    [Senate Hearing 112-187, Part 2]
    [From the U.S. Government Publishing Office]

                                                            S. Hrg. 112-187

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

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

                                    HEARINGS

                                    before a

                              SUBCOMMITTEE OF THE

                COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE

                          ONE HUNDRED TWELFTH CONGRESS

                                 FIRST SESSION

                                       ON

                                   H.R. 2219

      AN ACT MAKING APPROPRIATIONS FOR THE DEPARTMENT OF DEFENSE FOR THE
         FISCAL YEAR ENDING SEPTEMBER 30, 2012, 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.gpo.gov/fdsys

                                   __________

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                          COMMITTEE ON APPROPRIATIONS

                       DANIEL K. INOUYE, Hawaii, Chairman
    PATRICK J. LEAHY, Vermont            THAD COCHRAN, Mississippi
    TOM HARKIN, Iowa                     MITCH McCONNELL, Kentucky
    BARBARA A. MIKULSKI, Maryland        RICHARD C. SHELBY, Alabama
    HERB KOHL, Wisconsin                 KAY BAILEY HUTCHISON, Texas
    PATTY MURRAY, Washington             LAMAR ALEXANDER, Tennessee
    DIANNE FEINSTEIN, California         SUSAN COLLINS, Maine
    RICHARD J. DURBIN, Illinois          LISA MURKOWSKI, Alaska
    TIM JOHNSON, South Dakota            LINDSEY GRAHAM, South Carolina
    MARY L. LANDRIEU, Louisiana          MARK KIRK, Illinois
    JACK REED, Rhode Island              DANIEL COATS, Indiana
    FRANK R. LAUTENBERG, New Jersey      ROY BLUNT, Missouri
    BEN NELSON, Nebraska                 JERRY MORAN, Kansas
    MARK PRYOR, Arkansas                 JOHN HOEVEN, North Dakota
    JON TESTER, Montana                  RON JOHNSON, Wisconsin
    SHERROD BROWN, Ohio

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

                            Subcommittee on Defense

                       DANIEL K. INOUYE, Hawaii, Chairman
    PATRICK J. LEAHY, Vermont            THAD COCHRAN, Mississippi
    TOM HARKIN, Iowa                     MITCH McCONNELL, Kentucky
    RICHARD J. DURBIN, Illinois          RICHARD C. SHELBY, Alabama
    DIANNE FEINSTEIN, California         KAY BAILEY HUTCHISON, Texas
    BARBARA A. MIKULSKI, Maryland        LAMAR ALEXANDER, Tennessee
    HERB KOHL, Wisconsin                 SUSAN COLLINS, Maine
    PATTY MURRAY, Washington             LISA MURKOWSKI, Alaska
    TIM JOHNSON, South Dakota            LINDSEY GRAHAM, South Carolina
    JACK REED, Rhode Island              DANIEL COATS, Indiana

                               Professional Staff

                                  Betsy Schmid
                                Nicole Di Resta
                                Kate Fitzpatrick
                                 Colleen Gaydos
                                   Katy Hagan
                                  Kate Kaufer
                                   Erik Raven
                                   Gary Reese
                                  Teri Spoutz
                                 Bridget Zarate
                           Stewart Holmes (Minority)
                           Alycia Farrell (Minority)
                             Brian Potts (Minority)
                         Rachelle Schroeder c(Minority)

                             Administrative Support

                                  Rachel Meyer

                                C O N T E N T S

                                  ----------

                             Tuesday, March 1, 2011

                                                                       Page

    Department of Defense............................................     1

                           Wednesday, March 16, 2011

    Department of Defense: Department of the Navy: Office of the
      Secretary......................................................    35

                           Wednesday, March 30, 2011

    Department of Defense: Department of the Air Force: Office of the
      Secretary......................................................   131

                            Wednesday, April 6, 2011

    Department of Defense: Medical Health Programs...................   187

                            Wednesday, May 11, 2011

    Department of Defense:
        National Guard...............................................   301
        Reserves.....................................................   335

                            Wednesday, May 18, 2011

    Department of Defense: Department of the Army: Office of the
      Secretary......................................................   413

                            Wednesday, May 25, 2011

    Department of Defense: Missile Defense Agency....................   479

                            Wednesday, June 15, 2011

    Department of Defense: Office of the Secretary of Defense........   501

                            Wednesday, June 22, 2011

    Nondepartmental Witnesses........................................   559

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                             TUESDAY, MARCH 1, 2011

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:34 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Mikulski, Reed, Cochran,
    Alexander, Collins, and Murkowski.

                             DEPARTMENT OF DEFENSE

    STATEMENT OF WILLIAM J. LYNN III, DEPUTY SECRETARY OF
                DEFENSE
    ACCOMPANIED BY ROBERT F. HALE, UNDER SECRETARY OF DEFENSE, COMPTROLLER

                 opening statement of chairman daniel k. inouye

        Chairman Inouye. Good morning. This morning marks our first
    Defense Appropriations Committee hearing of the 112th Congress.
    And I would like to remind my colleagues and the new members of
    the subcommittee that our first defense hearing of the year is
    typically reserved for the rollout of the coming year's budget.
        However, this morning, we will hear from Deputy Secretary
    of Defense Mr. William Lynn and the Under Secretary of Defense,
    the Comptroller, Mr. Robert Hale regarding the impact of a
    long-term continuing resolution on the Department of Defense.
    Today marks the first 5 months into the fiscal year 2011 and 3
    days before the current continuing resolution expires.
        The path forward on completing the appropriations bills for
    fiscal year 2011 is still challenging. Unless cooler heads
    prevail and both houses of Congress begin to make progress on
    passing this year's budget, there remains the possibility that
    the whole Government could be funded through a full-year
    continuing resolution. This hearing is intended to examine the
    consequences of putting the defense budget on autopilot for the
    next 7 months.
        We have military men and women fighting a war in
    Afghanistan, training forces in Iraq so that we can safely draw
    down our forces there, and operating around the globe to
    protect our national security. Yet under the current funding
    situation, each of the military services has already been
    adversely impacted by the current continuing resolution.
        The readiness of our forces is beginning to be threatened
    as flying hours and steaming days are reduced, exercises and
    training events are canceled, equipment is foregoing much-
    needed maintenance, and the list goes on and on.
        The Department's acquisition programs are also being
    adversely impacted. The Army has no funds to refurbish war-
    torn, high-mobility, multipurpose Humvees, which means that 300
    personnel have been released from two critical Army maintenance
    depots. The Navy cannot award contracts for a second Virginia-
    class submarine, a second DDG-51, or the first Mobile Landing
    Platform. The Air Force will not be able to procure additional
    MQ-9 Reaper unmanned aerial vehicles to increase the number of
    much-needed combat air patrols in Afghanistan. And these are
    just but a few examples.
        The military personnel accounts will face serious
    shortfalls if forced to operate at the fiscal year 2010 funding
    levels for the rest of the year. The Navy would be underfunded
    by $456 million, the Marine Corps by $468 million, and the Air
    Force would experience a $1 billion shortfall in military
    personnel accounts.
        The Defense Health Program would have to reduce the number
    of hours on patient care provider contracts and take other
    actions that will have an adverse effect on the quality and
    timeliness of medical care and resources for our military and
    their families.
        The list of affected programs and challenges goes on and
    on, but ultimately, it is the men and women in uniform that
    will pay the price. Secretary Gates summed it up best in late
    January when he said that continuing work under a continuing
    resolution would be ``the worst of all possible reductions.''
    He went on to say, ``That is how you hollow out a military,
    even in wartime.''
        So, Mr. Secretary and Mr. Hale, I look forward to hearing
    more from you about the specific actions the Department will
    have to take if forced to operate under a continuing resolution
    for the remainder of the fiscal year.
        But first, let me turn to Vice Chairman Cochran for his
    opening remarks.

                       statement of senator thad cochran

        Senator Cochran. Mr. Chairman, I join you in welcoming our
    distinguished witnesses to the subcommittee today. We
    appreciate their service to the Government and their continued
    willingness to serve in these important positions of
    responsibility with respect to the Department of Defense.
        We are kind of up against it, as they say down home. When
    you look at the facts about the needs and the funds that are
    required to maintain our deployments in key places around the
    world that are important to our national security, and then
    compare that with the reality of the squeeze on the budget and
    the lack of funds being requested for some programs that really
    need more funding than are being requested by the
    administration.
        So we have a hill to climb. We have a big challenge. And
    your being here and keeping it in perspective for us, and
    letting us know what the realities are from your point of view
    is a very helpful part of the process, and we thank you for
    your cooperation with our committee and your presence here
    today.
        Chairman Inouye. Senator Mikulski.

                    statement of senator barbara a. mikulski

        Senator Mikulski. Well, first of all, we want to welcome
    Secretary Lynn and Mr. Hale. I know we want to move right on to
    the hearing, but I am going to make two points.
        Number one, I really want to congratulate Secretary Gates
    on his reform effort in terms of really bringing the Department
    of Defense budget under control. I believe the reforms led by
    Secretary Gates, and that you and Dr. Carter have been
    pursuing, will give us a lot of guideposts for 2012. And you
    can count me on the reformer side of the ledger. But when we
    get into the areas of reform, I am going to talk about the
    impact on the continuing resolution and also the long-term.
        The other is--just as a general statement before we get
    into the specifics of the area--again, Mr. Lynn, if Secretary
    Gates were here, I would say this to him, and I would ask you
    to carry the message back.
        During the Walter Reed scandal, when it first broke,
    Secretary Gates responded with such swiftness that we all
    really appreciated that. He responded like a human being. He
    responded like a Secretary of Defense. He responded swiftly and
    effectively. We really are tremendously grateful for that as we
    worked in a very steadfast way to deal with that. Now we will
    be opening the new facility at Naval Bethesda, which will be a
    wonderful day.
        But so much remains on the area of military medicine,
    particularly how we deal with the post traumatic stress
    syndrome, the fact that I am calling it ``the 50-year war''
    because the permanent wounds of war and the permanent impact of
    war will go on with these men and women and their families for
    years. So we want to continue that. I will reserve those
    questions for the separate hearing.
        But Gates really led the way. He is leading the way on
    reform. He is leading the way, he led the way, and we look
    forward to working with you at really trying to get highest
    value for our dollar, both to our troops when they fight over
    there, but for them and their families when they come back
    here.
        Chairman Inouye. Thank you.
        Senator Collins.

                       statement of senator susan collins

        Senator Collins. Thank you, Mr. Chairman. Let me thank you
    and the vice chairman for holding this very important hearing.
        Last fall, when it was evident that we had reached an
    impasse on many issues, I went to both the majority leader and
    the minority leader to suggest that we pass a combination of
    the DOD appropriations bill, the Homeland Security bill, and
    the VA/MilCon bill--a so-called ``minibus.'' I believe that
    such a package would have passed last fall and avoided the
    problems that we now face.
        I subsequently, this year, wrote to both leaders, and I am
    sending a second letter today that I would ask unanimous
    consent be included in the hearing record, urging them to
    immediately go to the defense appropriations bill.
        [The information follows:]
                                           U.S. Senate,
                    Homeland Security and Governmental Affairs,
                                         Washington, DC, March 1, 2011.
    Hon. Harry Reid,
    Majority Leader, U.S. Senate,
    Washington, DC.
    Hon. Mitch McConnell,
    Minority Leader, U.S. Senate,
    Washington, DC.
        Dear Senator Reid and Senator McConnell: As we approach the March 4
    expiration of the resolution that is currently funding Government
    operations, I want to reiterate my strong belief that the Senate must
    pass, as soon as possible, a funding bill that provides the Department
    of Defense the resources it needs to sustain current operations and
    readiness and to prepare to meet future challenge.
        The leadership of the military services have warned repeatedly that
    a year-long CR at reduced funding levels could negatively affect both
    their effectiveness and efficiency. Equipment maintenance would be
    deferred; facility repairs and construction would be curtailed; and
    military acquisition would be hampered. Last week, Secretary Gates
    testified before the Senate Armed Services Committee that operating
    under a CR or substantially reduced funding would lead to procurement
    delays and increasing costs for high demand assets, such as Unmanned
    Aerial Vehicles.
        The Congressional Research Service confirmed that an extension of a
    ``clean'' CR will result in insufficient funding for military personnel
    budgets and defense health programs, all of which are critical to
    supporting our men and women in uniform and their families. The
    operations & maintenance accounts would also face significant
    shortfalls, including a six percent reduction in war-related operations
    funding. For these reasons, Secretary Gates stated in his testimony
    that, ``Cuts in operations would mean fewer flying hours, fewer
    steaming days, and cutbacks in training for home-stationed forces--all
    of which directly impacts readiness. That is how you hollow out a
    military--when your best people, your veterans of multiple combat
    deployments, become frustrated and demoralized and, as a result, begin
    leaving military service.''
        The impact of a full-year CR on the $16 billion Navy shipbuilding
    budget, an account that makes up just three percent of the defense
    budget request for fiscal year 2011, is indicative of how a full-year
    CR would negatively affect the servicemen and women who rely on stable
    funding from Congress. The result would be higher costs for the
    taxpayers and fewer ships towards the Navy's goal of a 313-ship fleet.
        Admiral Gary Roughead, the Chief of Naval Operations, described
    this impact to me last week during a visit to Bath Iron Works in Maine.
    He said that, ``the lack of a final budget for the military could
    undermine the Navy's shipbuilding plans,'' including the Virginia-class
    attack submarine program and the DDG-51 destroyer program. The
    shipbuilding program faces executability challenges under the CR
    because of increases in fiscal year 2011 ship quantities and funding
    levels compared to fiscal year 2010 levels. Although the shipbuilding
    budget request for fiscal year 2011 is about $1.9 billion more than the
    amount appropriated in fiscal year 2010, the potential shortfall is
    actually $5.6 billion because a CR may not include transfer authority
    or provide funding increases in other budget lines. The disruptive
    impact of a full-year CR on the shipbuilding account is just one
    example of the result that congressional inaction is having on our
    military service members and their families.
        While there are a number of areas where our two parties may have
    significant differences, providing our military the funding it needs to
    succeed should not be among them. Traditionally, senators from both
    parties have been able to work together to provide our men and women in
    unifolin the resources they need to accomplish what is asked of them.
    It concerns me that this process of keeping security spending separate
    from the spirited disagreement regarding domestic spending appears to
    be over. I truly hope that is not the case, and I urge you to work
    together to bring the fiscal year 2011 funding bill to the Senate floor
    as soon as possible so that can work with our colleagues in the House
    to send a bill to the President for signature.
                Sincerely,
                                              Susan M. Collins,
                                                          U.S. Senator.

        Senator Collins. The patent reform bill, which is on the
    floor this week, is important legislation. But it is a bill
    that has been pending for years and does not have the urgency
    of the defense appropriations bill.
        So I join in the frustration of our military leaders and
    Secretary Gates that Congress has not completed its work in
    this vital area. That is what we ought to be doing on the
    Senate floor right now, in my view.
        Finally, let me just quote further from Secretary Gates's
    testimony before the Armed Services Committee last week. And it
    goes along with what the chairman said about hollowing out the
    force. He could not have been clearer. He said cuts in
    operations would mean fewer flying hours, fewer steaming days,
    and cutbacks in training for home station forces, all of which
    directly impacts our readiness.
        The Chief of Naval Operations was with me in Maine last
    week. He made very similar comments about the dramatic and
    draconian impact on the Navy if we continue to operate under a
    continuing resolution. So we need to get our job done, and I
    think we should bring this bill to the Senate floor as a
    separate bill today.
        Thank you, Mr. Chairman.
        Chairman Inouye. I thank you very much.
        And now may I call upon the Deputy Secretary, the Honorable
    Mr. Lynn.
        Mr. Lynn. Thank you very much, Mr. Chairman, Senator
    Cochran, members of the subcommittee.
        If it pleases the subcommittee, what I would like to do is
    summarize the written statement, enter the written statement in
    the--the full written statement in the record.
        Chairman Inouye. Your statement will be part of the record.
        Mr. Lynn. What I would start with is a few opening comments
    on the fiscal 2012 bill, but then turn to impact of the year-
    long continuing resolution as the primary subject of the
    hearing.
        The fiscal year 2012 budget that we have submitted seeks
    $671 billion from Congress in discretionary budget authority.
    That is divided between $553 billion in the base defense
    program and nearly $118 billion in the overseas contingencies
    operation budget. In our judgment, this budget is both
    reasonable, in that it meets our national security needs, and
    prudent, in that it supports the administration's plans for
    deficit reduction.
        Through the efficiencies initiative that Senator Mikulski
    has already referenced, the services have identified $100
    billion in savings and then reinvested those savings into
    higher-priority programs that strengthen our warfighting
    capabilities. At the same time, we identified at a department-
    wide level $78 billion from outside the service accounts in
    defense-wide efficiencies, and we devoted that savings to the
    administration's efforts to hold down the deficit across the
    period of fiscal year 2012 to 2016.
        The overall budget itself takes care of our people. It
    continues to rebalance the U.S. defense posture to ensure that
    we meet immediate warfighting needs, as well as longer-term
    modernization needs. And it provides our deployed forces with
    everything that they need to carry out their mission.
        And finally, it continues the Secretary's reform agenda by
    focusing on streamlining business operations. In short, it is
    our hope that the Congress will support this request and enact
    an appropriations bill for fiscal year 2012 at the start of the
    fiscal year in October.
        But as has been referenced by all the members of the
    subcommittee, even as we discuss the fiscal year 2012 budget,
    there is unfinished business that concerns us greatly. The
    Department of Defense has been operating under a continuing
    resolution for more than 5 months.
        If the Congress is unable to enact an appropriation, the
    Department would presumably continue to operate under a
    continuing resolution like the one currently in effect for
    months more, or perhaps even for the entire year. In our view,
    this is not a workable approach.
        The existing continuing resolution has caused regrettable
    complications. A year-long continuing resolution would have a
    further deleterious impact on the people who make up our
    fighting forces and their readiness to defend the Nation.
    Simply put, the continuing resolution would provide inadequate
    resources. It would put funding in the wrong places. In other
    words, we wouldn't have the money to pay must-pay bills in the
    medical and personnel area. And it would not allow for the
    management flexibility, particularly new start authority and
    the ability to start new military construction projects.
        With regard to the funding levels, a year-long continuing
    resolution would cut DOD's fiscal 2011 base budget by $23
    billion below the President's request of $549 billion, the
    request he made in February of last year. At this low base
    budget level, the services will be forced to reduce their
    operating tempo, and DOD would not receive even enough
    additional funds to cover must-pay bills, including $8 billion
    for military pay raises and increases in the costs of medical
    care, fuel, and inflation.
        To cover these unavoidable expenses, we would be forced to
    play a shell game. We would rob Peter to pay Paul. Moving funds
    in this way is detrimental to our readiness, our modernization,
    and to efficient business practices.
        For example, funding would likely be reduced for some or
    all of the three brigade combat teams that will be returning
    from Iraq and Afghanistan soon. The Navy would likely be forced
    to reduce flying hours and steaming days and to cancel
    exercises and training events. The Air Force would face a 10
    percent cut in its flying hours. Equipment maintenance would
    also have to be deterred--deferred, excuse me. All of these
    cuts would impact on readiness.
        Continuation of the current continuing resolution
    throughout the year would also prohibit us from starting new
    weapons programs or increasing production rates of existing
    ones. Already, the Navy was unable to purchase Government-
    furnished equipment for the second DDG-51 destroyer as planned,
    and it has been unable to contract for the second Virginia-
    class submarine.
        The Army has had to defer a contract for new Chinook
    helicopters and delay refurbishment of war-torn Humvees. If the
    current continuing resolution continues throughout the year,
    problems like these will snowball.
        The facilities we need to carry out our national security
    mission will also be affected. Under the continuing resolution,
    the services have had to delay 75 projects across the Nation.
    These delays not only affect our capabilities, but also the
    quality of life for our servicemen and women.
        Finally, there will be harmful management consequences
    associated with the year-long continuing resolution, many of
    them difficult to notice from here in Washington. But program
    managers will delay contracting actions out of necessity, only
    to be required at a later date to hastily make up for that by
    contracting too quickly without the appropriate safeguards.
        In the face of uncertainty, other managers will resort to
    short-term contracts that add expense for the taxpayer and
    instability for the industrial base. In a time of war, with
    soldiers, sailors, airmen, and Marines on the front lines, DOD
    needs an appropriations bill with the reasonable level of
    spending and the flexibility necessary to meet our warfighters'
    needs.

                               PREPARED STATEMENT

        In short, a year-long continuing resolution will damage
    national security. It presents the Department and the Nation
    with what Secretary Gates has aptly described as a crisis at
    our doorstep. For all of these reasons, we strongly urge
    Congress to enact the defense appropriations bill for fiscal
    year 2011.
        With that, Mr. Chairman, happy to take the subcommittee's
    questions.
        [The statement follows:]
                   Prepared Statement of William J. Lynn III
        Mr. Chairman and members of the committee, thank you for this
    opportunity to discuss the fiscal year 2012 budget proposal for the
    Department of Defense, as well as the serious problems we face if we
    are required to operate under a Continuing Resolution for the remainder
    of fiscal year 2011.
                      budget proposal for fiscal year 2012
        The budget request, submitted to Congress 2 weeks ago to support
    the mission of the Department in fiscal year 2012, seeks about $671
    billion of discretionary budget authority--including $553.1 billion to
    fund base defense programs and $117.8 billion to support Overseas
    Contingency Operations (OCO), primarily in Afghanistan and Iraq.
        In our judgment, this budget is both reasonable, in that it meets
    national security needs, and responsible, in that it supports the
    administration's plan to hold down deficits. It is built around several
    broad themes:
      --The proposed budget takes care of our people. That is our top
            priority, since the all-volunteer force is America's greatest
            security asset. We propose a military pay raise of 1.6 percent,
            which will match the Employment Cost Index and keep growth in
            military salaries on a par with those in the private sector. We
            are also asking for $8.3 billion for family support programs, a
            sum that fully supports the President's military families
            initiative. For military healthcare, we are asking for $52.5
            billion, including $677 million for research and support for
            traumatic brain injury and psychological healthcare, and more
            than $400 million to continue medical research on behalf of
            wounded, ill, and injured Service Members.
      --The proposed budget also continues to rebalance the U.S. defense
            posture to provide the capabilities needed to fight current
            wars while also building capability for potential future
            conflicts. To support current war efforts, we plan substantial
            investment ($4.8 billion) in intelligence, surveillance, and
            reconnaissance capabilities, including various unmanned
            aircraft, which are in high demand by Combatant Commanders. We
            are also proposing to invest $10.6 billion in rotary wing
            aircraft. In addition we are requesting funding for cyber
            activities, chemical and biological defenses, and security
            assistance programs to build up the capabilities of our allies.
      --To prepare our forces for potential future conflicts, our budget
            proposal for fiscal year 2012 invests in advanced capabilities.
            We request $9.4 billion for the Joint Strike Fighter (JSF)
            program, including funds to purchase 32 aircraft and to support
            continued development. We will also instill discipline in this
            major program by imposing a 2-year ``probation'' period for the
            STOVL (Short Take Off and Vertical Landing) variant while we
            seek to fix various design challenges. Meanwhile, we plan to
            buy 41 additional F/A-18 aircraft and extend production through
            fiscal year 2014. We plan an aggressive shipbuilding program of
            11 ships in fiscal year 2012 and 56 over the next 5 years,
            investment in a family of long-range strike options, including
            a new long-range bomber program, and $900 million for the KC-X
            tanker program. We have a new family of armored vehicles in the
            works, and we are requesting $10.7 billion for ballistic
            missile defenses, including $8.6 billion for the Missile
            Defense Agency.
      --The proposed budget provides our deployed forces with everything
            they need to carry out their mission. It includes significant
            expenditures for reset of damaged and destroyed equipment, for
            purchases of force protection equipment, for high priority
            infrastructure projects in Afghanistan that support
            counterinsurgency objectives, for the Commander's Emergency
            Response Program (CERP)--a valuable tool in theater--and for
            funding to assist the transition to a civilian-led mission in
            Iraq.
        In addition to these broad themes, our proposed budget continues
    the Secretary's reform agenda. That agenda began in fiscal year 2010
    and 2011, with a focus on the restructuring and termination of a number
    of weapons programs. Some programs, such as the F-22 and the C-17, were
    cancelled because we had already purchased enough of the capabilities
    they provide. Other programs, like the VH-71 Presidential helicopter,
    were terminated because of cost overruns, development problems, or
    because they would have provided what Secretary Gates has termed
    ``exquisite'' capabilities that are not central to our current security
    challenges.
        Secretary Gates has continued his reform agenda in fiscal year
    2012-2016 by focusing on streamlining business operations. Through his
    Efficiencies Initiative, the Services have identified $100 billion in
    savings and reinvested those savings into high-priority programs that
    strengthen warfighting capability. These savings will be realized
    through better business practices, reorganizations, and by terminating
    or restructuring weapons programs. Examples of proposed changes include
    the elimination of unneeded task forces, combining of air operations
    centers, consolidation of e-mail servers, and cutting back on lower-
    priority tasks associated with facilities sustainment and construction.
    The Services also propose terminating the Non-Line of Sight Launch
    System, the SLAMRAAM surface-to-air missile, and the Marine
    Expeditionary Fighting Vehicle (EFV).
        The EFV program alone would have consumed $12 billion in future
    procurement costs, including about half of all anticipated Marine Corps
    procurement funding from 2018 to 2025. While the planned EFV would have
    been a highly capable vehicle, its capability was needed only for a
    narrow range of high-end missions. After careful evaluation, both the
    Secretary of the Navy and the Commandant of the Marine Corps
    recommended termination of the EFV. The Marine Corps will sustain its
    amphibious assault mission by reinvesting EFV savings into upgrades of
    existing vehicles as well as a new amphibious vehicle designed to meet
    a more focused set of requirements.
        In addition, our budget identifies $78 billion in further defense-
    wide efficiencies in fiscal year 2012 through 2016. These efficiencies
    allow the defense topline to be reduced in support of the
    administration's deficit-reduction efforts, beginning with a $13
    billion reduction in fiscal year 2012. This topline reduction was
    largely achieved through changes in the portion of our budget less
    directly related to warfighting capability. These changes include
    revisions in military healthcare, changes in the economic assumptions
    that underlie the budget, and defense-wide personnel changes, including
    a freeze on civilian pay and personnel levels through fiscal year 2013
    (with limited exceptions) and a reduction in the number of contractors
    who augment Government staffs. We are also reducing, over 2 years, the
    number of general and flag officer billets by about 100 and civilian
    senior executive billets by about 200.
        DOD's medical costs have shot up from $19 billion in fiscal year
    2001 to $52.5 billion in fiscal year 2012. We offer proposals in this
    budget to slow the growth in medical care costs while continuing to
    provide high-quality military healthcare for our troops and their
    families. We also propose changes in pharmacy co-pays designed to
    increase the use of generic drugs and mail-order delivery. We are also
    propose a modest increase in TRICARE enrollment fees for working-age
    retirees--the first such increase since the mid 1990s--and indexing of
    those fees to a medical deflator. We intend to phase out subsidies for
    a number of non-military hospitals where the Department pays premium
    claims rates.
        This budget also proposes a decrease in the permanent end strength
    of the Army and Marine Corps starting in fiscal year 2015. In one of
    his first acts in office 4 years ago, and in the midst of our
    engagements in Iraq and Afghanistan, Secretary Gates increased
    permanent end strength by 65,000 for the Army and 27,000 for the
    Marines. By 2014 we will have completed the military mission in Iraq
    and largely shifted the security mission in Afghanistan from allied to
    Afghan forces. As a result, we believe that, in fiscal year 2015 and
    fiscal year 2016, we can reduce active duty end strength by 27,000
    within the Army and by 15,000 to 20,000 in the Marine Corps with
    minimal risk. If our assumptions about Iraq and Afghanistan prove
    incorrect or global conditions change for the worse, there will be
    ample time to adjust the size and schedule of this change, or reverse
    it altogether.
        The budget also requests $524 million in fiscal year 2012 for the
    Office of Security Cooperation--Iraq (OSC-I), which will assist in
    executing foreign military sales. OSC-I will also support military-to-
    military efforts to advise, train, and assist Iraq's security forces.
    The OSC-I is jointly funded with the State Department. In order to
    provide timely assistance, and help provide a timely transition to a
    civilian-led mission in Iraq, we need to begin funding OSC-I
    initiatives in fiscal year 2011 and then provide the requested funds in
    fiscal year 2012. DOD needs legislative authority to provide this
    assistance, and we ask Congress to include this authority in our
    appropriation bill for fiscal year 2011.
        Mr. Chairman, this is a thumbnail sketch of the Department's budget
    proposal for fiscal year 2012. We look forward to working with this
    Committee and the Congress as you consider our request. It is our hope
    that Congress will support this request and enact an appropriations
    bill for fiscal year 2012 before the start of the new fiscal year on
    October first.
       serious problems associated with a year-long continuing resolution
        Even as we start the debate over the fiscal year 2012 budget, there
    is unfinished business that concerns us greatly. The Department still
    needs an appropriation for fiscal year 2011. As members of this
    committee are aware, the Department of Defense has been operating under
    a Continuing Resolution (CR) for more than 5 months. The present CR is
    due to expire in 3 days.
        If the Congress is unable to enact an appropriation, the Department
    would presumably continue to operate for the remainder of the year
    under a CR like the one currently in effect--which I will refer to as a
    ``year-long CR'' in the remainder of my statement. In our view, this is
    not a workable approach.
        A year-long CR would adversely affect the people who make up and
    support our fighting forces and their readiness to defend the Nation.
    Serious problems are already occurring. Both the Army and the Marine
    Corps have imposed temporary civilian hiring freezes. This means that,
    for example, when a maintenance position becomes open due to normal
    attrition, that position cannot be filled. Such decisions save money,
    but they also plant the seeds for future problems with essential
    equipment. Because of the CR, the Navy has had to reduce its notice of
    Permanent Change of Station moves from the usual 6 months to 2, which
    hurts Navy personnel and puts a greater strain on their families.
        If the current CR continues throughout the year, it will cause
    significantly more harm. While the exact effects depend on decisions
    yet to be made, the broad consequences are already known. A year-long
    CR would force the Services to reduce their operating tempo, harming
    both training and readiness. For example, funding would likely be
    reduced for some or all of three Brigade Combat Teams returning from
    Iraq and Afghanistan. This would mean reductions in training at a time
    when these units will need it most. The Navy would likely be forced to
    reduce flying hours and steaming days and to cancel exercises and
    training events. The Air Force is likely to face at least a 10 percent
    cut in flying hours. All of these cuts would have a significant impact
    on readiness.
        If there were a year-long CR, it would be necessary for each
    Service to defer equipment maintenance. The Army estimates that a
    reduction of $200 million in depot maintenance could be required,
    adversely affecting the Blackhawk and Kiowa Warrior helicopters, among
    other platforms. The Navy may need to reduce maintenance by $900
    million, which would result in the cancellation of as many as 29
    surface ship maintenance availabilities out of a total of 85. A year-
    long CR would also mean deferred depot maintenance on as many as 70
    airframes and 290 aircraft engines, deferred maintenance on
    expeditionary equipment, and deferred torpedo and missile
    certifications. Deferring maintenance in this way does serious damage
    to the readiness of the world's finest military.
        A year-long CR would also seriously harm DOD acquisition programs--
    first because of a lack of funding and second because continuation of
    the current CR would prohibit us from starting new weapons programs or
    increasing production rates of existing ones. These prohibitions cost
    us the flexibility necessary to meet warfighter needs.
        As a result of the CR serious acquisition problems are already
    occurring. The Navy was unable to purchase Government Furnished
    Equipment for the second DDG-51 destroyer as planned on January 31,
    which will delay the program and add to its cost. Nor could the Navy
    contract the second Virginia class submarine. We are struggling to
    avoid disrupting the workforce at the shipyard as a result. Meanwhile,
    the Army has had to defer a contract for new Chinook helicopters and
    delay refurbishment of war-torn Humvees.
        If the current CR continues through the year, problems like these
    will snowball. The Air Force would be unable to increase the buy of
    Reaper unmanned aircraft from 24 to 36, delaying receipt of these
    critical assets. Under our current planning, the Air Force would let
    the Joint Air-to-Surface Standoff Missile (JASSM) slip by 1 year, and
    the Army would cancel procurement of Sentinel radars, leaving four
    battalions without advanced air defense. The Navy would buy fewer
    helicopters. The Missile Defense Agency would face a delay in the
    production of Terminal High Altitude Defense interceptors (known as
    THAAD), and the Special Operations Command would slow rotary wing
    capability improvements.
        The facilities we need to carry out our national security mission
    would also be affected. Under the CRs passed to date, the Services have
    not been able to start any new major construction projects. About 75
    projects across the country have already been delayed. Among them are
    training facilities in California and Texas, a test and evaluation
    facility in Maryland, a fuel tank project at Hickam Air Force Base in
    Hawaii, a new mess hall at Camp Lejeune, North Carolina, and an
    environmental, safety, and occupational health facility in Ohio. These
    delays not only affect our capabilities, but also the quality of life
    for servicemen and servicewomen. And they have a negative impact on
    project costs.
        Under a year-long CR, the Department would have to protect
    readiness at the expense of long-term facilities sustainment. As a
    result, conditions on bases and installations would deteriorate. The
    Army would meet only 75 percent of its Facilities, Sustainment,
    Restoration, and Modernization (FSRM) requirements, including delays in
    upgrades to training barracks. The Navy would meet only half of its
    FSRM requirements, jeopardizing bachelor quarters projects, dry dock
    certifications, and air station improvements. The Air Force is likely
    to face a cut of $400 million to its FSRM, forcing the deferment of
    maintenance contracts, dormitory projects, and utilities privatization.
        Finally, there will be harmful management consequences associated
    with a year-long CR, many of them difficult to notice from inside the
    Beltway. Program managers will delay contracting actions out of
    necessity, only to be required to act hastily at a later time in an
    effort to catch up. In the face of uncertainty, other managers will
    resort to short-term contracts that add expense for the taxpayer and
    instability for the industrial base.
        Wartime funding for OCO would also be impacted. Although funding
    levels would remain roughly equivalent, the funds would not be in the
    categories that meet current warfighter needs. For example, there would
    be too much funding for Mine Resistant Ambush Protected (MRAP) vehicles
    and not enough for Afghan National Security Forces. In order to move
    funds to where they are needed for warfighter requirements, the
    Department would need special transfer authority of about $13 billion.
        Although we may be able to surmount the transfer problem for OCO
    funding, deficits in the base budget under a year-long CR cannot be so
    easily overcome. Such a CR would cut DOD's fiscal year 2011 base budget
    by $23 billion below the $549 billion requested in the President's
    budget a year ago. This level of funding would not permit us to carry
    out our national security commitments properly. At this low base budget
    level, with many cuts coming half way through the year, DOD would not
    even receive enough additional funds to cover must-pay expenses,
    including $8 billion for military pay raises and increases in the costs
    of medical care, fuel, and inflation. To cover these unavoidable
    expenses, we would be forced to play a shell game, ``robbing Peter to
    pay Paul.'' Investment accounts would be especially hard hit, and we
    would exacerbate the detrimental effects I have just described to our
    readiness, modernization, and business practices.
        In a time of war--with soldiers, sailors, airmen and Marines on the
    front lines--DOD needs an appropriations bill with a reasonable level
    of spending. Again, the President's defense budget request for fiscal
    year 2011 asks for $549 billion. Based on a number of factors that have
    changed since our initial budget submission a year ago--including
    policy changes that led to lower personnel costs and reduced activity
    forced by the Continuing Resolution--we believe that the Department can
    now operate effectively with a budget lower than our initial request.
    However, in our judgment the Department needs an appropriation of
    approximately $540 billion for the fiscal year, in order for the
    military to carry out its missions properly and to maintain readiness
    and prepare for the future.
        In short, a year-long CR will damage national security. It presents
    the Department--and the Nation--with what Secretary Gates has aptly
    described as ``a crisis at our doorstep.'' For all of these reasons, we
    strongly urge Congress to enact a Defense appropriation bill for fiscal
    year 2011, and to provide funding for the Government as a whole.
        This concludes my prepared remarks. I welcome the committee's
    questions.

        Chairman Inouye. Thank you very much.
        I shall begin the questioning. Let me preface by saying
    emphatically that we have no intention or desire to shut down
    the Government. But as you know, there are press accounts
    suggesting that this might be a possibility. Now, if that
    should take place, I would like to know what DOD will do about
    it.
        Mr. Lynn. We will certainly agree with the chairman that no
    one, we think, wants a shutdown. And we certainly hope and
    believe a shutdown can be averted. That said, DOD, like all
    other agencies, has plans for a shutdown. These plans are
    routinely updated.
        In the aggregate, it would mean that we would have to do an
    unannounced furlough of probably up to one-half of our
    employees. The other one-half of our civilian employees would
    be exempt and would be able to continue to work, as would all
    members of our military, but we would be unable to pay them.
        So that when the first pay dates came, which now come in
    the middle of March, we would be unable to make good on those
    pay dates. It would certainly cause enormous disruption. It
    would cause an enormous distraction. And it is something I
    think that the country would want to avoid when the Nation is
    at war.

                    SHORTFALL IN MILITARY PERSONNEL ACCOUNTS

        Chairman Inouye. Under full continuing resolution, how much
    is the shortfall in the military personnel accounts?
        Mr. Lynn. We think that there are must-pay bills of about
    $8 billion. I think roughly one-half of those are in the
    military personnel accounts.
        Bob.
        Mr. Hale. Yes. I think best answer to say, given the fact
    that we won't have the pay raise funded and that we are seeing
    extraordinarily high retention, we would be short at least
    around $2.5 billion in the DOD personnel accounts. And since
    they are essentially entitlements--if you work for us, we are
    going to pay you--we would be forced into some really fairly
    brutal reprogramming actions to try to move that money into
    personnel in order to meet paydays.
        Chairman Inouye. And what about health programs?
        Mr. Lynn. There is a shortfall there, we think, of over $1
    billion, and we would have to find resources from other
    accounts to meet those bills because those, again, are must-pay
    bills we cannot avoid paying.
        Chairman Inouye. And my final question, a very important
    one, what impact would it have on readiness?
        Mr. Lynn. Well, I think the effect on readiness would be
    fairly far-reaching. We would reduce our operating tempo. We
    would be forced to reduce steaming days, flying hours, training
    days for the Army. So there would be a direct impact on
    readiness.
        There would be less direct, but equally problematic,
    impacts on equipment maintenance, which we would have to defer,
    and on base operating support and facility sustainment, which,
    over time, has an impact on quality of life and has an impact
    on readiness. So we think it would be a fairly far-reaching and
    broad-gauged effect on readiness.
        Chairman Inouye. Are you concerned about what is happening
    in Libya, Egypt, and Tunisia?
        Mr. Lynn. We are very concerned about what is happening
    across all of those nations. There is certainly an enormous
    amount of instability that has been caused by this, and we are
    trying to work with all those nations to ensure that the
    reforms are able to be made without further violence, that we
    end up with stable, broad-based governments in each of those
    states.
        Chairman Inouye. Senator Cochran.

                    OPERATING UNDER A CONTINUING RESOLUTION

        Senator Cochran. Mr. Chairman, I wonder if the witnesses
    can tell us what the practical consequences of operating under
    a continuing resolution for 5 months will have on the
    Department of Defense and the programs that it administers?
        Mr. Lynn. Well, Senator, you indicate, we have already been
    operating for 5 months under a continuing resolution. We have
    operated under continuing resolutions in the past. But usually,
    it is for 1 or 2 months, and the short-term nature of those
    reduces the impact.
        Now that we are into a much longer term, we have had an
    impact on contracts. As I mentioned, we have been unable to
    contract for the second submarine, for equipment for a DDG-51,
    for Chinook helicopters.
        Those cost the Government money. When we do do this, we
    will have to do it at greater expense. And of course, it delays
    the influx of greater new capabilities and better technology
    into the force.
        Senator Cochran. Secretary Hale.
        Mr. Hale. Senator Cochran, picking up what Mr. Lynn said,
    there will be a variety of effects, and some of them are
    already occurring. The Army and the Marine Corps both have
    freezes, temporary freezes, on civilian hiring. So if a tank
    mechanic leaves, we can't fill the job. If a clerk handling
    training orders leaves, we can't fill the job.
        The Navy has decided to make people aware of Permanent
    Change of Station (PCS) moves, with only 2 months of notice
    rather than 6. That preserves funding flexibility for the Navy,
    and I understand why they are doing it. But, of course, it is
    hard on the members, and it puts greater strain on military
    families.
        And these kinds of changes are going to snowball if we have
    to continue under a continuing resolution. We will try, and we
    are trying now, to postpone those actions that would be most
    damaging to readiness as long as we can. But we are going to
    hold our breath so long, but we are starting to turn blue. We
    really do need help.
        Senator Cochran. I wonder, too, about the impact this has
    on recruiting and retention of well-qualified and experienced
    people to stay in the military. Is there any effect that you
    know that can be measured, or surmised even, with the fact that
    we are not able to have a predictable level of funding for
    these activities?
        Mr. Lynn. I think, in theory, you would be right, Senator.
    We haven't seen that yet. And in fact, at this point, we are
    blessed with extraordinarily high retention levels, and we are
    hitting all of our recruiting targets. So I would have to say
    we have not seen any immediate impact, but that type of erosion
    over time could occur.
        Mr. Hale. I think there is good news here, Senator Cochran,
    is that troops are paying attention to their job, and they are
    letting us worry about this, which is how they should do. We
    need to come through for them.
        Senator Cochran. Well, thank you very much for your service
    in helping manage these important functions of our Federal
    Government.
        Chairman Inouye. Thank you.
        Senator Mikulski.
        Senator Mikulski. Thanks.

                               MILITARY MEDICINE

        I am going to pick up on two issues. One, military medicine
    and the other on the must-pay bills. In terms of military
    medicine, you talked about the fact that it could be $1
    billion. Now we are talking about a $600 billion defense
    appropriations, $1 billion doesn't seem like a lot. But it
    seems a lot to doctors, nurses, lab technicians, the
    contractors who provide so many of the supplies necessary.
        Could you go into more detail, if we continue the
    continuing resolution, both at military hospitals, and then
    also what you think--and perhaps Mr. Hale could help--also the
    impact on TRICARE, where the troops really and their families,
    really are relying on this health infrastructure. Could you
    share with us what that means?
        Does it mean TRICARE won't get paid? Does it mean the
    nurses at Naval Bethesda won't get paid? Does it mean the
    people selling the bandages and the petri dishes and all that
    won't get paid? And so, we are going to ask them to work for
    nothing, or not get paid?
        Mr. Lynn. Senator, we consider the military, the health of
    our military force, particularly that of our wounded warriors,
    to be other than the war itself, frankly, the highest priority
    that we have.
        So that there would be shortfalls in the medical accounts
    if there were a year-long continuing resolution, frankly, we
    would transfer money from other accounts to ensure the medical
    accounts are fully funded. And so, the impact of the continuing
    resolution would more be on the accounts that we transferred
    from rather than the medical accounts themselves.
        As you indicated, $1 billion in a $600 billion or $550
    billion, $530 billion budget seems like a small amount of
    money. But, in fact, even with a budget that size, all of the
    money is spoken for. All of the money is dedicated to a
    particular mission, whether it is a readiness mission or an
    acquisition mission or a medical mission.
        So we would have to deprive one of those readiness or one
    of those acquisition missions of probably $1.3 billion in order
    to ensure that we paid our military medical bills.

                                    TRICARE

        Senator Mikulski. Does that also mean that TRICARE will
    continue to be funded?
        Mr. Lynn. We would continue to fund TRICARE, but we would
    have to reprogram resources to do that. And that is a difficult
    process.

                                 REPROGRAMMING

        Senator Mikulski. Then let us go to the reprogramming and
    then--first of all, thank you for that. Which means we will
    meet our obligation both to the wounded warriors and the
    troops, but also to their families who, in many instances, bear
    other kinds of wounds because of this repeated deployment. The
    impact on children, on mental health for both spouses and
    children, you know are quite severe.

                                 MUST-PAY BILLS

        Now let me go to the must-pay bills. I was at a constituent
    meeting with small business yesterday with Senator Cardin. And
    one of the things that we heard from small business--it was
    going on with this SBA deal. That is another topic. But they
    were worried about what happens now in this contract world.
        So you hear from woman-owned veteran herself--disabled,
    female, small business contractor. She says, ``Wow, if we don't
    get paid, I have very thin margins in order to even compete.''
    What happens now to these small to medium-size contractors, and
    will they get paid?
        And number two, as you talked about the reprogramming and
    so on that goes on, and perhaps Mr. Hale can provide it, you
    didn't give a dollar figure. You know, that one day we are
    going to have to do it. It is either going to be--in MilCon, it
    is going to be deferred maintenance. It is going to be deferred
    contracts, paying more for these contracts.
        So here is the question. Are the medium to small business
    contractors going to be paid, number one? And number two, if
    either you or Mr. Hale have a dollar figure on really what
    deferment means? That deferment isn't saving money. We are
    really burning money, and we will burn it later at a faster
    rate and perhaps even get into more of a jackpot on waste.
        Mr. Lynn. Well, let me, and then I will ask Mr. Hale to
    follow on. The first question is would we be paying small and
    other business owners? And the answer is we can't say
    precisely, but we would have to move resources from areas,
    particularly in contracts.
        So we would have to defer and cancel some contracts.
    Surely, some of those would be small and disabled businesses.
    That would be, I think, inevitable in order to pay those
    medical and personnel bills that the department is obligated to
    pay.
        So there would have to be some impact. It would require
    decisions at multiple levels to decide exactly which contracts
    you are going to defer and which contracts you are not. So I
    can't give you a precise answer.
        In terms of your second question, which was what does this
    cost? That is really impossible to answer because what you are
    talking about is friction at multiple levels. We are going to
    defer some contracts. We are going to cancel some contracts.
    Then we are going to reengage with contractors later on to do
    that same work.
        The charges are going to go up. We are going to lose
    options. We are going to lose the bids that we have. We are
    going to pay more. But trying to total that up, these are
    thousands and thousands of different contractors.

                          MILCON/DEFERRED MAINTENANCE

        Senator Mikulski. But what about in MilCon and deferred
    maintenance on the things that you really know are very
    specific?
        Mr. Lynn. Well, I think we can tell you right now we have
    deferred--because we don't have the authority to go forward--75
    military construction projects. And if this goes on, we will
    have to defer hundreds of millions of facility maintenance
    projects because we won't have the resources.
        Senator Mikulski. And then presuming, say, we pass the
    continuing resolution maybe around like April, and we kind of
    get into it before the Easter-Passover break. Do you have any
    sense about how, when you go back to do some of these must-do,
    must-pay projects what it will cost? In other words, won't it
    increase the cost?
        Mr. Lynn. It will certainly increase the cost, but I can't
    give you a precise figure. I don't know, Bob, whether you----
        Mr. Hale. Well, I can't give you a figure, either, but I
    know it will. I mean, it will do so in a variety of ways. We
    will have a contracting workforce that is essentially treading
    water to some extent right now. At least for some of these
    projects, they can't move forward.
        If, in April--and I hope it is before then, that we get a
    bill, they will have to catch up from the last 6 months and do
    the next 6 months of work. And it just inevitably means they
    will have less time to do good market surveys to find the best
    prices. And again, I can't give you a precise number, but it
    will be expensive.

                              REPROGRAMMING ISSUE

        Let me address the reprogramming issue. In the unfortunate
    event--I would call it tragic event--that we find ourselves
    under a year-long continuing resolution, we will have to
    reprogram extensively. I can't give you a precise number, but
    it would start with that $2.5 billion in personnel and the $1
    billion, $1.3 billion that we need in the healthcare program.
    And there will be many others.
        And we will need the help of the subcommittee at that point
    and all of the Congress in a couple of respects. First, there
    are some who believe we don't have the authority to reprogram
    in the absence of a budget. But we can't meet our national
    security needs without reprogramming if we did end up under a
    continuing resolution.
        And second, we will need help with agreement on sources,
    which is always very difficult. We will have to look to some
    probably acquisition programs and terminate them, or at least
    cut back significantly on them. And that is always very painful
    because we are affecting jobs and commitments that were made by
    the Congress, but we won't have a choice.
        So if we do end up under a year-long continuing resolution,
    we really will need the help of the committee and the Congress
    in order to make this work.
        Senator Mikulski. Thank you. Thank you.
        Chairman Inouye. Senator Collins.
        Senator Collins. Thank you, Mr. Chairman.

                      IMPACT ON PRIVATE SECTOR EMPLOYMENT

        Secretary Lynn, Mr. Hale, I want to follow up on some of
    the issues that my colleague from Maryland has just raised with
    you. The military leaders and Secretary Gates have talked a lot
    about the extraordinarily adverse impact on the military
    itself. But there is also a very negative impact on the private
    sector.
        New starts won't occur. The new destroyer contract, the new
    submarine contract will not be signed. There is an impact on
    defense contractors and the thousands of people that they
    employ as well.
        We are at a time in our economy where we are very concerned
    that unemployment remains so high. Has the Department done any
    estimate of what the impact would be on private sector
    employment in terms of jobs lost if the Pentagon continues to
    operate under a continuing resolution? I know I saw a statistic
    that the Navy put together that indicated that thousands of
    jobs would be in jeopardy. Do you have an overall estimate?
        Mr. Lynn. We don't. I think the only thing that you could
    do to produce that kind of estimate is that if we requested
    $549 billion under the a year-long continuing resolution, that
    would go to something probably $23 billion lower than that.
    That has employment impacts.
        You could try and translate that number into employment
    impacts. We have not tried to do that, but clearly, you are
    right. You know, the economy is in something of a fragile
    state. The defense budget represents 3 percent or 4 percent of
    that economy, and so it would have an impact if we go to a
    year-long continuing resolution.

                                  PAYING MORE

        Senator Collins. I also believe that another negative
    consequence is that the Pentagon would end up paying more for
    certain goods, services, and weapons than it would if we were
    funding you at an appropriate level. As we know from our
    experience in shipbuilding, if you don't have a sustainable
    procurement rate, you end up paying more per ship than if the
    contractors can plan the workload in an orderly way.
        Is it a concern of yours that we may end up having to spend
    more money if you do not receive the funding that you have
    requested in a timely way?
        Mr. Lynn. I think, Senator, you are absolutely right. I
    think there is no question that we will spend more money for
    the same goods if we don't receive the money in a timely way.
        Indeed, it goes in exactly the opposite direction of the
    efficiencies initiative that Secretary Gates is moving forward
    on, which is to try and get the same things for less money.
    This undercuts that greatly. And the instability that it
    creates and the friction that it creates costs the taxpayers
    real dollars.
        Mr. Hale. I think it has probably already happened, Senator
    Collins.
        Senator Collins. I think so, too.
        Mr. Hale. The GFE delay and the DDG-51, I think that will
    add to costs, not being able to award that second Virginia-
    class submarine. The Army just issued a stop-work order on the
    Striker Mobile Gun System.
        These are costly actions that we will want to reverse. But
    we won't do it at the same price.
        Senator Collins. Mr. Hale, let me now switch to a provision
    in the President's budget request. The Department of Defense
    offers a managed care option that is known as the Uniformed
    Services Family Health Plan, through six specific healthcare
    providers in six geographic regions. I know that Johns Hopkins
    is one for Maryland. Martin's Point is one based in Portland,
    Maine.

                     UNIFORMED SERVICES FAMILY HEALTH PLAN

        And these have been very successful managed care providers
    that have helped to deliver, in my view, higher quality care at
    an effective price. Yet the Department's budget would preclude
    enrollment in the Uniformed Services Family Healthcare Plans
    for beneficiaries that reach 65 years of age and instead would
    ship them to Medicare.
        Now this sounds to me like an example of DOD just shifting
    costs to another agency. So we are going to end up paying in
    any event. But I would appreciate assurances from you that the
    Department is committed to working with these six managed care
    healthcare providers.
        First of all, it is my understanding that no current
    enrollee in the plan would be affected. Is that accurate?
        Mr. Hale. That is accurate. And moreover, they could
    continue to receive their care at the hospitals, and they would
    still be under TRICARE for life.
        But the major change that would occur is that they would be
    under Medicare, like all of our retirees are. They would need
    to pay Part B of the Medicare premiums, like all of our
    retirees. And the hospitals would be compensated, or payments
    would be made for claims, at the same level as for all of our
    hospitals, namely, at the Medicare rates.
        But we are committed to avoiding adverse effects on
    hospital care. And if those appear likely, we will work with
    the hospitals in terms of a phase-in plan.
        Senator Collins. And it is broader than hospital care, I
    might add. And I would really encourage you to take a look at
    the managed care that is being done by these organizations
    because I think you will find that the recipients are extremely
    satisfied.
        I have looked at the satisfaction rates. They are extremely
    high. And that particularly in the management of chronic
    diseases----
        Senator Mikulski. That is exactly right.
        Senator Collins [continuing]. Like diabetes, congestive
    heart failure, that they are able to actually hold down costs
    and deliver better care. So I look forward to working with my
    colleague from Maryland, since I know her State has the same
    program.
        Senator Mikulski. Mr. Chairman, I just would like to
    associate myself with the remarks from the Senator from Maine.
    We have, in these six managed care institutions, really iconic,
    world-class, internationally branded institutions taking care
    of our military and having spectacular results not only in
    treating acute care, but in managing chronic illness, which are
    lessons learned.
        So it is not--really, we want you to work with them not
    only if they are in trouble, but we want you to work with them.
    And I look forward to working with Senator Collins. Perhaps we
    could have a meeting with the leadership to see where we are
    going with this. We understand the fiscal reality, but they are
    really doing breakthrough stuff that are lessons learned even
    for the rest of the military and the VA.
        So thank you very much for raising it, Senator Collins.
        Senator Collins. Thank you, Mr. Chairman.
        Mr. Hale. It is definitely not our goal to adversely affect
    the quality of care. But we would like to pay claims on a
    consistent basis across the Department.
        Chairman Inouye. Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.
        Gentlemen, welcome.
        I recognize that today's hearing is on the impacts of a
    long-term continuing resolution, and I have been following
    closely the questions and the answers that have been provided.
    I think we all share those same concerns about the impact to
    the men and women who serve us and the level of care, whether
    it is while they are serving or whether they are home. And I
    appreciate your responses here today.

                                 ENERGY ISSUES

        I will have to admit, I have been a little bit single-
    focused this past week up in the State, focusing on energy
    issues. Mr. Chairman, you asked the Deputy Secretary if he is
    concerned about Tunisia, Egypt, Libya--I think we all are--and
    the implications of what is happening in the Middle East.
        We are seeing an increase in the price of oil, over $100 a
    barrel. We are seeing that translate at the local level, at the
    price at the pump. It is certainly getting the attention of
    folks.
        And in my State, where we have been providing a level of
    domestic supply of oil for the past 30-some odd years, at one
    point in time 20 percent of our domestic supply, we are now
    looking at a situation where, with lower throughput coming down
    through the line, that oil pipeline could actually be
    decommissioned because our throughput is so low.
        Which puts us in a situation, as a Nation, we are still
    reliant. Last time I checked, you still needed that product to
    get the planes in the air, to get the tanks moving, to move the
    trucks. And we know that within Department of Defense, one of
    the biggest consumers of energy is the Department.
        What we do to ensure, from a national security perspective,
    our opportunities as a Nation--and again, from a security
    angle--is critically import. I would like just a general sense
    from you, Mr. Secretary, in terms of the direction that we are
    going as a Nation in becoming more increasingly reliant on
    foreign sources of oil, while at the same time, we see the
    Middle East in a state of--it is beyond a state of unrest at
    this point in time.
        We can't predict which nation is going to be on the front
    page of the news next week, in terms of who is going to be
    overthrown. Can you give me just a sense from the Department of
    Defense's perspective, in terms of our national security
    implications with what is going on in the Middle East and what
    is happening domestically with our available supplies of oil?
        Mr. Lynn. As you indicated, Senator, the Department is one
    of the or perhaps the largest consumer of fuel. So we are very
    concerned both about the price in the short term. The price is
    now over $100 a barrel. And we have concerns about what that
    means for our working capital funds.
        In some of the marks, we think, that were originally placed
    in indicated that we would have lower fuel prices and could
    reduce working capital funds. We think that is not going to
    come through in current circumstances. So we want to ensure
    that as we move to enact a fiscal 2011 bill, we take account of
    those short-term fuel increases.
        Over the longer term, I think the instability in the Middle
    East just reinforces the direction the Department is already
    trying to move, which is to develop much greater and much
    broader approaches to fuel efficiency, to use the fuel that we
    have much more effectively, to develop more fuel-efficient
    vehicles, to develop more fuel-efficient practices in our bases
    so that we are able to deal with these kinds of instabilities
    by reducing the reliance that we have on that source of fuel.

                               ALTERNATIVE FUELS

        Senator Murkowski. One of the things that, of course, has
    been looked at with great scrutiny is the possibility of the
    synfuels, whether it is using natural gas or whether it is
    coal, using the Fischer-Tropsch process. What is the commitment
    from Department of Defense to go in this direction, to using
    these alternative fuels?
        Mr. Lynn. We have a very broad-gauged effort that includes
    synthetic fuels. It includes fuel cells. It includes trying to
    save on fuel. So we are trying to pursue an across-the-board
    approach and not rely on just a single avenue to address this
    issue.
        Senator Murkowski. We are looking at some proposals up
    north that I would like to be able to speak with some in the
    Department about in terms of opportunities to advance these
    synfuels and how we can really reduce that reliance on oil. So
    I look forward to working with you on that.
        Mr. Lynn. If you have something specific, Senator, I would
    be happy to take a look at that and get back to you.

                                 ARCTIC POLICY

        Senator Murkowski. Yes. It is a little bit of a detour from
    the long-term continuing resolution. But last week, there was
    an article that was written. It came out of the Heritage
    Foundation. And the comment from the individual was it is time
    for the United States to jumpstart an Arctic policy that is as
    cold as a dead car battery.
        Well, coming from the Arctic and recognizing that the
    United States is an Arctic nation, that is somewhat disturbing
    to hear the policy described that way. I have been working with
    Secretary Clinton from the time that she was still here in the
    Senate, to her work now as Secretary of State, trying to do
    what we can to advance that Arctic policy.
        But again, from a national security perspective, do you
    think that, in fact, we do have a policy that is as dead as a
    car battery? And if so, how do we jumpstart that at a time when
    we are clearly concerned about budget implications?
        We are trying to get an icebreaker online. We have one
    functioning icebreaker in this country right now. China beats
    us considerably. What are your thoughts, very quickly, on where
    we are with the Arctic policy?
        Mr. Lynn. Well, I wouldn't say that we couldn't make
    improvements in our Arctic policy. I think that description is
    probably overblown.
        We have been working with the Canadians on Arctic policies
    and frankly, I think where you are going with the implications
    of global warming and the gradual opening of the Arctic, it has
    been part of, as NATO starts to reshape itself to focus on the
    new world, Arctic policy is an important piece of that. There
    are several Arctic nations involved, and they are very focused.
    And we have been working with them.
        I think we need to go further and shape those policies, but
    it is certainly a concern. And as I think you rightly
    indicated, Secretary Clinton and the State Department are
    certainly taking a lead internationally in developing the U.S.
    position on Arctic policy.
        Senator Murkowski. Thank you, Mr. Chairman.
        Chairman Inouye. Senator Reed.
        Senator Reed. Thank you, Mr. Chairman.
        Thank you, gentlemen.
        Just a point of clarification, Secretary Lynn. In your
    testimony, you essentially say that the overseas contingency
    operations funding is adequate, but it has to be reprogrammed
    to the tune of about $13 billion. And you would need authority
    to do that from us?
        Mr. Lynn. Yes.
        Senator Reed. And those are ongoing operations--Iraq and
    Afghanistan?
        Mr. Lynn. Yes, sir.

                     OVERSEAS CONTINGENCY OPERATIONS BUDGET

        Senator Reed. A related question. Mr. Hale was at the Armed
    Services Committee hearing with Secretary Gates and Admiral
    Mullen, where they talked very passionately about the overseas
    contingency operations budget for the State Department.
        Now if that is a casualty of this long-term continuing
    resolution, does that put pressure on you within your OCO funds
    to sort of compensate for the failure in transition? Or is
    there no coordination, or is it going to be just, sorry, you
    know, you are on your own? We get our funding, and we are
    headed out of town in Iraq, and we are doing what we should do
    in Afghanistan.
        Mr. Lynn. No, I don't think we can afford to take that
    attitude, Senator. This is an important partnership we have
    with State, in particular in the areas that you mentioned. We
    are at a critical juncture in Iraq, where we are handing over
    many of the functions that we have carried out for several
    years, such as police training.
        We are transitioning those to the State Department. If the
    State Department doesn't get adequate funding for things like
    police training, I think we risk losing the gains that we have
    made in Iraq at great sacrifice of not only dollars, but of
    lives.
        So I think it is critical that not only Congress address
    the defense needs, but address the State Department needs as
    well.
        Mr. Hale. If I could add to that briefly?
        Senator Reed. Yes, Mr. Hale.

                                   COST-SHARE

        Mr. Hale. And that is in many cases, we don't have
    authority to help the State Department. And if I can take an
    opportunity to ask the committee's help on one specific
    instance, there is a group called the Officers Security
    Cooperation in Iraq, which overseas foreign military sales. We
    are trying to cost-share with the State Department as we move
    toward setting up that office and try to support the Iraqi
    military.
        And we need legislative authority to do that cost-sharing.
    We have been working with your staff to provide that. And I am
    hopeful that that might find its way onto an appropriations
    bill that I know you are going to pass soon for the Department
    of Defense.
        So if there is anything we can do to be helpful, we would
    like to. But there are authority issues in terms of our
    cooperation.
        Senator Reed. Clearly, under the agreements entered into in
    the Bush administration, our military presence is ending in
    Iraq in the end of this year. And we are on track to do that. I
    was there about 1 month ago.
        The problem I think is, is what you suggested, that on the
    ground, you are going to be faced with some ingenious ways to--
    if we don't fully fund your accounts and give you the authority
    to move money around within DOD accounts, if we don't fund
    State, et cetera, you are going to have to figure out how we
    can keep the lights on literally and keep this effort going
    forward, which is going to be more expensive in the long run
    and less effective than passing the legislation, the
    appropriate appropriations.
        Is that a fair sort of judgment or estimate?
        Mr. Lynn. I think that is an entirely fair judgment,
    indeed. What we are trying to do--the transition we are trying
    to make between defense and State has not, at least at this
    scale, been done before. So it is going to be extraordinarily
    difficult in normal times to try and I think make this
    transition.
        And as you said, you were just there. I think the forces on
    the ground are working very closely with the Embassy. I think
    they have a terrific plan. I think that they understand the
    challenges, and they are working through those. But if they are
    forced to try and do it without adequate resources, I think you
    are really, really undercutting the likelihood that we will
    have success.
        Senator Reed. Let me just follow up with one final area.
    And that is we have just focused briefly on the overseas
    contingency operations fund. But you have got, as you have
    suggested before in your comments, a number, perhaps hundreds
    of different specific changes in reprogramming and issues, as
    Mr. Hale suggested, in terms of setting up this new office in
    Iraq.
        So, effectively, without a real bill, if we are just going
    with a year-long continuing resolution, this continuing
    resolution is going to be full of essentially what looks like,
    in some cases, a normal appropriations/authorization bill, full
    of different twists and turns, some of them coordinated, some
    of them just what you could get in the list, luckily enough,
    and some things falling by the wayside.
        That just doesn't strike me as a very efficient way to
    appropriate money, and particularly in the context of the
    Department of Defense.
        Mr. Lynn. No, I think it would be very strongly negative.
    As I said at the outset, if we had a year-long continuing
    resolution, we would not have enough money, we think, to meet
    the national security needs. The money that we do have wouldn't
    be in the right places. So we would have to move enormous
    amounts of money around, which is a very difficult process and
    causes great inefficiency.
        And then, finally, we wouldn't have the management
    authority that we would need to do new starts, to increase
    production, to do new military construction projects. So on all
    three of those grounds--it isn't just money. It is management
    and having the money in the right places.
        Mr. Hale. Did you see the movie ``Groundhog Day,'' Senator?
    I mean, that is what we are talking about here, the ``Groundhog
    Day'' of budgeting.
        Senator Reed. I am a big Bill Murray fan. And that was one
    of the great films.

                          CONTRACT OVERSIGHT AND AUDIT

        This follows, too, in terms of the context of managing, and
    the comment is that one of the problems we have, frankly, is
    contract oversight and audit. It is ubiquitous, but it is
    particularly ubiquitous when it is not clear what the contract
    is, who is in charge.
        It is just an opportunity really for, in some cases, not
    just inefficiency, but criminality. And I would assume that you
    are having problems developing good audit trails, good
    oversight, good contract enforcement if you are not quite clear
    what the contract is or whatever it is a short-term contract or
    it is something you are writing sort of just to get through the
    day.
        Is that fair? Or can you comment on the scope of this audit
    issue and contract supervision issue?
        Mr. Hale. Well, in terms of the audit, let me talk first
    about contract audits, which I think is what you were focusing
    on. We will certainly make every attempt, whether it is a
    continuing resolution or not, to maintain verifiable contracts.
    We will go ahead with the audit process.
        I hope it wouldn't be seriously adversely affected,
    although, frankly, the continuing resolution has caused us to
    slow hiring at the Defense Contract Audit Agency, which we are
    trying to grow modestly in size. And we have had to actually
    stop the increase in hiring for the moment there to preserve
    our funding flexibility.
        I am not sure whether you were asking the broader audit
    question, audit ability in the Department. Was that something
    of interest?
        Senator Reed. No, it just, strikes me that we have
    recognized over the last several years, particularly in these
    contingency operations, where there is a significant amount of
    money flowing into areas where there is not good tried and true
    practice locally.
        And yet, through principally, I have to say, Senator McCain
    and Senator Levin, their acquisition reforms, we started on a
    path of better oversight. That is going to be disrupted, as you
    suggest.
        Mr. Hale. I think that is fair. I mean, this will cause
    inefficient practices. It will leave our contracting officers
    with less time to do a good job. I can't see anything good
    coming out of that in terms of acquisition reform.
        Senator Reed. Secretary Lynn, any comment?
        Mr. Lynn. No, I just add to what Bob said by saying, we
    have tried to, in preparing for today's testimony, to identify
    the impacts that we can see and project. In many ways, since we
    have never had a year-long continuing resolution for DOD and
    certainly never had one during a war, it is, in many ways, the
    effects that we can't see that I am, in many ways, more worried
    about.
        And I think the kind of audits concerns and unintended
    consequences that you are talking about may well be the worst
    effects, rather than the ones that we have already described.
        Senator Reed. Thank you very much.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Alexander.
        Senator Alexander. Thank you, Mr. Chairman.

                            RESEARCH AND DEVELOPMENT

        I would like to ask about research and development. There
    is I think I see about a $75 billion figure for R&D in the
    continuing resolution. Tell me a little bit about how research
    and development is affected by the continuing resolution. And I
    am especially interested in what is going on these days in
    Defense Advanced Research Projects Agency (DARPA), which is a
    small amount of money, and wondering what you can tell me about
    that.
        Over time, Defense Department R&D has been a big part of
    our country's sponsored research and development. And out of
    that has come a lot of remarkable inventions that affect our
    standard of living, like the Internet and other things.
        So what can you tell me about the effect of the continuing
    resolution on R&D generally? And what can you tell me about the
    condition of DARPA, especially as it might be exploring new
    ways to produce energy that might be useful to the military
    first and to the country second?
        Mr. Lynn. Senator, I think you could broadly say there
    would be three impacts on the research and development
    accounts. One is that the resources wouldn't be able to
    increase as they are projected to do. You would stay at the
    fiscal 2010 level.
        Second, you probably would not be able to keep all of those
    resources, even at that level, in the R&D account because, as
    in the discussion we talked about earlier, there would be must-
    pay bills in the medical area and the personnel area.
    Undoubtedly, we would have to reach into some of the R&D
    accounts and pull resources from there, move them to medical
    and personnel accounts, in order to pay those bills that are
    the obligation of the department to pay.
        And then, finally, under a year-long continuing resolution,
    we wouldn't be able to any new starts. So any further ideas--
    you mentioned DARPA. When DARPA has a new idea on energy, they
    would have to wait until they had a full appropriations bill
    before they could act on that request. And what happens to the
    research in that interim period is anybody's guess.
        Senator Alexander. What is the condition of DARPA these
    days? Is it healthy and functioning and innovating, as it did
    before?
        Mr. Lynn. They are. We have a terrific director in Regina
    Dugan, who had enormous amount of energy and is building on the
    success of the past and taking DARPA into new areas. In
    particular, in the fiscal 2012 request, we have moved about
    $500 million more into DARPA over a 5-year period to do
    research on cybersecurity.
        DARPA has--as you indicated, they were part of the origin
    of the Internet, and they have enormous expertise in
    information technology. And we want to build on that and try
    and get to the next level using DARPA's great resources.
        Senator Alexander. Recently, the Congress decided, through
    the America Competes Act, to try to emulate DARPA at the Energy
    Department with something called ARPA-E. And it is off to a
    good beginning.
        I think that--just as one voice, I think as we deal with
    this very tough challenge we are faced with, a Government that
    is spending $3.7 trillion and collecting $2.2 trillion, I want
    to make sure that we are smart and not cheap, and that we
    remember that it is out of our research and development in
    defense and in the universities, the laboratories, and these
    small agencies like DARPA and ARPA, which spend relatively very
    small amounts of money, out of which have come the ideas that
    have been a big part of our ability as a country to produce
    about 25 percent of all the money in the world each year.
        So as we wade through this unpleasant task over the next
    year or two, I am going to be one voice that keeps trying to
    put the spotlight on the importance of research and development
    and making it easier, not harder, to fund that as a priority
    within a reduced level of spending.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        I listened to the questions of Senator Mikulski and Senator
    Collins and Senator Alexander. And it just reminded me of the
    numbers of letters I receive on the same theme.
        Why are medical costs so expensive in the military, much
    more than nonmilitary sector of our country? I would like to
    point out that in World War II, most of the men and women in
    uniform were single. Today, most of the men and women are
    married and have dependents.
        Secondly, I would like to point out that it took 9 hours to
    evacuate me from the battlefield to the field hospital. Today,
    if I were injured in Afghanistan, I would be in a hospital
    within an hour.
        Third, the technology research that we have been doing is
    so successful that the survival rates have just increased
    tenfold. This is hard to believe, but in the regiment which I
    served with, with all the casualties, not a single double
    amputee survived. Today, double amputees are commonplace
    because of the speed of rescuing and the medical practices.
        However, we have one other problem that we did not see in
    World War II. Today, we have instant communication. Wives talk
    to their husbands on a daily basis by cell phone. Then in the
    evening, they watch CNN and see their husbands in action. And
    to top it off, they come home, and after 6 months go back
    again. I can't imagine what the stress is like.
        So I hope that the people of the United States would keep
    in mind that the sacrifices being made by men and women in
    uniform are intense, and they have consequences that we may not
    know about. I am always grateful to them for what they have
    done and what they are doing.
        So, with that, do you have any other questions?
        If not, thank you, Mr. Secretary, Under Secretary Hale, for
    your testimony. I will assure you that we look forward to
    continue working with you, especially on matters involving the
    continuing resolution.

                         ADDITIONAL COMMITTEE QUESTIONS

        It is my hope, however, that we can complete our work on
    this fiscal year 2011 defense appropriations bill and turn our
    attention to the fiscal year 2012.
        [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. William J. Lynn III
                   Questions Submitted by Senator Tom Harkin
        Question. As I understand it, the Department of Defense (the
    ``Department'') intends to reduce its overhead costs by $54 billion
    over the next 5 years. The bulk of that reduction will come from a
    freeze of civilian employee pay and the size of the workforce. Are
    concurrent reductions being required of the service contractor
    workforce? If not, will such a one-sided approach just increase
    reliance on service contractors regardless of cost, given that the
    workforce freeze will make it very difficult to use civilian employees,
    even when it would be less costly or is required by law?
        Answer. The Secretary directed reductions to all overhead,
    including both planned growth in the civilian workforce and current
    levels of contract support. In particular, the Department will reduce
    service support contract levels, focusing on those contracts designed
    to augment the civilian workforce.
        The Department will strive to find the appropriate balance between
    civilian employees and contract staff, working to ensure that
    appropriate controls remain in place and that civilians remain
    responsible for the work best suited for Government employees.
        Question. I am interested in getting a better sense of how the
    Department reviewed its service contracts as part of the Efficiency
    Initiative. As I understand it, the Department limited its review to
    support service contracts. However, support service contracts are a
    relatively small portion of all service contracts. Given the
    Department's concern about the growth of contractor costs generally,
    can you explain why the review was so limited? How will the cuts in
    support service contracts be enforced? How will growth in non-support
    service contracts be constrained?
        Answer. The Department explicitly focused on service support
    contractors given the continued cost growth in this area over the past
    few years. These contracts, particularly those providing administrative
    and staff support, are lower priority and do not represent best value
    or practice for the Department.
        The President's fiscal year 2012 budget represents efficiencies in
    other areas as well, impacting a broad range of contract types. So
    while service support contracts received significant attention, the
    Secretary remains committed to broadening the scope of the initiative.
    Rather than a one-time reduction, these decisions as well as the
    ongoing work represent an effort to inculcate a ``culture of savings''
    within the Department at all levels.
        In keeping with this approach, the Department will closely monitor
    the execution of the service support contract efforts in the future,
    through the established budget formulation and execution processes. The
    Secretary expects full adherence to the execution goals laid forth in
    the budget submission.
                                     ______

                Questions Submitted by Senator Dianne Feinstein
                               operations in iraq
        In accordance with a Status of Forces Agreement, by the end of
    calendar year 2011, all US military servicemembers will leave Iraq. A
    small cadre will remain, working in the Office of Security
    Cooperation--Iraq in order to facilitate foreign military sales and to
    provide training assistance to the Iraqi military. Many of the missions
    the military are currently leading will transition to the Department of
    State. I am specifically interested in the training of Iraqi police and
    the important work being done by the Provincial Reconstruction Teams.
    In multiple statements this year, both Secretary of Defense Gates and
    Chairman of the Joint Chiefs of Staff Admiral Mullen have reiterated
    the importance of funding the Department of State's transition
    activities in Iraq ahead of their assuming those missions. This was
    also addressed in the January 30, 2011 Special Inspector General for
    Iraq Reconstruction report.
        Question. Secretary Lynn, what would be the consequences if the
    Department of State is unable to assume those missions effectively?
        Answer. The United States' continued engagement in Iraq remains
    vital. We are now at the point where the strategic dividends of our
    sacrifice are within reach as long as we take the proper steps to
    consolidate them. A long-term strategic partnership with Iraq, based on
    mutual interests and mutual respect, presents many advantages for the
    United States. Recent turmoil in the Middle East highlights the
    importance of active U.S. engagement and building and maintaining
    relations with our key regional partners. U.S. support in recent years
    has proven critical to the emergence of a sovereign, stable, and self-
    reliant Iraq that is a long-term strategic partner of the United
    States. We must stay focused on Iraq in order to advance our broader
    regional objectives of peace, prosperity, and security.
        Reduced funding for the State Department's Iraq program would
    severely affect our ability to meet national objectives in Iraq. As
    Secretary Gates has stated, these cuts threaten the enormous national
    investment and sacrifices the United States has made in Iraq. Fully
    resourcing the State Department mission to its completion is vital to
    ensuring that investment produces enduring results. We are 10 yards
    from the goal line and need one final push. A sovereign, stable, self-
    reliant Iraq that is a partner with the U.S. and a force for stability
    in a strategically critical region is within reach.
        Question. If the Department of State is unable to successfully
    assume those missions in 2012 and a new agreement can be reached with
    the Government of Iraq, is the military prepared to stay longer?
        Answer. We should not engage in speculation. The Government of Iraq
    has not asked for a new agreement for U.S. forces to remain after
    December 31, 2011. In compliance with the U.S.-Iraq Security Agreement
    and consistent with Presidential direction articulated on February 27,
    2009, the United States is committed to completing the drawdown of U.S.
    forces from Iraq by the end of 2011.
        All departments and agencies of the U.S. Government have undertaken
    unprecedented levels of coordination and planning for the transition in
    Iraq to ensure that the Department of State is able to assume lead for
    the U.S. mission in Iraq successfully in 2012. As one would expect with
    a transition of this scope and complexity, challenges exist. DOD is
    working very closely with the State Department to ensure their success.
                        overseas contingency operations
        I am concerned that a year-long continuing resolution at 2010
    levels might jeopardize the operational readiness of our military and
    their ability to successfully conduct the missions we have asked them
    to do. In your statement, you said that a year-long continuing
    resolution at 2010 levels would require the services to defer equipment
    maintenance.
        Question. Secretary Lynn, how would this affect operations in Iraq
    and Afghanistan? I am not only concerned about the military currently
    operating in Afghanistan and Iraq, but units training for future
    deployments to those operations.
        Answer. Contingency Operations in Iraq and Afghanistan will be our
    highest priority and will be fully funded. Forward deployed forces and
    next to deploy forces are receiving, and will continue to receive, the
    gear and equipment needed to sustain current in theatre operations.
    Training for all other forces, and maintenance of equipment and weapons
    systems not assigned to next deploying forces would be reduced.
        Specific impacts on readiness include reductions in Army Depot
    Maintenance and High Mobility Multipurpose Wheeled Vechicle
    Recapitalization programs. The Navy will cancel ship maintenance,
    cancel participation in four Global Employment Force planned
    deployments, and reduce noncontingency flying hours and steaming days.
    The Air Force will defer depot maintenance and reduce weapon system
    sustainment. The USSOCOM has already delayed the implementation of the
    congressionally approved Underwater Systems Acquisition Strategy, and
    delayed other actions resulting in negative impacts to USSOCOMs ability
    to sustain flight testing, test support and analysis timelines for the
    MH-60 platform.
        Many of the Defense Agencies and Defense-wide Activities are
    restricting the hiring of civilians to fill only the most critical
    positions which slow the accomplishment of key areas such as contract
    management audits (DCAA and DCMA) and joint operational contract
    support planners to the Combatant Commands (DLA). While operations in
    Iraq and Afghanistan will be fully funded, operating under a year-long
    continuing resolution will negatively impact readiness during fiscal
    year 2011 and into fiscal year 2012.
                              defense procurement
        Department of Defense leaders have been clear that a year-long CR
    including defense will have disruptive impacts on every aspect of our
    national security infrastructure including our military personnel and
    both public and private sectors. One specific example is the inability
    under a continued CR to execute shipbuilding contracts for a number of
    fiscal year 2011 Navy and Marine Corps programs including the Mobile
    Landing Platform (MLP). The MLP shipbuilder in San Diego, our last
    full-service Navy shipbuilder on the West Coast, recently had to notify
    employees that it may have to lay-off up to 1,500 workers soon unless
    the Navy is able to execute the construction contract for the first-of-
    three MLP ships. This program received initial funding in fiscal year
    2010 for design and long-lead material procurement. Failure to execute
    the MLP shipbuilding contract very soon will not only impact the
    shipyard and her employees but also the ultimate costs of acquiring
    this military capability.
        Question. Secretary Lynn, would you please comment on the impact
    the current CR has already had and what impact a year-long CR would
    likely have on the Navy's ability to execute the MLP and other major
    ship construction contracts in a timely and cost-efficient manner?
        Answer. In terms of major ship construction contracts, to date, the
    Department has not been able to award a second Virginia-class SSN as
    planned in January. Under a year-long CR, without authority to increase
    production levels, the Department would not be able to go from one to
    two DDG-51s and Virginia-class SSNs; without the authority for new
    starts, the Department would not be able to procure the Mobile Landing
    Platform, the LHA(R) and the Oceanographic Ship. Additionally, Carrier
    construction and refueling overhauls will face schedule and cost
    disruption because we will be constrained at fiscal year 2010 levels
    for CVN 79 ($425 million less than planned fiscal year 2011 funding)
    and Refueling Overhaul for USS Abraham Lincoln ($197 million less than
    planned fiscal year 2011 funding). The impact on CVN 79 will result in
    insufficient funding to accomplish planned work, affecting
    approximately 600 contractor employees. The impact on the Lincoln
    overhaul will delay the start of the RCOH and follow on RCOHs. All of
    these actions would disrupt workload across the shipbuilding industrial
    base, increase costs, and delay providing operational capabilities to
    the fleet.
        Question. Is it fair to assume that a year-long CR will add
    hundreds of millions if not billions cumulatively to the cost of
    procuring required defense systems including ships?
        Answer. Yes. It is fair to assume that a year-long CR will add
    hundreds of millions if not billions cumulatively to the cost of
    procuring required defense systems. In fact, a year-long CR will add
    approximately $15 billion in deferred requirements to the Future Years
    Defense Program, given the fiscal year 2010 enacted baseline
    restriction and the inability to reprogram funds to higher strategic
    priorities.
                               military equipment
        The January test flight of the Chinese J-20 stealth aircraft
    reiterated the need for our military forces to have the most capable
    equipment we can provide them. In the fiscal year 2012 budget, only 32
    F-35 Joint Strike Fighters are being procured. The shortfall in
    aircraft is being made up with F/A-18's and F-16's. The F-22 stealth
    program has been cancelled.
        Question. Secretary Lynn, will this aircraft mix provide our
    military with the necessary capabilities to counter threats like the J-
    20 in the future?
        Answer. When the J-20 is just reaching its initial operating
    capability at the end of this decade, the U.S. will have procured 187
    F-22 Raptors and about 800 F-35 Joint Strike Fighters. The aero
    performance, stealth, and sensing of the F-22, combined with the sensor
    fusion, stealth, electronic warfare, and munitions capabilities of the
    F-35, will ensure our air supremacy for years to come.
        Question. How much funding is being dedicated to research and
    development of technologies aimed at countering emerging threat
    capabilities? How would a year-long continuing resolution affect that
    research and development?
        Answer. The Department does not have a precise definition of
    emerging threats for the purpose of identifying specific funds
    supporting emerging threat capabilities. However, within the
    Department, we have a Rapid Fielding office within Assistant Secretary
    of Defense (Research and Engineering) organization responsible for
    initiating programs countering new threats quickly.
        The impact would be severe because emerging threats require new
    starts; since new starts are not allowed, a one year CR means we lose
    12 months in a dynamic technology world. Without funding for new
    projects in fiscal year 2011, the Quick Reaction Special Projects and
    the Joint Capability Demonstration Programs will be unable to start
    more than 77 new projects totaling $71 million from their planned
    fiscal year 2011 funding. The delay in receipt of a fiscal year 2011
    appropriation is limiting opportunities to develop: unmanned systems
    command and control and unmanned resupply helicopters; protection from
    cyber attacks; automated processing and rapid distribution of very high
    volume wide area surveillance data; improved information operations;
    open source data exploitation; expanded red teaming; maritime security;
    surveillance capabilities that would afford our forces the ability to
    operate within the enemy's cycle of adaptation; increased force
    protection and situational awareness; and enhancing our understanding
    of networks that can threaten our security before they strike.
        Question. How would a year-long continuing resolution at fiscal
    year 2010 levels affect the procurement of these advanced aircraft?
        Answer. A year-long Continuing Resolution (CR) at fiscal year 2010
    levels would have a significant impact on F-35 procurement. The fiscal
    year 2011 President's budget requested procurement for 42 total
    aircraft as follows: 22 Conventional Take-Off and Landing (CTOL); 13
    Short Take-Off and Vertical Landing (STOVL); and 7 Carrier Variant
    (CV). However, because of production rate caps imposed by a CR, the
    Department would be limited to the fiscal year 2010 procurement rates,
    30 in total. This would limit the procurement of CTOL aircraft to no
    more than 10, and CV aircraft would be capped at 4, rather than the 7
    requested in the budget. The CR would not affect the procurement of
    STOVL aircraft because the Department seeks to buy fewer in fiscal year
    2011 (3) than the fiscal year 2010 procurement quantity (16).
        H.R. 1473, the Department of Defense and Full-Year Continuing
    Appropriations Act, 2011, was signed into law on April 15, 2011. H.R.
    1473 provides appropriations for up to 35 total F-35 aircraft. The
    Department is reviewing the adequacy of appropriated funding to
    determine the final quantity.
                         defense department budget cuts
        As a member of the Department of Defense Appropriations
    Subcommittee and Chairman of the Select Committee on Intelligence, I
    strongly believe that our first responsibility is to the safety and
    security of the United States and its citizens. While the Defense
    Department has and will be subject to some budget reductions, many
    other Government agencies, also involved in national security
    activities, have had their budgets deeply cut. I believe that we can
    make targeted, prudent reductions to the Defense portion of a
    continuing resolution that would provide billions in additional funds
    for the non-defense discretionary accounts with national security
    interests.
        Question. Secretary Lynn, please identify some lower priority
    Defense Department programs where that money can be applied to other
    national security activities outside of the Defense Department.
        Answer. The Department just completed a thorough program review
    that identified programs that should be eliminated or reduced in order
    to ensure that the Department can meet current and future operational
    requirements. While we will continue to look for more opportunities to
    improve both efficiency and effectiveness, we cannot recommend
    additional programs for elimination at this time.
        Question. Please identify programs in the Defense Department and
    the military services where activities are redundant and can be
    consolidated to achieve budget savings.
        Answer. The Department just completed a thorough program review
    that included the identification and elimination of redundant and low-
    priority activities. While we will continue to look for more
    opportunities to improve both efficiency and effectiveness, we cannot
    recommend additional activities for elimination at this time.
                                     ______

                Questions Submitted by Senator Barbara Mikulski
        fiscal year 2012 legislative proposal on u.s. family health plan
        The U.S. Family Health Plan (USFHP) designed by Congress in 1996
    provides the full TRICARE Prime benefit for military beneficiaries in
    16 States and the District of Columbia for over 115,000 beneficiaries.
    Beneficiaries are highly satisfied with this healthcare option. In
    fact, the subcommittee understands that in 2010 over 91 percent of
    USFHP beneficiaries were highly satisfied with the care they received,
    making it the highest rated healthcare plan in the military health
    system. The fiscal year 2012 President's budget request includes a
    proposed legislative provision that future enrollees in USFHP would not
    remain in the plan upon reaching age 65.
        Question. Public Law 104-201 Sec. 726(b) mandates the Government
    cannot pay more for the care of a USFHP enrollee than it would if the
    beneficiary were receiving care from other Government programs. Is the
    Department of Defense (DOD) in compliance with this requirement? If you
    are not in compliance with the law or disagree with the above, please
    explain. In that this requirement implies that the offset to the DOD
    budget would be exactly offset by the cost increases to Medicare please
    elaborate in detail how the fiscal year 2012 USFHP legislative proposal
    will result in a net savings to the taxpayer?
        Answer. This proposal has no impact on current USFHP enrollees. The
    proposed change to USFHP would only affect future USFHP enrollees, once
    they attain Medicare eligibility. Upon reaching age 65, those enrolled
    in USFHP could enroll in Medicare Part B and receive the TRICARE for
    Life (TFL) benefit as a supplement to their Medicare coverage. USFHP
    beneficiaries are not required to pay Part B premiums as other
    Medicare-eligible beneficiaries must do to receive a comprehensive
    benefit from DOD. Under current law, these enrollees are allowed to
    remain in USFHP, whether they enroll in Medicare Part B or not.
        The administration estimates the proposal will save the Government
    $279 million over the next decade. Under the proposal, Medicare would
    see an increase in Part B premiums collected. While current law
    precludes DOD from spending more on USFHP than it would cost the
    Government to provide care through TFL and Medicare, the law requires a
    negotiation and mutual agreement between the Secretary of Defense and
    designated providers in determining payments to USFHP. Since the
    inception of this program in 1995, the rates provided to these plans
    have been based primarily on data from the general Medicare population.
    However, since the TFL program began in 2001, the Department has been
    able to gather detailed data specific to the Medicare-eligible TRICARE
    beneficiary population. The savings estimated for the proposal are
    based on the delta between the historically used rates and estimates
    derived from the actual data accumulated for Medicare-eligible TRICARE
    beneficiaries.
        More importantly, this proposal provides equitable treatment for
    all Medicare-eligible retirees by offering a single program design
    across the country. Most retirees do not live in one of the USFHP
    service areas, and their only option for healthcare is Medicare and TFL
    (requiring payment of their Medicare Part B premium).
        Question. Of the total DOD TRICARE population over the age of 65
    years, how many beneficiaries are covered under the USFHP? How many
    beneficiaries over the age of 65 are covered by a combination of
    TRICARE and Medicare Part A and B but not covered by USFHP?
        Answer. There are approximately 37,000 DOD beneficiaries over the
    age of 65 who are covered by the USFHP program. Approximately 1.9
    million DOD beneficiaries over the age of 65, who have both Medicare
    Part A and Part B, are not covered by USFHP.
        Question. The USFHP provides prevention and wellness programs as
    well as effective disease and care management programs designed to care
    for beneficiaries' healthcare needs over their lifespan. Given the
    longitudinal approach of the program in managing the healthcare needs
    of the USFHP beneficiaries, and the Department's interest in the
    medical home model, why would you not consider expanding such
    innovative techniques in healthcare delivery?
        Answer. The Military Health System (MHS) has embraced the Patient-
    Centered Medical Home (PCMH) as the key paradigm for the provision of
    primary care services for all of our enrolled beneficiaries. Plans and
    activities are moving forward to implement the PCMH in multiple sectors
    of the MHS, with the target of providing this model of care to all of
    our enrolled beneficiaries over the next few years. Likewise, each of
    the Military Services are moving forward with transforming their
    primary care services to a PCMH model and options are being intensively
    explored for similar efforts in the Purchased Care Sector. In addition,
    the Centers for Medicare & Medicaid Services has launched PCMH
    demonstration projects for Medicare populations in several States. It
    is anticipated that those efforts will be expanded as well and provide
    even broader access to the PCMH for all of the Medicare population
    including Department of Defense beneficiaries enrolled in TFL.
        Question. The proposed legislation, if enacted, would force future
    enrollees to disenroll from this effective and well managed program
    upon reaching age 65. The remaining beneficiaries would be at risk
    because the ability to sustain disease management and prevention
    programs for them, a core aspect of the plan's success, would be
    compromised, effectively removing the option of long term participation
    in clinical programs aimed at actively engaging beneficiaries in
    managing their health. Is this consistent with the DOD's stated
    priorities of population health, improved health management and
    continuity of care?
        Answer. The MHS considers population health, optimal health
    management, and continuity to be high priorities for all of our
    beneficiaries. The TRICARE benefit, including the TFL provision, was
    dynamically designed to enforce those priorities and to optimize care
    and access for Department of Defense beneficiaries throughout their
    life. Beneficiaries who age out of TRICARE Prime will continue their
    relationship with their medical providers and continue disease
    management and prevention programs--hallmarks of quality patient
    management--just as other TRICARE enrollees who age out of Prime.
    Although Medicare becomes the primary payer when our beneficiaries age
    out of Prime, with TFL, our beneficiaries continue to be eligible for
    the much richer TRICARE benefit. TFL has been a valuable addition for
    our beneficiaries over age 65 and has greatly enhanced access and
    continuity beyond the basic Medicare benefit. More importantly, this
    proposal provides equitable treatment for all Medicare-eligible
    retirees by offering a single program design across the country. Most
    retirees do not live in one of the U.S. Family Health Plan service
    areas, and their only option for health care is Medicare and TFL
    (requiring payment of their Medicare Part B premium).
                                     ______

                  Questions Submitted by Senator Thad Cochran
                             efficiency initiatives
        Question. Secretary Hale, how will the budget documents provided to
    Congress track savings from the Department's ``efficiency initiatives''
    on a year-to-year basis?
        Answer. The fiscal year 2012 budget included efficiencies that
    contributed to the $78 billion reduction to the Department of Defense
    (DOD) projected budget over the next 5 years; and efficiencies that
    contributed to reinvesting $100 billion in key combat capabilities and
    higher than expected operating costs. The Department is currently
    working on new processes and metrics that will be used to monitor
    progress by Components in meeting these efficiency goals. As part of
    the efficiencies initiative we are specifically monitoring: service
    support contract reductions; report studies, boards and commissions
    reductions; senior leadership positions reductions; and the overall
    freeze in personnel levels. Actual performance will be reviewed by
    Department leadership throughout the year and results will be reflected
    in the prior year data submitted in budget documents.
        Tracking these efficiency savings from year-to-year will be part of
    the dynamic nature of the budget process. The Military Departments,
    Defense Agencies, and the Department are in a continuous process of
    planning and budgeting that reacts to execution realities and
    reprioritizes programs to balance capability with affordability. The
    Service specific efficiencies that contributed to reinvesting in key
    combat capabilities will be monitored and evaluated by the Services as
    they formulate the next year's plan and budget. Adjustments required
    due to execution realities will be reflected as program adjustments in
    the Service budget documents.
                            dod financial statements
        Question. Secretary Hale, the Department is one of the few cabinet
    level agencies not to produce auditable financial statements despite
    many years of investment by the Department. Do you have the necessary
    resources and people in place to meet the Department's goal for
    achieving fully auditable financial statements by September 2017?
        Answer. Yes. Until recently the Army and Air Force had not devoted
    sufficient resources to achieving auditable financial statements. We
    have remedied that and feel that the approximately $200 million to $300
    million we are investing to improve processes and internal controls
    over the next several years is the appropriate amount to achieve
    success. The Department is also investing significant amounts in modern
    systems to support auditability. While these systems have broad
    operational improvement goals they are also working to improve business
    processes in a way to support audited financial statements. The
    Department does not need further resources to achieve auditable
    financial statements at this time.
                                 iraq drawdown
        Question. Secretary Lynn, as U.S. efforts in Iraq transition from
    the Department of Defense to the Department of State at the end of 2011
    will the Iraqi Government or contractors be able to provide the
    security, logistics and emergency medical care for Department of State
    personnel? If the Iraqi Government or contractors cannot provide the
    necessary security, logistics and other basic requirements for State
    Department personnel to operate in 2012, will the U.S. military be
    forced to make-up the capability shortfall? Is your Department doing
    any contingency planning for this eventuality?
        Answer. The Iraqi Government is not yet able to provide security,
    logistics, or emergency medical care for Department of State personnel.
    Although the Iraqi Government dedicates a significant portion of
    revenues to security, Iraq is still a post-conflict, developing country
    facing considerable fiscal challenges. The Iraqi Government's fiscal
    management is improving with each passing year, but its available
    fiscal resources are not yet sufficient to meet security requirements.
    Even with increases in oil production, Iraq may not see significant net
    revenue increases for the next 3 to 5 years.
        DOD and the State Department are working together to ensure that
    the State Department can execute the civilian-led mission in Iraq. With
    the exception of medical services, DOD will provide Embassy Baghdad
    basic life support, core logistics services, and contract management on
    a reimbursable basis through the U.S. Army Logistics Civil Augmentation
    Program (LOGCAP IV), and other contracted support.
        DOD plans for a whole variety of different contingencies, but the
    preponderance of effort has been on facilitating transition to the
    State Department. DOD is doing everything it can to help set up the
    State Department for success. The State Department, DOD, and other
    agencies and offices have undertaken unprecedented levels of
    coordination and planning for the transition in Iraq. The State
    Department and DOD have an excellent working relationship and are
    working together at all levels to achieve a successful transition. As
    one would expect with a transition of this scope and complexity,
    challenges exist.
                             efficiency initiatives
        Question. Secretary Lynn, the budget request includes a number of
    initiatives to streamline Department of Defense business operations and
    overhead. Does the Department have the tools and processes in place to
    measure the effectiveness of these initiatives and to determine if they
    achieve the saving assumed in the budget?
        Answer. The Department currently has a number of tools in place
    that will help to monitor both execution and effectiveness of the
    initiatives laid out in the President's fiscal year 2012 budget
    submission. Additionally, the various components have developed a
    number of internal processes and tools to assist with implementation,
    monitoring, and assessment. The Secretary and I are strongly committed
    to meeting the goals and to finding new ways to improve how the
    Department conducts business, thereby better using the scarce resources
    of the Nation.
                     decreased nasa funding--impact on dod
        Question. Secretary Lynn, has the Defense Department's budget for
    space capabilities been adjusted or impacted to compensate for the
    President's decision to freeze NASA funding at the 2010 level?
        Answer. No, the Defense Department's budget for space capabilities
    currently has not been adjusted or impacted to compensate for the
    President's decision to freeze NASA funding at the 2010 level.
         handheld global positioning systems (gps) for platoon leaders
        Question. Secretary Lynn, on page three of your prepared testimony,
    you state ``the proposed budget provides our deployed forces with
    everything they need to carry out their mission.'' However, I have been
    informed that Army platoon leaders deployed to Afghanistan do not have
    handheld GPS Receivers which would improve their situational awareness
    and targeting. Would you look into this and let the committee know if
    this useful piece of gear is being issued at the platoon level in
    sufficient quantities?
        Answer. The Global Positioning System (GPS) is issued at the
    platoon level according to Army authorizations. For an Infantry
    formation, a GPS capability is issued to commanders, S3/operations, S4/
    logistics, platoon leaders, squad leaders and other vehicle platforms
    as well to include our Force XXI Battle Command Brigade and Below/Blue
    Force Tracker systems and Mine Resistant Ambush Protected vehicle
    platforms. All deploying forces are equipped with their required
    authorization quantity and if required, our industrial production line
    has ample quantities to support any shortfall. There is no current
    Operational Need Statement for GPS. There is no indication of any
    significant shortfall in Defense Advanced GPS Receiver (DAGR) in
    theater. Theater has a large number of the Precision Lightweight GPS
    Receivers (PLGR) devices which can augment the DAGR.
                                     ______

              Questions Submitted by Senator Kay Bailey Hutchinson
        Under a Continuing Resolution (CR) at fiscal year 2010 levels, the
    Army would be limited to acquisition of only 8 AH-64 Apache helicopters
    instead of the 16 requested in the fiscal year 2011 President's budget,
    and could not acquire the 1 combat loss replacement helicopter. Also,
    under a CR at fiscal year 2010 levels, the Army would be limited to
    acquisition of only 34 CH-47 Chinook helicopters instead of the 40
    requested in the fiscal year 2011 President's budget, and could not
    acquire the 6 helicopters added in the Overseas Contingency Operations
    (OCO) account.
        Question. Can you talk about how these limited acquisitions would
    affect adversely the Army's ability to carry out its missions?
        Answer. The limited acquisition of Apache Block III will delay the
    First Unit Equipped (FUE) by 6 months and delay that capability from
    deploying to theater as scheduled. While this will have minimal impact
    on the Army's ability to carry out its immediate missions in Operation
    Enduring Freedom (OEF) and Operation New Dawn (OND); it will extend the
    timeframe necessary to modernize the Apache fleet. Limiting fiscal year
    2011 quantities and funding levels to the fiscal year 2010 equivalents
    will also have cost and contract implications. It will result in a
    decrease in Low Rate Initial Production (LRIP) aircraft quantities and
    the reduced procurement in fiscal year 2011 will adversely affect the
    overall procurement unit cost of the helicopters by an unknown amount.
    The prime contractor has already submitted a proposal for the LRIP
    effort. Any decrement to aircraft quantities will invalidate the
    current contractor proposal. These resulting inefficiencies and the
    loss of cost and schedule synergies with current the Foreign Military
    Sales, will result in a total decrease of up to ten aircraft during
    LRIP .
        The limited acquisition of Chinooks due to a year-long continuing
    resolution will extend modernization of the Army National Guard's CH-
    47D to CH-47F program by 3 months. The limited acquisition will have
    minimal immediate impact on the Army's ability to carry out its
    missions in OEF and OND. The ARNG's Chinook shortages will be filled by
    1st Qtr fiscal year 2013 with a mix of CH-47D and CH-47F aircraft. The
    ARNG's pure fleet to the CH-47F will extend to 1st Qtr fiscal year 2018
    vice 4th Qtr fiscal year 2017.
        The Texas and Mississippi National Guards need a fiscal year 2011
    programmatic increase of $654,200 to convert Apache ``A'' models to the
    ``D'' models required for a deployment in Central Command. The House
    Defense Appropriations Subcommittee, the Senate Appropriations
    Committee, and the proposed defense omnibus appropriations bill all
    provide such funds. The CR does not.
        Question. How will this limitation on funding affect Central
    Command's ability to prosecute the wars in Afghanistan and Iraq?
        Answer. The absence of Apache conversion funding for elements of
    the Texas and Mississippi Nation Guard (1-149 TX/MS) in the fiscal year
    2011 CR will not impact U.S. Central Command's ability to conduct
    operations in Afghanistan and Iraq because 1-149 TX/MS will be deployed
    to Iraq or Afghanistan.
        The conversion (and training) for Apache ``A'' to ``D'' models for
    1-149 TX/MS is expected to be complete in fiscal year 2016. When the
    conversion and training is completed, 1-149 TX/MS will be ready for
    deployment and available for consideration to meet future operational
    requirements.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The Defense Subcommittee will reconvene on
    Wednesday, March 16, at 10:30 a.m. And at that time, we will
    receive testimony from the Navy and Marine Corps on the fiscal
    year 2012 budget request.
        And we now stand in recess. Thank you very much.
        Mr. Lynn. Thank you, Mr. Chairman.
        [Whereupon, at 11:42 a.m., Tuesday, March 1, the
    subcommittee was recessed, to reconvene at 10:30 a.m.,
    Wednesday, March 16.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                           WEDNESDAY, MARCH 16, 2011

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 11:17 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Cochran, Murkowski, and Coats.

                             DEPARTMENT OF DEFENSE

                             Department of the Navy

                            Office of the Secretary

    STATEMENT OF HON. RAY MABUS, SECRETARY OF THE NAVY

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. The subcommittee meets this morning to
    receive testimony on the fiscal year 2012 budget request for
    the Navy and Marine Corps.
        And I'm pleased to welcome the Secretary of the Navy, Mr.
    Ray Mabus, and the Chief of Naval Operations, Admiral Gary
    Roughead, and the Commandant of the Marine Corps, General James
    Amos. I look forward to your testimony. I'd like to thank all
    of you for your prepared testimony. And, without objection, the
    full statement will be made part of the record.
        For fiscal year 2012, the President's budget requests $161
    billion in base funding for the Department of the Navy. This is
    an increase of just one-half of 1 percent over last year's
    request. In addition, the budget seeks to reduce overseas
    contingency operation funding from $18.5 billion to $15
    billion, reflecting the changing missions in Iraq and
    Afghanistan.
        The very low growth of the Navy and Marine Corps budget is
    partly attributable to the Secretary of Defense's efficiency
    program. The request includes many commendable proposals, such
    as cutting energy costs by making our ships, aircraft, and
    facilities more efficient and increasing the use of alternative
    energy sources.
        But, the subcommittee may have questions about other
    programs that are claimed as cost savings. For example, the
    Marine Corps' expeditionary fighting vehicle (EFV) has been
    terminated, and three new programs are being established to
    fill the void. While we know how much money will be saved by
    canceling the EFV, it is hard to estimate how much money we
    will spend on the three follow-on programs.
        In an age of tightening budgets, Congress needs to have a
    clear understanding of what budgetary proposals will produce
    real savings that can be better invested for our
    servicemembers, as opposed to delaying tough spending decisions
    for another day.
        While the subcommittee will have many questions about the
    proposed budget over the coming months, there is no doubt about
    the importance of the Navy and the Marine Corps in the world
    today. Even while supporting combat missions overseas, marines
    and sailors are now performing life-saving humanitarian relief
    efforts in Japan after the catastrophic earthquake and tsunami.
    They are delivering supplies, searching for survivors, and
    rendering aid to the victims of this disaster. The people of
    the United States and Japan are grateful for the life-saving
    efforts of these men and women, and our thoughts are with all
    of the victims of this terrible catastrophe.
        In these challenging fiscal times, it is all the more
    important that each dollar that Congress provides to the Navy
    and Marine Corps is put to its fullest use. I'm mindful that
    many of the budget proposals that were delivered to Congress in
    February were based on deliberations that occurred last summer
    and last fall. No matter how well planned the budget may be, it
    cannot predict the future. It is the job of this subcommittee
    and Congress to make adjustments to the defense budget, to
    redirect unneeded spending to higher priorities, based on new
    information and new developments.
        This hearing is just the beginning of the process of
    learning how the budget request will support our national
    priorities. So, I look forward to working with our
    distinguished panel throughout the year so that our fiscal year
    2012 appropriations bill will best reflect the needs of our
    Armed Forces.
        And I'd like to now call upon Senator Cochran, the vice
    chairman, for his statement.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you very much.
        I'm pleased to join you in welcoming our distinguished
    panel of witnesses this morning. Secretary Mabus, our former
    distinguished Governor of Mississippi, is doing a fine job, in
    my opinion, as Secretary of the Navy. He's reflecting credit on
    our State and our Nation and the United States Navy. And
    Admiral Roughead has become almost like a citizen of
    Mississippi. It seems like we turn around and he's down there
    at a commissioning or a christening, helping to ensure that our
    shipbuilding maintains a pace that will help defend our
    national interests in the waters of the world. And he has had a
    distinguished career in the Navy, and we're pleased to call him
    a friend.
        General Amos, we appreciate very much your being a part of
    this panel and your leadership for the Marine Corps. We're glad
    to have you here.
        Mr. Secretary, I know that we've had an opportunity to
    visit and stay in close touch on issues here. There will be
    questions that'll arise during the hearing, but I think I'll
    reserve my further comments or questions until later in the
    hearing.
        Welcome.
        Chairman Inouye. Thank you very much.
        May I now call upon the Secretary.
        Secretary Mabus.

                      SUMMARY STATEMENT OF HON. RAY MABUS

        Mr. Mabus. Mr. Chairman, vice chairman, members of the
    subcommittee, I have the honor of appearing here today,
    representing the sailors, marines, and civilians that make up
    the Department of the Navy.
        Please let me to first express my deepest sympathies to
    those affected by the terrible events in Japan. Our thoughts
    and our prayers go out to the families of the thousands of
    people who have lost their lives in the earthquake and the
    subsequent tsunami.
        The Navy and Marine Corps are absolutely committed to
    humanitarian assistance and disaster relief operations. Ships
    from the 7th Fleet, including carrier USS Ronald Reagan and its
    strike group, the USS Essex amphibious group, with the 31st
    Marine Expeditionary Unit, embarked, and the command ship USS
    Blue Ridge, as well as helicopters and marines from the 3rd
    Marine Expeditionary Force in Okinawa, are already on station
    or moving to provide assistance. And they will stay in place as
    long as they are needed.
        Ongoing operations in Japan underscore the fact that,
    across the world, Navy and Marine Corps are conducting missions
    over the full range of military operations. They remain the
    most formidable expeditionary force the world has ever known.
    And, thanks to your support, they will continue to meet the
    multiplicity of missions entrusted to them by our Nation.
        Today, I want to spend just a minute talking about an
    immediate crisis that we face: the absence of a Defense
    appropriations bill and the increasingly serious problems of
    operation under a continuing resolution. The pressure of the
    continuing resolution has already significantly impacted
    procurement and reduced the resources available to maintain
    readiness. If the continuing resolution continues for the
    entire year, we will be forced to reduce aircraft flight hours
    and ship-steaming days, cancel up to 29 of 85 ship
    availabilities, defer maintenance on as many as 70 aircraft and
    290 aircraft engines, and defer up to 140 maintenance and
    construction projects across the country. In addition, we will
    be prevented from constructing one Virginia-class submarine,
    two Arleigh-Burke destroyers, and one mobile landing platform.
    It will prevent procurement of two nuclear reactor cores and
    delay increased funding for the Ohio-class submarine
    replacement. It will reduce Marine Corps procurement by up to
    one-third, after the Marine Corps rebalances its manpower
    counts. And it will create nearly a $600 million shortfall in
    combined Navy and Marine Corps manpower accounts. These
    measures not only place additional stress on the force and our
    families, they will weaken the industrial base and affect over
    10,000 private-sector jobs.
        The disruption to our fleet and shore maintenance and
    modernization schedules may take years to recover from and will
    come at a much greater cost. We strongly request congressional
    action to address the implications of this continuing
    resolution. It's particularly important, considering that the
    submission of the 2012 budget was keyed off the 2011 numbers.
        As you pointed out, Mr. Chairman, the budget request for
    the Department of the Navy is a one-half of 1 percent increase
    over the fiscal year 2011 request. It includes funds for 10
    ships and 223 aircraft. It maintains our commitment to take
    care of our people, build a strong R&D and industrial base, and
    to grow the fleet.
        The OCO request, which, as you pointed out, again,
    represents a drop of $3.5 billion, includes funds to sustain
    operations, manpower, and infrastructure, as well as procure
    equipment to support operations in Afghanistan.
        During this budget development, and today, we are keenly
    aware of the fiscal position of the country and the necessity
    to be, in your words, responsible stewards of taxpayer dollars.
    This request, we believe, is a strategy-driven document that is
    informed by fiscal realities. It balances competing
    requirements and does what is best for the country, the Navy
    and Marine Corps, and our sailors and marines.
        We started this cycle by examining every aspect of
    everything we do. Consequently, $42 billion in Department of
    the Navy efficiencies were identified over the 5-year period.
    As a result of these efficiencies, we've been able to add one
    aegis destroyer, three TAO(X) oilers, and one T-AGOS ocean
    surveillance ship to our shipbuilding program. With a dual-
    block littoral combat ship (LCS) strategy, this increases the
    total number of ships in the FYDP from 50 to 56, including one
    joint high-speed vessel to be built for the Army. The savings
    also allow us to buy additional F-18s, extend the service life
    of up to 150 aircraft, as a hedge against any delay in the
    deployment of the F-35 Bravo, and allow us to continue
    investing in unmanned systems.
        The upcoming year will see deployment of the unmanned Fire
    Scout system to Afghanistan, and continuing testing of the
    UCLASS D, the forerunner of an integrated carrier-based system.
        In 2010, one of the most important efforts was a decision,
    endorsed by Congress, to pursue the new littoral combat ship
    through a dual-block-buy procurement strategy. At an average
    cost of less than $440 million per ship, and with the cost
    reductions we have seen on LCS-3 and -4, the new strategy will
    save taxpayers $2.9 billion. This is a plan that's good for the
    Navy, good for the taxpayers, and good for the country, and
    shows what can be accomplished when sound acquisition
    principles are enforced.
        We heard the message from Congress very clearly: We need
    more ships, but they have to be affordable. The LCS strategy
    supports the industrial base by keeping workers employed at two
    shipyards, and is indicative of the Department's push to ensure
    acquisition excellence. We believe that the fixed-price
    contracts used for LCS are a model.
        Significant additional savings were also achieved through
    the termination, as you pointed out, Mr. Chairman, of the
    expeditionary fighting vehicle for the Marine Corps. I believe
    it's very important to emphasize that this decision in no way
    changes our Nation's commitment to amphibious warfare. We have
    to maintain an amphibious assault capability that will put
    marines ashore, ready for the fight. But, the EFV is simply not
    the vehicle to do this. Its cost per unit would have consumed
    one-half the Corp's total procurement and 90 percent of its
    vehicle-related operation and maintenance account in the years
    2018 to 2025.
        In aviation programs, we're closely monitoring the Joint
    Strike Fighter (JSF), particularly the Marine Corps variant,
    the B. After a 2-year period of very focused scrutiny, we'll
    make an informed recommendation about resolving the technical
    and the cost issues.
        Ashore, we continue to confront rising healthcare costs
    caused by an increasing number of beneficiaries, expanded
    benefits, and increased utilization. To deal with these trends,
    we must implement systematic efficiencies in specific
    initiatives that improve the quality of care and customer
    satisfaction, but, at the same time, much more responsibly
    manage costs. We concur with the recommendations made by the
    Secretary of Defense to ensure fiscal solvency and benefit
    equity for our retirees.
        Finally, as the chairman pointed out, we are continuing
    efforts to invest in and develop alternative energy. The latest
    headlines from around the world reinforce this basic point.
    Energy is, first and foremost, an issue of national security.
    We cannot allow volatile regions of the world to control the
    price and affect the supply of fuel we use.
        In the last year, the Navy and Marine Corps took huge steps
    forward, flying an F-18 Hornet on biofuel, conducting a large-
    scale expansion of solar power, and beginning extensive
    expeditionary energy initiatives in Afghanistan. What we're
    doing in Afghanistan is already saving lives as we reduce our
    reliance on fossil fuels.
        In closing, I want to thank you again for your support.
    Thank you for always looking out for our sailors, marines, and
    their families, and for your support of efforts to make the
    Navy and Marine Corps better, stronger, and better able to
    defend our Nation.

                               PREPARED STATEMENT

        It's a solemn privilege to lead the naval services during
    an era of protracted war and national challenge. I have been
    profoundly moved by the sacrifice and devotion I have witnessed
    in the sailors and the marines who defend us. The Navy and
    Marine Corps are, and will remain, ready to do any mission
    America gives.
        Thank you.
        Chairman Inouye. I thank you very much, Mr. Secretary.
        [The statement follows:]
                 Prepared Statement of the Honorable Ray Mabus
        Chairman Inouye and Vice Chairman Cochran, I have the honor of
    appearing here today on behalf of the nearly 900,000 Sailors, Marines,
    and civilians that make up the Department of the Navy. I have appeared
    before this Committee on a number of occasions, and I am happy to be
    here again, along with the Chief of Naval Operations and the Commandant
    of the Marine Corps, to report on the readiness, posture, progress, and
    budgetary requests of the Department. We consider ourselves privileged
    to lead the dedicated men and women of the Department who are
    selflessly serving the United States all around the world.
        Today, your Navy and Marine Corps are conducting missions across
    the full range of military operations. They are engaged in combat in
    Afghanistan, stability operations in Iraq, deterrence and ballistic
    missile defense in the Pacific, Arabian Gulf, and the Mediterranean, as
    well as humanitarian assistance and disaster relief operations across
    the globe. Our unmatched global reach, endurance, and presence continue
    to allow the Navy and Marine Corps--in partnership with our sister
    services--to secure and advance America's interests wherever challenges
    or crises have arisen, as well as operate forward to prevent crises
    from occurring. We remain the most formidable expeditionary fighting
    force the world has ever known, and with your continued support, the
    Navy and Marine Corps will continue to meet the multiplicity of threats
    that endanger international peace and security.
        But today we are very concerned about the absence of a Defense
    Appropriations Bill for fiscal year 2011 and the negative effects of
    operating under a continuing resolution for the remainder of the year.
    We are equally concerned about passage of a bill that reduces the
    topline from the level requested in the fiscal year 2011 President's
    budget. Either course of action significantly impacts the resources
    available to grow the fleet and jeopardizes recent efforts to restore
    and maintain readiness levels commensurate with the standards expected
    of the Navy and Marine Corps.
        Without legislative action, limiting fiscal year 2011 procurement
    accounts to fiscal year 2010 levels will:
      --Prevent start of construction of one Virginia-class submarine to be
            built in Groton and Newport News which will break the existing
            Multi-year Contract.
      --Prevent start of construction of one Mobile Landing Platform to be
            built in San Diego.
      --Prevent start of construction of one or possibly both programmed
            Arleigh Burke-class destroyers to be built in Bath and
            Pascagoula due to DDG 1000/DDG 51 swap language that prevents
            award of either ship unless both are authorized and
            appropriated.
      --Preclude fourth and final increment of full funding for
            construction of CVN 78 (U.S.S. Gerald Ford) and advance
            procurement for CVN 79.
      --Prevent procurement of two nuclear reactor cores for refueling of
            one aircraft carrier and one ballistic missile submarine, as
            well as delay increased funding for research and development of
            the Ohio-class replacement and replacement of two Moored
            Training Ships that provide half of the force's nuclear
            training capability.
      --Prevent completion of one Arleigh Burke-class modernization.
      --Reduce Marine Corps procurement by $563 million. This would add to
            equipment shortfalls generated by 9 years of conflict and
            prevent equipment replacement or purchase of 4 H-1 helicopters,
            numerous LAVs, MTVRs, LVSRs; tech upgrades to counter IED
            jammers; communication and intelligence equipment; tactical
            fuel systems to power our vehicles and generators; engineering
            equipment to move ammo, gear and supplies; air conditioners and
            heaters to take care of Marines and sensitive gear; and EOD
            improvements to protect them.
        Reductions to expected procurement levels will create additional
    stress on the force, as units in service pick up additional commitments
    to cover the seams created by fewer available platforms.
        Likewise, fixing fiscal year 2011 operations to fiscal year 2010
    levels has created a $4.6 billion shortfall in Navy and Marine Corps
    operations, maintenance, and training accounts. Faced with this
    prospect, the Department began efforts in January to mitigate the
    impacts of operating under the continuing resolution, which over the
    course of the fiscal year will cause us to:
      --Reduce aircraft flight hours and ship steaming days, including a
            reduction of four non-deployed air wings' flight hours to
            minimal flight-safety levels.
      --Cancel up to 29 of 85 Surface Ship availabilities.
      --Defer maintenance on 70 aircraft and 290 aircraft engines, bringing
            the combined backlog of aviation maintenance close to 1-year
            redlines.
      --Defer 41 facilities maintenance projects and 89 new construction
            projects in Arizona, California, Florida, Georgia, Hawaii,
            Louisiana, Maryland, North Carolina, Rhode Island, South
            Carolina, Virginia, and Guam. These cuts equal an approximate
            50 percent reduction and will eliminate, among many projects,
            dry dock certifications, bachelor quarters maintenance
            projects, repairs to Explosive Handling Wharves (EHW) at Bangor
            and Kings Bay that support ballistic missile operations, and
            modernization projects to support introduction of new training
            aircraft.
        The combined effects of the continuing resolution will directly
    impact the strength of the industrial base and over 10,000 private
    sector jobs at shipyards, factories, and Navy and Marine Corps
    facilities across the country. The degradation or loss of perishable
    skill-sets within our workforce, including many nuclear workers, and
    the disruption to both our fleet and shore maintenance and
    modernization schedules will take 3 years to recover based on
    rotational schedules alone--and only at significantly greater cost than
    requested in the fiscal year 2011 President's budget.
        Finally, there is almost a $600 million shortfall in Navy and
    Marine Corps manpower accounts. As a result of this shortfall, the
    Services must raid other accounts in order to meet payroll for the
    duration of the year. We are currently living within funding
    constraints by limiting or conducting short-notice permanent change of
    station moves; however, this tactic places significant hardship on our
    military families and is not sustainable over the entire fiscal year.
        We strongly request congressional action to address the
    implications of the continuing resolution on our forces and our people
    by taking action to enact the fiscal year 2011 President's budget.
                            departmental priorities
        As I testified last year, there are four imperatives I believe the
    Department of the Navy must address to maintain preeminence as a
    fighting force and successfully meet the challenges of the future. They
    are: Taking care of our Sailors, Marines, civilians, and their
    families; treating energy as a strategic national security issue;
    creating acquisition excellence; and continuing development and
    deployment of unmanned systems.
        These priorities underpin every action of the Department, from
    supporting current operations to developing the current year's budget
    request, finding efficiencies within the Department, and preparing our
    Navy and Marine Corps for the future.
        Fundamentally, it comes down to a question of resources, of
    ensuring that our people have what they need to do their jobs, ensuring
    the Nation that the Navy and Marine Corps uses our fiscal and energy
    resources wisely, and ensuring that seapower, as a resource, remains
    readily available to meet the Nation's policy requirements and the
    orders of the Commander in Chief.
                     seapower: a critical strategic enabler
        It is clear that we live in a time of sweeping change and an era of
    strategic realignment. The President has stated that we ``must pursue a
    strategy of national renewal and global leadership--a strategy that
    rebuilds the foundation of American strength and influence.'' Seapower
    has always been a part of that foundation and will continue to be an
    indispensible asset to American leadership and economic strength in the
    global community of nations. American seapower, as it has done for
    generations, continues to guarantee freedom of navigation and
    international maritime trade, underpinning global economic stability
    and facilitating continued global economic growth. No other component
    of American military power is as flexible or adaptable as seapower. I
    see one of my primary responsibilities as Secretary to be ensuring
    continuation of this responsiveness, flexibility, and adaptability
    through the policies we adopt and in the ships, aircraft, and weapons
    systems that we build.
        Maritime nations have many inherent strategic advantages. Naval
    forces operating in the open ocean provide an effective conventional
    deterrent to those who threaten regional stability or promote
    extremism. Strong expeditionary forces can swiftly respond to crises
    and make potential adversaries pause before committing hostile actions.
    But should deterrence fail, our combat ready naval forces must be
    prepared to conduct sustained combat operations.
        The Navy and Marine Corps are America's ``Away Team.'' They exist
    primarily to protect our Nation far from home and respond quickly to
    crises wherever and whenever they occur. Exploiting their inherent
    mobility and maneuverability at sea, naval forces gather information,
    perform surveillance of seaborne and airborne threats, defend regional
    partners, deter prospective adversaries, interdict weapons of mass
    destruction, disrupt terrorist networks, conduct humanitarian
    assistance and disaster relief, and support the work of American
    diplomacy. This variety of capabilities is a primary feature of
    seapower, and it provides the President and our Nation with unmatched
    flexibility to deter conflict and, if necessary, project power from the
    sea to defend U.S. national security interests. The ability to
    accomplish these tasks without placing a large presence ashore and
    absent concerns of sovereignty is absolutely critical in our world of
    increasingly sophisticated threats and growing geopolitical complexity.
        It is for these reasons, and in order to improve global force
    projection capabilities that the Navy, Marine Corps, and Air Force are
    working on an Air Sea Battle (ASB) concept to improve joint
    capabilities and cooperation in addressing anti-access/area-denial
    challenges.
        Unique in history, the blanket of maritime security and stability
    provided by American maritime power is the first to be used for the
    good of the whole world. But in order to ensure continued American
    leadership in issues of maritime policy and security, we strongly
    recommend accession of the United States to the Convention on the Law
    of the Sea, an action that has been similarly and repeatedly
    recommended by multiple Secretaries of the Navy and Chiefs of Naval
    Operation. Accession by the United States would enhance stability of
    the navigational rights inherent to the Convention and would strengthen
    our bargaining position in international discussions of Arctic Policy
    and access to resources and sea lines of communication.
                               current operations
        Over the past year, our forces have successfully navigated the
    world's growing complexity and have consistently demonstrated the
    utility, effectiveness, and flexibility of seapower and maritime
    forces.
        Following completion of the Marines Corps' mission in Iraq, the
    primary operational focus of the Department has been supporting the war
    effort in Afghanistan. Over 30,000 Marines and Sailors are committed to
    the fight there, working all across the country, with the largest
    concentration operating as Regional Command Southwest (RC-SW) along the
    Helmand River Valley.
        In my visits to the Marines on the ground throughout the year, I
    had the opportunity to look firsthand at the progress made by our
    increased presence in Helmand. In December, I visited three Forward
    Operating Bases (FOBs) with increasing levels of stability in three
    separate districts of Helmand: Sangin, Marjah, and Nawa--or as the
    Marines put it, I went to look at where the fight is, where the fight
    was, and where there is no fight.
        In Nawa, I saw a strong partnership between the local government,
    Afghan National Police, the Afghan National Army, and our Marines--who
    have built the capacity of their partners so that they may shortly
    assume responsibility for their own security. The district is very
    safe, and because of the success of the counter-insurgency effort, Nawa
    is growing in both political strength and economic activity.
        In Marjah, after successful operations to clear it last spring, the
    markets are open, schools are being built, and a local government is
    working to build capacity. In my visit just 3 months ago, I personally
    walked the streets of Marjah to witness the progress, something that
    even in the summer of 2010 would have been unthinkable. Then, just
    stepping outside the gates of our forward operating base would have
    generated a pitched battle. Now, it brought out street vendors and men
    on motorbikes.
        I also went to Sangin District near the Kajaki Dam in Northern
    Helmand, which has been a Taliban stronghold for years and for the past
    few months has been the main effort of the fight in Helmand. Our
    Marines in Sangin have been conducting intensive combat and security
    missions in support of the counterinsurgency strategy, and
    concurrently--even in the midst of the fight, have been testing new
    solar energy equipment to expand their operational reach. Together with
    their partners from the Afghan National Security Forces, they have
    taken the fight to the Taliban and are facilitating the Afghan
    Government's reestablishment of local control.
        Elsewhere across Central Command, the Navy has over 14,000 Sailors
    on the ground supporting joint and coalition efforts and another 10,000
    Sailors at sea supporting combat operations, including from our
    carriers operating in the Indian Ocean, where we are launching
    approximately 30 percent of the strike or close air support missions
    that watch over our Marines and Soldiers on the ground in Afghanistan.
        In addition to combat operations, the Navy and Marine Corps remain
    globally engaged in a host of other security and stability operations.
    On any given day, more than 72,000 Sailors and Marines are deployed and
    almost half of our 286 ships are underway, ready to respond where
    needed.
        It was the Navy and Marine Corps that were the first on scene after
    both the devastating earthquake in Haiti and the summer's catastrophic
    floods in Pakistan. Within hours of the January 12th earthquake, both
    Navy and Marine Corps assets were en route to Haiti. A total of over
    10,000 Sailors and Marines and 23 ships, including the carrier U.S.S.
    Carl Vinson, the Bataan and Nassau Amphibious Ready Groups, and the
    hospital ship U.S.N.S. Comfort ultimately participated in Operation
    Unified Response.
        Halfway around the world, after Pakistan was struck by devastating
    August floods that impacted nearly a fifth of its population,
    helicopters from the U.S.S. Peleliu and the 15th Marine Expeditionary
    Unit supported the Government of Pakistan through delivery of 2,000
    tons of relief supplies and by contributing to the rescue of over
    10,000 people. Later, the ships of the Kearsarge Amphibious Ready Group
    deployed early to provide a continuous U.S. humanitarian presence.
        In response to the administration's strategic direction, the Navy
    is scaling up our ballistic missile defense (BMD) force and their
    deployments to enhance our deterrent posture, especially in the defense
    of Europe. Our multi-mission, BMD-capable, Aegis cruisers and
    destroyers now routinely deploy to the Mediterranean and the Arabian
    Gulf, as well as the Western Pacific to extend our deterrent umbrella
    for our allies. I had the opportunity a few months ago to visit the
    destroyer U.S.S. Ramage after she completed her first BMD deployment,
    and I can assure you that the Sailors on these ships are some of the
    most professional and dedicated men and women in the country, and they
    are incredibly excited about their work. We appreciate Congress'
    continued support of the destroyer and cruiser modernization programs
    that are bringing additional BMD capability to the fleet.
        Our growing BMD capability is complemented by our traditional sea-
    based, strategic nuclear deterrent centered upon our globally deployed
    and proficient ballistic missile submarine force.
        In the Western Pacific, as an integral part of U.S. diplomatic
    actions, several times last year the U.S.S. George Washington sortied
    to the South China Sea and the Sea of Japan in response to territorial
    disputes with North Korea and open North Korean provocation. In late
    November, after the North Korean artillery attacks on Yeonpyeong Island
    west of Inchon, the George Washington strike group conducted a training
    exercise with the South Korean Navy in order to demonstrate the
    continuing value and strength of our alliance.
        We are also working to build regional capacity and resolve security
    issues of common international concern.
        In support of our Maritime Strategy, both the Navy and Marine Corps
    routinely engage with nations all around the world to build capacity
    and forge stronger maritime partnerships. In the ``Rim of the Pacific''
    or RIMPAC exercise, 32 ships, five submarines, and more than 170
    aircraft from 14 nations participated in the world's largest
    multinational maritime exercise encompassing every aspect of
    traditional naval warfare.
        Global Partnership Stations in Africa, South America, and the
    Pacific are training hundreds of Sailors, Marines, and Coast Guardsmen
    from dozens of nations and are bringing advanced medical and civil
    engineering assistance to those in need. The Africa Partnership Station
    alone has trained with 32 African and European partners since 2007. And
    between them, Pacific Partnership 2010--conducted by the U.S.N.S.
    Mercy--and Continuing Promise 2010--conducted by the U.S.S. Iwo Jima--
    treated over 100,000 patients and conducted over 20 civil engineering
    projects.
        In the Caribbean and South America, we continue to work with the
    Coast Guard-led Joint Interagency Task Force--South to synchronize
    forces from 13 nations and interdict the flow of illegal narcotics into
    the United States. In 2010 naval forces contributed to the seizure of
    over 133.2 tons of cocaine, 3.2 tons of marijuana, 92 boats and
    aircraft, and $2.7 billion in drug revenue.
        In the Gulf of Aden and western Indian Ocean, the Navy remains
    committed to counter-piracy efforts with approximately 16 partner
    nations. Combined Task Force 151, in cooperation with forces from the
    EU, NATO, and other nations deploying individual units or task groups,
    is operating off of Yemen and in the Somali Basin to protect the safe
    passage of maritime commerce. Where our forces are located, pirate
    activity has fallen, but the areas involved are huge, and as Secretary
    of State Clinton said in April 2009, the solution to Somalia piracy
    lies largely with Somalia, through building its capacity to police
    itself and offering young pirates viable alternatives to that way of
    life. We are treating the symptoms of piracy, rather than its
    fundamental cause: Somalia's failure as a state. Despite the
    international community's commitment, piracy has both continued to
    increase and move further offshore, a measure of pirate resiliency and
    the strong economic incentives that underpin it. Nine of ten pirates
    captured are ultimately freed as there is often insufficient evidence
    or political will to prosecute them, or to incarcerate them after
    conviction. We strongly endorse additional international efforts to
    address these concerns.
                       fiscal year 2012 budget submission
        Over the past year, I have visited with thousands of Sailors and
    Marines stationed with our forward operating forces at sea and our
    combat forces in Afghanistan. I can report, based on both the direct
    observations I mentioned and from personal inputs from Joint and
    Combined commanders, that the quality of our Sailors and Marines is
    superb and we are continuing to protect America's interests abroad. But
    while we are prevailing today, we must also build the foundation for
    the Navy and Marine Corps of tomorrow.
        During the development of the President's fiscal year 2012 budget
    submission our Navy and Marine Corps leadership team made numerous
    difficult tradeoffs to preserve current readiness while better
    posturing the Navy and Marine Corps for the challenges of the future. I
    believe that the result provides a balanced approach that will enable
    the Services we lead to successfully perform our assigned missions,
    even while setting a course for future success. It is important,
    however, to reiterate that the fiscal year 2012 budget was developed
    based upon ultimate passage of the President's fiscal year 2011 budget.
    If the continuing resolution now in place remains the de facto budget
    for the year, or if a Defense appropriations bill is passed that
    reduces the amounts requested in the fiscal year 2011 President's
    budget, the proposed fiscal year 2012 budget will not be sufficient to
    recover from delays, cancellations, and mitigations we have been forced
    to put in place this year.
        Over the past year, we have examined every aspect of what we do and
    how we do it in order to eliminate waste and move every resource
    possible toward operations and successfully executing our missions now,
    and in the future. At the direction of the Secretary of Defense, in
    June 2010, the Services were formally asked to continue this process
    through an efficiencies review, which we developed through three
    complementary approaches; buying smarter, streamlining our organization
    and operations, and being more efficient in the way we use, produce,
    and acquire energy. This effort has had a substantial impact on our
    overall budget, allowing us to invest more in our core warfighting
    missions and enhance our acquisition plans. Savings were also derived
    from OSD-mandated, Defense-wide efficiencies.
        Since the review began, the Department of the Navy has identified
    approximately $35 billion in self-generated efficiencies over the next
    5 years. When DOD-wide efficiencies are factored in we will achieve $42
    billion in savings. These savings will facilitate adding one guided-
    missile Aegis destroyer, three T-AO(X) fleet oilers, and one T-AGOS
    ocean surveillance ship to our shipbuilding plan, which with our dual-
    block LCS strategy will increase the total number of ships in the FYDP
    from 50 to 56, including one JHSV to be built for the Army, an average
    of more than 11 ships per year. We were also able to accelerate a
    Mobile Landing Platform from fiscal year 2015 to fiscal year 2012 and
    increase R&D funding to support the accelerated procurement of the T-
    AO(X), and the development of the next amphibious dock-landing ship
    (LSD(X)).
        The savings allowed additional investments in the Next Generation
    Jammer to provide greater protection for tactical aircraft, electronic
    warfare systems, ballistic missile sets, and the new air and missile
    defense radar that will equip our DDG-51 Flight III destroyers. The
    savings allowed increased funding for a new generation of sea-borne
    unmanned strike and surveillance aircraft; and gave us the ability to
    buy additional F/A-18s and extend the service life of 150 aircraft as a
    hedge against more delays in the deployment of the F-35B, the Short
    Take-Off and Vertical Landing (STOVL) variant of the Joint Strike
    Fighter.
        We addressed Marine Corps needs by increasing equipment funding for
    units in dwell and for repair and refurbishment of Marine equipment
    used in Iraq and Afghanistan. Based on heavy usage rates, we requested
    $2.5 billion for Marine reset in the fiscal year 2012 OCO request, and
    estimate a $5 billion reset liability upon termination of the conflict
    in Afghanistan. We also added funding for fire and maneuver platforms,
    command and control capabilities, and intelligence, surveillance, and
    reconnaissance.
        We found the $35 billion through a close and systematic review of
    our programs and by cutting excess capacity in our support
    establishment. Over the FYDP, with congressional support we will reduce
    Navy manpower ashore and reassign over 6,000 personnel to operational
    missions at sea; use multi-year procurement and production efficiencies
    to save more than $1.1 billion on the purchase of new airborne
    surveillance, jamming, and fighter aircraft; and disestablish both
    Second Fleet and excess staffs for submarine, patrol aircraft, and
    destroyer squadrons plus one carrier strike group staff.
        Programmatically, one of the most important efficiency efforts was
    the decision endorsed by Congress to pursue the new Littoral Combat
    Ship (LCS) through a dual-block buy procurement strategy. Over the past
    years the message from Congress has been clear, we must build more
    battle force ships as affordably as we can, consistent with the
    statutory requirements laid out in the Weapons System Acquisition
    Reform Act of 2009. We heard that message clearly, and are grateful to
    the administration for its support and to the many Members of Congress
    who worked with the Navy to make the LCS program an example of what can
    be done right when strict acquisition standards are laid out and
    enforced.
        With an average cost of $440 million per ship, and with the cost
    reductions we have seen demonstrated on LCS 3 and 4, the Navy will save
    taxpayers approximately $1.9 billion in fiscal year 2012-16. More
    importantly, the fact that prices were so dramatically reduced from the
    initial bids in 2009 will allow us to save an additional $1 billion--
    for a total of $2.9 billion--through the dual award of a 10-ship
    contract to each bidder. This plan is truly one that is good for the
    Navy, good for taxpayers, and good for the country.
        At the recommendation of both the Commandant and myself,
    significant additional savings were also achieved by the Department of
    Defense through termination of the Expeditionary Fighting Vehicle (EFV)
    program. The Nation absolutely must retain and rebuild an amphibious
    assault capability that will get Marines from ship to shore in a
    protected amphibious tracked vehicle ready for the fight. This is a
    core capability the Marine Corps must have. But the EFV is not the
    vehicle to do this. Conceived in the 1980s, the EFV was the previous
    generation's solution to a tactical problem that has since
    fundamentally changed. Just as importantly, the EFV's cost per unit
    would have eaten up over half of the Corps' total procurement account
    and 90 percent of the Corps' vehicle-related operation and maintenance
    account; the requirements levied on the vehicle outstripped what could
    affordably be achieved.
        We are committed to developing and fielding an effective,
    survivable and affordable amphibious capability that will meet the
    Corps' amphibious requirements. This will be done through upgrading
    existing vehicles, through service-life extensions, and by working with
    OSD and industry to go as fast as possible in the acquisition and
    contracting process to develop a successor program to the EFV, one that
    will meet today's requirements for this critical Marine Corps
    capability.
        We are also closely overseeing the Joint Strike Fighter program. In
    particular, we are providing additional focused attention on the Marine
    Corps variant, the F-35B, which the Secretary of Defense has placed on
    a 2-year probation. During this time, solutions to the unique F-35B
    technical issues will be engineered and assessed while production will
    be held to a minimum sustaining production rate of six aircraft per
    year in fiscal year 2012 and fiscal year 2013. This low-production rate
    is required to ensure continuity in the engineering workforce involved
    in the design and assembly of the F-35B at the prime contractor and key
    vendors without a loss in learning and to sustain the supplier base of
    F-35B unique parts. After this 2-year period of focused F-35B scrutiny,
    an informed decision will be made about how to proceed with development
    and production of this variant, to include the potential for program
    cancellation.
        I want to point out that it is only the F-35B (STOVL) variant that
    is on probation. The F-35C variant, which will be flown off of our
    aircraft carriers, is doing satisfactorily and will be procured by both
    the Navy and the Marine Corps.
        The President's budget request of $161 billion will maintain our
    commitment to take care of our people, build a strong R&D and
    industrial base, and grow a fleet capable of sustaining our preeminence
    as the world's most formidable expeditionary force. The fiscal year
    2012 request of $15 billion for contingency operations includes
    incremental costs to sustain operations, manpower, equipment and
    infrastructure repair as well as equipment replacement to support our
    operations in Afghanistan and elsewhere.
        The fiscal year 2012 President's budget request includes funds for
    10 Navy battle force ships, including: 2 Virginia-class submarines, 1
    Arleigh Burke-class destroyer, 1 Mobile Landing Platform ship, 1 Joint
    High Speed Vessel, 1 Amphibious Transport Dock Ship, and 4 Littoral
    Combat Ships.
        In aviation, we have requested 223 aircraft in the fiscal year 2012
    baseline budget, including: 13 F-35 Joint Strike Fighters for both the
    Navy and Marine Corps, 24 MH-60R and 11 P-8As to replace the aging
    current ASW and maritime patrol squadrons, 18 MH-60S for logistics
    support, 1 KC-130J, 25 H-1 variant helicopters, 30 MV-22 tilt-rotor
    aircraft, 28 F/A-18E/F fighter/attack planes, 12 E/A-18G to continue
    replacing the veteran EA-6B, 5 E-2D Advanced Hawkeyes, 36 Joint Primary
    Aircraft Trainers for our student aviators, and 20 Unmanned Aircraft.
        The fiscal year 2012 President's budget request also contains
    funding for the Navy Unmanned Combat Aerial System demonstration and
    continues development of the Broad Area Maritime Surveillance (BAMS)
    unmanned system.
        The individual efficiency initiatives the Department has put in
    place will continue to further streamline our organizations and
    operations, will reshape and reduce both capacity and personnel
    associated with the Department's ``tail,'' and will contribute to the
    dramatic transformation already underway in how the Department does its
    business. More importantly, they will sharpen the operating ``tooth,''
    free up critical resources for maintaining and accelerating our
    shipbuilding and aviation acquisition plan, maximize fleet
    capabilities, and help preserve a strong industrial base.
         taking care of sailors, marines, civilians, and their families
        The Navy and Marine Corps have continued to recruit and retain the
    high quality men and women we brought into the Services in the past
    years, and 2010 was no exception. Both the Navy and Marine Corps met or
    exceeded their mission quotas and quality standards.
        We recognize that quality of life programs are important for morale
    and the military mission. We recruit Sailors and Marines, but we retain
    families. We continue to provide a wide array of readiness programs,
    including deployment support services, morale and welfare services, and
    child and teen programs. These award winning career management,
    training, and life-work balance programs are nationally recognized for
    their excellence not only by respected national human resource
    organizations, but even more by the Marines and Sailors that benefit
    directly from them.
        Medical care for our Wounded Warriors, already outstanding,
    continued to get better throughout the year. Since Operations Enduring
    Freedom and Iraqi Freedom began, over 12,000 Marines and Sailors have
    been wounded in action. Their service and sacrifice mandates that we
    provide quality care for those who have given so much for our country.
    Our medical community continues to meet this challenge and make
    advances in dealing with the signature wounds of the current wars:
    traumatic brain injuries, mental health issues, amputation, and
    disfiguring injuries, and Navy Medicine continues to reach out to its
    colleagues in both civilian and Veterans Affairs hospitals to improve
    our understanding and improve overall care for our people.
        But care for our Wounded Warriors does not end in the hospital. We
    have undertaken a commitment to bring our Veterans back into the
    workforce of the Department of the Navy through several Wounded Warrior
    outreach programs and hiring conferences. We are not there yet, but we
    are moving toward the goal of being able to say to every Wounded
    Warrior--if you want a job, we have one for you. As a representative
    example, in the past year alone, the Naval Sea Systems Command hired
    200 Wounded Warriors. In 2011 we will continue to make employment
    opportunities for Wounded Warriors a priority for the Department.
        It is important to note that rising healthcare costs within the
    Military Health System continue to present a fiscal challenge for the
    Department. Like the Secretary of Defense, both I and Departmental
    leadership are particularly concerned that the rate at which healthcare
    costs are increasing and the relative proportion of the Department's
    resources devoted to healthcare cannot be sustained; the Military
    Health System is not immune to the pressure of inflation and market
    forces evident in the civilian healthcare sector.
        The military faces a growing number of eligible beneficiaries,
    expanded benefits, and increased utilization throughout the military
    healthcare system. As a Department, we must be resolute in our
    commitment to implement systemic efficiencies and specific initiatives
    which will improve quality of care and customer satisfaction but will
    at the same time more responsibly manage cost. We have made progress,
    but there is more to do. We concur with the recommendations made by the
    Office of the Secretary of Defense; we must create incentives such as
    the Home Delivery Pharmacy Program and implement modest fee increases,
    where appropriate, to both ensure the fiscal position of the system and
    ensure equity in benefits for our retirees.
        Taking care of Sailors and Marines also means aggressively
    addressing the issues of sexual assault prevention and response. Last
    year, you supported the establishment of a new Office of Sexual Assault
    Prevention and Response (SAPRO) reporting directly to me to focus
    attention on the issue, develop effective training, and coordinate
    prevention and response programs across the Navy and Marine Corps.
    However, it is clear through sexual assault surveys that this crime
    remains a significant problem in the services, and within some
    populations we have seen a negative trend of an increased number of
    assaults. But I can assure you that we are not accepting this trend,
    and we will not rest while any cases of this awful crime continue to
    occur.
        In 2010, the Department moved forward on expanding the
    opportunities for women in the Navy. We established a comprehensive
    plan to integrate women into the submarine force, beginning with our
    ballistic missile and guided missile Ohio-class submarines. This
    summer, the first 21 women officers were selected for nuclear
    training--and they have begun their approximately 15-month training
    pipeline. The first of these officers will get to their boats beginning
    in November 2011.
        We are preparing to move forward with successfully implementing
    congressional guidance with respect to repeal of ``Don't Ask, Don't
    Tell'' in 2011.
        Overall, the fiscal year 2012 budget reflects a carefully crafted
    request for the fiscal support and resources necessary to sustain the
    force in light of the ongoing demands on our people and their families.
    Thank you for your continuing support.
                         energy security and leadership
        Energy consumption in the Navy and Marine Corps has become a
    strategic vulnerability, an operational Achilles' heel, and a readiness
    challenge. This has made our energy usage a national security issue of
    rising importance. As a Department, we rely too much on fossil fuels,
    making our forces susceptible to fluctuations in both price and supply.
    Dramatic shifts in cost and availability can be caused by a host of
    man-made or natural events in volatile areas of the world. Those
    potential shocks could have, in turn, strategic, operational, and
    tactical effects upon our forces. A survey of headlines around the
    world today demonstrates exactly the point we are trying to make--
    energy is first and foremost an issue of national security.
        Without sustainable and reliable sources of energy and increased
    efficiency in our platforms, we may find ourselves paying an exorbitant
    price for operating our fleet, training our aviation and ground forces,
    and running our installations that support them. The ability to train
    and prepare forces for deployment could be curtailed. Worse still, our
    naval forces may find that future adversaries target our operational
    dependence on petroleum, as we see in attacks on fuel convoys in
    Afghanistan today. Our dependence on a fragile fuel distribution
    network increases our footprint, drains resources from the tip of the
    spear to supporting logistics lines, and ties up combat forces for
    security. Thus, energy diversity and efficiency are essential to
    maintain our warfighting capabilities and enhance our combat
    effectiveness.
        This is a topic I have spoken on a great deal, in front of this
    committee last year, around the world in speeches to industry and
    military audiences, and in conversations with international leaders.
    Through these events and discussions, it has become clear that energy
    security is not just an American issue--it is an issue that affects
    both our allies and potential adversaries alike. History has taught us
    that competition for resources has been one of the fundamental causes
    of conflict for centuries, and today, competition for energy still
    provides one of the most inflammatory sources of potential conflict.
        Energy, or more specifically denial of energy, could affect many of
    our NATO partners in Europe and indeed the strength of the alliance
    itself. Many of our partners are dependent upon external sources for
    their energy, so for them--denial of energy is a weapon, one just as
    real as the threat of tanks or airplanes.
        For all these reasons, and in order to improve our long-term
    strategic position and enhance the future operational effectiveness of
    our forces, I have charged the Navy and Marine Corps with accelerating
    the exploration and exploitation of new ways to procure, produce, and
    use energy.
        This effort began in October 2009, when I issued my five energy
    goals for the Department, the most important of which commits the Navy
    and Marine Corps to generate at least 50 percent of all the energy we
    use from alternative sources no later than 2020. Alternative sources
    include all renewable forms of energy such as solar, wind, geothermal,
    and ocean energy, as well as biofuels and nuclear energy.
        We are on track to meet all our goals, and throughout 2010, we
    demonstrated progress through many energy programs, partnerships, and
    initiatives. Throughout the year, we successfully conducted both ground
    and airborne tests of an F/A-18 Hornet and MH-60 Seahawk helicopter,
    and ran a Riverine Command Boat (experimental) on renewable biofuel
    blends made from either camelina or algae. Recently, we also completed
    testing of a marine gas turbine engine that will enable us to certify
    our frigates, destroyers and cruisers for biofuel operations. In each
    case, there was no impact on performance and no degradation to engine
    reliability. Together, these tests represent critical milestones for
    the Department's goal of demonstrating the Great Green Fleet in 2012
    and its planned deployment in 2016. In late 2010, the Navy conducted
    concurrent but unrelated tests of a more efficient F/A-18 engine in
    order to generate an increase in the aircraft's range.
        Afloat, as I discussed last year, the U.S.S. Makin Island is using
    a hybrid-electric drive to dramatically lower its fuel usage at slow
    speeds, which we estimate will generate life-cycle savings of up to
    $250 million at today's fuel prices. Over the next few years, we will
    continue to move forward with installation of a similar system on new
    construction DDGs and look at the feasibility of retrofitting the fleet
    with these systems in the course of routine shipyard availabilities.
        The Marine Corps is also aggressively exploring energy efficiency
    solutions in its operating forces in theater and in the supporting
    establishment. The Marines realize that energy as a resource influences
    a Commander's operational freedom of maneuver, and its conservation and
    wise use can save lives on the battlefield. Reduced logistics support
    and fewer convoys for expeditionary forces would free up resources and
    limit the exposure of Marines to ambush and IEDs. Energy efficiency
    equals better combat effectiveness.
        At home, the Marine Corps demonstrated their traditional spirit of
    innovation by scouring the commercial world for rugged solutions,
    building two Experimental Forward Operating Bases (ExFOB) at Quantico
    and Twentynine Palms. New alternative energy technologies tested at the
    ExFOB deployed this fall with the Third Battalion, Fifth Marines (3/5),
    posted to Sangin District in the north of Helmand Province. Immediately
    upon arrival, they began evaluating expeditionary solar power
    generators at their forward operating bases and combat outposts to
    supplement or replace fossil fuels. They have done this even while
    engaged in near constant combat against a determined enemy in one of
    the most hotly contested districts of the war.
        When I visited Sangin, I heard first-hand from a Marine First
    Lieutenant about what worked, what did not, and how his Marines in
    India Company of 3/5 were using the equipment. Two patrol bases are
    operating entirely on renewable energy, and another with a 90 percent
    reduction. One of the team-portable systems, called GREENS (Ground
    Renewable Expeditionary Energy Network System), is being used to
    provide power for the Operations Center, small radios, and small
    electronic equipment. And across the battalion's operating area, man-
    portable SPACES (Solar Portable Alternative Communications Energy
    System) are being used by individual squads to recharge their radios
    and other combat electronics. This capability made it possible for a
    foot patrol to operate for 3 weeks without battery resupply, reducing
    their burden by 700 pounds and saving more than $40,000.
        By deploying these renewable solar energy technologies the Marines
    in Sangin have been able to expand their operational reach, eliminate
    or minimize their need for fossil fuels in their generators, and
    dramatically reduce the need for often dangerous logistic support.
        At Camp Leatherneck, the Marines have likewise begun a small bio-
    fuel pilot project for Helmand Province, purchasing locally produced
    cotton oil from an Afghan facility to mix with their own fuel. At
    Leatherneck, a standard generator is producing power from a 20-80 mix
    of cotton oil to fuel, yielding a 20 percent reduction in demand for
    fuel, while simultaneously demonstrating to Afghan farmers that there
    are alternatives to opium, and demonstrating to Afghan leaders that
    they can power their own economy from within Afghanistan. I am
    monitoring its progress closely.
        As the ExFOB gets all this feedback from returning Marines, our
    expeditionary energy systems and programs will continue to improve and
    we will move even further down the road of energy efficient, combat
    effective forces.
        In addition to these tactical and platform applications, we have
    implemented a number of energy projects at our facilities ashore. We
    are actively exploring for new geothermal resources to augment our
    existing 270 MW geothermal powerplant at China Lake. Last year we
    established the Nation's first grid-connected wave buoy at MCB Kaneohe
    Bay, Hawaii. Last December the Marines completed a 1.5 MW solar
    installation situated atop six acres of a landfill. The installation
    was unique because the equipment foundations were designed not to
    perforate the membrane covering the garbage below. Our budget request
    asks for continued support of these and similar projects in order to
    enhance our efficiency and maximize our move to greater independence
    and more resilient infrastructure.
        And finally, throughout the year we developed partnerships with a
    number of Federal agencies, States, academic institutions, and industry
    partners including the Departments of Energy and Agriculture, NASA, and
    the Small Business Administration.
        It is precisely because of the spirit of innovation that these
    partnerships embody that our Nation remains a world leader in its
    unrivaled capacity to stimulate and exploit cutting-edge ideas and new
    technologies. The U.S. Navy has always been a technological leader and
    has excelled at embracing change, particularly in propulsion systems
    and energy sources. We moved from wind to coal in the 19th century,
    from coal to oil early in the 20th century, and added nuclear power 60
    years ago. In every transition there were opponents to change, but in
    every case these changes increased our combat effectiveness by an order
    of magnitude.
        I have tasked the Navy and the Marine Corps to once again pioneer
    technological change through alternative energy sources. I am pleased
    with the progress to date, and expect it to sharply enhance the long-
    term strategic agility of our operating forces, as well as better
    posture the Department for an age of fiscal austerity and potential
    energy volatility. I want to stress, however, that every action and
    program we undertake is focused on generating improved warfighting
    capability and strategic flexibility, it is not just change for
    change's sake.
                        creating acquisition excellence
        Our future combat readiness is dependent upon the design,
    development and acquisition of weapons, platforms, and information
    technology. The current ships and aircraft of the Navy and Marine Corps
    provide decisive advantages over today's threats. But that edge must be
    constantly sharpened and modernized against constantly evolving
    technologies. We must continue to invest in intelligence, precision
    missiles and munitions, networked command systems, stealth technology,
    unmanned vehicles and ground fighting systems. To retain our advantage
    across multiple warfighting areas, we rely heavily upon both our
    dedicated personnel and the expertise resident in America's private
    sector. Throughout my tenure, I have taken the opportunity to visit
    shipyards, aircraft plants, vehicle factories, maintenance facilities,
    and warfare centers for detailed briefings and a firsthand look at the
    people responsible for designing and building our fleet and equipping
    our Sailors and Marines with vital weapon systems and technologies
    necessary to do their jobs. One cannot fail to recognize the
    creativity, dedication, and skills of our Nation's workforce.
        Yet, with Government spending increasingly constrained,
    affordability, cost containment and total ownership costs are more
    important than ever. Because acquisition costs are rising faster than
    our top-line and because replacement systems can be more expensive than
    the platforms or weapon systems being replaced, we are putting
    tomorrow's force at risk.
        Both on our own and as a result of Secretary Gates' guidance, the
    Department has devoted considerable effort to finding efficiencies,
    reducing support costs, and scrubbing our acquisition process to
    mitigate this impact. In accordance with the Weapons System Acquisition
    Reform Act passed by Congress in 2009, we have made the requirements
    and acquisition processes more rigorous in order to better manage the
    resources entrusted to us by the American taxpayer, and we are working
    with OSD to develop a streamlined process for acquiring information
    technology in a more responsive manner to better equip the warfighter
    with emerging technologies and ward off the cyber threat.
        This requires constant examination of every single one of our
    policies, practices, priorities, and organizations, with a clear focus
    on controlling cost. Our acquisition community has been extensively
    engaged with industry and the Services to streamline processes, and
    they are ruthlessly evaluating both requirements and the supporting
    analyses in order to get more value out of the overall acquisition
    system.
        The Navy and Marine Corps will continue initiatives already in
    place to improve processes and to instill discipline in procurement. In
    2010, we strengthened our cost estimating group and met statutory
    requirements to obtain independent cost estimates, and we have
    incorporated Defense-wide best practices in the formulation of all our
    major programs. We have made our cost estimates more realistic and are
    using these improved cost and schedule plans to make necessary
    capability tradeoffs and difficult investment decisions at the front
    end of the requirements process rather than during design or
    construction.
        A professional acquisition workforce is a key element in our
    overall acquisition excellence initiative and a driver in our strategy
    to preserve our fighting edge at an affordable cost. Accordingly, and
    with your strong support, we are rebuilding the acquisition workforce
    within Government to fulfill Federal oversight of the acquisition
    process and ensure that accountability to taxpayers is the foremost
    concern of our employees. In the last year, the Department has added
    nearly 1,300 acquisition professionals toward the goal of increasing
    the community by 5,090 over the FYDP.
        Our acquisition strategies have been shaped to expand the use of
    fixed price contracts, leverage competition, and tighten up on the use
    of incentive and award fees to ensure quality systems are consistently
    delivered on budget and on schedule. The new acquisition plan for the
    Littoral Combat ship epitomizes this strategy, and is indicative of the
    type of fixed price contracts that will be the model for the future.
    The LCS block-buy contracts are the result of effective competition and
    give the Government full ownership of the technical data package used
    in construction. This will ensure our ability to pursue competitive
    strategies for LCS Seaframe requirements in fiscal year 2016 and beyond
    and affords greater congressional oversight of the program. With the
    new LCS strategy, we get more ships, at a faster rate, and at less
    cost.
        The LCS dual-block procurement strategy also contributes to meeting
    another acquisition goal of both this committee and the Navy through
    its strong support of the industrial shipbuilding base. Modernizing
    today's force and recapitalizing the fleet affordably cannot be
    accomplished without a healthy industrial base and strong performance
    by our industry partners. We have worked hard to procure our ships,
    aircraft, and weapon systems at a rate intended to bring stability to
    the industrial base and enable efficient production. The Navy's
    shipbuilding and aviation plans were developed with particular regard
    to maintaining the unique characteristics and strength of the
    industrial base and our efforts have promoted increased competition,
    greater innovation, and better capacity within the base.
        Over the FYDP, we will continue to build upon our progress to date
    and we will work with our shipyards, aircraft manufacturers, weapon
    systems providers and systems integrators to build the best possible
    fleet for the future.
                 development and deployment of unmanned systems
        The complex nature of today's security environment, as well as
    current and future anti-access/area-denial threats faced by the United
    States, require that the Navy and Marine Corps continue to advance in
    unmanned systems and exploit the contributions they make to warfighting
    capability. Unmanned systems are unobtrusive, versatile, persistent,
    and they reduce the exposure of our Sailors and Marines to unnecessary
    threats or dangerous environments. They can perform a vast array of
    tasks such as intelligence, surveillance and reconnaissance,
    hydrographic monitoring, mine detection, targeting, and precision
    strike.
        Navy and Marine Corps unmanned systems have already made key
    contributions to operations in Iraq and Afghanistan. In Operation Iraqi
    Freedom and Operation Enduring Freedom, unmanned aircraft systems have
    flown thousands of flight hours, enhancing the effectiveness of our
    combat operations and undoubtedly saving lives. Unmanned ground
    vehicles employed by the Marine Corps have conducted thousands of
    missions detecting and/or neutralizing improvised explosive devices.
    And off the Horn of Africa, unmanned systems contribute to surveillance
    and tracking of suspected or confirmed pirate vessels.
        The range of tasks that these capabilities may fulfill will grow
    substantially over time. I am determined to ensure that your Navy and
    Marine Corps are at the cutting edge of this military capability.
        Our vision for the future will exploit unmanned systems in every
    domain of our operating environment (sea, air, and land) while
    maintaining an affordable price. The Department's Unmanned Systems will
    move from adjunct capabilities supporting manned systems and platforms
    to providing autonomous, networked, and interoperable independent
    capabilities--much as naval aviation matured from an adjunct to the
    Battle Fleet to a combat capability in its own right in the first half
    of the 20th century.
        We will field unmanned systems in the near term to:
      --Provide sensing, influence and effects where manned systems are
            limited by range, endurance or risk.
      --Shift from relying primarily on manned platforms to accomplish
            missions to combinations of manned platforms, robots, augmented
            human performance, and remotely operated and unmanned systems
            that make operational sense.
      --Increase the combat effectiveness of Sailors and Marines, their
            platforms and combat organizations to better operate against
            multiple types of threats.
        In implementing this vision, we will embrace Unmanned Systems as
    critical tools in our warfighting quiver of capabilities. We will
    integrate them into everything we do across the full range of military
    operations to enhance our combat effectiveness and efficiency. And we
    will invest in the infrastructure to ensure we have the capabilities
    and capacity to properly task, collect, process, exploit and
    disseminate the information so the intelligence data gets to the
    decisionmakers and warfighters. The initiatives and investments
    contained in the fiscal year 2012 budget request will continue moving
    us along this desired track. I look forward to reporting our progress
    toward this vision throughout the year.
                                   conclusion
        Today I have laid out our strategic posture as well as the goals
    and priorities that guide the Department's investment portfolio and
    future direction. These goals and programs will significantly influence
    our future capabilities and ensure we remain ready to deter regional
    conflict or respond rapidly and decisively to emerging crises. Our
    specific requests are reflected in the President's fiscal year 2012
    budget submission.
        In order to retain a ready and agile force capable of conducting
    the full range of military operations, we must carefully weigh risks
    and apply our available resources efficiently and carefully. This
    year's request reflects our strategy-driven priorities and the
    disciplined trade-offs that you and the American taxpayer expect of us.
    The Department's efficiency efforts have been beneficial in terms of
    enhancing our ability to invest in the future even while preserving and
    extending our force structure.
        This is not a one-time event, as we will continuously work to
    increase efficiencies in every project, program, and operation, afloat
    and ashore. The budget request ensures that we will retain the world's
    most powerful and agile expeditionary force. The CNO, Commandant, and
    myself are committed to that aim and to being effective stewards of the
    Nation's resources.
        As Secretary, I have seen firsthand the selfless courage of our
    young Marines and Sailors in Helmand; the dedication of our medical
    community caring for our wounded; the professionalism of our surface,
    submarine and aviation Sailors; and the incredible technical skills of
    the maintenance crews that sustain them. I have also borne witness to
    the sacrifices of our personnel in hospitals in theater and at the
    National Naval Medical Center. A single visit to Bethesda will make you
    marvel at the resilience of the human spirit and the unflagging
    patriotism of our American service men and women.
        Your Navy and Marine Corps are performing at a high operational
    tempo, at unparalleled levels of skill and dedication, and with
    remarkable results afloat, at depth, aloft, in cyberspace, and ashore.
    Thanks to your support, this level of performance has been sustained
    with the modern platforms, weapons systems, and training necessary to
    underwrite our readiness. Your continued support recognizes and
    sustains the sacrifice of our Sailors, Marines, civilians and their
    families. The support of this committee for our key programs and our
    people has been instrumental to operational success of the Navy and
    Marine Corps and maintenance of the world's most flexible instrument of
    national policy--a modernized and ready naval expeditionary force.
        It is a solemn privilege to lead the Naval Services during an era
    of protracted war and national challenge. I have been honored by the
    trust the President and Congress have placed in me, and even more
    honored by the sacrifice and sterling devotion I have witnessed by
    those Sailors and Marine who go forward into harm's way to defend us.
    Preserving our values and our way of life is ultimately dependent upon
    our being prepared to use decisive force against those who threaten
    them. The Navy and Marines have been ready to do so for 235 years, and
    will continue to be ready. You can count on it.
        Thank you again for your support. Godspeed.

        Chairman Inouye. And now, may I call upon the Chief of
    Naval Operations (CNO), Admiral Roughead.
    STATEMENT OF ADMIRAL GARY ROUGHEAD, CHIEF OF NAVAL
                OPERATIONS, UNITED STATES NAVY
        Admiral Roughead. Thank you very much, Mr.
    Chairman.Chairman Inouye, Vice Chairman Cochran, and members of
    the subcommittee, it's my honor to appear before you in my
    fourth year as the Chief of Naval Operations, representing more
    than 600,000 sailors, Navy civilians, and families who operate
    and live globally. I appreciate your continued support for them
    as they continue to carry out our maritime strategy.
        I echo the Secretary's comments in extending our
    condolences to the people of Japan, with whom we enjoy a very
    unique relationship with our forward-deployed naval forces
    assigned there.
        Our Navy continues to meet operational commitments and
    respond to crises as they emerge. We're engaged in Afghanistan
    and in Iraq, with about 14,000 sailors on the ground in those
    countries, and another 14,000 at sea in the region. From our
    aircraft carriers there, we fly about 30 percent of the fixed-
    wing aircraft sorties over Afghanistan.
        Our presence in the Middle East also gave us the
    flexibility to respond to the events that we see taking place
    there and elsewhere. We have elements of the Kearsarge
    amphibious ready group, with the 26 MEU, in the waters off of
    Libya, and several destroyers and submarines in the
    Mediterranean, available for tasking, as required.
        But, our interests extend beyond the Middle East, and so do
    our operations. Today, we have about 70,000 sailors deployed
    globally, with 40 percent of our ships, aircraft, and
    submarines deployed, as well. They're globally present,
    persistently engaged.
        We provide deterrence in Northeast Asia and forward
    presence in the western Pacific, which has enabled our swift
    response to the natural disaster in Japan, and our good friends
    and allies there. The ships of the USS Ronald Reagan carrier
    strike group remain underway off the east coast of Honshu, with
    significant fixed-wing and helicopter assets supporting search-
    and-rescue and humanitarian assistance. At least five more
    ships will soon arrive from exercises in Southeast Asia. These
    include ships from the USS Essex amphibious ready group, which
    has the 31st MEU embarked, and which will bring additional
    humanitarian aid, advanced medical capability, and seaborne
    lift support to the Japanese Government.
        We continue our counterpiracy efforts in the Indian Ocean,
    and we continue to build maritime partnerships in Africa and
    South America and throughout the Pacific.
        These operations represent part of the growing demand for
    the offshore option that our Navy and Marine Corps team
    provides the Nation. We assume the lead for the first phase of
    ballistic missile defense of Europe, and are working with the
    Missile Defense Agency on providing that same capability
    ashore. We created the new Information Dominance Directorate,
    on my staff, which has enabled us to make better decisions and
    investments in countering the anti-access and area-denial
    strategies that we see in the world today. We recently
    established the U.S. 10th Fleet, our cyberfleet, which has
    demonstrated its expertise by conducting joint and naval
    operations in cybernetwork, cryptology, and space arenas.
        To deliver the above, we've been pushing the fleet hard. We
    have 288 ships today. It is the smallest fleet since 1916, when
    our interests and responsibilities were nowhere near what they
    are today. And that's why 313 ships remains the floor of our
    future force, and why sustaining fleet capacity is essential to
    reaching that floor.
        Since I became CNO, I've focused on ensuring that the Navy
    is ready, that our quality of work and quality of life are
    fulfilling to the men and women of our Navy, and that we place
    underperforming programs back on track. We have introduced
    stability, affordability, and capacity into our shipbuilding
    and aviation plans, and, with the assistance of Congress, we've
    advanced capabilities to meet the most likely evolving threats.
    We've secured a fixed-price dual award for 20 littoral combat
    ships, as the Secretary has mentioned. We've addressed our
    strike fighter capacity with a multiyear F/A-18 procurement.
    And pending a decision on the continuing resolution, we will
    build two Virginia-class submarines a year, another DDG-51,
    start the mobile landing platform, construct and refuel our
    aircraft carriers as planned, and continue the design of our
    replacement strategic submarine.
        I'm pleased with our accomplishments to date, and I thank
    Congress for their continued support of our acquisition
    strategy. Our fiscal year 2012 budget request is a balanced
    approach to increasing fleet capacity, maintaining warfighting
    readiness, and developing and enhancing our Navy total force.
    This budget goes beyond ships and aircraft. It enhances
    electronic warfare, information dominance, integrated air and
    missile defense, and antisubmarine warfare capabilities for
    evolving challenges. It continues to develop a family of
    unmanned systems that will work in concert with our manned
    systems to secure access and establish maritime superiority
    where and when we choose. It continues our effort, over the
    last 2 years, to reduce total ownership costs, and leverages
    the opportunity presented by the Secretary of Defense's
    efficiencies to reduce excess overhead, improve readiness, and
    reinvest in warfighting capability and capacity that improves
    the long-term sustainability of our force.
        Importantly, it supports the Secretary of Defense's
    healthcare initiatives, included in the President's budget,
    which continues our efforts to improve healthcare, improve
    internal efficiency, incentivize behavior, and ensure all our
    beneficiaries are treated equitably, and enhance our ability to
    deliver high-quality healthcare for years to come.
        You can be exceptionally proud of our sailors and our Navy
    civilians, who they are and what they do. Today's sailors are
    the best with whom I have ever served.

