submitted by........................275, 334, 340, 347, 391, 457, 466
    Bergman, Lieutenant General Jack W., Commander, Marine Forces
      Reserve, United States Marine Corps, Department of Defense.....   196
        Prepared Statement of........................................   197
        Questions Submitted to.......................................   228
    Berman, Jonathan D., MD, Ph.D., Colonel, United States Army
      (Ret.), Secretary-Treasurer, American Society of Tropical
      Medicine and Hygiene...........................................   573
        Prepared Statement of........................................   574
    Bond, Senator Christopher S., U.S. Senator From Missouri:
        Questions Submitted by......................................92, 274
        Statement of..........................................281, 351, 402
    Boudjouk, Philip, Ph.D., Vice President, Research, Creative
      Activities and Technology Transfer, North Dakota State
      University; Chair, Coalition of EPSCoR/IDEA States.............   557
        Prepared Statement of........................................   558
    Bruzek-Kohler, Rear Admiral Christine M., Director, Navy Nurse
      Corps, United States Navy, Medical Health Programs, Department
      of Defense.....................................................    49
        Prepared Statement of........................................    52
        Questions Submitted to.......................................   111
    Byrd, Senator Robert C., U.S. Senator From West Virginia,
      Questions Submitted by.........................................   387

    Casey, General George W., Jr., Chief of Staff, Office of the
      Secretary, Department of the Army, Department of Defense.......   235
        Prepared Statement of........................................   237
    Cochran, Elizabeth, Secretary, Associations for America's Defense   550
        Prepared Statement of........................................   551
    Cochran, Senator Thad, U.S. Senator From Mississippi:
        Questions Submitted by.......................................   91,
                           101, 107, 166, 169, 273, 339, 344, 389, 397, 455
        Statements of.......................3, 119, 236, 280, 350, 401, 505
    Conway, General James T., Commandant, United States Marine Corps,
      Department of the Navy, Department of Defense..................   299
        Questions Submitted to.......................................   341
        Prepared Statement of........................................   301

    Dahlman, George, Senior Vice President for Public Policy, The
      Leukemia & Lymphoma Society....................................   576
        Prepared Statement of........................................   578
    Davis, John R., Director, Legislative Programs, Fleet Reserve
      Association....................................................   501
        Prepared Statement of........................................   502
    Debbink, Vice Admiral Dirk J., Chief, Navy Reserve, Department of
      Defense........................................................   190
        Questions Submitted to.......................................   226
        Prepared Statement of........................................   191
    Donley, Hon. Michael B., Secretary of the Air Force, Office of
      the Secretary, Department of the Air Force, Department of
      Defense........................................................   349
        Prepared Statement of the....................................   354
        Questions Submitted to.......................................   381
        Summary Statement of.........................................   352
    Dorgan, Senator Byron L., U.S. Senator From North Dakota,
      Questions Submitted by...................166, 167, 223, 226, 228, 388
    Dunn, Lieutenant General Michael M. (Ret.), President/Chief
      Executive Officer, Air Force Association.......................   581
        Prepared Statement of........................................   583
    Durbin, Senator Richard J., U.S. Senator From Illinois, Questions
      Submitted by...................162, 168, 224, 227, 229, 230, 452, 464

    Feinstein, Senator Dianne, U.S. Senator From California,
      Questions Submitted by.........................................   453

    Gates, Hon. Robert M., Secretary of Defense, Office of the
      Secretary, Department of Defense...............................   399
        Prepared Statement of........................................   405
        Questions Submitted to.......................................   442
    Geren, Hon. Pete, Secretary of the Army, Office of the Secretary,
      Department of the Army, Department of Defense..................   235
        Prepared Statement of the....................................   237
    Gregg, Senator Judd, U.S. Senator From New Hampshire, Question
      Submitted by...................................................   274