                               PREPARED STATEMENT

        I ask for your strong support of our fiscal year 2012
    budget. And I thank you for all that you do to support the men
    and women of the United States Navy, our enduring global force
    for good.
        Thank you very much.
        Chairman Inouye. All right. Thank you very much, Admiral.
         [The statement follows:]
                  Prepared Statement of Admiral Gary Roughead
        Chairman Inouye, Vice Chairman Cochran, and members of the
    Committee, it is my honor and pleasure to appear before you, in my
    fourth year as CNO, representing the more than 600,000 Sailors and
    civilians of the United States Navy. As we have done for more than 235
    years, our Navy is forward-deployed around the world protecting our
    national security and prosperity. Today, our dedicated Navy men and
    women are operating globally at sea, on land, in the air, and in space
    and cyberspace. I appreciate your continued support for them and their
    families.
        As the demand for our Navy continues to grow, our Maritime
    Strategy, which I issued more than 3 years ago with the Commandants of
    the Marine Corps and the Coast Guard, continues to guide our Navy's
    operations and investments. Its core tenets are enduring and our Navy
    is executing daily the six core capabilities it articulates for our sea
    Services: forward presence, deterrence, sea control, power projection,
    maritime security, and humanitarian assistance and disaster response.
        With your support, since becoming CNO, our Navy has placed
    underperforming programs back on track; we have introduced stability,
    affordability, and capacity into our shipbuilding and aviation plans;
    and we have advanced capabilities to meet the most likely evolving
    threats. We improved the performance of several programs, most notably
    the Littoral Combat Ship. After cancelling the LCS ships we had planned
    for 2007 because of unacceptable costs, last year we were able to
    secure a price for 20 ships through a dual award strategy that will add
    new and needed capabilities to our Fleet, bring important stability to
    the industrial base, and get us closer to the minimum of 313 ships our
    Navy needs. I thank Congress for their support of this strategy. We
    delivered five new ships in 2010, including one Virginia class
    submarine, two Arleigh Burke Destroyers, and two T-AKE logistics ships.
    We commenced testing and low rate initial production of the P-8A
    Poseidon Multi-Mission Maritime Aircraft and continued testing and low
    rate initial production of the E-2D Advanced Hawkeye. Through multi-
    year procurement contracts for F/A-18E/F and EA-18G, and Virginia class
    submarines, and planned multi-year procurements for the MH-60R/S and E-
    2D, we are introducing affordability in our aviation and shipbuilding
    plans and realizing significant savings. For example, on the Virginia
    class multi-year procurement alone, the savings has been $3.2 billion.
    We are advancing capability to meet emerging threats, particularly in
    Ballistic Missile Defense (BMD) and information dominance. In BMD, we
    assumed lead for the first phase of the President's Phased Adaptive
    Approach (PAA) for BMD of Europe and we are working with the Missile
    Defense Agency on providing Aegis Ashore capability to support the
    second phase of the PAA. Our newly established Fleet Cyber Command/U.S.
    Tenth Fleet demonstrated its expertise conducting joint and naval
    exercises and operations in the cyber, network, cryptology, signals
    intelligence, information warfare, electronic warfare, and space
    arenas. We also achieved the early operational deployment of the MQ-8B
    Fire Scout Vertical Takeoff and Landing Tactical Unmanned Air Vehicle,
    the first successful flight of our Navy Unmanned Combat Air System
    demonstrator, and a memorandum of agreement with the Air Force to
    pursue increased commonality between the Global Hawk and Broad Area
    Maritime Surveillance programs.
        Our Navy continues to meet planned operational commitments and
    respond to crises as they emerge globally. We remain engaged in
    operations in Afghanistan and in Iraq. Our Navy has more than 14,000
    active and reserve Sailors on the ground and another 10,000 at sea in
    Central Command, including ongoing Individual Augmentee support to both
    operations. Our aircraft carriers provide about 30 percent of the close
    air support for troops on the ground in Afghanistan and our Navy and
    Marine Corps pilots fly an even greater percentage of electronic attack
    missions there.
        Because our national interests extend beyond Iraq and Afghanistan,
    so do the operations of our Navy. More than 40 percent of our Navy is
    underway daily; globally present and persistently engaged. Last year,
    our Navy provided deterrence against North Korea; conducted counter-
    piracy operations in the Indian Ocean with a coalition of several
    nations; trained local forces in maritime security as part of our
    Global Maritime Partnership initiatives in Africa and the Pacific;
    responded with humanitarian assistance and disaster relief to the
    earthquake in Haiti and the flood in Pakistan; and conducted the
    world's largest maritime exercise, which brought together 14 nations
    and more than 20,000 military personnel, to improve coordination and
    trust in multi-national operations in the Pacific. Navy sealift
    continues to deliver the lion's share of heavy war and humanitarian
    equipment in the Central Command and Pacific Command areas of
    responsibility, while Navy logisticians operate the seaport and airport
    facilities that ensure this vital materiel arrives on time. Our Sailors
    remain forward throughout the world, projecting U.S. influence,
    responding to contingencies, and building international relationships
    that enable the safe, secure, and free flow of commerce that underpins
    our economic prosperity.
        Our Navy's global presence guarantees our access and freedom of
    action on and under the sea. We are developing with the Air Force and
    Marine Corps the Air Sea Battle concept that will identify the
    doctrine, organization, training, procedures, and equipment needed for
    our Navy to counter growing military threats to our freedom of action.
    This joint effort will inform the conceptual, institutional, and
    material actions needed to employ integrated forces that support U.S.
    operations to project power and influence, protect allies and partners,
    and secure our national objectives in peace and war.
        I remain committed to supporting our active and reserve Sailors,
    Navy civilians, and their families. Our Navy continues to be recognized
    as a highly ranked place to work as a result of its workforce planning,
    life-work integration, diversity, and training opportunities. We met or
    exceeded overall officer and enlisted active recruiting goals last year
    and we are accessing a force of extreme high quality. We continue to
    move forward on assigning women into our submarine force, with the
    first women submariners on track to report aboard SSBNs and SSGNs by
    the end of this year. We remain committed to performance as a criterion
    for promotion in our Navy, and have successfully transitioned the
    majority of our civilian personnel out of the National Security
    Personnel System (NSPS). Our remaining NSPS employees are scheduled to
    convert by the end of this year. I appreciate the support of Congress
    for our Fleet and the dedicated Sailors, Navy civilians, and their
    families that serve our nation every day.
        My priorities for the Navy remain unchanged: to build tomorrow's
    Navy, to remain ready to fight today, and to develop and support our
    Sailors, Navy civilians, and their families. We continue to advance our
    Navy in each of these areas thanks to your support.
        Our Navy remains the most capable maritime force in the world;
    however, we are stretching our force to meet Combatant Commander
    demands. Since 2000, our Navy's ship-underway days have increased by
    approximately 15 percent, yet we have about 10 percent fewer ships in
    our Fleet. Greater demand for our forces has led to longer deployments
    and shorter dwell, or turnaround times, which increase stress on our
    Sailors and drive up maintenance requirements for our ships and
    aircraft. We are implementing force management measures in the near
    term to stretch the capacity of our 286-ship force to meet increasing
    global requirements while providing the necessary maintenance our Fleet
    needs to reach its expected service life. Our Navy is different from
    other Services in that we reset our force ``in stride''; that is, we
    rely upon regular maintenance of our ships and aircraft, and training
    and certification of our crews between deployments, to sustain our
    force. I thank Congress for their support of our fiscal year 2011
    Operations and Maintenance (O&M) request, which would enable our Navy's
    continuous reset and translate into decades of service for each ship
    and aircraft, a significant return on investment.
        Regrettably, the continuing resolution (CR) for fiscal year 2011
    prevents us from applying the increased fiscal year 2011 O&M funding to
    improve our readiness, and it negatively impacts our ability to procure
    our future Navy and support our Sailors, Navy civilians, and their
    families. It has forced us to take mitigation measures that include:
    reducing operations, limiting numerous contracts for base operating
    support, slowing civilian hiring, reducing Permanent Change of Station
    notifications for our Sailors from about 6 months lead time to less
    than 2 months, not initiating the Small Business Innovative Research
    program, and delaying procurement contracts for new capabilities and
    existing production lines. Starting this month, we will cancel or scale
    back ship maintenance availabilities in Norfolk, Mayport, and San
    Diego, and cancel more than a dozen Milcon projects in several States.
    If the CR lasts all year, we will have no choice but to make permanent
    these mitigations and others, significantly reducing our operations,
    maintenance, and training. We will be forced to further reduce
    facilities sustainment, cancel training events and additional surface
    ship availabilities, and defer maintenance on our aircraft, which would
    result in almost a 1-year backlog in aviation maintenance. The impact
    of these actions will jeopardize the efforts we made in recent years to
    restore Fleet readiness. Without relief, we will procure only one
    Virginia class submarine and break the multiyear contract. Agreements
    made with our surface combatant builders, as a result of the DDG 1000/
    DDG 51 swap, precludes us from awarding any DDG 51s in fiscal year 2011
    unless both ships are appropriated. In addition, without relief, we
    will delay the new start Mobile Landing Platform; we will constrain
    aircraft carrier construction and refueling, negatively impacting
    operational availability, increasing costs, and delaying CVN 79
    delivery by up to 1 year; and we will limit aviation and weapons
    procurement to fiscal year 2010 quantities, impacting E-2D and Standard
    Missile production. A full-year continuing resolution will also defer
    essential research and development in unmanned aerial systems and
    significantly delay the design of our replacement strategic deterrent
    submarine and the recapitalization of our nuclear operator training
    infrastructure. It will eliminate our ability to source out-of-cycle
    overseas contingency operations demands for increased Fleet presence
    and activated Navy Reserve Sailors. Operating under a continuing
    resolution for a full year at the fiscal year 2010 level would have
    negative effects on our Fleet, on the ship and aviation industrial
    base, and on the many workers who support naval facilities. Your
    support in addressing this critical current and long term readiness
    issue is appreciated greatly.
        Our fiscal year 2012 budget submission achieves the optimal balance
    among my priorities, but it is based on our funding request for fiscal
    year 2011. If the CR lasts all year, we will need to revisit our fiscal
    year 2012 request to properly balance our Navy for today and in the
    future. Our fiscal year 2012 budget request continues to rely on a
    combination of base budget and overseas contingency operations (OCO)
    funding, but it reduces the extent to which we rely on OCO funding for
    enduring missions. Our fiscal year 2012 request continues the effort we
    started 2 years ago to reduce the cost to own and operate our Fleet. We
    leveraged the opportunity presented by the Secretary of Defense to
    significantly reduce excess overhead costs, and apply the savings to
    warfighting capability and capacity, by executing a deliberate,
    thoughtful, and integrated approach to finding efficiencies that
    improve the long-term sustainability of our force. We are taking steps
    to buy smarter, streamline our organizations and operations, realign
    manpower, and pursue energy efficiencies. Through these efforts, and
    with your support, we will improve readiness and warfighting
    capabilities and optimize organizations and operations, including
    increasing the number of ships and aircraft in our procurement plans
    and enhancing or accelerating anti-access capabilities, unmanned
    systems, and energy initiatives.
        Our fiscal year 2012 budget request supports our Maritime Strategy
    and continues to support our forces, take care of our people, rebalance
    our force to meet current and future challenges, and reform how and
    what we buy. Highlights follow.
                             build tomorrow's navy
        Since the release of our Maritime Strategy, I have stated our Navy
    requires a minimum of 313 ships to meet operational requirements
    globally. This minimum remains valid; however, we continue to examine
    this requirement to address increased operational demands and expanding
    requirements for ballistic missile defense, intra-theater lift, and
    forces capable of confronting irregular challenges. Our fiscal year
    2012 submission funds 10 ships, including two Virginia class fast
    attack submarines, one Joint High Speed Vessel (JHSV), one LPD 17, one
    Mobile Landing Platform (MLP), one DDG 51, and four Littoral Combat
    Ships (LCS), which reflects our new LCS procurement plan under the dual
    award strategy. Our submission also supports the acquisition of an
    oceanographic ship. I thank Congress for their support of our LCS
    acquisition strategy and for our shipbuilding program. With your
    support over the last 3 years, we have been able to improve the balance
    among capability, capacity, affordability, and executabilty in our
    shipbuilding plan.
        As I reported last year, I remain concerned about the capacity of
    our Fleet in the future. Starting in the 2020s, many of our existing
    cruisers, destroyers, and submarines will reach the end of their
    service lives. During this period, it will be particularly critical to
    procure sufficient new ships to offset these decommissionings to avoid
    a rapid decline in force structure. In the same timeframe, we will
    begin to procure the replacement for our Ohio class ballistic missile
    submarine, the most survivable leg of our Nation's nuclear deterrent
    triad. While we have reduced the cost of that submarine substantially,
    our total shipbuilding budget will be pressurized in that decade as we
    seek to recapitalize our surface and submarine forces while sustaining
    warfighting readiness and supporting our people. I am confident our
    near-term force structure plans provide the capability and capacity we
    need to meet demands today, but in this decade we must address how to
    best resource the shipbuilding programs required in the 2020s.
        Our fiscal year 2012 program funds 203 manned aircraft. We have
    increased our procurement of P-8A Poseidon Maritime Patrol Aircraft to
    provide needed anti-submarine warfare capacity to our Fleet and
    facilitate a successful transition from our legacy P-3 Orion aircraft.
    Our fiscal year 2012 submission also procures 28 F/A-18 E/F aircraft,
    extending the F/A-18 procurement through fiscal year 2014 and
    purchasing 41 more aircraft than requested in last year's budget
    submission. I remain committed to the F-35 Joint Strike Fighter, and
    was pleased to see the first flight of the F-35C last year. The timely
    delivery of the F-35C remains critical to our future carrier airwing
    strike fighter capacity; however, we are procuring additional F/A-18
    Super Hornets to address the decrease in strike fighter capacity we
    have identified. I thank Congress for their continued support of the F-
    35 program and our overall strike fighter fleet.
        Our Navy is also looking beyond our ships and aircraft and
    investing in information capabilities that span space, cyberspace, and
    the electromagnetic spectrum. We moved boldly last year with the
    establishment of U.S. Tenth Fleet and the Deputy CNO for Information
    Dominance. That restructuring has enabled us to focus on enhancing our
    electronic warfare, information dominance, integrated air and missile
    defense, and anti-submarine warfare capabilities. I request Congress'
    support for these programs as they position our Navy to successfully
    conduct operations in an evolving anti-access environment today and in
    the future.
        A viable, highly technical, and specialized industrial base is
    essential to sustaining the capability and capacity of our future Navy.
    Our shipbuilding and aviation industrial base is a strategic national
    asset and a significant contributor to our Nation's economic
    prosperity, employing more than 97,000 uniquely skilled Americans while
    indirectly supporting thousands more through second and third tier
    suppliers. The highly specialized skills in our shipbuilding base take
    years to develop; and, if lost, cannot be easily or quickly
    reconstituted. A viable shipbuilding industrial base, underpinned by
    predictable, level-loaded ship procurement, is essential to meet our
    nation's naval requirements.
        I remain committed to delivering a balanced and capable Fleet that
    will meet our national security requirements. I seek your support for
    the following initiatives and programs:
                               aviation programs
    Aircraft Carrier Force Structure
        Our nuclear-powered aircraft carrier fleet is capable of flexibly
    employing capabilities that span from power projection and deterrence
    to humanitarian assistance and disaster response. Our 11-carrier force
    structure is based on worldwide presence and surge requirements, while
    also taking into account training and maintenance requirements. Our
    Navy has put in place measures to minimize the impact of the 10-carrier
    period between the inactivation of U.S.S. Enterprise (CVN 65) and
    commissioning of U.S.S. Gerald R. Ford (CVN 78). After the delivery of
    CVN 78, we will maintain an 11-carrier force by continuing the
    refueling program for Nimitz class ships and delivering our Ford class
    carriers at 5-year intervals starting in 2020.
        CVN 78, which is approximately 20 percent complete, is the lead
    ship of our first new class of aircraft carriers in nearly 40 years.
    These new carriers incorporate an innovative flight deck design that
    provides greater operational flexibility, a nuclear propulsion plant
    that generates more than 50 percent greater energy while decreasing
    maintenance requirements, and a combination of measures that reduce
    manning by more than 1,200 Sailors. Among the new technologies being
    integrated in these ships are the Dual Band Radar, the Electromagnetic
    Aircraft Launch System (EMALS), and the Advanced Arresting Gear (AAG),
    which will enable the carrier to increase its sortie generation rate by
    25 percent and lower total ownership costs. AAG is currently undergoing
    commissioning testing at our land-based testing facility and, in
    December, EMALS successfully launched an F/A-18 aircraft. Both systems
    are on schedule to support delivery of CVN 78 in September 2015.
    Strike Fighter Capacity
        I remain committed to the F-35 Joint Strike Fighter (JSF) program.
    The timely delivery of the F-35C carrier variant is critical to our
    future carrier airwing strike fighter capability and capacity. As a
    result of delays in the F-35 program, we are closely managing our
    strike fighter inventory to address the decrease in strike fighter
    capacity that is projected to peak in 2018 as our F/A-18A-D aircraft
    reach the end of their service life. Our actions include managing the
    service life of our A-D aircraft, extending the service life of our A-D
    aircraft, buying new F/A-18E/F Super Hornet aircraft, and maintaining
    wholeness in the F-35C program. With these measures, we can manage our
    current strike fighter inventory to meet TACAIR requirements.
                F-35 Lightning II Joint Strike Fighter (JSF)
        The F-35 program gives us the advanced sensor, precision strike,
    firepower, and stealth capabilities our Fleet needs. I continue to base
    our Initial Operating Capability (IOC) timeline for the F-35C on the
    level of capability delivered at the completion of Initial Operational
    Test and Evaluation of the F-35C equipped with Block 3 software. We are
    reviewing the results of the in-depth Technical Baseline Review and
    restructuring of the System Development and Demonstration (SDD) phase
    to determine our IOC. While the overall system demonstration and
    development schedule has slipped, we have not reduced the total number
    of airplanes we plan to buy. Our fiscal year 2012 request procures
    seven F-35C aircraft. We are monitoring the program closely and
    managing our existing strike fighter capacity to meet power projection
    demands until the F-35C is delivered. Procurement of an alternate
    engine for the F-35 increases our risk in this program. The Navy does
    not have a requirement for an alternate engine; indeed, we would only
    take one model to sea. Its additional costs threaten our ability to
    fund currently planned aircraft procurement quantities, which would
    exacerbate our anticipated decrease in strike fighter capacity
    throughout the remainder of this decade.
                F/A-18A-D Hornet and F/A-18E/F Super Hornet
        Our F/A-18A-D Hornet aircraft were originally designed for a
    service life of 6,000 flight hours. Through a life assessment program
    and High Flight Hour (HFH) inspections, which have been in place for 3
    years, we have been able to extend the service life of our legacy F/A-
    18A-D aircraft to 8,600 flight hours. Our fiscal year 2012 budget
    requests funding to pursue a Service Life Extension Program (SLEP) for
    150 F/A-18A-D aircraft, commencing in fiscal year 2012 at a rate of
    about 40 per year, that would further extend the service life of these
    aircraft to 10,000 flight hours. We are also conducting a life
    assessment program for our Super Hornet aircraft to extend their
    original 6,000-hour service life design to 9,000 hours. The F/A-18A-D
    HFH and SLEP are necessary measures to address our strike fighter
    inventory while preserving our investment in F-35C. To further reduce
    risk, we are accelerating the transition of 10 legacy F/A-18C squadrons
    to F/A-18 E/F Super Hornets, and our fiscal year 2012 budget requests
    funding to procure more F/A-18E/F Super Hornets than we requested last
    year. I thank Congress for their support of the F/A-18 program as we
    introduce F-35C into our Fleet.
    EA-18G Growler
        The Navy has been a leader in Airborne Electronic Attack (AEA) for
    more than half a century and AEA is in high demand. AEA provides one of
    the most flexible offensive capabilities available to the joint
    warfighter and is becoming increasingly important as technology capable
    of manipulating the electromagnetic spectrum matures. We are leveraging
    the mature and proven F/A-18E/F Super Hornet airframe to recapitalize
    our AEA capability with the EA-18G Growler. Although the EA-18G
    currently utilizes the same ALQ-99 Tactical Jamming System as the EA-
    6B, we are developing a new system, the Next Generation Jammer, as a
    replacement for the aging ALQ-99. The Next Generation Jammer will
    incorporate a Modular Open System Architecture and improved reliability
    and maintainability to provide a robust, flexible jamming capability
    that can evolve to address emerging threats. The EA-18G is in full rate
    production and we have accepted delivery of 43 aircraft. We have
    transitioned three EA-6B Prowler squadrons to EA-18G Growlers and two
    more squadrons are currently in transition. Our first EA-18G squadron
    deployed in November to Iraq. Our program of record will buy 114 total
    EA-18G aircraft, recapitalizing 10 carrier-based EA-6B squadrons and
    four expeditionary squadrons, all to be stationed at NAS Whidbey
    Island. The program continues to deliver on schedule and our fiscal
    year 2012 budget requests funding for 12 EA-18Gs.
    P-3C Orion and P-8A Poseidon Multi-Mission Maritime Aircraft
        Our P-3C Orion aircraft remain in high demand today across a range
    of missions including Anti-Submarine Warfare, Anti-Surface Warfare, and
    time-critical Intelligence, Surveillance and Reconnaissance. Our
    Maritime Patrol Aircraft (MPA) force is a direct enabler for troops on
    the ground in Central Command while also ensuring access and battle
    space awareness at sea. Because we are operating our P-3Cs at a high
    rate, about 100 P-3 aircraft have been grounded since February 2005 for
    fatigue life and we anticipate continued groundings through the
    remainder of the P-3 program. Through significant congressional support
    for P-3C wing repairs and sustainment, as of February, we have a
    current inventory of 84 mission aircraft; a 58 percent increase since
    last year. Our fiscal year 2012 budget requests about $100 million to
    continue our P-3C sustainment program. Continued investment in this
    program and in the modernization of our P-3s is critical to ensure we
    retain sufficient capacity to conduct maritime battle space awareness
    and support to land forces in Central Command, while successfully
    transitioning to the P-8A.
        The P-8A Poseidon Multi-Mission Maritime Aircraft is ideally suited
    for regional and littoral operations, and is our pre-eminent airborne
    capability against submarine threats. Procurement of P-8A will deliver
    needed capacity for these missions. The P-8A is scheduled to reach
    initial operating capability and will begin replacing our aging P-3
    Fleet in 2013. The current delivery schedule enables transition of two
    squadrons per year. Our fiscal year 2012 budget requests funding for 11
    P-8A aircraft. I request Congress' support for the P-8A program
    schedule and for our P-3 sustainment and modernization program, the
    combination of which is essential to our transition to the next
    generation of MPA capability while avoiding future gaps in our MPA
    force.
    E-2D Advanced Hawkeye
        The E-2D Advanced Hawkeye aircraft, will replace the E-2C and
    represents a two-generation leap in airborne radar surveillance
    capability. The E-2D will improve nearly every facet of tactical air
    operations and add overland and littoral surveillance to support
    theater Integrated Air and Missile Defense (IAMD) against air threats
    in high clutter, complex electro-magnetic and jamming environments. The
    airborne radar on the E-2D, with its improved surveillance capability,
    is a key pillar of the Navy Integrated Fire Control-Counter Air (NIFC-
    CA) concept. Four test aircraft have been delivered to the Navy and we
    will commence operational test and evaluation in late 2011. The first
    Fleet squadron transition is planned for 2013, with an IOC scheduled
    for late 2014. Our fiscal year 2012 budget requests six E-2D aircraft.
    We plan to procure 75 aircraft, with the final aircraft procurement in
    2019 and Full Operational Capability (FOC) in 2022.
    MH-60R/S Multi-Mission Helicopter
        The MH-60R and MH-60S are in full rate production. The MH-60R
    multi-mission helicopter replaces the surface combatant-based SH-60B
    and carrier-based SH-60F with a newly manufactured airframe and
    enhanced mission systems. With these systems, the MH-60R provides
    focused surface warfare and anti-submarine warfare capabilities for our
    strike groups and individual ships. The MH-60S supports surface
    warfare, combat logistics, vertical replenishment, search and rescue,
    air ambulance, airborne mine counter-measures, and naval special
    warfare mission areas. We have delivered 85 MH-60R and 187 MH-60S to
    our Fleet and our fiscal year 2012 budget requests funding for 24 MH-
    60R and 18 MH-60S helicopters.
                             surface ship programs
    Littoral Combat Ship (LCS)
        LCS is a fast, agile, networked surface combatant optimized to
    support naval and joint force operations in the littorals with
    capability to support open-ocean operations. It will operate with
    focused-mission packages to counter mine, small boat, and submarine
    threats in the littorals. The modular design and open architecture of
    the seaframe and mission modules provide the inherent flexibility to
    add or adapt capabilities as new technologies mature or to counter
    threats that emerge beyond the Mine Countermeasures, Surface Warfare,
    and Anti-Submarine missions currently planned for LCS. These ships will
    employ a combination of manned helicopters and unmanned aerial,
    surface, and undersea vehicles.
        U.S.S. Freedom (LCS 1) completed her first operational deployment
    to the Southern and Pacific Commands in April 2010, 2 years early.
    While deployed, U.S.S. Freedom successfully conducted counter-drug
    missions and validated its open ocean capability, allowing us to learn
    valuable lessons from these real-world operations. U.S.S. Independence
    (LCS 2) was commissioned in January 2010 and is currently in Norfolk
    undergoing post-delivery tests and trials. We are seeing demonstrated
    performance and stability in the construction of LCS 3 and LCS 4 that
    captures lessons learned from the first ships. PCU Fort Worth (LCS 3)
    was launched and christened in December and is completing final
    construction. PCU Coronado (LCS 4) is almost 50 percent complete and is
    scheduled to be launched and christened later this year. Both LCS 3 and
    LCS 4 are experiencing minimal change and are scheduled to be delivered
    to the Navy in 2012 on cost and on schedule.
        I thank Congress for approving the Navy's dual award strategy in
    December 2010. This strategy enables the Navy to save over $2 billion
    in acquisition costs and acquire these ships well below the
    congressionally mandated $480 million cost cap set in 2009. It allows
    our Navy to acquire an additional Littoral Combat ship, increasing
    needed capacity in our Fleet. I am impressed and satisfied with the
    capabilities of both LCS designs and remain committed to procuring 55
    of these ships. Consistent with the dual award strategy, our fiscal
    year 2012 budget requests four LCS seaframes at a total cost of $1.8
    billion. The budget also requests two mission packages in fiscal year
    2012. These packages provide the vital center for LCS's combat
    capability and we have aligned LCS mission module procurement with that
    of our LCS seaframes. I request your continued support as we continue
    to acquire the future capacity and capability the Fleet requires.
    Ballistic Missile Defense (BMD)
        The Navy's mature and proven maritime Ballistic Missile Defense
    (BMD) capability will play a primary role in the first phase of our
    Nation's Phased Adaptive Approach (PAA) for the missile defense of our
    NATO Allies in Europe. Our fiscal year 2012 budget requests funding to
    increase our current BMD ship capacity from 21 ships (5 cruisers and 16
    destroyers) to 41 BMD capable ships by 2016. This planned capacity
    expansion will eventually include all of the Navy's Arleigh Burke class
    destroyers and nine Ticonderoga class cruisers. Until we grow our BMD
    ship capacity, our existing BMD ships may experience longer deployment
    lengths and less time between deployments as we stretch our existing
    capacity to meet growing demands.
        As part of the PAA, we are working with the Missile Defense Agency
    to adapt Navy's proven and flexible Aegis BMD capability for use in an
    ashore configuration by repackaging components of the afloat Aegis
    Weapons System into modular containers for deployment to pre-prepared
    forward sites. The Aegis Ashore Missile Defense Test Complex is
    currently under development, with fabrication to begin in Kauai, Hawaii
    in 2013. This complex is a key enabler of the Aegis Ashore capability,
    which will be tested prior to shore placement overseas in 2015. This
    phased approach provides needed technology and capacity to pace the
    threat; it serves as a conventional counter to trends in global
    ballistic missile technology; and it allows for technological
    maturation through 2020.
    DDG 51 Flight IIA and Flight III
        To keep pace with the evolving air and missile defense threats, we
    restarted the DDG 51 Flight IIA production line in the fiscal year 2010
    and fiscal year 2011 budgets with advanced procurement buys for DDG
    113, 114, and 115. The restarted DDG 51 Flight IIA destroyers provide
    Navy with a proven multi-mission combatant that fills critical
    warfighting needs across the spectrum, and is the first warship built
    from the keel up to conduct maritime Ballistic Missile Defense. They
    will be the first Aegis ships to be built with the Open Architecture
    Advanced Capability Build (ACB) 12 Aegis Combat System. ACB-12 will
    allow these surface combatants to be updated and maintained with
    commercial off-the-shelf (COTS) technology, yielding reduced Total
    Ownership Cost and enhancing the ability to adapt to future military
    threats. Our fiscal year 2012 budget requests funding for the
    construction of DDG 116 as part of our plan to build seven more of the
    Flight IIA class over the FYDP (an increase of one DDG 51 over last
    year's budget). We also request just over $75 million to support
    Research and Development for ACB-12, which will support the integration
    of this critical system on DDG 113 and our development of Aegis Ashore.
        The follow-on to DDG 51 Flight IIA is the DDG 51 Flight III, which
    will commence with the construction of DDG 123. Flight III ships will
    be tailored for Integrated Air and Missile Defense (IAMD) and include
    the Air and Missile Defense Radar (AMDR), upgraded command and control
    software and hardware, and enhanced electrical power and cooling. Our
    fiscal year 2012 budget requests funding for a total of eight DDG 51
    class ships, including funding for the first Flight III ship in fiscal
    year 2016.
    Modernization
        To counter emerging threats, we continue to make significant
    investments in cruiser and destroyer modernization to sustain our
    combat effectiveness and to achieve the 35 year service life of our
    Aegis fleet. Our destroyer and cruiser modernization program includes
    Hull, Mechanical, and Electrical (HM&E) upgrades, as well as advances
    in warfighting capability and open architecture to reduce total
    ownership costs and expand mission capability for current and future
    combat capabilities. In addition to HM&E upgrades, key aspects of our
    Destroyer and Cruiser modernization programs include the installation
    or upgrade of the Aegis weapons system to include an open architecture
    computing environment, addition of the Evolved Sea Sparrow Missile
    (ESSM), an upgraded SQQ-89A(V)15 anti-submarine warfare system, and
    improved air dominance with processing upgrades and Naval Integrated
    Fire Control-Counter Air capability. Our Destroyers also receive
    integration of the SM-6 missile, while our Cruisers receive
    installation of the AN/SPQ-9B radar and an upgrade to Close In Weapon
    System (CIWS) Block 1B. Maintaining the stability of the cruiser and
    destroyer modernization program is critical to our ability to provide
    relevant capability and capacity in our future Fleet. Our fiscal year
    2012 budget requests funding for the modernization of four cruisers
    (three Combat Systems and one HM&E) and three destroyers (one Combat
    System and two HM&E).
    DDG 1000
        The DDG 1000 Zumwalt guided missile destroyer will be an optimally
    crewed, multi-mission surface combatant optimized for long-range
    precision land attack. In addition to providing offensive, distributed
    and precision fires in support of forces ashore, these ships will serve
    as test-beds for advanced technology, such as integrated power systems,
    a sophisticated X-Band radar, and advanced survivability features,
    which can inform future ship designs. Following a Nunn-McCurdy breach
    due to the reduction in procurement to three ships, we restructured the
    DDG 1000 program to remove the highest risk technology, the Volume
    Search Radar, from integration into the platform. DDG 1000 is more than
    37 percent complete and is scheduled to deliver in fiscal year 2014
    with an initial operating capability in fiscal year 2016.
    Joint High Speed Vessel (JHSV)
        The JHSV will deliver a new level of organic logistic and maneuver
    flexibility for Combatant Commanders. JHSV is a high speed, shallow
    draft ship. Its unique design allows the ship to transport medium
    payloads of cargo and/or personnel to austere ports without reliance on
    port infrastructure. JHSV-1 and -2 are currently under construction by
    Austal USA in Mobile, AL and are scheduled to be delivered in fiscal
    year 2012 and 2013. Our fiscal year 2012 budget requests funding for
    the construction of the third JHSV. We are currently developing a
    Memorandum of Agreement with the Army that would transfer programmatic
    oversight and responsibility for the entire JHSV program, including
    operations and maintenance, to the Navy. Upon the signing of the
    agreement, all JHSVs when delivered would be operated by the Navy's
    Military Sealift Command and manned by civilian or contract mariners.
                               submarine programs
    Virginia Class SSN
        The Virginia class submarine is a multi-mission submarine designed
    to dominate the undersea domain in the littorals, access denied
    environments, and the open ocean. Now in its 14th year of construction,
    the Virginia program is demonstrating its continued ability to deliver
    this critical undersea asset affordably and on time. The Navy continues
    to realize a return on investment in the Virginia cost reduction
    program and construction process improvements through enhanced
    shipbuilder performance on each successive ship. A majority of the
    submarines contracted via multiyear procurement have delivered under
    budget and ahead of schedule, and their performance continues to exceed
    expectations with every ship delivered. I am pleased with the
    accomplishments of the combined Navy-Industry team and anticipate
    additional improvements as we ramp up production to two submarines per
    year, as requested in our fiscal year 2011 and 2012 budget submissions.
    SSBN and Ohio Replacement
        The Navy remains committed to recapitalizing the Nation's sea-based
    strategic deterrent, the most survivable leg of our nuclear triad. With
    a fleet of 14 Ohio class ballistic missile submarines (SSBN), we have
    been able to meet the strategic needs of the Nation since 1980. This
    class will begin retirement after more than 40 years of service in
    2027.
        The 2010 Nuclear Posture Review reaffirmed that our Nation will
    continue to rely on a reliable and survivable sea-based strategic
    deterrent for the foreseeable future. To ensure the Navy is able to
    meet the Nation's demand in this critical capability, our fiscal year
    2012 budget requests research and development funds for the design of
    the Ohio class replacement, enabling construction of the class
    beginning in 2019. The Ohio replacement will possess the endurance and
    stealth required for continuous, survivable strategic deterrence for
    decades to come. Appropriate R&D investment is essential to design a
    reliable and survivable submarine capable of deterring all potential
    adversaries. Over the past year, the Ohio replacement program has been
    thoroughly reviewed and all aspects of the program were aggressively
    challenged to drive down engineering and construction costs. Our fiscal
    year 2012 request represents best balance of needed warfighting
    capabilities with cost. The Ohio replacement program will leverage the
    many successes of the Virginia SSN program to achieve acquisition and
    total ownership cost goals. These efficiencies and a record of
    acquisition excellence are critical to minimize risk to our total force
    structure while recapitalizing sea-based strategic deterrence between
    fiscal year 2019 and fiscal year 2033.
                            amphibious warfare ships
    LPD 17 Class Amphibious Warfare Ship
        The San Antonio class LPD (LPD 17) amphibious warfare ships provide
    the Navy and Marine Corps the ability to embark, transport, control,
    insert, sustain, and extract combat marines and sailors on missions
    that range from forcible entry to forward deployed crisis response.
    These ships have a 40-year expected service life and will replace four
    classes of older ships: the LKA, LST, LSD 36, and the LPD 4. Of the 11
    ships in our program of record, five ships have been delivered, three
    have completed their initial deployments, and four are under
    construction. We continue to resolve material reliability concerns with
    the class and apply the lessons learned during initial operation of the
    early ships to those under construction. Quality continues to improve
    with each ship delivered as we work closely with the shipbuilder to
    address cost, schedule, and performance issues. Our fiscal year 2012
    budget requests funding to procure the final ship in the program.
    LHA Replacement (LHA(R))
        LHA(R) is the replacement for our aging Tarawa class ships, which
    will reach the end of their extended service life between 2011-2015.
    LHA(R) will provide flexible, multi-mission amphibious capabilities by
    leveraging the LHD 8 design. The America (LHA 6) is now more than 30
    percent complete and on schedule for delivery in fiscal year 2014.
    Beginning with LHA 8, the Navy will reintegrate the well deck into the
    large deck amphibious assault ships. Our fiscal year 2012 budget
    requests funding for research and development to support reintegration
    of the well deck into the design of the large deck amphibious ship and
    the construction of LHA 8 in fiscal year 2016.
    Mobile Landing Platform (MLP)
        Based on commercial technology, the Mobile Landing Platform (MLP)
    will enable the transfer of equipment, personnel, and sustainment at-
    sea, and delivery ashore in support of a wide range of contingency
    operations. Our fiscal year 2012 budget requests funding for one MLP
    and we intend to procure a total of three MLPs. We expect the first
    ship to deliver in fiscal year 2013 and project initial operating
    capability and incorporation into the Maritime Prepositioning Force
    (MPF) for 2015. In the Maritime Preposition Force, each of our existing
    Maritime Preposition Squadrons will be augmented by one MLP, one T-AKE
    combat logistics ship, and a Large Medium-Speed Roll-on/Roll-off (LMSR)
    cargo ship. The three T-AKE are all under contract with projected
    delivery dates beginning this year and going through fiscal year 2013.
                         information dominance programs
    Unmanned Systems
        Our Navy is developing a ``family'' of unmanned systems over, on,
    and under the sea to provide unique capability, in concert with our
    manned platforms, to rapidly secure access and establish maritime
    superiority at the time and place of our choosing. We are developing
    information architecture that will allow us to rapidly assimilate data
    into information for our commanders, enabling shorter decision cycles
    that will give us an advantage in joint and maritime operations.
                Unmanned Aircraft Systems (UAS)
        Our unmanned aircraft family of systems includes the Broad Area
    Maritime Surveillance (BAMS) UAS, which will enhance our situational
    awareness and shorten the sensor-to-shooter kill chain by providing
    persistent, multiple-sensor capabilities to Fleet and Joint Commanders.
    Through our recent memorandum of agreement with the Air Force, we are
    pursuing greater commonality and interoperability between BAMS and the
    Air Force's Global Hawk UAV. Our Vertical Take-off and Landing Tactical
    Unmanned Air Vehicle (VTUAV) is on its second deployment aboard the
    U.S.S. Halyburton (FFG 40) and will deploy in an expeditionary role to
    support combat operations in Afghanistan later this year. Our fiscal
    year 2012 budget includes about $12 million in research and development
    funding to facilitate development of a weapons-capable VTUAV ready for
    deployment in late fiscal year 2012. Our fiscal year 2012 request also
    includes funding to develop a medium range maritime-based UAS (MRMUAS)
    and a Small Tactical Unmanned Aerial System (STUAS) that will support a
    variety of ships, Naval Special Warfare and Navy Expeditionary Combat
    Command units, and Marine Corps elements.
        The Navy Unmanned Combat Aircraft System Demonstration (NUCAS-D)
    will prove carrier suitability of an autonomous, unmanned, low-
    observable, carrier-based aircraft. This effort includes maturing
    technologies for aircraft carrier catapult launches and arrested
    landings, as well as integration into carrier-controlled airspace.
    Initial flight tests to demonstrate carrier suitability are scheduled
    to start next year and autonomous aerial refueling demonstrations are
    planned for 2014. We will leverage the lessons learned from operating
    the demonstrator in developing a low-observable unmanned carrier-
    launched airborne surveillance and strike system (UCLASS). The UCLASS
    program will shorten the timeline to find, fix, track, target, engage,
    and assess time sensitive targets. UCLASS will integrate with the
    carrier air wings and increase the flexibility, versatility, and
    capability of the carrier force. We are currently developing the UCLASS
    acquisition strategy with OSD.
                Unmanned Underwater Vehicles (UUV)
        UUVs provide an innovative technological solution to augment manned
    platforms. Our Navy has logged more than 85,000 hours of UUV operations
    to improve battlespace awareness. Our small-body Littoral Battlespace
    Sensing (LBS) oceanographic autonomous undersea gliders have
    demonstrated the ability to conduct 6-month long autonomous operations
    and will achieve Initial Operating Capability this year. Our fiscal
    year 2012 budget requests about $13 million for research, development,
    and procurement of the LBS glider. We are also developing Large
    Displacement UUVs (LDUUVs) with the capability to autonomously deploy
    and manage a variety of sensors and payloads. The development of these
    highly capable vehicles will require investment in commercially and
    militarily beneficial alternative energy technologies, including
    refinement of fuel cell technology and cutting edge battery
    technologies. Our fiscal year 2012 budget requests about $50 million to
    develop an LDUUV, and I remain committed to conduct fully independent
    UUV missions with durations of 2 months by 2017. This capability will
    allow full scale employment and deployment of LDUUV squadrons in the
    2020s.
    Mobile User Objective System (MUOS)
        Our Maritime Strategy demands a flexible, interoperable, and secure
    global communications capability that can support the command and
    control requirements of highly mobile and distributed U.S. and
    coalition forces. Satellite communications give deployed forces a
    decisive military advantage and often offer the only communication
    means to support ongoing operations. Rapidly expanding joint demand for
    more access at ever-higher data rates requires moving beyond our
    current legacy Ultra High Frequency (UHF) satellite capabilities. The
    Mobile User Objective System (MUOS) will help satisfy those demands
    when initial operational capability is reached in fiscal year 2012. The
    first satellite in our planned constellation of five is scheduled for
    on-orbit capability in May 2012. Our fiscal year 2012 budget submission
    continues our investment in MUOS to replace the aging UHF Follow-On
    (UFO) constellation. I request your continued support of MUOS and the
    critical narrowband communication capability it will provide to the
    joint warfighter.
    Next Generation Enterprise Network (NGEN)
        The Next Generation Enterprise Network (NGEN) is a Department of
    the Navy (DON) enterprise network that will provide secure, net-centric
    data and services to Navy and Marine Corps personnel after the current
    Navy-Marine Corps Intranet (NMCI) network stands down. In July, Navy
    awarded Hewlett Packard Enterprise Services with the Navy-Marine Corps
    Intranet (NMCI) continuity of services contract to transition the Navy
    out of Navy-Marine Corps Intranet (NMCI) and into NGEN. NGEN will
    sustain the services currently provided by NMCI, while increasing
    government command and control of our network and enabling secure,
    reliable, and adaptable global information exchange. The initial NGEN
    contracts are expected to be awarded in the first quarter of fiscal
    year 2012. Our fiscal year 2012 budget requests an additional $22
    million to support government command and control of our networks and
    improve our network situational awareness and defense.
                          remain ready to fight today
        Our Navy continues to experience a high tempo of global operations
    which I expect to continue even as combat forces draw down in
    Afghanistan. Global trends in economics, demographics, resources, and
    climate change portend an increased demand for maritime power and
    influence. America's prosperity depends upon the seas: 90 percent of
    world trade moves on the world's oceans and underwater
    telecommunications cables facilitate about $3.2 trillion of commerce
    each year. As new trade patterns emerge, such as those that will result
    from the expansion of the Panama Canal and the opening of the Arctic,
    and as disruption and disorder persist in our security environment,
    maritime activity will evolve and expand. Seapower allows our Nation to
    maintain U.S. presence and influence globally and, when necessary,
    project power without a costly, sizeable, or permanent footprint
    ashore. We will continue to maintain a forward-deployed presence around
    the world to prevent conflict, increase interoperability with our
    allies, enhance the maritime security and capacity of our traditional
    and emerging partners, confront irregular challenges, and respond to
    crises.
        High operational demand for our force over the last decade has led
    to longer deployments, lower dwell time, and reduced maintenance time
    for our surface ships. If these trends continue, our force will be less
    ready and less available than it is today because of increased stress
    on our Sailors and a reduction in our Fleet capacity as ships fail to
    reach their expected service lives. We have initiatives currently
    underway to address these trends. We are moving approximately 1,900
    Sailors from shore billets onto our ships to meet operational demands
    while maintaining acceptable Fleet readiness levels and Sailor dwell
    time. To enhance the material readiness of our Fleet, we are improving
    our ability to plan and execute maintenance by increasing manning at
    our Regional Maintenance Centers (RMCs), and by institutionalizing our
    engineered approach to surface ship maintenance, converting the
    successes of our Surface Ship Lifecycle Maintenance (SSLCM) initiative
    I began 2 years ago into the Surface Maintenance Engineering Planning
    Program Activity (SURFMEPP). I remain focused on ensuring our Navy has
    a force that is maintained and trained to provide the capability and
    forward presence required in the two areas of interest identified in
    our Maritime Strategy, the Western Pacific and the Arabian Gulf, while
    preserving our ability to immediately swing from those regions and our
    Fleet concentration areas in the United States to respond to
    contingencies globally.
        Our fiscal year 2012 base budget and Overseas Contingency
    Operations (OCO) funding requests balance the need to meet increasing
    operational requirements, sustain our Sailors' proficiency, and conduct
    the maintenance required to ensure our ships and aircraft reach their
    full service lives. It does not address the potential impacts of a
    full-year continuing resolution on our ongoing operations and
    maintenance afloat and ashore. Highlights follow of initiatives that
    ensure our Navy remains ready to fight today.
    Depot Level Maintenance
        Our ships and aircraft are valuable capital assets that operate in
    unforgiving environments. Keeping these assets in acceptable operating
    condition is vital to their ability to accomplish assigned missions and
    reach their expected service lives. Timely depot level maintenance,
    based on an engineered assessment of expected material durability and
    scoped by actual physical condition, will preserve our existing force
    structure. Continued investment in depot level maintenance is essential
    in achieving and sustaining the force structure required to implement
    our Maritime Strategy. Our combined fiscal year 2012 base budget and
    OCO funding requests fulfill 94 percent of the projected ship depot
    maintenance requirements necessary to sustain our Navy's global
    presence and 95 percent of our aviation depot maintenance requirements,
    servicing 742 airframes and 2,577 engines. The actual extent of our
    depot maintenance requirements will be determined by the final funding
    levels for fiscal year 2011. I request that you fully support our
    baseline and contingency funding requests for operations and
    maintenance to ensure the effectiveness of our force, safety of our
    Sailors, and longevity of our 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. High operational
    demands, rising manpower costs, and an aging Fleet of ships and
    aircraft cause us to take deliberate risk in shore readiness,
    specifically in sustaining our shore infrastructure. We have focused
    our facilities sustainment, restoration, and modernization funds on
    improving our housing for unaccompanied Sailors and investing in energy
    efficient building modifications. To source these enhancements, we have
    temporarily cancelled our demolition program and reduced our facilities
    sustainment posture to 80 percent of the modeled requirement. We have
    targeted our shore readiness investments in areas that have the
    greatest impact on achieving our strategic and operational objectives.
    These areas include support to our warfighting missions and
    capabilities, nuclear weapons security, quality of life for our Sailors
    and their families, and energy enhancements. We remain on track in our
    Homeport Ashore initiative to provide sufficient accommodations to our
    junior single Sailors by 2016, and we continue our support for family
    services. We plan to complete an expansion of 7,000 child care spaces
    in fiscal year 2011, allowing us to meet OSD's mandate of providing
    child care for 80 percent of the potential need in fiscal year 2012.
    Training Readiness
        Our Navy is leveraging Modeling and Simulation (M&S) extensively
    across the Fleet training continuum to reduce at-sea training
    requirements and associated operating costs and energy use. These
    virtual environments stress critical command and control warfare skills
    and fine tune basic warfighting competencies without going to sea. They
    provide synthetic events that are scalable and repeatable, including
    the ability to train multiple strike groups simultaneously. Synthetic
    training provides a complex, multi-faceted threat environment that
    cannot be efficiently recreated at sea on a routine basis. Ship command
    and control simulations, in conjunction with the Fleet Synthetic
    Training (FST) program, support unit level and integrated pre-
    deployment training and certification, including Joint Task Force
    Exercises (JTFEX), Ballistic Missile Defense Exercises (BMDEX), and LCS
    qualification and certification training. In fiscal year 2012, our
    Navy's use of simulators will reduce steaming days by 603 days for a
    savings of $30 million, and flying hours by 5,400 hours, for a savings
    of $35 million. The Fleet has placed FST as a top training priority
    with the objective to increase simulator use and synthetic training to
    reduce Fleet operating costs.
        Although we are maximizing our use of synthetic training, it cannot
    completely replace our need to conduct live training. Simulators cannot
    replicate the physical environment, risks, stress, or experiences that
    live training provides. Naval units must be able to practice and hone
    their skills in the air and at sea. Having the right facilities and the
    ability to practice skill sets in a live operating environment are
    necessary for the proficiency and safety of our Sailors and for the
    warfighting effectiveness of our Fleet.
        The proliferation of advanced, stealthy submarines continues to
    challenge our Navy's ability to guarantee the access and sustainment of
    joint forces. Robust Anti-Submarine Warfare (ASW) training with active
    sonar systems is vital for our Navy to effectively address this threat.
    The Navy remains a world leader in marine mammal research and we will
    continue our investment in this research in fiscal year 2012 and
    beyond. Through such efforts, and in full consultation and cooperation
    with other Federal agencies, we have developed effective measures that
    protect marine mammals and the ocean environment from adverse impacts
    of mid-frequency active (MFA) sonar while not precluding critical Navy
    training. We continue to work closely with our interagency partners to
    further refine our protective measures as scientific knowledge evolves.
    It is vitally important that any such measures ensure the continued
    flexibility necessary to respond to future national security
    requirements.
        In January, we announced our plan to initially focus Joint Strike
    Fighter (JSF) homebasing on the west coast in accordance with 2010
    Quadrennial Defense Review direction and the JSF Transition Plan. We
    also announced that we are suspending work on the Outlying Landing
    Field (OLF) draft environmental impact statement (EIS) planned for the
    east coast until at least 2014. At that time, we will re-evaluate the
    requirement for an OLF based on our east coast JSF basing and training
    requirements. We continue to experience capacity shortfalls at our
    current east coast field carrier landing practice sites that present
    challenges to meeting our current training requirements under both
    routine and surge conditions for existing Navy aircraft. We will
    continue to ensure we meet all our training requirements by
    implementing the measures necessary to use all available facilities.
    Energy and Climate Change
        The Secretary of the Navy and I are committed to advancing our
    energy security. I consider energy an operational imperative and I
    established the Navy's Task Force Energy more than 2 years ago to
    improve combat capability, assure mobility, and green our footprint. We
    will achieve these goals through energy efficiency improvements,
    consumption reduction initiatives, and the aggressive adoption of
    alternative energy and fuels. Reducing our reliance on fossil fuels
    will improve our combat capability by increasing time on station,
    reducing time spent alongside replenishment ships, and producing more
    effective and powerful future weapons.
        Our tactical energy efforts fall into two categories: technical and
    behavioral changes that use energy more efficiently, and testing/
    certification of alternative fuels. We are making good progress on our
    efficiency initiatives. The U.S.S. Makin Island (LHD 8) uses hybrid
    propulsion and we are installing the same system on LHA-6 and LHA-7. We
    are developing a hybrid electric drive system for the DDG-51 class and
    I anticipate a land-based test as early as this summer. We continue to
    introduce advanced hull and propeller coatings and solid state lighting
    in our ships, and we are developing the Smart Voyage Planning Decision
    Aid to achieve more efficient ship routing. We are also implementing
    policies that encourage Sailors to reduce their personal energy usage.
    These incremental initiatives add up to significant efficiency
    improvements.
        Our alternative energy programs are progressing. We are
    aggressively certifying elements of our operational force for biofuel
    use. To date we have operated the ``Green Hornet'' F/A-18 and MH-60S on
    camelina-based JP-5 fuel and the RCB-X riverine craft on algal-based F-
    76 fuel. Operational testing of energy efficiency upgrades to the
    Allison 501k engine completed last month and is a key milestone toward
    certification of our Navy combatants with marine gas turbine engines.
        We have reduced our energy use ashore by more than 14 percent since
    2003, as a result of our energy efficiency efforts, including energy
    efficiency building upgrades, energy management systems, procurement of
    alternative fuel vehicles, and achievement of sustainable building
    standards for all new construction and major renovation projects. Our
    continued investments in advanced metering and energy audits will help
    identify further opportunities for efficiency gains and alternative
    energy use. Our approach remains focused on integrating the right
    technology at the right time in the right place while transforming Navy
    culture and behavior for long term sustainability.
        Since establishing Task Force Climate Change in 2009, our Navy has
    taken several actions to better understand and address the potential
    impacts of climate change on our Navy. We have increased our
    operational engagement in the Arctic, participating this past summer in
    Operation NANOOK/NATSIQ with Canada. We are re-assessing regional
    security cooperation, through our African, Southern, and Pacific
    Partnership station missions to include consideration of climate change
    adaptation, especially with respect to improving water security. We are
    also participating with the National Oceanographic and Atmospheric
    Administration (NOAA) and other Federal agencies to survey in the
    Arctic and improve our environmental observation and prediction
    capability worldwide. Scientific observations indicate that current
    changes to the climate are occurring on a decadal scale, giving our
    Navy enough time to conduct the studies and assessments necessary to
    inform future investment decisions.
    Second East Coast Carrier-Capable Homeport
        The Navy continues to focus on achieving the 2010 Quadrennial
    Defense Review direction to upgrade the carrier port of Mayport. Much
    like the dispersal of west coast aircraft carriers between California
    and Washington, a second homeport on the east coast to maintain
    aircraft carriers is prudent in the event of a natural or man-made
    disaster in Hampton Roads. The dredging project funded in fiscal year
    2010 is underway and will ensure unimpeded access to Mayport. Our
    fiscal year 2012 budget requests funding for the Massey Avenue corridor
    improvement projects. We plan to request funding for the Wharf F
    recapitalization in fiscal year 2013, and the remaining projects within
    the FYDP, to establish Naval Station Mayport as nuclear carrier-capable
    homeport by 2019.
    United Nations Convention on the Law of the Sea
        The Navy has consistently supported a comprehensive and stable
    legal regime for the exercise of navigational rights and other
    traditional uses of the oceans. The Law of the Sea Convention provides
    such a regime with robust global mobility rules. I believe it essential
    that the United States become a full Party to the treaty. The
    Convention promotes our strategic goal of free access to and public
    order on the oceans under the rule of law. It also has strategic
    effects for global maritime partnerships and American maritime
    leadership and influence. Creating partnerships that are in the
    strategic interests of our Nation must be based on relationships of
    mutual respect, understanding, and trust. For the 160 nations who are
    parties to the Law of the Sea Convention, a basis for trust and mutual
    understanding is codified in that document. The treaty provides a solid
    foundation for the United States to assert its sovereign rights to the
    natural resources of the sea floor out to 200 nautical miles and on the
    extended continental shelf beyond 200 nautical miles, which in the
    Arctic Ocean is likely to extend at least 600 nautical miles north of
    Alaska. As a non-Party to the treaty, the United States undermines its
    ability to influence the future direction of the law of the sea. As the
    only permanent member of the U.N. Security Council outside the
    Convention, and one of the few nations still remaining outside one of
    the most widely subscribed international agreements, our non-Party
    status hinders our ability to lead in this important area and could,
    over time, reduce the United States' influence in shaping global
    maritime law and policy. The Law of the Sea Convention provides the
    norms our Sailors need to do their jobs around the world every day. It
    is in the best interest of our Nation and our Navy to ratify the Law of
    the Sea Convention. We must demonstrate leadership and provide to the
    men and women who serve in our Navy the most solid legal footing
    possible to carry out the missions that our Nation requires of them.
       develop and support our sailors, navy civilians and their families
        Our Sailors, Navy civilians, and their families are the backbone of
    our Maritime Strategy. They make us who we are. Their skill,
    innovation, and dedication turn our ships, aircraft, weapons and
    systems into global capabilities that prevent conflict, build
    partnerships, and, when necessary, project combat power to prevail in
    war. Our investment in our Sailors, Navy civilians, and their families
    ensures our Navy's continued maritime dominance today and in the
    future.
        Our fiscal year 2012 budget requests authorization and funding for
    325,700 active and 66,200 reserve end strength. This request includes
    the migration of more than 1,800 military billets from shore and staff
    activities into the Fleet to man new ships and squadrons, restore
    optimal manning cuts, add needed information technology and nuclear
    operators to our force, and restore billets for fiscal year 2013 to
    extend U.S.S. Peleliu in commission. This migration will enhance our
    forces afloat; however, the transition will present challenges to our
    ability to maintain sea-shore flow for some of our enlisted Sailors and
    sustain manning levels across the force. We are aware of these
    challenges and believe the transition is manageable. Our fiscal year
    2012 end strength request also begins to move end strength previously
    supported by OCO funding, namely our Navy Individual Augmentees (IAs),
    into our baseline program. We will execute a phased draw down of our
    OCO end strength as we project a gradual reduction of IA demands in
    Iraq and Afghanistan. Should IA demand remain at current levels, or
    increase over time, we will be challenged to meet manning requirements
    for our Fleet. Our Navy continues to size, shape, and stabilize our
    force through a series of performance-based measures designed to retain
    the skills, pay grades, and experience mix necessary to meet current
    and future requirements.
        Our fiscal year 2012 endstrength reflects efficiencies in our
    manpower account that reduce excess overhead by disestablishing several
    staffs, but not their associated ships and aircraft, for submarine,
    patrol aircraft, and destroyer squadrons, as well as one Carrier Strike
    Group staff. We are disestablishing the headquarters of Second Fleet
    and transferring responsibility for its mission to U.S. Fleet Forces
    Command. These efficiencies streamline our organizations and allow us
    to reinvest the savings into warfighting capability and capacity.
        I would like to touch briefly on the issue of changes to the
    healthcare benefit. Navy Medicine has been a leader in implementing
    pilot testing for the Department in a new concept called the Patient-
    Centered Medical Home. Beneficiaries have welcomed Navy Medicine's
    Medical Home Port initiative and it shows in their satisfaction scores.
    I am convinced that our beneficiaries will readily accept very modest
    changes to copayments as long as we continue to invest in these
    transformational approaches to delivering high quality healthcare. The
    proposals in the President's budget are consistent with our efforts
    over the last several years: a focus on internal efficiency,
    incentivizing the health behaviors we want, and ensuring all of our
    beneficiaries are treated equitably. I request you support these timely
    and appropriate efforts.
        The tone of our force continues to be positive. In 2010, we
    conducted the Navy Total Force Survey, which was the first of its kind
    to assess the work-related attitudes and experiences of active and
    reserve Sailors and Navy civilians. The survey reported that Navy
    personnel are, overall, satisfied with the quality of their leadership,
    benefits, compensation, and opportunities within the Navy for personal
    growth and development. The survey results reaffirmed what more than 20
    national awards have recognized: that our Navy is a ``Top 50''
    organization and an employer of choice among today's workforce.
        Our fiscal year 2012 budget request represents a balanced approach
    to supporting our Sailors and their families, sustaining the high tempo
    of current operations, and preserving Fleet and family readiness.
    Highlights follow of our efforts to develop and support our Sailors,
    Navy civilians and their families.
    Recruiting and Retention
        Our Navy has enjoyed strong recruiting success over the past 3
    years, and we expect this trend to continue through fiscal year 2011.
    Fiscal year 2010 marked the third consecutive year Navy met or exceeded
    its overall enlisted recruiting goals in both the Active and Reserve
    Components and we continue to exceed Department of Defense quality
    standards in all recruit categories. We accessed the highest quality
    enlisted force in history last year, with more than 97 percent having
    traditional high school diplomas. Active officer recruiting for fiscal
    year 2010 also exceeded our overall goals. Reserve officer recruiting
    exceeded our fiscal year 2009 levels, but achieved only 95 percent of
    our fiscal year 2010 goal. Reserve medical officer recruiting continues
    to be our greatest challenge as the requirement for medical officers
    has increased by more than 100 percent since fiscal year 2008. We
    continue to explore new avenues for recruiting, including expanding our
    social media engagement to maintain a dialogue with potential
    applicants and influencers nationwide.
        Navy will remain competitive in the employment market through the
    disciplined use of monetary and non-monetary incentives. Using a
    targeted approach, we will continue our recruiting and retention
    initiatives to attract and retain our best Sailors, especially those
    within high-demand, critical skill areas that remain insulated from
    economic conditions. We are taking advantage of current high retention
    rates and success in accessions by reevaluating all special and
    incentive pays and bonuses and reducing them where possible. Judicious
    use of special and incentive pays remains essential to recruiting and
    retaining skilled professionals in the current economic environment,
    and will increase in importance as the economic recovery continues. Our
    goal remains to maintain a balanced force, in which seniority,
    experience, and skills are matched to requirements.
        To ensure we stay within our congressionally authorized end
    strength, we are executing force stabilization measures that include
    Perform-to-Serve (PTS) for enlisted Sailors and a series of Selective
    Early Retirement (SER) boards for Unrestricted Line (URL) Captains and
    Commanders. PTS considers the manning levels in each enlisted rating
    and reviews the record of Sailors eligible for reenlistment to
    determine if the Sailor should remain in the rating, convert to an
    undermanned specialty, transition to the reserves, or separate from the
    Navy. The SER boards will address the excess inventory of active
    component Captain (O6) and Commander (O5) URL officers in our Navy to
    ensure sufficient senior officers are available at the right time in
    their careers to serve in critical fleet billets. We project
    approximately 100 URL Captains and 100 URL Commanders will be selected
    for early retirement through this process. With these performance-based
    measures, we expect to meet our fiscal year 2011 authorized active end
    strength of 328,700 and reserve end strength of 65,500 by the end of
    the fiscal year. We will be challenged to meet our active and reserve
    end strength targets in fiscal year 2012 using existing force shaping
    measures. As a result of continued high retention and low attrition
    across the force, we are facing increasing pressure to use involuntary
    force shaping measures to remain within our authorized end strength.
    Diversity
        Demographic projections estimate that today's minorities will make
    up more than one-third of our Nation's workforce by 2020; by 2050, that
    projection increases to about half of our workforce. Our ability to
    access and retain the talents of every component group in our society
    is critical to our mission success. Recruiting and retaining a diverse
    workforce, reflective of the Nation's demographics at all levels of the
    chain of command, remains a strategic imperative and a focus area for
    leaders throughout our Navy. To foster a Navy Total Force composition
    that reflects America's diversity, we are focusing our efforts on
    outreach, mentoring, leadership accountability, training, and
    communication. Our diversity outreach efforts have contributed to our
    2014 U.S. Naval Academy and NROTC classes being the most diverse
    student bodies in our history. We have increased diverse accessions
    through targeted recruiting in diverse markets, developing
    relationships with key influencers in the top diverse metropolitan
    markets, and aligning Navy assets and organizations to maximize our
    connection with educators, business leaders and government officials to
    increase our influencer base. We continue to expand our relationships
    with key influencers and science, technology, engineering, and
    mathematics (STEM)-based affinity groups to inform our Nation's youth
    about the unique opportunities available in our Navy. We are also
    building and sustaining a continuum of mentorship opportunities that
    includes the chain of command, individual communities, social
    networking, peer-to-peer relationships, and affinity groups. We will
    continue to ensure that all Sailors are provided with opportunities to
    develop personally and professionally.
    Women on Submarines
        After notifying Congress last year of our intent to assign women to
    submarines, the Secretary of the Navy and I have authorized female
    officers to serve aboard Ohio class SSBN and SSGN submarines. This will
    enable our submarine force to leverage the tremendous talent and
    potential of the women serving in our Navy. The first 18 female
    submarine officers commenced the standard 15-month nuclear and
    submarine training pipeline in 2010, and will begin arriving at their
    submarines at the end of this year. These officers will be assigned to
    two ballistic missile (SSBN) and two guided missile (SSGN) submarines
    which have the space to accommodate female officers without structural
    modification. The plan also integrates female supply corps officers
    onto SSBNs and SSGNs at the department head level. In December, the
    Secretary of Defense notified Congress of Navy's intent to expend funds
    to commence design and study efforts regarding reconfiguration of
    existing submarines to accommodate female crew members, as well as to
    design the Ohio replacement SSBN with the flexibility to accommodate
    female crew members.
    Don't Ask, Don't Tell
        I am pleased Congress voted to repeal section 654 of Title 10,
    United States Code, commonly referred to as the ``Don't Ask, Don't
    Tell'' (DADT) statute. Legislative repeal affords us the time and
    structured process needed to effectively implement this significant
    change within our Armed Forces. As I testified in December, we will be
    able to implement a repeal of DADT in our Navy. I assess the risk to
    readiness, effectiveness, and cohesion of the Navy to be low. Our
    implementation process will be thorough, but timely. We are preparing
    the necessary policies and regulations to implement this change in law
    and training Sailors and leaders at all levels to ensure they
    understand what repeal means to them, their families, and the Navy.
    Before repeal can occur, the President, Secretary of Defense, and
    Chairman of the Joint Chiefs must certify that the change can be made
    in a manner consistent with the standards of military readiness,
    military effectiveness, unit cohesion, and recruiting and retention of
    the Armed Forces. I will provide Navy's input to the certification
    process and I remain personally engaged in this process.
    Sailor and Family Continuum of Care
        We remain committed to providing our Sailors and their families a
    comprehensive continuum of care that addresses all aspects of medical,
    physical, psychological, and family readiness. Our fiscal year 2012
    budget request expands this network of services and caregivers to
    ensure that all Sailors and their families receive the highest quality
    healthcare available.
        Navy Safe Harbor is at the forefront in Navy's non-medical care for
    all seriously wounded, ill, and injured Sailors, Coast Guardsmen, and
    their families. We have expanded our network of Recovery Care
    Coordinators and non-medical Care Managers to 12 locations across the
    country. Safe Harbor continues to provide exceptional, individually
    tailored assistance to a growing enrolled population of more than 600
    individuals. Over 116,000 Sailors and their spouses have participated
    in Operational Stress Control (OSC) training, which actively promotes
    the psychological health of Sailors and their families by encouraging
    them to seek help for stress reactions early, before they become
    problems. The Warrior Transition Program (WTP) and Returning Warrior
    Workshops (RWW) are essential to post-deployment reintegration efforts.
    The WTP offers an opportunity for IA Sailors redeploying from a combat
    zone to decompress, turn in their gear, and receive tools that will
    help them ease their transition back to their home and families. The
    RWW is designed to address personal stress that may be generated by
    deployment activities and it supports and facilitates the reintegration
    of the deployed Sailor with his/her spouse and family. The RWW also
    provides a safe, relaxed atmosphere in which to identify and address
    potential issues that may arise during post-deployment reintegration.
    Stress on the Force
        While the overall tone of our force remains positive, current
    trends suggest that high operational tempo, increasing mission demands,
    lean manning, force shaping, and economic conditions are placing
    increased stress on our Navy personnel. Our fiscal year 2012 budget
    requests increased funding to improve our program manager-level support
    of our suicide prevention and stress control programs.
        Suicide dramatically affects individuals, commands and families.
    Over the last year, we expanded our approach to preventing suicides
    from historic suicide surveillance and annual awareness training to
    include more comprehensive resilience building and tailored suicide
    prevention training, peer intervention, research and analysis. We saw a
    reduction in our number of suicides from 46 in calendar year 2009 to 38
    in calendar year 2010. Our calendar year suicide rate also decreased
    from 13.3 per 100,000 Sailors in 2009 to 10.9 per 100,000 Sailors in
    2010. Our 2010 suicide rate is below the national rate of 19.0 per
    100,000 individuals for the same age and gender demographic; however,
    any loss of life as a result of suicide is unacceptable. Suicide
    prevention is an ``all hands, all the time'' effort involving our
    Sailors, families, peers, and leaders. We continue to work toward a
    greater understanding of the issues surrounding suicide to ensure that
    our policies, training, interventions, and communications are meeting
    intended objectives.
        We are integrating our suicide prevention efforts into the broader
    array of programs we offer to improve the resilience of our force.
    These programs, aimed at reducing individual stress, address issues,
    such as substance abuse prevention, financial management, positive
    family relationships, physical readiness, and family support.
        We continue our efforts to eliminate sexual assault by fostering a
    culture of prevention, victim response and offender accountability.
    Sexual assault is incompatible with our Navy core values, high
    standards of professionalism, and personal discipline. We have
    organized our efforts in this critical area under the Navy Sexual
    Assault Prevention and Response (SAPR) program. The SAPR program and
    the Naval Safety Center and Alcohol and Drug Prevention Program are
    currently developing an integrated approach to sexual assault
    prevention that includes clear leadership communication, bystander
    intervention training for Sailors to help them recognize and interrupt
    risky situations, and training for military investigators and lawyers
    on issues specific to sexual assault investigation and prosecution.
    Learning and Development
        Education and training are strategic investments that give us an
    asymmetric advantage over adversaries. To develop the highly skilled,
    combat-ready force necessary to meet the demands of the Maritime
    Strategy and the Joint Force, we have 15 learning centers around the
    country providing top-notch training to our Sailors, Navy civilians and
    members of the other Services. In fiscal year 2010, we completed
    learning and development roadmaps for all enlisted ratings, providing
    Sailors with detailed information about the required training,
    education, qualifications and assignments they need to succeed in their
    career fields. We continue to leverage a blended training approach,
    integrating experienced instructors, advanced technology, and state-of-
    the-art delivery systems with modularized content in order to provide
    the right training at the right time in a Sailor's career. We are
    balancing existing education and training requirements with growth in
    important mission areas such as cyber defense, missile defense, and
    anti-submarine warfare. Cultural, historical, and linguistic expertise
    remain essential to successfully accomplishing the Navy's global
    mission, and our budget request supports our Language, Regional
    Expertise, and Culture (LREC) program as well as the Afghanistan-
    Pakistan (AF-PAK) Hands Program sponsored by the Joint Staff. Last year
    the LREC program provided language and cultural training to more than
    120,000 Sailors en route to overseas assignments. We recognize the
    importance of providing our people meaningful and relevant education,
    particularly Joint Professional Military Education (JPME), which
    develops leaders who are strategically minded, capable of critical
    thinking, and adept in naval and joint warfare. Our resident courses at
    Naval War College, non-resident courses at Naval Postgraduate School
    and in the Fleet Seminar program, and distance offerings provide ample
    opportunity for achievement of this vital education.
                                   conclusion
        You can be exceptionally proud of our Sailors. They are our
    Nation's preeminent force at sea, on land, and in air, space, and
    cyberspace. While the future is not without challenges, I am optimistic
    about our future and the global opportunities our Navy provides our
    Nation. Our fiscal year 2012 budget request represents a balanced
    approach to increasing Fleet capacity, maintaining our warfighting
    readiness, and developing and enhancing our Navy Total Force. I ask for
    your strong support of our fiscal year 2012 budget request and my
    identified priorities. Thank you for your unwavering commitment to our
    Sailors, Navy civilians, and their families, and for all you do to make
    our United States Navy an effective and enduring global force for good.

        Chairman Inouye. And may I now call upon the Commandant of
    the Marine Corps, General Amos.
    STATEMENT OF GENERAL JAMES F. AMOS, COMMANDANT, UNITED
                STATES MARINE CORPS
        General Amos. Mr. Chairman, Ranking Member Cochran, members
    of the subcommittee, it's my honor to appear before you today,
    for the first time, as our Nation's Commandant of the Marine
    Corps.
        The Corps serves as America's expeditionary force in
    readiness, a balanced air-ground logistics team of 202,000
    Active, 39,000 Reserve, and 35,000 civilian marines.
        Today, there are over 32,000 marines forward-deployed
    around the world. As we sit here in the comfort of this hearing
    room, it's just past 8:30 in the evening in Afghanistan. The
    rainy season has hit. The evenings remain cold and damp. It's
    in this nation where 20,000 of our young men and women are
    engaged in full-spectrum combat and counterinsurgency
    operations. I'm encouraged by the significant progress they
    have made in the Helmand Province. And you have my assurance
    that this effort remains my top priority.
        Sergeant Major Kent and I spent Christmas with our marines
    and sailors in Afghanistan, and I'm happy to report that their
    morale is high and their belief in their mission remains
    strong.
        Partnered with the United States Navy, we are forward-
    deployed and forward-engaged. This past year alone, our float
    forces conducted humanitarian assistance missions in Pakistan,
    Haiti, and the Philippines, recaptured the pirated ship,
    Magellan Star, from its Somali pirates. And 2 weeks ago,
    marines from the 1st Battalion, 2d Marine Regiment, rapidly
    deployed to the Mediterranean to join their brothers and
    sisters on board two amphibious ships. This formidable force is
    underway now, prepared to do our Nation's bidding.
        Likewise, on the opposite side of the world, marines based
    on Okinawa rapidly responded to our ally, Japan, following this
    week's devastating earthquake and tsunami. Within hours of this
    tragedy, marine aviation units from the Marine Corps Air
    Station Futenma Okinawa began transporting humanitarian
    assistance goods, disaster response planning teams, and
    personnel to impacted areas. We have established a forward-
    refueling and operating base, just west of the devastation, to
    facilitate around-the-clock search-and-rescue and transport
    operations. Our marines already on the ground are being joined
    by 2,200 marines and sailors from the three amphibious ships of
    the 31st Marine Expeditionary Unit. In addition to a multitude
    of other capabilities, the 31st MEU is optimized for
    humanitarian assistance and disaster response operations.
        Evidenced by what has unfolded globally just within the
    last 2 weeks, our role as America's crisis response force
    necessitates that we maintain a high state of readiness. Our
    mission is simple. We need to be ready to respond to today's
    crisis, with today's force, today.
        I am keenly aware of the fiscal realities confronting our
    Nation. During these times of constrained resources, the Marine
    Corps remains committed to being the best stewards of scarce
    public funds. We maintain a longstanding tradition in Congress
    as the Department of Defense's penny-pinchers. Our
    institutionalized culture of frugality positions us as the best
    value for the Defense dollar.
        For approximately 8.5 percent of the annual Defense budget,
    the Marine Corps provides the Nation 31 percent of its ground
    operating forces, 12 percent of its fixed-wing tactical
    aircraft, and 19 percent of its attack helicopters. This year's
    budget submission was framed by my four service-level
    priorities: We will, one, continue to provide the best-trained
    and -equipped marine units to Afghanistan; two, rebalance our
    Corps and posture it for the future in a post-Afghanistan
    environment; three, better educate and train our marines to
    succeed in increasingly complex environments; and last, but not
    least, we will keep faith with our marines, our sailors, and
    our families.
        While these priorities will guide our long-term planning
    for the Marine Corps, there are pressing issues that face our
    Corps today that concern me, issues for which I ask for
    Congress' continued assistance in solving. Our equipment abroad
    and at home stations has been heavily taxed in the nearly 10
    years of constant combat operations. The price tag for reset
    today is $10.6 billion. The F-35B STOVL Joint Strike Fighter is
    vital to our ability to conduct expeditionary airfield
    operations. Continued funding and support from Congress for
    this important program is of utmost importance to me and the
    Marine Corps.
        You have my promise that, during the next 2 years of F-35B
    scrutiny, I will remain personally engaged with the program,
    closely supervising it. Both the Secretary of Defense and the
    Secretary of the Navy have reaffirmed the necessity of the
    Marine Corps' amphibious assault mission. We must develop an
    affordable and capable amphibious vehicle to project marines
    from sea to land in permissive and uncertain and in hostile
    environments. I ask for your support to reach this goal.
        To ensure the Marine Corps remains a relevant force with a
    capacity and capability to respond to the demands of the future
    security environment, we recently conducted a detailed and
    internally driven force-structure review. The results of this
    effort provide America a strategically mobile, middleweight
    force, optimized for forward presence in crisis response.
        Finally, I would like to comment on the impact of--the
    current continuing resolution has had on our operations and
    programs. As of this morning, $1 billion in military
    construction contracts have not been awarded; $2.4 billion of
    Milcon is at risk for the remainder of the year. These project
    impact--projects impact the lives of marines, the local
    economies and communities around our bases and stations, and
    are projected to generate over 63,000 jobs, from the Carolinas
    to Hawaii.
        If the continuing resolution extends through the entire
    fiscal year, 13 bachelor enlisted quarters (BEQ), totaling
    5,000 affected spaces, will not be built, thus stymieing our
    BEQ modernization plans. These 13 BEQs will allow eight
    infantry battalions to move out of 50-year-old cold war-era
    barracks.
        Finally, a continuing resolution could prove catastrophic
    to our procurement accounts, resulting in the loss of almost
    one-third or our procurement budget.
        Last, you have my promise that, in these challenging times
    ahead, the Marine Corps will only ask for what it needs, not
    what it might want. We will make the hard decisions before
    coming to Congress, and we will redouble our efforts toward our
    traditional culture of frugality.

                               PREPARED STATEMENT

        Once again, Mr. Chairman, I thank you, and each of you, for
    your continued support. I'm prepared to answer your questions.
        Chairman Inouye. Thank you very much, Commandant.
         [The statement follows:]
                  Prepared Statement of General James F. Amos
                   america's expeditionary force in readiness
        The Marine Corps is America's Expeditionary Force in Readiness--a
    balanced air-ground-logistics team. We are forward-deployed and
    forward-engaged: shaping, training, deterring, and responding to all
    manner of crises and contingencies. We create options and decision
    space for our Nation's leaders. Alert and ready, we respond to today's
    crisis, with today's force . . . Today. Responsive and scalable, we
    team with other services, allies and interagency partners. We enable
    and participate in joint and combined operations of any magnitude. A
    middleweight force, we are light enough to get there quickly, but heavy
    enough to carry the day upon arrival, and capable of operating
    independent of local infrastructure. We operate throughout the spectrum
    of threats--irregular, hybrid, conventional--or the shady areas where
    they overlap. Marines are ready to respond whenever the Nation calls .
    . . wherever the President may direct.

                                                  General James F. Amos
                   america's expeditionary force in readiness
        Today, your United States Marine Corps is foremost America's
    Expeditionary Force in Readiness. Established originally by an act of
    the Second Continental Congress on November 10, 1775, your Marine Corps
    has evolved over 235 years into a balanced air-ground-logistics team
    that is forward deployed and forward engaged: shaping, training,
    deterring, and responding to all manner of crises and contingencies.
        Through the ongoing support of Congress and the American people,
    your Marine Corps is a cohesive force of 202,100 Active Duty Marines;
    39,600 Selected Reserve Marines; and 35,000 Civilian Marines. At any
    given time, approximately 30,000 Marines are forward deployed in
    operations supporting our Nation's defense.\1\ This year, as our Nation
    recognizes a decade since the tragic events of 9/11, your Marine Corps
    has been conducting Overseas Contingency Operations for an equal amount
    of time. From Task Force 58 with 4,400 Marines launching from six
    amphibious ships to secure critical lodgments in Afghanistan in late
    2001 to our counterinsurgency efforts in the Al Anbar province of Iraq
    and to our current operations in the Helmand River Valley of
    Afghanistan, your Marines have been forward deployed in the service of
    our Nation.
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        \1\ As of December 2010, there were approximately 20,700 Marines in
    Afghanistan including Marines serving in external billets (e.g.
    transition teams and joint/interagency support, etc.); 6,200 at sea on
    Marine Expeditionary Units; and 1,600 Marines engaged in various other
    missions, operations and exercises. The 30,000 statistic excludes over
    18,000 Marines assigned to garrison locations outside the continental
    United States such as in Europe, the Pacific, etc.
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        Yet, during this time the Marine Corps has not been confined solely
    to major combat operations and campaigns. From our rapid response
    aiding fellow Americans and enabling joint and interagency relief
    efforts following Hurricane Katrina's floods, to our non-combatant
    evacuation operation of 14,000 American citizens from Lebanon in 2006,
    to our numerous and ongoing security cooperation missions with nations
    of Africa, Eastern Europe, the Pacific Rim, and Latin America, the
    United States Marine Corps continues to demonstrate the agility and
    flexibility expected of America's principal crisis response force. Over
    the course of the past year alone, your brave men and women who wear
    the Marine uniform and who bring a diversity of talent in service to
    our Nation, have simultaneously:
      --Waged an aggressive full-spectrum counterinsurgency operation in
            Afghanistan while concurrently increasing combat power nearly
            two-fold (i.e. from 10,600 to 19,400) in accordance with the
            President's December 2009 Afghanistan-Pakistan strategy;
      --Successfully completed our mission in Iraq, bringing stability to
            Al Anbar province. This achievement was not without sacrifice
            and suffering in that 1,022 \2\ Marines gave their lives and
            8,626 Marines were wounded in action;
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        \2\ 1022 deaths = 851 killed in action (hostile) and 171 deceased
    (non-hostile).
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      --Partnered with allied forces in engagement missions throughout
            every Geographic Combatant Commander's Area of Responsibility;
      --Conducted foreign humanitarian assistance and disaster relief
            missions in Pakistan, Haiti, and the Philippines;
      --Participated in maritime security operations to ensure freedom of
            navigation along vital sea lines of communication, to include
            the recapture of the vessel Magellan Star and rescue of its
            crew from Somali pirates; and
      --Rapidly reinforced U.S. Embassies in Port au Prince, Haiti;
            Conakry, Guinea; Bishkek, Kyrgyzstan; and most recently Cairo,
            Egypt to assist and protect diplomatic personnel amidst crises
            in these foreign capitals.
        Their actions align with the functions of our Corps as seen in the
    new Department of Defense Directive 5100.01, Functions of the
    Department of Defense and Its Major Components, and are a critical link
    to the continued prosperity and security of our Nation and the survival
    of our friends, allies and partners. The performance of your Marines on
    the global stage adds to our storied legacy of sacrifice and success--
    under even the most adverse conditions--inspiring a sense of pride and
    confidence in the American public that their Marines are able to
    respond quickly, ensuring the Nation's interests will be protected.
                          future security environment
        Public law, defense policy, our doctrine and operating concepts,
    and the future security environment shape how we organize, train, and
    equip our forces. As we look ahead, we see a world of increasing
    instability, failed or failing states, and conflict characterized by:
    Poverty, unemployment, urbanization, overpopulation, and extremism;
    competition for scarce natural resources; and rapid proliferation of
    new technologies to include capabilities to disrupt cyber networks,
    advanced precision weaponry, and weapons of mass destruction.
        These troubling socio-economic and geopolitical trends converge in
    the littorals--regions along the world's coastline where the sea joins
    with the land. The majority of the world's population lives near the
    sea. The trend toward accelerated birth rates in the developing world,
    coupled with ongoing migration from rural to urban landscapes, results
    in hyper-populated coastal regions, burdened by the cumulative
    stressors of criminality, extremism, and violence.
        Littoral cities increasingly may assume what some have called feral
    qualities, raising the potential for conflict, providing a measure of
    sanctuary for our adversaries, and posing challenges to governmental
    sovereignty and regional security. It is in this complex environment
    that your United States Marine Corps will operate. We stand optimally
    postured to conduct a range of operations for Joint Force commanders,
    bridging the gap between operations at sea and on land.
        Nonetheless, we are committed to the prevention of conflict as we
    are to responding to it. Indeed, 21st century security challenges
    require expansion of global engagement--facilitated through persistent
    forward naval presence--to promote collective approaches to addressing
    common security concerns. Accordingly, forward deployed Marine forces
    will increasingly conduct theater security cooperation activities and
    will build partnership capacity through security force assistance
    missions with our allies and partners around the globe. The goal of our
    engagement initiatives is to minimize conditions for conflict and
    enable host nation forces to effectively address instability as it
    occurs.
                            role of the marine corps
        The United States is a maritime nation with global
    responsibilities. With a naval tradition as the foundation of our
    existence, we remain firmly partnered with the U.S. Navy. Forward
    deployed, we retain the ability to come from the sea rapidly to conduct
    missions across the range of military operations. Our persistent
    forward presence and multi-mission capability present an unparalleled
    ability to rapidly project U.S. power across the global commons--land,
    sea, air, space, and cyber.
        Amphibious forces with robust and organic logistical sustainment
    provide a maritime Super Power significant advantages, including the
    ability to overcome the tyranny of distance and to project power where
    there is no basing or infrastructure--a strong deterrent capability for
    our Nation. To Marines, ``expeditionary'' is a state of mind that
    drives the way we organize our forces, train, develop and procure
    equipment. By definition, our role as America's crisis response force
    necessitates a high state of unit readiness and an ability to sustain
    ourselves logistically. We must be ready to deploy today and begin
    operating upon arrival, even in the most austere environments. The
    United States Marine Corps affords the following three strategic
    advantages for our Nation:
      --A versatile ``middleweight'' capability to respond across the range
            of military operations. We fill the gap in our Nation's defense
            as an agile force capable of operating at the high and low ends
            of the threat spectrum or the indistinct areas in between.
      --An inherent speed and agility that buys time for National leaders.
            Our flexibility and rapid response capability present unique
            opportunities to develop strategic options, shape the
            environment, and set conditions to deploy the full capabilities
            of the Joint Force and other elements of National power.
      --An enabling and partnering capability in joint and combined
            operations. Our unique forward posture aboard amphibious ships,
            manned by well trained, uniformed sailors, positions us to be
            the ``first to fight.''
                                usmc priorities
        My four service level priorities informed this year's budget
    submission. These priorities were influenced by and derived from a
    number of factors to include our understanding of the 21st century
    battlefield based on lessons learned over nearly a decade at war, our
    examination of the future security environment, our doctrine and
    operating concepts, and our current and future budgetary and
    programmatic requirements.
        These priorities are aligned with the principal recommendations of
    the 2010 Quadrennial Defense Review, meeting its end state of ensuring
    that the Marine Corps is able to ``prevail in today's wars, prevent and
    deter conflict, prepare to defeat adversaries and succeed in a wide
    range of contingencies, and preserve and enhance the All-Volunteer
    Force.'' My priorities also support America's four enduring strategic
    interests as identified in the 2010 National Security Strategy.\3\ To
    that end, we will:
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        \3\ (1) Security of the United States, its citizens, and U.S.
    allies and partners; (2) a strong, innovative, and growing U.S. economy
    in an open international economic system that promotes opportunity and
    prosperity; (3) respect for universal values at home and around the
    world; (4) and an international order advanced by U.S. leadership that
    promotes peace, security, and opportunity through stronger cooperation
    to meet global challenges. 2010 National Security Strategy Pg, 7.
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      --Continue to provide the best trained and equipped Marine units to
            Afghanistan;
      --Rebalance our Corps, posture it for the future, and aggressively
            experiment with and implement new capabilities and
            organizations;
      --Better educate and train our Marines to succeed in distributed
            operations and increasingly complex environments; and
      --Keep faith with our Marines, our Sailors and our families.
        The above priorities guide my long-term plan for the Marine Corps;
    however, there are pressing issues facing our Corps today that give
    cause for concern.
      --Equipment.--Our equipment abroad and at home station has been
            ``heavily taxed'' in the nearly 10 years of constant combat
            operations. We require funding to reset equipment being
            utilized overseas and to reconstitute home-station equipment
            and modernize for the future. This is critical to maintaining
            readiness throughout the Corps.
      --The Short Take-Off and Vertical Landing F-35B Joint Strike
            Fighter.--The F-35B is vital to our ability to conduct combined
            arms operations in expeditionary environments. Continued
            funding and support from Congress for this program is of utmost
            importance.
      --Amphibious Combat Vehicle.--We will begin the development of an
            affordable and capable amphibious combat vehicle to replace the
            recently cancelled Expeditionary Fighting Vehicle program. The
            capability inherent in a ship-to-shore connector is critical to
            our expeditionary nature, as affirmed by the Secretary of
            Defense.
      --End Strength.--The drawdown of our active component from 202,100 to
            186,800 must be conditions-based, and only after completion of
            our mission in Afghanistan. We must keep faith with our Marine
            Corps family by allowing appropriate time and support for those
            departing the force and to ensure the resiliency of our units
            still engaged in war.
      --Family Readiness Programs.--Like our equipment, Marines and their
            families have been ``heavily taxed'' since 9/11. We will
            continue to fund family readiness and family support programs
            that are vital to the health and welfare of our entire Marine
            Corps family.
      --Amphibious Ships.--The Navy and Marine Corps have determined a
            minimum force of 33 ships represents the limit of acceptable
            risk in meeting the 38-ship amphibious force requirement for
            the Assault Echelon. Marines are best postured to engage and
            respond to the Nation's security interests from amphibious
            ships.
        The Marine Corps needs the continued support of Congress in
    confronting these critical issues and the many others discussed below.
    My promise to Congress is that we will do our part by continuing to be
    good stewards of our taxpayers' dollars.
                     fiscal year 2012 budgetary submission
        The Marine Corps maintains a longstanding tradition in the
    Department of Defense as being ``Penny Pinchers.'' A prime example of
    our many noteworthy cost-saving measures is our practice of units
    deploying to Afghanistan utilizing equipment sets maintained and
    repaired in country--a measure saving significant funds annually on
    costs associated with the cycle of deployment and redeployment. Our
    institutionalized culture of frugality, streamlined business practices,
    lean structure, and multi-mission capability, position us as the ``best
    value'' for the defense dollar. This fiscal year we are seeking over
    $40 billion \4\ to fund ongoing operations, provide quality resources
    for our Marines, Sailors and their families, conduct reset of equipment
    stressed from nearly 10 years at war, and prepare our forces for future
    missions. For approximately 8.5 percent \5\ of the annual Defense
    budget, the Marine Corps provides the Nation approximately 31 percent
    of its ground operating forces (Combat, Combat Support and Combat
    Service Support), 12 percent of its fixed wing tactical aircraft, and
    19 percent of its attack helicopters.
    ---------------------------------------------------------------------------
        \4\ This sum includes both ``Blue in Support of Green'' funding,
    Overseas Contingency Operation funding, and other Navy funding for USMC
    needs (e.g. chaplains, medical personnel, amphibious ships, etc)
        \5\ Based on provisions of the fiscal year 2010 National Defense
    Authorization and Appropriation Acts.
    ---------------------------------------------------------------------------
        During these times of constrained resources, the Marine Corps
    remains committed to streamlining operations, identifying efficiencies,
    and reinvesting savings to conserve scarce public funds. At the
    direction of the Secretary of Defense in June 2010, the services
    conducted an efficiencies review and our fiscal year 2012 budget is the
    result of a thorough study of all of our business activities. Already
    one of the most economical of the military services, we achieved our
    DOD efficiency goal. We captured overhead efficiency savings by
    focusing on three main efforts: Buying smarter through acquiring
    platforms more intelligently; streamlining our operations; and being
    more efficient in the way we use, produce, and acquire energy.
        This effort has had a marked impact on our overall budget, allowing
    us to invest more in our core warfighting missions and enhancing our
    acquisition plans. The efficiency initiative drove adjustments to our
    programs and ensured restoration of funding in areas where needed most.
    Additionally, we used funds realized from efficiencies to support
    programs originally not funded. We re-invested savings into critical
    war fighting programs to enhance readiness. We anticipate unit
    equipment readiness to increase by fiscal year 2014 through the
    purchase of additional equipment beginning in fiscal year 2012. This
    readiness increase will allow the Marine Corps to equip, train, and
    prepare units earlier in the pre-deployment cycle. Other expansions
    that we were able to address include enhancing funding for facilities
    with direct operational impact, energy and water investments at bases
    and installations, command and control and logistics programs, and
    equipment modernization.
        In addition to our frugality and aggressive pursuit of finding
    efficiencies to enhance our warfighting capacity inherent in our budget
    request, your Marine Corps remains the first and only military service
    whose financial statements have been deemed audit ready. We are
    continually striving to be good stewards of the public trust and know
    the ongoing financial audit will serve to both strengthen our financial
    management practices and give us actionable business intelligence to
    support our decisionmaking process in supporting our operational forces
    at home, abroad and in harm's way.
    priority #1: continue to provide the best trained and equipped units to
                                  afghanistan
        Operation Enduring Freedom.--We have made great progress in
    Afghanistan; this effort remains our number one priority until we
    attain our National objectives. At present over 20,000 Marines are
    deployed in Afghanistan. This mission ultimately involves almost 60,000
    Marines, or just under one-third of our active duty force, factoring in
    deployment, redeployment, training cycles and other direct support. We
    will continue providing forces in Afghanistan capable of full-spectrum
    combat and counterinsurgency operations, while balancing our
    capabilities to perform what the Nation will likely ask of us in the
    future. We will ensure that Marines, Sailors, and the units in which
    they serve, receive the best possible training and equipment to succeed
    in the many types of missions we are conducting in this complex,
    dynamic environment.
        Our successes within Helmand Province are paving the way for
    economic development and governance. Marine commanders on the ground
    and Afghan officials indicate that freedom of movement for the local
    populace has improved. Bazaars and markets are flourishing; critical
    infrastructure projects are underway. Today, 10 of 13 districts in
    Helmand Province are under the control of the Afghan central
    government. Daily, 135,000 children attend school, which is more than a
    60 percent increase from 2008 levels. Formerly dangerous places like
    Marjah, Now Zad, and Garmsir, un-trafficable due to improvised
    explosive devices just 1 year ago, now have significant activity
    occurring in commercial centers. Yet, other challenges remain as we now
    seek to capitalize on our 2010 successes. We are currently expanding
    battle-space northward into other hostile locations such as the
    district of Sangin, where our forces are going ``head-to-head'' with
    Taliban resistance.
        As America's Expeditionary Force in Readiness, we are ready to
    execute any mission assigned in support of crisis and contingency
    response. In addition to our Afghanistan commitment, we continue to
    source forward-based and deployed forces to meet Geographic Combatant
    Commander requirements. In light of our operational demands, and
    through the support of Congress in authorizing our end strength of
    202,100 active duty forces, our combat units are beginning to realize
    an approximate 1:2 dwell time.\6\ Other units vary at more favorable
    dwell time levels depending on their mission. We anticipate the 1:2
    dwell ratio for combat units to remain relatively stable provided
    current deployed force levels are not increased; however, increased
    operational demands in Afghanistan or elsewhere may result in dwell
    times inconsistent with fostering a resilient Total Force.
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        \6\ Infantry battalions will continue to remain just below 1:2
    dwell time due to relief in place/transfer of authority requirements.
    ---------------------------------------------------------------------------
        Some Marines in select military occupational specialties continue
    to fall into what is known as a high-demand, low-density status. This
    is a key indicator that the combat demand for Marines with these skills
    does not match, or exceeds, the current manpower requirement and/or
    inventory. In addition, there are currently 14 of 211 occupational
    specialties where the on-hand number of Marines is less than 90 percent
    of what is required.\7\ Our recently completed force structure review
    addressed all these concerns. We are working actively to recruit,
    promote, and retain the right number of Marines in the right
    occupational specialties thus promoting resiliency of our Total Force.
    ---------------------------------------------------------------------------
        \7\ Our most stressed occupational specialties based on percentage
    of Marines beyond a 1:2 dwell are (1) Geographic Intelligence
    Specialist, (2) Imaging Analyst/Specialists, (3) Signals Collection
    Operator/Analyst, (4) Unmanned Aerial Systems Operator/Mechanic, and
    (5) European, Middle East, and Asia-Pacific Cryptologic Linguists.
    ---------------------------------------------------------------------------
        Training for Full Spectrum Counter-Insurgency Operations.--Our
    comprehensive training program conducted at our premiere desert
    training base in Twentynine Palms, California, has been credited by
    leaders throughout the Corps with providing a dynamic environment that
    replicates the many tasks, challenges, and requirements required of
    units in a counterinsurgency setting. Our newly instituted Infantry
    Immersion Trainers are realistic, reconfigurable, and provide
    comprehensive training environments that develop small unit tactics and
    individual skills for deploying infantry squads. The Infantry Immersion
    Trainer supports essential training such as control of supporting arms,
    language, improvised explosive device recognition and defeat measures,
    human terrain understanding and close quarters battle. Introducing
    battlefield effects simulators, culturally appropriate role players,
    and interactive avatars at the Infantry Immersive Trainers teaches
    Marines to make legally, morally, ethically, and tactically sound
    decisions under situations of great stress. It also contributes to
    reducing the effects of combat stress. I view this training program to
    be of vital importance to our Operating Forces.
        Equipping for the Afghan Effort.--Marine units are operating in
    Afghanistan with high rates of ground equipment readiness. Through the
    generosity of Congress, we have received funds for the rapid fielding
    of urgent need items in support of our Afghanistan effort. The Mine
    Resistant Armor Vehicle Program continues to meet urgent requirements
    while we actively pursue vehicle upgrades to outpace emerging threats,
    enhance mobility, and improve vehicle performance. We can accomplish
    this goal through engineering changes and capability insertions in
    current production, planned orders, and fielded vehicles. We have a
    requirement for 3,362 vehicles in the family of Mine Resistant Armor
    Protected vehicles, including 1,454 Mine Resistant Armor Protected All
    Terrain Vehicles. To date, we have fielded 1,214 Mine Resistant Armor
    Protected All Terrain Vehicles to our units in Afghanistan and have met
    the theater requirement.
        To date, we have fielded 34 Assault Breacher Vehicles, 5 of which
    are in Afghanistan, to enhance the mobility of the Marine Air Ground
    Task Force (MAGTF). We plan to field a total of 52 Assault Breacher
    Vehicles. Production of the remaining 18 vehicles remains on schedule
    and is fully funded with final delivery scheduled for the second
    quarter of fiscal year 2012.
        In our continuing efforts to find improvised explosive devices by
    all possible means, we are tripling our successful Improvised Explosive
    Device Dog Detection program and are also undertaking a research and
    development effort to train dogs with improved detection capabilities
    with fielding expected this fall. This year, we will have fielded 647
    specially trained Labrador Retrievers who work off-leash, supporting
    our infantry units in ground combat operations. We also have fielded a
    wide array of intelligence collection sensors and analytic and
    processing systems to include the Multimedia Archival Analysis System,
    the Ground Based Observational Surveillance System, the Tactical Remote
    Sensor System, the Communication Emitter Sensing and Attacking System,
    and improvements to the Tactical Exploitation Group, to name a few.
        Last, in December 2010, we deployed a reinforced company of 17 M1A1
    Main Battle Tanks to join our efforts in Regional Command SouthWest to
    provide increased force protection and firepower. Today, these tanks
    are fully integrated with our forces operating in our most highly
    contested regions, and are rapidly proving their utility in this
    environment by enabling our Marines to increase operational tempo. They
    also demonstrate the commitment of Coalition Forces to the security of
    Southern Afghanistan.
         priority #2 rebalance the corps, posture for the future, and
        aggressively experiment with and implement new capabilities and
                                 organizations
        Posture for the Future and Force Structure Review.--The Marine
    Corps has deployed MAGTFs in support of irregular warfare missions such
    as our counterinsurgency effort in Afghanistan, humanitarian assistance
    and disaster relief efforts in Pakistan, Haiti, and the Philippines,
    and engagement missions such as our theater security cooperation
    exercises in support of every Geographic Combatant Commander.
        Despite these and many other operational successes over the past
    decade, new challenges await us requiring the same spirit of innovation
    and institutional flexibility that have been the bedrock of our Corps
    for 235 years. The 2010 Quadrennial Defense Review highlights an
    expanding need over the next two decades for military forces skilled at
    countering irregular threats,\8\ and the 2010 National Security
    Strategy signals a need for increased engagement activities. Both of
    these thrusts necessitate Marines who are not only fighters, but also
    trainers, mentors, and advisors. The 2011 National Military Strategy
    advances the idea that ``strengthening international and regional
    security requires that our forces be globally available, yet regionally
    focused.'' \9\ Likewise, Geographic Combatant Commanders have continued
    to register their growing need for forward--postured amphibious forces
    capable of conducting security cooperation, regional deterrence, and
    crisis response.\10\
    ---------------------------------------------------------------------------
        \8\ ``The wars we are fighting today and assessments of the future
    security environment together demand that the United States retain and
    enhance a whole-of-government capability to succeed in large-scale
    counterinsurgency, stability, and counterterrorism operations in
    environments ranging from densely populated urban areas and mega-
    cities, to remote mountains, deserts, jungles, and littoral regions.''
    2010 Quadrennial Defense Review Report, Pg 20.
        \9\ 2011 National Military Strategy of the United States, pg 10.
        \10\ In the past 20 years, U.S. amphibious forces have responded to
    crises and contingencies 114 times--a response rate double that during
    the Cold War.
    ---------------------------------------------------------------------------
        This past fall, we conducted a detailed force structure review to
    develop the optimum mix of capabilities for our role as America's
    Expeditionary Force in Readiness in the post-Afghanistan security
    environment. The force structure review addressed 21st century
    challenges confronting our Nation and its Marine Corps, aiming to build
    on our historic role as the Nation's crisis response force. The review
    sought to provide the ``best value'' in terms of capability, cost, and
    readiness relative to the operational requirements of our forward-
    engaged Geographic Combatant Commanders. The results of that effort
    provide for a strategically mobile, ``middleweight'' force optimized
    for forward-presence and rapid crisis response. We will be light enough
    to leverage the flexibility and capacity of amphibious ships, yet heavy
    enough to accomplish the mission when we get there. Sea-based forces,
    in particular, will be invaluable for discreet engagement activities,
    rapid crisis response, and sustainable power projection.
        Our review also aimed for a force structure that provides
    capability and capacity across the range of military operations, while
    simultaneously providing for resiliency in our Total Force. With likely
    reductions in forward basing and strategic transportation, the
    importance of regionally focused headquarters and forces, both forward-
    postured and immediately deployable with a minimum of strategic lift,
    is paramount. We have thus built a Joint Task Force capable
    headquarters at several Geographic Combatant Command locations. As we
    aim to implement signature outcomes of the force structure review,
    Marines on a day-to-day basis will be forward-deployed and engaged,
    working closely with our joint and allied partners. When crises or
    contingencies arise, these same Marines will respond--locally,
    regionally, or globally if necessary--to accomplish whatever mission
    the Nation asks of us.
        To best meet Geographic Combatant Commander needs and ensure
    optimal configuration as America's Expeditionary Force in Readiness, we
    require Congressional support to reset our equipment, develop new
    organizational structures, and begin implementing initiatives from our
    force structure review. These measures ultimately will improve our
    ability to function within the Joint Force, execute distributed
    operations, command and control in complex environments, and conduct
    persistent engagement missions. As we are entrusted with the resources
    and funding to posture ourselves for the future, we will continue to
    conduct responsible examination required of a disciplined force to
    ensure that we implement every refinement--from the smallest to the
    most sweeping--in a manner that provides the Nation with a lean force,
    capable of rapidly projecting the Nation's power and strategic
    influence.
    Equipping
        Reset of the Total Force.--Resetting the Marine Corps for the
    future after nearly a decade at war is my number one equipping
    priority. This past year, we completed our mission in Iraq, effecting
    the retrograde of more than 25,000 Marines,\11\ 382,000 items of
    equipment, 10,800 short tons of aviation support equipment, and nearly
    11,000 containers from Al Anbar province via Jordan and Kuwait to the
    United States and elsewhere. This drawdown of equipment over the course
    of 1 year was a significant logistical and operational achievement. We
    also accomplished the rapid shift of critical equipment from Iraq to
    Afghanistan in support of the deployment of the 2d Marine Expeditionary
    Brigade. This shift of materiel within a theater of operation became
    one of the largest redeployments in U.S. history, both in terms of
    equipment moved and distances involved.
    ---------------------------------------------------------------------------
        \11\ At present, approximately 100 Marines remain in Iraq serving
    in individual augment, transition team and other miscellaneous billets.
    ---------------------------------------------------------------------------
        The Marine Corps is currently sourcing highly trained and ready
    forces to meet global combatant commander requirements.
      --Approximately 98 percent of deployed units report the highest
            levels of readiness for their assigned mission.
        However, high deployed-unit readiness has come at the expense of
    home-station, non-deployed units, which have sourced organic equipment
    and personnel to meet the needs of our deployed forces.
      --Approximately 68 percent of non-deployed units report degraded
            levels of readiness. The largest contributing factor is
            equipment; approximately 37 percent of non-deployed forces
            report degraded levels of equipment supply. This lack of
            equipment impacts the ability of non-deployed forces to respond
            rapidly to other potential contingencies and represents lost
            core training opportunities early in the deployment cycle in
            preparation for Overseas Contingency Operations.
        The equipment redeployed from Iraq to Afghanistan in support of the
    2009 surge included most of our deployed medium tactical fleet, the
    majority of our fleet of Mine Resistant Armor Protected vehicles, light
    armored reconnaissance vehicles, other hard-to-move equipment, and
    theater-specific items. While shifting this equipment directly to
    Afghanistan enabled the Marine Corps to meet critical operational
    timelines, it resulted in the deferment of previously planned post-
    Operation Iraqi Freedom reset actions. These same assets comprise a
    significant portion of the Marine Corps' total reset liability and
    depot maintenance costs. Thus, a consequence of delaying reset actions
    on this equipment is the acceptance of considerable risk in the long-
    term readiness and future availability of our ground equipment. In
    addition, increased usage rates of our ground equipment and harsh
    operating environments over these many years at war have resulted in
    our ground equipment far exceeding planned peacetime usage rates by a
    factor of six.
        It is vital that we reset our equipment from nearly 10 years at war
    to maintain the necessary levels of readiness to posture ourselves for
    the future.
      --We estimate the cost of reset for the Marine Corps to be $10.6
            billion. $3.1 billion has been requested in fiscal year 2011 to
            reduce this liability, leaving a $7.5 billion deficit. $5
            billion of the $7.5 billion reset liability will be incurred
            upon termination of the conflict in Afghanistan. (Note: $2.5
            billion has been requested for reset in fiscal year 2012. These
            estimates assume no reset generation beyond fiscal year 2012
            and thus do not include any reset requirements for fiscal year
            2013 and fiscal year 2014.)
        This funding will support the depot-level maintenance of our
    Operation Enduring Freedom equipment, procurement of combat vehicles
    and major weapons systems, engineering equipment, ammunition
    expenditures, and combat losses. The reset estimate is based on current
    circumstances and will change as operational requirements are re-
    evaluated. Moreover, as long as the war continues, our costs for reset
    will grow accordingly.
        Reconstitution of Equipment.--Our experiences in combat operations
    over the past decade have shown us that our legacy 20th century tables
    of equipment are inadequate with regard to the demands of the modern
    battlefield. As we move toward finalizing our force structure review by
    conducting a thorough Doctrine, Organization, Training, Materiel,
    Leadership and Education, Personnel, and Facilities assessment, we will
    finalize determination on the costs associated with modernization of
    equipment sets necessary to support our future operations.
      --However, at this time, our initial estimate of reconstituting our
            tables of equipment is $5 billion, which is an amount entirely
            separate from our reset costs. We have begun to address our
            reconstitution shortfall by requesting $253 million in fiscal
            year 2012 for equipment procurement.
        As our force structure review is implemented, we will continue with
    deliberate assessments of the modernization requirements for equipment
    that optimizes our post-Afghanistan posture while simultaneously
    reinforcing our frugal and responsible roots. Our Service
    Reconstitution Equipment Strategy will guide the identification of
    emerging requirements for refining the capabilities of our status as a
    middleweight force, our support to the Geographic Combatant Commanders,
    our service level prioritization, and resource allocation.
        Marine Aviation.--We are transitioning our entire inventory of
    fixed and rotary wing aircraft to support our future force and require
    ongoing support from Congress for this comprehensive aviation
    modernization effort. The continued development and fielding of the
    short take-off and vertical landing (STOVL) F-35B Joint Strike Fighter
    remains the centerpiece of this effort. The capability inherent in a
    STOVL jet facilitates our maneuver warfare doctrine and fills our need
    for close air support in the many austere conditions and locations
    where we will likely operate in the future. Around the world, there are
    10 times as many 3,000-foot runways capable of handling a STOVL jet as
    there are 8,000-foot runways required of conventional fighter aircraft.
    Additionally, we maintain the organic ability to build an expeditionary
    3,000-foot runway in a matter of days in support of aviation
    operations. The capabilities of the STOVL F-35B enable the Marine Corps
    to replace three legacy aircraft types--F/A-18, EA-6B, and AV-8B--which
    once fielded will save the Department of Defense approximately $1
    billion per year in operations and maintenance costs. The F-35B program
    has made significant progress to date including 22 successful vertical
    landings so far this year which is more than double that achieved all
    last year. I am confident that we will field this aircraft in
    accordance with responsible timelines. This matter has my unwavering
    attention, and I am personally overseeing this program. With a fully
    fielded fleet of F-35Bs, the Nation will maintain 22 capital ships--11
    carrier and 11 amphibious assault--with fifth generation strike assets
    aboard--a significant deterrent and response capability for our Nation.
        Our legacy aircraft supporting operational missions are consuming
    service life at a rate up to three times faster than scheduled.
    Averaged across our complete fleet, we are consuming aircraft service
    life at a rate 1.85 times faster than planned. This reality results in
    compressed timelines between re-work events and in earlier retirement
    of aircraft than originally programmed. The majority of our legacy
    platforms are nearing the end of their service lives, and most
    production lines are closed. New aircraft with low average ages and
    robust service life projections are the future of our aviation force
    and its support of Marine Corps and joint operations. As we transition
    to these new capabilities, we are mindful of the need to ensure a fully
    integrated and networked force to provide Marine aviation to the MAGTF
    and the Joint Force.
        We are exploring the viability of transformational platforms such
    as the Cargo Unmanned Aircraft System. The Cargo UAS will facilitate
    the delivery of logistics to remote locations when weather or threat
    systems preclude manned aviation sorties or overland resupply convoys.
        Our new aircraft will provide increased range, speed, standoff,
    time on station, lift capability, and will be critical to tomorrow's
    MAGTF. By 2020, we will transition more than 50 percent of our aviation
    squadrons to new aircraft and complete fielding of the tilt-rotor MV-22
    Osprey assault support aircraft and the upgraded UH-1Y Huey utility
    helicopter. We will field new close air support platforms such as the
    AH-1Z attack helicopter and the STOVL F-35B. We also will have new
    platforms for intelligence, surveillance and reconnaissance and an
    entirely new family of Unmanned Aircraft Systems. Last, we will
    introduce greater lifting power to the MAGTF with a new model of the
    heavy-lift CH-53 cargo helicopter.
        Ground Combat and Tactical Vehicle Strategy.--The priority for our
    Ground Combat Element is our ship to shore tactical mobility. The
    seamless transition of our Operating Forces from the sea to conduct
    sustained operations ashore, in particular to support three balanced
    Marine Expeditionary Brigades (i.e. two sea-based Joint Forcible Entry
    Marine Expeditionary Brigades reinforced by a third Maritime
    Prepositioning Force-based Marine Expeditionary Brigade) as well as for
    conducting irregular warfare missions, necessitates an appropriate mix
    of ground combat vehicles. We are focusing our efforts on developing
    and fielding a family of vehicles with a balance of performance,
    protection, payload, transportability, fuel efficiency, and
    affordability that supports the rapid concentration and dispersion of
    combat power, supports strategic deployment concepts and meets our
    world-wide operational commitments.
        Our Ground Combat and Tactical Vehicle Strategy is currently in its
    third phase of development. Its overall goal is to field a ground
    combat vehicle portfolio structured to support the ground combat
    element. Vehicles in this portfolio include the Joint Light Tactical
    Vehicle, the Marine Personnel Carrier, and a new amphibious combat
    vehicle.
        In the complex future security environment, the execution of
    amphibious operations requires the use of the sea as maneuver space. An
    amphibious combat vehicle is essential to our ability to conduct
    surface littoral maneuver and seamlessly project ready-to-fight Marine
    units from sea to land in permissive, uncertain, and hostile
    environments. As the Secretary of Defense affirmed earlier this year,
    the cancellation of the Expeditionary Fighting Vehicle is by no means a
    rejection of the Marine Corps amphibious assault mission.
        The standing, validated requirement for, and development of, an
    amphibious combat vehicle will ensure we continue to develop the right
    platform--at the right price--to support rapid ship to shore movement.
    To that end, we are now pursuing an integrated new vehicle program with
    three components, crafted from inception for affordability and
    leveraging the investment made in the EFV. We intend to mitigate risks
    associated with a new vehicle program and to maximize value by use of
    an integrated acquisition portfolio approach. This approach will have
    three synchronized efforts: Acceleration of the procurement of Marine
    Personnel Carriers; investment in a service life extension program and
    upgrades for a portion of the existing amphibious assault vehicles; and
    development of a new amphibious combat vehicle.
        We intend to manage these complementary capabilities, requirements
    and acquisitions from a portfolio perspective.
    Navy Support
        The Navy Marine Corps Team.--As part of the Joint Force, the Marine
    Corps and the Navy partner to leverage the significant advantages
    provided by amphibious forces--a point reinforced by joint
    doctrine.\12\ The Navy and Marine Corps team will be postured and
    engaged forward to be most operationally relevant to the needs of our
    Nation. Together, we provide the capability for massing potent forces
    close to a foreign shore while maintain a diplomatically sensitive
    profile. And, when needed, we are able to project this power ashore
    across the range of military operations at a time of our Nation's
    choosing, collectively demonstrating the essence of naval deterrence.
    ---------------------------------------------------------------------------
        \12\ ``Timely response to crisis situations is critical to U.S.
    deterrent and warfighting capabilities. The timeliness of U.S. response
    is a function of U.S. forward deployed forces and prepositioned forces
    with adequate organic movement capability . . ..'' Joint Publication 3-
    35, Joint Deployment and Redeployment Operations, 7 May 2007, pg I-8.
    ---------------------------------------------------------------------------
        Amphibious Shipping.--The Marine Corps' requirement to deploy
    globally, rapidly respond regionally, and train locally necessitates a
    combination of tactical airlift, high-speed vessels, amphibious ships,
    maritime preposition shipping, organic tactical aviation, and strategic
    airlift. The inherent flexibility and utility of amphibious ships is
    not widely understood, as evidenced by the frequent--and erroneous--
    assumption that ``forcible entry capabilities'' alone define the
    requirement for amphibious ships. The same capabilities that allow an
    amphibious task force to deliver and support a landing force on a
    hostile shore enables it to support forward engagement and crisis
    response. In fact the most frequent employment of amphibious forces is
    for steady state engagement and crisis response. The Geographic
    Combatant Commanders have increased demand for forward-postured
    amphibious forces capable of conducting security cooperation, regional
    deterrence, and crisis response reflecting the operational value of
    amphibious forces for missions across the range of military
    operations.\13\ In an era of declining access and strategic
    uncertainty, I anticipate that this upward demand trend will continue.
    ---------------------------------------------------------------------------
        \13\ Since 9/11 U.S. amphibious forces have responded to crises and
    contingencies at least 50 times, a response rate more than double that
    of the Cold War.
    ---------------------------------------------------------------------------
        Our principal contribution to U.S. Global Defense Posture is our
    ``rotationally responsive'' forces aboard amphibious ships. These
    forces combine the advantages of an immediate, yet temporary, presence,
    graduated visibility, and tailored, scalable force packages structured
    around the MAGTF. Rotational Amphibious Ready Groups/Marine
    Expeditionary Units forward deployed in three Geographic Combatant
    Command areas of responsibility, not only provide the capability for
    crisis response, but also present a means for day-to-day engagement
    with partner nations. Rotational forces also offer additional
    flexibility for decisionmakers in the event that forces are required to
    rapidly re-deploy across divergent regions and conflicts.
        In January 2009, the Navy and Marine Corps agreed that the force
    structure requirement to support a 2.0 Marine Expeditionary Brigade
    lift is 38 total amphibious assault ships. In light of the fiscal
    constraints, the Department of the Navy agreed to sustain a minimum of
    33 total amphibious ships in the assault echelon. This number gives a
    capability needed for steady state operations and represents the
    minimum number of ships needed to provide the Nation with a sea based
    power projection capability for full spectrum amphibious operations--
    including the amphibious assault echelon of two Marine Expeditionary
    Brigades.
        The Marine Corps is committed to the spiral development of the
    America Class LHA (R), which is 27 percent complete. We expect the Navy
    to take delivery of LHA-6 in fiscal year 2014 with availability to
    deploy beginning in fiscal year 2017. In terms of LHA-7, we anticipate
    the contract award in late fiscal year 2011 with fabrication commencing
    the following year. These two ships are maximized for aviation, and I
    believe it is essential that a well-deck be reintroduced in LHA-8 as
    currently planned. The ongoing procurement and commissioning of the
    final 2 of our planned 11 San Antonio class LPD-17 ``Common Hull
    Forms'' is critical to providing the lift capacities and operational
    capabilities to support the full range of military operations up to and
    including forcible entry.
        Maritime Prepositioning Assets.--The Maritime Prepositioning Force
    (MPF) program exists to enable the rapid deployment and engagement of a
    Marine Air Ground Task Force anywhere in the world in support of our
    National Military Strategy. The current MPF force, which has been
    employed 55 times since 1985, is composed of a fleet of 16 ships
    divided into three Maritime Pre-Positioning Ships Squadrons located in
    the Mediterranean Sea, Indian Ocean (Diego Garcia), and Pacific Ocean
    (Guam and Saipan). With the restructure of the Maritime Prepositioning
    Force-Future, the Marine Corps and Navy have focused on an interim
    solution to enhance current MPF with three new ships to enable future
    sea-basing concepts. The addition of three Mobile Landing Platforms
    (MLP) and three T-AKE auxiliary dry cargo ships to the Maritime
    Prepositioning Ship Squadrons, coupled with existing Large, Medium-
    Speed, Roll-On, Roll-Off (LMSR) cargo ships, will enable the MPS
    squadrons to conduct at-sea, sea-state three, selective offload of
    vehicles, personnel, and equipment without complete reliance on fixed
    ports ashore. The introduction of MLPs, T-AKEs, and LMSRs provide the
    Navy and Marine Corps team a substantial step in enhancing our current
    sea-basing capabilities.
        The Department of the Navy is currently funding the full MPF
    program of 16 ships through fiscal year 2012; however, the DON POM-13
    places one Maritime Prepositioning Squadron (six ships) in a Reduced
    Operational Status beginning in fiscal year 2013. We will continue to
    optimize the MPF program to remain responsive and relevant to
    Geographic Combatant Commander requirements.
        Naval Surface Fire Support.--The Marine Corps has an enduring
    requirement for fire support from naval vessels in the range of 41-63
    nautical miles to support amphibious operations in the littorals. These
    fires are needed by tactical commanders to maneuver toward battlefield
    objectives once ashore, contributing to joint doctrine for assured
    access. They serve as a component of the balanced and complementary
    joint triad of fires. Yet, unlike tactical aviation and ground fire
    systems, naval surface fires are unique and vital for their volume,
    lethality, accuracy and all-weather capability.
        Planned reductions in the procurement of certain naval ships along
    with cancellation of specific weapons programs over the past few years
    have led to a deficiency in systems available for naval surface fires.
    Completed in 2009, the Joint Expeditionary Fires Analysis of
    Alternatives identified the optimum U.S. Navy programs to support
    Marine Corps naval surface fire support requirements. This study
    established the baseline capabilities of the current naval surface fire
    support program of record (13nm projectile of the 5-inch gun and the
    Advance Gun System of the DDG 1000) to be insufficient in mitigating
    fire support gaps. The study determined that extended range 5-inch
    munitions would serve as a complementary alternative to the three DDG
    1000s. Dramatic improvements in 5-inch projectiles can extend the naval
    surface fire support maximum range, across the 106 guns in the surface
    fleet, from 13 to 52 nautical miles with precision, high angle attack
    for use in operations in urban terrain, and potential effectiveness
    against moving targets. We also support ongoing research and
    development of transformational technologies like the Electro-Magnetic
    Rail Gun with its potential to revolutionize the reach, coverage, and
    responsiveness of ship-based naval gunfire to ranges in excess of 200
    nautical miles.
        Assured Access.--We remain vigilant of burgeoning anti-access/area
    denial threats proliferating around the globe, particularly in the
    Pacific Rim. The family of guided rockets, artillery, mortars, missiles
    and subsurface systems like mines and quiet submarines, pose a
    challenge to the power projection capability of seaborne expeditionary
    forces and threatens DOD's ability to prevent and deter conflicts and
    prepare for a wide range of contingencies.
        Marine Air Ground Task Forces ashore and aboard amphibious shipping
    will support operations to ensure the freedom of action of U.S. and
    Allied forces by establishing expeditionary bases and airfields or
    defending advance bases. Marine Short Take-off and Vertical Landing
    aviation assets will be of particular value in overcoming adversary
    anti-access and area denial capabilities since they can operate from
    short or degraded airfields, can be rapidly dispersed, and can utilize
    both large carriers and amphibious ships for attack, maintenance, force
    protection, and dispersal purposes. The Joint Force Commander can
    leverage these unique capabilities to ensure the sea control necessary
    for the conduct of subsequent joint operations, whether they be power
    projection, forcible entry, or freedom of navigation.
        In this regard, we are partnered with the joint community to
    develop an overarching concept to attain operational access. This year,
    we will employ our war-gaming capability in Expeditionary Warrior 2011
    to examine operations designed to overcome anti-access challenges. We
    are partners with the U.S. Navy and the U.S. Air Force in the
    development of the Air-Sea Battle Concept aimed at integrating
    capabilities to defeat these advanced weapon systems in maritime areas
    of strategic interest. We also continue to participate in the U.S.
    Army's Joint Forcible Entry Warfighting Experiment, examining
    capabilities to conduct airborne and amphibious forcible entry
    operations.
    Personnel and Organizatonal Initiatives
        People.--Today's Marine Corps represents less than one-tenth of 1
    percent of the U.S. population, and the individual Marine remains our
    most valuable asset. Our 202,100 Active Duty and 39,600 Selected
    Reserve end strength allow us to meet current operational commitments
    while promoting resiliency throughout our Total Force. In fiscal year
    2010 Marine Corps Recruiting Command accessed 1,703 officers (100.18
    percent of the 1,700 officer goal). Our fiscal year 2011 accession
    mission is 1,650 active duty officer accessions with the same goal
    projected in fiscal year 2012. In terms of enlisted accessions, we are
    exceeding our internal quality standards of 95 percent enlisted
    recruits entering the Marine Corps possessing a high school diploma and
    63 percent qualifying in the DOD I-IIIA mental group categories (DOD
    quality standards are 90 percent and 60 percent respectively). We will
    achieve our mission of 31,500 enlisted active component non-prior
    service recruits in fiscal year 2011. Enlistment Bonuses remain vital
    to meeting the continuing requirement for high demand skills. We are
    continuing to experience unprecedented retention in both first-term and
    career Marines.
        We will continue to shape our Total Force to provide the ideal
    grade and military occupational specialty mix needed for sustainment.
    Our force structure review developed ways to increase unit readiness
    within our operating forces to ensure 99 percent manning of enlisted
    billets and 95 percent manning of officer billets. At the close of the
    Future Years Defense Program, we will work with the Secretary of
    Defense on a responsible drawdown of our end strength that is aligned
    with the future mission demands of a post-Operation Enduring Freedom
    security environment. I am determined to ``keep faith'' with our
    Marines and their families by designing and executing a responsible
    drawdown from our current 202,100 end strength such that we avoid
    reduction-in-force actions and early retirement boards.
        The Marine Corps is committed to making concerted efforts to
    attract, mentor, and retain the most talented men and women who bring a
    diversity of background, culture and skill in service to our Nation.
    Our diversity effort is structured with the understanding that the
    objective of diversity is not merely to achieve representational
    parity, but to raise total capability through leveraging the strengths
    and talents of each and every Marine. The success of our pioneering
    Female Engagement Team program in Afghanistan, which is an offshoot of
    a similar effort we employed in Iraq, is one way that the Marine Corps
    utilizes diversity within our ranks for operational benefit.
        We are currently developing a comprehensive, Service-wide strategy
    on diversity, an effort facilitated through our standing Diversity
    Review Board and a Diversity Executive Steering Committee chartered to
    establish the foundations for diversity success in the Total Force. The
    Marine Corps has established minority officer recruiting and mentoring
    as the highest priority in our recruiting efforts. Along with the other
    Services, we have provided timely input to the congressionally
    sanctioned Military Leadership Diversity Commission and look forward to
    release of the Commission's final report scheduled for March 2011.
        Marine Air Ground Task Force Enhancements.--To further posture
    ourselves for the future, we are evaluating the internal workings of
    our MAGTFs to account for the distributed operations, decentralized
    command and control, dispersed forces and diffuse threats inherent on
    the modern battlefield. We are implementing a diverse suite of command
    and control systems within all elements of the MAGTF. We continue to
    work to build the capacity of new organizations like the Marine Corps
    Information Operations Center to achieve non-lethal effects in today's
    irregular and complex environments. We are ensuring the rapid analysis,
    fusion, and dissemination of intelligence down to the tactical level by
    continuing implementation of the Marine Corps Intelligence,
    Surveillance, and Reconnaissance Enterprise. We also aim to reorganize
    our intelligence collection and exploitation capabilities, increasing
    the ratio of resources to users. We will also capitalize on the
    capabilities of unmanned aircraft systems via an increase in capacity.
        We are developing regionally focused Marine Expeditionary Brigade
    command elements that are joint task force capable, with habitually
    aligned subordinate elements, to improve Geographic Combatant Commander
    effectiveness and speed of response. We have recently stood up one such
    element in Bahrain in support of U.S. Central Command. To better
    standardize operations and training for units and staff in our ground
    combat element, we established the Marine Corps Tactics and Operations
    Group, which reached full operational capability in May 2010. Among
    other measures, this organization's mission is to support the
    refinement of our doctrine, including how our infantry companies will
    fight in the future. Building on the successes of the Marine Corps
    Tactics and Operations Group for the ground combat element, we are also
    developing and establishing a Marine Corps Logistics Operations Group
    capability for the Logistics Combat Element along with reorganizing
    Marine Logistics Groups to establish standing Combat Logistics
    Battalions habitually aligned to specific Marine Expeditionary Units
    and infantry regiments.
        Over the past decade, we have become more reliant on equipment sets
    resulting from the emergence of new threats, perhaps most notably the
    improvised explosive device. This trend has resulted in the acquisition
    of some resources that are incompatible with the ethos of an agile,
    expeditionary force. To that end, we have begun an effort known as
    ``Lightening the MAGTF,'' a measure aimed at reducing the size, weight,
    and energy expenditure of our forces from the individual rifleman to
    wholesale components of the MAGTF.
        Sustained combat operations and worldwide theater security
    cooperation and training commitments over the last decade point toward
    an essential requirement for the Marine Corps Reserve to continue
    focusing at the operational, rather than strategic level of warfare.
    Since 9/11, our Marine Corps Reserve has engaged continuously in combat
    operations as well as in regional security cooperation and crisis
    prevention activities in support of the Geographical Combatant
    Commanders. This operational tempo has built a momentum among our war
    fighters and a depth of experience throughout the ranks that is
    unprecedented in generations of Marine Corps Reservists. In fact,
    today's Marine Corps Reserve is more highly trained, capable, and
    battle-tested than at any time since the Korean War.
        The transition in utilization of the Marine Corps Reserve from a
    strategic to operational Reserve, as affirmed by our force structure
    review, expands our ability to perform as America's Expeditionary Force
    in Readiness. Sharing the culture of deployment and expeditionary
    mindset that has dominated Marine Corps culture, ethos and thinking
    since our beginning more than two centuries ago, the Marine Corps
    Reserve is optimally organized, equipped, and trained to perform as an
    operational Reserve.
        Institutions for Irregular Warfare.--Irregular operations (e.g.
    Counterinsurgency, Stability Operations, Foreign Internal Defense,
    Unconventional Warfare and Counterterrorism) often occur in response to
    crisis and are executed in austere conditions--situations often
    entailing employment of Marines. Our experiences countering irregular
    threats in ``Small Wars'' is a result of responding to complex crises
    involving a mix of security, economic, political, and social issues--
    usually under austere physical conditions. Our approach to irregular
    warfare is based on the understanding that people, ideas and
    organizations--not platforms and advanced technology--are the keys to
    success in operating in complex and irregular warfare environments.
    Naval forces conducting theater security operations and security force
    assistance to build partnership capacity also provide the Nation the
    potential for immediate crisis response capability and options for
    escalation or de-escalation. Building on our lessons learned in Iraq
    and Afghanistan, we are developing options to re-organize, consolidate,
    and strengthen our institutions that emphasize our irregular warfare
    and multi-mission capability such as the Center for Advanced
    Operational Culture and Learning, the Security Cooperation Training and
    Education Center, and the Center for Irregular Warfare. The objective
    is to gain unity of effort, increase effectiveness and efficiency, and
    reduce redundant capacity.
        We established the Marine Corps Training and Advisory Group (MCTAG)
    within the past 5 years to train, equip, and deploy Marines for
    Security Force Assistance missions in support of Geographic Combatant
    Commander theater security cooperation plans. The MCTAG provides
    conventional training and advisor support to Host Nation Security
    Forces. This organization also offers planning assistance to Marine
    regional component commands in developing and executing partner nation
    training programs. The MCTAG is scheduled to reach full operating
    capability in September 2011 and to date has directly trained more than
    180 Marines and Sailors and assisted in the training of more than 600
    Marines and Sailors, who themselves have conducted in excess of 150
    deployments to more than 50 countries worldwide. The MCTAG has also
    developed programs of instruction to train joint service advisors/
    trainers deploying on theater security cooperation missions as well as
    programs of instruction to train light infantry battalions from the
    Republic of Georgia in executing combat operations in Afghanistan.
        Because the Marine Corps functions in an integrated fashion
    throughout all traditional domains--land, sea, air, and space--it is a
    logical step forward for us to be optimally organized, trained and
    equipped to operate synergistically on the modern battlefield, which
    now includes the cyber domain. As U.S. Cyber Command matures and
    sponsors initiatives to increase cyber operational capacity, we are
    taking deliberate steps to build additional Marine Corps cyber
    capability and capacity to meet joint and service-level demands.
        We see the continued development of organic cyber capabilities,
    capacities, and awareness as a critical element to retain speed,
    precision, and lethality across the entire spectrum of operations. We
    are working to incorporate scenarios into our exercises to increase
    opportunities for Marines to leverage cyber capabilities while also
    training Marines to operate where cyber-enabled warfighting capability
    may be degraded and/or contested. Additionally, we are integrating
    tailored cyber education into our officer and enlisted professional
    education programs. We are continuing to examine our options for
    recruiting, training and retaining our cyber workforce. This is
    especially challenging given the highly specialized skill sets and the
    competition for such in both the Federal and Private sectors.
        Formed in 2006, Marine Special Operations Command (MARSOC) is
    currently conducting an internal reorganization into three mirrored
    battalions. Upon completion of this reorganization in fiscal year 2014,
    Marine Special Operations Command will have one regiment consisting of
    three battalions, 12 companies, and 48 Marine Special Operations Teams.
    Since December 2009, MARSOC has maintained an enduring battalion-level
    Special Operations Task Force headquarters and two companies in
    Afghanistan along with persistent Marine Special Operations Team
    engagements in other high priority regions.
        Since its inception, the Marine Corps has resourced Marine Special
    Operations Command with significant investments in military
    construction for training facilities, barracks and headquarters. In the
    near term, MARSOC will have 2,678 personnel. Our force structure review
    recently evaluated ways to increase the number of combat support and
    combat service support Marines (e.g. logisticians, intelligence
    personnel, etc.) enabling MARSOC's operations. I intend to add 1,001
    Marines to MARSOC, which will increase its capacity by 44 percent.
    These Marines, who are above and beyond the planned fiscal year 2014
    personnel increase, will better enable it for effective special
    operations.
        The Marine Corps serves as the Department of Defense Non-Lethal
    Weapons Executive Agent responsible for developing program
    recommendations and stimulating non-lethal weapons requirements. Non-
    lethal effects are part of the Department of Defense portfolio of
    capabilities that enhance the Joint Force Commander's ability to act in
    a timely manner to detect, deter, prevent, defeat, or, if necessary,
    mitigate the effects of an attack. Non-lethal capabilities provide the
    Joint Force the ability to selectively target hostile threats, covered
    or concealed by civilian assets, while avoiding collateral damage.
    Geographic Combatant Commands are registering increased demand for non-
    lethal weapons options to include items such as arresting nets, dazzler
    lasers, acoustic hailing devices, electric stun guns, blunt impact
    munitions, and non-lethal warning munitions. The Joint Non-Lethal
    Weapons Program continues to support joint and combined non-lethal
    weapons research, development, training and exercises in support of all
    Geographic Combatant Commands.
        Expeditionary Energy.--The Marine Corps is leading the development
    of expeditionary energy solutions for DOD and the Department of the
    Navy--reducing energy demand in our platforms and systems, increasing
    the use of renewable energy, and instilling an ethos of energy and
    water efficiency in every Marine. Our priority is force protection--
    saving lives by reducing the number of Marines at risk on the road
    hauling fuel and water. We also aim to help Marines travel lighter and
    move faster through the reduction in size and amount of equipment and
    the dependence on bulk supplies.
        In February 2011, we issued a ``Bases to Battlefield''
    Expeditionary Energy Strategy Implementation Planning Guidance, which
    sets goals, performance metrics, and a plan for implementation by 2025.
    This strategy supports congressional and Department of the Navy goals
    to increase energy security through the use of alternative fuels and
    energy efficiency. Since 2009 we have aggressively pursued renewable
    energy and energy efficient capabilities that will make Marine units
    more energy self-sufficient, and ultimately increase our combat
    effectiveness.
        Within 1 year, we stood up an Experimental Forward Operating Base,
    sourced commercial and government technologies, trained an infantry
    company with renewable energy technology, and deployed them to
    Afghanistan in the winter of 2010 where they operated two patrol bases
    entirely on renewable energy. As a result, our forces required less
    fuel and batteries, reducing risk to Marines and saving money. This
    year, the Experimental Forward Operating Base will focus on the
    requirements of a major battlefield energy user--the Command Operations
    Center and the Command Element--and will evaluate a second round of
    energy technologies to support expeditionary operations.
        In fiscal year 2012 we are devoting more resources--in current
    programs and new areas--to build a foundation to achieve our goals for
    increased energy efficiency and renewable energy by 2025. As a starting
    point, we anticipate savings of petroleum over the Future Years Defense
    Program in our Overseas Contingency Operations of 100,000 to 150,000
    barrels. For example this year, we are procuring mobile electric power
    sources to achieve 17 percent fuel efficiency using U.S. Army funded
    development and Marine Corps funded procurement monies. We are also
    fielding Enhanced Efficiency Environmental Control Units to achieve 15-
    30 percent power efficiency improvements.
        Installation Energy.--We are also devoting more resources to our
    Energy Investment Program than ever before. These funds will be used to
    implement the results of recent and ongoing energy audits at our
    installations; install more efficient systems and reduce overall energy
    consumption. Additionally, new facilities will continue to incorporate
    the latest energy sustainability and efficiency features. This effort
    aboard our installations complements our Corps-wide initiative to
    develop an energy ethos and culture of conservation.
    Training
        Training MAGTFs.--We are utilizing our Marine Corps Service
    Campaign Plan as a roadmap to strengthen and maintain our core
    competencies and to ensure we remain America's Expeditionary Force in
    Readiness well into the future. This effort also will also help
    synchronize our Service level security cooperation activities in
    support of national strategy and guide the type of training and
    exercises we must conduct, in particular at the Marine Expeditionary
    Brigade level.
        Our amphibious core competency figures prominently in our Service
    Campaign Plan, and as a result we have undertaken an array of exercise
    planning in this critical skill area. We will soon be conducting a
    MAGTF Large Scale Exercise that will refine our capability to conduct
    amphibious power projection and sustained operations ashore in a joint
    and inter-agency environment. In late-2010 we conducted Exercise Bold
    Alligator 2011, the first large-scale amphibious training exercise with
    the Navy on the east coast in almost 10 years. This synthetic training
    event practiced planning for forcible entry operations against
    conventional and asymmetric threats and a large scale non-combatant
    evacuation operation. We will take lessons learned from this exercise
    and build upon them for the next iteration of this important exercise
    with the U.S. Navy scheduled in the coming year.
        We are reviewing the core functions of our organizations and, where
    appropriate, adding irregular warfare capabilities to reflect the full
    spectrum of possible employment options as a core task set for the
    Marine Expeditionary Brigade. We view integration with other government
    agencies and coordination with non-government organizations as
    essential to our success in irregular warfare and have significantly
    increased interagency participation in numerous exercises and training
    venues such as Expeditionary Warrior-09/10, Emerald Express, Joint
    Urban Warrior-09, and Joint Irregular Warrior-10. We aim to capitalize
    on our current theater security cooperation and partnership capacity
    building activities with our allies and partners in all operational
    environments providing our National leaders with strategic options to
    shape outcomes, prevent and deter conflicts, strengthen ``at risk''
    states, and deny enemy safe-havens.
        priority #3 better educate and train our marines to succeed in
          distributed operations and increasingly complex environments
        Professional Military Education and Small Unit Leader
    Development.--We are planning more investments in the education of our
    non-commissioned officers and junior officers, as they have assumed
    vastly greater responsibilities in both combat and garrison. This focus
    on education will better train them for decisionmaking during
    distributed operations against more diffused threats over broader areas
    of the battlefield. The primary initiative to address this priority is
    to increase markedly their opportunities to attend resident
    professional military education. We are currently evaluating ways to
    increase throughput at resident professional military education courses
    with options for both constrained and unconstrained manpower and
    resource increases. We are evaluating traditional paradigms relative to
    course lengths and instructional methodology, with the specific
    objectives of tripling throughput at the Expeditionary Warfare School
    (Career level) and doubling resident Command and Staff College
    (Intermediate Level) throughput.
        These key leaders also impact unit cohesion and our overall
    effectiveness in combat. Introducing these leaders into a unit at the
    right time and stabilizing them in a life cycle continuum of a unit
    positively impacts a unit's effective training, performance and
    resiliency during pre-deployment training and post combat. These
    leaders are in the best position to influence our cultural ethos with
    its emphasis on intangible qualities such as esprit de corps,
    integrity, and ``service to country during time of war.'' We are
    currently reviewing manpower policies and models and will ensure these
    key leaders are present and able to lead a cohesive unit throughout its
    life-cycle continuum, including rigorous pre-deployment training and
    post deployment actions. This effort will ready our units for any
    fight, whether irregular or combat.
        We also intend to infuse Values Based Training, rooted in our core
    values of Honor, Courage and Commitment, at all levels of professional
    development to foster resilience and to enable effective operations,
    especially in complex irregular environments. Our overall goal is to
    institutionalize efforts to develop more mature, educated, and capable
    non-commissioned officers and maneuver unit squad leaders. As these
    concepts mature, there will be costs in terms of military instruction
    and facilities for which we will require congressional support.
        Regionalization and Specialization.--The increased call for
    engagement, as seen in our force structure review and in strategic
    guidance, requires Marines with improved cultural and language skills
    and formal education. To develop better specialization for anticipated
    future missions and operating environments, we will expand our Foreign
    Area Officer and Regional Affairs Officer programs, as well as
    opportunities to send more officers through graduate level training,
    fellowships and research opportunities--ideas supported by findings and
    recommendations of the 2010 Quadrennial Defense Review and the 2010
    Quadrennial Defense Review Independent Panel Report.\14\ This effort
    will extend to our ``Whole of Government'' approach toward irregular
    warfare as we seek greater exchanges and fellowships with the elements
    of the Interagency.
    ---------------------------------------------------------------------------
        \14\ 2010 Quadrennial Defense Review Report, pg 54; 2010 QDR
    Independent Panel Report, pgs 75-77.
    ---------------------------------------------------------------------------
        Marine Corps University.--We are continuing to implement
    recommendations of our 2006 Officer Professional Military Education
    Study (the Wilhelm Report) and are making significant strides in terms
    of resources and facilities enhancing the campus of the Marine Corps
    University (MCU). We have programmed approximately $125 million in
    Military Construction between fiscal year 2011-12 for new academic
    facilities for the Marine Corps War College, Command and Staff College,
    and the School of Advanced Warfighting. In addition, we will expand the
    Staff Noncommissioned Officer Academy at the main campus in Quantico.
    These funds represent only a down payment on a larger commitment to
    double the size of the University campus and to upgrade our enlisted
    academies world-wide. Completion of the MCU master plan will require
    the demolition and relocation of tenant units aboard the campus.
    Detailed documentation of costs associated is ongoing; however, we
    estimate over $400 million is needed to complete the master plan. Our
    ultimate goal is to develop the MCU into a premier institution with
    world-class faculty, facilities, students, and curricula; we will
    require the assistance of Congress in this goal.
     priority #4 keep faith with our marines, our sailors and our families
        Keeping Faith.--We expect and demand extraordinary loyalty from our
    Marines--a loyalty to country, family, and Corps. Our Nation has been
    at war for a decade, placing unprecedented burdens on Marines, Sailors,
    families, Wounded Warriors, and the families of the fallen. They have
    all made tremendous sacrifices in the face of danger. We owe them all a
    reciprocal level of loyalty. Our approach to caring for their needs is
    based on the same unwavering faithfulness they have demonstrated to the
    Marine Corps. We will ensure their needs are met during times of
    deployment and in garrison by providing the services, facilities, and
    programs to develop the strength and skills to thrive on the challenges
    of operational tempo. When needed, we will restore them to health. We
    will also transition them back to civilian life, and in the cases of
    our fallen Marines, we will support and protect their surviving spouses
    and dependents. We will do this by focusing on several areas this
    fiscal year.
        Combat Stress, Resiliency, Medical and Mental Health Care.--We
    continue to advocate for the highest quality medical care and
    facilities for our service members, retirees, and their families. To
    ensure the Department can continue to provide the finest healthcare
    benefits in the country to our beneficiaries, we fully support the
    medical efficiencies and adjustments in TRICARE included in the
    President's budget proposal.
        The evolving security environment requires a physically and
    mentally resilient Marine able to endure extended exposure to
    ambiguous, stressful, and ever-changing situations. Young leaders find
    themselves on the vanguard of a protracted war, adapting to a variety
    of situations and scenarios. To improve their resilience, we are
    working aggressively and creatively to build a training continuum that
    better prepares them for the inevitable stress of combat operations and
    to equip them with the necessary skills required to cope with the
    challenges of life as a Marine.
        Instruction founded and focused on our core values helps provide
    some of this resilience, especially in irregular warfare and complex
    environments. A program combining the ``best practices'' of mental,
    emotional and physical fitness will best instill in our Marines the
    resiliency needed to endure the stressors of combat and enhance their
    ability to perform effectively across the range of military operations.
    We are developing a comprehensive program to improve the resiliency of
    our Marines both in garrison and in combat.
        We are partnered with the Navy to address the nationwide dearth of
    qualified mental healthcare providers, which challenges our ability to
    provide care at some of our bases and stations and, in some cases, to
    our reservists in remote locations. During calendar year 2010, we saw a
    nearly 30 percent decrease in the number of suicides within our Total
    Force.\15\ We are too early in our suicide studies to identify what
    specific initiative(s) have resulted in this dramatic turnaround.
    However, we have implemented a number of measures on multiple fronts.
    Some of these include the following:
    ---------------------------------------------------------------------------
        \15\ Calendar year 2010 suicides = 37 whereas calendar year 2009
    suicides = 52.
    ---------------------------------------------------------------------------
      --Evocative Peer-led Training Program.--``Never Leave a Marine
            Behind'' suicide prevention program for non-commissioned
            officers and Junior Marines. We are expanding this training to
            include staff non-commissioned officers and commissioned
            officers this year.
      --DSTRESS Line Pilot Program with TRICARE West.--``By Marines-For
            Marines'' call center designed to assist with problems at an
            early stage. The call center is staffed by veteran Marines,
            providing anonymous service to all current Marines, veteran
            Marines, their families and loved ones.
      --Combat and Operational Stress Control and Operational Stress
            Control and Readiness Teams.--Utilizing unique training
            programs across the Total Force and ensuring the presence of
            mental health professionals in front-line units as a primary
            prevention tool to help Marines identify and mitigate stress.
      --Marine Resilience Study to Assess Risk and Resilience.--We are
            participating in a longitudinal research study that will
            examine risk across three domains: biological, psychological
            and social. The outcome of this study will inform our future
            work in the area of building and maintain resiliency across the
            Corps.
        We will continue advocating to the medical community for better
    diagnostic and increased treatment options for Marines with severe
    injuries including Post Traumatic Stress and Traumatic Brain Injury. In
    collaboration with the other services, we developed a set of events-
    based parameters, mandating that our leaders search out Marines who
    have experienced a concussive event. This measure no longer relies on
    identification of impacted service members solely on their willingness
    to seek help on their own initiative. These protocols are in place now
    in Afghanistan, and we are already seeing a culture change in the
    attitude of Marines about being treated early for a Traumatic Brain
    Injury.
        We have established an in-theater Restoration Center that brings
    comprehensive concussion diagnosis and management as close to the front
    lines as possible to ensure that appropriate care is available as
    quickly as possible. We are currently developing policy and
    applications to track Traumatic Brain Injury from ``point of injury''
    to ``return to full duty'' separately but in parallel with medical
    documentation. These measures will empower commanders with the
    information they need to monitor the health of a Marine who has
    suffered a concussive event and intervene appropriately for the
    duration of a Marine's career and long after the initial injury.''
        Transition Assistance.--We believe transition assistance should be
    a process not an event. We have established a goal to make the Marine
    Corps Transition Assistance Management Program more value added for our
    departing Marines. From 2009 to 2010, we conducted functionality
    assessments of the Transition Assistance Management Program and the
    Lifelong Learning Program and noted many deficiencies. In response, we
    established two Transition Assistance Operational Planning Teams in
    2010 to assess existing programs. We have developed an ``end to end''
    process improvement plan that will begin at the point of initial
    accession into the Marine Corps and continue through post separation.
    We are initiating actions and integrating existing capabilities that
    will most directly improve the quality of support provided to Marines
    within 6 months prior to separation and those who have been separated
    at least 6 months.
        Marines have expressed a desire for assistance navigating
    Department of Veterans Affairs benefit processes such as in cases of
    enrollment for and access to education benefits. We will modify
    existing websites to improve access and enhance opportunity for
    separating Marines to speak directly to Marine Corps support personnel
    who are trained to remove administrative benefit processing barriers.
    We will improve networking opportunities to help Marines find
    meaningful employment and are adapting our current job fairs to support
    increased networking opportunities that will allow them to meet mentors
    and employers.
        Marines have asked for an opportunity to connect with employers and
    learn how to translate their intangible and tangible attributes. Our
    transition workshops will be overhauled to address these needs. Marines
    are also seeking help to simplify enrollment processes for the post 9/
    11 Montgomery GI bill and to gain access to academic institutions that
    will provide the quality and level of business education and skills
    private industry demands. We have initiated a Leader-Scholar Program,
    which includes academic institutions who value Marines' service
    commitment and pledge special enrollment consideration. While the
    support varies from school to school, we now have 75 participating
    institutions with the goal of an additional 25 by the end of this year.
    As we gain momentum, we will continue to change the transition
    assistance program from its current event focus to that of a process
    that reintegrates Marines into the civilian sector with the knowledge,
    skills, and abilities to leverage and communicate their Marine Corps
    time and experience.
        Family Readiness Programs.--We increased baseline funding for
    family support programs beginning in fiscal year 2010 to ensure
    appropriate wartime footing. Programs benefitting from this measure
    include the Unit, Personal and Family Readiness Program; Marine Corps
    Family Team Building Program; Exceptional Family Member Program; School
    Liaison Program; and other miscellaneous Marine Corps Community
    Services Programs supporting remote and isolated commands, deployed
    Marines, and independent duty Marines and families. We are currently
    conducting a complete review to ensure effectiveness and efficiency of
    these programs. Our goal is to determine where expansion may be needed
    to further assist our families and where programs can be streamlined to
    reduce redundancy.
        Wounded Warrior Care.--Marines continue to suffer numerous wounds,
    trauma, and injuries during operations in combat and during training
    missions. Many of these brave heroes with significant injuries are
    convalescing at military treatment facilities here in the National
    Capital Region and across our Nation at other major military treatment
    facilities. Our Wounded Warrior Regiment provides non-medical care
    management services to wounded, ill, and injured Marines and their
    families. The Wounded Warrior Regiment continues to improve existing
    programs and add new support mechanisms. We have increased support to
    wounded, injured, and ill reserve Marines through additional Recovery
    Care Coordinators, enhanced family support at military treatment
    facilities, and one-on-one orientation sessions. We also provide
    Integrated Disability Evaluation System Support through Regional
    Limited Duty Coordinators and Wounded Warrior Attorneys. We have also
    initiated a mandatory Warrior Athlete Reconditioning Program. Outreach
    is an important aspect of the Regiment's non-medical care delivery and
    management. The Sergeant Merlin German Wounded Warrior Call Center
    extends support to Marines and families through advocacy, resource
    identification and referral, information distribution, and care
    coordination, 24 hours a day, 7 days per week.
        The comprehensive care coordination provided by the Wounded Warrior
    Regiment throughout the phases of recovery has been highly successful.
    The results of internal assessments have substantiated that creation of
    the Wounded Warrior Regiment has had a positive impact on the support
    offered wounded, injured and ill Marines and families. The Marine Corps
    will continue to honor the commitment to our Wounded Warriors and to
    help them return to full duty or successfully reintegrate into their
    communities.
        Behavioral Health Integration.--Behavioral health needs since 9/11
    have become increasingly complex with individuals often requiring
    assistance in a number of areas at one time. Marines with more than two
    deployments have been identified as a higher risk population. According
    to the Joint Mental Health Assessment Team, psychological health
    problems remain steady at 11 percent of Marines for the first and
    second deployments, but increase to 22 percent for those who have
    deployed three or more times. Sixty-five percent of Marines are under
    25 years old. Associated with this young force are high-risk factors
    that include communication and coping skills, isolation, combat-related
    wounds and substance abuse. Drawdown of end strength following
    Operation Enduring Freedom and return to garrison life will likely
    result in additional behavioral healthcare requirements as Marines
    redeploy and adjust to the garrison environment. We continue to move
    forward with our integration of prevention and intervention programs
    initiated in 2009. We have established a Behavioral Health Branch at
    our headquarters for Manpower & Reserve Affairs. Headquarters Marine
    Corps Health Services also has created and filled a new billet for a
    Director of Psychological Health.
        Military Construction.--The Marine Corps maintains its commitment
    to facilities and infrastructure supporting both operations and quality
    of life. Our military construction and family programs are important to
    success in achieving and sustaining our force structure and maintaining
    readiness. For many years, we funded only our most critical facility
    needs. As a result, our installations were challenged to properly house
    and operate the additional forces required to meet our planned end
    strength increase. Between fiscal years 2007-10, we received $6.9
    billion in new construction and design. With this funding, we are
    providing new quality of life facilities, improved operational and
    training facilities, and more modern utility infrastructure systems.
        Our fiscal year 2012 military construction budget request is $1.4
    billion. With these requested funds, we will provide Bachelor Enlisted
    Quarters, aviation support facilities, and improvements to quality of
    life, utilities and infrastructure, and professional military education
    facilities. Additional family housing efforts in fiscal year 2012
    include improvements to existing housing units and funding for the
    operations, maintenance, and leasing of 1,100 units worldwide and
    oversight of 22,000 privatized units.
                                   conclusion
        The United States Marine Corps remains the Nation's crisis response
    force-of-choice. Our continued success in Afghanistan and throughout
    the globe is made possible by the loyal sacrifice of our incredible men
    and women in uniform, Civilian Marines, and our Marine Corps family.
    The personnel, equipment, and training that have given us success over
    the nearly past 10 years at war has come through the ongoing support of
    Congress and the American people. I promise that your Marine Corps
    understands the value of each dollar provided and will continue to
    provide maximum return for every dollar spent.
        In the coming year, we will begin a deliberate transformation into
    a force optimized for the likely threats of the next two decades. We
    understand and appreciate the contribution that each Marine has made
    for this great Nation, and we recognize the heavy burden it has placed
    on their loved ones. We remain ``Always Faithful'' to our Marine Corps
    family, to Congress, to our chain of command and to the American
    people.

                      LITTORAL COMBAT SHIP SPLIT BUY PLAN

        Chairman Inouye. If I may, I'd like to begin asking
    questions.
        Mr. Secretary, you have received authorizations to have a
    split buy on the LCS. How will that benefit the Navy?
        Mr. Mabus. Mr. Chairman, as you pointed out, we have
    received authority to buy both variants, both the one made in
    Marinette, Wisconsin, and the one made by Austal in Mobile,
    Alabama. These ships bring us differing but important
    capabilities, each one of them.
        When I became Secretary, this program, in the summer of
    2009, bid out three ships. We had planned to buy both versions
    at the time, but the bids came in just unacceptably high. So,
    we made the decision to reduce that to one version, have the
    two yards compete against each other.
        Over the course of the next year, the bids came in
    dramatically reduced. The average ship cost, over 10 ships, for
    each variant is less than $440 million. By doing both versions
    and using two yards--and we had always planned on using two
    yards, whether we had one version or two--we were able to speed
    up the delivery of the ships. We were able to buy 10 ships,
    from 2011 to 2015, and to buy--from each supplier--which will
    get us almost one-half the class of ships--55--that we're
    planning to build with the littoral combat ship.
        This ship, and its two variants, is incredibly important to
    the Nation's future and to the Navy's ability to do the
    missions that we're given. Shallow draft, very fast, manning of
    about 40 people for the core crew, and another 30 for the
    weapons systems, gives us great flexibility to meet the
    challenges that we see in the future.
        Finally, the fact that it--that both these ships are
    modular, that you can take one weapon system off and put
    another one on, means, as technology improves and as weapon
    systems change, we can keep up with the technology, we can
    change weapon systems without changing the hull, without
    changing the entire ship.
        So, we think that this is going to provide us an incredible
    capability at a greatly reduced cost, almost $3 billion in
    savings, from the first 20 ships, and that it will give us the
    flexibility that we need to perform the missions that the Navy
    has been given.
        Chairman Inouye. You've spoken about the continuing
    resolution, and all of you have done the same. I can assure you
    that this subcommittee is very much against the continuing
    resolution, because that's no way to run the Government. And
    we'll do our best to go back into regular order. As you know,
    in the last fiscal year, we did--12 subcommittees--come through
    with our bills on time.

                 CONTINUING RESOLUTION IMPACTS ON 313 SHIP GOAL

        On the matter of 313, as Admiral Roughead stated--the base,
    the minimum--how will the continuing resolution and the
    budgetary crisis affect this number?
        Mr. Mabus. We have, as I pointed out, 56 ships across the
    FYDP. But, because of the continuing resolution, we are unable
    to begin one Virginia-class submarine this year. We have
    planned to build two each year, over the next--well, starting
    in 2011, over the next 6 years. And we have a multiyear
    procurement authorized by Congress to do that. If we are unable
    to start the second Virginia-class, we will break the
    multiyear, and we'll have to go in and renegotiate the cost of
    future Virginia-class submarines. We have two Arleigh-Burke
    DDG-51 destroyers that we cannot start as long as we are
    operating under the current continuing resolution.
        The impact--and one MLP--one mobile landing platform--the
    impact from not beginning those ships will have ripple effects
    as we go forward. It will keep us from reaching the numbers
    that we need as quickly as we need. It will mean that the ships
    will almost inevitably cost more, which may mean fewer ships.
    If our shipbuilding plan, that we submitted for fiscal year
    2011 and updated for fiscal year 2012, is fully built and
    funded, we will not only get to the 313 floor, but we will
    reach in the neighborhood of 325 ships early in the 2020s,
    which will give us what we need to have for a global fleet.
    But, we are very concerned that if we are unable to start these
    ships this year, in fiscal year 2011, that the ripple effects
    will have huge impacts as we go forward.
        Chairman Inouye. Thank you very much.

                            RUSSIAN NAVY ASSESSMENT

        Admiral Roughead, in recent months very little, if
    anything, has been said about the Russian navy. If you look at
    the front pages, you don't see anything about the Russian navy.
    But, at one time, it used to be a formidable force. What is
    your assessment of the Russian navy today?
        Admiral Roughead. Thank you very much, Senator.
        And, to your point, the Russian navy has not been in the
    news that much. And that really, in my opinion, is because, in
    the period of the 1990s, that the navy was significantly
    reduced in capability and capacity. The funding had fallen off.
    Several of the shipbuilding programs had stopped or atrophied.
        That has since changed in recent years. And with the
    economy contributing to the resources that are now made
    available to the Russian navy, I believe you're going to see an
    increase in the capability, the capacity, new shipbuilding
    programs taking hold. Recently, there are negotiations taking
    place, between France and Russia, on construction of a large
    amphibious ship. And so, I believe that the Russian navy, which
    still has great ambition, great pride in the fact that they are
    at a world-class level of capabilities, will now begin to, for
    want of a better term, rebuild itself, bring more modern
    capabilities to bear, and to be able to operate more widely.
        That said, I believe it's important that we work closely
    with the leadership of the Russian navy to see where there are
    opportunities for cooperation, to see where we can join
    together and have a relationship that is constructive and
    globally relevant.
        I think it's also important to note that we have been
    conducting operations with the Russian navy in the
    counterpiracy area.
        But, clearly I think, after a period of stagnation in the
    1990s, the Russian navy is moving again.

                            CHINESE NAVY ASSESSMENT

        Chairman Inouye. Can you give us an assessment of the
    Chinese navy?
        Admiral Roughead. Thank you, Senator.
        And I've been an observer of the Chinese navy now for
    probably over 15 years, where, because of my assignments in the
    Pacific, I've had an opportunity to not only visit China on
    several occasions, but also to be present when Chinese ships
    have called in Hawaii, when I was commanding there, and to have
    had the opportunity to spend several sessions with my Chinese
    counterpart, Admiral Wu Sheng Li. The Chinese navy is--has been
    advancing, developing, expanding their shipbuilding programs,
    increasing the level of technology that is available to them,
    and also beginning to operate more globally.
        Like the Russian navy, we also, for the last 2 years, have
    been operating daily with the PLA navy in counterpiracy
    operations.
        But, we see their submarine fleet expanding, surface
    combatants are expanding. But, it's also how they're using
    command and control and the nature of the operations that tend
    to expand beyond what we call the ``first island chain,'' in
    the western Pacific.
        It's a navy that's also seen the value, as we have, in
    aircraft carriers. And they have an aircraft carrier
    development program that's underway. The initial phase will be
    based on a former Russian aircraft carrier. But, I see that
    developing. And, as you know, the PLA has a longer view of
    time. And it's a very thoughtful approach on how you bring
    these capabilities to bear.
        Similarly, I believe it's important that we look for ways,
    as we're doing off the coast of Somalia, to develop a
    professional relationship, and to also develop personal
    relationships with the leaders in the PLA navy, so that we,
    too, can operate in ways that enhance the safety and the
    security of the world oceans. But, it's a navy that I would say
    is the fastest-growing, not just in capacity, but also in
    capability, in the world today.
        Chairman Inouye. I've been told that the Chinese have more
    submarines than we have. Is that correct?
        Admiral Roughead. Yes, sir, in terms of numbers. But, I
    also believe that there's a qualitative dimension to the
    submarine force. And there is no question in my mind that we,
    in the Navy--in the United States Navy--operate the most
    capable submarine force in the world. And with the advent of
    the Virginia-class submarine into our inventory, there's no
    finer submarine, no more capable submarine in the world today
    than the Virginia. And that's why being able to get to the
    build of two per year, to be able to take advantage of the
    multiyear, that the Secretary pointed out, why getting out from
    under the continuing resolution is key, because the Virginia
    submarine is the most capable warship that we have.
        Chairman Inouye. Thank you.
        May I ask General Amos a few questions.

           UNITED STATES MARINE CORPS FORCE STRUCTURE CHANGE IMPACTS

        The Marine Corps recently announced significant force-
    structure changes that will greatly affect the composition of
    your units in the future, making them lighter and more agile.
    This review stated that these changes will impact your budget
    request for fiscal year 2013 and beyond. However, we have
    before us the 2012 request for equipment that will likely start
    delivering when you begin implementing these changes. Can you
    explain to the subcommittee the immediate impact these force-
    structure changes on the procurement programs, such as MRAP
    tactical vehicles and other equipment will have?
        General Amos. Chairman, just a quick note on the effort
    itself. It began last fall, spent all fall with a lot of really
    smart folks working to determine what the Marine Corps should
    look like in a post-Afghanistan environment. That was the
    framework we began with. We began with the mission of the
    Marine Corps, which is America's expeditionary force and
    readiness, this crisis response force. So, using that as the
    background, and understanding that--and informed by, this would
    be a force post-Afghanistan, we began to take a look and say,
    ``Okay, with the future security environment that we will be
    likely working in for the next two decades, what would that
    force be required to do?'' And, again, informed with history,
    we said, ``What should it do? What kind of equipment would it
    need? How big would it need to be?'' So, the results were
    finished right around Christmas, and briefed to the Secretary
    of the Navy in January, the Secretary of Defense in early
    February.
        Right now, the Marine Corps sits at 202,000 marines. We
    grew--started in 1990---excuse me--started in 2007, from about
    182,000, up to 202,000. And that was so we could get some dwell
    time in our units, in--that are combat units that were
    deploying constantly in and out of Iraq, and certainly now in
    Afghanistan. That's happened, that's been very beneficial. But,
    does the Marine Corps need 202,000 in a post-Afghanistan
    environment? And the answer was no.
        So, based on that, we built a force with capability sets
    learned from the lessons--or, educated by the lessons of 9
    years of combat. I think it's a more capable force. We will go
    down to 186,800 marines. The guidance I have been given by the
    Secretary of Defense and the Secretary of the Navy is that that
    is conditions based. It is not designed to do this now, while
    we have 20,000 marines on the ground in Afghanistan. This is
    post-Afghanistan.
        So, we are looking now--when I made the comment, in my
    statement, that we were--they will have some immediate, during
    fiscal year 2012, changes; that's predominantly within the
    structure that we currently own. In other words, we're going to
    eventually reduce 21 headquarters as we flatten the Marine
    Corps to make it more capable and less complicated by higher
    levels of decisionmaking. So, we've collapsed or eliminated 21
    headquarters. We've eliminated three infantry battalions. But,
    those will not go away until the end of--until our war is over,
    until we come out of Afghanistan.
        So, within fiscal year 2012, there will be very little,
    other than just moving some capabilities around internally
    within the Marine Corps. For example, we'll probably go ahead
    and collapse a couple of these headquarters in fiscal year
    2012. We're going to take some of the structure that we
    currently have, and we're going to start putting it into our
    Cyber Command so we can beef that up. We're going to take some
    of our current 202,000 marines and move them into Marine
    Special Operations Command and begin that migration.
        So, the actual cost in 2012 will be transparent. Where we
    think we're going to begin to see some cost breaks will begin
    in 2013. We don't know precisely what that will be, because
    we're going through all the detailed analysis now of: Precisely
    when do you start drawing down equipment? Or, when do you stop,
    perhaps, buying equipment that you had planned on buying, at
    the rate that you were buying?
        So, we don't know the answers to that yet, Chairman. But,
    we will know that probably by June, as we begin to really get
    serious about the fiscal year 2012 budget. So, the end state
    will be a very capable force, capable of doing everything that
    we have done in the past, be slightly larger than what the
    force was when we began the buildup in 2007. But, it will be
    informed and--by all the lessons learned of almost--really,
    almost 10 years of hard combat.
        Chairman Inouye. Thank you very much.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you.

             U.S. NAVY DISASTER RELIEF ASSISTANCE TO JAPAN--SECNAV

        Mr. Secretary, we all have been watching the news reports
    from Japan and the vicinity, about the effects of the
    earthquake and other related collateral damages that may have
    been done in that region. Do we have naval forces that have
    been affected directly by this tragedy? And, if so, what are we
    doing to position for either relief efforts for our own troops
    and ships or land-based personnel who happen to be in the area?
    To what extent is the Navy involved in that?
        Mr. Mabus. Senator, first, thank you for your very kind
    remarks in your opening statement.
        We are very involved in all aspects of the relief effort in
    Japan. As CNO pointed out, we have, or will soon have, 14 ships
    and more than 10,000 people in Japan, or in the waters off
    Japan, to do humanitarian assistance and disaster relief. The
    marines have--from the 3rd Marine Expeditionary Force in
    Okinawa--have brought a headquarters company up, with 500
    marines, to very close to the affected area to do things like
    radiological testing, to do humanitarian assistance planning.
    They've also established a refueling station so that we can use
    our helicopters more effectively.
        We're also flying with fixed-wing aircraft to deliver
    humanitarian assistance. We're flying our helicopters--and we
    will soon have almost 70 helicopters--in the region or in the
    area that was affected. We're moving Japanese first-
    responders--Japanese troops--by ship to the affected area.
        In terms of our own folks there, as you well know from your
    visits there, we have ships home-ported in Japan. In Yokosuka,
    we have the USS George Washington and a couple of other support
    ships there. We have been monitoring the--what has been going
    on with this disaster. A couple of days ago, because of a wind
    shift, we recommended that our people in Yokosuka and other
    bases that we have on Honshu, the main island in Japan, remain
    indoors, to the maximum extent possible, because of radiation
    exposure. We didn't believe it was a threat to health or to
    life, but, out of precautions, we urged them to stay inside.
    The wind has since shifted again, and we've removed those
    precautions.
        We have moved our ships off the coast of Japan to keep them
    out of the plume that is developing. We are monitoring
    individuals that are actively engaged in the relief effort, to
    make sure that their radiation exposure is within appropriate
    bounds. We have done decontamination work on equipment, which
    mainly involves just washing them--washing surface radiation
    off--to date.

               U.S. NAVY DISASTER RELIEF ASSISTANCE TO JAPAN--CNO

        But, we're going to continue to, every moment, monitor the
    situation to--and, in case there are changes, to make the
    appropriate changes for our people who are there permanently
    and to the forces that we have sent to help in this
    humanitarian disaster.
        Senator Cochran. Admiral Roughead, do you have any comments
    to make along those lines?
        Admiral Roughead. Just to echo what the Secretary said. I
    think the benefit of having the forces forward-deployed, but
    also the flexibility that we derive from a global forward-
    deployed Navy, allowed us to move one of our aircraft carriers
    into position very promptly. The USS Ronald Reagan is off the
    coast of Honshu, operating in areas that are safe to operate
    in. And the nature of being able to close forces, to pick up
    from an exercise in Southeast Asia and, in a matter of days,
    move off the coast of Japan to be able to provide this
    assistance--and it's coming from all of our ships; it's not
    just the aircraft carrier. We have guided-missile destroyers
    that are serving as fueling pads for the helicopters that are
    involved in search and rescue. Our amphibious ships, with their
    capacity--and, as the Secretary mentioned, one of our
    amphibious ships is up on the island of Hokkaido, loading
    Japanese self-defense forces to be able to then go down to
    Honshu.

               U.S. NAVY DISASTER RELIEF ASSISTANCE TO JAPAN--CMC

        And I think what it describes is a global Navy that's
    forward, that's ready, that can respond, but it has a variety
    of capabilities that gives you that balance that can swing
    from, in one case, combat operations, all the way to
    humanitarian assistance. I think it's important to realize that
    the USS Ronald Reagan and her strike group were on its way to
    conduct combat operations in Afghanistan when, on a moment's
    notice, it shifted into a full humanitarian mode. That shows
    the flexibility of our force. Most importantly, it shows the
    flexibility and the compassion of our people.
        Senator Cochran. Thank you.
        General Amos, do you have Marine Corps forces in the
    region? And, if so, what's the effect on them?
        General Amos. Senator, we do. We have about 500 marines on
    the ground right now. They're at various locations. Some are at
    the Naval Air Station Atsugi, which is just south of--it's
    really in the suburbs of Tokyo. We have some at Yokota Air
    Force Base, where we brought in what we call our Expeditionary
    Mobile Command Post, which is a very capable trailer-like
    setup, where we can talk to just about anybody in the world,
    with enormous capability. So, we brought that in. And then we
    set up--just as the Secretary said, just east of the affected
    area, we set up a--what we call a forward arming and refueling
    point. We're certainly not doing any arming, but--that's what
    we call them--but, it's where we bring in the actual fuel and
    bladders. We bring in pumps. We bring in hoses. We can hook up
    to any jet aircraft. We can hook up to any helicopter. And
    that's what we do with expeditionary marine aviation.
        So, for us, being able to work in a very austere
    environment suits our capabilities well. So, we bring that. So,
    we are forward to the east, and we're south with command and
    control. And, as the Secretary and the CNO have said, we've got
    2,200 marines on board the USS Essex and that marine
    expeditionary unit.
        So, yet to be seen what they're going to do, but everybody
    is poised to assist with humanitarian operations. It can be
    everything from medical--it can be just evacuation. It can be
    food and water--clean water. It's a host of things, Senator.
    And so, we do this. We practice it. As I said, in my opening
    statement, we did it in Haiti, just about this time last year.
    We did it in Pakistan, 400 miles deep, when the floods--we've
    done it on the backside of the Philippines, when that super
    typhoon, Megi, came through. So, we actually--this naval force
    has an enormous capability.
        I was particularly proud and pleased that, within 12 hours
    notice, that eight C-130Js and eight 40-year-old CH-46
    helicopters, with their marines and their equipment, flew out
    of the Marine Corps air station, Futenma Okinawa, and headed
    north to help out their brothers and sisters on the mainland
    Japan.
        Senator Cochran. Thank you. We appreciate your leadership
    in monitoring U.S. interests in that region, and being a good
    neighbor at the same time.
        Thank you.
        Chairman Inouye. Thank you.
        Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.
        Gentlemen, thank you.
        And I, too, will echo the comments of the chairman and the
    vice chairman here in thanking you and the men and women that
    are working so hard and in such an incredibly capable way to
    provide for the level of rescue and relief, as we watch, in
    Japan.
        And I appreciate the fact that we have the ability to be
    nimble as a Navy, as the marines, as our armed services are. We
    never know what's going to hit us, whether it's an earthquake
    or a tsunami, or what the disaster might be. But, one way or
    another, we figure it out.

                         EVOLVING ARCTIC CONSIDERATIONS

        We've got a situation, up in the Arctic, that is not
    something that is happening overnight. We are seeing an
    evolving Arctic; an opportunity, viewed by many, but also a
    very noticeable challenge to us, as we, as an Arctic nation,
    work and act to be engaged in an area that, quite honestly, we
    haven't had to look at. When something's been locked up in ice,
    it's kind of put on hold, out of sight, out of mind. That
    situation is changing as we see the impact of receding ice, as
    we see a level of commercial activity, of military activity, of
    tourism up in the Arctic. And it brings to mind the question as
    to, how nimble, how flexible we will be--can be--in an area
    that we just have not really had to have much of a presence?
        There's a report that was released recently by the National
    Academy of Sciences. And they state that, ``Even the most
    modest current trends in climate change, if continued, will
    present new national security challenges for the U.S. Navy, for
    our Marine Corps, and our Coast Guard.''
        We've seen reports that China plans to receive over 150,000
    tons of oil, 600,000 tons of iron ore, and about 400,000 tons
    of gas condensate this year, all of which is going to be
    traveling in the maritime route, up north, through the Northern
    Sea Route. And depending on the size of any of these vessels,
    China's looking to receive anywhere from 7 to 28 tankers
    through the Northern Sea Route this year, an incredible
    increase from what we have seen last year. And it's not just
    what we're seeing from China in that activity. As I mentioned,
    we're seeing cruise ships that are coming up above the top;
    obviously, a greater increase in shipping activity. And the
    expanding role up there is something that--those of us that
    focus on the Arctic issues are concerned about our readiness.
        The question that I have to you, Admiral, is, do we have
    the resources--the assets, the staffing, the training, the
    funding--that is necessary to develop the national security,
    the sovereignty concerns, as we see increased international
    presence within the Arctic?

           EVOLVING ARCTIC CONSIDERATIONS--TASK FORCE CLIMATE CHANGE

        I note that you, in response to the chairman, indicated
    that China has more submarines than we do as a nation. I
    understand that China has more icebreakers than the United
    States has. And we're the Arctic nation, they are not. So, can
    you speak to the--again, the changing role that we have, and
    our readiness?
        Admiral Roughead. Thank you very much, Senator. And I thank
    you for your interest in the Arctic.
        A couple of years ago, I put together something that I
    called Task Force Climate Change, to really look at the changes
    that were taking place, primarily in the Arctic, but it also
    expands into other areas of the globe.
        But, there is no question in my mind that the Arctic is
    changing. I often, in public comments, refer to ``the opening
    of the fifth ocean,'' which is the Arctic Ocean. We have not
    had an ocean open since the end of the ice age. So, this is a
    big deal. And the changes that you described--the fishing
    fleets beginning to migrate with the fishing stocks, mineral
    extraction will be taking place. Ultimately, we'll get to a
    point where we have profitable commercial channels that are now
    open. And that probably is within the next two decades.
        And so, what we've done with Task Force Climate Change is,
    we've begun to look at, what is it that we must be putting in
    place as this ocean opens up? We have put some money toward
    that continued study and thinking about where we have to be.
    We're working very closely with the Coast Guard on how they see
    that future and how we must cooperatively work together to have
    in place the right types of equipment and communications and
    surveillance systems in the polar areas so that we have a
    better understanding of what's going on up there.

              ARCTIC CONSIDERATIONS--CONVENTION ON LAW OF THE SEA

        But, I would say the most important thing that I think we
    should do is to become party to the Convention on Law of the
    Sea. And I know that, in some areas, that may not be a popular
    view, but my sense is that if we are not party to that treaty,
    then we will not have a seat at the table as this unfolds.
        Senator Murkowski. Can you go into, I think, a little more
    detail, in terms of what it means to not have a seat at the
    table? Does this limit our ability, within the U.S. Navy,
    within the Marine Corps, to be engaged, to be responsive, to be
    a participant in what is happening in the evolving Arctic?
    Because this is an issue that I'm very focused on----
        Senator Roughead. Yes, ma'am.
        Senator Murkowski [continuing]. And I'm not seeing the
    urgency that I feel needs to be taking place on this issue.
        Admiral Roughead. I think it--first off, if I could say
    about the convention, there are some who believe that being
    party to this convention will inhibit our ability, as a Navy,
    to conduct the operations that we conduct, and that we must, to
    support the interests of the Nation, be able to conduct. That
    is simply not the case. It in no way inhibits us.
        But, what it does do, as issues of the Arctic and claims
    that are being adjudicated and discussed are taking place--not
    being party to that treaty, we will not be part of that
    discussion.
        I would also submit that we, as a global Navy, as a Nation
    with global interests, the leadership role that we play in many
    venues is significant. And countries look to us to be able to
    take the principled positions that we do, and to lead in those
    positions. And as these issues that are being discussed,
    adjudicated, for example, in the Arctic, not only will we not
    be there, we will not be able to be that leader that I think
    many countries look to and will continue to look to in the
    future. So, I think it will inhibit and, I think, would--will
    be a detriment to us, as a Nation. But, in no way will it limit
    our ability to operate effectively as a Navy.
        Senator Murkowski. Well, I appreciate your leadership and
    your outspokenness on that as an issue. I do feel pretty
    strongly that we need to take the initiative, here in the
    Senate, to move toward ratification of that treaty.
        Thank you, gentlemen.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        I'd like to welcome back Senator Coats. Welcome back, sir.
        Senator Coats. Thank you, Mr. Chairman and Senator Cochran
    and Senator Murkowski. I am pleased to be on the subcommittee,
    and appreciate the opportunity to do this.
        I need to make a bit of a confession. I--during my first
    term of service, I was an authorizer on the Senate Armed
    Services Committee for 10 years, and I must admit, I was--there
    were times when I was grumbling about the role of the Senate
    Defense Appropriations Committee. Now I are one. And so, I'm
    looking forward to working with both the chairman and the
    ranking member and others on the subcommittee, and hopefully
    finding some seamless ways in which we can coordinate with the
    authorization committee to strengthen and make sure we have the
    kind of national security apparatus that has sustained this
    country for so long, and hopefully we can maintain that.
        So, thank you, Mr. Chairman, for your welcome.

                      U.S. NAVY-CHINESE NAVY RELATIONSHIPS

        Admiral Roughead, I was interested in your response,
    relative to the relationships that you've developed with the
    Chinese navy. It wasn't that long ago--just a couple weeks, I
    think--when DNI Director Clapper told a Senate subcommittee
    that China was one of the two major threats. And we have seen a
    significant increase in spending and development of not only
    the Chinese navy, but the Chinese military.
        And so, I wonder if you could just delve a little more into
    that, in terms of your relationship, what your response is to
    DNI Clapper's view, in terms of the Chinese navy being a major
    threat to the United States, and give us some of your thoughts
    in that regard.
        Admiral Roughead. Thank you very much, Senator.
        And whenever I talk about a threat, whether it's another
    navy or simply walking down a road, I think a threat requires
    two things. It requires the capability to do you harm, and it
    also requires an intent to do that. And so, I think those are
    two components of threat. As I look at the PLA navy, and I look
    at how their capabilities are developing, as I do globally,
    with any navies around the world, I look at what those
    capabilities are, how they're employed, what the competence of
    their people are. And so, I continue to watch that. And, as the
    leader of our Navy, my obligation, my duty, is to make sure
    that we, as a navy, are never denied any options when it comes
    to capability.
        And as you look at our programs that we have laid out
    within this budget, they are focused on not just the types of
    wars that we find ourselves in today, but also, where is
    technology taking naval warfare? And how do we, as a navy and
    as a Nation, always enjoy the advantages of being able to be in
    an unfair fight, from our perspective? So, that's what I do, as
    the Chief. So, I'm comfortable with the programs that we have
    put together, with the initiatives that we have put in place
    here.
        I do--as I mentioned, in my earlier remarks, I think it's
    important to try to gain insight into what their intent is and
    how they intend to use that navy. So, watch developments very
    closely, build programs so that we are not disadvantaged. And I
    think that's why you've seen the emphasis on antisubmarine
    warfare in this budget--integrated air and missile defense,
    electronic warfare, cyberwarfare--because that's the world that
    we're going to be operating in for the foreseeable future.

                       CHINESE NAVY STRATEGIC INTENTIONS

        Senator Coats. Well, in listing those decisions, which I
    think are appropriate decisions, I mean, is it fair to--what do
    we think the intent of the Chinese is, relative to their navy
    and its--what is their objective? What is their--what are their
    strategic objectives? Can you give us some insights into that?
        Admiral Roughead. Yes, sir. I would say it's the objective
    that nations and navies have had throughout history. With
    regard to countries whose economies rise, and if those
    economies are built on transoceanic trade, it follows that
    there will be a strong navy. It happened with the Portuguese,
    the Spanish, the Dutch, the British, and with the United
    States. And as China's economy has grown, and as the resources
    have been available, and as they rely on the sea lanes of the
    world to bring resources in and goods out, they want to ensure
    that those sea lanes are able to be used. And that's what
    navies have done throughout history. And so, that's how I see
    the PLA navy developing, being able to control the sea lanes
    that are important to them, the areas around their country that
    are important to them. That's the path I see them on.

                          CHINESE MISSILE DEVELOPMENT

        Senator Coats. What's your read on the Chinese development
    of a new missile capability in taking out carriers? I mean,
    there's a lot been written in--about that. This is more than
    just defending sea lanes for trade. This is a very aggressive
    weapon designed to take out a hugely expensive piece of
    property. That has immense implications, should something like
    that happen.
        Admiral Roughead. Yes, sir. I would say that--and I know
    there's been a lot of discussion about the DF-21 missile, which
    is what has been developed. But, I think throughout war--the
    history of warfare, there have always been, how do you develop
    new capabilities to counter a capability that someone else has?
        I would submit that the DF-21 is no more an anti-access
    weapon than a submarine is. Because I could argue that you can
    take a ship out of action by putting a hole in the bottom
    faster than you can by putting a hole in the top. So, I think
    it's all part of being able to control sea space, control
    access into the ocean areas. So, I think that that has--is part
    of it.
        But, I would also say that, even though the DF-21 has
    become a weapon of--a newsworthy weapon, the fact is that our
    ships, particularly our aircraft carriers, can maneuver. We
    have systems to counter weapons like that. And so, you would
    expect me, as someone who wears this uniform, to prefer to be
    on that aircraft carrier, that can move and do other things,
    than to be on a fixed shore base where the targeting problem is
    extraordinarily easy, relative to trying to find, then target,
    and then hit a moving ship.
        Senator Coats. I don't want to get into a classified area,
    but I assume, on the basis of what you've said, that we are
    pursuing, or have effective--what we believe to be, or will be,
    effective defensive systems to protect against that kind of a
    threat.
        Admiral Roughead. Senator, my objective for our Navy is--
    whether it's a submarine, another ship, an anti-ship cruise
    missile, low-flying missile, or a ballistic missile--is to not
    be denied ocean areas where we can operate, or not be
    restricted in our ability to operate.
        Senator Coats. Yeah.

                           F-35B (STOVL) DEVELOPMENT

        Mr. Commandant, General, just one question, in the
    interests of time here. The F-35B, the V/STOL, now under
    moratorium for 2 years--what if the worst-case scenario
    happened--either funding wasn't available to go forward with
    that, or the technical issues associated with the development
    of that were prohibitive, or the combination of the two, the
    funding and the technical problems--and we couldn't build that
    or couldn't source you with that. What are your alternatives?
    How serious an issue is this, relative to your capabilities in
    the future, if we were not able to do that?
        General Amos. Senator, the short answer to your question--
    then I'd like to put a little bit more on the back side--is,
    there is no alternative right now. And the impact is more than
    just to the Marine Corps. This is our Nation. Right now, today,
    we have 11 carriers--11 carriers that transit the world, and
    some of which are off the coast of Japan right now, and off the
    coast, doing combat operations in the Southwest Asia area.
        We also have 11 large-deck amphibious ships, one of which
    is the USS Essex, that's--that will arrive off the coast of
    northern Japan later today. So, 22 capital ships flying fixed-
    wing aircraft off. Now, our amphibious ships, we fly MV-22
    Ospreys, we fly helicopters, attack helicopters, and we've got
    about 500 marines on board one of those large-deck ships. And
    then we spread the other marines out.
        But, what this means for the Nation is, if we lose this
    capability, the ability to take a fixed-wing aircraft and land
    it vertically on board a--large-deck amphibious ships, then our
    Nation now is reduced, by 50 percent, its ability to influence
    and--its--you know, its will, around the world, at any given
    time.
        You take the F-35B, which is the Marine Corps version,
    short takeoff and vertical landing--we'll take off from that
    amphibious ship. It is a fifth-generation aircraft. It not only
    is a strike aircraft, but it's what we call an ISR platform--
    intelligence, surveillance, reconnaissance. It has the ability
    to do electronic jamming, electronic warfare, just inherent in
    the basic platform. It will have the ability to do information
    management, and spread that out over large portions of the
    battlefield, down to a marine corporal who's on the ground. It
    has that ability inherent in the platform. That makes it, along
    with its ability to carry weapons, its stealth, a fifth-
    generation fighter.
        So, in a nutshell, if we lose this, our AV-8B Harriers, the
    ones that you see land vertically--and we've been flying them
    for so--for a long time--will begin to run out of service life
    around 2020, 2022. So, if we lose this airplane, then what
    you'll have is, you'll have 11 large-deck ships--carriers--with
    fifth-generation airplanes, and you'll have 11 large-deck
    amphibious ships with rotary-wing aircraft doing rotary-wing-
    type missions instead of having the ability to have fifth-
    generation fighters on there.
        The last thing I'd say, Senator, is--I've been tracking the
    F-35B--as I said in my opening statement and in my written
    statement--very, very carefully. If--in my office, I watch the
    metrics of how that program is progressing. Tomorrow, the
    program manager and the senior leadership of Lockheed Martin
    and the senior leadership of the Department of Defense come to
    my office--tomorrow will be my first monthly meeting--where we
    sit down and we go over the progress of this airplane. I will
    not be surprised by this. The airplane is--by order of the
    Secretary of Defense, is on a 2-year probation period. I don't
    want it to last 2 years. I don't think it needs to last 2
    years. I think we'll be able to prove the airplane's
    performance and ability to meet standards well before then.
    But, that's the decision my seniors have to make.
        But, I want this subcommittee to know that I'm tracking it.
    I'm watching it. I'm very encouraged by what I've seen, just in
    the last 70 days. This year alone, the airplane has flown over
    140 percent of its scheduled test flights. That's our version,
    the one that's on probation. It's flown more than four times
    the amount of vertical landings that it flew all last year, in
    the first 60 days of this year. This year, it's scheduled for
    480 test points. Every airplane that goes up on a test flight
    has to hit certain specific test points to determine the--how
    the airplane is performing. We've flown almost one-half of
    those test points--not quite; about 40 percent--just in the
    first 70 days of this year's schedule.
        So, I'm encouraged. The engineering fixes are coming along.
    But, I'm not a Pollyanna. I'm going to watch it very, very
    carefully. And as I said to the Secretary of the Navy and the
    Secretary of Defense, that if this airplane is not performing,
    much like the EFV, then I'll be the first person that comes
    forward and says, ``Okay, then we need to cancel it.'' But, I'm
    optimistic. I don't think that that will happen.
        Senator Coats. Okay.
        Mr. Chairman, thank you.
        Mr. Secretary, thank you for your service. I don't have any
    questions.
        I appreciate being a part of the subcommittee and look
    forward to future times together.
        Chairman Inouye. Welcome back.
        I have many other questions I'd like to submit to the panel
    for their responses. But, may I ask one question.
        The front pages have been filled with articles on the
    unrest and the instability of the Middle East. I'd like to know
    about the Navy's readiness posture. Are we ready to respond to
    anything?
        Mr. Mabus. Mr. Chairman, I'll give you the overall answer,
    and then I'd like the CNO to give you details. But, the overall
    answer is, yes, sir, we can respond to whatever mission is
    given to us in the Middle East or anyplace else in the world.
    And we are--we have the readiness and the capability to do
    that.
        Admiral Roughead. To follow up on the Secretary, Mr.
    Chairman, as you know, we maintain a ready force in the Central
    Command area of operations, the Middle East. We currently have
    two aircraft carriers that are deployed there--submarines,
    surface ships. And when they go forward, they are prepared for
    a range of operations, all the way from high-end combat to, as
    we see, humanitarian assistance. But, we train them to go
    forward, to be prepared, to be ready for sustained combat at
    sea. That has not changed, and that will not change.
        And so, the forces that are in the Arabian Gulf, in the
    North Arabian Sea, are prepared and very flexible to do
    whatever would be required of them.
        And then, we've also put some forces into the
    Mediterranean, because of the unrest that has taken place in
    the Magreb, particularly in Libya--took some ships from the
    Amphibious Ready Group that was there, put them in the
    Mediterranean. Destroyers and submarines are also present
    there. So, it's also the place where we have our 5th Fleet
    Headquarters, in Bahrain, where the 5th Fleet commands the
    operations in the Central Command area of operation.

                  U.S. NAVY AND MARINE CORPS READINESS POSTURE

        I'm in daily contact with our commander there. The unrest
    has not been manifested toward the United States, or, indeed,
    any Westerners. And the 5th Fleet operations continue.
        In the last couple of days, there was an authorized
    departure that was put in place for our dependents in Bahrain,
    and some of the families have started to take advantage of
    that.
        But, we remain ready. We are ready. Our command and control
    is in place, and our capability is in place. And those naval
    forces are ready to do whatever is asked of them.
        Chairman Inouye. General?
        General Amos. Sir, we have--as you know, most of our forces
    are on the ground, currently, in Afghanistan. Although we have
    a MEU, a marine expeditionary unit, that should be arriving
    there in the next couple of days, we have a portion of a marine
    expeditionary unit currently on the ground, in Afghanistan. So,
    those forces that are attached to naval vessels are ready, sir.
    And we are bringing in this capability from the west coast--
    should arrive here shortly. But, all those forces at a very
    high state of readiness before they leave the United States,
    headed toward the Central Command area of operations.
        Chairman Inouye. General Amos, this may be your first
    appearance before a congressional committee, but I'm certain
    your fellow marines would be proud to have seen you respond and
    answer all those questions. You've done very well, sir.

                         ADDITIONAL COMMITTEE QUESTIONS

        I'd like to thank the panel for their testimony, and I'll
    be submitting more questions.
        [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. Ray Mabus
                Questions Submitted by Chairman Daniel K. Inouye
                             health care proposals
        Question. I believe that the healthcare benefits we provide to our
    servicemembers and their families are one of the most important
    benefits we provide to the men and women serving our Nation. The
    Department of Defense is proposing several changes to the military
    health system that would raise out-of-pocket costs for military
    families. Could you please explain why these changes are necessary, and
    what impact they might have on military personnel and their families?
        Answer. The Secretary of Defense has articulated that the rate at
    which healthcare costs are increasing, and relative proportion of the
    Department's resources devoted to healthcare, cannot be sustained. He
    has been resolute in his commitment to implement systemic efficiencies
    and specific initiatives which will improve quality and satisfaction
    while more responsibly managing cost. We recognize that the Military
    Health System is not immune to the pressures of inflation and market
    forces evident in the healthcare sector. In conjunction with a growing
    number of eligible beneficiaries, expanded benefits and increased
    utilization throughout our system, it is incumbent upon us to ensure
    that we streamline our operations throughout the system in order to get
    the best value for our expenditures.
        The Department of the Navy supports the Secretary's Defense Health
    Care Reform initiatives and believes these proposals are consistent
    with our efforts over the last several years including focusing on
    internal efficiencies, incentivizing healthy behaviors and ensuring all
    of our beneficiaries are treated equitably. These proposals are modest
    and provide an opportunity for all participants--the Government,
    providers of healthcare, and beneficiaries--to share in the
    responsibility to better manage our healthcare costs.
        Question. I believe that the healthcare benefits we provide to our
    servicemembers and their families are one of the most important
    benefits we provide to the men and women serving our Nation. The
    Department of Defense is proposing several changes to the military
    health system that would raise out-of-pocket costs for military
    families. Secretary Mabus, increases in co-pays were proposed and
    rejected just a few years ago. Could you explain how these proposals
    are different, and why they should be reconsidered by Congress at this
    time?
        Answer. The rising healthcare costs within the Military Health
    System continue to present challenges. The Secretary of Defense has
    articulated that the rate at which healthcare costs are increasing, and
    relative proportion of the Department's resources devoted to
    healthcare, cannot be sustained. TRICARE Prime enrollment fees for
    retirees have not changed since 1996. The Secretary's proposals include
    a modest adjustment in TRICARE Prime enrollment fees for all retirees
    under age 65 ($5/month for families or $2.50/month for individuals) as
    well as modest adjustments (none more than $3) to pharmacy co-pays for
    all beneficiaries (except active duty) to promote the use of the
    TRICARE Home Delivery program.
        The Department of the Navy supports the Secretary's reform
    proposals to better manage our health benefit in a way that delivers a
    superb benefit while more responsibly managing cost.
                                  navy energy
        Question. Secretary Mabus, for the last 4 years, this Committee has
    added funds to the budget to increase Navy research efforts on
    alternative fuels, and we have supported your initiatives to reduce the
    dependence of the Navy and Marine Corps on fossil fuels. A recent study
    has questioned the value of the military's use of alternative fuels.
    Could you comment on the findings of that report, and explain why your
    initiatives are important to the Navy and Marine Corps?
        Answer. The RAND Corporation Report was not well researched and did
    not take into account the recent research and development advances in
    the biofuels technologies. RAND stated in their report that the
    Fischer-Tropsch coal-to-liquid/biomass-to-liquid fuels are the most
    promising near-term options for meeting the Department of Defense's
    needs cleanly and affordably. Currently, there are no Fischer-Tropsch
    plants here in the United States. Additionally, under the guidelines of
    the Energy Independence and Security Act (EISA) of 2007, section 526,
    any replacement fuel has to have a greenhouse gas emission profile less
    than petroleum. In order to meet this guideline, any Fischer-Tropsch
    coal-to-liquid plant would have to have carbon capture and
    sequestration incorporated into this overall process. While there is
    important carbon capture and sequestration research and development
    ongoing at DOE, there has not been any carbon capture and sequestration
    process built to commercial scale in the United States. In summary, due
    to the EISA 2007, section 526 guidelines and the cost prohibitive
    carbon capture and storage process, we feel that the Fischer-Tropsch
    coal-to-liquid/biomass-to-liquid fuels are not the most promising near-
    term option for meeting the Department of Defense's needs cleanly and
    affordably.
        In the RAND report, some of the conclusions suggested that the
    alternative fuel industry is immature, could not scale up to make an
    appreciable difference as a domestic alternative, and recommended that
    DOD not invest in this market. We have found that the biofuel industry
    appears to be well poised to be of commercial size and ready to meet
    Department of Navy (DON) demands by 2016 for the Secretary of the Navy
    (SECNAV) Great Green Fleet goal. According to Biofuels Digest, there
    are 110 companies that are currently working on various biofuel
    products including mixed alcohols, bio-crude oils, and drop-in fuels.
        The Navy prefers to see itself as an ``early adopter'' of available
    biofuels. The military has often led in the development of new
    technologies where there was a compelling military use, even if the
    civilian use was ultimately greater (ex. GPS, the Internet). The
    operational use of alternative fuels by the Department of the Navy will
    be hastened by collaborating with Federal agencies and private industry
    at every step of the research, development, and certification process.
    The alternative fuel program establishes the Department of the Navy as
    an early adopter for investors in a nascent industry that could
    significantly enhance energy security, and thereby national security,
    in the mid- to long-term. By positioning itself as an early adopter by
    testing available biofuels and certifying them ``fit for use across our
    major platforms and leveraging test and certifications accomplished by
    the other services that meets our specifications'', the Navy is better
    poised to reap the following benefits:
      --Cost Savings.--Increasing our use of alternative energy sources
            helps us achieve a level of protection from energy price
            volatility. For every $10 increase in the cost of a barrel of
            oil, the Navy spends an additional $300 million a year.
            Operating more efficiently saves money by reducing the amount
            we spend for fuel. Savings can be reinvested to strengthen
            combat capability. The cheapest barrel of fuel afloat or
            kilowatt-hour ashore is the one we will never use.
      --Guaranteed Supply.--Our reliance on energy can be exploited by
            potential adversaries. Efficiency and alternatives may be our
            best countermeasure. Energy efficiency increases our mission
            effectiveness by expanding our range and endurance, and
            reducing our need for logistics support. Efficiency
            improvements minimize operational risks of that logistics
            tether, saving time, money, and lives. Alternative fuels
            provide the Navy an ``off-ramp from petroleum,'' mitigating the
            risk to a volatile and ever more expensive petroleum market.
      --Early Adopter of Technologies.--The military has often led in the
            development of new technologies where there was a compelling
            military use, even if the civilian use was ultimately greater
            (ex. GPS, the Internet). The operational use of alternative
            fuels by the Department of the Navy will be hastened by
            collaborating with Federal agencies and private industry at
            every step of the research, development, and certification
            process. The alternative fuel program establishes the
            Department of the Navy as an early adopter for investors in a
            nascent industry that could significantly enhance energy
            security, and thereby national security, in the mid- to long-
            term.
      --Fossil Fuel Independence.--The Navy recognizes that our dependence
            on fossil fuels and foreign sources of oil makes us more
            susceptible to price shocks, supply shocks, natural and man-
            made disasters, and political unrest in countries far from our
            shores.
      --Combat Capability.--Making our ships and aircraft more efficient
            improves their fuel economy. We can increase the days between
            refueling for our ships, improving their security and combat
            capability. We can also extend the range of our aircraft strike
            missions, allowing us to launch our aircraft farther away from
            combat areas. Increasing our efficiency and the diversity in
            our sources of fuel improves our combat capability
            strategically and tactically.
        Question. Secretary Mabus, are there particular alternative energy
    technologies which you find are most promising at this time?
        Answer. The Department of Navy (DON) is exploring multiple
    solutions to reduce reliance on fossil fuels. It is critical to have a
    broad solution to this issue due to difficulties in predicting which
    solutions will be best suited for production at an industrial scale and
    at an acceptable price point.
        The DON is aggressively moving to demonstrate and certify
    alternative fuels for tactical application. Although the DON has not
    specified any particular feedstock, alternative fuels considered by DON
    must comply with EISA 2007 section 526 and not compete with food
    production. The DON has been evaluating 50/50 blends of hydrotreated
    plant and algal oils with petroleum-vased fuel. These blends have
    looked promising in both laboratory and aircraft and ship operation
    tests conducted to date. The DON is confident that its strategy of
    partnering with a broad coalition and demonstrating its commitment to
    and ability to use alternative sources of energy will lead to the
    successful development of clean alternatives and more secure domestic
    sources of energy.
        Question. The Navy has been working aggressively to identify
    savings which can be reinvested throughout the department. The list of
    initiatives described in your budget rollout includes $2.3 billion of
    savings on energy. Could you please detail the source of these savings?
        Answer. There are numerous energy efficient initiatives and
    renewable/alternative energy programs that the Navy and Marine Corps
    are pursuing. The reduced reliance on fossil fuels will achieve lower
    energy consumption, strategic security, avoided energy cost, and a more
    sustainable Fleet. Here are the major program areas along with examples
    of projects with estimated savings.
    Major Energy Program areas
        Shore:
      --Steam plants decentralizations
      --Lighting systems upgrades
      --Renewable energy systems (solar & photovoltaic)
      --Rooftop solar thermal hot water projects
      --LED street lighting projects
      --Ground source heat pumps
      --Boiler heat recovery upgrades
      --Control system improvements
      --Alternative Powered Vehicles
        Tactical/Expeditionary:
      --Hull coatings
      --Propeller coatings
      --Stern Flaps
      --Allison 501K Efficiency Initiatives
      --Aviation Simulators
      --Smart voyage planning software
      --USS Truxtun hybrid energy drive retrofit
      --Alternative fuels testing and certification program
      --Incentivized Energy Conservation Program (i-ENCON)
      --Expeditionary Forward Operating Base (Ex-FOB)
      --SPACES portable solar systems
      --Light Emitting Diode (LED) Lighting
      --Renewable battery charging systems
    Examples of Projects for Navy Tactical with estimated savings
        Stern Flaps for Amphibious Ships:
      --Shown to have an average payback period of less than 1 year on FFG/
            CG/DDG platforms
      --Currently undergoing testing on amphibious ships
      --Savings estimated at 5,500 BBLs/ship/year for LHD
        Hull/Propeller Coating:
      --Easy release hull/propeller coating system allows Navy ships to
            shed bio-fouling once underway
      --Reduces costly periodic hull/propeller cleanings
      --Savings estimated at 1,800 BBLs/ship/year
        Solid State Lighting:
      --Uses LEDs for platform illumination
      --LED lights in commercial applications last almost 50 times longer
            than Incandescent and 6 times longer than Fluorescent lights;
            provide the same illumination with 25 percent of the energy
      --Currently testing on DDG-108 and LSD-52
      --Payback estimated at 3 years, depending on fixture (savings of 335
            BBLs/ship/year for DDG)
        Navy also continues to develop technologies that will be
    implemented in future years; the implementation schedule for these
    initiatives is subject to impacts based on final fiscal year 2011
    budget:
        Hybrid Electric Drive for DDG/LHD/LHA:
      --Fuel savings by securing LM2500 propulsion turbines at low speed
            while loading gas turbine electric generators to more efficient
            operating condition (savings estimated at 8,500 BBLs/ship/year)
      --Land-based prototype scheduled for testing mid-2011
      --First afloat hybrid drive installed in USS Makin Island (LHD-8)
      --Hybrid drive will be installed in USS America (LHA-6), which is
            scheduled for completion in 2012.
      --USS Truxtun (DDG-103) scheduled to be first operational
            installation in fiscal year 2012 as an afloat test platform
        Engine efficiency modifications for the F-35 Joint Strike Fighter:
      --Improvement in F135 Block 5+ engine fuel economy and lifecycle cost
            through component upgrades and software cycle optimization
      --Estimated Fleet-wide savings of 35,000 BBLs in 2023 (upon delivery
            of Block 5 aircraft), increasing to 178,000 BBLs/yr by 2029
                                     ______

                Questions Submitted by Senator Dianne Feinstein
                                military health
        Question. Secretary Mabus, the suicide rate in the military is at
    an all time high. While both the Navy and the Marine Corps numbers seem
    to have decreased, one suicide is one too many.
        What is your department doing to prevent suicides in the Navy and
    the Marine Corps?
        Answer. We believe preventing suicide hinges on our leaders'
    ability to intervene early and lead a culture change to induce help
    seeking behavior. We continually improve the guidance and program
    support provided to leaders at all levels to combat this preventable
    loss of life.
        Suicide prevention initiatives in the Navy include training aimed
    at front line supervisors to boost their understanding of the sailors
    they command, recognize changes in behavior, signs of concern, and
    engage early with appropriate support. Leadership seminars focus
    attention during times of transition and stress due to loss, including
    loss of status or career standing. Seminars also address the concept of
    continuously building and reinforcing connections with families and
    support structures to facilitate communication in times of need.
    Recognizing that people exposed to suicide are an at-risk group,
    expanded post-suicide-event training and guidance has recently been
    added to assist leaders in the aftermath of a tragedy to prevent future
    suicides. Suicide prevention coordinator and first responder training
    were provided world-wide and at Navy Reserve locations via Navy Reserve
    psychological health outreach teams.
        For the Marine Corps leaders educate all marines about the
    relationship between suicide and stressors, warning signs, and risk
    factors--both through annual awareness and prevention training, and
    through additional training embedded in all formal schools from recruit
    training to the Commander's Course. Marines are also taught how to
    fulfill their duty to seek help for themselves or a fellow Marine at
    risk for suicide. The importance of seeking help early, before problems
    escalate to the point of suicide risk is also emphasized.
        The ``Never Leave a Marine Behind'' suicide prevention training
    series is being expanded. In January 2011, we provided a junior Marine
    module as well as an update to the existing award-winning NCO module.
    In development for release soon are officer and staff noncommissioned
    officer modules that will help leaders to manage command climate in a
    way that builds resilience and encourages help-seeking in their
    marines.
        To truly build a resilient force that fosters the ability of
    marines to cope with the widely varying stress of life, we must
    recognize the interconnectedness between physical health, behavioral
    health, wellness, and spirituality. We will accomplish this by better
    integrating our existing resilience programs, improving efficiency and
    effectiveness, and making resources more useful to leaders. To that
    end, many programs have been reorganized under a new behavioral health
    branch with the end state of one mission. Effectively leveraging other
    programming across the spectrum of behavioral health and extending into
    other wellness areas will proactively prevent suicide.
        We recognize that strong partnerships are necessary to stay abreast
    of the latest available information within the suicide prevention arena
    and also to explore programming needs. The Marine Corps has
    collaborated with the American Association of Suicidology. Both the
    Navy and Marine Corps collaborate with Office of the Secretary of
    Defense (Readiness), Sister Services, other Federal, and civilian
    agencies, to continually adapt our efforts and reflect the latest
    public health science; and the ever-changing needs of the Navy and
    Marine Corps family.
        Question. I am concerned that many programs are only directed to
    active duty servicemembers. What are the Navy and the Marine Corps
    doing to assist Reservists with psychological health issues as they
    transition back to civilian life and may not have access to military
    treatment facilities?
        Answer. I agree with you that one suicide is too many, which is why
    the Department of the Navy continues to build a culture of support for
    psychological health and suicide prevention focused on prevention and
    early intervention while working to overcome the stigma associated with
    seeking needed care for the Total Force, including Reservists and their
    families.
        Enabling a continuum of service, Reserve commands have trained
    Combat/Operational Stress Control (C/OSC) caregivers and C/OSC training
    is conducted regularly at all levels in order to prevent suicide,
    sexual assault and family violence, and to normalize buddy-care and
    help-seeking behavior as early as possible. Reserve Psychological
    Health Outreach Program (PHOP) teams, embedded in the Navy and Marine
    Corps Reserve communities geographically, support Commanders in
    identifying Navy and Marine Corps Reservists and their family members
    who may be at risk for stress injuries following deployments or other
    transitions and provide outreach, support, assessment, referrals and
    follow-up to local resources to assist with issue resolution,
    psychological resilience and growth. Along with mental health
    referrals, many successful referrals by the PHOP teams involve helping
    Reservists with financial and employment concerns that can affect
    psychological health and impact performance. Another effective tool is
    the Returning Warrior Workshops (RWW), a 2 day weekend program designed
    specifically to support the reintegration of returning Reservists and
    their families following mobilization. PHOP teams serve as facilitators
    at these Yellow Ribbon Reintegration Program signature events. In
    addition, FOCUS (Families OverComing Under Stress), a family centered
    resilience training program based on evidence-based interventions that
    enhance understanding of combat and operational stress, psychological
    health and developmental outcomes for highly stressed children and
    families, is available for reservists serving in areas with a high-
    active duty fleet concentration.
        Question. What programs have been the most successful? I urge you
    to share those best practices with the other services.
        Answer. Leadership at all levels is focused and engaged in suicide
    prevention, working hard to build individual and unit resilience, and
    to encourage sailors and marines to engage helping services.
        The Navy suicide prevention program has been successful on a number
    of fronts. It builds on the premise that suicide prevention must be a
    local effort to be effective. Service level efforts have been designed
    to support local command suicide prevention programs. Navy training and
    communications emphasize a simple message--ACT: Ask, Care, Treat.
    Recent surveys show that more than 80 percent of sailors (and growing)
    know the acronym ACT and understand it. More than 90 percent report
    that they know what to do if someone talks about suicide, can explain
    appropriate actions to take, and believe that their shipmates will get
    needed help. We have an increasing number of reports from commands that
    describe how members either sought help for themselves or a leader,
    peer or family member sought assistance for the individual. We believe
    this is a successful element of our program based on survey results and
    the increasing number of reports of sailors and family members taking
    necessary action.
        Navy policy requires commands to have written crisis response plans
    that itemize suicide safety precautions and appropriate actions to get
    emergency assistance for someone who demonstrates signs of acute
    suicide risk. We know of at least 2 specific instances and have several
    anecdotal reports that such plans made the critical difference by
    reaching someone in time to save their life.
        In 2009, the Marine Corps redesigned its suicide prevention and
    awareness training with the noncommissioned officer Never Leave a
    Marine Behind course. A junior Marine course followed in January 2011,
    and officer and staff noncommissioned officer versions are expected to
    be released in March 2011. Marines from the operating forces were
    included in all stages of course development. The courses contain
    various degrees of training in intervention skills, frontline
    supervisor awareness, and managing command climate to build resilience
    and encourage help-seeking behavior. Marines and instructors in formal
    schools, such as recruit training and Corporal's course, continue to
    receive suicide prevention and awareness instruction.
        The Corps continues to embed behavioral health providers in
    deploying units, and recently began providing awareness and
    intervention training to those who support behavioral health providers,
    such as medical providers, corpsmen, chaplains, and religious
    personnelmen. In addition, 40-50 marines in each deploying unit are
    offered nonmedical training in how to identify fellow marines
    experiencing stress reactions, and how and where to refer them for
    additional help if needed. It is that relationship and interaction
    between individual marines that is so important to maintaining a
    healthy force.
        Our programs have many other evidence-informed elements in our
    suicide prevention programs including peer-to-peer training, front line
    supervisor training, assessment and management of suicide risk for
    mental health providers.
        Both the Navy and Marine Corps collaborate with Office of the
    Secretary of Defense (Readiness), Sister Services, other Federal, and
    civilian agencies, to continually adapt our efforts and reflect the
    latest public health science; and the ever-changing needs of the Navy
    and Marine Corps family.
                                nuclear funding
        Question. Secretary Mabus, in H.R. 1, the House has decided to
    protect Defense spending from massive budget cuts proposed in other
    departments. This includes preserving research and development funding
    for a new generation of Ohio class ballistic missile submarines. It
    cuts funding, however, for the National Nuclear Security Administration
    which would build the nuclear engine to power the submarines. Can you
    reconcile these policy choices?
        Answer. Among its other missions, National Nuclear Security
    Administration (NNSA) enhances global security by providing naval
    nuclear propulsion for the most survivable leg of the nuclear triad,
    developing and maintaining the nuclear warheads which arm this
    platform, and preventing the proliferation of nuclear weapons.
        The funding provided for NNSA in H.R. 1 is approximately $1 billion
    less than the fiscal year 2011 request including a $125 million
    shortfall for Naval Reactor's efforts. If funded at the levels in this
    legislation, Naval Reactors will not be able to deliver on commitments
    made to the Department of Navy. In particular, this bill will adversely
    impact the reactor design work for the OHIO Replacement Submarine and
    delay refueling of the Land-Based Prototype. Within NNSA, Naval
    Reactors has overall responsibility for the reactor plant design for
    the next generation ballistic missile submarine, OHIO Replacement, and
    its NNSA funding request will continue specific work on the reactor
    plant (reactor core and supporting systems). Should the funding level
    in H.R. 1 become law, at a minimum, there would be a:
      --Six to nine month delay to the OHIO Replacement Program and
            resultant loss of synchronization with the Navy's work on the
            ship.
      --Staffing reduction of over 50 personnel at shipyards and Naval
            Reactors' laboratories.
      --Deferral in planned hiring of 150 personnel at shipyards and Naval
            Reactors' laboratories.
      --Deferral in reactor plant component design subcontract placements.
      --Other impacts to Naval Reactors, including the delays to the
            manufacturing demonstration of alternate core materials and
            fuel systems technology, the S8G prototype refueling, and a
            large majority of previously planned General Plant Projects
            (GPP).
        These shortfalls are particularly damaging in the early stages of
    the project when we are trying to mature the design and set plant
    parameters that will, for the most part, refine the cost and schedule
    for ultimate delivery of the reactor plant to support ship
    construction.
        Question. What impact will the cut for the nuclear engine program
    have on the new Ohio class ballistic missile submarine program?
        Answer. A strong Navy is crucial to the security of the United
    States, a Nation with worldwide interests that receives the vast
    majority of its trade and energy via transoceanic shipment. Navy
    warships are deployed around the world every hour of every day to
    provide a credible ``forward presence,'' ready to respond on the scene
    wherever America's interests are threatened. Nuclear propulsion plays
    an essential role in this, providing the mobility, flexibility, and
    endurance that today's smaller Navy requires to meet a growing number
    of missions. About 45 percent of the Navy's major combatants are
    nuclear-powered, including 11 aircraft carriers, 53 attack submarines,
    14 strategic submarines (the Nation's most survivable nuclear
    deterrent), and 4 strategic service submarines converted to covert,
    high-volume, precision strike platforms.
        The mission of the Naval Nuclear Propulsion Program, under DOE as
    Naval Reactors, is to provide militarily effective nuclear propulsion
    plants and ensure their safe, reliable, and long-lived operation and
    disposal. This mission requires the combination of fully trained U.S.
    Navy men and women with ships that excel in speed, endurance, stealth,
    and independence from logistics supply chains. Because of the Program's
    demonstrated reliability, U.S. nuclear-powered warships are welcomed in
    more than 150 ports of call in over 50 foreign countries and
    dependencies.
        Within NNSA, Naval Reactors is responsible for naval nuclear
    propulsion design, technology development and regulatory oversight. The
    Navy sets the requirement, and Naval Reactors delivers the reactor
    plants.
        The funding levels proposed by both the House and the Senate's year
    long continuing resolution would not allow Naval Reactors to honor
    commitments made to the U.S. Navy to deliver the OHIO class Replacement
    submarine on the required schedule. If no additional funding is made
    available to Naval Reactors, this would result in at least a 6 month
    deferral of planned reactor plant component design subcontracts,
    including development of the pressurizer, control drive mechanisms, and
    core and reactor component development efforts which support reactor
    compartment design and arrangements; a staffing reduction of over 50
    personnel at Naval Reactors' laboratories and the shipyard in Groton,
    CT for the last 3-4 months of fiscal year 2011; and a deferral in
    required hiring of approximately 150 personnel at Naval Reactors'
    Knolls Atomic Power Laboratory in Schenectady, New York. The
    combination of these factors would result in a delay of at least 6-9
    months to the OHIO Replacement program, and ship design and
    construction schedules would need to be revised and sub-optimized from
    their current cost minimizing approach.
        Among the most significant requirements for the OHIO class
    Replacement is a life-of-the-ship core. To provide a life of the ship
    core for the OHIO class Replacement, NR needs to use an alternate
    cladding material. Failure to receive the full fiscal year 2011 request
    could prevent the required insertion of alternate core materials and
    fuel system technology into the Land-Based Prototype or delay the
    refueling schedule. For the refueling of the Prototype, Naval Reactors
    will test and demonstrate the manufacturability of the alternate core
    materials and fuel system technology required for the OHIO class
    Replacement life-of-the-ship core. This work must continue in fiscal
    year 2011 to establish production processes for the OHIO class
    Replacement core prior to full-scale production and procurement.
        In addition to the important research and development mission this
    platform performs, the prototype serves as a training platform for our
    sailors. Delays to the refueling of the prototype will impact the
    readiness of our nuclear fleet by delaying training of our Nuclear
    qualified operators. All nuclear operators go through a rigorous
    initial training and qualification program that includes qualifying to
    operate either one of the Land-Based Prototype or one of the Moored
    Training Ships. During this training, operators develop a respect for
    the unforgiving nature of nuclear propulsion technology and, from the
    very beginning of their careers in the Program, develop confidence in
    their ability to safely operate a reactor plant. These highly trained
    and qualified operators are key to our record of safe and reliable
    operation.
        The proposed funding levels are concerning on a higher level in
    that Naval Reactors has a long, successful track record of rigorously
    defining requirements and executing major projects efficiently on
    budget, on schedule, and of the quality demanded by complex nuclear
    technology that has a very high consequence of failure.
                              humanitarian relief
        Question. As evidenced by this past year's events, the U.S.
    military's involvement in disaster and humanitarian relief has become
    more and more important. I note specifically aid to Haiti both after
    the earthquake and the hurricane in 2010, aid to Pakistan after the
    2010 floods, and most recently aid to Japan in the aftermath of the
    earthquake and tsunami. This type of assistance is vital to our global
    relationships and I applaud you for your consistent quick reaction and
    comprehensive support. Is the Navy-Marine Corps team adequately
    equipped to conduct these missions?
        Answer. The Department of Navy (DON) is adequately equipped and
    trained to conduct Humanitarian Relief missions when called upon. This
    is exemplified by the recent response to the earthquake, tsunami and
    nuclear reactor disasters in Japan which had minimal impact on DON
    missions. These responses showed the flexibility of Navy and Marine
    Corps assets. The same platforms and the same people can conduct a wide
    range of missions.
        Humanitarian Assistance/Disaster Relief (HA/DR) is crucial to
    fostering and sustaining cooperative relationships in times of calm so
    that during crisis previously established working relationships improve
    response efficiency and efficacy. We will continue to mitigate human
    suffering as the vanguard of interagency and multinational efforts,
    both in a deliberate, proactive fashion and in response to crises.
    Human suffering moves us to act, and the expeditionary character of the
    maritime forces uniquely positions us to provide assistance. With HA/DR
    being a core capability as outlined in the current maritime strategy,
    it has been, and will continue to be, part of who we are as maritime
    services.
        Our greatest current concern related to Humanitarian Relief is the
    fiscal strain placed on DON by the voluntary departure of military
    dependents from the Island of Honshu, Japan. With an estimated cost of
    $54.5 million through April 8, and the tremendous strain our sailors
    are already bearing due to the reduction of PCS order lead-time from 6
    months down to as little as 2 months, we simply cannot absorb these
    costs within MILPERS accounts under the Continuing Resolution (CR). The
    Department has submitted a CR exception request to the President's
    Office of Management and Budget (OMB) for additional cash under the
    ``Safety of Human Life'' exception to fund the additional cost for
    travel, lodging, meals, and per diem for evacuees through April 8,
    2011. This short-term solution has been approved by OMB. The annual
    funding picture remains unresolved and a full year funding strategy
    cannot be determined until congressional action on the fiscal year 2011
    President's budget is complete. We appreciate any help you can provide
    on this matter.
        Question. What kind of training do our sailors and marines receive
    with respect to humanitarian missions?
        Answer. The Navy established Humanitarian Assistance and Disaster
    Response (HA/DR) as a core capability of our Maritime Strategy. As
    such, it is now a competency that is woven into the fabric of daily
    naval operations. The conduct of Global Maritime Partnership missions,
    as well as other partner building activities, connect development and
    diplomacy priorities to fleet-planned activities. When disasters occur,
    the Navy's globally distributed and regionally concentrated forces are
    ideally suited for HA/DR operations in the littorals where the
    preponderance of the world's population resides. Naval forces can
    quickly respond to security related crisis operations in large measure
    due to how naval forces are trained, organized, deployed, and employed.
    The Department of Navy (DON) sailors and marines provide support for
    humanitarian missions by performing functions which are already part of
    their daily Service mission.
        Two enduring missions that practice proactive HA/DR are PACIFIC
    PARTNERSHIP, conducted in East Asia and Oceania, and CONTINUING
    PROMISE, conducted in South America and the Caribbean. These missions,
    which are coordinated with each Country Team, build critical partner
    capacity and improve disaster response readiness for both our partners
    and our sailors through the development of habitual relationships with
    relevant partner ministries, departments, and officials. The deliberate
    day-to-day coordination of the Naval Service with international
    partners, joint, interagency, international, and NGO efforts
    strengthens relationships and sets the conditions for effective
    collaboration and rapid response when an in-extremis response is
    required.
        Recently, the RONALD REAGAN Strike Group's quick response to the
    earthquake and tsunami in Japan highlighted the Navy's unique ability
    to provide expeditious humanitarian relief around the globe.
        Question. Are there additional resources that would make you more
    efficient or effective in providing this type of assistance?
        Answer. Additional resources are not required to make the Navy more
    efficient or effective in providing Humanitarian Assistance (HA) and
    Disaster Relief (DR) to emergent events such as Haiti, Pakistan, and
    Japan. These operations are the core capabilities of the Navy's
    maritime Strategy.
        HA/DR is funded by Overseas Humanitarian, Disaster and Civic Aid
    (OHDACA) funds approved by Office of Secretary of Defense (OSD). OSD
    authorizes designated Combatant Commanders (COCOM) to render
    assistance, including transportation of personnel and supplies,
    assessments of affected areas and purchase of relief supplies in
    coordination with U.S. Agency for International Development (USAID)--
    lead agency for Disaster response.
        With no timetables for disasters, DR cannot be budgeted and OHDACA
    reimburses Navy for use of OMN funds to support HA/DR operations.
                                     ______

                    Questions Submitted by Senator Herb Kohl
                            ship to shore connector
        Question. Secretary Mabus, the Navy is in the middle of the process
    of choosing a contractor for a new Ship to Shore Connector (SSC) to
    replace the LCAC's that currently move equipment between ships and the
    shore. As the Navy prepares to evaluate the two proposals that are
    expected at the end of this month, can you explain how the Navy will
    take into account Total Ownership Costs as it makes its decision?
        Answer. The exact number of proposals which will be received for
    the Ship to Shore Connector (SSC) is unknown. An Offeror's proposal
    will be evaluated in accordance with the criteria set forth in the
    final Request for Proposals (RFP). Currently, in the draft RFP, Total
    Ownership Cost (TOC) is included in the technical evaluation of the
    Offerors' Detail Design and Engineering Approach, as well as Build
    Approach.
        The evaluation process will consider, among other things, an
    Offeror's top three TOC reduction initiatives inherent in their
    proposed approaches to developing the SSC Detail Design and producing
    the resultant craft. This will be part of the overall best value
    determination.
        Question. Is there a defined process for considering Total
    Ownership Costs (TOC)? If so, how does that work?
        Answer. Yes, for this solicitation there is a defined process for
    considering Total Ownership Costs outlined in the draft Ship to Shore
    Connector (SSC) Request for Proposal (RFP) released on March 1, 2011
    via a FedBizOps announcement.
        According to the draft RFP, evaluation factors include non-price
    (technical evaluation) factors and a price factor. These factors will
    be used to evaluate the extent to which proposals address, and meet or
    exceed, the requirements of the SSC solicitation. These evaluation
    factors are as follows:
      --Technical Evaluation: Factor 1--Detail Design and Engineering
            Approach; Factor 2--Build Approach; Factor 3--Management
            Approach; and Factor 4--Past Performance.
      --Price Evaluation: Factor 5--Price.
        Total Ownership Cost is included in the technical evaluation of
    Factor (1), Detail Design and Engineering Approach, and Factor (2),
    Build Approach. For Factors (1) and (2), the evaluation process will
    consider, among other things, an Offeror's top three Total Ownership
    Cost (TOC) reduction initiatives inherent in their proposed approaches
    to developing the SSC Detail Design and producing the resultant craft.
    The corresponding technical factors will then be assigned an adjectival
    rating, which will be part of the overall best value determination.
        Question. What are some examples of TOC initiatives in acquisition
    programs?
        Answer. Total Ownership Costs (TOC) reduction initiatives include
    the following areas: Training, Maintenance, Energy Usage, Supply
    Support, Configuration Management, Operations, Environmental Impact,
    and Craft Disposal.
        Some examples of TOC reduction initiatives in surface shipbuilding
    programs include:
      --The T-AKE contract was awarded on the basis of TOC, not primarily
            acquisition costs. In addition, a formal TOC reduction program
            was instituted which incorporated design features projected to
            save over $700 million over the life of the class. The ship is
            outfitted with an integrated electric drive that allows for
            optimum fuel economy over the full range of operation.
      --The Mobile Landing Platform design leverages an existing production
            design (General Dynamics NASSCO's BP Tanker). As a result,
            program risk was greatly reduced and coupled with requirements
            tradeoffs, the Navy saved over $2 billion.
      --Provided Auxiliary Propulsion System in LHD 8 and LHA 6.
      --Reduced permanent manning levels in LPD 17 class, DDG 1000 and
            Littoral Combat Ship programs.
      --Combined Government Furnished Equipment (GFE) buy across the ship
            classes for the Commercial Broadband Satellite Program (CBSP).
            The DDG 113 Advance Procurement, T-AKE and JHSV planned buys
            were adjusted to take advantage of the stepped pricing
            structure of the CBSP equipment contract, which resulted in
            approximately $1.4 million in savings per system.
      --Issued Stern Flap Modification for DDG 79-112, resulting in a total
            savings through the 35-year life span.
      --Deleted the port anchor and forward kingpost on DDG 113 and follow-
            on ships.
      --Combined GFE buys for machinery control system between DDG
            Modernization and DDG 113 and follow-on ships.
      --Maximize competition for subcomponent procurements for DDG 113 and
            follow-on ships (e.g., Main Reduction Gears).
      --Use refurbished equipment on DDG 113 and follow-on ships (e.g.,
            High Frequency Radio Group).
        Question. How does the evaluation process ensure that a competitor
    is not penalized for increased acquisition cost that may be necessary
    for a TOC initiative that will dramatically reduce operating or
    maintenance costs?
        Answer. For Ship to Shore Connector (SSC), an Offeror's proposal
    will be evaluated based on four non-price (technical) factors and a
    price factor. Total Ownership Cost is included in the technical
    evaluation of Factor (1), Detail Design and Engineering Approach, and
    Factor (2), Build Approach.
        For Factors (1) and (2), the evaluation process will consider,
    among other things, an Offeror's top three Total Ownership Cost
    reduction initiatives inherent in their proposed approaches to
    developing the SSC Detail Design and producing the resultant craft. The
    corresponding technical factors will then be assigned an adjectival
    rating, which will be part of the overall best value determination. A
    best value determination is based on an assessment as to which proposal
    demonstrates the greatest technical merit at a reasonable cost.
                                     ______

                  Questions Submitted by Senator Patty Murray
                                  p-8a basing
        Question. In the President's budget for fiscal year 2012, no money
    was included for military construction projects at Naval Air Station
    Whidbey Island to begin preparing the facility for P-8A aircraft
    basing. When does construction on the necessary MILCON projects need to
    begin in order to have NAS Whidbey prepared to receive aircraft by
    2017?
        Answer. Naval Air Station (NAS) Whidbey Island is currently planned
    to transition to P-8 outside the FYDP, in 2017 or later. Preliminary
    design and subsequent construction would require approximately 3 years
    to complete prior to P-8 arrival. As the P-8 program matures and
    delivery schedules, operational employment, and transition plans are
    implemented, the specific timeline will be determined.
        Question. What construction projects are required to upgrade the
    base and how much do they cost? Has the Navy given any consideration to
    less expensive alternatives for military construction at Whidbey?
        Answer. Naval Air Station (NAS) Whidbey Island is currently planned
    to transition to P-8 outside the Future Years Defense Plan, in 2017 or
    later. To support P-8 operations, approximately $330 million would be
    required for a 3-bay P-8 hangar, a Fleet Training Center, and P-8
    related base infrastructure modifications. The Navy will continue to
    give consideration to less expensive alternatives such as reuse and or
    consolidation of existing facilities at NAS Whidbey Island as the
    transition to P-8 progresses.
        Question. When will the Navy make a final decision regarding
    whether or not to follow the ROD?
        Answer. The 2008 Record of Decision (ROD) is the Navy's current
    guidance for long term basing of the P-8 force. The ROD identified five
    operational squadrons and one Fleet Replacement Squadron at Naval Air
    Station (NAS) Jacksonville, Florida; three squadrons in Marine Corps
    Base Hawaii (MCBH) Kaneohe Bay; and four squadrons in NAS Whidbey
    Island, Washington. Within the current Future Years Defense Plan
    (FYDP), P-8 will be introduced in NAS Jacksonville and MCBH Kaneohe
    Bay. NAS Whidbey Island is currently planned to transition to P-8
    outside the FYDP, in 2017 or later. Unless otherwise amended by a new
    ROD, NAS Whidbey Island will continue to support Airborne Electronic
    Attack, Fleet Reconnaissance, and Maritime Patrol squadrons.
        Question. What justification (both budget and strategic) would
    support an alternate basing plan for stationing P-8A aircraft only at
    Jacksonville and Kaneohe Bay? And, are those facilities able to sustain
    the additional four squadrons that would have been based at Whidbey?
        Answer. The 2008 Record of Decision (ROD) is the Navy's current
    guidance for long term basing of the P-8 force. NAS Whidbey Island is
    currently planned to transition to P-8 outside the FYDP, in 2017 or
    later. Unless otherwise amended by a new ROD, NAS Whidbey Island will
    continue to support Airborne Electronic Attack, Fleet Reconnaissance,
    and Maritime Patrol squadrons. Any change to the ROD to station four
    operational squadrons in NAS Whidbey Island would require strategic,
    fiscal, environmental, and facilities assessments to address impacts
    across the force.
                                     ______

                   Question Submitted by Senator Thad Cochran
                        aegis ballistic missile defense
        Question. Secretary Mabus, the Navy has assumed the lead for the
    first phase of the European missile defense plan. This first phase
    began last Monday with the USS Monterey beginning a 6 month deployment
    to the Mediterranean. With the immediate need to support the European
    missile defense plan along with the current demand from Combatant
    Commanders in other parts of the world for ships, are there enough
    ships available to support the ballistic missile defense mission? Can
    the current ship maintenance schedule support deployment of phase one
    and phase two of the European missile defense plan?
        Answer. The Navy currently has sufficient capacity to meet the most
    critical demands for multi-mission surface combatants; however, Navy
    does not have the capacity to meet all Geographic Combatant Commander
    (GCC) demands for Ballistic Missile Defense (BMD)-capable ships without
    breaking established Personnel Tempo program limits for deployment
    lengths, dwell and homeport tempo.
        In the near-term, surface combatants with Aegis BMD capability are
    allocated to GCCs through the Department of Defense Global Force
    Management (GFM) process taking into consideration GCC surface
    combatant requirements all mission areas. The Navy employs the Fleet
    Response Plan (FRP) as the framework to structure, prepare and posture
    ready Navy forces to meet GFM requirements, to include BMD. The FRP
    balances the requirements to maintain and upgrade equipment, train for
    the full spectrum of operations and deploy in support of GCC
    requirements.
        The required ship maintenance and Aegis Modernization plan supports
    the expected requirements of Phase 1 and Phase 2 of the European
    missile defense plan. To meet the increasing demand for these ships and
    reduce the risk to our long term force structure caused by the
    increased operational tempo from longer deployment lengths, the Navy,
    in conjunction with MDA, has established a plan to increase the number
    of BMD-capable Aegis ships from 23 in fiscal year 2011 to 41 in fiscal
    year 2016 (see Figure 1 below). This plan balances the need for meeting
    current operational requirements against the need to upgrade existing
    surface combatants with BMD capability to pace the future threat.
    Included in this plan are increases in both the Navy's capacity and
    capability of Aegis ships through the installation of Aegis BMD 3.6.1/
    4.0.1 suite, the Aegis Modernization program (Aegis BMD 5.0 suite), and
    new construction (commencing with DDG-113). The current Continuing
    Resolution (CR) and the President's budget for fiscal year 2012 may
    impact this plan.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    Figure 1.--Aegis BMD Ship Profile, Presidential budget for fiscal year
                                     2012.

                                     ______

                  Question Submitted by Senator Susan Collins
                      brunswick naval air station closure
        Question. The Brunswick Naval Air Station is slated to close as an
    active military installation on May 31, bringing to a close a proud era
    in naval aviation in Brunswick, Maine. The Senate Armed Services
    Committee has provided the necessary conveyance authorities to transfer
    property under BRAC quickly. Recently, several of the initial
    conveyance packages to Southern Maine Community College have been
    delayed without explanation. Buildings 151 and 512 at NAS Brunswick,
    which are projected to serve as the new Maine Advanced Technology and
    Engineering Center (MATEC) and Southern Maine Community Residence Hall
    respectively, are essential resources for the start of the College's
    upcoming Fall Semester. The property was originally scheduled to be
    conveyed to the College in January through the Department of Education,
    but the properties still remain under the Navy's control. Given that
    these properties require up to 6 months of redevelopment and the start
    of the Fall semester is August 2011, the education of students relying
    upon the College's new campus is in jeopardy unless this conveyance
    occurs in the near future. Secretary Mabus, will you review the status
    of this conveyance and commit to a conveyance date in the near future?
        Answer. I share your desire to transfer the property to the
    Brunswick community as expeditiously as possible. On March 29, 2011,
    Navy assigned 10 acres of Brunswick Naval Air Station, including
    Buildings 151 and 512, to the Department of Education for conveyance.
        The Department of Education will conduct the conveyance of
    Brunswick Naval Air Station property to Southern Maine Community
    College through a public benefit conveyance.
                                     ______

                 Questions Submitted by Senator Lisa Murkowski
                  u.s. navy environmental remediation on adak
        Question. As you might be aware, environmental remediation at
    multiple sites on the island of Adak has been ongoing since 1986. The
    U.S. Navy, in conjunction with the EPA and the State of Alaska, have
    been working since that time to restore the lands on Adak to an
    environmentally stable state following the Navy occupation of those
    lands. While through fiscal year 2009, the Navy has spent $289.8
    million on restoration activities on Adak, it is my understanding that
    the Navy anticipates that another $102.5 million would be needed to
    complete the restoration projects. I have been recently informed that
    the majority of restoration efforts that the Navy has conducted have
    been focused on lands that are not available for habitation or economic
    development by the communities on Adak. Is there a process by which the
    Navy determines which lands receive remediation funding and projects
    before others?
        Answer. The Navy funds cleanup to protect human health and the
    environment and meet legal obligations, including agreements with
    States and the U.S. EPA, such as the Adak Federal Facility Agreement
    (FFA). For BRAC sites, cleanup schedules are also aligned with property
    redevelopment timelines to the best extent possible. If additional
    funds are made available by Congress, projects that accelerate property
    transfer are then considered.
        Question. Does the Navy have a long term plan in place that defines
    which lands will be remediated and in which order?
        Answer. The Navy has a plan which includes a schedule for
    investigation, cleanup and long-term monitoring of all Navy
    environmental sites on Adak. The Navy consults with the local
    Restoration Advisory Board (RAB) and regulatory agencies when
    developing and updating the plan.
        Question. What is the Navy's projected timeframe for the completion
    of the remediation projects on Adak?
        Answer. The Navy has a schedule to complete all cleanup actions by
    fiscal year 2016. The remedy selected for some environmental sites
    include long-term monitoring consisting of periodic inspection and
    repair of landfills, groundwater sampling and analysis, marine tissue
    sampling and analysis, and inspection and repair of institutional
    controls. Long-term monitoring requirements are documented in the Adak
    Comprehensive Monitoring Plan (CMP) and are scheduled to continue until
    fiscal year 2041.
                  Questions Submitted to Admiral Gary Roughead
                Questions Submitted by Chairman Daniel K. Inouye
                           navy shift in sea billets
        Question. Admiral Roughead, the Navy recently announced its plans
    to shift approximately 6,800 billets through fiscal year 2016 to
    realign them for warfighting capabilities. A portion of this shift will
    increase the number of sea billets while cutting shore billets. What
    led the Navy to initiate this shift, and what effect will this have on
    the ship to shore rotation of sailors?
        Answer. The Navy shifted these billets from support staff to
    operational roles to improve warfighting readiness and support the
    Navy's future force and warfighting capabilities. The reduction in
    staff billets allowed us to increase operational, sea going billets for
    the LHA-7, DDG-51 class destroyers, LCS class ships, unmanned and
    helicopter aviation detachments to support the LCS, Virginia class
    submarines, new E-2D Advanced Hawkeye aircrews, and the outfitting of
    an additional Riverine Squadron.
        With Navy's increased focus on enhancing efficiencies in our
    operations, this will require some sailors to serve longer sea tours.
    The necessary realignments toward operations will likely require
    implementation of risk mitigation strategies to support sea intensive
    communities and ratings. Some of the initiatives being considered are
    Sea Duty Incentive Pay (SDIP), increased general shore duty billeting
    in recruiting commands, and increased in-rate shore duty billets at
    regional maintenance centers and waterfront school houses.
        Question. Are you concerned that this tighter ship to shore
    standard will have a negative effect on families and retention?
        Answer. While sea/shore rotation does factor in to retention
    decisions, we do not anticipate this realignment to cause retention
    statistics to fall outside of historic norms. Currently, the Navy is
    experiencing unprecedented retention, which is expected to continue,
    based on current economic indicators. Disregarding the current positive
    impact of the economy and the high operational tempo, 65 percent of
    sailors beyond 6 years of service remain in the Navy and 80 percent of
    sailors with greater than 10 years of service decide to Stay Navy based
    on historical averages. The Navy has established maximum allowable sea
    tour lengths to preserve positive tone-of-the-force and to minimize
    retention risk.
        The billet realignment was approved only after careful analysis of
    operational needs, fleet readiness requirements, and input from fleet
    sailors. The increase in manning at sea is anticipated to have positive
    effects that will reduce the workload of sailors currently on sea duty
    and increase the opportunity for sailors to obtain professional
    qualification through participation in Fleet operations.
        We remain steadfast in our commitment to provide exceptional
    support to mitigate the adverse impacts families may experience during
    deployments. We offer a broad array of services through Navy Fleet and
    Family Support Centers, military medical treatment facilities, child
    care centers, and morale, welfare and recreation programs. These,
    coupled with ready access to command ombudsmen and referral services
    through Military OneSource, provide a network of support to sustain
    families enduring the hardships associated with prolonged family
    separations while their loved ones are away.
                             aegis missile defense
        Question. Admiral Roughead, Aegis cruisers and destroyers provide a
    crucial capability for conducting ballistic missile defense operations.
    The administration's Phased Adaptive Approach (PAA) for ballistic
    missile defense operations includes operating Aegis ships in European
    waters. Do you have sufficient resources to carry out this additional
    mission?
        Answer. The Navy currently has sufficient capacity to meet the most
    critical demands for its multi-mission Aegis ships; however, we do not
    have the capacity to meet all Geographic Combatant Commander (GCC)
    demands for Ballistic Missile Defense (BMD) without exceeding
    established Personnel Tempo program limits for deployment lengths,
    dwell tempo, or homeport tempo. Based on threat analysis and current
    indications from GCCs, and assuming standard 6 month deployment
    lengths, the Navy and the Missile Defense Agency (MDA) concluded that
    GCC demand for surface combatants with Aegis BMD capability will
    outpace capacity through approximately 2018.
        To meet the increasing demand for these ships and reduce the risk
    to our long term force structure caused by the increased operational
    tempo from longer deployment lengths, the Navy, working in conjunction
    with MDA, has established a plan (see Figure 1 below) to increase the
    number of BMD-capable Aegis ships from 23 in fiscal year 2011 to 41 in
    fiscal year 2016. This plan balances the need for meeting current
    operational requirements against the need to upgrade existing BMD-
    capable Aegis ships to pace the future threat. Included in this plan
    are increases in the Navy's capacity and the capabilities of Aegis
    ships through the installation of an Aegis BMD 3.6.1/4.0.1 suite, the
    Aegis Modernization program, or new construction (commencing with DDG-
    113).

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    Figure 1.--Aegis BMD Ship Profile, Presidential budget for fiscal year
                                     2012.

        Question. Admiral Roughead, are you concerned that the heightened
    demand for Aegis Ballistic Missile Defense will detract from other,
    non-BMD missions?
        Answer. With the exception of our SSBN's strategic deterrence
    patrols, the Navy does not deploy ships with a single mission purpose.
    Single mission use of our Aegis ships for Ballistic Missile Defense
    (BMD) will result in shortages in other mission areas and a loss of
    operational flexibility for the Geographic Combatant Commanders (GCCs).
        To ensure GCCs demands are met, the Navy employs Aegis ships in
    multi-mission roles rather than for exclusive missions on an enduring
    basis. These ships can perform a variety of other non-BMD missions such
    as strike warfare, air warfare, submarine warfare, surface warfare,
    information warfare, high-value asset protection, or maritime
    interdiction either concurrently or sequentially as the GCC requires.
    The Navy has created a flexible operating concept for maritime BMD
    which features a graduated readiness posture that allows BMD-capable
    Aegis ships to be on an operational tether and available for other
    tasking when not directly involved in active BMD operations. Aegis
    ships operating in support of a BMD mission do not lose the capability
    to conduct other missions; however, specific mission effectiveness may
    be affected by ships' position and/or application of ship resources to
    those missions.
                   aegis ballistic missile defense operations
        Question. Admiral Roughead, the USS Monterey recently deployed as
    the first asset in European missile defense. Could you provide the
    Committee with an update on those operations?
        Answer. While the Navy has previously deployed BMD-capable ships to
    the European region, USS Monterey is the first deployed BMD-capable
    multi-mission ship to support the European Phased Adaptive Approach
    (EPAA). This deployment will lay the foundation for the EPAA, by
    developing a better understanding of what is necessary to execute
    ballistic missile defense from the sea in Europe and how to operate in
    coordination with Allies and partners.
        USS Monterey will engage with our NATO Allies and European partners
    to promote the U.S. commitment to the EPAA mission and the broader
    U.S.-NATO theater security cooperation efforts. To date, this
    engagement included participation in the NATO Air Defense Committee
    conference in Antwerp, Belgium and future engagements are planned with
    our Allies and partners in the Black Sea and Eastern Mediterranean.
        During her deployment, USS Monterey will continue integration and
    testing of U.S. BMD capabilities with NATO's existing missile defense
    framework, including the emerging NATO command and control network.
        As a BMD-capable multi-mission ship, USS Monterey also remains
    ready to provide a wide range of capabilities enabling her to promote
    peace and security, preserve freedom of the seas and provide
    humanitarian aid and disaster response as necessary.
                          bow wave in ship procurement
        Question. Admiral Roughead, the Navy's stated force structure goal
    is 313 ships. However, your most recent 30-year shipbuilding plan
    submitted to Congress shows that beginning in fiscal year 2027, the
    Navy fleet will fall well below that number and drop to less than 290
    ships. What steps are you taking to mitigate these projected
    shortfalls?
        Answer. With the need for multi-mission platforms vice single
    mission platforms, and recognizing the significantly increased
    capabilities of current new construction ships, the Navy cannot
    recapitalize our battle inventory to replace its legacy ships at the
    same rate at which they were originally procured in the 1980s and 1990s
    and maintain an affordable, balanced procurement plan. To manage this
    inventory issue with our current fiscal constraints, the Navy will
    manage the service lives of our existing ships through modernization
    and maintenance over the Future Years Defense Plan and into the 2020s
    to mitigate the impact of the upcoming block obsolescence of the ships
    procured in large quantities during the 1980s. This management approach
    will minimize gaps in capacity through the 2020s in a cost efficient
    manner. To enhance our combat capability for our existing ship designs
    we will continue our spiral capability upgrades to prevent
    technological obsolescence and to extend the service lives of specific
    ship classes. Both of these initiatives will mitigate the decline in
    our battle force inventory during the 2020s and early 2030s.
        During the period fiscal year 2031 to fiscal year 2040, we have
    assumed a procurement strategy based on sustaining procurement rates.
    Wherever feasible, the Navy will procure new ships at a steady state
    reducing the magnitude of annual funding variations and providing a
    more stable demand to industry. In some cases, where rapid retirement
    rates are anticipated, it may be necessary to start procurement of next
    generation ships earlier than might otherwise be required or accept
    ``bathtubs'' in certain ship classes until procurement rates catch up
    with retirement of ships procured during the 1980s. As requirements,
    resources and the industrial landscape come into better focus for the
    post-2020 timeframe, the Navy will continue to consider mitigation
    strategies for these anticipated shortfalls in future plans.
        Question. Admiral Roughead, the Congressional Budget Office
    estimates that the Navy's ship procurement budget is 19 percent below
    what is required to execute your current 30-year shipbuilding plan. Do
    you agree with this assessment?
        Answer. No, I do not agree with this assessment. Navy's anticipated
    annual procurement budget averages about $15.9 billion in fiscal year
    2010 per year over the 30 year shipbuilding plan period. This average
    includes those funds necessary to recapitalize the OHIO Class ballistic
    missile submarines. The Navy and Congressional Budget Office (CBO)
    estimates for the near-term (fiscal year 2011-fiscal year 2020) reflect
    a less than 5 percent difference. Given known ship capability and
    quantity requirements, the Navy cost estimates are judged to be
    accurate in this period.
        What has driven the 19 percent difference in our estimates has been
    the far term (fiscal year 2031 to fiscal year 2040) where CBO and Navy
    estimates differ by 37 percent. The requirements during this period are
    not as well defined as those for the near or mid-term. The CBO made
    several different assumptions than the Navy in its assessment,
    particularly in the far-term. Those differences result partly from
    different methods of estimating shipbuilding inflation during the
    period as well as different assumptions about the design and
    capabilities of future ships. The number, types and capabilities of
    ships are estimated based on anticipated Joint and Navy war-fighting
    requirements, and cost estimates are fluid due to both the uncertainty
    of business conditions affecting the shipbuilding industry and the
    inherent technology costs of future combat systems.
        There are several uncertainties that must be resolved regarding the
    Navy's missions in the next decade; the relative threat levels that
    will exist at that time and the extent to which we will adjust the
    force to meet these challenges. Each of these issues will have a direct
    bearing on the overall costs required to recapitalize this force.
    Ultimately, this will require that we set funding priorities properly,
    adjust capabilities in the ships being built and readdress risk in
    those mission areas where appropriate. We must and will continue to
    conduct thorough reviews of each facet of our budget to ensure we are
    providing the Nation with the needed level of capability in all areas
    in the most cost efficient manner.
        Question. Admiral Roughead, do you intend to provide an updated
    long-range shipbuilding plan to Congress this year?
        Answer. No, we do not intend to submit an updated long range
    shipbuilding plan to Congress. Section 231 of Title 10, United States
    Code (section 231) was amended by the National Defense Authorization
    Act for fiscal year 2011, deleting the requirement for the Secretary of
    Defense (SECDEF) to submit with the Defense Budget an annual long-range
    plan for construction of naval vessels commonly know as ``The 30-Year
    Shipbuilding Plan''. As amended, section 231 now requires that
    concurrent with submission of the President's budget (PRESBUD) during
    each year in which SECDEF submits a Quadrennial Defense Review (QDR),
    the Secretary of the Navy (SECNAV) shall submit a long-range
    shipbuilding plan that supports the force structure recommendations of
    the QDR and will be assessed by Cost Assessment and Program Evaluation
    Office (CAPE) to determine if the level of funding is adequate and
    determine potential risk in supporting the requirements of the
    Combatant Commanders.
        In any year in which a QDR is not submitted and the number of ships
    decreases in the Future Years Defense Plan (FYDP), SECNAV shall submit
    an addendum to the most recent QDR that fully explains and justifies
    the decrease.
        Consistent with the amended section 231, the Navy does not intend
    to submit an updated long-range shipbuilding plan to Congress this year
    because the number of ships has increased with the PRESBUD 2012 Future
    Years Defense Plan (FYDP); however, we are providing updated 10-year
    data tables per the House Committee of Armed Services request of
    February 15, 2011.
             effects of continuing resolution on military personnel
        Question. Admiral Roughead and General Amos, how has the series of
    short-term continuing resolutions negatively affected the Navy and
    Marine Corps's ability to manage its military personnel accounts? For
    example, how much notice is being given for sailors and marines to
    prepare to move to their next assignment, and what is the goal?
        Answer. Operating the military personnel accounts under a series of
    short-term continuing resolutions (CR) and reduced funding has
    presented many execution challenges. Under the full year CR, the
    Military Personnel, Navy (MPN) appropriation is underfunded by $415
    million. This shortfall is due to the difference between the annualized
    amount of the fiscal year 2010 appropriation and the requested fiscal
    year 2011 President's budget. Additionally, the MPN account is
    underfunded by an additional $41 million from additional requirements
    and work in the year of execution resulting from high retention. The
    added costs associated from the evacuations of Japan and Bahrain, as
    well as Operation Odyssey Dawn, will further pressurize the MPN
    account.
        To preserve cash to pay our sailors and civilians and to avoid an
    Anti-Deficiency Act (ADA) violation, the Navy deferred 20,000 Permanent
    Change of Station (PCS) moves and reduced lead times from 6 months down
    to 2 months. Lack of lead time on PCS orders hurts military families as
    they have less time to plan for major life changes associated with
    moves (i.e. home sales, lease expirations, overseas screening,
    uncertainty, etc). Historical goals for lead time are approximately 4
    months for CONUS moves and 6 months for overseas moves.
        Navy has also reduced Active Duty for Operational Support Orders
    (ADOS) by $20 million. ADOS is used to facilitate emergent, unplanned
    and non-recurring short term projects. This reduction restricts our
    ability to support Fleet operations.
                     navy cybersecurity and the tenth fleet
        Question. Admiral Roughead, as you know, cyber security is one of
    the most significant challenges facing our Nation today. Modern warfare
    has become highly dependent upon computers and networks; therefore
    protecting this capability is vitally important. Could you explain the
    cyber security initiatives in the budget, and what are the near-term
    priorities you have established for this critical mission area?
        Answer. The Navy's focus in cyber security is on delivering game-
    changing information capabilities that advance our operational
    proficiency in cyberspace and enhance our other information
    capabilities. Navy is improving its cyber-security by implementing an
    improved Defense in Depth infrastructure that is aligned to the
    Department of Defense (DOD) Information Assurance Boundary
    Architecture. In our PB 2012 budget request, we include the following
    cyber security initiatives:
      --Computer Network Defense (CND).--This program's capabilities secure
            Navy networks and information systems. This program oversees
            our firewall components, Virtual Private Networks (VPNs),
            Intrusion Prevention/Detection Systems, Boundary Protection,
            Host Based Security System (HBSS), Administrator Access
            Controls, and diverse network security tools and filtering
            routers.
      --Cyber Security Inspection and Certification Program (CSICP).--CSICP
            provides the capability to detect vulnerabilities in Navy
            networks, provide assistance to network operators to correct
            and prevent vulnerabilities, and ensure compliance with Navy
            and DOD Information Assurance directives.
      --Communications Security (COMSEC).--The Navy's cryptographic
            equipment procurements are facilitated through these accounting
            lines and include procurement of KIV-7M, a replacement
            cryptography suite, Cryptographic Universal Enclosures (CUE),
            and various other cryptographic devices.
      --DOD-wide deployment of PKI certificates for identity
            authentication.
      --Procurement of secure voice tactical hardware, Next Generation
            Internet Protocol Phones and Navy, and Certificate Validation
            Infrastructure Cards.
      --Electronic Key Management System (EKMS) upgrades and initiatives
            for web based order support.
      --Secure Communication Interoperability Protocol (SCIP) Inter-Working
            Function (IWF) capabilities to provide sea-shore secure
            telephony communications.
        Question. Admiral, what advantages do you anticipate as a result of
    classifying your Cyber Command as a weapons system?
        Answer. Last year, I established the U.S. Tenth Fleet and the
    Deputy CNO for Information Dominance. This restructuring has enabled
    the Navy to focus on enhancing our capabilities in electronic warfare
    and cyber operations. However, Fleet Cyber Command/U.S. Tenth Fleet is
    not considered a weapons system. It is a Navy component command that
    executes its unique cyber capability at the operational level of war
    through the forces under the command of Tenth Fleet. This approach has
    provided an alignment of effort through the use of a single operational
    commander for Cyber operations that is responsible for the
    orchestration of the Navy's global resources and activities in
    cyberspace.
        Question. Admiral, recently you turned on a new system that gives
    the Navy its first real-time view of all traffic into and out of the
    networks. What have you learned about the health of your network since
    initiating the use of this system?
        Answer. We are learning a tremendous amount about the trends and
    patterns of information flow. The insights from our trend analysis and
    the new data on information flow has allowed us to characterize network
    activity faster and allows us to recognize areas that require further
    analysis earlier.
                  next-generation ballistic missile submarine
        Question. The Navy has initiated a program to replace the Ohio-
    class submarines beginning in 2029, but concerns have persisted about
    the price tag of the replacement. These submarines are an indispensible
    part of our nuclear triad, and it is important that we have them ready
    on schedule at an affordable cost. Admiral Roughead, could you comment
    on the steps that are being taken to make sure that this program does
    not suffer the all-too-common problems of being over budget and past
    schedule?
        Answer. Through thorough research by the Navy and OSD on the
    history of the last 50 years of survivable sea-based strategic
    deterrence, we have been able to determine the high-level baseline ship
    characteristics to establish affordability goals to be used during ship
    design for the OHIO Replacement (OR). This early and well understood
    basis for all requirements is necessary to prevent cost growth and
    control costs.
        The Department is committed to provide the required and proper
    level of investment in up-front research and development to mature
    critical technologies and prove construction techniques to support lead
    ship construction. The use of appropriately mature technologies will be
    a major driver in controlling construction costs while recapitalizing
    the SSBN fleet. Likewise, achieving a sufficient level of maturity in
    the overall design will be critical to cost effective construction.
    Where practical, OR will use existing VIRGINIA Class technologies and
    components.
        The OHIO Replacement Program will leverage design and construction
    lessons learned from the VIRGINIA Class to continue our ongoing and
    highly successful cost reduction initiatives. In addition, Navy will
    leverage the same design contract strategies from VIRGINIA to ensure OR
    is designed and procured at the lowest possible cost. The Navy is
    investing an additional $50 million/year in fiscal year 2012-fiscal
    year 2014 to enhance designing the OR for affordability. The Design for
    Affordability (DFA) effort will be a joint Government and Shipbuilder
    effort focused on reducing Total Ownership Costs. The DFA process will
    specifically target reductions in lead ship Non-Recurring Engineering
    (NRE) cost, reducing construction time and cost, balancing acquisition
    and lifetime operations and support (O&S) costs, and the process will
    provide shipbuilder research & development incentives based on
    validated proposals for cost estimate reductions, DFA design schedule,
    and additional cost reduction initiatives.
                                     ______

                Questions Submitted by Senator Dianne Feinstein
                           chinese military advances
        Question. Admiral Roughead, we have recently seen a great deal of
    discussion about China's development of a new anti-ship missile, the
    DF-21D or ``carrier killer'' which is intended to hit a well-defended
    target, such as one of our carriers, with pinpoint accuracy. The
    concern is that such a missile will put our carriers at risk and hamper
    the Navy's ability to intervene in a conflict over Taiwan or North
    Korea. Vice Admiral Scott van Buskirk, commander of the U.S. 7th Fleet,
    downplayed concerns about the missile noting that it was just ``one
    weapons system, one technology that it out there.'' What is your
    assessment of the threat this weapon poses to our carrier fleet?
        Answer. The DF-21D Anti-Ship Ballistic Missile (ASBM) is but one
    system in China's arsenal that challenges naval operations in contested
    areas. To successfully employ an ASBM, or any long-range maritime
    weapon, China needs a robust command, control, communications,
    computers, intelligence, surveillance and reconnaissance (C\4\ISR)
    capability to find and relay targeting information to decision makers
    and firing units. While China operates a wide range of ISR assets, the
    aggregation of near-real-time information that is required for the PRC
    to move quickly from initial detection to engagement is a highly
    complex problem, especially against one of our aircraft carriers that
    would be maneuvering at sea. Additionally, the Navy has made
    significant investment in kinetic and non-kinetic capabilities to
    counter anti-ship ballistic missiles and advanced cruise missiles,
    including increased investment in Aegis modernization, which will
    upgrade our existing Aegis technology to continually improve our
    Integrated Air and Missile Defense capability. More details in response
    to this question are best provided in a classified setting.
        Question. What is the U.S. response?
        Answer. The Navy has made significant investment in kinetic and
    non-kinetic capabilities to counter the threat of anti-ship ballistic
    missiles and advanced cruise missiles, including increased investment
    in Aegis modernization, which will upgrade our existing Aegis
    technology to continually improve our Integrated Air and Missile
    Defense capability. A more detailed response to this question is best
    provided in a classified setting.
        Question. What other challenges to the U.S. Navy's presence in the
    Pacific do you see arising from China and how should we respond?
        Answer. There are an increasing number of foreign capabilities,
    including those of China, that have the potential to slow or disrupt
    the deployment of friendly forces into a theater or cause our forces to
    operate from distances farther from a conflict than desired.
    Capabilities that impact our forces in this manner are termed ``anti-
    access'' capabilities and include long-range, precise, anti-ship and
    land attack ballistic and cruise missile systems; advanced combat
    aircraft and electronic warfare technologies; advanced Integrated Air
    Defense systems; submarines and subsurface warfare capabilities;
    surface warfare capabilities; C\4\ISR capabilities, and cyber warfare
    technologies. The Navy has and will continue to develop programs and
    capabilities to address the anti-access environment emerging in the
    Western Pacific and other theaters of operation. Accordingly, we are
    mindful of the need to be prepared to respond to all challenges by
    strengthening our alliances and partnerships, modernizing our forces,
    fielding new capabilities and technologies, and developing new
    operational concepts.
                       naval tactical aircraft shortfall
        Question. In June 2009, the Navy testified to Congress that its
    aircraft fleet was facing a potential shortfall of 243 tactical
    aircraft in the next decade. We understand that the less than 2 years
    later, the Navy is now stating a shortfall of only 65 aircraft. I am
    interested in how the Navy determined this new shortfall estimate. Has
    the Navy assumed additional risk in order to reduce the shortfall? If
    so, what are those risks?
        Answer. Based on the 2012 President's budget, the Department of the
    Navy projects it will experience a peak inventory shortfall of 65
    aircraft in 2018, should the following conditions exist: accelerated
    transition of 10 F/A-18 legacy Hornet squadrons into Super Hornets; the
    service life extension of approximately 150 legacy Hornets; and
    procurement of a total of 556 F/A-18E/F Super Hornets. This aircraft
    shortfall is manageable.
        Question. What are the practical consequences of the strike fighter
    shortfall?
        Answer. Based on the 2012 President's budget, the Department of the
    Navy projects it will experience a peak inventory shortfall of 65
    aircraft in 2018, should the following conditions exist: accelerated
    transition of 10 F/A-18 legacy Hornet squadrons into Super Hornets; the
    service life extension of approximately 150 legacy Hornets; and
    procurement of a total of 556 F/A-18E/F Super Hornets. This aircraft
    shortfall is manageable.
        Question. What is the Navy doing to mitigate this shortfall?
        Answer. Based on the 2012 President's budget, the Department of the
    Navy projects it will experience a peak inventory shortfall of 65
    aircraft in 2018, should the following conditions exist: accelerated
    transition of 10 F/A-18 legacy Hornet squadrons into Super Hornets; the
    service life extension of approximately 150 legacy Hornets; and
    procurement of a total of 556 F/A-18E/F Super Hornets. This aircraft
    shortfall is manageable.
                                  shipbuilding
        Question. Admiral Roughead, your budget request includes funding
    for 10 ships in fiscal year 2012 with a total of 50 ships over the
    Future Year Defense Plan. Will this production rate support your stated
    goal of a 313 ship Navy?
        Answer. Yes. The Navy plans to procure a total of 55 ships in the
    PB 2012 Future Years Defense Program (FYDP), an increase of 5 from last
    year's plan. This production rate will reach a battle force inventory
    of 313 ships in the near-term (fiscal year 2011-fiscal year 2020)
    reaching 315 ships in fiscal year 2020. President's budget (PB) 2012
    achieves a balanced and executable shipbuilding program which provides
    additional capability while gaining stability and efficiency in the
    shipbuilding industrial base.
        Question. How will the current set-backs related to the constraints
    of the Continuing Resolution affect the fiscal year 2012 procurement
    rates?
        Answer. Without the fiscal year 2011 requested SCN budget, the
    future build plan for shipbuilding, including fiscal year 2012, would
    have to be reprioritized and rephased. There could be future cost
    impacts attributed to revised workload at major shipbuilders, rate
    increases associated with protracted schedules, and inefficient
    procurement of major systems. There are secondary impacts to the Navy
    as delays in delivery could result in delays to initial operating
    capabilities or the ability to retire fleet assets as planned. Under
    the CR, the inability to increase procurement quantities, initiate new
    starts, increase funding levels, or reallocate funding constitutes a
    considerable impact to the FYDP for shipbuilding.
        Currently, the Navy plans to procure a total of 55 ships in the
    fiscal year 2012 President's budget FYDP with 10 ships budgeted in
    fiscal year 2012. The CR's limitation in the shipbuilding program to
    the fiscal year 2010 funding levels and procurement quantities
    negatively impacts Navy's fiscal year 2011 build program. Specifically,
    the CR prohibits the procurement of a second Virginia Class Submarine,
    a second DDG-51 Class Destroyer, a LHA replacement amphibious ship, an
    oceanographic ship, a Mobile Landing Platform, and several smaller
    programs. Available funding under the CR does not provide required
    advanced procurement funding for future platforms to include the
    Carrier Replacement and Carrier Refueling Overhaul Programs, nor does
    it provide the final increment of funding required for the CVN 78.
        Question. How will the Navy mitigate those effects?
        Answer. In developing our shipbuilding plan, we assessed risk
    mindful of the uncertainties of the future to achieve the best balance
    of missions, resources and requirements possible for our PB 2012 Navy
    procurement request.
        PB 2012 achieves a balanced and executable shipbuilding program
    which provides additional capability while gaining efficiency in the
    shipbuilding industrial base. The Navy has requested to procure a total
    of 55 ships in the PB 2012 FYDP, 5 more than last year due to our
    efficiencies and acquisition strategies. This request includes ten
    ships in fiscal year 2012. These ships include: a continuation of the
    fiscal year 2010 restart of the DDG 51 program, with an additional ship
    in fiscal year 2014; an additional Littoral Combat Ship (LCS) in fiscal
    year 2012 to support an acquisition strategy of two 10 ship block
    procurements from each contractor, continuation of the SSN 774 program
    at two ships per year through fiscal year 2016; acceleration of the new
    Mobile Landing Platform (MLP) program aimed at increasing the capacity
    and capability of the existing Maritime Prepositioning Ship (MPS)
    fleet; continuation of the CVN 78 program; procurement of the eleventh
    LPD 17 ship, meeting the Marine Corps lift requirements for this class
    of ship; and a substantive increase in the Navy's ability to meet
    theater cooperation demands and intra-theater lift requirements through
    capitalization of a more robust Joint High Speed Vessel (JHSV) program.
    Overall, the fleet additions represented by the additions to the PB
    2012 FYDP will position the Navy to meet its obligations and mission
    requirements through the next decade.
                                     ______

                  Questions Submitted by Senator Patty Murray
                               great green fleet
        Question. Has the composition and homeport of the Great Green Fleet
    been decided?
        Answer. No final decision regarding the composition of the Great
    Green Fleet has been made. The individual Navy units that would deploy
    in 2016 have not been identified, but the Great Green Fleet will be
    composed of ships from various home ports. As such, it will not have a
    single home port.
        Question. Will the fiscal year 2011 Continuing Resolution impact
    the timeline for the 2012 Green Strike Group? If so, what specifically
    will be impacted?
        Answer. The continuing resolution (CR) necessitated the
    reprogramming of $5.5 million above the $4.5 million received in fiscal
    year 2010. This reprogrammed funding for fiscal year 2011 was not
    received until April 2011, causing schedule delays to the program.
    Currently Navy has received $10 million of $10.8 million programmed for
    the testing and certification needed to support the Great Green Fleet.
    Efforts are ongoing to identify avenues to mitigate delays. Navy plans
    to be back on track within the next 3 months to complete the fuel
    certification required for ship and aircraft systems to conduct the
    demonstration of the Green Strike Group in 2012.
        Question. Where is the Navy getting the fuel currently being used
    for testing? When does the Navy think the fuel will be ready for
    certification?
        Answer. The Navy receives all of its fuels through the Defense
    Logistics Agency--Energy through competitive procurement. The test and
    certification process of the fuels necessary for the Great Green Fleet
    is currently underway. Current funding puts the Navy on track to
    complete the fuel certification required for ship and aircraft systems
    to conduct the demonstration of the Green Strike Group in 2012.
        Question. After the 2012 test, is the Navy planning to transition
    more bio-fuels capability to the fleet or will that occur after the
    2016 demonstration?
        Answer. The Navy plans to use certified, cost-competitive
    alternative fuels as they become available. If certified bio-fuels are
    commercially available at a competitive price earlier then the
    objectives set by the Secretary of the Navy, the Navy will pursue their
    competitive procurement.
        Question. What is the cost to modify ship and aircraft engines to
    use bio-fuels instead of conventional? What are the potential long term
    savings for using a renewable energy source for fuel?
        Answer. There is no need to modify ship and aircraft engines to use
    bio-fuels instead of conventional fuel. Navy requires alternative fuel
    suppliers to engineer the fuel so that it closely mirrors the current
    fossil fuels of F-76 and JP-5; the fuels are a 'drop-in' replacement
    for 100 percent petroleum and can be mixed freely with it. There is a
    potential for long-term cost savings by using renewable biofuels if the
    cost of petroleum keeps rising and eventually exceeds the declining
    cost to produce biofuels.
        Question. Does the Navy have any plans to add hybrid tugs to the
    Fleet? If so, what is the timeframe by which they intend to acquire
    them?
        Answer. The Navy does not currently have any plans to add hybrid
    tugs to the Fleet.
                                     ______

                   Question Submitted by Senator Thad Cochran
                           high performance computing
        Question. Admiral Roughead, The Naval Meteorology and Oceanography
    Command and its associated supercomputing capability have proven to be
    valuable assets in a host of mission areas including ocean modeling,
    weather modeling, and disaster relief, such as, the Gulf oil spill last
    year. Can you describe for the Committee the importance of
    Supercomputing capacity and how it has assisted the Navy in
    accomplishing its mission?
        Answer. The Department of the Navy utilizes High Performance
    Computing (HPC) resources to accelerate development and transition of
    advanced defense technologies into superior war-fighting capabilities,
    and to support our operational needs. Specifically, the Navy Research,
    Development, Test, and Evaluation (RDT&E) community utilizes HPC assets
    for modeling and simulation. HPC allows the Navy to develop physics-
    based simulations, which create realistic warfare environments that
    allow us to evaluate the performance of new technologies and tactics in
    real-time. The simulated environments enabled by HPC are essential,
    especially in cases where no test range exists to emulate combat
    environments, where physical testing has unacceptable safety risks,
    where physical testing is prohibitively expensive, and where we have to
    rapidly test new systems to counter emerging threats in ongoing
    conflicts. HPC allows us to conduct classified and unclassified early
    advanced research, and it reduces the cost, acquisition time, and risk
    for our major defense programs by optimizing the mix of simulation with
    physical testing. The use of HPC enables Navy's RDT&E infrastructure to
    deliver necessary capabilities to our sailors faster and cheaper.
        The Navy also relies on HPC to support our operations. The Naval
    Oceanographic Office (NAVOCEANO) relies on HPC resources for
    operational oceanographic applications, including numerical ocean
    prediction, and our Fleet Numerical Meteorology and Oceanography Center
    (FNMOC) greatly benefits from HPC resources that support R&D and
    production of operational products designed to keep Navy assets safe
    from weather threats.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
                         phalanx close-in weapon system
        Question The Phalanx Close-In Weapons System is an important aspect
    of our naval defense, protecting our sailors and marines against
    threats ranging from anti-ship missiles to small boats and unmanned
    aerial vehicles. I am informed that the Navy has recognized the
    importance of this system by investing $1.42 billion to upgrade 252
    Phalanx mounts to the appropriate configuration. In your letter to me
    dated December 3, 2010, you stated that to maintain these systems the
    Navy needed to begin funding 36 overhauls per year, starting with the
    fiscal year 2012 budget. I see that the fiscal year 2012 budget request
    includes funding for only three Phalanx overhauls in a year, which
    would take the Navy 80 years to complete. Given the clear safety and
    security implications for our sailors and marines, what is the Navy's
    plan to meet this shortfall in fiscal year 2012?
        Answer. Navy continues to procure and install Phalanx Block 1B
    systems at an accelerated pace and is on schedule to have 252 Phalanx
    Block 1B mounts in service by fiscal year 2014. This accelerated
    schedule of installations replaces normal Class ``A'' overhauls
    necessary to maintain system reliability and maintenance. We will
    complete Phalanx Block 1B upgrades as follows: 37 in fiscal year 2011;
    29 in fiscal year 2012; 21 in fiscal year 2013; 55 in fiscal year 2014.
    As a result of this accelerated upgrade plan, the fiscal year 2011 CIWS
    maintenance backlog (all variants) will decrease from 60 systems today
    to less than 40 systems in fiscal year 2014.
        Question And is there any progress being made to re-prioritize this
    overhaul in future years?
        Answer. We are not planning to adjust our approach to the Phalanx
    Close-In Weapons System. The Navy continues to procure and install
    Phalanx Block 1B systems at an accelerated pace and is on schedule to
    have 252 Phalanx Block 1B mounts in service by fiscal year 2014. This
    accelerated schedule of installations replaces normal Class ``A''
    overhauls necessary to maintain system reliability and maintenance. We
    will complete Phalanx Block 1B upgrades as follows: 37 in fiscal year
    2011; 29 in fiscal year 2012; 21 in fiscal year 2013; 55 in fiscal year
    2014. As a result of this accelerated upgrade plan, the fiscal year
    2011 CIWS maintenance backlog (all variants) will decrease from 60
    systems today to less than 40 systems in fiscal year 2014.
                                     ______

                  Questions Submitted by Senator Susan Collins
                          ddg 51 multiyear procurement
        Question. The fiscal year 2012 President's budget request would
    continue DDG 51 ship procurement at a single ship in fiscal year 2012,
    two ships in fiscal year 2013 through fiscal year 2015, and returning
    to a single ship in fiscal year 2016. The addition of a second ship in
    fiscal year 2014 represents an improvement over last year's budget plan
    for DDG 51 procurement, which I applaud. However, buying an average two
    or fewer DDG 51s per year raises a number of near-term and long-term
    concerns. Admiral Roughead, you have previously expressed concern in
    testimony before Congress about the Navy's future force structure in
    the next decade, stating that, ``many of our existing cruisers and
    destroyers will reach the end of their service lives,'' and in the mean
    time, ``our existing BMD ships may experience longer deployments and
    less time between deployments as we stretch current capacity to meet
    growing demands.'' Would you agree then, that if a way could be found
    to procure DDG 51s at a rate greater than one or two per year, the
    Fleet would face less operational risk in meeting mission requirements,
    there would be less concern regarding the looming cruiser and destroyer
    retirements, and the shipbuilding industrial base could produce these
    ships at a lesser, and more affordable, unit cost per ship?
        Answer. The Navy's shipbuilding plan, combined with our plan for
    DDG/CG modernization to upgrade our existing ships, provides the best
    balance among capability, capacity, and affordability for our Navy. The
    current shipbuilding plan allows continuous, stable construction of 13
    ships and related combat system components from fiscal year 2010-fiscal
    year 2017, which address the Navy's near term requirements while
    mitigating technology/design risk and production limitations. The
    shipbuilding plan also permits economic order quantity procurements and
    the efficient production and delivery of materiel and services, which
    reduces the cost of material and labor. Navy will continuously analyze
    force structure requirements over the next decade relative to future
    threats, requirements, and fiscal conditions to determine what the
    composition of the future force should be and the ability of our Fleet
    to meet those challenges.
                             navy shipbuilding plan
        Question. The Navy's current 30-year shipbuilding plan calls for a
    minimum of 88 cruisers/destroyers. Implementing the Navy's current
    shipbuilding plan would result in a cruiser-destroyer force that falls
    below the 88-ship minimum requirement beginning in fiscal year 2028 and
    would remain below the 88-ship floor for 14 years. The shortfall exists
    for more than one-third of the timeframe covered by the 30-year
    shipbuilding plan and reaches a shortfall of 20 ships in fiscal year
    2034. This projected cruiser-destroyer shortfall is the single largest
    projected shortfall of any ship category in the Navy's 30-year
    shipbuilding plan. Given funding pressures the Navy faces in its
    shipbuilding budget during the 2020's by the Navy's need to procure new
    SSBN(X) ballistic missile submarines, it would seem prudent to program
    additional DDG 51s to the shipbuilding plan in the fiscal years prior
    to fiscal year 2019. Admiral Roughead, if the Navy increased the
    production rate for DDG 51's under the forthcoming Force Structure
    Assessment, would that help reduce the projected cruiser-destroyer
    shortfall in fiscal year 2027-fiscal year 2040?
        Answer. If the Navy increased the procurement rate of our large
    surface combatants in the near-term it would mitigate the shortfall in
    the far-term. However, the Navy's current shipbuilding plan represents
    a balance among Fleet requirements for presence, partnership building,
    humanitarian assistance, disaster relief, deterrence, and war-fighting
    by the COCOMs and our resources.
        The procurement rates in the late 1980s and early 1990s for large
    surface combatants should not necessarily be replicated today. The DDG
    51s in the restart program represent three decades of technological
    evolution. The warfighting demands for this ship class will define the
    inventory requirement for the future and it is undetermined whether
    this will involve one-for-one replacement. The inventory objective for
    this ship class will be the subject of further study in the future. The
    ships procured between fiscal year 2016 and fiscal year 2031 will
    replace our existing CG 47 Class cruisers with Air and Missile Defense
    Radar (AMDR) capable destroyers.
        The options to shift resources within the budget to increase force
    structure are limited. Within the President's budget submittal for
    fiscal year 2012's Future Year Defense Plan (FYDP), several ship
    construction programs cannot be accelerated at this time due to
    technological, design risk or industrial production limitations. For
    programs without these risks, the Fleet inventory will reach its
    objective with current construction plans. Due to the Navy's
    efficiencies and cost savings through our LCS acquisition strategy,
    Navy had sufficient resources within the FYDP to procure an additional
    DDG 51 in fiscal year 2014. If additional funding was provided to fund
    SSBN(X) procurement during the period from fiscal year 2020-fiscal year
    2029, the Navy would be able to apply its shipbuilding funds to raise
    other ship procurement rates to reduce the impact on the shipbuilding
    industry and to increase the overall battleforce inventory. This
    additional funding would help reduce future ship inventory shortfalls
    and provide a more stable production base.
                          ddg 51 multiyear procurement
        Question. Admiral Roughead, I understand that for each of the
    previous two DDG 51 multiyear procurement (MPY) contracts, in fiscal
    year 1998-2001 and fiscal year 2002-2005, the Navy received MYP
    authority 1 year in advance (in fiscal year 1997 and fiscal year 2001).
    The Navy states that it wants another DDG-51 MYP starting in fiscal
    year 2013, but the Navy has not requested authority for this MYP as
    part of its fiscal year 2012 budget submission. When does the Navy plan
    to submit to Congress its request for authority for a DDG-51 MYP
    starting in fiscal year 2013?
        Answer. The fiscal year 2012 President's budget highlights the
    Navy's intent to request congressional approval for a DDG 51 fiscal
    year 2013-fiscal year 2017 Multiyear Procurement (MYP). The Navy
    intends to submit the MYP legislative proposal as part of the fiscal
    year 2013 President's budget commensurate with the first year of
    funding for the MYP.
                                     ______

                 Questions Submitted by Senator Lisa Murkowski
                                   earthquake
        Question. Two weeks ago we conducted a hearing in this subcommittee
    on the impact that the failure to complete a fiscal year 2011 Defense
    Appropriations Bill is having on our military services. That was before
    the Navy and Marine Corps were pressed into service in response to the
    devastating earthquake and tsunami in Northern Japan which comes over
    and above everything else your services are doing around. If the Navy
    and Marine Corps were financially stressed in performing their missions
    before how does the unanticipated challenge of responding to an
    earthquake and tsunami further stress the ability of your service to
    perform its mission?
        Answer. The Department of Navy (DON) response to the earthquake,
    tsunami and nuclear reactor disasters in Japan has had minimal impact
    on DON missions. Total costs through March 25, 2011 were $26.5 million
    with at least $10.5 million recoverable by reimbursement from the
    Overseas Humanitarian Disaster Assistance and Civic Aid (OHDACA)
    appropriation.
        The greatest impact to our mission and budget has been the prudent,
    but voluntary, departure of military dependents from the island of
    Honshu, Japan. Through April 8, this operation has cost approximately
    $54.5 million. Navy cannot simply absorb these costs within MILPERS
    accounts that have already been stressed under the Continuing
    Resolution (CR). Navy has submitted a CR exception request to the
    President's Office of Management and Budget (OMB) for additional
    appropriation under the ``Safety of Human Life'' exception to fund the
    additional cost for travel, lodging, meals, and per diem for evacuees
    through April 8, 2011. This short-term solution has been approved by
    OMB.
        Question. In Alaska we are no stranger to earthquakes and as you
    know we are home to the Pacific Alaska Tsunami warning center. Events
    such as those in Japan have refocused Alaska on our own level of
    preparedness if we were to experience an event like we did in Japan.
    And like Japan our runways in the Anchorage Bowl not only vulnerable to
    earthquake damage but also to flooding. If Alaska were to experience a
    catastrophic earthquake what role would you expect the Navy to play in
    a response?
        Answer. The Navy in its supporting role to Combatant Commands
    (COCOMs) provides maritime forces to accomplish their assigned
    missions, which include humanitarian assistance and disaster relief. In
    the event of a catastrophic earthquake in Alaska, U.S. Northern Command
    and U.S. Pacific Command would coordinate with the Joint Chiefs of
    Staff to determine specific Requests for Forces and/or Requests for
    Assistance to the Navy and other Services. Navy's forces would
    contribute capabilities to the overall response effort performing
    evacuation, medical assistance, delivery of relief supplies, and
    possibly reconstruction. Additionally, other U.S. Government agencies
    such as DHS and FEMA would contribute their capabilities to provide a
    more robust, whole-of-Government response to a natural disaster.
                                     ______

                  Questions Submitted to General James F. Amos
                Questions Submitted by Chairman Daniel K. Inouye
             effects of continuing resolution on military personnel
        Question. Admiral Roughead and General Amos, how has the series of
    short-term continuing resolutions negatively affected the Navy and
    Marine Corps's ability to manage its military personnel accounts?
        Answer. This question is overcome by events due to passage of the
    fiscal year 2011 Appropriations bill.
        Question. General Amos, what is the current dwell time ratio for
    the Marine Corps, and what is the goal?
        Answer. Our deployment to dwell ratio goal is 1:2. In light of our
    operational demands, and through the support of Congress in authorizing
    our end strength of 202,100 active duty forces, our combat units are
    beginning to realize an approximate 1:2 dwell time.\1\ Other units vary
    at more favorable dwell time levels depending on their mission. We
    anticipate the 1:2 dwell ratio for combat units to remain relatively
    stable provided current deployed force levels are not increased;
    however, increased operational demands in Afghanistan or elsewhere may
    result in dwell times inconsistent with fostering a resilient Total
    Force.
    ---------------------------------------------------------------------------
        \1\ Infantry battalions will continue to remain just below 1:2
    dwell time due to relief in place/transfer of authority requirements.
    ---------------------------------------------------------------------------
        Some marines in select military occupational specialties continue
    to fall into what is known as a high-demand, low-density status. This
    is a key indicator that the combat demand for marines with these skills
    does not match, or exceeds, the current manpower requirement and/or
    inventory. In addition, there are currently 14 of 211 occupational
    specialties where the on-hand number of marines is less than 90 percent
    of what is required.\2\ Our recently completed force structure review
    addressed all these concerns. We are working actively to recruit,
    promote, and retain the right number of marines in the right
    occupational specialties thus promoting resiliency of our Total Force.
    ---------------------------------------------------------------------------
        \2\ Our most stressed occupational specialties based on percentage
    of marines beyond a 1:2 dwell are (1) Geographic Intelligence
    Specialist, (2) Imaging Analyst/Specialists, (3) Signals Collection
    Operator/Analyst, (4) Unmanned Aerial Systems Operator/Mechanic, and
    (5) European, Middle East, and Asia-Pacific Cryptologic Linguists.
    ---------------------------------------------------------------------------
                                     ______

                Questions Submitted by Senator Dianne Feinstein
                         usmc f-35 joint strike fighter
        Question. General Amos, you have testified to the importance of
    having strike aircraft that can operate from amphibious shipping and
    austere airfields. You have placed the F-35B on a 2-year probation. Can
    you please explain what that probation entails?
        Answer. Establishing a period of scrutiny for the F-35B was prudent
    in light of the progress the Joint Strike Fighter program has made. The
    STOVL technical challenges are typical of this developmental stage and
    none of the known issues are considered to be insurmountable.
    Corrective actions have either already been incorporated into
    production aircraft or they are being proactively analyzed. We now have
    the time to focus resources, ensure the solutions are effective, and
    incorporate them in the most efficient means possible while avoiding
    costly design changes.
        Question. What are the problems with the program and what are you
    expecting to occur over the next 2 years?
        Answer. There are three factors impacting delivery of the Joint
    Strike Fighter: production delivery delays, flight test progress, and
    the rate of software development. For the F-35B, the STOVL variant,
    developmental testing lagged last year as the program identified some
    anomalies in the design that need to be corrected.
        I am personally engaged with the Joint Program Office and prime
    contractors to ensure we have instituted the most efficient and
    effective processes for resolving these challenges. As a result, the
    program will deliver a higher quality of aircraft in the shortest
    amount of time.
        Question. If there are problems with the aircraft, why are we
    purchasing 6 of them in fiscal year 2012?
        Answer. Our plan is to reduce fiscal year 2012 and fiscal year 2013
    production to a rate of 6 per year. This will prevent the loss of
    valuable manufacturing experience gained since the start of production
    while the program develops and implements solutions for the technical
    challenges discovered in developmental testing. It is prudent to
    optimize the production rate to incorporate lessons learned into as
    many of the early lot aircraft as possible, to deliver a higher quality
    of aircraft in the shortest amount of time.
        Question. If the F-35B program does not meet the requirements to
    continue, do you have a plan to replace the aging AV-8B Harrier II
    population?
        Answer. Within our current inventory of our operational tactical
    aircraft, the AV-8B is the least affected by service life longevity. We
    anticipate flying the AV-8B well into the next decade, giving us time
    to develop a replacement plan if F-35B falters. However, the
    improvements we have seen in F-35B program since the first of the year
    indicate the STOVL challenges will be solved and will meet or exceed
    our requirements.
        Question. To quote your testimony, ``The F-35B is vital to our
    ability to conduct combined arms operations in expeditionary
    environments.'' What are the implications to the Marine Corps mission
    if they do not have this capability?
        Answer. The F-35B is the tactical aircraft we need to support our
    Marine Air Ground Task Force from now until the middle of this century.
    Our requirement for expeditionary tactical aircraft has been
    demonstrated repeatedly since the inception of Marine aviation. Our
    ability to tactically base fixed wing aircraft in the hip pocket of our
    ground forces has been instrumental to our success on the battlefield.
    Given the threats we will face in the future, the F-35B is clearly the
    aircraft of choice to meet our operating requirements.
        The implications of not having a STOVL tactical aviation capability
    reach far beyond the Marine Corps and directly affect our ability to
    support our national strategy. I am confident the F-35B will surpass
    expectations and be a key resource in our arsenal of expeditionary
    capabilities.
                                     ______

                   Question Submitted by Senator Thad Cochran
             operational impact of amphibious ship decommissionings
        Question. General Amos, the Department of the Navy has determined a
    minimum force of 33 amphibious ships is the limit of acceptable risk in
    meeting a 38-ship amphibious force requirement. However, the number of
    amphibious ships in inventory will reach 29 ships this year as more
    ships are decommissioned. With the current unrest in Africa and the
    Middle East, and the earthquake in Japan what is the demand for
    amphibious ships currently and what has been the demand from the
    combatant commanders over the last year or so?
        Answer. Demand by Combatant Commanders (CCDR) for naval forces has
    remained high during the last 5 years.

    ----------------------------------------------------------------------------------------------------------------
                                              COCOM ARG/MEU Requirement \1\     COCOM Independent Amphib Requirement
                                         --------------------------------------                  \1\
                 Fiscal year                                                   -------------------------------------
                                            Demand/Sourced        Percent         Demand/Sourced        Percent
    ----------------------------------------------------------------------------------------------------------------
    2008................................           3.4/2.62                 77           3.5/1.88                 54
    2009................................           3.4/2.47                 73          2.58/1.09                 42
    2010................................          4.57/2.62                 57          3.89/1.49                 38
    2011 \2\............................           4.4/2.68                 61          3.83/0.76                 20
    2012 \2\............................          4.44/2.54                 57          4.41/0.93                 21
    ----------------------------------------------------------------------------------------------------------------
    \1\ COCOM Amphib Ship Demand Based on Fleet Forces Command Data (Ships required computed at a 1:3.7 Rotation
      Rate).
    \2\ 2011/2012 Demand reflects Global Force Management Allocation Plan (GFMAP) Baseline data . . . does not
      include Requests for Forces.

        While not able to meet the cumulative annual global CCDR ARG/MEU
    demand, the Navy is meeting SECDEF tasks as noted in the Global Force
    Management Allocation Process information above. The table shows that
    CCDR demand for crisis response forces and engagement are only being
    partially met.
        As current events in North Africa, the Horn of Africa, much of
    Central Command, and in the Pacific reinforce, amphibious forces remain
    the cornerstone of our Nation's ability to respond to crisis and
    overcome access challenges.
        The current inventory of amphibious ships will not support
    continuous deployments in the PACOM, CENTCOM, EUCOM and AFRICOM that
    are being requested by the combatant commanders today. An inventory of
    33 ships (11 large deck/11 LPD/11 LSD) would adequately support these
    regions with an ARG/MEU presence. Thirty-eight ships would support the
    ARG/MEU demand plus single ship deployments to meet the CCDR
    requirements to support additional forward engagement activities.
                                     ______

                  Question Submitted by Senator Lisa Murkowski
                                   earthquake
        Question. Two weeks ago we conducted a hearing in this subcommittee
    on the impact that the failure to complete a fiscal year 2011 Defense
    Appropriations Bill is having on our military services. That was before
    the Navy and Marine Corps were pressed into service in response to the
    devastating earthquake and tsunami in Northern Japan which comes over
    and above everything else your services are doing around the world.
        If the Navy and Marine Corps were financially stressed in
    performing their missions before, how does the unanticipated challenge
    of responding to an earthquake and tsunami further stress the ability
    of your service to perform their mission?
        Answer. Recent USMC support to humanitarian assistance/disaster
    relief operations in Japan combined with no-fly zone enforcement
    support in Libya has forced the Marine Corps to reprioritize some of
    its resources in order to provide maximum support. The Marine Corps
    anticipates Overseas Humanitarian Disaster and Casualty Assistance
    (OHDACA) reimbursements from the State Department to provide funding
    for many of the costs incurred from the Humanitarian Relief effort
    associated with Operation Tomodachi. Outside of the relief efforts in
    Libya, the Marine Corps has incurred approximately $600,000 in expenses
    which are not eligible for OHDACA reimbursement. Reprioritizing
    includes the delayed support to a wide range of Theater Security
    Cooperation (TSC) events. Specifically, Marine forces postponed planned
    exercises with India, Sri Lanka, and the Maldives during the late
    March-early April timeframe. Two other planned exercises with South
    Korea and Indonesia were cancelled during this same period.
        In the cases noted above, events were postponed or cancelled due to
    higher priority missions, not because of a lack of funding.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. And the next hearing of this subcommittee
    will be on March 30. At that time, we'll receive testimony from
    the Department of the Air Force.
        Thank you very much.
        [Whereupon, at 12:40 p.m., Wednesday, March 16, the
    subcommittee was recessed, to reconvene subject to the call of
    the Chair.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                           WEDNESDAY, MARCH 30, 2011

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:31 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Johnson, Cochran, Hutchison,
    Collins, Murkowski, and Coats.

                             DEPARTMENT OF DEFENSE

                          Department of the Air Force

                            Office of the Secretary

    STATEMENT OF MICHAEL B. DONLEY, SECRETARY

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning, we welcome back the
    Secretary of the Air Force, the Honorable Michael Donley, and
    the Air Force Chief of Staff, General Norton Schwartz.
        Gentlemen, we thank you for being here with us today as we
    review the Air Force's budget request for fiscal year 2012. And
    we thank you also for submitting your prepared testimony.
    Without objection, the full statement will be made part of the
    record.
        For fiscal year 2012, the Air Force is requesting $150
    billion in base budget. This funding level is roughly equal to
    your fiscal year 2011 request. The Air Force is also requesting
    $16.4 billion for overseas contingency operations for fiscal
    year 2012, which is a decrease of $4.4 billion from last year's
    request, and reflects the ongoing drawdown from our forces in
    Iraq.
        The lack of growth in the Air Force is partly a result of
    the Secretary of Defense's efficiency initiatives, and I look
    forward to hearing today how the Air Force plans to reduce
    overhead, streamline logistics, improve satellite procurement,
    and reduce energy consumption as part of your efficiencies.
        The subcommittee commends the Department of Defense for
    examining ways to make operations more efficient and
    affordable; however, we must ensure that we are achieving true
    savings and not just deferring tough decisions to a later date.
        In addition to achieving the efficiency savings that have
    been identified, in the near term the Air Force must meet
    growing demands for cyber security and nuclear security and
    intelligence, surveillance, reconnaissance (ISR).
        In theater, the situational awareness requirements of our
    forces continue to grow. Good progress has been made toward
    achieving this goal of operating 65 continuous combat air
    patrols in theater with remotely piloted vehicles. However, the
    Air Force must still address how to fulfill long-term manpower
    requirements of these operations and how to incorporate the
    ever increasing number of ISR assets into the Air Force's force
    structure.
        Over the next decade, the Air Force will face growing
    budgetary pressures as several expensive recapitalization
    programs get underway. But, first, let me commend both of you
    on the successful award of the aerial refueling tanker
    contract. This is a critical step in replacing our aging tanker
    fleet.
        But as you know, the commencement of work on the new tanker
    comes at the same time as the development of a new penetrating
    bomber begins and Joint Strike Fighter (JSF) production ramps
    up. These efforts will place significant pressure on the budget
    at a time of tightening budgets.
        To this end, to add to the Air Force's already full plate,
    you are now heavily engaged in operations in Libya. And I look
    forward to hearing from you today about the extent of Air Force
    support to the coalition forces operating in Libya, as well as
    the cost of these operations, and what you see as the end game
    of our involvement there.
        Gentlemen, these are challenging times, to say the least,
    and we have many difficult choices in front of us. I look
    forward to working with both of you to ensure that the fiscal
    year 2012 appropriations reflects the current and future needs
    of the Air Force.
        And now, I wish to turn to our vice chairman, Senator
    Cochran, for his opening statement.
        Senator Cochran.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you. I am pleased to
    join you in welcoming our panel of witnesses at our hearing
    today. We are looking, of course, at the budget request that
    has been submitted for the Department of the Air Force, and
    anxious to learn what the reaction of the Uniformed Services
    and the Secretary are to the budget request, and whether it
    meets the needs that you have, particularly in light of
    developments in Libya. We are interested to know what are the
    consequences in terms of the budget request of--for the actions
    that we are taking and the obligations that we have assumed in
    that part of the world. Your insights would be helpful to us to
    understand what we are facing there in terms of the need for
    appropriated dollars.
        I join the chairman in thanking you for your service. We
    appreciate very much what you are doing for the safety and
    security of our country.
        Thank you.
        Chairman Inouye. I thank you very much. And, Mr. Secretary?
        Mr. Donley. Thank you. Mr. Chairman, Senator Cochran,
    members of the subcommittee, it is certainly a pleasure to be
    here today representing more than 690,000 active duty, Guard,
    Reserve, and civilian airmen. I am also joined this morning
    with my teammate and a tireless public servant, General Norty
    Schwartz.
        We are pleased to report that America's Air Force continues
    to provide the Nation's unmatched global vigilance, reach, and
    power as part of the joint team, with an uncompromising
    commitment to our core values of integrity, service before
    self, and excellence in all we do.

                          AIR FORCE GLOBAL OPERATIONS

        Today, we are bringing this capability to bear in
    operations across the full spectrum, from humanitarian support
    to our Japanese friends in need, to the ongoing stability and
    counter insurgency operations in Iraq and Afghanistan, to the
    no fly zone enforcement and protection of the civilian
    population in Libya, to the continuous air sovereignty, space,
    and cyber, and nuclear deterrence missions--the speed,
    precision, and versatility of your Air Force is being tested
    and proven daily.
        We are, as you suggested, Mr. Chairman, requesting $150
    billion in our baseline budget, and $16 billion in the overseas
    contingency operations supplemental appropriation to support
    this work. Our budget request represents a careful balance of
    resources among Air Force core functions necessary to implement
    the President's national security strategy, and between today's
    operations and investments in the future.
        Before discussing our fiscal year 2012 budget request, I
    would like to address some unfinished business from fiscal year
    2011, and also set in context the changes in your Air Force
    over the last several years.

       EFFECTS OF OPERATING UNDER FISCAL YEAR 2011 CONTINUING RESOLUTIONS

        Operating without a defense appropriations bill in fiscal
    year 2011 is having a significant impact on the Air Force. A
    decision to extend the continuing resolution at fiscal year
    2010 levels through the remainder of this year would delay our
    ability to reach and sustain the Secretary of Defense's
    directed goal of reaching 65 MQ-1/9 Combat Air Patrols by 2013
    in support of operations in Afghanistan. And it would cause a
    production break and the likely increase in the unit cost of F-
    15 radar modernization, among other programs. Deeper reductions
    to our modernization programs would be required to fund over $4
    billion in must-pay bills for urgent operational needs, like
    those in Afghanistan, Iraq, military healthcare, and the
    military pay raise of 1.4 percent, which Congress authorized,
    but which has not yet been funded. Without fiscal year 2011
    appropriations, we would face delay or cancellation of some
    depot maintenance, facilities maintenance, and other day-to-day
    activities in order to prioritize our most critical needs under
    the lower funding levels in a full year continuing resolution.
    Finally, fiscal year 2011 appropriations are also required for
    44 military construction projects now on hold, which support
    ongoing operational needs and improve the quality of life for
    airmen and their families. Passing a fiscal year 2011 Defense
    appropriations bill is essential to avoid the severe
    disruptions. And we certainly appreciate, Mr. Chairman, your
    personal leadership, Senator Cochran, your personal leadership,
    and the help of this subcommittee currently underway to resolve
    this situation.

             RESHAPING THE AIR FORCE FOR PRESENT AND FUTURE THREATS

        Over the past decade, the Air Force has substantially
    reshaped itself to meet the immediate needs of today's
    conflicts and position itself for the future. While we have
    grown in some critical areas, it has been at the expense of
    others. We have added intelligence, surveillance, and
    reconnaissance capacity with 328 remotely piloted aircraft and
    over 6,000 airmen to collect, process, exploit, and disseminate
    intelligence. We added over 17 aircraft and nearly 2,400 airmen
    to bolster special operations capacity necessary in counter
    insurgency operations. We added over 160 F-22s and 120 C-17S to
    our inventory and funded over 30 satellites. We added 2,200
    airmen for critical nuclear and cyber operations and to support
    our acquisition process.
        In the same period, however, we retired over 1,500 legacy
    aircraft. We cancelled or truncated procurement of major
    acquisition programs. We shed manpower in career fields less
    critical for the current fights, and deferred much-needed
    military construction in order to balance these capabilities
    within the resources available. In all, during the past 7
    years, the size of the active duty Air Force has been reduced
    from 359,000 in 2004 to approximately 333,000 today. And the
    Air Force's baseline budget, when adjusted for inflation and
    setting aside the annual wartime supplemental appropriations,
    has remained flat.
        Looking ahead, we face a multiyear effort to recapitalize
    our aging tanker, fighter bomber, and missile forces; continue
    to modernize critical satellite constellations; meet dynamic
    and growing requirements in the cyber domain; and also replace
    aging air frames for pilot training and presidential support.
        We continue to recognize the requirement for fiscal
    restraint and are committed to remaining good stewards of every
    taxpayer dollar, improving management and oversight at every
    opportunity.

                          EFFICIENCIES ACROSS THE FYDP

        The fiscal year 2012 budget request incorporates over $33
    billion in efficiencies across the future year's defense plan,
    which will be shifted to higher priority combat capability by
    reducing overhead costs, improving business practices, and
    eliminating excess troubled or lower priority programs. By
    consolidating organizational structures, improving our
    acquisition processes, procurement, and logistic support, and
    streamlining operations, we have been able to increase
    investment in core functions, such as global precision attack,
    intelligence, surveillance, and reconnaissance (ISR), in space
    and air superiority, reducing risk by adding tooth through
    savings in tail.
        We are fully committed to implementing these planned
    efficiencies and have already assigned responsibilities to
    senior officials, and put in place the management structure to
    oversee this work and track progress on a regular basis. Having
    faced the need to reshape our force structure and capabilities
    within constrained manpower and resources over the last several
    years, we do not view the current need for efficiencies as a
    singular event, but rather as an essential and continuing
    element of prudent management in our Air Force.
        Our investment priorities remain consistent with minimizing
    risk and maximizing effectiveness and efficiency across the
    full spectrum of potential conflict. Proceeding with the
    development and production of the KC-46 tanker aircraft,
    implementing the Joint Strike Fighter restructure, and meeting
    the Combatant Commanders' need for more ISR, investing in the
    long-range strike family of systems, including a new
    penetrating bomber, and enhancing space control and situational
    awareness, all remain critical capabilities for both today's
    and tomorrow's Air Force.
        In addition to these investments, we will continue to
    address challenges in readiness, in particular, the slow, but
    persistent, decline in materiel readiness most notable in our
    non-deployed forces, and the personnel challenges across
    roughly 28 stressed officer and enlisted career fields, both of
    which are the result of today's high operational tempo.

                         CARING FOR TOTAL FORCE AIRMEN

        And, of course, Mr. Chairman, we will continue to support
    our Active, Guard, Reserve, and civilian airmen and their
    families with quality housing, healthcare, schools, and
    community support.
        With respect to healthcare, I would like to convey the Air
    Force's support for DOD's TRICARE reforms that will modestly
    increase premiums for working-age retirees, premiums that have
    not changed since they were initially sent--set in 1995.
        Going forward, we must continue to seek and develop reforms
    in the benefits that our men and women in uniform earn to make
    them economically sustainable over the long term.

                               PREPARED STATEMENT

        Mr. Chairman, good stewardship of the United States Air
    Force is a responsibility that General Schwartz and I take very
    seriously, and we remain grateful for the continued support and
    service of this subcommittee. We look forward to discussing our
    proposed budget.
        Thank you.
        Chairman Inouye. All right. Thank you very much, Mr.
    Secretary.
        [The statement follows:]
             Prepared Statement of the Honorable Michael B. Donley
        The United States faces diverse and complex security challenges
    that require a range of agile and flexible capabilities. From the
    ongoing conflicts in Afghanistan and Iraq, to potential confrontation
    with aggressive state and non-state actors, to providing humanitarian
    assistance, the United States Air Force continues to provide
    capabilities across the full spectrum of potential military operations.
    The Air Force's fiscal year 2012 budget request aims for balance and
    versatility to meet the demands of this environment. We believe the
    request enables our efforts to prevail in today's wars, prevent and
    deter conflict, and prepare to defeat adversaries across the range of
    military operations--all the while preserving and enhancing the all-
    volunteer force.
        We remain mindful of our Nation's budgetary challenges and fiscal
    constraints, because fiscal responsibility is a national security
    imperative. This environment requires that we balance our capabilities
    between current combat operations and the need to address emerging
    threats and challenges. We continue to pursue cost-effective systems
    that leverage existing capabilities and maximize interoperability and
    integration of legacy and future systems. The commitment of the Air
    Force to collectively discern, access and provide tailored and scalable
    effects with Global Vigilance, Reach, and Power virtually anywhere in
    the world is reflected in our acquisition priorities. These priorities
    are:
      --Tanker Recapitalization (KC-X);
      --Joint Strike Fighter (F-35) Restructure and F-16 Service Life
            Extension Program (SLEP);
      --Intelligence, Surveillance, and Reconnaissance (ISR) Systems;
      --Long-Range Strike Family of Systems; and
      --Space Systems and Launch Capability Acquisition Strategy.
        Global Vigilance is the ability to provide surveillance around the
    world. As the demand for ISR continues to grow, the Air Force is
    aggressively fielding enhanced ISR capability and capacity across the
    widest range of military operations to counter threats and defeat our
    adversaries. The Air Force will continue to enhance space control and
    situational awareness capabilities, as well as space management, to
    ensure we operate effectively in the increasingly competitive,
    congested and contested space domain. This includes implementing the
    Evolutionary Acquisition for Space Efficiency (EASE) concept to drive
    down costs, improve stability in the fragile space industrial base,
    invest in technology that will lower risk for future programs, and
    achieve efficiencies through block buys of satellites. There is also an
    ongoing collaboration between the Air Force, the National
    Reconnaissance Office (NRO) and the National Aeronautics and Space
    Administration (NASA) to maintain a healthy industrial base to meet
    government launch and range requirements in an efficient manner.
        Global Reach is the ability to project capability responsively and
    advantageously without regard to distance. Air Force mobility assets
    are essential to Joint, Interagency and Coalition operations in peace
    and war as we provide critical supplies and personnel through strategic
    and tactical delivery--airlift and airdrop. Air refueling aircraft play
    an integral role by providing reach and persistence for aircraft to
    operate inter-theater and intra-theater, alike. As such, the
    procurement of the KC-X remains the top acquisition and
    recapitalization priority for the Air Force.
        Global Power is the ability to hold at risk any target in the
    world. The Air Force must continue to modernize and recapitalize our
    aircraft inventory to remain effective against global and regional
    competitors as they continue to modernize and improve their own air
    defense capabilities and harden valued targets. We will continue to
    work with Congress to enhance capabilities in our existing fighter and
    bomber fleets to mitigate delays in the F-35 development and
    procurement programs. One key to that mitigation effort is a focused F-
    16 SLEP. We must sustain our ability to consistently hold any target on
    the planet at risk with the development of a Long-Range Strike Family
    of Systems capability--including a new penetrating bomber--to create
    desired effects across the full range of military operations in both
    permissive and contested environments. Last, a multi-faceted effort is
    underway to enhance our air superiority legacy fighters, maximize the
    capabilities of the F-22 fleet, invest in preferred air-to-air
    munitions, and optimize our electronic warfare systems.
        The Air Force must take the necessary steps today that will allow
    future generations to continue to provide consistent, credible and
    effective air, space and cyber capabilities on which our Nation
    depends. Our ability to do so is constrained by the increasing costs to
    design and build platforms and by the accelerating costs of personnel
    benefits and other must-pay operational bills in a particularly
    challenging budget environment. We will ensure we maximize combat
    capability out of each taxpayer dollar by identifying waste,
    implementing efficiencies, pursuing continuous process improvement
    initiatives and making smart investments. We will provide the necessary
    capability, capacity and versatility required to prevail today and in
    the future.
        Last, our fiscal year 2012 budget request recognizes the need to
    properly manage our force structure. We recognize that our most
    valuable assets--our people--are critical to achieving our broadest
    strategic goals, and our near- and far-term mission success is
    inextricably linked to the overall well-being of our Airmen and their
    families.
        Operating without a defense appropriations bill in fiscal year 2011
    is having a significant impact on the Air Force. Under a Continuing
    Resolution (CR), we are unable to raise procurement to requested levels
    in several critical areas. Constraining MQ-9 procurement to 24 aircraft
    versus the 48 requested will delay our ability to reach the Secretary
    of Defense's directed goal of 65 MQ-1/9 Combat Air Patrols (CAPs) by
    2013 in support of ongoing operations in Afghanistan. The inability to
    initiate a contract for the Wideband Global SATCOM (WGS)-7 satellite
    will cause a production break and a likely increase in unit cost.
    Production breaks and delayed procurements will also negatively affect
    the Joint Air-to-Surface Standoff Missile (JASSM), F-15 active
    electronically scanned array (AESA) radar, F-15 APG 63 radar, and other
    programs. In addition to these impacts, deeper reductions to our
    modernization programs would be required to fund over $3 billion in
    must-pay bills for urgent operational needs in Afghanistan and Iraq,
    military healthcare, and the military pay raise of 1.4 percent, which
    was authorized by Congress and is being implemented, but was not
    funded. Fiscal year 2011 appropriations are also required for 75
    military construction (Milcon) projects, now on hold, which support
    ongoing operational needs and improve the quality of life for Air Force
    personnel and their families. Last, the Air Force would have to delay
    or cancel some depot maintenance, weapon system sustainment and other
    day-to-day activities in order to prioritize our most critical needs
    under the lower funding levels in a full year CR.
        In summary, continuing the CR far beyond March 4 would severely
    impact program and budget execution in the Air Force, delaying
    modernization and causing significant restructuring and potential cost
    increases to many acquisition programs, and creating larger backlogs
    for maintenance and other operations. Passing a fiscal year 2011
    defense appropriations bill is essential to avoid these severe
    disruptions.
        In June 2010, the Secretary of Defense challenged the Services to
    increase funding for mission activities by identifying efficiencies in
    overhead, support and other less mission-essential areas. The
    efficiency target for the Air Force was $28.3 billion across this
    Future Years Defense Program (FYDP). The Air Force is committed to
    enhancing capabilities by reducing expenses allocated to overhead and
    support functions, while shifting resources to modernization and
    readiness programs.
        As part of the fiscal year 2012 budget, the Air Force exceeded our
    efficiency target by $5 billion and identified $33.3 billion in
    efficiencies in an effort to make resources available to better support
    warfighter and readiness programs across the FYDP. Examples of these
    efficiencies include:
      --Consolidating three Numbered Air Forces with colocated Major
            Command staff and consolidating the activities of four Air and
            Space Operations Centers into two, thereby achieving a
            redistribution of 347 military authorizations (228 in fiscal
            year 2012 and 119 in fiscal year 2013) across the FYDP and
            eliminating 212 civilian authorizations beginning in fiscal
            year 2013 which will save $100.1 million across the FYDP;
      --Consolidating installation support management to improve Air Force-
            wide standardization and prioritization;
      --Reallocating 5,600 active duty billets over the FYDP from lower
            priority support functions to higher priority, growth areas;
      --Saving more than $3 billion from anticipated growth in Weapon
            System Sustainment (WSS) portfolio efficiencies across the FYDP
            by reviewing operational requirements, depot processes and the
            sustainment of the supply chain without degrading operational
            capabilities or support to the warfighter;
      --Reducing fuel consumption within the Mobility Air Forces by
            leveraging proven commercial aviation practices for flight
            planning and weight reduction, and implementing other
            initiatives to save $715 million (net) across the FYDP;
      --Reducing acquisition costs by consolidating services, scrutinizing
            contracts, reducing contract support, and more efficiently
            using resources to deliver capabilities and support to the
            warfighter;
      --Reducing information technology costs by more than $1.2 billion
            over the FYDP by adopting DOD-level Enterprise Information
            Services including enterprise core services, consolidating and
            standardizing the network information technology infrastructure
            from nine Air Force and Air National Guard Regional Processing
            Centers to five centrally controlled centers, and migrating
            current and developmental applications, services and data to
            DOD-provided enterprise computing centers; and
      --Improving our procurement of satellites with a new acquisition
            strategy which, subject to congressional approval, will lower
            procurement costs and stabilize the defense industrial base.
        The realization of these efficiencies allowed the Air Force to
    reallocate funding to modernize and recapitalize weapons systems,
    improve capabilities and enhance warfighter operations. Examples of
    these enhancements include:
      --Investing in the Long-Range Strike Family of Systems, including a
            new penetrating bomber as a key component of the Joint
            portfolio;
      --Investing an additional $3.5 billion to fund the Evolved Expendable
            Launch Vehicles (EELV) program to the Office of the Secretary
            of Defense (OSD) Independent Cost Assessment, with the
            Department of Defense (DOD) committed to buying five boosters
            per year to meet national space launch requirements and
            stabilize the industrial base;
      --Repurposing 5,600 active duty billets over the FYDP to support ISR
            capability, U.S. Pacific Command force structure requirements,
            Total Force Integration, the U-2 continuation, building
            partnership capacity, increasing support to the Air Force
            District of Washington UH-1N mission, among other increases;
      --Procuring an additional 16 simulators for F-35 aircrew training
            bringing the total procurement to 30 simulators to ensure an
            effective training pipeline throughput and operational unit
            pilot proficiency and cost control;
      --Recapitalizing the aging special operations forces MC-130H/W
            aircraft;
      --Improving the aircraft computer infrastructure of the B-52 to
            enable more rapid machine-to-machine retargeting;
      --Enhancing combat capability of the F-15C and F-15E with additional
            AESA radars and electronic protection software upgrades;
      --Continuing to fund the development of next-generation Global
            Positioning System (GPS) III Operational Control Segment;
      --Researching and developing electronic protection and suppression of
            enemy air defense (SEAD) capabilities for the F-22;
      --Transitioning MC-12W Liberty Project from Overseas Contingency
            Operations (OCO) funding into the Air Force baseline budget
            beginning in fiscal year 2013;
      --Continuing maximized production of the MQ-9 Reaper to ensure
            delivery of 65 CAPs by the end of fiscal year 2013;
      --Extending U-2 operations through fiscal year 2015 to ensure a
            smooth high-altitude transition; and
      --Baselining the Air Sovereignty Alert program across the FYDP to
            solidify support to homeland security operations.
        The Air Force leadership recognizes the importance of achieving
    planned efficiencies to avoid future bills and a negative impact to our
    mission and our Airmen. We are taking a long-term view of this
    initiative and will address our efficiency targets annually to further
    refine and identify follow-on opportunities. We assigned responsibility
    for initiatives to individual senior leaders who are developing their
    detailed implementation plans to oversee our efforts. Quarterly
    executive-level reviews will monitor plans and progress, and ensure
    that efficiency initiatives do not inadvertently impact readiness,
    mission performance, or quality of life for our Airmen. Our continuous
    process improvement program, Air Force Smart Operations for the 21st
    Century (AFSO21), is well-established and provides our Airmen with the
    tactics, techniques and procedures to improve performance while
    achieving efficiencies.
        In order to ensure Air Force leadership has reliable and relevant
    financial information to monitor our efficiency goals, we are further
    emphasizing our work in Financial Improvement and Audit Readiness. In
    fiscal year 2012, the Air Force is dedicating $29 million to audit
    readiness and validation and $327 million to modernize our business
    systems.
        Mission effectiveness of the Air Force is linked to the overall
    well-being of our Airmen and their families. The Air Force will
    continue to find innovative and efficient ways to provide and sustain
    programs that support our Airmen and their families, including our
    critical civilian personnel. We must ensure programs and services
    foster a greater sense of community, strengthen a sense of belonging
    and value to the Air Force, and improve Airman and family resiliency.
        As mission demands continue to evolve and budgets flatten, the Air
    Force is making key strategic choices to leverage the collective talent
    and experience of our Total Force. Through improved integration across
    the Total Force Enterprise of active, Guard and Reserve forces, we are
    seeking greater Service-wide efficiencies and effectiveness to maximize
    combat capability for the Joint warfighter. We are developing business
    case analyses to inform decisions on how best to structure Active and
    Reserve Component relationships, especially in new areas. As missions
    such as cyber and dynamic battlefield ISR mature, so too will the Total
    Force investment in these areas.
        End Strength, Retention and Recruiting.--The overall programmed Air
    Force end strength for fiscal year 2012 is more than 690,000 personnel.
    This includes 332,800 active duty, 71,400 Reserve, 106,700 Air National
    Guard, and more than 182,000 civilian personnel. To support the efforts
    of our Airmen and to recruit and retain the highest quality Air Force
    members, the fiscal year 2012 budget request includes $30.2 billion in
    military personnel funding and a military pay raise in fiscal year 2012
    of 1.6 percent.
        The retention rates in the Air Force are the highest they have been
    in 16 years and recruiting has also been successful. Therefore, the
    $626.6 million requested in the fiscal year 2012 budget for recruiting
    and retention bonuses is highly targeted. Bonuses are proposed for
    specific career fields with critical wartime skills including pilots,
    control and recovery, intelligence, contracting, security forces,
    health professionals, civil engineering, special operations and
    explosive ordnance disposal.
        In addition, the current economy has slowed attrition from the Air
    Force and had the effect of increasing active duty manning above
    planned levels. As a result, the Air Force is making difficult, but
    fiscally responsible decisions to implement force management programs
    that allow us to remain within authorized end strength ceilings.
    Specifically, we continue to progress toward an active duty end
    strength goal of 332,800 by the end of fiscal year 2012. To address
    excess end strength, particularly in the officer force, we will reduce
    accessions, continue to waive Active Duty Service Commitment and Time
    in Grade requirements for voluntary separations and retirements,
    continue to conduct enlisted Date of Separation rollbacks, and
    institute involuntary separation and retirement programs for officers
    through Selective Early Retirement, Reduction in Force and Force
    Shaping boards. We will also work with OSD to seek additional
    legislative authority to help the Air Force meet end strength ceilings
    by the end of fiscal year 2012 and maintain the appropriate level in
    fiscal year 2013 and beyond.
        Civilian Workforce.--The Secretary of Defense has limited our
    civilian workforce to fiscal year 2010 levels, with limited growth
    allowed for specific priorities like the acquisition workforce. This
    policy will require significant changes to previously planned civilian
    growth. The Air Force will also conduct an enterprise-wide review of
    civilian personnel end strength to facilitate DOD's efforts for
    efficiencies and reinvestment possibilities.
        Contractor Reductions.--The Air Force is looking at the way we
    utilize the contract workforce as we answer the Secretary of Defense's
    challenge to find efficiencies and to reduce duplication, overhead, and
    excess, and reinforce our culture of efficiency and restraint across
    the Air Force. This will impact the service support contract workforce
    in the following areas:
      --Reduce our staff support contractor workforce by 10 percent per
            year, over the next 3 years in accordance with DOD's guidance
            with an estimated fiscal year 2012 savings of $127 million; and
      --Reduce the funding for advisory studies by 25 percent from the
            fiscal year 2010 levels over the FYDP with an estimated fiscal
            year 2012 savings of $41 million.
      --The Air Force identified two other areas that will result in
            reductions to its headquarters contract workforce and release
            resources for warfighter use. These include: Knowledge-based
            services estimated at $252 million in fiscal year 2012; and
            Program Management Administration estimated at $191 million in
            fiscal year 2012.
        Man-Days.--Active Duty Operational Support days play a critical
    role in resourcing extended military operations. They allow for the
    active duty appropriation to pay for temporary use of National Guard
    and Reserve personnel to support military missions beyond the regular
    component's capability. In support of the Secretary of Defense's
    efficiency initiative, the Air Force reduces, by 1,250 work years, the
    Reserve Component fiscal year 2012 man-day program that supports non-
    critical administrative and overhead activities.
        The demand for global mobility and related airlift support remains
    high in fiscal year 2012 as the Air Force will continue to support a
    large footprint in Afghanistan. The Air Force identified $1.4 billion
    to support fiscal year 2012 OCO requirements. Our reliance on the Total
    Force is by design, and we recognize and value the contributions of the
    members of the Reserve Components who have performed tirelessly in
    support of our Nation. The Air Force will continue to prioritize
    Reserve Component requirements prudently and in accordance with mission
    needs as we transition to a lower steady state tempo.
        Diversity.--The Air Force widened the aperture beyond traditional
    views of diversity, and defined it to include personal life
    experiences, geographic background, socioeconomic background, cultural
    knowledge, educational background, work background, language abilities,
    physical abilities, philosophical/spiritual perspectives, age, and
    more. We declared diversity a military necessity, as both a source of
    greater combat effectiveness and as means toward a force that more
    closely mirrors American society. Deliberate plans are being developed
    to attract, recruit, develop, and retain a more diverse force.
        Repeal of ``Don't Ask, Don't Tell''.--The Air Force will execute
    the plan established by OSD for the effective implementation of the
    repeal of Section 654 of Title 10 of the United States Code, known as
    ``Don't Ask, Don't Tell.'' We are also developing strategic
    communications, and we will provide initial and sustainment education
    and training at all levels.
        Readiness.--With Air Force personnel deployed to more than 135
    locations worldwide on an average day, we rely heavily on the Total
    Force. Currently, more than 37,000 Airmen are deployed and more than
    57,000 are forward-stationed. In addition, approximately 134,000 Airmen
    are directly supporting Combatant Commander requirements from their
    home stations daily. These Airmen contribute in a variety of ways, to
    include operating the Nation's space and missile forces, processing and
    exploiting remotely collected ISR data, providing national intelligence
    support, operating and defending our networks, and executing air
    sovereignty alert missions.
        The Air Force has flown more than 419,000 sorties in support of
    Operations Iraqi Freedom and New Dawn and more than 244,000 sorties in
    support of Operation Enduring Freedom since September 11, 2001. During
    this time, we delivered over 6.3 million passengers and 3.3 million
    tons of cargo, employed almost 23,800 tons of munitions, flew more than
    15,750 personnel recovery sorties recording over 2,900 saves and 6,200
    assists, and transported more than 85,000 patients and more than 15,400
    casualties from the U.S. Central Command alone. In 2010, our Airmen
    averaged approximately 400 sorties every day.
        This level of activity reflects our commitment to provide Global
    Vigilance, Reach, and Power in today's Joint fight. However, our high
    operations tempo (OPTEMPO) has also had some detrimental effects on our
    overall readiness. Readiness for full spectrum military operations is a
    challenge for our combat air forces and some other limited-supply/high-
    demand aviation units. Since 2003, we have seen a slow but steady
    decline in reported readiness indicators. Our OPTEMPO since 2001 has
    produced lower deploy-to-dwell ratios for high-demand skills. At
    present, 19 enlisted and nine officer career fields are ``stressed.''
    We have improved funding to WSS; however, sustainment challenges
    continue as we field new weapon systems and balance contract versus
    organic sources of repair. To address these readiness issues, we must
    keep aircraft recapitalization and procurement programs on track and
    continue managing our force to ensure the right numbers and mix of
    skills in our highly tasked and highest priority mission areas.
        The Air Force Core Functions, assigned by the Secretary of Defense
    and recognized by the Joint community, provide a framework for
    balancing investments across Air Force capabilities. While this
    document describes the Core Functions individually, we recognize the
    inherent interdependence of these capabilities within the Air Force,
    the Joint force, and throughout the United States Government. When
    considered together, the Core Functions encompass the full range of Air
    Force capabilities. The budget request in this posture statement
    provides an appropriate balance of investment across our Core
    Functions. The table below depicts the fiscal year 2012 budget request
    and the projected allocation of resources across the FYDP, by Air Force
    Core Function.

                            [In billions of dollars]
    ------------------------------------------------------------------------
                                                    Fiscal Year
                Air Force Core Function               2012 PB        FYDP
                                                      Request
    ------------------------------------------------------------------------
    Nuclear Deterrence Ops........................          5.2         28.0
    Global Precision Attack.......................         16.0         93.7
    Air Superiority...............................          9.2         46.1
    Rapid Global Mobility.........................         15.9         89.5
    Global Integrated ISR.........................          8.2         41.4
    Space Superiority.............................         11.6         56.2
    Cyberspace Superiority........................          4.6         21.9
    Command and Control...........................          6.3         33.5
    Special Operations............................          1.4          6.5
    Personnel Recovery............................          1.6          9.0
    Building Partnerships.........................          0.5          1.9
    Agile Combat Support..........................         33.8        175.0
    ------------------------------------------------------------------------
    Note 1: This table does not include OCO, Non-Blue or classified
      programs.
    Note 2: The funding for Nuclear Deterrence Operations includes weapon
      systems, support systems, as well as nuclear command, control, and
      communications requirements.

                         nuclear deterrence operations
        Continuing to strengthen our nuclear enterprise remains the number
    one Air Force priority, and we have taken positive steps within the
    fiscal year 2012 budget request to continue to strengthen and improve
    this Core Function.
        Air Force Global Strike Command achieved full operational
    capability (FOC) on September 30, 2010, moving all Air Force nuclear-
    capable bombers and Intercontinental Ballistic Missiles (ICBMs) under
    one command. The Air Force Nuclear Weapons Center continues to pursue
    vital and deliberate sustainment of the nuclear enterprise through
    efforts such as the Air Force Comprehensive Assessment of Nuclear
    Sustainment process. Bomber force modernization continued in an effort
    to maintain a viable force beyond 2030. We have completed the
    transition to four B-52 operational squadrons with the addition of the
    69th Bomb Squadron at Minot Air Force Base, North Dakota. ICBM
    modernization and sustainment also continued with investments in new
    test equipment and launch facility environmental control systems.
    Although an initial study for the Ground Based Strategic Deterrent to
    replace the Minuteman III will begin in fiscal year 2011, we must
    continue sustainment efforts to ensure Minuteman III viability through
    2030.
        An important event for the ICBM force in 2010 was a temporary loss
    of the ability to monitor the status of 50 missiles at F.E. Warren Air
    Force Base, Wyoming. At no time was there any danger to the public or
    to the safety and security of the weapon system. The missiles are
    protected by multiple and redundant safety, security, and command and
    control features. The root cause of this communication interruption was
    identified, and the necessary technical and procedural changes to
    prevent future occurrences have ensued. In addition, the Air Force has
    completed a number of assessments including initiatives to address
    systemic issues with ICBM infrastructure and operating procedures as
    well as a report on the age and pedigree of the infrastructure and
    equipment associated with the ICBM system. Based on these assessments,
    it is clear that a significant portion of the existing infrastructure
    will eventually require modernization or complete replacement in the
    years ahead.
        The fiscal year 2012 budget request of $5.2 billion continues to
    invest in the future of nuclear deterrence. The Air Force is committed
    to sustaining the ICBM force through 2030 with investment including
    command and control, cryptographic improvements and ballistic missile
    fuze sustainment. Bomber modernization and sustainment efforts include
    the B-52 Combat Network Communications Technology program, the B-2
    Extremely High Frequency communications program and the Defensive
    Management Systems program. The Air Force removed early-to-need
    procurement funding in bomber extremely high frequency communications
    and the ground element of the Minimum Essential Emergency
    Communications Network program due to program delays. The Air Force is
    committed to continuing to strengthen the nuclear enterprise through
    other programs such as the tail kit portion of the B61 nuclear weapon
    life extension program, the future long-range standoff weapon, and the
    Common Vertical Lift Support Platform. Beyond weapon system sustainment
    and modernization, the Air Force is focusing on human capital as we
    carefully balance requirements for our limited, intensively
    scrutinized, high-demand Airmen in the nuclear enterprise.
        The Air Force is prepared for a new verification regime and is
    planning for the elimination and conversion of launchers under the New
    Strategic Arms Reduction Treaty. We will work with the OSD and U.S.
    Strategic Command to identify and assess options for future force
    structure adjustments consistent with the Treaty provisions.
                            global precision attack
        Many of our global precision attack forces are meeting the current
    requirements of ongoing contingency operations by performing precision
    strike and ISR support roles. However, the proliferation of anti-access
    and area-denial capabilities will challenge the ability of current
    fourth-generation fighters and legacy bombers to penetrate contested
    airspace in the longer term.
        The Air Force used a balanced approach across the global precision
    attack portfolio in fiscal year 2011, prioritizing investment in fifth-
    generation aircraft while sustaining legacy platforms as a bridge to
    the F-35, Joint Strike Fighter. We continue to modernize our bomber
    fleet to sustain our capability and capacity as we invest in a Long-
    Range Strike Family of Systems.
        The fiscal year 2012 budget request for this Core Function is $16
    billion. Investments in global precision attack will fund modernization
    of legacy fighters and the B-1B, development and procurement of the F-
    35A, preferred munitions, and simulators for Tactical Air Control
    System training. The fiscal year 2012 budget request adds $15 million
    to begin design and development of structural and capability
    modifications for the F-16 Block 40/42/50/52 fleet. The SLEP
    initiatives for the F-16 airframe are scalable and responsive to the
    Air Force's total fighter requirements. The Air Force is also studying
    F-16 modernization efforts, to include a new AESA radar, center
    displays, electronic warfare defensive suite, and an improved data-link
    in anticipation of F-35A delivery delays.
        The multi-role F-35A is the centerpiece of the Air Force's future
    precision attack capability. In addition to complementing the F-22's
    world class air superiority capabilities, the F-35A is designed to
    penetrate air defenses and deliver a wide range of precision munitions.
    This modern, fifth-generation aircraft brings the added benefit of
    increased allied interoperability and cost-sharing across Services and
    partner nations. It will also serve to fulfill our commitment to NATO's
    dual-capable aircraft mission. The fiscal year 2012 budget includes
    $5.3 billion for continued development and procurement of 19 F-35A,
    Conventional Take-Off and Landing (CTOL), production aircraft.
        The F-35A program team achieved a number of accomplishments over
    the past year, including the first flight of the first mission systems
    aircraft, arrival of the first four F-35A test aircraft at Edwards Air
    Force Base, California, completion of F-35A static structural testing 5
    months ahead of schedule with no failures, roll out of the first Low
    Rate Initial Production (LRIP) F-35A, completion of 410 total F-35 test
    flights in 2010 of which 171 were F-35A flights, negotiation of the
    first fixed price type production contract (LRIP Lot 4--10 CTOL
    aircraft), and the signing of a Letter of Acceptance to procure the F-
    35A by Israel.
        Also in 2010, the Air Force announced the preferred alternatives
    for F-35A operational and training bases. Those bases are Hill Air
    Force Base, Utah, and Burlington Air Guard Station, Vermont for
    operational squadrons and Luke Air Force Base, Arizona for training.
        The program continues to experience challenges as it transitions
    from development to production despite the significant accomplishments.
    The Secretary of Defense announced a program restructure in February
    2010. The restructure resulted in increased funding for development and
    production in accordance with Joint Estimate Team II estimates, reduced
    procurement by 122 aircraft over the FYDP in the fiscal year 2011 PB,
    upgraded the Program Executive Office position from a 2-star to 3-star
    flag rank, extended development by 13 months, added an additional LRIP
    lot prior to entering full rate production, and reduced the ramp rate
    to less than 150 percent of the previous year's production. Program
    cost growth, including growth from the restructure, resulted in a
    critical Nunn-McCurdy breach in March 2010. The Under Secretary of
    Defense for Acquisition, Technology, and Logistics subsequently
    certified the program in accordance with the Nunn-McCurdy statute,
    allowing the F-35 program to continue.
        The DOD tasked the program office to perform a bottom-up review of
    the remaining development effort after the program Nunn-McCurdy
    certification. This Technical Baseline Review (TBR), completed in
    November 2010, became the basis for additional program restructuring
    within the fiscal year 2012 PB. The TBR informed the need for an
    additional $4.6 billion to complete the Joint development effort. To
    fund this new development effort, and recognizing a continued lagging
    performance in production, the DOD reduced procurement by 124 aircraft
    over the FYDP in the fiscal year 2012 PB, 57 of which were F-35As.
        The Air Force intends to accelerate the procurement of the F-15E
    AESA radar modernization program, funding 88 radars and electronic
    protect software upgrades across the FYDP to keep our legacy platforms
    viable well into the future. Other legacy fighter improvements in the
    fiscal year 2012 budget include the continuation of the A-10C wing
    replacement program.
        The fiscal year 2012 budget request includes funds to modernize the
    B-1B fleet, including the central integrated test system, fully
    integrated data link, and vertical situation display unit. To provide
    the funds to modernize the B-1B fleet, the fiscal year 2012 budget
    request also reduces B-1B force structure by six primary aircraft
    authorizations leaving 60 B-1Bs in our inventory. Investing in a new
    penetrating bomber is critical to maintaining our long-range strike
    capability in the face of increasing risk associated with anti-access
    and area-denied environments.
        To this end, the Secretary of Defense announced on January 6, 2011,
    that the Air Force will invest in a new long-range, penetrating, and
    nuclear-capable bomber capable of both manned and unmanned operations.
    A major focus of this program is to develop an affordable, long-range
    penetrating strike capability that delivers on schedule and in
    quantity. This aircraft will be designed and built using proven
    technologies, will leverage existing systems to provide sufficient
    capability, and allow growth to improve the system as technology
    matures and threats evolve. This program should start now to ensure
    that the new bomber can be ready before the current aging B-52 and B-1
    bomber fleets go out of service. The follow-on bomber represents a key
    component of a Joint portfolio of conventional deep-strike
    capabilities, an area that must be a high priority for future defense
    investment given the anti-access challenges our military faces. It is a
    central element in a Family of Systems that includes enabling
    electronic warfare, ISR, and communications capabilities, as well as
    new weapons.
        Anti-access and area-denial challenges have also caused us to
    pursue the Air-Sea Battle concept in partnership with the U.S. Navy and
    Marine Corps, so that together we can preserve and bolster our Nation's
    freedom of action in the air, maritime, space, and cyberspace domains.
    Once implemented, Air-Sea Battle will guide us to develop a more
    permanent and better-institutionalized relationship between Departments
    that will ultimately shape our Service organizations, inform our
    operational concepts, and guide our materiel acquisitions.
        This budget request also includes Developmental Test (DT)/
    Operational Test (OT) and procurement of the Joint Air-to-Surface
    Stand-off Missile baseline and Extended Range programs. As Small
    Diameter Bomb (SDB)-1 production concludes in fiscal year 2011, the Air
    Force plans to transition to development and production of the SDB-II
    in fiscal year 2012. Additionally, the fiscal year 2012 budget request
    continues funding for integration of the Hard Target Void-Sensing Fuze
    onto the BLU-113 and BLU-109 weapons, and funds weapon DT/OT for the
    Massive Ordnance Penetrator.
        Fiscal year 2012 budget investments in global precision attack
    reflect the requirement to win today's fight while recognizing that
    proliferation of anti-access and area-denial capabilities will
    increasingly challenge America's ability to penetrate contested
    airspace. The Air Force continues to modernize the legacy fighter and
    bomber fleet to maintain sufficient capability and capacity as we
    transition to a fully operational F-35A fleet and field a modern Long-
    Range Strike Family of Systems.
                                air superiority
        Air superiority is crucial in modern warfare. It enables air, land
    and maritime operations in support of our Joint, Interagency and
    Coalition partners. For over five decades, Air Force investments,
    expertise and sacrifice in achieving air superiority have ensured that
    friendly ground forces operate without threat of attack from enemy
    aircraft. Airspace control remains vitally important in all operating
    environments to ensure the advantages of rapid mobility, ISR and
    precision strike are broadly available to the Combatant Commander.
    Ongoing air defense modernization efforts by global and regional
    competitors will challenge the Air Force's ability to attain the same
    degree of control in the future. The fiscal year 2012 budget request
    for air superiority is $9.2 billion.
        We plan to continue upgrading to a fifth-generation fleet with F-22
    modifications to provide fleet commonality and ensure the viability of
    our legacy weapons systems. We will also continue the development of
    preferred air-to-air munitions and defenses such as the AIM-9X, AIM-
    120D and electronic warfare capabilities.
        We are currently modernizing our legacy fleet of F-15 fighter
    aircraft with AESA radars to ensure their viability well into the
    future. Other F-15C/D modernization programs underway include an
    advanced display core processor upgrade with vertical situation
    display, beyond line of sight radios, and Link-16 cryptographic
    upgrades. The fiscal year 2012 budget request continues funding for the
    F-15C/D AESA radar modernization program. The Air Force has recently
    restructured this program, procuring 90 radars across the FYDP and an
    additional eight radars in fiscal year 2017.
        The Air Force is also incrementally modernizing the F-22 Block 30/
    35 aircraft and requests funding in the fiscal year 2012 budget for the
    F-22 Block 20/30/35 Common Configuration, Reliability and
    Maintainability Maturation Program and enhancement of the air-to-air
    and SEAD capabilities on F-22 Block 30/35 aircraft.
        Select electronic warfare enhancements continue in fiscal year
    2011, including EC-130H Compass Call fleet upgrades, and a flight deck
    and mission crew simulator to increase training capacity. The fiscal
    year 2012 budget request begins funding 13 electronic attack pod sets
    for MQ-9s and the conversion of a C-130 to EC-130H Compass Call
    aircraft, adding two mission aircraft authorizations across the FYDP.
    The fiscal year 2012 budget also funds concurrent production of
    Miniature Air-Launched Decoy (MALD)/MALD-Jammer (MALD-J) and
    development of MALD-J Increment II to improve the system's electronic
    warfare capabilities.
        The Air Force continues to enhance development, production, and
    integration of critical munitions for air superiority. The fiscal year
    2012 budget requests funds for the development and full-rate production
    of the AIM-9X Block 2; development, integration, and production of the
    AIM-120D; and development and integration of the AGM-88 HARM control
    section modification. The fiscal year 2012 budget also requests
    research and development funding for the ``Next Generation Missile,''
    an air launched missile to replace both the AIM-120D and the AGM-88.
    This funding will provide for a competitive prototype demonstration and
    technical development preceding entrance into the Engineering and
    Manufacturing Development phase of the program.
        Other key enhancements in the fiscal year 2012 budget request
    include the development and fielding of new training range equipment
    and updates to threat systems to provide realistic combat training.
    Among these are the P5 Combat Training System and Joint Threat
    Emitters. Also, the fiscal year 2012 budget request provides
    procurement of F-16 Block 40/50 Full-Mission Simulators, affording
    high-fidelity simulation for use in Distributed Mission Operations.
    Enhanced opportunities to migrate aircrew training into high fidelity
    simulators will help realize efficiencies in the peacetime flying hour
    program, as well as support energy efficiency.
        The proposed fiscal year 2012 investments will sustain America's
    air superiority advantage and expand the multi-role capability of the
    Air Force's most advanced aircraft. Additionally, these investments
    continue the development and procurement of electronic warfare
    capabilities and preferred air-to-air munitions.
                             rapid global mobility
        The Air Force continues to provide unparalleled airlift and air
    refueling capability to support our national defense. Mobility forces
    provide a vital deployment and sustainment capability for Joint and
    Coalition forces, globally delivering equipment, personnel, and
    materiel essential for missions ranging from major combat to
    humanitarian relief operations worldwide.
        The Air Force is accelerating the retirement of our oldest legacy
    airlifters, the C-5A and C-130E, in fiscal year 2011. Airlift capacity
    and capability will be maintained through continued recapitalization
    and modernization. The Air Force will take delivery of seven C-130Js,
    and continue to ensure world-wide airspace access through avionics
    modernization of C-130H2/3, KC-10 and the C-5. In 2010, the C-27J
    completed transition from a Joint to an Air Force-led program, and we
    continued C-27J procurement as an investment in overall fleet
    viability.
        The fiscal year 2012 budget request balances tanker and airlift
    requirements to ensure that we sustain the critical needs of the
    warfighter. This is accomplished by prioritizing recapitalization of
    the tanker aircraft while ensuring the continued viability of the
    legacy fleet. Tanker capability investments of $877 million are heavily
    weighted toward our top acquisition priority, the KC-X program. The Air
    Force submitted a Request for Proposal for a KC-X replacement tanker in
    February 2010, and is anticipating contract award in early 2011. While
    moving aggressively to recapitalize the tanker fleet, we also continue
    maintaining the health of legacy aircraft. The budget includes $147.4
    million in fiscal year 2012 for the airspace access requirement and
    sustainment of the KC-10 and KC-135 fleets.
        In conjunction with the continued procurement of C-130Js, the
    fiscal year 2012 budget continues to modernize C-130Hs through the
    Avionics Modernization Program, ensuring continued global airspace
    access. Similar efforts to modernize C-5 avionics remain on track and
    the C-5B/C Reliability Enhancement and Re-engine Program (RERP) has
    completed operational testing. In October 2010, OSD approved RERP for
    full rate production with the final C-5M ``Super Galaxy'' scheduled for
    delivery in the third quarter of fiscal year 2016. Additionally, in
    accordance with the results of the Mobility Capabilities and
    Requirements Study 2016, and subject to authorization by the Congress,
    we intend to retire some of the oldest, least capable C-5As and C
    130H1s. The C-17 Globemaster III remains the backbone of our Nation's
    strategic airlift fleet, and the Air Force takes delivery of 11 new C-
    17s in fiscal year 2011 and eight in fiscal year 2012. These additions
    bring the total C-17 fleet to 221 aircraft. The Air Force will continue
    to modernize its mature C-17s to the production line standard by
    accelerating the Block 13-17 upgrade program, and retrofitting the
    aircraft with extended range fuel tanks and an improved on-board inert
    gas generating system.
        Efforts to increase direct support airlift continue, with plans to
    beddown 38 C-27Js in the Air National Guard. The Air Force continues
    Operational Support Aircraft/Very Important Person Special Airlift
    Mission modernization with the upgrade of VC-25 avionics, with
    completion in fiscal year 2018 enabling unrestricted global access for
    the Presidential aircraft.
        global integrated intelligence, surveillance and reconnaissance
        The Air Force continues to rapidly increase its ISR capability and
    capacity to support all military operations. Air Force ISR provides
    timely, fused, and actionable intelligence to the Joint force from
    forward-deployed locations and distributed processing centers around
    the globe.
        The exceptional operational value of Air Force ISR assets has led
    Joint force commanders in Iraq, Afghanistan and the Horn of Africa to
    continually increase their requests for support. To help meet this
    demand, the Air Force currently has more than 90 percent of all
    available ISR assets deployed. Over the last 2 years, the Air Force
    increased the number of remotely piloted aircraft (RPA) and completed
    deployment of 30 MC-12W Project Liberty aircraft to theater to
    complement remotely piloted capabilities. This is being accomplished as
    we transitioning MC-12W Liberty Project from OCO funding into the Air
    Force baseline budget beginning in fiscal year 2013. Additionally, the
    Air National Guard, already full partners in the RPA enterprise, has
    also deployed the RC-26B in support of operations in Iraq. Finally,
    both the Air Force and Air National Guard operate the RC-135 Rivet
    Joint and Senior Scout, respectively, in support of global signals
    intelligence taskings.
        In fiscal year 2011, we will increase the number of CAPs in theater
    to 50, maximize the MQ-9 production rate to 48 per year, complete the
    procurement of 11 RQ-4 Block 40, and will deliver five additional MC-
    12W aircraft. We also will maintain our current Joint Surveillance
    Target Attack and Radar System-based Ground Moving Target Indicator
    (GMTI) capability as we complete an Analysis of Alternatives to
    determine the future of GMTI.
        Our fiscal year 2012 ISR budget request of $8.2 billion fully
    supports the Joint force emphasis on ISR capacity and allows the Air
    Force to sustain maximum MQ-9 production and achieve 65 RPA CAPs in
    theater by the end of fiscal year 2013. In intelligence production, we
    corrected an internal Operation and Maintenance shortfall within the
    Air Force Distributed Common Ground System to sustain intelligence
    analysis and dissemination. The budget request also continues support
    for the U-2 Dragon Lady manned aircraft through the end of fiscal year
    2015 to ensure a smooth high-altitude transition to the unmanned RQ-4
    Global Hawk. This extension enables a measured reduction of the U-2
    program as RQ-4 Block 30 aircraft become operational and ensures
    continued support to national leadership, Combatant Commanders and
    Joint warfighters.
        The fiscal year 2012 ISR budget also realigns resources within the
    RQ-4 program to correct a $979 million diminishing manufacturing
    sources disconnect across the FYDP. To optimize our support of the
    overall RQ-4 program, the Air Force decided to curtail production of
    the RQ-4 Block 40 at 11 aircraft. This decision allows the Air Force to
    fully support and sustain the required RQ-4 Block 40 capability already
    procured and concentrate on fielding effective Block 30 multiple
    intelligence platforms on time.
                               space superiority
        The DOD, civilian agencies and our Nation rely on space
    capabilities developed and operated by the Air Force. The fiscal year
    2012 space superiority budget request of $11.6 billion will enable the
    Air Force to field, upgrade and sustain vital space systems for the
    Joint warfighter. As part of the Joint force, we integrate and operate
    these capabilities to execute the space support, force enhancement,
    space control and force application missions; and, as launch agent for
    both the defense and intelligence sectors, provide reliable and timely
    space access for national security purposes.
        Space capabilities provide the United States and our allies'
    unprecedented national security advantages in national decisionmaking,
    military operations, and homeland security. The Air Force's budget
    priorities align closely with the goals and principles outlined in the
    National Space Policy (NSP) and support the DOD's National Security
    Space Strategy (NSSS) and the National Military Strategy with specific
    emphasis on building international partnerships to establish mutually
    beneficial space capabilities and developing a better understanding of
    the space domain. International agreements are being pursued to expand
    space-based communication capability through the procurement of a ninth
    Wideband Global SATCOM satellite (WGS-9), and to meet National Search
    and Rescue requirements by working to integrate the Canadian-provided
    Distress Alerting Satellite Systems as a secondary payload on GPS Block
    III Increment B & C satellites. Additionally, realizing the space
    domain is becoming increasingly congested, contested and competitive,
    we will continue efforts to establish a Space Situational Awareness
    (SSA) partnership with Australia by jointly employing and operating a
    space object detect and track radar in Australia. This system will
    provide better understanding of the current and future strategic space
    environment and establish a foundation for continuing nation-to-nation
    cooperation.
        In close cooperation with OSD and the Office of Management and
    Budget, the fiscal year 2012 Air Force budget request proposes a new
    acquisition strategy for buying military spacecraft, Evolutionary
    Acquisition for Space Efficiency (EASE). The current practice of
    procuring satellites one-at-a-time or on a just-in-time basis has
    inadvertently increased costs due to production line breaks, parts
    obsolescence, and inefficient use of labor. Numerous space experts and
    congressional committees have expressed concern with the inefficiency
    and disruption caused by the status quo approach to procuring
    satellites. EASE is an acquisition strategy that encompasses the
    following tenets: block buys of satellites, fixed price contracting,
    stable research and development investment, and a modified annual
    funding approach. We believe this approach will result in savings that
    can be reinvested in research and development that will further improve
    the performance and lower the cost of follow-on systems. Commitment to
    satellite production and reinvestment in technology development
    provides stability and predictability for a fragile space industrial
    base.
        The Air Force budget request reflects the use of EASE for
    acquisition of the next blocks of Advanced Extremely High Frequency
    (AEHF) protected communications satellites in fiscal year 2012 and
    Space Based Infrared System (SBIRS)-Geosynchronous missile warning
    satellites in fiscal year 2013. Once the EASE approach is proven, we
    will examine the application of this acquisition strategy to a wider
    portfolio of space programs. Relying on a combination of regular
    appropriations, advance appropriations, and multi-year procurement
    authority, the EASE proposal is consistent with the full funding
    principle and is a critical part of the Air Force's efficiency agenda.
    The Air Force recognizes the need to work with Congress to define and
    obtain the necessary legislative authorities to achieve our vision.
        Spacelift is a critical component of the national security space
    enterprise. Despite our having achieved a record 76 consecutive
    successful launches since 1999, spacelift is still a complex and costly
    undertaking. Three recent launch studies reached the same conclusion
    that immediate commitment to a fixed annual production rate for launch
    vehicles is imperative to sustain the industrial base and control
    costs. To ensure this commitment, the fiscal year 2012 budget
    submission requests an additional $3.5 billion across the FYDP to
    procure five DOD launches each year. In addition, the Air Force is
    working aggressively to reduce the cost of providing this critical
    launch capability. Additionally, the Air Force is collaborating with
    the NRO and NASA to explore synergistic solutions to maintain a healthy
    industrial base and meet government launch requirements.
        Our Combatant Commanders and national leadership rely on satellite
    communications for continuous secure communications around the world.
    In fiscal year 2010, we successfully launched the third Wideband Global
    SATCOM (WGS) satellite and first AEHF satellite. AEHF will provide 10
    times the throughput and greater than 5 times the data rate of the
    current MILSTAR II Satellite Communication System. To increase the
    effectiveness of our Joint warfighting operations, we are expanding
    communications capability with the launch of another WGS satellite in
    fiscal year 2012. Each WGS satellite delivers the equivalent capacity
    of the entire existing Defense Satellite Communications System
    constellation. WGS has become the keystone for international
    cooperation measures in space, with our Australian allies funding the
    sixth WGS satellite in return for a portion of the overall bandwidth.
    We requested $469 million in the fiscal year 2012 budget request to
    fully fund WGS to meet Combatant Commander's bandwidth requirements.
    These essential systems provide our forces the vital communications
    needed to remain effectively coordinated, synchronized, and responsive
    in global operations.
        For over 20 years, GPS has been the global standard for
    positioning, navigation and timing (PNT) and is used in everything from
    consumer automobiles, precision farming and smart phones, to enabling
    the Nation's most sophisticated weaponry and financial systems. In
    fiscal year 2011, we will continue to launch GPS Block IIF satellites
    to maintain the constellation as a global utility. The fiscal year 2012
    budget request includes $1.7 billion for PNT capability and
    incorporates initial funding of the next generation GPS III satellite
    production, development of the next-generation operational control
    segment and upgraded military user equipment.
        Our fiscal year 2012 budget request also includes $87 million for
    the Operationally Responsive Space program to pursue innovative
    capabilities that can be rapidly developed and fielded in months rather
    than years to respond to Combatant Commanders' immediate space
    requirements. In the critical areas of missile warning and SSA, we
    requested $1.2 billion for the SBIRS program, which will launch the
    first geosynchronous satellite in fiscal year 2011 to begin our
    transition to a highly effective space-based missile warning system,
    and $122.1 million for the Joint Space Operation Center Mission System.
    We will continue to improve SSA ground-based systems and space-based
    capabilities to ensure continued freedom to operate in the space
    domain. The Air Force also recognizes that space capabilities are
    essential to the nuclear enterprise for its operational readiness,
    providing key decisionmaking information through missile warning and
    nuclear event detection, along with essential communications. Weather
    and forecasting data is another important source of information for our
    forces in peacetime and in conflict. We requested $444.9 million for
    the Defense Weather Satellite System in fiscal year 2012. This system
    will replace the Defense Meteorological Satellite Program in the early
    morning orbit slot, ensuring continuity of detailed overhead weather
    imagery and sensing information. All elements of space capability must
    operate through the full spectrum of potential contingencies.
        While participating, last year, in the DOD's development of the
    national long-term space strategy as part of the Space Posture Review
    and Quadrennial Defense Review, the Air Force recognized a need to
    review our own internal space governance structure to better position
    us to properly execute the direction resulting from these reviews.
    During our review, the position of the Under Secretary of the Air Force
    was identified as the focal point for oversight of all Air Force space
    activities. In addition, space acquisition responsibilities were
    consolidated in the Office of the Assistant Secretary of the Air Force
    for Acquisition. At the DOD level, the Secretary of the Air Force was
    revalidated as the DOD Executive Agent (EA) for Space. The EA is
    charged with the integration and assessment of the DOD overall space
    program, the conduct and oversight of long-term space planning and
    architecture development, and the facilitation of increased cooperation
    with the intelligence community. The EA also chairs the newly
    established Defense Space Council with representatives from across the
    DOD, and was directed to establish a jointly manned space office to
    restructure and replace the current National Security Space Office.
    This organization will not only better position the DOD to coordinate
    implementation of space policy and strategy, it will also provide the
    framework for the DOD's support for development of new national
    security space capabilities. Furthermore, the Secretary of the Air
    Force, in his role as the EA for Space is fully engaged with the DOD in
    the implementation of the recent NSP and NSSS.
                             cyberspace superiority
        The Air Force fiscal year 2012 budget request includes $4.6 billion
    to sustain and maintain our critical cyberspace capabilities and to
    enable Air Force expeditionary and Conus-based operations in support of
    Joint force commanders. The Air Force contributes to the Joint force by
    developing, integrating, and operating cyberspace capabilities in three
    mission areas: support, defense, and offense.
        Cyberspace superiority enables precise force application in all
    domains, generates effects across the full spectrum of operations, and
    preserves an agile and resilient cyberspace infrastructure for assured
    mission execution.
        Access to cyberspace is increasingly critical to meet Joint and
    allied requirements for freedom of maneuver in all domains. Air Force
    networks face a continuous barrage of assaults from State-sponsored
    actors, terror networks, international criminal organizations,
    individual hackers, and all level of threats in between. We are
    expanding collaboration with Service, Joint, Interagency, academic, and
    international partners on several cyber initiatives to safeguard our
    access to the cyberspace domain. To this end, we are operationalizing
    our approach to cyberspace with emphasis in this budget request on
    protecting the Air Force infrastructure, developing expertise to meet
    mission needs, and accelerating our acquisition processes.
        The 24th Air Force, the Air Force component of U.S. Cyber Command,
    achieved FOC on October 1, 2010, and the Air Force will expand the
    cyber rapid acquisition process to cope with constantly evolving
    technologies. The Air Force is also aligning education and training
    programs with our operational approach to cyberspace to properly
    develop our cyberspace professionals. In December 2010, we graduated
    our first cadre of cyberspace operators. Additionally, efforts to
    enhance the cyber-related investigative and forensic capabilities
    resident in the Air Force are forging a solid foundation for Service
    and Joint cooperation. For example, Air Force Space Command
    transitioned the Defense Cyber Crime Center back to the Air Force
    Office of Special Investigations to help strengthen the ties.
        The Air Force has strengthened its efforts in the support mission
    area by continuing work on the Single Air Force Network migration,
    which increases situational awareness of Air Force networks while
    securely improving information sharing and transport capabilities.
    Examples of this support are reflected in several investments in this
    budget. The Air Force continues to support its capability for live,
    virtual, and constructive simulation and training. Based on the Fort
    Hood follow-on review, enhancements were made to the Installation
    Emergency Management system to ensure a standardized, robust emergency
    notification system.
        For the defense mission area, the Air Force invested in additional
    network defenders to increase protection of information vital to Joint
    force operations. The Air Force continues to invest in network defense
    tools and other advanced technologies to monitor and secure classified
    and unclassified networks.
        In the offensive mission area, the Air Force seeks to field
    appropriate and sanctioned capabilities supporting assigned missions.
    The Air Force established formal training programs for both initial and
    mission qualification to provide trained forces to U.S. Cyber Command
    when tasked. Additionally, as the lead support agency to U.S. Cyber
    Command, the Air Force is responsible for the construction and
    installed infrastructure for the new U.S. Cyber Command Integrated
    Cyber Center at Fort Meade, Maryland.
                              command and control
        Command and Control (C\2\) of our forces has never been more vital
    or more difficult than in the 21st century. Supporting the National
    Security Strategy requires commanders to integrate operations in
    multiple theaters, at multiple levels, and across the full range of
    military activity. Secure strategic and nuclear C\2\ remains an Air
    Force priority. The Air Force must sustain, modify, and enhance current
    command and control systems, and develop deployable, scalable and
    modular systems that are interoperable with Joint, Interagency and
    Coalition partners.
        In fiscal year 2011, we will improve assured communication links
    for U.S. Strategic Command's Distributed Command and Control Node and
    U.S. Northern Command's National Capital Region-Integrated Air Defense
    System. The Air Force has also done the following: expanded the
    training pipelines for Joint Terminal Attack Controllers (JTACs); began
    fielding advanced video downlinks, and airborne radio and datalink
    gateways to improve the connectivity of air support operations centers
    and JTACs; and modernized the 1970s-era technology of the E-3 airborne
    C\2\ node with the Block 40/45 program. In addition, the Air Force
    created pipeline training in support of the warfighting elements of the
    Commander, Air Force Forces theater staff.
        In fiscal year 2012, the Air Force requests $6.3 billion for full
    spectrum C\2\ sustainment, replacement, and development efforts. Of
    note, $19.1 million is requested to bolster the Air and Space
    Operations Center's (AOC) C\2\ capability and interoperability with
    programmed Joint systems to execute the Integrated Air and Missile
    Defense mission. Secure and reliable strategic level communications are
    improved with a $53.2 million request for modernization to Senior
    Leader Command and Control Communication Systems for senior leader
    support aircraft and the E-4 National Airborne Operations Center.
    Support to Combatant Commanders is also enhanced with almost $60
    million in fiscal year 2012 for improved airborne and mobile C\2\
    systems. The Air Force maintained our commitment to the Joint
    development of the Three-Dimensional Expeditionary Long-Range Radar.
    Three-Dimensional Expeditionary Long-Range Radar will be the future
    long-range, mobile ground-based sensor for detecting, identifying,
    tracking, and reporting aircraft and missiles in defended airspace.
    Additionally, the United States secured a cooperative development
    position in the NATO Airborne Warning and Control System avionics and
    navigation modernization program.
                               special operations
        Geographic Combatant Commanders and U.S. Special Operations Command
    rely heavily on Air Force Special Operations (AFSOC) capabilities to
    support missions worldwide. As the DOD continues to develop
    capabilities effective against irregular and hybrid threats, increased
    Air Force Special Operations close air support, foreign internal
    defense and ISR capabilities will be required.
        In fiscal year 2011, the Air Force will continue procurement of
    five CV-22s and MC-130Js for the recapitalization of AFSOC's MC-130E/P
    and AC-130H aircraft. The fiscal year 2012 budget request includes an
    investment of $503.7 million toward recapitalization of AFSOC's MC-
    130H/W fleet, with an additional investment of $26 million across the
    FYDP to align MC-130J program funding with OSD cost estimates.
    Additional investments were made to enhance CV-22 mission capability
    with upgraded cockpit data recording and Communication Navigation
    System/Air Traffic Management modifications. Finally, a low-cost engine
    wiring modification allowed the Air Force to realize a $9.6 million
    efficiency and reduce MC-130J spare engine inventories.
                               personnel recovery
        Personnel recovery (PR) remains a vital core function in support of
    every contingency operation. The increased utilization of military and
    civilian personnel in support of OCO has significantly increased the
    demand for Air Force rescue forces beyond the conventional combat
    search and rescue mission. Air Force PR forces are fully engaged in
    Afghanistan, Iraq and the Horn of Africa, accomplishing lifesaving
    medical and casualty evacuation missions, while also supporting
    domestic civil land and maritime search and rescue, humanitarian
    assistance/disaster relief (HA/DR) and mass casualty evacuation
    missions.
        In fiscal year 2011, the Air Force will continue to recapitalize
    HC-130N/P aircraft and procure H-60 Blackhawk helicopters under the
    operations loss replacement (OLR) program to restore the fleet to 112
    HH-60G aircraft. The fiscal year 2012 request funds four HH-60G OLR
    aircraft, and provides a $2 billion investment for procurement of 54
    HH-60 replacement aircraft across the FYDP. We will also accelerate the
    procurement of our HC-130J rescue/tanker aircraft by procuring three
    aircraft in fiscal year 2012 to replace the 1960s-era HC-130P fleet on
    a one-for-one basis, up to 37 aircraft. Finally, the fiscal year 2012
    budget funds $73 million for the Guardian Angel program which will
    standardize and modernize mission essential equipment for an additional
    five pararescue teams.
                             building partnerships
        Developing mutually beneficial partnerships with militaries around
    the world is vital for the Air Force. Successful partnerships ensure
    interoperability, integration and interdependence between Coalition
    forces while providing our partner nations the capability and capacity
    to resolve their own national security challenges. Today's engagements
    require Airmen to perform their duties effectively and achieve
    influence in culturally complex environments around the globe.
        The Air Force continues to emphasize extensive language skills and
    regional knowledge in its growing cadre of Regional Affairs
    Strategists. These personnel possess a regionally focused advanced
    academic degree and language proficiency. They work with partner
    nations as attaches and Security Cooperation Officers. Political-
    Military Affairs Strategists and best-fit officers also fill positions
    requiring in-depth understanding of the interagency processes key to
    building partnerships. The Air Force has also increased the culture and
    language content of selected pre-deployment training courses and
    recently inaugurated a new language learning program--the Language
    Enabled Airman Program. This program provides an opportunity to create
    a cadre of language-capable Airmen who are deliberately developed for
    requirements, leverages the capability attained in foreign language
    accession programs, and provides a systemic opportunity for these
    Airmen to maintain these skills throughout their careers. Our fiscal
    year 2012 budget request includes funding to expand foreign language
    instruction for officer commissioning programs as well.
        The Air Force continues to engage our international partners across
    the spectrum of operations. The fielding of the F-35, Joint Strike
    Fighter, will further our partnerships with more established allies,
    while the three C-17s procured for the 12-nation Strategic Airlift
    Capability are fully operational and currently meeting the airlift
    requirements of our European allies. We are funding new initiatives
    which support longer term Building Partnerships Capacity (BPC) efforts.
    For instance, $65.7 million was budgeted toward the procurement of 15
    Light Mobility Aircraft (LiMA) to assist partner nations in building
    their airlift capability in fiscal year 2011. These aircraft are
    scheduled to be fielded and achieve initial operating capability (IOC)
    in the second quarter of fiscal year 2012. We are also requesting $159
    million in fiscal year 2012 to procure the first nine of 15 Light
    Attack/Armed Reconnaissance (LAAR) aircraft. These LAAR aircraft will
    be used to train a cadre of pilots who will subsequently export their
    BPC aviation skills to international partners who may operate the same
    or similar platforms. To ensure the proper capability is provided to
    build partner capacity by Contingency Response Forces, LiMA and LAAR
    personnel, we funded the formal establishment of an Air Advisor Academy
    in fiscal year 2011 to expand our current efforts that include training
    air advisors heading to Iraq and Afghanistan and training air advisors
    for engagements globally. English language proficiency is a
    prerequisite to nearly all of the education and training that the
    Services provide to our partner nations. To meet increasing partner
    demand for English language training, the fiscal year 2012 Air Force
    program expands the capacity at the Defense Language Institute English
    Language Center.
                              agile combat support
        Underpinning the work of all Air Force Core Functions are the
    capabilities included in agile combat support (ACS). ACS is the ability
    to create, protect, and sustain air and space forces across the full
    spectrum of military operations and spans a diverse set of Air Force
    functional capabilities. The fiscal year 2012 budget request of $33.8
    billion for ACS accounts for efforts affecting our entire Air Force--
    from the development and training of our Airmen to regaining
    acquisition excellence.
        Airmen and Families.--The Air Force is proud of its commitment to
    supporting its Airmen and families. The nearly two decades of sustained
    combat operations has imposed extraordinary demands on them and
    underscores the need to remain focused on sustaining quality of life
    and supporting programs as a top priority. To help address the demands,
    in 2010 the Air Force executed the Year of the Air Force Family and
    highlighted support programs focused on three outcomes: Fostering a
    Strong Air Force Community; Strengthening an Airman's Sense of
    Belonging; and Improving Airman and Family Resiliency.
        The Year of the Air Force Family deepened leadership's
    understanding of current support services and capabilities and what
    needs to be done in the future to maintain and improve outcomes in the
    three primary focus areas.
        First, the Air Force will maintain an enduring emphasis on Airmen
    and families by actively engaging the entire Air Force Community: Total
    Force Airmen, Department of the Air Force civilians, single and married
    personnel, primary and extended family members, retirees, and on and
    off-base community partners. The Air Force will maintain an atmosphere
    that is supportive, team-oriented, and inclusive, but diverse enough to
    meet the current and emerging needs of the entire Air Force Community.
    Policy and process priorities have been translated into actions and
    tasks that will be accomplished over the next few years, perpetuating
    the Air Force's commitment to strengthening our ties to one another,
    improving our operational abilities and ensuring our Air Force
    Community is best positioned to meet future commitments and
    requirements.
        Second, we continue to strengthen our Air Force Community by
    expanding child care through different programs such as the Extended
    Duty Program, Home Community Care, Missile Care, and the new
    Supplemental Child Care initiative to provide flexibility in meeting
    child care needs. In fiscal year 2011, the Air Force will continue to
    demonstrate our commitment to military child education, funding full
    time School Liaison Officers (SLO) Air Force-wide. SLOs and our new Air
    Force Exceptional Family Member Program Coordinators will work in close
    collaboration to address educational and other assistance for families
    with special needs. The Air Force fiscal year 2012 budget request
    includes $4 million to assist with respite child care for military
    family members with special needs children.
        Third, the budget reflects a $4.4 million increase to our Air Force
    Mortuary Affairs program, supporting travel for family members from
    home of record to Dover Port Mortuary to receive and honor fallen loved
    ones. Increases also reflect our commitment to maintaining the Port
    Mortuary's Center for the Families of the Fallen, used as the reception
    facility and host site for visiting family members at Dover Air Force
    Base, Delaware.
        Airman dining facilities remain an important commitment of the Air
    Force as we plan to increase funding for dining facilities at basic
    military training and technical training bases by $14.9 million in
    fiscal year 2012. In fiscal year 2011, we launched the Food
    Transformation Initiative (FTI) to address Airmen's concerns with
    dining facility closings, lack of healthy food options, and
    insufficient hours of operation. FTI is designed to enhance food
    quality, variety and availability while maintaining home base and
    warfighting capabilities.
        The Air Force continues to expand our efforts to improve resiliency
    of Airmen and their families before, during, and after deployments and
    has significantly expanded capabilities to ensure support and
    reintegration of our Total Force. In continuing its efforts to improve
    the resiliency of Airmen and their families, the Air Force moved
    forward with several initiatives in 2010.
        We established a new Resiliency Division at the Air Force level to
    take the lead and develop an overarching Air Force Resiliency Roadmap.
    The Deployment Transition Center (DTC) was established at Ramstein Air
    Base, Germany on July 1, 2010. The DTC and Chaplain Corps Care for the
    Caregiver programs provide valuable decompression, reintegration and
    resiliency training for those exposed to significant danger and stress
    in combat zones. To support these efforts, the Air Force fiscal year
    2012 budget request includes $8 million for the Air Force Resiliency
    Program for research, curriculum development, materials and
    intervention training for the DTC. We will continue to develop our
    Airman Resiliency Program by identifying needs, researching best
    practices, partnering with internal and external organizations, and
    developing targeted and tiered training that is integrated into an
    Airman's career to allow a building block approach that leads to life-
    long resiliency that benefits both Airmen and their families. We are
    also requesting an increase in the Chaplain Recruitment program by $1.5
    million in fiscal year 2012 to better provide for religious
    accommodation and support of Airmen. This includes chaplain-led
    MarriageCare Retreats, that help heal and save marriages, and
    deployment reintegration programs expanded to meet the needs of
    redeploying Airmen.
        The Air Force is highly committed to the Wounded Warrior Program
    that ensures access to medical and rehabilitation treatments for the
    ill and wounded. The Air Force Warrior and Survivor Care Division is
    dedicated to building a culture of understanding and concern for
    wounded, ill and injured Airmen. The Air Force has hired 33 Recovery
    Care Coordinators and a Program Manager to support 31 locations across
    the Air Force. Recovery Care Coordinators serve as the focal point for
    non-clinical case management, development of comprehensive recovery
    plans and creation of timelines for personal and career
    accomplishments. Additionally, the Air Force has implemented new
    personnel policies regarding retention, retraining, promotions,
    assignments and evaluation of Wounded Warriors. In fiscal year 2012,
    the Air Force is requesting $2.8 million for additional case workers
    and program managers to provide non-clinical case management services
    to meet the growing demands of the Wounded Warrior population.
        Healthcare Initiatives and Costs.--As key team members of the
    Federal and Military Health System (MHS), the Air Force Medical Service
    (AFMS) is seeking innovative solutions to deliver world class care
    while slowing the rising costs of healthcare. For example, the AFMS is
    taking the lead in building the largest patient centered medical home
    capability in the DOD over the next 12 months. This includes the Family
    Health Initiative, designed to improve continuity of care and healthier
    outcomes. Additional emphasis is being placed on delivering better care
    by streamlining our hospital surgical operations and improving the
    experience of care. Current efforts have demonstrated recapture of
    services in key market areas with the overall results of reduced cost,
    increased currency of our surgeons, and improved patient satisfaction.
    In addition, the AFMS is transitioning from healthcare delivery to
    delivering health. Through patient-centered care, improved teamwork
    with our patients, and leveraging partnerships with DOD, VA and
    civilian institutions, Air Force medicine is shaping the future of
    healthcare.
        Our strategy to control DOD healthcare costs is the right approach
    to manage the benefit while improving quality and satisfaction.
    Adjustments to the benefit such as raising TRICARE enrollment fees for
    working retirees, phasing out enrollment for some high-cost health
    plans, paying community hospital Medicare rates, and incentivizing the
    use of the most effective outlets for prescriptions is prudent. There
    will be limited impact (prescription only) on active duty family
    members. By implementing these important measures, we will be able to
    positively address the rising costs of healthcare and improve the
    health of our population.
        Suicides.--Air Force suicide rates have been on the rise since
    2007, although primary risk factors for suicide among Airmen remain the
    same. The most commonly identified stressors and risk factors have
    remained the same over the last 10 years: relationships, financial
    problems and legal problems. Although deployments can stress Airmen and
    their families, deployment does not seem to be an individual risk
    factor for Airmen--many Airmen who have committed suicide have never
    deployed. The Air Force is providing additional support to our most at-
    risk Airmen by providing additional frontline supervisor suicide
    prevention training to all supervisors in career fields with elevated
    suicide rates. In addition, mental health providers are based in
    primary care clinics across the Air Force to counsel patients who may
    not otherwise seek care in a mental health clinic because of the
    perceived stigma. The Air Force has significantly expanded counseling
    services in addition to those available through the chaplains or the
    mental health clinic.
        Other helpful programs that provide non-medical counseling include
    Military Family Life Consultants, which can see individuals or couples,
    and Military OneSource, which provides sessions for active duty for up
    to 12 off-base sessions.
        Fort Hood.--In the wake of the Fort Hood shooting, the Secretary of
    Defense directed the Air Force to conduct a follow-on review to
    identify ways to better protect Airmen and families. Our review yielded
    118 findings and 151 recommendations. The key revelation of the study
    is that we must do a better job of preventing and responding to
    violence. Specifically, we must improve our ability to identify
    indicators of potential violence and share that information with those
    who are best positioned to prevent a violent outcome. This will require
    improved understanding, education, processes and training, as well as
    more integrated processes at both the installation and interagency
    levels. To undertake these efforts, the fiscal year 2012 budget request
    includes $37 million across the FYDP. We anticipate that our resource
    requirements will increase as we refine the implementation of our
    recommendations. We are confident that the resources Congress provides,
    coupled with our sustained effort, will help the Air Force reduce the
    likelihood of tragedies like Fort Hood and position us to respond more
    effectively should prevention fail.
        Information Protection.--The Air Force will enhance its
    capabilities to assess and mitigate risks to national security
    information across the enterprise. It will advance efforts to identify
    risks that reduce the surety of research, development, and acquisition
    and operations or enable potential opponents to illicitly increase
    their technological capabilities. These efforts will enable commanders
    to effectively execute intelligence-led, risk based protection across
    the Air Force.
        Science and Technology.--Air Force warfighting capabilities have a
    proud heritage of being born from the very best science and technology
    (S&T) our Nation can produce. The creation of the Air Force is closely
    intertwined with the development of advances in S&T. In 2010, the Air
    Force presented the ``Technology Horizons Study'' to serve as a roadmap
    for guiding Air Force science and technology investments during the
    next 20 years. Despite current fiscal constraints, the Air Force is
    increasing its investment in basic research by $18 million and in
    Advanced Technology Development by $76 million, while continuing fiscal
    year 2011-level investment in Applied Research.
        Acquisition Excellence.--The Air Force continues to strive for
    acquisition excellence by increasing the rigor and transparency of its
    processes and by stabilizing requirements and funding. As one of our
    top five Air Force priorities, we have taken a multi-faceted approach
    to recapturing acquisition excellence to include:
      --Rebuilding the acquisition workforce;
      --Delivering a fully implemented Acquisition Improvement Plan (AIP)
            to guide and shape current and future efforts;
      --Creating a foundation for a robust Continuous Process Improvement
            (CPI) function within acquisition; and
      --Implementing approximately 75 efficiency initiatives that range in
            scope and impact throughout the acquisition enterprise.
        Continued improvements support moving resources from ``tail to
    tooth'' to fully support the Air Force's direct mission activities.
    Efficiency savings in overhead, support and other less mission-
    essential areas will increase funding available for our critical
    mission functions. The Air Force, as a good steward of taxpayer
    resources, is committed to delivering products and services that
    perform as promised--on time, within budget, and in compliance with all
    laws, policies and regulations.
        An example of the successful implementation of recapturing
    acquisition excellence is the consolidation of fiscal year 2008 OCO,
    fiscal year 2009 OCO and base-year funding, fiscal year 2010 base-year
    funding, and Foreign Military Sales C-130J contracts into one
    negotiation. By taking advantage of economies of scale, the Air Force
    realized a savings and was able to procure two additional C-130Js. This
    effort reduced the number of aircraft the Air Force needs to buy in the
    out-years to meet its requirement.
        Installations and Operational Energy.--The Air Force views energy
    efficiency as a mission enabler that can increase combat effectiveness,
    expand reach and minimize operational risks. The Air Force is
    integrating energy considerations across the Air Force enterprise with
    a three-pronged approach: reduce demand, increase supply, and culture
    change. We can identify efficiencies that increase our capabilities and
    reduce our costs, while also increasing and diversifying our energy
    supply to improve our energy security and our ability to meet our
    critical operational requirements. Finally, by creating a culture that
    makes energy a consideration in everything we do, and that values
    energy as a limited mission-critical resource, we ensure enduring and
    far-reaching utilization improvements and savings.
        As part of our institutional effort to utilize energy to maximize
    mission effectiveness, the Air Force is requesting over $550 million
    for energy initiatives in fiscal year 2012. Initiatives include
    investments in reliable alternative energy resources, enhancing energy
    efficiency, and reducing environmental impacts and life cycle costs. In
    addition, the Air Force is continuing to take steps to reduce mission
    risk by increasing critical infrastructure resiliency to ensure
    reliable energy availability at Air Force installations.
        We have reduced energy use at facilities by nearly 15 percent since
    2003, and expect to achieve nearly a 30 percent reduction by 2015. In
    addition, we have instituted a number of fuel saving initiatives and
    reduced the amount of fuel our aircraft have consumed by over 46
    million gallons since 2006, despite increased operational requirements
    associated with ongoing operations. The Air Force is continuing to
    explore opportunities to reduce demand for aviation fuel. For example,
    the 618th Tanker Airlift Control Center is optimizing flying routes by
    working clearances to allow flights to transit through previously
    denied airspace. We can save the Air Force an estimated 2.6 million
    gallons of fuel per year by optimizing our flight routes and
    clearances. Some of the initiatives we will pursue to achieve fuel
    efficiencies are:
      --Providing aircrews in-flight guidance on the optimum airspeed and
            altitude based on current flight conditions;
      --Expanding the use of simulators to conduct training;
      --Implementing a program, already an industry standard, that cleans
            components allowing the engine to run cooler saving fuel and
            prolonging engine life; and
      --Refining fuel and cargo policies to reduce carrying costs and
            potentially the number of missions required to support the
            Combatant Commanders.
        We are also increasing the energy supplies we can use to meet our
    mission. We have certified over 99 percent of our aircraft fleet for
    unrestricted operational use of a synthetic aviation fuel blend. This
    fuel can be produced domestically, and we are looking to industry to
    help us meet our needs. We are in the process of certifying our fleet
    to use biofuel blends as well. These alternatives provide our fleet
    with additional flexibility and enable our freedom of action. The Air
    Force is also looking at alternative sources for energy at our
    facilities. In the upcoming years, we will quadruple on-base solar
    energy production and dramatically increase the amount of wind energy
    consumed. These clean sources of energy will serve to enhance our
    energy security.
        The Air Force is working cooperatively with the Army and the
    Marines to reduce fuel requirements at forward operating bases by
    decreasing energy demand, utilizing efficient power distribution and
    increasing alternative supplies. These bases require generators,
    typically running on diesel, that require fuel to be brought in by
    convoy. We are working to improve the energy efficiency of our Basic
    Expeditionary Airfield Resources assets, commonly called BEAR, in the
    expeditionary environment. One of the Air Force's efforts is focused on
    reducing the energy demand for expeditionary shelters by 50 percent,
    while using photovoltaic tent flys to generate a minimum of three
    kilowatts per shelter. We are also working with industry to design a
    portable, expandable microgrid for our remote airfields. The system
    will integrate solar, wind and other renewable sources of energy into
    the existing BEAR power grid, reducing the system's reliance on
    traditional, carbon-based fuel by as much as 25 percent. It will be
    able to withstand the harsh conditions in which our military operates.
    More importantly, it will help reduce the inherent wartime dangers that
    come with delivering the fuel by convoy.
        We have made significant and positive progress in reducing our
    consumption, increasing the energy available to the operational Air
    Force and changing the culture within the Air Force to ensure energy is
    a consideration in everything we do. Energy availability and security
    impact all Air Force missions, operations and organizations. The Air
    Force will increase warfighting capabilities, and efficiency, and help
    the Nation reduce its dependence on imported oil by continuing to
    ensure energy availability and re-engineering our business processes to
    become more efficient.
        Reducing Excess Physical Plant and Infrastructure.--The fiscal year
    2012 budget request includes a $300 million demolition and $100 million
    consolidation investment to reduce long-term fixed costs through the
    consolidation and demolition of unneeded facilities and infrastructure.
    In line with the June 10, 2010 Presidential memorandum, the Air Force
    intends to reduce energy use and curtail unnecessary sustainment
    activities by eliminating physical plant that is no longer needed.
        Military Construction.--The Air Force's fiscal year 2012 $1.4
    billion Milcon request provides funding for our most critical
    requirements including new construction aligned with weapon system
    deliveries and the Combatant Command priorities. This includes projects
    supporting beddowns and upgrades for F-22, F-35, HC-130J, EC-130H, RPA
    and B-52, as well as projects supporting our mission support facilities
    most in need of recapitalization. The Air Force Milcon program supports
    the U.S. Strategic Command Headquarters replacement facility in three
    increments beginning in fiscal year 2012, the new U.S. Cyber Command
    Headquarters in fiscal year 2013, an additional phase of the Blatchford
    Preston Dormitory Complex at Al Udeid, Qatar, and an air freight
    terminal on Guam.
        Additionally, the budget request sustains our effort to provide
    quality housing for Airmen and funds $254 million in improvements to
    meet DOD performance standards to provide 90 percent of our permanent
    party dorm rooms in good or fair (Q-1 or Q-2) condition. The Air Force
    investment strategy is to fund improvements in all Q-3 and Q-4 dorms,
    referred to as Tier 1 dorms in the 2008 Dorm Master Plan, by 2017.
        The Air Force recognizes the critical role Milcon holds in
    successful mission execution and is taking action to increase Milcon
    funding in the near years of the FYDP--the Air Force proposes to
    increase Milcon in fiscal year 2012, fiscal year 2013, and fiscal year
    2014 by a combined $1.8 billion over the fiscal year 2011 PB
    submission.
        Finally, in an effort to ensure the most critical mission and
    infrastructure projects are funded first, the Air Force used asset
    management and efficient facility operations processes to evaluate
    Milcon requirements. In essence, the Air Force is considering how these
    projects and programs help reduce our out-year investment needs as part
    of our overall cost control strategy.
        Logistics.--WSS is a vital element in sustaining Air Force
    readiness. The Air Force faced a $7 billion increase in WSS
    requirements across the FYDP at the beginning of the fiscal year 2012
    budget cycle, largely due to increasing numbers of weapon systems, such
    as C-17, F-22 and MQ-1/9 aircraft that use contractor logistics
    support. We recognized that we cannot sustain that kind of growth in
    requirements, so we implemented a WSS end-to-end assessment to identify
    efficiencies with respect to supply chain management, centralized asset
    management, and depot performance.
        We were able to reduce WSS investment from $7 billion to $4 billion
    through efficiencies in depot and supply chain processes identified in
    the assessment. While we will still experience growth, this $3 billion
    FYDP offset represents important savings that the Air Force applied
    elsewhere. Prior to the WSS end-to-end assessment, the sustainment
    funds requested in fiscal year 2012 would have supported 80 percent of
    the WSS requirement. Following the assessment, and the resulting
    reduction in growth, the same amount of funds requested will actually
    support 84 percent of the fiscal year 2012 WSS requirement.
        While the peacetime flying hour program is fully funded,
    reprogramming may be necessary to cover increased fuel costs due to the
    volatility of fuel prices. Over the longer term, enactment of the DOD's
    legislative proposal for the Refined Petroleum Products Marginal
    Expense Transfer Account would reduce disruptions to operations and
    investment programs by providing the flexibility to meet fuel price
    fluctuations.
        The Air Force is successfully fielding a pilot of the first
    increment of the Expeditionary Combat Support System (ECSS). We will
    conduct an independent cost estimate as part of, and in conjunction
    with, the ongoing Critical Change Review to assess the cost
    effectiveness of proceeding with additional ECSS releases that support
    retail and wholesale supply and depot maintenance activities. The Air
    Force will continue to maintain legacy logistics support systems while
    determining the best course of action for developing information
    technology tools to enhance the visibility and management of supplies
    and equipment.
        Financial Improvements.--The Chief Financial Officers' Act provides
    direction for achieving a clean audit through leadership commitment,
    modernized government financial management systems, and strengthened
    financial reporting. Sound financial management helps to ensure the
    maximum combat capability for each taxpayer dollar. The Air Force is
    committed to achieving the legislative requirement for a clean audit by
    2017. While 2017 is a challenging deadline for a military organization
    as large and diverse as the Air Force, the strong engagement of Air
    Force leadership, additional financial resources provided in recent
    years, and focus on fielding effective financial systems will help
    achieve it. We are focusing our efforts on the information most
    relevant to decision makers, and the Air Force Financial Improvement
    Plan is closely aligned with the DOD strategy to achieve a clean audit.
        Strategic Basing.--In 2009, the Air Force established a
    standardized, repeatable, and transparent Strategic Basing Process.
    Guided by the Strategic Basing Executive Steering Group and coordinated
    through the lead Major Commands, over 115 basing actions have been
    accomplished ensuring that mission and Combatant Commander requirements
    are linked to installation attributes that identify those locations
    that are best suited to support any given mission. This process
    supports IOC, aircraft delivery, personnel movement, and other mission
    requirements. Recent improvements in the process have formalized
    actions to expedite simple, specialized or particularly time-sensitive
    basing initiatives, to support more timely decisions.
        During 2011, the Air Force will utilize the Strategic Basing
    Process to support basing decisions for the MQ-1/9, LiMA, LAAR, and KC-
    X.
        In developing our fiscal year 2012 budget request, we looked at
    ways to maximize combat capability out of each taxpayer dollar by
    identifying waste, implementing efficiencies, pursuing continuous
    process improvement initiatives and making smart investments.
    Recognizing the need to shift resources from ``tail to tooth,'' the Air
    Force identified efficiencies across the enterprise that will enable
    investments in enhancements to increase our warfighting capabilities.
    This includes the continued pursuit of cost-effective systems that
    leverage existing capabilities and maximize interoperability and
    integration of legacy and future systems.
        Our ability to project Global Vigilance, Reach, and Power is
    constrained by the increasing costs to design and build platforms in a
    particularly challenging budget environment. Our fiscal year 2012
    budget request reflects the difficult choices that will allow the Air
    Force to provide the necessary capability, capacity, and versatility
    required to prevail in today's wars, prevent and deter conflict,
    prepare to defeat adversaries and succeed across the range of potential
    military operations--all the while preserving and enhancing the all-
    volunteer force.
        We are confident in our Airmen. They are the best in the world, and
    we rely on them to meet any challenge, overcome any obstacle and defeat
    any enemy as long as they are given adequate resources. We are
    committed to excellence and we will deliver with your help. We ask that
    you support the Air Force budget request of $119 billion for fiscal
    year 2012.