    Hale, Hon. Robert F., Under Secretary of Defense (Comptroller),
      Office of the Secretary, Department of Defense.................   399
    Hesdorffer, Mary, Nurse Practitioner, Medical Liaison,
      Mesothelioma Applied Research Foundation (MARF)................   569
        Prepared Statement of........................................   570
    Holahan, Colonel William, United States Marine Corps (Ret.),
      Director, Member Services, Reserve Officers Association of the
      United States..................................................   543
        Prepared Statement of........................................   544
    Horoho, Major General Patricia D., Chief, Army Nurse Corps,
      United States Army, Medical Health Programs, Department of
      Defense........................................................    62
        Prepared Statement of........................................    64
        Questions Submitted to.......................................   112
    Hruska, Kelly B., Government Relations, Deputy Director, National
      Military Family Association....................................   483
        Prepared Statement of........................................   485
    Hutchison, Senator Kay Bailey, U.S. Senator From Texas, Questions
      Submitted by.................................................332, 389

    Inouye, Chairman Daniel K., U.S. Senator From Hawaii:
        Opening Statements of...............1, 117, 235, 279, 349, 399, 469
        Questions Submitted by.......................................   87,
      97, 105, 111, 112, 114, 161, 226, 229, 272, 330, 335, 341, 381, 393,
                                                                   442, 458

    Jones, Richard A. ``Rick'', Legislative Director, National
      Association for Uniformed Services.............................   532
        Prepared Statement of........................................   533

    Leahy, Senator Patrick J., U.S. Senator From Vermont:
        Questions Submitted by.....................................273, 451
        Statement of.................................................   401

    Mabus, Hon. Raymond, Secretary of the Navy, Office of the
      Secretary, Department of the Navy, Department of Defense.......   279
        Prepared Statement of........................................   282
        Questions Submitted to.......................................   330
        Statement of.................................................   281
    McCauslin, Command Master Sergeant John R., United States Air
      Force (Ret.), Chief Executive Officer, Air Force Sergeants
      Association....................................................   505
        Prepared Statement of........................................   506
    McConnell, Senator Mitch, U.S. Senator From Kentucky, Questions
      Submitted by...................................93, 103, 109, 456, 464
    McKinley, General Craig R., Chief, National Guard Bureau,
      Department of Defense, prepared statement......................   120
    Mullen, Admiral Michael G., U.S. Navy, Chairman, Joint Chiefs of
      Staff, Office of the Secretary, Department of Defense..........   399
        Prepared Statement of........................................   413
        Questions Submitted to.......................................   458
        Statement of.................................................   411
    Murray, Senator Patty, U.S. Senator From Washington, Questions
      Submitted by....................90, 100, 106, 165, 225, 227, 229, 231

    National Military and Veterans Alliance, Prepared Statement of
      the............................................................   585

    O'Shea, Gavin, Ph.D., on behalf of the American Psychological
      Association....................................................   510
        Prepared Statement of........................................   511

    Petkoff, Alec, Deputy Director, National Security Commission, The
      American Legion................................................   469
        Prepared Statement of........................................   471
    Pollak, Andrew N., M.D., Chair, Extremity War Injuries and
      Disaster Preparedness Project Team, American Academy of
      Orthopaedic Surgeons...........................................   513
        Prepared Statement of........................................   514
    Puzon, Captain Ike, United States Navy (Ret.), Director of
      Legislation, Association of the United States Navy.............   566
        Prepared Statement of........................................   567

    Raymond, Sandra C., President and Chief Executive Officer, Lupus
      Foundation of America, Inc.....................................   559
        Prepared Statement of........................................   560
    Robinson, Vice Admiral Adam M., Jr., Surgeon General of the Navy,
      United States Navy, Medical Health Programs, Department of
      Defense........................................................    17
        Prepared Statement of........................................    19
        Questions Submitted to.......................................    97
    Roudebush, Lieutenant General James G., Air Force Surgeon
      General, United States Air Force, Medical Health Programs,
      Department of Defense..........................................    23
        Prepared Statement of........................................    26
        Questions Submitted to.......................................   105
    Roughead, Admiral Gary, Chief of Naval Operations, Department of
      the Navy, Department of Defense................................   285
        Prepared Statement of........................................   287
        Questions Submitted to.......................................   335
    Rowles, Jackie S., CRNA, MBA, MA, FAAPM, President, American
      Association of Nurse Anesthetists (AANA), Prepared Statement of   529