        Chairman Inouye. And now, General Schwartz.
    STATEMENT OF GENERAL NORTON A. SCHWARTZ, CHIEF OF STAFF
        General Schwartz. Mr. Chairman, Senator Cochran, and
    members of the subcommittee, I am privileged to be here today
    with Secretary Donley, representing the men and women of our
    United States Air Force.
        Our airmen continue to inspire us with their dedication and
    their service, quietly and proudly serving alongside their
    Army, Navy, Marine, and Coast Guard teammates. Every day airmen
    act on behalf of the American people as stewards of the
    Nation's trust and defenders of her security.

                        FULL SPECTRUM OF AIR OPERATIONS

        This budget request, fully appreciating the Nation's
    extraordinary fiscal conditions, supports our airmen and our
    continuing efforts to structure the force for maximum
    versatility and the full spectrum of operations. This includes
    humanitarian relief operations in Japan, where several hundred
    airmen and Air Force civilians have deployed, with more on the
    way, to assist 13,000 Air Force personnel already stationed in
    Japan. Along with their joint and interagency teammates, they
    are all working hard to provide some measure of comfort to the
    victims of multiple concurrent disasters.
        In the immediate aftermath, airmen at Yokota Air Base
    received a dozen or so commercial aircraft and more than 500
    passengers that were bound for Narita International Airport in
    an ongoing support to Operation Tomodachi, they continue to
    receive more than triple the average amount of aircraft on
    their flight line.
        Members of the 33d Rescue Squadron from Kadena Air Base in
    Okinawa continue to partner with their Japanese self-defense
    force counterparts to conduct search and rescue operations,
    while teammates from the 352d Special Operations Group, also
    from Kadena, work to open a couple of hard hit airfields,
    including Sendai and Matsushima.
        For the world--the wide angle view, RQ-4 Global Hawks and
    the U-2 aircraft continue to gather imagery of the devastation,
    while WC-135s operate in international airspace to collect
    atmospheric data to support ecological awareness efforts.
        Airmen who provide inter- and intra-theater airlift
    capability have transported more than 900 passengers, including
    aeromedical patients, and delivered more than 5 million pounds
    of cargo via C-17s, C-130s, and other airborne assets, while on
    the ground, other airmen have contributed to transport and
    deliveries of critical supplies and equipment.
        Meanwhile, in North Africa, B-2 bombers from Whiteman Air
    Force Base in Missouri led U.S. strikes on a variety of
    strategic targets, for example, military command and control
    sites as well as air defense systems, that posed a direct
    threat to Libya civilian population and partner nation forces.
        Other Air Force assets, F-15Es and F-16 CJs, along with a
    multitude of AWACs, tankers, and other support aircraft, joined
    coalition aircraft from Britain, France, and others to help
    gain control of the airspace, establish a no fly zone over
    Libyan opposition forces, and protect Libyan citizens from any
    further harm from Moammar Gadhafi's regime. The Joint Task
    Force Odyssey Dawn leaders closely monitor the situation and
    ensure close coordination and transition to our NATO allies.
    Airmen stand ready to continue supporting the enforcement of
    U.N. Security Council Resolution 1973 by providing unique air
    and space power for United States, allied, and coalition
    forces.

            OPERATING UNDER FISCAL YEAR 2011 CONTINUING RESOLUTIONS

        As you can see, airmen and their joint teammates are doing
    tremendous work on behalf of the American people, and we would
    be remiss to allow current budgetary pressures to adversely
    affect their performance and their safety. I, therefore, echo
    Secretary Donley's concerns about operating under a continuing
    resolution. Without a fiscal year 2011 Defense appropriations
    bill, we will have to further reduce flying hours, cancel
    training and exercise opportunities, delay or cancel weapon
    system sustainment and depot maintenance activities, and
    disrupt a multitude of other day-to-day activities.
        Current reductions to the President's budget request not
    only create inefficiencies that basically reverse the
    efficiency measures that Secretary Gates has directed, they
    adversely affect military readiness and performance as well.
        We appreciate your efforts to pass a Defense appropriations
    bill to provide for the critical needs for our uniformed men
    and women.
        Airmen are committed to the task of leveraging the air and
    space power with all of its inherent versatility, and
    presenting to the President and the national leadership a range
    of strategic options to meet the following national military
    objectives: countering violent extremism, deferring and
    defeating aggression, strengthening international and regional
    security, and shaping the future force.

                          COUNTERING VIOLENT EXTREMISM

        To counter violent extremism, airmen continue to make vital
    contributions to our Nation's strategic objective of
    disrupting, dismantling, and defeating Al Qaeda and its
    affiliates, and inhibiting their return to former sanctuaries.
    More than 42,000 airmen--approximately 6 percent of our force--
    are forward deployed worldwide. Of this group, nearly 30,000
    are on a continually rotating basis to directly contribute to
    operations in the U.S. Central Command area of responsibility,
    including nearly 11,000 airmen in Afghanistan providing close
    air support, air mobility, personnel rescue, air medical
    evacuation, leadership of provincial reconstruction teams, and
    training to develop our partner air force.
        In direct support of combatant and command requirements, we
    have 57,000 total force airmen--or about 11 percent of the
    force--who were forward stationed overseas, as well as
    approximately 218,000 airmen, or some 43 percent of the Air
    Force force--who stand nuclear alert, operate our satellites,
    process intelligence, surveillance, and reconnaissance data,
    and do much, much more.
        To deter and to defeat aggression, we maintain vigilance
    across the entire spectrum of conflict, from our recent
    experience in counter insurgency operations, to more
    traditional roles of air mobility and precision strike.
        At the upper end of the continuum, we continue to provide
    two of the Nation's three arms of nuclear deterrence with
    steadfast excellence, precision, and reliability.
        And across the remainder of the operational spectrum, we
    will maintain robust conventional deterrence by building on our
    comprehensive portfolio of air, space, and cyber capabilities,
    with multirole systems that can flex to fulfill different
    warfighting requirements.

               STRENGTHENING INTERNATIONAL AND REGIONAL SECURITY

        To strengthen international and regional security, we will
    translate air power's inherent versatility and ability to
    traverse vast distances with unmatched speed, ensuring U.S.
    forces are globally available, yet tailored to be regionally
    focused. And we will continue to coordinate efforts to build
    international partner capabilities, which can help prevent
    lower intensity problems from escalating into full-scale
    crises. For instance, nearly 300 airmen are deployed as members
    of the Iraq Training and Advisory Mission Air Force, supporting
    the development of counterpart capabilities in some 425
    specialties. Similarly, airmen supporting combined Air Power
    Transition Force not only advise and train Afghanistan airmen,
    they help to set the conditions for a viable and self-
    sustaining Afghan national army/air force to meet a range of
    security requirements.
        Finally, to shape the future force we will work hard to
    ensure readiness, training, and equipage because mission
    success relies on resilient airmen as much, if not more, than
    on weapons systems.

                      CARING FOR AIRMEN AND THEIR FAMILIES

        Airmen are the lifeblood of our Air Force, to whom we owe
    our fullest commitment--particularly our wounded warriors and
    their families. And during this time of sustained and frequent
    deployments, we will bolster our capacity to assist our airmen
    in managing both the obvious and the less obvious challenges of
    returning home from war.
        We intend to continue to progress since July when we
    established the Deployment Transition Center at Ramstein Air
    Base in Germany. Nearly 1,200 personnel have attended programs
    to decompress and begin their healthy reintegration into family
    life and unit of assignment. And we will further strengthen our
    efforts to develop the Air Force Resiliency Program in its
    ongoing assessment of the fitness of the Force, which will
    inform our continued efforts to improve quality of
    comprehensive support services.

                        CONTROLLING DOD HEALTHCARE COSTS

        In closing, I'd like to affirm my personal support for
    efforts to better control the cost of DOD healthcare. I respect
    and I celebrate the service and sacrifice of our retirees. They
    are, and always will be, honored members of the Air Force
    family. But I do believe that current DOD proposals are both
    modest and responsible.

                                   CONCLUSION

        Mr. Chairman and subcommittee members, the Air Force
    remains committed to providing global vigilance, reach, and
    power for America's requirements today and for her challenges
    tomorrow. Thank you for your continued support of the United
    States Air Force and for our airmen and their families.
        Sir, I look forward to your questions.
        Chairman Inouye. All right. Thank you very much, General
    Schwartz.

                             NEW PENETRATING BOMBER

        I'd like to begin the questioning with a question on the
    new penetrating bomber. When is the initial operating
    capability planned for this aircraft?
        Mr. Donley. We estimate initial operating capability in the
    mid-2020s, Mr. Chairman. This is a very important initiative
    for us.
        Chairman Inouye. And how many do you plan to acquire?
        Mr. Donley. Between 80 and 100 is the target. This program
    is very much focused on affordability and poised for technical
    success, lower technological risk. We plan on taking advantage
    of existing technologies and other programs that are mature, a
    streamlined management process, and a strict limitation on
    requirements for the system going forward as ways to control
    cost curves and to keep it on schedule.
        Chairman Inouye. To the extent possible, realizing this is
    not a classified hearing, can you describe this new penetrating
    bomber's capabilities?
        General Schwartz. Mr. Chairman, the platform we envision
    would be a nuclear capable, optionally manned in either
    remotely or piloted variants, as the case may be, and it will
    be part, sir, of a family of systems. This will not be a lone
    wolf platform. It will be a platform that is part of the family
    of systems that includes direct and stand-off munitions, that
    includes intelligence, surveillance, and reconnaissance
    capabilities, that includes electronic attack capabilities, not
    necessarily all on board the aircraft, but provided, again, in
    a family of systems of context.
        Chairman Inouye. Mr. Secretary, General, thank you very
    much.
        The word efficiency has been used quite a bit today. When
    you do feel that you have realized this efficiency?

                          REALIZATION OF EFFICIENCIES

        Mr. Donley. Well, Mr. Chairman, the effort to identify
    lower priority programs and activities and to wring out greater
    productivity and efficiency in our organizations and how we
    manage our acquisition process and other dimensions, was a
    major focus for the Department of Defense, including the Air
    Force, at the end of last year. So the $33 billion that we have
    identified has been moved inside our future year defense
    program for over the next 5 years. So it is spread out over the
    5 years. We are tracking it in about 12 different categories,
    and each of those categories has a lead senior official, a
    general officer, or a Senior Executive Service (SES) senior
    civilian, who is tracking the progress of that work. And much
    of that work has already started. We are already down the track
    of restructuring our air operations centers, and we are in the
    process of making decisions on collapsing and combining some of
    our headquarters activities.
        The acquisition community has already booked in excess of
    $600 million in savings from tougher negotiations and smarter
    management of our acquisition programs. So these are--also fuel
    is a major issue for us. We have booked about $700 million in
    savings across the--on more efficient operational and
    infrastructure practices to get savings from fuel.
        Chairman Inouye. In bringing about this efficiency program,
    do you work together with other services because you are part
    of a team?
        Mr. Donley. We are working with other services. Sometimes
    we are taking best practices, if you will, from other services
    and bringing them over. In the case of, for example, the
    evolved expendable launch vehicle (EELV), we have worked
    carefully with the National Reconnaissance Office and NASA to
    get a stable investment--in that case, an investment rather
    than an efficiency, but to control costs and get a stable
    industrial base for the EELV program. So, that has been a focus
    of cross-agency work, to get the best value for the taxpayer
    across the full scope of government interaction with that
    contractor.
        Chairman Inouye. In describing the light attack on
    reconnaissance plane, you spoke of building partnership
    capacity. What do you mean by that?

                 BUILDING PARTNERSHIPS WITH EMERGING AIR FORCE

        General Schwartz. Mr. Chairman, many air forces we interact
    with can operate--have the sophistication and the resources to
    operate F-16 equivalent aircraft or C-17 equivalent aircraft.
    But the reality is, is that many nascent air forces around the
    world with whom we want to establish a relationship, that are
    strategically important, cannot afford and do not have the
    level of technical expertise yet to operate those kind of
    aircraft. And so, it is a recognition of that reality that we
    need to be able to interact with them with something that is
    not quite what we routinely operate in our own Air Force.
        And, therefore, both on the lift side and on the light
    strike side, we are proposing to field modest aircraft that
    will enable us, again, to train with and advance these nascent
    air forces in a more resource conservative way that can be
    sustained by these nations.
        And in the process, Mr. Chairman, what we do is not just
    airplane stuff, but this is really about the whole of what an
    air force does, from operating air fields, to having
    engineering capacity, to how you care medically for aviators
    and others, and air traffic control, and logistics. These are
    the things that enable an air force to fulfill national
    taskings, and this is what we are talking about when we address
    building partner capacity.
        Chairman Inouye. All right. Thank you very much. My time is
    up.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I am pleased to join you in
    thanking the leadership of the Air Force for the excellent job
    they are doing.
        And I wonder, is it a concern to you that we may be trying
    to do too much, given the current economic realities that have
    changed the price of fuel, the cost of operations, maybe
    realignment of foreign governments, resource allocations to its
    military forces? Is it time to sit back or step back and take a
    new look at our obligations that we are assuming and that we
    are asking you to perform, and say, hey, wait a minute, you
    know, we really need to start cutting back in some areas that
    have been perceived to be immune from cuts or sacrosanct for
    whatever reasons for morale. A pilot we know is not going to be
    interested in staying in the Air Force for a career if there is
    not going to be any flying hours, or if the equipment and
    material that they are given to use and operate is dangerous
    because of lack of repair and that kind of thing.
        Have we gotten to a point where we need to take a hard look
    at some of these huge dollar amount costs that are
    skyrocketing, and we are just keeping on flying right up into
    the ionosphere with them? I worry about that. Do you?

                    DIFFICULT RESOURCE ALLOCATION DECISIONS

        General Schwartz. We certainly do. In fact, all the chiefs
    do. And the commitment that each of us has made is that we are
    not going to follow the path that has occurred in the past
    where the forces became hollow, Senator Cochran. We would much
    prefer to be good--great, if you will--and smaller than to
    maintain our current size, if that is what is in the cards, and
    not be ready and not be capable. So if the resources require us
    to make these trades, as painful as they are, we prefer to
    remain the quality Air Force and the quality Army and the
    quality Marine Corps and Navy that the American people expect.
        Senator Cochran. Mr. Secretary?
        Mr. Donley. Well, sir, I think the President's national
    security strategy, the space strategy, other aspects of our
    work are effectively addressing the issues that you raise here,
    trying to balance internal commitments with overseas
    commitments, and really broadening the aperture for how we look
    at national security. We recognize in the Department of
    Defense, certainly in the counter insurgency operations that we
    have experienced in the USCENTCOM area of responsibility, that
    this is not just momentary work. There is whole of Government
    work that is required here where we require the commitment and
    the capabilities of other Government agencies and civilian
    expertise to help build capacity for self-government and
    economic sustainability in these challenged environments. So
    the military solution is not the only tool that we need to
    apply in these situations.
        I think we are also taking a broader look, and you see it
    in the President's policy with respect to Libya, toward
    coalition operations. Again, these complex political military
    situations we find ourselves in do not belong solely to the
    United States. They have a regional context. They have a global
    context that applies to our allies and partners in those
    affected regions, who need to be part of our work going
    forward. And so, I think you see that in the space policy as
    well, and I think you see a broadening perspective of how we
    need to work more closely with industries in the cyber field
    and also in reducing the cost of our acquisition process. I
    mean, it is getting major attention in DOD.
        Senator Cochran. At the time the budget request was
    submitted to Congress for the Air Force for the next fiscal
    year, we did not have the Mediterranean crisis on our hands and
    calling on us to supply airplanes and other defense forces to
    that region if we are called when needed. What is the impact on
    the budget of this situation in the Mediterranean right now?
    Have you had time to assess? Are you going to be submitting a
    supplemental request for the Congress to review any time soon?

                          OPERATION ODYSSEY DAWN COSTS

        General Schwartz. Sir, I can tell you that the current
    monetary investment is in the neighborhood of $50 million for
    the Air Force for what we have already done in terms of
    employment, and it is substantially higher than that, of
    course, for the entire DOD. I am not in a position to predict
    whether the administration will submit a supplemental request
    for operations in Libya.
        Senator Cochran. Mr. Secretary, what is your take on that?
        Mr. Donley. Well, the first thing we did was to start
    tracking the additional costs. We--again, we are in
    conversation with the DOD Comptroller, the Office of Management
    and Budget, and others on how these bills will be paid, and
    that is unresolved. But as the Chief indicated, the cost,
    depending on the expenditure of munitions, has been running for
    the Air Force roughly $4 million a day, so we are at the $50
    million point today. At the end of the 2-week--first 2 weeks,
    we will probably be in the $70 million range, and then we will
    have to assess, based on the changes in operational emphasis,
    which the President has announced and which are underway now in
    which coalition partners will take a stronger role on the
    strike side, and the U.S. Air Force and other parts of the U.S.
    military will provide--continue to provide much of the enabling
    capabilities underneath. As that stabilizes, then we will be
    able to see what sustaining costs would be going forward.
        Senator Cochran. Thank you, Mr. Chairman.
        Thank you very much.
        Chairman Inouye. Thank you.
        Senator Johnson.
        Senator Johnson. Thank you, Mr. Chairman.
        Secretary Donley and General Schwartz, thank you for being
    here today, and thank you for your service to this country.
        Secretary Donley, I appreciated speaking to you--with you
    in February about the proposed retirements of the B-1 fleet. At
    that time, you assured me that my staff and I would receive a
    detailed briefing in the coming weeks. Six weeks have passed.
    Can you tell me when we can expect a briefing?

                            B-1 FLEET MODERNIZATION

        Mr. Donley. Very soon, Senator. That work is coming to
    closure. The Chief and I have had preliminary briefs outlining
    how this will work.
        As you are aware, the B-1s are deployed, of course, at----
        Senator Johnson. Yeah.
        Mr. Donley [continuing]. Ellsworth, and also at Dyess Air
    Force Base, Texas and so we are working through the details of
    where those aircraft will come from. I can tell you, the
    solution will involve both bases, and it will be taking into
    account that the schoolhouse is at Dyess. It is not completely
    an apples-to-apples comparison in terms of how those
    adjustments are made. But we are working through the final
    stages of that and should have that ready for your staffs in
    the next week or two.
        Senator Johnson. Mr. Secretary, how has the Air Force
    determined that 60 aircraft will be enough to meet both current
    and future operational needs?
        Mr. Donley. Well, Senator, for the B-1 and for other
    aircraft in our fleet, this is a fleet management issue in
    terms of how much resources are available and what draw those
    fleets are making on our maintenance requirements going
    forward. And it is part, I think, of a pattern of managing a
    fleet across the Air Force. We have often in the past adjusted
    the size of the fleet by a few tails at a time to help provide
    the resources required to modernize the fleet, in this case, to
    upgrade some cockpit avionics for the B-1, make some other
    modifications, and also meet the increasing requirements for
    maintenance for this aircraft as well. So those are the factors
    that go into the sizing of----
        General Schwartz. Senator Johnson, I would only mention----
        Senator Johnson. Yeah. Yeah.
        General Schwartz [continuing]. That it is important to take
    the entire bomber fleet----
        Senator Johnson. Yeah.
        General Schwartz [continuing]. Into consideration when we
    address a question such as you asked, that it is the 60 or 66
    B-1s, but it is also the 76 B-52s. It's the 20----
        Senator Johnson. Yes.
        General Schwartz [continuing]. B-2s that we take into
    consideration in making that assessment.
        Senator Johnson. Yeah. Are efforts--Mr. Secretary, are
    efforts still on track for the MQ-9 squadron to arrive at
    Ellsworth Air Force Base in early 2012? Does the Air Force
    still estimate the assignment of about 280 personnel to
    Ellsworth to support this mission? General?
        General Schwartz. Yes. It is still on track. It would be
    about 280 folks. And, again, that particular unit is part of
    our growth path to 65 orbits of remotely piloted aircraft
    capability by 2013.
        Senator Johnson. General, the extended comment period for
    the Powder River Training Complex environmental impact
    statement ended on January 20, 2011. When does the Air Force
    anticipate issuing the final environmental impact statement on
    the proposed expansion of the training area?

                       POWDER RIVER TRAINING COMPLEX EIS

        General Schwartz. Senator, I do not have that right off the
    top of my head. With your permission, I would like to present
    that for the record.
        [The information follows:]

        The Air Force is preparing a Powder River Training Complex
    Environmental Impact Statement (EIS) for the expansion of the
    current Powder River Military Operations Area and Powder River
    Air Traffic Control Assigned Airspaces to help meet military
    flight training needs and enhance training capabilities in
    regions of South Dakota, North Dakota, Wyoming and Montana. A
    Federal Register Notice of Availability (NOA) for the Draft EIS
    was published on August 20, 2010. In response to a
    congressional request, the Air Force extended the public
    comment period beyond the required 45 days, from November 15,
    2010 to January 20, 2011.
        The EIS process is continuing to move forward with a target
    issuance of an NOA for the Final EIS in the first half of 2012.
    To issue the NOA, the Air Force is working to resolve all
    aeronautical issues identified by the Federal Aviation
    Administration (FAA) (a Cooperating Agency for this EIS) and to
    complete the consultation process for the National Historic
    Preservation Act (NHPA) and the Endangered Species Act. A
    mandatory 30-day waiting period will begin after the NOA for
    the Final EIS is published in the Federal Register after which
    the Air Force can sign a Record of Decision. The FAA has
    overall authority for charting new airspace and its own
    procedural requirements. The FAA will consider the Air Force
    decision and its own findings before making the final decision
    on the Powder River airspace proposal.

        Senator Johnson. Yeah. When the Air Force Financial
    Services Center was created, it was touted as a way to save
    money and promote efficiency. Now, just 5 years later, I
    understand the Air Force is proposing undoing many of those
    changes. Has the Air Force come to determine that those changes
    are necessary? Can you speak specifically as to what services
    will be sent back out to the bases, and what financial services
    will remain at Ellsworth Air Force Base? How many jobs, both
    military and civilian, will be impacted by those changes?

                      AIR FORCE FINANCIAL SERVICES CENTER

        Mr. Donley. Sir, we are working through the numbers that
    you refer to as part of our briefing to you in the next couple
    of weeks, which will include the B-1 adjustments you previously
    referenced.
        Our experience on the consolidation of financial services
    simply was that, with respect to military, I believe there were
    individual specific changes for each airman that would be more
    effectively accomplished, in terms of adjustments to their
    military pay, if we had personnel more closely connected to
    these airmen. And at the recommendation of our major commands,
    the financial management community made the decision to
    redistribute those folks from a centralized posture at
    Ellsworth Air Force Base, South Dakota back to the major
    commands. So that is the big picture for what is intended. We
    are working through the numbers, and you will get a full
    briefing on that in the next couple of weeks.
        General Schwartz. Senator, I would only add that that part
    of the reason this has occurred--sort of the head fake, if you
    will----
        Senator Johnson. Yeah.
        General Schwartz [continuing]. Is that the Enterprise
    Resource Planning System, that was supposed to underwrite
    this--it is the defense integrated military human resources
    system (DIMHRS)--never came to pass.
        Senator Johnson. Yeah.
        General Schwartz. And so, given the absence of that
    architecture, it became necessary to move back away from a
    centralized model to something more distributed.
        Senator Johnson. My time has expired. Thank you.
        Chairman Inouye. Thank you.
        Senator Coats.
        Senator Coats. Thank you, Mr. Chairman. Thank you,
    gentlemen, for your testimony here.
        I wonder if I could drill down and do a specific topic, and
    I am trying to get my knowledge base built on this alternative
    engine issue.
        The--I generally hold the principle view--foundational
    view--that competition generally results in a better product at
    a lower price over a period of time. And I have supported
    competition in systems on a number of occasions for that
    reason.
        However, we are in a unique time now relative to our
    deficit, our costs. We are stretched thin. You are stretched
    thin. You have to prioritize in ways perhaps you have not had
    to do in some time. And so, I am trying to get a handle on what
    potential--there have been a number of estimates--potential
    long-term savings would be over the life of the F-35 or the
    engine--the 135, 136--as compared to what the cost is going to
    be in the short term, and potentially how that savings--
    potential savings could be directed to either lowering the cost
    per copy of the plane--and I understand some allies are
    concerned and some others are concerned about the increasing
    cost per copy of that plane--or perhaps moved and shifted to
    some other higher priority. So can you help me a little bit
    better understand that, why that decision was made? I know it
    was made by the Department, but how--what the Air Force take on
    that is?

                     JOINT STRIKE FIGHTER ALTERNATE ENGINE

        Mr. Donley. Senator, I think you put your finger on it,
    that the Department's analysis of this issue at the highest
    level really was that the sure costs in the near term of
    funding a second engine were more clear than the long-term
    savings to the program, which were more murky. That economic
    analysis is down at the DOD level.
        There are, I think, two additional perspectives on this. I
    know General Schwartz can add to this as well. The Joint Strike
    Fighter Program, is our largest program, but it has had
    difficulty, and we have had to restructure that program twice
    in the last year. We think we are getting a better handle on
    it, but committing to a second engine in this program now would
    add to the cost of the Joint Strike Fighter Program even more.
    And we are reallocating dollars to get this program on track,
    so it would be yet another brick on top of the Joint Strike
    Fighter Program at a time where we are trying to get control
    over costs in that program.
        And finally, we like competition. We like the idea of
    having backups and backups to backups, and backups to backups
    in the Department of Defense. But in this fiscal environment,
    we need to make some tough choices about where to put marginal
    dollars. And in this case, we felt like the reliability that
    goes with modern engines compared to those of a generation or
    two ago justified this decision. Chief?
        General Schwartz. Sir, if I may just elaborate at the
    practical level. As the Secretary suggested, this is a question
    of balancing near term firm costs versus longer-term soft
    savings.
        But fundamentally, the question for us is, a second engine
    means a second supply chain. It means a second training
    pipeline. There are costs in manpower associated with that.
        The truth of the matter is that we operate a number of our
    aircraft with one engine. Now admittedly, it is not a single
    engine plane like the F-35, but the F-22 has one engine. The
    FA-18 EF has one engine. The big airplanes all have a single
    engine, although multiple engines on one machine. And so, the
    notion that there is inherent risk in this, based on our
    experience, we think that is manageable.
        Equally important is that the F135 is a descendant of the
    F119, which is in the F-22, and we have had pretty good
    experience with that. So, on balance, this is one of those
    close calls. I think the Secretary and I endorse the notion of
    competition, but the question is, what can we afford? And at
    the moment, the judgment is this is one of those things that we
    can pass on, sir.
        Senator Coats. Relative to the F-22, let me ask a question
    about their current activities in North Africa. We have been
    launching a lot of Tomahawks. Would it have been more cost
    effective to use the F-22? Could we have accomplished the same
    mission at lower cost? What is your take on that?

                      F-22 AND ACTIVITIES IN NORTH AFRICA

        General Schwartz. Senator, clearly had the F-22s been
    stationed in Europe, both closer in proximity and, therefore,
    more available, they undoubtedly would have been used. But as
    this came together fairly quickly, the judgment was made to
    apply the various tools that we have in our tool kit, as we
    did, using the resources that were in close proximity, both in
    Europe, in southern Europe, in the Mediterranean, and so on.
    So, the fact that the F-22 did not perform in this particular
    mission was not an ad hominem against that weapon system at
    all. It really was an expedient judgment with respect to
    putting the plan together, to executing on a very rapid time
    line, and so on.
        Mr. Donley. Just to amplify briefly as well, the F-22, of
    course, has some air-to-ground capability, but it is optimized
    for air-to-air engagements. So the air-to-ground capability is
    somewhat more limited than that of the F-15Es, for example,
    which were already available in Europe. And I would say, in
    terms of operational efficiency--and the Chief is more of an
    expert on this than I am--I would say one of the initial
    outcomes--very premature and still early in the Libya
    operation--has been just to reinforce the effectiveness and the
    efficiency of the bomber forces in environments, such as this,
    where they have been able to, with very few missions, drop lots
    of ordnance very accurately against multiple targets. The
    bomber force has proven to be very effective in this operation.
        Senator Coats. Mr. Chairman, I noticed that my time is
    running out. Let me just say at the end here, I like to
    associate myself with the remarks of Senator Cochran relative
    to the fiscal crunch that we are now in and the need to really
    establish priorities. The realities are that--and I am not
    picking on any one service here or even the Department of
    Defense. Everybody that's come before me personally relative to
    their program or appropriation request or in public here, I
    have basically made the same pitch, and that is, I think it is
    incumbent on all of us to, in a sense, think in terms of a plan
    B. What if we do not get the budget line that we think we need?
    And I know everything has been scrubbed, and efficiencies have
    been built in, and so forth, but even having said that, I think
    it is possible that we are not going to get the numbers we need
    in the future. And, so, therefore I think the prioritization
    of, you know, what is absolutely essential, what is very, very
    important, but not absolutely essential, what is important, but
    not very, very important, and on down the line is something
    that we need to look at. And I know the Department is looking
    at that, and it is unfortunate that we are in this situation,
    even when it comes to national security issues. I think the
    reality is we are going to have to make some of those tough
    decisions, and it really is going to be helpful if we are able
    to turn to each of the agencies and say, have you scrubbed this
    thing through and, because we cannot go here, but can go here,
    how do we do it? It is, I think, much better if you can present
    us with your plan as to how that can be best accomplished
    rather than having us try to make that determination. So I
    would just throw that out there as a two cents worth of counsel
    and advice in terms of what I think is coming down the line.
        Thanks, Mr. Chairman.
        Chairman Inouye. Thank you. Senator Hutchison.
        Senator Hutchison. Well, thank you very much, Mr. Chairman.
        And just following up on a couple of areas, one that
    Senator Coats was just mentioning. I mean, that is a
    realization that we all agree with. The F-35, you have said
    that they are performing satisfactorily, and yet you are
    cutting back on the production--57 aircraft over the next 5
    years. And that is going to raise the price of each model
    approximately $5 million per unit. So I just would ask in that
    context, is that saving money now, but paying the piper later?
    And what is your thinking on doing that?

                                F-35 PRODUCTION

        Mr. Donley. Well, Senator, the F-35 has a long history. It
    has been a very concurrent program from its origins, and a very
    aggressive program from its origins. Bringing on new
    technologies, even after the F-22's capabilities and experience
    from that program, additional capabilities into the F-35
    program. But a lot of concurrent development and planning for
    production that was a very high risk venture from the
    beginning.
        Senator Hutchison. Now are you talking about the vertical
    capability factor?
        Mr. Donley. The fact that we were building three variants
    at the same time. The fact that we had all our international
    partners in from the beginning is a good thing, but, again, a
    complicating factor. We had to invent new capabilities for the
    F-35 that had not been demonstrated previously in any other
    fighter platform. So, it had a number of challenges with it.
        And the last 2 or 3 years of this program, we have focused
    very carefully on balancing the continuation of development and
    the need to work the kinks out of the program--before we get
    too far up the production ramp. And that is really where we
    are, making that delicate transition from development to
    production, where both are going on at the same time.
        Senator Hutchison. So you are really experimenting
    continually, and that is why you are slowing down?
        Mr. Donley. We have stretched out the development and
    slowed down the production. We paid for the additional
    development by taking dollars from the plan for production and
    putting them into the development program. So that is where we
    have been the last couple of years.
        We have this year, I think, 32 Joint Strike Fighters across
    all the services proposed for this fiscal year 2012 budget. And
    we are building them at low rates, but they will not have all
    the capability that we want, so we do not want to build too
    many of those early.
        But we are committed to this program. There have been cost
    increases. There is no question we are very frustrated with
    this, but we are also very focused on how to wring the cost out
    of that program where we can. But we are committed to going
    forward with this program. Our Air Force is committed to this
    program, and so are about eight or nine other allied air forces
    as well. So, we are committed to completing this program and
    getting on with it.
        Senator Hutchison. Let me ask you on the B-1, you are
    cutting back, as was mentioned earlier, six of the aircraft.
    And yet it is certainly performing in Afghanistan on a
    continuing basis. You are saying that the savings in the out-
    years will be about $357 million. You will reinvest in
    modernization about $125 million. My question is, of course,
    are you thinking that that is enough modernization to get us to
    the mid-20s when you intend to start replacing? I am concerned
    that you are cutting back six, and then only modernizing at
    maybe a modest level. So what is the thinking there?

                            B-1 FLEET MODERNIZATION

        General Schwartz. Ma'am, your numbers are exactly right.
    And in 2012, we are talking about $67 million in savings to
    be--with about $32 million reinvested.
        What we are doing on the airplane is what we need to do--
    make improvements in the cockpit, communications, and so on. It
    is a good airplane, as you suggested. It is serving extremely
    well in Afghanistan in what essentially is a close air support
    role. It currently flew missions in Libya departing from
    Ellsworth Air Force Base, South Dakota, went all the way into
    theater, and has since returned.
        But our belief, again, based on that theme I mentioned
    earlier on quality is that this is a rational fleet management
    decision in order to maintain the remaining aircraft at the
    level of capability and reliability that we want for the next
    decade at least.
        Senator Hutchison. And--but the 6, when they are retired,
    are they going to be unable to be returned if you did need
    them?
        General Schwartz. Ma'am, we have not made that decision in
    terms of precisely what status it would have in the bone yard.
    There are different levels of maintaining aircraft. My hunch
    would be, given the financial situation we face, that it would
    be in long-term storage and not immediately recoverable.

            PREPARING/DELIVERING SPACE SHUTTLE ``ATLANTIS'' TO OHIO

        Senator Hutchison. Let me just ask you. I was interested
    and also somewhat concerned about a $14 million request for the
    Air Force budget for the preparation and delivery of the Space
    Shuttle Atlantis to the museum in Ohio. And I am concerned
    about that because presumably the administration says that they
    have not made a decision about those, and there are other
    places where the National Aeronautics and Space Administration
    has had a significant impact, including Houston, that very much
    wants to have something so significant to our history. And my
    question is, is that a subsidy that would give a preference to
    the Air Force and to Ohio, and is that warranted with this kind
    of a budget constraint? Secretary Donley, or either one of you.
        General Schwartz. Ma'am, I----
        Senator Hutchison. Whoever would like to take that ball.
        General Schwartz. I would just say that whoever gets these
    platforms will have to have certain expenses in terms of
    transporting them to their ultimate destination and preparing
    them for safe display in a non-operational mode. So that is
    what these dollars were intended to do. The dollars were in our
    budget request. We were planning ahead, and obviously we put
    the 2012 budget submission together last year in anticipation
    of a positive decision.
        I might just mention that with respect to the Atlantis,
    that platform has flown more dedicated DOD missions than any
    other space shuttle. Thirty-eight members of the various
    services flew on the Atlantis, so it has some legacy with
    respect to DOD.
        Senator Hutchison. I understand that totally. I mean, and I
    relate to that. I think there are several areas that have
    legacy claims. I think you are one. I just hope that there is
    not a decision that puts it ahead of legacies in basically
    Florida, Houston, and California. I mean, there--I wish there
    were four or five that we could split up, but I was concerned
    that there might be an advantage already in place, and I hope
    that is not the case.
        Thank you.
        Chairman Inouye. Thank you.
        Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.
        General and Mr. Secretary, thank you for your testimony
    this morning, and thank you for your service. Appreciate it.
        Talking a little bit about energy this morning, and the
    President is going to be speaking to that just about now, I
    guess, and our energy policy. I know that within the Air Force,
    it is my understanding now that about 99 percent of the Air
    Force fleet is certified for the Fisher-Tropsch process using
    either coal to liquids or gas to liquids technology. I think
    that that is--that is a good move, that it is positive. We
    certainly encourage that.
        Back in the 2009 the Defense appropriations bill, the Air
    Force was directed to conduct a study on a coal to liquids
    plant up in Eielson Air Force Base, Alaska. And we have had
    conversation in previous subcommittee hearings about the status
    of that study and the monies that were spent.

                           COAL TO LIQUIDS TECHNOLOGY

        The question that I have to you gentlemen this morning is,
    give me a little bit more of an update in terms of where you
    feel the Air Force is going with regard to the development of
    alternative fuel sources, and particularly in relation to our
    Alaska facilities. Our Alaska bases, as you know, we have got
    incredible coal supplies, incredible natural gas supplies. I
    happen to think that we could be the fueling station for the
    country in many regards.
        I would also like a little bit of an update in terms of
    where the $10 million kind of went in terms of studying that
    feasibility on the coal to liquids plant at Eielson Air Force
    Base, Alaska. So, if you could give me an update on that, and
    then kind of project out a little, if you will.
        Mr. Donley. Sure. We have expended the $10 million. It was
    divided into basically two halves. Part of that went to the
    Patel Corporation. I think the University of Alaska, if I'm not
    mistaken. Part of the money was spent to investigate the
    feasibility of the basic technology and the work at Eielson,
    and then part of it went to the site survey work at that
    location. I do not have a specific outcome of that for you. I
    can provide that----
        Senator Murkowski. That would be appreciated.
        Mr. Donley [continuing]. For the record.
        Senator Murkowski. Thank you.
        [The information follows:]

        The Air Force is interested in environmentally friendly,
    domestically produced and cost competitive alternative aviation
    fuels to enhance its energy security posture through diverse
    fuel sources. In support of this, the Air Force conducted
    several analyses to study viability of a coal-to-liquid plant
    at Eielson Air Force Base in Alaska using funds authorized by
    Congress ($5 million for operations and maintenance; $5 million
    for research, development, testing and evaluation).
        The $5 million in operations and maintenance funds was used
    by the Air Force, led by the Air Force Real Property Agency, to
    complete a mission impact analysis and a business case analysis
    in August 2010. The mission impact analysis determined there
    would be minimal impact to operational and support missions.
    However, the business case analysis concluded that development
    of coal-to-liquid production facility was not feasible due to
    high capital costs, limited local market for fuels, low crude
    oil prices (less than $99/barrel), uncertainty in carbon
    requirements and sequestration, and availability of government
    loan guarantees to secure lower financing costs.
        The $5 million in research, development, testing and
    evaluation funds was used by the Air Force, led by the Air
    Force Research Laboratory, to complete a scientific survey and
    a technical analysis. Both technical reports are currently
    under review and thus have not been publically released. The
    scientific survey, which was done by the Alaska Center for
    Energy and Power at the University of Alaska, Fairbanks,
    assessed options for geologic sequestration, biological
    sequestration, and other carbon management and disposal
    options. The initial analyses do not identify any engineering
    issues; however, the lack of technical maturity adds high
    project risk.
        The technical analysis performed by the Air Force Research
    Laboratory in February 2011, preliminarily found that, although
    the project is technically feasible, there are a number of
    significant concerns with implementation. These concerns
    include the disposal of generated waste (i.e., slag, coal ash,
    and sulfur); major environmental issues (i.e., PM2.5 emissions,
    ice fog formation, and effects on local hydrology, particularly
    ground water); transportation impacts; air emission permitting;
    and a chemical process hazard subject to the Department of
    Homeland Security's chemical security requirement.

        Mr. Donley. At the larger level, obviously we are a primary
    consumer of energy. We are very interested in having developed
    alternative sources of energy, whether it be coal to liquid,
    gas to liquid, biomass, or other renewables, both for our
    flying operations and our installations as well. But we do not
    see ourselves as a manufacturer or a provider, so we are very
    interested in working with the rest of the Department of
    Defense and with the Department of Energy to sort through what
    the optimal aviation fuel blends will be for the future--which
    of those will--are not just scientifically feasible, but which
    are most economically viable and sustainable going forward.
        Senator Murkowski. Are you sorting that through now?
        Mr. Donley. Those discussions are being undertaken at the
    DOE and DOD level. It is not an Air Force decision. And the
    aviation industry is part of this as well going forward. But
    not all of that work has gelled yet. As you indicated, we
    certified our engines for alternative sources, so we have
    confidence that we can fly our airplanes with these alternative
    fuels. So, that work is largely complete. The issue now in
    front of us is where will alternative fuels come from, and
    which will be the most economically viable. But we are ready to
    buy them, and especially if they will be available at
    competitive economic prices.
        Senator Murkowski. Well, I think we would be interested in
    perhaps learning a little bit more as you sort through where
    you feel not only the most economic, but really in terms of
    greatest efficiencies and performance needs, because, again, we
    have got a little bit of everything up there. But we need that
    customer, and happy to be working with the Air Force--with the
    military to advance this.

                             PACIFIC RANGE COMPLEX

        General Schwartz, I wanted to ask you just very quickly,
    your comments on the proposed enhancements to the Joint Alaska
    Pacific Range Complex. In my visit to Afghanistan, as we were
    doing the fly over, looking down over so many parts of that
    country, it sure reminded me of home. And your time in Alaska
    and your opportunity to fly over our ranges, and I am sure you,
    too, have noted the comparison of the extreme open spaces and
    big mountains and lots of snow.
        The question that I have, as we look to the various
    proposals that are out there to modernize the Alaska Range
    Complex--we have got an environmental study that is underway
    right now--can you comment on the proposed enhancements--the
    value of these to the Joint War Fighter, the additional
    capabilities that would be provided?
        General Schwartz. Clearly, you know, Alaska is unique and
    the Pacific Range Complex is a unique installation, both in
    terms of its scope, the air space available, the land ranges
    beneath, and so on. At the moment, we have five exercises a
    year, three of which are known as Red Flag Alaska, and two of
    which are Joint Chiefs of Staff sponsored exercises yearly.
    That tempo we expect to remain at least at that level. And so,
    this is, along with just a handful of other ranges in the lower
    48, this is a very important place that we, as a joint team,
    will continue to utilize in the years ahead. There is no doubt
    about that.
        And so, the study that you referred to, in terms of the
    improvements, is not yet final, and that certainly will inform
    decisions as we go forward. But I think the key thing is there
    is not another location that has the combination of land and
    air space that the Pacific Range Complex does.
        Senator Murkowski. Well, as you indicated, that study is
    still underway. There have been issues that have been raised
    within the State about the proposed expansion. I think it is
    fair to say, though, that Alaskans--the Alaskan civilian
    community wants to work with the Air Force, with our military
    community, as we provide this incredible training range to the
    Nation.
        With that, I thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Collins.
        Senator Collins. Thank you, Mr. Chairman.
        I want to begin my questioning by just making two comments.
        First, and I know the chairman and the vice chairman share
    this concern, I am increasingly worried about the impact not
    only on the Air Force, but on the entire Department, of the
    Pentagon having to operate under short-term continuing
    resolutions. At a time when we are involved in three wars, I
    just think it is an irresponsible situation, and we have got to
    get the work done on the budget. If it cannot be done, then I
    really hope that we will move the DOD appropriations bill
    separately and to get that done, because I know it is creating
    very real problems. And ironically, it is going to end up
    increasing costs in the long term if you are having to put out
    stop orders, and disrupting the supply chain, and juggling your
    accounts. We are going to end up paying more.
        So, I just--I realize I sound like a Johnny one note on
    this issue, but I feel so strongly about it.
        Second, I do want to take a moment to recognize and thank
    all the Air Force personnel who have been so involved in the
    military operations in Libya. Regardless of my individual view
    on whether that is a wise operation or not, there is no doubt
    that as usual our military has operated superbly. And I know
    that the Air National Guard Air Refueling Wing in Bangor,
    Maine, where I live, has been playing a supporting role by
    refueling aircraft en route to supporting the North Atlantic
    Treaty Organization (NATO) operation and the efforts in Libya.
    So, I just want to express my thanks to the men and women of
    the Air Force as they are involved in this mission.
        Mr. Secretary, the chairman asked you about the
    efficiencies that the Air Force had identified, and you
    indicated fuel savings would be part of those efficiencies, and
    Senator Murkowski also sort of followed up in that area as
    well. The Comptroller of the Pentagon has indicated that the
    increase in oil prices is increasing the cost of fuel, and that
    is a potentially very serious problem for the Pentagon. And
    obviously, the Air Force is particularly affected when there
    are increases in oil prices.

                   STRATEGIC BASING PROCESS FOR KC-46A TANKER

        I understand that the Air Force is currently in the
    strategic basing process to select the locations for basing the
    first KC-46A aircraft. Earlier this year, I wrote to you
    encouraging the Air Force to consider the proximity of
    candidate bases to operational air refueling tracks. And to me,
    this makes all the sense in the world because it minimizes the
    fuel that is consumed in the time that it takes to fly from the
    home base to the point where the aircraft are actually
    refueled. And in learning more about this, because of the
    critical role that the Air National Guard base in Bangor has
    been playing with our operations in Afghanistan, Iraq, any
    overseas operations, I learned that taxpayers pay about $85 per
    minute in fuel costs alone for the current tanker in our fleet.
        My question is to you, Mr. Secretary, where--will these
    real world operational costs, such as the distances to
    operational refueling tracks, be considered in the basing
    criteria?
        Mr. Donley. Senator, we are still working through the
    criteria. We have not settled on them yet. General Schwartz and
    I will be reviewing those probably in the summer timeframe.
    This work is scheduled to get underway to the back half of this
    calendar year.
        First of all, we will want to take advantage of and
    understand completely the new capabilities that will be
    available through the KC-46, and take into account the
    operational improvements that come with that. We will be
    looking at obviously the Air Force operational requirements
    across the United States and elsewhere, but also the Combatant
    Commanders' requirements in various regional contingencies.
    That is our starting point at this point in time. We have not
    zeroed down beyond that.
        I would say that the current KC-135 fleet is in excess of
    400 aircraft. This initial KC-46--the KC-46 buy is 179
    aircraft, and it is going to take the better part of 12 years
    roughly to buy those 179 aircraft. So we are not going to make
    the beddown decisions on the KC-46 in advance of need. We need
    to let the time unfold as those tankers are being delivered,
    make sure we make the decisions in advance of but not too far
    in advance of need.
        So, just as a reminder, there are many bases that want to
    be the first in the Air Force to get the KC-46, but there will
    be 179 of them, and hopefully modernized tankers beyond that.
    We will be taking the kinds of issues that you raised into
    consideration.
        Senator Collins. General.
        General Schwartz. If you would allow me just to brag on the
    Air National Guard a little bit, the wing that is flying in
    support of Libya out of Moron, Spain is led by an Air National
    Guard colonel from the Pittsburgh unit, and aircraft from
    Bangor are there as well. So, I think the key thing is here
    that the Air National Guard has been all in, and we certainly
    salute that.
        Senator Collins. Absolutely. They have been absolutely
    critical, and that base in Bangor is much busier than many
    active duty bases, in fact, in its refueling mission.
        Just a very quick follow-up. There have been reports that
    can be read to suggest that you have already made tentative
    decisions to select 11 bases. That has appeared twice. If you
    have not settled on the criteria, then I assume that those
    reports are not accurate. General Schwartz.
        General Schwartz. They are not accurate. What happened was
    in order to run the competition for source selection of the KC-
    46, we had to have representative bases to look at in order to
    do the bed down analysis. And there were 11 bases, nine United
    States and two overseas. That was not presumptive in terms of
    what the actual bed down would be, as the Secretary suggested,
    in the years ahead, not presumptive at all.
        Senator Collins. Thank you.
        Thank you, Mr. Chairman.

                         ADDITIONAL COMMITTEE QUESTIONS

        Chairman Inouye. All right. Thank you very much. The vice
    chairman and I will be submitting questions for your
    consideration. And we thank you for your testimony this
    morning.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
                    Questions Submitted to Michael B. Donley
                Questions Submitted by Chairman Daniel K. Inouye
              affordability of air force recapitalization strategy
        Question. Secretary Donley, over the next several years the Air
    Force is planning to recapitalize portions of its fighter, tanker,
    bomber, and helicopter fleets which will cost billions of dollars per
    year. Given the current budgetary environment, how does the Air Force
    plan to afford all of these programs simultaneously?
        Answer. Based on strategic and fiscal guidance, the Air Force
    Corporate Structure develops a Program Objective Memorandum (POM) that
    achieves the right balance of resources between providing capabilities
    for today's commitments and posturing for future challenges. During
    Corporate Structure deliberations, savings through efficiencies, cost
    growth issues, and program phasing and quantities are thoroughly
    reviewed to ensure the resources allocated to Air Force operations and
    capabilities investment are optimized to the greatest extent practical.
    Using this process, we intend to maximize use of every dollar in the
    fiscal year 2012 PB through prioritizing our requirements to meet
    strategic guidance, force structure management, and resource
    management. Strategic resource management will include evaluation of
    our investment in existing fleets during transition to maintain the Air
    Force operational capability. As resources are further constrained,
    more difficult decisions will be required.
        Question. Secretary Donley, which recapitalization program has the
    largest risk of cost overruns and what is the Air Force doing to
    mitigate those issues?
        Answer. The F-35 program, in particular, has seen significant cost
    growth due to a multitude of reasons, as discussed and examined in many
    forums. Going forward, the Air Force believes the F-35 program is on
    solid ground, with realistic development and production goals and a
    significant reduction in concurrency, as a result of the recent
    Technical Baseline Review. Also, the Government awarded a fixed price
    contract for the fourth low rate initial production lot (LRIP Lot 4) on
    November 19, 2010. This is the first fixed price production contract
    for the program, and it occurred 2 years earlier than envisioned in the
    acquisition strategy. With regard to engine affordability, the F-35
    engine Joint Assessment Team (JAT) investigated F135 propulsion costs
    in 2010 and provided a should cost objective. The propulsion team is in
    the process of implementing the JAT recommendations with a focus in the
    coming year to ensure we make the necessary investments to achieve F135
    cost reduction goals.
        The Air Force is committed to reducing the risk of cost overruns in
    this and other recapitalization programs using techniques we are
    applying across the force; by improvements in our program management
    processes, including cost estimation, contracting, and acquisition
    strategies that emphasize competition and using proven technology when
    possible.
        One key step to avoiding an overrun in the future is to start with
    an accurate estimate up front. The Air Force has made a concerted
    effort to utilized Fixed-Price and Fixed-Price Incentive Firm Target
    type contracts whenever possible and at the earliest phases of a
    program to stabilize costs. These incentives encourage contractor
    innovation to bring programs in below target cost by sharing those
    savings with the contractor.
        The Air Force is also focused on managing the cost of our
    acquisition programs with continuing efforts to manage technology
    maturation and transfer to development, understand and reduce overhead
    costs, negotiate better prices, and execute more economical and
    efficient production rates.
        The KC-46A and the helicopter recapitalization programs will use
    competitively selected non-developmental aircraft platforms as their
    foundations, thus avoiding the large cost uncertainty of development
    and testing of a new platform.
                              healthcare proposals
        Question. Secretary Donley, the increases in co-pays have been
    proposed previously. Could you explain how these proposals are
    different and why they should be reconsidered by Congress at this time?
        Answer. The TRICARE Prime enrollment fee was established in 1995
    and set at $230/$460 for individuals/families. This fee has not changed
    in 16 years. Enrollees who pay this fee subsequently pay no TRICARE
    deductible (reducing the effective cost of enrollment to $80/$160 per
    year). The expectation had always been to raise the enrollment fee on a
    periodic basis, but this has never happened. In 2005, DOD attempted to
    increase the TRICARE enrollment fee by approximately 300 percent over 3
    years to again have some parity with civilian health premiums. This
    proposal was met by significant resistance from beneficiary
    organizations, and Congress ultimately decided the increase was too
    severe and prohibited any increase in TRICARE Prime enrollment fees.
    Having learned lessons from the previous attempts at increasing TRICARE
    enrollment fees, and out of genuine concern to not introduce unexpected
    and steep hikes in out-of-pocket costs, the Department has put forward
    the most modest fee increase possible ($2.50 or $5/month for
    individuals/families). The proposal indexes any future enrollment fees
    to a medical inflation rate, thereby moving to a regular and gradual
    increase from year to year, and also excludes from fee increase the
    following special populations of retirees: survivors (regardless of
    when or how the service member died), and medically retired military
    members and their families.
        We believe this proposal represents a fair and responsible increase
    in TRICARE Prime enrollment fees, and provides a balanced approach to
    managing the escalating healthcare costs of our Military Health System
    while ensuring we continue to provide the best healthcare in the world
    for our warriors and their families.
                remotely piloted aircraft personnel requirements
        Question. Secretary Donley, the Air Force has quickly expanded its
    unmanned aerial vehicle missions in the past few years.
        How is the Air Force doing in meeting the requirement for pilots
    for these Remotely Piloted Aircraft (RPA)?
        Answer. The Air Force is training at maximum capacity and has
    enough pilots to meet the current RPA requirement. Due to increased
    operational demands, the Air Force continues to operate MQ-1 and MQ-9
    aircraft at surge manning levels. As the operations tempo slows, pilot
    production will enable the Air Force to begin normalizing RPA pilot
    manning levels.
        Question. With the information being generated from this increase
    in Remotely Piloted Aircraft patrols, does the Air Force have enough
    personnel to process the additional data?
        Answer. Yes. The Air Force has planned, programmed, and is fielding
    the requisite number of analysts to support the RPA mission growth
    through streamlined operations. Using streamlined crewing procedures,
    Air Force Distributed Common Ground System (DCGS) analysts are aligned
    against the highest priority intelligence requirements to address the
    exponential increase in ISR demand. Due to the training lead times,
    much of the programmed manpower increases in Air Force DCGS have not
    yet reached the field, but the Air National Guard, through volunteerism
    at its Air Force DCGS sites, has surged to help mitigate any current
    shortfalls. Additionally, the Air Force is taking steps to maximize the
    analytical effectiveness of our ISR force by (1) partnering with
    National Geospatial-Intelligence Agency, Air Force Research
    Laboratories, Defense Advanced Research Projects Agency, and industry
    to find and integrate automated target cueing and exploitation tools;
    and (2) federating mission exploitation with other military Services
    and Coalition partners.
                         satellite acquisition strategy
        Question. Over the years, the Air Force has struggled with many of
    its satellite acquisition programs, with schedule delays measured in
    years, and cost overruns measured in the billions. The budget includes
    a proposal to bring satellite costs under control through incremental
    funding and $3.2 billion in advance appropriations for fiscal years
    2013 through 2017.
        Secretary Donley, what other options did the Air Force consider to
    control satellite costs? How much will the Air Force save under this
    strategy, and when do you expect those savings to start?
        Answer. The Air Force is proposing the Evolutionary Acquisition for
    Space Efficiency (EASE) approach to address some of the cost and
    schedule difficulties experienced in satellite acquisition. Over the
    past several Program review cycles, as many of our complex satellite
    systems have begun transitioning from development to production
    programs, we have been struggling with how to most affordably procure
    these systems under our current policies and procedures. We have tried
    and employed several methods and strategies including: buying on need;
    inducing production pauses to spread funding requirements; stretching
    Advanced procurement limits in both dollar limits and number of years;
    breaking out components of cost from the full funding requirements
    (e.g. Government Support and launch operations). Unfortunately, none of
    these options could address the bottom line of overall efficiency and
    affordability to these systems, and instead often created more
    inefficient behavior in order to balance budget issues. OSD-CAPE has
    collected and analyzed comprehensive satellite development and
    procurement data on both unclassified and classified programs over the
    past several years. The EASE strategy incorporates the cost
    efficiencies demonstrated in block buying of large satellite systems,
    within the constrained budgetary environment. The Air Force envisions
    implementing the EASE concept to drive down costs, improve stability in
    the fragile space industrial base, invest in technology that will lower
    risk for future programs, and achieve efficiencies through block buys
    of satellites.
        The satellite unit cost savings gained from this strategy will vary
    by program. The estimated savings for the Advanced Extremely High
    Frequency (AEHF) block buy in fiscal year 2012 is greater than 10
    percent but is contingent on contract negotiations. Through aggressive
    negotiations with the contractor, the Air Force will work to achieve
    the best possible savings for the taxpayer at AEHF contract award in
    fiscal year 2012. Savings realized through block buys will be
    reinvested in research and development for technology enhancement to
    advance mission area capabilities.
                            air force role in libya
        Question. Secretary Donley, now that there is an agreement that
    NATO will assume command and control responsibility for the no-fly zone
    over Libya and that the role of the U.S. forces is projected to
    decline, do you have a cost estimate for the Air Force operations to
    date and the anticipated costs to continue this level of support to
    coalition forces?
        Answer. The Air Force's costs for the first 14 days of operations
    were $75 million, or $5.4 million per day. With NATO assuming command
    and control responsibility for the no-fly zone over Libya, the
    projected costs will decrease to approximately $1.1 million per day. If
    operations continue through the fiscal year, the Air Force's estimate
    is an additional $199 million, bringing the total to $275 million for
    the entire operation. If the cost to replace munitions is included,
    this estimate would increase by $48 million, to $323 million.
                                     ______

                Questions Submitted by Senator Dianne Feinstein
                large military aircraft defense industrial base
        Question. The ability of the U.S. industrial base to support the
    production of large military aircraft is a growing concern. Today C-17
    production shutdown is imminent. A former Commander of Air Mobility
    Command testified before Congress that, I would like to see the C-17
    line stay open, because it's our only insurance policy right now if
    anything else goes wrong or if there's another development that we need
    to look at. Instead of preserving the insurance policy and the
    industrial base, we are conducting a study of how to store the tooling
    for potential future use. A restart of this production capability in
    the future would cost billions.
        How are we going to protect our vitally important strategic airlift
    capability and maintain America's current leadership in the area of
    producing large military aircraft?
        Answer. The Air Force is conducting a major Aircraft Industrial
    Base study that is expected to complete in the summer of 2011 and
    results from this study should help inform Air Force decisions
    impacting the industrial base. The Air Force is concerned with
    maintaining and enhancing its ability to perform all 12 of its Core
    Functions to include rapid global mobility. We depend on the industrial
    base to design, develop, produce, and sustain the components and
    systems used to perform these Core Functions; however, the simple
    reality is our leadership, in any of these functions, comes with a
    price tag. In the current fiscal planning environment, it is clear the
    Air Force must take a very critical look at its processes and programs
    to improve efficiencies and increase our internal multipliers. The
    results of these analyses will be reflected in future budget requests;
    however, it is imperative that our investment decisions provide the
    capabilities the Air Force needs to continue to fly, fight, and win in
    air, space, and cyber.
        Question. What are you doing to maintain the U.S. industrial base
    and ensure our Nation retains its technology and capability edge in
    supporting and winning future wars?
        Answer. The Air Force is concerned about the current and projected
    state of the domestic industrial base, particularly with respect to its
    capabilities to support emerging Air Force requirements across the
    three Air Force domains air, space, and cyber. We recognize that
    today's fiscal realities will drive some very difficult budget choices.
    In that regard, it becomes even more critical for the Air Force to make
    data-driven investment decisions whether on research, engineering
    design and development, sustainment, or weapon systems upgrades. The
    Air Force is working with the Office of the Secretary of Defense as it
    leads a sector-by sector, tier-by-tier review of the current network of
    the Department's suppliers. We expect this initial review, and
    subsequent updates, to provide all of the Department of Defense with a
    shared view of how the industrial base segments interface to support
    each of our capabilities. With this knowledge of the industrial base,
    the Air Force will be better informed so that our investment decisions
    can preserve the critical domestic industrial base capabilities needed
    for the Air Force to continue to fly, fight, and win in air, space, and
    cyber.
        Question. What alternatives do you see for future airlift
    production if the C-17 production line shuts it doors and closes?
        Answer. The United States has a diverse aerospace industrial base
    with sales in 2010 of over $200 billion as reported by the Aerospace
    Industries Association [Source: AIA, 2010 Year-end Review and Forecast,
    accessed at: http://www.aia-aerospace.org/assets/YE_Analysis.pdf on
    April 8, 2011]. While aircraft designed and produced to enable the Air
    Force to perform our rapid global mobility Core Function do differ from
    their commercial cousins, there are commonalties in areas such as
    avionics, propulsion, environmental controls, and others. In the past,
    the Air Force has leveraged both the intellectual and physical assets
    of the commercial aerospace industry and we expect to do so in the
    future. In those areas needed to provide military-unique capabilities,
    the Air Force uses its research and development programs to grow those
    capabilities.
        Question. Is modernizing the C-5 fleet the most cost effective
    means of meeting the U.S. military's strategic airlift requirements?
        Answer. During the C-5 Reliability Enhancement and Re-engining
    Program (RERP) Nunn-McCurdy certification process, the Department
    examined several alternatives for meeting strategic airlift
    requirements. In the final analysis, a restructured C-5 RERP (or C-5M)
    effort of 52 aircraft was certified as the least costly alternative to
    meet strategic airlift requirements. Subsequently, the Mobility
    Capability and Requirements Study 2016 (MCRS-16) demonstrated that a
    strategic airlift fleet with the capacity to provide 32.7 million ton
    miles/day (MTMs/D) was sufficient to satisfy the most demanding case in
    the study. The programmed fleet with a mix of 222 C-17s, 52 modernized
    C-5Ms, and 59 legacy C-5As provided MTMs/D in excess of the 32.7 MTM/D
    requirement. It is not cost effective for the Air Force to maintain
    aircraft in excess of requirements; therefore, a plan to retire 32
    excess C-5A aircraft will be executed assuming fiscal year 2010
    National Defense Authorization Act fleet limits are lifted by Congress.
                             helicopter acquisition
        Question. I understand that the Air Force is planning to replace
    their Combat Search and Rescue helicopters with an upgraded version of
    the HH-60 they are currently flying. I am also told that the Air Force
    plans to replace the UH-1 Huey's currently being used for force
    protection at the ICBM fields and for transport of government officials
    in the event of an emergency in Washington, DC with the Common Vertical
    Lift Support Platform (CVLSP). There seems to be a disconnect in the
    Air Force message regarding the sourcing of this helicopter. In
    February, Lieutenant General Jim Kowalski of the Air Force Global
    Strike Command told reporters he wanted to avoid competition while last
    week, Secretary Donley told the Senate Armed Services Committee that he
    is ``absolutely sure competition will be involved''.
        What is the Air Forces plan for sourcing the Common Vertical Lift
    Support Platform?
        Answer. General Schwartz and I approved proceeding with the Common
    Vertical Lift Support Platform acquisition program based on a full and
    open competition and contract award in fiscal year 2012 leading to an
    initial operational capability in fiscal year 2015. Following an
    Acquisition Strategy Panel in the third quarter of fiscal year 2011, we
    anticipate release of a request for proposal in the fourth quarter of
    fiscal year 2011 for a Non-Developmental Item/Off-The-Shelf solution to
    program requirements. Source selection will be conducted in fiscal year
    2012.
        Question. Will there be a competitive process or will the Air Force
    choose from a platform currently in production?
        Answer. The Common Vertical Lift Support Platform program will
    award a contract on the basis of a full and open competition. However,
    we anticipate the request for proposal to solicit a non-developmental,
    off-the-shelf solution to the meet the warfighters' requirements.
      increased intelligence surveillance and reconnaissance capabilities
        Question. I was pleased to hear this month that the final decision
    was made to base MC-12 Liberty aircraft at Beale Air Force Base in
    California. I understand that the MC-12 has been very successful in
    Iraq and Afghanistan and we are proud to host them. Over the years, the
    success of our manned and unmanned intelligence, surveillance, and
    reconnaissance systems has been well documented. There seems to be an
    insatiable need for the information that these assets provide. In the
    fiscal year 2012 budget, the Air Force wants to procure 48 MQ-9 Reaper
    unmanned aerial systems and 3 RQ-4 Global Hawk systems. With this
    increase in platforms, there will be in increase in the amount of
    information available that will need to be processed and analyzed.
        The intelligence professional force is already stretched thin, do
    you have enough personnel to support the increase in platforms both
    operationally and to exploit the intelligence?
        Answer. The Air Force is extremely proud of California's
    longstanding support for all of our intelligence, surveillance, and
    reconnaissance (ISR) assets and personnel that are hosted at Beale AFB,
    California, a relationship that I hope will continue to flourish after
    the MC-12W Liberty fleet arrives. The concern over the ability of our
    analysts to analyze the amount of data being produced by a variety of
    new ISR platforms and sensors is certainly a valid one; however, I
    believe the Air Force has planned, programmed, and is fielding the
    requisite number of analysts in order to support ongoing mission
    requirements. The Air Force is taking steps to maximize the analytical
    effectiveness of our ISR force by (1) partnering with the National
    Geospatial-Intelligence Agency, Air Force Research Laboratories,
    Defense Advanced Research Projects Agency, and industry to find and
    integrate automated target cueing and exploitation tools; and (2)
    federating mission exploitation with other military Services and
    Coalition partners.
                                     ______

                  Questions Submitted by Senator Patty Murray
                              kc-46a clear winner
        Question. The words ``the clear winner'' were used when referring
    to the Air Forces selection of Boeing to build the new tanker aircraft.
    Can you elaborate on how the decision was made and what aspects of
    their bid delineated them as the clear winner, including value and
    cost?
        Answer. In accordance with Section M of the Request for Proposal,
    Boeing was rated acceptable for all subfactors in Mission Capability,
    Factor 1. Additionally, the difference between the Total Evaluated
    Prices in present value terms of the offerors was greater than 1
    percent, yielding substantial savings. The Total Evaluated Price (TEP)
    is the sum of the Total Proposal Price (TPP), Integrated Fleet Aerial
    Refueling Assessment (IFARA) Fleet Effectiveness adjustment, military
    construction adjustment, and Fuel Burn adjustment.
        Boeing was considered the clear winner because the TEP was more
    than 1 percent less than their competitors. In the overall source
    selection strategy, had both offerors' TEPs been within 1 percent of
    each other, the score of the non-mandatory capabilities would have been
    used to determine the winner. This was not the case as Boeing's TEP was
    more than 1 percent lower than their competitor's. Consequently, they
    were considered the ``clear'' winner.
                                kc-46a timeline
        Question. What is the current timeline for the KC-46A Tanker
    Program?
        Answer. The contract for the KC-46A was awarded to Boeing on
    February 24, 2011. The Engineering Manufacturing Development (EMD)
    contract includes 4 RDT&E aircraft that will be converted after testing
    is complete into production representative aircraft. The initial flight
    of the KC-46A aircraft is scheduled for late calendar year 2014. By
    fourth quarter fiscal year 2017, the Air Force will have 18 operational
    aircraft. The KC-46 Program is working toward a late August Integrated
    Baseline Review (IBR) that will generate a Program Management Baseline
    (PMB). This Baseline may result in an overall schedule adjustment,
    although that is not anticipated.
                             kc-46a basing process
        Question. What is the status of the KC-46A Tanker basing process
    and what is the timeline for the decisionmaking process?
        Answer. The Air Force is using its Strategic Basing Process to
    determine the future locations for the KC-46A. Our Strategic Basing
    process uses criteria-based analysis and the application of military
    judgment, linking mission and Combatant Commander requirements to
    installation attributes to identify locations that are best suited to
    support any given mission. The results of this analysis will be used to
    inform the basing decisions made by General Schwartz and me.
        In support of KC-46A basing decisions, Air Mobility Command (AMC)
    is developing basing criteria in a way that best quantifies both
    operational and support requirements related to KC-46A basing from a
    Total Force perspective. After the criteria are finalized and approved
    later this year, a briefing will be made available to interested
    Members of Congress and their staffs. AMC will then evaluate all Air
    Force installations against the criteria in an Enterprise-wide Look, to
    identify candidate bases.
        After the release of the candidate bases list, Air Force site
    survey teams will conduct detailed, on-the-ground, evaluations at each
    candidate location covering a range of operational and facility issues.
    The results of the site surveys will be briefed to General Schwartz and
    I, and we will then select the preferred and reasonable alternatives
    for beddown locations.
        Once the preferred and reasonable alternatives are identified,
    environmental analysis will be conducted in accordance with the
    National Environmental Policy Act. The site location decision will
    become final after the Environmental Impact Analysis Process is
    completed.
                       kc-46a milestone in basing process
        Question. When is the next milestone in this basing decision?
        Answer. The Air Force is using its Strategic Basing Process to
    determine the future locations for the KC-46A. Our Strategic Basing
    process uses criteria-based analysis and the application of military
    judgment, linking mission and Combatant Commander requirements to
    installation attributes to identify locations that are best suited to
    support any given mission. The results of this analysis will be used to
    inform the basing decisions made by General Schwartz and me.
        The next milestone for the KC-basing process is determining the
    criteria on which to analyze potential beddown locations. Air Mobility
    Command is developing basing criteria in a way that best quantifies
    both operational and support requirements related to KC-46A basing.
    After the criteria are finalized and approved by the Secretary later in
    2011, a briefing will be made available to interested members of
    Congress and their staffs.
                  kc-46a base selection and number of aircraft
        Question. When do you expect to identify the bases selected to
    house the KC-46A and how many aircraft they will receive?
        Answer. The Air Force is using its Strategic Basing Process to
    determine the future locations for the KC-46A. Our Strategic Basing
    process uses criteria-based analysis and the application of military
    judgment, linking mission and Combatant Commander requirements to
    installation attributes to identify locations that are best suited to
    support any given mission. The results of this analysis will be used to
    inform the basing decisions made by General Schwartz and me.
        In support of KC-46A basing decisions, Air Mobility Command (AMC)
    is developing basing criteria in a way that best quantifies both
    operational and support requirements related to KC-46A basing. After
    the criteria are finalized and approved by the Secretary later in 2011,
    a briefing will be made available to interested Members of Congress and
    their staffs. AMC will then evaluate all Air Force installations
    against the criteria in an Enterprise-wide Look, to identify candidate
    bases.
        After the release of the candidate bases list, Air Force site
    survey teams will conduct detailed, on-the-ground, evaluations at each
    candidate location covering a range of operational and facility issues.
    The results of the site surveys will be briefed to General Schwartz and
    me who will then select the preferred and reasonable alternatives for
    beddown locations.
        Once the preferred and reasonable alternatives are identified,
    environmental analysis will be conducted in accordance with the
    National Environmental Policy Act (NEPA). The Secretary and Chief of
    Staff site location decision will become final after the Environmental
    Impact Analysis Process is completed. No specific dates/timelines have
    been identified for the preferred alternative decisions and no final
    decision dates can be identified until NEPA actions have been
    completed.
                             kc-46a basing criteria
        Question. When will the Air Force share the basing criteria for the
    KC-46A?
        Answer. The Air Force is using its Strategic Basing Process to
    determine the future locations for the KC-46A. Our Strategic Basing
    process uses criteria-based analysis and the application of military
    judgment, linking mission and Combatant Commander requirements to
    installation attributes to identify locations that are best suited to
    support any given mission. The results of this analysis will be used to
    inform the basing decisions made by General Schwartz and me.
        In support of KC-46A basing decisions, Air Mobility Command is
    developing basing criteria in a way that best quantifies both
    operational and support requirements related to KC-46A basing. After
    the criteria are finalized and approved by the Secretary later in 2011,
    a briefing will be made available to interested Members of Congress and
    their staffs.
                                     ______

                   Questions Submitted by Senator Tim Johnson
                     b-1 fleet reductions and consolidation
        Question. During the last round of B-1 fleet reduction and
    consolidation, the Air Force said that they would reinvest the savings
    into the B-1 fleet and additional investments would be made in B-1
    modernization. Unfortunately, over the years, much of that funding did
    not materialize. Now we again find ourselves being told that there's a
    need to cut the B-1 fleet and that some of the savings would be
    reinvested in B-1 modernization.
        Secretary Donley, what reassurances can you provide that this time
    when the Air Force says it will reinvest the savings, it means it?
        Answer. During the previous round of B-1 fleet reductions and
    consolidation, the Air Force did reinvest in capability enhancements
    based on anticipated program performance. Today's ongoing modernization
    efforts, critical to the continued viability of the B-1 fleet, were
    born as a result of funding made available from previous fleet
    reductions, as well as the cancellation of the Defensive Systems
    Upgrade Program in 2002 due to cost and schedule overruns. The Air
    Force fully intends to make the required investments in B-1
    modernization to ensure the remaining fleet is viable to conduct its
    assigned missions. These actions also contribute toward the objectives
    of the 2010 Quadrennial Defense Review; to rebalance capabilities to
    prevail in today's war while building the capabilities needed to deal
    with future threats.
        The retirement of six B-1s will provide a total savings of $61.9
    million in fiscal year 2012 in procurement and sustainment funding. Of
    these savings, the Air Force is reinvesting $32.9 million in fiscal
    year 2012 into critical B-1 sustainment and modernization programs to
    ensure the health of the remaining fleet. These programs include
    procurement and installation of Vertical Situation Display Upgrade and
    Central Integrated Test System sustainment efforts, Fully Integrated
    Data Link capability upgrade, and procurement of critical initial
    spares for these modifications. The Department applied the remainder of
    the savings from the B-1 reduction to other Air Force and Department of
    Defense priorities including strengthening the nuclear enterprise.
        Question. I appreciate the Air Force's efforts to pursue
    alternative fuels. I am told that alternative fuel producers would
    require contracts of 15 to 20 years in order to attract the private
    financing needed to build a ``first-of-a-kind'' plant.
        Does the Air Force have sufficient statutory authority to enter
    into contracts of this length for alternative fuels?
        As the largest buyer of fuel within the government, DOD could
    catalyze the development of multiple plants and technologies to produce
    domestic alternative fuels, particularly jet fuel. In order to do so,
    it is my understanding that DOD would need to enter into long-term (15-
    20 year) supply agreements with fuel producers, which would allow those
    producers to attract private investment to build the plant(s) that
    would make the fuel to meet the military's needs. However, currently
    there is uncertainty surrounding what authority the Pentagon has to
    enter into long term agreements.
        Question. How do you anticipate using these contracts to get new
    domestically produced alternative fuel plants up and running to meet
    the military's goals?
        Answer. Currently, over 99 percent of the Air Force fleet is
    certified for unrestricted operational use of a 50/50 synthetic fuel
    blend, where the synthetic component is produced via the Fischer-
    Tropsch process. The Air Force is in the process of certifying the RQ-
    4, commonly called the Global Hawk, which represents the only remaining
    Air force-owned platform not yet certified, and is working with the
    Navy to test and certify the CV-22 and F-35. Both airframes are Navy-
    owned assets.
        The Air Force is positioning itself to integrate cost competitive,
    environmentally friendly, domestically produced alternative fuel blends
    by 2016, and will purchase available alternative fuel blends if they
    meet the Air Force technical, legal, environmental and economic
    requirements. Currently, there is no significant commercial scale
    market in place that is developing sufficient enough quantities at
    price cost competitive with traditional JP-8; however, even the limited
    production is yielding falling prices for alternative aviation fuels.
        Question. Can you also tell me when the Air Force expects to
    conclude testing of Fischer-Tropsch fuels?
        Answer. Certification activities are expected to be completed for
    the synthetic fuel blend by the end of 2011 completion. To date, no
    performance or safety-of-flight anomalies have been identified.
                                     ______

                   Question Submitted by Senator Thad Cochran
                    new penetrating bomber aircraft program
        Question. Secretary Donley, how is the Air Force going to be able
    to afford to buy this new long-range bomber given other high costs Air
    Force programs, such as, the Joint Strike Fighter aircraft, the new
    aerial refueling tanker aircraft, and satellite programs?
        Answer. The fiscal year 2012 Air Force budget request represents a
    careful balance of resources among Air Force Core Functions necessary
    to implement the President's National Security Strategy and our
    Nation's defense. The Air Force realizes that it must balance between
    today's operations and investments to develop capabilities for the
    future.
        The fiscal year 2012 budget request incorporates over $33 billion
    in efficiencies across the Future Years Defense Program to improve
    business practices and eliminate excess troubled or lower priority
    programs. By consolidating organizational structures, improving
    acquisition processes, procurement, and streamlining operations, we
    have been able to increase investment in Core Functions, such as global
    precision attack in ISR in space and air superiority, and enhance
    combat capability through such programs as the new penetrating bomber.
        The DOD aircraft procurement plan for fiscal years 2012-2041,
    presented to Congress on April 12, 2011 provides a comprehensive look
    at the Department of Defense's plan to ensure we have the capabilities
    needed to meet current and projected national security objectives,
    while prudently balancing security risks against fiscal realities.
                                     ______

                  Questions Submitted by Senator Susan Collins
                 kc-46a basing and active duty associate units
        Question. Secretary Donley, it was of interest to me that of the
    National Guard bases among the 11 bases included in the KC-X RFP each
    of them had an active duty ``associate unit.'' Given your previous
    comments that these bases are not tied to the actual bed down selection
    process, can you reassure the committee that the presence of an
    associate Active Duty Unit will not be a requirement for National Guard
    candidate bases competing in the KC-46A basing process?
        Answer. The Air Force is using its Strategic Basing Process to
    determine the future locations for the KC-46A. Our Strategic Basing
    process uses criteria-based analysis and the application of military
    judgment, linking mission and Combatant Commander requirements to
    installation attributes to identify locations that are best suited to
    support any given mission. The results of this analysis will be used to
    inform the basing decisions made by General Schwartz and me. There is
    nothing in this process to preclude an Air National Guard base from
    competing.
        In support of KC-46A basing decisions, Air Mobility Command (AMC)
    is developing basing criteria in a way that best quantifies both
    operational and support requirements related to KC-46A basing from a
    Total Force perspective. After the criteria are finalized and approved,
    a briefing will be made available to interested Members of Congress and
    their staffs. AMC will then evaluate all Air Force installations
    against the criteria in an Enterprise-wide Look, to identify candidate
    bases.
        After the release of the candidate bases list, Air Force site
    survey teams will conduct detailed, on-the-ground, evaluations at each
    candidate location covering a range of operational and facility issues.
    The results of the site surveys will be briefed to General Schwartz and
    I, and we will then select the preferred and reasonable alternatives
    for beddown locations.
        Once the preferred and reasonable alternatives are identified,
    environmental analysis will be conducted in accordance with the
    National Environmental Policy Act. The site location decision will
    become final after the Environmental Impact Analysis Process is
    completed.
                                     ______

               Questions Submitted to General Norton A. Schwartz
                Questions Submitted by Chairman Daniel K. Inouye
                              healthcare proposals
        Question. General Schwartz, I believe that the healthcare benefits
    we provide to our servicemembers and their families are one of the most
    basic benefits we can provide to the men and women serving our Nation
    and I also believe it is one of the most effective recruiting and
    retention tools you have at your disposal. The Department of Defense is
    proposing several changes to the military health system that could go
    into effect as early as October of this year.
        Do you support these cost saving measures? Could you please explain
    what impact they might have on recruiting and retention?
        Answer. As stated in our February 11, 2011, letter, I strongly
    support these modest changes to the military healthcare program in the
    fiscal year 2012 budget request.
        I believe we have included the appropriate safeguards to ensure a
    careful and measured approach to protect our most vulnerable
    beneficiaries, while continuing to provide free healthcare to our
    active duty personnel. Additionally, all Services and the TRICARE
    Management Activity have looked internally to identify efficiencies and
    incorporate those into the system before the decision to pursue these
    changes.
        Our commitment to our beneficiaries remains unchanged, with
    continued investment in wounded warrior care and enhanced access to
    superior health services to all our beneficiaries. I believe these
    changes to the military health system are critical to our continuing to
    provide the finest healthcare benefit in the world while also slowing
    the cost growth in that same healthcare system.
        While there are many dynamics that impact military recruiting and
    retention, we do not believe the proposed change to TRICARE fees for
    working age retirees will adversely impact our recruiting and
    retention. Without these adjustments, we will need to reduce funding in
    other areas such as those programs supporting Airmen and their
    families. The latter funding reductions would more adversely impact
    recruiting and retention.
                remotely piloted aircraft personnel requirements
        Question. General Schwartz, what is the status of using technology
    to ease some of the burden of processing, exploiting, and disseminating
    the additional data derived from the increase in Remotely Piloted
    Aircraft flights?
        Answer. The Air Force is aware of the enormous tasking, processing,
    exploitation, and dissemination burden that the rapid expansion in the
    number of intelligence, surveillance, and reconnaissance (ISR) Remotely
    Piloted Aircraft missions is placing on our ISR analysts. While
    automation cannot completely replace the need for human analysis, the
    Air Force is taking the following steps to maximize the analytical
    effectiveness of our ISR force:
      --Partnering with the National Geospatial-Intelligence Agency, Air
            Force Research Laboratories, Defense Advanced Research Projects
            Agency, and industry to find and integrate automated target
            cueing and exploitation tools that reduce overall analyst
            workload.
      --Working with other military Services and Coalition partners to
            federate mission data, employing technology and forming
            habitual relationships to bring to bear more intelligence
            expertise from distributed locations.
        The long-term solution for reducing the burden on Air Force
    analysts is through the continuous evaluation and integration of
    available technologies while also leveraging industry, other Service,
    and intelligence community investment in emerging technologies.
                            air force role in libya
        Question. General Schwartz, now that there is an agreement that
    NATO will assume command and control responsibility for the no-fly zone
    over Libya and that the role of the U.S. forces is projected to
    decline, how dependent will the coalition air forces be on continuing
    U.S. support for fighter and tanker aircraft and intelligence,
    surveillance, and reconnaissance (ISR) assets to enforce the no-fly
    zone?
        Answer. The Air Force will provide tanker and ISR support to meet
    NATO requirements. Strike support is in reserve and will require
    additional coordination between NATO and the United States.
        Question. Will you have to reallocate assets from other ongoing
    operations in the region to continue to provide this level of support
    to the coalition?
        Answer. No reallocation is anticipated at this time.
        Question. How long do you expect this operation to continue?
        Answer. The Air Force cannot speculate on the length of the Libya
    operation; however, the Air Force will provide capabilities as long as
    our civilian leadership deems this support vital to U.S. national
    interests.
        Question. General Schwartz, could you tell us what types of
    aircraft and capabilities the coalition nations are contributing to
    enforce the no-fly zone.
        Answer. Coalition forces provide the following capabilities: Strike
    (Mirage, Tornado, F-16); Air Intercept (Rafale, F-16); Command and
    Control (E-2, E-3); Air Refueling (KC-135F, VC-10, KC-150);
    Intelligence, Surveillance, Reconnaissance (ISR) (specific aircraft are
    classified); and Theater Airlift (C-160).
                             role for f-22 in libya
        Question. General Schwartz, there has been speculation in the press
    as to why the F-22 has not participated in Operation Odyssey Dawn over
    Libya. Could you explain why the F-22 was not used?
        Answer. Whenever forces are required to support an operation, they
    are allocated via Global Force Management, a joint structure to
    identify and provide the most appropriate and responsive force or
    capability that best meets the Combatant Commander's requirement. For
    Operation Odyssey Dawn, adequate capabilities were available in Europe
    to meet the Combatant Commander's needs.
        Question. Was the F-22's limited air-to-ground capability a factor
    in the decision not to deploy it?
        Answer. The F-22's air-to-ground capability was not a factor in the
    deployment decision. The Air Force had sufficient assets available in
    the area of responsibility to satisfy the Combatant Commander's request
    to accomplish the desired mission sets.
        Question. General Schwartz, do you have a funded program to upgrade
    the F-22's air-to-ground capability? How much will it cost?
        Answer. Yes, the F-22 has a funded program to upgrade the F-22s
    air-to-ground capability. Follow-on Test and Evaluation for F-22
    Increment 3.1 began in January 2011 and is expected to be complete in
    June 2011 and will begin fielding in July 2011. Increment 3.1 will add
    air-to-ground capabilities including electronic location of surface
    threat emitters, radar ground mapping, and carriage of small diameter
    bombs.
        Note, these upgrades are in addition to current F-22 air-to-ground
    capabilities provided through internal carriage and supersonic delivery
    of two 1,000 pound Joint Direct Attack Munitions.
        The fully funded Increment 3.1 retrofit program will cost $150
    million in fiscal year 2011 through fiscal year 2016.
                                     ______

                    Questions Submitted by Senator Herb Kohl
             primary aircraft authorized by truax field, wisconsin
        Question. Recently, the Air Force and National Guard Bureau
    announced a decision to reduce the Primary Aircraft Authorization at
    Truax Field in Madison, Wisconsin from 18 to 15 F-16 fighters. I
    understand that this was part of a larger reduction in the Primary
    Aircraft Authorization for F-16 fighters, which is being implemented
    over several years at many bases.
        Did the Air Force consult the leadership of the Wisconsin Air
    National Guard in this decision? When was the decision made to reduce
    the Primary Aircraft Authorization at Truax Field, and when were the
    Wisconsin Air National Guard leaders informed of the decision?
        Answer. The decision to reduce the Primary Aircraft Authorization
    at Truax Field was made early in 2006 as part of the fiscal year 2008
    President's budget request. The leadership of the Wisconsin Air
    National Guard was informed of this action in December 2010 by the
    Director of the Air National Guard, approximately 4 months prior to the
    planned official force structure announcement.
        Question. I understand that the decision to reduce the Primary
    Aircraft Authorization at Truax Field will lead to the loss of one
    full-time technician job and 76 drill-status guardsmen.
        How will the people in these positions transition into other jobs
    and responsibilities with the Wisconsin Air National Guard?
        Answer. With regard to the 76 drill-status guardsmen positions that
    will be affected by the reduction of primary aircraft authorization at
    Truax Field, there are provisions in written guidance, (Air National
    Guard Instruction 36-2101), that allow for the reassignment of
    personnel based on force structure changes. These force management
    decisions would be made by the wing commander and the squadron
    commanders of the units affected in conjunction with State Headquarters
    Human Resources department. The National Guard Bureau would function in
    an advisory capacity to assist units with interpreting the above
    mentioned guidance and on how best to apply it to their situations.
        In regard to the one full-time technician who is impacted by the
    reduction of the primary aircraft authorization at Truax Field,
    Wisconsin, there are provisions in written guidance, reference TPR 300,
    The Technician Personnel Regulation and TPR 303, The Military
    Technician Compatibility Program, that provide procedural directions
    based on force structure changes and manpower criteria. The National
    Guard Bureau, J1-Technician Program Division, will function in an
    advisory capacity to assist the Wisconsin Joint Forces Headquarters-HRO
    to execute the proper notification procedures, in compliance with the
    Technician Program Regulations, to reassign this technician into
    another full-time technician position that will closely align with
    their current position series, pay, duties, and responsibilities.
        Question. On March 18, 2011, the Air Force Magazine reported that
    senior Air Force leaders are concerned about a shortfall in fighters
    over the next several years.
        Given this concern, is this the right time to reduce the Primary
    Aircraft Authorization for F-16 fighters in the Air National Guard?
        Answer. The Air Force manages a balanced Total Force mix of
    approximately 1,200 Primary Mission Aircraft Inventory and 2,000 Total
    Aircraft Inventory combat fighter aircraft to execute the National
    Defense Strategy at a moderate risk level. The small aircraft reduction
    in the Air National Guard F-16 fleet transitions aircraft to the Backup
    Aircraft Inventory while retaining them in the total aircraft
    inventory. The Air Force's warfighting analysis accounted for this
    planned F-16 reduction over the recent budgetary cycles since it was
    implemented in the fiscal year 2008 program. The reduction does not
    increase current shortfall projections, but rather was a deliberate
    decision to accept near term risk while bridging to a fifth generation
    fleet.
                                     ______

                  Questions Submitted by Senator Patty Murray
                    analysis of alternatives on jstars gmti
        Question. We understand that Air Combat Command (ACC) is finalizing
    an Analysis of Alternatives (AOA) on the Joint STARS Ground Moving
    Target Indicator (GMTI) Mission Area, which is planned to be completed
    this year.
        Is the Air Force looking at efficient alternatives such as existing
    systems like the Navy P-8 that DOD has already invested in as an
    alternative for Joint STARS?
        Answer. The ACC analysis underway is studying 29 alternatives
    ranging from existing systems to future concepts. The 29 alternatives
    being evaluated were provided by both the Office of the Secretary of
    Defense, Cost Assessment and Program Evaluation (OSD-CAPE) and
    identified via industry days. The analysis is considering the P-8
    option, future KC-X platforms, a Business Jet, multiple remotely
    piloted aircraft (RPA), and an airship among others.
        Question. Would the re-engining of the E-8 platform create a
    significant increase in the fleet's overall mission capability and what
    is the cost of that program?
        Answer. We believe re-engining the E-8 would increase overall
    mission capability. However, until the results of both the analysis of
    alternatives and the Fleet Viability Board are complete and presented,
    it is premature to invest in fleet-wide re-engining.
        Question. Beyond re-engining, are the current E-8 cockpits fully
    compliant with all operational requirements?
        Answer. Yes, the E-8 cockpit is currently fully compliant. ACC is
    working an avionics Diminishing Manufacturing Source (DMS) program to
    ensure the E-8 is compliant with pending FAA/ICAO regulations.
        Question. What would be needed to upgrade the E-8 to the same
    capabilities as a P-8 AGS and how much would the program cost?
        Answer. Until the results of both the analysis of alternatives and
    the Fleet Viability Board are completed and presented, it is premature
    to speculate in favor of one system or another. We will know much more
    as these studies report out.
        Question. When will the new AOA be completed?
        Answer. The analysis of alternatives is scheduled to complete by
    September 2011.
        Question. What specifically will be addressed in the AOA?
        Answer. As detailed in the original Resource Management Directive
    700 direction, the analysis of alternatives team will evaluate materiel
    solutions to fulfill all, or part of, the Departments overall Synthetic
    Aperture Radar/MTI requirements. The team was further instructed by
    OSD-CAPE to investigate alternatives to replace, refurbish, modernize
    JSTARS and to support acquisition of JSTARS replacement, refurbishment
    or other SAR/MTI system(s).
        Question. Will the Air Force consider other platforms in lieu of
    the E-8, such as capitalizing on other DOD programs with similar
    requirements?
        Answer. The ACC analysis underway is studying 29 alternatives which
    were provided by both the Office of the Secretary of Defense, Cost
    Assessment and Program Evaluation (OSD-CAPE) and identified via
    industry days. The analysis is considering the P-8 option, future KC-X
    platforms, a Business Jet, multiple remotely piloted aircraft, and an
    airship among others.
                                     ______

                   Question Submitted by Senator Tim Johnson
                                 b-1s in libya
        Question. To what extent are B-1s being used in Libya?
        Answer. B-1B aircraft based in Continental United States (CONUS)
    were utilized in support of Operation Odyssey Dawn. A pair of B-1
    aircraft conducted two sorties, striking over 40 fixed targets in Libya
    in order to protect the Libyan population as outlined in United Nation
    Security Council Resolution 1973. This marked the first time CONUS B-1
    aircraft were launched to strike overseas targets. CONUS aircraft were
    utilized to minimize impact to OND/OEF missions. Currently, B-1
    aircraft are not directly tasked in support of Operation Unified
    Protector (previously Operation Odyssey Dawn); however, aircraft remain
    postured to support Global Strike Command missions if tasked.
                                     ______

                   Question Submitted by Senator Thad Cochran
                    new penetrating bomber aircraft program
        Question. General Schwartz, your prepared testimony indicates that
    the Air Force is developing a new long-range, penetrating bomber with a
    focus on affordability. Our experience with the B-1 and B-2 bomber
    programs resulted in very high development and production costs for
    relatively few aircraft. Can you share with the Committee in further
    detail how the Air Force plans to meet requirements while controlling
    costs and maintaining schedule on this new bomber program?
        Answer. The new penetrating bomber program is very much focused on
    affordability, constraining requirements, and lowering technological
    risk. The program will use a streamlined management and acquisition
    approach to balance capability with affordability. The new bomber will
    use existing, mature technologies and leverage systems and subsystems
    from other programs to the maximum extent practical. Additionally, the
    Air Force will limit requirements based on affordability using
    realistic cost targets to inform capability and cost trade-offs.
                                     ______

                 Questions Submitted by Senator Lisa Murkowski
                            military sexual assault
        Question. Concerning sexual assault in the Air Force, can you
    comment on what is being done on the front lines of this fight to
    protect airmen. Is specialized training given to the most vulnerable,
    which studies consistently indicate are the female, junior enlisted?
        Answer. All Airmen receive initial accessions training, that is
    scenario/vignette based education, when they first enter military
    service that incorporates learning what constitutes sexual assault;
    differences between offenders, victims, facilitators, and bystanders;
    and effective risk reduction strategies that include the following:
      --Clearly communicate boundaries. If you are in any kind of
            relationship, talk with your partner. If you are unsure about
            what your partner wants or is thinking, ask. Don't make
            assumptions. State your boundaries and be aware of non-verbal
            communications that could send unintended messages.
      --Assert yourself. If you don't want to do something, say ``No''
            clearly. Avoid phrases meant to let him/her down easy; these
            are often misunderstood. ``I don't know,'' ``I don't think
            so,'' and ``We'll see,'' can each be interpreted as ``Keep on
            coming.'' When you mean no, say, ``No!''
      --Be ``situation smart.'' Don't drink alone with people you do not
            know well or who are all drinking. Leave a public place with a
            peer, not alone. Don't go to a room after a night of drinking
            alone with another person.
      --Use the buddy system. Your job may be to protect your wingman--but
            it's also your wingman's job to protect you. Make a plan for
            getting home together. Give each other feedback on how much
            you've been drinking to reduce the risk of assault. Develop a
            signal you can use when you are in an uncomfortable situation.
      --Be smart if using alcohol. Drink responsibly and don't accept
            ``freebies.'' Watch out for dates who try to get you drunk or
            high. Don't EVER leave your drink alone or accept a drink from
            someone else. Date rape drugs are used by perpetrators to take
            advantage of victims.
      --Trust your instincts. You know when things don't feel right or
            safe. Have the intelligence and strength to trust yourself in
            those situations, and get out of danger. Tell your wingman you
            need support to get out now--then do it. Furthermore, annual
            refresher training incorporates the cycle of sexual assault,
            circumstances in which it occurs, and broad awareness of
            situations when Airmen may be most at risk. The Air Force is
            committed to eliminating behavior that may lead to sexual
            assault and implemented bystander intervention training (BIT):
            BIT is designed based on specific target populations for women,
            men, and leaders. Bystander intervention is a strategy that
            motivates and mobilizes people who may see, hear or otherwise
            recognize signs of an inappropriate or unsafe situation, to
            act. Using an interactive and dynamic model, the 90-minute
            courses provide basic education about recognizing dangerous
            situations/behavior, analyzing for best approach, and
            practicing effective bystander intervention strategies. The Air
            Force has a keen focus on key learning objectives for all of
            its target populations; here are key learning objectives for
            the women's (includes junior enlisted members) module:
        --Raise awareness of female Airmen regarding the continuum of
                behaviors that can lead to a sexual assault.
        --Empower female Airmen to develop concrete Bystander Intervention
                Strategies and problem solving competencies.
        --Foster female Airman responsibility, for ourselves and fellow
                Airmen, in addressing inappropriate sexual behaviors at all
                levels of conduct.
          Additionally, the Air Force is finalizing a Risk Reduction module
            designed uniquely for the female most at-risk population. The
            design of Risk Reduction includes education for those actions
            and choices individuals may make to ensure their own safety and
            increase situational awareness. However, this must be done
            carefully to avoid any inherent victim self-blame/guilt if
            sexually assaulted even after following all possible safety
            measures.
        Question. Alcohol is prominent as a factor in reported sexual
    assaults and from reviewing specific cases, is an obstacle to
    prosecuting offenders. How are you addressing the role of alcohol in
    your prevention efforts?
        Answer. The Air Force remains committed to eliminating situations
    and circumstances which may lead to sexual assault through educating
    Airmen in effective bystander intervention training (BIT) in separate
    sessions for men, women, and leaders. Since the majority of known
    reports involve alcohol, and the vast majority of sexual assaults are
    committed by males, the men's BIT module has specific learning points
    focused exclusively on alcohol related sexual assault. As part of the
    interactive, facilitated sessions, dialogue introduced includes:
      --People are always looking for a bright line where alcohol and
            consent are involved. There isn't one. The legal definition of
            consent in this area is ``Words or overt acts indicating a
            freely given agreement to the sexual conduct at issue by a
            competent person.'' When alcohol is involved, you can't consent
            if you are ``substantially incapable of appraising the nature
            of the sexual conduct at issue due to mental impairment or
            unconsciousness resulting from consumption of alcohol, drugs, a
            similar substance, or otherwise.''
      --You have to look at the facts of each situation, and if there isn't
            ``freely given agreement to the sexual conduct at issue by a
            competent person'' because the person was too drunk to
            understand what was going on, there isn't consent.
      --Participants are provided an alcohol based scenario to further
            discussion of the issues surrounding alcohol and sexual
            consent. This is a highly realistic and common scenario. Most
            Airmen have been in this situation, either as participants or
            observers.
      --Alcohol impairs cognitive functioning, specifically increases focus
            on short-term positive outcomes, and lessens consideration of
            long-term negative consequences of actions. Alcohol makes it
            easier for individuals to cross their personal violence
            threshold and feel justified for using force. Perpetrator
            motives may vary. It takes multiple motives and the ``right''
            circumstances when sexual assault may occur. Alcohol increases
            the likelihood that an individual will cross his/her personal
            violence threshold more easily.
          After consuming two standard alcoholic drinks, cognitive
            impairments may include: Abstraction. conceptualization,
            planning, problem solving, integration of conflicting
            information, response inhibition, and focus on short-term
            rewards.
      --The facilitated learning also includes highlighting some ``pre-
            game'' strategies that offenders develop in trying to
            facilitate sex for themselves and their friends. Examples
            include having punch with higher alcohol content at parties for
            women to drink and beer for men.
          Again, the Air Force remains committed to eliminating situations
            and circumstances which may lead to sexual assault.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. And the Defense Subcommittee will
    reconvene next Wednesday, April 6, at 10 a.m., at which time we
    will receive testimony from defense health activities.
        We stand in recess.
        [Whereupon, at 11:55 a.m., Wednesday, March 30, the
    subcommittee was recessed, to reconvene at 10 a.m., Wednesday,
    April 6.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                            WEDNESDAY, APRIL 6, 2011

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

                             DEPARTMENT OF DEFENSE

                            Medical Health Programs

    STATEMENT OF LIEUTENANT GENERAL ERIC B. SCHOOMAKER,
                SURGEON GENERAL, DEPARTMENT OF THE ARMY

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. I would like to welcome all of you to this
    special hearing.
        There will be two panels this morning. First, we will hear
    from the Surgeons General, Lieutenant General Eric B.
    Schoomaker, Vice Admiral Adam Robinson, Jr., and Lieutenant
    General Charles Green. Then we will hear from our Chiefs of the
    Nurse Corps, Major General Patricia Horoho, Rear Admiral
    Elizabeth Niemyer, and Major General Kimberly Siniscalchi.
        I understand that this will be the last hearing for General
    Schoomaker and Admiral Robinson, and I would like to thank both
    of you for your dedicated service and wish you well in your
    future endeavors.
        General Green, I look forward to continuing our work to
    ensure the future of our military medical programs and
    personnel.
        Every year, the subcommittee holds this hearing to discuss
    the critically important issues related to the care and well-
    being of our service members and their families. As such, the
    Surgeons General and nurses have been called upon to share
    their insight on medical issues that need improvement and areas
    that are seeing continued success and progress.
        The healthcare benefits we provide to our service members
    and their families are one of the most basic benefits we can
    provide to the men and women serving our Nation. It is also one
    of the most important effective recruiting and retention tools
    we have at our disposal.
        The advancements military medicine has made over the last
    several decades has not only dramatically improved medical care
    on the battlefield, but also enhanced healthcare delivery and
    scientific achievements throughout the aspects of medicine. The
    result impacts millions of Americans who likely have no idea
    that these improvements were initiated by the military.
        While there has been significant success and momentum
    advanced in modern medicine and the care we provide, there is
    much more to be done. The Department of Defense must stay ahead
    of the curve and remain vigilant to the ever-changing
    healthcare needs of our forces and their families. Even in this
    challenging fiscal environment, we must continue to provide the
    resources required to maintain and grow the expertise needed to
    stay at the forefront of military medicine.
        Times have certainly changed since I was a soldier. For
    instance, when I was injured in World War II, it took 9 hours
    to evacuate me. Now the military's goal is to evacuate within
    the so-called Golden Hour. In my regiment, for example, there
    were no double amputee or traumatic brain injury survivors
    because they died en route. Today, thanks to military medicine
    advancements and helicopter and other transport devices, our
    men and women in uniform survive these grave injuries.
        Despite the great progress made by the military medical
    community, more and more of our troops are suffering from
    medical conditions that are much harder to identify and treat,
    such as traumatic brain injury (TBI), post-traumatic stress,
    and depression. I know that all of you here today are striving
    to address these issues, and I applaud your efforts to place
    more mental health providers throughout the medical facilities,
    and especially within primary care offices. In addition, you
    employ more of these specialists in theater to provide early
    intervention and prevent further escalation.
        Due to the prolific number of medical assistance efforts
    being offered, there can be confusion on where to seek help. I
    have heard many stories of service members who have six
    different magnets on their refrigerators identifying a website
    or a phone number for where to seek help. I believe it is
    essential that we offer these services, both anonymously and
    officially, but it can also be very difficult to navigate
    through this maze of options that are available. It is my hope
    that in your efforts to provide increased and advanced
    services, that you work to consolidate these services and make
    it easier for service members and their families to find the
    help they need.
        These are some of the issues we hope to discuss today. I
    look forward to your testimony and note that your full
    statements will be included in the record.
        I wish to now call upon the vice chairman of this
    subcommittee, Senator Cochran, for his opening statement.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you very much.
        I am pleased to join you in welcoming this distinguished
    panel of witnesses to our subcommittee today, the Surgeons
    General of our military forces. We appreciate your
    distinguished service, and thank you for your cooperation with
    our subcommittee to assess and review the budget request for
    the next fiscal year.
        Thank you.
        Chairman Inouye. All right. Thank you very much.
        Our witnesses on the first panel are Lieutenant General
    Eric B. Schoomaker, Surgeon General of the Army, Vice Admiral
    Adam Robinson, Jr., Surgeon General of the Navy, and Lieutenant
    General Charles B. Green, Surgeon General of the Air Force.
        Surgeon General of the Army.
        General Schoomaker. Thank you, sir.
        Chairman Inouye, Vice Chairman Cochran, and distinguished
    members of the subcommittee, thank you for providing me this
    opportunity to talk with you about the dedicated men and women
    of the United States Army Medical Department, who bring value
    and inspire trust in Army medicine.
        As you noted, Mr. Chairman, I am joined today by my Deputy
    Surgeon General and our Chief of the Army Nurse Corps, Major
    General Patty Horoho. Some of my staff have characterized this
    as an awful Broadway production of ``Beauty and the Beast''.
        Despite over 9 years of continuous armed conflict, every
    day our soldiers and their families are kept from injuries,
    illnesses, and combat wounds through our health promotion and
    prevention measures, are treated in state-of-the-art fashion
    when prevention fails, and supported by a talented medical
    force, including those with a warrior on the battlefield.
        Army medicine partners with our soldiers, their families,
    our veterans, our fellow service members, and the interagency
    to provide innovations in trauma care and preventive medicine.
    We save lives and we improve the well-being of our warriors,
    delivering the very best care at the right time and place.
        Let me discuss our work through the lens of five Es:
    Enduring, early, effective, efficient, and in an enterprise
    fashion.
        We have an enduring commitment through initiatives, such as
    our Warrior Care and Transition Program and the soldier medical
    readiness campaign plan. We have an enduring responsibility as
    part of the military health system and with the Department of
    Veterans Affairs to provide care and rehabilitation for our
    wounded, ill, and injured for many, many years to come.
        The United States Army's Warrior Transition Command, under
    the leadership of Brigadier General Darryl Williams, is a key
    part of the enduring provision of care and provides oversight
    of the Army's Warrior Care and Transition Program. Since the
    inception of these Warrior Transition Units in June 2007, more
    than 40,000 wounded, ill, and injured soldiers and their
    families have either progressed through or are now being cared
    for by these dedicated caregivers. Over 16,000 of these
    soldiers have rejoined the force, and the remainder remain--
    have been returned to the community with dignity and respect.
        The Soldier Medical Readiness Campaign helps to maintain a
    healthy and resilient force. Major General Richard Stone, our
    Deputy Surgeon General for Mobilization, Readiness, and Reserve
    Affairs, leads that campaign. Among the campaign's tasks are
    the--are to provide commanders with a tool to manage their
    soldiers' medical requirements, identify those medically non-
    ready soldiers, and reduce this population so that we can have
    a fully fit and capable, ready Army. The end state is healthy
    soldiers and increased medical readiness.
        Those soldiers who no longer meet retention standards must
    navigate the Physical Disability and Evaluation System.
    Assigning disability has long been a contentious issue. The
    Department of Defense and VA have jointly designed a new
    Disability Evaluation System that integrates DOD and the
    Veterans Administration (VA) processes with a goal of
    expediting the delivery of VA benefits to service members. The
    pilot of the new Integrated Disability Evaluation System, or
    the IDES, began in November 2007 at Walter Reed. It is now in
    16 medical treatment facilities, and it will be the DOD and VA
    replacement for this Legacy Disability Evaluation System that
    we have had for upwards of 60 years.
        But even with this improvement, disability evaluation
    remains complex and adversarial. Our soldiers still undergo
    dual adjudication with the military rates only for unfitting
    conditions and the VA rates for all service-connected
    conditions. Dual adjudication is confusing to soldiers. It
    leads to serious misperceptions about the Army's appreciation
    of the wounded, ill, and injured soldiers' complete medical and
    emotional situation. The IDES has not changed the fundamental
    nature of the dual adjudication process. Under the leadership
    of our Army Chief of Staff General George Casey and the Army G-
    1, we continue to forge the consensus necessary for a
    comprehensive reform of the Physical Disability and Evaluation
    System, which the Army and DOD only determines fitness for duty
    and the VA determines disability compensation.
        Our second strategic aim is to reduce suffering, illness,
    and injury through early prevention. Army Public Health
    protects and improves the health of Army communities through
    education, the promotion of healthy lifestyles, and disease and
    injury prevention.
        The health of the total Army is essential for readiness,
    and prevention is the key to health. Examples of our practices
    include the implementation of the Patient-Centered Medical Home
    for Primary Care Delivery, something that we are doing in
    concert with our fellow service members, led by the Air Force,
    frankly, the Army's development and use of vaccines, and the
    early advocation of management of battlefield concussion.
        We lead in the recognition and treatment of mild traumatic
    brain injury, or concussion, through what's called the educate,
    train, treat, track strategy. Under the personal leadership of
    the Vice Chief of the Army, General Pete Chiarelli, and refined
    by Brigadier General Richard Thomas, our Assistant Surgeon
    General for Force Projection, we have fielded a program that
    has led to increased awareness and screening for traumatic
    brain injury and decreased the stigma associated with seeking
    early diagnosis and treatment.
        This leads into the use of evidence-based practices aimed
    at the most effective care. As an example, Army medicine now
    strengthens our soldiers' and families' behavioral health and
    emotional resiliency through a campaign to align the various
    behavioral health programs with the deployment and reset cycle,
    a process we call the Comprehensive Behavioral Health System of
    Care. Under the leadership of the Deputy Surgeon General, Major
    General Patty Horoho, this program uses multiple touch points
    to assess both the health and behavioral health for a soldier
    and the family. Coupled with the advances in battlefield care
    under the Joint Theater Trauma System, we have made great
    strides in managing the physical and emotional wounds of war.
        Additionally, we have developed a comprehensive pain
    management strategy to address chronic and acute pain that many
    of our soldiers face. This strategy uses state-of-the-art
    modalities and technologies. It focuses on the use of non-
    medication pain management modalities, incorporating
    complementary and alternative or integrative approaches, such
    as acupuncture and massage therapy, yoga, and other tools. We
    were recently recognized by the American Academy of Pain
    Medicine with a Presidential commendation for the impact on
    pain management in the United States.
        Our fourth strategic aim is optimizing efficiencies through
    leading-edge business practices, partnerships with our other
    services and veterans organizations, to support the DOD and VA
    collaboration on treating post-traumatic stress disorder, and
    pain, and other healthcare issues, and electronic health
    records should seamlessly transfer patient data between
    partners to improve efficiencies, effectiveness, and the
    continuity of care.
        No two health organizations in the Nation share more non-
    billable health information than the Department of Defense and
    the Veterans Administration. The Departments continue to
    standardize sharing activities and deliver information
    technologies to improve the secure sharing of information.
        Finally, our fifth aim is the Army enterprise approach. We
    have reengineered Army medicine, such as the creation of a
    provisional Public Health Command, to optimally serve the
    soldier. We have aligned our regional medical commands with the
    TRICARE regions, resulting in improved readiness and support
    from the managed care support contractor to our regions. Three
    standardized continental United States-based regional medical
    commands are now aligned with the three TRICARE regions in the
    continental United States.
        We also have regional readiness cells now that can reach
    out to our Reserve components within their areas of
    responsibility, ensuring that all medical services required are
    identified and provided at all times. Part of this
    reorganization has been the standup of a public health command
    under the command of Brigadier General Tim Adams. This
    consolidation has already resulted in an increased focus on
    prevention, health promotion, and wellness.
        As you have noticed here, this is my last congressional
    hearing cycle as the Army Surgeon General and the Commanding
    General of the United States Army Medical Command. I thank the
    subcommittee for allowing me to highlight the accomplishments
    we have made, the challenges we continue to face, to hear your
    perspectives regarding health of our extended military family
    and the healthcare we provide. I have appreciated your
    questions, your insights, and your commitment to our Army
    soldiers and their families.

                               PREPARED STATEMENT

        On behalf of the over 140,000 soldiers, civilians, and
    contractors that make up my command in Army medicine, I also
    thank Congress for your continued support and for providing the
    resources that we have needed to deliver leading edge health
    services and build healthy and resilient communities.
        I welcome your questions.
        Chairman Inouye. All right. Thank you very much, General
    Schoomaker.
         [The statement follows:]
          Prepared Statement of Lieutenant General Eric B. Schoomaker
        Chairman Inouye, Vice Chairman Cochran and distinguished members of
    the committee. Thank you for providing me 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 bring value and inspire trust in Army
    Medicine.
        Now in my last congressional hearing cycle as the Army Surgeon
    General and Commanding General, U.S. Army Medical Command (MEDCOM), I
    would like to thank the committee for the opportunities provided over
    the past 4 years that have allowed me to share what Army Medicine is,
    to highlight the accomplishments we have made, to detail the challenges
    we have faced, and to hear your collective perspectives regarding the
    health of our extended Military Family and the military healthcare we
    provide. On behalf of the over 70,000 dedicated Soldiers, civilians,
    and contractors that make up Army Medicine, I also thank Congress for
    your continued support of Army Medicine and the Military Health System,
    providing the resources we need to deliver leading edge health services
    to our Warriors, Families and Retirees.
        Despite over 9 years of continuous armed conflict for which Army
    Medicine bears a heavy load, every day our Soldiers and their Families
    are kept from injuries, illnesses, and combat wounds through our health
    promotion and prevention efforts; are treated in state-of-the-art
    fashion when prevention fails; and are supported by an extraordinarily
    talented medical force including those who serve at the side of the
    Warrior on the battlefield.
        Army Medicine is a dedicated member of the Military Health System
    and is equally committed to partnering with our Soldiers, their
    Families, and our Veterans to achieve the highest level of fitness and
    health for each of our beneficiaries. Army Medicine historically is a
    leader in developing innovations for trauma care and preventive
    medicine that save lives and improve well-being for our uniformed
    personnel, improvements which have also favorably influenced civilian
    care. We are focused on delivering the best care at the right time and
    place. Army Medicine operates using the following strategic aims--The
    Five E's: Enduring, Early, Effective, Efficient, and Enterprise to
    reflect our commitment to selfless service.
      --To provide Enduring care through initiatives such as the Warrior
            Care and Transition Program and the Soldier Medical Readiness
            Campaign Plan.
      --To reduce the need for subsequent care through Early prevention;
            for example, Army Medicine identifies medical issues early with
            its concussive protocols and behavioral health practices, and
            promotes healthy lifestyles with the patient-centered medical
            home model of primary care delivery.
      --To use evidence-based practices which provide the most Effective
            treatment for medical issues such as pain management and post-
            traumatic stress (PTS).
      --To optimize Efficiencies through leading edge business processes
            and partnerships with other services and veterans
            organizations.
      --To be an integral part of the Army Enterprise approach through re-
            engineering Army Medicine such as the provisional Public Health
            Command (PHC) to keep the Army strong and with other Army
            commands and agencies to optimally serve the Soldier and
            Family.
        We must continue to provide the very best ongoing care for wounded,
    ill, or injured Soldiers. We have an enduring responsibility--alongside
    our sister services and the Department of Veterans Affairs (VA)--to
    provide care and rehabilitation of our wounded, ill, and injured for
    many years to come. The U.S. Army Warrior Transition Command (WTC) is a
    Major Subordinate Command under the MEDCOM and a key part of the
    enduring provision of care. The WTC Commander, Brigadier General Darryl
    Williams is also the Assistant Surgeon General for Warrior Care and
    Transition. The WTC's mission is to provide centralized oversight of
    the Army's Warrior Care and Transition Program. This includes providing
    the necessary guidance and advocacy to empower wounded, ill, and
    injured Soldiers and Families with dignity, respect, and the self-
    determination to successfully reintegrate either back into the force or
    into the community. The WTC supports Army Force Generation (ARFORGEN)
    by supporting those who have returned from combat and require
    coordinated, complex care management to help them cope with and
    overcome the cumulative effects of war and multiple deployments.
        At the heart of the Warrior Care and Transition Program are 29
    Warrior Transition Units (WTUs) located at major Army installations
    worldwide, and nine Community Based Warrior Transition Units (CBWTUs)
    located regionally around the United States and Puerto Rico. Today,
    4,280 highly trained cadre and staff oversee a current population of
    10,011 wounded, ill and injured Soldiers. Since their inception in June
    2007, more than 40,000 wounded, ill, or injured Soldiers and their
    Families have either progressed through or are being currently cared
    for by these dedicated caregivers and support personnel. Over 16,000 of
    those Soldiers have been returned to the force.
        The Army, with great support of Congress, has spent or obligated
    more than $1.2 billion in military construction projects to improve the
    accessibility and quality of Wounded Warrior barracks, including the
    development of Warrior Transition complexes that will serve both
    Warriors in Transition and their Families. Construction of complexes
    continues through fiscal year 2012 at which time 20 state-of-the-art
    complexes will be in operation.
        Since 2004, the Army Wounded Warrior Program (AW2) has supported
    the most severely wounded, ill, and injured Soldiers. Soldiers are
    assigned an AW2 Advocate who provides personalized assistance with day-
    to-day issues that confront healing Warriors and their Families,
    including benefits counseling, educational opportunities, and financial
    and career counseling. AW2 Advocates serve as life coaches to help
    these wounded Warriors and their Families regain their independence.
    Since its inception, AW2 has provided support to nearly 8,000 Soldiers
    and Veterans.
        The WTC is refining a policy change to enhance the Army's ability
    to ensure Reserve Component Soldiers recovering at home from wounds,
    illnesses, or injuries incurred while on Active Duty benefit from the
    same system of care management and command and control experienced by
    Soldiers who are recovering in WTUs. The revised policy makes it easier
    for Reserve Component Soldiers who do not require complex medical care
    management to heal and transition closer to home.
        To support each wounded, ill, or injured Soldier in their efforts
    to either return to the force or transition to Veteran status, the Army
    has created a systematic approach called the Comprehensive Transition
    Plan (CTP). The CTP is a six-part multidisciplinary and automated
    process which enables every Warrior in Transition to develop an
    individualized plan that will enable them to set and reach their
    personal goals. These end goals shape the Warrior in Transition's day-
    to-day work plan while healing.
        Additionally to help Warriors in Transition achieve their physical
    fitness goals, WTUs offer several adaptive sports options to supplement
    the Warrior in Transition's therapy, often in coordination with the
    U.S. Olympic Committee's Paralympic Military Program. The WTC is also
    coordinating the Army's participation in the 2011 Warrior Games to be
    held at the U.S. Olympic Training Center in Colorado Springs, Colorado
    May 16-21, 2011.
        We created a Soldier Medical Readiness Campaign to ensure we
    maintain a healthy and resilient force. Major General Richard Stone,
    Deputy Surgeon General, Mobilization, Readiness, and Reserve Affairs,
    is the campaign lead. The deployment of healthy, resilient, and fit
    Soldiers and increasing the medical readiness of the Army is the
    desired end state of this campaign.
        The campaign's key tasks are to provide Commanders the tools to
    manage their Soldiers' medical requirements; coordinate, synchronize
    and integrate wellness, injury prevention and human performance
    optimization programs across the Army; identify the medically not ready
    (MNR) Soldier population; implement medical management programs to
    reduce the MNR Soldier population, assess the performance of the
    campaign; and educate the force.
        Those Soldiers who no longer meet retention standards must navigate
    the Physical Disability Evaluation System (PDES). Assigning disability
    has long been a contentious issue. The present disability system dates
    back to the Career Compensation Act of 1949. Since its creation
    problems have been identified include long delays, duplication in DOD
    and VA processes, confusion among Service members, and distrust of
    systems regarded as overly complex and adversarial. In response to
    these concerns, DOD and VA jointly designed a new disability evaluation
    system to streamline DOD processes, with the goal of also expediting
    the delivery of VA benefits to service members following discharge from
    service. The Army began pilot testing the Disability Evaluation System
    (DES) in November 2007 at Walter Reed Army Medical Center and has since
    expanded the program, now known as the Integrated Disability Evaluation
    System (IDES), to 16 military treatment facilities. DOD is now planning
    on replacing the military's legacy disability evaluation system with
    the IDES.
        The key features of the of the IDES are a single physical
    disability examination conducted according to VA examination protocols,
    a single disability rating evaluation prepared by the VA for use by
    both Departments for their respective decisions, and delivery of
    compensation and benefits upon transition to veteran status for members
    of the Armed Forces being separated for medical reasons. The DOD PDES
    working group continues to reform this process by identifying steps
    that can be reduced or eliminated, ensuring the service members receive
    all benefits and entitlements throughout the process.
        The WTC is also working with U.S. Army Medical Command staff to
    develop the concept of ``Medical Management Centers.'' Medical
    Management Centers utilize the case management approaches developed for
    the WTUs to assist Soldiers who remain in their units but require a
    PDES determination. The WTC is also working closely with Army Reserve
    and Army National Guard leadership to develop and provide necessary
    support to the Reserve Component Soldier Medical Support Center
    (RCSMSC) being established in Pinellas Park, Florida. The RCSMSC is
    intended to ensure the PDES process also runs smoothly and efficiently
    for Reserve Component Soldiers not on Active Duty or in WTUs.
        Army Medicine strives to reduce the need for subsequent care
    through early prevention and the emphasis on health promotion. Over the
    past year Army medicine has initiated multiple programs in support of
    this aim and I would like to highlight a few of those starting with the
    new U.S. Army Public Health Command (Provisional) (PHC).
        As part of the overall U.S. Army Medical Command reorganization
    initiative, all major public health functions within the Army,
    especially those of the former Veterinary Command and the Center for
    Health Promotion and Preventive Medicine have been combined into a new
    PHC, located at Aberdeen Proving Ground in Maryland, under the command
    of Brigadier General Timothy K. Adams. The consolidation has already
    resulted in an increased focus on health promotion and has created a
    single accountable agent for public health and veterinary issues that
    is proactive and focused on prevention, health promotion and wellness.
    The PHC reached initial operational capability in October 2010 and full
    operational capability is targeted for October 2011.
        Army public health protects and improves the health of Army
    communities through education, promotion of healthy lifestyles, and
    disease and injury prevention. Public health efforts include
    controlling infectious diseases, reducing injury rates, identifying
    risk factors and interventions for behavioral health issues, and
    ensuring safe food and drinking water on Army installations and in
    deployed environments. The long-term value of public health efforts
    cannot be overstated: public health advances in the past century have
    been largely responsible for increasing human life spans by 25 years,
    and the PHC will play a central role in the health of our Soldiers,
    deployed or at home.
        The health of the total Army is essential for readiness, and
    prevention is the best way to health. Protecting Soldiers, retirees,
    Family members and Department of Army civilians from conditions that
    threaten their health is operationally sound, cost effective and better
    for individual well-being. Though primary care of our sick and injured
    will always be necessary, the demands will be reduced. Prevention--the
    early identification and mitigation of health risks through
    surveillance, education, training, and standardization of best public
    health practices--is crucial to military success. Army Medicine is on
    the pathway to realizing this proactive, preventive vision.
        While the PHC itself is relatively new, a number of significant
    public health accomplishments already have been achieved. Some
    examples:
      --Partnering with Army installations to standardize existing Army
            Wellness Centers to preserve or improve health in our
            beneficiary population. The centers focus on health assessment,
            physical fitness, healthy nutrition, stress management, general
            wellness education and tobacco education. They partner with
            providers in our Military Treatment Facilities (MTFs) through a
            referral system. I hold each MTF Commander responsible for the
            health of the extended military community as the installation
            Director of Health Services (DHS).
      --Hiring installation Health Promotion Coordinators (HPCs) to assist
            the MTF Commander/DHS and to facilitate health promotion
            efforts on Army installations. HPCs are the ``air traffic
            controllers'' or coordinators of services and identifiers of
            service needs; they work with senior mission commanders and
            installation Community Health Promotion Councils to synchronize
            all of the installation health and wellness resources.
      --Providing behavioral health epidemiological consultations to advise
            Army leaders and program developers on the factors that
            contribute to behavioral health issues including high-risk
            behaviors, domestic violence and suicide.
      --Identifying Soldier physical training programs that optimize
            fitness while minimizing injuries and resultant lost-duty days
            and improve Soldier medical readiness.
      --Decreasing the rate of overweight and obese Family members and
            retirees by adopting the Healthy Population 2010 goals for
            weight and obesity and implementing a standardized weight-
            management program developed by the VA.
      --Integrating human and animal disease surveillance to better assess
            health risks.
        The Army recognizes that traumatic brain injury or TBI is a serious
    concern, and we will continue to dedicate resources to research,
    diagnose, treat and prevent mild, moderate, severe, and penetrating
    TBI. The Army is leading the way in early recognition and treatment of
    mild TBI or concussive injuries with our ``Educate, Train, Treat, and
    Track'' strategy. Under the personal leadership of the Vice Chief of
    Staff of the Army, General Peter Chiarelli and refined by Brigadier
    General Richard Thomas, Assistant Surgeon General for Force Projection,
    we are fielding a program which some have called ``CPR for the brain''.
    Our education and training efforts have led to increased awareness and
    screening for TBI and have contributed to decreasing the stigma
    associated with seeking diagnosis or treatment for TBI. TBI training
    has been integrated into education and training initiatives of all
    deploying units to increase awareness and education regarding
    recognition of symptoms as well as emphasize commanders and leaders'
    responsibilities for ensuring their Soldiers receive prompt medical
    attention as soon as possible after an injury.
        DOD policy changes in June 2010 implemented mandatory event-driven
    protocols following exposure to potentially concussive events in
    deployed environments. Events mandating an evaluation include any
    Service Member in a vehicle associated with a blast event, collision,
    or rollover; all personnel within close proximity to a blast; or anyone
    who sustains a direct blow to the head. Additionally, the command may
    direct a medical evaluation for any suspected concussion under other
    conditions. All new medics and Physician Assistants at the Army Medical
    Department Center and School are being trained on their roles in
    supporting this policy. During my recent visit to Afghanistan with my
    fellow Surgeons General in February 2011, discussions with Warriors and
    medical personnel at a number of sites lead me to conclude that these
    protocols are aggressively endorsed by commanders and are being
    complied with.
        The Army along with the DOD is implementing computerized tracking
    of these events for the purposes of providing healthcare providers with
    awareness of an individuals' history of proximity to blast events,
    allowing for greater visibility of at risk Soldiers during post-
    deployment health assessment, informing Commanders, and to provide
    documentation to support Line of Duty investigations for Reserve and
    Guard members. The program from August to December 2010 has documented
    1,472 Soldiers. We are working hard to overcome the technical barriers
    for complete data input. My fellow Surgeons General and I saw this
    first hand in our trip to Afghanistan last month. We saw, as well, the
    complete commitment of all field commanders, small unit leaders, and
    medical professionals to the implementation of these protocols.
        To further the science of brain injury recovery, the Army relies on
    the U.S. Army Medical Research and Materiel Command's TBI Research
    Program. The overwhelming generosity of Congress and the DOD's
    commitment to brain injury research has significantly improved our
    knowledge of TBI in a rigorous scientific fashion. Currently, there are
    almost 350 studies funded by DOD to look at all aspects of TBI. The
    purpose of this program is to coordinate and manage relevant DOD
    research efforts and programs for the prevention, detection, mitigation
    and treatment of TBI. Some examples of the current research include
    medical standards for protective equipment, measures of head impact/
    blast exposure, a portable diagnostic tool for TBI that can be used in
    the field, blood tests to detect TBI, medications for TBI treatment,
    and the evaluation of rehabilitation outcomes. The TBI Research Program
    leverages both DOD and civilian expertise by encouraging partnerships
    to solve problems related to TBI. The DOD partners with key
    organizations and national/international leaders, including the VA, the
    Defense Centers of Excellence for Psychological Health and TBI, the
    Defense and Veterans Brain Injury Center, academia, civilian hospitals
    and the National Football League, to improve our ability to diagnose,
    treat and care for those affected by TBI.
        Similar to our approach to concussive injuries, Army Medicine
    harvested the lessons of almost a decade of war and has approached the
    strengthening of our Soldiers and Families' behavioral health and
    emotional resiliency through a campaign plan to align the various
    Behavioral Health programs with the human dimension of the ARFORGEN
    cycle, a process we call the Comprehensive Behavioral Health System of
    Care (CBHSOC). This program is based on outcome studies that
    demonstrate the profound value of using the system of multiple
    touchpoints in assessing and coordinating health and behavioral health
    for a Soldier and Family. The CBHSOC creates an integrated,
    coordinated, and synchronized behavioral health service delivery system
    that will support the total force through all ARFORGEN phases by
    providing full spectrum behavioral healthcare. We leveraged experiences
    and outcome studies on deploying, caring for Soldiers in combat, and
    redeploying these Soldiers in large unit movements to build the CBHSOC.
    Some have been published, such as the landmark studies on concussive
    brain injury and PTSD by Charles Hoge, Carl Castro and colleagues or
    the recent publication of a forerunner program to the CBHSOC in the 3rd
    Infantry Division by Chris Warner, Ned Appenzeller and their co-
    workers. These studies will be discussed further later.
        The CBHSOC is a system of systems built around the need to support
    an Army engaged in repeated deployments--often into intense combat--
    which then returns to home station to restore, reset the formation, and
    re-establish family and community bonds. The intent is to optimize care
    and maximize limited behavioral health resources to ensure the highest
    quality of care to Soldiers and Families, through a multi-year campaign
    plan.
        Under the leadership of Major General Patricia Horoho, the Deputy
    Surgeon General, the CBHSOC campaign plan has five lines of effort:
    Standardize Behavioral Health Support Requirements; Synchronize
    Behavioral Health Programs; Standardize & Resource AMEDD Behavioral
    Health Support; Access the Effectiveness of the CBHSOC; and Strategic
    Communications. The CBHSOC campaign plan was published in September
    2010, marking the official beginning of incremental expansion across
    Army installations and the Medical Command. Expansion will be phased,
    based on the redeployment of Army units, evaluation of programs, and
    determining the most appropriate programs for our Soldiers and their
    Families.
        Near-term goals of the CBHSOC are implementation of routine
    behavioral health screening points across ARFORGEN and standardization
    of screening instruments. Goals also include increased coordination
    with both internal Army programs like Comprehensive Soldier Fitness,
    Army Substance Abuse Program, and Military Family Life Consultants.
    External resources include VA, local and state agencies, and the
    Defense Centers of Excellence for Psychological Health.
        Long-term goals of the CBHSOC are the protection and restoration of
    the psychological health of our Soldiers and Families and the
    prevention of adverse psychological and social outcomes like Family
    violence, DUIs, drug and alcohol addiction, and suicide. This is
    through the development of a common behavioral health data system;
    development and implementation of surveillance and data tracking
    capabilities to coordinate behavioral health clinical efforts; full
    synchronization of Tele-behavioral health activities; complete
    integration of the Reserve Components; and the inclusion of other Army
    Medicine efforts including TBI, patient centered medical home, and pain
    management. Integral to the success of the CBHSOC is the continuous
    evaluation of programs, to be conducted by the PHC.
        For those who do suffer from PTSD, Army Medicine has made
    significant gains in the treatment and management of PTSD as well. The
    DOD and VA jointly developed the three evidenced based Clinical
    Practice Guidelines for the treatment of PTSD, on which nearly 2,000
    behavioral health providers have received training. This training is
    synchronized with the re-deployment cycles of U.S. Army Brigade Combat
    Teams, ensuring that providers operating from MTFs that support the
    Brigade Combat Teams are trained and certified to deliver quality
    behavioral healthcare to Soldiers exposed to the most intense combat
    levels. In addition, the U.S. Army Medical Department Center & School,
    under the leadership of Major General David Rubenstein, collaborates
    closely with civilian experts in PTSD treatment to validate the content
    of these training products to ensure the information incorporates
    emerging scientific discoveries about PTSD and the most effective
    treatments.
        Work by the Army Medical Department and the Military Health System
    over the past 8 years has taught us to link information gathering and
    care coordination for any one Soldier or Family across the continuum of
    this cycle. Our Behavioral Health specialists tell us that the best
    predictor of future behavior is past behavior, and through the CBHSOC
    we strive to link the management of issues which Soldiers carry into
    their deployment with care providers and a plan down-range and the same
    in reverse.
        As mentioned previously, the results of a recent Army study
    published in January in the American Journal of Psychiatry by Major
    Chris Warner, Colonel Ned Appenzeller and colleagues report on the
    success of pre-deployment mental health support and coordination of
    care that dramatically reduced adverse behavioral health outcomes for
    over 10,000 Soldiers who received pre-deployment support prior to
    deployment compared to a like group of over 10,000 Soldiers who were
    deployed to the same battle space but were unable to receive the pre-
    deployment behavioral health assessment and care coordination. These
    results show the Army, as part of its Comprehensive Behavioral Health
    System of Care Campaign Plan, is moving in the right direction
    implementing new policies and programs to enhance pre- and post-
    deployment care coordination for Soldiers. This study demonstrates the
    ability to bridge the gap between identification through pre-deployment
    screening, as required by the National Defense Authorization Act for
    Fiscal Year 2010, Sec. 708 and actively managing and coordinating care
    for Soldiers with existing behavior health concerns to insure a
    successful deployment that benefits the Army and continued support to
    Soldiers and Families.
        The results are significant and provide the first direct evidence
    that a program that combines pre-deployment support and coordination of
    care that includes primary care managers, unit surgeons and behavioral
    health providers is effective in preventing adverse behavioral health
    outcomes for Soldiers. The study results move away from a perception of
    use of mental health screenings by Army and DOD as a tool to ``weed
    out'' Soldiers and service members deemed mentally unfit, to one of use
    and integration of behavioral health screenings as a routine part of
    Soldiers' and service members primary care during deployment. Coupled
    with insights provided by Walter Reed Army Institute of Research
    (WRAIR) researchers, such as Dr. Charles Hoge and COL Carl Castro about
    the relationship between concussive injury and PTSD as well as 7 years
    of annual surveys of BH problems and care in the deployed force through
    the WRAIR Mental Health Advisory Teams, we are making giants steps
    forward in prevention, early recognition, and mitigation of the
    neuropsychological effects of prolonged war on our Soldiers and
    Families.
        Much of the future of Army Medicine will be practiced at the
    Patient-Centered Medical Home (PCMH). The PCMH is a model of primary
    care-based health improvement and healthcare services being adopted
    throughout the Military Health System and in many venues in civilian
    practice. I commend the Air Force for taking the lead on some PCMH
    practices. The PCMH will be the principal enabler to improve readiness
    of the force and continuity of access to tailored patient services. It
    is a design that the Army will apply to all primary care settings.
        Dr. Paul Grundy, Director of Healthcare Transformation at IBM,
    pointed out that ``a smarter health system forges partnerships in order
    to deliver better care, predict and prevent disease and empower
    individuals to make smarter choices.'' In his estimation, the PCMH is
    ``advanced primary care.'' According to Dr. Grundy the PCMH can build
    trust between patient and physician, improve the patient experience of
    care, reduce staff burnout, and hold the line on expenditures.
        The Medical Home philosophy concentrates on what a patient requires
    to remain healthy, to restore optimal health, and when needed, to
    receive tailored healthcare services. It relies upon building enduring
    relationships between patient and their provider--doctor, nurse
    practitioner, physician assistant and others--and a comprehensive and
    coordinated approach to care between providers and community services.
    This means much greater continuity of care, with patients seeing the
    same physician or professional partner 95 percent of the time. The
    result is more effective healthcare for both the provider and the
    patient that is based on trust and rapport.
        The PCMH integrates the patient into the healthcare team, offering
    aggressive prevention and personalized intervention. Physicians will
    not just evaluate their patients for disease to provide treatment, but
    also to identify risk of disease, including genetic, behavioral,
    environmental, or occupational risk. The healthcare team encourages
    healthy lifestyle behaviors, and success will be measured by how
    healthy they keep their patients, rather than by how many treatments
    they provide. The goal is that people will live longer lives with less
    morbidity, disability and suffering.
        Community Based Medical Homes (CBMHs) are part of the Army's
    implementation of the Patient Centered Medical Home. CBMHs are Army
    operated primary care clinics located in leased space in the off-post
    communities in which many of our active duty Families live. These
    clinics are extensions of the Army Hospital and staffed by government
    civilians. Active duty Family members receive enrollment priority. This
    initiative was undertaken to improve access and continuity to
    healthcare services, including behavioral health, for active duty
    Family members by expanding capacity and extending MTF services off-
    post. The Army has grown and consumption of healthcare services is on
    the rise as a result of the war. These clinics will help Army Medicine
    improve quality of care and the patient experience; improve value
    through standardization and optimization of resources enabling
    operations at an economic advantage to the DOD; and improve the
    readiness of our Army and our Army Families. Clinics are placed where
    Families lacked access to Army primary care services and currently 17
    clinics are being developed in 13 markets. Recently clinics supporting
    Fort Campbell, Fort Sill, Fort Stewart and Fort Bragg have opened and
    initial feedback has been outstanding.
        The CBMHs build upon and are in many ways the culmination of a
    MEDCOM--wide campaign to closely monitor and reduce barriers to access
    and continuity; improve clinic productivity through standardization of
    administrative operations and support; to leverage improved health
    information management tools like AHLTA; and to incentivize commanders
    and providers to provide the right kind of care so as to improve
    individual and community health and outcomes of healthcare delivery in
    accordance with evidenced-based practices for chronic illness.
        We are adopting other methods as well to ensure better outcomes for
    patient care. At the MEDCOM, we have implemented a performance-based
    adjustment model (PBAM) to increase hospital and department
    responsibilities for how our funding is spent in health improvement and
    the delivery of healthcare services. PBAM creates a justifiable budget
    by a business planning process that links to outputs, such as volume or
    complexity of procedures. With the need for greater accountability and
    transparency, the MEDCOM has used PBAM to create performance measures
    that are consistent and can be compared across our facilities. We have
    experienced gains in total output, gains in provider efficiency, and
    increases in coding accuracy all aimed at improved outcomes of care--a
    more effective system for our beneficiaries and the Army. Incentives
    which are built into the program have measurably improved health and
    compliance with science--or--evidence-based care for chronic disease
    like diabetes and asthma.
        Army Medicine is committed to using evidence-based practices which
    provide the most effective treatment for the variety of medical issues
    confronting our patient population and especially those issues caused
    by the almost 10 years of war such as pain management. An Army at war
    for almost a decade recognizes it has accumulated significant issues
    with acute and chronic pain amongst its Soldiers. In August 2009, I
    chartered the Army Pain Management Task Force to make recommendations
    for a MEDCOM comprehensive pain management strategy. I appointed
    Brigadier General Richard Thomasas the Task Force Chairperson. Task
    Force membership included a variety of medical specialties and
    disciplines from the Army, as well as representatives from the Navy,
    Air Force, TRICARE Management Activity, and VA.
        The Pain Management Task Force developed 109 recommendations that
    lead to a comprehensive pain management strategy that is holistic,
    multidisciplinary, and multimodal in its approach, utilizes state of
    the art/science modalities and technologies, and provides optimal
    quality of life for Soldiers and other patients with acute and chronic
    pain. The Army Medical Command is operationalizing recommendations
    through the Pain Management Campaign Plan. I am proud to say that Army
    Medicine was recognized by the American Academy of Pain Medicine with
    the Presidential Commendation for its impact on pain medicine in the
    United States.
        An important objective of the Pain Management Task Force calls for
    building a full spectrum of best practices for the continuum of pain
    care, from acute to chronic, which is based on a foundation of the best
    available evidence based medicine. This can be accomplished through the
    adoption of an integrative and interdisciplinary approach to managing
    pain. Pain management should be handled by integrated care teams that
    use a biopsychosocial model of care. The standard of care should
    decrease overreliance on medication driven solutions and create an
    interdisciplinary approach that encourages collaboration among
    providers from differing specialties.
        The DOD should continue to responsibly explore safe and effective
    use of advanced and non-traditional approaches to pain management and
    support efforts to make these modalities covered benefits once they
    prove safe, effective and cost efficient. One way to achieve an
    interdisciplinary, multimodal and holistic approach to pain management
    is by incorporating complementary and alternative therapies--
    integrative approaches--into an individualized pain management plan of
    care to include acupuncture, massage therapy, movement therapy, yoga,
    and other tools in mind-body medicine. To best address the goal of
    patient-centered care, providers must work in partnership with patients
    and Families in providing health promotion options while maintaining
    efficacy and safety standards. This integration needs to be methodical,
    appropriate, and evaluated throughout the process to ensure the best
    potential outcomes.
        While the Pain Management Task Force has worked to expand the use
    of non-medication pain management modalities, as combat operations
    continue, more Soldiers are presenting with physical or psychological
    conditions, or both, which require clinical care, including medication
    therapy. Consequently, some of them may be treated for multiple
    conditions with a variety of medications prescribed by several
    healthcare providers. While the resulting ``polypharmacy''--the use of
    multiple prescription or other medications--can be therapeutic in the
    treatment of some conditions, in other cases it can unwittingly lead to
    increased risk to patients. New Army policies and procedures to
    identify and mitigate polypharmacy have reduced the risk of these
    factors in garrison and deployed environments.
        Polypharmacy is not unique to military medical practice and is also
    a patient safety issue in the civilian medical community. The risks of
    polypharmacy include overdose (intentional or accidental); toxic
    interactions with other medications or alcohol; increased risk of
    adverse effects of medications; unintended impairment of alertness or
    functioning that may result in accident and injury; and the development
    of tolerance, withdrawal, and addiction to potentially habit-forming
    medications.
        U.S. Army Medical Command has issued guidance for enhancing patient
    safety and reducing risk via the prevention and management of
    polypharmacy. For example, Soldiers and Commanders are educated to take
    responsibility for, and active roles in, ensuring effective
    communication between patients and primary care managers to formulate
    treatment plans and address potential issues of polypharmacy. Annual
    training on managing polypharmacy patients is required for clinicians
    who prescribe psychotropic agents or central nervous system
    depressants. And through the electronic health record, patient health
    information, including prescriptions, is shared among providers to
    increase awareness of those patients with multiple medications.
        Evidence-based science makes strong Soldiers and we rely heavily on
    the U.S. Army Medical Research and Material Command (MRMC). Under the
    leadership of Major General James Gilman, MRMC manages and executes a
    robust, ongoing medical research program for the MEDCOM to support the
    development of new healthcare strategies. I would like to highlight a
    few research programs that are impacting health and care of our
    Soldiers today.
        The Combat Casualty Care Research Program (CCCRP) reduces the
    mortality and morbidity resulting from injuries on the battlefield
    through the development of new life-saving strategies, new surgical
    techniques, biological and mechanical products, and the timely use of
    remote physiological monitoring. The CCCRP focuses on leveraging
    cutting-edge research and knowledge from government and civilian
    research programs to fill existing and emerging gaps in combat casualty
    care. This focus provides requirements-driven combat casualty care
    medical solutions and products for injured Soldiers from self-aid
    through definitive care, across the full spectrum of military
    operations.
        The mission of the Military Operational Medicine Research Program
    (MOMRP) is to develop effective countermeasures against stressors and
    to maximize health, performance, and fitness, protecting the Soldier at
    home and on the battlefield. MOMRP research helps prevent physical
    injuries through development of injury prediction models, equipment
    design specifications and guidelines, health hazard assessment
    criteria, and strategies to reduce musculoskeletal injuries.
        MOMRP researchers develop strategies and advise policy makers to
    enhance and sustain mental fitness throughout a service member's
    career. Psychological health problems are the second leading cause of
    evacuation during prolonged or repeated deployments. MOMRP
    psychological health and resilience research focuses on prevention,
    treatment, and recovery of Soldiers and Families behavioral health
    problems, which are critical to force health and readiness. Current
    psychological health research topic areas include behavioral health,
    resiliency building, substance use and related problems, and risk-
    taking behaviors.
        The Clinical and Rehabilitative Medicine Research Program (CRMRP)
    focuses on definitive and rehabilitative care innovations required to
    reset our wounded warriors, both in terms of duty performance and
    quality of life. The Armed Forces Institute of Regenerative Medicine
    (AFIRM) is an integral part of this program. The AFIRM was designed to
    speed the delivery of regenerative medicine therapies to treat the most
    severely injured U.S. service members from around the world but in
    particular those coming from the theaters of operation in Iraq and
    Afghanistan. The AFIRM is expected to make major advances in the
    ability to understand and control cellular responses in wound repair
    and organ/tissue regeneration and has major research programs in Limb
    Repair and Salvage, Craniofacial Reconstruction, Burn Repair, Scarless
    Wound Healing, and Compartment Syndrome.
        The AFIRM's success to date is at least in part the result of the
    program's emphasis on establishing partnerships and collaborations. The
    AFIRM is a partnership among the U.S. Army, Navy, and Air Force, the
    Department of Defense, the VA, and the National Institutes of Health.
    The AFIRM is composed of two independent research consortia working
    with the U.S. Army Institute of Surgical Research. One consortium is
    led by the Wake Forest Institute for Regenerative Medicine and the
    McGowan Institute for Regenerative Medicine in Pittsburgh while the
    other is led by Rutgers--the State University of New Jersey and the
    Cleveland Clinic. Each consortium contains approximately 15 member
    organizations, which are mostly academic institutions.
        MRMC is also the coordinating office for the DOD Blast Injury
    Research Program. The Blast Injury Research Program is addressing
    critical medical research gaps for blast-related injuries and is
    developing partnerships with other DOD and external medical research
    laboratories to achieve a cutting-edge approach to solving blast injury
    problems. One of the program's major areas of focus is the improvement
    of battlefield medical treatment capabilities to mitigate neurotrauma
    and hemorrhage. Additionally, the program is modernizing military
    medical research by bringing technology advances and new research
    concepts into DOD programs.
        We created a systematic and integrated approach to better organize
    and coordinate battlefield care to minimize morbidity and mortality,
    and optimize the ability to provide essential care required for
    casualty injuries--the Joint Theater Trauma System (JTTS). JTTS focuses
    on improving battlefield trauma care through enabling the right
    patient, at the right place, at the right time, to receive the right
    care. The components of the JTTS include prevention, pre-hospital
    integration, education, leadership and communication, quality
    improvement/performance improvement, research and information systems.
    The JTTS was modeled after the civilian trauma system principles
    outlined in the American College of Surgeons Committee on Trauma
    Resources for Optimal Care.
        Effectiveness and efficiency are also enhanced by electronic tools.
    To support DOD and VA collaboration on treating PTSD, pain, and other
    healthcare issues, the Electronic Health Record (EHR) should seamlessly
    transfer patient data between and among partners to improve
    efficiencies and continuity of care. The DOD and the VA share a
    significant amount of health information today and no two health
    organizations in the nation share more non-billable health information
    than the DOD and VA. The Departments continue to standardize sharing
    activities and are delivering information technology solutions that
    significantly improve the secure sharing of appropriate electronic
    health information. We need to include electronic health information
    exchange with our civilian partners as well--a health information
    systems which brings together three intersecting domains--DOD, VA,
    civilian--for optimal sharing of beneficiary health information and to
    provide a common operating picture of healthcare delivery. These
    initiatives enhance healthcare delivery to beneficiaries and improve
    the continuity of care for those who have served our country.
    Previously, the burden was on service members to facilitate information
    sharing; today, we are making the transition between DOD and VA easier
    for our service members.
        The Office of the Surgeon General (OTSG) works closely with Defense
    Health Information Management System of Health Affairs/TRICARE
    Management Activity in pursuing additional enhancements and fixes to
    AHLTA. The OTSG Information Management Division also continues to
    implement the MEDCOM AHLTA Provider Satisfaction Program, which now
    provides dictation and data entry software applications, tablet
    computing hardware, business process management, clinical business
    intelligence, and clinical systems training and integration to the
    providers and users of AHLTA. OTSG is taking the EHR lead in designing
    and pursuing the next generation of the EHR by participating in DOD and
    Inter-agency projects such as the EHR Way Ahead, the Virtual Lifetime
    Electronic Record Pilot Project, Nationwide Health Information Network,
    In-Depth EHR Training, and VA/DOD Sharing Initiatives. We are aligned
    with the Air Force's COMPASS program in ensuring that our providers and
    our clinics have the best and most user-friendly EHR.
        The Medical Command was reorganized in October 2010, to align
    regional medical commands (RMCs) with TRICARE regions with the
    resulting effect of improved readiness and support for the Army's
    iterative process of providing expeditionary, modular fighting units
    under the ARFORGEN cycle. We are well on the way to standardizing
    structure and staffing for RMC headquarters to provide efficiencies and
    ensure standardized best practices across Army Medicine. Three CONUS-
    based regional medical commands, down from four, are now aligned with
    the TRICARE regions to provide healthcare in a seamless way with our
    TRICARE partners.
        In addition to TRICARE alignment, each region will contain an Army
    Corps headquarters, and health-care assets will be better aligned with
    beneficiary population of the regions. Each RMC has a deputy commander
    who is responsible for a readiness cell to coordinate and collaborate
    with the ARFORGEN cycle. This regional readiness cell will reach out to
    Reserve Component elements within their areas of responsibility to
    ensure that all medical and dental services required during the
    ARFORGEN cycle of the Reserve units are also identified and provided.
        In recent years, the Army has transformed how it provides
    healthcare to its Soldiers, with improvements impacting every aspect of
    the continuum of care. The Patient Centered Medical Home and the
    Warrior Transition Command are examples of the Army's strong commitment
    to adapt and improve its ability to provide the best care possible for
    our Soldiers and their Families. We have a duty and responsibility to
    our Soldiers, Families, and retirees. The level of care required does
    not end when the deployed Soldier returns home; there will be
    considerable ongoing healthcare costs for many years to support for our
    wounded, ill, or injured Service members. They need to trust we will be
    there to manage the health related consequences of over 9 years of war,
    including behavioral healthcare, post-traumatic stress, burn or
    disfiguring injuries, chronic pain or loss of limb. We will require
    ongoing research to establish more effective methodologies for
    treatment. Army Medicine remains focused on developing partnerships to
    achieve the aims of the MHS as we work together to provide cost
    effective care to improve the health of our Soldiers. The goal is to
    provide the best care and access possible for Army Families and
    retirees and to ensure optimal readiness for America's fighting forces
    and their Families.
        Last, I would like to join General Casey in expressing support for
    the military healthcare program changes included in the fiscal year
    2012 budget. The changes include modest enrollment fee increases for
    working-age retirees, pharmacy co-pay adjustments, aligning Defense
    reimbursements to sole community hospitals to Medicare consistent with
    current statute, and shifting future Uniformed Services Family Health
    Plan enrollees into the TRICARE-for-Life/Medicare program established
    by Congress in the fiscal year 2001 National Defense Authorization Act.
        In closing, over the past 40 months as the Army Surgeon General I
    have had numerous occasions to appear before this subcommittee, meet
    individually with you and your fellow members and interact with your
    staff. I have appreciated your tough questions, valuable insight, sage
    advice and deep commitment to your Army's Soldiers and their Families.
    Thank you for this opportunity to share Army Medicine with you. I am
    proud to serve with the Officers, Non-commissioned Officers, the
    enlisted Soldiers and civilian workforce of Army Medicine. Their
    dedication makes our Nation strong and our Soldiers and Families
    healthy and resilient.
        Thank you for your continued support of Army Medicine and to our
    Nation's men and women in uniform.
        Army Medicine: Building Value . . . Inspiring Trust

        Chairman Inouye. And now may I call upon Admiral Robinson.
    STATEMENT OF VICE ADMIRAL ADAM M. ROBINSON, JR.,
                SURGEON GENERAL, DEPARTMENT OF THE NAVY
        Admiral Robinson. Good morning.
        Chairman Inouye, Vice Chairman Cochran, I am pleased to be
    with you today, and I want to thank the subcommittee for the
    tremendous confidence and unwavering support of Navy medicine,
    particularly as we continue to care for those who go in harm's
    way, their families, and all beneficiaries.
        Force health protection is the bedrock of Navy medicine. It
    is our duty, our obligation, and our privilege to promote,
    protect, and restore the health of our sailors and marines. The
    mission spans the full spectrum of healthcare from optimizing
    the health and fitness of the force, to maintaining robust
    disease surveillance and prevention programs, to saving lives
    on the battlefield. It also involves providing humanitarian
    assistance and disaster response around the world, and this is
    no more evident than in our efforts currently underway in Japan
    following the devastating earthquake and tsunami last month. I,
    along with my fellow surgeons general, traveled to Afghanistan
    in February and again witnessed the stellar performance of our
    dedicated men and women, both Active and Reserve, delivering
    expeditionary combat casualty care. At the NATO Role 3
    Multinational Medical Unit, Navy medicine is currently leading
    the joint and combined staff to provide the largest medical
    support in Kandahar. We are working side by side with Army and
    Air Force medical personnel, rapidly implementing best
    practices and employing unique skill sets in support of their
    demanding mission, leaving no doubt that the historically
    unprecedented survival rate from the battlefield is the direct
    result of better trained and equipped personnel, in conjunction
    with improved systems of treatment and casualty evacuation.
        We spend a lot of time discussing what constitutes world
    class healthcare. There is no doubt in my mind that the trauma
    care being provided in theater today is truly world class, as
    are the men and women delivering it. I am pleased to report to
    you that their morale is high and professionalism is unmatched.
        We also had the opportunity to visit our Concussion
    Restoration Care Center at Camp Leatherneck in Helmand
    Province. The center, which opened last August, assesses and
    treats service members with concussion, or mild traumatic brain
    injury, and musculoskeletal injuries. The goal is safely
    returning them to duty--to full duty following recovery. The
    Restoration Center, along with the initiatives like OSCAR, our
    Operational Stress Control and Readiness Program, where we
    embed full-time mental health personnel with deployed marines,
    continues to reflect our priority of positioning our medical
    personnel with deploying marines--our medical personnel and
    resources where they are most needed.
        Navy medicine has no greater responsibility than caring for
    our service members, wherever and whenever they need us. We
    understand that preserving the psychological health of service
    members and their families is one of the greatest challenges we
    face today. We also know that nearly a decade of continuous
    combat operations has resulted in a growing population of
    service members suffering with traumatic brain injury. We are
    forging ahead with improved screening, surveillance, treatment,
    education, and research; however, there is still much we do not
    yet know about these injuries and their long-term impact on the
    lives of our service members.
        I would specifically highlight the issuance of the
    directive-type memorandum in June 2010, which has increased
    line leaders' awareness of potential traumatic brain injury
    exposure, and, importantly, it mandates post-blast evaluations
    and removal of blast-exposed warfighters to promote recovery.
        We also recognize the importance of collaboration and
    partnership. Our collective efforts include those coordinated
    jointly with the other services, the Department of Veterans
    Affairs, the Centers of Excellence, as well as leading academic
    and research institutions.
        Let me now turn to patient and family centered care.
    Medical Home Port is Navy medicine's patient-centered medical
    home model, an important initiative that will significantly
    impact how we provide care to our beneficiaries. Medical Home
    Port emphasizes team-based, comprehensive care and focuses on
    the relationship between the patient, their provider, and the
    healthcare team. We continue to move forward with the phased
    implementation of Medical Home Port at our medical centers and
    family medicine teaching hospitals. An initial response from
    our patients and our providers is very encouraging.
        Finally, I would like to address the proposed Defense
    Health Program cost efficiencies. Rising healthcare costs
    within the military health system continue to present
    challenges. The Secretary of Defense has articulated that the
    rate at which healthcare costs are increasing and the relative
    proportion of the Department's resources devoted to healthcare
    cannot be sustained. The Department of the Navy fully supports
    the Secretary's plan to better manage costs moving forward and
    ensure our beneficiaries have access to the quality care that
    is the hallmark of military medicine.
        In summary, I am proud of the progress we are making, but
    not satisfied. We continue to see groundbreaking innovations in
    combat casualty care and remarkable heroics in saving lives.
    But all of us remain concerned about the cumulative effects of
    worry, stress, and anxiety on our service members and their
    families brought about by a decade of conflict. Each day
    resonates with the sacrifices that our sailors, marines, and
    their families make quietly and without bravado. It is this
    commitment, this selfless service, that helps inspire us in
    Navy medicine. Regardless of the challenges ahead, I am
    confident that we are well positioned for the future.
        As my last cycle of hearings is now coming to a close, as
    is my Navy career, I would like to thank this subcommittee and
    the entire Congress for their support of Navy medicine and
    everything that you have done to make sure that our men and
    women have the best in every possibility, both on the
    battlefield, in their recovery, and after they are out of the
    service.