    Schoomaker, Lieutenant General Eric B., M.D., Ph.D., Surgeon
      General, U.S. Army Medical Command, Medical Health Programs,
      Department of Defense..........................................     1
        Prepared Statement of........................................     6
        Questions Submitted to.......................................    87
    Schwartz, General Norton A., Chief of Staff, United States Air
      Force, Office of the Secretary, Department of the Air Force,
      Department of Defense..........................................   349
        Prepared Statement of........................................   354
        Questions Submitted to.......................................   393
        Summary Statement of.........................................   362
    Shelby, Senator Richard C., U.S. Senator From Alabama, Statement
      of.............................................................   352
    Siniscalchi, Major General Kimberly A., Assistant Air Force
      Surgeon General for Nursing Services, United States Air Force,
      Medical Health Programs, Department of Defense.................    70
        Prepared Statement of........................................    72
        Questions Submitted to.......................................   114
    Stenner, Lieutenant General Charles E., Jr., Chief, Air Force
      Reserve, Department of Defense.................................   208
        Prepared Statement of........................................   210
        Questions Submitted to.......................................   229
    Stultz, Lieutenant General Jack C., Chief, Army Reserve,
      Department of Defense..........................................   171
        Prepared Statement of........................................   172
        Questions Submitted to.......................................   223
    Tenenbaum, Cara, Senior Policy Director, Ovarian Cancer National
      Alliance.......................................................   540
        Prepared Statement of........................................   541

    Vaughn, Lieutenant General Clyde A., Director, Army National
      Guard, Department of Defense...................................   117
        Prepared Statement of........................................   120
        Questions Submitted to.......................................   161
    Visco, Fran, J.D., President, National Breast Cancer Coalition...   522
        Prepared Statement of........................................   523

    Wicks, Terry, Past President, on behalf of the American
      Association of Nurse Anesthetists (AANA).......................   527
    Wyatt, Lieutenant General Harry M., III, Director, Air National
      Guard, Department of Defense...................................   142
        Prepared statement...........................................   126
        Questions Submitted to.......................................   167

    Zitnay, George A., Ph.D., Co-founder, Defense and Veterans Brain
      Injury Center..................................................   561
        Prepared Statement of........................................   562

                                 SUBJECT INDEX

                                  ----------

                             DEPARTMENT OF DEFENSE

                          Department of the Air Force

                            Office of the Secretary

                                                                       Page

    A Balanced Approach..............................................   354
    Additional:
        Committee Questions..........................................   381
        F-22 Purchases...............................................   389
    Age and Health of Tanker Fleet...................................   393
    Agile Combat Support.............................................   358
    Air Force:
        Acquisition..................................................   354
        Activity in USCENTCOM Area of Responsibility.................   374
        Combat Capability............................................   353
        Core:
            Functions................................................   355
            Values...................................................   362
        Nontraditional Support to Army and Coalition Forces..........   366
        Nuclear Enterprise...........................................   383
        Personnel....................................................   353
        Strategic Priorities.........................................   352
    Air Superiority and Global Precision Attack......................   355
    Balancing Air Force Priorities to Meet Challenges................   362
    Building Partnerships............................................   358
    B-52 Squadron at Minot Air Force Base, North Dakota..............   373
    Command and Control..............................................   357
    Communications and Electronics Center of Excellence..............   367
    Contractor to Civilian Conversions...............................   390
    Cyberspace Superiority...........................................   358
    C-17:
        Joint Cargo Aircraft.........................................   372
        Program......................................................   383
    C-5 Aircraft.....................................................   387
    Effective Use of Forces Across the Spectrum of Conflict..........   364
    End Strength...................................................383, 394
    Export Version of the F-22.....................................386, 396
    Fairchild Air Force Base, Washington--Aerial Refueling Mission...   379
    Fifth Generation Aircraft........................................   395
    Fighters in the Air National Guard.............................385, 395
    Force Restructuring..............................................   391
    Future of 36th Rescue Flight--Fairchild Air Force Base,
      Washington.....................................................   380
    F-15 Radar Upgrades..............................................   397
    F-16 Reductions at Hill Air Force Base, Utah.....................   375
    F-35:
        Basing.......................................................   376
        Software Workload............................................   393
        Squadron at Hill AFB.........................................   392
        Technical Training...........................................   389
    Global Integrated ISR............................................   357
    Hill Air Force Base and ICBM Solid Rocket Industrial Base........   374
    Hiring of Government Civilians to Replace Contractors............   367
    Intelligence, Surveillance and Reconnaissance..................385, 395
    Irregular Warfare.........................................363, 394, 396
    Joint Cargo Aircraft............................384, 388, 390, 395, 397
    Major Range and Test Facility....................................   391
    Minuteman III....................................................   391
    Next Generation:
        Bomber.....................................................369, 388
        Fighter Aircraft.............................................   368
    Nuclear Deterrence Operations....................................   355
    Personnel Recovery...............................................   358
    Rapid Global Mobility............................................   356
    Readiness and Resourcing.........................................   360
    Recruitment and Retention........................................   373
    Reductions to Contractor Workforce...............................   389
    Retiring Obsolescent Aircraft....................................   370
    Space Superiority................................................   358
    Special Operations...............................................   357
    Structural Repairs of KC-135 Tankers.............................   382
    Summary..........................................................   361
    Support to States--Potential Mobility Capability Gap.............   389
    Tanker:
        Acquisition..................................................   370
        Competition and Industrial Base..............................   377
        Contract Award...............................................   381
        Dual Buy Strategy............................................   381
    Test and Evaluation Support......................................   390
    The Cyber Command................................................   386
    Timing of Tanker Request for Proposal............................   378
    Training Aircraft................................................   365
    24th Air Force Mission...........................................   365
    Unmanned Aerial Vehicles.........................................   371