                               PREPARED STATEMENT

        I appreciate the opportunity to be here today, and I look
    forward to your questions. Thank you very much.
        Chairman Inouye. Thank you very much, Admiral.
         [The statement follows:]
            Prepared Statement of Vice Admiral Adam M. Robinson, Jr.
                                  introduction
        Chairman Inouye, Vice Chairman Cochran, distinguished Members of
    the Subcommittee, I am pleased to be with you today to provide an
    update on Navy Medicine, including some of our accomplishments,
    challenges and strategic priorities. I want to thank the Committee
    Members for the tremendous confidence and unwavering support of Navy
    Medicine, particularly as we continue to care for those who go in
    harm's way, their families and all beneficiaries.
        Navy Medicine delivers world class care, anytime, anywhere. We are
    forward-deployed and engaged around the world every day, no matter what
    the environment and regardless of the challenge. The operational tempo
    of this past year continues to demonstrate that we must be flexible,
    adaptable and ready to respond globally. We will be tested in our
    ability to meet our operational and humanitarian assistance
    requirements, as well as maintain our commitment to provide patient and
    family centered care to a growing number of beneficiaries. However, I
    am proud to say that Navy Medicine is responding to these challenges
    with skill, commitment and compassion.
               strategic alignment, integration and efficiencies
        Strategic alignment with the priorities of the Secretary of the
    Navy, Chief of Naval Operations and Commandant of the Marine Corps is
    critical to our ability to meet our mission. As a world-wide healthcare
    system, Navy Medicine is fully engaged in carrying out the core
    capabilities of the Maritime Strategy and the Cooperative Strategy for
    the 21st Century Seapower around the globe. Our ongoing efforts,
    including maintaining warfighter health readiness, conducting
    humanitarian assistance and disaster relief missions, protecting the
    health of our beneficiaries, as well as training our future force are
    critical to our future success.
        We also recognize the importance of alignment within the Military
    Health System (MHS) as evidenced by the adoption of the Quadruple Aim
    initiative as a primary focus of the MHS Strategic Plan. The Quadruple
    Aim applies the framework from the Institute for Healthcare Improvement
    (IHI) and customizes it for the unique demands of military medicine. It
    targets the MHS and Services' efforts on integral outcomes in the areas
    of readiness, population health and quality, patient experience and
    cost. The goal is to develop better outcomes and implement balanced
    incentives across the MHS.
        Within Navy Medicine, we continue to maintain a rigorous strategic
    planning process. Deliberative planning, constructive self-assessment
    and alignment at all levels of our organization, have helped create
    momentum and establish a solid foundation of measurable progress that
    drives change. It's paying dividends as we are seeing improved and
    sustained performance in our strategic objectives.
        This approach is particularly evident in our approach to managing
    resources. We are leveraging analytics to target resource decisions. An
    integral component of our Strategic Plan is providing performance
    incentives that promote quality and directly link back to workload,
    readiness and resources. We continue to evolve to a system which
    integrates requirements, resources and performance goals and promotes
    patient and family centered care. This transformation properly aligns
    authority, accountability and financial responsibility with the
    delivery of quality, cost-effective healthcare that remains patient and
    family centered.
        Aligning incentives helps foster process improvement particularly
    in the area of quality. Our Lean Six Sigma (LSS) program continues to
    be highly successful in identifying projects that synchronize with our
    strategic goals and have system-wide implications for improvement.
    Examples include reduced cycle time for credentialing providers and
    decreased waiting times for diagnostic mammography and ultrasound. I am
    also encouraged by our collaboration with the Johns Hopkins' Applied
    Physics Laboratory to employ industrial engineering practices to
    improve clinical processes and help recapture private sector workload.
        Navy Medicine continues to work within the MHS to realize cost
    savings through several other initiatives. We believe that robust
    promotion of TRICARE Home Delivery Pharmacy Program, implementation of
    supply chain management standardization for medical/surgical supplies
    and the full implementation of Patient-Centered Medical Home (PCMH)
    will be key initiatives that are expected to successfully reduce costs
    without compromising access and quality of care.
        Rising healthcare costs within the MHS continue to present
    challenges. The Secretary of Defense has articulated that the rate at
    which healthcare costs are increasing and relative proportion of the
    Department's resources devoted to healthcare, cannot be sustained. He
    has been resolute in his commitment to implement systemic efficiencies
    and specific initiatives which will improve quality and satisfaction
    while more responsibly managing cost.
        The Secretary of the Navy, Chief of Naval Operations and Commandant
    of the Marine Corps recognize that the MHS is not immune to the
    pressure of inflation and market forces evident in the healthcare
    sector. In conjunction with a growing number of eligible beneficiaries,
    expanded benefits and increased utilization throughout our system, it
    is incumbent upon us to ensure that we streamline our operations in
    order to get the best value for our expenditures. We have made
    progress, but there is more to do. We support the efforts to
    incentivize TRICARE Home Delivery Pharmacy Program and also to
    implement modest fee increases, where appropriate, to ensure equity in
    benefits for our retirees.
        The Department of the Navy (DON) fully supports the Secretary's
    plan to better manage costs moving forward and ensure our beneficiaries
    have access to the quality care that is the hallmark of military
    medicine. As the Navy Surgeon General, I appreciate the tremendous
    commitment of our senior leaders in this critical area and share the
    imperative in developing a more affordable and sustainable healthcare
    benefit.
        Navy Medicine has worked hard to get best value of every dollar
    Congress has provided and we will continue to do so. The President's
    budget for fiscal year 2012 adequately funds Navy Medicine to meet its
    medical mission for the Navy and Marine Corps. We are, however, facing
    challenges associated with operating under a potential continuing
    resolution for the remainder of the year, particularly in the areas of
    provider contracts and funding for facility special projects.
                            force health protection
        Force Health Protection is the bedrock of Navy Medicine. It is what
    we do and why we exist. It is our duty--our obligation and our
    privilege--to promote, protect and restore the health of our Sailors
    and Marines. This mission spans the full spectrum of healthcare, from
    optimizing the health and fitness of the force, to maintaining robust
    disease surveillance and prevention programs, to saving lives on the
    battlefield. When Marines and Sailors go into harm's way, Navy Medicine
    is with them. On any given day, Navy Medicine is underway and forward
    deployed with the Fleet and Marine Forces, as well as serving as
    Individual Augmentees (IAs) in support of our global healthcare
    mission.
        Clearly, our focus continues to be combat casualty care in support
    of Operation Enduring Freedom (OEF). I, along with my fellow Surgeons
    General, recently returned from the Central Command (CENTCOM) Area of
    Responsibility (AOR) and again witnessed the stellar performance of our
    men and women delivering expeditionary combat casualty care. At the
    NATO Role 3 Multinational Medical Unit, Navy Medicine is currently
    leading the joint and combined staff to provide the largest medical
    support in Kandahar with full trauma care to include 3 operating rooms,
    12 intensive care beds and 35 ward beds. This state-of-the-art facility
    is staffed with dedicated and compassionate active and reserve
    personnel who are truly delivering world-class care. Receiving 70
    percent of their patients directly from the point of injury on the
    battlefield, our doctors, nurses and corpsmen apply the medical lessons
    learned from 10 years of war to achieve a remarkable 97 percent
    survival rate for coalition casualties.
        The Navy Medicine team is working side-by-side with Army and Air
    Force medical personnel and coalition forces to deliver outstanding
    healthcare to U.S. military, coalition forces, contractors, Afghan
    national army, police and civilians, as well as detainees. The team is
    rapidly implementing best practices and employing unique skill sets
    with specialists such as an interventional radiologist, pediatric
    intensivist, hospitalist and others in support of their demanding
    mission. I am proud of the manner in which our men and women are
    responding--leaving no doubt that the historically unprecedented
    survival rate from battlefield injuries is the direct result of better
    trained and equipped personnel, in conjunction with improved systems of
    treatment and casualty evacuation.
        Combat casualty care is a continuum which begins with corpsmen in
    the field with the Marines. We are learning much about battlefield
    medicine and continue to quickly put practices in place that will save
    lives. All deploying corpsmen must now complete the Tactical Combat
    Casualty Care (TCCC) training. TCCC guidelines for burns, hypothermia
    and fluid resuscitation for first responders have also been updated.
    This training is based on performing those interventions on the
    battlefield that address preventable causes of death. In addition, we
    have expanded the use of Combat Application Tourniquets (CATs) and
    hemostatic impregnated bandages as well as improving both intravenous
    therapy and individual first aid kits (IFAKs) and vehicle medical kits
    (VMKs).
        We continue to see success with our Forward Resuscitative Surgical
    System (FRSS) which allows for stabilization within the ``golden
    hour''. The FRSS can perform 18 major operations over the course of 72
    hours without being re-supplied. Our ability to send medical teams
    further forward has improved survivability rates. To this end, we are
    clearly making tremendous gains in battlefield medicine throughout the
    continuum of care. Work being conducted by the Joint Theatre Trauma
    Registry and Joint Combat Casualty Research Teams are enabling us to
    capture, evaluate and implement clinical practice guidelines and best
    practices quickly.
                  humanitarian assistance and disaster relief
        Navy Medicine continues its commitment to providing responsive and
    comprehensive support for Humanitarian Assistance/Disaster Relief (HA/
    DR) missions around the world. We are often the first responder for HA/
    DR missions due to the presence of organic medical capabilities with
    forward deployed Navy assets. Our hospital ships, USNS Mercy (T-AH 19)
    and USNS Comfort (T-AH 20) are optimally configured to deploy in
    support of HCA activities in South America, the Pacific Rim and East
    Asia.
        Navy Medicine not only responds to disasters around the world and
    at home, we also conduct proactive humanitarian missions in places as
    far reaching as Africa through Africa Partnership Station to the
    Pacific Rim through Pacific Partnership and South America through
    Continuing Promise. Mercy's recent deployment in support of Pacific
    Partnership 2010, the fifth annual Pacific Fleet proactive humanitarian
    mission, is strengthening ongoing relationships with host and partner
    nations in Southeast Asia and Oceania. During the 144-day, six nation
    mission, we treated 109,754 patients, performed 859 surgeries and
    engaged in thousands of hours of medical subject matter expert
    exchanges.
        Our hospital ships are executing our Global Maritime Strategy by
    building the trust and cooperation we need to strengthen our regional
    alliances and empower partners around the world. With each successful
    deployment, we increase our interoperability with host and partner
    nations, non-governmental organizations and the interagency partners.
    Today's security missions must include humanitarian assistance and
    disaster response,
        Enduring HA missions such as Pacific Partnership and Continuing
    Promise, as well other Medical Readiness Education Training Exercises
    (MEDRETEs) provide valuable training of personnel to conduct future
    humanitarian support and foreign disaster relief missions. Our
    readiness was clearly evident by the success of Operation Unified
    Response (OUR) following the devastating earthquake in Haiti last year.
    Our personnel were trained and prepared to accomplish this challenging
    mission.
                                concept of care
        Patient and family centered care is our core philosophy--the
    epicenter of everything we do. We are providing comprehensive,
    compassionate healthcare for all our beneficiaries wherever they may be
    and whenever they may need it. Patient and family centered care helps
    ensure patient satisfaction, increased access, coordination of services
    and quality of care, while recognizing the vital importance of the
    family. Navy Medicine serves personnel throughout their treatment
    cycle, and for our Wounded Warriors, we manage every aspect of medicine
    in their continuum of care to provide a seamless transition from
    battlefield to bedside to leading productive lives.
        Medical Home Port is Navy Medicine's Patient-Centered Medical Home
    (PCMH) model, an important initiative that will significantly impact
    how we provide care to our beneficiaries. In alignment with my
    strategic goal for patient and family centered care, Medical Home Port
    emphasizes team-based, comprehensive care and focuses on the
    relationship between the patient, their provider and the healthcare
    team. The Medical Home Port team is responsible for managing all
    healthcare for empanelled patients, including specialist referrals when
    needed. Patients see familiar faces with every visit, assuring
    continuity of care. Appointments and tests get scheduled promptly and
    care is delivered face-to-face or when appropriate, using secure
    electronic communication. PCMH is being implemented by all Services and
    it is expected to improve population health, patient satisfaction,
    readiness, and is likely to impact cost in very meaningful ways.
        It is important to realize that Medical Home Port is not brick and
    mortar; but rather a philosophy and commitment as to how you deliver
    the highest quality care. A critical success factor is leveraging all
    our providers, and supporting information technology systems, into a
    cohesive team that will not only provide primary care, but integrate
    specialty care as well. We continue to move forward with the phased
    implementation of Medical Home Port at our medical centers and family
    medicine teaching hospitals, and initial response from our patients is
    very encouraging.
              caring for our heroes, their families and caregivers
        We have no greater responsibility than caring for our service
    members, wherever and whenever they need us. This responsibility spans
    from the deckplates and battlefield to our clinics, hospitals and
    beyond. This commitment to provide healing in body, mind and spirit has
    never been more important. Our case management programs, both medical
    and non-medical, play a vital role in the development of Comprehensive
    Recovery Plans to provide our war-injured service members' optimal
    outcomes. Case management is the link that connects resources and
    services for our Wounded Warriors and their families.
        Associated with this commitment, we must understand that preserving
    the psychological health of service members and their families is one
    of the greatest challenges we face today. We recognize that service
    members and their families are resilient at baseline, but the long
    conflict and related deployments challenge this resilience. DON is
    committed to providing programs that support service members and their
    families.
        The Navy Operational Stress Control program and Marine Corps Combat
    Operational Stress Control programs are the cornerstones of our
    approach to early detection of stress injuries in Sailors and Marines
    and are comprised of line-led programs which focus on leadership's role
    in monitoring the health of their people; tools leaders may employ when
    Sailors and Marines are experiencing mild to moderate symptoms; and
    multidisciplinary expertise (medical, chaplains and other support
    services) for more affected members.
        Navy Medicine's Psychological Health (PH) program supports the
    prevention, diagnosis, mitigation, treatment and rehabilitation of
    post-traumatic stress disorder (PTSD) and other mental health
    conditions, including planning for the seamless transition of service
    members throughout the recovery and reintegration process. We have
    increased the size of the mental health workforce to support the
    readiness and health needs of the Fleet and Marine Corps throughout the
    deployment cycle and, during fiscal year 2010, funded 221 clinical and
    support staff positions at 14 Navy military treatment facilities (MTFs)
    to help ensure timely access to care.
        Stigma remains a barrier; however, Navy and Marine Corps' efforts
    to decrease stigma have had preliminary success--with increased active
    leadership support and Operational Stress Control (OSC) training
    established throughout the Fleet and Marine Forces.
        Within the Marine Corps, we continue to see success with the
    Operational Stress Control and Readiness (OSCAR) program as well as the
    OSCAR Extender program. OSCAR embeds full-time mental health personnel
    with deploying Marines and uses existing medical and chaplain personnel
    as OSCAR Extenders and trained senior and junior Marines as mentors to
    provide support at all levels to reduce stigma and break down barriers
    to seeking help. Our priority remains ensuring we have the service and
    support capabilities for prevention and early intervention available
    where and when it is needed. OSCAR is allowing us to move forward in
    this important area.
        We recently deployed our third Navy Mobile Mental Health Care Team
    for a 6-month mission in Afghanistan. The team consists of three mental
    health clinicians, a research psychologist and an enlisted psychiatry
    technician. Their primary tool is the Behavioral Health Needs
    Assessment Survey (BHNAS). The results give an overall assessment of
    real time force mental health and well-being every 6 months, and can
    identify potential areas or sub-groups of concern for leaders. It
    assesses a wide variety of content areas, including mental health
    outcomes, as well as the risk and protective factors for those outcomes
    such as combat exposures, deployment-related stressors, positive
    effects of deployment, morale and unit cohesion. The Mobile Care Team
    also has a mental health education role and provides training in
    Psychological First Aid to Sailors in groups and individually.
    Ultimately, Psychological First Aid gives Sailors a framework to
    promote resilience in one another.
        Our Naval Center for Combat & Operational Stress Control (NCCOSC)
    is one way we are developing an environment that supports
    psychologically fit, ready and resilient Navy and Marine Corps forces.
    The goal is to demystify stress and help Sailors and Marines take care
    of themselves and their shipmates. NCCOSC continues to make progress in
    advancing research for the prevention, diagnosis and treatment of
    combat and operational stress injuries to include PTSD. They are
    involved in over 64 ongoing scientific projects with 3,525 participants
    enrolled. NCCOSC has recently developed a pilot program, Psychological
    Health Pathways, which is designed to ensure that clinical practice
    guidelines are followed and evidence-based care is practiced and
    tracked. To date, 1,554 patients have been enrolled into the program
    with 600,062 points of clinical data gathered. The program involves
    intensive mental health case management, use of standardized measures,
    provider training and comprehensive data tracking.
        In November 2010, we launched a pilot program, Overcoming Adversity
    and Stress Injury Support (OASIS) at the Naval Medical Center, San
    Diego. Developed by Navy Medicine personnel and located onboard the
    Naval Base Point Loma, California, OASIS is a 10-week residential
    program designed to provide intensive mental healthcare for service
    members with combat related mental health symptoms from post-traumatic
    stress disorder, as well as major depressive disorders, anxiety
    disorders and substance abuse problems. The program offers a
    comprehensive approach, focusing on mind and body through various
    methods including yoga, meditation, spirituality classes, recreation
    therapy, art therapy, intensive sleep training, daily group therapy,
    individual psychotherapy, family skills training, medication management
    and vocational rehabilitation. We will be carefully assessing the
    efficacy of this pilot program throughout this year.
        Associated with our Operational Stress Control efforts, suicide
    prevention remains a key component. Suicide destroys families and
    impacts our commands. We are working hard at all levels to build the
    resilience of our Sailors and Marines and their families, as well as
    foster a culture of awareness and intervention by the command and
    shipmates. Our programs are focused on leadership engagement,
    intervention skills, community building and access to quality
    treatment. All of us in uniform have a responsibility to care for our
    shipmates and remain vigilant for signs of stress. A-C-T (Ask--Care--
    Treat) remains an important framework of response. In 2010, both the
    Navy and Marine Corps saw reductions in the number of suicides from the
    prior year, with the Navy seeing a reduction of 17 percent while the
    Marine Corps realized a 29 percent drop.
        We are also committed to improving the psychological health,
    resiliency and well-being of our family members. When our Sailors and
    Marines deploy, our families are their foothold. Family readiness is
    force readiness and the physical, mental, emotional, spiritual health
    and fitness of each individual is critical to maintaining an effective
    fighting force. A vital aspect of caring for our Warriors is also
    caring for their families and we continue to look for innovative ways
    to do so.
        To meet this growing challenge, Navy Medicine began an unparalleled
    approach in 2007 called Project FOCUS (Families OverComing Under
    Stress) to help our families. FOCUS is a family centered resiliency
    training program based on evidenced-based interventions that enhances
    understanding, psychological health and developmental outcomes for
    highly stressed children and families. FOCUS has been adapted for
    military families facing multiple deployments, combat operational
    stress, and physical injuries in a family member. It is an 8-week,
    skill-based, trainer-led intervention that addresses difficulties that
    families may have when facing the challenges of multiple deployments
    and parental combat related psychological and physical health problems.
    It has demonstrated that a strength-based approach to building child
    and family resiliency skills is well received by service members and
    their family members. Notably, program participation has resulted in
    statistically significant increases in family and child positive coping
    and significant reductions in parent and child distress over time,
    suggesting longer-term benefits for military family wellness.
        Project FOCUS has been highlighted by the Interagency Policy
    Committee on Military Families Report to the President (October 2010)
    and has been recognized by the Department of Defense (DOD) as a best
    practice. Given the success FOCUS has demonstrated thus far, we will
    continue to devote our efforts to ensuring our service members and
    their families have access to this program. To date, over 160,000
    Service members, families and community support providers have received
    FOCUS services, across 23 locations CONUS and OCONUS.
        Our programs must address the needs of all of our Sailors, Marines
    and families, including those specifically targeted to the unique needs
    of reservists and our caregivers. The Reserve Psychological Health
    Outreach Program (RPHOP) identifies Navy and Marine Corps Reservists
    and their families who may be at risk for stress injuries and provides
    outreach, support and resources to assist with issue resolution and
    psychological resilience. An effective tool at the RPHOP Coordinator's
    disposal is the Returning Warrior Workshop (RWW), a 2-day weekend
    program designed specifically to support the reintegration of returning
    Reservists and their families following mobilization. Some 54 RWWs have
    been held since 2008 with over 6,000 military personnel, family members
    and guests attending.
        Navy Medicine is also working to enhance the resilience of
    caregivers to the psychological demands of exposure to trauma, wear and
    tear, loss, and inner conflict associated with providing clinical care
    and counseling through the Caregiver Occupational Stress Control
    (CgOSC) Program. The core objectives are early recognition of distress,
    breaking the code of silence related to stress reactions and injuries,
    and engaging caregivers in early help as needed to maintain both
    mission and personal readiness.
        In addition, the Naval Health Research Center (NHRC) produced ``The
    Docs'', a 200-page graphic novel, as a communication tool to help our
    corpsmen with the stresses of combat deployments. ``The Docs'' is the
    story of four corpsmen deployed to Iraq. While some events in the novel
    are specific to Operation Iraqi Freedom (OIF), it is not intended to
    depict any specific time period or conflict but rather highlight
    general challenges faced by corpsmen who serve as the ``Docs'' in a
    combat zone. It was developed with the intent to instill realistic
    expectations of possible deployment stressors and to provide examples
    for corpsmen on helpful techniques for in-theater care of stress
    injuries. This format was chosen for its value in providing thought-
    provoking content for discussion in training scenarios and to appeal to
    the targeted age group.
        Nearly a decade of continuous combat operations has resulted in a
    growing population of service members suffering with Traumatic Brain
    Injury (TBI), the very common injury of OEF and OIF. The majority of
    TBI injuries are categorized as mild, or in other words, a concussion.
    We know more about TBI and are forging ahead with improved
    surveillance, treatment and research. However, we must recognize that
    there is still much we do not yet know about these injuries and their
    long-term impacts on the lives of our service members.
        Navy Medicine is committed to ensuring thorough screening for all
    Sailors and Marines prior to expeditionary deployment, enhancing the
    delivery of care in theater, and the identification and testing of all
    at-risk individuals returning from deployment. We are committed to
    enhancing training initiatives, developing better tools to detect
    changes related to TBI and sustaining research into better treatment
    options.
        Pre-deployment screening is prescribed using the Automated
    Neuropsychological Assessment Metrics (ANAM). Testing has expanded to
    Navy and Marine Corps worldwide, enhancing the ability to establish
    baseline neurocognitive testing for expeditionary deployers. This
    baseline test has provided useful comparative data for medical
    providers in their evaluation, treatment and counseling of individuals
    who have been concussed in theater.
        In-theater screening and treatment has also improved over time. The
    issuance of the Directive-Type Memorandum (DTM) 09-033 in June 2010 has
    increased leaders' awareness of potential TBI exposure and mandates
    post-blast evaluations and removal of blast-exposed warfighters from
    high risk situations to promote recovery. Deploying medical personnel
    are trained in administering the Military Acute Concussion Evaluation
    (MACE), a rapid field assessment to help corpsmen identify possible
    concussions. Additionally, deploying medical providers receive training
    on the DTM requirements and in-theater Clinical Practice Guidelines
    (CPGs) for managing concussions.
        In August 2010, the Marine Corps, supported by Navy Medicine,
    opened the Concussion Restoration Care Center (CRCC) at Camp
    Leatherneck in Helmand Province to assess and treat service members
    with concussion or musculoskeletal injuries, with the goal of safely
    returning as many service members as possible to full duty following
    recovery of cognitive and physical functioning. The CRCC is supported
    by an interdisciplinary team including sports medicine, family
    medicine, mental health, physical therapy and occupational therapy. I
    am encouraged by the early impact the CRCC is having in theatre by
    providing treatment to our service members close to the point of injury
    and returning them to duty upon recovery. We will continue to focus our
    attention on positioning our personnel and resources where they are
    most needed.
        Post-deployment surveillance for TBI is accomplished through the
    Post-Deployment Health Assessment (PDHA) and Post-Deployment Health
    Reassessment (PDHRA), which are required for returning deplorers.
    Further evaluation, treatment and referrals are provided based on
    responses to certain TBI-specific questions on the assessments.
        TBI research efforts are focused on continuing to refine tools for
    medical staff to use to detect and treat TBI. Two specific examples are
    a study of cognitive and physical symptoms in USMC Breacher instructors
    (who have a high lifetime exposure rate to explosive blasts) and an
    ongoing surveillance effort with USMC units with the highest identified
    concussion numbers to determine the best method for identifying service
    members requiring clinical care. These efforts are coupled with post-
    deployment ANAM testing for those who were identified as sustaining at
    least one concussion in theater. Other efforts are underway to identify
    physical indicators and biomarkers for TBI, such as blood tests, to
    help in diagnosis and detection. We are also conducting evaluations of
    various neurocognitive assessment tools to determine if there is a
    ``best'' tool for detecting concussion effects in the deployed
    environment. Our efforts also include those coordinated jointly with
    the other Services, the Defense and Veterans Brain Injury Center
    (DVBIC), and the Defense Centers of Excellence for Psychological Health
    and Traumatic Brain Injury (DCoE).
        I am committed to ensuring that we build on the vision advanced by
    the Members of Congress and the hard work of the dedicated
    professionals at all the Centers of Excellence, MTFs, research centers
    and our partners in both the public and private sectors. These Centers
    of Excellence have become important components of the Military Health
    System and their work in support of clinical best practices, research,
    outreach and treatment must continue with unity of effort and our
    strong support.
        Our service members must have access to the best treatment,
    research and education available for PH and TBI. We continue to see
    progress as evidenced by the opening of the National Intrepid Center of
    Excellence (NICoE) onboard the National Naval Medical Center campus. As
    a leader in advancing state-of-the-art treatment, research, education
    and training, NICoE serves as an important referral center primarily
    for service members and their families with complex care needs, as well
    as a hub for best practices and consultation. NICoE also conducts
    research, tests new protocols and provides comprehensive training and
    education to patients, providers and families--all vital to advancing
    medical science in PH and TBI.
        Navy Medicine is also working with the DCoE, its component centers
    including DVBIC, the Department of Veterans Affairs, research centers,
    and our partners in both the public and private sectors to support best
    clinical practices, research and outreach. We continue to see gains in
    both the treatment and development of support systems for our Wounded
    Warriors suffering with these injuries; however, we must recognize the
    challenging and extensive work that remains. Our commitment will be
    measured in decades and generations and must be undertaken with urgency
    and compassion.
                             the navy medicine team
        Our people are our most important assets, and their dignity and
    worth are maintained through an atmosphere of service, professionalism,
    trust and respect. Navy Medicine is fortunate to have over 63,000
    dedicated professionals working to improve and protect the health of
    Sailors, Marines and their families. Our team includes officers,
    enlisted personnel, government civilians and contractors working
    together in support of our demanding mission. I have been privileged to
    meet many of them in all environments--forward-deployed with the
    operating forces, in our labs and training facilities, at the bedside
    in our medical centers and hospitals--and I'm always inspired by their
    commitment.
        We are working diligently to attract, recruit and retain our Navy
    Medicine personnel. Overall, I remain encouraged with the progress we
    are making in recruiting and overall manning and we are seeing the
    successes associated with our incentive programs. In fiscal year 2010,
    we met our Active Medical Department recruiting goal and attained 90
    percent of Reserve Medical Department goal, but there was a notable
    shortfall in Reserve Medical Corps recruiting at 70 percent. Given the
    relatively long training pipeline for many of our specialties, we
    clearly recognize the impact that recruiting shortfalls in prior years,
    particularly in the Health Professions Scholarship Program (HPSP), can
    have in meeting specialty requirements today and moving forward.
    Recruiting direct accession physicians and dentists remains
    challenging, requiring our scholarship programs to continue recent
    recruiting successes to meet inventory needs. Retention has improved
    for most critical wartime specialties, supported by special pay
    initiatives; however, some remain below our requirements and continue
    to be closely monitored.
        Within the active component Medical Corps, general surgery, family
    medicine and psychiatry have shortfalls, as does the Dental Corps with
    general dentistry and oral maxillofacial surgery specialties. We are
    also experiencing shortfalls for nurse anesthetists, perioperative and
    critical care nurses, family nurse practitioners, clinical
    psychologists, social workers and physician assistants.
        The reserve component shortages also exist within anesthesiology,
    neurosurgery, orthopedic surgery, internal medicine, psychiatry,
    diagnostic radiology, comprehensive dentistry and oral maxillofacial
    surgery as well as perioperative nursing, anesthesia and mental health
    nurse practitioners.
        We appreciate your outstanding support for special pays and bonus
    programs to address these shortages. These incentives will continue to
    be needed for future success in both recruiting and retention. We are
    working closely with the Chief of Naval Personnel and Commander, Naval
    Recruiting Command to assess recruiting incentive initiatives and
    explore opportunities for improvement.
        For our civilian personnel within Navy Medicine, we are also
    coordinating the National Security Personnel System (NSPS) replacement
    for 32 healthcare occupations to ensure pay parity among healthcare
    professions. We have been successful in hiring required civilians to
    support our Sailors and Marines and their families--many of whom
    directly support our Wounded Warriors. Our success in hiring is in
    large part due to the hiring and compensation flexibilities that have
    been granted to the DOD's civilian healthcare community over the past
    several years.
        Our priority remains to maintain the right workforce to deliver the
    required medical capabilities across the enterprise, while using the
    appropriate mix of accession, retention, education and training
    incentives.
        I want to also reemphasize the priority we place on diversity. Navy
    Medicine has continued to emerge as a role model of diversity as we
    focus on inclusiveness while aligning ethnic and gender representation
    throughout the ranks to reflect our Nation's population. Not only are
    we setting examples of a diverse, robust and dedicated healthcare
    force, but this diversity also reflects the people for whom we provide
    care. We take great pride in promoting our message that we are the
    employer of choice for individuals committed to a culturally competent
    work-life environment; one where our members proudly see themselves
    represented at all levels of leadership.
        For all of us in Navy Medicine, an excerpt from the Navy Ethos
    articulates well what we do: ``We are a team, disciplined and well-
    prepared, committed to mission accomplishment. We do not waiver in our
    dedication and accountability to our Shipmates and families.''
          excellence in research and development and health education
        World-class research and development capabilities, in conjunction
    with outstanding medical education programs, represent the future of
    our system. Each is a force-multiplier and, along with clinical care,
    is vital to supporting our health protection mission. The work that our
    researchers and educators do is having a direct impact on the treatment
    we are able to provide our Wounded Warriors, from the battlefield to
    the bedside. We will shape the future of military medicine through
    research, education and training.
        The overarching mission of our Research and Development program is
    to conduct health and medical research, development, testing, and
    evaluation (RDT&E), and surveillance to enhance the operational
    readiness and performance of DOD personnel worldwide. In parallel, our
    Clinical Investigation Program activity, located at our teaching MTFs
    is, to an increasing degree, participating in the translation of
    appropriate knowledge and products from our RDT&E activity into proof
    of concept and cutting edge interventions to benefit our Wounded
    Warriors and our beneficiaries. We are also committed to connecting our
    Wounded Warriors to approved emerging and advanced diagnostic and
    therapeutic options within and outside of military medicine while
    ensuring full compliance with applicable patient safety policies and
    practices.
        Towards this end, we have developed our top five strategic research
    goals and needs to meet the Chief of Naval Operations and Commandant of
    the Marine Corps warfighting requirements. These include:
      --Traumatic brain injury (TBI) and psychological health treatment and
            fitness for both operational forces and home-based families.
      --Medical systems support for maritime and expeditionary operations
            to include patient medical support and movement through care
            levels I and II with emphasis on the United States Marine Corps
            (USMC) casualty evacuation (CASEVAC) and En Route Care systems
            to include modeling and simulation for casualty prediction,
            patient handling, medical logistics, readiness, and command,
            control, communications and intelligence (C\3\I).
      --Wound management throughout the continuum of care, to include
            chemical, molecular, and cellular indicators of optimum time
            for surgical wound closure, comprehensive rehabilitation; and
            reset to operational fitness.
      --Hearing restoration and protection for operational maritime surface
            and air support personnel.
      --Undersea medicine, diving and submarine medicine, including
            catastrophe intervention, rescue and survival as well as
            monitoring and evaluation of environmental challenges and
            opportunities.
        During my travel overseas this past year, including Vietnam,
    current partnerships and future partnerships possibilities between Navy
    Medicine and host nation countries were evident. Increasing military
    medical partnerships are strengthening overall military to military
    relationships which are the cornerstone of overarching bilateral
    relations between allies. These engagements are mutually beneficial--
    not only for the armed forces of both countries, but for world health
    efforts with emerging allies in support of global health diplomacy.
        Graduate Medical Education (GME) is vital to our ability to train
    our physicians and meet our force health protection mission. Vibrant
    and successful GME programs continue to be the hallmark of Navy
    Medicine and I am pleased that despite the challenges presented by a
    very high operational tempo and past year recruiting shortfalls, our
    programs remain strong. All of our GME programs eligible for
    accreditation are accredited and most have the maximum or near maximum
    accreditation cycle lengths. In addition, our graduates perform very
    well on their Specialty Boards--significantly exceeding the national
    pass rate in almost every specialty year after year. The overall pass
    rate for 2009 was 97 percent. Most importantly, our Navy-trained
    physicians continue to prove themselves to be exceptionally well
    prepared to provide care in austere settings from the battlefield to
    disaster relief missions.
        In addition to GME, we are leveraging our inter-service education
    and training capabilities with the new state-of-the-art Medical
    Education and Training Campus (METC) in San Antonio, Texas. Now
    operational, METC represents the largest consolidation of Service
    training in the history of DOD, and is the world's largest medical
    training campus. Offering 30 programs and producing 24,000 graduates
    annually, METC will enable us to train our Sailors, Soldiers and Airmen
    to meet both unique Service-specific and joint missions. Our corpsmen
    are vital to saving lives on the battlefield and the training they
    receive must prepare them for the rigors of this commitment. I am
    committed to an inter-service education and training system that
    optimizes the assets and capabilities of all DOD healthcare
    practitioners yet maintains the unique skills and capabilities that our
    corpsmen bring to the Navy and Marine Corps--in hospitals, at sea and
    on the battlefield.
                            collaboration engagement
        Navy Medicine recognizes the importance of leveraging collaborative
    relationships with the Army and Air Force, as well as the Department of
    Veterans Affairs (VA), and other Federal and civilian partners. These
    engagements are essential to improving operational efficiencies,
    education and training, research and sharing of technology. Our
    partnerships also help create a culture in which the sharing of best
    practices is fundamental to how we do business and ultimately helps us
    provide better care and seamless services and support to our
    beneficiaries.
        The progress we are making with the VA was clearly evident as we
    officially activated the Captain James A. Lovell Federal Health Care
    Center in Great Lakes, Illinois--a first-of-its-kind fully integrated
    partnership that links Naval Health Clinic Great Lakes and the North
    Chicago VA Medical Center into one healthcare system. We are grateful
    for all your support in helping us achieve this partnership between the
    Department of Veterans Affairs, DOD and DON. We are proud to able to
    provide a full spectrum of healthcare services to recruits, active
    duty, family members, retirees and veterans in the Nation's first fully
    integrated VA/Navy facility. We look forward to continuing to work with
    you as we improve efficiencies, realize successes and implement lessons
    learned.
        Navy Medicine has 52 DOD/VA sharing agreements in place for medical
    and ancillary services throughout the enterprise as well as 10 Joint
    Incentive Fund (JIF) projects. When earlier JIF projects ended, they
    were superseded by sharing agreements. Naval Health Clinic Charleston
    and the Ralph H. Johnson VA Medical Center celebrated the opening of
    the new Captain John G. Feder Joint Ambulatory Care Clinic. This newly
    constructed outpatient clinic located on Joint Base Charleston Weapons
    Station is a state-of-the-art 188,000 square foot facility that is
    shared by the VA and the Navy Health Clinic Charleston. This project is
    another joint initiative such as the Joint Ambulatory Care Center in
    Pensacola that replaced the former Corry Station Clinic; and another in
    Key West where the VA's Community Based Outpatient Clinic (CBOC) and
    the Navy Clinic are co-located, continuing collaboration and providing
    service at the site of our first VA/DOD Joint Venture.
        We are also continuing to work to implement the Integrated
    Disability Evaluation System (IDES) at our facilities in conjunction
    with VA. To date, this program has been implemented at 15 of our MTFs.
    This world-wide expansion, to be completed in fiscal year 2011, follows
    the DES Pilot program and the decision of the Wounded, Ill and Injured
    Senior Oversight Council (SOC) Co-chairs (Deputy Secretary of Defense
    and Deputy Secretary of Veterans Affairs) to move forward to streamline
    the DOD DES process.
        One of our most important projects continues to be the successful
    transition of the new Walter Reed National Military Medical Center
    (WRNMMC) onboard the campus of the National Naval Medical Center,
    Bethesda. This realignment is significant and the Services are working
    diligently with DOD's lead activity, Joint Task Force Medical--National
    Capital Region to ensure we remain on track to meet the Base
    Realignment and Closure (BRAC) deadline of September 15, 2011. Our
    priority continues to be properly executing this project on schedule
    without any disruption of services. We also understand the importance
    of providing a smooth transition for our dedicated personnel--both
    military and civilian--to the success of WRNMMC. We recognize that
    these dedicated men and women are critical to our ability to deliver
    world class care to our Sailors, Marines, their families and all our
    beneficiaries for whom we are privileged to serve.
                                the way forward
        I am proud of the progress we are making, but not satisfied. We
    continue to see ground-breaking innovations in combat casualty care and
    remarkable heroics in saving lives. But all of us remain concerned
    about the cumulative effects of worry, stress and anxiety on our
    service members and their families brought about by a decade of
    conflict. Each day during my tenure as the Navy Surgeon General, we
    have been a Nation at war. Each day resonates with the sacrifices that
    our Sailors, Marines and their families make, quietly and without
    bravado. They go about their business with professionalism, skill, and
    frankly, ask very little in return. It is this commitment, this
    selfless service, that helps inspire us in Navy Medicine. Regardless of
    the challenges ahead, I am confident that we are well-positioned for
    the future.
        I will be retiring from Naval Service later this year and I want to
    express my thanks for all the support you provide to Navy Medicine and
    to me throughout my tenure as the Navy Surgeon General.

        Chairman Inouye. And now, may I call upon General Green.
    STATEMENT OF LIEUTENANT GENERAL CHARLES B. GREEN,
                SURGEON GENERAL, DEPARTMENT OF THE AIR
                FORCE
        General Green. Good morning.
        Chairman Inouye, Senator Cochran, distinguished members of
    the subcommittee, I truly appreciate the opportunity to meet
    with you today and represent the men and women of the Air Force
    Medical Service. We could not achieve our goals of better
    readiness, better health, better care, and best value for our
    heroes and their families without your support. And we thank
    you.

                      MILITARY HEALTH SYSTEM ACHIEVEMENTS

        Military Health System achievements have changed the face
    of war. We deploy and set up hospitals within 12 hours of
    arrival anywhere in the world. We move wounded warriors from
    the battlefield to operating rooms within minutes and have
    achieved and sustained the less than 10 percent died of wounds
    rate.
        We move our sickest patients in less than 24 hours of
    injury and get them home to loved ones within 3 days to hasten
    their recovery.
        We have safely evacuated more than 85,000 patients since
    October 2001, 11,300 just this last year, many of them
    critically injured.
        The Air Force Medical Service has a simple mantra:
    ``Trusted Care Anywhere.'' This fits what we do today and will
    continue to do in years ahead. It means creating a system that
    can be taken anywhere in the world and be equally effective,
    whether it is for war or for humanitarian assistance.
        Air Combat Command's new Expeditionary Medical System, the
    Health Response Team, is capable of seeing the first patient
    within 1 hour of arrival anywhere in the world, and performing
    surgery within 3 to 5 hours. Our Radiological Assessment Team
    was in place quickly to assist Japan in measuring the levels of
    radiation, food and water safety, overall impact on health, and
    to distribute personal dosimeters for protection of our
    personnel. Our deployed systems are linked back to American
    quality care and refuse to compromise on patient safety.
        Providing trusted care anywhere requires the Air Force
    Medical Service to focus on patients and populations. By the
    end of 2012, the Air Force Patient-Centered Medical Home will
    provide 1 million of our beneficiaries new continuity of care
    via single provider-led teams at all Air Force facilities.
        Patient-Centered Care builds new possibilities in
    prevention by linking the patient to a provider team, and both
    the patient and the provider team to decision support from
    informatics networks dedicated to improving care. Efficient and
    effective health teams allow recapture of care in our medical
    treatment facilities to sustain our currency and offer best
    value. We will do all in our power to improve the health of our
    population while working to control the rising costs of
    healthcare.
        The Air Force Medical Service treasures our partnership
    with OSD, the Army, Navy, VA, civilian and academic partners.
    We leverage all the tools that you have given us to improve
    retention and generate new medical knowledge. We will continue
    to deliver nothing less than world class care to military
    members and their families, wherever they may serve around the
    world.

                               PREPARED STATEMENT

        And I stand ready to answer your questions. Thank you.
        Chairman Inouye. All right. Thank you very much.
         [The statement follows:]
        Prepared Statement of Lieutenant General (Dr.) Charles B. Green
        Military Health System achievements have changed the face of war.
    We deploy and set up hospitals in 12 hours of arrival almost anywhere
    in the world. We move wounded warriors from the battlefield to an
    operating room within minutes and have achieved and sustained less than
    10 percent died-of-wounds rate. We move our sickest patients in less
    than 24 hours of injury and get them home to loved ones within 3 days
    to hasten recovery. We have safely evacuated more than 86,000 patients
    since October 2001, 11,300 in 2010 alone, many of them critically
    injured. This is all pretty amazing.
        The Air Force Medical Service (AFMS) has a simple mantra: ``Trusted
    Care Anywhere.'' This fits what we do today and will continue to do in
    the years ahead. It means creating a system that can be taken anywhere
    in the world and be equally as effective whether in war or for
    humanitarian assistance. This system is linked back to American quality
    care and refuses to compromise on patient safety. These are formidable
    challenges, but we have the foundation we need and the best creative
    minds working with us to achieve this end.
        Providing Trusted Care Anywhere requires the AFMS to focus on
    patients and populations. Patient-centered care builds new
    possibilities in prevention by linking the patient to a provider team
    and both patient and provider team to an informatics network dedicated
    to improving care. Efficient and effective health teams allow recapture
    of care in our medical treatment facilities (MTFs) to sustain currency.
    Continually improving our readiness ensures patients and warfighters
    always benefit from the latest medical technologies and advancements.
                         patient-centered medical home
        To improve Air Force primary care and achieve better health
    outcomes for our patients, we implemented our Family Health Initiative
    (FHI) in 2009, which is a team-based, patient-centered approach
    building on the Patient-Centered Medical Home (PCMH) concept
    established by the American Academy of Family Physicians. We aligned
    existing resources and now have PCMH at 32 of our MTFs caring for
    340,000 enrolled patients. By the end of 2012, 1 million of our
    beneficiaries will have a single provider and small team of
    professionals providing their care at all AFMS facilities. This means
    much greater continuity of care, with our patients seeing the same
    physician or their professional partner 95 percent of the time. The
    result is more effective healthcare based on trust and rapport for both
    the patient and the provider.
        Air Force Medical Home integrates the patient into the healthcare
    team, offering aggressive prevention and personalized intervention.
    Physicians will not just evaluate their patients for disease to provide
    treatment, but also to identify risk of disease, including genetic,
    behavioral, environmental and occupational risks. The healthcare team
    will encourage healthy lifestyle behavior, and success will be measured
    by how healthy they keep their patients, rather than by how many
    treatments they provide. Our goal is that people will live longer lives
    with less morbidity. We are already seeing how PCMH is bringing that
    goal to fruition. For example, diabetes management at Hill AFB, Utah,
    showed an improvement in glycemic control in 77 percent of the diabetic
    population, slowing progression of the disease and saving over $300,000
    per year.
        Patient feedback through our Service Delivery Assessment survey
    shows an overall improvement in patient satisfaction for patients
    enrolled in PCMH, with the greatest improvement noted in the ability to
    see a personal provider when needed. As relationships develop, our
    providers will increase their availability to patients after hours and
    through secure patient messaging. This will further enhance patient
    satisfaction and reduce costs by minimizing emergency department
    visits.
        Our next step is to embark on an innovative personalized medicine
    project called Patient Centered Precision Care, or PC\2\, that will
    draw and build on technological and genetic based advances in academia
    and industry. Effective, customized care will be guided by patient-
    specific actionable information and risk estimation derived from robust
    Health Information Technology applications. We're excited about our
    collaboration opportunities with renowned partners, such as the Duke
    Institute for Genome Sciences and Policy, IBM, and others.
        Patient-centered care includes caring for Air Force special needs
    families, and we are working closely with our personnel community to
    ensure these families receive the specialized medical or educational
    support they require. The Air Force Exceptional Family Member Program
    (EFMP) is a collaborative and integrated program that involves medical,
    family support, and assignment functions to provide seamless care to
    these families. Enhanced communication of the program will be
    facilitated by an annual Caring for People Forum at each installation,
    giving families an opportunity to discuss concerns and receive advice.
    Starting in fiscal year 2012, the Air Force will begin adding 36 full-
    time Special Needs Coordinators at 35 medical treatment facilities
    (MTFs) to address medical concerns and assignment clearance processes.
        An important aspect of patient-centered preventive care includes
    safeguarding the mental health and well-being of our people and
    improving their resilience, because no one is immune to the stresses
    and strains of life. While Air Force suicide rates have trended upward
    since 2007, our rate remains below what we experienced before the
    inception of our suicide prevention program in 1997. The most common
    identified stressors and risk factors have remained the same over the
    last 10 years: relationship, financial and legal problems. Although
    deployment can stress Airmen and their families, it does not seem to be
    an individual risk factor for Airmen, and most Airmen who complete
    suicide have never deployed. We are redoubling our efforts to prevent
    suicide and specifically target those identified at greatest risk.
        We use the Air Force Post-deployment Health Assessment (PDHA) and
    Post-deployment Health Reassessment (PDHRA) to identify higher risk
    career groups for post-traumatic stress disorder (PTSD). While most Air
    Force career fields have a very low rate of PTSD, others such as EOD,
    security forces, medical, and transportation have higher rates of post
    traumatic stress symptoms.
        Advances in treatment, such as the Virtual Reality Exposure Therapy
    (VRET) system we call ``Virtual Iraq,'' have been fielded to treat
    service members returning from theater with PTSD and other related
    mental health disorders. This system is founded on two well established
    forms of psychotherapy: Cognitive-Behavioral Therapy and Prolonged
    Exposure Therapy. VRET is now deployed at 10 Air Force mental health
    clinics and is lauded by patients.
        The Air Force provides additional support to our most at-risk
    Airmen with frontline supervisor's suicide prevention training given to
    all supervisors in career fields with elevated suicide rates. Mental
    health providers are seeing patients in our primary care clinics across
    the Air Force. They see patients who may not otherwise seek care in a
    mental health clinic because of perceived stigma. We have significantly
    expanded counseling services beyond those available through the
    chaplains and mental health clinic. Other helping programs include
    Military Family Life Consultants, who see individuals or couples; and
    Military OneSource, which provides counseling to active duty members
    off-base for up to 12 sessions.
        A recent example of how suicide prevention skills saved a life is
    the story of how Senior Airman Jourdan Gunterman helped save a friend
    from halfway around the world in Afghanistan. His training first helped
    him recognize the warning signs of a friend in trouble: drinking
    heavily, violent outbursts, disciplinary actions, and recent discharge
    from the Air Force following a challenging deployment. A cryptic
    emotional message on Facebook from the friend led Airman Gunterman to
    question his friend's disturbing behavior. He discovered his friend had
    ingested a bottle of pills.
        When his troubled friend no longer responded, Airman Gunterman
    obtained the friend's phone number on-line from another friend, Senior
    Airman Phillip Sneed, in Japan. Airman Sneed promised to keep calling
    the friend until he picked up. Meanwhile Airman Gunterman enlisted the
    help of his chaplain to locate the suicidal friend. Finally, locating a
    hometown news release about his friend, Airman Gunterman was able to
    learn his friend's parents' names and then used a search engine to find
    their address. He contacted the local police, who rushed to the
    friend's house and saved him. Airman Gunterman is an expert with social
    media--but more important--he is an incredible wingman who saved his
    buddy's life.
        Resiliency is a broad term that describes the set of skills and
    qualities that enable Airmen to overcome adversity and to learn and
    grow from experiences. It requires a preventive focus based on what we
    have learned from individuals who've been through adversity and
    developed skills to succeed. Distilling those skills and teaching them
    will lead to a healthier force.
        The Air Force uses a targeted resiliency training approach,
    recognizing different Airmen will be in different risk groups. For
    those who have higher exposure to battle, we have developed initiatives
    such as the Deployment Transition Center (DTC) at Ramstein Air Base,
    Germany, which opened in July. The DTC provides a 2-day reintegration
    program en route from the war zone, involving chaplain, mental health,
    and peer facilitators. The DTC provides training, not treatment--the
    focus is on reintegration into work and family. Feedback from deployers
    has been overwhelmingly positive.
        We teach our Airmen that seeking help is not a sign of weakness,
    but a sign of strength. Lieutenant Colonel Mary Carlisle is an Air
    Force nurse who struggled with PTSD following her deployment. She
    shares her story of how she was able to overcome PTSD by seeking help
    and treatment. She realized that she would be affected forever, but is
    now more resilient from her experience and treatment. She shared her
    story with over 700 of my senior medics at a recent leadership
    conference. Lt. Col. Carlisle's openness and leadership are an
    invitation to others to tell their stories, and in so doing change our
    culture and shatter the stigma associated with mental healthcare.
        In addition to the Air Force-wide approach, some Air Force
    communities are pursuing other targeted initiatives. The highly
    structured program used by Mortuary Affairs at Dover AFB, Delaware,
    where casualties from OIF and OEF are readied for burial, is now being
    used as a model for medics at our hospitals in Bagram, Afghanistan, and
    Balad, Iraq, where the level of mortality and morbidity are much higher
    than most medics see at home station MTFs. The Air Force continually
    seeks to leverage existing ``best practice'' programs such as Dover's
    for Air Force-wide use. If we can help our Airmen develop greater
    resiliency, they will recover more quickly from stresses associated
    with exposure to traumatic events.
                   recapturing care and maintaining currency
        Trusted Care means good stewardship of our resources. In an era of
    competing fiscal demands and highly sought efficiencies, recapturing
    patients back into our MTFs is critical. Where we have capability, we
    can provide their care more cost-effectively by managing care in our
    facilities. Equally important is building the case load and complexity
    needed to keep our providers' skills current to provide care wherever
    the Air Force needs them. We have expanded our hospitals and formed
    partnerships with local universities and hospital systems to best
    utilize our skilled professionals.
        We value our strong academic partnerships with St. Louis
    University; Wright State University (Ohio); the Universities of
    Maryland, Mississippi, Nebraska, Nevada, California and Texas, among
    others. They greatly enrich our knowledge base and training
    opportunities as well as provide excellent venues for potential
    resource sharing.
        Since the early 1970s, many Air Force Graduate Medical Education
    (GME) programs have been affiliated with civilian universities. Our
    affiliations for physician and dental education at partnership sites
    have evolved to include partnership sponsoring institutions for
    residencies. In addition, our stand-alone residency programs have
    agreements for rotations at civilian sites. Our Nurse Education
    Transition Program (NETP) and Nurse Enlisted Commissioning Program
    (NECP) have greatly benefited from academic partnerships. The NETP is
    available at 11 sites with enrollment steadily increasing, while the
    NECP enrolls a total of 50 nursing students per year at the nursing
    school of their choice. A nursing program partnering with Wright State
    University and Miami Valley College of Nursing in Ohio, and the
    National Center for Medical Readiness Tactical Laboratory has produced
    a master's degree in Flight Nursing with Adult Clinical Nurse
    Specialist in disaster preparedness, a first of its kind in the
    country.
        Our GME programs are second to none. Our first-time pass rates on
    specialty board exams exceed national rates in 26 of 31 specialty
    areas. Over the past 4 years, we've had a 92 percent overall first time
    board pass rate. I am very proud of this level of quality in our medics
    and grateful to our civilian partners who help make Air Force GME a
    success.
        Partnerships leveraging our skilled work force prepare us for the
    future. Our Centers for the Sustainment of Trauma and Readiness (C-
    STARS) in Baltimore, Cincinnati and St. Louis continue to provide our
    medics the state-of-the-art training required to treat combat
    casualties. In 2009 we complemented C-STARS with our Sustainment of
    Trauma and Resuscitation Program (STARS-P) program, rotating our
    providers through Level 1 trauma centers to hone their war readiness
    skills. Partnerships between Travis AFB and University of California at
    Davis; Nellis AFB, and University Medical Center, Nevada; Wright-
    Patterson AFB and Miami Valley Hospital; Luke AFB and the Scottsdale
    Health System; MacDill AFB and Tampa General Hospital; and others, are
    vital to sustaining currency.
        Our hospitals, C-STARS and STARS-P locations are enhanced by the
    Air Force medical modeling and simulation Distributed High-Fidelity
    Human Patient Simulator (DHPS) program. There are currently 80 programs
    worldwide and the AFMS is the Department of Defense lead for medical
    simulation in healthcare education and training. Over the next year, we
    will link the entire AFMS using Defense Connect Online and our new Web
    tele-simulation tool. This will enable all Air Force MTFs to play real
    time medical war games that simulate patient management and movement
    from point of injury to a Level 3 facility and back to the States.
        Our partnership with the Department of Veterans Affairs (VA) has
    provided multiple avenues for acquiring service, case mix, and staffing
    required for enhancing provider currency. Direct sharing agreements,
    joint ventures and the Joint Incentive Fund (JIF) have all proved to be
    outstanding venues for currency and collaboration.
        A great example is the JIF project between Wright-Patterson Medical
    Center and the Dayton VA. The expansion of their radiation-oncology
    program includes a new and promising treatment called stereotactic
    radio surgery. This surgery, really a specialized technique, allows a
    very precise delivery of a single high dose of radiation to the tumor
    without potentially destructive effects to the surrounding tissues.
    Without a single drop of blood, the tumor and its surrounding blood
    supply are destroyed, offering the patient the hope of a cure and
    treatment that has fewer side effects.
        In another Air Force/VA success story, Keesler AFB, MS and VA Gulf
    Coast Veterans Health Care System Centers of Excellence Joint Venture
    is receiving acclaim. Ongoing clinical integration efforts have shown
    an increase in specialty clinic referrals. Plans for continued
    integration are on track, with many departments sharing space and staff
    by fiscal year 2012 and the joint clinic Centers of Excellence in place
    by fiscal year 2013.
        Providing a more seamless transition for Airmen from active duty to
    the VA system remains a priority. This process has been greatly
    enhanced with the Integrated Disability Evaluation System (IDES).
    Expansion of the initial pilot program is occurring by region in four
    stages, moving west to east, and centered around the VA's Veteran
    Integrated Service Networks (VISN). Phase 3 of the expansion has added
    an additional 18 Air Force MTFs for a total of 24. The Services and the
    VA continue to conduct IDES redesign workshops to further streamline
    the process to be more timely and efficient for all transitioning
    Service members. The goal is to provide coverage for all Service
    members in the IDES by September 2011.
        We continue to look for innovative ways and new partnerships to
    meet our currency needs and provide cutting-edge care to our military
    family. We will expand partnerships with academic institutions and the
    VA wherever feasible to build new capabilities in healthcare and
    prevent disease.
                    continuously improving readiness assets
        We have made incredible inroads in our efforts to be light, lean
    and mobile. Not only have we vastly decreased the time needed to move
    our wounded patients, we have expanded our capabilities. Based on
    lessons learned from our humanitarian operations in Indonesia, Haiti
    and Chile, we developed obstetrics, pediatrics and geriatrics modules
    that can be added to our Expeditionary Medical System (EMEDS). We
    simply insert any of these modules without necessarily changing the
    weight or cube for planning purposes. Medics at Air Combat Command are
    striving to develop an EMEDS Health Response Team (HRT) capable of
    seeing the first patient within 1 hour of arrival and performing the
    first surgery within 3-5 hours. We will conduct functional tests on the
    new EMEDS in early 2011.
        On the battlefield, Air Force vascular surgeons pioneered new
    methods of hemorrhage control and blood vessel reconstruction based on
    years of combat casualty experience at the Air Force Theater Hospitals
    in Iraq and Afghanistan. The new techniques include less invasive
    endovascular methods to control and treat vascular injury as well as
    refinement of the use of temporary shunts. Their progress has saved
    limbs and lives and has set new standards, not only for military
    surgeons, but also for civilian trauma.
        A team of medical researchers from the 59th Medical Wing Clinical
    Research division has developed a subject model that simulates leg
    injuries seen in Iraq and Afghanistan to enable them to try
    interventions that save limbs. The team is also studying how severe
    blood loss affects the ability to save limbs. Their findings show blood
    flow should be restored within the first hour to avoid muscle and nerve
    damage vs. traditional protocol that allowed for 6 hours. Team member
    and general surgery resident Captain (Dr.) Heather Hancock, stated,
    ``You cannot participate in research designed to help our wounded
    soldiers and not be changed by the experience.''
        We are also advancing the science and art of aeromedical evacuation
    (AE). We recently fielded a device to improve spinal immobilization for
    AE patients and are working as part of a joint Army and Air Force team
    to test equipment packages designed to improve ventilation, oxygen,
    fluid resuscitation, physiological monitoring, hemodynamic monitoring
    and intervention in critical care air support.
        We are finding new ways to use specialized medical equipment for
    our wounded warriors. In October, we moved a wounded Army soldier with
    injured lungs from Afghanistan to Germany using Extracorporeal Membrane
    Oxygenation (ECMO) support through the AE system--the first time we
    have used AE ECMO for an adult. The ECMO machine provides cardiac and
    respiratory support for patients with hearts and/or lungs so severely
    diseased or damaged they no longer function. We have many years of
    experience with moving newborns via the 59th Medical Wing (Wilford
    Hall) ECMO at Lackland AFB, Texas, but the October mission opened new
    doors for wounded care.
        Another new tool in battlefield medicine is acupuncture. The Air
    Force acupuncture program, the first of its kind in DOD, has expanded
    beyond clinic care to provide two formal training programs. Over 40
    military physicians have been trained. We recognize the success of
    acupuncture for patients who are not responding well to traditional
    pain management. This is one more tool to help our wounded Soldiers and
    Airmen return to duty more rapidly and reduce pain medication usage.
        We've made progress with electronic health records in the Theater
    Medical Information Program Air Force (TMIP-AF), now used by AE and Air
    Force Special Operations. TMIP-AF automates and integrates clinical
    care documentation, medical supplies, equipment and patient movement
    with in-transit visibility. Critical information is gathered on every
    patient and entered into our deployed system. Within 24 hours, records
    are moved and safely stored in our databases stateside.
        Established in May 2010 with the Air Force as lead component, the
    Hearing Center of Excellence (HCE) is located at Wilford Hall in San
    Antonio, TX. This center continues to work closely with Joint DOD/VA
    subject matter experts to fine-tune concepts of operation. Together we
    are moving forward to achieve our goals in the areas of outreach,
    prevention, care, information management and research to preserve and
    restore hearing.
        DOD otologists have worked internally and with NATO allies to
    investigate emerging implant technologies and have developed plans to
    test a central institutional review board (IRB) in a multi-site,
    international study to overcome mixed hearing loss. The HCE is also
    pursuing standardization of minimal baseline audiometric testing and
    point of entry hearing health education within DOD. They are working
    with the Defense Center of Excellence for Psychological Health and
    Traumatic Brain Injury (DCoE) to establish evidence-based clinical
    practice guidelines for management of the post-traumatic patient who
    suffers from dizziness. The HCE has worked with analysts within the
    Joint Theater Trauma System to develop the Auditory Injury Module (AIM)
    to collect auditory injury data within the Joint Theater Trauma
    Registry (JTTR). These, among others, are critical ways the HCE
    supports the warfighter in concert with our partners at DCoE and the
    VA.
        All of these advances I've addressed are critical to improving
    medical readiness, but the most important medical readiness assets are
    our people. Recruiting and retaining top-notch personnel is
    challenging. We continue to work closely with our personnel and
    recruiting partners to achieve mission success. Optimizing monetary
    incentives, providing specialty training opportunities, and maintaining
    a good quality of life for our members are all essential facets to
    maintaining a quality workforce.
        The AFMS continues to optimize the use of monetary incentives to
    improve recruiting and retention. We are working with the Air Force
    personnel and recruiting communities to develop a sustainment model
    specific for each of the AFMS Corps. Specifically, we are targeting the
    use of special pays, bonuses, and the Health Professions Scholarship
    Program (HPSP) to get the greatest return on investment. Congress'
    support of these programs has helped to maintain a steady state of
    military trained physicians, dentists, nurses, and mental health
    professionals.
        The new consolidated pay authority for healthcare professionals
    allows greater flexibility of special pays to enhance recruitment and
    retention of selected career fields. While we use accession bonuses to
    attract fully qualified surgeons, nurses, mental health specialists,
    and other health professionals to the AFMS, HPSP remains the number one
    AFMS pipeline for growing our own multiple healthcare professionals.
        We were able to execute 100 percent of HPSP in fiscal year 2009 and
    fiscal year 2010 and were able to graduate 219 and 211 new physicians,
    respectively, in these years. In fiscal year 2010, 49 medical school
    graduates from the Uniformed Services University of the Health Sciences
    also joined the Air Force Medical Service. These service-ready
    graduates hit the ground running. Specialized military training and
    familiarity with the DOD healthcare system ensures more immediate
    success when they enter the workforce. Once we have recruited and
    trained these personnel, it is essential that we are able to keep them.
    We are programming multiyear contractual retention bonuses at
    selectively targeted healthcare fields such as our physician and dental
    surgeons, operating room nurses, mental health providers, and other
    skilled healthcare professions to retain these highly skilled
    practitioners with years of military and medical expertise.
        For our enlisted personnel, targeted Selective Reenlistment
    Bonuses, combined with continued emphasis on quality of life, generous
    benefits, and job satisfaction, positively impact enlisted recruiting
    and retention efforts. Pay is a major component of recruiting and
    retention success, but we have much more to offer. Opportunities for
    education, training, and career advancement, coupled with state-of-the-
    art equipment and modern facilities, serve together to provide an
    excellent quality of life for Air Force medics. Successful and
    challenging practices remain the best recruiting and retention tool
    available.
        We look 20 to 30 years into the future to understand evolving
    technologies, changing weapon systems, and changes in doctrine and
    tactics to protect warfighters from future threats. This ensures we
    provide our medics with the tools they need to fulfill the mission.
        We continue to build state-of-the-art informatics and telemedicine
    capabilities. Care Point now allows individual providers to leverage
    our vast information databases to learn new associations and provide
    better care to patients. These same linkages allow our Applied Clinical
    Epidemiology Center to link healthcare teams and patients with best
    practices. VTCs are now deployed to 85 of our mental health clinics
    broadening the reach of mental health services, and our teleradiology
    program provides digital radiology systems interconnecting all Air
    Force MTFs, enabling diagnosis 24/7/365.
        We are engaged in exciting research with the University of
    Cincinnati to enhance aeromedical evacuation, focusing on the
    challenges of providing medical care in the darkened, noisy, moving
    environments of military aircraft. We are studying how the flight
    environment affects the body, and developing possible treatments to
    offset those effects. Clinical studies are examining the amount of
    oxygen required when using an oxygen-concentrating device at higher
    altitudes. Simulators recreate the aircraft medical environments and
    are used extensively to train our medical crews. This new research
    expands our knowledge and training opportunities, and offers the
    possibility of future partnering efforts.
        We are also developing directed energy detection and laser assisted
    wound healing; advancing diabetes prevention and education; and
    deploying radio frequency identification technology in health
    facilities. We partner with multiple academic institutions to advance
    knowledge and apply evidence based medicine and preventive strategies
    with precision. These are some of the critical ways we seek to improve
    readiness, advance medical knowledge and keep the AFMS on the cutting
    edge for decades to come.
                                 the way ahead
        While at war, we are successfully meeting the challenges of Base
    Realignment and Closure as we draw near to the 2011 deadline. We have
    successfully converted three inpatient military treatment facilities to
    ambulatory surgery centers at MacDill AFB, Florida; Scott AFB,
    Illinois; and the USAF Academy, Colorado. By September of this year,
    the medical centers at Lackland AFB, Texas; and Joint Base Andrews,
    Maryland are on track to convert to ambulatory surgery centers. The
    medical center at Keesler AFB, Mississippi, is poised to convert to a
    community hospital. Medical Groups at Joint Base Lewis-McChord,
    Washington and Pope AFB, North Carolina have been effectively realigned
    as Medical Squadrons. Military treatment facilities at Shaw AFB, South
    Carolina; Eglin AFB, Florida; Joint Base McGuire, New Jersey; and Joint
    Base Elmendorf, Alaska; have been resourced to support the migration of
    beneficiaries into their catchment areas as a result of BRAC
    realignments.
        At Wright-Patterson AFB, Ohio, we have relocated cutting-edge
    aerospace technology research, innovation, and training from Brooks
    AFB. In tandem with our sister Services, we have also relocated basic
    and specialty enlisted medical training to create the new Medical
    Education and Training Campus (METC), the largest consolidation of
    training in DOD history.
        Our strategy to control DOD healthcare costs is the right approach
    to manage the benefit while improving quality and satisfaction.
    Adjustments to the benefit such as minimally raising TRICARE enrollment
    fees for working retirees, requiring future enrollees to the U.S.
    Family Health Plan to transition into TRICARE-for-Life upon turning 65
    years of age, paying sole-source community hospitals Medicare rates,
    and incentivizing the use of the most effective outlets for
    prescriptions are prudent. There will be limited impact (prescription
    only) on active duty family members. By implementing these important
    measures we will be able to positively affect the rising costs of
    healthcare and improve the health of our population.
        The AFMS is firmly committed to MHS goals of readiness, better
    health, better care and best value. We understand the value of teaming
    and treasure our partnerships with the Army, Navy, VA, academic
    institutions, and healthcare innovators. We will continue to deliver
    nothing less than world-class care to military members and their
    families, wherever they serve around the globe. They deserve, and can
    expect, Trusted Care Anywhere. We thank this Subcommittee for your
    support in helping us to achieve our mission.

                        RECRUITING MEDICAL PROFESSIONALS

        Chairman Inouye. General Green, let us start with you.
        The subcommittee has been advised that an important aspect
    of your work is the recruiting of medical professionals, and
    you need them to carry out the services. But I have been told
    that it is a challenge because, for example, the Government
    Accountability Office (GAO) reported that hiring civil servants
    at the Defense Centers of Excellence for Traumatic Brain Injury
    took an average of about 4 months. And the nomination of
    medical officers can take just as long. What are you doing to
    streamline this effort?
        General Green. Sir, your information is correct. It can
    take significant time to bring a fully qualified individual on
    board. Our major effort in terms of what we as medics have been
    doing is to shift some of our recruiting for fully qualified
    and the dollars associated into our scholarship programs. And
    over the last 3 to 4 years, we have expanded our scholarships
    through the Health Professional Scholarship Program by nearly
    400, from about 1,266 to 1,666. This is not just used for
    physicians, but also for pharmacists and for psychologists,
    trying to bring in the right expertise. And although there is a
    longer trail to get these folks, we now have a more reliable
    understanding of what is in the pipeline and when we will we
    have solutions.
        With regard to the specific questions regarding hiring
    civilians, we find frequently that we have to go after
    contractors rather than using general schedule (GS). It takes a
    little longer to get GS positions on our books, and so, when we
    have a more immediate need, we will substitute a contractor
    until we can get those positions into our books where we can
    use them. There has been a lot of effort in our A-1 community
    to try and streamline civilian hiring, and we are making
    progress. If you would have asked me this same question really
    within the last 1\1/2\ or 2 years, you would not have been
    talking to me about 4 months; you might have been talking about
    6 months and longer. And so, we are making progress in terms of
    our civilian hiring.
        When you talk to the military side and the scroll process
    in terms of how we get our officers, we continue to work with
    our A-1 personnel community to try and shorten that process.
    And when needed for specific expertise, we have been able to
    come through the process more rapidly. But it remains a
    process, as defined in law, that is fairly lengthy to ensure we
    bring the right people when we are bringing them on our books
    as Federal employees.

                               MEDICAL PAY SCALES

        Chairman Inouye. Do you find that the pay scale provided is
    competitive?
        General Green. I think that we have many special pays
    available, not just to the military, but also to our GS that
    does make them competitive. It is on the Active duty side, we
    certainly have a dynamic ability to move dollars to the
    specialties that we need and make ourselves competitive. On the
    civilian side, it is sometimes more difficult, but there are
    pays associated that do drive for the non-super specialist
    competitive pay. If you are asking me if I can get in the GS
    world a competitive salary for a neurosurgeon, the answer is
    no, and it has to do with what the civilian world is driving in
    terms of salaries for these folks. But that is not true
    necessarily for some of the areas where we are the shortest in
    terms of our flight surgeons and our family practitioners. When
    you start talking to trauma surgeons, particularly to try and
    hire them into a GS position, that is more difficult.
        And so, from a military perspective, the answer is, we have
    the authorities we need to offer pay that will retain and
    recruit new members on the GS side. I think that we are
    competitive in the primary care specialties, but not as
    competitive in the sub-specialties.
        Chairman Inouye. All right. Thank you very much. I will be
    submitting questions, if I may.
        General Green. Yes, sir, of course.
        Chairman Inouye. Admiral Robinson, when I first visited
    Afghanistan, I was impressed and surprised to note that the
    Navy was running the hospital, and it was landlocked.

                      MEDICAL SERVICES TO DEPLOYED MARINES

        Admiral Robinson. It still is.
        Unidentified Speaker. We are under the bridge now.
        Admiral Robinson. We tried to move it to the water, but it
    did not work.
        Chairman Inouye. How do you provide services to, say, the
    marines that are usually deployed to forward operating bases? I
    notice that some of the reports coming in indicate the
    difficulty involved in evacuating them. Do you have any special
    techniques?
        Admiral Robinson. No, sir. I am not sure I understand your
    question. How do we provide support to forward deployed medical
    personnel or forward deployed naval personnel?
        Chairman Inouye. Forward deployed marines.
        Admiral Robinson. Marines, I am sorry. Forward deployed
    marines have--we have a methodology that includes having with
    them FRSs, forward resuscitative surgical teams, and also
    surgical trauma platoons that usually operate with the marines
    in their forward areas.
        The first line of medical defense or the first line of
    medical operations would be the corpsmen. The corpsmen are
    there and are going to provide the type of emergency care with
    tourniquets and with the ABCs, airway, breathing, and
    circulation control. That is going to be followed by the
    corpsmen teaching buddy care to the other marines that are in
    the units that are there. This is very important because very
    often my corpsmen are also injured and injured in very grave
    ways. So often, the immediate care that they need has to come
    from a buddy who has in fact been instructed in the proper
    utilization and the use of tourniquets.
        As the injuries occur and as the word gets out that we have
    injuries, we then have the FRSs, the forward resuscitative
    surgical teams, that are forward deployed and can do
    resuscitative surgery in a very timely fashion. The
    resuscitative surgery is meant to be lifesaving only--to
    staunch the bleeding, to meet the immediate needs of the
    patient to restore circulation, to restore volume, and then to
    evacuate the patient to a higher level of care, which is
    usually at a Role 3 facility, such as Kandahar.
        Chairman Inouye. All right. Thank you very much. And I will
    be submitting more questions, if I may.
        Admiral Robinson. Yes, sir.
        Chairman Inouye. General, I am constantly amazed at the
    advancements we have made in medicine, plus other things like
    body armor and greater armor on our trucks and vehicles. And,
    for example, I was pleased with some of the advancements made
    in protecting hearing because of the explosions in the cars.
    But I am well aware that you are currently working on many
    other advancements. I will give you an opportunity to brag
    about it now. What are we doing?
        General Schoomaker. Well, sir, I think you have heard my
    colleagues describe--and you yourself described--some of the
    things that you have seen improvements in since you were a
    soldier in the Second World War. And those advances are
    really--have taken place, as you point out, all the way from
    protecting soldiers--changing combat tactics on the
    battlefield--to further protect soldiers and reduce risks, to
    the development of improved body armor, vehicles, combat
    goggles, ballistic goggles, hearing protection, better helmets,
    and the like. In fact, we have a program that is done in a
    joint environment. In fact, most of what is being described
    here and what you have alluded to is actually a joint effort,
    meaning all services are involved in either--even other
    agencies.
        The program to improve body armor, personal protective
    equipment for the soldier or their vehicles, and aviation
    equipment is known as the Joint Theater Analysis for Protection
    of Injury in Combat, the JTAPIC program. And this tracks
    injuries, both survivable and non-survivable injuries, and then
    looks at the vehicle, the personal protective equipment, and
    goes to the next level to develop a better protection, a better
    vehicle for them. And that has been very successful.
        But we have done what Admiral Robinson talked about. We
    have better trained the individual combatant as to how they can
    do lifesaving on themselves. We have issued better bandages to
    the individual soldier, a tourniquet for every soldier, and we
    train young soldiers to be almost medics, combat lifesavers.
    So, it is frequent that a combatant who is injured in combat
    would be first treated by himself or a colleague, and then a
    medic would appear on the scene, or a corpsmen in the case of
    the Navy. That corpsman is better trained and that medic is
    better trained than in past wars.
        And then evacuation has improved. We have seen recently in
    Afghanistan when we visited that the footprint of air
    evacuation, which is largely through the Army, is very robust.
    In fact, every casualty in which a aircraft is not launched
    within 15 minutes of having a request or does not complete the
    mission within 60 minutes, is briefed all the way up to the top
    of the Department of Defense really, and they have to explain
    why they could not meet that Golden Hour. And that is generally
    because of weather or operational, or someone makes a
    decision--an appropriate clinical decision--to overfly the most
    immediate, you know, surgical site to go to a better and more
    definitive care site. That has been very successful.
        We have also placed critical care nurses now on the--
    selected medivac flights and have seen improvements in
    survival.
        A consequence of all of this through the Joint Theater
    Trauma System is that incrementally we have improved every
    stage of care of the combatant from the point of injury through
    the evacuation chain to forward resuscitative care and how
    surgeons are doing. We are really directing even trauma care
    for the world at large in the civilian sector, who benefited
    greatly from and have contributed to our understanding of this.
        What we are currently seeing as a consequence of that--I
    will just make a note of this--is that the survivors of some of
    these really grievous wounds now are not they themselves very
    grievously wounded. And we are working in concert with the
    other services and the VA to better care for a much more
    complex injury than we have seen in previous conflicts, or even
    earlier in this conflict.
        I hope that addresses your question, sir.
        Chairman Inouye. Yes. I have just one other.
        A couple of years ago, I learned at one of these hearings
    that the man who is deployed out on the front lines has on his
    body something like 100 pounds of armor and equipment. And so,
    I took a special effort to weigh what I had to carry, and mine
    was less than 25 pounds. That included a medical kit and
    ammunition boots, helmet, my gun. Can we lighten the load?
        General Schoomaker. Yes, sir. There is a very active
    program in the Army, and I think in all the services. The
    Soldier Program is intended to do exactly what you have talked
    about, but I think there are limitations to the weight and
    cube. Every item that goes into the basic load for a combat
    soldier, right down to the packaging of their meals or the
    material that goes into their uniforms, is evaluated for its
    relative contribution for cost and weight.
        But you heard Sergeant Giunta, who is our first living
    recipient of the Medal of Honor, when you honored him here in
    Congress, mentioned that he used to complain about those
    ceramic sappy plates and his body armor until he was shot twice
    and survived it. And he said, I'll never complain about
    carrying that load again. It is a very delicate balance, and I
    do not mean to trivialize or minimize what the soldier or the
    marine, any combatant is carrying. But I think it is an active
    process of looking at reducing that weight.
        Chairman Inouye. Thank you very much.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you.
        Thank you all for being here this morning and helping us
    with your assessment of the needs for funding of the programs
    and activities of the U.S. military. We appreciate your careers
    of service.
        I was especially taken with the comments about how in our
    medical assessment of fitness for duty--I think General
    Schoomaker made this point--after a person has fulfilled a
    requirement of service of tours of duty on a voluntary basis,
    and there is a question about fitness or physical impairment
    caused by service in the military, that there are two really
    distinct questions that have to be answered when there is a
    claim for disability. One is an assessment of fitness for duty,
    which is a military issue, and the other is a medical issue.
    How do you sort out the differences and what the impacts are in
    terms of individual claims under our current state of the law?
    Would you like to take a shot at that first, General
    Schoomaker?
        General Schoomaker. I will, then I would love to hear from
    General Green, who is actually one of the co-chairs of the
    Disability Evaluation System for the--a review for the
    Department of Defense. I do not mean to pass the buck here, but
    we have been sort of fighting this war for, literally and
    figuratively, for a very long time, Senator, so I appreciate
    that question.
        The current law and policy that governs the disability
    adjudication for an individual soldier--I am a solider, so I
    will use the term soldier, but it extends to sailors, airmen,
    and marines as well--is a dual system in which the military
    makes a judgment about any conditions which are unfitting for
    service, and then makes a decision about the unfitting
    condition that would lead to separation of that soldier.
        Ironically, the termination of the disability that derives
    from that condition is identical to what the Veterans
    Administration uses. We actually use the same tables; they were
    developed in concert. But then the Veterans Administration--the
    Veterans Benefits Administration--looks at the same soldier and
    the same constellation of problems, but adjudicates disability
    on the basis of the whole person concept, in which every
    individual illness or injury, current or past, can be put into
    the equation, and comes up with a whole person disability kind
    of equation.
        The two are high disparate. The difficulty we face is that
    soldiers get direct benefits from the military on the basis for
    that single unfitting condition. And as benefits have improved,
    especially--health benefits under the TRICARE program, if you
    can pass in the military side a critical threshold of 30
    percent disability, you are entitled then to the benefits of
    healthcare for yourself, which follow any military medical
    disability, but for your family as well. It has become a very,
    very desirable benefit to have. And soldiers are confused and
    their families are angered by the fact that we adjudicate for
    only that one unfitting condition and yet pass to the VA, and
    they see that, you know, had you been evaluated by a much
    more--a much larger, more composite system, it might have been,
    I would have been eligible for a higher degree of benefit from
    that.
        So we have eliminated some of the confusion and
    miscommunication, and we have accelerated the rate at which
    soldiers and their families can get VA benefits by this
    integrative process whereby a single physical exam is conducted
    by the VA in an adjudication of the total disability. But we
    still are required under the current state to adjudicate in the
    military system for the unfitting condition and in the VA
    system for the total person. We are advocating for the DOD--the
    Army--to adjudicate for--excuse me, determine unfitness, which
    is our title X authority and requirement, but then pass to the
    VA, which is--are the experts in disability adjudication, the
    responsibility for doing more comprehensive disability
    evaluation.
        With that, with your permission, sir, I will just pass to
    General Green.
        Senator Cochran. Sure.
        General Green.

                         ASSESSING PHYSICAL DISABILITY

        General Green. Yes, sir. I am the co-chairman with Dr.
    Karen Guice from the VA on the Recovering Warrior Task Force,
    which has now had three meetings and basically three site
    visits. We are still in our discovery phase, if you will, in
    terms of the differences in approach between the services.
        Within the current constraints, we do see--or current laws,
    basically--we do see some differences as--in terms of each
    service's approach. But there are similarities, and that is the
    area where Dr. Schoomaker is talking. Basically, we now are all
    using a single physical for the assessment of disability.
    Because we all use the same tables, it makes sense for everyone
    to use the same physical assessment.
        The place where there is some variance is in the service's
    assessment of ability to continue on active duty. Today once
    the average soldier, sailor, or airman go through the DES
    process, the current return to duty, even having gone all the
    way through the DES, is about--I will use the Air Force's
    numbers--17 to 20 percent in terms of being a little high. And
    so, you would think that once the physical is done that we
    could assess whether that person could stay on Active duty or
    not and that it would not necessarily go through the remainder
    of the disability system evaluation. But the way it is
    currently being run, there are slight differences in terms of
    each service.
        The other thing that happens, as Dr. Schoomaker was
    outlining, is that the VA looks at a total person for their
    disability rating. So, whereas--I will use something non-combat
    related. Whereas your cardiovascular disease may be significant
    enough to prevent you from being able to stay on Active duty,
    some of the other things that are rated in terms of the total
    disability are not necessarily disabling for DOD service,
    things like flat feet, or a recurrent rash, or mild hearing
    loss, things that could actually--you could stay on Active duty
    if you did not have the cardiovascular disease. And so, if we
    were to move to a system wherein the DOD simply paid for the
    total disability, there is a significant cost to the
    Government, whereas the current system basically has DOD paying
    for that ailment, if you will, that is disabling from further
    service.
        I think that as the task force continues, we will have some
    recommendations. You folks have been kind enough to give the
    task force some time to look at this as we kind of check out
    whether the systems that have been put in place are providing
    the best service to our recovering warriors. I do not want to
    speak for the committee because we really are still in
    discovery phase, but just to reaffirm the things we are seeing
    confirmed, some of the things that Dr. Schoomaker is talking
    about.

                              DISABILITY SERVICES

        Senator Cochran. Admiral Robinson, do you have any comments
    you would like to share with the subcommittee on that subject?
        Admiral Robinson. Sir, I think it has been covered very
    well. I just would make one comment. Usually General Schoomaker
    makes a note about the fact that the disability system that we
    use needs an overhaul since it is about 40 or 50 years old. And
    I think that actually General Green's committee and a lot of
    the input that we have given as SGs through the last 3 or 4
    years--is getting us there. We are working hard on this.
        Senator Cochran. Thank you very much.
        Thanks, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Mikulski.
        Senator Mikulski. Mr. Chairman, and the Surgeon Generals.
        First of all, we in Maryland feel very close to military
    medicine. We are the home of Naval Bethesda, and in a short
    time, sir, will be the home to Walter Reed Naval Bethesda, and
    I hope this later this summer, perhaps the subcommittee could
    go out and take a tour of what is being done there. And I think
    we would be very proud of it.
        We are proud of USU, which is the Military Medical School
    in Nursing and Public Health, and Battleship Comfort--or, I
    should say, not battleship. It fights other battles, but
    Hospital Ship Comfort and Fort Detrick. So, we feel very close
    to you.
        In terms of our work here today, I am going to pick up on
    the Dole-Shalala report. And I would like, General, to talk to
    you because we went through a lot. And I want to just use that
    as kind of the grid to see progress made and where we are
    heading, okay?
        So, in Dole-Shalala, first of all, remember what happened--
    the terrible national scandal at Walter Reed. Secretary Gates
    immediately responded. There was a change in personnel and I
    think a real commitment to upgrade. And then, our own
    colleague, Senator Dole, and Secretary Shalala issued this
    great report.
        Now, I am going to focus on issues related to preventing
    and treating post-traumatic stress disorder and brain injury,
    strengthening support for the families, and their
    recommendations to transfer the work with VA-DOD, and the
    workforce issues at Walter Reed.
        The workforce issues, though, I think go well beyond acute
    care medicine, and I will be raising that with our nurses in a
    short time.
        But, General, let us go to what Dole-Shalala recommended,
    and I know you might not have the report before you. But it
    said that we should aggressively treat post-traumatic stress
    and traumatic brain injury, and yet now we are seeing in that--
    so, could you tell me where we are in the progress made, how
    you see it improving, and then tell me why we have such
    increased rates of suicides and such increased rates of
    addictions to the very drugs that are supposed to treat post-
    traumatic stress?
        General Schoomaker. Well, ma'am, a complex question with
    several parts.
        I think the last----
        Senator Mikulski. But it goes to the heart of kind of where
    we are in this.
        General Schoomaker. Yes, ma'am. I do not deny that.
        Let me try to address, first, suicides. I think the suicide
    question is--remains a challenge and is perplexing for all of
    the services. The Army saw a very disturbing doubling or more
    of the suicide rate from where it was 6 or 7 years ago in which
    it was age and employment adjusted and gender adjusted
    comparison to the public at large, kept by the Centers for
    Disease Control and Preventive medicine in Atlanta. We went
    from roughly one-half of a comparable population in the United
    States to being on par, if not exceeding that.
        This is a problem that was tackled by the Vice Chief of
    Staff of the Army himself, stood up a task force, which has
    been in operation for almost 2 years now looking very carefully
    at all the factors. And as it recently----
        Senator Mikulski. But what are we doing where we are?
        General Schoomaker. We have made this a commanders' and a
    leaders' issue and problem. The factors that go into reducing
    risks and identifying soldiers and families at risk, and the
    many factors that lead to our soldiers turning to suicide in
    desperation--as we have said, a permanent solution to temporary
    problems that they may suffer----
        Senator Mikulski. But do you feel that you are on track to
    cracking this?
        General Schoomaker. I think we are making progress, ma'am.
    We are beginning to see--let me give you a----
        Senator Mikulski. And this is not meant to be aggressive to
    you. We have been down this road now for over 4 years.
        General Schoomaker. Yes, ma'am, and it is--frankly, it has
    involved bringing in national leaders in this--the National
    Institutes for Mental Health for the $50 million Stars Program.
        But as a real quick example of this, we got a notice the
    other day from one of our posts that one of our warriors in
    transition--that is, one of the soldiers going through an
    injury and illness recovery--in interacting with the small unit
    leader, dropped clues that she was in distress, wanted a
    chronic pain problem solved permanently for her. And when she
    could not be reached, the NCO leadership reached out to her,
    actually drove to her home off post. When they could not get in
    the door or she would not respond, they called the police. The
    police broke down the door and found her hung in the home, but
    still alive, got her to the hospital in time. So, I think that
    is a small example of what we see as----
        Senator Mikulski. Yes, but, General, that is indeed a
    poignant problem. And, I mean, that is a very poignant story. I
    have very limited time here.
        General Schoomaker. Yes.
        Senator Mikulski. So, here are my questions. Let us go at
    this way. I love hearing stories. Remember me, I am the social
    worker at the table.
        General Schoomaker. Yes, ma'am, I know.
        Senator Mikulski. So, and I am going to approach it as a
    social worker. Do you feel you have adequate mental health
    personnel? And do you feel that they are adequately trained in
    the warrior culture? As you know, there is a great gap growing
    between civilian culture and military culture. Also, from what
    I understand from other data, that often in the first hour of
    the first treatment, the military facing this problem walks out
    and tells the counselor essentially to go to hell because they
    do not feel they get it, and they are so upset. So, my question
    is, let us go to adequacy of capacity and adequacy of training.
    And then we will go to new techniques and approaches, because
    obviously standard talk therapy and meds, as we know it, are
    not working. Can you----
        General Schoomaker. We are working very actively in finding
    evidence-based approaches to the treatment of post-traumatic
    stress disorder, which I think in the main is--can be treated
    successfully. And we are seeing that.
        Suicide, I think, is far more complex. It is not a medical
    problem. I think this is one of the things that vice has said,
    it is a larger command problem. Frankly, one-half or more of
    people who commit suicide have never seen a mental health
    provider or been identified as having a problem.
        We are working very hard----
        Senator Mikulski. Do you have adequacy of mental health
    professionals?
        General Schoomaker. I think the Nation is facing a problem
    with mental health professionals----
        Senator Mikulski. No, do you have it? I am not talking
    about the Nation.
        General Schoomaker. As a microcosm of the Nation, we have
    problems, especially as----
        Senator Mikulski. Again, I am not being--I really----
        General Schoomaker. We have problems, ma'am.
        Senator Mikulski. I so admire what you have done and the
    leadership you have provided. I want to be very clear about
    that. But do you see my level of frustration? They are calling
    my office because they need help accessing services, not
    knowing where to go. So----
        General Schoomaker. I think the two things that we face----
        Senator Mikulski. And what about the tying in the warrior
    culture?
        General Schoomaker. The things that we face most--and,
    frankly, I think is a subordinate element of this warrior
    culture issue might be present in some cases, but not
    universally. Our people do a good job with that. We are working
    hard to prevent post-traumatic stress by rapid identification
    of concussion on the battlefield and reducing that. We have got
    a comprehensive behavioral health system of care now that ties
    every phase of soldier deployment to each other phase and
    passes information. That has resulted in remarkable reductions
    in stress problems.
        And what we have residual problems with in the Reserve
    component who go home to communities where access to care is a
    problem for all care, but especially behavioral health, and in
    remote size within the Army where it is tough to compete for
    civilian employees of any kind. But in some of our places where
    we have camps, posts, and stations, in the desert in
    California, for example, it is hard to recruit and retain high-
    quality people.
        Senator Mikulski. All right. So, here is what I would like
    in my limited time. I appreciate that and the challenges. But I
    would really like to hear, based on the Dole-Shalala
    recommendations, what, from your--and I mean the group--
    perspective--on what is the progress made. But the Army assumed
    primary responsibility for implementing Dole-Shalala. And then
    also on the adequacy of training.
        The other question I have is, we have to--and, Mr.
    Chairman, with your indulgences--support for the families. You
    know, when a warrior bears this either permanent wound or
    permanent impact, it is the spouse or the mother or the family,
    and it is also the children who bear this often--well, there is
    a saying in both the civilian and military world, post-
    traumatic stress is contagious. In other words, if one person
    has it, the family has it. So, it is not like isolated like
    cardiovascular disease where you have got it. Maybe the spouse
    is helping with a better diet and lifestyle. Can you tell me--
    again, going to Dole-Shalala--where we are in the support for
    the family?
        General Schoomaker. Yes, ma'am. We are working very
    actively on programs to support families, especially children,
    but spouses as well. We are reaching out into communities,
    engaging schools, churches, other community members, to extend
    the reach of insulation-based services into the communities to
    highlight that these are families of the military that face
    great stresses in their lives and identify children who are at
    risk and spouses who are at risk.
        Ma'am, in an earlier meeting several years ago, you
    challenged me, without any data at the time, to rank order
    three elements of deployment in terms of their impact on
    soldiers and families: the frequency of deployment, the length
    of a deployment----
        Senator Mikulski. Right.
        General Schoomaker [continuing]. The time between
    deployments we call dwell. And what I told you was we suspect
    that probably of the three, the most important is the dwell
    between deployments, and then after that, the length of the
    deployment, and then the frequency of deployment. We have
    special operations units that have deployed and individuals
    that have deployed a dozen times or more. But they are shorter
    deployments and they have adequate dwell between.
        One thing we cannot--we now have good science to document,
    through surveys on the battlefield and from returning soldiers,
    that not allowing a soldier and a family to have a minimum of
    24 months of dwell between deployments does not allow them to
    restore their psychological state.
        Senator Mikulski. That is a good point.
        General Schoomaker. And one of the things that I think we
    need real support from the Congress in is to not--is to allow
    us to resume a, we call boots on the ground to dwell rate of
    one to two; that is, 2 years back home for every year that you
    are in combat. That, I think, will make a significant--have a
    significant impact on the mental state and the psychological
    state of both families and soldiers.
        Senator Mikulski. Well, General Schoomaker, thank you.
        Mr. Chairman, you have been indulgent. I could talk all day
    with this panel. Perhaps you and I could meet and talk over
    this in more detail, and then take some ideas to the chairman.
        Thank you very much.
        Chairman Inouye. Thank you.
        Senator Mikulski. But, you know, this deployment is a big
    issue. If we are going to cut the military, then we got to
    cut--like, we are going to shrink the Marine Corps, you know,
    the old budget? But if we are going to shrink the Marine Corps,
    then we should shrink what we ask the Marine Corps to do. And
    that would go for every military service, so I think we have
    got to keep this in mind.
        Chairman Inouye. It is a major challenge to all of us here.
        Senator Mikulski. For every year you are deployed, you need
    2 years at home to stay connected to your family to deal with
    exactly some of these really horrific situations you and I have
    just discussed.
        General Schoomaker. Yes, ma'am. And the Army, in 10 years
    of war, has never been able to achieve a 2-year dwell. In fact,
    on average it has been at 1.3 years----
        Senator Mikulski. Well----
        General Schoomaker [continuing]. Of dwell for every year of
    deployment.
        Senator Mikulski. Thank you.
        Chairman Inouye. Thank you very much.
        Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.
        And I want to recognize the comments of my colleague from
    Maryland, talking about not only the impact to the individual,
    to the soldier, to those that are actively serving, but to the
    health and well-being of the families that are at home and
    supporting them. So I appreciate, General, your comments and
    recognition that it is the health of the whole family, not just
    the soldier, that we need to address here. It is a considerable
    challenge, but I think when we think about our effectiveness,
    our ability to recruit, our preparedness, it all has to come
    together. And I appreciate the discussion here this morning.
        Gentlemen, welcome, and thank you all for your service,
    greatly appreciate it in so many ways.
        General Green, it was a pleasure to have the opportunity to
    meet with you when you were in Alaska to attend the retirement
    ceremony for a friend of ours, Colonel Powell. At that time, we
    discussed the efforts to bring Fisher House to Alaska, and that
    is now a reality. We greatly appreciate that--your efforts and
    then your support for what Colonel Powell was trying to do,
    which was to focus on the hometown healing, has been remarkably
    successful. So we have got some good news to report up north.
        My question today, and this is for you, General Green, is
    regarding the Elmendorf Hospital facility. As you know, it is a
    joint venture facility with the Air Force and the VA. And
    recognizing that it truly is joint venture in the sense that we
    have got the other services involved--Air Force, Army, and also
    serving our Coast Guard families. So, it clearly is a benefit
    to the region.
        What I want to ask you today is whether or not the Air
    Force and the VA are in alignment when it comes to meeting the
    staffing needs there at Elmendorf Hospital.
        We have got a situation where within the VA, far too many
    of our veterans are being sent outside--being sent to Seattle
    and parts outside the State simply because the services cannot
    be obtained there, or because the VA says we are going to do it
    outside, even when the services are available. I had an
    opportunity to discuss this with Secretary Shinseki at an
    Approps meeting last week, and he has pledged to me we are
    going to work to do better in purchasing care for our veterans
    there.
        But what I am trying to determine is whether or not within
    this joint venture hospital we are truly able to meet the
    needs, given the strains that we have on capacity within the
    community, given the issues that we have in meeting the needs
    for certain specialties. And what I am looking for this morning
    is an assurance that we can be working to ensure that the joint
    venture hospital has what it needs--the people--to serve both
    the active military populations as well as our veteran
    population.

                  ELMENDORF HOSPITAL--A JOINT VENTURE FACILITY

        General Green. Yes, ma'am. Thank you, and I appreciate our
    luncheon with Eli Powell, too, who is a good friend of mine.
        Senator Murkowski. Yeah.
        General Green. In answer to your question, I think that you
    will kind of get a sense of the commitment we have to this
    venture.
        The joint venture with the VA at Elmendorf is one of six
    that the Air Force is now doing with the VA. We have now
    invested about $7 million in JIF funds just at Elmendorf. We
    have about $100 million in all of our joint ventures across the
    world where we are partnered with the VA. My commitment up
    there has been to basically increase the manpower by about just
    under 200 positions to try and augment the staffing at
    Elmendorf to pick up on some of the workload, strongly
    encouraging further joint ventures with the Indian Health
    Service, which, as you know, is one of the larger hospitals in
    the Federal system there. And we have had people working in the
    Indian health hospital as well as we try to--they are a level 2
    trauma hospital now--as we try to maintain skills.
        We have also increased the budget up at Elmendorf by about
    $4 million annually in addition to just adding manpower, and we
    have seen an output from that of nearly 40 percent increase in
    surgeries that can be now in Alaska instead of people being
    sent elsewhere.
        My commitment to the joint venture is very solid. I would
    love to see Elmendorf thrive. We have talked about whether or
    not we can bring graduate medical education up there. I have
    worked with some of your community physicians as they look to
    bring a pediatric residency to see if we can join them in that
    effort. And we have also talked with the family practice
    residency up there to see how we can basically partner.
        Some of this has to do with how the hospital grows and how
    long it takes for construction in your State sometimes. The new
    VA clinic up there has been very successful, and my hope is we
    can do even more. And my hope is we can do even more. So, you
    have my commitment, and I won't speak for the VA, but when I
    talk with them, they are very committed also to expanding
    services.
        Senator Murkowski. Well, what we would like to do is to be
    able to identify those areas or perhaps those gaps within the
    VA system, whether it is in orthopedics, ENT, neurology,
    wherever that is, and see if in fact there is a--there is the
    ability within the Air Force to kind of reach in and fill those
    gaps as we look to how we staff and truly meet the needs of,
    again, our Active service men and women and our veterans up
    there. But I appreciate your commitment, and I look forward to
    working with you on that.
        General Green. Yes, ma'am. We send you very talented people
    that I----
        Senator Murkowski. Yes, you do.
        General Green [continuing]. Expect to help me grow that
    particular area.
        Senator Murkowski. We appreciate that as well.
        General Schoomaker, this is probably for you as the Army is
    the one that administers the congressionally directed Medical
    Research Program. And my question to you this morning is about
    the research program as it pertains to ALS, or Lou Gehrig's
    disease, a horrible disease for all--those of us that know of
    it, but a concern for us in the military as we look to the
    exceptionally high incidence--incident rate of those who
    contract ALS, who are our military heroes. It strikes those in
    the military at approximately twice the rate as the general
    public.
        Back in 2008, ALS, as I understand, was determined to be a
    presumptive disability by the VA, a service-related disease.
    And again, those of us who have been in a situation where we
    know someone with ALS know that this is a condition that moves
    quickly--5- to 6-year life expectancy from diagnosis, and a
    terribly, terribly horrific and debilitating disease that cost
    incredible amounts of money as we provide for that level of
    care and that level of treatment.
        And so, when we look to the statistics, it causes one to
    wonder, well, what will the impact to our military systems be
    as we pick up the costs for those that are afflicted with ALS?
    We are all very cognizant that we are in times of greatly
    reduced budgets, and some would look at these programs--these
    congressionally directed medical research programs--as being
    something that are perhaps nice, but not necessary. So, I would
    like to hear from you this morning kind of where you are coming
    from on these congressionally directed medical research
    programs, more specifically, ALS, whether you think that it is
    something that should be continued to be funded in terms of the
    research, and whether or not you think that that research is
    making a difference in the lives of our service members who
    have been afflicted.
        General Schoomaker. Yes, ma'am. Thanks for that question.
    And I think you have made exactly the case I would make for
    these programs.
        Congress has been remarkably enlightened and forthcoming
    with funds for congressionally directed research dollars and
    for programs which are, as you point out, ma'am, administered
    through the Medical Research and Materiel Command at Fort
    Detrick under the congressionally directed medical research
    program and other congressional special interest programs.
        They currently--we have got a very effective, I think, and
    efficient process by which research dollars and programs are
    targeted for our review for both scientific credibility and for
    programmatic integrity; that is, that they will be successfully
    executed. We have a very good program of soliciting the best
    investigators from across the country, both inside and outside
    the military, but largely outside the military, to conduct
    this. And the programs that they--that are addressed in these
    include amyotrophic lateral sclerosis that you have talked
    about, ALS, but also prostate cancer, breast cancer, and a
    variety of other problems that afflict not only the population
    at large, but military members and families as soldiers,
    sailors, airmen, and marines.
        We try to make these as appropriate as possible to the
    military population, but we admit that a lot of these
    breakthroughs have overflow or application to other neurologic
    problems. I mean, insights into ALS will give us insights into
    other problems from an injury or illnesses that afflict
    soldiers.
        Currently, the limit on earmarks is going to threaten about
    50 percent of the total research that is done within the
    Medical Research and Materiel Command.
        Senator Murkowski. What do you think that will do to the
    status of research?
        General Schoomaker. Well, I mean, it is going to take down
    my structure. It is very hard to rebuild the structure that is
    the people and the programs that administer these programs for
    the military. You cannot snap your fingers and rebuild them,
    and so we are going to have to take those down over the next
    few months and have already started that process.
        I am very eager to see the Congress come up with a solution
    that allows us to keep some of the critical programs because
    they have been very innovative and been very successful in
    delivering, you know, insights into new products to improve the
    lives of people who are suffering from these problems.
        Senator Murkowski. Well, it is difficult to hear that we
    would go backward on our research--go backward on the progress
    that we have made. And I hate to try to put a dollar on, you
    know, what it costs to deal with somebody that is afflicted,
    again, with a disease where, again, you are looking at
    incidence rates within our military that are twice the number
    within the general population out there. You would hate to
    think that somebody would hesitate to join up and become a
    member of our military because they are concerned that somehow
    or other they may be afflicted with a disease that they really
    want to steer clear of.
        I recognize that these are difficult budget times, but I
    also recognize that the advancements that we have made, the
    investments that we have made in our research and technology,
    are not something that we want to dial back on. So, I would
    hope that we could work with you as we try to make more forward
    progress in this area.
        Mr. Chairman, I have yet another question, but I have taken
    plenty of time this morning. But I will defer to Senator Leahy.
        Chairman Inouye. Thank you very much.
        Senator Leahy.
        Senator Leahy. Thank you, Mr. Chairman.
        I have found the questions here and answers interesting.
    You have a panel of three very, very well qualified people to
    answer them, and I appreciate that.
        General Schoomaker, recently 42 Members of Congress joined
    me in sending a letter to the Army and the Guard Bureau asking
    them to fund eight States' National Guard outreach programs.
    The programs are going to expire soon. Now, in full disclosure,
    one of them is in my own State of Vermont.
        But I think when we have heard the questions, especially
    those of the last two Senators, I would add to their points by
    saying these programs fill a serious gap in the Guard
    behavioral health. These programs are kind of like the MRAP,
    although it was an entirely different thing, but the program
    seemed like an idea where the Army and the Congress can work
    together to do the right thing. We did, getting the troops that
    equipment. Now we are talking about our soldiers and how we
    take care of them.
        You have made great strides, and I listened to what you and
    Senator Mikulski were saying about suicide prevention in recent
    years. But last year's doubling of Army Guard suicides shows
    that the Army falls short when it comes to the needs of the
    Army Guard and Reserve. They do not have a base. They are not
    going back to a port or a base where you can have the services
    within a limited geographical area. A State like Vermont, which
    has no active duty installations, the Guard uses its outreach
    programs to reach out to personnel where they live in home
    towns across the State. That may be a town like the one I live
    in with 1,500 people; it may be in one with 100 people, or it
    may be a community like Burlington that has a larger
    population. And our own adjutant general, Mike Dubie, whom I
    believe you know, told me that there had been many potential
    suicides that had been averted by this outreach program.
        Now, the funds needed to preserve these programs are less
    than $10 million for the remainder of the fiscal year. Are
    these programs going to be funded for this year and for the
    future?
        General Schoomaker. Well, sir, first of all, I want to
    thank you for the advocacy you showed for the 86th Infantry
    Brigade Combat Team that did deploy and then redeployed through
    Fort Drum, and I think illustrated the progress we have made in
    trying to bring back, redeploy, and then demobilize our Guard
    and Reserve.
        What you have highlighted, and other members of the
    subcommittee have highlighted, are the problems that are
    inherent within the operationalization of the Reserves. The--
    our Guard and Reserve, which was within the Army, conceived of
    in past times as a strategic reserve ready to get launched one
    time for a major Nation-threatening, you know, war or conflict
    has now been, for the last 10 years, integrated fully into the
    deployment of the Army through an operational Reserve. And in
    doing that, what we have identified are shortcomings and
    challenges in providing care for National Guard and Reserve
    soldiers and families when they get back to their communities.
        Senator Leahy. And providing that care is a little bit
    different than going back to a base, going back to----
        General Schoomaker. Sure. No question.
        Senator Leahy [continuing]. Fort Hood or somewhere else.
        General Schoomaker. And the rules that govern access to
    that care are quite different. I mean, while the soldier is on
    Active duty, if the soldier incurs an injury or an ailment as a
    consequence of that deployment or that training to go to
    deployment, there is no question we have ready access to
    military units and military healthcare, and our TRICARE
    network, for that matter. But it does become a challenge when
    soldiers are redeployed and demobilized and then sent back home
    where they may face environments. And you are not alone in
    Vermont in facing this problem.
        I am working very closely with the Guard and Reserve. I
    think one of the major efforts that Major General Rich Stone,
    who is a mobilized reservist in the South out of Michigan, and
    a physician in practice, but has left his practice to work with
    us and orchestrate a program to look at how we can better
    support the Guard and Reserve. We have been looking for the
    last couple of years at exactly how we can better care for and
    reach out to the Guard and Reserve through TRICARE and our
    other efforts. So, we are looking at the programs that are
    threatened by the loss of funding, sir.
        Senator Leahy. Well, please look carefully and work with my
    office. We have had, you know, a redeployment. We talked about
    the Warrior Transition Program. And I know that there is a
    pilot program established at Fort Drum which still has some
    issues to work out. It is far superior than what the 86th
    Brigade had before, though. And I just would like to see these
    things around the country because when you have been in Iraq
    and you have been in Afghanistan, as I have, and you see these
    people out in the field, you cannot look at the soldiers going
    in and say, well, that one is a Guard member and--you cannot
    tell, nor are their duties any different.
        And I have one other question, and actually I pass this on
    to all of you, General, to you, and Admiral Robinson, and
    General Green. I have long supported improvements in military
    medical care through information technology and increased use
    of it. I have supported a military medical decisionmaking tool
    called CHART. The Office of the Secretary of Defense plans to
    mandate it for use by the services in pre- and post-deployment
    healthcare screening. A recent study by an Army doctor in the
    American Journal of Psychiatry linked deployment screenings to
    improved mental health outcomes. Are your services going to be
    using CHART and interface with your readiness systems?
        Admiral Robinson, would you like to----
        Admiral Robinson. Sir, I----
        Senator Leahy [continuing]. Take a swing at that one?
        Admiral Robinson. I will take a swing at it. I am not
    familiar with CHART, so I do not know whether we will be using
    it or not. But I can certainly take this for the record and get
    back to you.
        Senator Leahy. Would you please?
        Admiral Robinson. I certainly will do that.
        Senator Leahy. Thank you.
        [The information follows:]

        An electronic tool to integrate multiple health assessment
    questionnaires and display results in the DOD electronic health
    record system would he beneficial. In its current Conn, CHART
    has multiple shortcomings, and requires major enhancement
    before it can be considered as an acceptable solution for the
    Services.
        Each of the Services currently possesses operational
    readiness information systems with an integrated health
    assessment questionnaire capability. These systems manage each
    Service's unique readiness requirements and operate in their
    unique fielding environments. CHART as a health assessment
    questionnaire tool would duplicate and fragment our ability to
    assess and monitor readiness of Soldiers, Airmen, Sailors, and
    Marines. For these reasons, CHART is currently ranked very low
    in the overall funding priority.

        General Schoomaker. Sir, and for the Army, I am not
    familiar with that as well, but I will--this is a good point
    for me to make a pitch for this behavioral health system of
    care that Major General Horoho is taking personal leadership
    in. It allows us to look at programs like CHART, or any other
    program, in an objective way and do a head-to-head comparison
    with our existing systems, and see if it delivers a better
    outcome. So, I think----
        Senator Leahy. I mean, we all want the same thing. We want
    the best outcome. And I am just pushing to make sure we have
    it.
        And, General Green? And certainly all three of you please
    do give me something for the record on this.
        General Green.

                           ELECTRONIC HEALTH RECORDS

        General Green. Yes, sir. And I will take the question for
    record on the CHART, specific question.
        I would add that we now have almost 5 years of data from
    our electronic health record. And so, leveraging the data that
    is in AHLTA and basically linking that with the pharmacy
    transaction databases as well as the M-2, we are now leveraging
    informatics to try and get to new levels of decision support
    that will really change medicine over time. I strongly believe
    that if we can get better information to the patient so that
    they make sound decisions, that we can then also get them to
    the healthcare team which can augment and give them even
    further information, we will see tremendous change in medicine
    because we will be able to pinpoint prevention back to the--
    what is necessary for patient care.
        Senator Leahy. Well, take a look at this one and take a
    look at any of the DOD directives on it, because there has to
    be follow-up to make it work, and that is what I am most
    concerned about. I worry very, very much that some of these
    brave men and women we have deployed fall off the screen
    because they are not treated properly. I do not pretend to be
    knowledgeable on this, but I know when my wife was working as a
    registered nurse, she saw a lot of these people that should
    have been helped--that was a different time--should have been
    helped, could have been helped. And I go to some places where
    the care is superb, and the person might have committed suicide
    somewhere else, or might have dropped off the screen somewhere
    else, or had debilitating illness that could have been
    corrected and was not. We ask them to put their lives on the
    line, then--I mean, you know that, and you believe as I do. I
    think we owe them something when they come back. So, let us see
    what this is going, let us see what the directives are, and let
    us see what the implementation might be.
        Thank you.
        Mr. Chairman, thank you for this hearing.
        Chairman Inouye. All right. Thank you very much.
        And, General Schoomaker, Admiral Robinson, General Green, I
    thank you very much on behalf of the subcommittee. And I wish
    you well also.
        And now we will have the second panel: Major General
    Patricia Horoho, Chief, Army Nurse Corps, Rear Admiral
    Elizabeth S. Niemyer, Director of the Navy Nurse Corps, Major
    General Kimberly Siniscalchi, Assistant Air Force Surgeon
    General for Nursing Services.
    STATEMENT OF MAJOR GENERAL PATRICIA HOROHO, CHIEF, ARMY
                NURSE CORPS, DEPARTMENT OF THE ARMY
        General Horoho. Good morning, sir.
        Chairman Inouye, Vice Chairman Cochran, and distinguished
    members of the subcommittee, it is an honor to speak before you
    today on behalf of the nearly 40,000 officer, civilian, and
    enlisted team members that represent Army nursing. Your
    continued support has enabled Army nursing in support of Army
    medicine to provide exceptional care to those who bravely
    defend and protect our Nation.
        It is a privilege to share with you today what is happening
    across Army nursing.
        Our strategic priority, the Patient CareTouch System, was
    implemented in February of this year at three medical treatment
    facilities, Madigan, Brooke, and Womack Army Medical Centers,
    and then this month we began the roll out of the remaining
    facilities. Army-wide implementation of Patient CareTouch will
    be complete by December 2011. This system is fully embraced by
    all medical leaders and is successfully being implemented
    across Army medicine.
        The Patient CareTouch System is comprised of five elements,
    which we truly believe guide, gauge, and ground patient-
    centered care delivery. The elements are patient advocacy,
    enhanced care team communication, clinical capability building,
    evidence-based practices, and healthy work environments. There
    are 10 supporting components that enhance these elements.
        A key element of the Patient CareTouch System is evidence-
    based practice, and nursing researchers, embedded in newly
    formed centers for nursing science and clinical inquiry,
    translating research into practice to optimize the quality of
    care provided to our patients.
        Army nursing is continuing to answer the call of the
    combatant commander for critical care nurses who are prepared
    and dedicated to care delivery in the back of medical
    evacuation helicopters.
        In December 2007, nurses assigned to the Medical Task Force
    in Iraq leveraged the capabilities of our critical care and
    emergency nurses. We created and then codified a premier en
    route care transport program that ensured our wounded, ill, and
    injured receive the right care at the right time by the right
    provider. Since last year, we have performed nearly 450 en
    route care transport missions. This capability directly
    impacted the 98 percent survival rate for wounded service
    members in Iraq, and is now the standard across all theaters of
    operation.
        The demand for increased numbers of trauma nurses in both
    theaters of operation prompted me to make a decision this year
    to establish a separate area of concentration for trauma
    nurses. This required a consolidation of critical care and
    emergency nursing specialties from which this new specialty,
    the 66th Tango, was established. This consolidation will
    provide unparalleled level of trauma nursing capability for
    military medicine, and it will be the force multiplier in both
    our fixed and deployed hospitals.
        I would like to provide you with an update of several
    programs that I introduced to you last year.
        The Brigadier General Retired Anna May Hayes Clinical Nurse
    Transition Program continues to prepare our novice nurses to
    provide patient-centered care. Since 2009, over 520 novice
    nurses have completed this program, achieving a higher advanced
    beginner competency. This program continues to exceed the
    national standard.
        Since the inception of the Virtual Leader Academy, we have
    graduated over 500 officers, non-commissioned officers, and
    civilians from our courses. This Academy focuses on capability
    and facilitates lifelong learning.
        Army nursing is committed to the education of its advanced
    practice nurses. To that end, Uniformed Services University has
    once again proven to be the stalwart partner of Army nursing,
    as well as to our sister services to ensure the development of
    the curriculum to tackle the requirements for transition from
    Masters to DMP Program by 2015.
        An area that we have focused our effort pertains to
    behavioral health. We have refined the clinical capability for
    the Advanced Practice Army Behavioral Health Nurse
    Practitioners, a key member of the behavioral health team. We
    have leveraged their capability toward building resiliency in
    our deployed service members and their families.
        Over the past year, 424 Army nurses deployed with two
    medical brigades and four combat support hospitals in support
    of Operation New Dawn and Operation Enduring Freedom. We had
    the extreme honor of celebrating the successful command tour of
    two combat support hospital nurse commanders. These nurses were
    integral in leading healthcare delivery and facilitating
    medical diplomacy across Iraq.
        Army nurses are writing our history with each patient they
    touch, with each experience they have, and each story that they
    tell.
        On February 2, we celebrated 110 years of proud service to
    our Nation. We thank you, Mr. Chairman, and Senator Murkowski
    for introducing Senate Resolution 31 to commemorate this
    historic occasion.
        Mr. Chairman, we also thank you for the very touching,
    heartfelt video message for the many years of unwavering
    support of Army and Army nursing.
        I continue to envision an Army Nurse Corps of the future
    that we leave its mark on military nursing and will be a leader
    of nursing practice reform at the national level. We are
    committed to leveraging lessons learned from the past, engaging
    present innovation, and shaping the future of professional
    nursing. Our priority remains our patients and their families,
    and our common purpose is to support and maintain a system for
    health. In order to achieve this common purpose, we serve with
    the courage to care, the courage to connect, and the courage to
    change, so that we may provide the best possible healthcare to
    those that wear the cloth of our Nation.

                               PREPARED STATEMENT

        On behalf of the entire Army Nurse Corps, serving both home
    and abroad, I would like to thank each of you for your service
    to our Nation and your unwavering support.
        Thank you.
        Chairman Inouye. General Horoho, thank you very much for
    you testimony. We appreciate it very much.
        [The statement follows:]
             Prepared Statement of Major General Patricia D. Horoho
        Chairman Inouye, Vice Chairman Cochran and distinguished members of
    the committee, it is an honor and a great privilege to speak before you
    today on behalf of the nearly 40,000 Active component, Reserve
    component and National Guard officers, non-commissioned officers,
    enlisted and civilians that represent Army Nursing. It has been your
    continued tremendous support that has enabled Army Nursing, in support
    of Army Medicine, to provide exceptional care to those who bravely
    defend and protect our Nation.
                            patient caretouch system
        I am pleased to provide you with an update on Army Nursing and to
    share with you my strategic priority, the Patient CareTouch System. The
    Patient CareTouch System implementation began on February 7, 2011 at
    three medical treatment facilities: Madigan Army Medical Center, Brooke
    Army Medical Center, and Womack Army Medical Center. Seven facilities
    will begin their roll out this month: Walter Reed Army Medical Center,
    DeWitt Army Community Hospital, Tripler Army Medical Center, Landstuhl
    Regional Medical Center, William Beaumont Army Medical Center, Carl
    Darnall Army Medical Center, and Blanchfield Army Community Hospital.
    The remaining facilities will join the process in three implementation
    phases beginning in mid-May. Army-wide implementation at every patient
    touch point will be completed by December 2011. The Patient CareTouch
    System spans all care environments where nurses touch patients by
    ensuring quality care is delivered carefully, compassionately and in
    accordance with standards for best practice. The Patient CareTouch
    System is comprised of five elements, which we believe guide, gauge,
    and ground patient centered care. These elements include: Patient
    Advocacy, Enhanced Care Team Communication, Clinical Capability
    Building, Evidence-Based Practices, and Healthy Work Environments. The
    elements are supported by 10 components that include core values for
    patient care, care teams, peer feedback, standardized documentation,
    skill building, talent management, clinical leader development,
    optimized clinical performance, Centers for Nursing Science and
    Clinical Inquiry (CNSCI), and shared accountability for quality of
    patient care delivery.
        The Patient CareTouch System provides a sustainable framework for
    our transition from a healthcare system to a system for health. It
    cultivates trust by providing a standard by which care can be measured
    across Army Medicine, and it allows us to look critically at what we
    do, how we do it, and how we can improve. The Patient CareTouch System
    ensures that our patients know that we have their best interest at the
    forefront of all care decisions and it promotes standards, not
    standardization, for nursing care Army-wide. We found, when we piloted
    the Patient CareTouch System at Fort Campbell, Kentucky, that we had a
    positive impact on patient outcomes, patient satisfaction, clinical
    communication, provider-nursing staff collaboration, and provider
    satisfaction. We believe these results will be reproducible across Army
    Medicine and we are using evidence based metrics to benchmark nurse
    sensitive indicators against national standards. This will validate our
    firm belief that our patients are receiving world class, high quality
    nursing care.
                        optimizing patient care delivery
        Evidence based practice is a key element in the Patient CareTouch
    System and nursing researchers, embedded within newly formed CNSCIs are
    translating research into practice to optimize the quality of care
    provided to our patients. The CNSCIs are promoting enhanced nursing
    decision support, evidence-based practice and research. Nurse
    scientists, Clinical Nurse Specialists, and Nurse Methods Analysts
    comprise the CNSCI. These experts working together are affecting the
    transition from a ``question-to-answer model'' to the more valuable
    ``question-to-translation-to-evaluation model.'' Consolidating nursing
    support assets who are working on a common sense research priority
    agenda increases the capacity for evidence-based management and
    evidence-based practice Army Nursing wide.
        Research and evidence-based practice are overarching and core
    constructs in the Army Nursing Campaign Plan. Army Nursing is
    transforming from an expert-based practice model to a systems-based
    care model in order to leverage nursing assets and realize the benefits
    of knowledge management and research translation. This is critical to
    improve patient outcomes, safety, healthcare value, and quality. Tenets
    of a systems-based care model includes system resourcing, healthcare
    economics, teamwork, cost-benefit considerations, and practice
    management. Key to success is uniting various types of nursing support
    experts to better meet the needs of bedside nurses and the nurse
    leaders who provide and direct the delivery of patient care.
        Army Nurse scientists are collaborating in joint, multinational and
    academic settings to infuse nursing practice with evidence based
    science. The premier Army Nursing Practice Council (ANPC), established
    in the fall 2010, is providing the critical connection between nursing
    science and nursing practice. The ANPC meets monthly to review
    evidence, data, and science to develop evidence-based nursing tactics,
    techniques and procedures (TTP) that then become the standards across
    Army Medicine. Recently published standards include an innovative falls
    prevention program, structured nursing hourly rounding, and bedside
    shift reporting. TriService Nurse Research Program (TSNRP) funded
    studies support several evidence-based nursing TTPs. For example, in
    the Emergency Room at Bayne Jones Army Community Hospital, Fort Polk,
    Louisiana, white boards in the patient rooms facilitate real time
    status updates on medications, procedures, and tests completed to
    enhance communication between emergency room staff and the patient and
    family members.
        The TSNRP funded an evidence-based practice project titled:
    ``Evaluating Evidence-Based Interventions to Prevent Falls and Pressure
    Ulcers.'' This study was the basis for revising clinical practice
    guidelines for prevention of falls and skin breakdown within the
    Madigan Army Medical Center. It was also the means by which their CNSCI
    team introduced patient-centered rounds and monitoring of nurse-
    sensitive outcomes such as nurse satisfaction, patient satisfaction,
    and rates of falls and pressure ulcers.
                                  warrior care
        Enroute care transport is not a new mission for Army Nursing; we
    have been providing this type of care for over 60 years. In 1943 the
    first Army nurses formally trained in air evacuation procedures were
    assigned to secret missions in North Africa, New Guinea, and India.
    Army nurses cared for patients on helicopter ambulances, transporting
    over 17,700 U.S. casualties of the Korean War. During the Vietnam war,
    Army Nurses were aboard helicopters moving almost 900,000 United States
    and allied sick and wounded Soldiers.
        Army Nursing is continuing to answer the call of the combatant
    commander for critical care nurses who are prepared and dedicated to
    care delivery in the back of a medical evacuation helicopter. In
    December 2007, nurses assigned to the medical task force in Iraq
    leveraged the capabilities of our critical care and emergency nurses
    and created, then codified, a premier enroute care transport program
    that ensured our wounded, ill and injured service members received the
    right care, at the right time, by the right provider. This program
    directly impacted and sustained the 98 percent survival rate for
    wounded service members in Iraq.
        The Army Nursing Enroute Care Transport Program was so successful
    in Iraq in decreasing the incidence of hypothermia, accidental
    endotracheal tube extubation, and prevention of hypovolemic shock in
    our Wounded Warriors that the program is currently in place in
    Afghanistan. Army nurses continue to refine and improve the program,
    maintaining a focus on nursing TTPs for critical care patients
    transports. I am so proud of our Army nurses who, at the beginning of
    the war in Iraq, saw a gap in rotor wing critical care patient
    transport and identified processes to fill the gap. As a result, our
    enroute care transport program is unparalleled in terms of the quality
    of nursing care that our combat veteran critical care nurses provide to
    Wounded Warriors. The quality of care during the strategic evacuation
    care continuum does not end in the theater of operation. Landstuhl
    Regional Medical Center's (LRMC) unique TriService Air Evacuation
    mission processes all casualties through the Deployed Warrior Medical
    Management Center. The nursing care provided to wounded, ill and
    injured Warriors and coalition armed forces air evacuated from
    Operation Iraqi Freedom, Operation Enduring Freedom, Operation New Dawn
    and other Overseas Contingency Operations to LRMC significantly
    contributed to LRMC being awarded the Association of Military Surgeons
    of the United States (AMSUS) 2010 Facility-based Healthcare (Hospital)
    Top Federal Hospital for fiscal year 2010. Continuing their high
    operational tempo, the LRMC's triservice nursing team cared for 11,185
    casualties (4,284 inpatient casualties and 6,901 outpatients) in fiscal
    year 2010.
        Nursing staff augmented the Contingency Aeromedical Staging
    Facility on Ramstein Air Base, enabling continuous casualty flow from
    LRMC to CONUS medical centers. Receiving casualties from over 500 Air
    Evacuation flights, LRMC nurses have significantly supported the
    aeromedical evacuation process. On any given day at LRMC, nursing staff
    on the medical-surgical units will discharge 10 inpatients and admit 11
    new patients, illustrative of the high operational tempo that is
    commonplace at LRMC.
        Nurse researchers like Lieutenant Colonel Betty Garner, are
    augmenting warrior care efforts by conducting studies designed to
    produce evidence for new nursing care modalities. Lieutenant Colonel
    Garner and her team are determining the impact nursing care has on
    injured Soldiers and their families after a traumatic brain injury
    (TBI). Understanding the needs of the Wounded Warrior and their
    families are imperative to improve the quality of life among those
    affected by TBI.
        These examples of Army Nursing's clinical initiatives illustrate an
    amazing flexibility and agility to ensure that we are responsive to the
    needs of our wounded, ill, and injured service members. I would like to
    provide you with an update of several programs that I introduced to you
    last year, and are key enablers of Army Nursing's strategic
    initiatives.
                              capability building
    Talent Management
        Inherent in clinical capability building is leadership, and in
    order to best leverage the capabilities of our nursing team, we
    examined the methods by which we identified, managed, and developed
    clinical leader talent. The Army Nurse Corps' (ANC) talent management
    strategy is a mission critical process that ensures the Corps has the
    right quantity and quality of leaders in place to meet the current and
    future Army Medical Department missions and priorities. Our strategy
    covers all aspects of the ANC life cycle, to include aligning the Corps
    strategic goals with capability requirements and distributing the right
    talent for the right position at the right time and rank.
        We partnered with U.S. Army Accessions Command and implemented
    precision recruiting to ensure we are recruiting the right capability
    in order to develop clinical leader talent. In spring 2010, for the
    first time, our Human Resources Command, Army Nurse Corps Branch
    executed a formalized capability-based assignment process, placing
    senior officers in key positions based on their skills, knowledge, and
    behaviors instead of on availability. In addition, we defined and
    established a sustained succession plan for key leadership positions in
    the ANC. Our talent management strategy enables us to assign full
    spectrum leaders across all care environments in support of the Army
    Medicine mission.
    Leader Academy
        Since the inception of our virtual Leader Academy, we have
    graduated over 500 officers, non-commissioned officers and civilians
    from our courses. Over the past year we analyzed ways to optimize the
    Leader Academy to ensure agility in meeting evolving requirements. We
    have sequenced learning and redesigned a ``building block'' curriculum
    to facilitate lifelong learning at all professional development phases.
    The five core elements of the Patient CareTouch System serve as the
    foundational framework for the Leader Academy and the key components
    are threaded throughout the curriculum of all courses offered.
        The BG(R) Anna Mae Hays Clinical Nurse Transition Program (CNTP)
    continues to prepare our novices with good results. Preliminary program
    evaluation results presented at the 2010 Phyllis J. Verhonick Nursing
    Research conference indicate that of the four cohorts evaluated, all
    participants achieved advanced beginner competency at the end of the
    program. In order to stabilize the program, all director positions are
    now being filled by competitively selected non-rotating civilians, two
    of which are Doctoral prepared and the remaining are Master's prepared.
    A review of current studies revealed that standardized preceptorship
    programs (preceptor training and tracking) increases nurse transition
    from academia to practice. As a result of this evidence, the CNTP
    directors adopted a Preceptor Development Program and established
    guidelines now being implemented at all transition sites. The Patient
    CareTouch System provides a framework for the program and the evidence
    and science inform the standards by which nurses deliver care across
    the age spectrum. Patient responses have been favorable, specifically
    complimenting nurse transition program participants in hospital
    satisfaction surveys. As we interview new lieutenants in the program,
    we have found that many, who were planning to leave at the end of their
    initial service commitment, are instead continuing their careers in the
    ANC as a result of the enculturation process that is inherent in the
    CNTP. Retaining new graduate nurses preserves the knowledge, experience
    and confidence gained during the first year of professional practice
    and has a positive impact on the quality of patient care.
        There has been an array of secondary benefits resulting from the
    creativity of the nurses participating in the CNTP. At Madigan Army
    Medical Center, novice nurses developed and implemented a program to
    track chart audits and produced a training video on ``Preventing
    Patient Falls.'' At Womack Army Medical Center, novice nurses presented
    an abstract entitled ``Response to Enhance the Quality and Consistency
    of Shift Reports'' at the Karen A. Reider Federal Nursing Research
    poster session during the AMSUS conference.
                             portfolio of expertise
        We are constantly refining our clinical capabilities to meet the
    ever-changing complexity of providing care in challenging care
    environments. As a result of increasing demands for trauma nurses and
    the complexity of care required in both theaters of operation we made
    the decision to establish a separate area of concentration
    consolidating intensive care unit (ICU) and emergency nursing with the
    educational and clinical focus on combat trauma care. This new area of
    concentration will provide us a flexible and agile economy of force,
    while providing an economy of effort for training.
        We are re-shaping our ICU and emergency nursing courses into one
    curriculum focused on acquisition of trauma nursing and critical care
    competencies. The Army trauma nurse area of concentration will result
    in assignment flexibility in both our hospitals and deployed combat
    support hospitals (CSH) and provide an unprecedented level of trauma
    nursing capability for military medicine. We are also analyzing ways to
    leverage potent Army medicine force multipliers such as our psychiatric
    nurse practitioners and psychiatric nurses.
        This year, in response to increasing requirements for trauma
    trained nurse, we expanded our emergency nursing course by adding a
    second training site at Madigan Army Medical Center and graduated our
    first class at this location in December 2010. This additional program
    doubles the number of emergency nurses trained annually and enhances
    our ability to provide world class care at home and abroad.
        Through the efforts of our Perioperative Nurse Consultant, in
    collaboration with the national perioperative nursing organization, we
    have added additional sterilization procedures to the curriculum for
    both our Perioperative Nurse and Operating Room Technician programs.
    This proactive initiative addresses a national health concern regarding
    potential infectious disease transmission resulting from improper
    sterilization processing of surgical scopes. Currently, we are
    developing a pilot program for the utilization of graduate prepared
    Perioperative Clinical Nurse Specialists as Perioperative Nurse Case
    Managers responsible for the coordination of clinical care across the
    perioperative continuum from preoperative preparation to post-
    anesthesia care. We are closely examining operating room processes,
    with a focus on the perioperative nurse.
        The operating room can be one of the busiest touch points in a
    facility, and as a result an area that we want to ensure quality and
    safe care delivery. We believe that a critical examination of an
    expanded role of the perioperative clinical nurse specialist is needed.
    This role will concentrate on quality assurance with a focus on patient
    safety and perioperative arena efficiency to include the operating room
    and the centralized sterile processing department. This role is unique
    in that it cannot be replaced by a non-perioperative advanced practice
    nurse.
        Last year I discussed our initiative related to critical care
    skills for our enlisted licensed practical nurses (LPN). In October, we
    conducted our first pre-deployment critical care course for enlisted
    practical nurses from one of our deploying CSH. The Soldiers received
    didactic instruction and clinical rotations in critical care and burn
    care at Brooke Army Medical Center and the Institute of Surgical
    Research. Three enlisted practical nurses from the deploying 115th CSH
    attended a ``critical care skills during deployment'' pilot. On
    average, students demonstrated a 42 percent increase in self-reported
    skills related to chest tube drainage system set up, cardiac strip
    interpretations, and patient report/handoff. With the success of this
    pilot, we are currently developing a pre-deployment LPN course that
    will prepare deploying LPN's for the complex trauma missions they will
    support. Every Army Nurse is a trauma nurse.
        During calendar year 2010, Army nurses deployed with two Medical
    Brigades and four CSHs in support of Operation New Dawn and Operation
    Enduring Freedom to provide force health protection and combat health
    support to United States and coalition forces. Two CSHs were commanded
    by Army nurses--Colonel Barbara Holcomb, Commander of 21st CSH, Iraq
    and Colonel Judy Lee, Commander of 14th CSH, Iraq--who facilitated
    healthcare delivery and medical diplomacy.
        Major Pamela Atchison, an Army nurse, deployed with Task Force MED
    East in support of Operation Enduring Freedom, developed the
    Afghanistan Trauma Mentorship Program for the Afghanistan Theater of
    Operation. Major Atchison implemented the Afghanistan Trauma Mentorship
    Program at two Afghanistan civilian hospitals and trained over 500
    medical personnel (Physicians, Medics and Nurses) assigned to the
    Afghanistan National Security Force and Afghanistan National Army. Her
    contribution to Health Sector Development for Afghanistan, will have a
    lasting effect for both the civilian and military medical communities
    throughout the Afghanistan Theater of Operation.
        Major Michael Barton developed the United States Forces Afghanistan
    policies for Infectious Diseases, Needle Stick Injuries, and
    Surveillance. Major Barton's efforts had a significant impact on the
    quality of care that U.S. Service Members and Coalition Forces received
    throughout the Afghanistan Theater of Operation. Major Barton also
    compiled monthly reports for Task Force Medical commanders throughout
    the theater, which consisted of information regarding epidemiological
    investigations and disease non-battle injuries. The report enabled the
    Task Force Medical commanders to focus on medical readiness issues for
    both U.S. and Coalition Soldiers.
        Colonel William Moran deployed with Task Force (TF) 62 MED as the
    Patient Safety Officer for the Afghanistan Theater of Operation. He
    implemented the first ever formal Patient Safety Program in that
    theater that positively impacted over 1,900 service members, 3 Level
    III hospitals, and 12 Level II Forward Surgical Teams/Elements. In
    order to decrease variance in patient safety management, Colonel Moran
    travelled to each TF 62 MED subordinate units to train 28 Patient
    Safety Officers and establish unit based patient safety programs.
    Colonel Moran significantly improved patient safety and the overall
    delivery of healthcare in theater by establishing an environment of
    trust, teamwork, and communication based on standards that improved
    patient safety and prevented adverse events.
        Army nurses are contributing significantly to the success of
    multinational operations and working collaboratively with coalition and
    Afghan healthcare professionals. I'm very proud of the medical
    diplomacy efforts, displayed by the nursing leaders in command of the
    Forward Surgical Teams (FST) in Afghanistan.
        Lieutenant Colonel Ruth Timms commanded the 160th FST in support of
    Operation Enduring Freedom. Her team was embedded within a German NATO
    Role III hospital and provided direct support to over 11,000 U.S. and
    Coalition Soldiers that comprised 15 nations. Lieutenant Colonel Timms
    was an integral proponent for initiating mentorship programs between
    United States, German, and Afghan providers which is enabling an Afghan
    Healthcare system fully capable of providing comprehensive healthcare
    services to the people of Afghanistan.
        Captain Roger Beaulieu commanded the 934th FST in support of
    Operation Enduring Freedom. He and his team cared for over 460 wounded
    service members, performed over 160 surgeries and improved the medical
    capabilities of the local national hospital by training four Afghan
    Surgeons and nearly 100 Afghan medical support personnel.
        These Army nurses are writing Army nursing history, and on February
    2 of this year, we celebrated 110 years of proud service to our country
    as a recognized Corps of the United States Army. We thank you, Mr.
    Chairman, Vice Chairman Cochran and Senator Murkowski for introducing
    Senate Resolution 31 to commemorate this historic occasion. Chairman
    Inouye, we also thank you for the very touching, heartfelt video
    message and for your many years of unwavering support of Army nursing.
    We marked this day and its meaning by laying a wreath at the Nurse
    Memorial located in Arlington Cemetery to pay respect to all Army
    nurses who came before us. We honor them for their service, dedication,
    and vision.
        In the National Capital Area over 500 nurses, active, retired,
    reserve, and civilian, family and friends of nursing gathered on
    February 5, 2011 to commemorate this monumental milestone in our rich
    history. Together, we celebrated ``Touching Lives for 110 Years,''
    which really resonated with me and illustrated what I believe is the
    true essence of Army Nursing. We have been on the battlefield, serving
    with our fellow Soldiers, throughout our remarkable history and we
    continue to do so today. Our collective success has been the result of
    compassion, commitment, and dedication. I am inspired by the pride,
    enthusiasm, and openness to change that I see across the ANC in support
    of Army Medicine and our Nation's missions. My number one priority is
    the Patient CareTouch System that will serve as the cornerstone to
    improving the healthcare that provides patient care to our Soldiers and
    the Families that support them.
        I continue to envision an ANC of the future that will leave its
    mark on military nursing, and will be a leader of nursing practice
    reform at the national level. Our priority remains our patients and
    their families, and our common purpose is to support and maintain a
    system for health. In order to achieve this common purpose, we serve
    with the courage to care, the courage to connect, and the courage to
    change so that we may provide the best possible care to those who wear
    the cloth of our Nation. The ANC is committed to leveraging lessons
    learned from the past, engaging present innovations, and shaping the
    future of professional nursing.
        On behalf of the entire Army Nurse Corps, serving both at home and
    abroad, I would like to thank each of you for your unwavering support,
    and I look forward to continuing to work with you. Thank you.

        Chairman Inouye. Admiral Niemyer.
    STATEMENT OF REAR ADMIRAL ELIZABETH S. NIEMYER,
                DIRECTOR, NAVY NURSE CORPS, DEPARTMENT OF
                THE NAVY
        Admiral Niemyer. Good morning.
        Chairman Inouye, Vice Chairman Cochran, and distinguished
    members of the subcommittee, thank you for the opportunity to
    speak today on the state and future vision of the Navy Nurse
    Corps.
        Nowhere is Navy nursing's commitment to the operational
    forces more evident than in our active engagement in military
    operations in Southwest Asia, at the Expeditionary Medical
    Facilities in Kuwait and Kandahar, and with the 1st Marine
    Logistics Group in Afghanistan. We are clearly essential to our
    military's medical successes on the front lines of Operation
    Enduring Freedom.
        Nurse practitioners manage the clinical operations at NATO
    Role 3 in the urgent care clinic and participate in the
    Shoulder-to-Shoulder Project at Kandahar Regional Military
    Hospital. In this role, they mentor Afghan nurses in the
    classroom and in the clinical setting. The promise of enhanced
    clinical care in the Afghan healthcare system is a vision
    shared by all those stationed at NATO Role 3.
        Navy nurses are also members of embedded training teams and
    provincial reconstruction teams, collaborating with Coalition
    partners and offering assistance to military and civilian
    healthcare providers in Afghanistan.
        We played a key role in humanitarian assistance and
    disaster relief operations in support of Operation Unified
    Response in Haiti, Pacific Partnership 2010, and Continuing
    Promise 2010. These operations present a unique opportunity to
    test our education and clinical skills in rudimentary
    healthcare environments while strengthening our capability to
    partner with host nations, U.S. Government agencies, non-
    governmental agencies, and academic institutions.
        Navy nurses continue to support the fleet and expand the
    services they provide to our sailors and marines at sea. Nurses
    assigned to aircraft carriers and fleet surgical teams are
    actively involved in operational missions around the globe and
    are essential members of shipboard medical teams.
        The role of Navy nurses assigned to the Marine Corps
    continues to expand and diversify. Currently, 18 nurses are
    directly attached to the Marine Corps serving in clinics and
    advanced leadership roles. For the first time in our history,
    the 2d Marine Expeditionary Fleet surgeon is a nurse.
        Today Navy Nurse Corps' active component is manned at 92
    percent, and for the fifth consecutive year, we have achieved
    Navy nursing's active component recruiting goal. The Reserve
    component is 85.9 percent manned and has reached 48 percent of
    their fiscal year 2011 recruiting goal. I attribute our
    recruiting successes to the continued funding and support for
    our accession and incentive programs, the local recruiting
    efforts of Navy recruiters, direct involvement of Navy nurses,
    and the continued positive public perception of service to our
    country.
        Mr. Chairman, I am privileged to provide an update to you
    and your subcommittee on the progress of our initiative for
    doctoral preparation of nurse practitioners and nurse
    anesthetists.
        For the past 2 years, we have selected nurses to transition
    their education programs to a doctorate of nursing practice,
    either to transition from a master's program to the Doctorate
    of Nursing practice, or transition from a bachelors program
    directly to doctoral level work.
        Staff members from my office are diligently working on a
    promotion and schooling plan to maximize opportunities to send
    newly trained nurse practitioners and nurse anesthetists to
    study directly for their doctoral education. I am committed to
    making this education transition the standard for our advanced
    practice nurses.
        We have numerous Navy nursing and joint research and
    evidence-based projects in progress, and continue to be
    extremely grateful for your ongoing support of the Tri-Service
    Nursing Research Program. One study of interest is a
    collaborative project the Navy is leading that will gather
    first-person accounts of nurses caring for wounded service
    members and the memories of the experience from the service
    members themselves. The knowledge gained about their wounded
    care journey is essential in order to develop and sustain
    nursing competencies, and to examine the factors affecting
    reintegration of the wounded warrior.
        Coordination of seamless care is a top priority for the
    ongoing care of our wounded warriors. This year, we will staff
    a Navy Nurse Corps officer directly to a newly created position
    at the VA headquarters. This nurse will work directly with the
    Federal Recovery Coordinator Program to uncover process issues
    and craft solutions to streamlined care.
        In September 2010, I met with a core group of leaders to
    formulate my 2011 Navy Nurse Corps Strategic Plan. We
    identified objectives within five areas of focus: workforce,
    nursing knowledge, nursing research, strategic partnerships,
    and information management. I look forward to updating you on
    Nurse Corps accomplishments on these initiatives in support of
    Navy medicine.
        Being in the military has its challenges, yet it is these
    challenges that allow Navy nurses to excel both personally and
    professionally. Our Navy medicine concept of care is patient
    and family focused, never losing perspective in the care for
    those wounded, ill, or injured, their families, our retirees
    and their families, and each other.

                               PREPARED STATEMENT

        Chairman Inouye, thank you for your unwavering support of
    the commitment to the Navy Nurse Corps, and thank you for
    providing me this opportunity to speak today. I am honored to
    represent the total force, Navy Nursing Team, and look forward
    to continued service as the 23d Director of the Navy Nurse
    Corps.
        Thank you.
        Chairman Inouye. I thank you very much, Admiral.
        [The statement follows:]
            Prepared Statement of Rear Admiral Elizabeth S. Niemyer
                                  introduction
        Good Morning. Chairman Inouye, Vice Chairman Cochran, and
    distinguished members of the subcommittee, I am Rear Admiral Elizabeth
    Niemyer, the 23d Director of the Navy Nurse Corps. Thank you for the
    opportunity to speak today on the state and future vision of the Navy
    Nurse Corps. I first want to recognize Rear Admiral Karen Flaherty, the
    22d Director of the Navy Nurse Corps, who turned over the helm to me
    this past August, and now serves as the Deputy Surgeon General. I
    sincerely thank her for her hard work and dedication which provided for
    a smooth transition for the Nurse Corps.
        Dr. Jonathan Woodson, our new Assistant Secretary of Defense for
    Health Affairs, recently spoke about the well-being of service members
    at the 2011 Warrior Resiliency Conference. The 2-day conference focused
    on Total Force Fitness, an initiative by the Joint Chiefs of Staff.
    Attendees delved into a more holistic approach to the health of service
    members and their families. Woodson said; ``Resiliency is key to the
    welfare of the modern troop, as extended warfare is now commonplace.''
    He echoed Admiral Michael Mullen, Chairman of the Joint Chiefs of
    Staff, by saying; ``Resiliency training must be incorporated into all
    levels of leadership and stages of a service member's military
    career.'' Navy nurses understand the importance of fostering resiliency
    in our patients, their families, our staff, and ourselves as we adapt,
    overcome, and grow stronger in the enormous challenge of supporting
    healthcare in a variety of contingencies.
        Today, I will highlight the accomplishments of the Navy Nurse Corps
    over the past year and discuss issues facing the Navy Nurse Corps in
    2011, as we care for the health of the Force. The total Navy Nurse
    Corps is comprised of 3,987 Active and Reserve component nurses and
    almost 2,000 government service civilian nurses. Working together, we
    are a collegial team of clinicians, patient advocates, mentors, and
    leaders, who are a caring and compassionate face to those affected by
    armed conflict, natural disasters and the day-to-day challenges of
    work, life and family.
        I will also tell you about the successes and accomplishments
    achieved by our Corps since we last presented to you, concluding with a
    discussion of the future of the Navy Nurse Corps as we forge ahead to
    advance nursing care, integrate evidence into practice, and elevate
    nursing at all levels. My strategic focus is on five key areas: Our
    Workforce, Nursing Knowledge, Research, Strategic Partnerships, and
    Information Management. It is within these five areas that I will talk
    about our successes and address our future efforts. However, before
    discussing these areas of focus, I want to share the many incredible
    accomplishments of Navy nurses in operational settings with the Fleet
    and Fleet Marine Forces, as well as review the increasingly important
    role that Navy nurses play in humanitarian and disaster relief
    missions.
                              operational support
        Nowhere is Navy nursing's commitment to the operational forces more
    evident than in our active engagement in military operations in
    southwest Asia at the Expeditionary Medical Facilities in Kuwait and
    Kandahar, and with the 1st Marine Logistics Group in Afghanistan.
    Currently there are over 70 Active and 60 Reserve component nurses
    deployed in a variety of missions in the Central Command Area of
    Responsibility. At the NATO Role 3 Multinational Medical Unit in
    Kandahar, Afghanistan, Navy nurses have taken unprecedented leadership
    positions both in the hospital and in the battle space of southern
    Afghanistan. We are clearly essential to our military's medical
    successes on the front lines of Operation Enduring Freedom. For
    example, nurse practitioners manage the clinical operations of the NATO
    Role 3 Urgent Care Clinic, responsible for providing urgent, emergent,
    and non-emergent healthcare services to 30,000 NATO, coalition, and
    civilian Afghan personnel residing on the Kandahar Air Field. Navy
    nurses have taken a lead role in the highly successful enroute care
    program where specially trained flight nurses are being stationed with
    outlying Forward Surgical Teams, providing critical care in the air
    during patient transfers from distant locations to the NATO Role 3.
    Having flown over 100 flights in 2010, this program has recorded a
    remarkable 100 percent survival rate. An initiative undertaken by Navy
    nurses at the NATO Role 3, and one which contributes greatly to our
    efforts to improve conditions in Afghanistan is their participation in
    the Afghan National Army Nurse Corps' Shana baShana (Shoulder-to-
    Shoulder) Project at the Kandahar Regional Military Hospital. In this
    project, Navy nurses work in concert with a U.S. Air Force mentoring
    team in a recurring 2-week curriculum where Navy nurses enhance and
    update the nursing skills of Afghan military nurses in both a classroom
    and clinical setting. The promise of enhanced clinical care in the
    Afghan healthcare system is a vision all those stationed at the NATO
    Role 3 share.
        Navy nurses are also members of Embedded Training Teams and
    Provincial Reconstruction Teams, collaborating with coalition partners
    and offering assistance to military and civilian healthcare providers
    in Afghanistan. Let me share with you the experience of one of our
    nurses, LCDR Zaradhe Yach, who served with the Provincial
    Reconstruction Team (PRT) at the Forward Operation Base (FOB) Ghazni.
    This base is located in one of the largest and most dangerous provinces
    in the Regional Command East. During the first 90 days in country, FOB
    Ghazni was rocketed by enemy forces over 40 times. During this same
    timeframe the PRT experienced more than 15 significant activities while
    conducting mounted combat patrols throughout the province and LCDR Yach
    was present each time, providing medical assessments and emergency
    treatments to wounded service members. Patrols were engaged in complex
    attacks of multiple improvised explosive devices (IEDs), rocket
    propelled grenades (RPGs), indirect fire, and small arms fires. One IED
    struck her vehicle, causing catastrophic damage and injuries. The
    convoy was able to suppress fire and return, while LCDR Yach and her
    team, along with the Air Force Forward Surgical Team (FST) staff,
    ensured all injuries were thoroughly evaluated and treated.
        During her deployment LCDR Yach facilitated health sector
    development between coalition partners, meeting multiple times with
    Afghan leaders. Additionally, she served as a mentor while leading the
    daily operations of the PRT aid station which provided care for
    coalition forces, contractors and local interpreters. Under her
    leadership and guidance, her clinic was able to help over 3,000
    patients and distribute over $150,000 in humanitarian aid and medical
    supplies, greatly enhancing the quality of life of the Afghan people.
    Her selfless performance of duties in a combat zone resulted in
    awarding of the Bronze Star Medal by the Secretary of the Army.
        Navy nurses played a key role in humanitarian assistance and
    disaster relief operations in support of Operation Unified Response in
    Haiti. On January 16, 2010 USNS Comfort (T-AH 20) deployed to Haiti
    within 72 hours notice to provide disaster relief following a magnitude
    7.0 earthquake that devastated the Haitian capital and surrounding
    countryside. The first patient was received on January 19, just 7 days
    after the disaster. Nearly 200 patients were admitted within the first
    40 hours on station, and the inpatient census peaked at 411 patients on
    January 28. There were a total of 1,002 admissions and 931 surgical
    procedures conducted during this mission. Seven operating rooms ran 12
    hours per day and three ran ``around the clock'' to accommodate
    surgical emergencies. For three weeks, Comfort was the most advanced
    and busiest orthopedic trauma center in the world.
        Nurses aboard USS Bataan (LHD 5) and USS Carl Vinson (CVN 70) also
    made significant contributions to Operation Unified Response. Fleet
    Surgical Team EIGHT nurses aboard the Bataan participated in the care
    of 97 patients who were evacuated to the ship and assisted in the
    delivery of a healthy newborn. The sole Ship's Nurse on Carl Vinson
    worked with a small group of medical augmentees in caring for 60
    patients admitted to the ship for medical, surgical and post-partum
    care. The magnitude of the mission brought an unprecedented number and
    complexity of casualties. Once again, Navy nursing demonstrated its
    flexibility, commitment, and professionalism in responding to a
    humanitarian crisis. Mr. Chairman, I am exceedingly proud of this
    amazing demonstration of how nurses from joint and international
    military services and non-governmental organizations united together as
    a global force to support the population of Haiti in their time of
    need.
        Other significant humanitarian operations included the deployments
    of USNS Mercy (T-AH 19) during Pacific Partnership 2010, and USS Iwo
    Jima (LHD 7) for Continuing Promise 2010. In support of these missions,
    Navy nurses traveled to Vietnam, Cambodia, Indonesia and Timor-Leste,
    as well as Haiti, Colombia, Guatemala, Nicaragua, Costa Rica, Panama,
    Suriname and Guyana. These operations presented a unique opportunity to
    test our education and clinical skills in rudimentary healthcare
    environments, while strengthening our capability to partner with host
    nations, U.S. government agencies and academic institutions,
    international military medical personnel, regional health ministries,
    and nongovernmental agencies through medical, dental, and engineering
    outreach projects
        Navy nurses continue to support the Fleet and expand the services
    they provide to our Sailors and Marines at sea. Nurses assigned to
    aircraft carriers and Fleet Surgical Teams are actively involved in
    operational missions around the globe and are essential members of
    shipboard medical teams. The nurse aboard USS Harry S. Truman (CVN 75)
    deployed with Strike Group 10 and Carrier Air Wing 3 in support of the
    wars in Afghanistan and Iraq. During this deployment, our nurse
    provided training to over 5,000 personnel, to include instruction in
    basic wounds, First Aid, and Basic Cardiac Life Support. Aboard Iwo
    Jima, a certified registered nurse anesthetist (CRNA) from Fleet
    Surgical Team FOUR assisted in a research study conducted by the Navy
    Environmental and Preventive Medicine Unit to evaluate occupational
    exposure to anesthetic gases among operating room personnel at sea.
    Furthermore, Fleet Surgical Team nurses flew 20 medical evacuation
    missions from large deck amphibious ships to USNS Comfort or various
    shore-based facilities, configuring rotary wing aircraft to accommodate
    critically ill or injured patients, and providing life sustaining
    enroute nursing care under dangerous and austere conditions.
        The role of Navy nurses assigned to the Marine Corps continues to
    expand and diversify. Currently, 18 nurses are directly attached to the
    Marine Corps, serving in clinics and in advanced leadership roles. For
    the first time in the history of the Navy Nurse Corps, the Second
    Marine Expeditionary Fleet Surgeon is a nurse. Battalion nurses provide
    operational nursing support to the Forward Resuscitative Surgical
    Systems (FRSS), the Shock Trauma Platoons (STPs), and to enroute care
    missions. The nurse at the Marine Corps Training and Education Command
    oversees the training plans and the Readiness Manual for Marine Corps
    Health Services, while nurses at the Field Medical Training Battalions
    provide training for all corpsman and officers attached to Marine units
    in support of operational missions.
        Navy nurses remain inherently flexible and capable of supporting
    multiple missions in many settings and various platforms. I am
    continually awed by the men and women in the Navy Nurse Corps. They
    demonstrate daily that they are uniquely suited to answer the call when
    a medical response is required.
        Mr. Chairman, the remainder of my testimony is organized around my
    five key areas of strategic focus: Our Workforce, Nursing Knowledge,
    Research, Strategic Partnerships and Information Management.
                                 our workforce
        Today's Navy Nurse Corps active component (AC) is manned at 92.0
    percent with 2,852 nurses currently serving around the world. For the
    fifth consecutive year, we have achieved Navy nursing's AC recruiting
    goal. This is quite an accomplishment only 7 months into the current
    fiscal year. The reserve component (RC) is 85.9 percent manned with
    1,135 nurses in inventory, and has reached 48 percent of their fiscal
    year 2011 recruiting goal with 5 months remaining this fiscal year. I
    attribute our recruiting successes to the continued funding support for
    our accession and incentive programs, the local recruiting activities
    of Navy Recruiters, direct involvement of Navy nurses, and the
    continued positive public perception of service to our country.
        The top two direct accession programs that favorably impact our
    recruiting efforts in the Active component include the Nurse Accession
    Bonus and the Nurse Candidate Program. The Nurse Accession Bonus
    continues to offer a $20,000 sign-on bonus for a 3-year commitment and
    $30,000 for a 4-year commitment; and the Nurse Candidate Program,
    tailored for students who need financial assistance while attending
    school, provides a $10,000 sign-on bonus and $1,000 monthly stipend. I
    would like to thank you Mr. Chairman, Vice Chairman Cochran, and all
    committee members for this ongoing and vital support.
        For the RC, a vigorous recruiting plan requires flexible tools to
    ensure we target high quality officers with appropriate skill sets.
    Incentive programs have proven to be key to recruiting the correct
    number of officers with the right skills. It is essential that our
    critical shortage of registered nurses in the specialties of CRNAs,
    critical care, medical-surgical, perioperative, and psychiatric nursing
    as well as mental health nurse practitioners are offered competitive
    incentives. The new officer affiliation and incentive program available
    to registered nurses in our critical shortage specialties is favorably
    impacting our reserve component recruiting efforts this fiscal year.
    The new incentives offer $10,000-$25,000 per year depending on the
    specialty area of practice and service obligation incurred. Loan
    repayment programs have also proven to be of great value in attracting
    critical shortage specialties, such as, advanced practice CRNAs and
    mental health nurse practitioners.
        We know that as the economy improves and civilian nursing
    opportunities expand through the Affordable Care Act we might once
    again be faced with recruiting and retention challenges. In
    anticipation of these challenges, we are inviting nursing students and
    new graduate nurses to participate as American Red Cross volunteers at
    our hospitals and clinics to enhance exposure to the military.
    Additionally, we assigned a Nurse Corps fellow to my staff to monitor
    recruitment and retention, and to ensure that both remain a priority.
        The education and training department at Naval Medical Center
    Portsmouth assists with a monthly recruitment seminar in which Corps
    representatives speak to prospective nurses and physicians about Navy
    Medicine. These sessions allow for arranging tours and one-on-one
    meetings with junior nurses to answer questions about military
    healthcare. Additionally, nurses aboard aircraft carriers, hospital
    ships and on Fleet Surgical Teams contribute to the recruiting effort
    by providing shipboard tours to prospective nurses, dentists,
    physicians and other healthcare professionals, ultimately enhancing
    their knowledge of and exposure to operational medicine and shipboard
    life.
        With the ongoing war, we are keenly aware of the need to grow and
    retain nurses in our critical war-time subspecialties. Though loss
    rates have improved overall, there remains a gap in the inventory to
    authorized billets for junior nurses with 5 to 10 years of commissioned
    service. Key efforts which have positively impacted retention continue
    to include Registered Nurse Incentive Special Pay (RN-ISP), which
    targets bonuses to undermanned clinical nursing specialties, and the
    Health Professional Loan Repayment Program (HPLRP), which offers
    educational loan repayment up to $40,000 per year. Full-time Duty Under
    Instruction (DUINS) further supports Navy recruitment and retention
    objectives by encouraging higher levels of professional knowledge and
    technical competence. Training requirements are selected on Navy
    nursing needs for advanced skills in war-time critical subspecialties.
    Seventy-six applicants were selected for DUINS through the fiscal year
    2011 board.
        We remain diligent in our efforts to grow and sustain our community
    of mental health nurses. The Navy Nurse Corps is entering its fourth
    year of officially recognizing the psychiatric mental health nurse
    practitioner specialty. Restructuring this manpower shift has not been
    without its challenges, but we are actively involved in building and
    expanding the close network of advanced practice psychiatric mental
    health nurses with their peers outside the mental health arena. We
    currently have two mental health nurse practitioners assigned to the
    U.S. Marine Corps at the 1st and 2d Marine Divisions, and a majority of
    our mental health nurse deployments have been in support of Joint
    Medical Task Force, Guantanamo Bay, Cuba. Many of our Navy psychiatric
    mental health nurses remain fully integrated in one collaborative
    mental healthcare approach and are active members of Wounded, Ill and
    Injured programs.
                               nursing knowledge
        Care for both service members and their families is the top
    priority for Navy Nursing, Navy Medicine and the Department of Defense.
    Nurses are a key component of Family and Patient Centered Care
    initiatives, and I would like to share with you a few success stories
    where Navy nurses are leading the charge.
        Nurse Case Managers provide services to the Wounded Warrior that
    span the entire care continuum from point of injury to either return to
    active duty or medical separation from service. The journey from
    theatre to stateside care is only the beginning of a long road of
    recovery for returning Wounded, Ill and Injured warriors who are often
    facing extensive care and rehabilitation for life-changing physical,
    psychological and cognitive injuries. The complexity of medical
    healthcare and military systems is often overwhelming to the Wounded,
    Ill and Injured service members, thus driving a critical need for
    someone to coordinate care and support services. Nurse case managers
    are the ``SOS or 1-800'' contact for the patient and family throughout
    the continuum of care. The nurse case managers, along with Navy Safe
    Harbor and the U.S. Marine Corps Wounded Warrior Regiment, bring a more
    holistic approach to transition of the Wounded, Ill and Injured into
    the Veterans Affairs (VA) or civilian care by addressing the medical
    and the non-medical needs concurrently. This collaboration is important
    to reducing stress and confusion during transition. I am proud to
    report that our Clinical Case Management Program has been recognized
    nationally by being awarded the 2010 Platinum Award for the Best
    Military Case Management Program. This award was presented by the Case
    Management Society of America and was featured in their journal, Case
    In Point in May 2010. Case management is at the heart of ensuring the
    development of comprehensive plans of care and ensuring smooth
    transitions for all Wounded, Ill and Injured service members and their
    families.
        In support of the Navy's efforts to develop resilience in Sailors,
    Marines, families and commands, we have detailed a senior mental health
    nurse to the Chief of Naval Personnel to implement the Navy's
    Operational Stress Control (OSC) program. This comprehensive effort is
    line-owned and led, integrating policies and initiatives under one
    overarching umbrella. The program is designed to build resilience and
    to increase the acceptance of seeking help for stress-related injuries
    through education, training and communication. Twenty-three modules of
    formal curriculum have been developed and are being taught at key nodes
    in a Sailor's career--from boot camp to the Naval War College, with
    more than 206,000 receiving training to date. We are working hard to
    develop a culture that rewards preventive actions and recognizes that
    seeking help is a sign of strength. Navy nurses are uniquely qualified
    to function in this non-traditional role where the focus is on building
    resilience and prevention vice treating injury or illness.
        During the past year we completed a nurse led Navy Medicine
    assessment of caregiver occupational stress. Not surprisingly, the
    study found evidence of caregiver occupational stress. The study also
    identified that meaningful work, good training, and engaged clinical
    leaders all contribute to building caregiver resilience. Our future
    efforts will continue to invest in strategies that enhance resilience
    and performance while identifying and mitigating expected caregiver
    demands.
        Clinical excellence is the cornerstone of Navy Nursing. An
    innovative program titled ``The Immersion in Critical Care and
    Emergency Nursing'' (ICE) program at Naval Medical Center Portsmouth
    has been designed to train and sustain skills essential to our critical
    wartime specialties. This three-part program, consists first of
    prerequisite training with introductory courses and modules available
    to and within the Military treatment facility (MTF). The second phase
    is the Simulation/Skills Lab which targets skills review and specific
    patient scenarios for high risk situations encountered by the nurse.
    The final phase involves a practicum with time spent delivering hands-
    on patient care, focused on specific areas of the specialty. The first
    nurses to attend this program are just weeks into their deployment
    rotation at the Expeditionary Medical Facility in Kuwait, so feedback
    has not been obtained post-deployment. However, we anticipate that ICE
    will be of great value in introducing nurses to critical care and
    emergency nursing situations prior to future deployments.
        To promote clinical excellence for families of Sailors and Marines
    we are preparing nurses for unexpected emergencies both stateside and
    overseas. This year our nurses participated in Mobile Obstetric
    Emergencies Simulator training at Madigan Army Medical Center, Fort
    Lewis, along with health providers from all branches of the armed
    forces. Additionally, we joined in community outreach by partnering
    with Baby Connections, a care-giver and infant learning/play group
    facilitated by the local county health department, providing
    information to caregivers regarding development, infant care,
    breastfeeding, and dental care for newborns to 3 year olds. Navy nurses
    serve as members of breastfeeding coalitions and have established
    lactation consultant presence in hospitals, clinics, and at fleet
    commands, all in support of initiatives to meet the Healthy People 2020
    goals. Nurses are involved in numerous programs which support family
    centered care, including the Happiest Baby on the Block and parent-
    infant bonding programs. Family centered care is the foundation of our
    care delivery model in all treatment facilities.
        Nurse Corps officers are actively involved in mentoring
    baccalaureate and master's students at universities throughout Navy
    Medicine. Naval Medical Center Portsmouth identified the need for a
    Nurse Education Coordinator who has the responsibility of coordinating
    the activities for over 30 local and distance learning schools of
    nursing from the licensed practical nurse-level to the facilitation of
    graduate-level clinical experiences. We realize that community
    involvement with the future nursing workforce is key to both our
    recruiting and retention efforts as well as to creating a multi-
    talented, diverse workforce. We are committed to providing high quality
    clinical experiences to students whenever possible.
        For the third year, I am pleased to tell you that funding has
    allowed us to continue support of the Graduate Program for Federal
    Civilian Registered Nurses (GPFCRN). We recognize the challenges
    associated with recruitment and retention of civilian nurses for
    Federal service positions, and continue to see this program as a way to
    cultivate clinical expertise and future nursing leaders from our
    civilian workforce by offering graduate nursing education. In the fall
    we will select another five nurses to attend programs across the
    country to develop skills as a clinical nurse specialist. After
    graduation, they will continue their Federal service, directing expert
    clinical nursing practice across the enterprise.
        Navy nurses are at the forefront of Navy Medicine leadership. There
    are currently eight Nurse Corps Officers serving as commanding
    officers. In addition, nurses are encouraged to assume leadership
    positions as associate directors and directors, sometimes in non-
    traditional nursing roles. Our operational nurses also serve in key
    leadership roles while underway. This year, the first Nurse Corps
    Officer held the position of Deputy Commander for the Joint Medical
    Group with the Joint Task Force Guantanamo, Guantanamo Bay, Cuba.
    Leaders in executive medicine positions showcase the versatility of our
    Corps and pave the path for an expanded role for future Nurse Corps
    leaders.
        This year, 22 nurses aboard aircraft carriers and amphibious ships
    earned the Surface Warfare Medical Department Officer qualification.
    This qualification is earned by Medical Department officers who attain
    extensive shipboard knowledge and experience outside of the medical
    professions. This includes knowledge of engineering systems, navigation
    methods, communication and weapon systems and offensive and defensive
    capabilities. The qualification requires knowledge of watch standing
    responsibilities on the Bridge and in the Combat Information Center and
    culminates with a final qualifying oral board. Nurses also earn and
    wear the Fleet Marine Force (FMF) Qualified Officer Insignia. The FMF
    insignia is earned by Navy officers assigned to the Fleet Marine Force,
    and it clearly makes a statement that the wearer is a key member of the
    Marine Corps team. Earning this designation requires serving for 1 year
    in a Marine Corps command, passing an arduous written test, completing
    the Marine physical fitness test, and passing an oral board conducted
    by FMF qualified officers. To date, we have 56 nurses holding this
    qualification, from our junior lieutenant junior grades officers, to
    officers holding the rank of captain.
        Nurses are not just caregivers, but are a vital part of our
    organizational structure as mentors to junior officers and our enlisted
    personnel. Navy-wide, nurses are seen leading Junior Officer Career
    Development seminars, speaking at local high schools, health fairs, and
    community colleges. We are actively involved with Navy Nurse Corps
    students at our Reserve Officer Training Corps (NROTC) programs,
    frequently attending activities to support and mentor students during
    their time in school. These experiences are mutually beneficial,
    providing opportunities for junior nurses to be involved within our
    community by establishing and maintaining professional relationships,
    and allowing junior nurses and nurse candidates to seek guidance from
    senior nurses.
        Deployed nurses also serve as mentors and educators for other
    officers and enlisted personnel. One Navy Nurse recently returned from
    a 6-month deployment as an individual augmentee in Camp Bastion,
    Helmand Province, Afghanistan. He was an integral part of the
    Emergency/Trauma Department where they provided direct patient care to
    4,000 combat and non-combat injured patients, delivering over 3,600
    units of blood products. During his deployment, this officer conducted
    TeamSTEPPS Essential training to the Emergency Department. The
    Department of Defense, in collaboration with the Agency for Healthcare
    Research and Quality (AHRQ), developed the TeamSTEPPS program to serve
    as a powerful, evidence-based teamwork system to improve communication
    and teamwork skills. I am proud this energetic Navy Nurse took this
    training to the deck plate, recognizing that we demand excellence in
    healthcare quality even at our most remote locations. It is this type
    of engaged leadership that is the hallmark of Navy Nursing.
        Mr. Chairman, I am privileged to provide an update to you and your
    Committee on the progress of the Navy Nurse Corps initiative for
    doctoral preparation of our nurse practitioners and nurse anesthetists.
    As you recall, the 2009 National Defense Authorization Act (Senate
    Report 111-74, page 275) provided direction from this committee,
    describing your support of graduate nursing education through our Duty
    Under Instruction (DUINS) program for training nurse practitioners. The
    Committee directed the Service Surgeons General, in coordination with
    the Nurse Corps Chiefs, to provide a report outlining a critical
    analysis of emerging trends in graduate nurse practitioner education,
    with an emphasis on the consideration of replacing Master's in Nursing
    preparation with a Doctorate of Nursing Practice degree program. We
    submitted that Report to Congress in March 2009, and I am pleased to
    tell you we immediately identified top performers who were completing
    their Masters degrees, selecting them to add additional time onto their
    schooling to complete their Doctorate of Nursing Practice. This past
    November, we selected seven additional nurses to either transition
    their Master's program to a Doctorate of Nursing Practice, or to pursue
    education which will take them from their Bachelor's nursing degree
    directly into doctoral level work, bypassing the Masters degree. Staff
    members from my office are diligently working on a promotion and
    schooling plan to send newly trained nurse practitioners and nurse
    anesthetists to study directly for their doctoral education.
                                nursing research
        The National Institute of Health (NIH), through The National
    Institute of Nursing Research (NINR), defines nursing research as the
    development of knowledge to build a scientific foundation for clinical
    nursing practice, prevent disease and disability, manage and eliminate
    symptoms caused by illness, and enhance end-of-life and palliative
    care. We have numerous Navy Nursing and joint research and evidence-
    based projects in process, and continue to be extremely grateful for
    your ongoing support of the TriService Nursing Research Program.
    Research projects are currently being conducted by active and reserve
    component nurses on clinical topics such as; heat illness, hemorrhagic
    shock, development of Navy-wide evidence-based guidelines for wound
    care management and pressure ulcers, ultrasound guided and peripheral
    nerve stimulation techniques, catheter removal and motor function
    recovery, the role of nursing in implementation of a Patient Centered
    Medical Home (PCMH) in MTFs, virtual reality for stress inoculation,
    clinical knowledge development and continuity of care for injured
    service members, competency and work environments of perioperative
    nurses, moral distress, and nurse-managed clinics.
        One study of interest is a collaborative project Navy is leading
    which includes nurse researchers from the Army, Air Force and the VA.
    The purpose of this study is to gather first person experience-near
    accounts of experiential learning of military and civilian nurses
    caring for wounded service members, along with first person accounts of
    service members' memories of all levels of care and transitions from
    the combat zone to rehabilitation. The knowledge gained about their
    wounded care journey is essential in order to develop and sustain
    nursing competencies, and to examine the acute and rehabilitative
    factors affecting reintegration of the wounded warrior. This study also
    has critical utility for optimal functioning of service members
    returning to the United States, transitioning into the military and
    Veterans Affairs healthcare systems, and for developing training
    programs with military healthcare personnel who work with service
    members in acute and rehabilitation healthcare settings. Preliminary
    data analysis is underway. Nurses have shared their expertise and
    knowledge, and lessons learned are being formulated to improve patient
    care throughout the Department of Defense and VA healthcare systems.
        Nurse researchers are also actively conducting research to explore
    retention of recalled reservists, psychometric evaluation of a triage
    decisionmaking, and construction of learning experiences using clinical
    simulations. Without your initial support of the TriService Nursing
    Research Program in the early 1990's this would have been a very
    difficult task to achieve. Ongoing support of military nursing research
    as a unique and distinct entity is vital to the advancement of this
    important niche of science to our Nation.
                             strategic partnerships
        A collaborative approach between Services and Federal agencies has
    never been more important than it is today. Navy nurses, find
    themselves serving as individual augmentees (IAs) with sister Services,
    working in Federal healthcare facilities such as the James Lovell
    Federal Health Care Center in Great Lakes, supporting academia in
    facilities such as the Uniformed Services University Graduate School of
    Nursing and serving in Joint Commands.
        The Captain James A. Lovell Federal Health Care Center (FHCC) is
    the Nation's first fully integrated medical facility between the VA and
    DOD. Established on October 1, 2010, the facility integrates all
    medical care into a Federal healthcare center with a single combined VA
    and Navy mission, serving military members, Veterans, military family
    members and retirees. Integrating many ``types'' of nurses has been
    rewarding, and had very few challenges. Combining the strengths of
    active duty, DOD, VA nurses and contract nurses, we have formed one
    orientation nursing program, increased the venues for active duty
    nurses to obtain their clinical sustainment hours, and combined forces
    for one Executive Committee of the Nursing staff, with Navy and VA
    Nursing Executives as equal co-chairs.
        Coordination of seamless care is a top priority for the ongoing
    care of our Wounded Warriors. I am pleased to tell you about a joint
    initiative between the Deputy Secretary of Veterans Affairs and the
    Deputy Secretary of Defense to staff a Navy Nurse Corps officer
    directly to a newly created position at the VA Headquarters in
    Washington, DC. This nurse will work directly with the Federal Recovery
    Coordinator Program to uncover process issues and craft solutions to
    streamline care. The nurse will serve as a vital link between the
    Veterans Affairs Federal Recovery Coordination Program and the MTFs to
    assist severely Wounded, Ill and Injured patients and their family
    members in the complex coordination of their care throughout the
    rehabilitation continuum. I look forward to providing additional
    information to you next year on this important role.
        Our nurses in Guam have joined their civilian counterparts from
    Guam Memorial Hospital and Air Force nurses from Anderson Air Force
    Base to share their skills and experiences. Navy nurses provide the
    Trauma Nursing Core Course both for providers and instructors. This
    course has been instrumental in building the confidence and honing
    assessment skills of nurses who normally do not work in an Emergency
    Department setting. Naval Hospital Guam also included Joint Medical
    Attendant Transport Team (JMATT) members in their Emergency Department,
    allowing them to receive this training at no-cost.
        The nurses in the Primary Care Clinic at Naval Health Clinic Corpus
    Christi (NHCCC) collaborated with our Air Force Nursing counterparts at
    Wilford Hall Medical Center Diabetes Center of Excellence in San
    Antonio regarding Diabetes Education. The staff at Wilford Hall Medical
    Center routinely travels to Naval Health Clinic Corpus Christi to
    provide monthly diabetic education classes to our patients. In
    addition, they provide ``train the trainer'' sessions so our staff can
    assume the role as the trainer. Naval Health Clinic Corpus Christi also
    established a collaborative relationship with Brooke Army Medical
    Center for supplementary clinical experiences.
        Naval Hospital Pensacola maintains a Memorandum of Understanding
    with the local trauma center, allowing collaboration for training and
    clinical sustainment in critical care, pediatrics, neonatal, and high
    risk obstetrics. Additionally, the civilian community nurses provide
    trainers for our specialty neonatal course that prepares staff in the
    care of high acuity newborns needing transfer to a higher level of
    care. Recognizing that our nurses must be operationally prepared for
    deployment, but may have limited inpatient nursing care exposure while
    working in the clinic environment similar arrangements with inpatient
    facilities have been made in Hawaii at Tripler Army Medical Center and
    Newport, Rhode Island with the Providence Veteran's Hospital. We remain
    grateful to the Army, Air Force, Veterans Affairs and civilian
    facilities for these partnerships.
        Our RC nurses routinely participate in joint initiatives. Through
    their reserve commands, Nurse Corps Officers take part in joint
    training exercises with the Coast Guard, Seabee forces through Naval
    Mobile Construction Battalions, and Air Force and Army medical teams.
    Our Operational Hospital Support Units have agreements with Veterans
    Affairs Medical Centers in several States to provide real time patient
    treatment both for nurses and hospital corpsmen during drill weekends.
    This not only supports their continued training and clinical
    sustainment requirements, but provides additional resources for the VA
    facility.
        I am excited to tell you about our annual ``Host Nation Symposium''
    event at Naval Hospital Rota, Spain, where healthcare providers in the
    community and military gather to share education and best practices
    between the two unique healthcare systems. It also provides an
    opportunity for members of Navy Medicine to meet their counterparts and
    build camaraderie. We are also partnering with the head of the Spanish
    Nurse Corps in Rota to allow newly graduated Spanish military nurses to
    work in our facility. Their graduates spend approximately 2 weeks at
    our hospital shadowing fellow American nurses. In turn, select military
    nurses then travel to a trauma course hosted in Madrid. Both the
    Commanding Officer and Surgeon General from Spain are very optimistic,
    seeing this exchange as an opportunity to provide diverse experiences
    and better understand the diverse cultures and healthcare needs of our
    allies.
                             information management
        The sharing and quick dissemination of news, resources and
    announcements is a top priority of the Navy Nurse Corps. From a needs
    assessment, we know that nurses want rapid and easy online access to
    information which can be accessed at work whether in a traditional or
    deployed environment. Navy Knowledge Online serves as one platform for
    that capability and we are working to maximize its utility while we
    leverage other means of communication.
        Last year we reported the launch of the active duty Nurse Corps
    Career Planning Guide, a web-based mentoring tool for nurses at each
    stage of their career. Informally the feedback received has been
    overwhelmingly positive. Within the past several months we deployed
    similar Career Planning Guides for Reserve Nurse Corps Officers and
    Government Service Civilian nurses on Navy Knowledge Online. Both
    groups play a critical role in contributing to the Nurse Corps and Navy
    Medicine as we meet our peace and wartime missions. As ``One Team,''
    our civilian nurses work with our military staff, providing continuity,
    experience, and enabling our military nurses to deploy in support of
    our warriors in the field. Navy Nursing is committed to providing all
    of our nurses the opportunities to enhance their understanding of
    operational medicine, grow professionally, and give them the tools to
    be leaders in Navy Medicine. The web-based Career Planning Guides
    (active, reserve and government service) provide a ``point and click''
    list of resources to maximize career opportunities and knowledge for
    all nurses commensurate with rank and time in service. For example,
    under ``Operational Support,'' information on Navy War College Distant
    Learning Courses are provided, plus numerous links, and articles to
    enhance their operational skills & knowledge. To help nurses grow
    professionally, all the Bureau of Medicine and Surgery training and
    reimbursement opportunities are placed in a ``one stop'' shop. Finally,
    civilian nurses serve in leadership positions as directors, department
    heads and division officers. Our Civilian Career Planning Guide gives
    them comprehensive information and links to help them manage their
    military and civilian workforce, and grow as a leader in Navy Medicine.
    We are able to meet our mission requirements because of our dedicated
    civilian nurses, and it is an honor to work with them side-by-side in
    today's Navy Medicine. We will formally evaluate all three Career
    Planning guides and will to continue to adjust information based on
    feedback from the end users.
                                future direction
        In September 2010, I met with a core group of leaders to formulate
    my 2011 Navy Nurse Corps Strategic Plan. Included in the discussions
    were Specialty Leaders representing over 70 percent of all Nurse Corps
    officers; headquarters staff; junior officers from Navy Medicine East,
    West, and the National Capital Region; and the Army Deputy Commander
    for Nursing Services from the National Naval Medical Center. During
    this 2-day offsite meeting, five key goals were identified and Team
    Champions named. Since then, the Strategic Goal teams--comprised of
    nurses from around the world--have collaborated on projects to meet
    identified objectives within the five areas of focus: Workforce
    (maximizing human capital), Nursing Knowledge, Nursing Research,
    Strategic Partnerships, and Information Management. I recently had my
    first quarterly update, and I am confident the teams are on track to
    make solid recommendations for action. I look forward to my next report
    when I can share with you the accomplishments of Navy nurses throughout
    2011 and update you on their initiatives in support of Navy Medicine.
                                   conclusion
        Navy Nurse Corps officers are healers of mind, body and spirit;
    ambassadors of hope; respected nursing professionals and commissioned
    officers. Being in the military has its challenges, yet it is these
    challenges that allow Navy nurses to excel both personally and
    professionally. Mr. Chairman, Vice Chairman Cochran, and distinguished
    members of the subcommittee, thank you for providing me this
    opportunity to share the state and future direction of the Navy Nurse
    Corps and our continuing efforts to meet Navy Medicine's mission. Our
    Navy Medicine concept of care will remain patient and family focused;
    never losing perspective in the care for those wounded, ill, or
    injured, their families, our retirees and their families, and each
    other. I am honored to be here today to represent the Navy nursing
    team, and I look forward to continuing to serve as the 23d Director of
    the Navy Nurse Corps.

        Chairman Inouye. And now may I call upon General
    Siniscalchi. General.
    STATEMENT OF KIMBERLY SINISCALCHI, ASSISTANT SURGEON
                GENERAL FOR NURSING SERVICES, DEPARTMENT OF
                THE AIR FORCE
        General Siniscalchi. Mr. Chairman, Mr. Vice Chairman, and
    esteemed members of this subcommittee, it is my distinct honor
    and privilege to once again represent over 18,000 men and women
    of the Air Force Nurse Corps and share our successes and
    challenges as we execute our strategic plan for global
    operations, force development, force management, and patient-
    centered care.

                          AEROMEDICAL CREWS SAVE LIVES

        Across the globe, our Aeromedical Evacuation and Critical
    Care Air Transport Teams continue to be a vital link in saving
    lives.
        In 2010, our Aeromedical Evacuation crews accomplished
    26,000 patient movements on over 1,800 missions. David Brown,
    from the Washington Post, reported on an Army sergeant from
    California who was critically injured in Afghanistan in October
    2010. In his article, Brown stated, ``In any U.S. hospital,
    Sergeant Solorzano would be considered too sick to put on an
    elevator and take to the CT-scan suite. Now, he's about to fly
    across half of Asia and most of Europe. The U.S. military's
    ability to take a critically ill soldier on the equivalent of a
    7-hour elevator ride epitomizes an essential feature of the
    doctrine for treating war wounds in the 21st century: Keep the
    patient moving.''
        Members of Congress, thank you for passing Resolution 1605
    recognizing airmen who perform our aeromedical evacuation
    mission.
        Recently, I was afforded the opportunity to meet my nursing
    colleague, Brigadier General Rahimi Razia of the Afghanistan
    National Army. She expressed appreciation for the many
    contributions our senior mentors and training teams are making
    to advance nursing. They are helping her create a fundamental
    nursing education program and a scope of practice.

                           NURSE TRANSITION PROGRAMS

        Our outstanding success could not be possible without
    investing in our future. We completely transformed our nurse
    transition program for new graduates into four strategically
    located centers of excellence in an effort to broaden clinical
    training. Tampa General Hospital was recently approved as our
    newest site, and a training affiliation agreement was signed in
    February. This site will complement our other three sites at
    Scottsdale, Arizona, University of Cincinnati, Ohio, and San
    Antonio Military Health System, Texas. We also created a Phase
    2 component enabling us to advance the National Council of
    State Boards of Nursing Transition to Practice Model. Our pilot
    program at the 59th Medical Wing in San Antonio is leading the
    charge to deliberately develop our Nurse Transition Program
    graduates through a comprehensive, 9-month mentoring program.
        The American Association of Colleges of Nursing declared
    entry for advanced practice nurses to be at the doctorate level
    by 2015. Mr. Chairman, sir, your support of this initiative has
    been instrumental in our progression from masters to doctorate
    at the Uniformed Services University of the Health Sciences. We
    are preparing to send students to this program in 2012 and have
    three students starting the civilian programs in 2011.

                          ADVANCED IN MEDICAL TRAINING

        We continue to advance enlisted training. A ribbon-cutting
    was held in May 2010 at the new Medical Education and Training
    Campus in San Antonio, where all services will train their new
    enlisted medical personnel. This state-of-the-art training
    platform will graduate technicians in 15 different specialties
    to support the Department of Defense mission and optimize our
    interoperability across services.
        As we are developing our airmen, we are also developing our
    civilians. In January 2011, we conducted our first Nurse
    Civilian Developmental Board. This inaugural event served as a
    benchmark to create a civilian force development model that
    aligns with our officer and enlisted programs.
        Our goal of force management is to design and resource our
    nurse corps to sustain a world-class healthcare force. In 2010,
    we achieved 102 percent of our recruiting goal. Consistent with
    the line of the Air Force initiative to meet end strength
    requirements, our recruiting goals were reduced in 2011.
    However, we continue to work with the Office of Manpower
    Personnel and Services to ensure we maintain a robust
    recruiting program to preserve our quality force.
        Our Nurse Enlisted Commissioning Program creates a legacy
    career path in Air Force nursing. In 2010, 45 enlisted
    graduates were commissioned into the Nurse Corps. As we enter
    our third year of the Incentive Special Pay Program, we are
    seeing positive impacts on professional satisfaction and
    retention.
        We recognize the value of keeping clinical experts at the
    bedside, table side, and litter side. We developed a clinical
    track for master clinicians and researchers through the rank of
    colonel to foster a higher level of excellence within our
    nursing practice. One of our critical care master clinicians,
    Colonel McNeil, is currently deployed to Afghanistan and is
    making a significant difference in trauma and critical care
    outcomes.
        As we aim to provide better health, better care, best
    value, we are committed to the family health initiative, the
    Air Force's Pathway to Patient-Centered Medical Home. Our
    advanced practice nurses, clinical nurses, and technicians are
    positively impacting access, quality of care, patient outcomes,
    disease management, and case management. Within our patient-
    centered care philosophy is the need to address resiliency and
    mental health of our airmen and families. Last year, I reported
    that a mental health nurse course was being developed at Travis
    Air Force Base in California. I am pleased to announce our
    first students started in February.
        The psychiatric Mental Health Nurse Practitioner Program at
    the Uniformed Services University of the Health Sciences is one
    of the few in the country that includes psychopharmacology and
    addresses behavioral techniques specific to the unique needs of
    our military population. We currently have four students
    enrolled in this program and four to start this summer.

                               PREPARED STATEMENT

        Mr. Chairman and distinguished members of the subcommittee,
    it is an honor to represent such a dedicated, strong nurse
    corps. Your continued support as we execute our priorities to
    advance military nursing is greatly appreciated. Our wounded
    and their families deserve nothing less than educated, skilled
    nurses and technicians who have mastered the art of caring. It
    is through the medic's touch, compassion, and professionalism
    that we answer our Nation's call to care for those who served
    yesterday, today, and will serve tomorrow.
        Thank you, and I welcome your questions.
        Chairman Inouye. All right. Thank you very much, General.
        [The statement follows:]
          Prepared Statement of Major General Kimberly A. Siniscalchi
        Mr. Chairman, and distinguished members of the committee, it is
    again my honor to represent the over 18,000 members of our Total
    Nursing Force (TNF). Together, with my senior advisors, Brigadier
    General Catherine Lutz of the Air National Guard (ANG), and Colonel
    Lisa Naftzger-Kang of the Air Force Reserve Command (AFRC), along with
    my Aerospace Medical Service Career Field Manager, Chief Master
    Sergeant Joseph Potts, we thank you for your continued support of our
    many endeavors to advance military nursing. It is a privilege to report
    on this year's achievements and future strategies.
        We are a total force nursing team delivering evidence-based,
    patient-centered care to meet global requirements. We have developed
    four strategic priorities in consonance with those of the Secretary and
    the Chief of Staff of the Air Force. They are: (1) Global Operations,
    (2) Force Development, (3) Force Management, and (4) Patient-Centered
    Care. These priorities are built on a foundation of education, training
    and research. This testimony will reflect our successes and challenges
    as we strive to execute our strategic priorities.
                               global operations
        For over two decades, our TNF has been supporting humanitarian
    missions and contingency operations that span the globe. We recognize
    that our mission effectiveness is contingent upon medics who are
    equipped, trained, and proficient at implementing Air Force
    capabilities across the full spectrum of operational environments. Air
    Force medics are truly expeditionary, and frequent deployments are a
    part of our culture. The nature of our current operating environment
    has reshaped the Air Force Medical Service (AFMS) and our Corps.
    Together we have experienced amazing success in the global environment.
        At a flight nurse and technician graduation ceremony at Brooks City
    Base in San Antonio, Texas on January 29, 2011, the guest speaker, Army
    Master Sergeant Todd Nelson, gave a poignant talk to our new flight
    crews. Sergeant Nelson was the personal recipient of aeromedical care
    after being injured by an Improvised Explosive Device blast during a
    convoy in Afghanistan. The explosion and shrapnel caused massive head
    and facial injuries; he was in grave status from the beginning. After
    receiving initial life-saving surgeries, Sergeant Nelson started his
    journey home, his condition still life-threatening. Despite the
    severity of his injuries, Sergeant Nelson remembers the aeromedical
    team as ``a phenomenal team of flight nurses and technicians who did
    not see me as a statistic, but as someone for whom they would do
    everything to ensure I survived and got home to my family. They didn't
    just see me as another patient, but as a person.'' In his closing
    comments to the class, he concluded, ``for those of you who are
    starting out and who will be caring for warriors such as myself, I
    thank you. It is because of you that I am standing here today. It is
    not only I who thank you, but my wife and my children for enabling me
    to continue to be a part of this family and their lives.''
        Aeromedical Evacuation (AE) Crews and Critical Care Air Transport
    Teams (CCATT) remain busy. In 2010, our Total Force Flight Nurses and
    Technicians accomplished 26,000 patient movements on over 1,800
    missions globally; approximately 11,500 of these patients originated in
    Central Command. Nearly 10 percent of these missions were for
    critically injured or ill patients who required a CCATT. While the
    number of patients has not drastically changed, there has been a shift
    of casualties from Iraq to Afghanistan. Battle injuries in Iraq have
    decreased but patients continue to require evacuation for medical
    illnesses and non-battle related injuries. We continue to see many
    polytrauma and critically injured patients originating in Afghanistan.
    Over 1,100 medics deploy each year supporting the AE mission.
        Validating this success, a major research study from the Tri-
    Service Nursing Research Program was concluded this year. This study
    evaluated the care of over 2,500 critically ill and injured casualties
    as they moved through the continuum of care from the battlefield to
    home. As published in the July-September 2010 quarterly journal for the
    American Association of Critical-Care Nurses, Colonel Elizabeth
    Bridges, U.S. Air Force Reserves (USAFR), reported that despite having
    higher acuity than civilian trauma patients, and undergoing a 7,000
    mile transport in less than 7 days, the outcomes for critically injured
    combat casualties are equal to, or better than, outcomes for patients
    in the most sophisticated trauma systems in the United States.
    Additionally, the results of this study, along with research which has
    validated operational nursing competencies, has the potential to
    standardize and advance evidence-based practices for nurses in all
    Services, and to ensure training is focused on the highest priority
    areas including blast injuries, head trauma, shock, amputations, pain
    management, and patient transport.
        David Brown from The Washington Post reported in November 2010 on
    Army Sergeant Diego Solorzano, who was injured in Afghanistan, ``In any
    U.S. hospital, Solorzano would be considered too sick to put on an
    elevator and take to the CT-scan suite. Now he's about to fly across
    half of Asia and most of Europe . . . the U.S. military's ability--not
    to mention its willingness--to take a critically ill soldier on the
    equivalent of a 7-hour elevator ride epitomizes an essential feature of
    the doctrine for treating war wounds in the 21st century: Keep the
    patient moving.'' Despite the noise, vibration, temperature extremes,
    and pressure changes, AE and CCATT have truly been the critical link
    providing world-class care across the continuum from the battlefield to
    the United States.
        On September 28, 2010, members of the U.S. House of Representatives
    unanimously passed a resolution honoring the Airmen who support and
    perform AE. House Resolution 1605 recognizes the service of the medical
    crews and aircrews in helping our Wounded Warriors make an expeditious
    and safe trip home to the United States, commending the personnel of
    the Air Force for their commitment to the well-being of all our service
    men and women who help to guarantee wounded service men and women are
    quickly reunited with their families and given the best medical care.
    During a press release, Congressman Mike Thompson stated ``These men
    and women put their lives on the line on a regular basis to protect
    their fellow Americans.'' The ability to rapidly move patients from
    point of injury, to initial intervention, and then on through the
    system to the United States in 3 days or less for definitive care
    continues to sustain the lowest mortality rate of any war in United
    States history.
        While our AE crews and CCATT members are the most visible members
    of our AE system, it is the men and women in our Patient Movement
    Requirements Centers who work behind the scenes to coordinate all
    patient movements. Be it a tactical or strategic transport, patient
    movement requests are validated at the requirements center and then
    passed through an AE Control Team to match patients to AE crews, air
    crews, and aircraft. Personnel in these centers have knowledge in both
    the challenges of AE and an understanding of clinical pathologies. They
    use this combined knowledge to facilitate patient movement in the most
    timely and efficient manner possible. These individuals are integral to
    the extraordinary patient outcomes we are experiencing.
        Within the Pacific Theater, we constantly battle the tyranny of
    distance to meet patient movement requests. Our Theater Patient
    Movement Requirements--Pacific created a Joint-Medical Attendant
    Transport Team (JMATT) Training Program to augment our AE system. These
    multi-service medical attendants move critically ill or injured
    patients within and across the Pacific Command Theater of Operations.
    Since 2008, 98 Joint Department of Defense, Hawaii's Disaster Medical
    Assist Team, and international medics from Australia, India, Indonesia
    and Singapore have been trained to move high-acuity patients to augment
    our AE system. This permits us to optimize critical care resources for
    expedited patient movement.
        In addition to the over 100 AE flyers in the combat environment,
    over 1,300 nursing personnel support ground missions to include theater
    taskings such as trauma hospitals, provincial reconstruction and
    teaching teams, and forward-deployed and convoy medical missions.
    Working side-by-side with our sister Services and Coalition Partners
    enables us to integrate into the Joint environment and support our
    Secretary and the Chief of Staff's priorities to partner to win today's
    fight.
        Captain Denise Ross, who is currently deployed to Kandahar,
    Afghanistan, is a member of an Air Force multidisciplinary Medical
    Embedded Training Team (METT) which enables Afghan National Security
    Force nurses to train within their own hospitals using their own
    personnel and equipment resources. This program empowers the staff to
    problem solve using available resources. The development of this
    internal reliance is leading the creation of a self-sustaining program
    in order to ensure its continued success after North Atlantic Treaty
    Organization forces are no longer required.
        During a recent visit to Afghanistan, Brigadier General Rahimi
    Razia, Chief Nurse of the Afghanistan National Army, expressed her
    deepest appreciation for the contributions the METTs and our Senior
    Military Mentors have made to advance nursing for the Afghan National
    Army. These teams are assisting General Razia in developing a
    sustainable, 1 year basic nursing education program, and defining a
    fundamental scope of practice. This elemental program is essential to
    the evolution of nursing practice in Afghanistan. As we transition to
    an advisory role in Iraq and support ongoing operations in Afghanistan,
    we continue to educate and mentor the local national healthcare
    providers as they evolve their own healthcare system.
        Building partnerships is all about developing trust-based
    relationships in the global environment. Across the globe our medics
    collaborate with our Joint colleagues and National partners to advance
    the practice of nursing. Under the direction of Colonel Elizabeth
    Bridges, USAFR, the Defense Institute of Medical Operations initiated a
    new international trauma course. The course, which is the first of its
    kind, was developed to advance trauma nursing in developing nations.
    Additionally, the course focuses on the leadership role of nurses in
    developing trauma systems and in responding to disasters. Since May,
    the course has been presented to over 120 nurses from five nations,
    including Estonia, Latvia, Lithuania, Pakistan, and Nigeria, with a
    future course to be presented in Iraq. Feedback from the participants
    and the host nations has been positive, as exemplified by the feedback
    from Brigadier General Raiz, Commandant of the Pakistani Military
    Academy, who had glowing praise for the Trauma Nursing and First
    Responder courses. With regards to the nursing course, he stated that
    45 nurses have already returned to their home stations and are teaching
    other nurses using the course materials provided by the team.
        Another exciting area within this global spectrum is our
    International Health Specialist Program. This program is comprised of
    Total Force officers and enlisted members who focus on capacity
    building efforts and forging medical partnerships through humanitarian,
    civic assistance, and disaster response. One such example is Operation
    Pacific Angel in the Philippines, which is aimed at improving military-
    civilian cooperation. During this operation in February 2010, the
    medical teams treated nearly 2,000 Filipino patients. This program
    assists Philippine officials to build capacity within their cities,
    focusing on basic life support, infectious disease prevention and
    treatments, disaster readiness, and public health.
        This year, officials from the United States and Republic of the
    Philippines co-hosted the 4th annual Asia-Pacific Military Nursing
    Symposium in Manila, Republic of the Philippines for more than 200
    nurses from 13 countries. This annual conference ignites the spirit of
    collaboration to focus on nursing education, career development, global
    pandemic preparedness, and disaster management. Through this unique
    symposium, participants learn about each other's healthcare systems,
    infection control practices, and nursing services. Colonel Narbada
    Thapa, the head delegate from the Nepalese Armed Forces, commented on
    the opportunity to build relationships and acquire knowledge on nursing
    from many armed forces from around the world, making the symposium a
    memorable event for all.
                               force development
        Our outstanding success in mission support could not be possible
    without a solid investment in developing our nursing force. Grounded in
    education, training and research, we are generating new knowledge and
    advancing evidence-based care necessary to enhance interoperability in
    nursing operations. Stepping into the future, we are preparing our
    Total Nursing Force to meet emerging challenges as we develop globally
    minded medics capable of providing world-class healthcare on the
    strategic battlefields of today and tomorrow.
        Our Nurse Transition Program (NTP) continues to be an integral
    component in developing our new nurses. We graduated 212 nurses in
    fiscal year 2010 from eight military and two civilian locations. In
    December 2010, we graduated the third class from Scottsdale Healtcare
    System in Arizona. This outstanding civilian program has produced 56
    nurses since its inception. As a Magnet facility, Scottsdale Healthcare
    System is one of only 382 hospitals recognized world-wide for nursing
    excellence. This program provides complex clinical training under a
    preceptor-led transition model for new graduates. Under the supervision
    of Lieutenant Colonel Deedra Zabokrtsky, NTP Course Director--
    Scottsdale, our new nurses are clinically prepared and gaining the
    confidence to take on their own clinical practice. Program excellence
    can be noted in a diary entry from one NTP student who had just begun
    her week in Obstetrics (OB). This student was assigned a patient who
    was failing to progress in labor and was informed that a cesarean
    section was believed inevitable. Based on current research, she decided
    to take an evidence-based approach as encouraged by her preceptor.
    Garnering support from her fellow nurses and agreement from her patient
    to try a new approach, a unique plan of care was initiated, to include
    rotation of the patient's position every 15-30 minutes. The final
    result: a vaginal birth of a beautiful baby boy. As the student stated,
    ``This situation has affected the way I will educate my OB patients in
    the future . . . the best we can do as nurses is make sure our patients
    are well informed . . . this is true for all areas of nursing.'' This
    exemplar highlights the critical thinking and sound, evidence-based
    nursing practice needed from today's nurses.
        Due to the resounding success of this military-civilian
    collaboration, we decided to consolidate resources and create four NTP
    Centers of Excellence. A civilian Magnet facility, Tampa General
    Hospital, Florida, was recently approved as one of these sites and the
    training agreement was signed February 24, 2011. The remaining three
    Centers of Excellence will be in Scottsdale, Arizona; San Antonio,
    Texas; and Cincinnati, Ohio; and will provide our new nurses with the
    experiences so crucial to their professional development.
        Our Nurse Enlisted Commissioning Program (NECP) continues to be a
    balanced source of nurse accessions as we ``grow our own'' from our
    highly trained enlisted medics. In fiscal year 2010 we enrolled 46,
    students nearing our goal of 50 students per year. The graduates from
    this program are commissioned as Second Lieutenants and will continue
    their active duty service in the Nurse Corps.
        As we strive to create full-spectrum leaders and nursing
    professionals, our recently launched Project Lieutenant is designed to
    improve skills and reinforce training with increased oversight and
    mentoring during our new nurses' first year. Over the years, the
    National Council of State Boards of Nursing (NCSBN) has researched the
    issues of education, training, and retention of novice nurses and found
    that the inability of new nurses to properly transition from student
    into a new practice can have grave consequences. The NCSBN reported
    that approximately 25 percent of new nurses leave a position within
    their first year of practice. The increased turnover, consequently, has
    a potentially negative effect on patient safety and healthcare
    outcomes. The NCSBN's Transition to Practice Model provides a way to
    empower and formalize the journey of newly licensed nurses from
    education to practice. Project Lieutenant is our pilot program to
    support our nurses' successful completion of the nurse residency
    program and transition into new clinical practice areas. Established at
    the 59th Medical Wing, Joint Base San Antonio, Texas, Project
    Lieutenant is leading the charge to deliberately develop our newly
    graduated NTP nurses through a comprehensive 9 month mentoring program.
    The deliberate development of the novice nurse is in step with the
    NCBSN's model and will be replicated at several sites to ensure
    consistent quality of patient care and address the concerns of the new
    nurse, ultimately promoting public safety and positive patient
    outcomes.
        As we aim to improve upon positive patient outcomes, we are
    committed to serving our Wounded Warriors. As we enter our 10th year of
    intensive combat operations, we are not only faced with the challenge
    of caring for those with physiological wounds but also those with
    psychological wounds as well. As Secretary Gates stated, there is ``no
    higher priority in the Department of Defense, apart from the war
    itself, than taking care of our men and women in uniform who have been
    wounded, who have both visible and unseen wounds.'' The National
    Defense Authorization Act 2010, Section 714, directed an increase in
    the number of active duty mental health personnel and, to meet the
    Secretary's priority of taking care of our Airmen and families, we are
    launching a program to develop mental health nursing professionals from
    within our Corps. Our pilot class started at Travis Air Force Base,
    California, on February 14, 2011, and our next class is set to begin in
    June 2011, projecting eight graduates this year.
        The Uniformed Services University of Health Sciences (USUHS)
    Graduate School of Nursing recently stood up a Psychiatric Mental
    Health Nurse Practitioner Program (PMH-NP). This new program has
    graduated two Air Force advance-practice nurses, with two Air Force
    students currently enrolled and four more students planned for 2011.
    The PMH-NP is one of the few programs in the country that includes
    psycho-pharmacology and addresses behavioral techniques specifically
    designed for clinical care of the military population. The program also
    has specific training in the logistics of delivering healthcare in
    military populations and education in Compassion Fatigue/Resiliency to
    decrease the risk of mental health issues and burnout.
        We also recognize our unique role in supporting the AE System
    within the AFMS. In 2009, we developed an Air Force Institute of
    Technology Master's degree in Flight Nursing with a concentration in
    Disaster Preparedness. This program was developed in partnership with
    Wright State University, the Miami Valley College of Nursing, Dayton,
    Ohio, and the Health and National Center for Medical Readiness Tactical
    Laboratory. Additionally, a disaster training facility, called
    Calamityville, is being created and may be incorporated into civilian
    and military training programs. Our first student started the flight
    nurse graduate program in July of 2010 and another student is
    programmed to begin this summer. Upon graduation, these individuals
    will have been educated in emergency and disaster preparedness and they
    will be eligible to take the Adult Health Clinical Nurse Specialist and
    American Nurse Credentialing Center certification exams. This expertise
    will be invaluable to our current and future operational environment.
        A major movement in advanced practice nursing education was
    stimulated by the American Association of Colleges of Nursing (AACN) as
    they voted to move the current level of educational preparation from
    the master's level to the doctorate level by 2015. To maintain
    professional standards and remain competitive for high quality students
    amongst military advanced practice nurses, Senator Inouye addressed
    Congress in December to recognize the need to make this transition at
    USUHS. Along with our sister Service nursing colleagues, we are working
    with USUHS to develop the curriculum for a Doctorate of Nursing
    Practice (DNP) with a transition plan to meet this goal. By 2015, all
    students entering the nurse practitioner career path will graduate with
    a DNP. This entry level to advanced practice will apply also to direct
    advanced practice nurse accessions. The Health Professions Education
    Requirements Board (HPERB) allocated nine DNP positions for an August
    2011 start. Four of the candidates will go from a master's to doctorate
    level and five will progress from the baccalaureate level to the
    doctoral level to meet the new requirement.
        In addition to our DNP programs, we continue to bolster our
    evidence-based care through investment in nurse researchers. We
    recently developed a nursing research fellowship and the first
    candidate began in August 2010. This 1 year pre-doctoral research
    fellowship focuses on clinical and operational sustainment platforms.
    The intent of this program is for the fellow to develop a foundation in
    nursing research and ultimately pursue a Ph.D. Following the
    fellowship, they will be assigned to work in Plans and Programs within
    the Human Performance Wing of the Air Force Research Laboratory. This
    direction also reflects the National Research Council of the National
    Academies recommendation that those planning for careers with a heavy
    concentration in research have doctoral preparation.
        Major Candy Wilson and Major Jennifer Hatzfeld both received their
    Ph.D.s in Nursing Science through the Air Force Institute of Technology
    civilian institution program. The Air Force's investment in doctorally
    prepared researchers equipped these nurses to deploy as integral
    members of the Joint Combat Care Research Team with the clinical and
    scientific expertise needed to make a difference for our Wounded
    Warriors. The research and statistic expertise of these nurses in
    conjunction with their clinical expertise was pivotal in projecting the
    medical resources needed for casualties during the surge in combat
    operations and assisting the Afghan government in evaluating the effect
    of a Strong Food program supported by the U.S. Agency for International
    Development. The investment in military nurse education is critical for
    improving the lives of deployed U.S. military members, coalition
    partners, and host nationals.
        With a goal to advance cutting-edge, evidence-based nursing
    practice, we have further developed the clinical career track for
    Master Clinicians and Master Researchers through the rank of Colonel.
    Master Clinicians are board certified nursing experts with a minimum
    preparation of a master's degree and at least 10 years of clinical
    experience in their professional specialty. They serve as the
    functional expert and mentor to junior nurses. Our Master Researchers
    are Ph.D. prepared and have demonstrated sustained excellence in the
    research arena. Both of these highly respected positions facilitate
    critical thinking and research skills, and foster the highest level of
    excellence in care across our healthcare system. We currently have
    eight Master Clinicians and three Master Researchers within designated
    medical and research facilities.
        In addition to training our newest nurses, we have realized the
    efficiencies in Joint training for our enlisted medical technicians as
    well. Teaming with our Joint partners, a ribbon cutting ceremony was
    held in May 2010 at the new Joint Service Medical Education and
    Training Campus (METC). This training campus will grow to be home to
    nearly 8,000 students with an operating staff and faculty of over 1,400
    civilian and Joint military personnel. In March 2011 a Memorandum of
    Agreement and Board of Governers Charter was signed by all three
    service Surgeon Generals. Creating this state-of-the-art training
    platform will produce technicians in 15 different specialties to
    support the DOD mission and optimize our interoperability amongst the
    next generation of medics in the ever-growing Joint environment.
        An ongoing effort in the development of our enlisted members is the
    transition of our Independent Medical Technicians (IDMTs) and Aerospace
    Medical Technicians (4NOs) to certified paramedics. This advancement
    will continue to decrease our reliance on contract emergency response
    systems and with an end goal of 700 paramedics. In 2010 we certified 46
    paramedics, bringing our total over 200. To enhance the tremendous
    capability of our IDMTs, our goal is to reach 100 percent within this
    constrained career field over the next 5 years.
        We believe this advancement in the development of our medics will
    eliminate the stove pipe that has limited career opportunities within
    the IDMT specialty field and over the long run enhance career
    progression for these highly qualified medics. Additionally, our IDMTs
    are eligible for the selective reenlistment bonus which has aided in
    the recruitment and retention of these highly valuable assets. Our
    IDMTs are enlisted professionals who serve as physician extenders and
    force multipliers and who are capable of providing medical care, often
    in isolated locations. Senior Master Sergeant Patrick McEneany, who is
    just one of these valued medics, deployed for 7 months as an IDMT to
    Iraq with a Joint Special Operations task force. As a provider in a
    remote location, he supervised an urgent care medical clinic, serving a
    camp of 1,200 individuals. His accomplishments during this deployment
    included the resuscitation and stabilization of combat traumas and
    emergencies and the treatment of 1,500 ill and injured patients.
    Additionally, he evaluated multiple Combat Search and Rescue exercises
    at forward operating bases to validate the care for Special Operations
    Pararescuemen. For his efforts, Sergeant McEneany was awarded the
    Bronze Star.
        Further opportunities to maximize the potential of our Airman and
    grow the next generation of Noncommissioned Officers are available
    through the Air Force Institute of Technology (AFIT) for certain key
    enlisted specialties. To date, we have three such positions identified;
    one in education and training at the Air Force Medical Operations
    Agency, another within our Modeling and Simulation program at Air
    Education and Training Command, and the third within the research cell
    at Wilford Hall Medical Center. Our most recent addition to the
    research cell is Senior Master Sergeant Robert Corrigan, who just
    arrived to Wilford Hall Medical Center.
        Just as we are developing our Airmen, the development of our
    civilians is critical to our overall mission success. We are
    establishing a career path from novice to expert and offering
    deliberate, balanced, and responsive career opportunities for our
    civilians. Just as the career path for our military nurses and medics,
    this career path will focus on the right experience, training, and
    education, at the right time. In January 2011, we conducted our first
    Civilian Developmental Board at the Air Force Personnel Center. The
    goal of this board is to present the opportunity to our civilian nurses
    for deliberate development and vectoring from the Force Development
    team, similar to the feedback given to their military counterparts.
    During this inaugural event, Level I and Level II Civilian Nurse
    Supervisors volunteered their records for this formal review and career
    counseling opportunity. This program will be a benchmark for the AFMS
    as we continue to expand this vectoring process across all of our
    Corps.
                                force management
        The goal of Force Management is to design, develop, and resource
    the Air Force Nurse Corps to sustain a world-class healthcare force in
    support of our National Security Strategy and align our inventory and
    requirements by specialty and grade. We must have the right number of
    people to accomplish the mission. In fiscal year 2010, we recruited 170
    fully qualified nurses and selected 126 new nursing graduates exceeding
    our recruiting goal of 290. In line with initiatives to decrease Air
    Force end-strength, Nurse Corps recruiting service goals were reduced
    in 2011. As we face force shaping initiatives, it is critical that we
    continue to develop programs that provide the clinical ability
    essential to the sustainment of our nursing force.
        In fiscal year 2008, the long-needed increase in colonel
    authorizations for the Nurse Corps created a deficit to the grade
    ceiling. With current personnel and year-group sizes, filling the
    authorized grades at the senior level remains challenging. In an effort
    to resolve the persistent grade level imbalances, nursing leadership
    has been working closely with the Office of Deputy Chief of Staff,
    Manpower, Personnel and Services to develop options, to include the
    possibility of the Defense Officer Personnel Management Act relief.
    This scenario would allow the colonel grade ceiling to reach allowable
    guidelines by 2016. The Nurse Corps is continuing to pursue the optimal
    solution in keeping with the Chief of Staff of the Air Force's
    direction. These critical Nurse Corps positions are not affected by
    current Air Force efforts to reduce its endstrength to authorized
    levels.
        In light of the significant limitations placed on direct
    accessions, it is imperative that we focus on the retention of our
    experienced nurses. As we enter our third year of the Incentive Special
    Pay (ISP) program, we continue to see the positive impact this program
    has on enhancing the professional satisfaction and retention of our
    experienced clinical experts. This program, which incentivizes clinical
    excellence at the bedside, tableside and litter-side, is crucial in
    maintaining the needed staffing in career fields that are critically
    manned.
        Another incentive for our nursing force is the Health Professions
    Loan Repayment Program targeted at those specialties with identified
    shortages. Health professionals who qualify for the program are
    eligible for up to $40,000 of school loan repayment in exchange for an
    extended service agreement. In 2010, 53 nurses elected to use this
    opportunity for financial relief in paying back school loans.
        With Chief Master Sergeant Joseph Potts leading our enlisted force,
    he is pleased to report success in securing a Selective Reenlistment
    Bonus (SRB) for the 4N enlisted career field fiscal year 2010. As
    mentioned, our IDMTs, along with medical technicians in several other
    critically manned career fields such as the surgical sub-specialties,
    Ear Nose and Throat, urology and orthopedics, are eligible for this
    bonus. The SRB allows us to focus our resources in areas where we can
    best retain medics in our critically needed specialties.
        The Graduate School of Nursing (GSN) at USUHS continues to provide
    cutting-edge academic programs to prepare nurses with military unique
    clinical and research skills in support of delivery of patient care
    during peace, war, disaster, and other contingencies. The GSN helps to
    ensure the Services meet essential mission requirements and has a
    history of rapidly responding to Service needs that is not possible in
    civilian institutions. For example, the GSN established the
    Perioperative Clinical Nurse Specialist and Psychiatric Mental Health
    Nurse Practitioner Program; as well as focusing research and evidence-
    based practice initiatives on pain management, traumatic brain injury,
    and the care of deployed and Wounded Warriors.
                             patient centered care
        As we mold our nursing force today, we are shaping our capabilities
    for tomorrow's fight. Our success will be measured continuously through
    conscious and deliberate planning and development. We strive to
    establish leadership and professional development opportunities to meet
    current and future Joint and Air Force requirements while building
    trust through continuity and patient centered care. ``Trusted Care
    Anywhere'' is the mantra of the Air Force Medical Service.
    Understanding the value of patient-centered care, the AFMS is focusing
    on ``Better Health, Better Care, Best Value'' through the Family Health
    Initiative.
        Across the globe, our healthcare teams are focused on building
    patient-centered platforms able to perform the full scope of medical
    and preventive care to our patients at home and abroad. We are
    committed to the execution of the Family Health Initiative (FHI), the
    Air Force's pathway to Patient-Centered Medical Home, which provides
    continuity of care, team work and fosters improved communication; all
    maximizing patient outcomes. Our Disease Managers and Clinical Case
    Managers (CCMs) play an integral part in this process. At several
    locations, our telephone consults have decreased by 21 percent from
    2009, and our network referrals to an Urgent Care Clinic have decreased
    by 50 percent since the FHI was started. This decrease in urgent care
    referrals has saved over $174,000 for Joint Base Elmendorf Richardson
    in Alaska. As well, a set of performance measures developed by the
    National Committee for Quality Assurance, Healthcare Effectiveness Data
    and Information Set (HEDIS), is used to measure clinical outcomes since
    FHI inception. The HEDIS results demonstrated an overall improvement in
    diabetic screening results and reporting. F.E. Warren Air Force Base,
    Wyoming reports patient satisfaction is at an all time high of 96
    percent for 2010. Additionally, many other sites are reporting similar
    experiences as a result of this modification in how we care for our DOD
    beneficiaries.
        Alongside our Disease Managers, our CCMs are helping patients
    receive safe, timely, cost-effective healthcare. The Air Force has 113
    CCMs and in fiscal year 2010 there were 47,000 CCM encounters, a 50
    percent increase over fiscal year 2009. Additionally, 4,000 of these
    encounters were with Wounded Warriors, a 100 percent increase over
    fiscal year 2009. Based on Air Force Audit projections, CCMs have
    generated over $300,000 in savings compared to fiscal year 2009. The
    CCM is integral to patient care coordination and the FHI, ensuring our
    patients see the right provider, at the right time, and at the right
    place. The goal of the Medical Home Model is to strengthen the
    partnership between the patient and the healthcare team, and continue
    to look at ways to provide timely, cost-effective care while focusing
    on patient safety, and decreasing variance at every point of healthcare
    delivery.
        Patient safety remains paramount. For AE, the rate of patient
    safety incident reports was less than 5 percent of patient moves. Of
    note, most of these events were near-miss, meaning the event was
    prevented and never reached the patient. To strengthen our Patient
    Safety Program, Air Mobility Command has created an Aeromedical
    Evacuation Patient Safety Course modeled on the principles of the
    Department of Defense's Patient Safety Program. Ms. Lyn Bell, a retired
    Lieutenant Colonel flight nurse and Chief, Aeromedical Evacuation
    Patient Safety, taught the first class in December 2010. She trained 17
    safety monitors from 10 total force agencies including AE Squadrons,
    the Patient Movement Requirements Center and Staging Facilities. This
    new program focuses on accurately capturing and documenting actual and
    potential patient safety concerns. It teaches units how to incorporate
    patient safety into their training scenarios and prepare the units for
    the high operations tempo in the combat theater. With these continued
    efforts, we hope to further enhance our culture that protects patients
    and advances process improvements.
        Beginning November 2010 through June 2011, the Air Force Medical
    Operations Agency (AFMOA), in conjunction with the DOD, is implementing
    the Patient Safety Reporting (PSR) System in Air Force military
    treatment facilities worldwide. The PSR provides staff with a simple
    process for reporting patient safety events using DOD standard
    taxonomies, which enhance consistency and timely event reviews. The PSR
    event data will be analyzed for trends and assist in identifying
    targets for process improvement, both at Air Force and DOD levels.
        A final note on patient safety: We have initiated a 1 year
    fellowship in Patient Safety incorporating all areas within the AFMS,
    to include the clinical, logistical, financial, and environment aspects
    of care. This fellowship includes education on patient safety event
    reporting, sentinel and adverse events, root cause analysis, proactive
    risk assessment, and risk management. The fellow will also become
    knowledgeable in patient safety database systems and strategic
    communication to allow them to engage with Air Force and DOD
    leadership.
        We also recognize our responsibility in caring for victims of
    sexual assault within our military healthcare system. Medical treatment
    facilities team with installation Sexual Assault Response Coordinators
    to deliver care to victims via coordination with Victim Advocates and
    Medical Specialists. To ensure the integrity of forensic evidence and
    guarantee access to care, most sexual assault exams are done off-base
    via a memorandum of understanding with local treatment facilities. In
    the deployed environment, seven of eight medical treatment facilities
    perform exams on-site while one location uses a co-located Army
    hospital. Upgraded First Responder training has been implemented to
    increase training efficiency; over 6,000 medics completed First
    Responder Training in fiscal year 2010.
        At the root of patient care is nursing research yielding evidence
    based practices. In fiscal year 2010, the Tri-Service Nursing Research
    Program (TSNRP) awarded 18 research grants, including five awards
    totaling $1,015,045 to Air Force nurse scientists. These investigators
    are now studying military unique and military relevant topics such as
    positive emotion gratitude, the resilience of active duty Air Force
    enlisted personnel, and military medics' insight into providing women's
    health services in a deployed setting.
        Under Colonel Marla De Jong's leadership, and for the first time in
    its history, TSNRP offered research grant awards to nurses at all
    stages of their careers--from novice nurse clinician to expert nurse
    scientist. The Military Clinician-Initiated Research Award is targeted
    to nurse clinicians who are well-positioned to identify clinically
    important research questions and conduct research to answer these
    questions under the guidance of a mentor. The Graduate Evidence-Based
    Practice Award is intended for DNP students who will implement the
    principles of evidence-based practice and translate research evidence
    into clinical practice, policy, and/or military doctrine. It is
    critical that funded researchers disseminate the results of their
    studies so that leaders, educators, and clinicians can apply findings
    to practice, policy, education, and military doctrine as appropriate.
    This grant will enhance this dissemination and uptake of evidence.
        This year, Air Force nurses authored more than 10 peer-reviewed
    publications and delivered numerous presentations at nursing and
    medical conferences. Also in 2010, the TSNRP's Battlefield and Disaster
    Nursing Pocket Guide and clinical practice guidelines were established
    as the primary performance criteria for the Air Force Nurse Corps
    readiness skills verification program. The integration of these
    evidence-based recommendations will ensure that all nurses are prepared
    and provide the highest quality, state-of-the-art care under
    operational conditions.
        We are also leveraging data gained from the Joint Theater Trauma
    Registry to create innovative solutions for the battlefields of
    tomorrow, today. In summer of 2011, in collaboration with our Joint and
    Coalition Partners, we are establishing an enroute critical care
    patient movement system to augment our existing tactical transport.
    Once wounded, a patient is transferred as quickly as possible to a
    forward surgical team, normally within 1 hour. These patients may
    undergo life-saving damage control resuscitation and surgery.
        Most often these patients are then transferred via helicopter to a
    trauma center where their wounds can be treated more extensively by
    medical specialists. These seriously and critically injured patients
    receive en-route care by an Emergency Medical Technician with basic or
    intermediate clinical skills or a facility must provide an attendant to
    accompany the patient. This latter option limits the availability of
    these skilled clinicians who may be needed for other incoming patients.
        Neither solution was considered optimal in terms of ensuring
    clinicians with the right skill sets are available while not reducing
    the availability of care providers. As a result, of these challenges,
    the Air Force developed Tactical Critical Care Evacuation Team, or
    TCCET, to augment these inter-hospital transfers. The current TCCET
    composition consists of two certified registered nurse anesthetists and
    an emergency room physician. This team possesses advanced clinical
    skills to support ventilated patients as well as patients who are
    hemodynamically unstable. The team can function as a whole or each
    provider can perform separately to meet the patient or mission needs.
    The TCCET will augment the Army flight medic, or Air Force
    pararescuemen on missions, and will also be able to support AE missions
    or augment the CCATT, if needed.
        Prior to deployment, these providers will hone their critical care
    skills by attending our Centers for Sustainment of Trauma and Readiness
    Skills (CSTARS) program at University of Cincinnati, Ohio. They will
    attend the Joint Enroute Care Course at Fort Rucker, Alabama to become
    familiar with rotary wing operations. The team will carry backpack
    sized equipment packs to support most critical care patients, to
    include pediatric patients. By inserting this higher level of
    specialized care at the earliest juncture in the injury spectrum, we
    hope to improve overall outcomes for the Wounded Warrior.
        In the area of skills sustainment, our partnerships with high
    volume civilian trauma centers continue to thrive. Our CSTARS platforms
    provide invaluable opportunities to hone war-readiness skills. In 2010,
    907 doctors, nurses, and medical technicians completed vital training
    at one of these three centers located in Baltimore, Maryland;
    Cincinnati, Ohio; and St. Louis, Missouri. Another example of our
    skills sustainment initiatives lies within the 88th Medical Group at
    Wright Patterson AFB, Ohio. The Medical Group stood up a state-of-the-
    art Human Patient Simulation Center for providing realistic training
    opportunities for healthcare personnel in 2009 with completion of the
    center in 2010.
        The Center has incorporated simulation into various training
    courses including Advanced Cardiac Life Support, Pediatric Advanced
    Life Support, and the Neonatal Resuscitation Programs as well as the
    Aerospace Medical Service Apprentice Phase II and III program, and the
    Nurse Transition Program. The Simulation Center also initiated monthly
    Mock Code drills using human patient simulators and implemented Team
    Strategies and Tools to Enhance Performance and Patient Safety
    (TEAMSTEPPS) into simulation training scenarios. This center is also
    the primary pediatric simulation site for military and civilian medical
    students attending the region's Dayton Area Graduate Medical Education
    Consortium.
        Because of their efforts, the 88th Medical Group won the Air Force
    Modeling and Simulation Annual Innovative Program Team Award for their
    live training via a remote presence robot on the care of burn
    casualties. The team connects via laptop with a robot at Brooke Army
    Medical Center's burn unit during interventional patient care, and an
    on-site facilitator describes the treatment procedure in real time. The
    program was coordinated through the Army Institute of Surgical
    Research.
        Within our patient-centered care philosophy is the recognition of
    the need to address the resiliency of our Airmen and families as well
    as to care for the caregiver. As an experienced critical care nurse,
    Lieutenant Colonel Mary Carlisle thought she could handle anything on
    deployment to Iraq. But the casualties she saw daily took a toll on her
    psychological health. When Colonel Carlisle returned home, her war
    wounds were invisible. She became increasingly lost in sorrow, becoming
    absorbed and distracted by thinking ``What if?'' and ``Why?'' She
    sought solace at the National Mall in Washington, DC, studying the
    faces of the Vietnam Women's Memorial monument, identifying with each
    of the women depicted in the monument. During her 2010 Memorial Day
    speech at the Vietnam War Memorial she reflected how she was, during
    different times of her deployment, each one of those women. She states
    ``I was the woman kneeling, looking down, defeated, holding the helmet
    that will never be worn again. I was the woman cradling the Wounded
    Warrior, fighting with everything I had to save his life. And, I was
    the woman gazing skyward; grasping the arm of my colleague,
    anticipating whatever was to come.''
        Colonel Carlisle found the courage to seek help for her wounds and
    hidden trauma. She further states ``now I am at peace knowing I--we--
    did the best we could, and the fallen angels were not lost in vain, and
    America's freedom still reigns.'' Colonel Carlisle became a spokeswoman
    for nurses and other medical personnel with post-traumatic stress or
    other war-related adjustment issues. Instead of being rebuked by her
    upper command for openly talking about her experiences, Colonel
    Carlisle is praised for her efforts to encourage other troubled nurses
    and medical technicians to see help. Colonel Carlisle helps to show our
    Airmen that she is a senior officer who has experienced the same
    feelings they may be having and they should feel comfortable talking
    about their experiences and feelings. We are changing our culture to
    promote the building of resilience, facilitate recovery, and support
    reintegration of returning Service members.
                                   way ahead
        The United States Air Force Nurse Corps consistently achieves
    excellence in all that we do. The use of professional clinical judgment
    in delivering evidence-based care is essential in enabling our Airman
    and their families to improve, maintain, or recover health, and achieve
    the best possible quality of life. By partnering with our civilian
    institutions, Joint, and Coalition partners we are building the next
    generation of care and capability. As we step into the 21st century, we
    are forging our future by addressing our stressors, embracing our
    professional diversity, and fortifying our Total Nursing Force with
    education, training and research.
        Mr. Chairman, and distinguished members of the Subcommittee, it is
    an honor to be here with you today and represent a dedicated, strong
    Total Nursing Force. Our Wounded Warriors and their families deserve
    nothing less than educated and skilled nurses and technicians who have
    mastered the art of caring. It is through the medic's character,
    compassion and touch that we answer our nations call to care for those
    who served yesterday, today and tomorrow.

        Chairman Inouye. And now, if I may, I was in the Army about
    69 years ago. That is a long time ago. And at that time, the
    highest-ranking nurse, I believe, was a colonel--one colonel.
    And in the hospital that I spent 2 months in Italy, the
    highest-ranking nurse was a major. The theater commander of the
    nurse corps was a lieutenant colonel. In the hospital in
    Atlantic City and Michigan, the highest-ranking nurse was a
    lieutenant colonel.
        As we all know, in 2003, we made nurses two stars. Now I
    have been told that the Secretary of Defense has come up with
    efficiencies, and he recommends a reduction from two stars to
    one star.
        I would just like to have your views, General Horoho.
        General Horoho. Yes, sir.
        First, sir, I would like to thank you very much for the
    support because I would not be sitting here as a two-star
    general without your support. So, thank you.
        We used the launching of the rank of two star to actually
    leader develop across all of our corps across Army medicine. We
    have right now nurses that are commanding at the level 2
    command within the theaters of operation. We also have them
    commanding across Army medicine. We have nurses that have
    strategic input into decisionmaking at the strategic level, and
    so we now have I think a very competitive field for our nurses
    to be able to be competitive for branch materiel one star and
    then also at the two-star level.
        Chairman Inouye. So, you are not in favor of the
    Department's recommendation?
        General Horoho. Sir, I will support the Secretary of
    Defense and his efficiencies, and I----
        Chairman Inouye. You are a good soldier.
        General Horoho [continuing]. Am very, very grateful for the
    rank of two star. Thank you.
        Chairman Inouye. Well, I will make certain you keep your
    two stars. I think it is about time we recognize the value of
    nurses. When I was in the hospital, other than the time spent
    on the operating table, in the wards I saw the doctor about
    once a week, nurses 24 hours per day. She is the one who
    provided minor surgery, all the medicine, all the care. But she
    was a second lieutenant. I think it is about time we recognize
    their value, and I think if a man gets two stars for commanding
    10,000 troops, I think a nurse should get two stars for
    commanding 18,000 troops.
        Senator Mikulski. Hear hear.
        Chairman Inouye. That is how I get my votes.
        Does the Navy support----
        Admiral Niemyer. Well, sir, I want to extend our grateful
    appreciation for the support you have provided to military
    nurses. It has enabled us to achieve both civilian nursing and
    military medicine respect commensurate with the rank of a two
    star, and the scope of responsibility of a two star as well.
        I have had the unique opportunity of being able to be
    selected as a one star and work in a very challenging joint
    position, which I believe enabled me to better lead the Nurse
    Corps today. We are extremely grateful, and I, too, would not
    be sitting here as a two star without your support and this
    subcommittee's support.
        Thank you.
        Chairman Inouye. General, does the Air Force support two
    stars or one star?

                          MILITARY NURSING LEADERSHIP

        General Siniscalchi. Sir, military nurses will continue to
    provide the best patient care possible and will continue to
    lead at whatever rank we are asked to lead at. But having
    served as a two star, and I thank you for your continued
    advocacy for military nursing and for the support that military
    nursing received in 2003, to have the leadership position
    raised to a two star. And when you look at our scope of
    leadership and our scope of responsibility and for the Air
    Force having to include our total force Active, Guard, Reserve,
    officer, enlisted, and civilian, we are close to 19,000. And to
    provide policy and directives for a total nursing force of that
    size, the two star rank has served us very well. And it is
    commensurate given our total nursing force engagement in global
    operations. But we will continue to support whatever decision
    is made, sir. Thank you.
        Chairman Inouye. Today's war has much trauma, brain
    injuries, multiple amputations, and it is a bloody war, much
    more severe than World War II. Are the nurses getting
    specialized training for this type of service?
        General Horoho. Mr. Chairman, we are looking at the Joint
    Trauma Tracking Registry System to get lessons learned, and we
    have changed, over these last several years, our training
    platform in the area of trauma nursing. We also made a decision
    with--over the last couple of years that every single nurse
    needs to be a trauma nurse. It is at our core competency. So,
    we have the combat trauma tactical course that our medics focus
    on. Everyone who deploys gets trauma training prior to their
    deployment, whether that is in San Antonio or it is in Florida
    at the University of Miami. And then we are constantly refining
    and looking out at what is occurring in the civilian sector,
    which is part of what develops our Virtual Leader Academy, is
    that we looked at competencies and capabilities, and we
    redesigned all of our training programs to better support the
    complexity of the wounds that we are seeing in this war.
        Chairman Inouye. Before I call upon Senator Cochran,
    listening to our two ladies, I could not help but think about
    the trauma that families have to go through. For example, today
    a spouse can call her husband in Afghanistan every day----
        General Horoho. Yes, sir.
        Chairman Inouye [continuing]. On a telephone that is not
    censored. Every evening she can watch CNN or whatever it is and
    see her husband's unit in action, and she has to sweat it out
    until the next day, and she does not hear from him. And you
    wonder why someone gets stress disorders. In my time, I made a
    telephone call before I left Hawaii. The next telephone call I
    made to Hawaii was 3 years later on my way home. The letters
    that I wrote to my family were all censored. All I could say
    was the food is terrific, Italy is a wonderful place, I love
    France and Paris--nothing about action or injuries.
        I can understand why there are more suicides today. I can
    imagine coming back, getting together with your family and 6
    months later have to ship off again. That is not the way to
    serve. We will have to do something about this.
        What are the nurses thinking about stress disorder and
    suicides?

                              MENTAL HEALTH ISSUES

        General Horoho. I will let you, and then we will just kind
    of go down the line.
        Admiral Niemyer. Thank you, Senator.
        The issue of families and our service members with post-
    traumatic stress and mental health is a concern for all of us.
    We have tried to build resilience programs, not just for the
    service members themselves, but for our families as well. I
    know we have FOCUS, which is Families Overcoming Under Stress
    for our Navy personnel and Marine Corps personnel, and use that
    as a training platform to discuss those issues proactively. The
    goal currently is to build resilience and strengthen our
    soldiers, sailors, airmen, and marines, as well as each other.
    And that is just one type of program that we are using to
    address the families.
        We have also looked at building stigma reducing portals for
    our service members and their families to access mental health.
    An area where mental health psychiatric nurse practitioners are
    making a difference, as well as all of our mental health
    personnel, is to embed them in primary care areas where they
    are accessible to those that need them in an attempt to ward
    off and address those issues before they become problematic.
    Any one suicide is one too many, so building that resilience
    and looking proactively is one of the ways that we are trying
    to address that.
        General Horoho. Mr. Chairman and the subcommittee, part of
    what we learned over the last 10 years of supporting a Nation
    at war is that we cannot just treat the warrior, that we
    absolutely have to treat the family. And where social
    networking came in, which you mentioned, is that because of
    that, it connects the home to the battlefield, and all of the
    stressors that are at home are felt by the soldiers, and
    sailors, airmen, and marines, and Coast Guards that are
    deployed, as well as what is going on in theater is also known
    by the families.
        A couple of things that we have done: We have implemented
    in nursing as part of all of this--we have implemented the
    Comprehensive Behavioral System of Care, which has five touch
    points. And we evaluate 100 percent, so to try to reduce the
    stigma, it is mandatory from our privates to our general
    officers to be evaluated by either a psychologist, a
    psychiatrist, a psych nurse practitioner, or a social worker,
    and then primary care that are trained in behavior health. That
    evaluation then allows us to get them help as soon as possible
    if it is needed. We have also embedded our behavior health into
    primary care because what we found is a lot of our patients
    come in for healthcare, and it is a low back pain or maybe a
    headache when it really is something that has to do with stress
    or anxiety. Then when they are in the deployed theater and we
    have our nurses as part of the combat support teams, 100
    percent are evaluated prior to them redeploying back. That
    information of whether they are high risk, moderate, or a low
    risk is then sent back to the installation that is going to
    receive them. And we have behavior health and nursing as part
    of that team. When we talk behavior health, it is the entire
    complement from our medics, our nurses, psychiatrists,
    psychologists, and social workers, so when I use that, that is
    the team that I am talking about. They evaluate at each one of
    those touch points.
        We also found that we needed to leverage virtual behavior
    health when we talked about how difficult it is to be able to
    get a--national shortage of resources--how do we get that? So
    we leveraged virtual behavioral health, and we have over hired,
    and we have platforms in Europe as well as at Fort Louis,
    Washington, Walter Reed, and Brooke Army Medical Center, and
    then Eisenhower. And we use those electrons to be able to get
    healthcare to those that are needed. And when we marry the
    family up, what we are testing right now is using virtual
    behavior health and counseling of a family of children and the
    wife with a service member that is deployed to be able to keep
    continuity of care and look at trying to reduce the stressors
    of healthcare if we can deal with those issues now instead of
    delaying that till they redeploy back.
        And then on the children's side, we are also working, and
    actually all of our services are working with us and Department
    of Defense, to embed behavior health into the school system so
    that we can help with the young children that are stressed
    because of either multiple deployments of their parents. And so
    that is part of our school-based programs that we are using as
    pilots across, and we are starting to see whether or not that
    impacts by being proactive.
        Thank you, sir.
        Chairman Inouye. Thank you very much.
        General.

                        TIERED-BASED MODEL OF RESILIENCY

        General Siniscalchi. Sir, it is a very stressful time for
    our military members and their families. But what we are
    finding is that prevention is key, and it has to start from the
    very beginning and continue throughout their entire
    professional career.
        We are looking at a tiered-based model of resiliency that
    incorporates multi-dimensions of human wellness from the
    physical to the social to the psychological and the spiritual.
    And our tier-based resiliency model begins from the beginning,
    whether it be in basic military training, technical training,
    and officer training. And we instill a culture of resiliency,
    recognizing signs and symptoms of post-traumatic stress, de-
    stigmatizing behavioral care, and encouraging our military
    members, their families, to seek behavioral health when
    necessary.
        And as we continue throughout the professional career, we
    look at multiple points throughout the career to introduce
    training, whether it be through professional military education
    or through leadership training. And then as we identify groups
    that are at high risk for post-traumatic stress, for
    depression, for suicide, then the training and the education is
    tailored to them and their families to help minimize and help
    to moderate their risk.
        We have used a Mortuary Affairs Model from Dover Air Force
    Base that has incorporated strength-based training and
    resiliency, and we incorporated that model throughout our
    different levels of command-based resiliency programs.
        We have targeted pre- and post-deployment training, and
    while in theater, those individuals who have been serving
    outside the wire or have been exposed to multiple trauma, then
    as they pass through Germany, they go through our Deployment
    Transition Center, and that helps to prepare them as they go
    back to their families and to their bases. And it better
    enables them to reintegrate and rejuvenate as they come back
    from deployment.
        We have reached out to our senior leaders, who have
    deployed and have experienced post-traumatic stress. And we
    have two of our senior leader nurse officers--critical care
    nurses, Lieutenant Colonel Mary Carlisle and Lieutenant Colonel
    Blackledge. And they came back from multiple deployments and
    recognized that they were experiencing signs of post-traumatic
    stress. And in our effort to incorporate behavioral health into
    our family home model and to de-stigmatize behavioral health,
    both of these senior nurses sought behavioral healthcare, and
    then decided to take their message forward. And they have
    produced videos in multiple forums. They have shared their
    experiences that not only they went through individually, but
    what their families also went through when it came to post-
    traumatic stress.
        We recently had a nursing conference last week in Dallas,
    and Lieutenant Colonel Blackledge came and shared her message
    to close to 500 nurses and technicians. And we also had a
    social worker on site who met in small groups with our nurses
    and technicians recently coming back from deployment who
    experienced post-traumatic stress.
        I think the best approach that we can take is the tiered
    model for resiliency, targeting those groups that are at high
    risk, de-stigmatizing mental health, encouraging all of our
    members to openly communicate when they are recognizing signs
    of stress, to focus pre-deployment, during deployment, and
    post-deployment, and then looking at success stories out there,
    which have been the Mortuary Affairs Group at Dover, and then
    emulating programs that they have put in place.
        Chairman Inouye. Thank you very much.
        General Siniscalchi. Thank you, sir.
        Chairman Inouye. Senator Cochran.
        Senator Cochran. Mr. Chairman, I have been impressed with
    the comments that I have read and the testimony that you
    prepared for our subcommittee before the hearing. And we thank
    you for that. I was particularly impressed with the training
    programs, and I was looking at the Air Force experience as
    defined in your testimony that you prepared, General
    Siniscalchi.
        We appreciate the fact that it does not just happen on
    instinct or spontaneous judgment, but a lot of people spend a
    lot of time drawing on their experiences and presenting it to
    others who would be confronted with long flight times coming
    back from combat areas, critically injured soldiers and sailors
    who have to have special care and treatment. And the scope and
    involvement of so many people in the success of these
    operations is really quite awesome. I cannot imagine any
    military force in the world being able to come close to what
    our military, and particularly the Nursing Corps in all of our
    services, have done to help make it such a successful and
    caring, lifesaving experience for many men and women.
        Do you have any comments about that, and is there funding
    available in the request for funding that will continue these
    programs and help support what you have designed as the best
    that you know, the state of the art?

              FUNDING TO SUPPORT AN INCENTIVE SPECIAL PAY PROGRAM

        General Siniscalchi. Sir, funding is available. Our
    Incentive Special Pay Program, first and foremost, is helping
    us to retain our clinical experts. So, being able to have
    funding to support an Incentive Special Pay Program is helping
    us to retain seasoned clinicians.
        Our strength in the care that we are to provide and to have
    the successes that we--that you have just mentioned comes
    through our ability to build partnerships. As we continue to
    partner with our sister services in critical care training, as
    we continue to partner with academic institutions for our nurse
    transition program, we currently have partnerships at
    Baltimore, at St. Louis, University of Cincinnati for our C-
    Stars, our critical skills sustainment training. We have,
    again, academic partnerships and partnerships with civilian
    trauma centers that allow us to send our nurses into their
    facilities for sustained training. So our goal is to ensure
    that if we do not have robust training platforms within our
    military treatment facilities, that we establish robust
    partnerships with our sister services, with academic
    institutions, academic--or civilian trauma centers, and the VA
    so that we have a ready force with sustainment training, that
    we have platforms in place for going out the door so they can
    hone their critical care and trauma skills, so that we can
    continue to provide the care that we provide. But we do that
    through training affiliation agreements and robust
    partnerships.
        Senator Cochran. Thank you.
        Mr. Chairman, thank you.
        Chairman Inouye. Thank you.
        Senator Mikulski.
        Senator Mikulski. Mr. Chairman.
        First of all, I would like to say to the entire nursing
    leadership of all the services, we just want to thank you for
    what you do every day. Every day in every way, you do high tech
    and high touch patient-centered healthcare, and I just want you
    to know I think all the Members of the Congress, they do not
    thank you every week--we cannot thank you enough for what you
    do.
        And, Admiral Niemyer, I understand you are a graduate of
    the University of Maryland. Is that right?
        Admiral Niemyer. Yes, ma'am. I am in your State. I am a
    home grown Annapolis girl.
        Senator Mikulski. I know. I have got the accent, you know.
    We both have the same accent, and I graduated from the
    University of Maryland School of Social Work.

                   NAVAL BETHESDA--WALTER REED NURSE STAFFING

        Admiral Niemyer. Yes, ma'am, I saw that.
        Senator Mikulski. I think we were a couple of yearbooks
    away from each other, but nevertheless, we were at the downtown
    campus.
        I have two questions, one related to acute care, and then
    the other to this more chronic behavioral post-deployment care.
        Admiral, we are going to be opening a Naval Bethesda Walter
    Reed, and my question is, number one, as we gear up, first of
    all, who is going to actually be in charge of the nursing
    clinical services? It is an unusual governance mechanism. We
    are looking forward to it. I am really excited about it. And,
    perhaps, General, you could help. Who is going to be in charge?
    And then the second question: Do you feel that as we are
    gearing up, that there will be adequacy for both nursing care
    as well as the very important Allied Health Services?
        Admiral Niemyer. Yes, ma'am. The current Director of
    Nursing Services at the now National Naval Medical Center, soon
    to be Walter Reed Military Medical Center, is Colonel Ellen
    Forster, she is an Army colonel. The nurses there, and at Fort
    Belvoir and Walter Reed, have blended nicely to create an
    executive nursing staff to work together. So, to answer your
    question, the governance and who is in charge of the nurses at
    Bethesda, it will be Colonel Ellen Forster. I believe she is
    here in the room today as well.
        Senator Mikulski. Is she here? Could she hold up her hand?
    Well, we are glad to see you, and we will be out to see you.
        Tell me about adequacy. Thank you.
        Admiral Niemyer. In terms of adequacy, from my
    understanding, yes. As we move the patients over, we have the
    nursing staff and the facility support to take care of the
    patients there. So, in terms of adequacy, I do not see any
    issues in bringing our patients and combining our patient force
    there.
        Senator Mikulski. General.
        General Horoho. Ma'am, one of the things is looking a
    little bit broader than Walter Reed Military Medical Center is
    actually looking at Belvoir, because both Belvoir and Walter
    Reed are Tri-Service-based hospitals, and looking at an
    integrated healthcare system. And so, with that, one of the
    things that we did on the nursing side is we have already sent
    Army, Navy, and Air Force nurses to Champion training to
    support the Patient CareTouch System, to really look at
    providing one standard of nursing care, decreasing variance,
    and really focusing on the patient being in the center, and
    improving the health of the patient and their family members.
    So, I think adequacy of training is going to be just fine, and
    I actually think it may be expanded as we learn from each of
    our services what we offer the best in a large beneficiary
    population in the National Capital Area.
        Senator Mikulski. First of all, that is so heartening to
    hear. I go back, again, to the awful times of Walter Reed in
    2007. And now we are looking ahead, and part of the looking
    ahead was not only the immediate treatment of acute care, which
    I think everybody says is actually stunning, stunning in the
    annals of medicine, military or civilian. It is truly stunning
    in battlefield to back home.
        But I want to hear, if I could just for a minute, this
    Patient CareTouch System, because I think that was what I was
    trying to get at with General Schoomaker. It says patient
    advocacy, enhanced care team communication, clinical capacity,
    and evidence-based, which we want, and healthy environment.
    Could you describe for me, from the patient standpoint, what
    does that mean, because we hear touch tones, benchmarks, yadda
    yadda.
        General Horoho. Yes, ma'am. If I can back up first and just
    explain how we even came to develop the Patient CareTouch
    System. We actually looked across Army, Navy, and Air Force,
    and looked at what were the common elements of high-performing
    systems. We also then looked across the civilian sector to see
    the magnet hospitals and what did they have in common. And then
    we realized that there was not one system out there that put
    all of those elements together. So we developed that and we
    piloted it at Fort Campbell, Kentucky. And what we found is
    that we actually had an increase in patient satisfaction. We
    had an increase in communication between our clinicians and the
    ancillary staff and the physicians. We had patient involvement
    with the family members and positive feedback. We had a
    decrease in left without being seen in our emergency rooms. We
    had a decrease in medical errors. We had an increase in
    critical lab value reporting. So, all of our nurse-centric and
    nurse-sensitive measures we saw very positive outcomes. So,
    after we piloted that for about 9 months and made some
    adjustments is when we then developed the training program to
    support that.
        And the Patient CareTouch System, what it does is it
    actually focuses on having the patient in the center of every
    touch point--every place, whether it is in the ambulatory arena
    or whether it is inpatient, that we make sure that the patient
    is involved in decisionmaking. We do hourly nursing rounds. We
    actually use white boards to communicate so that if family
    members come in, instead of the patient having to say, this is
    what the physician just told me, this is what the nurse just
    did, these are the reports we are waiting for, we take that
    burden off of our patient, and it is the clinical team working
    together, better communicating that information.
        We also identified data mechanisms and data that we wanted
    to track that really led to positive outcomes in healthcare,
    because we needed to be able to say what is the value of nurses
    providing patient care, whether it is inpatient or outpatient?
    And how do I know, as the Chief of the Army Nurse Corps,
    whether or not we are making improvements in patient care? So,
    we have a database now that looks at the health of our
    patients, that the head nurse or the clinical officer in charge
    can look at their patient and see how they are doing in patient
    care performance. That is rolled up to the Deputy Commander of
    Nursing, and then I across the Corps can then look at the
    health of our patients.
        We also added a peer review, so if you look at our officer
    evaluation----
        Senator Mikulski. My time is going to run out.
        General Horoho. I am sorry.
        Senator Mikulski. But that is the evaluation.
        General Horoho. There is a lot. There is a lot----
        Senator Mikulski. I am going to stick to--well, what I
    would appreciate, because the chairman has been generous with
    my time, though I know he is very passionate about this because
    it is the follow through. As nurses, social workers, we say
    this. It is not only when they are in the ER or the OR, it is
    the rest of the R; it is rehabilitation, it is follow through,
    it is the management of chronic pain, etc.
        What I would like is a white paper actually, or any color--
    a paper describing really what it is and what it does, and
    perhaps some casing samples, I think in case examples, which I
    think you do, too, in addition to this epidemiology and all you
    are looking at. So, I really would follow this through because
    I think you are on to something, and I think you are on to
    exactly what I am on to, that you need a patient advocate and
    all the way through inside. So, let us work together.
        [The information follows:]

        A top to bottom review of Army Nursing revealed that high
    quality care was being delivered but that it varied from
    facility to facility. The variability challenged patients,
    their families, and the nurses providing care. Notable in this
    review was the impact that the high technology environment had
    on patient care and a shift from those things that are
    considered unique to the art of nursing.
        The Patient CaringTouch System was developed in order to
    optimize care delivery. A pilot program was conducted at
    Blanchfield Army Medical Center in 2008 and this pilot revealed
    performance improvement across multiple dimensions within 6
    months of implementation, and suggested that broad
    implementation of the Patient CaringTouch System can create
    real value for Army Medicine. The following areas showed
    statistically significant improvement: (1) Decreased medication
    errors, (2) decreased risk management events, (3) decreased
    left without being seen from the emergency department, (4)
    increased pain reassessment, (5) increased critical lab
    reporting, (6) increased nurse retention and intent to stay
        The Patient CaringTouch System is what Army Nursing (AN)
    believes and values about the profession of nursing, delineates
    AN professional practice, articulates a capability-building and
    talent management strategy to ensure the right quantity and
    quality of AN leaders, and describes how AN delivers evidence-
    based care in accordance with best practice standards across
    care environments.

        Senator Murkowski. I worked with your predecessors on the
    nursing shortage. We want to continue that. And we have a real
    champion in Senator Inouye. We all--we are all in love with
    Senator Inouye. And--but we want to thank you again for your
    service and look forward to working with you.
        General Horoho. Thank you.
        Admiral Niemyer. Thank you, Senator.
        Chairman Inouye. Thank you very much.
        Senator Murkowski.

                                 SEXUAL ASSAULT

        Senator Murkowski. Thank you, Mr. Chairman. And I
    appreciate the time that the subcommittee has given to this
    very important testimony here today. Thank you all again for
    your service.
        I want to ask a question this morning about military sexual
    trauma. The fact that the three of you, this panel, is all
    female has nothing to do with my question. I had actually hoped
    to ask it to panel one, but I ran out of time. So, but it is
    equally applicable from the nursing perspective as well.
        As you are aware, the Women's Veterans Health Care
    Improvement Act put these new responsibilities on the VA to
    care for our discharged members of the armed forces who are
    suffering from military sexual trauma. The question to you all
    is, are we doing enough within the military medicine field here
    to identify, to treat these cases of military sexual trauma at
    the time that the service member has been victimized, or is
    this going to be a situation where the treatment for these
    individuals will be at the end when the service member is now
    part of the VA system and then discharged? And then, in
    addition to answering that question, if you will, are we doing
    okay, I guess, in terms of maintaining the records that we will
    need in determining the incidence of military sexual trauma and
    the outcomes in treating these victims? Is the process set up
    to work, and then, again, are we tending to the situation at
    the time that the sexual trauma has occurred, or are we waiting
    until this individual is part of the VA system? So, if you
    could just very quickly--and I recognize that this is an issue
    of time here this afternoon, but this is a very important
    issue, I think, as we know within all branches of our service
    right now. And I will throw it out to anyone who wants to
    start.
        Admiral Niemyer. I would be happy to just make a comment. I
    think the issue is so much broader than the medical parts, and
    although I cannot speak directly to your question about the
    records at this point, I would be happy to provide that back as
    a Navy response.
        The issue is so much broader than medical, and even today,
    I read this morning a white paper on sexual trauma. We have not
    progressed where we need to be. It is still a prevalent issue,
    and despite much of the training that we have done and the
    focus, it still remains an issue.
        That being said, I think we are doing a great deal in the
    military today with our line leadership to highlight this very
    prevalent issue and to focus on decoupling the alcohol
    incidence that at times accompanies sexual assault. We have a
    zero tolerance in the Navy, and I know for the other services
    as well.
        So, I can speak on the broad sense and would be happy to
    provide a more detailed medical response on that. But like
    suicide, any assault, and any particularly when it is our own
    folks, it is something that we clearly have zero tolerance for.
        Senator Murkowski. Oh, I would welcome a follow-up from you
    from the Navy's perspective if I could.
        Admiral Niemyer. Yes, ma'am.
        [The information follows:]

        Senator, Navy Medicine has taken an active role in
    supporting victims of sexual assault through the provision of
    medical care and the ability to support legal action by the
    completion of a sexual assault forensic examination when a
    victim presents to our facilities after an assault. Specific
    Navy Bureau of Medicine and Surgery (BUMED) initiatives include
    the establishment of a training program on the sexual assault
    forensic examination for medical providers stationed at
    overseas (OCONUS) commands. Not all of our medical treatment
    facilities (MTFs) within the United States offer in-house
    forensic evidence exams after an assault, but great care has
    been taken to establish Memorandums of Understanding (MOUs) at
    high-quality civilian facilities to meet this need. In
    addition, BUMED has initiated a study with the Center for Naval
    Analysis to gain understanding why some victims are choosing
    not to seek medical care or have a forensic examination at the
    time the assault occurs. Interventions will be initiated based
    on the finding of the study.
        The incidence and tracking of sexual assaults is reported
    via two sources. Naval Criminal Investigative Services reports
    and tracks unrestricted cases and the Sexual Assault Response
    Coordinators monitor and track the cases for victims who choose
    a restricted report. The challenge of accurate record keeping
    in the Navy is two pronged. First is the issue of under
    reported data. As many victims of sexual assault, both in the
    military and our society in general, continue to be concerned
    with the stigma associated with the crime and the fear of
    privacy breaches. Second, and specific to Navy Medicine, is the
    electronic medical record. Currently the required documentation
    for the forensic medical exam is Defense Form 2911 (per the
    DOD-I 6495.02). This form is not in electronic format but
    requires a scanned entry to be maintained in the electronic
    medical record, which is happening.
        Navy Medicine has an important and specialized role in
    caring for sexual assault victims. Our care for sexual assault
    victims encompasses the full scope of medical and psychological
    care with a priority on care that includes access to personnel
    trained to perform forensic examinations and psychological care
    aimed at providing the means to resume a healthy lifestyle. We
    realize that sexual assault affects more than just our Sailors
    and Marines. Sexual assault erodes unit cohesion, denigrates
    Navy core values and can adversely affect fleet readiness and
    retention. We allow victims of sexual assault the right to
    choose the option for care that is best for them, allowing them
    time to regain control of normal life functions. Our leaders
    are highly encouraged to use Sexual Assault Awareness Month to
    further educate sailors about the Navy sexual assault
    prevention and response program to include the role of medical
    personnel. Posters, educational leadership guides and other
    materials are readily available for download to assist in
    providing quality educational programs, encouraging an emphasis
    on a climate that values responsible behavior and active
    intervention. Navy Medicine, along with all Navy leaders stands
    ready to meet the challenge of eliminating sexual assault from
    our ranks.

        Senator Murkowski. General.
        General Horoho. Ma'am, we started about 2 years ago with
    Secretary Geren of having a campaign to increase awareness,
    that it really was an affront to our warrior ethos, whether it
    is a female being assaulted, or if it is a male being
    assaulted. So we looked at it with both demographics.
        I believe we have enough trained counselors to provide that
    level of care. Part of it, though, is creating that safe
    environment for people to feel comfortable coming forward,
    which is what you are talking about, the early intervention.
    And I think that is a work in progress, to be perfectly honest.
        We have also worked very closely with the VA. We have a
    midwife, Colonel Carol Hage, who actually works at the Office
    of the Surgeon General that has established a partnership with
    the VA to look at women's health issues, and this is one piece
    of that, because the demographics of the VA have changed, and
    then the impact of deployment with behavioral health and other
    issues, we wanted to make sure that we had the right programs
    in place to support. So we are evolving as time goes on.
        Senator Murkowski. Are you satisfied with the records that
    are being kept at this point, or do you know?
        General Horoho. Ma'am, if they come in and it gets into our
    electronic health record, then absolutely it is being
    documented and it is being kept in the system. And then we have
    got a lot of work that is being done right now with DOD
    partnering with the VA so that we have one electronic health
    record sharing that information. So, I think once it is in the
    system, it is absolutely in the system and is being maintained.

                  INCIDENCE OF SEXUAL ASSAULT IN THE MILITARY

        Senator Murkowski. We've got to get in the system.
        General Horoho. Yes, ma'am.
        Senator Murkowski. General.
        General Siniscalchi. Thank you, ma'am, for your question.
    And we all are concerned about the incidence of sexual assault
    in the military.
        In 2004, General Casey McLean from the Air Force was
    charged to stand up a task force, and did a remarkable amount
    of work to advance training and prevention regarding sexual
    assault. As a result of the work done by the group that she
    led, we moved to restricted and unrestricted reporting of
    sexual assault. There had been numerous years from this initial
    task force where the Air Force focused on various training
    programs, various approaches to reduce sexual assault, and ways
    to advance treatment when sexual assault did occur, and then
    focusing on restricted and unrestricted reporting.
        Now in 2010, there was a Gallup survey that the Air Force
    did to establish a baseline looking at the incidence of sexual
    assault. When the results of that Gallup survey came out, there
    was a Sexual Assault Prevention Council that was stood up, and
    I was asked to represent the medical--surgeon general--on this
    council. So, this group of senior leaders did a very in-depth
    analysis of this Gallup survey, the result. And what we found
    was that once a sexual assault occurs, that across 100 percent
    of our military treatment facilities within the United States,
    overseas, and at deployed locations, that we have the
    appropriate response teams in place, whether they be sexual
    assault forensic examiners, sexual assault trained nurses, or
    sexual assault examiners, that they are either within the
    facilities or that we have memorandums of understanding
    established with a civilian facility to provide that level of
    response.
        And so, the response to a sexual assault, we have made
    tremendous strides. When it occurs, the care--the immediate
    care--we found that one of our longest treatment lines to
    response was at one of our overseas locations, and that
    treatment was still under 2 hours. We have really made great
    strides in treating sexual assault.
        However, what the Gallup report showed is that there still
    is significant improvement that needs to be made when it comes
    to prevention and training. Our working group is now looking at
    ways to enhance training and areas that were identified focused
    on leadership. We are looking at training programs, whether
    they be through, you know, modular training, distance learning
    programs, face-to-face training, to enhance awareness and
    sexual assault training, and then put better programs in place
    that focus on prevention.
        Senator Murkowski. Well, I appreciate what you have
    provided me. If there is any follow-up that you can offer, I
    would be interested in that as well. I often wonder whether the
    same stigma that attaches to just the need for services for
    behavioral health might also attach when it comes to issues as
    they relate to sexual trauma, sexual harassment, because that
    is also part of what we deal with within the definition of
    military sexual trauma. And it is something that as we think
    then as to the treatments beyond, again, it is not just the
    physical, but it is as we deal with those mental health issues
    that may last for considerable periods of time. So, this is an
    issue that I appreciate your attention to and to the surgeon
    generals that I know are all still here. I thank you for that.
    But any efforts that we can make to improve this is greatly
    appreciated.
        With that, I thank the chairman and the vice chairman.
        Chairman Inouye. Thank you very much.

                         ADDITIONAL COMMITTEE QUESTIONS

        General Schoomaker, Admiral Robinson, General Green,
    General Horoho, Admiral Niemyer, and General Siniscalchi, thank
    you very much for your testimony, and, above all, thank you for
    your service to our Nation.
        [The following questions were not asked at the hearing, but
    were submitted to the Department of response subsequent to the
    hearing:]
    Questions Submitted to Lieutenant General Eric B. Schoomaker and Major
                            General Patricia Horoho
                Questions Submitted by Chairman Daniel K. Inouye
             sources of help for servicemembers and their families
        Question. General Schoomaker, are there efforts within the
    Department of Defense and amongst the Surgeons General to coordinate
    their approach on access to psychological healthcare needs and work
    towards one dedicated DOD Web site and phone line for all services?
        Answer. The Defense Centers of Excellence for Psychological Health
    and Traumatic Brain Injury (DCoE) is the Department of Defense (DOD)
    effort to coordinate psychological healthcare needs for servicemembers
    and their families across all services. The DCoE was established to
    assess, validate, and oversee prevention while facilitating the
    resilience, recovery and reintegration of servicemembers and their
    families needing help with psychological health and traumatic brain
    injury. The DCoE Web site (www.dcoe.health.mil) has a wealth of
    information to include information on the 24/7 outreach center. This
    center can be reached via phone at 866-966-1020, email at
    resources@dcoeoutreach.org, or via live chat.
        Military One Source is a single virtual portal to behavioral health
    (BH) care to meet the needs of all servicemembers and their families,
    including Guard and Reserve, regardless of activation status. This DOD
    level resource serves as an extension of installation services to
    improve access to BH care while reducing stigma.
                              psychological health
        Question. General Schoomaker, there has been an effort to expand
    psychological treatment options across the Army healthcare system. How
    is the Army providing expanded access to these services, both for
    soldiers and their families?
        Answer. In the past year the Army implemented the Comprehensive
    Behavioral Health System of Care Campaign Plan. This initiative is
    nested under the Army Campaign Plan for Health Promotion, Risk
    Reduction and Suicide Prevention. The Comprehensive Behavioral Health
    System of Care is intended to further standardize and optimize the vast
    array of behavioral health policies and procedures across the Medical
    Command to ensure seamless continuity of care to better identify,
    prevent, treat and track behavioral health issues that affect soldiers
    and families during every phase of the Army Force Generation cycle.
        The U.S. Army Medical Command currently supports over 90 behavioral
    health programs. The ``Virtual Behavioral Health program for
    Redeploying Soldiers'' (VBH) was established to maximize behavioral
    health assets and modern communications technology to provide uniform
    contact with all redeploying soldiers. VBH is meant to provide a
    positive experience for soldiers, so that they are more likely to seek
    behavioral health assistance in the future if needed. Additionally, the
    Army is enhancing behavioral health services provided to its Family
    members through Child, Adolescent and Family Assistance Centers and the
    School Behavioral Health Programs.
        In theater there has been a robust Combat and Operational Stress
    Control presence since the beginning of the war, with deployed
    behavioral health assets supporting both Operation Enduring Freedom and
    Operation New Dawn. Beginning in fiscal year 2012, the Army will
    increase behavioral health teams assigned to all its brigade size
    operational units. The increase will provide two behavioral health
    providers and two behavioral health technicians assigned to every
    Brigade Combat Team, Support Brigade and Sustainment Brigade in the
    Active, Reserve and National Guard Army inventory. The process will be
    complete by fiscal year 2017 and increase the total available uniformed
    behavioral health force by over 1,000 additional personnel.
                         patient centered medical homes
        Question. General Schoomaker, the Army's new community-based
    medical homes are located off-post in communities in order to provide
    increased capacity for primary care. How is the Army expanding this
    program and when will it be available service-wide?
        Answer. By the end of fiscal year 2011 the Army will have opened 17
    Community Based Medical Homes (CBMHs) in 11 markets. Two additional
    CBMHs will open in early 2012 bringing the total to 19 clinics in 13
    markets and complete phase 1 of the project. Phase 1 focused on meeting
    the primary care needs of our active duty family members. Once our
    CBMHs are proven to achieve desired results (improved access,
    satisfaction and health, and reduced utilization and cost), the Army
    plans to expand our community based presence. Phase 2 of the project
    will move some primary care services off-post to generate on-post space
    for specialty services and Warrior care. By doing so we will be able to
    better leverage our advanced on-post medical infrastructure,
    consolidate on-post services, and achieve the advantages of CBMHs.
    Phase 2 will begin in late 2012. Phase 3 of the project will explore
    opening additional services such as physical therapy, obstetrics,
    pediatrics, imaging, and refill pharmacy in community-based settings to
    generate positive value for DOD. Phase 3 planning will begin in late
    2011 with clinic expansion possible by 2013.
                           recruitment and retention
        Question. General Horoho, as the United States enters our tenth
    year of intensive combat operations, nurses have been heavily engaged
    in both wartime and humanitarian missions. How has the deployment tempo
    of nurses serving in critical nursing career fields affected the
    ability of the Army to recruit and retain nurses in these particular
    high demand fields?
        Answer. Six month deployments were initiated in summer of 2008
    which has had a positive effect on improving and maintaining the
    resiliency among Army critical care nurses. These deployments are
    better for the nurses and their Families. The critical care nurses as a
    group are very resilient and the majority do well post-deployment. In
    fiscal year 2010, the Army was able to recruit 642 nurses, meeting 105
    percent of its active duty need and 94 percent for the reserve. This
    includes some precision recruiting of experienced critical care nurses.
                                nursing research
        Question. General Horoho, I understand that the Army Nurse Corps
    has realigned nursing research assets, has embraced evidence based
    practice, and is an active participant in the TriService Nursing
    Research Program. How has this impacted nursing research opportunities
    in the Army?
        Answer. Army Nursing follows the American Nurses Association
    research participation guidelines that it is the expectation that
    nurses at every level participate in research activities appropriate to
    their educational preparation. Every nurse is involved in Evidence
    Based Practice (EBP) of which, research is one component.
        We are building a culture in all nurses at all levels that evidence
    drives practice. The goal is to have a core group of champions at all
    levels to sustain the application of research and use of evidence. EBP
    is built into curriculum at every level for Army professional nursing
    courses. This includes EBP and research lectures to the Clinical
    Transition Program, hospital or facility orientation, all specialty
    courses (Intensive Care Unit, Perioperative) and preceptor training.
    Army nursing has the support of Tri-Service Nursing Research Program in
    EBP and research grant camps.
                                 nursing issues
        Question. General Horoho, are Army military treatment facilities
    staffed to the actual patient load or to the number of beds?
        Answer. The Army staffs to nursing care hours, the same as both the
    civilian community and Veterans Administration, using a research-based
    workload management system which adjusts for complexity of patient care
    and type of nursing care provider required.
        Question. General Horoho, nurses working in patient care areas
    often voice concerns that there are not enough nurses performing
    patient care duties. What is the ratio of Army nurses delivering
    traditional hands on nursing care to those conducting research,
    performing administrative duties or involved in functions that are not
    directly involved in the delivery of patient care?
        Answer. The ratio of nurses delivering direct patient care vs.
    research and administrative duties is approximately 5:1 or 83 percent.
                                     ______

                  Questions Submitted by Senator Patty Murray
                               medical community
        Question. General Schoomaker, when the Army made the decision to
    ``Grow the Force,'' did it factor the size of its medical community
    into its billet needs? Was military construction for medical facilities
    factored into this process?
        Answer. Yes, the U.S. Army Medical Command (MEDCOM) participates in
    the Total Army Analysis (TAA) which is a phased force structure
    analysis process. Furthermore, MEDCOM employed a multi-factorial
    process in determining specific needs to support Grow the Army that
    included population changes, access to care challenges, network
    availability, the inability to hire civilian staff, medical treatment
    facility productivity and new operational requirements. Military
    construction of medical facilities was factored into the process.
        Question. How has the Army evaluated the capacity of its medical
    community against the current and future structure?
        Answer. The Army evaluates capacity annually using the enrollment
    capacity model (ECM). Inputs to the ECM are current and expected force
    structure, productivity benchmarks, and expert clinical input. The ECM
    allows the Army to project needed or unused capacity for all Army
    military treatment facilities to meet the needs of its beneficiaries.
                                 mental health
        Question. Does the Army have enough mental health providers to meet
    soldier and family member needs?
        Answer. While the Army has increased its behavioral health
    inventory by 90 percent since 2007, we still do not have enough
    providers and continue to work toward hiring more. As of February 2011,
    the Army had 4,998 behavioral healthcare providers. The current
    estimated active component Army behavioral health requirement is 6,107
    providers, which represents an unmet requirement of 1,109 providers.
        Question. If there is a gap in mental health providers, what
    efforts are being taken to get more providers in the system?
        Answer. The Army is using numerous mechanisms to recruit and retain
    both civilian and uniformed behavioral health (BH) providers including
    bonuses, scholarships, and an expansion in training programs. The U.S.
    Army Medical Command has increased funding for scholarships and bonuses
    to support expansion of our provider inventory and provided centrally
    funded reimbursement of recruiting, relocation, and retention bonuses
    for civilian BH providers to enhance recruitment of potential
    candidates and retention of staff. The Army expanded the use of the
    Active Duty Health Professions Loan Repayment Program and offers a
    $20,000 accessions bonus for Medical and Dental Corps health
    professions scholarship applicants; has allowed recruitment of legal
    non-resident healthcare personnel to fill critical shortages; used a
    one-time Critical Skills Retention Bonus (CSRB) for social workers and
    BH nurses and the Army Medicine CSRB for clinical psychologists; and
    implemented an officer accessions pilot program that allows older
    healthcare providers to enter the Army, serve 2 years, and return to
    their communities.
        Additionally, in partnership with Fayetteville State University,
    MEDCOM developed a Masters of Social Work program which graduated 19 in
    the first class in 2009. The program has a current capacity of 30
    candidates. This program is fully funded by the Army with all graduates
    incurring a 62 month service obligation. To improve the accession of
    Clinical Psychologists, MEDCOM increased the number of Health
    Professions Scholarship Allocations dedicated to Clinical Psychology
    and the number of seats available in the Clinical Psychology Internship
    Program.
        Question. What programs are being undertaken to address the mental
    health needs of spouses and dependent children?
        Answer. The Army has an extensive array of behavioral health (BH)
    services and resources that have long been available to address the
    strain on military Families. These services include but are not limited
    to routine BH care, Chaplains, Military One Source, Comprehensive
    Soldier Fitness, Psychological School Programs and Army Community
    Service (ACS), Family Assistance for Maintaining Excellence (FAME), and
    the Warrior Resiliency Program (WRP). New initiatives include the
    Comprehensive Behavioral Health System of Care Campaign (CBHSOC) and
    our Child and Family programs available through the Child, Adolescent
    and Family Behavioral Health Office (CAF-BHO).
        The CAF-BHO is the lead office within the Army Medical Command
    (MEDCOM) for integrating and coordinating Child and Family BH programs.
    CAF-BHO promotes optimal military readiness and wellness in Army
    Children and Families through the Child and Family Assistance Centers
    (CAFAC), School Behavioral Health (SBH) and Medical Home BH support.
    Plans are being considered to implement CAFACs and SBHs across the Army
    to meet the goals of the Army's CBHSOC Plan.
        CAFACs provide cost-effective, comprehensive, integrated BH system
    of care to support military Children, their Families, and the Army
    Community throughout the Army Force Generation (ARFORGEN) and Family
    Life Cycle. CAFACs focus on coordinating, integrating, and
    synchronizing available BH and related services on an installation, and
    filling identified service gaps. The programs use a Public Health Model
    continuum of care, focusing on prevention and early intervention to
    promote wellness and resilience, and providing a higher level of BH
    care when needed.
        SBH programs provide cost-effective, comprehensive BH services to
    support military children, their families, and the Army community in
    schools. The overarching goal is to facilitate access to care by
    embedding BH within the school setting, and to provide state of the art
    prevention, evaluation, and treatment through standardization of SBH
    services and programs. Services are directed at improving student
    academic achievement, maximizing wellness and resilience of Army
    children and families, and ultimately promoting optimal military
    readiness.
                             alternative treatment
        Question. What efforts are being taken to provide for alternate
    sources of pain management? Has the Army looked at civilian best
    practices? What are their plans for incorporating them?
        Answer. The U.S. Army Medical Command (MEDCOM) Comprehensive Pain
    Management Campaign Plan (CPMCP) is a phased effort that has been
    working to standardize pain care across MEDCOM, establish
    interdisciplinary pain centers in each Regional Medical Command, de-
    emphasizing medication-only treatment of pain, address the challenge of
    poly-pharmacy with improved oversight of those on multiple medications,
    and improve access to non-medication pain treatments--complementary and
    alternative medicine (such as acupuncture, massage therapy, and
    movement therapies such as yoga.
        Expanding the availability of non-medication approaches for pain
    management has been an area of special emphasis and careful execution.
    The Army has continued to reach out to civilian experts who have had
    experience and success in incorporating integrative medicine into their
    medical practices and healthcare systems. Clinical practice and
    research initiatives with Samuelli Institute and Bravewell
    Collaborative are two examples of the MEDCOM's ongoing collaboration
    with civilian experts.
        MEDCOM has also been developing a model for MEDCOM/Veterans
    Affairs/civilian academic medicine pain management consortiums. These
    collaborative efforts have been developed to share clinical expertise,
    best practices, and education/training opportunities across these
    organizations. The first of these consortiums is located in the
    Seattle, Washington area and involves Madigan Army Medical Center,
    Puget Sound Veterans Affairs Hospital, and University of Washington
    Center for Pain Relief.
                              task force treatment
        Question. I am concerned about the increasing amputation rates
    among servicemembers and understand there was a task force recently
    established with experts in trauma, orthopedic surgery, wound patterns
    and analysis and rehabilitation specialists.
         What is the status of this task force?
         What best practices have been identified with treating these
    casualties?
         What do these trends mean for future combat care?
         Is there any applicability to civilian trauma care? Has the Army
    looked at public-private ventures to create more training opportunities
    for state-side medical personnel?
         Have any additional methods been identified to prevent, protect
    and reduce the impact of these injuries?
        Answer. The Dismounted Complex Blast Injury Task Force was
    established in early February 2011 and recently completed an analysis
    of trauma data that addresses many of these concerns. The Task Force
    report is nearly complete and will include recommendations on the best
    clinical practices to care for these soldiers and their families from
    the point of injury and throughout the evacuation, care, and
    rehabilitation continuum. The report will also include recommendations
    for future combat care and protection of our Warriors, and strategies
    for the mitigation of injury severity.
        These injuries represent the extreme of combat injuries, and go far
    beyond the most severe injuries ever encountered in civilian trauma.
    Our surgeons and rehabilitation experts have the most current
    experience in these uncommon injuries. Where we rely upon civilian
    expertise and cooperation is in the area of regenerative medicine
    approaches, skin and muscle reconstruction and associated
    rehabilitation.
                                medical training
        Question. The Army is producing medics with a wealth of experience
    in a variety of medical specialties like trauma care. Has there been
    any effort to align training programs with civilian training
    requirements? If no, then why not?
        Answer. The Army aligns training programs with civilian training
    requirements in areas where civilian requirements match military
    medicine mission. Applying civilian trauma care principles without
    adapting them to the tactical environment is not only frequently
    ineffective but may lead to more casualties. In October 2001, evidence
    based research drove the Army to incorporate the National Registry of
    Emergency Medical Technicians--Basic (EMT-B) as the necessary baseline
    for all students of the U.S. Army Combat Medic course. This program
    emphasizes increased trauma training by incorporating a standardized,
    externally validated civilian curriculum into the Army's program.
    National certification is a Combat Medic (68W) graduation and
    sustainment requirement. The basic skills of the Combat Medic overlap
    with competencies of the EMT-B; however, the Combat Medic has been
    trained to be more uniquely skilled and capable of providing advanced
    combat casualty care. Care in combat is focused not just on injuries
    suffered by the soldier but on the tactical situation surrounding the
    event. The Department of Combat Medic Training holds annual curriculum
    committee meetings to assess training needs, considering civilian
    training requirements, evidence-based research, and lessons learned.
                       acquisition community interaction
        Question. How well does your medical community interact with your
    acquisition community? As different injuries are identified as
    prevalent within your service, what are the procedures to work with the
    acquisition community to acquire equipment, tools, or clothing to limit
    or prevent these injuries?
        Answer. The U.S. Army Medical Department (AMEDD) is fully
    integrated with the Acquisition community under the DOD 5000 process
    which governs and implements policies of the defense acquisition
    system. The U.S. AMEDD Center and School serves as the Combat Developer
    defining requirements and the U.S. Army Medical Research and Materiel
    Command (USAMRMC) serves as the Materiel Developer providing materiel
    solutions. The Commanding General, USAMRMC, serves as the Deputy for
    Medical Systems to the Assistant Secretary of the Army for Acquisition,
    Logistics, and Technology (ASA(ALT)). In this role the Commanding
    General, USAMRMC, is the senior medical officer providing information
    to the ASA(ALT) regarding medical acquisition initiatives and the
    medical implications of non-medical acquisition initiatives.
        There are multiple ways that the needs identified on the
    battlefield are incorporated into the acquisition process to include
    working with the Rapid Equipping Force, the Army Materiel Command's
    Forward Area Support Team--which is deployed in Theater and includes at
    least one medical representative, the Combatant Command Technology
    Assessment and Requirements Analysis, the other services, and the
    operational needs statement process to name a few. In each initiative
    mentioned above, personnel closely affiliated with the acquisition
    community are intimately involved with every step of the process from
    capturing the Warfighter's requirements, through fielding a potential
    solution. Each of these initiatives complements the traditional
    acquisition process and allows the AMEDD to respond to Warfighter
    identified needs in a timely and controlled fashion. The Army utilizes
    the Joint Theater Trauma Registry to analyze the types and trends of
    injuries and the causes to inform the developers on improving
    operational approaches and materiel solutions.
                                     ______

                   Questions Submitted by Senator Tim Johnson
                            electronic health record
        Question. Secretary Gates and Secretary Shinseki recently announced
    that the Department of Defense and the Department of Veterans Affairs
    will develop a joint electronic health record. On April 1, 2011, the
    Department of Veterans Affairs also announced that it will form an open
    architecture community around the VA's electronic health record, VISTA.
    Are these the same thing or will each Department still keep its own
    version of VISTA and AHLTA?
        Answer. Yes, these are the same. Secretary Gates and Secretary
    Shinseki met in March and agreed to a joint electronic health record
    called iEHR (integrated electronic health record) that will replace
    VISTA and AHLTA.
        Question. Do the Departments envision the joint electronic health
    record replacing VISTA and AHLTA?
        Answer. Yes, Secretary Gates and Secretary Shinseki met in March
    and agreed to a joint electronic health record called iEHR (integrated
    electronic health record) that will replace VISTA and AHLTA.
        Question. When will the Departments release details and a
    comprehensive plan forward on the joint electronic health record?
        Answer. The two Departments will meet over the coming months to
    develop a comprehensive implementation plan. Once complete, we envision
    the plan and details will be released by the Departments.
                                     ______

           Questions Submitted to Vice Admiral Adam M. Robinson, Jr.
                Questions Submitted by Chairman Daniel K. Inouye
             sources of help for servicemembers and their families
        Question. Each service has taken a different approach to address
    the psychological health needs of their service members and their
    families. In addition, the Department of Defense and the Tricare
    contractors have also instituted programs to help provide this type of
    care. Rather than streamlining those services, new Web sites and phone
    lines are created. On top of those efforts, the private sector, the
    Department of Veteran's Affairs, and non-profits are all trying to
    address these issues. This is all well intended but more often than not
    it is challenging for servicemembers and family members to guide their
    way through a maze of avenues to seek for sources to help.
        On one Navy pamphlet to combat operational stress there are 16
    different Web sites and phone numbers and on another there eight. Each
    one has very little information associated with them, forcing the
    individual to access each Web site to decipher if that meets their
    needs. One Air Force pamphlet has 13 and on one Army pamphlet there are
    19. People seeking help should not have to go through a maze like this.
        Admiral Robinson, as I mentioned in my opening statement it can be
    quite confusing for a servicemember who is seeking help to deal with
    combat stress or other psychological health needs. On one Navy pamphlet
    provided to me there is a list of 16 different Web sites or phone
    numbers for sources of help. It takes so much to get someone to seek
    the help they need, we don't want to discourage them by making it
    difficult to find the appropriate help. Could you explain how you are
    attempting to consolidate these efforts and make the process less
    confusing for those that need it?
        Answer. The Navy is committed to fostering a culture that promotes
    resilience and wellness, and that empowers leaders to ensure the health
    and readiness of service members and their families. We concur that
    there have been a proliferation of services available to service men
    and women affected by post traumatic stress and traumatic brain injury.
    We must balance the desire to provide service members with options;
    understanding that one size does not fit all, with the possibility of
    creating confusion by providing too many alternatives.
        To address this issue we are working with the Naval Center for
    Combat and Operational Stress Control (NCCOSC) to develop consolidated
    strategic communications for psychological health initiatives across
    the Department of the Navy. Similarly we are working with the Defense
    Center of Excellence to consolidate resources and Web sites supported
    by the Military Health System and Department of Defense.
        Furthermore, across DOD strides are being taken to address
    effecencies within the multiple programs offered to our wounded, ill
    and injured service members. The Department of Defense (DOD) Task Force
    on the Care, Management and Transition of Recovering Wounded Ill and
    Injured Members of the Armed Forces, also known as the Recovering
    Warrior Task Force (RWTF) provides DOD with advice and recommendations
    on matters related to the effectiveness of the policies and programs
    developed and implemented by DOD, and by each of the military services
    in caring for our wounded, ill and injured service members. The goal of
    this task for is to look at best practices and various ways in which
    DOD can more effectively address matters relating to the care,
    management, and transition of these warriors.
                            recruiting and retention
        Question. The Air Force is short surgeons, family practitioners,
    clinical psychologists, and technicians. In addition to compensation,
    the Air Force identifies the lengthy hiring process for both officers
    and civil service health professionals as a top recruiting challenge.
        The Army faces personnel shortages in numerous healthcare
    specialties including: neurosurgeons, nurse anesthetists, behavioral
    health experts, physical therapists, oral surgeons, and others. Some of
    these areas are staffed at less than 50 percent of need. The Army is
    seeking to increase compensation for critical skills to reduce the gap
    between civilian and military pay, as well as leverage its Health
    Professions Scholarship Program.
        Overall, the Navy has somewhat improved recruitment and retention
    of medical officers over the last 3 years. The greatest challenges
    remain in the areas of general surgery, family medicine, oral surgeons,
    general dentists, and psychiatry. The problem is more severe in the
    reserve component.
        Admiral Robinson, some medical specialties are severely
    understaffed, particularly in the reserve component. For example, less
    than one-quarter of critical care medicine and cardiology positions are
    filled. How is the Navy ensuring that it has the number of reserve
    physicians it needs?
        Answer. Direct appointment recruiting of physicians and dentists
    remains a challenge, primarily because these healthcare professionals
    have well-established medical practices and are very well compensated
    in the civilian market. Interrupting their civilian medical careers is
    often personally and financially unattractive to many private medical
    providers. Additionally, retention has improved in the active forces,
    reducing Navy Veterans available for Reserve appointments.
        We are developing incentives within budgetary constraints to target
    specific communities that are, and will remain, critical to our
    mission. A credible recruiting bonus is critical and remains the
    primary incentive to attracting these professionals.
        We have collaborated with Navy Recruiting Command at a recently
    held Medical Stakeholders Conference and have developed a Medical
    Professionals Task Force Charter group in an effort to improve access
    and to collaboratively market targeted specialties to achieve
    recruiting goals. Working closely with Navy Recruiting Command, we have
    also restructured the Training Medical Specialties Drilling option (one
    of the most successful Physician recruiting options) to ensure the
    program is meeting the needs of Navy Medicine as well as attracting
    candidates.
        Despite these Reserve shortages, Navy Medicine continues to meet
    its global commitments in support of all contingency operations.
                               military medicine
        Question. Since fiscal year 2010, the Department of Defense (DOD)
    has requested funds for the advancement of military medicine. Prior to
    that, the majority of these funds were provided to the Department
    through earmarks and nationally competed programs added to the Defense
    budget by Congress. In the fiscal year 2012 budget request the
    Department is requesting $438 million through the Defense Health
    Program and the Defense Advanced Research Projects Agency (DARPA) to
    further these efforts.
        Admiral Robinson, we are currently investing in medical research
    applicable to the needs of our current warfighter but what do we know
    about the issues we might face in the future and how are we attempting
    to stay ahead of that curve?
        Answer. In my testimony, I outlined a strategic vision for Navy
    Medicine that keeps us as a world leader in patient and family centered
    medical care. We manage the spectrum of current needs, while ensuring
    that the urgencies of the present do not diminish the intensity of our
    focus on the future. That focus is a critical element of our RDT&E and
    medical education vision and mission.
        One-third of our research portfolio of over 1,200 individual
    research studies is focused on the delivery of technologies to the
    Warfighter in the near-term through advanced development. Another third
    targets the next 10 to 20 years (technology development), with the
    balance addressing technology innovation for 20 to 50 years out (basic
    research). Where appropriate, this research is executed both at our
    research and development facilities in CONUS and overseas as well as in
    our Medical Treatment Facilities (MTF) by our experienced clinicians
    and our most promising graduate trainees, where appropriate. Navy
    Medicine demonstrates excellence in research in each domain. While our
    research focuses on Navy and Marine Corps requirements, our efforts
    complement and are closely coordinated with our sister services, the
    Defense Health Program, and DARPA.
        We are expanding the envelope of the possible, providing
    technologies, procedures, and practices that promote reintegration of
    our wounded warriors into productive roles in the services and in
    society. We will continue to expand on our progress in the areas of
    rehabilitative and regenerative medicine. The revolutionary advances we
    have made in wound management are a prelude to upcoming developments in
    prosthetics, transplantation, and regeneration.
        We recognize the critical role personalized medicine will play in
    maintaining the capabilities of our Fleet and Marine Forces. With small
    unit, agile forces on the ground and reduced manned ships at sea, the
    importance of each individual is magnified. Our progress in
    individualized medical care, personalized health maintenance and
    promotion, and enhanced individual and unit readiness will play a
    critical role in the future effectiveness of the DOD.
        History tells us that during peace-time and during armed conflict,
    more of our service members are rendered less than fully operational by
    disease than by bullets and bombs. As we evolve our global military
    presence, Navy Medicine is enhancing our capabilities through global
    health initiatives with our international partners and through a global
    presence. We are at the forward edge of battle in combating emerging
    diseases and solving health problems worldwide.
        Every day, the CONUS and OCONUS Navy Medical Research labs and the
    MTF-based Clinical Investigation Programs conduct cutting edge research
    to answer issues, both current and projected to arise. These facilities
    are necessarily lean and our researchers are few in number, but they
    have made significant contributions to the men and women who wear the
    cloth of our Nation and for the world. We will continue to develop
    innovative technologies to save the life and limb and to expand the
    operational envelope of our Navy and Marine Corps Warfighters.
                              psychological health
        Question. There has been a significant expansion of psychological
    healthcare across the military health system. This includes increasing
    the number of specialists in psychiatry, psychology, mental health, and
    social work, to provide more services at a greater number of locations.
    Psychological treatment options are also being integrated into primary
    care to provide more comprehensive and holistic support.
        Early identification and treatment of psychological health issues
    can accelerate healing and improve long-term outcomes. This is
    supported by numerous campaigns to train service members to identify
    warning signs of excessive stress, suicidal tendencies, depression, or
    other mental health concerns. Given the stress of combat operations and
    repeated deployments, the services are striving to place more
    psychological health providers in theater, as well as continued
    screening for symptoms long after service members return.
        Admiral Robinson, the services are seeking to provide early
    identification and treatment of psychological health needs in theater
    by deploying additional psychological health professionals to forward
    operating bases. Since the Marines are sometimes located in remote
    locations with limited access to even basic services, how can the Navy
    ensure this care reaches them?
        Answer. Within the Marine Corps, we continue to see the
    effectiveness of the Operational Stress Control and Readiness (OSCAR)
    program, as well as the OSCAR Extender program. OSCAR embeds full-time
    mental health personnel with deploying Marines and uses existing
    medical and chaplain personnel as OSCAR Extenders together with trained
    senior and junior Marines as mentors to provide support at all levels
    to reduce stigma and break down barriers to seeking help. Embedded
    mental health providers can provide coordinated, comprehensive primary
    and secondary prevention efforts throughout the deployment cycle,
    focusing on resilience training, stress reduction efforts, and when
    necessary, timely access to a known provider with reduced stigma
    associated with mental health intervention. Our priority remains
    ensuring we have the service and support capabilities for prevention
    and early intervention available where and when it is needed. OSCAR is
    allowing us to make progress in this important area.
                         patient centered medical homes
        Question. The fiscal year 2012 budget request supports the phased
    implementation of the Patient Centered Medical Home concept for
    delivering primary care for all three services. This concept,
    originating in the private sector, seeks to improve quality of care and
    the patient experience by integrating primary care into a comprehensive
    service. Patients will have an ongoing relationship with a personal
    physician leading a team of professionals that collectively takes
    responsibility for the individual's or family's healthcare needs.
        The Army is beginning with Community Based Medical Homes, which are
    Army-run clinics located off-post. They function as extensions of the
    Army hospital and are staffed by civil servants. Seventeen are
    currently underway in communities which needed increased access to
    primary care, including one in Hawaii.
        The Air Force was the first service to implement the concept, which
    it termed the Family Health Initiative, beginning in 2008. It will soon
    be expanding the concept across all the clinics service-wide. The Navy
    is also ramping up its program to convert its facilities, started in
    May 2010, called Medical Home Port. Over 200,000 sailors and family
    members are already enrolled.
        Admiral Robinson, as the Navy creates additional Medical Home
    Ports, how will this new reorganization lead to more comprehensive
    service to patients and better continuity of care?
        Answer. Medical Home Port is Navy Medicine's Patient-Centered
    Medical Home (PCMH) model, an important initiative that will
    significantly impact how we provide care to our beneficiaries. In
    alignment with my strategic goal for patient and family centered care,
    Medical Home Port emphasizes team-based, comprehensive care and focuses
    on the relationship between the patient, their provider and the
    healthcare team. The Medical Home Port team is responsible for managing
    all healthcare for empanelled patients, including specialist referrals
    when needed. Patients see familiar faces with every visit, assuring
    continuity of care. Appointments and tests get scheduled promptly and
    care is delivered face-to-face or when appropriate, using secure
    electronic communication.
        It is important to realize that Medical Home Port (MHP) is not
    brick and mortar; but rather a philosophy and commitment as to how you
    deliver the highest quality care. A critical success factor is
    leveraging all our providers, and supporting information technology
    systems, into a cohesive team that will not only provide primary care,
    but integrate specialty care as well. We continue to move forward with
    the phased implementation of Medical Home Port at our medical centers
    and family medicine teaching hospitals, and initial response from our
    patients is very encouraging. To date, there are 68 MHP teams across
    seven Navy Medical Treatment Facilities with over 225,000 beneficiaries
    enrolled.
                                     ______

                  Questions Submitted by Senator Patty Murray
                            medical force structure
        Question. Has the Navy evaluated the capacity of its medical
    community against the current and future structure?
        Answer. Navy Medicine evaluates annually and as needed our current
    and future total force structure in response to changing requirements
    to ensure that the correct mix of medical, dental, medical service,
    nurse and hospital corps professions are available to support our
    Nation's needs. Included in these analyses are our total force of
    active, reserve, civilian and contract professional to meet the
    operational and beneficiary missions.
                         mental health force structure
        Question. Does the Navy have enough mental health providers to meet
    soldier and dependent needs? If there is a gap in mental health
    providers, what efforts are being taken to get more providers in the
    system? What programs are being undertaken to address the mental health
    needs of spouses and dependent children?
        Answer. We are committed to improving the psychological health,
    resiliency and well-being of our Sailors, Marines and their family
    members and ensuring they have access to the programs and services they
    need. We recognize that shortfalls within the market of qualified
    mental health providers has led to challenges in contracting and
    filling provider and support staff positions; however, recruitment and
    retention of uniformed personnel have improved. Current Navy inventory
    for mental health professionals (February 2011) is as follows:
      --Psychiatrist: 73 percent--projected to be at 86 percent end of
            fiscal year 2012.
      --Psychologist: 75 percent--projected to be at 93 percent end of
            fiscal year 2012.
      --Clinical Social Worker: 48 percent--projected to be at 44 percent
            end of fiscal year 2012. This is due to significant billet
            growth, from 35 billets in fiscal year 2010 to 86 billets in
            fiscal year 2012.
      --Mental Health Nurse Practitioner: 57 percent--projected to be 100
            percent end of fiscal year 2012.
      --Mental Health Nurse: 111 percent.
        Mental Health Professional recruiting remains a top priority. Navy
    uses numerous accession and retention bonuses to attract and retain
    mental health professionals. Medical Special and Incentive Pays are
    critical to attracting and retaining Navy medicine professional staff
    inventory.
      --Psychiatrists.--In fiscal year 2011 there is a $272,000 critical
            wartime skills accession bonus available to Psychiatrists
            entering the Navy. In addition, up to $63,000/year is available
            through Incentive Special Pay/Multi-Year Special Pay for
            current Navy psychiatrists who qualify.
      --Psychologists & Clinical Social Workers.--The Accession Health
            Professionals Loan Repayment Program pays out up to $40,000 to
            qualified licensed clinical social workers up to $80,000 to
            clinical psychologists. The Health Professions Scholarship
            Program is available to attract and train clinical
            psychologists by paying for tuition, books, fees and a stipend.
            The Health Services Collegiate Program is available to attract
            and train licensed clinical social workers paying E6 salary and
            benefits while candidates are in training. In addition, a
            clinical psychologist accession bonus pays up to $60,000 for a
            4 year obligation, and clinical psychologist incentive pay is
            $5,000/year. The clinical psychologist retention bonus pays up
            to $80,000 for a 4 year obligation, and the licensed clinical
            social worker accession bonus pays up to $30,000 for a 4 year
            obligation. Board certification pay of $6,000/year for both
            specialties is also available to these mental health
            professionals. A retention bonus for clinical social workers
            has recently been submitted and is pending review and approval.
      --Mental Health Nurse Practitioner & Mental Health Nurse.--In fiscal
            year 2011 there is up to $30,000 available through the Nurse
            Corps accession bonus for nurses entering the Navy. In addition
            up to $20,000/year is available through Registered Nurse
            Incentive Special Pay.
        When our Sailors and Marines deploy, families are their foothold.
    Family readiness is force readiness and the physical, mental,
    emotional, spiritual health and fitness of each individual is critical
    to maintaining an effective fighting force. A vital aspect of caring
    for our service members is also caring for their families. FOCUS is a
    family centered resiliency training program based on evidenced-based
    interventions that enhances understanding, psychological health and
    developmental outcomes for highly stressed children and families. FOCUS
    has been adapted for military families facing multiple deployments,
    combat operational stress, and physical injuries in a family member.
    The program provides community outreach and education, resiliency skill
    building workshops and at the center of the program a 8-week, skill-
    based, trainer-led intervention that addresses difficulties that
    families may have when facing the challenges of multiple deployments
    and parental combat related psychological and physical health problems.
    It has demonstrated that a strength-based approach to building child
    and family resiliency skills is well received by servicemembers and
    their family members. Notably, program participation has resulted in
    statistically significant increases in family and child positive coping
    and significant reductions in parent and child distress over time,
    suggesting longer-term benefits for military family wellness. To date
    over 200,000 Service members, families and community providers have
    received FOCUS services.
        In addition to FOCUS, the Reserve Psychological Health Outreach
    Program (RPHOP) identifies Navy and Marine Corps Reservists and their
    families who may be at risk for stress injuries and provides outreach,
    support and resources to assist with issue resolution and psychological
    resilience. An effective tool at the RPHOP Coordinator's disposal is
    the Returning Warrior Workshop (RWW), a 2-day weekend program designed
    specifically to support the reintegration of returning Reservists and
    their families following mobilization.
        The Naval Special Warfare (NSW) Family Resiliency Enterprise (FRE)
    program was designed toward enhancing the performance and readiness of
    the force by increasing resilience of the service member and his or her
    family--and thus the team, squadron, group and overall NSW community.
    To date, each NSW SEAL Team has conducted seven or more consecutive
    combat deployments resulting in cumulative exposure to wartime events
    and extensive familial separations. The goal has been to build
    resilience by collecting baseline information (seven main areas:
    psychological, neuropsychological, physiological, relationships,
    spirituality, finances, and lifestyle) about service members and their
    spouses/significant others; identifying areas of concern and providing
    training as indicated; and providing forums (overnight retreats) for
    family members to network to build support during deployments, as well
    as celebrate return from deployment and facilitate reintegration. To
    date, about 5,500 participants have attended NSW FRE retreats.
                           medical training programs
        Question. The Navy is producing medics with a wealth of experience
    in a variety of medical specialties like trauma care. Has there been
    any effort to align training programs with civilian training
    requirements? If no, then why not?
        Answer. Yes, our enlisted training programs are aligned and often
    exceed civilian training programs. Similar to civilian medical
    training, military medical training is nationally accredited by the
    American Council on Education and the Council on Occupational
    Education, representing higher education and quality for the U.S.
    Government. The academic programs for enlisted medic training are under
    the auspices of the National License Practical Nursing guidelines for
    our basic hospital course and the National Emergency Medical Technical
    for field training.
        The Navy Credentialing Opportunity Online (COOL) program provides
    expanded opportunities to earn civilian occupational licenses and
    certifications. The program promotes recruiting and retention and
    further enhances the Sailor's ability to make a smooth transition to
    the civilian workforce. The Navy's credentialing program has two key
    components--dissemination of information on civilian licensure and
    certification opportunities and payment of credentialing exam fees.
        Community College of Air Force (CCAF) is a multi-campus community
    college accredited through the Southern Association of Colleges and
    awards course college credits to the enlisted personnel of the Air
    Force (AF) Medical Program. Navy corpsman participating in consolidated
    courses with the Air Force (AF), such as those offered at Medical
    Enlisted Training Campus (METC) in San Antonio, Texas or Sheppard AFB,
    are awarded college credits for training (i. e. emergency medicine,
    biomed tech, surgical tech, radiology, etc.) in both hospital corpsman
    basic and technical medical course work.
        In addition, Navy Medicine is formally affiliated with the LA
    County Trauma Center, California, approved by American College of
    Surgeons and sends medical teams (nurses, physicians and corpsman) to
    train in level 1 trauma care. This training opportunity allows for
    integration of knowledge and skill performances of civilian and
    military working side by side in trauma teams.
                          medical acquisition programs
        Question. How well does your medical community interact with your
    acquisition community? As different injuries are identified as
    prevalent within your service, what are the procedures to work with the
    acquisition community to acquire equipment, tools, or clothing to limit
    or prevent these injuries?
        Answer. Let me share how various aspects of Navy Medicine work
    together to improve medical care for Wounded Warriors.
        In the scenario you describe, surgeons at a forward operating base
    would note a change in the type or severity of injuries being treated.
    The change might be caused by new weapons or tactics employed by the
    enemy. The surgeons at the forward operating base would describe the
    new injuries and define a new medical capability needed to meet the
    threat. In this scenario, this information would go to the Navy
    Medicine Specialty Leader for Surgery. This senior surgeon represents
    the entire surgical community to Navy Medicine at large. There are
    specialty leaders for all aspects of clinical care.
        The Surgical Specialty Leader validates the new capability that is
    needed and determines whether the new capability can be satisfied by
    using a new surgical protocol or through the use of new or additional
    equipment not currently in theater. If the new capability can be
    achieved through the use of new surgical protocols, the Surgical
    Specialty Leader initiates the change in procedure.
        If the Surgical Specialty Leader determines new or additional
    medical equipment is needed, Navy Medicine's clinical engineers will
    write the specifications for the new equipment and our acquisition
    office will purchase it. These three groups--specialty leaders,
    clinical engineers, and acquisition professionals--have established
    procedures to validate, define, and procure medical supplies and
    equipment for our forward deployed providers.
        If the Surgical Specialty Leader determines that the new and needed
    medical capability cannot be satisfied using existing equipment or
    techniques, then the requirement is turned over to the Navy Medicine
    Research Center. These skilled and dedicated researchers work with
    colleagues in academia and industry to put new medical capability into
    the hands of our clinicians.
                                     ______

                   Questions Submitted by Senator Tim Johnson
                           electronic health records
        Question. Secretary Gates and Secretary Shinseki recently announced
    that the Department of Defense and the Department of Veterans Affairs
    will develop a joint electronic health record. On April 1, 2011, the
    Department of Veterans Affairs also announced that it will form an open
    architecture community around the VA's electronic health record, VISTA.
    Are these the same thing or will each Department still keep its own
    version of VISTA and AHLTA?
        Do the Departments envision the joint electronic health record
    (EHR) replacing VISTA and AHLTA?
        When will the Departments release details and a comprehensive plan
    forward on the joint electronic health record?
        Answer. Department of Defense (DOD) is leading the way forward on
    Electronic Health Records (EHR) and Navy Medicine is providing support
    for this mission.
        DOD and Veterans Affairs (VA) will continue to synchronize EHR
    planning activities for a joint approach to EHR modernization. The
    Departments have already identified many synergies and common business
    processes, including common data standards and data center
    consolidation, common clinical applications, and a common user
    interface. The VA has released a request For proposal to evaluate open
    source management options, and DOD is working with the VA to identify
    opportunities to contribute and participate in the open source
    collaboration. As the open source communities mature, DOD and VA will
    continue to analyze open source components that fit the architectural
    construct for use in the future EHR.
        The following excerpt from the April 6, 2011 testimony of Ms. Beth
    McGrath, DOD Deputy Chief Management Officer, before the House Armed
    Services Subcommittee on Emerging Threats and Capabilities additionally
    supports the commitment by both the DOD and VA to develop a joint
    approach to EHR modernization.

        ``In the field of health IT, DOD and the Department of Veterans
    Affairs (VA) have committed to a full and seamless electronic exchange
    and record portability of healthcare information in a secure and
    private format, wherever needed, to ensure the highest quality and
    effective delivery of healthcare services for our military
    servicemembers and Veterans, from their accession into service and
    throughout the rest of their lives. To this end, the Departments are
    collaborating on a common framework and approach to modernize our
    Electronic Health Record (EHR) applications. On March 17, the Secretary
    of Defense and Secretary of Veterans Affairs affirmed we will continue
    to synchronize our EHR planning activities to accommodate the rapid
    evolution of healthcare practices and data sharing needs, and to speed
    fielding of new capabilities. The Departments have already identified
    many synergies and common business processes, including common data
    standards and data center consolidation, common clinical applications
    and a common user interface.''
                          vision center of excellence
        Question. As Chairman of the Military Construction and VA
    Appropriations Subcommittee, I have closely followed the development of
    the Vision Center of Excellence and pressed for better cooperation
    between the Department of Defense and the VA. I have been frustrated
    with the delays in funding, full military staffing, and operational
    support for this important project.
        Admiral Robinson, what are the Navy's budgetary plans for fiscal
    year 2012-fiscal year 2015 for the Vision Center of Excellence? Where
    is the Navy currently at with staffing the Vision Center of Excellence?
    What staffing levels--military, Federal, and contractor support--are
    necessary to be fully operational and when do you anticipate reaching
    that point?
        Answer. The Joint DOD/VA Vision Center of Excellence (VCE) is a
    demonstration of a high level of cooperation between the DOD and VA. It
    continues to advance the coordination of vision care and research
    across both Departments and the VCE's work on the Joint Defense and
    Veterans Eye Injury and Vision Registry is an excellent example of how
    the two Departments can integrate processes. Further, the VCE has an
    integrated staff and is funded by both Departments.
        Oversight and direction of the VCE is accomplished jointly,
    specifically by the VA/DOD Health Executive Council (HEC) and the Joint
    Executive Council (JEC). The VCE is included in the VA/DOD JEC Joint
    Strategic Plan reported to Congress annually.
        The Navy has operational authority for the VCE, and the Assistant
    Secretary of Defense for Health Affairs has funding responsibility. The
    Navy is developing a transition plan for the transfer of funding and
    staffing responsibility from Health Affairs to the Navy.
        My office works closely with Health Affairs to adequately fund the
    VCE. Most of the leadership is in place now and additional key staff
    will be on board in fiscal year 2012. The VCE is funded at $17.9
    million in fiscal year 2012, which will support requisite operations,
    registry development, contractors, and DOD civilians (an increase of 18
    from the current 6 DOD civilian staff). Additionally, there are a total
    of 13 Federal staff members at the VCE, including 5 VA and 2 military.
    Our estimate is 111 staff will be required to achieve full operating
    capability by fiscal year 2017. We will continue to work with the VCE
    the requirements, as well as continue to evaluate all of our
    organizations to support DOD efficiency initiatives.
                 joint veterans eye injury and vision registry
        Question. Admiral Robinson, what is the status of the
    implementation of the Joint Defense Veterans Eye Injury and Vision
    Registry? How soon will this become fully operational? Does the Navy
    have the funding necessary for full implementation?
        Answer. Development of the Defense and Veterans Eye Injury and
    Vision Registry is progressing very well and is 6 months ahead of
    schedule. During the first year of operations of the Vision Registry,
    the Joint Department of Defense (DOD) and Department of Veterans
    Affairs (VA) Vision Center of Excellence (VCE) will validate the
    registry capabilities; collect and enter ocular data of Service Members
    and Veterans with ocular injuries into the registry; and identify
    future registry requirements and capabilities. We expect the Vision
    Registry to be fully operational by first quarter fiscal year 2013.
        The VCE is developing the Vision Registry to be a dynamic tool. As
    the first central repository of DOD and VA clinical ocular related
    data, the Vision Registry will provide the quantitative data necessary
    to perform longitudinal analyses for the development of preventative
    measures and for recognition of best practices for treatment and
    rehabilitation of injuries and disorders of the visual system.
        Personnel and operational costs for the Vision Registry sustainment
    and continued development are included in the proposed VCE fiscal year
    2013-17 POM.
                                     ______

           Questions Submitted to Lieutenant General Charles B. Green
                Questions Submitted by Chairman Daniel K. Inouye
             sources of help for servicemembers and their families
        Question. General Green, what role do you see the private sector
    playing in your efforts to reach out to servicemembers and their
    families to provide access to psychological health services?
        Each Service has taken a different approach to address the
    psychological health needs of their servicemembers and their families.
    In addition, the Department of Defense and the Tricare contractors have
    also instituted programs to help provide this type of care. Rather than
    streamlining those services, new Web sites and phone lines are created.
    On top of those efforts, the private sector, the Department of
    Veteran's Affairs, and non-profits are all trying to address these
    issues. This is all well intended but more often than not it is
    challenging for servicemembers and family members to guide their way
    through a maze of avenues to seek for sources to help.
        On one Navy pamphlet to combat operational stress there are 16
    different Web sites and phone numbers and on another there eight. Each
    one has very little information associated with them, forcing the
    individual to access each Web site to decipher if that meets their
    needs. One Air Force pamphlet has 13 and on one Army pamphlet there are
    19. People seeking help should not have to go through a maze like this.
        Answer. Private sector organizations and individual providers play
    a critical role in the delivery of psychological health services to
    service members and families. TRICARE providers, community resources
    and non-medical counseling options supplement the direct military
    medical care system. They also offer options which may be perceived as
    bearing lower stigma for military families.
        In the Air Force, most formal mental healthcare for family members
    is provided by TRICARE providers or through other community agencies.
    Unfortunately, anecdotal reports from geographically remote bases
    particularly indicate that child and adolescent mental health services
    may be hard to find. There is a nation-wide shortage of qualified
    mental health providers. This situation becomes more problematic in
    remote locations or where there are low numbers of providers accepting
    TRICARE.
        While not providing formal mental healthcare, Military One Source
    counselors available through on-line or toll-free call referral, or
    Military and family life consultants and child and youth behavioral
    consultants working out of base Airman and Family Readiness Centers
    provide confidential, non-medical, short term counseling services to
    address issues common in the military community, with no medical
    documentation.
        Case management and referral management occurs both through private
    and military offices. Medical treatment facilities assist in locating
    specialty care for their enrolled patients and TRICARE regional
    contractors offer this service as well. Additionally, there are
    numerous private and local advocacy groups and offices that aid with
    access to services. The Defense Veterans Brain Injury Center provides
    coordination of care for individuals suffering from a Traumatic Brain
    Injury (TBI).
        Indeed there are many Web sites, agencies and advocacy groups
    providing resources for individuals and families with needs in the area
    of mental health. There are DOD/VA workgroups in place which are
    working to further consolidate and simplify these resources and
    establish one site for patients to seek medical information regarding
    psychological health. The breadth of resources is reflective of the
    wide array of topics being addressed: from type of problem (post
    traumatic stress disorder, depression, suicide, deployment related
    issues, TBI) to demographic or beneficiary issues (Guard/Reserve,
    Active Duty, family/individual, and age). Fortunately, in the military
    medical system, each patient has his/her own primary care physician as
    the first and best advocate to assist in the management of services.
        Because of the importance of the relationship with a primary care
    manager, the Air Force is placing behavioral health providers in
    primary care clinics. Where this is in place, patients see mental
    health providers for targeted, brief care in the primary care clinic
    avoiding the stigma of making a mental health clinic appointment. When
    further care is required the provider can refer the patient to the
    community to see a private sector or TRICARE provider or other
    appropriate resources.
                               military medicine
        Question. General Green, a key element to the improvement of care
    is how fast we are able to transport servicemembers from the point of
    injury to the care they need. Can you detail some of the advancements
    in our aeromedical evacuations and what areas you are researching to
    further these efforts?
        Since fiscal year 2010, the Department of Defense has requested
    funds for the advancement of military medicine. Prior to that, the
    majority of these funds were provided to the Department through
    earmarks and nationally competed programs added to the Defense budget
    by Congress. In the fiscal year 2012 budget request the Department is
    requesting $438 million through the Defense Health Program and the
    Defense Advanced Research Projects Agency to further these efforts.
        Answer. Evolutionary advancements in technology, and improvements
    in clinical interventions enable movement of the most severely injured
    or ill patients. Recent technology advancements introduced by the Air
    Force include: advanced ventilators, video assisted intubation devices,
    improved aircraft configuration equipment for litter patients, improved
    aircraft lighting systems, an extracorporeal membrane oxygenation
    device for adult patients, and improved virtual training for medical
    personnel to name a few.
        Aeromedical evacuation today is done flawlessly but must always be
    focused on continuous improvement to care for ever more complex
    patients. Based on operational outcomes, effects, and well defined
    capability gaps, the major focus areas for enroute care research are:
    patient stabilization; patient preparation for movement; patient
    staging; impacts of in-transit environment on patient physiology and
    medical crew/attendant performance; occupational concerns for medical
    staff; human factors and patient safety; medical personnel training and
    equipment; environmental health issues; infectious disease and cabin
    infection control; burn and pain management; resuscitation; life saving
    interventions; nutrition; alternative medicine; and a wide variety of
    organ system effects (neurologic, psychologic, orthopedic, pulmonary,
    cardiovascular, gastrointestinal, renal, and respiratory). Air Force,
    Army, Navy, public and private academia, and industry partners are
    engaged in research in these focus areas.
                         patient centered medical homes
        Question. General Green, the Air Force continues to transition its
    clinics to the patient centered medical home model. This concept
    organizes health professionals into teams able to provide more
    comprehensive primary care. Each patient's personal physician leads the
    team and serves as a continuous point of contact for care. Has the Air
    Force seen improvements in patient satisfaction or cost control with
    this initiative?
        The fiscal year 2012 budget request supports the phased
    implementation the Patient Centered Medical Home concept for delivering
    primary care for all three services. This concept, originating in the
    private sector, seeks to improve quality of care and the patient
    experience by integrating primary care into a comprehensive service.
    Patients will have an ongoing relationship with a personal physician
    leading a team of professionals that collectively takes responsibility
    for the individual's or family's healthcare needs.
        The Army is beginning with community based medical homes, which are
    Army-run clinics located off-post. They function as extensions of the
    Army hospital and are staffed by civil servants. Seventeen are
    currently underway in communities which needed increased access to
    primary care, including one in Hawaii.
        The Air Force was the first service to implement the concept, which
    it termed the Family Health Initiative, beginning in 2008. It will soon
    be expanding the concept across all the clinics service-wide. The Navy
    is also ramping up its program to convert its facilities, started in
    May 2010, called Medical Home Port. Over 200,000 sailors and family
    members are already enrolled.
        Answer. The Air Force Medical Service has seen improvement in
    patient satisfaction and access at locations that have implemented FHI.
    Early data from the RAND (Research and Development) evaluation of the
    Air Force Medical Home Model (RPN PA06R-R190) study show a 1.3 percent
    increase in patient satisfaction. Additionally, continuity between
    patients and their providers is on the rise changing from an average of
    40 percent of patients seen by their assigned clinical to 60 percent
    following FHI implementation. Continuity with the assigned team is even
    higher averaging greater than 80 percent of the time seeing either the
    physician or the extender on the health team. A secondary effect of
    this improved continuity is decreased demand for acute appointments and
    improved access to care. Patients have shown less need for follow-up
    appointments as their assigned providers are able to provide more
    comprehensive care to patients they know, driving down the total number
    of overall healthcare visits. Provider satisfaction with this model of
    care has also led to a 5 percent reduction in attrition of our family
    physicians.
        We are also monitoring Emergency Department (ED)/Urgent Care Clinic
    utilization to see if the increased continuity can reduce high cost ED
    visits. As continuity increases patients learn that visits to their
    assigned provider, who are familiar with their medical history, offer
    advantages over convenience of acute care clinics. The roll out of
    Relay Health secure patient messaging over the next year will allow
    simpler communication with patients electronically and further enhance
    continuity.
        Disease management and case management programs built into PCMH are
    maturing and health indicators (such as diabetes compliance) are
    improving. The patient linked as partner with a specific healthcare
    team allows our extensive informatics network to provide decision
    support to both patients and the care team. Aggregating patient data
    into the informatics network will allow better care to populations as
    we tie specialty consultants and analytic experts together to improve
    care. It all starts with the partnership between patient and the
    healthcare team in PCMH.
                                     ______

                  Questions Submitted by Senator Patty Murray
        Question. Has the Air Force evaluated the capacity of its medical
    community against the current and future structure?
        Answer. Yes, the Air Force uses current and projected mission
    changes to align resources where most appropriate. Beginning with Base
    Realignment and Closure 2005, and continuing in subsequent program
    objective memorandum (POM), the Air Force Medical Service (AFMS) has
    realigned manpower and medical facility capability based on changing
    mission requirements, including those mission changes associated with
    BRAC decisions or other Department of Defense mission movements or
    beneficiary changes.
        We continue to use staffing models, beneficiary population, and
    projected mission changes from the Air Force and the Office of the
    Secretary of Defense communities to place resources where they can be
    most effective, and where our deploying medics can receive the most
    current, diverse case-mix. Beginning in the fiscal year 2010 POM, and
    continuing today, the AFMS is aligning resources back into our
    inpatient platforms, with plans to increase enrollment by 35,000 and
    increasing inpatient capability at several of our larger Military
    Treatment Facilities. Specifically, the AFMS increased Joint Base
    Elmendorf by 200 personnel to account for force structure changes,
    beneficiary recapture opportunity, and to improve currency. Similar
    initiatives are in progress at Joint Base Langley-Eustis, and Eglin and
    Nellis Air Force Bases in response to mission changes. These efforts
    will result in medical personnel being better prepared for deployment
    to the area of responsibility), and will bring care back into the
    Direct Care System, a critical long-term goal to reduce costs and
    improve efficiency.
        The AFMS reviews current and future healthcare needs and directs
    changes within the assigned force structure (specialties) of each
    Corps. Under direction of the National Defense Authorization Act 2010,
    Section 714, the AFMS is increasing the active duty mental health
    authorizations by 25 percent to better address the needs of our service
    members and their families. These additional authorizations are built
    based both on the identified needs of our beneficiaries as well as our
    projected ability to recruit and retain professionals in these
    specialties. Although all active duty mental health professions will
    increase in the next 5 years, the largest growth will be in social
    workers, who we have had recent success in recruiting. We will also
    increase both psychiatrists and psychiatric nurse practitioners to
    increase our ability to provide psychiatric medication management
    services. We recently reviewed our current force structure to realign
    mental health resources and support the needs of our beneficiary
    population while maintaining manning levels within the current Air
    Force manpower constraints. Additionally, the AFMS is adding more
    contract mental health professionals as a gap-fill measure until the
    added active duty manpower needs are filled. This increase in mental
    health manning does not increase the overall manning numbers of the
    AFMS, but realigns the mix of specialty resources of our current
    medical program to more effectively recapture costs and provide
    expanded mental health services of these essential programs.
        Question. Does the Air Force have enough mental health providers to
    meet soldier and dependent needs?
        Answer. Through the TRICARE network and community organizations,
    the Air Force Medical Service (AFMS) has the mental health staffing to
    meet the treatment needs for Airmen and family members. The
    availability of resources varies depending on geographical region and
    catchment area but it is adequate to provide for mental health needs in
    a manner equal to other types of insurance.
        Question. If there is a gap in mental health providers, what
    efforts are being taken to get more providers in the system?
        Answer. There is a nationwide shortage of mental health providers
    which the AFMS confronts in a three-pronged approach addressing: (a)
    educational programs and scholarships, (b) direct compensation, and (c)
    quality of life (QOL) initiatives.
        (a) Due to historical difficulties recruiting fully qualified
    specialists, the AFMS places emphasis and funding into educational
    scholarships.
        (b) We use accession bonuses to recruit fully qualified specialists
    into the Air Force and retain them through the use of retention
    bonuses.
        (c) The AFMS addresses QOL initiatives such as family services,
    medical practice, educational or leadership opportunities, or frequency
    of moves and deployments to recruit and retain our health
    professionals.
        Question. What programs are being undertaken to address the mental
    health needs of spouses and dependent children?
        Answer. A variety of programs provide support for the mental health
    needs of spouses and dependent children. Each installation has a Family
    Advocacy Program (FAP) that provides outreach and prevention services
    to families. One novel FAP approach is the New Parent Support Program
    (NPSP), which provides support and guidance in the home to parents
    screened as high risk for family maltreatment. Educational and
    Development Intervention Services (EDIS) are provided by a child
    psychologist for special education children in DOD schools. Other
    programs provide education on common family issues like good parenting,
    couples communication, or redeployment integration. Counseling for
    families is also available. Military One Source is a DOD program using
    a civilian network that provides face-to-face, telephonic, or online
    counseling/consultation to service members and families for up to
    twelve sessions. Also providing nonmedical counseling, Airman and
    Family Readiness Centers have Military and family life consultants and
    child and youth behavioral consultants. These provide confidential,
    non-medical, short term counseling services to address issues common in
    military families such as deployment stresses and relocation. Other
    nonmedical counseling alternatives for family members not able to be
    seen at military medical treatment facilities have access to services
    through community TRICARE providers. These providers offer an array of
    services from individual counseling and group therapy, to inpatient
    behavioral healthcare.
        Question. The Air Force is producing medics with a wealth of
    experience in a variety of medical specialties like trauma care. Has
    there been any effort to align training programs with civilian training
    requirements? If no, then why not?
        Answer. We have established multiple training affiliations with our
    civilian counterparts in numerous settings aimed at providing mutual
    exchange of education. The purpose is not to align our training
    programs with civilian requirements, but to optimize the respective
    programs for both military and civilian students for the best outcomes.
    We have military instructors embedded in civilian institutions where we
    have military students for both GME (Graduate Medical Education) and
    sustainment training. In turn, several civilian schools use our medical
    facilities for student training with experiences unique to the
    military.
        Many of our surgical trauma experts are now in faculty positions in
    different private sector university hospitals. Our Centers for
    Sustainment of Trauma and Resuscitation Skills share expertise at
    University of Maryland, University of Cincinnati and St Louis
    University. Our Sustainment of Trauma and Resuscitation Skills Programs
    also share expertise with Tampa General Hospital, University of
    California--Davis, Scottsdale Medical Center, Miami Valley Medical
    Center, and University of Texas-San Antonio. We also have surgeons
    working closely with the Veterans Administration Hospitals, University
    of Alabama-Birmingham and University of Pittsburgh Medical Centers.
        Three of the four Centers of Excellence for the Nursing Transition
    Program are civilian medical centers, two having achieved Magnate
    status. These institutions provide a rich environment for our new nurse
    graduates as they transition from new nurse graduate to military nurse.
    Our military instructors and students provide our civilian colleagues
    with unique training opportunities as experiences with the phenomenal
    care we give our wounded warriors, establishing a collaborative process
    of information sharing for optimal patient outcomes.
        Question. How well does your medical community interact with your
    acquisition community? As different injuries are identified as
    prevalent within your service, what are the procedures to work with the
    acquisition community to acquire equipment, tools, or clothing to limit
    or prevent these injuries?
        Answer. The medical community and acquisitions community work
    closely together. Human Systems Integration has been a focus of the Air
    Force Medical Service and the Vice Chief of Staff of the Air Force for
    over 7 years to ensure new high cost military equipment addresses the
    needs of the human that will operate it. There are continuous efforts
    with Air Force logistics and the Army to mitigate the impact of combat
    injuries by evaluating protective equipment and improving it. Once
    protective equipment is identified as needed, our Air Force Medical
    Service Medical Logistics Division at Fort Detrick, Maryland, works
    with the acquisition community to contract for needed medical supplies,
    equipment and services based on clinically identified requirements and
    specific items are obtained as needed.
                                     ______

                   Question Submitted by Senator Tim Johnson
        Question. Secretary Gates and Secretary Shinseki recently announced
    that the Department of Defense and the Department of Veterans Affairs
    will develop a joint electronic health record. On April 1, 2011, the
    Department of Veterans Affairs also announced that it will form an open
    architecture community around the VA's electronic health record, VISTA.
    Are these the same thing or will each Department still keep its own
    version of VISTA and AHLTA?
        Do the Departments envision the joint electronic health record
    replacing VISTA and AHLTA?
        When will the Departments release details and a comprehensive plan
    forward on the joint electronic health record?
        Answer. The Department of Veterans Affairs and the Department of
    Defense are collaborating on the Integrated Electronic Health Record
    (iEHR) program which will operate in the future as a common EHR. Given
    the iEHR is a complex, multi-year development program, a DOD-VA
    Integrated Program Office is being created to coordinate the
    development and deployment of the iEHR and then the sun-setting of
    VISTA and AHLTA. During the initial planning, the Departments have
    identified common business processes and practices, including common
    data standards, data center consolidation, common clinical
    applications, and a common user interface. Coordinating the efforts
    between the Departments sets the course toward a seamless electronic
    health record exchange and portability of health information in a
    secure and private format.
        The EHR Senior Working Group and various subgroups are currently
    assembling the information needed to put together a comprehensive plan.
    The plan is considering the budget, architecture, security, policies,
    and business processes. A high level project plan is being constructed
    that includes cost models, proposed timelines, and joint assumptions.
    The Secretary of Defense and the Secretary of the Veterans Affairs are
    scheduled to receive a status brief on cost, schedule and performance
    on May 2, 2011.
                                     ______

            Questions Submitted to Rear Admiral Elizabeth S. Niemyer
                Questions Submitted by Chairman Daniel K. Inouye
                     pediatric injuries on the battlefield
        Question. Since 2002, DOD hospitals in Iraq and Afghanistan have
    treated over 2,000 injured children with over 1,000 of these children
    having suffered from blast injuries. Children have unique physiological
    responses to illness and injury. Therefore, the treatment of children
    demands specific training, equipment and approaches that are different
    than those required for adults. Children injured in war zones are
    sometimes treated as ``little adults'', and the healthcare
    professionals do not have the experience or training necessary to
    appropriately care for pediatric trauma injuries.
        Admiral Niemyer, our military medical personnel in theater are
    treating a wide array of civilian cases in addition to caring for our
    servicemembers. As a result, they are seeing numerous pediatric
    injuries similar to injuries sustained by adults. Has the Navy
    implemented any pre-deployment training for nurses to address the
    unique needs of pediatric casualties of war?
        Answer. In 2002, the Navy established the Navy Trauma Training
    Center (NTTC), a joint cooperative medical venture with the Los Angeles
    County-University of Southern California Medical Center, to train our
    nurses, doctors, and corpsmen in real world trauma medicine skills and
    experiences. Staff teaching this course solicit feedback from students
    who have completed the course and deployed. Over time our personnel
    noted a change in the demographic population of those injured in
    Afghanistan to include children. This feedback was used to begin
    incorporating a more robust training module highlighting the
    physiologic differences and responses to pediatric trauma, injury
    patterns, and pediatric specific treatments. Furthermore, because of
    this feedback clinical rotations in the Pediatric Intensive Care Unit
    and Pediatric Trauma Emergency Department have increased. Approximately
    75 percent of NTTC students deploy with Marine units.
        One of our pediatricians, Captain Jon Woods, was involved with
    extensive pediatric trauma in Afghanistan. He identified the
    requirement for qualified nurses trained specifically in military
    transport of pediatric patients. Staff at Naval Medical Center San
    Diego took this information and are in the process of creating a
    certified training program using their extensive simulation resources.
    The plan is to create a simulated space equivalent to that found inside
    a Blackhawk transport helicopter, where students in full battle gear
    will have pediatric trauma simulation experiences in which care is
    affected by significant limitations in visibility, communication, and
    movement.
                           recruitment and retention
        Question. Despite well known shortages in the nursing profession,
    the three services have continued to do well in recruiting nurses into
    the military. Last year, the Air Force testified that one of the
    challenges the nurse corps faced was the development of new flight
    nurses and technicians in the pipeline to meet the needs of the ever
    growing aeromedical evacuation mission. Flight nurses remain the lowest
    manned specialty in the nurse corps (78 percent), and have one of the
    highest demands. For the fifth consecutive year the Navy has achieved
    their active component nursing goal (92 percent manning) and they have
    2,852 nurses currently serving around the world. In fiscal year 2010,
    the Army was able to recruit 642 nurses, meeting 105 percent of its
    active duty need and 94 percent for the reserve.
        Admiral Niemyer, how are deployments affecting the Navy nurse
    corps' ability to retain experienced nurses, particularly those working
    in high demand, low occupancy nursing career fields?
        Answer. With the ongoing war efforts, we are keenly aware of the
    need to grow and retain nurses in our critical war-time subspecialties.
    Though loss rates have improved overall, there remains a gap in the
    inventory to authorized billets for junior nurses with 5 to 10 years of
    commissioned service.
        Key efforts which have positively impacted retention include
    Registered Nurse Incentive Special Pay (RN-ISP), which targets bonuses
    to undermanned clinical nursing specialties, and the Health
    Professional Loan Repayment Program (HPLRP), which offers educational
    loan repayment up to $40,000. Full-time Duty Under Instruction (DUINS)
    further supports Navy recruitment and retention objectives by
    encouraging higher levels of professional knowledge and technical
    competence through graduate education. Training requirements are
    selected based on Navy nursing needs for advanced skills in war-time
    critical subspecialties. Seventy-six applicants were selected for DUINS
    through the fiscal year 2011 board.
        Tracking specific reasons for losses is complex, but currently the
    Center for Naval Analysis is completing a follow-up study where intent
    to leave is one of the outcome variables. As the economy improves and
    civilian nursing opportunities expand through the Affordable Care Act,
    we might once again be faced with recruiting and retention challenges.
    In anticipation of these challenges, we are inviting nursing students
    and new graduate nurses to participate as American Red Cross volunteers
    at our hospitals and clinics to enhance exposure to the military.
    Additionally, we assigned a Nurse Corps Fellow to my staff to monitor
    recruitment and retention, and to ensure that both remain a priority.
                                nursing research
        Question. Scientific inquiry, planned and conducted by nurses, is a
    vital part of improving the health and healthcare of Americans. Nursing
    research has been a long time catalyst for many of the positive changes
    that we have seen in patient care over the years. The National
    Institute of Nursing Research defines nursing research as the
    development of knowledge to build a scientific foundation for clinical
    nursing practice, prevent disease and disability, manage and eliminate
    symptoms caused by illness, and enhance end-of-life and palliative
    care. The TriService Nursing Research Program (TSNRP) is one such venue
    to help ensure nursing care remains evidence based.
        Admiral Niemyer, nurses have a long history of promoting quality
    healthcare that is not only focused on the needs of the patient but
    also on the needs of their families. Nursing research has played a big
    part in how we take care of patients today. How are you ensuring that
    Navy nurses at all levels in the organization understand the research
    process and are given opportunities to participate in nursing research
    efforts?
        Answer. The Navy Nurse Corps has aligned nursing research
    priorities with military relevant Surgeon General's priorities and has
    embraced evidence based practice. ``Invigorating Nursing Research'' is
    a priority and one of the five Navy Nurse Corps' Strategic Goals for
    2011. It is aligned with the Navy Medicine Goal of Research and
    Development and Clinical Investigation programs. Also an active
    participant in the Tri-Service Nursing Research Program (TSNRP), the
    Navy Nurse Corps' aim is to continually increase the interest,
    submission, and subsequent selection of military relevant funded
    research projects to improve the health of our patients and/or add to
    the body of nursing knowledge.
        Our Nursing Research assets are aligned regionally and are aimed at
    providing guidance, communication, and mentoring to nurses at all
    levels of the organization. These assets actively advertise and provide
    TSNRP and other educational research and evidence based practice course
    offerings through presentations, site visit training, postings on the
    Navy Knowledge Online Navy Nurse Corps Web site, and enterprise-wide
    emails. Due to the efforts of the Strategic Goal Team and the synergy
    of the research assets in the region (both active component and reserve
    component), an overwhelming successful number of nurses have applied to
    participate in the TSNRP Research Development Course offered in San
    Diego in May 2011. Twenty-one Navy Nurses were selected to fill 25 Tri-
    Service seats.
                                     ______

                  Questions Submitted to Kimberly Siniscalchi
                Questions Submitted by Chairman Daniel K. Inouye
                           recruitment and retention
        Question. General Siniscalchi, last year you testified that one of
    the challenges the nurse corps faced was the development of new flight
    nurses and technicians in the pipeline to meet the needs of the ever
    growing aeromedical evacuation mission. Would you please provide us
    with an update on the status of those initiatives to increase this
    career field?
        Despite well known shortages in the nursing profession, the three
    services have continued to do well in recruiting nurses into the
    military.
        Last year, the Air Force testified that one of the challenges the
    nurse corps faced was the development of new flight nurses and
    technicians in the pipeline to meet the needs of the ever growing
    aeromedical evacuation mission. Flight nurses remain the lowest manned
    specialty in the nurse corps (78 percent), and have one of the highest
    demands.
        For the fifth consecutive year the Navy has achieved their active
    component nursing goal (92 percent manning) and they have 2,852 nurses
    currently serving around the world.
        In fiscal year 2010, the Army was able to recruit 642 nurses,
    meeting 105 percent of its active duty need and 94 percent for the
    reserve.
        Answer. Despite this critically manned, high demand specialty,
    Aeromedical Evacuation (AE) nurses and technicians continue to perform
    superbly with a 100 percent mission success. In fiscal year 2010, AE
    authorizations increased and as a result, the percentage of staffed
    versus authorized dropped significantly. At the same time, we relocated
    the Air Force School of Aerospace Science from Brooks City-Base, San
    Antonio to Wright-Patterson AFB, Ohio, which temporarily affected our
    training pipeline.
        Several initiatives are now underway to fill AE requirements. To
    improve retention, flight nurses are now offered Incentive Special Pay
    (ISP). The ISP program is making a positive impact on professional
    satisfaction and retention. To maximize our training investment in both
    AE nurses and technicians, the Air Force Personnel Center initiated
    several changes to allow nurses and technicians to complete a full 3-
    year tour with the option to extend. An AE force development model was
    developed to allow nurses and technicians to weave in and out of flying
    assignments throughout their career. Developmental leadership positions
    were also established so nurses and technicians can return to AE and
    provide the much needed leadership and clinical mentorship for our
    junior AE nurses and technicians. Previous flyers are being asked to
    volunteer to return to flying assignments and many are eager to have
    the opportunity to return to flying. We project filling 100 percent of
    our allocated training seats this year.
        In addition, we are currently working on AE training
    transformation. We scheduled a utilization and training workgroup in
    fiscal year 2011 to streamline training by leveraging distance learning
    and creating modular training. The new format will increase the volume
    of Phase I students and decrease training time needed for Phase II
    students with a flying assignment pending. Our partnership with Wright
    State University in Dayton, Ohio is progressing well as we continue to
    refine the new graduate program in Flight Nursing. This new program
    offers didactic and clinical training in flight nursing, disaster
    preparedness/homeland defense, and adult health clinical nurse
    specialist. Our first student graduates in May 2012.
                                nursing research
        Question. General Siniscalchi, how are you fostering nurse
    researchers in the Air Force?
        Scientific inquiry, planned and conducted by nurses, is a vital
    part of improving the health and healthcare of Americans. Nursing
    research has been a long time catalyst for many of the positive changes
    that we have seen in patient care over the years. The National
    Institute of Nursing Research defines nursing research as the
    development of knowledge to build a scientific foundation for clinical
    nursing practice, prevent disease and disability, manage and eliminate
    symptoms caused by illness, and enhance end-of-life and palliative
    care. The TriService Nursing Research Program (TSNRP) is one such venue
    to help ensure nursing care remains evidence based.
        Answer. In addition to our Master Clinician's and Master Research
    career paths, we recently developed a nursing research fellowship and
    the first nurse started in August 2010. This 1 year, pre-doctoral
    research fellowship, focuses on clinical and operational sustainment
    platforms. The intent of this program is for the fellow to develop a
    foundation in nursing research and ultimately pursue a Ph.D. Following
    the fellowship, they will be assigned to work in Plans and Programs
    within the Human Performance Wing of the Air Force Research Laboratory.
    This direction is consistent with the National Research Council of the
    National Academies recommendations for research career paths.
        Under Air Force Colonel Marla De Jong's leadership, and for the
    first time in its history, TSNRP offered research grant awards to
    nurses at all stages of their careers--from novice nurse clinician to
    expert nurse scientist. The Military Clinician-Initiated Research Award
    is targeted to nurse clinicians who are well-positioned to identify
    clinically important research questions and conduct research to answer
    these questions under the guidance of a mentor. The Graduate Evidence-
    Based Practice Award is intended for Doctor of Nursing Practice
    students who will implement the principles of evidence-based practice
    and translate research evidence into clinical practice, policy, and/or
    military doctrine. It is critical that funded researchers disseminate
    the results of their studies so that leaders, educators, and clinicians
    can apply findings to practice, policy, education, and military
    doctrine as appropriate. This grant will enhance this dissemination and
    uptake of evidence.
        Further opportunities to maximize the potential of our Airman and
    grow the next generation of noncommissioned officers are available
    through the Air Force Institute of Technology for certain key enlisted
    specialties. To date, we have three such positions identified; one in
    education and training at the Air Force Medical Operations Agency,
    another within our Modeling and Simulation program at Air Education and
    Training Command, and the third within the research cell at Wilford
    Hall Medical Center. Our most recent addition to the research cell is
    Senior Master Sergeant Robert Corrigan, who just arrived to Wilford
    Hall Medical Center.
                                 nursing issues
        Question. General Siniscalchi, the acuity of patients, level of
    experience of nursing staff, layout of the unit, and level of ancillary
    support are all key components in establishing the ``right'' nurse-
    patient ratio for any unit. This year I reintroduced The Registered
    Nurse Safe Staffing Act which addresses those concerns. How does the
    Air Force ensure adequate nurse staffing levels on inpatient units?
        A new study published in the New England Journal of Medicine shows
    that inadequate staffing is tied to higher patient mortality rates
    which supports the principles that call for nurse staffing to be
    flexible and continually adjusted based on patients' needs and other
    factors.
        Answer. A workload data review is conducted on a facility's patient
    census and acuity to establish a workload average over a 4 year period.
    From this data review, staffing levels are set at 15 to 20 percent
    greater than the average census to cover the anticipated patient load.
    Through the Tri-Service Patient Acuity and Staff Scheduling System
    Working Group, a model is being developed to staff according to patient
    need, nurse experience, and acuity versus a fixed nurse to patient
    ratio. Currently, there is no national standard for nurse staffing,
    however, the American Nurses Association provides a compilation of
    State regulated requirements which are taken into consideration for the
    current Air Force manpower model.
        In step with our manpower and staffing initiatives, our Air Force
    Medical Operations Agency in conjunction with the Department of Defense
    (DOD), implemented the Patient Safety Reporting (PSR) System in Air
    Force Military Treatment Facilities worldwide. The PSR provides staff
    with a simple process for reporting patient safety events using DOD
    standard taxonomies, which enhance consistency and timely event
    reviews. The PSR event data will be analyzed for trends and assist in
    identifying targets for process improvement, both at Air Force and DOD
    levels.
        Question. General Siniscalchi, how many nursing positions does the
    Air Force have for senior nurses to remain in direct patient care?
        Answer. We have developed a career track for Master Clinicians and
    Master Research positions through the rank of Colonel. This career
    track will allow our expert clinicians and researchers to stay within
    their realm of expertise without sacrificing promotion opportunity.
        Master Clinicians are board certified nursing experts with a
    minimum preparation of a master's degree and at least 10 years of
    clinical experience in their professional specialty. They serve as the
    functional expert and mentor to junior nurses. Our Master Researchers
    are Ph.D. prepared and have demonstrated sustained excellence in the
    research arena.
        Both of these highly respected positions are critical in the
    advancement of nursing practice and to the mentoring of our novice
    nurses. Currently we have 19 Master Clinician and 3 Master Researcher
    positions established at designated areas. In addition to our Master
    Clinicians, 3,073 of our 3,355 nurses or 92 percent of our nurses are
    in direct patient care positions.
        Question. General Siniscalchi, how many nursing positions does the
    Air Force have for senior nurses to remain in direct patient care?
        A new study published in the New England Journal of Medicine shows
    that inadequate staffing is tied to higher patient mortality rates
    which supports the principles that call for nurse staffing to be
    flexible and continually adjusted based on patients' needs and other
    factors.
        Answer. We have developed a career track for Master Clinicians and
    Master Research positions through the rank of colonel. This career
    track will allow our expert clinicians and researchers to stay within
    their realm of expertise without sacrificing promotion opportunity.
        Master Clinicians are board certified nursing experts with a
    minimum preparation of a master's degree and at least 10 years of
    clinical experience in their professional specialty. They serve as the
    functional expert and mentor to junior nurses. Our Master Researchers
    are Ph.D. prepared and have demonstrated sustained excellence in the
    research arena.
        Both of these highly respected positions are critical in the
    advancement of nursing practice and to the mentoring of our novice
    nurses. Currently we have 19 Master Clinician and 3 Master Researcher
    positions established at designated areas. In addition to our Master
    Clinicians, 3,073 of our 3,355 nurses or 92 percent of our nurses are
    in direct patient care positions.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The subcommittee will reconvene on
    Wednesday, April 13 at 10:30 for a classified briefing with the
    Commander of the United States Pacific Command. Until then, we
    stand in recess.
        [Whereupon, at 12:34 p.m., Wednesday, April 6, the
    subcommittee was recessed, to reconvene subject to the call of
    the Chair.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                            WEDNESDAY, MAY 11, 2011

                                           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, Murray, Cochran, Graham,
    and Coats.

                             DEPARTMENT OF DEFENSE

                                 National Guard

    STATEMENT OF GENERAL CRAIG R. McKINLEY, CHIEF, NATIONAL
                GUARD BUREAU

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. Before proceeding with the hearing, I
    would like to make an announcement of some good news.
        Last evening, the National Lupus Foundation presented their
    highest award to the senior Senator from Mississippi, Senator
    Thad Cochran, the vice chair of this committee. It was an award
    for his tireless leadership in providing funds for biomedical
    research to find a cure for lupus.
        And at the same time, the Food and Drug Administration
    announced the approval of the first drug that can be used for
    the cure of lupus. So I would like to publicly congratulate my
    colleague.
        Senator Cochran. Mr. Chairman, thank you very much for
    those very generous comments. But without your leadership, I
    don't think it would have been possible for us to get the
    funding that is necessary to do what is being done in the
    research and treatment field of this very troubling, dangerous
    disease.
        So thank you for your continued support for all of those
    efforts.
        Chairman Inouye. This morning, the subcommittee meets to
    receive testimony on the fiscal year 2012 budget of the
    National Guard and Reserve components.
        From the National Guard, we are pleased to have the Chief
    of the National Guard Bureau, General Craig McKinley; and the
    Director the Army National Guard, General Raymond Carpenter;
    and the Director of the Air National Guard, General Harry
    Wyatt.
        And from the Reserve, we will welcome the Chief of the Army
    Reserve, General Jack Stultz; the Chief of the Naval Reserve,
    Admiral Dirk Debbink; the Acting Commander, Marine Forces
    Reserve, General Darrell Moore, who is appearing before this
    subcommittee for the first time; and the Chief of the Air Force
    Reserve, General Charles Stenner.
        And I thank all of you for joining us this morning as the
    subcommittee reviews the fiscal year 2012 budget for the
    Reserve components.
        Over the last several years, the Guard and Reserve have
    made important changes as they transition from a strategic to
    an operational reserve. This shift requires them to have
    deployment-ready units available at all times.
        The Department has improved this resourcing with the Guard
    and Reserve, and the services have made significant strides in
    integrating the Reserve components in an effort to create one
    total force. The subcommittee is interested in hearing your
    views on how best to utilize this new operational reserve as we
    draw down our military involvement in Iraq and Afghanistan.
        The Guard and Reserve have also recovered from the
    recruiting and retention difficulty they confronted over the
    last several years. Although retaining personnel in certain
    high-demand career fields remains a challenge, the significant
    personnel shortages seen a few years ago have been eliminated,
    and the Reserve components now have the opportunity to focus on
    refining their personnel mix to get the right person in the
    right position.
        However, many challenges remain. The Guard and Reserves
    must continue to improve reintegration and family support
    programs. Reservists and their families lack the support
    network provided at active duty installations. So it is
    essential that we do everything we can to support Reserve
    families during deployment and as reservists transition back to
    civilian life.
        The Yellow Ribbon program is a step in the right direction,
    but I encourage you to continue improving the program to better
    fit the needs of service members. So I look forward to hearing
    today what each component is doing to improve support to our
    reservists and their families.
        The Guard and Reserves still face significant equipment
    shortfalls. For this reason, last year Congress provided $850
    million for the National Guard and Reserve equipment account to
    allow the Reserve components to purchase additional equipment
    they need for pre-deployment training and operation at home and
    abroad.
        Congress has provided additional equipment funding for the
    Guard and Reserve in each of the last 31 years because, year
    after year, the President's budget fails to sufficiently fund
    the Reserve components. Some critics decry the additional funds
    by this subcommittee as unnecessary earmarks. But I am certain
    that the witnesses here today agree that without this
    additional funding, our Reserve components would be woefully
    underequipped.
        We owe it to the men and women of the Guard and Reserve who
    are called on, just like their active duty counterparts, to
    deploy in harm's way to make certain they are adequately
    trained and equipped.
        As citizen warriors, members of the Guard and Reserve rely
    heavily on the support of their civilian employers. The
    commitment, dependability, and discipline that they learn and
    exhibit in their military capacity are all valuable skills that
    they can contribute to the civilian workforce. We must continue
    to promote this concept to ensure that we maintain the support
    of the business community in hiring and supporting reservists.
        So I look forward to hearing your perspective on these
    issues and working with you this year in support of our
    guardsmen and reservists. And I thank all of you for your
    testimony this morning. And may I assure you that your full
    statements will be included in the record.
        And we will begin this hearing with the panel from the
    National Guard, but first, I would like to turn to the vice
    chairman, Senator Cochran, for his remarks.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, I am pleased to join you in
    welcoming the leaders of the National Guard and Reserve
    components to today's hearing.
        I have a prepared statement, which I will ask unanimous
    consent be printed at this point in the record.
        Chairman Inouye. Without objection.
        [The statement follows:]

                   Prepared Statement of Senator Thad Cochran

        Mr. Chairman, I am pleased to join you in welcoming the
    leaders of the National Guard and Reserve Components to today's
    hearing.
        The Guard and Reserve components are an essential element
    to the success of our military forces. They contribute at home
    as citizens and serve our Nation in uniform to help protect our
    freedom and liberty. They must always be ready, trained and
    equipped to help defend our homeland, and be ready to deploy
    overseas in support of our national security interests. Our
    successes overseas and in response to natural disasters would
    not be possible without these dedicated men and women.
        We appreciate the efforts and unselfish service of those
    who are keeping this Reserve force ready to protect our
    national security interests.

        Chairman Inouye. And now may I call upon General McKinley.
        General McKinley. Chairman Inouye, Vice Chairman Cochran,
    Senator Coats, Senator Murray, thank you very much for the
    opportunity to be here today.
        I am obviously joined by my colleagues in the National
    Guard, Bud Wyatt, former Adjutant General of Oklahoma; Ray
    Carpenter, South Dakota guardsman. I have also got Randy Manner
    in the room with me, who is our Director of our Joint Staff, a
    significant new contribution that the National Guard has made
    to homeland security.
        Today, we have about 460,000 members of the Army and the
    Air National Guard on duty, serving here at home and abroad.
    Our strength, as you said, Mr. Chairman, is good, and our
    retention is even better. As the United States Armed Forces
    continue to conduct operations in Iraq, Afghanistan, and
    elsewhere around the world, the National Guard participates as
    a full partner with our United States Army and our United
    States Air Force.
        As a member of the total force, the National Guard has
    successfully transformed into an operational force. This
    transformation would not be possible without the significant
    investments this subcommittee has made in the National Guard
    and Reserve, and we thank you all very much for that support.
        We must continue to be utilized as a part of the
    operational force, so that this significant investment is not
    squandered. We are in the midst of a transition, bordering on
    transformation, and must maintain readiness and continue to be
    part of the national security framework.
        I would say that during the past 10 years, the Department
    of Defense has initiated a series of fundamental changes in
    both culture and operational capability in order to better
    protect the United States homeland from catastrophic events,
    natural and man-made.
        The citizen soldiers and airmen of the National Guard are a
    great value for America, as are our colleagues in the Reserve.
    The citizen soldiers who work side-by-side with our active duty
    do bring that unique blend of civilian skills, Senator,
    enabling them to conduct smart power missions with exceptional
    effectiveness.
        We have demonstrated that unique capability through a
    number of National Guard specific missions, including our
    support to the combatant commanders around the world through
    the State Partnership Program, which I know you all are very
    familiar with; the agribusiness development teams in
    Afghanistan; and as a critical partner in the Department of
    Defense CBRNE Enterprise.
        None of these missions would succeed without the dedication
    of our National Guard men and women. Today's men and women
    volunteer to join or stay in the National Guard fully expecting
    to be deployed. This shift in expectation is a central aspect
    of the National Guard shift from strategic reserve to
    operational force.
        Overall, we can say that the budget request for fiscal year
    2012 meets the critical needs of the Army and the Air National
    Guard. In this era of persistent conflict overseas and dealing
    with the ongoing threats to American lives and property here in
    the homeland, of particular importance to us is continued
    funding to sustain the National Guard as an operational force.
        As the fiscal year 2012 budget was developed, we worked
    closely with the Office of the Secretary of Defense to ensure
    adequate funding for the entire CBRNE Enterprise, including
    standing up the remaining eight new Homeland Response Forces. I
    am especially proud of Ohio and Washington State, who have
    taken on this very daunting challenge to be the first two
    States to stand up our Homeland Response Force units.
        The transformation to an operational force has increased
    stress on families, as you stated, Chairman. And that is why it
    is critical that family programs within the fiscal year 2012
    request are fully funded.
        All of us in the National Guard are highly mindful and
    deeply grateful for the strong support this subcommittee has
    shown to us in the past. We are particularly grateful for the
    additional funds which this subcommittee has provided to the
    National Guard and Reserve equipment account.
        We have used those funds to fill critical shortages in the
    Army National Guard and to provide technological modernization
    and enhancements in our Air National Guard capabilities.
        We are proud to have increased our obligation rates and our
    efficient use of those funds, and we are working closely with
    the services to improve these obligation rates. And we will
    continue to work with the subcommittee to ensure we are good
    stewards of the funds and to make your National Guard stronger
    than ever.
        A top priority during my tenure as Chief is to ensure the
    organization of the National Guard Bureau supports our new role
    as an operational force and fosters the development and
    mentorship for future general officers to serve in my current
    position. I will continue to work within the Pentagon to
    validate and fund the necessary general officer positions
    required to support the National Guard Bureau.
        In order to move quickly to your questions, Senators, I
    would like to ask the two Directors to make brief statements.
        [The statement follows:]
                Prepared Statement of General Craig R. McKinley
                                opening remarks
        Chairman Inouye, Ranking Member Cochran, distinguished members of
    the subcommittee; I am honored to appear before you today, representing
    465,000 Citizen-Soldiers and Airmen in the Army and Air National Guard,
    an organization that is historically part of the foundation of our
    great democracy.
        America's National Guard remains ready, reliable, and accessible.
    As members of an operational force, regularly used by the President and
    State Governors, the Soldiers and Airmen of the National Guard
    contribute daily to our Nation's overseas and domestic security
    objectives.
                            national guard overview
        The National Guard is at a crossroads. As we approach fiscal year
    2012, a national debate is addressing the most cost-effective way to
    run the Nation, the Federal Government, and the Department of Defense.
    One of the main issues concerning our military forces involves
    determining the appropriate mix of active duty and reserve forces. To
    that end, we need to ascertain the correct balance of utilization
    rates--somewhere between the current National Guard operations tempo
    and what is sustainable over the long term.
        On average, 63,000 National Guard members are either deployed or
    mobilized at any given time for Federal missions and about 5,800 are
    activated for domestic missions. I believe that this utilization rate
    of National Guard personnel is appropriate and that we can sustain this
    level of activation providing the deployments are programmed as far in
    advance as reasonably possible.
        In the coming months, the Department of Defense, the
    administration, and Congress will analyze the current status of the
    National Guard. I am confident they will conclude that our organization
    is as strong as it has ever been. The investment made in the National
    Guard over the past decade must be capitalized upon and leveraged for
    the future.
        The National Guard has effectively used its appropriated funds over
    the past year, and we as an organization, intend to continue being good
    stewards of the taxpayers' dollars entrusted to us in fiscal year 2012.
    As we embark upon this new fiscal year, we plan to make the National
    Guard stronger, more capable, and more ready.
        The National Guard Bureau's Army, Air, and Joint Directorates each
    work with the Adjutants General of the 50 States, three territories,
    and the District of Columbia to execute the strategies set forth by
    National and State leaders. This synergistic effort is at the heart of
    our success. The National Guard fosters and nurtures a deep-rooted
    connection to the more than 3,300 communities across our country that
    allows the men and women of the National Guard to be an accessible,
    strong, and capable asset--one that is always ready, always there.
        The Army National Guard and Air National Guard are full partners
    with their respective services in providing combat resources and
    enabling units for the overseas fight. However, the National Guard also
    makes ground and air forces available to the Governors when needed. The
    National Guard Bureau team works closely with the Army and Air staffs
    to:
      --Maintain endstrength at or above 358,200 for the Army National
            Guard (ARNG) and 106,700 for the Air National Guard (ANG), with
            a primary focus on caring for the Guard members and their
            Families.
      --Modernize and re-capitalize the ARNG and ANG equipment. This means
            equip the ARNG to no less than 80 percent of its equipment
            requirements, ensuring that the ARNG always has the level of
            equipment needed to meet domestic operational requirements
            regardless of a unit's status.
      --Ensure the ANG is equipped concurrently and in balance with the
            Total Air Force.
      --Stabilize the force to build readiness and train forces to the
            ARFORGEN level of proficiency and to support the Air
            Expeditionary Force.
        Since the National Guard Bureau's official designation as a joint
    activity of the Department of Defense (DOD), we have been forging ahead
    to develop our dual-mission capabilities, both domestic and overseas.
    We have focused on developing strategic relationships within DOD and
    other Federal agencies to implement efficient and effective response
    capabilities. The goal is to ensure the American people have ready
    access to the essential capabilities of homeland response. To support
    our domestic response priorities, the National Guard Bureau is:
      --Enhancing Chemical, Biological, Radiological, Nuclear, and high-
            yield Explosive (CBRNE) Enterprise response capability at the
            State level;
      --Establishing a Homeland Response Force (HRF) in each FEMA region;
            and
      --Documenting the State Joint Force Headquarters requirements to
            further improve command and control capacity during the
            response.
        The tremendous value that the National Guard provides can be
    effectively described through our four broad mission areas--our core
    competencies: Overseas defense mission; support to global engagements;
    domestic response mission; and Soldier, Airman, and Family support
    programs.
                            overseas defense mission
        Overseas, the National Guard will continue its full engagement in
    current operations. As of September 30, 2010, the National Guard have
    mobilized nearly 650,000 Soldiers and Airmen in support of Overseas
    Contingency Operations since the attacks of September 11, 2001. In many
    cases, these men and women have mobilized for combat multiple times.
    Most Americans know that the Army and Air National Guard provide many
    of the forces in Afghanistan and Iraq, but few are aware that the vast
    majority of the forces in Bosnia, Kosovo, the Sinai, and Guantanamo
    Bay, Cuba are National Guard members. These missions are critical to
    our National security and garner significant international support in
    keeping peace across the globe.
                         support to global engagements
        Global engagement is another National Guard core competency. Since
    the end of the cold war the National Guard, through its State
    Partnership Program (SPP), has established enduring and mutually
    beneficial relationships between American States and more than 60
    foreign nations. Working with the Department of State, military
    commands, and other agencies, the State Partnership Program is an
    integral component of the Defense Department's global security
    cooperation strategy, the geographic Combatant Commanders' theater
    engagement programs, and the U.S. Ambassadors' Mission Strategic
    Resource Plans. These partnerships work to advance regional security,
    stability, and prosperity. By fostering relationships with other
    countries, we develop more understanding and familiarity with each
    other, thereby creating a foundation of trust, appreciation, and
    burgeoning global security.
        Furthermore, as the demand for Overseas Contingency Operations
    forces declines, there is opportunity to preserve operational National
    Guard capability by expanding the experience gained through the SPP.
    Using contingency forces in its 1 year of rotational availability
    permits it to prepare for 5 years with personnel costs that are a small
    fraction of the active component. National Guard units that are used
    for these purposes can offer the Combatant Commander the predictability
    and stability inherent in the operational RC, which in turn provides
    the benefit of continuity in sourcing and building long-term
    relationships.
        The National Guard is ideally suited for providing support to
    Combatant Commanders. Soldiers with valuable civilian skills and
    expertise from professional, technical, and managerial fields in the
    private sector make up the National Guard. Moreover, retaining specific
    skill sets within particular units is possible because National Guard
    Soldiers characteristically spend their entire career in the same unit.
    Skill sets not only apply to those that are civilian acquired, but also
    military investments made in language training and cultural awareness.
    The National Guard's proven track record in recruiting and retaining
    prior service personnel preserves the training expense already invested
    while on active duty.
        The Afghanistan Agribusiness Development Program is a unique
    engagement program of the National Guard. The Agribusiness Development
    Teams provide training and advice to Afghan agricultural universities,
    provincial ministries, and local farmers, leading to increased
    stability and improved opportunities for Afghanistan's reemerging
    agribusiness realm. Thanks to the National Guard, Afghanistan reports
    declines in poppy production and increases in harvests of apples,
    grapes, pomegranates, cherries, almonds, wheat, corn, alfalfa, and
    saffron.
                           domestic response mission
        Domestically, the National Guard is ready to respond on a moment's
    notice to any emergency, manmade or natural. The National Guard will
    have 10 Homeland Response Force units that are either dedicated to or
    dual-hatted for this critical homeland mission. These units will
    complement and enhance the existing civil-support structure in National
    Guard units across the Nation.
                 soldiers, airmen, and family support programs
        The National Guard seeks to provide exemplary support to our
    Soldiers, Airmen, and their Families. Programs, such as the Army's
    Warrior Transition Units (WTUs) and Community-Based Warrior Transition
    Units (CBWTUs), focus on caring for wounded warriors from across the
    Army. The Army National Guard supports the Army's WTUs and CBWTUs at
    all levels of the organization from squad leader to battalion
    commander.
        The Yellow Ribbon Reintegration Program provides information,
    services, referrals, and proactive outreach to Soldiers, spouses,
    employers, and youth throughout the different stages of mobilization:
    pre-alert, alert, pre-deployment, deployment, post-deployment, and
    reintegration.
        Our Citizen-Soldiers, who in their civilian lives are in positions
    of influence across the spectrum of business, education, and
    Government, make up the backbone of the National Guard Youth ChalleNGe
    Program (NGYCP). This award-winning, community-based program leads,
    trains, and mentors high school dropouts to become productive citizens
    in America's future. ChalleNGe has 32 sites in 28 States and Puerto
    Rico, offering a 5-month ``military style'' residential phase and a 1-
    year post-residential mentoring phase for unemployed youth ages 16-18.
    ChalleNGe saves States approximately $175 million annually in juvenile
    corrections costs, while keeping youths off Federal assistance.
                           a great value for america
        Investment in the National Guard is a great value for America.
    These brief examples display only a fraction of what we currently
    accomplish and I am confident that we can provide more in the years to
    come.
        We must sustain the National Guard as a ready and accessible force.
    We must find a sustainable balance between operational utilization and
    overuse of these dedicated Citizen-Soldiers and Citizen-Airmen. The
    National Guard currently provides 35-40 percent of the Army and Air
    Force operational force for less than 7 percent of the base defense
    budget--precisely the type of efficiency the Department of Defense is
    seeking. With the proper disbursement of scarce defense dollars, the
    National Guard is an investment with a very high return.
        Today and in the future, the National Guard will continue to
    simultaneously defend the Nation's interests overseas, support the
    homeland, and serve as an indispensable, cost-effective military option
    for the United States. For 375 years, our National Guard has proven
    itself a great value for America. With a deliberate decision to support
    the Reserve Component as an operational force, and the discovery of the
    critical balance between funding and use, the National Guard will be
    successful in fiscal year 2012, and emerge as an even greater value in
    the future.
                                closing remarks
        Thank you for the opportunity to be here today, I look forward to
    your questions.