                             Department of the Army

                            Office of the Secretary

    Accomplishments..................................................   247
    Additional Committee Questions...................................   271
    America's Army--The Strength of the Nation.......................   247
    Army:
        End Strength.................................................   264
        Helicopter Modernization.....................................   271
        National Guard:
            End Strength...........................................265, 269
            Equipping................................................   266
        Posture......................................................   257
    Camp Williams....................................................   277
    Comprehensive Soldier Fitness Program............................   268
    Dugway Proving Ground--U.S. Army Unmanned Aerial Vehicle Testing.   275
    Equipping........................................................   270
    Fire Scout UAS...................................................   263
    Future Combat System (FCS).......................................   272
    Global Commitments...............................................   239
    Grow the Army....................................................   261
    Helicopter:
        Pilots.......................................................   262
        Training.....................................................   263
    Individual Ready Reserve Force...................................   274
    Joint Cargo Aircraft...........................................272, 273
    Manned Ground Vehicles...........................................   264
    Mine-resistant, ambush protected vehicles........................   268
    National Guard State Partnership Program.........................   276
    Setting Conditions for the Future: Six Essential Qualities of Our
      Army...........................................................   245
    Stewardship/Innovations..........................................   246
    Strategic Context................................................   238
    Stress on the Force..............................................   267
    Stryker..........................................................   261
    Third Generation Extended Cold Weather Clothing System (GEN III
      ECWCS).........................................................   274
    Two Critical Challenges..........................................   241
    2009 Army Posture Statement--America's Army: The Strength of the
      Na-
      tion...........................................................   237