        Chairman Inouye. Bud. General Wyatt.
    STATEMENT OF LIEUTENANT GENERAL HARRY M. WYATT III,
                DIRECTOR, AIR NATIONAL GUARD
        General Wyatt. Chairman Inouye and Vice Chairman Cochran,
    Senator Murray, Senator Coats, I also want to thank the
    subcommittee for its support for the extraordinary men and
    women who serve in America's Air National Guard, some 106,700
    strong.
        I am privileged to have with me today the Command Chief
    Master Sergeant of the Air National Guard, my senior enlisted
    adviser, Chris Muncy from Ohio, who is seated behind me in the
    audience.
        Before I get into the future of the Air National Guard, I
    would like to open with a brief review of 2010 before looking
    to the future of the Air National Guard.
        Your Air Guard airmen continue to make a significant
    contribution to the Nation's defense, both here at home and
    around the globe. Last year, Guard airmen filled 52,372
    requests for manpower. Eighty-nine percent of these requests
    were filled by volunteers. Forty-eight thousand five hundred
    thirty-eight served in Federal or title X status primarily
    overseas, with the bulk of those serving in Iraq and
    Afghanistan and surrounding areas.
        But Air Guard members also served in Central and South
    America, Asia, Europe, Africa, and Antarctica. The Air National
    Guard is currently providing nine remotely piloted aircraft
    combat air patrols over Afghanistan and has been asked to do a
    10th, which we will accept and take on.
        And the Air Guard airmen serving in harm's way are not just
    flying airplanes. In fact, some of the skills in greatest
    demand are not in flight operations, but rather security
    forces, intelligence, computer support, and vehicle
    maintenance.
        Domestically, your Guard airmen are helping with Southwest
    border security, the counterdrug program, and guarding the
    skies above our Nation in the Air Sovereignty Alert Mission. In
    addition, Guard airmen almost daily are in our communities
    protecting property and saving lives.
        Guard combat search and rescue personnel in Alaska,
    California, and New York are frequently called upon to help
    search for lost hikers or rescue stranded climbers. The Air
    National Guard modular air firefighting units have supported
    the Forest Service in numerous missions and, in fact, have just
    returned from missions in western Texas.
        Guard airmen also made significant contributions to
    earthquake relief in Haiti, the oil clean-up in the gulf,
    floods and tornadoes in the Midwest, and recently, the Hawaii
    Air Guard airmen even helped with the State flu vaccination
    program in public schools.
        Every day, somewhere in America, there are Air Guard
    members supporting civil authorities and protecting our
    citizens. Congress' investment has created the greatest Air
    National Guard in the organization's history, but continued
    investment in the Air National Guard is critical for national
    security, and the Air National Guard continues to be a great
    value to America.
        As we prepare for the future, the Air National Guard wants
    to build upon the lessons of the past. Today's Air National
    Guard integrates seamlessly into Air Force global operations
    because we have the same equipment with similar capabilities.
    And our Air Guard airmen maintain the same standards of
    training and education.
        Our goal is to continue to be an equal partner through the
    Air Force's recapitalization and modernization process. Since
    9/11, the Air National Guard has increased its role in domestic
    operations, including participation in joint domestic response
    teams such as the new Homeland Response Forces that General
    McKinley referenced.
        With continued support from Congress, we will continue to
    improve and enhance our ability to support civil authorities
    through prudent investment in dual-use capabilities.
        Mr. Chairman, thank you and the members of the
    subcommittee. I am grateful for the opportunity to be here,
    look forward to your questions.
        Thank you, sir.
        Chairman Inouye. Thank you, General Wyatt.
        [The statement follows:]
          Prepared Statement of Lieutenant General Harry M. Wyatt III
                                opening remarks
        Chairman Inouye, Ranking Member Cochran, and distinguished members
    of the subcommittee; I am honored to appear before you today on behalf
    of the outstanding men and women serving in our Nation's Air National
    Guard. I would like to begin by expressing my sincere appreciation to
    the Committee for its tremendous support to the Air National Guard.
    Your work ensures America continues to have a ready, reliable, and
    accessible Air National Guard, responsive to our domestic needs as well
    as providing operational capabilities critical to the success of our
    Total Force. As we face increasingly limited resources and tight or
    declining defense budgets, we must accentuate the strength of the Air
    National Guard--our cost effectiveness.
                     air national guard in national defense
        Facing a need to reduce the Defense budget in response to domestic
    priorities and the need to sustain defense capabilities in light of
    growing foreign challenges, Secretary of Defense Melvin B. Laird put
    his faith in the Reserve Components. Secretary Laird wrote, ``Within
    the Department of Defense . . . economics will require reductions in
    overall strengths and capabilities of the active forces, and increased
    reliance on the combat and the combat support units of the Guard and
    Reserves.'' \1\ He understood that by increasing the readiness of the
    Guard and Reserves and then relying upon them ``to be the initial and
    primary source for augmentation of the active forces in any future
    emergency'' \2\ the Nation would maintain its defense capability and
    capacity while decreasing the overall costs.
    ---------------------------------------------------------------------------
        \1\ Melvin B. Laird, Memorandum to the Secretaries of the Military
    Departments, Subj: Support for Guard and Reserve Forces, August 21,
    1970.
        \2\ Ibid.
    ---------------------------------------------------------------------------
        The U.S. Air Force leadership recognized that as the Nation's first
    military responder, increased reliance on the Reserve Components meant
    the Air Force Reserve and Air National Guard must be able to respond
    quickly and integrate seamlessly into any operation; they would require
    equipment and training comparable to the regular, active duty Air
    Force. The ANG, with significant help from Congress, began trading in
    its obsolete Korean War vintage equipment for newer, and in some cases
    brand new aircraft. The ANG also received additional funds for
    training, including modern flight simulators, and full-time Guard
    Airmen (Active Guard and Reserve (AGR) and Technicians) to oversee the
    increased training regimen.
        Improved operational readiness brought with it a rejuvenated desire
    by Guard Airmen to do more than just train--to demonstrate their
    capabilities. ANG units began volunteering to augment the Regular Air
    Force by participating in ongoing operational missions around the
    world. To the customer, the Air National Guard became indistinguishable
    from the Regular Air Force. This was done within the fundamental
    framework of a part-time professional force.
        Today's National Guard Airmen have been fighting alongside our
    regular, active duty and Air Force Reserve brothers and sisters since
    Operation Desert Shield in 1991, and they have proven to be equal
    partners in our Nation's defense. Last year (CY2010), Guard Airmen
    filled 48,538 manpower requests, and 89 percent of these Guard Airmen
    responded to the call voluntarily, without the need for ``involuntary
    mobilization.'' They have served honorably in Iraq and Afghanistan, but
    also in Bosnia, throughout Africa, South America, Europe (including
    countries of the former Soviet Union), Korea, and, under Operation Deep
    Freeze, New Zealand and Antarctica.
        The world is a very different place today than when Secretary Laird
    established the Total Force, but the underlying principle of the Total
    Force remains true: the Nation can maintain defense capabilities at
    less total cost through careful balance of Active Component and Reserve
    Component forces.
        Secretary Gates has charged the Department ``to generate efficiency
    savings by reducing overhead costs, improving business practices, or
    culling excess or troubled programs.'' \3\ While our leadership is
    making tough decisions, we know the Air National Guard is well situated
    as a cost-effective answer in both our defense and domestic response
    roles.
    ---------------------------------------------------------------------------
        \3\ Robert M. Gates, Statement on Department Budget and
    Efficiencies, January 6, 2011.
    ---------------------------------------------------------------------------
        The Air Guard provides a trained, disciplined, and ready force for
    a fraction of the cost. The Air National Guard savings are due to our
    part-time business model. Approximately 70 percent of our Guard Airman
    are traditional part-time professionals, meaning that they are only
    paid when serving or on active duty for training. Also, the Air
    National Guard seldom pays subsistence or housing allowances, or for
    permanent change of station moves for the members and their families.
        Another key factor to our cost effectiveness is the infrastructure
    savings inherent in the Air National Guard basing model that not only
    allows us to operate efficiently, but also allows us to be a part of,
    and contribute to, communities across the country. With some of our
    leases costing as little as $1 annually, the Air Guard is able to
    realize even more cost savings through its supporting infrastructure.
    In fact, for less than $4 million annually through Joint Use
    Agreements, the Air National Guard provides stewardship to
    approximately $12 billion in infrastructure.
                              domestic operations
        This year the Air National Guard began a process to better define
    and prepare for its role in domestic operations. In CY2010, 3,739
    National Guard Airmen performed domestic missions under Title 32
    including U.S. air defense, border security, counterdrug operations,
    and search and rescue. Many other Guard Airmen were called to State
    Active Duty by their governors to augment local police forces and help
    with disaster relief.
        Many are unaware of the contributions and skills our Guard Airmen
    provide to domestic support. The Air National Guard has particular core
    capabilities for which we are uniquely trained and equipped. Many have
    been used in the past year alone, to include: Air Defense (Air
    Sovereignty Alert); Air Traffic Control; Airlift (transportation,
    supply, and evacuation); Civil engineering; Specialized medical care;
    Law enforcement; Aerial firefighting; Mortuary affairs; Urban search
    and rescue; and Communications.
        The Air National Guard's support to civil authorities is based upon
    the concept of ``dual use,'' i.e., equipment purchased by the Air Force
    for the Air National Guard's Federal, combat mission, can be adapted
    and used domestically when not needed overseas. For example, an Air
    National Guard F-16 wing contains not only F-16 fighter aircraft but
    fire trucks, forklifts, portable light carts, emergency medical
    equipment including ambulances, air traffic control equipment,
    explosives ordinance equipment, etc., as well as well trained experts--
    all extremely valuable in response to civil emergencies. If the F-16
    wing converts to a non-flying mission or even a Remotely Piloted
    Aircraft mission, much of this equipment may leave with the F-16
    aircraft. As the Air Force proceeds with its recapitalization and
    modernization plans, we need to ensure our citizens are not left
    without essential disaster response capabilities.
        Looking to the future, the Air National Guard recognizes the
    growing importance of its domestic response capabilities and the many
    threats to domestic peace. Our Airmen are working closely with the
    National Guard Bureau, USNORTHCOM, the Department of Homeland Security,
    as well as other local, State, and Federal agencies to help identify
    and fill capability gaps in the U.S. regional response framework.
                                closing remarks
        Our National Guard Airmen have proven themselves to be ready,
    reliable, and accessible in recent actions here at home and overseas.
    Every dollar spent on the Air National Guard provides our Nation an
    unmatched return on investment. Given adequate equipment and training,
    the Air National Guard will continue to fulfill its Total Force
    obligations and seamlessly integrate into the Joint theater operations
    and respond to domestic emergencies.
        We need your help to ensure that the Air National Guard of tomorrow
    is as a ready, reliable, accessible, and cost effective as it is today.
        Thank you for the opportunity to be here today, I look forward to
    your questions.

        Chairman Inouye. General Carpenter.
    STATEMENT OF MAJOR GENERAL RAYMOND W. CARPENTER,
                DIRECTOR, ARMY NATIONAL GUARD
        General Carpenter. Chairman Inouye, Vice Chairman Cochran,
    Senator Murray, Senator Coats, it is my privilege and honor to
    be here today to represent 360,000 plus soldiers in the Army
    National Guard. Of those soldiers, nearly 34,700 are currently
    mobilized, and more than half have had combat experience.
        The sacrifice of these soldiers, their families, and
    employers is something we not only acknowledge, but deeply
    appreciate. Today, I wish to thank you for the opportunity to
    share relevant information about the Army National Guard and
    also thank you for your continued support.
        I am accompanied today by Command Sergeant Major Burch, the
    senior enlisted soldier in the Army National Guard and Nebraska
    guardsman, and Command Chief Warrant Officer Nisker, the Senior
    Command Chief Warrant for the Army National Guard.
        The last decade has seen the Army National Guard transform
    to an operational force. The congressional initiatives and
    investments in the Army National Guard have contributed to our
    transformation and enhanced readiness as we continue to deploy
    in service to our Nation.
        Recent initiatives include soldier and support programs
    that allow us to recruit and retain the best and brightest. You
    have supported the resourcing for equipment modernization for
    our brigade combat teams, including One Stryker Brigade and our
    Combat Aviation Brigades, among other forces inside the Army
    National Guard.
        Through the support of this subcommittee, our Nation has
    invested billions of dollars in equipment for the Army National
    Guard in the past 6 years. The delivery of that equipment has
    nearly doubled our equipment on-hand rates for the critical
    dual-use equipment over the last 5 years.
        I would be remiss if I did not point out how important
    NGREA and, again, the work of this subcommittee have been in
    modernizing and equipping the Guard. This year, we have
    achieved a critical dual-use equipment. That is equipment that
    has utility both in the war fight and homeland. The fill rate
    is 89 percent, 76 percent on-hand in the units available to the
    Governors should they need it tonight.
        The Army National Guard Aviation Program is a great
    example. Both fixed- and rotary-wing aircraft have provided
    huge benefits in support of domestic and overseas operations
    since 9/11. Army Guard aircraft regularly respond by
    transporting emergency supplies and personnel during floods,
    wildfires, during the Deepwater Horizon oil spill, and most
    recently, the tornadoes across the South and flooding we are
    now experiencing from Minnesota to Louisiana.
        Army Guard aviation provides a critical dual-use
    capability, whether in the mountains of Afghanistan or the
    Mississippi Delta. Through your efforts, we have come a long
    way in moving to modernize our aircraft from the venerable Huey
    to the LUH-72, UH-60 Lima and Mike models, CH-47 Delta
    Chinooks, and the AH-64 Delta Apaches. Again, we are well on
    our way in the modernization effort, but there remains work to
    do.
        Turning to our human dimension, we have learned a lot about
    support to our soldiers, their families, and employers over the
    past decade. It is critical that we work to ensure our force is
    employed, that they are physically and mentally fit, and that
    we understand the stresses that we ask them to endure, whether
    deployed or at home.
        It is vital that we continue to fund soldier and family
    outreach programs. In calendar year 2010, the number of
    reported Army Guard suicides nearly doubled--62 in calendar
    year 2009, compared to 113 in calendar year 2010. Within the
    Army Guard, we have set a goal to cut that number by one-half
    to 60 in 2011, knowing full well 1 suicide is too many.
        Most States have developed comprehensive social support and
    mental health initiatives. These programs emerged out of a need
    to strengthen soldier resilience. Several of our States,
    including Michigan, Nevada, Nebraska, California, Wisconsin,
    Kansas, Hawaii, Vermont, and Illinois, have innovative
    resiliency programs. Across the Nation, the adjutant generals
    are committed and actively engaged in this effort. I credit
    them with the current downward trend we are experiencing in
    reported suicides.
        The Nation will benefit from the past investment and
    experience of the Army National Guard in the future. In a
    budget-constrained environment, the operational Army National
    Guard is a cost-effective solution.
        Again, I would like to acknowledge the critical role this
    subcommittee has played in building and sustaining the best
    National Guard I have seen in my career of nearly four decades.
    I look forward to your questions and comments.
        Chairman Inouye. Thank you very much, General.
        [The statement follows:]
            Prepared Statement of Major General Raymond W. Carpenter
                                opening remarks
        Chairman Inouye, Ranking Member Cochran, distinguished members of
    the subcommittee; I am honored to appear before you today, representing
    360,000 plus Citizen-Soldiers in the Army National Guard, an
    organization that is historically part of the foundation of our great
    democracy.
               citizen soldiers as part of the operational force
        Our Army National Guard (ARNG) is approaching a decade of war with
    an all-volunteer force. Our Army National Guard Mobilizations in
    Support of Overseas Contingency Operations in fiscal year 2010,
    including Soldiers who have mobilized multiple times, were 41,744 for
    Operation Enduring Freedom (Afghanistan) and Operations Iraqi Freedom
    and New Dawn, and another 3,054 mobilizations to the Balkans, Sinai,
    and elsewhere around the world. A staggering 477,323 Soldiers have been
    activated since 9/11, and 34,700 Soldiers are currently mobilized as of
    March 5, 2011.
        We are an operational force in a transition mode within the
    ARFORGEN rotational cycle. To the credit of our Soldiers and their
    leaders, we are experiencing huge successes in our homeland defense and
    overseas missions. We continue to see young and not-so-young people who
    want to join and serve in the ARNG. Just as impressive are the
    retention rates of our current serving force; most are combat veterans
    who make the decision to continue to serve at historic rates; they
    clearly understand we are at war. Our reenlistment rate as of EOM
    February 2011 for enlisted Soldiers is 72.4 percent of our total force
    and 73.8 percent of our Soldiers with Mobilization experience. These
    retention numbers are especially impressive when we consider that at
    the end of fiscal year 2010 the average dwell time for our Soldiers
    with mobilization experience was 2.4 years. As a first step, the Army
    goal is to achieve 4 years dwell by 2014, but balancing the force will
    not happen overnight.
        The experience we have gained since 9/11, the modern equipment
    fielded, the training delivered to our Soldiers, and the frequency of
    deployments, have resulted in a highly seasoned, well-equipped combat
    force. As of end of month December 2010, 53 percent of ARNG Soldiers
    are combat veterans; more than half of our force--and we hope to retain
    that level of experience. Our force has truly become an operational
    force. At the end of fiscal year 2010, 84.45 percent of ARNG forces
    were Duty Military Occupational Specialty (MOS) Qualified--an
    escalating increase from 73.27 percent at the end of fiscal year 2008
    and 83.06 percent in fiscal year 2009. The experience of our Army
    National Guard in recent years has strengthened our Soldiers and units
    to the benefit of our Nation like no other time in recent history.
    Several high-level research studies have been commissioned to guide the
    future of our Army National Guard operational force including an OSD-RA
    study and the General Reimer study. Ultimately, these studies agree
    that for a relatively modest investment, an Operational Army National
    Guard can be sustained. In return, the Nation will benefit from the
    past investment and experience of the ARNG. In a budget-constrained
    environment, the Army National Guard is an extremely cost-effective,
    substantially paid-for option that the Nation needs to sustain. It is
    important that we maintain our key force structure elements of 8
    Divisions, 8 Combat Aviation Brigades, and 28 Brigade Combat Teams
    (BCTs).
                        equipment and critical dual use
        Our Nation has invested over $37 billion in equipment for the Army
    National Guard in the past 6 years. That investment was made in both
    Critical Dual Use (CDU) and other required equipment, used for both
    domestic homeland crisis response missions and overseas contingency
    operations. Overseas contingency operations have spurred improvements
    in the capacity of the ARNG to support the war effort, to respond to
    natural and man-made disasters, to provide critical assistance during
    State and national emergencies, and to be prepared to respond to
    potential terrorist attacks in defense of the homeland. Our homeland
    response enterprise includes 10 Homeland Response Forces (HRFs)--2
    validated in fiscal year 2011 and 8 in fiscal year 2012, 17 Chemical,
    Biological, Radiological, Nuclear and High Yield Explosive (CBRNE)
    Enhanced Response Force Packages (CERFPs), and 57 Civil Support Teams
    (CSTs).
        CDU equipment includes tactical radios, rotary aircraft, ground
    transportation vehicles, and digital command and control enablers. The
    Army has made significant efforts to improve the ARNG CDU equipment
    posture and remains committed to ensuring the ARNG has the CDU
    equipment required to support Homeland Defense/Homeland Security (HLD/
    HLS) and Defense Support to Civil Authorities (DSCA) operations. To
    highlight this level of commitment, ARNG equipment-on-hand rates for
    Critical Dual Use equipment are projected to increase to 94 percent by
    October 2012. That's an increase of 19 percent over the 4 years since
    the ARNG began monitoring CDU rates.
        During fiscal year 2010, the ARNG received over 154,000 pieces of
    new equipment valued at $9.8 billion. With this influx of new
    equipment, the on-hand percentage for all equipment is currently at 92
    percent and continues to be maintained at levels greater than 90
    percent. The Army continues to improve the equipment on hand and
    modernization levels for the Army National Guard. The Army views this
    as critical for the ARNG to be employed as an operational force. The
    Army Equipping Strategy established equipping aim points for units as
    they progress through the Army Force Generation (ARFORGEN) process
    which will help build unit readiness and maintain unit parity in terms
    of both modernization and interoperability.
                               quality facilities
        The Army National Guard is a community based force. As such, our
    facilities are often the foundation for community support of an all-
    volunteer force. The ARNG has made some great progress with several
    LEED (Leadership in Environmental and Energy Design) Silver certified
    facilities meeting the qualifying requirements for recycled material
    usage, natural lighting, and energy conservation. We have further
    opened the call for volunteer installations to take part in Army
    IMCOM's Net Zero initiative. The ARNG, however, still has much work to
    do to provide quality facilities to perform our dual mission across the
    54 States and Territories. Quality facilities link directly with
    Soldier readiness, family, youth, and morale programs such as Yellow
    Ribbon and Youth ChalleNGe. The ARFORGEN model requires increased usage
    of ARNG facilities. Forty percent of ARNG readiness centers are more
    than 50 years old and require substantial modernization or total
    replacement to meet the needs of an operational force. To achieve
    quality in facilities, we have thus far executed 99 percent of Milcon
    funds in fiscal year 2010 and estimate we will need $774 million in
    Milcon dollars for fiscal year 2012.
                                aviation support
        The Army National Guard (ARNG) aviation program, both fixed and
    rotary wing aircraft, provided huge benefits in supporting Domestic
    Operations this past year. Every year offers ARNG aviation a new set of
    challenges. Last year, fixed-wing aircraft transported emergency
    supplies and personnel during floods, wildfires, and other emergencies
    across the Nation and throughout the gulf coast during the aftermath of
    the Deepwater Horizon oil spill. During the oil spill recovery effort,
    ARNG aviation crews logged 3,722 hours and moved over 16 million pounds
    of cargo. The Operational Support Airlift Agency provided critical
    combat support by transporting blood donations and Wounded Warriors
    across the United States. Fixed-wing aircraft also transported much-
    needed supplies and personnel to Haiti after the January 2010
    earthquake. At home and abroad, these aircraft flew 53,029 hours,
    completed 11,312 missions, transported over 3.5 million pounds of
    cargo, and carried more than 70,000 passengers.
        Rotary wing units and aircraft in fiscal year 2010 flew
    approximately 50,000 hours in civil support. These missions included
    support of disasters and declared emergencies in which Guard aviation
    displayed versatility and flexibility such as responding to the largest
    oil spill to affect the United States, the Deepwater Horizon spill.
    ARNG rotary wing crews flew missions such as sand bag emplacement,
    personnel evacuation, engineer damage assessment, and law enforcement
    agency support. In Haiti the Puerto Rico National Guard flew two UH-60s
    based out of the Dominican Republic in support of the American Embassy
    in Port-au-Prince giving an early signal that help was on the way to
    support the restoration of health services. ARNG Security and Support
    aircraft and crews continue to provide planned support to counterdrug
    operations nation-wide and notably along the Southwest border. Our
    aviation forces responded to floods in Arizona, North Dakota,
    Louisiana, and West Virginia; provided wildfire support in Minnesota;
    and flew search and rescue missions in California, Colorado, New
    Mexico, Nevada, and Oregon. ARNG rotary wing missions crossed the full
    spectrum of domestic support.
        ARNG fixed wing and rotary wing capabilities have been and continue
    to be a critical dual use asset that the Army and Adjutants General
    rely heavily upon. The operational tempo of our ARNG aviation units
    continues to be elevated as overseas commitments and domestic support
    requirements remain steady.
        Army National Guard aviation not only supports Domestic Operations
    such as responses to hurricanes, oil spills, search and rescue
    operations, forest fires, floods, and weather emergencies, in addition,
    we continue to support overseas deployments such as Operation Enduring
    Freedom, Operation New Dawn, and Kosovo. We do so with an aging
    aircraft fleet. Since 2001, the ARNG has retired over 600 legacy
    aircraft and fielded 300 modernized aircraft. The ARNG is
    simultaneously modernizing aircraft to reduce sustainment costs,
    increase readiness, and support interoperability for the deploying
    force. ARNG aviation also includes Unmanned Aircraft Systems and
    related Ground Support Equipment. Aviation and related support systems
    remain persistent items of interest on modernization priority lists.
        The Army needs to continue its modernization plan if the ARNG is to
    meet current and future demands in the Homeland and on missions abroad.
    The ARNG fleet currently has shortfalls in CH-47 Chinook and AH-64D
    Apache airframes.
        The Assistant Secretary of the Army (Acquisitions, Logistics and
    Technology) recently directed the Program Executive Office--Aviation to
    divest the C-23 Sherpa aircraft not later than December 31, 2014. In
    accordance with Army guidance, the ARNG developed a plan to retire the
    42 existing C-23 aircraft in 2011-2015. The 2010 Vice Chief of Staff,
    Army capability portfolio review directed a requirements-based
    assessment on the need for Army utility fixed wing aircraft. The ARNG
    expects more fidelity from HQDA in the coming months on the number of
    utility fixed wing aircraft the ARNG will continue to retain and
    operate to meet Army fixed wing requirements.
               national guard and reserve equipment appropriation
        The National Guard and Reserve Equipment Appropriation (NGREA) is a
    special Defense Appropriation that complements each Service's base
    appropriation. NGREA is intended to procure critical modernization
    items of equipment that the base appropriation is not able to fund.
        The Army's goal is to ensure that ARNG units are equipped properly
    with Critical Dual Use (CDU) capabilities to execute Homeland Defense
    and Defense Support to Civil Authorities (HLD/DSCA) missions
    effectively. These missions include Federal such as overseas
    deployments and state such as disaster relief in support of the
    governors. Our specific ARNG goal is to equip the ARNG with over 80
    percent of the CDU requirement. The Army has committed to keeping CDU
    equipment levels above 80 percent on hand. According to the National
    Guard and Reserve Equipment Report (NGRER) 2010 report, the ARNG has
    the following key equipping challenges: Achieving full transparency for
    procurement and distribution; equipping units for pre-mobilization
    training and deployment; equipping units for their Homeland Missions;
    modernizing our helicopter fleet; and modernizing our Tactical Wheeled
    Vehicle (TWV) fleet.
        The above challenges involve obtaining a full complement of ``heavy
    tactical vehicles, small arms, communications systems, field artillery
    systems, and combat systems'' (NGRER, 2010, p. 1-8)
                         military construction (milcon)
        Currently, 40 percent of or Readiness Centers are over 50 years
    old. Not only do many of these facilities fail to meet the needs of a
    21st century operational force, many fall short of DOD, Federal, or
    State building standards and requirements to include: anti-terrorism/
    force protection, energy efficiencies, and Americans with Disabilities
    Act (ACT) requirements. The Army National Guard fiscal year 2012
    military construction request for $774 million is focused on improving
    this situation and making additional Milcon improvements in the
    categories of Grow the Army, Modernization, Transformation, Training
    Support, and Planning and Design and Unspecified Minor Military
    Construction. Under the Grow the Army category, we are submitting a
    request of $101 million for 11 Readiness Centers. These new Readiness
    Centers will be implementing the energy efficiencies. For
    Modernization, our budget request includes $197.7 million for 11
    projects including readiness centers and aviation support centers in
    support of our modern missions. For Transformation, we are requesting
    $197.9 million for 10 projects which include 3 Tactical Unmanned
    Aircraft System Facilities (TUAS), 5 Readiness Centers, 1 Army Aviation
    Support Facility, and 1 Field Maintenance Shop. For Training Support:
    In fiscal year 2012, the Army National Guard is requesting $245 million
    for 16 projects which will support the training of our operational
    force. These funds will provide the facilities our Soldiers require as
    they train, mobilize, and deploy. Included are five Operations
    Readiness and Training Complexes (ORTC), seven range projects, one
    Maneuver Area Training and Equipment Site (MATES), one railhead
    expansion and container facility, and two deployment processing
    facilities. For Other Support Programs, our fiscal year 2012 Army
    National Guard budget contains $20 million for planning and design of
    future projects and $12 million for unspecified minor military
    construction to address unforeseen critical needs or emergent mission
    requirements.
        Lack of a fully funded Milcon request creates a significant backlog
    for construction projects. Deficiencies primarily exist in four main
    areas within ARNG facilities: readiness centers, training facilities,
    maintenance facilities, and infrastructure. The funding backlog for
    readiness centers is $30.3 billion; the majority of these facilities
    cannot meet anti-terrorism/force protection (AT/FP) requirements.
                                arng resilience
        People are our most precious resource. The quality of the Citizen-
    Soldiers of the Army National Guard is unprecedented. However, we are
    experiencing a troubling increase in the incidence of suicides. In
    calendar year 2010, the ARNG suicide rate nearly doubled; the number of
    ARNG suicides for calendar year 2009 and calendar year 2010 were 62 and
    112, respectively. Ninety-one percent of the ARNG Soldiers who
    committed suicide were Traditional Drilling Guardsmen vs. full-time
    Army National Guard and are not eligible for many of the support
    services available to the AC or our Title 32 Active Guard and Reserve
    Soldiers. Some had deployed in support of Army operations and over half
    had not deployed or were still in the process of being indoctrinated
    into the ARNG. While we do not know what triggers their decisions, we
    do know that the stressors that may affect their outlook such as
    employment, relationship issues and previous behavioral health issues
    must be identified and mitigated to promote their welfare and well-
    being. Subsequently, the ARNG is teaming with DOD and the Army to
    incorporate Traditional Drilling Guardsmen into future studies such as
    the Study to Access Risk and Resilience in Our Service Members
    (STARRS).
        The ARNG has made the promotion of Resilience and Risk Reduction
    with a corresponding decrease in suicidal behavior our top priority.
    The ARNG has developed a holistic approach to enhance the resilience
    and coping skills of our Soldiers, Families, and Civilians by promoting
    risk reduction through leadership awareness, training and intervention
    programs. The ARNG Resilience, Risk Reduction and Suicide Prevention
    Campaign Plan was developed to promote an integrated program of
    prevention, intervention and mitigation at all levels. This document
    nested all other collaborative efforts within DOD, Army and NGB to
    promote unity of effort and synchronize our objectives. The plan was
    also distributed to State Leadership to shape and focus their efforts
    on improving the mental, physical, and spiritual health of their
    Soldiers and Families throughout our formations.
        Since our Citizen-Soldiers are reflective of society as a whole, it
    comes as no surprise that in-depth analysis indicates the increased
    ARNG suicide rate may correspond to an increasing national trend in at-
    risk and suicidal ideations and attempts. In addition to our efforts to
    promote Soldier resilience, the ARNG leadership also recognizes the
    role of ARNG Families, Peers, and Employers as providing the foundation
    of each Soldier's support network. These groups are present in the
    Soldier's life between their traditional drill periods and have the
    ability to identify and address negative behaviors before they lead to
    functional impairment or at-risk behaviors. The ARNG provided the
    States with training programs for both family members and employers to
    assist in identifying those that should be referred to unit leadership
    for assistance and the applicable support services available in their
    community. States have capitalized on community based resources and
    solutions to provide services beyond the installation.
        The ARNG resourced 54 Suicide Prevention Program Managers in the
    States in fiscal year 2010 and trained over 200 Master Resiliency
    Trainers assigned to brigades and battalions. We are striving to help
    each of our Soldiers become ready and resilient. For instance, the ARNG
    Leader's Guide to Soldier Resilience was developed to provide ``battle
    drills'' for common Soldier issues; this publication complements the
    ARNG CSM's Soldier to Soldier Peer Support program promoting ``Buddy
    Aid'' including basic intervention skills and trigger points for
    referrals or emergent care. The ARNG CSM has emphasized the roles and
    responsibilities of leadership during his two national CSM conferences
    this past year. Our Soldiers and families are encouraged to take the
    Global Assessment Tool, which identifies individual resilience levels
    and uses the self developmental modules to increase self awareness and
    resilience. Additionally, we increased collaboration with the Army
    Center for Substance Abuse in order to address substance abuse
    prevention, outreach and treatment for Soldiers, as well as Leaders and
    Families, so they understand their roles. Our efforts to increase
    assets available to Commanders to improve Soldier resilience include
    partnerships with national and community organizations such as the
    American Red Cross, Substance Abuse and Mental Health Services Agency,
    counselors and clergy, and use of the Army's Comprehensive Soldier
    Fitness Program.
        Within the Army National Guard, we have set an ultimate goal of
    zero suicides. Our current count is 12 suicides so far this calendar
    year versus 22 this time last year. At this time it is too early to
    determine State level trends but we will continue to monitor them.
    Several States have developed comprehensive social support and mental
    health initiatives. These programs emerged out of a need to promote
    Soldier and family resilience and reduce potential stressors including
    employment and financial issues, domestic strife and promoting
    reintegration following deployment. Several of our States including
    Michigan, Nevada, Nebraska, California, Wisconsin, Kansas, and Illinois
    have innovative resilience programs and the National Guard Bureau is
    encouraging the exchange and expansion of best practices. The Army
    National Guard, in conjunction with the Active Army, the Department of
    Defense, the Department of Veterans Affairs, and each of the States,
    territories, and District of Columbia has made turning this trend
    around a priority. Many more efforts too numerous to cover here are
    ongoing and I am confident that, as a team we will turn this trend
    around. In the end, I believe the Soldiers and Families of the Army
    National Guard will be more resilient and ready in the service to the
    communities, States and the Nation.
        While the ARNG is making great strides within States to integrate
    suicide prevention, intervention, and risk mitigation at all levels,
    more work needs to be done in this area. Desired ARNG capabilities, in
    terms of resilience, risk reduction, and suicide prevention, include
    emergent care and treatment for ARNG Soldiers regardless of status;
    behavioral health and substance abuse treatment for Soldiers,
    regardless of status; resources to train and support State Resilience
    and Crisis Intervention personnel; and embedded behavioral health
    capability at the brigade level to promote healthy lifestyles and
    provide early identification of the potential at-risk Soldiers. After a
    nearly decade-long era of ``persistent engagement,'' ARNG families have
    been truly remarkable and their health and well-being are absolutely
    critical to the security of the Nation. The services are vital to
    sustain our role as an operational force as well as promoting the
    continuum of care for those AC Soldiers who will transition to the RC
    during the upcoming reduction in the Army's end strength.
        Acknowledging unemployment as a stressful challenge affecting our
    Soldiers and Families, the Army National Guard implemented employment
    outreach as a necessary step in building resilience. The Job Connection
    Education Program is an employment initiative designed to help improve
    quality of life for unemployed or underemployed Soldiers. This program
    focuses on how Soldiers seek, obtain, and retain civilian employment.
        In 2009, the Army Reserve and the Army National Guard became
    partners in a collaborative effort to build relationships with
    employers. In 2010, the employment program was renamed to the Employer
    Partnership Office (EPO). The goal of the EPO program is to create
    employment opportunities for Soldiers by establishing a good working
    relationship with the private sector. The program, in 2011, is known as
    the Employer Partnership of the Armed Forces. Members from all the
    Reserve components, their Families, and Veterans have access to the
    tools and benefits of this program.
        Of most importance is the effort to build resilience in our
    Soldiers. We are training ``Master Resilience Trainers'' and
    ``Resilience Training Assistants'' both of whom are Soldiers with
    acquired resources and insights. They will be assigned to every
    Company-size unit and will be responsible for teaching Soldiers coping
    skills. There are many more efforts too numerous to cover here that are
    ongoing and I am confident that, as a team we will turn this trend
    around. In the end, I believe the Soldiers and Families of the Army
    National Guard will not just be physically strong, but will be an
    emotionally and spiritually stronger force in service to our States,
    territories, District and Nation.
                               medical readiness
        Medical readiness of the Army National Guard is one of our highest
    priorities and as such we have provided the States with additional
    resources in support of the medical readiness mission. A national Case
    Manager/Care Coordinator contract has been in place since 2006 to
    assist in supporting the management of Soldiers identified with medical
    conditions that prevent deployment. Currently 100 Nurse Case Managers
    and 328 Care Coordinators are supporting all medical issues to ensure
    Soldiers have the best opportunity to regain medical deployability
    status.
        In the past 2 years we have added full-time Medical Readiness NCOs
    (Non-Commissioned Officers) located in Battalion and above
    organizations. Medical Readiness NCOs are responsible for the
    identification of medical conditions which may require some action by
    the case management team and serve as the medical readiness advisor to
    the commander.
        Medical care has always been in place to support any Soldier in the
    ARNG with an injury or illness proven to be in the Line of Duty (LOD).
    The care is coordinated with the Military Medical Support Office
    through our Joint Force Headquarter Health Systems Specialist (HSS).
    Medical care provided based on an LOD is limited to the condition that
    occurred while in a duty status.
        Additional efforts have been made administratively to provide
    assistance to those Soldiers identified that have certain medical
    conditions. The ARNG Medical Management Processing System was
    introduced this past December and provides a framework to manage
    Soldiers identified with medical conditions through the complexities of
    our healthcare systems. Effective use of this framework can assist in
    the return of Soldiers into our formations or into the Physical
    Disability Evaluation System (PDES).
        In an effort to assist reserve component Soldiers who were having
    difficulty in negotiating through the Army PDES, the Army established
    the Reserve Component Soldier Medical Support Center. The purpose of
    the RC SMSC is to expedite and assist Soldiers with PDES processing and
    ensure packets going through this system are complete, validated and
    tracked through the Electronic Medical Board system (eMEB). We are
    currently validating our numbers, however, it appears up to 12,000
    Soldiers in the ARNG may require processing through the Medical
    Evaluation board/Physical Evaluation Board (MEB/PEB).
        When preparing our Soldiers for mobilization much time and effort
    is taken to ensure all Soldiers meet the medical standards as outlined
    by the theater of operation. Today, units arrive at mobilization
    stations with over 90 percent of all Soldiers in the ARNG arriving at
    the mobilization station ready for deployment. The other 10 percent
    have minimal medical actions required in order to clear them for
    deployment. With that said less than 1 percent of the ARNG Soldiers
    sent to mobilize come back to the State with an identified medical
    concern that prevents them from deploying into their theater of
    operation.
        Since September 2001, 640 ARNG Soldiers have paid the ultimate
    sacrifice in combat operations while 5,152 were wounded in action. As
    of March 7, 2011 the ARNG has 1,795 Soldiers assigned to the Warrior
    Transition Unit (WTU), 1,481 assigned to the Community Based Warrior
    Transition Unit (CBWTU) with a combined population of 3,276 Soldiers
    currently assigned. The cumulative numbers of Soldiers assigned since
    September 2001 is 29,007. Additionally, 5,164 Soldiers have been
    wounded in action and 10,702 suffered from disease or non-battle
    injuries while deployed in support of contingency operations.
        Soldiers who have deployed in support of a contingency operation
    have additional medical resources to call upon when the need arises.
    All Soldiers who deploy are eligible for TRICARE Early Eligibility 180
    days prior to mobilization and 180 days post mobilization through the
    Transitional Assistance Management Program (TAMP). Eligible family
    members are also able to participate in TRICARE during the Soldiers
    mobilization. Soldiers can also enroll in the Department of Veterans
    Affairs (VA) healthcare system during demobilization. Recently
    discharged combat Veterans are eligible to take advantage of an
    enhanced healthcare enrollment opportunity for 5 years after discharge.
    After the 5 year period, these Veterans will still be able to apply for
    health benefits with VA, but will have their status for receiving VA
    healthcare determined under normal VA procedures that base healthcare
    priority status on the severity of a service-connected disability or
    other eligibility factors. This would mean some Veterans could face
    income or asset-based restrictions, as well as delays in establishing
    their VA healthcare eligibility while their disability status is
    determined.
        Providing care for our Soldiers who have never deployed has
    improved since Congress passed legislation in 2008 to support
    participation in the TRICARE network via TRICARE Reserve Select (TRS).
    TRS is a premium based health plan available for members of the Ready
    Reserve and their family members. Current premiums are $53.16 per month
    for member only coverage and $197.76 a month for member and family
    coverage. Although that might not seem like a lot of money, for a
    junior enlisted Soldier that could mean his or her entire monthly drill
    check going to pay for healthcare premiums. As of January 2011, 15,769
    Soldiers are currently enrolled in TRS in the Army National Guard. The
    ARNG is focusing on reducing the number of medically non-deployable
    Soldiers within our formations, but without a full-time healthcare
    benefit medical readiness remains a challenge.
                                closing remarks
        I appreciate the opportunity to be here today and invite your
    questions and comments.

        Chairman Inouye. And now, may we begin the questioning?
        General McKinley, as we noted, the equipment levels of the
    Army and Air Guard have improved significantly, and I think it
    is due partly to the funding provided by Congress. The Army
    Guard now is 77 percent of the equipment requirements, up from
    40.
        Now, I have two questions, General. Have these increases
    improved readiness? And second, what additional equipment
    challenges remain?
        General McKinley. Chairman Inouye, I agree explicitly with
    your comment. We have really had a marvelous turnabout in our
    equipment fill rates. And I say that because your adjutants
    general tell me that. And my predecessors, our predecessors,
    working with your subcommittee, you know, put a line in the
    sand and said we need your help.
        And through the National Guard and Reserve equipment
    account, we have been able to fill out most of our critical
    needs. For us, the dual-use critical needs that can be used
    overseas and here at home to protect lives and property.
        I can assure you that it has improved readiness, and I will
    turn to my two colleagues to give you specific examples. But we
    cannot rest on our laurels. And that is the key for this
    operational force. This operational force did not just happen.
    It came on the backs of the taxpayers in this great country and
    by the fact that this subcommittee watched out for its National
    Guard and Reserve so carefully.
        After every major conflict that our country has faced and
    finished, the Guard and Reserve have been put back on a shelf
    to allow to deteriorate and go back to a state of unreadiness.
    And I think that my colleagues here at this table would ask
    that we not squander those gains because it has come at a great
    price. And we do have a magnificent National Guard today that
    all of you have seen, as you have gone home to visit.
        Ray, can you comment on the specific readiness
    improvements?
        General Carpenter. Senator, I would tell you, in the Army
    National Guard over the last 6 years what we have witnessed is
    fill rates inside of the organization that we never experienced
    before. We were short when we started into this global war on
    terrorism about 10,000 Humvees. We have all those Humvees now.
        The task now is modernization of equipment. We have nearly
    60 percent of our UH-60 Alpha model fleet that needs to be
    modernized over the next 7 years, and we have a plan, along
    with the Army, to make sure that that happens.
        We are still in the business of modernization in terms of
    our wheeled vehicle fleet, both in terms of medium trucks and
    heavy trucks. We have got shortfalls in communications
    equipment, night vision goggles, and some of the weapons
    systems. So even though we have the fill of the equipment, much
    of it is legacy, and the work left to do is modernization in
    the Army National Guard.
        General Wyatt. The Air National Guard has been fortunate in
    the past, oh, 10, 15 years in that the Air Force has relied
    upon us to be that operational force and has funded us
    adequately to do that. The issues today, however, are twofold
    for the Air National Guard, very similar to the issues that the
    United States Air Force faces, and that is we have a lot of old
    equipment.
        We have a recapitalization plan that we are working with
    the United States Air Force. We, to remain an operational
    force, need to be recapitalized concurrently at the same time
    as our active brothers and sisters and in a balanced fashion
    across all three of the components.
        To the extent that we must continue to rely upon legacy
    equipment--and we will continue to do that--modernization
    becomes the key. And this is where the NGREA account and the
    support that we have gotten from Congress has been significant
    and will be critical in the out-years. Because we know we are
    going to have to rely upon some of these legacy aircraft, some
    of these legacy systems, to remain that operational force that
    the country needs and that the Air Force needs.
        Right now, our equipment on hand is around 88 percent.
    Historically, it has been a little bit higher than that. With
    the current funding in the out-years, unfortunately we see that
    percentage dropping 1 to 2 percent per year through the next 4
    or 5 years without any additional support.
        So that is where the key support from Congress that we rely
    upon is to make sure that we use those monies smartly to make
    sure that our legacy systems are modernized for not only the
    overseas fight, but for the domestic protection of our citizens
    here at home.
        Chairman Inouye. Gentlemen, it has been suggested that in
    order to maintain effectiveness and readiness, family support
    services are absolutely essential. We have heard a lot about
    Yellow Ribbon. Can you tell us the present status of it?
        General McKinley. I think from my perspective, Senator
    Inouye, these last 10 years have been a challenge for the
    National Guard that they have met, in that our force was never
    designed in the 20th century for what it has been asked to do
    in the 21st century. A huge burden of that redesign has come on
    the backs of our employers and our families.
        Our traditional strategic force very rarely took employees
    in large numbers out of our local businesses, industry, police
    forces, firemen. That has changed dramatically. Our employers
    deserve a great deal of credit for that.
        Most importantly, and to your question, Yellow Ribbon. How
    do we bring our returning airmen and soldiers home, reintegrate
    them with their families, give them the care, and the necessary
    outreach that brings them back here, to treat their medical
    issues, to treat the issues that they experienced while they
    were deployed, and then to have those families come back
    together as a unit?
        I think Yellow Ribbon, and through the support of this
    subcommittee, has done a great deal to bring us back together
    as a family and a team. Our communities have done a great job.
    Our Governors in our States, territories, and the District have
    done exceedingly well. But we are still on the leading edge of
    this, and we will have decades to go to make sure we do not
    leave any guardsman or woman behind.
        Ray, would you like to comment on Yellow Ribbon?
        General Carpenter. Yes, sir.
        Senator, as you well know, the structure of the Reserve
    component is a geographically dispersed force that we only see
    in most cases once a month. And so, the challenge is how do we
    provide the same kind of service that our soldiers or the
    soldiers in the active component get from their installations?
    And Yellow Ribbon has been critical in that effort.
        In fiscal year 2011, we have conducted over 500 events. We
    have touched over 34,000 soldiers and families in that process.
    And it has been critical for us not only to maintain contact
    with those families and with those soldiers, but to provide the
    support and care that is necessary for them to sustain
    themselves and to make sure that we can maintain the Army
    National Guard that I described in my opening statement.
        General Wyatt. The Yellow Ribbon has been critical, I
    think, for the support of our airmen, both pre-deployment,
    during deployment, and post deployment. I have gone out to the
    States on several occasions and helped to present some of those
    programs to our airmen in the field.
        And the thing I want to do is take my hat off to the
    adjutants general because I think they have done a marvelous
    job of leveraging the resources provided through the Yellow
    Ribbon program with volunteers within their States, with some
    of the resources provided by some of the State agencies to take
    care of our airmen.
        I can give you a practical example of how we in the Air
    National Guard have specifically relied upon the Yellow Ribbon
    program to address the suicide issue that General Carpenter
    mentioned on the Army National Guard side of the house. We have
    the same issues in the Air National Guard side of the house,
    and we feel the strength of our organization is at the wing
    level.
        We have 89 wings in all 50 States, Guam, Puerto Rico,
    Virgin Islands, and the District of Columbia. And we made a
    decision this last year when funding was not available for
    embedded mental health professionals in each of the wings to
    use some of the Yellow Ribbon program to access the mental
    health professionals and place them at the wing locations. Had
    it not been for the Yellow Ribbon program, we would probably
    have not been able to do that.
        We are seeing significant improvements this year versus
    last year. We had 19 suicides in the Air National Guard last
    year, an all-time high. At this point in time last year, we had
    seven. So far this year, we have two. Some of the credit to
    that I am sure belongs to the Yellow Ribbon program and the
    health professionals that we have at each of the wings.
        Thank you.
        General McKinley. Senator, I am a little concerned--if I
    could just put something on the table for discussion--that most
    of the funds for our family programs are in overseas
    contingency operations (OCO) funding, supplemental funding. And
    had it not been for this subcommittee to provide monies that
    the Army and the Air National Guard could redirect to Yellow
    Ribbon and other things, we would not have that money in the
    budgets.
        And our Army and our Air Force realize that, and they are
    working hard with us to try to build these family programs into
    the base budget. But as you know, that will be a challenge in
    the future. So we continually depend on your help to make sure
    that the National Guard doesn't get left behind in the critical
    programs that I said will take decades to overcome. And we
    thank you.
        Chairman Inouye. I can assure you that this subcommittee,
    if we are to send men and women into harm's way, make certain
    they are properly equipped and properly trained. That is our
    promise.
        I have many other questions relating to suicides and the
    Southwest border mission and equipment shortfalls, but I will
    submit them to you, if I may?
        And now may I call upon the vice chairman?
        Senator Cochran. Mr. Chairman, thank you.
        I am curious to know what the status is between the panel
    we have here and the assessment of the need to cooperate with
    State and local governments when they are confronted with
    natural disaster challenges, such as the Lower Mississippi
    River Valley flooding situation right now.
        Is there a protocol or a regime for communication? Have you
    been called on to provide any additional resources to the
    States in that general area because of the Mississippi River
    flooding? Would that be something that you are authorized or
    required to respond to under the current state.
        General McKinley. Senator Cochran, by statute, the National
    Guard Bureau, the colleagues that are here in front of you
    today, are the channel of communications between the Department
    of Defense and the States, territories.
        I have talked to General Freeman, your adjutant general in
    Mississippi, on numerous occasions as the flood waters have
    increased. I have offered the services of our directorates here
    in Washington. He and Governor Barbour have asked for
    additional resources. They have sent those requests for
    additional funds to the Secretary of Defense, and the Secretary
    of Defense is working those on a case-by-case basis.
        But as you know, we are dealing with a crisis, multiple
    States, multiple jurisdictions. And it is our role to make sure
    that the adjutants general in those States communicate directly
    with us so that we can convey their issues and concerns to
    Secretary Gates through Secretary Paul Stockton, Secretary for
    Homeland Defense.
        Senator Cochran. Well, I think the good news is, from what
    I understand the facts to be, that the protection system of
    levees and preparation that have been undertaken over the last
    several years have worked to protect against flooding from the
    main stem, the Mississippi River itself, into those States that
    I mentioned.
        But what we are seeing develop is a backing up of waters
    outside the main levee system in the lower reaches of the river
    and backing up against the levees from the outside in and
    thereby causing a lot of farm land and other lands to be
    flooded at a very serious and dangerous level right now.
        That is one concern that I have. And I wonder if that is
    being discussed or your team is assessing all aspects of the
    situation there?
        General McKinley. Our team is more involved in the
    resourcing, providing resources to the National Guard in
    support of the Governor. The Army Corp of Engineers is doing a
    great job looking at those structural issues which you talk
    about. This is a centuries-long process. This flood is going to
    cause issues for months, maybe a year ahead of time.
        And I know it starts up in Indiana. I visited Marty
    Umbarger here last week. All the way down the Mississippi River
    basin, we are seeing the effects of this. So it is going to
    challenge all the Governors, all the States. It is going to
    require the National Guard to be there to support. And I pledge
    my firm commitment to you, Senator, to all of the States along
    the Mississippi River, our full support.
        Senator Cochran. We thank you very much for that
    commitment.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Coats.
        Senator Coats. Thank you, Mr. Chairman.
        And thank you, gentlemen, for your service to the country.
    I appreciate that, as we all do.
        General McKinley, you just mentioned our Adjutant General
    Umbarger. It is my understanding you will be in Indiana next
    week. I wish I could be with you because we have a little
    treasure down there in central-southern Indiana that has turned
    into a pretty remarkable training site for any number of
    functions.
        You know, one minute you are--you would swear you are in
    the middle of an Iraqi war zone city. Next moment you are in a
    place where our uniformed personnel are interrogating an Afghan
    tribal leader. The flexibility and the capability of that
    facility down there at Muscatatuck is something that you can
    only appreciate when you see it.
        So I really thank you for taking the time to go down and
    look at that. I think it is somewhat unique. And it is
    adaptable to just any number of situations. You can crawl
    through tunnels. You can storm buildings. You can, as I say, do
    interrogations and be in the simulated war zones, all on the
    same piece of property. So thank you for doing that. Trust you
    have a successful trip.
        General Wyatt, I would like to just ask you a question
    about the 122nd Fighter Wing in Fort Wayne, Indiana. There has
    been a successful conversion from F-16s to A-10s. I don't know
    what your future plans are relative to the A-10 mission, but I
    don't want to put you on the spot here.
        But I would be happy to work with you in terms of whatever
    issues that you might have as we go forward to ultimately,
    hopefully, a transition to the F-35s. But that has been a unit
    up there that has been part of base relocations, and it is a
    facility that I think meets the needs. And again, I would like
    to continue to work with you on that.
        I have been asking this question of just about everybody
    that comes before the Appropriations Committee. So I will ask
    it to you. Each group that comes forward expresses legitimate
    needs, and yet we are facing a serious deficit, debt problem.
    And it looks as if in order to address it we might have to have
    some shared sacrifice on a number of things and swallow hard on
    some decisions.
        And so, I have been urging anyone on the receiving end of
    appropriations going forward to in a sense have at least some
    thoughts about a plan B on the shelf. If the numbers don't come
    in where we would like them to come in, how do we prioritize
    the essential--I mean, the absolute essential from the ``like
    to have but not absolutely essential,'' from the, you know,
    ``if we were king and could have everything'' categories?
        So I just encourage you to be thinking along those lines
    because we face some hard realities in terms of the numbers,
    which is going to force all of us, I think, to think smarter,
    work harder, try to do more with less.
        And in that regard, I don't know if any of you want to
    comment on that. I know that you think about this all the time.
    I know that you have been going through these exercises. But is
    this something that is a priority, recognizing the reality of
    our budget situation?
        General McKinley. Senator Coats, let me just start, and
    then I will let my colleagues jump in from their perspectives
    from the Air Force and the Army. First of all, thanks for your
    acknowledgment of the National Level Exercise 11 (NLE 11) that
    will take place along the Mississippi River. It is a New Madrid
    Fault scenario that the Federal Emergency Management Agency
    (FEMA) has put in place for next week.
        They didn't expect to be dealing with real-world
    operations, but we are going to continue with NLE 11. And a
    major part of that will be conducted in Indiana at the Camp
    Atterbury training site and at Muscatatuck. It is hard to learn
    to say that name, but we have finally got it down.
        Senator Coats. It is. It took me a while also.
        General McKinley. Yes, sir. But it is a world-class
    training facility, one of several that the Army National Guard
    and the Air National Guard have around the Nation. And we thank
    you for your support. It is one of a kind.
        Facing hard realities. Obviously, being in the Department
    of Defense, Secretary Gates has set the bar very high for all
    of us to find efficiencies, to drill down and make sure
    everything we do comports with what we believe will be a
    declining budget.
        I am here to say, and I am sure my Reserve colleague chiefs
    will say, that the Reserve and the Guard provide a great value
    to America. About 7 cents of the dollar funds the National
    Guard, the Army and the Air. And our budgets are relatively
    spartan compared to some other budgets that we see.
        But that does not mean we should be immune from any of the
    discussions, the decisions, and the efficiency drills that are
    going on out there. And I can pledge to you that we are doing
    exactly that.
        Bud.
        General Wyatt. On the Air National Guard side of the house,
    you know, the point that you bring to the forefront, Senator,
    when we take a look at whether we will be able to fully
    recapitalize the United States Air Force I think remains to be
    seen.
        And you talked about the fighter wing at Fort Wayne. I had
    the privilege of visiting Fort Wayne in the first year that I
    was in the seat. They were just in that transition period from
    the F-16 to the A-10. And you are correct. They have made that
    transition very smoothly and are combat ready as we speak. That
    unit is a good example of what we are faced with, and I will
    talk about the fighter force in general.
        We have some of the oldest airplanes in the United States
    Air Force. And our challenge is to make sure that they remain
    combat capable, that our people are trained at the operational
    standards that they currently are at, as we take a look to see
    what the final recapitalization decisions will be.
        I don't think that we have the luxury of assuming that the
    recapitalization, as envisioned by the Air Force, will take
    place on time, on schedule, on budget. I think we have to be
    realistic to recognize that some of our legacy platforms are
    going to be around for a while. And the sooner we start--and we
    have started on all of our fighter aircraft and large airplanes
    also to make investments in the modernization of those
    aircraft.
        For example, in the C-130 fleet, we are making investments
    in the AMP program, which Congress has supported, to make sure
    that those aircraft can continue to fly while we wait for C-
    130J recapitalization, if and when that might come.
        In the fighter fleet, we are investing in structural
    enhancements through service life extension programs. In the
    Block 30 F-16 fleet, we have done the same thing. In the A-10
    fleet, trying to modernize situational awareness, a fusion of
    intel and sensors across all the platforms. And we will
    continue to do that.
        I think the key, though, is we have a tendency to focus on
    the equipment. But I think our real focus should be on our
    people. Because we have the most experienced, the most mature
    air crew maintenance crews in the Air National Guard that we
    have ever had. And if we don't focus on our people, we will
    find out one of these days that we have allowed our
    capabilities to atrophy.
        We have got to take a look at prioritization and maybe take
    a look at some of the lesser important jobs and capabilities,
    not doing that any more, to make sure that our front-line
    military capability remains what it is. Those are the tough
    decisions that you have talked about.
        As most of the members of the subcommittee know, the
    Quadrennial Defense Review (QDR) requirements for the fighter
    force set forth certain numbers of total aircraft inventory and
    primary aircraft inventory, and that plan is at a moderate risk
    assumption. And we are at that point right now. So we have got
    to be very judicious as we go out in the future, whether it is
    acquisition of new airplanes or modernizing our old ones.
        Senator Coats. Yes, thank you.
        General Carpenter. Senator, I am a veteran of being dragged
    through the tunnels of Muscatatuck by General Umbarger also.
    But it is a great training site, and it provides value not just
    to DOD, but also for the other Government agencies.
        With regard to your comment about looking forward to the
    budget challenges, the reference point for us is we are still
    at two wars. And the Army and the ground forces and marines are
    fully engaged in that.
        Between General Stultz, my Army Reserve partner, we are
    working with the Army to ensure that we make the right
    decisions about where we make reductions and to sustain this
    operational force. Because, frankly, the huge investment that
    has been made in terms of equipment, training, and manpower, if
    we don't take advantage of the Guard and Reserve in that
    particular perspective, we will be poorer, and we will have
    slighted the taxpayer.
        Senator Coats. Thank you.
        Mr. Chairman, thank you.
        Chairman Inouye. Thank you.
        Senator Murray.
        Senator Murray. Thank you very much, Mr. Chairman, and
    thank you to all of you.
        General McKinley, it is really disheartening to hear the
    stories from our National Guard members who are coming home
    from deployment into a poor economy and joblessness, no health
    insurance, financial hardship. And after all they have done for
    us, we want them to come home and be able to have good jobs and
    not feel like the ground is shifting underneath them.
        We have to, I believe, work really hard to help them
    assimilate back into the civilian world and be productive
    members in our workforce. It is my understanding that the
    demobilization process has to be done rapidly because the
    service members' deployment orders are cut for a specific
    length of time, and I wanted to ask you what recommendations
    you have to better maximize that transition assistance during
    that very abbreviated process.
        General McKinley. Thanks, Senator Murray.
        Obviously, General Lowenberg in Washington State has done
    some very creative things in working with Chambers of Commerce
    and other organizations to help alleviate some of the
    unemployment problems that we are seeing with some of our
    returning Army Guardsmen.
        That cannot stop. We have to continue and redouble our
    efforts in that area. And I, like you, am concerned about
    assimilation and will continue to focus on it.
        I would like to turn to Ray and talk about the mobilization
    process because it affects mostly the Army National Guard and
    some of my colleagues who will be on the next panel.
        General Carpenter. Senator, I think you are well aware of
    the discussions inside the Army in support of the 41st Brigade
    as they came through Joint Base Lewis-McChord. And the Army
    took that on as a challenge, and what we have done now is
    extended the timeframe that these soldiers spend at the
    demobilization site, as well as their entry into warrior
    transition units, if necessary.
        I think that, you know, your personal experience in the
    State of Washington with the 81st Brigade here almost 1\1/2\
    years ago, where that brigade came back with almost 33 percent
    unemployment, over 800 soldiers unemployed. And through the
    Joint Services Support program initiated in the State of
    Washington, we now see that number around 250, if my statistics
    are correct.
        But by and large, I just came from Iraq and Afghanistan in
    the last couple of months. And as I talked to the commanders in
    theater, they have already identified the people who are
    unemployed. And they are working with the States and with their
    communities to ensure that when they come back that they will
    have a job or they will be entered into the program to ensure
    that we take action to support them.
        And inside of those discussions, we have one State that has
    recently held a job fair, where 100 employers showed up. Nine
    hundred jobs were found for Guardsmen in that particular
    effort.
        And so, we are being innovative. We are arranging for
    soldiers to go to school there. The new GI bill, which has been
    supported by this subcommittee, is paying huge dividends in
    terms of retraining our soldiers for a job that they could
    access or one that they can get when they get back home.
        But the behavioral health piece is a big deal for us. And
    what we have told soldiers is you need to take the time when
    you go through the demobilization site. There are behavioral
    health specialists. They will counsel every soldier that goes
    through that site.
        It is going to cause them to be at those demob sites
    longer, but it is better to get the service at that point,
    rather than trying to go back and get it later. And we agree
    with you, the soldiers need to get the service equal to the
    service that they have provided to this country.
        Senator Murray. Okay. You have touched on a lot of issues.
    Obviously, the mental health issues, the California model of
    embedding, has been working very well. We are looking at trying
    to make that broader.
        But it is also getting to know what jobs and skills are
    available in the community that you are going back to, not just
    where you go back to your demob site. Are we trying to do a
    better job of actually helping our guardsmen really know what
    jobs are back in their own communities, and not just where they
    are demobilized?
        General Carpenter. Yes, Senator. We have taken that on. The
    53d Brigade that came back to Florida went through Fort Stewart
    in Georgia here about 4 months ago.
        And in conjunction with the employer partnership initiative
    that we have partnered with General Stultz and the Army
    Reserve, we had employers present at Fort Stewart. And in
    conjunction with that, we also had vans there where soldiers
    could get online and look and see what jobs were available in
    their communities through the employment offices there, as well
    as the initiatives for job fairs.
        This is a problem for us. And frankly, some of it is a
    reflection of the unemployment rates in the local populations.
    But we are doing the most innovative things we can to ensure
    that we employ our soldiers because, frankly, if they don't
    have a job, they are not going to stay in the National Guard
    because they won't be able to.
        Senator Murray. Right. And I am introducing legislation
    actually right now, focused on this whole issue of employment
    for all of our service members. And one of the things we are
    going to be looking at is mandating the TAP program for all
    service members, including the Guard, to make sure that our
    unemployed guardsmen are actually able to continue accessing
    some of the resources.
        So that is a critical part of our legislation. I hope to
    share that with all of you because you are right, General
    Carpenter. We have to keep people in the Guard and Reserves.
    And if they go home and can't find a job, they are going to
    abandon us.
        We have spent a lot of money on educating and giving
    training and skills to these service members. We don't want to
    lose that. So you will be hearing more about that.
        General McKinley, I would love for you to look at in-depth
    some of the excellent transition programs that are out there
    and identify some of the elements that have been particularly
    successful so we can consider incorporating them into the
    entire DOD effort.
        General McKinley. Thanks, Senator Murray.
        I will be meeting with the adjutants general in
    Indianapolis first week of June. If I could work with you and
    your staff and we could put out some best practices to all of
    our States, territories, and the District, I think that would
    be very helpful for all of us.
        Senator Murray. Great. Look forward to working with all of
    you on that. Thank you very much.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Graham.
        Senator Graham. Thank you, Mr. Chairman.
        Thank you all for your service. And like you say, the Guard
    and Reserve is a great bang for the buck when it comes to the
    American taxpayer and defending the Nation.
        In recruiting and retention terms, do you have the
    flexibility, in terms of bonuses, focusing on key areas, where
    there is a lot of pressure in terms of OPTEMPO?
        Anything we could do here to give you more flexibility to
    recruit and retain key specialty areas in the Army or the Air
    Force?
        General McKinley. Senator Graham, I will let my colleagues
    talk from their specific service vantages. But I will tell you
    that the Army and the Air Force generally have been very
    supportive during these last 8 years to target bonuses to those
    critical skills that we are losing.
        Obviously, in high cost-of-living areas around the country,
    we have to target certain critical skills so that we can keep
    those guardsmen and women located in those areas.
        I will let General Carpenter start, because the Army has a
    wide range of activities. I think, to your question, can we do
    better? Will we need to be more efficient?
        Senator Graham. I guess my question is, is there anything
    lacking that comes to mind that you would like to have?
        General McKinley. Ray.
        General Carpenter. Senator, at this point, we have got a
    lot of flexibility. The only limitation is the budget, for the
    most part.
        Beyond that, we are experiencing, you know, some difficult
    economic times, which, frankly, has yielded some increases in
    recruiting production and also, you know, an increased
    retention rate that we didn't experience 4 or 5 years ago.
        But when we see the economy turn around, we are going to be
    back probably looking at the bonuses programs and see where we
    go with that. And so, I would say the limiting factor in the
    out-years will be, as you might suspect, the budget.
        Senator Graham. General Wyatt, what percentage of the
    refueling fleet, at any given time, is manned by Guard and
    reservists?
        General Wyatt. Together, we comprise about 45 percent of
    the total air refueling capability across the United States Air
    Force, sir.
        Senator Leahy. What percentage?
        General Wyatt. Forty-five percent, sir.
        Senator Graham. Is there anything you would like to have on
    the Air Force side for critical skills that you don't have, in
    terms of flexibility?
        General Wyatt. Sir, you hit the nail on the head. Our
    actual end strength is right on par with our authorized end
    strength.
        But the issues that we have are getting the right people
    with the right skills in the right place. For example, even
    though our end strength is okay, we are short 1,300 officers.
        Senator Graham. Right.
        General Wyatt. And this comes at a time when the Air Force
    has an abundance of officers and, in fact, has some voluntary
    separation programs to help them leave active duty.
        I would like to see an easier transition from active duty
    to the Guard. We have some policies that we need to address
    inside the United States Air Force that I think would ease that
    transition.
        But some of the hurdles that we have to overcome, I think,
    were appropriately designed for a different time and a
    different era. We need to be able to move people through a
    continuum of service and make it easier for them, for example,
    if they want to come off active duty and serve a period in the
    Guard or the Reserve, to be able to do that. And then if there
    are life opportunities presented and they can go back on active
    duty, that would be great, too.
        We have a tendency to once a person separates, they are
    separated. And I would like to address it more in a transition
    mode, as opposed to separation mode.
        But from a dollar standpoint, the Air Force has been very
    helpful, giving us the flexibility we need to target recruit,
    which is what we are doing right now.
        Senator Graham. And I may not be here for the next panel,
    but I will have the same question, if you could give us any
    ideas about more flexibility? Two quick questions, and I will
    let you go.
        Any recommended changes in the mobilization statutes to
    make life easier for those mobilized and more flexibility for
    the commander to be able to shape the force? And the other
    question is on the budget side, how do we deal with the
    escalating cost of healthcare within DOD's budget? It affects
    you in the sense it absorbs dollars.
        We are talking about 16 percent of the budget in the next
    20 years being spent on DOD healthcare. We haven't had a
    premium increase in TRICARE since 1989. Is that sustainable,
    and what would be your recommendation to the subcommittee as to
    how to address that issue?
        General McKinley. I will let General Carpenter talk on the
    mobilization process question because I think the Army National
    Guard and, obviously, the Army Reserve will have the most
    comments on that.
        On healthcare costs, obviously, Secretary Gates has told us
    all to think about new ways of doing business better. It is a
    huge chunk of our appropriation, and we don't see a lot of
    guardsmen, young guardsmen taking the TRICARE program. They
    must feel like they don't need it. They may not be expected to
    do it.
        But over time, we are going to need to work the healthcare
    budget for Guard equally as hard as the active component, sir.
    So I will work with Secretary Gates and his team to make sure
    that is on our high-priority list.
        But if I could ask Ray to talk about the mobilization
    issues?
        General Carpenter. Senator, very quickly, I think probably
    the best thing that happened to us in mobilization was the 1-
    year mobilization for the Reserve component. Because we had
    seen some units go down range, do 1 year boots on the ground,
    extend it for 3 months, end up with 15 months, and by the time
    you put the 6 months in front of that that they had at
    mobilization station, it was almost 2 years away from home. And
    you can't sustain a reserve component with that. And so, the 1-
    year mob was terrific for us.
        The other side issue is, is when we get done with what we
    are doing in Iraq and Afghanistan, we think that the Guard and
    Reserve should be engaged in theater cooperation and security-
    building in terms of other combatant commands around the world.
    And inside of the Department, we are looking at some provisions
    for involuntary mobilization for doing those kinds of things on
    a lot shorter basis, maybe 60 days or 90 days or something like
    that.
        So we can continue to use, again, the investment we have
    made in the Reserve component to do preventive things out
    there, so we don't end up where we are at right now in the
    current world environment.
        Chairman Inouye. I thank you very much.
        Senator Leahy.
        Senator Leahy. Thank you, Mr. Chairman.
        I want to compliment Senator Murray on her legislation,
    which she is introducing today. I will cosponsor and support it
    again.
        And General McKinley, of course, always a pleasure to see
    you, and I want you to know that Senator Graham and I are
    determined to keep empowering the Guard, as Senator Bond and I
    did in the past as the co-chairmen of the National Guard
    Caucus.
        I know you have been without a deputy at the National Guard
    Bureau for some time, and I believe I can speak for both of us
    that we believe it would help you further if your staff
    director was replaced by a vice chief position at the three-
    star level. Now what do you think of that proposal?
        General McKinley. That is a rhetorical question, I am sure,
    Senator. But quite frankly, I think for us in the National
    Guard to function as a full-spectrum bureau--because we are not
    a headquarters. We uniquely serve the States. So we are a
    bureau. Without that position filled, we can't represent the
    States and the territories at the critical meetings and the
    junctures that we have to attend.
        And as you know, in our building, if you are not wearing
    the proper grade or rank, you are not going to be offered a
    seat at that table. So we fully support that. We know it is in
    an era of diminished resources and our rank structure is coming
    down, but we appreciate all the support we can get.
        Senator Leahy. Well, both Senator Graham and I have had
    discussions at the highest levels on this, and it will happen,
    I think, at some point. Just like your own position was one
    that Senator Bond and I pushed hard for with the support of
    each of the Senators who are here.
        Now, for a long time earlier, I worked with Senator Bond to
    include funds for the National Guard and Reserve equipment
    account, and we want to continue to do this. We pursued a
    separate funding for the Guard and Reserve components because I
    was concerned they never seemed to get a concurrent and
    proportional amount of equipment.
        And I am just wondering, do you face these kind of
    shortages, and have they been exacerbated by the needs of the
    Guard and Reserve in Iraq and Afghanistan?
        General McKinley. I think it is a very relevant question
    because, as you know, the funding does come through to us
    through the Army and the Air Force, and we do diligence with
    their staffs to obtain the proper amounts of funding. I don't
    think any program gets the full amount, but we have been
    adequately financed by our services over time.
        What concerns me, Senator Leahy, is the fact that the
    domestic operation, the taking care of the homeland, the
    equipping of our units to handle large-scale natural disaster,
    man-made disaster, we have got to make sure, as National Guard
    Bureau staff, that the States get their fair share of that.
        And as we have talked about with Senator Cochran, this
    historic flooding along the Mississippi River, multiple States,
    the States are going to need some resources. FEMA is doing a
    great job. Administrator Fugate doing that exceedingly well,
    but we want to make sure the National Guard is able to do their
    job, too.
        Senator Leahy. Well, let me talk about that because when
    you watch the news--certainly Senator Cochran knows this far
    better than I because he has talked to his constituents along
    there--but just looking at the horrific news and what is
    happening, we know the Guard has got to be called out.
        And I always worry when we have these natural disasters,
    the Pentagon has to shift money around instead of having money
    prepared for it. In my own State, we have had unprecedented
    water this spring from snow runoff. Lake Champlain is at the
    historic high of 102 or 103 feet above sea level.
        I flew up there Friday, and just looking out the windows as
    I flew up, I could see areas that normally have small rivers,
    small streams are now flooding fields, farm land, roads,
    bridges.
        Governor Shumlin has called out the Guard to respond. Of
    course, the Guard responds immediately, as they do, whether it
    is in Vermont or Mississippi or Hawaii, or anywhere else. And
    shouldn't we have special funding for such domestic disasters?
    We would like to think there never will be any, but every year
    there is something.
        General McKinley. It is really my role, and I have tried to
    assume this mantle of working with FEMA, Department of Homeland
    Security, Department of Defense through Secretary Stockton in
    homeland defense and DOD, we feel the adequate funds are there,
    but they are difficult to get.
        The Governors have got to meet certain criteria for what we
    call 502(f) funding sourcing through the department. It is
    cumbersome, and my job has been to try to make this more
    seamless, more easily accessible, and get the funding to the
    States and the Governors when they need it in a timely manner.
        We are not there yet, in my opinion. We have got to
    continue to do a much better job.
        Senator Leahy. Well, let us work on that because the key is
    responding in a timely manner. When the Mississippi is flooding
    or when there is an ice storm, which happened a few years ago
    in the province of Quebec, and it knocks out power to a large
    portion of my State, if it had not been for the Guard, it would
    have been a total disaster. And they were the only ones able to
    move in immediately before commercial entities could go in.
        And General Carpenter, I will work with Senator Murray on
    the issues that she talked about, and I appreciate what you
    said.
        Last, General Wyatt, I don't have to tell you that many of
    the Air Guard wings are already experiencing a drawdown of
    their fighter aircraft. You and I have talked about this
    before. In Vermont, the 158th Fighter Wing is going to have
    three F-16s shifted into back-up inventory, and we assume that
    is just the beginning.
        This was the fighter wing that flew air cover for a long
    period of time over New York City after 9/11. Now some Air
    Guard wings will eventually receive replacement F-35s, but the
    overall number suggests some Air Guard wings don't have any
    planned replacements.
        So what is the Air Force telling you about the future of
    these air wings? There are those back--I don't want to seem too
    parochial, but there are those back home who have some interest
    in your answer.
        General Wyatt. I imagine so, sir. No, I think you see in
    Vermont the issue that faces not just Vermont, but a lot of our
    fighter force and lift force, too, when you take a look at the
    age of our C-130 fleets. And we have only two units with C-130J
    models and one other unit that has some.
        The issue in the fighter fleet is that we are already at
    that number, that QDR number for national security on the
    numbers of total jets, combat fleet in the entire United States
    Air Force, and a lot of those reside in the Air National Guard.
    There are six States, including Vermont, who face what you just
    mentioned with a reduction of 3 of the 18 jets that they have
    on the ramp from primary aircraft inventory to back-up aircraft
    status.
        The good news is that there is weapons system sustainment
    for those monies. The bad news is that there are no flying
    hours for those airplanes that come along. So I am concerned
    about their readiness and the ability to train the pilots and
    the air crews in those particular units.
        Because the Air Force, I think, intends to rely upon the
    capabilities in the Air National Guard for a significant
    portion of the combat fleet. We fly about 33 percent of all the
    combat Air Force sorties. We are currently working with the Air
    Force. We have a few more processes inside the United States
    Air Force to accomplish, but we are working a plan that, if
    successful and depending upon budgets and everything else that
    we are faced with, trying to get those three aircraft back up
    on PAA status at all six of the units.
        Air Combat Command has been particularly helpful in helping
    us through that process and very supportive. And we should know
    here in the next few months whether we are successful or not.
    But the idea is that we cannot afford as a country to lose that
    capability, and we need to preserve the life of those airplanes
    as long as we can with the capabilities that our Air guardsmen
    provide until that point in time when recapitalization does, in
    fact, take place.
        Senator Leahy. Well, please keep me posted.
        Mr. Chairman, I was impressed--if I could just brag a
    little bit? After 9/11, I got a call from our adjutant general
    that we were flying air cover over New York City around the
    clock with our F-16s. And I said, ``Well, where are you basing
    them?'' He said, ``We are doing it right here in Burlington,
    Vermont,'' which is about 250 miles away.
        He did point out--Senator Graham, you will appreciate
    this--that it took them a lot less time to get to New York City
    than I do flying down commercially. But the thing is we had our
    mechanics, our air crews, everybody, a number of whom were
    heading off on vacation when they heard this.
        One senior crew chief did a U-turn on the interstate,
    headed back, got out of the car. At the gate told his wife,
    ``Send some clean clothes, you are not going to see me for a
    while.'' And he slept in the hangar and just kept working. He
    recalibrated all the weapons, all the things in a rather aging
    fleet and kept the planes flying. There wasn't any single
    mission that wasn't fulfilled during that time, around the
    clock.
        My last story, and I think General McKinley has heard this,
    my wife and I went to visit with the Air Guard after 2 or 3
    weeks of this to thank them. And I told the story about
    somebody who had written a letter to my office in August,
    complaining about the noise of F-16s and then called the office
    in early September and asked if I had gotten that letter.
        My staff said, ``Well, yes, but he has been a little bit
    busy. What is going on? He hasn't answered?'' My constituent
    said, ``No, no. Please tear up the letter. I think the planes
    sound wonderful.''
        Thank you.
        General McKinley. Thank you, Senator Leahy.
        And to Senator Graham, you will be pleased to know that the
    McEntire Swamp Fox just assumed alert in South Carolina. They
    joined our fleet of air sovereignty alert aircraft, and we
    thank you for that support.
        Chairman Inouye. General McKinley, General Wyatt, General
    Carpenter, the subcommittee thanks you for your testimony this
    morning. And we would like to indicate our appreciation and
    gratitude for your service to our country.
        Thank you very much.
                                    Reserves

    STATEMENT OF LIEUTENANT GENERAL JACK STULTZ, CHIEF,
                ARMY RESERVE
        Chairman Inouye. And now, may I call upon General Stultz,
    Admiral Debbink, General Moore, and General Stenner to come
    forward?
        Gentleman, welcome to the subcommittee. And may I now call
    upon General Stultz for his testimony?
        General Stultz. Mr. Chairman, Mr. Vice Chairman, it is an
    honor to be here today on behalf of 206,000 Army Reserve
    soldiers, men and women serving this Nation in uniform around
    the world.
        And I have submitted my statement for the record. So I will
    try to keep this brief in respect of the time we have got.
        But I would just make one comment. You, in your opening
    comment, sir, said you are interested in seeing the Reserve of
    the future. I am here to report to you today I have seen that
    Reserve of the future.
        Because in the past year, I have traveled around the world
    to 17 different countries, and I have visited Army Reserve
    soldiers in Ethiopia, Uganda, Kenya. Army Reserve soldiers just
    returning from Vietnam and Cambodia on their way to Jakarta.
    Army Reserve soldiers in El Salvador, Guatemala, Costa Rica.
    Army Reserve soldiers in Japan, Italy, Germany, Kosovo, as well
    as, we all know, Iraq and Afghanistan.
        And these Army Reserve soldiers are on-point for our
    Nation, standing side-by-side with Army Guard and active Army
    soldiers, and you can't tell the difference. In some cases, you
    can. In some cases, our Army Reserve and Army Guard soldiers
    are actually higher skill level than their active component,
    only because they have the civilian skill sets that create a
    force multiplier for them.
        And I have seen them in the combat role that we need them
    to be prepared and ready to go, and my formation is mostly in
    the combat support and service support formations. But I have
    also seen them in the humanitarian role--in theater engagement,
    security cooperation, providing medical, engineering, foreign
    army training, logistics, and other support to those nations
    that we aren't in conflict with. We are actually preventing
    those nations and helping them establish democracies and
    winning the hearts and minds of their people.
        And as we move forward as a Nation, confronted with the
    budget issues we are going to have, confronted with how do we
    reduce the deficits, confronted with the where do we get the
    biggest bang for our buck, biggest return on investment, what I
    can report to you and the others today is your Reserve
    component--and I speak for all my colleagues here, as well as
    our Guard colleagues--are a great return on investment. They
    have proven themselves.
        And as we are making decisions about what the structure of
    the military for the future needs to look like, my urging to
    you and others is your Reserve components are key, and we need
    to be resourced as such with the equipment. We need to be
    resourced as such with the funds needed to train, and we need
    to be resourced as such to take care of our families.
        And we give you a heck of a return on the investment. We
    have proven ourselves.
        And I think the other thing we have proven, as we have gone
    through the transition from a strategic to an operational, is
    we have got great men and women, a really national treasure
    that raise their hand, volunteer to serve their Nation, leave
    their civilian jobs, leave their families, leave that American
    dream that they are living, knowing that they may be called
    upon to make an ultimate sacrifice on the battlefield. And they
    are doing that in record numbers.
        Our recruiting, our retention is at all-time highs. So we
    know we have got a force there that is there for us. They love
    their country, and they know their country loves them.
        What we cannot afford to do is go back. We cannot afford to
    go back to that strategic model, that one weekend a month, 2
    weeks in the summer, that is all we are going to use you for,
    because we will lose that national treasure. Because they
    joined our force since 9/11, and they joined our force to be
    utilized.
        And as Ray already mentioned, it doesn't have to be for 12
    months. It can be for 3 months in El Salvador and come back
    home and feel good about what you have done, feel good that you
    have been utilized, but make a positive contribution for this
    Nation.
        So on behalf of that 206,000, sir, I appreciate all the
    support you have given us and all the support you will continue
    to give us. And I look forward to your questions.
        Thank you, sir.
        Chairman Inouye. Thank you very much.
        [The statement follows:]
              Prepared Statement of Lieutenant General Jack Stultz
                                  introduction
        Chairman Inouye, Senator Cochran, distinguished members of the
    subcommittee; thank you for the invitation to appear before you today
    to discuss the state of your Army Reserve. It is an honor to testify
    before you on behalf of more than 205,000 Army Reserve Soldiers.
        After nearly 10 years supporting the warfight in Afghanistan and
    Iraq, the Army Reserve is a battle-tested, seasoned, and a trusted part
    of the total force.
        Our formations routinely meet the demand for military capabilities
    that support domestic and expeditionary operations.
        As an operational force, we offer strategic agility and depth as a
    cost-effective solution in a resource-constrained environment.
        I strongly contend it is our obligation to the Nation, and to
    future generations of Army Reserve Soldiers, that we remain
    operational.
                          road map for the next decade
    2020 Vision and Strategy
        Details my vision for the Army Reserve as an enduring operational
    force and serves as a broad blueprint for achieving it.
        Establishes the foundations for the operational concepts and
    strategies; organized, modernized, postured, and resourced to provide
    support to the Total Army.
                          initial steps taken to date
        The Army Reserve Enterprise--new management culture where leaders
    function for good of the enterprise.
        Realignment of Army Reserve Headquarters, Legacy and Command and
    Control structure.
        Expanded Outreach to all Service Members and Families through three
    Virtual Installation pilot sites.
        Cultivating positive Soldier-Employer relationships--a must for an
    operational force of the future.
                          priorities for the next year
        Expand Virtual Installation to five pilot sites using fiscal year
    2012 Milcon appropriations.
        Strengthen Total Wellness Programs--improved medical and dental
    care, behavioral health support, and spiritual care.
        Develop a Program Objective Memorandum (POM) 13-17 strategy that
    reflects the resource requirements of an operational force in the Base
    Budget.
                    an operational force benefits the nation
        Helps the Army mitigate current capability shortfalls and allows
    for a greater role in the Nation's defense with: Combatant Commander
    Security activities; domestic disasters; Security Cooperation
    Operations; Contingency Operations; and Theater Security Cooperation
    Programs.
        The Army Reserve is a ``best value''--the Nation pays the full cost
    for a reserve component Soldier only when he/she is mobilized.
                                   conclusion
        We have built an Army that is dependent on having access to the
    reserve when it needs us.
        Choices made now will determine the Army force mix and capability
    for the future.
        Do we turn back the clock and revert to a strategic reserve, with
    limited readiness capabilities as the current conflicts resolve or do
    we ensure the defense of the Nation with an enduring operational force
    with the readiness levels that provide operational capabilities across
    the full spectrum of conflict.
        Thank you once again for inviting me today to speak before this
    committee and for supporting our Citizen-Warriors.
        I am ready to address your questions.
                                     ______

               United States Army Reserve 2011 Posture Statement
        The annual Army Reserve Posture Statement is an unclassified
    summary of Army Reserve roles, missions, accomplishments, plans, and
    programs. The 2011 Army Reserve Posture Statement also addresses the
    support required by the Army Reserve to continue its transition to an
    operational force during fiscal year 2012.
        Unless otherwise noted, all statistics and facts are current
    through March 2011.
        This document is available on the Army Reserve website at:
    www.usar.army.mil.

                                                            March 2011.
                         an enduring operational force
        For more than 100 years, the United States Army Reserve has served
    as the Nation's Federal strategic force in reserve, supporting the war
    and peacetime needs of the Regular Army. Since our Nation's involvement
    in Afghanistan and Iraq, combatant commanders have urgently called for
    many of the enabling capabilities resident within the Army Reserve,
    including logistics, engineering, security, medical and civil affairs
    support.
        The steady, consistent, and recurring demand for Army Reserve
    capabilities during this decade has posed significant challenges for a
    force organized and resourced as a strategic reserve. In response, the
    Army Reserve recast itself from the part-time strategic reserve role to
    a fully integrated and critical part of an operational, expeditionary
    Army that supports the Nation's evolving and challenging wartime
    requirements.
        In today's national economic and political climate at home and
    around the world, it makes good business sense to sustain the enabling
    capability provided by the Army Reserve. Compared to the cost of
    expanding the full-time Army force, a relatively smaller investment in
    the Army Reserve provides security at home and supports the fight
    against terrorism abroad. The Army Reserve responds to domestic
    disasters, when authorized by the President of the United States, and
    also participates in security cooperation operations while protecting
    national interests around the world. In support of contingency
    operations, the Army Reserve responds to life-threatening situations
    and fosters stability in underdeveloped nations where conditions are
    ripe for terrorists to gain a foothold. The Army Reserve is a ``best
    value'' in that the Nation pays the full cost for a reserve component
    Soldier only when he/she is mobilized.
        Many companies in private industry use a similar strategy. Firms
    that specialize in tax preparation, for example, hire certified
    accounts/tax preparers to handle the heavier customer demand that
    occurs from the beginning of a new year to the filing deadline of April
    15. They too cannot afford, nor would it make good business sense, to
    maintain a full-time accountant force during off-peak seasons. The
    relatively low cost of hiring seasonal workers adds to their bottom
    line.
        The Army Reserve conducted an analysis that shows over a 15-year
    period, an enduring operational Army Reserve provides key capabilities
    for the Army at significant cost savings. We measure the savings by
    comparing the active component and reserve component costs of building
    readiness, deploying and employing forces.
        The Army Reserve prepares for service by employing the Army Force
    Generation (ARFORGEN) model--a 5 year structured progression of
    increased unit readiness over time resulting in periods of available
    trained, ready, and cohesive units prepared for operational deployment.
        Under the current ARFORGEN process, an active component Army
    Soldier spends 2 years in a non-deployed status at a cost of $140,000
    per year--compared to his/her Army Reserve counterpart who spends 4
    years in a non-mobilized/non-deployed status costing $47,000 per year--
    that's about one-third the cost of an active component Soldier for
    train-up. This cost savings is achieved by providing cyclical
    capabilities to the Army and predictability for Soldiers and their
    Families.
        During a 15-year period, an active component Soldier spends 5 years
    deployed with an overall average cost of $143,000 per year compared to
    the Army Reserve Soldier who spends 3 years mobilized/deployed with an
    overall average cost of $68,000--that's about half the cost of an
    active component Soldier.
        An operational Army Reserve not only saves money, it helps the Army
    mitigate current capability shortfalls. For example, the Commander of
    Africa Command, General William E. ``Kip'' Ward, and the Commander of
    European Command, Admiral James G. Stavridis related in testimony
    before the Senate Armed Services Committee on March 9, 2010, that
    employing an operational Army Reserve to support combatant commander
    security activities would provide significantly more capability for the
    mission while maintaining invaluable operational experience, hard-won
    from current operations. Using the Army Reserve in security cooperation
    missions also reduces the demand for active Army capabilities, allows
    the active component to maximize time at home between deployments, and
    provides the Army Reserve with the opportunity to employ and refine its
    multifunctional skills.
        An operational Army Reserve can be key to developing cooperative
    security arrangements (collaboration with regional nations, interagency
    and non-governmental organizations, and regional institutions to
    respond to the broad range of regional contingencies) while building
    Partnership Capacity by strengthening and expanding relationships with
    allies and partners. The Army Reserve could also mitigate the costs
    that an active component unit would require in Korea (family housing,
    child-care, medical, etc.) by providing trained and validated units for
    1-year tours.
        It makes good business sense to sustain the enabling capability
    provided by the Army Reserve for now and into the future. Army Chief of
    Staff, General George W. Casey, Jr., has said there is no viable
    alternative to having a fully operational Army Reserve to sustain
    today's combat support needs and those of the future. As the Army
    evaluates the resource requirements to sustain and improve Reserve
    ``operational capabilities,'' decisions on full-time staff, funded
    training days, and sequencing of training (pre-mobilization/post-
    mobilization) drive the cost.
        Operationalizing the Army Reserve has thus created a requirement
    for an enduring level of readiness support that cannot be sustained
    with current supplemental funding. The Army Reserve must have
    predictable funding in the base budget to ensure Soldiers are well
    trained, well prepared, and well equipped at all times to respond to
    the Nation's needs. An enduring operational force cannot be fully
    effective if it has to borrow personnel and equipment from one unit to
    shore up another to meet mission requirements. Lending creates
    turbulence within units and diminishes gained efficiencies.
        For now and into the foreseeable future, the Army Reserve will
    function as an operational force. The required institutional, policy,
    and systemic resource processes and procedures are being transformed to
    ensure a sustainable and ready force capable of operating across the
    full spectrum of conflict.
        The Army Reserve is a positive investment for the Nation. We
    provide necessary combat support and combat service support to
    combatant commanders where and when needed, thereby saving limited
    resources. We train Soldiers who accomplish daunting tasks and provide
    critical support on the battlefield. We give back to the Nation highly
    trained, mature and refined Soldiers, who also provide civilian
    employers the kind of talent needed to sustain the local economy.
        America can make no better investment than sustaining an enduring,
    operational Army Reserve.

                             Lieutenant General Jack C. Stultz,
                                     Chief, United States Army Reserve.
                     Command Sergeant Major Michael D. Schultz,
                    Command Sergeant Major, United States Army Reserve.

        As America remains a Nation at war, the Army Reserve continues to
    be a cost-effective force as evidenced by what we accomplished with the
    fiscal year 2011 budget Congress appropriated to us. The $7.9 billion
    Army Reserve appropriation represented only 4 percent of the total Army
    budget; yet in 2010, we achieved the following results within the four
    core elements (Human Capital, Materiel, Readiness, and Services and
    Infrastructure) of the Army Reserve Enterprise as outlined below.
    Human Capital
        Human Resources.--In fiscal year 2010, the Army Reserve conducted
    525 Yellow Ribbon Reintegration Program events, serving 26,000 Soldiers
    and 28,000 Family members.
        Chaplain.--Army Reserve chaplains conducted over 300 Strong Bonds
    events throughout the country and territories, enhancing Soldier and
    Family communication and relationship skills. Some 12,500 Soldiers and
    Family members participated in these events and received this training.
        Behavioral Health.--Licensed clinicians are following up on the
    urgent referrals generated by the Periodic Health Assessment and Post
    Deployment Health Reassessments. Working on an ``Assess and Refer''
    model, clinicians conduct bio-psycho-social assessments of each
    individual who is referred and determine the appropriate level of
    follow-up. They do not provide treatment. The major illnesses being
    identified that are Post Traumatic Stress, Major Depression and
    Substance Abuse.
        Medical and Dental.--Army Reserve medical readiness improved from
    23 percent on October 1, 2008 to 60 percent as of September 23, 2010.
    Programs such as the Army Select Reserve Dental Readiness System
    (ASDRS) have been highly successful. Dental readiness, which is
    currently at 74 percent, has improved 21 percent over the last 2 years,
    and is one of the key elements improving medical readiness. We
    converted 168,829 Soldiers' paper records to an electronic Health
    Readiness Record, allowing us to take full advantage of efficiencies in
    time, cost, and services over the continued use of paper treatment
    records. The Army Reserve successfully conducted suicide prevention
    training throughout the force. As a result, we have seen an improvement
    in communication with at-risk Soldiers and proactive involvement on the
    part of our subordinate commands.
        Family Programs.--The Army Reserve Virtual Installation Program
    served some 5,501 military members and their families, from all
    branches of the armed services during fiscal year 2010--bringing the
    resources of active military installations to geographically dispersed
    military Families. Three pilot sites at Army Strong Community Centers
    offer information and assistance on many issues, such as concerns with
    TRICARE, legal matters, retirement, GI Bill, and child and youth
    services.
    Materiel
        The Army Reserve established new Equipment Fielding facilities to
    increase throughput of new equipment issues to units. This has allowed
    the Army Reserve to execute the largest distribution of new equipment
    in recent history. Over 23,000 pieces of equipment were provided to
    Army Reserve units, enhancing their readiness. Using near real time
    databases in ``bridging'' logistics information and management systems
    led to an automated process to define manpower requirements in
    equipment maintenance support structure. The Army Reserve is on track
    to successfully implement the Army's initiative for managing
    organizational clothing and individual equipment.
    Readiness
        Operations.--Army Reserve continues to provide vital capabilities
    to combatant commanders in support of overseas contingency operations.
    More than 196,711 Army Reserve soldiers have mobilized in support of
    Operation Iraqi Freedom/New Dawn (OIF/OND) and Operation Enduring
    Freedom (OEF) since September 11, 2001. Today, more than 15,584 Warrior
    Citizens are serving in Iraq, Afghanistan and 22 other countries around
    the globe. Army Reserve Aviation continues to lead the way in Air
    Traffic Simulation. Thanks to funds approved by Congress, the Army
    Reserve fielded more than 630 Laser Marksmanship Training Systems to
    346 Army Reserve locations during the past year, while having the means
    to develop and field ``bridging'' logistics management and information
    systems.
    Services and Infrastructure
        Facilities Management.--The Army Reserve successfully awarded over
    $432 million in Military Construction (Milcon) projects in 2010.
    Several new Army Reserve Centers will achieve net-zero energy usage
    (self-sufficient without drawing additional power from the electrical
    grid). The Army Reserve has developed innovative passive building
    design techniques to achieve low-technology, low-cost energy
    efficiency. We are installing solar collection fields, wind turbines,
    and geothermal plants at several new facilities. The Army Reserve has
    started a retrofit program, replacing lights, windows, roofs, and other
    components with new energy-efficient technology, resulting in
    substantial savings in utility costs.
        The Army Reserved also realized monetary benefits totaling
    approximately $232 million during the last year through the Office of
    Internal Review, which provides Army Reserve leadership timely,
    independent and professional review/audit, evaluation, and consulting
    services.
                            army reserve priorities
        Continue to transform to an enduring operational force.
        Continue to provide the best trained, best led, best equipped
    Soldiers and units to combatant commanders to achieve U.S. objectives
    and ensure national security.
        Recruit, retain, and reintegrate through a Continuum of Service the
    best and brightest Citizen-Soldiers to sustain a robust and capable
    operational Army Reserve.
        Provide Citizen-Soldiers 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
    Citizen-Soldier contributions 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, in accordance with the
    Army Reserve fiscal year 2012 budget request
                             the president's budget
        The President's budget will allow the Army Reserve to:
      --Continue Army Reserve internal transformation to an Enduring
            Operational Force.
      --Shape Army Reserve End-strength by recruiting, retaining, and
            reintegrating, through a Continuum of Service, the best and
            brightest Citizen-Soldiers.
      --Equip units and Soldiers to train and fight to achieve U.S.
            objectives and ensure national security.
      --Provide quality medical and dental services and support to Soldiers
            and their Families.
      --Sustain Army Reserve installations and facilities.
             the posture of the army reserve: where we stand today
        Today's Army Reserve is uniquely positioned and structured to
    provide operational support in complex security environments. We can
    meet Army requirements for combat support or combat service support
    roles. Many civil affairs, psychological operations, medical,
    transportation, engineer, and information operations capabilities
    reside exclusively, or predominately, within the Army Reserve. Our
    ability to mobilize quickly and responsively makes the Army Reserve
    ideally suited to meet our Nation's future requirements. Army Reserve
    Soldiers will remain a vital part of the Total Army Force facing the
    national security challenges of the next decade and beyond.
        During the Cold War era, the Army Reserve principally operated as a
    force in reserve. The first Gulf War, in 1990-1991, served as a
    catalyst for thinking about using the Army Reserve in a more
    operational capacity when large numbers of Reserve forces were engaged.
    Since the Gulf War, the Nation has employed the Army Reserve in many
    different ways and at unprecedented levels, most significantly after
    September 11, 2001. The demands of persistent conflicts over the past 9
    years were--and continue to be--beyond the ability of the Active
    component to meet alone. As a result, the Nation has relied heavily on
    the Army Reserve to fill operational requirements, fundamentally
    changing the role of the Army Reserve from a strategic to an
    operational force.
        Today, with the drawdown of forces in Iraq nearing completion and
    the proposed drawdown in Afghanistan, we can expect to see declining
    Department of Defense budgets for the near-to-mid term, as well as
    potential end-strength reductions, while still preparing for future
    operations in a volatile, uncertain, complex, and ambiguous security
    environment. A Total Force, maximized for strategic agility at reduced
    cost, provides the necessary capabilities to the combatant commander.
        The Nation and the Department of Defense are now at a strategic
    juncture with respect to the Army Reserve. Choices made now will
    determine the Army force mix and capability for the future. The choice
    can be to return to a strategic Reserve with limited readiness
    capabilities as the current conflicts resolve, or become an enduring
    operational force with the readiness levels that provide operational
    capabilities to meet the Nation's defense requirements across the full
    spectrum of conflict.
        Between 2001 and 2010 the Nation invested $52.7 billion to man,
    equip, train, and employ an operational force. The Department can
    choose to forgo the $52 billion investment, and over the next decade,
    the Army Reserve will revert to a strategic Reserve. This change would
    occur slowly over the first few years and then accelerate, by default,
    as the hard-won operational experience of our Soldiers atrophies and
    further resource constraints are implemented. Alternatively, for an
    estimated annual investment of $652 million, the Army can retain and
    sustain an operational Army Reserve. This will provide the Army
    necessary capability on time and at best value.
        Nine years of mobilization and employment for current contingencies
    has produced the most experienced, ready Army Reserve in history.
    Currently the Army Reserve is used as an operational force resourced
    only through Overseas Contingency Operations funding. With minimal
    recapitalization of readiness funded in the base budget and through
    annual employment of Army Reserve forces for operational missions such
    as Theater Security Cooperation, we can maintain these unprecedented
    readiness levels and support the National Security Strategy. This is
    the most efficient and cost-effective answer to the Nation's national
    security requirements.
        The Army Reserve culture has changed since 2001. Many Soldiers of
    the legacy strategic reserve left service in significant numbers
    between 2004 and 2006. Today, the Army Reserve is fully manned to its
    Congressionally authorized end-strength with Army Reserve Soldiers who
    have joined or re-enlisted to be part of an operational force.
    Reverting to a strategic Reserve would entail a similar significant
    loss of our most operationally experienced force and greatest asset--
    today's Army Reserve Soldier.
        Today, we are exploring the Army's Continuum of Service initiatives
    as a way of making the Army Reserve more attractive for Soldiers,
    Families, and Employers. When these initiatives become a program of
    record, they will facilitate a Soldier transfer from one Army component
    (for example from the Army Reserve to active duty) to another in a
    seamless, efficient manner that meets the needs of the Soldier as well
    as the readiness requirements for the Total Force. There is no
    degradation in personnel management, career opportunities or benefits
    for a reserve component Soldier's military and civilian career.
    Continuum of Service will provide choices for Soldiers, their Family
    members and Employers, which is essential in family and career
    planning.
        The Army Reserve Posture Statement lays out our accomplishments,
    our plans, and our continuing challenges in the Era of Persistent
    Conflict and it continues to illustrate through its capabilities and
    affordability that it is a good investment for the Nation. An enduring
    operational Reserve will provide the Army necessary capabilities at
    best value. This is the Army Reserve of today and the future.

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                                  document map
        The 2011 Army Reserve Posture Statement (ARPS) is the Army
    Reserve's Annual Report to Congress of the current posture of the Army
    Reserve to fulfill its Title 10 responsibilities. The Posture Statement
    also serves to educate and inform Congress of Army Reserve resourcing
    priorities in the fiscal year 2012 budget request that will enable the
    Army Reserve to continue its transition in support of an operational
    force. This document is organized to help advise Senate and House
    Committee appropriators in Committee Hearings addressing Personnel,
    Readiness and Equipping of the needs of an operational force.
    Programs Addressed in the President's Budget Request
        Personnel.--Shaping the Force, Building Resiliency, Health
    Promotion/Risk Prevention, Yellow Ribbon Reintegration Program,
    Spiritual Care, Behavioral Health, Healthcare, Family Programs, Full
    Time Support, Employer Partnerships of the Armed Forces.
        Readiness.--An Operational Force, Homeland Operations, Training,
    Training Equipment, Physical Security, Anti-Terrorism, Aviation, Army
    Reserve Command, Control, Communication, Computers/Information
    Technology (C\4\/IT), Training Facilities.
        Equipping.--Army Reserve Materiel, Equipment Maintenance, Logistics
    Contract Support.

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            the fiscal year 2012 budget request: where we are going
                                   personnel

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

               critical personnel needs of an operational reserve
        Appropriate resources for Recruitment and Retention of the right
    people and skill sets to sustain the force.
        Provide robust Suicide Prevention support and resources for trained
    caregivers, and training for Applied Suicide Prevention Skills.
        Continue support for the Yellow Ribbon Reintegration Program events
    and Family Member training.
        Resource Army Guard Reserve Family Life chaplain authorizations.
        Align and balance Family Programs capabilities/workforce to serve a
    geographically dispersed population.
        Ensure continuity of support to Army Reserve Soldiers and Families
    in the community where they live through Virtual Installations/Army
    Strong Community Centers.
        Deliver responsive and relevant Family Assistance and Support
    services to mobilized and non-mobilized Soldiers, Civilians, and their
    Families during military operations, emergency activities, and natural
    disasters.
        Improve and Sustain Medical, Dental and Behavioral Health
    Readiness.
        Maintain support levels for Full Time Support.

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    Shaping the Force
        The Army Reserve has undergone its largest ever transformation from
    a strategic reserve to an operational force. Additionally, the Army
    Reserve has exceeded its end-strength objective of 205,000--but has an
    imbalance in skills, in particular at the mid-grade ranks. As a result,
    we have shifted our focus to shaping the force to meet the needs of an
    Operational Army Reserve that actively supports current operations via
    the Army Force Generation model, also known as ARFORGEN.
        Our strategy will focus on proper balance and sustainment of the
    force rather than increasing end-strength. The Human Capital Enterprise
    will manage the accumulated end-strength to build and shape a force
    that best meets the Nation's near- and long-term demands. The Army
    Reserve will recruit, retain and transition the best and brightest and
    position them in the right place, in the right job, and at the right
    time.
        As part of shaping the force we requested and received Army
    approval to reimplement several boards that were previously suspended.
    These boards provide management tools that facilitate better management
    of senior grade positions, allow qualified Soldiers to progress at
    proper intervals in their careers, provide career incentives, and allow
    Soldiers to advance to higher grades at the peak years of their
    effectiveness. These boards include the Active Guard and Reserve (AGR)
    Release from Active Duty (REFRAD) Board (convened in April 2010) and
    the Army Reserve Troop Program Unit (TPU) Enlisted Qualitative
    Retention Board (scheduled to convene in 3rd Qtr fiscal year 2011).
    Building Resiliency
        The Army Reserve is continuing to build resiliency in our Soldiers,
    Families and Civilians--all of whom have been affected by the
    cumulative effects of 9 years at war. We have developed a comprehensive
    approach that puts mental fitness on the same level as physical fitness
    to build a resilient force for the future. No one individual program
    builds resiliency; rather, it results from combining the benefits of
    health promotion-risk deduction education, Yellow Ribbon Reintegration
    Program events, spiritual care, behavioral health programs, medical and
    dental readiness, and family program services.
                Health Promotion--Risk Reduction
        The Department of the Army and the Army Reserve have been in the
    forefront of health promotion--risk reduction efforts by using the
    Applied Suicide Intervention Skills Training (ASIST) program. Training
    materials ensure the education of first line supervisors, Army Reserve
    leadership, Army Civilians, and suicide prevention programs managers
    (DAC and other full-time support personnel). The key to suicide
    prevention is trained caregivers. The key requirement to success is to
    ensure that an appropriate number of individuals receive ASIST for
    Trainers across the Army Reserve, as well as having these ASIST
    Trainers conduct the required training to personnel throughout the
    fiscal year. The 2-day ASIST workshop conducted by ASIST Trainers is by
    far the most widely used, acclaimed and researched suicide intervention
    skills training for our Soldiers. The ASIST Training done by qualified
    ASIST Trainers is the best way to increase the number of Gatekeepers
    trained to recognize Soldiers who are at risk and know how to intervene
    to prevent the risk of suicidal thoughts becoming suicidal behaviors.
    Since history has shown that Soldiers are better able to help other
    Soldiers at risk when they receive ASIST Suicide prevention training,
    the Army Reserve is committed to early identification of at-risk
    Soldiers before a serious incident occurs or a Soldier seriously
    contemplates suicide.
                Yellow Ribbon Reintegration Program (YRRP)
        The mission for Yellow Ribbon Reintegration Program (YRRP) simply
    stated is to support Army Reserve Families and their Soldiers with
    sufficient information, resources and services, referral, and proactive
    outreach opportunities throughout the entire deployment cycle. The goal
    is to build self-sufficient and resilient Families and Soldiers. We
    accomplish this by developing skills in each Family member and Soldier
    to assure they are prepared and able to cope with the difficulties of
    extended separation and deployment. We help Families network together,
    and connect with each other, and their unit/command and Family
    Programs' Office. We also attend to both the Family members' and
    Soldiers' physical, behavioral and mental health needs. This requires
    trained professional speakers to come to units and regional venues to
    educate and assist attendees with knowledge, skills and practical
    hands-on participation.
        In fiscal year 2010, the Army Reserve conducted 525 YRRP events,
    serving 26,000 Soldiers and more than 28,000 Family members. These
    events proved successful because of direct support from a caring
    command staff, involvement by a myriad of community agencies, and the
    commitment of volunteers. Providing these services and support to Army
    Reserve Families and Soldiers on par with those for the Active
    component is a challenge since most of our Families do not live near a
    fort, camp, post or station where services are readily available. The
    geographic dispersion and numbers of Army Reserve Soldiers and
    Families, combined with the challenges that may exist with a civilian
    employer or educational pursuits, is unparalleled by any other military
    service or service component.
                Spiritual Care
        While resiliency is the operative word in today's Army concerning
    Soldier and Family well-being, it has always been the end state of a
    chaplain's ministry. Spiritual fitness is vital to maintaining a
    healthy and vibrant force. While chaplains are helpful agents during
    times of crisis, their greater value lies in their ability to enable
    Soldiers and Families to endure and successfully overcome a crisis when
    it does occur.
        As an operational force, it is important that we are properly
    structured and manned. In 2007, the Director of Force Management
    approved and directed the addition of Unit Ministry Team (UMT) force
    structure across all Army components. In order to support enduring
    requirements of an operational Reserve, this additional structure would
    enable the Army Reserve to place the Army Chaplaincy's Family Life
    function into its inventory. Family Life chaplains would oversee our
    successful Strong Bonds' program while also supplementing the Army
    Reserve's religious support capabilities in Family ministries and UMT
    training.
        We appreciate the resources Congress has approved for the Army
    Reserve Strong Bonds program. During fiscal year 2010, over 300 Strong
    Bonds events were conducted throughout the United States and its
    territories, enhancing Soldier and Family communication and
    relationship skills. Some 12,500 Soldiers and Family members
    participated in these events and received this training. Our goal is to
    provide Strong Bonds Relationship training to the maximum number of
    Army Reserve Soldiers and Families.

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

        When Families are supported, Soldier problems are lessened and
    Soldier retention increases. The Army Reserve is committed to providing
    its Soldiers and Families a level of benefits and quality of life that
    is commensurate with their service to the Nation.

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

                Behavioral Health
        The Department of Defense Mental Health Task Force of 2006
    recognized that the existing systems for psychological health were
    insufficient for current and future needs. Task Force recommendation
    5.4.1.16 stated that ``Each Reserve Component should appoint a full
    time director of Psychological Health to the staff of the Reserve
    Component Surgeon.'' It went on to specify that ``Where Reservists are
    organized by region, a full time Regional Psychological Health Director
    should be appointed.'' The Army Reserve has acted on these
    recommendations and has developed a limited Behavioral Health program.
    There is a Deputy Surgeon for Behavioral Health at the Surgeon's
    office, whose responsibilities center on program development. Three of
    the four Regional Support Commands have Directors of Psychological
    Health. The licensed clinicians are responsible for following up on the
    urgent referrals generated by the Periodic Health Assessment and Post
    Deployment Health Reassessments. Working on an ``Assess and Refer''
    model, they conduct bio-psycho-social assessments of each referred
    individual and determine the appropriate level of follow-up. They do
    not provide treatment. The major illnesses being identified , Post
    Traumatic Stress, Major Depression and Substance Abuse are treatable,
    but require a long-term commitment to care. Even as the current
    conflicts wind down, the psychological injuries sustained will require
    treatment far into the future. Four clinicians cannot adequately
    address the case management and monitoring needs that will be required
    by the growing numbers of Soldiers in the Army Reserve who struggle
    with these difficulties, especially considering the geographical
    dispersion of our units.
        A critical step for the future development of Behavioral Health
    programming within the Army Reserve is for all those who have a stake
    in the emotional well-being of Soldiers to share resources and develop
    multidisciplinary teams in order to most efficiently deal with the
    often complex and multidimensional needs of our Troops. The Army
    Reserve will be working with the other military Service reserve
    components and Congress to continue developing improvements to our
    infrastructure and processes to ensure our Soldiers receive appropriate
    care.
                Health Care
        The Army Reserve has served the Nation well while transforming from
    a strategic to an operational force. Soldiers not medically and
    dentally ready impair our ability to ensure predictability and reliance
    for the combatant commander. Army Reserve medical readiness improved
    from 23 percent on October 1, 2008 to 60 percent as of September 23,
    2010. Programs such as the Army Select Reserve Dental Readiness System
    (ASDRS) have been highly successful. Dental readiness, currently at 74
    percent has improved 21 percent over the last 2 years, and is one of
    the key elements improving medical readiness. Influenza compliance
    within the Army Reserve reached its highest compliance rate ever at 77
    percent, with H1N1 compliance at 79 percent.
        In 2010, we converted the paper records of 168,829 Soldiers to an
    electronic Health Readiness Record, allowing us to take full advantage
    of efficiencies in time, cost, and services over the continued use of
    paper treatment records. To improve data sharing, we obtained view
    capability of medical records stored in the Armed Forces Health
    Longitudinal Application, the active component medical database. We
    implemented the Medical Reserve Ready Response unit program, which
    enables our Army Reserve Physicians to review medical profiles and
    approvals from their home, capitalizing on the unique clinical skills
    found in the Army Reserve.
        Caring for our Wounded Warriors and assessing post deployment
    health issues are part of the Army's efforts to protect the health and
    well-being of Soldiers who have redeployed from combat. The Army
    Reserve tracks completion of the Post Deployment Health Reassessments
    to capture data and monitor the medical and behavioral needs of
    redeployed Soldiers. Soldiers complete these health assessments within
    3 to 6 months after returning from theater. As of September 15, 2010,
    84,419 Army Reserve Soldiers have been screened for post deployment
    health issues--a 95 percent compliance rate.
        As medical screening has improved, so has the identification of
    Soldiers who are not medically ready, and much work remains. There are
    approximately 15,500 Medically Non-deployable (MNDs) Soldiers who
    require a medical board and we are moving out aggressively to improve
    the boarding process.
                Family Support Programs
        Transformation from a strategic reserve to an operational force
    resulted in the need for standardizing programs and services to ensure
    Soldier and Family needs are met with the right resources, at the right
    time. Baseline services and outreach capability that sustain the
    quality of life of our Soldiers and Families are being integrated into
    the cycles of the ARFORGEN model. We employ metrics and administer
    surveys to gauge the quality and integrity of family program services
    for effectiveness and their value to our customers. This allows for the
    investment in high return services and the retirement of those that do
    not meet the needs of an operational force.
        An example of a promising high return service is the Army Reserve
    Virtual Installation Program. Operating at three pilot sites within
    three Army Strong Community Centers around the country, Virtual
    Installation brings the services and resources only found on active
    military installations to geographically dispersed military Families--
    of all branches of the armed services. These centers provide hands-on
    problem resolution and follow-up for a myriad of concerns ranging from
    military benefits and entitlements to community resources. The Fort
    Family Support & Outreach Center at Fort McPherson, Georgia is the
    nerve center of the Army Reserve Virtual Installation where the
    Outreach Center staff use cutting-edge technology, mapping programs,
    and resource databases as well as live, personal contact with highly
    skilled subject matter experts to serve and build community-based
    capacity for each pilot site.
    Full-Time Support (FTS)
        In July 2010, the Secretary of the Army directed the Assistant
    Secretary of the Army for Manpower and Reserve Affairs (ASA (M&RA)) to
    personally lead a study to determine the correct level of full-time
    support required for the Reserve Components. A memorandum and a term of
    reference will be sent to the reserve component leadership advising of
    the M&RA effort and task. There is also an initiative to have the
    reserve component re-validate the models that will identify/inform
    manpower requirements. These efforts will help the Army to determine
    the appropriate size of the FTS program for managing the reserve
    component as an operational force.
        The Army Reserve is currently funded at 75 percent of its
    requirements. This funding level is based on the requirements of a
    strategic reserve and in accordance with the Headquarters, Department
    of the Army ``HIGH RISK'' funding methodology. Funding must be
    maintained at this level.
        Civilian personnel programs (Military Technician and Army
    Civilians) are currently fully funded (based on 75 percent of FTS
    authorizations against validated requirements) and must remain so in
    order to provide required Army Reserve full-time support. The National
    Defense Authorization Act, Subtitle B--Reserve Forces, requires the
    Army Reserve to meet a Military Technician end-strength floor by
    September 30 each fiscal year. The ability to support an operational
    Army Reserve depends on being able to meet, or exceed within
    established standards, the authorized floor.
        The Army Guard and Reserve (AGR) program must also remain fully
    funded (based on 75 percent of FTS authorizations against validated
    requirements) in order to provide the required Army Reserve full-time
    support. Currently authorized 16,261 Soldiers, this program provides
    the bulk of full-time support at the unit level. They provide day-to-
    day operational support needed to ensure Army Reserve units are trained
    and ready to mobilize within the ARFORGEN model. The AGR program is
    absolutely vital to the successful transition to, and sustainment of,
    an operational force.

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        The Employer Partnership of the Armed Forces has more than 1,300
    employers and the list is growing. These Employer Partners represent 95
    of the 2010 Forbes Fortune 500 companies; they are military-friendly;
    and they value the skills, experiences and work ethic of those who
    serve.

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    Employer Partnership of the Armed Forces
        The Army Reserve's Employer Partnership Initiative has expanded far
    beyond serving only Army Reserve Soldiers. Today the Employer
    Partnership provides career continuum resources for the entire Service
    ``Family.'' It serves the civilian employment and career advancement
    needs of members of all seven Reserve Components, their Family members,
    Wounded Warriors and the Nation's veterans. With this fully
    encompassing focus the program is now the Employer Partnership of the
    Armed Forces.
        The Employer Partnership of the Armed Forces has more than 1,300
    participating employers and the list is growing. These Employer
    Partners represent 95 of the 2010 Forbes Fortune 500 companies; they
    are military-friendly; and they value the skills, experiences and work
    ethic of those who serve.
        Army Reserve leadership feels the Employer Partnership is realizing
    success, and that the program supports its Human Capital Strategy.
    Accordingly the Chief of the Army Reserve will spend as much as $5
    million during fiscal year 2011 for the program. This funds operations
    which include program support personnel dispersed across the United
    States, and other resources that help connect seekers to jobs.
        Last fall the Employer Partnership launched a state-of-the-art job
    search resource at the portal: www.EmployerPartnership.org. Through
    strategic partnerships the portal accesses approximately 600,000 jobs
    at any given time. In addition to robust search capabilities, seekers
    can use the resume builder and keep a detailed resume readily available
    within the portal. Employers may then reach in and conduct candidate
    searches based on seeker skills/experiences. This in effect allows
    ``jobs'' to actually ``find'' our seekers. The portal's user-friendly
    functionality makes it an efficient tool for both seekers and
    employers.
        The partnerships forged with civilian employers build operational
    capacity for the Army Reserve and the Reserve components; they fortify
    the resilience of our Families; they serve those who have served; and
    they strengthen our Employer Partners. The Army Reserve's underwriting
    of Employer Partnership of the Armed Forces program represents a
    positive investment for America.
     the employer partnership promotes skills and opportunity sharing with
                                 the home front
        program provides advantage to local communities and the military
        Employers realize that it makes sense to hire personnel already
    trained and experienced. Reserve Service members and Veterans fit this
    bill. They are skilled in a wide variety of disciplines including
    healthcare, transportation, logistics, supply chain management, law
    enforcement, public safety, construction, engineering, finance,
    information technology and telecommunications. By providing access to
    talented Service members, the Employer Partnership of the Armed Forces
    saves local employers time and money.
        The military also benefits. Best practices from industry, and
    experience with cutting edge technology and medical procedures flows
    into our Armed Forces through Reserve service. And, as the Employer
    Partnership (EP) helps Service members progress in their civilian
    career fields, increased expertise is brought to military assignments.
        Perhaps most important to the home front are the career
    opportunities the EP brings to Service members, their Families and our
    Veterans. The Employer Partnership program truly exemplifies a positive
    investment in America, and our commitment to taking care of our entire
    Military ``Family.''

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                      career opportunities across america
        The EP program has written agreements with more than 1,300 Employer
    Partners; with jobs in every U.S. State and territory.
                          strengthens local economies
        Efficient access to trained and qualified work force saves time.
    Hiring costs also lowered by reducing need for duplicate drug and
    aptitude screening.
                          inside track to opportunity
        Provides Service members with an inside track to employers who are
    committed to hiring Reservists and Veterans.
                        a concrete way to support troops
        The EP program gives employers a tangible way to support our troops
    while also strengthening America's economy.

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

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

     the army reserve's core competencies: battle tested, skill rich army
     reserve soldiers in an operational force provide strength for america
                                and it's economy
                                   logistics
        Logistics is one of the most important capabilities of the Army
    Reserve. From supply-chain management to land, water, and air
    operations, the Nation's defense depends on the efficiency of our
    Expeditionary Sustainment Commands; Transportation, Petroleum,
    Quartermaster and Supply units. Army Reserve Soldiers are skilled and
    experienced in delivering the right product at the right time to our
    customers world-wide.
                                   healthcare
        Breakthroughs in trauma techniques and procedures often originate
    from battlefield medicine. The majority of the U.S. Military's medical
    capability resides in the Reserve components. As a result of their
    military service, Army Reserve doctors, nurses, technologists and other
    medical service practitioners are able to bring extraordinary practical
    experience to local care providing institutions across the United
    States.
                           information/communications
        Information is critical to successful operations on the modern
    battlefield. Satellite, microwave, cell and fiber-optic are among the
    many means; code-division multiplexing, time division and frequency
    division multiple access are among the technical methods which enable
    this. Data collection, analysis and reporting activities form the
    information and intelligence that is communicated. The Reserve has
    operators, enablers and trainers in all of these disciplines. Army
    Reserve Communicators are information age proficient.
                                   management
        The development of leadership and management skills begins early in
    every service member's career. Military training stresses leadership
    principles, sound decisionmaking and overcoming challenges. This is
    important because Soldiers are responsible for major equipment systems,
    and above all, are responsible for the well-being of those they lead.
    Army Reserve Soldiers are responsible and capable leaders.

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                                   readiness

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               critical readiness needs of an operational reserve
        Adequate resources to respond to Homeland Defense missions.
        Additional mandays in the last 3 years of the ARFORGEN cycle.
        Provide Simulations and Simulators to enable operationally
    relevant, full spectrum training for Soldiers anytime/anywhere.
        Ensure Home station training capabilities to support critical home
    station pre-deployment training.
        Sustain the availability of training equipment.
        Support for programs to Protect the Force.
        Continue support for a fully integrated operational Aviation force.
        Provide a strong Army Reserve Network Defense.
        Funding for essential and mandatory secure communications.
        Creation of a standardized computing environment.
        Construction and upgrade of Army Reserve Centers, and Training
    Facilities.
        Support for programs to reduce energy usage, conserve natural
    resources, and develop alternate renewable energy.
        Continue the work of Army Reserve Virtual Installation Program.

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    Operations
                An Operational Force
        The Army Reserve continues to provide vital capabilities to
    combatant commanders in support of overseas contingency operations.
    More than 196,711 Army Reserve Soldiers have mobilized in support of
    Operation Iraqi Freedom/New Dawn and Operation Enduring Freedom since
    September 11, 2001. Today, more than 15,584 Warrior Citizens are
    serving in Iraq, Afghanistan and 22 other countries around the globe.
        We execute a pre-mobilization readiness strategy that provides the
    Army ready formations and soldiers on an annual, predictable cycle.
    Through the Army Force Generation (ARFORGEN) model, the Army Reserve
    synchronizes the plans and resources necessary to meet the readiness
    goals for units entering their available year. This maximizes ``boots
    on the ground'' time, builds cohesive teams and provides predictability
    for our Soldiers and Families.
                Homeland Operations (HLO)
        Homeland Operations, which includes Homeland Defense, Homeland
    Security and Defense Support of Civil Authorities, has become an
    increasingly important mission for the Army Reserve and its applicable
    capabilities. The Army Reserve currently provides 37 units in support
    of the Chemical Biological Radiological Nuclear Response Enterprise.
    Properly managing this Army Reserve commitment will necessitate growth
    of full-time manning and Troop Program Unit positions within the
    Homeland Defense Division.
        The Army Reserve has relevant and capable units that we leverage in
    a Defense Support of Civil Authorities environment. This includes, but
    is not limited to, the following types of units: medical aviation,
    transportation, engineering, communications, and Civil Affairs. These
    capabilities can be packaged with the appropriate command and staff
    structure to facilitate assistance to civil authorities. This packaging
    can also provide necessary command and control of Title 10 Department
    of Defense resources in a defined joint environment. When combined with
    legislative efforts to amend existing mobilization authorities, the
    U.S. Army Reserve can provide significant resources to support civil
    authorities in domestic disasters and emergencies.
                Theater Security Cooperation Programs (TSCP)
        As requirements for Deployed Expeditionary Forces decrease as the
    result of planned force drawdowns in Operations New Dawn and Enduring
    Freedom, the Army Reserve is exploring other missions in an effort to
    sustain experience and readiness levels. Combatant commander TSCP
    programs require a wide range of forces, such as military police, for
    missions of varying duration. In many cases, Army Reserve formations
    are ideally suited to conduct these missions. The use of Army Reserve
    units: reduces stress on the active component, preserves the readiness
    gains made in the reserve component over the last decade, and spreads
    the burden of defending American interests across a larger portion of
    the citizenry.
    Training
                Mandays to support an Operational Reserve
        Using a progressive training strategy, the Army Reserve is
    committed to providing trained companies and battle staffs to combatant
    commands upon mobilization. With adequate resources that support
    reoccurring operational employments, we can effectively fulfill our
    mission. A sufficient number of training mandays, during the last 3
    years of the ARFORGEN cycle, is imperative to meet established
    readiness aim points, which reduces post-mobilization training time and
    increases Boots on the Ground time for theater operations.
                Simulations and Simulators
        The Army Reserve continues to engage the Army's Training Support
    System Enterprise that provides networked, integrated and interoperable
    training support capabilities that enable operationally relevant, full
    spectrum training for Soldiers anytime/anywhere. The use of simulations
    and simulators minimizes turbulence for Soldiers and their Families
    caused by training demands during the first 2 years of the ARFORGEN
    process by enabling individuals and units to train at their home
    station and during exercises in a safe environment without the
    increased wear and tear on equipment. An example of the simulators used
    to train Soldiers is the fielding of more than 630 Laser Marksmanship
    Training Systems to 346 Army Reserve locations over the past year.
                Home Station Training Capabilities
        The Army Reserve remains dedicated to providing suitable platforms
    to support critical home station training for its units. Home station
    for the Army Reserve includes Reserve Centers, Local Training Areas,
    Regional Training Sites, and installations. Home stations must
    adequately portray the operational environment in training venues,
    facilities, and ranges with a mix of Live, Virtual (Simulators), and
    Constructive (Simulations), including gaming technologies. Modernizing
    our facility infrastructure through additional Military Construction
    and the retrofitting of existing facilities with state of the art
    classrooms and simulator/simulation rooms enhances our ability to
    conduct individual and collective training, such as the inclusion of
    the weapons simulator rooms in our new Army Reserve Centers. Upgrading
    our existing Local Training Areas, and Regional Training Sites with
    ranges and training facilities provides units the capability to master
    critical tasks while training close to home.
                Army Reserve Comprehensive Soldier Fitness
        Comprehensive Soldier Fitness marks a new era for the Army Reserve
    by comprehensively equipping and training our Soldiers, Family members
    and Army Civilians to maximize their potential and face the physical
    and psychological challenges of sustained operations. We are committed
    to Comprehensive Soldier Fitness that will enhance resilience and
    coping skills enabling the Force to grow and thrive in today's Army
    Reserve.
        This year, the Army Reserve trained over 100 Non-Commissioned and
    Commissioned Officers at the Department of the Army's Master Resiliency
    Trainer's Course. These trained leaders form the core of our resiliency
    effort and are currently conducting Resiliency Training at Army Reserve
    units globally. Initial feedback from Soldiers and Civilians that have
    attended this training, has been overwhelmingly positive.
                Training Equipment
        The Army Reserve has been able to meet both the logistics readiness
    requirements for mobilizing its units as an Operational Reserve force
    and the enduring standards outlined in regulations and directives.
    These results have been delivered through effective and intensive
    management, innovative programs, and strict adherence to priorities and
    effective enablers such as contracted maintenance and support to our
    units. We have developed and fielded ``bridging'' logistics management
    and information systems to augment those fielded and programmed by the
    Army. These systems have created a near ``real time'' data warehouse
    and responsive tools for our managers to quickly identify and resolve
    issues, especially in maintenance, property accountability and
    equipment distribution. We continue to find innovative ways to
    accomplish our missions with the resources provided as we move towards
    full implementation of our position as an Operational Reserve within
    the Army Force Generation Model.
    Security
        The Office of the Provost Marshall (OPM) manages the Force
    Protection of Army Reserve facilities and personnel. OPM's core
    functions are Antiterrorism, Police Operations, Physical Security and
    Law Enforcement. The Army Reserve has identified three mission
    priorities that OPM is responsible for managing which require funding:
                Installation Access Control
        Army Reserve facilities are distinctive because they are stand-
    alone facilities in remote parts of the country. Maintaining positive
    control of access to these facilities is paramount to ensuring that the
    Soldiers and equities inside these facilities remain ready and
    available to combatant commanders. Funding to modernize access to
    Reserve facilities supports the Army Reserve objective of Protecting
    the Force.
                Intrusion Detection System (IDS) Maintenance and Monitoring
        IDS systems monitor arms rooms at Army Reserve facilities 24-hours
    a day. Should an arms room at a remote facility be breached, creating
    the possibility that military weapons could fall into the hands of
    criminals or terrorists, the monitoring program ensures that
    authorities will be notified immediately.
                Antiterrorism Program Management
        Antiterrorism (AT) Assessment Specialists are the key component of
    the Antiterrorism Program. AT Specialists conduct inspections of Army
    Reserve facilities across the Nation to ensure facilities are in
    accordance with Department of Defense and Army standards. The Army
    Reserve spans over 1,100 stand-alone facilities across the continental
    United States. With appropriate funding the Army Reserve can protect
    Soldiers and equipment vulnerable to criminal and domestic terrorist
    threats.
    Aviation
        Army Reserve Aviation is a fully integrated, operational force with
    a fleet of more than 198 rotary wing and fixed wing aircraft. The
    diverse fleet provides speed, mobility, flexibility, agility, and
    versatility to the Army in support of full spectrum operations. Army
    Reserve Aviation has recently activated two new MEDEVAC companies. The
    MEDEVAC companies are located in Texas, Colorado, Pennsylvania, and
    Kentucky. Additionally, the Army Reserve aviation fixed wing units will
    accept delivery of six new C12V1 aircraft in 2011. These aircraft will
    fill a critical capability gap to meet Continental United States
    (CONUS) based training requirements in preparation for Overseas
    Contingency Operations. The Army Reserve continues to seek funds for
    the procurement four additional C12V1 aircraft. Lastly, Army Reserve
    Aviation continues to lead the way in Air Traffic Simulation. The first
    unit level Air Traffic Control simulator, located in the Marryman
    Simulation Complex, Fort Rucker, Alabama became operational this year.
    The system meets all Federal Aviation Administration requirements for
    certification. The simulator provides qualification and proficiency
    training for all Army controllers. This simulator is also used in
    aviation training exercises to validate controller skills prior to
    deployment.
    Base Realignment and Closure
        The Army Reserve is in its final year of the 6-year execution of
    the BRAC 2005 mandated execution--which officially ends on September
    15, 2011. Upon the conclusion of this BRAC window, the Army Reserve
    will have made significant changes shaping the force for relevant
    contributions well into the future. The year's execution will mark the
    culmination of the largest transformation of the Army Reserve since
    World War II by realigning the command and control structure into an
    operational configuration; realigning six major headquarters including
    Office of the Chief, Army Reserve and United States Army Reserve
    Command to new locations; disestablishing 12 Regional Readiness
    Commands; establishing four Regional Support Commands; activating five
    Sustainment Commands and eight Sustainment Brigades; constructing 125
    Armed Forces Reserve Centers; and closing 190 facilities or activities.
        BRAC provides an opportunity for the Army Reserve to power down to
    our major commands some of the functions that are typically managed at
    the Army Reserve Headquarters. We are implementing the Army's
    enterprise approach within our staff, which includes managing things
    like personnel issues and logistics issues at the lowest possible level
    of organization. When we power down some of these management issues to
    our regional and operational/functional commands during our BRAC move,
    it may make sense for those commands to retain management of some of
    those issues.
        Completing the construction of 61 Armed Forces Reserve Centers and
    relocating units into these new facilities remains the largest priority
    of execution for fiscal year 2011 as all actions must be completed by
    September 15, 2011. The relocation of units into these new facilities
    will facilitate the closure and disposal of the remaining 143 of 176
    Army Reserve Centers identified by BRAC for closure.
        Over the next year the Army Reserve will execute and complete the
    remainder of all Army Reserve BRAC actions. These remaining actions
    will mark the end of the largest transformation efforts the Army
    Reserve has seen in its storied history.
    Communication (Information Technology)
                Army Reserve Network
        The Army Reserve Network (ARNET) provides the Command and Control
    (C\2\) enablement in operationalizing the Army Reserve. The ARNET
    provides Army Reserve Leaders and Soldiers the ability to make timely
    informed decisions in the execution of overall C\2\ for all Army
    Reserve units throughout the contiguous United States and Puerto Rico.
    Over the past 2 years, the Army Reserve has worked closely with the
    Army in implementing the Global Network Enterprise Construct (GNEC)
    strategy as the way to grow and improve LandWarNet to an Enterprise
    activity. The ideal end-state is to provide Soldiers a universal email
    address, file storage, telephone number and a standardized
    collaboration tool set.
        The Army Reserve's contributions to GNEC began in 2002 with an Army
    Business Initiative Council approved project. Elements of the project
    re-structured the legacy ARNET into a portion of the LandWarNet and
    developed a consolidated Data Center providing centralized core
    services (i.e., Active Directory, email, collaboration, file storage
    and centralized application hosting) for the entire Army Reserve. With
    approximately 85 percent of the consolidation completed, continued
    funding of the ARNET is integral in maintaining a global warfighting
    C\2\ capability. The Army Reserve's accomplishments and experiences
    have been applicable to the Army as we continue to participate in GNEC
    planning forums in aligning Army initiatives and timelines while
    ensuring Army Reserve Title 10 operational capabilities are met.

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                                cyber operations
        Army Reserve Soldiers offer current skill-sets and leap-ahead
    capabilities in the cyber environment. Warrior-Citizens employed in
    leading-edge technology companies have critical skills and experience
    in fielding the latest information technology systems, networks, and
    cyber security protocols.

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                Secure Communication
        Secure communications is essential and mandatory, particularly with
    C\2\ and mobilization (i.e., deployment dates, passing mobilization
    orders, and C\2\ theater assets). Secure Internet Protocol Router
    Network (SIPR) and Secure Video Teleconference (SVTC) for all Battalion
    and above units are vital in meeting all pre-mobilization training/
    readiness gates, mobilization training actions and day-to-day secure
    operational planning. The security of the Global Information Grid (GIG)
    is a constant challenge and reflected in DOD's standup of Cyber Command
    and the associated service elements. The same is true in the overall
    security posture of the ARNET in ensuring the uninterrupted flow of
    information to all ARNET authorized users. Continued investment in the
    Army Reserve secure communications and defense of the ARNET supplies
    Army Reserve Leaders, Soldiers and Civilians the capability of
    attacking and exploiting network threats.
    Army Reserve Facilities
        Reserve Centers, Training Support and Maintenance facilities are
    designed to meet the unique requirements of our community-based force.
    Our Soldiers, Families, and Civilians are strategically located across
    the country in over 1,100 stand-alone facilities--Army Reserve Centers
    or Armed Forces Reserve Centers (which house other Department of
    Defense components along with Army Reserve). However, the needs of the
    Army Reserve are evolving. The Military Construction Army Reserve
    priorities for the fiscal year 2012-2017 Program Objective Memorandum
    are Army Reserve Centers, training support facilities, and maintenance
    facilities. The Army Reserve Centers are essential to training Reserve
    Soldiers for the full spectrum of operations and the operations of the
    Army Reserve. Training Support Facilities are critical to conducting
    Army Reserve and active-component unit and collective training tasks in
    support of the Army Force Generation Model requirements. These
    facilities also provide the training platform to support The Army
    School System, which is composed of the reserve component, the active
    component Military Occupational Skill reclassification, and Officer and
    Non-Commissioned Officer Professional Military Education. Maintenance
    Facilities are the third priority to the facility strategy required as
    the logistics support to Army Reserve Equipment.
        Base Realignment and Closure and emerging Army requirements for
    modular unit design, force protection, and energy efficiency continue
    to require new facilities or renovations to our existing facilities.
    Quality facilities are critical to the Army Reserve's ability to handle
    the increased training, mobilization, and Family and Soldier care
    activities that today's Army Reserve demands.
    Energy Conservation
        The Army Reserve is especially proud that our facilities are at the
    forefront of energy sustainability. In 2010, several new Reserve
    Centers will achieve net-zero energy usage (self-sufficient without
    drawing additional power from the electrical grid). We have established
    a solar energy farm at Fort Hunter Liggett, California, and are
    installing wind turbines and geothermal plants at several new
    facilities. The Army Reserve has started a retrofit program, replacing
    lights, windows, roofs, and other components with new energy-efficient
    technology, resulting in substantial savings in utility costs. The Army
    Reserve was the first Defense component to commission partnerships with
    local utility providers and to solicit third-party energy investors. In
    5 years every State and U.S. territory will have Army Reserve
    facilities that are energy self-sufficient (net-zero), with many
    providing renewable energy back to the electrical grid. To continue
    this progress, the Army Reserve must conduct a sustainability
    evaluation of each facility. This will establish a sustainability
    baseline, which will in turn enable us to create a sustainability
    strategy that addresses the unique characteristics of each site.
    Continuing to invest in sustainable facilities will enable the Army
    Reserve to meet or exceed the Department of Defense requirement for a
    completely net-zero footprint by 2025. More importantly, the Army
    Reserve will save American tax dollars, return a valuable energy
    resource to the community, and assure reliable energy for Army Reserve
    Soldiers and Families.
        Until energy independence is realized, it is imperative that the
    Army Reserve have fully funded utilities. In previous years utility
    costs have risen substantially, requiring the Army Reserve to re-
    program funds and accept risk in other areas. The Army's increasing
    emphasis on home-station training, ongoing deployments, and the needs
    of Army families in the community means that the Army Reserve needs
    constant, reliable access to energy in our Reserve Centers and training
    facilities now more than ever.

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        The Army Reserve was the first Defense component to commission
    partnerships with local utility providers and to solicit third-party
    energy investors.

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                                   equipping

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

               critical equipping needs of an operational reserve
        Resource Modernized equipment for the Army Reserve to improve Army
    Reserve readiness and capabilities within the ARFORGEN Model.
        Maintain Army Reserve equipment at or beyond the Army standard of
    90 percent Fully Mission Capable.
        Provide Contracted Support for logistics operations and information
    systems to sustain logistics readiness.
        Funding for state-of-the-art maintenance facilities.

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    Army Reserve Materiel
        The Army Reserve, thanks to the support of Congress, is at an
    aggregate total of nearly 90 percent of its required equipment on-hand.
    Sixty-five percent of our on-hand equipment is classified as
    ``modernized.'' However, we remain short in several areas of critical
    equipment. Around 35 percent of our required equipment lines are at
    less than 65 percent on hand. These shortages include tactical
    communications networks (satellite and terrestrial), command and
    control items and night vision systems. We have been able to sustain
    the pace of operations and training as an Operational Reserve by the
    continuous cross-leveling of available equipment among units. This does
    create an unsustainable level of friction, where a critical amount of
    equipment is not immediately available as the equipment is in transit
    (geographical dispersion of our units across the country), undergoing
    maintenance or awaiting deployment. In addition, some of our equipment
    is already deployed. The Army continues to work with us on identifying
    and filling shortages to improve readiness and capability to act as an
    Operational Reserve force under the Army Forces Generation Model.
    Equipment Maintenance
        The Army Reserve maintains its equipment at or beyond the Army
    standard of 90 percent Fully Mission Capable. This ensures the
    availability of equipment for training and mobilization to support the
    operational force within the Army Force Generation Model. Units cannot
    train or mobilize without equipment that is ready to perform. Field
    level maintenance keeps the equipment ready for use. Funding for tools,
    consumables, military technician mechanics and contracted support
    sustains our field level maintenance activities. Good maintenance
    reduces the amount of ``friction'' (equipment in shop, in transit,
    etc.) that removes equipment from use. Depot maintenance is important
    in keeping older equipment operable, relevant and safe to employ.
    Recapitalization of equipment provides a source of modernized and more
    capable items when new procurement is insufficient to meet shortfalls
    or inventory losses. Funding for military construction provides new,
    modernized or expanded facilities to perform maintenance and staging of
    equipment.
    Logistics Contract Support
        It is prudent to fund the Army Reserve for contract support for
    logistics operations and information systems to sustain logistics
    readiness. Contract support allows the Army Reserve to execute a
    vigorous assistance program in managing inventory and identifying and
    disposing of excess; providing field level repair and services during
    ``surge'' periods when units draw equipment for training or
    mobilization and in sustaining our critical logistics information and
    management systems. Contract support also strengthens our ability to
    meet operational demands and serve as an operational force within the
    Army Force Generation Model, while meeting Homeland Defense and Defense
    Support to Civil Authorities missions.

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

        However, we remain short in several areas of critical equipment.
    Around 35 percent of our required equipment lines are at less than 65
    percent on hand. These shortages include tactical communications
    network (satellite and terrestrial), command and control items and
    night vision systems.

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

        Leveraging contracted support, especially during periods of
    ``surge'' in mobilizing units, has supplemented our organizational
    capabilities. This enabler assists us in maintaining and preparing our
    equipment for training, mobilization and deployment, in operating and
    sustaining our logistics management and information systems in support
    of logistics operations and in managing the distribution of our
    equipment and identification and disposal of excess. We continue to
    find innovative ways to accomplish our missions with the resources
    provided as we move towards full implementation of our position as an
    operational force within the Army Force Generation Model.
    Equipment Facilities Management
        State-of-the-art maintenance facilities are the cornerstone of the
    Army Reserve's ability to sustain large equipment. The Army Reserve
    uses state-of-the-art environmental control features in maintenance
    facility designs that meet or exceed Federal design standards. Data
    ports at vehicle work bays, fluid distribution systems that eliminate
    spillage, and oil/water separators are examples of proven design
    features. These features improve efficiency and enhance collection of
    fossil fuel waste, further safeguarding surrounding communities' land
    and waterways from contamination and pollution. Fire suppression
    systems and eye wash stations are standard safety design elements. The
    Army Reserve will continue to upgrade our older maintenance facilities,
    because the condition of maintenance facilities is directly related to
    our ability to maintain equipment in acceptable condition. Continued
    deployments and heavy training have taken a toll on both equipment and
    facilities. Facility sustainment is critical--in fact, it is a cost-
    saving measure realized over the life-cycle of the facilities, if done
    properly. Facility deficiencies, if left unchecked, tend to worsen
    exponentially over time. The ongoing investment in the facilities we
    build will ultimately reduce repair, renovation, and replacement costs
    in the future.
                     conclusion: the force is in good hands
        As we travel around the United States and the world and witness
    what our Soldiers are doing for their country, it's just inspiring to
    see the quality, the dedication and the professionalism of our Soldiers
    serving in the Army Reserve. These are top-notch individuals that have
    put their civilian careers on hold. They are well educated and have
    very bright futures ahead of them--but they joined our ranks to serve
    their country.
        With more than 170,000 Army Reservists mobilized since the
    September 11, 2001 terrorist attacks on the United States, the force is
    more experienced than ever before and the Troops feel good about what
    they've accomplished and proven about the Army Reserve.
        Today's environment of multiple deployments is telling us, however,
    the Army Reserve will need to keep giving these quality Soldiers
    fulfilling training and missions, a fair benefits package and more
    balance in their lives to keep them on our team. We cannot continue to
    expect them to keep up with a rapid operational pace without more time
    at home with their families and civilian employers between deployments,
    and they need predictability about when they will deploy. Toward that
    end, the Army Reserve is working to give its Citizen-Soldiers a bit
    more time to be ``Citizens.''
        Today's Army Reserve recruits are attracted to an operational force
    because it enables them to serve their country in a meaningful way
    while allowing them to pursue a civilian career. When considering the
    future posture of the Army Reserve, we are convinced that after playing
    key roles in an operational force, they'll never be satisfied reverting
    to their long-abandoned ``weekend warrior'' status. We have
    transitioned our personnel and our mentality to an operational force
    and have created an environment and culture our Soldiers want to be
    part of--and that they feel good about. We have told the Army
    leadership and others there's no turning back. We cannot go back to a
    strategic reserve--one, because the Nation needs us; but two, because
    our Soldiers have proven themselves capable of supporting this role.
        Equally compelling, we as a military have come to the realization
    that we can't fight an extended conflict without the reserve. We have
    built an Army that is dependent on having access to the reserve when it
    needs us; and with the expectation that it is going to be trained and
    ready--a predictable capability that is not possible in a strategic
    posture.
        One thing is certain about the future--while looking for ways to
    cut costs and reap a ``peace dividend'' once the troops draw down in
    Iraq and Afghanistan, there will be the temptation to turn back the
    clock and reinstitute a strategic reserve. Such a plan would deprive
    the United States of an important, battle-tested and cost-effective
    resource.
        Operations Enduring Freedom, Iraqi Freedom and now New Dawn have
    demonstrated the capabilities the reserve components bring to the
    military. Particularly important are the ``enabling capabilities''
    resident in the Army Reserve: logistical, engineer, military police,
    medical and civil affairs support.
        We are now at a point where current and projected demands for Army
    forces will require continued access to the Army's reserve components,
    making real what has been in policy for some time. This means that
    mobilization and operational use of reserve component Soldiers and
    units will have to continue for the foreseeable future. The Army of the
    21st century will require a versatile mix of tailorable and adaptable
    organizations--both active component and reserve component--
    interdependently operating on a rotational cycle.
        Transforming the Army's reserve components into an enduring
    operational force provides a historic opportunity for the Army to
    achieve the most cost-effective use of its Total Force through
    investing in and relying on the Army's reserve components to take on a
    greater role in our Nation's defense.

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

        I am an American Soldier.
        I am a Warrior and a member of a team. I serve the people of the
    United States and live the Army Values.
        I will always place the mission first.
        I will never accept defeat.
        I will never quit.
        I will never leave a fallen comrade.
        I am disciplined, physically and mentally tough, trained and
    proficient in my warrior tasks and drills. I always maintain my arms,
    my equipment and myself.
        I am an expert and I am a professional.
        I stand ready to deploy, engage, and destroy the enemies of the
    United States of America in close combat.
        I am a guardian of freedom and the American way of life.
        I am an American Soldier.

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

                               your army reserve
        The United States Army Reserve provides trained units and qualified
    Soldiers available for active duty in the armed forces in time of war
    or national emergency, and at such other times as the national security
    may require. Throughout the United States, the Army Reserve has four
    Regional Support Commands that provide base support functions, and 13
    Operational and Functional Commands available to respond to homeland
    emergencies and expeditionary missions worldwide.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                             army reserve snapshot
        Mission.--The Army Reserve provides trained, equipped, and ready
    Soldiers and cohesive units to meet global requirements across the full
    spectrum of operations.
        Vision.--As an enduring operational force, the Army Reserve is the
    premier force provider of America's Citizen-Soldiers for planned and
    emerging missions at home and abroad. Enhanced by civilian skills that
    serve as a force multiplier, we deliver vital military capabilities
    essential to the Total Force.
    Key Leaders
        Secretary of the Army: The Honorable John McHugh
        Army Chief of Staff: General George W. Casey, Jr.
        Chief, Army Reserve and Commanding General, U.S. Army Reserve
    Command: Lieutenant General Jack C. Stultz
        Assistant Chief, Army Reserve: Mr. James Snyder
        Deputy Commanding General, U.S. Army Reserve Command: Major General
    Jon J. Miller
        Deputy Chief Army Reserve, Individual Mobilization AugmenteeMajor
    General Keith L. Thurgood
        Deputy Chief Army Reserve/Human Capital Enterprise: Brigadier
    General Leslie A. Purser
        U.S. Army Reserve Command Chief of Staff: Brigadier General William
    J. Gothard
        Director for Resource Management/Materiel Enterprise: Mr. Stephen
    Austin
        Deputy Chief of Staff, G-3/5/7/Force Programs Division/Readiness
    Enterprise: Colonel (P) Brian J. McKiernan
        Chief Executive Officer/Director, Services and Infrastructure
    Enterprise: Mr. Addison D. Davis
        Command Chief Warrant Officer: Chief Warrant Officer 5 James E.
    Thompson
        Command Sergeant Major: Command Sergeant Major Michael D. Schultz
    Army Reserve Basics
        Established: April 23, 1908
        Designated Direct Reporting Unit to Army: October 1, 2007
        2010 Authorized End Strength: 205,000
        Selective Reserve Strength: 205,281
        Accessions for fiscal year 2009: 23,684 (105 percent of actual
    goal)
        Reenlistments for fiscal year 2009: 12,227 (105 percent of annual
    goal)
        Accessions Goal for fiscal year 2010: 20,000
        Soldiers Deployed Around the World: 15,584
        Soldiers Mobilized Since September 11, 2001: 196,711
        Number of Army Reserve Centers: 1,100
    Distinctive Capabilities
        The Army Reserve contributes to the Army's Total Force by providing
    100 percent of the:
      --Theater Engineer Commands
      --Civil Affairs Commands
      --Training Divisions
      --Biological Detection Companies
      --Railway Units
      --Replacement Companies
         . . . more than two-thirds of the Army's:
      --Medical Brigades
      --Civil Affairs Brigades
      --PSYOPS Groups
      --Expeditionary Sustainment Commands
      --Dental Companies
      --Combat Support Hospitals
      --Army Water Craft
      --Petroleum Units
      --Mortuary Affairs Units
         . . . and nearly half of the Army's:
      --Military Police Commands
      --Information Operations Groups
      --Medical Units
      --Supply Units
    Army Reserve Demographics

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

    ------------------------------------------------------------------------
    Ethnicity (in percent):
        Caucasian..............................................        58.9
        Black..................................................        21.8
        Hispanic...............................................        12.8
        Asian..................................................         3.7
        Pacific Isl............................................         1.0
        Native Amer............................................         0.7
        Other..................................................         1.1
    Average Age................................................        32.1
        Officers...............................................        40.7
        Enlisted...............................................        30.3
        Warrant................................................        43.1
    Married (in percent).......................................        45.3
        Officers...............................................        66.9
        Enlisted...............................................        40.8
        Warrant................................................        72.2
    Gender (in percent):
        Male:..................................................        76.6
        Female.................................................        23.4
    ------------------------------------------------------------------------

    Army Reserve Budget Figures

    ------------------------------------------------------------------------
                                            Total fiscal      Total fiscal
                                              year 2011         year 2012
                                           budgeted: $8.1   programmed: $8.8
                                               billion           billion
    ------------------------------------------------------------------------
    Operations and maintenance..........      $3.2 billion     $3.1 billiion
    Military Personnel..................       4.7 billion       5.3 billion
    Military Construction...............       318 million   318,175 million
    ------------------------------------------------------------------------

    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. Admiral Debbink.
    STATEMENT OF VICE ADMIRAL DIRK DEBBINK, CHIEF, NAVY
                RESERVE
        Admiral Debbink. Chairman Inouye, Vice Chairman Cochran,
    thank you for the opportunity to appear before you today.
        I have the great appreciation for your support of our
    64,426 sailors and their families of our Navy Reserve. I would
    like to make a special mention of one of those sailors today,
    and that is our senior enlisted adviser, Force Master Chief,
    Ronney Wright, who is with me today. He will be retiring next
    month after 31 years in our Navy and 3 years as my senior
    enlisted adviser.
        I wanted to publicly wish both he and his wife, Donna, all
    the best in the future. Stand up?
        As I testify today, Navy Reserve sailors are operating
    globally. Approximately 30 percent of the Navy Reserve is
    providing support to Department of Defense operations,
    including more than 5,500 selected Reserve sailors either
    mobilized in support of overseas contingency operations or in
    training for their upcoming mobilization.
        While fully engaged in these operations, your Navy Reserve
    has answered the call to assist with major global crisis events
    during the last several months, including Operations Odyssey
    Dawn and Tomodachi. As our motto and our sailors proudly claim,
    the Navy Reserve, indeed, is ready now--anytime, anywhere.
        We have the ability and the flexibility to meet emergent
    mission requirements such as these, due in large part to this
    subcommittee's continued support. The $70 million in National
    Guard and Reserve equipment appropriations this subcommittee
    provided in fiscal year 2011 will be put to very good and
    timely use by the Navy Reserve.
        I also thank you for your demonstrated support of our Navy
    Reserve fleet, logistic aircraft, including the additional C-
    40A aircraft in the fiscal year 20l1 budget.
        Our 2012 budget request will enable your Navy Reserve to
    continue supporting current operations, while optimizing the
    strategic value of the Navy Reserve as a relevant force, valued
    for its readiness, its innovation, its agility, and its
    accessibility.
        Along with the other Guard and Reserve components, we
    played a critical role in the discussion and outcome of the
    recent comprehensive review of the future roles of the Reserve
    components by OSD. One of the products of this review was a
    legislative proposal before this Congress that allows for
    future routine deployments of the Reserve components as a
    resource to meet overseas requirements.
        This proposal signifies a fundamental shift in the use of
    the Reserves, recognizing both the high level of expertise, as
    General Stultz talked about in these forces, as well as a
    desire of today's Reserve sailors to continue performing real
    and meaningful work within the Navy's total force.
        Our Navy Reserve budget request also addresses the health
    and well-being of our sailors and their families. As written in
    the President's report, entitled ``Strengthening Our Military
    Families,'' stronger military families strengthen the fabric of
    America. Our budget request includes funding for vital programs
    in support of the physical, psychological, and financial well-
    being of Navy Reserve sailors and their families.
        It is a privilege to serve during this important and
    meaningful time in our Nation's defense, especially as a Navy
    Reserve sailor. I thank you for your continued support and
    demonstrated commitment to both the Navy and the Navy Reserve,
    and I look forward to your questions.
        Thank you, 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
    Senate Defense Appropriations Subcommittee, as I enter my third year as
    the Chief of Navy Reserve, I thank you for the opportunity to speak
    with you today about the capabilities, capacity, and readiness of the
    64,568 dedicated men and women who serve in our Navy's Reserve
    Component. I offer my heartfelt thanks for all of the support you have
    provided these great Sailors.
        The U.S. Navy is globally deployed, persistently forward, and
    actively engaged. America's Navy, year after year, in peace and war,
    carries out the core capabilities of forward presence, deterrence, sea
    control, power projection, maritime security, and humanitarian
    assistance and disaster response articulated in our maritime strategy A
    Cooperative Strategy for 21st Century Seapower (CS-21). This Nation's
    Navy derives its strength from the active and reserve Sailors and Navy
    civilians who comprise our Total Force. The Navy's Total Force is not
    just a concept; it is an operational and organizational reality.
    Operational Navy missions are executed by the Active Component (AC),
    the Reserve Component (RC), or a combination of both. AC and RC Sailors
    also provide strategic depth for maritime missions to ensure your Navy
    is always ready to respond globally to crisis situations while
    maintaining fiscal efficiency across the spectrum of operations.
        Our maritime strategy establishes naval power as an enduring
    concept and recognizes the Navy must constantly evolve and innovate to
    face emerging and future challenges. These two concepts--the enduring
    mission of our Navy and the reliance we place upon both components of
    Navy's Total Force to accomplish our objectives--inform our efforts as
    we review where we have been and consider our future.
        The Navy Reserve Strategic Plan charts our continued progress
    toward providing valued capabilities as part of Navy's Total Force. On
    October 1, 2010, we released the fiscal year 2011 update to Ready Now:
    The Navy Reserve Strategic Plan. Launched in early 2009, this Strategic
    Plan defines our mission, articulates our vision, and establishes
    strategic focus areas to organize our change efforts. In its third year
    of execution, this plan serves as the blueprint for shaping the Navy
    Reserve so it can effectively and efficiently carry out those Navy
    missions for which the Navy Reserve is well-suited. This year's update
    identifies 12 new initiatives focused on a wide range of improvements
    which include: making it more efficient for our Sailors to attain
    training and medical readiness; improving customer service; and
    determining the proper force mix of active and reserve contributions
    for current and future Navy capabilities across the mission spectrum.
        The foundation of all of our initiatives is to provide the
    necessary support to our Sailors and their families as one of my top
    priorities. This country owes a great debt to the men and women who
    have gone in harm's way to support contingency operations globally. It
    is our obligation to provide our Sailors every opportunity to succeed
    at home station and while deployed, and to provide the means to
    reintegrate once they return from overseas.
        Our Navy Total Force Vision for the 21st Century (NTF 21) clearly
    articulates Navy's vision for a Total Force and emphasizes our active
    Sailors, reserve Sailors, and Navy civilians as Navy's most important
    resource and a critical component to meeting the demands of CS-21. NTF
    21 guides our Navy's personnel policy and strategy and articulates our
    Total Force mission to attract, recruit, develop, assign, and retain a
    highly skilled workforce for the Navy. I discuss our various personnel
    policies in greater detail in Section III below.
                     2010: fully engaged--from peace to war
        Operationally, the Navy Reserve is fully engaged across the
    spectrum of Navy, Marine Corps, and joint operations, from peace to
    war. Right now, approximately 5,800 mobilized or deployed Navy Reserve
    Sailors are providing around half of the Navy's ground forces serving
    in the U.S. Central Command Area of Operations and in other critical
    roles worldwide.
        While executing these mobilizations, we are also providing valued
    capabilities for urgent requirements and ongoing operational support
    missions. In the immediate aftermath of the devastating earthquake in
    Haiti, the Navy Reserve was an important part of ``Operation Unified
    Response'' and Joint Task Force Haiti. Within hours, Navy Reserve Fleet
    Logistics Support Wing (VR) aircraft provided on-demand airlift,
    delivering urgently needed food, water, and medical supplies to the
    Haitian population. Navy Reserve doctors, nurses, and hospital corpsmen
    left their homes and families to serve ashore and on the hospital ship
    USNS Comfort. From medical professionals and Seabees to ground crews,
    logisticians and communicators, providing ``on-demand expertise'' is
    what makes the Navy Reserve a highly valued partner in Navy's Total
    Force.
        More recently, a VR C-40A Clipper was tasked to support the
    Department of State's (DOS) and Department of Defense's (DOD) Egypt
    contingency. The crew launched from Bahrain at 0400L and transported 33
    Marines from the theater's Fleet Anti-terrorism Security Team (FAST)
    and 7 Country Surveillance Assessment Team (CSAT) members from the
    Combined Forces Special Operations Component Command (CFSOCC) to Cairo
    International Airport. The FAST and CSAT members were tasked by DOS and
    DOD leadership to execute the Non-Combatant Evacuation Operation (NEO)
    for American citizens from the U.S. Embassy.
        Also, Navy Reserve assets played a critical role in Operation
    Tomodachi, the Department of Defense's assistance operation to Japan
    providing disaster relief following the 2011 Tohoku earthquake and
    tsunami. Over 5,000 man-days were used by Reserve Sailors participating
    in the relief effort. Such vital expertise as a 30-member Nuclear
    Emergency Response Team (from Norfolk, Virginia) and a 18-member
    Radiological Control Team (from Pearl Harbor) were transported to Japan
    on VR aircraft. These two teams were the primary teams to mitigate the
    contamination of U.S. aircrew and aircraft prior to returning to USS
    Ronald Reagan and other U.S. Navy ships on station.
        Every day Navy Reserve Sailors provide important operational
    support to this Nation with approximately one-quarter of our Sailors on
    full-time active duty, while many others provide their expertise on a
    ``part time'' basis. Some examples include the skilled engineers and
    technicians executing shipyard projects in the Naval Sea Systems
    Command's Surge Maintenance program; Full-Time Support (FTS) and
    Selected Reserve (SELRES) aviators serving as instructors for 20
    percent of the training sorties flown in Navy's aviation training
    pipeline; and our Intelligence community providing key global
    intelligence support. Ideally suited to take on periodic and
    predictable work, our ready and accessible force of skilled Sailors
    provides valued capabilities on an ongoing basis. In the case of SELRES
    Sailors, when their work is completed they leave Navy's payroll and
    return to their civilian employers.
        Navy Reserve Sailors are highly skilled professionals. More than 70
    percent of our Force are Navy Veterans--Sailors who still use the
    skills they were taught during their service in the AC. RC Sailors may
    also have industry-honed civilian skills that they bring to the Navy
    during periods of active service. These Sailors bring a wealth of
    experience, including expertise in high-end technology fields,
    knowledge of world-class business practices and an entrepreneurial
    mindset. This diverse work experience brings a unique and valued
    contribution to the Total Force.
        Navy Reserve Sailors are not only highly skilled; they are an
    efficient and effective workforce. In fiscal year 2010, the Navy
    Reserve provided 17 percent of the total Navy Uniform end strength,
    utilizing 7 percent of total Navy personnel costs, while accounting for
    more than 913,000 days of support. Your Navy Reserve is fully engaged
    and prepared to do the work of our Nation--from peace to war.
                               personnel policies
        The success of the Navy Reserve Force is due first and foremost to
    the professionalism of the Sailors who volunteer to serve in a wide
    array of environments. Since the start of the military engagements in
    Afghanistan and Iraq, every member of today's Reserve has enlisted or
    re-enlisted, and I am continually awestruck at the patriotism of these
    young Sailors. Navy Reserve leadership continually reviews policies and
    laws, ensuring our Sailors are afforded the greatest opportunity to
    participate in Navy's Total Force and ensure each Sailor's family and
    employer are appropriately recognized for their sacrifices on behalf of
    the service member. The fiscal year 2012 budget request of $2.005
    billion (including Overseas Contingency Operations (OCO) funding) for
    Reserve Personnel, Navy (RPN) will continue to support the Manpower
    needs and policies of the Navy Reserve.
        One of the Navy Reserve's strategic focus areas is to enable the
    Continuum of Service (CoS). CoS is not just a Reserve imperative, but a
    strategic imperative for the Department of Defense (DOD) and the
    Department of the Navy (DoN). CoS initiatives provide for seamless
    movement between the AC, RC, and civilian service, while delivering
    operational flexibility and strategic depth at the best value for the
    Navy. Enabling the CoS philosophy by fully incorporating opportunities
    unique to the reserve, we recruit Sailors once and retain them for life
    through variable and flexible service options that provide a career
    continuum of meaningful and valued work.
        Building on our CoS efforts is one of my top priorities for fiscal
    year 2011. In the upcoming year, we will investigate a variable service
    option, in which volunteer members in the Individual Ready Reserve
    active status pool with desired critical skill sets (e.g., medical
    professions, SEALs, field Corpsmen, etc.) are identified and ready to
    fill contingency operations requirements if they desire. We will also
    seek to implement a Career Intermission Program with a SELRES Option
    that allows program participants to continue community training and
    qualifications during an intermission from active duty. This initiative
    provides AC Sailors an alternative to permanent separation as they
    pursue personal or professional goals such as caring for an elderly
    family member, continuing education, or starting a family. This
    exciting new lane change option builds on a successful Career
    Intermission Pilot Program initiated in 2009. Further, we are currently
    implementing a process to establish an Intermediate Stop (I-Stop) in
    support of a Sailor's transition from AC to their gaining Navy
    Operational Support Center (NOSC). This initiative will allow Sailors
    to receive orders to their NOSC where the Sailors AC separation and RC
    gain transactions are completed.
        All Sailors returning from overseas mobilizations are encouraged to
    attend a Returning Warrior Workshop (RWW), Navy's ``signature event''
    within the DOD's Yellow Ribbon Reintegration Program (YRRP). The RWW is
    a dedicated weekend designed to facilitate reintegration of Sailors
    returning from combat zones with their spouses, significant others,
    employment, and communities. Staged at a high-quality location at no
    cost to the participants, the RWW employs trained facilitators to lead
    warriors and their families/guests through a series of presentations
    and tailored break-out group discussions to address post-combat stress
    and the challenges of transitioning back to civilian life. As of
    December 31, 2010, a total of 66 RWWs have been completed, attended by
    4,630 military personnel and 3,687 guests/family members. The fiscal
    year 2011-2012 budget supports 44 events, including four for the Marine
    Corps Reserve. Pioneered by the Navy Reserve, these workshops are
    available for all Navy Individual Augmentees. RWWs are a true success
    story in honoring our Sailors and their families. It is important to
    ensure this program continues to have both the full support of Navy
    leadership and the widest possible participation by all returning
    Sailors.
        RWWs serve as a key component of the Navy Reserve Psychological
    Health Outreach Program (PHOP). The PHOP employs dedicated teams of
    mental health professionals to provide psychological health
    assessments, outreach, and education, including Operational Stress
    Control (OSC) and Suicide Prevention training for the Navy and Marine
    Corps Reserve Communities. Regularly scheduled encounters are used to
    screen service members prior to and after deployment. The program is
    designed to identify potential stress disorders, facilitate early
    intervention, and provide access to psychological health support
    resources. The availability, quality, and effectiveness of
    psychological services utilized by Navy/Marine Corps Reservists and
    their families is closely monitored. In fiscal year 2010, PHOP teams
    conducted mental health assessments for more than 1,600 Reservists,
    provided outreach calls to more than 2,400 returning Reserve Sailors,
    followed up on more than 1,100 cases referred from Reserve commands or
    family members, and provided 300 visits to NOSCs conducting OSC briefs
    to more than 23,000 Sailors. In fiscal year 2011, the PHOP will deploy
    a user-friendly website providing both Sailors and their family members
    an easy-to-access database of PHOP work products and points of contact.
        The policies focused on enhancing the quality of life for Navy
    Reserve Sailors have paid dividends with regards to the end strength of
    the Force. Fiscal year 2010 marked a third consecutive year of notable
    Navy Reserve enlisted and officer recruiting achievements. Reserve
    enlisted recruiting met goal, and the measured educational achievement
    of our recruits was at the highest level ever. Since the active and
    reserve recruiting commands consolidated in 2004, more reserve officers
    were accessed in 2010 than in any year. Overall SELRES retention
    numbers were strong; however, increased pressure on members to prove
    their value to civilian employers, combined with a higher operational
    tempo, has resulted in higher attrition levels for members with
    critical skills sought both in and out of the military. Successful
    recruiting and retention strategies continue to play a critical role in
    attracting the right skill sets and talent to support the Fleet and
    Combatant Commands. Numerous initiatives are underway to get SELRES
    officer communities ``healthy'' by 2014, including targeted officer
    affiliation and future retention bonuses, the increase of accession
    goals, refinements in the Career Transition Office (CTO) process, and
    development of retention measurements and benchmarks. Incentives that
    target high-demand communities are essential in retaining members
    critical to mission accomplishment, and your support toward these
    efforts is very much appreciated.
        As we enter fiscal year 2011, the Navy Reserve expects high
    retention and low attrition rates to continue (similar to active duty
    trends), due to our ``Stay Navy'' campaign, the ability to provide real
    and meaningful work, as well as the effects of the current economy. Our
    close management of planned accessions and losses, coupled with current
    force-shaping and personnel policies, will ensure we retain the most
    qualified/capable Sailors while working toward the fiscal year 2012
    budgeted end-strength of 66,200 SELRES.
        Navy is actively preparing for repeal of ``Don't Ask, Don't Tell.''
    Sailors and leaders at all levels of the Total Force, including all
    Navy Reserve Sailors, are completing the required training in a face-
    to-face environment whenever possible. The central message of this
    training emphasizes the principles of leadership, professionalism,
    discipline, and respect.
        Our fiscal year 2012 budget request supports an emphasis on sexual
    assault prevention while continuing compassionate support for victims.
    This prevention emphasis includes 12 SAPR workshops in fleet
    concentration areas worldwide, execution of a pilot prevention program
    focusing on young Sailors, our most at-risk demographic, and most
    importantly, a clear and consistent message from leadership at all
    levels that sexual assault will not be tolerated in the United States
    Navy.
        There is no question the success of our Navy Reserve is due to the
    dedication, sacrifices and service of our Sailors, and the support they
    receive from their families and employers. I believe our policies
    reflect that same level of commitment, and I thank you for your support
    of our many programs, several of which have been described herein.
                              defining our future
        Numerous formal and informal studies examining the future role of
    the Reserve Components and the National Guard are in various stages of
    completion within and outside DOD. These studies are designed to assess
    the projected security environment of the world after the conclusion of
    the current Overseas Contingency Operations, as well as provide
    guidance on the capabilities that will be needed for our Nation's
    future security and continued prosperity. We are an active participant
    in these studies where appropriate. At the same time, we remain focused
    on the primary driving force defining our future: our integral role as
    an important component of Navy's Total Force.
        Navy's maritime strategy is founded upon the truth that the United
    States of America is a maritime nation. Some facts will not change: 70
    percent of the globe is covered by water; 80 percent of our population
    lives on or near the coast; and 90 percent of our commerce travels via
    the oceans. The oil that provides the energy for our modern world flows
    in tankers via a few strategic sea routes--routes that must be kept
    open. Our digital planet is linked by submerged fiber optic lines that
    transmit money and ideas across the planet 24/7. The enduring mission
    of our Navy to protect the global commons and maintain the stability
    necessary for prosperity will remain whether we are at peace or war.
        Bottom line: Demand for Navy capabilities will remain the same or
    increase in the future. The Navy Reserve will play a vital role in
    Navy's Total Force that will deliver these capabilities. As stated in
    the 2010 Quadrennial Defense Review (QDR) Report, ``prevailing in
    today's wars requires a Reserve Component that can serve in an
    operational capacity--available, trained, and equipped for predictable
    routine deployment. Preventing and deterring conflict will likely
    necessitate the continued use of some elements of the RC--especially
    those that possess high-demand skill sets--in an operational capacity
    well into the future.'' We thank Congress for their demonstrated
    interest in ensuring DOD has appropriate authority to access the RC in
    order to provide a more complete Total Force response to the
    requirements of the future.
        Today's Navy Reserve provides both strategic depth and operational
    capabilities. Depending on the mission, we mirror or complement the AC.
    We mirror the AC and provide rotational forces for those missions where
    it makes operational and fiscal sense. We complement the AC by
    providing unique capabilities in other areas, such as in the Intra-
    Theater Fleet Logistics Support, Counter-Narcotics Surveillance, and
    Navy Special Warfare Helicopter Support missions. The correct AC/RC mix
    varies with each of Navy's wide variety of missions and required
    capabilities. As new missions emerge and current missions evolve, AC/RC
    mix solutions are carefully and continually examined. As stated in the
    QDR, ``as the operational environment allows, DOD will seek ways to
    rebalance its reliance on the RC to ensure the long-term viability of a
    force that has both strategic and operational capabilities.'' The Navy
    Reserve's fiscal year 2012 Operations and Maintenance budget request of
    $1.397 billion (including OCO funding) will continue to provide the
    Joint Force with readiness, innovation, and the agility to respond to
    any situation.
        While we have become more operational, we have also become a
    smaller and more cost-effective force. Throughout the post-9/11 era,
    the Navy Reserve has pursued efficiencies while increasing our
    capabilities. We have eliminated staff and organizational redundancies
    wherever possible, leveraging the Navy's schools, bases, organizations
    and information technology infrastructure. We have honed our staff
    overhead to approximately 3,000 Sailors who serve and enable the
    remaining 62,000 Sailors of our Navy Reserve to contribute directly to
    active Navy commands.
        The Navy's RC is a force for innovation across all spectrums, but
    it is especially evident in the realm of Information Technology (IT).
    IT is critical to everything we do as a Navy, and the Navy Reserve is
    in the forefront on several IT initiatives, such as retiring our legacy
    networks and contributing to Navy Cyber Forces. The Navy Reserve is the
    only Navy echelon to have completely retired all legacy networks and
    operate exclusively within Navy Marine Corps Intranet (NMCI). As we
    progress from the NMCI contract to the Next Generation Enterprise
    Network, Navy Reserve is leading the effort to move to thin client
    computing and other efficiencies to provide our Sailors with the most
    secure, robust access available anytime, anywhere.
        In 2011, we are exploring new network access methodologies with
    further testing of the Secure Remote Access Pilot designed to empower
    the workforce to quickly and securely access their digital resources
    from any location, using any asset, at any time. The Navy Reserve will
    also deploy Wi-Fi access to all Navy Reserve facilities, generating
    cost savings and improving Sailor satisfaction. Also, by the end of
    fiscal year 2011, all Reserve travel arrangements and reimbursement
    claims will be handled through the Defense Travel System (DTS). Navy
    Reserve is the lead reserve and guard activity to migrate to DTS. This
    migration will eliminate the manual processing of 125,000 travel claims
    per year, freeing manpower for other customer service requirements and
    speeding pay to the reserve traveler from an average of 45 days to an
    average of 5 days.
        Navy is developing a data system--tentatively called the Integrated
    Pay and Personnel System--Navy (IPPS-N)--which will improve pay and
    service record support to both AC and RC Sailors. Historically, Reserve
    Readiness Commands, Personnel Support Detachments, and NOSCs have been
    unable to attain an accurate picture of manpower and personnel data
    despite exhaustive efforts to reconcile the information found in
    multiple ``authoritative'' sources and Reserve Headquarters Support
    databases. IPPS-N would allow for real-time service record
    documentation, end strength reporting, and pay-accounting across both
    the AC and RC. This is not just the design and building of an IT system
    but rather a complete review of all business processes. The
    Authoritative Data Environment, a key piece of the IPPS-N that the Navy
    Reserve is promoting, will be the single source for Sailor manpower and
    personnel records and provide the base for the complete solution. The
    end-state of this initiative is improved personnel management across
    the CoS and better support for service members and leadership.
        Ensuring our Reserve Force has the proper equipment to bring our
    military acumen to bear is one of my ongoing priorities. I thank
    Congress for the support they provide the Navy Reserve in the many
    appropriations for the Force. In particular, the Navy and the Joint
    Forces benefit greatly from Congress' support for recapitalizing Fleet
    Logistics aircraft by procuring C-40A airframes. The C-40A ``Clipper''
    is a Navy Unique Fleet Essential Airlift (NUFEA) aircraft that provides
    flexible, time-critical inter- and intra-theater air logistics support
    to Navy Fleet and Component Commanders as well as providing logistical
    support for the Navy Fleet Response Plan. The C-40A is a medium lift
    cargo aircraft, equipped with a cargo door and capable of transporting
    up to 36,000 pounds of cargo, 121 passengers, or a combination of each.
    The C-40A is the designated replacement for the Navy Reserve's legacy
    C-9B and C-20G aircraft. Aircraft recapitalization of the C-9B and C-
    20G is necessary due to increasing operating and depot costs,
    decreasing availability, inability to meet future avionics/engine
    mandates required to operate worldwide, and continued long-term use of
    the C-20G in the harsh desert environment. The C-40A has significantly
    increased range, payload, and days of availability compared to the C-9B
    and C-20G, and has the unique capability of carrying hazardous cargo
    and passengers simultaneously. Navy C-40A detachments are forward-
    deployed 12 months per year to provide around-the-clock support to the
    U.S. Pacific Command, U.S. Central Command, and U.S. European Command
    Areas of Responsibility. Additionally, these cargo airplanes are an
    integral first-responder in emerging Humanitarian Assistance/Disaster
    Relief core mission sets. Currently, 11 C-40A cargo aircraft are
    operational and one is on contract for an early fiscal year 2012
    delivery. Five aircraft are required to complete the minimum, risk-
    adjusted C-40A procurement plan of 17 aircraft which will complete the
    divestiture of the C-9Bs and C-20Gs. Congressional support for the Navy
    Reserve C-40A program has placed the VR fleet closer to realizing a
    more capable and cost-efficient NUFEA capability.
        Also, the National Guard and Reserve Equipment Appropriation
    (NGREA) funds equipment for the Navy Reserve. NGREA has allowed us to
    purchase expeditionary warfighting equipment for the Naval
    Expeditionary Combat Enterprise in support of operations in Iraq and
    Afghanistan, and essential training upgrades to the adversary mission.
    In the past, NGREA Funding has also allowed for the procurement of C-
    40A cargo aircraft to replace an aging fleet of C-9s, C-12s, and C-20s.
    The Navy Reserve has a solid record of executing NGREA funding,
    demonstrating our stewardship of these important taxpayer dollars. I
    thank you for all the support you have provided to the Navy Reserve
    through this appropriation in the past.
                                   conclusion
        As stated in the 2010 QDR, ``the challenges facing the United
    States today and in the future will require us to employ the National
    Guard and Reserve force as an operational reserve to fulfill
    requirements for which they are well suited.'' Our Navy Reserve Vision
    calls for us to be valued for three very important hallmarks of our
    Force: our ``readiness, innovation, and agility to respond to any
    situation.'' This applies operationally and strategically as Navy
    continuously evaluates and adjusts the AC/RC mix in any given naval
    capability. Through Navy's adaptable, dynamic, and requirements-driven
    process, the Navy Reserve has proven it has much to offer ``America's
    Navy--A Global Force for Good.''
        On a more personal level, as Chief of Navy Reserve I take to heart
    each Sailor has sworn to support and defend the Constitution of the
    United States. My covenant to them is to make each day in the Navy
    Reserve a day filled with real and meaningful work. My obligation to
    the Navy and our Nation is to ensure that your Navy Reserve has the
    right force structure today and in the future. Using our strategic plan
    as our blueprint for the future, we intend to live up to the promise of
    our Force Motto: Ready Now. Anytime, Anywhere.
        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 Navy's Total Force.