                             Department of the Navy

                            Office of the Secretary

    A Naval Force, for Employment as a MAGTF.........................   313
    Additional Committee Questions...................................   330
    Advance Seal Delivery System.....................................   337
    Aegis Ballistic Missile Defense..................................   336
    Amphibious:
        Lift Requirement.............................................   337
        Ship Requirements............................................   344
        Ships......................................................337, 343
    Aviation Support NAS Fort Worth..................................   333
    Build Tomorrow's Navy............................................   289
    Building and Balancing the Naval Force of the Future.............   285
    CNO Prior Experience.............................................   325
    Common Hull Forms................................................   339
    Considerations to Resource Additional Personnel..................   338
    Demands of Irregular Warfare.....................................   334
    Develop and Support Our Sailors and Navy Civilians...............   296
    F/A-18 E/F's Retire and JSF Shortfall............................   340
    Fire Scout Unmanned Aerial Vehicle...............................   339
        Benefits.....................................................   339
    Future of Testing at PMRF........................................   335
    Guam.............................................................   328
    Industrial Base..................................................   327
    Joint:
        Command Ship Replacement.....................................   324
        High Speed Vessel (JHSV)...................................340, 346
        Strike Fighter...............................................   326
    Littoral Combat Ship.............................................   339
    Long-Term Plan for End Strength..................................   338
    MEDEVAC Mission Support in Afghanistan...........................   345
    Marine Corps:
        Cargo Unmanned Air Systems (UAS).............................   346
        End Strength.................................................   341
        Force Size...................................................   323
        Move From Okinawa to Guam....................................   344
        Suicide and Divorce Rates....................................   341
    Meeting the Missions of Today....................................   284
    Mine Resistant All Terrain Vehicles for Afghanistan..............   343
    Modernize for Tomorrow...........................................   306
    Naval Aviation Training in South Texas...........................   332
    Navy Reserve.....................................................   326
    Next Generation Ballistic Submarine..............................   338
    Nuclear Aircraft Carrier Move to Mayport, Florida................   332
    Our Marines and:
        Families.....................................................   315
        Sailors in Combat............................................   302
    Piracy...........................................................   329
    Posture the Marine Corps for the Future..........................   319
    Remain Ready to Fight Today......................................   294
    Reset the Force..................................................   304
    Right-size the Marine Corps......................................   302
    SECNAV Naval Officer Experience..................................   324
    Ship:
        Count........................................................   322
        Depot Maintenance............................................   335
    Shipyards........................................................   323
    Strike Fighter Shortfall.......................................331, 333
    Surface Combatants...............................................   336
    Take Care of Our Sailors and Marines and Their Families..........   283
    T-6 Operational Facilities.......................................   333
    VH-71:
        Impact of Decisions..........................................   331
        Sustainment of Aircraft......................................   330
    V-22.............................................................   347

                            Medical Health Programs

    ANG and AFRC.....................................................    78
    Accounting for Contract Care in the Medical Record...............   106
    Additional Committee Questions...................................    87
    Advancements in Readiness........................................    26
    Air Force Theater Hospital.......................................    24
    Bright Future and Good Time to be in the Air Force Medical
      Service........................................................    30
    Building:
        A Joint and Effective Military Health System.................    30
        And Sustaining a Pre-eminent AFMS............................    28
        Enduring Competencies........................................    73
    Care of the Caregiver............................................    55
    Caregivers.......................................................    89
    Centers for Excellence...........................................32, 87
    Centers for Vision and Hearing...................................    88
    Clinical Excellence/Readiness and Clinical Proficiency...........    52
    Collaboration With Civilian Medical Institutions/Communities/
      Outreach.......................................................    54
    Communication....................................................    61
    Competing Initiatives............................................    89
    Competitive Grades...............................................    86
    Comprehensive Transition Planning................................    46
    DOD/VA:
        Coordination.................................................    48
        Facilities...................................................    97
    Department of Defense Fiscal Year 2008 Report on Sexual Assault
      in the Military................................................    43
    Deployment.......................................................    91
    Deployments/Operational Missions.................................    54
    Disability Evaluations...........................................    38
    Doctorate of Nursing Practice..................................113, 114
    Educational Partnerships.........................................    58
    Electronic Medical Information...................................   106
    Ensuring a Fit and Healthy Force.................................    27
    Enterprise Architecture.........................................90, 106
    Expeditionary Nursing............................................    74
    Federal Health Care Center at Great Lakes........................    31
    Force Shaping/Recruitment and Retention..........................    59
    Graduate Education...............................................    57
    Growing Mental Health Requirements/Psychiatric and Mental Health
      Nursing........................................................    56
    Humanitarian:
        Assistance Missions..........................................   112
        Missions.....................................................    79
    Impact of Deployment Length......................................    38
    Improved:
        Healthy and Protected:
            Families, Beneficiaries, and Army Civilians..............     9
            Warriors.................................................    11
        Patient and Customer Satisfaction............................    15
    Inspire Trust in Army Medicine...................................    16
    Ireland Army Hospital/Blanchfield Army Hospital..................94, 96
    JAG Prosecutions.................................................    90
    Joint:
        Air Force and Veterans Affairs Projects......................   108
        DOD/VA Clinics...............................................    87
        Training and Mutual Support With Other Uniformed Services and
          Countries..................................................    53
    Keesler Medical Center and Biloxi Veterans Hospital..............   107
    Leader Development and Sustainment...............................    64
    Leadership.......................................................61, 78
    Madigan Army Medical Center......................................    85
    Medical:
        Evacuations..................................................    33
        Health Screening.............................................    36
        Lifesaving Operations--Hurricanes Katrina and Rita...........    24
    Mentorship.......................................................    61
    Military Nurse Candidates........................................   113
    New Enterprise Architecture......................................    90
    Nurse:
        Accession Bonuses............................................    84
        Corps Officer Promotion......................................   113
        Recruiting...................................................    82
            And Retention............................................    80
        Retention...................................................83, 114
        Training.....................................................   114
    Nursing:
        Publications.................................................    58
        Research.....................................................    57
    Optimized Care and Transition of Wounded, Ill, and Injured
      Warriors.......................................................    10
    Organizational Structure.........................................    72
    Our Way Ahead....................................................    79
    PTSD/TBI........................................................95, 109
    Partnering With Civilian Nursing Schools.........................   114
    Post Deployment Health Reassessment..............................   107
    Productivity Initiatives.........................................    58
    Psychological Health of Our Airmen...............................    24
    Quality Care.....................................................    76
    Readiness........................................................    75
    Recognition......................................................    79
    Recruiting and Retention.........................................    77
    Research.........................................................    77
    Reserve Healthcare Requirements..................................    42
    Responsive Battlefield Medical Force.............................    13
    Servicemember Wellness/Family Advocacy...........................    33
    Servicemembers Treatment.........................................    92
    Sexual Assault...................................................    45
        And Response Program.........................................    43
    Soldier Suicides.................................................    93
    Sufficient Supplies and Personnel for Afghanistan................    34
    Suicides.......................................................106, 109
    Sustaining the Air Force Medical Service.........................    25
    TBI Registry.....................................................    41
    The Family.......................................................    56
    The Warfighter...................................................    55
    The Warfighter, Their Families and the Continuum of Care.........    55
    The Wounded Warrior Care Continuum...............................    57
    Training.........................................................    52
    Traumatic Brain Injury/Malaria Research..........................    88
    Troop Increase in Afghanistan....................................    35
    VA Vision Center of Excellence and Eye Trauma Registry..........91, 107
    Vision Center of Excellence and Eye Trauma Registry..............
    Well-being of Our Caregivers.....................................   105
    Wounded Warrior..................................................   109

                                 National Guard

    A Quick Review...................................................   127
    Additional Committee Questions...................................   161
    Aging Fleet......................................................   144
    Air National Guard:
        Family Support...............................................   168
        Military Construction........................................   168
    Air Sovereignty Alert............................................   149
    An Operational Force.............................................   120
    Blast Tracker....................................................   159
    Counterdrug Programs.............................................   133
    Deployment Challenges............................................   163
    Developing Adaptable Airmen......................................   127
    Domestic Operations..............................................   132
    End Strength.....................................................   166
    Family Readiness Levels..........................................   162
    Federal Employees in the National Guard and Reserves.............   169
    F-15 AESA Radar System...........................................   169
    F-35s............................................................   145
    Guard Presence on United States/Mexican Border...................   170
    HAMMER...........................................................   165
    In Memoriam......................................................   137
    Individual Ready Reserve (IRR)...................................   164
    Introduction and Executive Overview..............................   120
    Investing in:
        Equipment and Facilities.....................................   123
        Information Technology.......................................   126
        Operations...................................................   125
        Personnel....................................................   122
        Present and Future Value.....................................   122
    Joint:
        And Interagency Training.....................................   133
        Cargo Aircraft...............................................   147
    Light Utility Helicopter.........................................   161
    Message From The Director.................................122, 126, 131
    Mental Health....................................................   146
    Military Construction............................................   162
    Modernize and Recapitalize.......................................   128
    Monticello Readiness Center......................................   166
    National Guard Posture Statement 2010............................   120
    New Beginnings...................................................   120
    119th Wing, Hector Field, ND.....................................   167
    186th Air Refueling Wing.........................................   170
    Operation Jump Start.............................................   133
    Personnel........................................................   165
    Readiness......................................................120, 128
    Reserve Component Stress.........................................   167
    State:
        Adjutants General............................................   137
        Partnership Program..........................................   121
    Supporting the Warfighter........................................   135
    Technology Revolutionizes Emergency Response and Training........   134
    The Future.......................................................   121

                            Office of the Secretary

    Acquisition......................................................   438
        Reform.....................................................422, 439
            And Insourcing...........................................   406
            Requirements...........................................443, 459
    Additional Committee Questions...................................   441
    Afghanistan....................................................427, 432
        Troop Levels.................................................   431
    Age and Health of Tanker Fleet.................................448, 463
    Air Capabilities.................................................   408
    Air Force/Army Aircraft Acquisition Issues.......................   429
    Aircraft Issues................................................435, 441
    Balancing Global Strategic Risk..................................   419
    Budget Rationale.................................................   425
    Conflicts Between the Military Mission and Wind Power............   453
    Cyber Security...................................................   409
    De-Militarizing U.S. Foreign Policy............................444, 460
    Defend Vital National Interests in the Broader Middle East and
      South Central Asia.............................................   415
    Export Version of the F-22.......................................   450
    Fiscal Year 2010:
        Overseas Contingency Operations Request....................446, 461
        Tanker Contract Award Schedule...............................   448
    Ground-based Missile Defense (Alaska Interceptors).............445, 461
    Institutionalizing Irregular Warfare Capabilities..............442, 458
    Intelligence/Satellites..........................................   430
    Iran.............................................................   431
    Irregular Warfare..............................................442, 458
    Joint Strike Fighter.............................................   435
    Key Developments.................................................   414
    Land Capabilities................................................   409
    MRAP ATV.......................................................425, 427
    Maritime Capabilities............................................   408
    Mental Healthcare................................................   440
    Military:
        Healthcare...................................................   440
        Personnel Compensation.......................................   451
    Missile Defense...........................................409, 426, 436
    Modernization....................................................   407
    National Polar-Orbiting Operational Environmental Satellite
      System (NPOESS)................................................   445
    Naval:
        Issues.......................................................   426
        Ship Issues..................................................   430
    Our People.......................................................   405
    Overseas Contingency Operations..................................   410
    Persistent Engagement............................................   421
    Reset, Reconstitute, and Revitalize the Armed Forces.............   417
    Special Operations Command (SOCOM).............................450, 463
    Strain on the Force............................................446, 461
    Strategic Implications of Program Terminations.................444, 460
    Structural Repairs of KC-135 Tankers.............................   449
    Syria............................................................   437
    Tanker:
        Contract Competition.........................................   448
        Dual Buy Strategy............................................   449
    Today's Warfighter...............................................   406
    Trusted Foundry..................................................   451
    Veteran Health/Mental Care.......................................   441

                                    Reserves

    Additional Committee Questions...................................   223
    Army Reserve:
        Generating Return on Investment..............................   185
        Priorities...................................................   174
        Snapshot.....................................................   188
    Award of the Silver Star.........................................   186
    Broaden Total Force Initiatives..................................   214
    Casualty Assistance and Military Funeral Honors..................   208
    Changes in Reserve Personnel Policies............................   232
    End strength...................................................223, 225
    Equipment........................................................   202
    Equipping the Navy Reserve.......................................   193
    First Army Reserve Soldier Wins Army Soldier of the Year.........   187
    Facilities.......................................................   205
    Federal Employees in the National Guard and Reserves.............   230
    Fiscal Year 2008 Return on Investment............................   173
    Force Realignment................................................   229
    Health Services..................................................   205
    Individual Ready Reserve (IRR)...................................   224
    Modernize Equipment and Facilities...............................   215
    Operational Contributions........................................   191
    Operational, Combat Ready Force While Maintaining a Strategic
      Reserve........................................................   211
    People Policies and Programs.....................................   194
    Personnel......................................................200, 224
    Preserving the Viability of the Reserve TRIAD (Family, Air Force
      Reserve and Employer)..........................................   213
    Preserving, Leveraging and Improving Air Force Reserve Value and
      Our Priorities.................................................   211
    Quality of Life..................................................   206
    Recruiting and Retention.........................................   210
    Reserve Full Time End Strength...................................   231
    Special Honorees.................................................   186
    Strategic Context................................................   174
    Supporting the Sailor and Family.................................   193
    TRICARE........................................................225, 231
    The Army Reserve--A Positive Investment for America..............   172
    Today's Marine Corps Reserve.....................................   197
    Training.........................................................   203
    Yellow Ribbon Reintegration Program..............................   216

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