        Chairman Inouye. General Moore.
    STATEMENT OF MAJOR GENERAL DARRELL L. MOORE, ACTING
                COMMANDER, MARINE FORCES RESERVE, UNITED
                STATES MARINE CORPS
        General Moore. Good morning, sir. Thank you very much for
    this opportunity to be here.
        It was a real pleasure for me last week to meet the
    chairman and vice chairman in their offices, and I enjoyed that
    time with you.
        This morning, sir, thousands of Marine Reserves are on the
    ground in Afghanistan, serving side-by-side in combat
    operations along with active component marine units. Our
    Reserve units are being incorporated into the active deployment
    rotation cycle for the foreseeable future.
        Your Reserve marines work hard to stay ready, and we train
    vigorously for this fight during our annual training. We truly
    do serve in every clime and place. For example, besides this
    summer engaging in training operations in the Pacific and here
    in the United States at Twenty-Nine Palms and the Mountain
    Warfare Training Center, I will have marines engaged in theater
    security cooperation exercises in Morocco, Surinam, Ukraine,
    Georgia, South Africa, Uganda, Burundi, Senegal, Mauritania,
    and Belize.
        Marine Forces Reserve stands ready to deploy anywhere in
    the world as we are needed. We are an essential partner to
    keeping the United States Marine Corps as the Nation's force in
    readiness.
        I look forward to this opportunity to address any questions
    you or Senator Cochran may have.
        Thank you.
        Chairman Inouye. Thank you very much, General.
        [The statement follows:]
              Prepared Statement of Major General Darrell L. Moore
                                  introduction
        Chairman Inouye, Ranking Member Cochran, and distinguished Members
    of the Subcommittee, it is my honor to report to you on the state of
    the Nation's Marine Corps Reserve and our Marine Reservists, who truly
    epitomize the Marine Corps' values of honor, courage and commitment. I
    would also like to take this opportunity to discuss what the
    operational Reserve means for the defense of our Nation, support to its
    combatant commanders and commitment to our international partners.
        First and foremost, Marine Forces Reserve continues to be an
    integral element of the Total Force Marine Corps. We share the culture
    of deployment and expeditionary mindset that has dominated Marine Corps
    culture, ethos and thinking since our beginning more than two centuries
    ago. All Marines stand eternally ready to answer this Nation's call to
    arms. Accordingly, the U.S. Marine Corps Reserve is organized, equipped
    and trained in the same manner as the Active Component Marine Corps,
    and consequently, is interchangeable and forever leaning forward to
    deploy in any clime or place.
        Commandant of the Marine Corps Gen. James F. Amos recently stated
    in his planning guidance that ``the Marine Corps is America's
    Expeditionary Force in Readiness.'' General Amos' March 1, 2011, report
    to the House Armed Services Committee on the posture of the United
    States Marine Corps specifically addressed the Marine Corps Reserve's
    operational orientation within the Expeditionary Force in Readiness
    construct: ``The transition in utilization of the Marine Corps Reserve
    from a strategic to operational Reserve, as affirmed by the Marine
    Corps' recent force structure review, expands the Corps' ability to
    perform as America's Expeditionary Force in Readiness.
        The Marines themselves, most of whom came to our Nation's colors
    after 9/11 and have deployed deep into harms way, prefer this model and
    do not desire to assume lives as so called ``weekend warriors.'' This
    high level of flexibility, responsiveness and elan is only possible by
    the ever deepening bench of combat tested and uniquely qualified
    citizen ``Soldiers of the Sea.''
        I continue to be humbled on a daily basis in my interactions with
    these magnificent young Americans. Like their active-duty brothers and
    sisters, they sacrifice so much of their time--and so much of
    themselves--to protect and serve this great Nation. The way they
    balance their family responsibilities, civilian lives, and
    occupations--and still stay Marine--continues to amaze me. They do it
    with humility, without fanfare, and with a sense of pride and
    dedication that is consistent with the great sacrifices of Marines of
    every generation.
                             an operational reserve
        In the previous decade, this great Nation required its Marine Corps
    Reserve to be continuously engaged in combat operations in Iraq and
    Afghanistan as well as in regional security cooperation and crisis
    prevention activities in support of the various geographical combatant
    commanders. This operational tempo has built a momentum among our
    warfighters and a depth of experience throughout the ranks that is
    unprecedented in generations of Marine Corps Reservists.
        In addition to our service in and around combat zones, your Marine
    Corps Reserve's response to our Nation's needs echoes the February 2010
    Quadrennial Defense Review, which called for a Reserve Component that
    can serve in an operational capacity for predictable routine
    deployment. Accordingly, today's Marine Corps Reserve fully embodies
    the operational Reserve concept and has shaped itself to continue in
    this operational manner for the foreseeable future.
        Understanding that we are fighting a transnational enemy and that
    partner nations will continue to seek our training and mentoring
    capabilities, I expect our Marine Reservists to be in great demand
    during the coming years in a sustained manner. I am pleased to report
    that we are prepared to provide that persistent capacity. The nature of
    the fight in Afghanistan, for instance, is particularly suited to our
    Marine Reservists. It is a thinking man's fight that requires solutions
    at the grassroots level where our Marines operate best, which is among
    the population as evidenced by our combat prowess and ``Small Wars''
    mindset. To be sure, our recent successes in Iraq were hastened by the
    types and quality of individuals we have in our ranks, who often
    utilized civilian skills in ways not necessarily anticipated, but
    ultimately proving pivotal to the success in Al Anbar Province. I
    expect no difference with our Marine Reservists in Afghanistan. That
    maturity, creativity and confidence is what an operational Reserve
    brings to the fight. In fact, your Marine Corps Reserve is more highly
    trained, capable, and battle-tested than at any time since the Korean
    War. Without reservation, your Marine Corps Reserve continues to be an
    integral part of the Total Force Marine Corps, and its strength lies in
    the fact that Marine Corps Reservists blend seamlessly into the gaining
    force regardless of whether they deploy as individual augments, members
    of detachments, or operational units.
        As of January 31, 2011, more than 58,000 Reserve Marines have
    mobilized in support of Overseas Contingency Operations, previously the
    Global War on Terrorism, since September 11, 2001. The vast majority of
    these Marines deployed to the U.S. Central Command's area of
    responsibility, which includes Iraq, Afghanistan, and previously, the
    Horn of Africa. One-hundred percent of Marine Corps Reserve units at
    the battalion and squadron level have either been activated in their
    entirety or activated task-organized detachments. Thousands of other
    Marine Reservists deployed in support of combatant commanders' Theater
    Security Cooperation initiatives to South America, Eastern Europe,
    Asia, Africa, Australia, and various Pacific island nations. This year
    will be no different as Marine Reservists are scheduled to support
    planned exercises in Norway, Peru, Belize, Uganda, Estonia and Morocco,
    and again in various nations in Asia and the Pacific islands.
        Our Force Generation Model is one of the important planning
    mechanisms for an operational Reserve. The Model, which was developed
    and implemented during October 2006, continues to provide long-term and
    essential predictability of future activations and deployments for our
    Reservists. The Model provides my Marines, their families, and their
    employers, the capability to plan their lives 5 or more years out. It
    empowers them to strike the critical balance between family, civilian
    career, and service to the Nation, while allowing employers the time to
    manage the temporary loss of valued employees. The Force Generation
    Model also assists Service and joint force planners in maintaining a
    consistent and predictable flow of fully capable Marine Corps Reserve
    units. Internal to the Marine Corps, this flow of fully trained and
    capable Reserve units has proven essential in enabling Active Component
    combat units to start realizing an approximate 1:2 deployment-to-dwell,
    which was established by the Secretary of Defense.
        The Force Generation Model is a relatively simple management tool
    based on 1-year activations, to 4-plus years in a non-activated status,
    which makes continued programmed utilization of the Marine Corps
    Reserve sustainable at 1:5 deployment-to-dwell over the long term. In
    fact, the Marine Corps Reserve can potentially source 3,000 Marines per
    rotation and 6,000 Marines annually at a 1:5 deployment-to-dwell as
    programmed in the Force Generation Model. Furthermore, projecting
    predictable activation dates, mission assignments and geographical
    destination years in advance enables my units to orient training on
    core mission requirements early in the dwell period, then transition
    the training focus to specific mission tasks as soon as the unit is 12-
    18 months from activation.
        Marine Forces Reserve operations continued on a high operational
    tempo as we supported all of the geographical combatant commanders
    across the globe. Our Force units and major subordinate commands--the
    4th Marine Division, 4th Marine Aircraft Wing, and 4th Marine Logistics
    Group--were called upon to provide 1,920 Marines to support Operation
    Enduring Freedom and are in the final stages of preparing another 3,147
    Marines to deploy this fiscal year. Marine Forces Reserve also deployed
    Marines to a plethora of theater specific exercises and cooperative
    security efforts, which were designed to increase interoperability with
    our Partnership For Peace NATO allies as well as for developing Theater
    Security Cooperatives in countries such as Morocco, Mozambique,
    Romania, Georgia, the Black Sea region and partners throughout the
    Pacific Rim.
        Marine Forces Reserve's operational focus will continue to directly
    support the geographical combatant commanders this fiscal year in
    various roles that includes multiple bi-lateral exercises, such as
    Western Accord in Senegal, Sea Breeze in the Ukraine, African Lion in
    Morocco, and Agile Spirit, which is an ongoing effort with the Georgian
    Army in and around Tbilisi. The way ahead for Marine Forces Reserve
    includes building partner capacity in the Black Sea region on behalf of
    the geographical combatant commander by providing Marine Reservists to
    conduct operations of various sizes and complexities throughout the
    region to assure stability and sustainability in this high priority
    geopolitical region.
        For the third year in a row, Marine Forces Reserve will sponsor
    exercise Javelin Thrust stateside this July, which will focus on Marine
    Air-Ground Task Force core competency training. Javelin Thrust 2011
    will be conducted aboard installations throughout the Western United
    States with both virtual and real world aspects to the exercise. The
    scenario of this year's event is tailored to the current operating
    environment. A criterion for participating units was based on their
    future deployment schedule according to the Force Generation Model.
    Javelin Thrust will provide all elements of the Marine Air-Ground Task
    Force with the opportunity to complete some of the training necessary
    to expeditiously forward-deploy competently in any operational
    environment. Additionally, individuals serving on the exercise's Marine
    Air-Ground Task Force staffs will receive training that will enable
    them to competently perform as individual augments on a Marine Air-
    Ground Task Force staff or joint staff overseas. In addition to
    involving all of Marine Forces Reserve's Force units and three major
    subordinate commands, this year's exercise will include an integrated
    Active Component and Reserve Component headquarters. This aspect of the
    exercise is aimed at validating the Total Force approach with an
    emphasis on interoperability of Active Component and Reserve Component
    Marine forces.
        In addition to operational requirements, Marine Forces Reserve
    personnel and units conduct community relations events nationwide. Due
    to the command's unique geographical dispersion, Marine Forces Reserve
    personnel and units are advantageously positioned to interact with the
    American public, telling the Marine Corps story to our fellow citizens
    who typically have little or no contact with the Marine Corps.
        During the previous year, Marine Forces Reserve supported more than
    10 significant community relations events, which included among others:
    Marine Week Boston, Armed Forces Bowl in the Dallas/Fort Worth area,
    New York City Fleet Week, Baltimore Fleet Week, Public Service
    Recognition Week and Joint Service Open House in the District of
    Columbia area, and the commissioning of the USS New York. Marine Forces
    Reserve also supported more than 50 community relations events of a
    lesser scale that included various air shows, memorials and assorted
    flyovers across the Nation. Additionally, more than 200 community
    events of a routine nature were supported across the Nation, such as
    color guard details, vehicle and weapon static displays, and guest
    speakers.
        The significant community relations events required a footprint of
    Marine Forces Reserve assets that mirrored an operational Marine Air-
    Ground Task Force in structure. Of note is the Marine Week concept,
    which was held in Boston during fiscal year 2010. The Marine Week
    concept is a strategic communication initiative created to articulate
    to the American public what the U.S. Marine Corps stands for, what we
    do, who we are and what the Corps aspires to accomplish in the future.
    This successful week-long event encompassed a series of more than 60
    smaller events, which included formal ceremonies, various static
    displays of aircraft, vehicles and weapons, and other outreach events
    such as sports demonstrations and concerts. Marine Forces Reserve was
    the lead element for Marine Week Boston, with the 24th Marine Regiment
    sourcing the Marine Air-Ground Task Force command element and the
    subordinate units. Marine Forces Reserve will take the lead once again
    for Marine Week St. Louis this June and is likely to form the command
    element on behalf of the Marine Corps for all Marine Weeks hereafter
    due to our national footprint, deep connection with local communities,
    and integration of Active and Reserve Component personnel at our
    Reserve sites across this great Nation.
                                   personnel
        Marine Forces Reserve consists of the Selected Marine Corps Reserve
    and the Individual Ready Reserve, which form the Ready Reserve. The
    Selected Marine Corps Reserve is comprised of Marines in Reserve units,
    those in the Active Reserve program, Individual Mobilization
    Augmentees, and those in initial training. These categories of Marines
    form the inventory of the Selected Marine Corps Reserve's authorized
    end strength of 39,600.
        We continue to enjoy strong accessions and an increase in retention
    over the historical norm, which greatly enhanced our ability to improve
    our end strength during fiscal year 2010. Our bonus and incentive
    programs for Reserves were essential tools in achieving more than 99
    percent of our authorized end strength. Continued use of these programs
    will remain critical to both meeting our overall end strength this
    fiscal year and to continue shaping our Force. Our authorized end
    strength of 39,600 is appropriate for providing us with the Marines we
    require to support the Total Force while achieving the Commandant's
    goal of a 1:5 deployment-to-dwell for Selected Marine Corps Reserve
    units.
        I am pleased to report that the Marine Corps/Navy Reserve Team is
    as strong as ever. In the past year the Navy made sure that Marine
    Forces Reserve units were fully manned and supported with Program 9--
    U.S. Navy personnel in support of Marine Forces--and Health Service
    Augmentation Program personnel during all deployment phases. Five
    hundred thirty-six U.S. Navy personnel were sourced to staff Marine
    Forces Reserve units that deployed to Iraq and Afghanistan, as well as
    numerous joint and/or combined exercises. These individuals focused
    almost entirely on providing medical, dental and religious services.
    The Navy Mobilization Office works with my headquarters, as well as
    with my major subordinate commands, to source 100 percent of all
    requirements.
        Manning to authorized end strength requires an institutional
    approach. The Marine Corps is unique in that all recruiting efforts
    fall under the direction of the commanding general, Marine Corps
    Recruiting Command. This approach provides tremendous flexibility and
    unity of command in annually achieving Total Force recruiting
    objectives. Like the Active Component Marine Corps, Marine Corps
    Reserve units rely primarily upon a first-term enlisted force. Marine
    Corps Recruiting Command achieved 100 percent of its recruiting goal
    for non-prior service recruiting (5,868) and prior service recruiting
    (4,209) for fiscal year 2010. As of February 28, 2011, 2,576 non-prior
    service and 1,340 enlisted prior service Marines have been accessed,
    reflecting 45.86 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.
        Officer recruiting remains our most challenging area. Historically,
    the Active Component Marine Corps has been the exclusive source of
    senior lieutenants and captains for the Marine Corps Reserve, and it
    remains a source of strength in meeting our company grade requirements.
    Through our transition assistance and educational outreach programs, we
    continue to ensure that each transitioning Active Component Marine is
    educated on continued service opportunities in the Marine Corps
    Reserve. To compliment the Active-to-Reserve Component company grade
    accessions, we continue to offer three recently implemented Reserve
    commissioning initiatives that focus exclusively on the most crucial
    challenge of manning the Marine Corps Reserve with quality company
    grade officers. These Reserve commissioning initiatives are the Reserve
    Enlisted Commissioning Program (RECP), which was expanded to qualified
    active duty enlisted Marines in addition to qualified Reserve enlisted
    Marines; Meritorious Commissioning Program--Reserve (MCP-R), which is
    open to individuals of the Active and Reserve Components who have
    earned an Associate's Degree or equivalent in semester hours; and
    Officer Candidate Course--Reserve (OCC-R). Since 2004, these three
    programs have produced a total of 330 lieutenants for the Marine Corps
    Reserve. The OCC-R program has been the most successful of the three
    Reserve commissioning initiatives, producing 296 officers. It focuses
    on ground billets with an emphasis on ground combat and combat service
    support within specific Reserve units that are scheduled for
    mobilization. The priority to man units with these officers is once
    again tied to the Force Generation Model. All together, these programs,
    combined with our prior service recruiting efforts, are projected to
    provide at least 90 percent manning of critical combat arms and
    engineer company grade officer billets by September 30, 2015.
        Regarding retention, all commanders and senior enlisted leaders
    across Marine Forces Reserve are tasked to retain quality Marines
    through example, mentoring, and information and retention programs.
    This takes place across the Marine experience, not just in the final
    days of a Marine's contract. Those approaching the end of their current
    contracts--Active or Reserve Component--receive more focused counseling
    on the tangible and intangible aspects of remaining associated with, or
    joining, the Selected Marine Corps Reserve.
        Your continued support regarding enlistment, affiliation, and re-
    enlistment bonuses along with other initiatives greatly influences my
    ability to gain and retain the very best. I greatly appreciate the
    continuance of all of the many programs that help us recruit and retain
    the best young men and women this nation produces.
                                   equipment
        Established by the Commandant in his planning guidance, the Marine
    Corps' number one focus is to provide the best trained and best
    equipped Marine units to Afghanistan. Accordingly, Marine Forces
    Reserve has two primary equipping priorities--equipping individuals who
    are preparing to deploy and sufficiently equipping units to conduct
    home station training. I directed my staff to dedicate its efforts to
    ensure that every member of Marine Forces Reserve deploys fully
    equipped with the most current authorized Individual Combat Equipment
    and Personal Protective Equipment. Accordingly, we continue to equip
    individuals and units during their dwell periods with the best
    available equipment tailored specifically to their next mission in
    accordance with the Force Generation Model.
        Whereas individuals receive 100 percent of the necessary
    warfighting equipment, Marine Forces Reserve units are equipped to a
    level identified as a Training Allowance. The Training Allowance is the
    amount of equipment required by each unit to most effectively conduct
    home station training. My guidance to my commanders is to establish
    their Training Allowance to enable them to maintain the highest
    training readiness as defined by their mission requirements. As a
    contributing component of the Total Force Marine Corps, Marine Corps
    Reserve units are equipped with the same equipment that is utilized by
    the Active Component Marine Corps, but in quantities tailored to fit
    Reserve Training Center capabilities. To be sure, it is imperative that
    our units train with the same equipment they will utilize while
    deployed. I am pleased to report that as a whole, we are adequately
    equipped to effectively conduct home station and Force-level training.
        Although we have been engaged in combat operations for almost a
    decade, our equipment readiness rates remain above 97 percent. To
    maintain this level of readiness, we have relied heavily on
    supplemental funding in the Overseas Contingency Operational funding.
    Your continued support in this category has been critical in
    maintaining our current level of equipment readiness for combat
    operations and resultant contribution to Marine Corps combat
    capability.
        Several resources and programs combine to form the basis to the
    Marine Corps Reserve approach to maintenance. Routine preventive and
    corrective maintenance are performed locally by operator and organic
    maintenance personnel. This traditional approach to ground equipment
    maintenance was expanded to include an increasing reliance on highly
    effective contracted services and depot-level capabilities, which were
    provided by the Marine Corps Logistics Command. Over the past year, we
    experienced significant success with the Marine Corps Logistics
    Command's ``Mobile Maintenance Teams'' that have provided preventive
    and corrective maintenance support to all 183 Marine Corps Reserve
    sites across the United States. This maintenance augmentation effort
    has directly improved our equipment readiness as well as provided
    valuable ``hands on'' training to our organic equipment maintainers.
    Additionally, the Marine Corps Logistics Command's ``Enterprise
    Lifecycle Maintenance Program'' provides for the rebuilding and
    modifying of an array of principal end items, such as the Light Armored
    Vehicle, the Amphibious Assault Vehicle and our entire motor transport
    fleet. Finally, we continue to reap significant benefits from the
    Marine Corps Corrosion Prevention and Control Program. Dollar for
    dollar, this program has proven highly effective in the abatement and
    prevention of corrosion throughout the Force. Collectively, these
    initiatives and the hard work and dedication of our Marines and
    civilian Marines across Marine Forces Reserve sustain our ground
    equipment readiness rates at or above 97 percent.
        National Guard and Reserve Equipment Appropriations have been an
    important element of the Total Force Marine Corps ability to modernize
    the Reserve Component and have ensured that there is maximum
    compatibility between the Reserve and Active Components. During fiscal
    years 2008, 2009 and 2010, Marine Forces Reserve received $45 million,
    $65 million, and $45 million respectively through National Guard and
    Reserve Equipment Appropriations. We used these funds to augment
    regular procurement dollars and accelerate the fielding of various
    programs that touch every element of the Marine Air-Ground Task Force.
        With the fiscal year 2008 National Guard and Reserve Equipment
    Appropriation, we applied funding toward upgrades of aircraft which
    included the KC-130T, the F/A-18 and the UH-1. These upgrades enabled
    us to maintain compatibility with airframes being employed by the
    Active Component Marine Corps. We also purchased an operation support
    airlift UC-12 aircraft for our VMR Detachment at Naval Air Station
    Joint Reserve Base New Orleans. Funds were also used for Tactical
    Remote Sensor Suites and the Rover III Forward Air Control
    communications capability. Both of the previous items added to our
    ability to enhance command and control. Last, we invested in four
    modeling and simulation programs that increased the effectiveness of
    our Reserve training while reducing our training costs. These included
    two mobile HMMWV Egress Assistance Trainers, seven Medium Tactical
    Vehicle Replacement Operator Trainers, one Virtual Combat Convoy
    Training System, and 135 Digital-Virtual Training Environment suites.
        During fiscal year 2009, the Congress initially appropriated $40
    million in National Guard and Reserve Equipment Appropriations. An
    additional $25 million was subsequently provided in that year's
    supplemental. These funds provided Marine Forces Reserve with
    additional aircraft upgrades for the UH-1 and improved survivability of
    our UC-35 aircraft, additional command and control items with purchases
    of additional Tactical Remote Sensor Suites, Digital Terrain Analysis
    Mapping Systems, a Counter Intelligent/Human Intelligence Equipment
    Package, and various tactical laptop computers; supporting arms
    upgrades for our Digital-Virtual Training Environment program; 43
    Logistics Vehicle System Replacements; and 22 upgraded Light Armored
    Vehicles, which are a critical component to the Marine Air-Ground Task
    Force's combat power and mobility.
        With the $45 million in fiscal year 2010 National Guard and Reserve
    Equipment Appropriation, we increased our investment in Light Armored
    Vehicle purchases by ordering nine additional 25 mm canon variants and
    five command and control variants. We also purchased an Air Traffic
    Control simulation package, which will greatly improve the training
    capability for our Air Traffic Control Marines.
        In our fiscal year 2012 National Guard and Reserve Equipment Report
    published in February, we identified four modernization priorities that
    could be funded with the fiscal year 2011 National Guard and Reserve
    Equipment Appropriations you have already provided. The first priority
    is to procure the remaining Light Armored Vehicles for our 4th Light
    Armored Reconnaissance Battalion. At the time the report was published,
    we had 42 vehicles which still needed to be procured at a total cost of
    $109 million. Since that report was published, the Marine Corps has
    taken advantage of its repair depots' ability to convert recently
    returned A1 variant Light Armored Vehicles into A2 variants. This
    reduces our anticipated gap to 27 vehicles at an estimated cost of $68
    million. Using a portion of the $70 million provided in the 2011
    Department of Defense and Full-Year and Continuing Appropriations Act,
    we intend to procure 10 additional Light Armored Vehicle Logistics
    variants, which will further close out our Light Armored Vehicles gap.
        In the fiscal year 2012 National Guard and Reserve Equipment
    Report, we also discussed our priority to accelerate fielding of our
    KC-130J fleet. The KC-130J has already been fielded to the Active
    Component Marine Corps while the KC-130T will remain in service in the
    Reserve Component from now until beyond the year 2020. The first
    Reserve Component KC-130J is not scheduled for delivery until 2014.
    These two aircraft are very different airframes, each requiring
    completely different logistical, maintenance, and aircrew requirements.
    The longer we maintain both airframes, the longer we have to invest in
    twice the logistics, twice the maintenance training, and twice the
    aircrew training. The total cost to purchase all 28 Reserve Component
    KC130J aircraft is more than $2 billion. Currently, only 9 of the 28
    airframes are funded within the Future Years Defense Plan.
        The third priority outlined in the fiscal year 2012 National Guard
    and Reserve Equipment Report is the procurement of a KC-130J Weapons
    System Trainer for the Reserve Component at a cost of approximately $25
    million. As we transition models, there will be a need for this
    simulator in order to maintain combat qualifications. Without one in
    the Reserve Component, our aircrews will be competing for time in
    active component simulators, which are already over-scheduled.
        The fourth priority outlined in the fiscal year 2012 National Guard
    and Reserve Equipment Report is the modernization of our aging
    Logistics Vehicle System fleet. In addition to the 43 Logistics Vehicle
    System replacements purchased with the fiscal year 2009 National Guard
    and Reserve Equipment Appropriation, we requested to purchase an
    additional 108 vehicles using a significant portion of the $70 million
    provided in this year's appropriation Act. This not only provides for
    an additional 58 cargo variants, but also provides 37 tractor variants
    and 13 wrecker variants. The tractor and wrecker variants are just
    reaching full rate production and this investment continues to enhance
    our compatibility with the Active Component.
                                    training
        Language and culture training is available to all Marine Reservists
    and is delivered via a variety of techniques, from live instruction to
    portable media to web-based tutorials and applications. Our Afghanistan
    culture training leverages academia, utilizes Afghan-American
    expertise, and includes web-host detailed and tailored courses of
    instruction. These courses can be accessed by any computer and have the
    added functionality of being iPod-compatible to download for
    transportability and accessibility by our Marines. We are also beta-
    testing our first Pashtu language course for our next infantry
    battalion deploying to South Asia. This is an 18-week course that is a
    webinar-linked program, which allows geographically separated Marines
    and instructors to ``meet'' in a virtual classroom that consists of
    using course-provided computing systems. It's synonymous with the
    program Special Operations Command has been running for a number of
    years. This course is directed to provide Pashtu language capability
    down to the squad level with participants at the rank of lieutenant,
    sergeant, corporal and below. Additionally, my Marines also participate
    in introductory Pashtu immersion training, which is conducted in 5-week
    blocks of instruction and is supported by the Partner Language Training
    Center Europe (PLTCE) Garmisch, Germany. Last, given that our Marines
    deploy throughout the globe, we access a variety of other sources of
    language and cultural training such as the Marine Corps' Center for
    Advanced Operational Culture and Language, the Defense Language
    Institute and Regional Language Centers. Your continued support for
    these enhanced language and culture learning opportunities is crucial
    to our competence in the current fight in Afghanistan.
        One of the most exciting areas where we continue to transform the
    depth and scope of our training remains the cutting-edge arena of
    Training Simulation. Marine Forces Reserve continues to field several
    immersive complex digital video-based training systems, complete with
    the sights, sounds and chaos of today's battlefield environments. These
    systems are particularly important, considering the limited training
    time and facilities available to our commanders. Last year, we
    completed the fielding and upgrading of the Indoor Simulated
    Marksmanship Trainer-XP. These simulators make it possible for the
    Marines to ``employ'' a variety of infantry weapons--pistol through
    heavy machinegun--in rifle squad scenarios.
        Another simulator, the Virtual Combat Convoy Trainer-Reconfigurable
    Vehicle System, provides invaluable pre-deployment training for the
    drivers of all makes and models of tactical vehicles. This trainer
    provides various conditions of terrain, road, weather, visibility and
    vehicle condition as well as various combat scenarios, which includes
    routine movement, ambush, and IED, among others. The Virtual Combat
    Convoy Trainer-Reconfigurable Vehicle System 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. We are now preparing to accept the fourth
    generation of this system and have doubled student throughput.
        Another training simulation technology that has been fielded is the
    Deployable Virtual Training Environment, which provides small-unit
    echelons with the opportunity to continuously review and rehearse
    command and control procedures and battlefield concepts in a virtual
    environment. The Deployable Virtual Training Environment provides
    individual, fire team, squad and platoon-level training associated with
    patrolling, ambushes and convoy operations. Additional features of the
    Deployable Virtual Training Environment include supporting arms
    upgrades for virtual combined arms indirect fire and forward air
    control training, combat engineer training, small-unit tactics
    training, tactical foreign language training and event-driven, ethics-
    based, decisionmaking training.
        Finally, The HMMWV Egress Assistance Trainer and the Mine-Resistant
    Armor Protected (MRAP) Egress Trainer are mechanical simulation
    trainers that familiarize Marines with the techniques and procedures to
    egress a HMMWV or a MRAP vehicle that has overturned. Both Trainers are
    training tools that provide Marines with the opportunity to experience
    vehicle roll-over conditions to enable them to rehearse actions and
    physically execute the steps necessary to survive a vehicle rollover.
    These systems support the U.S. Central Command requirement for all
    Marines to complete vehicle roll-over training prior to deploying to
    designated combat zones.
        It is important to recognize the key role Congress has played in
    the fielding of these advanced training systems, all of which have been
    rapidly acquired and fielded with supplemental and National Guard and
    Reserve Equipment Appropriations funding.
                                   facilities
        Marine Forces Reserve is comprised of 183 sites in 48 States, the
    District of Columbia, and Puerto Rico. These facilities consist of 32
    owned sites, 151 tenant locations, three family housing sites, and a
    Marine barracks. Most of our Reserve sites are openly located within
    civilian communities, which require close partnering with State and
    local entities nationwide. Additionally, the condition and appearance
    of our facilities informs the American people's perception of the
    Marine Corps as well as the Armed Forces.
        Department of Defense policy and the use of standardized models for
    Marine Forces Reserve Facilities Sustainment, Restoration, and
    Modernization (FSRM) dollars have greatly improved funding profiles for
    our Reserve facilities over the last several years. We are experiencing
    some of the best levels of facility readiness due to increased funding
    in the last 3 years, which was complemented by an additional $39.9
    million in stimulus dollars from the American Recovery and Reinvestment
    Act (ARRA) of 2009. The ARRA funding was applied to 25 projects
    currently underway across 11 States that are providing much needed
    repairs, renovations or enhancing energy efficiency. Other projects
    funded by ARRA dollars include upgrades to meet antiterrorism force
    protection standards and compliance with American with Disability Act
    access.
        The Base Realignment and Closure 2005 and our normal Military
    Construction Naval Reserve (MCNR) Program enabled us to repair and
    upgrade sites across the country with projects continuing to completion
    in 2011, including replacement of more than 28 of our 183 Reserve
    centers in the next 2 years. This represents the largest movement and
    upgrade in memory for the Marine Corps Reserve.
        Marine Forces Reserve's research and investment for the last 2
    years in energy efficiency, sustainability, and renewable energy is
    coming to fruition this fiscal year. Every new FSRM renovation project
    or Military construction (Milcon) is targeted for energy efficiency and
    sustainability aspects in accordance with policy and Leadership in
    Energy and Environmental Design (LEED) guidelines. We recently
    commissioned our first LEED Silver building at Camp Lejeune--the first
    in the Marine Corps--and are anticipating award this year of our first
    LEED Silver rehabilitation project in Baltimore, Maryland, which is a
    potential first for the Marine Corps as well. All of our MCNR projects
    since fiscal year 2009 are on track to comply with directives to
    achieve LEED silver or higher as funding profiles permit.
        We are presently conducting energy assessments of all our 32-owned
    sites along with preparation of smart metering technology for each to
    enhance conservation and management. The Marine Forces Reserve approach
    combines efficiency, conservation, and renewable aspects to achieve
    optimal return on investment. We completed six solar energy and
    lighting projects at Reserve centers in California and have one solar
    project slated for completion in Louisiana as well. Our six wind
    turbine projects continue to proceed with suitability and environmental
    evaluations. Initial findings indicate that some projects may come on
    line during fiscal year 2012 with an anticipated payback of as little
    as 8 years. Our investment and implementation of these technologies
    provides energy security, efficiency, and cost avoidance for our
    geographically dispersed sites.
        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 MCNR program and a
    strong FSRM program are essential to addressing the aging
    infrastructure of the Marine Corps Reserve.
        The MCNR program for exclusive Marine Corps Reserve construction
    has been effectively prioritized by the Marine Corps within the FYDP to
    optimize our efforts in addressing the estimated $132 million in needed
    construction projects for our aging infrastructure. Increases in our
    baseline funding over the last 6 years have helped Marine Forces
    Reserve improve our overall facility readiness. More than 27 percent of
    the Reserve centers our Marines train in are more than 30 years old and
    of these, 55 percent are more than 50 years old. Past authorizations
    have improved the status of facilities in the 30 to 50 year range and
    continued investment will allow for further modernization. The $35
    million in additional MCNR funding in fiscal year 2010 enabled Marine
    Forces Reserve to commence several additional projects that further
    improved our readiness in both training and improvement of facilities
    infrastructure at greater rates than normal.
        The Base Realignment and Closure 2005 continues to move forward and
    the Marine Corps Reserve will relocate units to 10 consolidated Reserve
    centers this fiscal year. Marine Forces Reserve is executing 25 of the
    Marines Corps' 47 Base Realignment and Closure-directed actions. Of
    these 25 Base Realignment and Closure actions, 21 are linked to Army
    and Navy military construction projects. Our Base Realignment and
    Closure plans are tightly linked to those of other Services and
    government agencies as we develop cooperative agreements to share
    Reserve centers and coexist in emergent joint bases. All remaining
    Marine Corps Reserve Base Realignment and Closure closures are on track
    for successful completion within the directed timelines.
        Of special note is the movement of my Headquarters--Marine Forces
    Reserve--and consolidation of our major subordinate commands in New
    Orleans, Louisiana. This unique Base Realignment and Closure project,
    which integrated State, local and Federal efforts, is now well underway
    for the new headquarters compound and is tracking for an early
    completion. The State of Louisiana is providing construction dollars
    for the new headquarters facility, which saves the Federal Government
    more than $130 million. The Department of the Navy is providing the
    interior finishings, information technology, and security
    infrastructure in accordance with the lease agreement. This building
    will incorporate multiple energy and environmentally friendly processes
    to meet Leadership in Energy and Environmental Design certifiable
    standards. We were assisted by the Department of Energy's Federal
    Energy Management Program to identify future projects, which will
    further maximize the sustainability and energy efficiencies of the
    buildings and compound. Upon completion and certification, this
    building and its surrounding acreage will become the newest Marine
    Corps Installation: Marine Corps Support Facility, New Orleans.
                     health services and behavioral health
        Our Marines, Sailors and their families remain our highest
    priority. Therefore, we remain keenly attentive to their health and
    resiliency. Taking care of them is a sacred trust and a continuous
    process. During dwell, our health services priority is to attain and
    maintain the Department of Defense goal of 75 percent Fully Medically
    Ready. In fiscal year 2010, Marine Forces Reserve individual medical
    and dental readiness rates were 70 percent and 78 percent respectively.
    This reflects a continued improvement trend in overall individual
    medical readiness for the Force.
        Healthcare for the Reserve Component integrates many diverse
    programs across the spectrum of the deployment cycle--pre-mobilization,
    deployment and post-deployment--and is categorized into two areas: unit
    medical readiness and behavioral health. Unit medical readiness
    programs include the Reserve Health Readiness Program and TRICARE
    Reserve Select. Behavioral health programs include the Post Deployment
    Health Reassessment and the Psychological Health Outreach Program.
        The Reserve Health Readiness Program is the cornerstone for
    individual medical and dental readiness. This program funds contracted
    medical and dental specialists to provide healthcare services to units
    not supported by a military treatment facility. During fiscal year
    2010, the Reserve Health Readiness Program performed 10,947 Periodic
    Health Assessments; 2,803 Post-Deployment Health Reassessments; and
    7,821 Dental Procedures. TRICARE Reserve Select, a premium-based
    healthcare plan, is also available to our Marines, Sailors and their
    families.
        Behavioral health has increasingly become an integral part of
    medical readiness over the past few years. Navy medicine continues to
    address this complex issue through various independent contracted
    programs, such as the Post Deployment Health Reassessment and the
    Psychological Health Outreach Program. The Post Deployment Health
    Reassessment identifies health issues with specific emphasis on mental
    health concerns, which may have emerged since returning from
    deployment. The Psychological Health Outreach Program addresses post-
    deployment behavioral health concerns through a referral and tracking
    process. The above programs have proven effective in the overall
    management of identifying those Marines needing behavioral health
    assistance and have provided an avenue to those Marines seeking
    behavioral health assistance.
        The Commandant has also directed that we more fully integrate
    behavioral health services to help reduce redundancies and ultimately
    improve the overall quality and access to care. The Marine Corps is
    taking action to develop an integrated service delivery that provides
    innovative, evidence-based practices to commanders, Marines, and their
    families. This service delivery will be woven into the larger support
    network of our command structures and health and human services across
    the Marine Corps to better build resilience and strengthen Marines and
    families. This efficiency initiative successfully integrates our Combat
    and Operational Stress Control, Suicide Prevention, Sexual Assault
    Prevention and response, Substance Abuse Prevention and Family Advocacy
    Programs and will be instrumental in synchronizing our prevention
    efforts.
        Combat and Operational Stress Control training for leaders is being
    incorporated throughout Marine Forces Reserve at all levels. All units
    deploying more than 90 days receive pre-deployment training for
    Marines, Sailors, leaders, and families.
        Currently, we are implementing the Operational Stress Control and
    Readiness (OSCAR) training. This training provides knowledge, skills,
    attitudes, and tools required to assist commanders to prevent,
    identify, and manage combat and operational stress problems as early as
    possible. Your continued support enables us to continue to take care of
    our Marines, Sailors and their families.
                                quality of life
        My commitment to our Marines and Sailors in harm's way extends to
    their families at home. As part of Marine Corps reforms to enhance
    family support, we continue to place full-time Family Readiness Officer
    (FROs), which will be staffed entirely by civilians, at the battalion/
    squadron level and above to support the Commandant's family readiness
    mission. As you might imagine, an organization that is spread across
    the Nation and overseas has unique challenges, but communication
    technologies, improved procedures, and processes have effectively
    integrated our efforts to more effectively inform and empower family
    members--spouses, children and parents--who often have little routine
    contact with the Marine Corps and live far from large military support
    facilities. The installation of FROs at the battalions and squadrons
    bridges many gaps and overcomes many challenges that are unique to the
    Reserve Component. To be sure, the placement of Family Readiness
    Officers is a low cost solution that provides a significant return on
    investment.
        We fully recognize the strategic role our families have in personal
    and operational readiness, particularly with mobilization preparedness.
    We prepare our families for day-to-day military life and the deployment
    cycle by providing education at unit family days, pre-deployment
    briefs, return and reunion briefs, and post-deployment briefs. To
    better prepare our Marines and their families for activation, Marine
    Forces Reserve has fully implemented the Yellow Ribbon Reintegration
    Program, much of which we've had in place for quite some time. 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
    subjects such as parenting, childcare, education, finances, legal
    issues, deployment, crisis support, and relocation.
        The Marine Forces Reserve Lifelong Learning Program continues to
    provide educational information to service members, families, retirees,
    and civilian employees. More than 1,400 Marine Forces Reserve personnel
    (Active and Reserve) enjoyed the benefit of Tuition Assistance,
    utilizing more than $3.6 million that funded more than 4,600 courses
    during fiscal year 2010. The Marine Corps' partnership with the Boys
    and Girls Clubs of America and the National Association for Child Care
    Resources and Referral Agencies continues to provide a great resource
    for service members and their families in accessing affordable child
    care before, during, and after a deployment in support of overseas
    contingency operations. 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.
        The Chaplain Corps--Active and Reserve Component chaplains--is
    fully engaged to support my commitment to ensure care is provided for
    our Marines, Sailors, and their families. Working alongside FROs, they
    conduct informational briefs and provide counsel during all phases of
    the deployment cycle. One Religious Ministries Team works with the FRO
    through video-teleconferencing to provide pre-deployment, deployment
    and post deployment briefs for the entire Individual Ready Reserve
    population. The chaplains have also worked directly with the Casualty
    Assistance Calls Officers, providing them with immediate support,
    counsel and assistance during the time of deep emotional crisis.
      supporting our wounded, ill, and injured marines and their families
        The non-medical needs of our wounded, ill, and injured (WII)
    Marines and their families can be extensive and vary in type and
    intensity during the phases of recovery. There is not an ``one size
    fits all'' approach to WII care. The Marine Corps' Wounded Warrior
    Regiment (WWR) makes a concerted effort to ensure that WII Marine
    Reservists receive exemplary support as they transition through the
    recovery process. The WWR holds high levels of subject matter expertise
    with regard to the unique challenges faced by Marine Reservists and has
    set up component of care accordingly. For example, the WWR has
    dedicated staff--the Reserve Medical Entitlements Determinations
    Section--to specifically maintain oversight of all cases of Reservists
    who require medical care beyond their contract period for service-
    connected ailments. Additionally, the WWR has Reserve-specific recovery
    care Coordinators who provide one-on-one transition support and
    resource identification required to support WII Reservists and families
    who are often living in remote and isolated locations away from the
    support resident on bases and stations. Another significant support
    component of the WWR that makes a positive difference in the lives of
    our WII Reservists is the Sergeant Merlin German Wounded Warrior Call
    Center. This 24/7 Call Center provides support on numerous issues to
    include: referral for psychological health matters; pay and entitlement
    questions; financial assistance resources; awards; and information on
    benevolent organizations. The WWR also uses its Call Center to conduct
    important outreach calls to various populations to check on their well-
    being and update them on changes in benefits and entitlements.
                casualty assistance and military funeral honors
        Casualty assistance remains a significant responsibility of Active
    Component Marines who are assigned to our Inspector--Instructor and
    Reserve Site Support staffs. Continued operational efforts in
    Afghanistan and Iraq have required that these Marines remain ready at
    all times to support the families of our fallen Marines in combat
    abroad, or in unforeseen circumstances at home. By virtue of our
    geographic dispersion, Marine Forces Reserve personnel are best
    positioned to accomplish the vast majority of all Marine Corps casualty
    assistance calls and are trained to provide assistance to the families.
    Historically, my personnel have been involved in approximately 76
    percent of all Marine Corps casualty notifications and follow-on
    assistance calls 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 Calls Officers continue well beyond notification.
    We ensure that our Casualty Assistance Calls Officers are adequately
    trained, equipped, and supported by all levels of command. Once a
    Casualty Assistance Calls Officer is designated, he or she assists the
    family members from planning the return of remains and the final rest
    of their Marine to advice and counsel regarding benefits and
    entitlements. In many cases, our Casualty Assistance Calls Officers
    provide a permanent bridge between the Marine Corps and the family
    while providing assistance during the grieving process. The Casualty
    Assistance Calls Officer is the family's central point of contact and
    support, and he or she serves as a representative or liaison to the
    funeral home, Government agencies, or any other agency that may become
    involved.
        Additionally, Marine Forces Reserve units and personnel provide
    significant support for military funeral honors for our veterans. The
    active duty Reserve Site Support staff, with augmentation from their
    Reserve Marines, performed more than 14,550 military funeral honors
    during calendar year 2010, which was 90 percent of the Marine Corps
    total. We anticipate providing funeral honors to more than 17,500
    Marine veterans in calendar year 2011. Specific authorizations to fund
    Reserve Marines in the performance of military funeral honors have
    greatly assisted us at sites such as Bridgeton, Missouri, where more
    than 10 funerals are consistently supported each week. As with Casualty
    Assistance, we place enormous emphasis on providing timely and
    professionally executed military funeral honors support.
                                   conclusion
        Your Marine Corps Reserve continues to be operational in mindset
    and action and is fully committed to train and execute the Commandant's
    vision for the Total Force Marine Corps. The momentum gained over the
    last decade in Iraq, Afghanistan, and in support of theater engagements
    around the globe, remains sustainable through coordinated focus,
    processes and planning. To be sure, this momentum bears witness to the
    operational nature of your Marine Corps Reserve.
        In everything we do, we remain focused on the individual Marine and
    Sailor in combat. Supporting that individual requires realistic
    training, proper equipment, the full range of support services and
    professional opportunities for education, advancement and retention.
    Your continued unwavering support of the Marine Corps Reserve and
    associated programs enables my Reservists to competently perform as an
    operational Reserve and is greatly appreciated. Semper Fidelis.

        Chairman Inouye. Now, may I call upon General Stenner.
    STATEMENT OF LIEUTENANT GENERAL CHARLES E. STENNER,
                JR., CHIEF, AIR FORCE RESERVE
        General Stenner. Thank you, Chairman Inouye and Vice
    Chairman Cochran.
        I appreciate the opportunity to be here today to discuss
    Reserve component funding priorities for fiscal year 2012 and
    the other important issues that are also affecting the 72,000-
    plus citizen airmen making up our Air Force Reserve.
        But I would like to first take the opportunity to introduce
    Chief Master Sergeant Dwight Badgett. He is the command chief
    for the Air Force Reserve Command. And I will report he is not
    retiring, unless I don't know something.
        And he is going to assist me in the years to come managing
    this vital force called the enlisted members. It is the
    backbone of what we take. And Chief, if you would give a
    standup for a second? Thanks.

                          AIR FORCE RESERVE PRIORITIES

        My written testimony outlines our priorities. But briefly,
    I would like to mention the fact that our reservists continue
    to play an increasing role in ongoing global operations, no
    matter what service. They support our Nation's needs, providing
    operational capabilities around the world.
        As we speak, Air Force reservists are serving in every
    combatant command area of responsibility. There are
    approximately 4,300 Air Force reservists currently activated to
    support those missions. That number includes our force's
    contributions to the Japanese relief effort and direct support
    to coalition operations in Libya.
        Despite an increasing operations tempo, aging aircraft, and
    increases in depot scheduled downtime, we have improved fleet
    aircraft availability and mission-capable rates. The Air Force
    Reserve is postured to do its part to meet the operational and
    strategic demands of our Nation's defense, but that mandate is
    not without its share of challenges.
        Our continued ability to maintain a sustainable force with
    sufficient operational capability is predicated on having
    sufficient manpower and resources. And the work of this
    subcommittee is key to ensuring Reserve component readiness,
    and the National Guard and Reserve equipment account (NGREA) is
    our means for preserving that combat capability. That account
    guarantees that our equipment is relevant and allows for
    upgrades to be fielded in a timely manner.

                         NGREA AND SUPPLEMENTAL FUNDING

        Current levels of NGREA and supplemental funding have
    allowed the Air Force Reserve to make significant strides in
    meeting urgent warfighter requirements. Since 1997, the Air
    Force Reserve has obligated and executed 99.7 percent of our
    NGREA dollars, and we continue to work with the Air National
    Guard and regular Air Force communities to improve our process
    to obligate NGREA faster and in line with the OSD standards.
        Air Force NGREA funding of at least $100 million per year
    will provide parity and greatly enhance readiness, because, as
    we all know, our Nation relies on our capabilities, more today
    than ever before. Properly equipping the Reserve components
    will ensure the Nation continues to have a force in reserve to
    meet existing and future challenges.
        Equally as important as readiness is support to our airmen
    and their families. Our efforts in this area go toward
    resiliency training, suicide prevention, the Yellow Ribbon
    reintegration, and Employer Support of the Guard and Reserve
    (ESGR) and other programs that help support the all-important
    Reserve triad. That is the family, the reservists, and their
    employer, all a part of the fabric of this Nation's defense.
        In a time of constrained budgets and higher costs, in-depth
    analysis is required to effectively prioritize our service
    needs, for we must all appreciate the vital role the Reserve
    components play in supporting our Nation's defense and
    concentrate our resources in areas that will give us the most
    return on the investment.
        Thank you for asking me here today and discussing the
    important issues that are affecting us all. And I do look
    forward to your questions.
        [The statement follows:]
        Prepared Statement of Lieutenant General Charles E. Stenner, Jr.
                                  introduction
        The 21st century security environment requires military services
    that are flexible--capable of surging, refocusing, and continuously
    engaging without exhausting their resources and people. The United
    States Air Force continues to present capabilities in support of joint
    operations, and the Reserve Component has evolved to the point that we
    are critical to those operations. In an increasingly limited fiscal
    environment, Reservists remain efficient and cost-effective solutions
    to our Nation's challenges.
        In this dynamic environment, the Air Force Reserve (AFR) excels.
    Reserve Airmen support our Nation's needs; providing operational
    capabilities around the globe. Today, Air Force Reservists are serving
    in every Area of Responsibility (AOR), and there are approximately
    4,300 Air Force Reservists activated to support operational missions.
    Despite increased operations tempo, aging aircraft and increases in
    depot-scheduled down time, we have improved fleet aircraft availability
    and mission capable rates. We have sustained our operational
    capabilities for nearly 20 years--at a high operations tempo for the
    past 10. We accomplish this while continuing to provide a cost-
    effective and combat ready force available for strategic surge or
    ongoing operations.
        This year brings continued opportunities. Air Force Reserve Airmen
    are integrated into a wider variety of missions across the full
    spectrum of not only inherently Air Force operations, but joint
    operations as well. The Department of Defense (DOD) continues to seek
    innovative ways in which to gain greater access to, and leverage the
    unique experiences and skills of, Reservists. This effort recognizes
    our Citizen Airmen have talents that have been developed in the Air
    Force Reserve, but are strengthened in employment with civilian
    employers.
        While we remain focused on the Air Force's five priorities \1\, we
    are also guided by the following Reserve Component-unique focus areas
    that could be applied to the Total Force and will serve as the basis
    for this testimony: Force Readiness, Force Rebalance and Force Support.
    ---------------------------------------------------------------------------
        \1\ The Air Force Priorities are: (1) Continue to strengthen the
    nuclear enterprise; (2) Partner with the Joint and Coalition team to
    win today's fight; (3) Develop and care for our Airmen and their
    families; (4) Modernize our air, space, and cyberspace inventories,
    organizations, and training; and (5) Recapture acquisition excellence.
    ---------------------------------------------------------------------------
                                    overview
        The Air Force Reserve is helping to lead the way in improving Air
    Force capability for fiscal year 2012 and beyond. The fiscal year 2012
    President's budget request would fund Air Force Reserve requirements of
    approximately $5 billion. It provides for the operation and training of
    34 wings, funds 117,769 flying hours, maintains 344 aircraft, and
    provides for the readiness of 71,400 Reservists and 4,157 civilian
    employees. Our budget request is about 4 percent of the total Air Force
    budget, and includes $2.27 billion for operations and maintenance for
    air operations, service support and civilian pay; $1.7 billion for
    military personnel; and $34 million for military construction.
        Not only does our fiscal year 2012 budget request ensure Air Force
    Reservists are trained and prepared to support Air Force and Combatant
    Command requirements, but it also demonstrates our commitment to the
    DOD's focus on efficiencies. Through better business practices, by
    leveraging new technology, and by streamlining our force management
    efforts, we identified $195 million in efficiencies for fiscal year
    2012 alone. With your continued support and assistance in the coming
    year, we will be focused on rebalancing our force, recapitalizing our
    equipment and infrastructure, and supporting our Reservists and the
    balance between their civilian and military lives.
                                force readiness
        Reservists continue to play an increasing role in ongoing global
    operations. This reliance can be seen during surges such as those in
    Iraq and Afghanistan. Properly equipping the Reserve Components will
    ensure the Nation continues to have a ``Force in Reserve'' to meet
    existing and future challenges.
    Air Force Reserve Modernization
        A number of trends continue to influence dependence on Air Force
    Reserve forces to meet the operational and strategic demands of our
    Nation's defense: sustaining operations on five continents and the
    resulting wear and tear on our aging equipment; increasing competition
    for defense budget resources; and increasing integration of the three
    Air Force components. The Air Force leverages the value of its Reserve
    Components through association constructs in which units of the three
    components share equipment and facilities around a common mission.
    Increasing integration of all three Air Force components requires us to
    take holistic approach. To ensure our integrated units achieve maximum
    capability, the precision attack and defensive equipment the Air Force
    Reserve employs must be interoperable not only with the Guard and
    Active Component, but the Joint and Coalition force as well.
        The National Guard Reserve Equipment Account (NGREA) appropriation
    has resulted in an increase in readiness and combat capability for both
    the Reserve and the Guard. For example, using fiscal year 2009 NGREA,
    fiscal year 2009 OCO and fiscal year 2010 NGREA funds, the Air Force
    Reserve responded to a Combatant Commander Urgent Operation Need (UON)
    related to the capabilities of our A-10 and F-16 fleet. Through
    acquisition of the Helmet Mounted Integrated Targeting (HMIT) system we
    were able to enhance our pilots' capability to cue aircraft sensors and
    weapons well outside the Heads-Up Display (HUD) field of view of their
    aircraft. This commercial-off-the-shelf (COTS) system is a common
    solution for both the A-10 and F-16 aircraft. Additionally, HMIT
    incorporates color displays in its system and is compatible with
    current night vision goggle systems to enhance night time flying
    capabilities. These capabilities have the potential to increase the
    situational awareness of our A-10 and F-16 pilots by 400 percent and to
    decrease incidents of fratricide caused when pilots move their heads
    away from their controls to see targets on the ground. Actual purchases
    are expected to start at the end of fiscal year 2011 with delivery in
    fiscal year 2012.\2\
    ---------------------------------------------------------------------------
        \2\ In past years, the Air Force Reserve purchased HC-130 8.33
    radios to upgrade 5 AFR HC-130 aircraft. This upgrade allows these
    aircraft to comply with Certified Navigation System--Air Traffic
    Management (CNS-ATM), world-wide air traffic rules and requirements.
    The 8.33 radios also provided a situational awareness data link that
    allows crews to better identify ``friends'' versus ``foes'' and prevent
    ``friendly fire'' incidents. Without this upgrade, the movements of
    AFRC's HC-130s were limited and in some cases prevented in certain
    restricted airspace around the globe.
    ---------------------------------------------------------------------------
        Since the start of combat operations in Afghanistan and Iraq, the
    majority of our equipment requirements have been aircraft upgrades.
    These upgrades provide our aircraft with better targeting, self
    protection and communication capabilities. As legacy aircraft are
    called upon to support operational missions, the equipment is stressed
    at a greater rate. As new equipment is identified that will satisfy our
    capability shortfalls, we begin procurement, normally buying enough
    assets with ``first year'' dollars to equip a single unit of aircraft.
    With subsequent year funding we continue purchasing until our
    requirements are met. This method of procurement allows the expedient
    fielding of capabilities to our deploying units, but equipment levels,
    especially in the first few years of a program's execution, are not at
    sufficient levels to meet our overall requirements.
        In fiscal year 2008, we modified our requirements process to align
    with the Air Force Reserve corporate process. This alignment provides
    total visibility and support for our modernization needs from
    identification of a requirement until it is fully mission capable. The
    process also incorporates input from our units received through Combat
    Planning Councils (CPCs). Our unfunded requirements, after being vetted
    through our corporate process, reside on our Modernization List. Each
    year we review the list to determine where the best use of the allotted
    amount of NGREA will make the most impact. Additional supplemental
    funding has helped in procuring our needed equipment.
        Historically, the Air Force Reserve has been a prudent steward of
    NGREA funding with an average obligation rate of 99.7 percent prior to
    funding expiration.\3\ We are currently involved in a cooperative
    effort with the Air National Guard and the Active Component's
    acquisition communities to review our obligation processes and develop
    improvements to bring our obligation rates more in line with the
    Department's standards of 80 percent and 90 percent in the first and
    second years of execution.
    ---------------------------------------------------------------------------
        \3\ From fiscal year 1997 to fiscal year 2008, Congress provided
    the Air Force Reserve the following amounts in NGREA funding
    (associated obligation rates): 1997--$39,552,000 (99.05 percent);
    1998--$49,168,000 (99.99 percent); 1999--$20,000,000 (100 percent);
    2000--$19,845,000 (99.75 percent); 2001--$4,954,000 (99.98 percent);
    2002--$75,224,000 (99.88 percent); 2003--$9,800,000 (99.84 percent);
    2004--$44,666,000 (99.96 percent); 2005--$39,815,000 (100 percent);
    2006--$29,597,000 (99.75 percent); 2007--$34,859,000 (98.67 percent);
    and 2008--$44,695,000 (99.60 percent).
    ---------------------------------------------------------------------------
    Military Construction (Milcon) and Infrastructure Modernization
        Along with challenges in modernizing our equipment, we face
    challenges modernizing our infrastructure. During the fiscal year 2011
    budget formulation, both the Active Component and the Air Force Reserve
    continued to take risk in military construction and facilities
    maintenance in order to fund higher priorities. Over time, this
    assumption of additional risk has resulted in a backlog exceeding $1
    billion for the Air Force Reserve.
        The Air Force Reserve budget request of $34 million in fiscal year
    2012 Milcon funding will fund the construction of an airfield control
    tower at March Air Reserve Base, California, and a RED HORSE \4\
    readiness and training facility at Charleston Air Force Base, South
    Carolina. As we continue to work within fiscal constraints, we will
    optimize space allocation with increased facility consolidation and
    demolition. We will continue to mitigate risk where possible to ensure
    our facilities are modernized and provide a safe and adequate working
    environment.
    ---------------------------------------------------------------------------
        \4\ Rapid Engineer Deployable Heavy Operational Repair Squadrons
    (RED HORSE) provide the Air Force with a highly mobile civil
    engineering response force to support contingency and special
    operations worldwide.
    ---------------------------------------------------------------------------
    Air Force Reserve Manpower
        To meet the current needs of the Air Force, the Air Force Reserve
    will grow to programmed end strength of 71,200 this year. In the fiscal
    year 2012 President's budget, we have requested an end strength of
    71,400. These manpower increases are placing a premium on recruiting
    highly qualified and motivated Airmen and providing them with the
    necessary training. The Air Force Reserve recruiting goal for fiscal
    year 2011 is 10,480. While we exceeded our highest goal ever of 10,500
    new Airmen for fiscal year 2010, with tightening budgets and cuts in
    advertising, our forecast models indicate we may continue to face
    challenges in some aspects of the recruiting process.
        To provide a single point of entry for accessing Air Force Reserve
    forces, we recently established a Force Generation Center (FGC). This
    organization modernizes our force management practices to provide a
    unified picture of our combat capability, our total support to the Air
    Force and Combatant Commanders, and provides our customers with a
    single point of entry with a consistent set of business rules. We now
    have visibility and accountability of reserve forces in categories
    where we previously had limited or no real time information.
    Additionally, the Force Generation Center allows the Air Force Reserve
    to be more responsive to the needs of individual Reservists, providing
    them greater predictability while making participation levels more
    certain. This ultimately provides Combatant Commanders with more
    operational capability. Collectively, these actions will contribute to
    the overall health of the Air Force by improving the sustainability and
    operational capability of the Air Force Reserve required today and
    tomorrow.
        A recent survey highlighted the fact that one-in-three Air Force
    Reservists has volunteered to deploy. Since 9/11, more than 60,500 Air
    Force Reservists, which equates to 76 percent of our current force,
    have answered our Nation's call and deployed to combat or supported
    combat operations on active duty orders. We cannot take this high-level
    of commitment for granted, and must do our best to ensure their
    continued service is used appropriately and efficiently. Accordingly,
    these enterprise-wide actions will make Air Force Reservists more
    accessible and should provide Reservists with a greater sense of
    satisfaction about their service.
                                force rebalance
        Total Force Initiatives are not just a priority for the Air Force
    Reserve and Air National Guard, but the Air Force as a whole. All three
    components are committed to aggressively examining Air Force core
    functions for integration and force rebalancing opportunities. This is
    critical in an environment focused on efficiencies. As weapons systems
    become increasingly more capable but expensive, their numbers
    necessarily decrease. Aging platforms are being retired and are not
    replaced on a one-for-one basis. As a result, the Air Force is required
    to maintain the same combat capability with a smaller inventory. To
    this end, we are integrating wherever practical, exploring associations
    across the Total Force. We have established a wide variety of associate
    units throughout the Air Force, combining the assets and manpower of
    all three components to establish units that capitalize on the
    strengths of each component. There are currently more than 90
    Associations across all Air Force mission areas.
        The Air Force uses three types of associations to leverage the
    combined resources and experience levels of all three components:
    ``Classic Associations,'' ``Active Associations,'' and ``Air Reserve
    Component Associations.'' Under the ``Classic'' model a Regular Air
    Force unit is the host unit and retains primary responsibility for the
    weapon system, while a Reserve or Guard unit is the tenant. This model
    has flourished in the strategic and tactical airlift communities for
    over 40 years. We are also using this model 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 at Joint Base Elmendorf, Alaska, continues to mature as the first
    Air Force Reserve F-22A associate unit. This unit also achieved Initial
    Operating Capability in 2008 and will eventually grow into a two-
    squadron association.
        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. To better utilize the fleet
    at the 932nd, the Air Force created an Active Association of the C-40s.
        Under the ``Air Reserve Component (ARC)'' model, now resident at
    Niagara Falls Air Reserve Station (ARS), New York, the Air Force
    Reserve has primary responsibility for the equipment, while the Air
    National Guard works side-by-side in the operation and maintenance of
    the aircraft. At Niagara, the Air National Guard transitioned from the
    KC-135 air refueling tanker to the C-130, associating with the 914th
    Airlift Wing. The 914th added four additional C-130s, resulting in 12
    C-130s. This ARC Association model provides a strategic and operational
    force and capitalizes on the strengths of the Air National Guard and
    Air Force Reserve. Additionally, it provides the State of New York with
    the needed capability to respond to State emergencies.
        Associations are not simply about sharing equipment; they enhance
    combat capability and increase force-wide efficiency by leveraging the
    resources and strengths of the Regular Air Force, Air National Guard,
    and Air Force Reserve. But, they accomplish this while respecting
    unique component cultures and requirements. Air Force Reserve and Air
    National Guard members train to the same standards and maintain the
    same currencies as their Active Component counterparts. These Airmen
    also provide the insurance policy the Air Force and the Nation need: a
    surge capability in times of national crisis. As we have seen with the
    increased requirements in Afghanistan, the Air Force Reserve continues
    to play a vital role by mobilizing our strategic airlift resources and
    expeditionary support to provide capabilities needed for the joint
    effort.\5\
    ---------------------------------------------------------------------------
        \5\ In fiscal year 2010, Air Force Reserve C-5 and C-17 associate
    flying units flew 31,913 hours of overseas contingency support
    worldwide.
    ---------------------------------------------------------------------------
        To better accommodate the Air Force-wide integration effort, the
    Air Force Reserve is examining its four decades of association
    experience. With Regular Air Force and Air National Guard assessment
    teams, we developed analytical tools to evaluate different mixes of
    Reserve, Guard, and Active Component forces in any given mission set.
    This process for rebalancing of forces will give the Air Force a solid
    business case analysis tool for evaluating future associations and may
    lead to force decisions that support Reserve Component growth.
        For the Operational Reserve construct to remain viable, we must
    continue to use the long-term mobilization authorities that have been
    in continuous use for the past 10 years. If not, the Services will
    revert to volunteerism as the sole planning tool for force generation
    to meet Combatant Command requirements. The strategic nature of the
    Reserve Components historically made us vulnerable to reductions in
    resources and budgets. This often resulted in rebalancing resources
    among the components based on a strategy that favored near-term
    operational risk reduction over longer-term cost effectiveness and
    wartime surge capability. This was a logical approach to allocating
    risk at the time because Reserve Component daily operational
    capabilities depended almost exclusively on volunteerism, which was
    difficult for planners to quantify with a desired degree of assurance.
    That legacy model is now the exception rather than the rule, since risk
    associated with the Reserve Components can be both measured and
    controlled through management and integration of volunteerism with
    sustainable mobilization plans based on the force generation model
    construct. This allows the Services to make force rebalancing decisions
    today based on business case analysis rather than focusing exclusively
    on near-term risk avoidance.
        The traditional approach to rebalancing during a budget reduction
    has been to reduce Reserve Component force structure to preserve Active
    Component operational capabilities, or to reduce all components through
    some proportional or fair-share model to spread risk across the force.
    It is now possible to quantify and plan for a predictable level of
    access to operational support from the Reserve Components in critical
    capability areas, the traditional approach is no longer valid. Because
    access to operational support capability is quantifiable, it is
    possible to do reliable cost/capability tradeoff analysis to quantify
    both cost and risk for options placing greater military capability in
    the Reserve Components. This does not mean that Reserve Component
    growth will always be the prudent choice, but it does mean that the
    choice can be made based on measurable outcomes of cost, capability,
    and risk, rather than using arbitrary rules of thumb or notional
    ratios.
        A new approach to rebalancing allows for a force that is agile and
    responsive to uncertainty and rapid changes in national priorities, and
    mitigates the loss of surge capability and the high cost associated
    with the traditional approach to adjusting force mix. Any approach
    should acknowledge the Reserve Components have become and will remain a
    responsive operational force. Such a force necessarily allows the
    Services to respond quickly and efficiently to funding reductions
    without decreasing warfighting capability or incurring large Active
    Component recruiting and training costs.
                                 force support
        While the Air Force meets the needs of new and emerging missions,
    we face some recruiting challenges. Not only will the Air Force Reserve
    have access to fewer prior-service Airmen, we will be competing with
    other services for non-prior service recruits \6\. In the past year,
    the Air Force Reserve has experienced the most accessions in 16 years
    and the highest amount of non-prior service recruits in over 20 years.
    To improve our chances of success, we have increased the number of
    recruiters working in the field to attract quality candidates. While we
    focus on recruiting, we must remain mindful of the experienced force we
    need to retain. Air Force Reserve retention continues to show positive
    gains in all categories. In fiscal year 2010, both officer and enlisted
    retention rates increased, with career Airmen retention at its highest
    level since 2004 and officer retention recovering to fiscal year 2007
    levels.
    ---------------------------------------------------------------------------
        \6\ According to the Office of the Secretary of Defense, Personnel
    and Readiness, only about 26 percent of today's youth are qualified to
    serve without obtaining a waiver. Shrinking numbers of qualified youth,
    coupled with AFR's increased reliance on Non-Prior Service members, and
    a highly competitive recruiting atmosphere will continue to challenge
    our recruiting force.
    ---------------------------------------------------------------------------
        With congressional support, we have implemented a number of
    successful programs to increase and maintain high recruiting and
    retention rates. For example, we implemented a ``Seasoning Training
    Program''. This program allows recent graduates of initial and
    intermediate level specialty training to voluntarily remain on active
    duty to complete upgrade training. Since its implementation, nearly
    13,000 Reservists have become trained and available at an accelerated
    rate. With the increased number of non-prior service recruits coming
    into the Air Force Reserve, seasoning training has become a force
    multiplier and ensures the Air Force Reserve maintains its reputation
    for providing combat-ready Airmen for today's joint fight.
        The Bonus program has also been pivotal to recruiting and retaining
    the right people with the right skills to meet our requirements. The
    Bonus program enhances our ability to meet the demand for ``Critical
    Skills''--those skills deemed vital to mission capability. Ordinarily,
    critical skills development requires extensive training over long
    periods of time, and members who have these skills are in high demand
    within the private sector. Your continued support, allows us to offer
    the appropriate combination of bonuses for enlistment, reenlistment,
    and affiliation. The Bonus Program is effective; 2,676 Reservists
    signed agreements in fiscal year 2010. This figure is up 31 percent
    from fiscal year 2009.
    Preserving the Viability of the Reserve Triad
        Reservists balance relationships with their families, civilian
    employers, and the military--what we like to call ``The Reserve
    Triad.'' To ensure continued sustainability, our policies and actions
    must support these relationships. Open communication about
    expectations, requirements, and opportunities, will provide needed
    predictability and clearer expectations among sometimes competing
    commitments.
        The Air Force Reserve is proud of the close ties we have with our
    local communities. According to recent statistics provided by the
    Employer Support of the Guard and Reserve (ESGR), civilian employers
    continue to support and value the military service of their
    employees.\7\ Maintaining employer support and stability is critical to
    retaining the necessary experience at the unit level.
    ---------------------------------------------------------------------------
        \7\ ESGR USERRA case resolution statistics.
    ---------------------------------------------------------------------------
        The President has made supporting military families a top national
    security priority.\8\ Military families support and sustain troops,
    care for wounded warriors and bear the loss of our fallen heroes. The
    well-being of military families is a clear indicator on the well-being
    of the overall force. Less than 1 percent of the American population
    serves in uniform today. While the impact on war has had little direct
    impact on the general population, re-integration challenges faced by
    military families can have far reaching effects on local communities.
    We are committed to supporting our military families. Strong families
    positively impact military readiness and preserve the foundation of the
    ``Reserve Triad.''
    ---------------------------------------------------------------------------
        \8\ The President of the United States released the final report on
    Presidential Study Directive-9 (PSD-9) on January 24, 11. The report
    identified the administration's priorities to addressing challenges
    facing military families.
    ---------------------------------------------------------------------------
        We have placed added emphasis on suicide prevention and resiliency.
    Airmen in high-stressed career fields undergo a 2-day decompression
    program at the Deployment Transition Center. Additionally, at each home
    station installation, we implemented a tiered system of suicide
    prevention to address mental health concerns. The well-being of our
    force is a priority and we will continue to give it our undivided
    attention.
        Thanks to congressional initiatives, our Yellow Ribbon
    Reintegration Office is up and running and fully implementing
    Department of Defense directives. Our program strives to provide
    guidance and support to military members and their families at a time
    when they need it the most, to ease the stress and strain of
    deployments and reintegration back into normal family life. Since the
    standup of the program in August 2008, we have hosted 125 events across
    39 Wings and Groups. Nearly 21,000 Reservists and 15,000 family members
    have attended these events. From Yellow Ribbon event exit surveys and
    through both formal and informal feedback, we know attendees feel
    better prepared and more confident about the deployment cycle. The Air
    Force Reserve is leaning forward in meeting pre-, during and post-
    deployment needs of our members and their families.
                                   conclusion
        We take pride in the fact that when our Nation calls on the Air
    Force Reserve, we are trained and ready for the fight. As an
    operational force over 70,000 strong, we are mission-ready and serving
    operationally throughout the world every day.
        In a time of constrained budgets and higher costs, in-depth
    analysis is required to effectively prioritize our needs. We must
    understand the vital role we play in supporting our Nation's defense
    and concentrate our resources in areas that will give us the most
    return on our investment. Optimizing the capabilities we present is a
    top priority, but we must simultaneously support our Airmen, giving
    them the opportunity to have a predictable service schedule that meets
    the needs of Reservists, their families and their employers.
        The Air Force Reserve must also remain flexible, capable of
    surging, refocusing, and continuously engaging without exhausting
    resources and people. Approaching fiscal year 2012 and beyond, it is
    imperative that we preserve the health of our strategic reserve and
    improve our ability to sustain our operational capability. Going
    forward, we need to continuously balance capabilities and capacity
    against both near-term and long-term requirements. The actions we
    initiated in 2010 and those we advance in 2011 will preserve the health
    of our force.

        Chairman Inouye. Thank you very much.
        Over the last several years, Reserve components have
    transitioned from strategic to operational, but annual budget
    requests have not been adequately addressed for additional
    equipment. Now, what remaining equipment shortfalls concern
    you, and how does this shortfall affect your ability to train
    and deploy?

                     EQUIPMENT SHORTFALLS AND MODERNIZATION

        General Stultz. Sir, on the part of the Army Reserve, as
    General Carpenter stated earlier with the Army Guard, one,
    thanks for the support we have received in the past years
    because we have gotten unprecedented levels of dollars to get
    new equipment. Unfortunately, we are still not there.
        If you look at the Army Reserve today, the good news is I
    can report about 90 percent of the equipment on hand that I am
    authorized. However, only about 65 percent of that equipment is
    modernized. And so, we still have a lot of legacy equipment.
    And in some areas, it is very severe because it is an aging
    fleet, and it is not a fleet that is deployable.
        An example I would use is if you look at my dump trucks in
    my engineer battalions, on paper it says I have 100 percent of
    the dump trucks that I am authorized. But only 26 percent of
    them are modernized. So almost three-quarters are the old
    legacy fleet. If you look at the MTVs--medium tactical
    vehicles--on paper it says I am at 92 percent authorized. But I
    am 25 percent modernized. So it is a legacy fleet.

                        TRAINING ON MODERNIZED EQUIPMENT

        And I could go on and on with that, the point being--to
    your point--if we are going to employ this force on the modern
    battlefield, we are going to have to employ it with the
    equipment that is used on the modern battlefield. If we are
    going to train the force back home, we are going to have to
    train them on the equipment they are going to operate on the
    battlefield.
        And that is where I am really concerned, is making sure
    that, just as you said earlier, every soldier we send into
    battle goes properly trained, properly equipped. We know they
    are going to be falling in on the latest and greatest equipment
    when they get to Afghanistan. The key is am I going to be able
    to train them back here on that same level of equipment so that
    when they get there, there is no training required. They can go
    immediately to mission.
        And just as importantly, for those Army Reserve soldiers
    who are coming back from their deployment--and oftentimes,
    their second and third deployment--can I keep them engaged back
    here during those off-years if they don't have the modern
    equipment that they have been operating? And they come back and
    say, ``Why am I wasting my time training on this obsolete
    equipment? I just was in Afghanistan, and I know what the
    modern equipment looks like.''
        So we have got a bill out there of something like $3.4
    billion just in shortages. But more importantly, I have got a
    bill of about $9 billion to get modernized where I need to be.

                           SUICIDE PREVENTION EFFORTS

        Chairman Inouye. Well, I would like to talk about the
    suicide rate. It has gone up 42 percent in 2010 with 50
    reservists taking their lives. I note that most of the suicides
    occurred while they were in the civilian status. What have you
    done to respond to this?
        Admiral Debbink. Mr. Chairman, I will offer a couple of
    programs that we have in the Navy Reserve that I think are
    particularly effective. And one of those is the Psychological
    Health Outreach Program.
        And with that program, we have a total of 25 psychological
    health outreach counselors stationed throughout the country, 5
    in each region, who are very proactive in reaching out to each
    of our sailors as they return from their mobilization, as well
    as being available as a constant resource to our Navy
    operational support centers throughout the country, should they
    identify a sailor in need.
        The other thing I would offer is that we have a very close
    relationship with the active Navy and the fleet and family
    service centers. That has improved greatly over the past
    several years. And we believe that is an engagement, one sailor
    at a time, that will have the greatest impact on reducing the
    suicide rate, which every single one is a tragedy.
        Chairman Inouye. Have you noted that the rate is coming
    down, or is it still the same?
        Admiral Debbink. We have been very fortunate, Mr. Chairman,
    in the Navy Reserve at least, maintaining approximately four
    suicides per year for the last several years, down from six 3
    years ago. As I said, though, every suicide is tragic, sir.

                             AIR FORCE WINGMAN DAY

        General Stenner. Senator, if I could add to that just a
    touch? I think that in the Air Force Reserve we have kind of
    flat-lined. Of course, zero is the place we want to be, but we
    have flat-lined on what we are, in fact, seeing happen. And a
    lot of that I attribute to leadership involvement.
        We have what we call a Wingman Day. And on Wingman Day, we
    take the time off to sit down with each other in the small
    groups that we have and discuss the kinds of things that go
    into de-stigmatizing any kind of thoughts that folks have,
    either if they have ideations--suicidal ideations--and/or if
    somebody sees something, they should not feel too hard over
    talking to that person. There is no stigma on either side of
    that.
        But along with the leadership intent comes some results.
    What I have seen and I have documented are six ``saves,'' if
    you will, in the last several months that could have turned
    into something tragic that was averted because we do have that
    leadership involvement. We have taken the time out of our
    schedules to do a Wingman Day.
        We are looking at resiliency training coming out of the
    theater, taking 2 days to go through a resiliency training
    center in Germany and getting those kinds of things talked
    about before they return to the States and then reintegrate
    with the families and the jobs.
        Leadership is a big deal, along with the rest of the ideas
    that are coming from leadership and coming with the programs
    that you have funded us with.
        Thank you.
        Chairman Inouye. General.
        General Moore. Yes, sir. As Admiral Debbink indicated, we
    are drawing very heavily on the regional siting of the mental
    health professionals. And I think that is paying real dividends
    and certainly a program that has earned its keep.
        We also, as General Stenner just mentioned, we do spend
    quite a bit of time on what I would call resiliency, hardening,
    with our combat operational stress programs, both pre- and
    post-mobilization. And then, finally, as we have for 235 years,
    we rely on small unit leadership, in particular our NCOs and
    staff NCOs. They know their marines.
        And when a marine is at risk because of stressors, both as
    a result of service and then also in his or her life outside of
    the Marine Corps, we rely on those NCOs and staff NCOs, in
    particular, to minister, if you will, to their marines.
        So the numbers are trending positively. I mean, one is too
    many. But nonetheless, this year is looking pretty good,
    compared to the last.
        Thank you.
        Chairman Inouye. You have had a pretty hefty deployment
    record. Let us see--60,000 reservists, and 20,000 have been
    deployed more than once. You keep track of all of those after
    they get back?
        General Moore. Well, we certainly try, sir.
        As you know, if a marine chose to drop from the active
    drilling Marine Corps Reserve to the Individual Ready Reserve
    after he or she returns from a deployment, they aren't seen
    quite as frequently if they are in the Individual Ready
    Reserve. But we do track as closely as we can and continue to
    be engaged with marines that have multiple deployments.
        I was with 1st Battalion, 25th Marines at Fort Devens 1
    week ago when we activated that battalion for its final workup
    and then deployment to Afghanistan. The sergeant major of that
    battalion, this will be his fifth combat deployment. He went
    twice as a gunnery sergeant, twice as a first sergeant, and
    then now going forward as a sergeant major.
        Chairman Inouye. Is the sergeant major here?
        General Moore. He is not with me today, sir. He is at Camp
    Pendleton with his battalion as they begin their final workup
    before they deploy in July.
        Chairman Inouye. General Stenner, the Air Force Reserve has
    had a very active time. I think you have had over 60,000
    reservists called into active service. To facilitate this high
    operational tempo, what are you doing?

                       AIR FORCE RESERVE OPERATIONS TEMPO

        General Stenner. Senator, that is a great question, and I
    am very proud that we have had 60,000 of our reservists, 75
    percent of our force, has raised their hand at least once to do
    what this Nation has called them to do and what they have
    volunteered to do.
        I have got to tell you, they are doing a great job around
    the world with a three-component Air Force that is seamlessly
    integrated, trained to the same standards. And that, to me, is
    a big part of what we are doing to facilitate keeping that
    force strong and keeping that force in a ready state, but not
    overusing the force and monitoring the dwell that we have that
    is facilitated by the structures that we have called
    associations, where we put active, Reserve together or Guard
    and Reserve together and have a package of capability that can
    flex and surge as required by this Nation, which allows us to
    monitor and manage that all-important dwell, that time back
    home, back to their employers, back to their families.
        And more of that will have to happen as we rebalance this
    force to maintain that ready force, rebalance it, and thereby
    support it, with the help of this subcommittee and the
    appropriations that come. Make it ready, keep it ready,
    rebalance it where the mission sets require it, and we will be
    that operational force that is leveraged from a strategic
    reserve, integrated seamlessly with our active and Guard
    partners.
        Chairman Inouye. I have several other questions I would
    like to submit to all of you, and if you would give me a
    response, I would appreciate it very much.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I know that each chief has
    indicated they would like to have their service to be involved
    in Federal call-up, not only active duty military-type
    operations, but also in case of natural disasters.
        And I asked a question of an earlier panel about the
    capability of responding and what we could do to be helpful.
    And I wonder, in this situation, there is no certainty about
    what is going to happen with these emergency call-ups. Do you
    think you are organized to respond?
        And I will ask each of you that question. When, under the
    law, the President calls up Reserve units for active duty, is
    there anything we need to do in terms of appropriating for a
    special account to set aside for such operations, or can you
    manage that within your ability to borrow and then get
    reimbursed later from other accounts? What is your reaction to
    that?
        General Stenner.

                AIR FORCE RESERVE RESPONSE TO NATURAL DISASTERS

        General Stenner. Sir, I will start the conga line here with
    the responses. But are we organized to respond? As an Air Force
    Reserve and as a three-component Air Force, I do believe we
    have the ability to respond. And we will respond when there is
    life or limb at risk, and we will worry about how to get paid
    later.
        That happens, I think, on a more frequent basis than we
    might know because there are things going on across this
    country that need that kind of timely response.
        We are working today with our combatant command partners
    and the joint staff to figure out if there is, in fact, a more
    efficient way to do that. If there was some kind of a
    guaranteed funding stream, I am certain that that would be very
    much of an enticement to say, ``No worries, we will just keep
    on going.''
        But I will tell you that we haven't used that ``can we get
    reimbursed or not'' as the key to ``will we respond?'' We will
    respond, and we are working hard to make sure that we can send
    a unit, we can send a piece of a unit, or we can send an
    individual as required.
        Senator Cochran. Admiral.

                            RESERVE CALLUP RESPONSE

        Admiral Debbink. Senator Cochran, I am very pleased with
    the way the Navy and Navy Reserve is organized to respond to
    situations like Operation Tomodachi and Operation Odyssey Dawn,
    just most recently.
        Literally, in less than 24 hours, we had Navy Reserve
    sailors flowing to both of those, based upon the usage of our
    Navy Reserve order writing system and other electronic systems
    we had to notify people of the opportunities. So that is
    working well.
        With regard to the funding issue, my belief is that each of
    the services--in my case, the Navy--should be able to handle
    that within our MPN account. Because the opportunity to utilize
    these sailors will be such that it should be able to flow right
    in there side by side with the active duty. So I don't believe
    we need any additional funding.
        However, as I mentioned in my opening statement, the
    authority to deploy these sailors is important in a security
    force assistance environment in the future. And I believe that
    proposal is before you during this Congress.
        Senator Cochran. Thank you.
        General Stultz.

                   ORGANIZED TO RESPOND TO EMERGENCY CALLUPS

        General Stultz. Yes, sir. First, are we organized? Yes,
    sir, exactly. We, in the Army Reserve, are organized with
    functional command and control structure across the United
    States. So, for instance, between the Army Reserve and the
    National Guard, we have 75 percent of the engineer capability
    of the Army in our ranks.
        Now, within the Army Reserve, I have two engineer commands,
    two two-star commands, who command the engineer brigades and
    the engineer battalions within the Army Reserve. So they can
    call, they can direct, they can command and control those
    formations across the country.
        One of those two-star commands is the 412th Engineer
    Command in Vicksburg, Mississippi. And so, the commander of the
    412th Engineer Command has one-half of the Army Reserve's
    engineer capability at his behest because he commands them. He
    has authority over them.

                    TITLE X AUTHORITY FOR EMERGENCY CALLUPS

        So we are organized to respond with command and control,
    with capability, wherever needed. Do we have the authority? No.
    Currently, for the homeland, as you well know, for use of the
    title X reserve on an involuntary basis is limited to weapons
    of mass destruction instances.
        And we have proposed that that really is not fully utilized
    in the resources and the assets that we have available. The
    National Guard is going to always be the first military
    responder because the Governor has the capability in
    Mississippi to activate his National Guard, and they come forth
    and do a wonderful job.
        It is only when that State goes and says, ``We need more
    help beyond our capability, and we need Federal help,'' that we
    go to the Federal forces. But today, most likely, you will get
    the 82d Airborne coming from Fort Bragg, North Carolina, when,
    within the State of Mississippi, all of us sitting here
    probably have resources that are available, that are willing,
    and that are citizens of that State.
        So they have a vested interest in responding to those
    floods or whatever, if needed. And the other taxpayers within
    that State look and say, ``Why aren't they being utilized? We
    paid our tax dollars to buy that equipment for that engineer
    unit or for that medical unit or for that Medevac unit, or
    whatever. Why aren't they being utilized to help us when we
    need them?''
        And so, that is one area where we say we just need the
    authorities looked at to say we don't want to be the National
    Guard. We want to be the Federal, but let us be the Federal
    first response versus the active component, when we are
    available and we have the capabilities.

               ACCESS TO ARMY RESERVE FOR NON-EMERGENCY MISSIONS

        The second area, as Admiral Debbink has indicated, is for
    the overseas-type mission sets, the security cooperation
    theater engagement, those types, same thing.
        Give us the authority for the Secretary of Defense or the
    Secretary of the Services to utilize us when it is not a named
    contingency like New Dawn or Iraqi Freedom or Enduring Freedom,
    when it is just a need, and we need a Reserve unit to come in
    for 60, 90 days to help us out, provide medical support,
    whatever it is, to this Nation.
        Give us the authorities there. I think if we get the
    authorities, the funding streams will be worked out because the
    combatant commands have those types of funds for theater
    engagement. And as we have seen back home with FEMA and the
    other streams there, there are funds to respond for natural
    disasters. We will work that out once we get the authorities.
        Senator Cochran. Yes. Thank you, General Stultz.
        General Moore.

                          RESERVES AS FIRST RESPONDERS

        General Moore. Sir, we are organized to respond. Our
    capabilities are scalable and flexible. So I can answer ``rog''
    on that one, or yes.
        As each of the other flag officers have indicated, it is
    the authorities piece that currently needs some attention. I
    think there are two legislative proposals up here, both for,
    let us call it OCONUS use, not named contingency operations,
    and we have all had an opportunity to participate in the making
    of that piece of sausage as it got out of the building and came
    over this way.
        And then, second, as you have put your finger on, the use
    of title X forces inside the continental United States for
    something other than for weapons of mass destruction. And
    again, I believe there is a legislative proposal over here that
    you will see certainly either as part of the NDAA 12 or
    attached to some other piece of legislation.
        So if the authorities are in place, our abilities, our
    capabilities are there. And I think, as each of the generals
    have said, if tasked through the global force management
    process, then we certainly would respond, and we are ready to
    do so.
        Senator Cochran. Thank you very much.
        General Moore. Yes, sir.
        Senator Cochran. Thank you, Mr. Chairman.

                         ADDITIONAL COMMITTEE QUESTIONS

        Chairman Inouye. General Stultz, Admiral Debbink, General
    Moore, and General Stenner, the subcommittee thanks you 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 General Craig R. McKinley
                Questions Submitted by Chairman Daniel K. Inouye
                         army and air guard--equipment
        Question. General McKinley, the equipment levels of the Army and
    Air Guard have improved significantly in the last 4 years, in large
    part due to additional equipment funding provided by the Congress. The
    Army Guard now has 77 percent of its equipment requirements, up from 40
    percent in fiscal year 2006. How have these increases improved
    readiness, and what additional equipment challenges remain?
        Answer. A recently completed review of Army National Guard (ARNG)
    Equipment On-Hand (EOH) indicates that the ARNG units have an average
    of 88 percent of their authorized equipment. Since the end of 2006, the
    number of ARNG units that met minimum readiness standards for equipment
    on hand increased from 31 percent to 49 percent. Despite the overall
    improvement in the ARNG's equipping posture, critical shortfalls
    remain. Current equipment shortages, which constrain readiness, include
    medium tactical trucks and trailers (many are programmed for delivery),
    Warfighter Information Network-Tactical equipment (provides mobile
    satellite communication and ground-based network capabilities) and its
    associated command and control systems, Firefinder Radars, and the
    newer generation of engineer equipment.
        Question. General McKinley, what remaining equipment shortfalls are
    you most concerned about?
        Answer. The Army continues to improve the EOH and modernization
    levels for the ARNG. The ARNG's most critical equipment shortfalls are
    provided below:
      --General Engineering Equipment.--Horizontal/vertical construction,
            diving, and firefighting equipment for Homeland Defense
            Response missions.
      --Family of Medium Tactical Vehicles.--Replacement vehicles for
            existing, nondeployable M35 series, and 800/900 series 2.5- and
            5-ton trucks in the ARNG fleet.
      --Shadow Tactical Unmanned Aircraft System.--Equipment sets and
            associated Shadow Crew Trainers are high-value intelligence,
            surveillance, and reconnaissance assets for support of war-
            fighting missions across the full spectrum, as well as for
            homeland emergency support to civil authorities.
      --Command Posts (Tactical Operations Center and Standardized
            Integrated Command Post System).--Integrated command posts with
            Force XXI Battle Command, Brigade and Below.
      --Chemical/Biological Protective Shelter.--Chemical, Biological,
            Radiological, Nuclear, and Explosives (CBRNE) collective
            protective systems for Consequence Management Response Force
            (CCMRF) missions.
        The Air National Guard (ANG) is most concerned with the following
    equipment needs:
      --Upgrades to the fleet of 11 RC-26Bs to include flight deck
            avionics, Electro-optical/Infrared Full Motion Video sensor
            suite, Main Sensor Operator station, and communications suite.
            The upgrades would align the fleet with the current capability
            provided by the MC-12.
      --The ANG vehicle fleet which represents 15 percent of the vehicles
            operated by the Air Force. Approximately 2,300 of more than
            14,000 are replacement eligible/legacy vehicles. Each fiscal
            year, between 200 and 600 vehicles become replacement eligible.
      --F-16 and A-10 recapitalization and modernization and reducing
            current delays which are significantly impacting the aging
            fleets.
                   family support and yellow ribbon programs
        Question. Gentlemen, this subcommittee recognizes the contributions
    made by reservists over the past 10 years of war and wants to ensure
    that they and their families receive the support services they need.
    Outreach efforts such as the Yellow Ribbon Reintegration Program are
    particularly important for guardsmen and their families who are
    geographically dispersed across the country. Please update the
    subcommittee on your service's Yellow Ribbon efforts and their
    effectiveness.
        Answer. The National Guard Yellow Ribbon Reintegration Program
    supports servicemembers and their families with events and activities
    that focus on their physical, mental, social, spiritual, and financial
    wellbeing throughout the deployment cycle.
        In fiscal year 2009, the National Guard held 958 events in 353
    locations nationwide. A total of 63,775 service members attended these
    events, along with 31,674 family members. Each event, on average, drew
    100 attendees. In fiscal year 2010, the National Guard held 1,657
    events in 498 locations nationwide. A total of 127,844 servicemembers
    attended these events, along with 125,255 family members. Each event,
    on average, drew 153 attendees. For fiscal year 2011, as of March 31,
    2011, the National Guard has held 964 events in 352 locations
    nationwide. A total of 53,871 servicemembers attended these events,
    along with 50,011 family members. Average attendance at these events
    has been 153 attendees.
        The National Guard utilizes After Action Reports to determine the
    effectiveness of individual events. Participants are asked to complete
    surveys to provide feedback on the information they received regarding
    resources available to them and their families throughout the
    deployment. Participants are also asked to provide feedback on
    information received about the benefits they have earned as a result of
    being deployed, and how to access these benefits. In an effort to
    expand the support and services that are provided, the National Guard
    is focusing on collaboration, communication, and training in order to
    reinforce a seamless, comprehensive network of support services. This
    initiative will allow the National Guard to reach a wide range of
    stakeholders by providing training on best practices using a variety of
    tools (i.e. classroom, e-learning and virtual workshops), while
    ensuring services provided recognize the unique, State-oriented needs
    of the National Guard, and are also applicable to all Reserve
    Components.
        Question. Are family support programs fully funded in the fiscal
    year 2012 budget request? Are there programs, from your perspective,
    that could be improved?
        Answer. Family Assistance Centers are funded at $26 million in the
    base. Overall, $71 million exists in validated requirements. Family
    Readiness Support Assistants are funded at $15.6 million in the base,
    while $17.5 million exists in validated requirements. Child and youth
    programs are funded at $28 million in the base while there is $68.3
    million in validated requirements.
        We are continually improving our family support through improved
    training, expansion of our volunteer network and coordination with
    other support networks including other military programs, Federal and
    local government, and the private sector. We are very excited about the
    work being done through the Chairman of the Joint Chiefs of Staff
    Family Support meeting to revitalize Inter-Service Family Assistance
    Committees in support of all military members, their families and
    veterans. Inter-Service Family Assistance Committees are voluntary
    military/community coalitions that facilitate support through a series
    of networks. Through these networks, we will continue to work toward
    increased collaboration, cooperation, and communication.
              national guard and reserve equipment account (ngrea)
        Question. Gentlemen, this subcommittee recognizes the importance of
    providing the Guard funding for necessary new equipment and
    modernization of aging equipment and have consistently done so through
    the National Guard and Reserve Equipment Appropriation (NGREA). Please
    describe the importance of this additional funding to providing
    Critical Dual-Use (CDU) equipment for the Guard.
        Answer. The Army continues to address shortfalls in the ARNG while
    striving to modernize ARNG capabilities. The ARNG estimates it needs
    $3-$4 billion in annual programmed funding to maintain interoperability
    with Army units, sustain current EOH levels, and continue modernizing
    our equipment. The additional funding the ARNG receives from the
    Congress through the NGREA enables the ARNG to enhance the Army's
    already robust procurement plans, by focusing complementary funding on
    CDU equipment.
        The Family of Medium Tactical Vehicles (FMTV) is one of the
    mainstays of CDU equipment and continues to play an integral part in
    most ARNG missions. As such, the ARNG has invested large portions of
    the NGREA funding in modernizing its Medium Tactical Vehicle (MTV)
    fleet. Funding from fiscal years 2008-2010 the NGREA allocated for FMTV
    will result in the modernization of 12 percent of the ARNG's MTV fleet.
        The ARNG has also invested the NGREA funds in Tactical Battle
    Command Systems to enhance interoperability with Army units.
    Specifically, the ARNG invested the NGREA funds in CDU systems, such as
    the Tactical Operation Combat System, Standard Integration Command Post
    System (SICPS), and Warfighter Information Network-Tactical. These
    systems provide standardized communication infrastructure for
    commanders and staff to digitally plan, prepare, and execute operations
    related to their missions. With the NGREA funding, the ARNG was able to
    purchase SICPS and Command Post Platform systems for more than 47
    brigade/battalion level units.
        The ARNG continues to posture itself toward the Army's full-
    spectrum, ARFORGEN-based Equipping Strategy, by focusing on
    modernizing, improving equipment interoperability, and emphasizing CDU
    equipment. As a result of significant Army investment in ARNG equipment
    and the generous support from the Congress, the ARNG equipment on-hand
    percentage has risen to 88 percent, and the ARNG has 89 percent of its
    CDU EOH, as of March 2011.
        The NGREA is the life blood of the ANG modernization efforts. The
    Active Component's emphasis is on long-term recapitalization as
    Department of Defense budgets flatten, which increases the importance
    of the NGREA for modernizing legacy ANG aircraft. In addition, the
    Active Component has not yet recognized the unique requirements driven
    by the ANG's domestic mission--the NGREA is the primary means to
    fulfill these current domestic capability shortfalls.
        Question. Historically, the Department has had some trouble in
    obligating the NGREA funds in a timely manner. Please provide an update
    on current obligation rates.
        Answer. The ARNG obligation rates for the NGREA have significantly
    improved in the past 12 months, through the implementation of better
    business practices and communication with Department of the Army and
    Program Manager Offices. The ARNG NGREA obligation rates for fiscal
    year 2009 and fiscal year 2010 exceed both congressional and Office of
    the Secretary of Defense obligation standards. The ARNG NGREA
    obligation rates as of June 2011 are as follows: fiscal year 2009--98
    percent; fiscal year 2010--88 percent.
        The ANG changed the NGREA planning and execution process to meet
    the Office of the Secretary of Defense (OSD) goal of obligating 80
    percent of procurement funds in the first fiscal year of the
    appropriation. The Air Force is also providing assistance by issuing
    policy letters that will drive process changes to speed obligations.
    The ANG NGREA obligation rates are now within OSD standards, and as of
    June 2011 are as follows: fiscal year 2009--93.5 percent; fiscal year
    2010--83.5 percent.
                           hawaii army national guard
        Question. General McKinley, the National Guard Bureau (NGB) plans
    to relocate a Battalion Headquarters 29th Infantry Brigade from the
    Hawaii Army National Guard to the California Army National Guard upon
    conversion from the Brigade Special Troops Battalion (BSTB) to a
    Brigade Engineering Battalion (BEB). I am concerned that moving the
    headquarters to California would adversely affect Hawaii's homeland
    response capability, since this unit is currently dual-missioned as the
    command and control element of Hawaii's Chemical, Biological,
    Radiological and Nuclear Response Force Package (CERFP). Please provide
    an update on the decision to relocate the headquarters.
        Answer. The BEB Force Design Update (FDU) is pending approval by
    the Army Chief of Staff. It is one of several initiatives under
    consideration in the Total Army Analysis (TAA) 14-18. Until TAA 14-18
    resourcing requirements are clear--we anticipate this will be in 1st
    quarter fiscal year 2012--the ARNG will not make the BEB-related
    stationing decisions. Additionally, we will review the Hawaii National
    Guard's total force structure to ensure they have the necessary
    capabilities for homeland response.
                                     ______

                Questions Submitted by Senator Dianne Feinstein
                           marijuana on public lands
        Question. In the President's fiscal year 2012 budget, $179.7
    million is requested to support States' programs, again including
    eradication of marijuana on public lands.
        How effective can the National Guard be in fiscal year 2012 in
    eradicating marijuana on public lands without the kind of additive
    funding that was provided in fiscal year 2011? What would our
    operations look like without an additional $50 million?
        Answer. There is a direct correlation between funding and manning
    and results. By providing additional funding to State National
    Counterdrug Programs, they are able to resource more personnel to
    priority law enforcement counternarcotics missions and significantly
    impact there operations in a positive way. Marijuana eradication on
    public lands has historically benefited from additive funding. Without
    additive funding, all programs will be forced to curtail support
    operations to include priority missions aimed at specific threats. The
    second and third order of effects of no additive funding will sharply
    impact remaining priorities; thus, potentially allowing the always
    adapting threat to thrive in areas not fully resourced to meet
    requirements. Marijuana eradication is a deliberate 6-9 month operation
    for many States. Additive funding, if provided, is required early in
    the planning process to adequately meet customer requirements and also
    permit State programs to efficiently execute the additional resourcing.
        Without an additional $50 million, operations would be reduced from
    the fiscal year 2010 in the following manner: aviation reconnaissance
    would be reduced anywhere between 25-40 percent; high-priorities States
    could be impacted even more, potentially up to 50-60 percent of their
    historical support operations; and finally eradication efforts would
    not be in place to removed anywhere between 600,000 and 900,000 plants
    for fiscal year 2012.
        Question. How much of the National Guard's counterdrug funding is
    used for the eradication of marijuana on public lands? What other areas
    is it used for?
        Answer. For fiscal year 2010, 13 percent of the State Plans budget
    was used for aviation reconnaissance. Approximately 90 percent of
    aviation reconnaissance is used for marijuana spotting on public lands.
    This equates to a dollar value of $26.7 million for fiscal year 2010.
        For fiscal year 2011, 16 percent of the State Plans budget was used
    for aviation reconnaissance. Approximately 88 percent was used for
    marijuana spotting on public lands. This equates to a dollar value of
    $33.1 million for fiscal year 2011.
                                     ______

                  Questions Submitted by Senator Patty Murray
       s. 325, embedded mental health providers for reserves act of 2011
        Question. General McKinley, I am very concerned about the
    increasing rise in Guardsmen suicides. I know it can be challenging to
    reach out to servicemembers are they return to their communities, but I
    feel more can be done. The California National Guard has embedded part-
    time providers at some of their armories and they have noticed a
    dynamic increase in self-referrals over time.
        Do you think programs such as Embedded Mental Health Providers will
    increase the trust between Guardsmen and mental health providers;
    ultimately reducing some of the stigma associated with seeking mental
    health care?
        Answer. We do. One of our most interesting initiatives is a
    California National Guard (NGCA)-TRIWEST sponsored embedded counselor
    pilot program that started in 2006 and continues today. The program
    data elements collected so far indicates trust has been established.
        In 2006, only 36.28 percent of contacts by Guard members to
    embedded counselors were ``self-referred''; a Guard member initiated
    contact. To date, more than 50 percent of our Guard members are
    choosing to ``self-refer'' to an embedded counselor. In 2006, more than
    10 percent of Guard members were referred to an embedded counselor by a
    commander. To date, less than 3 percent are being referred by
    commanders. In 2006, 2.64 percent of the referrals were made by peers.
    To date, there have been no referrals suggested by a peer. Increased
    self referral rates, decreased command requested referrals, and a
    decrease in peer suggested referrals, most likely indicate either a
    reduction in stigma or an increase in trust associated with those
    seeking counseling services.
        In addition, most of the embedded counselors have remained with the
    units of original assignment. All have recently elected to continue
    contracting with TRIWEST in the embedded counselor program. Retention
    rates are indicators of positive job satisfaction; and clearly the
    embedded counselors must believe their efforts are making a difference.
        The design of the embedded counselor program places providers in
    high-risk units, at armories and wings well before deployment allowing
    ``relationships'' to become well established. While Guard members are
    deployed, families and Guard members who have not deployed, have a
    familiar and reliable resource available to them.
        It is well known that cohesiveness is an important factor within
    military units and trust is critical. We believe the embedded counselor
    program has forged a bond between our embedded counselors and our Guard
    members beyond initial expectations.
        Question. Post-deployment, where do National Guard members and
    their family members turn for support when the member is not on Active
    Duty status?
        Answer. Many National Guard servicemembers are remotely located
    (isolated) in terms of support systems when released from Active Duty.
        Because of the existing relationship with the embedded counselor in
    a specific unit, the opportunity for critical intervention is greatly
    enhanced. Access to mental health care has been a continued challenge
    for the members of the National Guard. The majority of clinical
    referrals are made to local and county mental health departments.
        One of our most interesting initiatives is a NGCA-TRIWEST sponsored
    embedded counselor pilot program that started in 2006 and continues
    today.
        During the past 16 months, the NGCA has met and briefed nearly all
    of the 58 California county directors and staff members on the embedded
    counselor program and feedback has been enthusiastic and supportive.
    Through these discussions, a need for ``military culture'' training was
    identified, developed and currently more than 20 counties and 1,000
    civilian providers have received this important orientation, which is
    critical to understanding the nuances associated with deployment and
    combat stress. In addition, the NGCA has initiated a behavioral health
    outreach effort to enhance the embedded counselor program with ``strike
    team'' capability to respond to critical incidents.
        Most recently, in order to provide empirical data to the embedded
    counselor model, the Walter Reed Army Research Institute has initiated
    a research study involving 12 units scheduled to deploy in 2011. The
    results of this study may provide conclusive data as to the efficacy
    and cost effectiveness of the embedded counselor program model.
                      national guard military construction
        Question. General McKinley, 40 percent of Army National Guard
    Readiness Centers are more than 50 years old, including some in my
    State of Washington. I am very concerned that after serving with their
    Active-Duty counterparts in state-of-the-art facilities on deployment,
    our servicemembers return home to insufficient facilities.
        Has the National Guard reviewed the condition of all of their
    facilities as a whole?
        Answer. Yes, each quarter the Army National Guard (ARNG) captures
    the condition of all federally supported facilities, and updates the
    Army Installation Status Report (ISR) database. Each State, Territory,
    and the District of Columbia captures information on a variety of
    condition factors for each facility and provides analysis of the
    overall facility condition.
        In addition, Senate Report 111-201 (Senate Armed Services
    Committee) directed the Secretary of the Army to conduct an independent
    study of all Army National Guard Readiness Centers. This study--
    considering several criteria, including size and condition--is in the
    pilot stage and defining the standards and methodology for conducting
    the study.
        Also, each year the Air National Guard (ANG) base leaders conduct
    facility assessments, prioritize requirements through a facility board
    process composed of senior leaders at the installation, and forward the
    prioritized requirements to the Installations and Mission Support
    Directorate at the National Guard Bureas (NGB) for inclusion in
    upcoming Sustainment, Restoration, and Modernization or Military
    Construction (MILCON) programs. While the ANG does have facility
    modernization needs, the sufficiency of our facilities continue to meet
    our airmen's needs.
        Question. How will the decrease in the MILCON funds in future years
    affect the ability to modernize and improve the quality of the
    facilities used by Guardsmen nationwide?
        Answer. The ARNG and its facilities will be adversely affected if
    the MILCON funds decrease in future years, as of today, 40 percent of
    the ARNG's 26,000 facilities are more than 50 years old in the States,
    Territories, and District of Columbia. Assuming current projected
    MILCON funding levels, the ARNG will replace less than 1 percent of
    these aging facilities each year. The result is an ARNG force supported
    by rapidly aging and outdated facilities that are inadequate to support
    operation readiness, and, because these facilities are not energy
    efficient, the structures are far more expensive to maintain.
        Decreased MILCON funding in future years will also adversely affect
    the ANG's ability to modernize and improve the quality of facilities
    used by Guardsmen. The ANG MILCON requirements are considered by the
    Air Force based on mission requirements and the merits of each project,
    and then ranked in priority with all Air Force and Air Force Reserve
    submissions. Each year the Air Force develops a total-force (ANG,
    Active Duty, and Air Force Reserve) prioritized list of new mission
    bed-down project requirements to address the needs for missions being
    changed, and a prioritized list of current mission recapitalization
    project requirements to address needs of existing missions with aging
    or degraded facilities.
        If future conditions fiscally constrain the Air Force MILCON
    program, fewer projects can be funded. A constrained MILCON program may
    only allow the Air Force to fund ``must do'' projects to bring new
    weapons systems on line, which may force difficult choices to defer
    current mission requirements. Should this lead to further constraints
    on the ANG MILCON funding, the ANG will continue to apply available
    sustainment, restoration, and modernization funds to existing
    facilities in order to keep the ANG missions viable as long as
    possible.
        Question. Is there a backlog of MILCON projects that need to be
    addressed? How large is it in cost?
        Answer. Yes, the Army ISR reflects a $28.2 billion backlog in
    MILCON. Today, 40 percent of the ARNG's 26,000 facilities are more than
    50 years old. Many of these older ANG facilities meet neither current
    anti-terrorism/force protection requirements, nor demographic shifts in
    population, and current square footage deficits have a direct effect on
    ANG mission readiness.
        The ANG submitted a fiscal year 2013-2016 Future Years Defense
    Program (FYDP) with requirements for major construction, unspecified
    minor military construction, and planning and design totaling more than
    $538 million. In addition, subject to the provisions of title 10,
    Section 10-543, the ANG submitted to Congress a prioritized list of
    more than $163 million in requirements that could be included in the
    FYDP, should additional capacity be provided through congressional
    action. These two prioritized lists of requirements, when combined,
    would exceed $700 million; thus, the ANG MILCON backlog of requirements
    is at least this large.
                                     ______

                   Question Submitted by Senator Thad Cochran
                          army national guard director
        Question. General McKinley, which is more important to the National
    Guard Bureau (NGB) and the effective operation of the Army Guard:
    getting a Director of the Army Guard nominated and confirmed, or
    getting a three star Vice Chief position for the Bureau?
        Answer. The most immediate need is for a Director of the Army
    National Guard (ARNG) to be confirmed as soon as possible. The position
    has been encumbered by an Acting Director (two-star) for more than 2
    years, and a permanent three-star is needed in order for ARNG equities
    to be appropriately represented at the highest levels of the Army. At
    the same time, converting and upgrading the current Director, NGB Joint
    Staff billet to a three-star Vice Chief, the NGB is imperative. The
    establishment of the NGB as a Joint Activity of DOD and elevation of
    the Chief, the NGB to a four-star in November 2008 added significant
    new roles and responsibilities. The commensurate increased requirements
    within Joint decisionmaking forums, all requiring three- or four-star
    level participants, drive the re-establishment of the Vice Chief, NGB
    position.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
        Question. What impact have National Guard counter-drug operations
    had on drug production? Why had this funding not been previously
    included in the National Guard's budget request? What steps does the
    National Guard Bureau (NGB) intend to take to keep these operations
    going in the future?
        Answer. In fiscal year 2010, the National Guard Counterdrug Program
    (NG CDP) assisted law enforcement in eradicating more than 10.1 million
    marijuana plants across the Nation. Of those, more than 7.6 million (or
    75 percent) marijuana plants were eradicated in the marijuana seven
    States (Hawaii, Washington, Oregon, California, West Virginia,
    Tennessee, and Kentucky).
        Each year, funding for the NG CDP is included in the President's
    budget request. Funding has been requested in the Program Objective
    Memorandum process to include additional unfunded requirements
    throughout the Future Years Defense Program (FYDP).
        Question. I am told that the National Guard will allocate proposed
    fiscal year 2012 counterdrug funding to States through a ``threat-based
    model'' formula. What facts and criteria were crafted for this model to
    be based on? Given that Kentucky consistently ranks as one of the top
    three States for marijuana production, where does Kentucky rank,
    according to this formula, in terms of States with serious drug
    threats? What will be the percent increase or decrease in funding for
    Kentucky compared to the fiscal year 2011 funding level? What rationale
    does the NGB have for this change in funding for Kentucky?
        Answer. The NG CDP is employing a new Threat Based Reduction Model
    (TBRM). This model uses an objective, threat based resourcing model
    that provides the Governors funding commensurate with their threat
    level yet flexible enough from year to year to adjust resourcing to
    meet emerging threats and the needs of our stakeholders and customers
    (States, law enforcement agencies, and community-based organizations)
        To properly identify the threat for each State, six separate
    vulnerability categories, or clusters, were identified that quantified
    the theat. These clusters align with the established National Drug
    Intelligence Center and NG CDP State Plan identification of threat
    criteria. These areas are: production, distribution, transportation,
    abuse, illicit finance and a catch-all cluster called related data.
    These areas are defined below:
      --Production.--Production vulnerabilities include producing crack
            cocaine from powder, growing marijuana both indoor and outdoor,
            and methamphetamine laboratories. These identify production
            trends associated with drug-trafficking organization (DTO) or
            criminal gangs.
      --Distribution.--Distribution vulnerabilities include a specific DTO
            or criminal gang and methods of distribution such as an illicit
            Internet pharmacy.
      --Transportation.--Transportation vulnerabilities include major
            highways, ports, airports, points of entry, borders, offshore
            locations, corridors passing from one State to another State,
            or a High Intensity Drug Task Area.
      --Abuse.--Drug abuse vulnerabilities include sociological impact and
            consumption amounts by demographics.
      --Illicit Finance.--Illicit finance includes common money laundering
            techniques such as the use of digital currency over the
            Internet, use of foreign banks or wire transmitters.
      --Related Data.--Those variables that do not fit into the above
            categories yet still have impact and require inclusion. These
            include interdiction, population and other contributing factors
            that are not accounted for in the State plan process.

    ------------------------------------------------------------------------
                                         Distribution       Illicit finance
              Abuse cluster                 cluster             cluster
    ------------------------------------------------------------------------
    Substance abuse treatment         Number of cities    Number of currency
     admissions (Ages  12-17).         reporting a         seizure incidents
                                       Mexican DTO         at ports of entry
                                       Presence.           or on internal
                                                           highways
    Illicit drug use rates in the     Gang members per    Number of SARS
     past month.                       capita.             money laundering
                                                           cases
    Illicit drug dependence in the    ..................  Amount of currency
     past year.                                            seized at land
                                                           ports of entry or
                                                           on internal
                                                           highways
    Substance abuse treatment
     admissions (not including
     alcohol) (all ages).
    Drug abuse violations...........
    Rates of abuse for cocaine,
     heroin, marijuana, and
     methamphetamine.
    Prescription drug abuse.........
    ------------------------------------------------------------------------

        The threat input from State counterdrug coordinators and
    Interagency partners is ongoing. The results of the model will not be
    known until mid-June at that time determinations for individual States
    will be made.
        The rationale comes from both Office of National Drug Control
    Policy (ONDCP) and the Deputy Assistant Secretary of Defense of
    Counternarcotics (DASD/CN) As of May 1, 2007, the ONDCP directed ``all
    national drug control programs to have a performance reporting program
    as an integral part of the agency's budget and management process.''
        The NG CDP's TBRM is the culmination of a 3-year effort to
    implement a more objective, threat-based methodology for determining
    overall threat levels within the States to better apportion individual
    State program appropriations. The ultimate objective is to allocate
    resources against the threat for the purpose of achieving clear
    outcomes under the National Security Strategy, National Drug Control
    Strategy and the Department of Defense Counternarcotics & Global
    Threats Strategy.
        If Kentucky's funding is reduced, it will be threat based and be
    supported by the customer's that request support in Kentucky, as well
    as supporting objectives and goals outlined in DASD/CN> and ONDCP
    strategies.
                                     ______

          Questions Submitted to Lieutenant General Harry M. Wyatt III
                Questions Submitted by Senator Dianne Feinstein
                              firefighting support
        Question. As you may know Lieutenant General Wyatt, the U.S. Forest
    Service (USFS) currently only has access to 19 firefighting aircraft in
    addition to your 8 planes. These planes are old, and they are all
    nearing the end of their operational service life. In order to make up
    this shortfall, some have proposed expanding the Air National Guard's
    (ANG) involvement in the firefighting mission.
        What is the status of the effort to obtain joint-use C-130J's to
    supplement the Guard's needs as well as the aerial firefighting needs
    of the USFS?
        Answer. The ANG is currently working with the Department of
    Agriculture and the Department of the Interior to examine how this can
    be accomplished. The ANG continues to work with the DOD on completion
    of the report on the joint use of Federal forest firefighting assets
    and C-130 firefighting capability, as required by the Fiscal Year 2010
    Defense Appropriations Bill. In addition, the ANG is examining the use
    of a ninth Modular Airborne Fire Fighting System and the best location
    to use that equipment. The pending RAND Studying (commissioned by the
    USFS to look at the possible purchase of additional C-130J's) will also
    help define the future strategy.
        Question. If additional planes were acquired, would the arrangement
    allow them to respond to a wildfire at a moment's notice? Would there
    be restrictions on the use of the planes that prohibit them from being
    used to perform initial wildfire attack?
        Answer. Yes. If deliberate planning is used, proper scheduling is
    defined, and an appropriated budget in place. There is no impediment to
    having our crews perform initial attack. The crews simply need to be
    properly trained and certified by the USFS.
        Question. If additional planes were acquired, would the planes be
    available for the duration of the fire season--between June and
    November in California--or would there be other demands that would
    render the planes unavailable for extended periods of time?
        Answer. There will always need to be a balance between the war-time
    mission and our domestic operations responsibility. Through proper
    scheduling of aircraft, aircrew, and maintenance personnel, aircraft
    and crews would actually be more available than they are currently to
    the State of California and other States.
                                     ______

                    Questions Submitted by Senator Herb Kohl
        Question. Recently, the Air Force and National Guard Bureau (NGB)
    announced a decision to reduce the Primary Aircraft Authorization (PAA)
    at Truax Field in Madison, Wisconsin from 18 to 15 F-16 fighters. I
    understand that this was part of a larger reduction in the PAA for F-16
    fighters, which is being implemented over several years at many bases.
    According to General Schwartz, this decision was made early in 2006 as
    part of the President's budget for fiscal year 2008, and the Wisconsin
    Air National Guard was notified in December 2010 about this decision.
        When was the Air National Guard (ANG) notified of this decision? If
    the decision was made several years ago, why were the leaders in the
    Wisconsin ANG notified only recently?
        Answer. The decision to reduce the PAA at Truax Field was made
    early in 2006 in conjunction with the ANG as part of the fiscal year
    2008 President's budget. Due to the restrictions placed on release of
    information contained in the President's budget, the Air Force provides
    a force structure announcement in the fiscal year prior to
    implementation. The NGB provides a more specific announcement to the
    Adjutants General following the Air Force announcement. However, in
    this case the leadership of the Wisconsin ANG was informed of this
    action in December 2010 by the Director, the ANG, approximately 5
    months prior to the planned official force structure announcement.
        Question. Your testimony stressed the importance of maintaining the
    readiness of the ANG to be an operational partner of the Active Duty
    Air Force.
        Will the readiness of the fighter wing at Truax Field be impacted
    by the loss of flying hours from the reduction of three F-16 fighters
    in their primary aircraft authorization?
        Answer. Yes, the reduction of 3 PAA of Block 30 aircraft, resulting
    in 15 PAA incurs more risk by the Wisconsin ANG, due to the decrease in
    manpower and the loss of 720 flying hours. Due to the decrease of PAA,
    the unit will need to eliminate one full-time maintenance position and
    76 part-time maintenance positions. Furthermore, the 115th Fighter Wing
    is an Air Sovereignty Alert (ASA) unit with an Air Expeditionary Force
    (AEF) rotational requirement. When mobilized for their AEF rotation,
    they are required to keep no less than ten Active Guard/Reserve pilots
    at home station to cover the alert mission, which is not possible to
    accomplish while supporting the AEF. Reduction from 18-15 PAA also
    directly impacts ability to support AEF. Six jets must remain behind
    plus associated support equipment for ASA commitment, leaving only nine
    jets remaining for AEF support.
        Question. General Schwartz stated that the reduction of F-16
    fighters in the ANG's primary aircraft authorization ``was a deliberate
    decision to accept near term risk while bridging to a fifth generation
    fleet.''
        As the Air Force transitions to a fifth-generation fleet, does the
    ANG plan to deliver fifth generation fighters to Truax Field?
        Answer. Burlington, Vermont has been selected as the preferred
    alternative for the first ANG F-35 location. Future ANG F-35 bed down
    locations have not yet been determined. While the ANG realizes the
    importance of future F-35 basing in the ANG, including Truax Field,
    analysis and responsibility for F-35 basing decisions resides with the
    Air Force's Executive Steering Group for Strategic Basing (ESG-SB). The
    ESG-SB will recommend F-35 basing candidates, including ANG units, to
    the Secretary of the Air Force and Chief of Staff of the Air Force for
    final selection, pending environmental analysis.
                                     ______

                  Question Submitted by Senator Lisa Murkowski
                168th air refueling wing communications facility
        Question. The project is not in the administration's fiscal year
    2012 request. Is the Air Force aware of the urgently needed repairs to
    the 168th Air Refueling Wing's Communications Facility and, if so, when
    would we expect to see funds requested?
        Answer. The Air National Guard (ANG) is aware of the proposed
    project to add to and alter the communications building in the ANG area
    of Eielson Air Force Base. At the request of the leadership of the
    Alaska ANG, the project was submitted to the Congress with ANG's fiscal
    year 2010, fiscal year 2011, and fiscal year 2012 President's budget
    justification materials as a requirement in the Future Year Defense
    Program. Other requirements of higher priority have been placed in the
    President's budget ahead of this project, and the Congress has not
    accelerated the project from future years into a current budget.
    Considering the continuing requirement, senior leaders from the ANG
    Readiness Center visited the site, examined the facility, and proposed
    a way forward to accommodate significant portions of the mission within
    available resources. The ANG will propose an unspecified minor military
    construction project to satisfy facility size shortfalls, and fund a
    sustainment, restoration, and modernization companion renovation of the
    existing facility to provide a safe, capable communications facility
    for the Alaska ANG at Eielson AFB in fiscal year 2012.
                                     ______

           Questions Submitted to Major General Raymond W. Carpenter
                Questions Submitted by Chairman Daniel K. Inouye
                    national guard southwest border mission
        Question. General Carpenter and General Wyatt, can you please
    update the subcommittee on the Guard's efforts on the Southwest Border?
    The original mission was scheduled to be completed by the end of June
    2011. Is this still on track?
        Answer. Since the National Guard reached full operating capability
    on October 1, 2010, National Guard forces have contributed to more than
    17,549 apprehensions and seizures of more than 52,000 pounds of
    marijuana on the Southwest Border. The National Guard's presence on the
    Southwest Border has made a measurable difference in curbing the
    thousands of weapons and $19 billion that are estimated to flow into
    Mexico annually. The National Guard has been actively coordinating with
    CBP and ICE and the 1,200 National Guardsmen from four States
    (California, Arizona, New Mexico, Texas) provided criminal
    investigative analysts and Entry Identification Teams in support of the
    Customs and Border Patrol along the Southwest Border. The Southwest
    Border mission will end on September 30, 2011.
        Question. Guardsmen were supposed to begin withdrawing from the
    border in May 2011. Has this drawdown begun as planned?
        Answer. The State drawdown plans have been adjusted so that the
    main drawdown will not being until after September 1, 2011, with a
    rapid drawdown instead of the gradual 4-month drawdown that was
    originally planned. The mission will end on September 30, 2011 per the
    request of the President.
                                 suicide rates
        Question. General Carpenter, the Army Guard's suicide rate
    increased an additional 13 percent last year after a 75 percent jump in
    2009. To respond to the increasing rate of suicides, the Army has added
    mental health professionals and launched a suicide prevention education
    program. Do you think these programs effectively target the Guard and
    address the wellness of Guard members beginning with recruitment and
    continuing throughout their entire service in the Guard?
        Answer. Note: the Army National Guard's (ARNG) suicide rate
    increased 81 percent last year, after a 3 percent jump in 2009.
        The additional, Army-contracted mental health professionals are
    extremely limited in what they may provide to ARNG soldiers. An ARNG
    soldier on title 10 Active Duty status is able to receive treatment at
    a military treatment facility, Veterans Administration (VA) facilities,
    and Military Medical Support Offices in remote areas. However, an ARNG
    soldier on title 32 status (participating in Inactive Duty for
    Training--traditional, once-a-month, ``drill status''--or Annual
    Training (AT)) may only receive prevention, crisis intervention, and
    referral services from Behavioral Health Officers (BHO). In addition,
    BHOs are typically only accessible during unit IDTs and ATs. If the
    ARNG Soldier neither qualifies for VA coverage, nor holds private
    health insurance, then the BHO may attempt to assist the ARNG soldier
    in finding pro-bono treatment. The BHOs cannot develop a treatment plan
    with or for the ARNG soldier.
        Much like the Active Army, services and treatment for behavioral
    health issues of geographically dispersed soldiers are critical to
    allaying the suicide rate, particularly for the many ARNG soldiers who
    lack traditional health insurance coverage.
        To alleviate the strain on the force, the ARNG recommends the
    following minimum actions:
      --Army provides emergency behavioral healthcare services to uninsured
            and underinsured servicemembers, regardless of duty status;
      --The ARNG is authorized full-time, uniformed behavioral health
            personnel; and
      --Add and embed behavioral health professionals to high-risk units,
            units who have experienced suicides, soldiers killed in action,
            or intense/prolonged combat.
        Question. General Wyatt, are you facing anything similar in the Air
    Guard with respect to suicide?
        Answer. After a low-suicide rate in 2008, we experienced a 65
    percent increase in 2009 and another 26 percent increase in 2010 for
    the highest rate we've had since tracking began. This year, we have
    lost nine members to suicide to date, compared to 9 of 19 at this time
    (June 15) last year. We have implemented a number of Air National Guard
    (ANG) initiatives and are continuing to build our Wingman Culture. Our
    primary fiscal year 2011 initiative is the embedding of Wing Directors
    of Psychological Health (WDPHs) in our 89 wings. These licensed mental
    health professionals provide consultation to wing commanders on wing
    psychological health issues and provide consultation, information,
    referral, and case management for airmen and their family members in
    need of assistance. Our Wingman Project provides training, awareness,
    and outreach to teach warfighters and their families how to identify
    symptoms of impending suicide and then intervene to save a life. The
    project provides customized marketing materials for each wing and
    provides tools accessible to airmen and their family members via a
    public website. We continue to train members how to assist fellow
    airmen in distress using the Ask, Care, Escort (ACE) suicide prevention
    model. We are having two Wingman Days this year, an opportunity for
    units to stand down and build resilience as a team, a key component in
    preventing suicide. The ANG suicide prevention booklets are being
    distributed to every airman. The Deployment Resiliency Assessment began
    April 1 and will aid in identifying and providing assistance to airmen
    at risk with an assessment prior to deployment and three follow up
    assessments. Our frontline supervisors in our high-risk-for-suicide
    career fields (security forces, communications, intelligence, and
    recommended for civil engineering) are being trained to identify and
    assist airmen in distress.
                        army guard equipment shortfalls
        Question. General Carpenter, in recent years the Army has made
    significant investments to more adequately resource the Guard and
    Reserve equipping requirements. The fiscal year 2012 budget request
    indicates that procurement funding for the Army Guard will decrease
    significantly from fiscal year 2012 onwards. Do you believe that the
    Army has adequately budgeted for Guard equipment requirements beyond
    fiscal year 2012?
        Answer. The Army continues to address shortfalls in the ARNG, while
    striving to modernize ARNG capabilities. The ARNG estimates it needs
    $3-$4 billion in annual programmed funding to maintain interoperability
    with Army units, sustain current Equipment On-Hand (EOH) levels, and
    continue modernizing ARNG equipment. Fiscal years 2012-2016 budgets
    average $2.4 billion per year for ARNG funding.
        Question. General Carpenter, what remaining equipment shortfalls
    are you most concerned about?
        Answer. The Army continues to improve the EOH and modernization
    levels for the ARNG. At this time, the ARNG's most critical equipment
    shortfalls are provided in the table below.

                            ARNG EQUIPMENT SHORTFALLS
    ------------------------------------------------------------------------
                      System                            Justification
    ------------------------------------------------------------------------
    General Engineering Equipment.............  Horizontal/Vertical
                                                 construction, diving, and
                                                 firefighting equipment
                                                 critically under filled.
                                                 Required for Homeland
                                                 Defense Response missions.
    Family of Medium Tactical Vehicles (FMTV).  FMTV are replacement
                                                 vehicles for existing,
                                                 nondeployable M35 series,
                                                 and 800/900 series 2.5- and
                                                 5-ton trucks in the ARNG
                                                 fleet.
    Shadow Tactical Unmanned Aircraft System    TUAS equipment sets and
     (TUAS).                                     associated Shadow Crew
                                                 Trainers are critically
                                                 required high-value
                                                 intelligence, surveillance,
                                                 and reconnaissance assets
                                                 for support of war-fighting
                                                 missions across the full
                                                 spectrum, as well as for
                                                 homeland emergency support
                                                 to civil authorities.
    Command Posts (Tactical Operations Center   Integrated command posts
     & Standardized Integrated Command Post      with Force XXI Battle
     System).                                    Command, Brigade & Below
                                                 continue to represent a
                                                 critical shortfall for the
                                                 ARNG.
    Chemical/Biological Protective Shelter....  Chemical, Biological,
                                                 Radiological, Nuclear, and
                                                 Explosives (CBRNE)
                                                 collective protective
                                                 systems are required for
                                                 Consequence Management
                                                 Response Force (CCMRF)
                                                 missions.
    ------------------------------------------------------------------------

                                     ______

                  Questions Submitted by Senator Patty Murray
                   national guard stryker brigade combat team
        Question. We in the State of Washington are very interested in
    adding a Stryker Brigade Combat Team (SBCT) to the ANG.
        How would an additional Stryker Brigade be beneficial to the ANG?
        Answer. The Army National Guard (ARNG) leadership validates the
    requirement for an additional Stryker Brigade in our Force Structure,
    based on a 2009 feasibility study. The ARNG study concluded that
    converting an existing Brigade Combat Team (BCT) to a Stryker Brigade
    would provide additional combat power, a more balanced mix of BCTs, and
    ensure relevancy within the Army Capstone Concept.
        A Stryker Brigade in the ARNG would be beneficial for many reasons:
      --The addition supports the Army Force Generation model;
      --A Stryker Brigade possesses necessary staff structure, facilities,
            and communications to Command and Control, and facilitate joint
            and inter-agency inter-operability; and
      --A Stryker Brigade provides additional capability for Homeland
            Defense and Federal and State mission support, for example:
        --Consequence Management (CM).
        --Chemical, Biological, Radiological, Nuclear, and Explosives
                (CBRNE) events and reconnaissance capability.
        --Domestic All-Hazards Response Team (DART) concept.
        --Engineer and wheeled vehicle capabilities for natural disasters.
        --Rapidly deployable, interstate navigable, and 100 percent mobile
                command posts to establish or augment a local or regional
                emergency operations centers.
        Requests for a force design update were submitted in November 2009
    from several States to Headquarters, Department of the Army (HQDA), and
    there are no plans to execute a conversion within the ARNG for any
    additional Stryker Brigades. Total Army Analysis 14-18 examines the
    feasibility, acceptability, and supportability of resourcing a second
    Stryker Brigade Combat Team via a holistic review of the Army's BCTs
    and enabler force requirements. Accordingly, the ARNG will work with
    HQDA to ensure the Army Operational Force is properly balanced.
        The stationing of a second SBCT will occur only after HQDA approval
    and is based on several factors: readiness for the least cost (to
    include geographic location, existing infrastructure, and level of
    modernization), available training areas and capacities, personnel
    strength, and demonstrated capacity to produce ready formations over
    time.
        Question. What are the prospects of adding a Stryker Brigade to the
    ARNG in Washington?
        Answer. The ARNG leadership validates the requirement for an
    additional Stryker Brigade in our Force Structure, based on a 2009
    feasibility study. The ARNG study concluded that converting an existing
    BCT to a Stryker Brigade would provide additional combat power, a more
    balanced mix of BCTs, and ensure relevancy within the Army Capstone
    Concept.
        Requests for a force design update were submitted in November 2009
    from several HQDA's, and there are no plans to execute a conversion
    within the ARNG for any additional Stryker Brigades. Total Army
    Analysis 14-18 examines the feasibility, acceptability, and
    supportability of resourcing a second SBCT via a holistic review of the
    Army's BCTs and enabler force requirements. Accordingly, the ARNG will
    work with HQDA to ensure the Army Operational Force is properly
    balanced.
        The stationing of a second SBCT will occur only after HQDA approval
    and is based on several factors: readiness for the least cost (to
    include geographic location, existing infrastructure, and level of
    modernization), available training areas and capacities, personnel
    strength, and demonstrated capacity to produce ready formations over
    time.
                                     ______

                   Question Submitted by Senator Thad Cochran
                         army guard permanent director
        Question. General Carpenter, as Acting Director of the Army
    National Guard (ARNG), part of your responsibility is to be a steward
    of the position until a permanent director is named. Are there
    decisions the Army Guard has delayed making due to your 2-year
    stewardship of the position?
        Answer. The twin challenges of having an acting Director and one
    not being at the three-star level have put the ARNG at a disadvantage
    from two aspects. First, it has hindered the ability of the
    organization to formulate and execute a long-term strategic plan and
    has delayed permanent manning of key positions on the team. The
    perceptions and realities generated by a Director in ``acting'' status
    for an extended period of time are counterproductive. Second, the ARNG
    has occasionally not had access to meetings and discussions that are
    limited to three- and four-star generals. This exclusion becomes even
    more critical as contentious budget deliberations occur in the months
    ahead.
                                     ______

                   Question Submitted by Senator Tim Johnson
        Question. With the increased reliance on the National Guard for
    operational mission support and the overwhelming need to improve
    facilities for training, are you receiving the appropriate support,
    despite eliminating earmarks, with getting construction projects onto
    the Future Years Defense Program (FYDP)?
        Answer. The Army National Guard (ARNG) and its facilities will be
    adversely affected if Military Construction (MILCON) funds decrease in
    future years, as of today, 40 percent of the ARNG's 26,000 facilities
    are more than 50 years old in the States, Territories, and District of
    Columbia. Assuming current projected MILCON funding levels, the ARNG
    will replace less than 1 percent of these aging facilities each year.
    Many of these older Army National Guard facilities meet neither current
    Anti-Terrorism/Force Protection requirements, nor demographic shifts in
    population, and current square footage deficits have a direct effect on
    the ARNG mission readiness. The result is an ARNG force supported by
    rapidly aging and outdated facilities that are inadequate to support
    operation readiness, and, because these facilities are not energy
    efficient, the structures are far more expensive to maintain.
        The Army Installation Status Report (ISR) currently reflects a
    $28.2 billion backlog in MILCON.
                                     ______

             Questions Submitted to Lieutenant General Jack Stultz
                Questions Submitted by Chairman Daniel K. Inouye
                       operational reserve's future role
        Question. General Stultz, the Army Reserve continues to transition
    from a strategic to an operational Reserve. What are the biggest
    challenges still remaining in making this transition, and what role do
    you see the operational Reserve playing in the near future as the wars
    in Iraq and Afghanistan wind down?
        General Stultz, do you believe the Army is adequately resourcing
    the Reserve to make this transition?
        Answer. Actually, the Army Reserve is now, and for the foreseeable
    future will continue to be, an operational force. Our soldiers and
    units are available to be mobilized worldwide in support of contingency
    operations and at home to respond to terrorism or threats of terrorism.
    We also have significant capabilities that can respond to natural and
    manmade disasters; however, our ability to do this readily is
    challenged by limited statutory call-up authority, which would like to
    see updated. We are planning on serving around the world with security
    cooperation and similar military engagement missions; however, here,
    too, updated statutory authority to access the Army Reserve and the
    other Reserve Component is needed.
        While the Army currently possesses an operational Reserve
    capability, we have yet to see an adequate investment of funding
    applied to our core manning and training base programs (which remain
    funded at the statutory minimum of approximately 39 days of training
    per year, throughout the force). All capabilities to train our
    operational force to a ``company level'' of proficiency have been
    realized through use of Overseas Contingency Operations (OCO) funding.
    Asthe OCO funding dwindles and eventually goes away, we are concerned
    that our operational capability will be lost when our primary source of
    funding is no longer available. The Army made a huge step toward
    formally recognizing this capability when the senior leadership
    recognized an increase to Army Reserve critical requirements in key
    manning and training base budget accounts; however, to this point the
    Army has elected to resource these additional requirements through OCO
    funding.
                           army reserve suicide rates
        Question. General Stultz, the Army Reserve's suicide rate increased
    42 percent in 2010 with 50 reservists taking their own lives. Most of
    these suicides occurred when the soldier was in civilian, rather than
    military, status. How is the Army Reserve responding to this trend and
    addressing the mental health of soldiers beginning with recruitment and
    continuing throughout their entire service in the Reserves?
        General Stultz, is the Army Reserve properly training recruiters to
    evaluate not only the physical but also the mental fitness of new
    recruits?
        Answer. Recruiters are not responsible for establishing an
    applicant's physical or mental qualification for military service and
    receive no training specific to evaluating mental suitability.
    Potential Army recruits are required to complete a ten page pre-
    qualification questionnaire, which asks an individual about their
    personal, educational, moral, physical, military, financial, and
    employment history. Recruiters use the applicant's voluntarily
    disclosed information to conduct preliminary screening to determine
    whether the applicant meets minimum qualification standards for the
    Army. If minimum qualifications are met, the next phase of the process
    is to determine whether the applicant meets physical and mental health
    standards; this phase of the recruitment process is accomplished at a
    Military Entrance Processing Stations (MEPS).
        The MEPS plays a vital role in maintaining the Nation's All
    Volunteer Force by ensuring that each new member of the Armed Forces
    meets mental, moral and medical standards required by the Department of
    Defense (DOD) and the military services. In accordance with policies
    and regulations governed by the Military Entrance Processing Command
    (MEPCOM), medically trained personnel use a combination of tools
    including but not limited to the Report of Medical History (DOD form
    2807), Supplementary Health Questionnaire and one-on-one interface with
    medical professionals, to render a determination about an applicant's
    suitability for service. Based on the outcome of a series of
    evaluations conducted at MEPS, applicants may or may not be permitted
    to proceed with the recruitment process depending on the overall
    assessment of both the recruiter and the medical community.
        Numerous initiatives are underway to address strengthening the
    recruiting process both through the VCSA's Health Promotion/Risk
    Reduction/Suicide Prevention Task Force which has recommended to re-
    scope Service entrance standards to evaluate candidates on their
    current/potential resiliency and maturity. An additional Assistant
    Secretary of the Army for Manpower & Reserve Affairs (ASA (M&RA)) work
    group is working with Accessions Command to develop tools to better
    identify candidates who may have pre-existing mental health problems.
    The United States Army Reserve has been involved and is supportive of
    these initiatives.
                          reserve equipment shortfalls
        Question. Gentlemen, over the last several years, the Reserve
    Components have transitioned from a strategic to an operational
    Reserve, but annual budget requests have not adequately addressed the
    additional equipment requirements associated with this new role. What
    remaining equipment shortfalls most concern you, and how do these
    shortfalls affect your ability to train and deploy?
        Gentlemen, how much additional funding would you need to fully
    equip your component?
        Answer. The Army Reserve equipment top equipment shortfalls are:
    Construction Equipment more specifically the Heavy Scraper; the Command
    Post Systems and Integration (SICPS); the Family of Medium Tactical
    Vehicles (FMTV), a replacement for the nonarmored HMMWV Ambulance and
    Simulators for training.
        The Army Reserve is able to train and deploy our units but is
    dependent on the use of the training sets and the availability of
    Theater Provide Equipment (TPE). However, the shortfall of this
    equipment limits our ability to support full spectrum operations.
        The Army Reserve estimates it would cost $8.9 billion to modernize
    100 percent of the current Army Reserve equipment requirements.
              national guard and reserve equipment account (ngrea)
        Question. Gentlemen, this Committee recognizes the importance of
    providing the Reserve Components funding for necessary new equipment
    and modernizations and has consistently done so through the the NGREA.
    Please describe the importance of this additional funding to providing
    critical equipment for the Reserves.
        Historically, the Department has had some trouble in obligating
    NGREA funds in a timely manner. Please provide an update on current
    obligation rates.
        Answer. NGREA is a valuable tool that enables the Army Reserve to
    procure un-resourced modernized equipment required to train and equip
    our soldiers and units in order to support Army Reserve missions for
    the Nation.
        The Army Reserve has obligate 100 percent of its NGREA within the
    3-year time period. The NGREA obligation rate for fiscal year 2008 was
    100 percent. As of May 11, the NGREA obligation rate for fiscal year
    2009 is 94 percent and for fiscal year 2010 is 93 percent. We do not
    anticipate any issues with obligating 100 percent by the end of the
    respective fiscal years. The Army Reserve has not received fiscal year
    2011 funds yet.
                                     ______

                  Questions Submitted by Senator Patty Murray
                                    suicide
        Question. The Army Reserve experienced 50 suicides in the last
    year--an increase of 16 from the year before. I find this large
    increase to be disturbing and want to know more about what is being
    done upon the servicemember's return.
        Post-deployment, where do Army Reserves members and their family
    members turn for support when the member is not on Active Duty status?
        What programs do you feel will have the biggest impact and will be
    the most successful to mitigate future Army Reserve suicides?
        Answer. In addition to the support provided by unit commanders and
    their staff, Army Reserve Soldiers and their Families, not on Active
    Duty have several avenues they can turn to for post-deployment
    behavioral health support.
        The Army Reserve will continue to grow its Army Strong Community
    Centers (ASCCs). These centers were created to assist geographically
    dispersed soldiers and their families who may not have ready access to
    the services typically available on a military installation. The ASCC
    (currently operating as a Pilot Program at four locations), connects
    those Families with support resources in their own community. The ASCCs
    provide access, support and resources commensurate with what they would
    expect to find on a military installation.
        Soldiers and families members can also turn to their regional
    Directors of Psychological Health (DPH) who are located within one of
    four Army Reserve Regional Support Commands. In addition to supporting
    soldiers and families, these directorates were tasked to develop the
    networks within their communities that are essential in facilitating
    referrals to care providers, volunteer groups and support services that
    are critical components in delivering care, counseling and support to
    soldiers and families.
        On redeployment, soldiers and families attend the Army Reserve
    Yellow Ribbon Program (YRP) where information is provided to facilitate
    access to services and support agencies for their health and well-
    being, and Families attend classes on suicide prevention. The Army
    Reserve YRP executes its mission by developing skills in each family
    member and soldier to assure they are prepared and able to cope with
    the difficulties of extended separation and deployment--helping
    families network together, connect with each other and their unit/
    command leadership and family programs' staff.
        Military OneSource offers nonmedical counseling options to Active
    Duty, Guard, and Reserve members and their families. The counseling
    services are designed to provide help for soldiers and families with
    short-term issues such as adjustment to situational stressors, stress
    management, decisionmaking. Military OneSource also offers post-
    deployment resource for soldiers and families is communication, grief,
    family issues, parenting-skills issues and short-term, solution-focused
    financial counseling. All of these services are offered at no cost to
    the soldiers and their family members.
        Currently the two programs that will have the biggest impact on
    reducing suicides in the Army Reserve are the Suicide Prevention
    Programs and the Comprehensive Soldier Fitness program.
        The Army Reserve's Suicide Prevention program is based around four
    pillars. These pillars involve educating the entire force; reducing the
    stigma associated with asking for help with behavioral/mental health
    issues; providing resources to geographically dispersed personnel; and
    involving Families in suicide prevention training. Examples of these
    efforts include the Ask, Care, and Escort (ACE) training for Soldiers
    and leaders; applied suicide intervention skills training (ASIST);
    battle buddy system with suicide prevention emphasis; and additional
    instructional material on suicide prevention at the Army Reserve's Pre-
    Command Courses and Yellow Ribbon and Strong Bonds events.
        One program that will undoubtedly have a major impact on mitigating
    future Army Reserve Soldier suicides is the Comprehensive Soldier
    Fitness (CSF) Program. The CSF program initiative uses individual
    assessments, tailored virtual training, class room training and
    embedded experts to provide the critical resiliency skills our
    soldiers, family members and Army civilians need in today's Army. The
    program tools include the Global Assessment Tool (GAT); Training and
    distributing Master Resiliency Trainers (MRT) and leveraging its Human
    Capital Core Enterprise (HCCE) structure to support soldiers health and
    wellness needs. For example, the MRTs will deliver vital resiliency and
    coping skills which ultimately enhances soldiers' and their families'
    ability to manage/balance the daily challenges of family, social and
    professional obligations.
                                     ______

                Questions Submitted to Vice Admiral Dirk Debbink
                Questions Submitted by Chairman Daniel K. Inouye
                        navy reserve--officer recruiting
        Question. Vice Admiral Debbink, over the last several years the
    Navy Reserve has struggled with officer recruiting and is still facing
    a serious officer shortage due to years of low recruiting. In 2010, the
    Navy followed the lead of the other Services and began commissioning
    some Naval Reserve Officer Training Corps (NROTC) accessions directly
    into the Reserve Component.
        Do you think this policy change will be enough to reduce the
    officer shortage within the Reserves?
        Answer. The policy change, which will commission Navy Reserve
    Officer Training Corps accessions into the Individual Ready Reserve
    (IRR) will not address shortages in the Selected Reserve (SELRES), and
    was not intended to do so. These newly commissioned officers, who do
    not possess the requisite skills, experience or seniority required in
    SELRES communities experiencing shortfalls, will remain in the IRR in
    non-pay, non-drill status until their training commences, or the
    beginning of the next fiscal year.
        Question. What additional measures are being considered by the Navy
    Reserve to address remaining officer shortages?
        Answer. To address challenges in the Reserve officer mission, we
    have:
      --Established targeted bonuses and incentives to increase Reserve
            affiliation and retention in specific officer communities based
            on relative need, while an officer retention bonus is currently
            being considered by OSD. In fiscal year 2011, an affiliation
            bonus for prior service officers, an accession bonus for direct
            commission officers, and health professional critical-skill
            shortage incentives were offered to SELRES officers.
      --Implemented a mobilization deferment policy that stipulates that an
            officer who affiliates within 6 months of release from Active
            Duty is guaranteed a 2-year mobilization deferment, while an
            officer who affiliates within 7-12 months receives a 1-year
            deferment.
      --Increased the number of officers accessed through direct commission
            (845 in fiscal year 2010 to 990 in fiscal year 2011) and the
            number of officer communities that have a direct commission
            officer program from 19 to 25.
      --Established a Career Transition Office (CTO) to increase Reserve
            affiliation rates by educating members leaving Active Duty
            about the benefits of continuing their Navy careers in the Navy
            Reserve and to streamline the transition process. Since the CTO
            was established in May 2009, we have increased, from 22 percent
            to 47 percent, the percentage of officers affiliating in the
            Reserve Component directly upon leaving Active Duty.
            Affiliation rates in fiscal year 2011 to date have exceeded 50
            percent, and we have increased from 25 percent to 99.8 percent
            the percentage of officers leaving Active Duty who have been
            educated about Reserve opportunities. The CTO has reduced
            average AC to RC transition time from more than a month to 5
            days, resulting in higher overall affiliation rates and fewer
            pay problems.
      --Instituted targeted leadership development and Interactive Customer
            Evaluation (ICE) at Reserve Forces Command to identify problem
            areas and improve the Navy drilling Reserve experience to
            increase retention.
                          reserve equipment shortfalls
        Question. Gentlemen, over the last several years, the Reserve
    Components have transitioned from a strategic to an operational
    Reserve, but annual budget requests have not adequately addressed the
    additional equipment requirements associated with this new role.
        What remaining equipment shortfalls most concern you, and how do
    these shortfalls affect your ability to train and deploy?
        Answer. The Navy Reserve equipment shortfalls are published in
    Table 8 of the National Guard and Reserve Equipment Report. The Navy
    Reserve's top equipment priorities continue to be aircraft procurement
    and the outfitting of the Navy Expeditionary Combat Command.
        Question. How much additional funding would you need to fully equip
    your component?
        Answer. The budget as submitted by the President will allow the
    Navy Reserve to carry out its mission as part of Navy's Total Force.
              national guard and reserve equipment account (ngrea)
        Question. Gentlemen, this Committee recognizes the importance of
    providing the Reserve Components funding for necessary new equipment
    and modernizations and has consistently done so through the NGREA.
        Please describe the importance of this additional funding to
    providing critical equipment for the Reserves.
        Answer. The NGREA has been a high-impact critical capital infusion
    for the Navy Reserve since its inception in 1981, but has taken on
    added importance in recent years with our transition to providing even
    more operational capabilities to the Navy and Marine Corps team, and
    joint forces. The appropriation has been instrumental in resourcing the
    capabilities of the Navy Expeditionary Combat Command (NECC) and has
    bolstered the recapitalization of critical Reserve Component (RC)
    equipment in both Naval Aviation and the Surface Navy. In fiscal year
    2010, the Navy Reserve executed NGREA funding to equip the Maritime
    Expeditionary Security Force (MESF), Explosive Ordnance Disposal (EOD),
    Naval Construction Force (NCF), Navy Expeditionary Logistics Support
    Group (NAVELSG), Naval Aviation and Surface Warfare units with:
    tactical and armored vehicles, civil engineering equipment,
    communications equipment, table of allowance items, aviation
    modernization upgrades and rigid hull inflatable boats.
        Question. Historically, the Department has had some trouble in
    obligating NGREA funds in a timely manner. Please provide an update on
    current obligation rates.
        Answer. Below are the current obligation rates for the three active
    NGREA appropriation years:

                                                  [Dollars in millions]
    ----------------------------------------------------------------------------------------------------------------
                                                  Final year        2nd year          1st year         Cong. Adds
    ----------------------------------------------------------------------------------------------------------------
    Fiscal year 2009:
        Appropriated..........................           $51.9             $51.9             $51.9             $25
        Percent obligated.....................        \1\ 94.3              87.3              17.4          \2\ 89.4
    Fiscal year 2010:
        Appropriated..........................  ..............             $55               $55    ................
        Percent obligated.....................  ..............          \3\ 65.5              37.1  ................
    Fiscal year 2011:
        Appropriated..........................  ..............  ................             $70    ................
        Percent obligated.....................  ..............  ................         ( \4\ )    ................
    ----------------------------------------------------------------------------------------------------------------
    \1\ The $3.2 million which is currently unobligated is for an F-5 Trainer upgrade and will be obligated before
      the end of the fiscal year.
    \2\ The $2.6 million which is currently unobligated is for the C-130 Electronic Prop Control System and will be
      obligated before the end of the fiscal year.
    \3\ The $19 million which is currently unobligated is for a C-130 Simulator upgrade and for some NCF equipment.
      Navy is on track to have all $55 obligated by the end of the 3rd year.
    \4\ The $70 million has not yet been received by OSD.

                       operational reserve's future role
        Question. Gentlemen, the Reserve Components continue to transition
    from a strategic to an operational Reserve.
        What are the biggest challenges still remaining in making this
    transition, and what role do you see the operational Reserve playing in
    the near future as the wars in Iraq and Afghanistan wind down?
        Answer. The greatest challenge will be to communicate a common
    understanding of the transition to ensure we do not inadvertently
    overburden our Guard and Reserve Components. The Navy Reserve provides
    strategic depth and delivers operational capability. For the sake of
    the Nation and to ensure our long-term viability, the Reserve Force
    needs to be able to perform both these missions. If we
    ``operationalize'' the entire Navy Reserve, it becomes unsustainable
    from a manpower and fiscal perspective. At any given time,
    approximately two-thirds of our Navy Reserve is providing strategic
    depth, while approximately one-third is in a more operational posture.
    To be able to deliver operational capabilities in the future, the other
    challenge in this period of transition is to provide timely access to
    Reserve Force personnel during periods of relative geopolitical
    stability. In an era in which emerging global contingencies, which do
    not warrant a congressional or Presidential declaration of war or
    national emergency, the Department of Defense lacks the flexibility to
    access RC members to participate in total force solutions to meet
    rapidly evolving requirements. Section 513 of the President's National
    Defense Authorization Request for fiscal year 2012, includes a
    provision which, if enacted, would amend title 10, United States Code,
    section 12304 to:
      --Enhance Total Force capacity by allowing RC units and members to be
            included in long-range planning processes;
      --Provide the opportunity to enhance dwell/ITEMPO to desired levels
            through increased capacity provided by RC units and members;
      --Enhance the overall readiness of RC units with high-demand skill
            sets, ensuring a more robust total force response capacity for
            future contingency operations;
      --Provide predictability of future routine military obligations for
            individual Reserve members, their families and their employers;
            and
      --Provide a mechanism to access RC members for routine requirements
            assured of the various protections currently granted for other
            involuntary duty assignments.
        I urge Congress to enact this important provision, to facilitate
    transition to an operational Reserve, as the National Defense
    Authorization Act is taken up in the weeks ahead.
        Question. Do you believe the Department is adequately resourcing
    the Reserves to make this transition?
        Answer. The Department is adequately resourcing the Navy Reserve as
    we continue transitioning from a strategic to an operational Reserve.
                                     ______

             Questions Submitted to Major General Darrell L. Moore
                Questions Submitted by Chairman Daniel K. Inouye
                   marine corps reserve--strain on the force
        Question. General Moore, the Marine Corps Reserve has maintained a
    high-operational tempo with nearly 60,000 marine reservists activated
    since 2001 and more than 20,000 marine reservists deployed more than
    once.
        While the operational tempo is beginning to slow, how has the
    Marine Corps Reserve been keeping track of the welfare and mental
    health of deactivated reservists who are returning from deployments?
        Answer. Our marines, sailors, and their families remain our highest
    priority. Accordingly, we are keenly attentive to their health and
    resiliency, especially for our reservists who are deactivated after
    returning home from theater security cooperation and overseas
    contingency operation deployments. There are three current initiatives
    that specifically support our returning warriors: medical intervention,
    the Psychological Health Outreach Program (PHOP), and incorporating
    Veterans Administration (VA) OIF/OEF Group support.
        First, returning marines who need prompt intervention are retained
    on medical hold (MedHold) or have Line of Duty (LOD) packages opened.
    These marines or sailors are then tracked until they are returned to
    full duty or have their cases referred to the Disability Evaluation
    System for final adjudication.
        The second initiative we implemented is the PHOP, which provides
    psychological health professionals at six regional Marine Forces
    Reserve sites to screen and refer Selected Marine Corps Reserve
    personnel for behavioral health services. Marines who self-refer or are
    referred to the program can be screened for behavioral health issues,
    appropriately referred, and provided a road to recovery. Outreach
    members follow each referred reservist through to the resolution of
    that member's case, whether it is return to Active Reserve status or
    resolution through the Disability Evaluation System.
        Our third initiative is the inclusion of VA OIF/OEF Groups at the
    local VA hospitals and clinics that support individual returning
    marines. These groups meet those returning marines at the Reserve-
    Intermediate Location (R-ILOC), enroll them in the VA healthcare system
    and provide them a medical home at the VA. The goal is to encourage
    every returning marine to be seen by the OIF/OEF Group at his or her
    local VA for a comprehensive evaluation as soon as possible after
    returning home and to have a primary care manager assigned.
        Our strategy is for the Medical Department Representative at the
    Home Training Center, the Psychological Health Outreach Coordinator,
    the VA OIF/OEF primary care manager, and the Wounded Warrior Regiment
    to work as a team to ensure that every returning marine is provided the
    care he or she needs. Every returning marine with a problem will be
    tracked to completion while we ensure he or she has a medical home at
    the VA.
        Question. General Moore, do you think the Marine Corps should
    follow the Army's lead and begin tracking Reserve Component suicides
    separately from the Active Component?
        Answer. The Marine Corps tracks and reports suicides of Reserve
    Component marines who are in an Active status in accordance with
    Department of Defense (DOD) policy. In January 2009, the Marine Corps
    began tracking suicides of Selected Reserve Marines who are not in an
    Active status, which is also consistent with DOD policy.
                          reserve equipment shortfalls
        Question. Gentlemen, over the last several years, the Reserve
    Components have transitioned from a strategic to an operational
    Reserve, but annual budget requests have not adequately addressed the
    additional equipment requirements associated with this new role.
        What remaining equipment shortfalls most concern you, and how do
    these shortfalls affect your ability to train and deploy?
        Answer. Current equipping priorities are focused on the
    modernization of existing capabilities. Since Marine Corps Reserve
    units deploy and fall in on equipment that is already in theater, it is
    essential that we continue to maintain our commitment to outfitting the
    Marine Corps Reserve with the same modernized equipment as the Active
    Component. This enables our Reserve Forces to be trained to the same
    standard on the same equipment that they will be using in combat. The
    top ten shortfalls listed in our fiscal year 2012 National Guard and
    Reserve Equipment Report fall into three main programs that continue to
    be our top priorities:
      --Light Armored Vehicles (LAV);
      --KC-130J refueler aircraft; and
      --Logistics Vehicle System Replacement (LVSR).
        The first priority is procurement of the few remaining A2-standard
    modernized LAVs. Through a combination of National Guard & Reserve
    Equipment Appropriation (NGREA) and baseline dollars, we have been able
    to close that gap to a shortfall of 18 vehicles. The estimated cost to
    procure those remaining vehicles is $50 million.
        The second priority is accelerating the transition from the KC-130T
    to the KC-130J aircraft. The Active Component has completely divested
    of legacy KC-130Ts and will complete KC-130J fielding in fiscal year
    2012. The Reserve KC-130J fielding schedule is programmed to begin in
    fiscal year 2015 and complete by fiscal year 2029. The additional cost
    to transition to a KC-130J-only fleet within this Future Years Defense
    Program (FYDP) is approximately $2.2B which equates to approximately
    $108 million per aircraft (total weapons system cost, which includes
    support equipment, tools, spares) for 20 aircraft plus $50 million for
    two KC-130J Weapons Systems Trainers.
      --The Marine Corps has eliminated all formal schooling and the Fleet
            Replacement Squadron for the KC-130T pilots and reduced the
            enlisted aircrew requirement from one enlisted crewmember in
            each of four enlisted aircrew Military Occupational Specialties
            (MOS) to two enlisted crewmen under one new enlisted aircrew
            MOS. Additionally, MOS schools are no longer teaching all of
            the KC-130T maintenance.
      --The elimination of all formal schooling and the Fleet Replacement
            Squadron for the KC-130T pilots along with the reductions in
            teaching KC-130T maintenance places an extensive on the job
            training (OJT) burden with the Reserve Component for training
            associated with the transition/conversion.
      --Because the Active Component and sister services have or are
            currently completing the KC-130J transition, the RC KC-130T's
            Full Mission Capability rate (FMC)--an individual aircraft's
            ability to perform 100 percent of the possible missions--
            continues to decline. Prolonged transition to the KC-130J
            increases risk for degraded operational capability due to
            nonavailability of parts as manufacturers discontinue
            production and civil Communication Navigation Surveillance and
            Air Traffic Management (CNS/ATM) mandates. A recent KC-130
            Program Office (PMA 207) Analysis of KC-130T FMC rates depicts
            them dropping below acceptable levels before 2020.
        The third modernization priority is replacement of the legacy
    Logistics Vehicle System (LVS) with the LVSR. Using fiscal year 2011
    NGREA, we have closed this gap significantly and require about $8
    million to procure 22 vehicles and achieve 100 percent of the required
    training allowance.
        Question. How much additional funding would you need to fully equip
    your component?
        Answer. Excluding the cost to accelerate transition from the KC-
    130T to the KC-130J, the Marine Corps Reserve's estimated wartime
    requirement shortfall is $776 million. Of that amount, $396 million
    represents today's best estimate of training allowance.
        In order to support and sustain combat operations, the Marine Corps
    has drawn equipment from many sources to include the Reserve Component.
    While the actual amount of equipment taken from the Reserve Component
    training allowance was very small, significant portions of ongoing
    procurements intended to be fielded to the Reserve Component were
    redirected to support combat operations that included both Active and
    Reserve units.
        Once the Marine Corps transitions from major combat operations and
    resets equipment, we expect that many of the current training allowance
    shortfalls will be filled. Additionally, as the Marine Corps works to
    define the right mix of ground equipment necessary to transition itself
    to a ``middleweight'' force, the character of the shortfall may change
    further. As this transition progresses, we will continue to focus
    resource advocacy toward the modernization programs listed above.
              national guard and reserve equipment account (ngrea)
        Question. Gentlemen, this subcommittee recognizes the importance of
    providing the Reserve Components funding for necessary new equipment
    and modernizations and has consistently done so through the National
    Guard and Reserve Equipment Appropriation (NGREA).
        Please describe the importance of this additional funding to
    providing critical equipment for the Reserves.
        Answer. For the last several years, the Marine Corps has relied on
    NGREA to accomplish three primary goals: availability of theater-
    specific equipment; training improvement; and modernization.
        The first goal was to ensure that units and marines preparing for
    deployment had available to them for training the same theater-specific
    equipment represented in combat operations. We were able to accomplish
    this through NGREA purchases such as Rifle Combat Optics and M-4
    Carbines, various Counter Intelligence and Human Intelligence packages,
    and specialized communications and sensor packages.
        The second goal was to improve training efficiency, cost
    effectiveness, and throughput by investing in modeling and simulation
    programs that related directly to the tactics and equipment being used
    in theater. One of our most significant investments and most successful
    example of this is the Virtual Combat Convoy Training System.
        The third goal was to invest in modernization programs of record
    (POR) such as Light Armored Vehicles and aircraft upgrades such as
    Bright Star FLIR. We expect that in the future NGREA will continue to
    be used primarily in support of accelerating modernization efforts
    within the Marine Reserve.
        Question. Historically, the Department has had some trouble in
    obligating NGREA funds in a timely manner. Please provide an update on
    current obligation rates.
        Answer. Fiscal year 2009 NGREA ($62 million) is currently 91.9
    percent obligated. Cost variations and economies provided us with an
    opportunity to invest in more equipment than was originally planned.
    The Marine Corps recently received approval to do final NGREA program
    realignments and is in the process of applying those funds to program
    lines and contracts for execution. We expect to obtain a 100 percent
    obligation rate by year end.
        Fiscal year 2010 NGREA ($45 million) is currently 56.8 percent
    obligated. All but $300,000 of the total appropriated is being invested
    in the procurement of LAVs at the A2 standard. LAV procurement occurs
    in two phases: vehicle manufacture, then installation of Government
    Furnished Equipment (GFE) at a government site. Delay in funds
    obligation stems from waiting to order GFE until anticipated delivery
    of completed vehicles. This process of separating the purchase into two
    phases provides maximum contracting flexibility and potential order
    economies. The LAV Program office estimates that fiscal year 2010 NGREA
    will be 80 percent obligated by the end of this fiscal year and
    foresees no challenges in reaching 100 percent obligation by the end of
    fiscal year 2012.
        Fiscal year 2011 NGREA spending plan is $70 million. The Marine
    Corps is awaiting final plan approval from OSD in order to distribute
    funds. The portion of our plan that invests in additional LAVs ($19
    million) will be subject to the same contracting strategy as above. The
    portion of our plan that invests in LVSRs may be able to take advantage
    of a large scale contract currently being put in place. If the option
    remains available to us, we should be able to rapidly obligate that
    portion of the fiscal year 2011 funding.
                       operational reserve's future role
        Question. Gentlemen, the Reserve Components continue to transition
    from a strategic to an operational Reserve.
        What are the biggest challenges still remaining in making this
    transition, and what role do you see the operational Reserve playing in
    the near future as the wars in Iraq and Afghanistan wind down?
        Answer. One challenge is ensuring we are able to access our Reserve
    units for peacetime missions unrelated to overseas contingency
    operations. Our Reserves are well-suited to perform missions, such as
    theater security cooperation, which will continue after the wars in
    Iraq and Afghanistan are over. However, to be cost-effective, we need
    to be able to access cohesive units rather than cobble together groups
    of individual volunteers. For this reason, we consider the legislative
    proposal to revise 10 USC Sec. 12304 to be critical to the success of
    an operational Reserve.
        Question. Do you believe the Department is adequately resourcing
    the Reserves to make this transition?
        Answer. Post OEF, the Marine Corps is committed to retaining and
    employing an Operational Reserve as part of our Total Force. The exact
    size and scope has yet to be determined and is likely to fluctuate
    based on the National Security Strategy and operational tempo. The most
    significant cost of employing our Reserves as an operational force
    comes in the form of manpower funding necessary for pay, allowances,
    and entitlements for reservists when on Active Duty. The Marine Corps
    will need to prioritize funding for the Operational Reserve among the
    existing Total Force programs and capabilities within our baseline
    budget.
                                     ______

       Questions Submitted to Lieutenant General Charles E. Stenner, Jr.
                Questions Submitted by Chairman Daniel K. Inouye
                   air force reserve--force generation center
        Question. General Stenner, since 2001, more than 60,500 Air Force
    Reservists have been called to Active Duty. In order to facilitate this
    high-operational tempo, the Air Force Reserve established the Force
    Generation Center (FGC) in 2010 to provide a standardized approach in
    preparing, processing, and deploying Reservists. What is the status of
    the FGC, and is it still on track to be fully operational by the end of
    2012?
        Answer. The FGC is up and running with 40 billets; about 25 moved
    from the Air Force Reserve Command Headquarters staff and 15 are new
    hires. The FGC is on track to be fully functional with 86 full time and
    27 part time reservists by August 2012.
        Question. How will the FGC benefit individual Air Force reservists?
        Answer. The establishment of the FGC provides the Air Force Reserve
    Command (AFRC) the ability to optimize force management and
    accountability of Air Force Reserve (AFR) forces by standardizing and
    streamlining coordination for the activation of Reserve Forces. The FGC
    does this by consolidating execution functions formerly fragmented
    across the AFRC HQ staff from the ``policy and guidance'' functions.
    The major commands and other users of Reserve Forces can now go to one
    center vice many sources to access AFR capability. The FGC also allows
    me to effectively track and validate from the AFR perspective where our
    folks are and how they are being used. This will increase visibility
    and accountability of Reserve Forces across all categories, some where
    we previously had limited or no real time information. As a result, the
    AFR can be more responsive to the needs of individual reservists,
    providing them greater predictability while making activation schedules
    more certain.
                          reserve equipment shortfalls
        Question. Gentlemen, over the last several years, the Reserve
    Components have transitioned from a strategic to an operational
    Reserve, but annual budget requests have not adequately addressed the
    additional equipment requirements associated with this new role. What
    remaining equipment shortfalls most concern you, and how do these
    shortfalls affect your ability to train and deploy?
        Answer. The most critical equipment shortfall for the Air Force
    Reserve (AFR) currently is the Large Aircraft Infrared Countermeasures
    System (LAIRCM) for our legacy mobility aircraft fleet. Our C-130
    fleet, with the help of National Guard and Reserve Equipment
    Appropriation (NGREA) funding, is well on its way to be completely
    modified. Air Mobility Command has a plan to modify our C-5's but
    currently is last in line to receive the upgrade. The KC-135 community
    has defined a cost-effective LAIRCM solution but is without funding.
    The Congress has been extremely generous to the AFR in the last few
    years with additive resources for modernizing our aircraft. The lack of
    these systems negatively affects our aircraft's ability to effectively
    operate and deploy in the combat environment. Non-LAIRCM equipped
    aircraft are easy prey for third- and fourth-generation man portable
    missiles being proliferated throughout the world.
        Question. Gentlemen, how much additional funding would you need to
    fully equip your component?
        Answer. The AFR currently has more than $957 million in unfunded
    equipment requirements. Of that, $70 million will be paid for with our
    fiscal year 2011 NGREA funding once our fiscal year 2011 Procurement
    Plan is approved through the Congress. We maintain the most efficient,
    experienced and operationally capable force, but operate some of the
    oldest aircraft in the Air Force fleet. The AFR is not programmed to
    recapitalize any of its legacy fleet through the current Future Years
    Defense Program (FYDP). Age of the fleet and more than 20 years of
    increased operations tempo will make replacement of our aircraft
    imperative in the years to come.
              national guard and reserve equipment account (ngrea)
        Question. Gentlemen, this Committee recognizes the importance of
    providing the Reserve Components funding for necessary new equipment
    and modernizations and has consistently done so through the NGREA.
    Please describe the importance of this additional funding to providing
    critical equipment for the Reserves.
        Answer. The NGREA is the cornerstone of the Air Force Reserve's
    (AFR) equipment modernization and replacement funding efforts. Congress
    has been extremely generous in providing the NGREA funding for the
    modernization and purchase of Air Reserve Component equipment. Without
    these funds, the modernization of AFR aircraft would have been almost
    nonexistent. The AFR does not usually rank high enough on Lead Major
    Command's modernization priority lists to receive Program Objective
    Memorandum funding. In today's constrained fiscal reality, that fact
    has even greater impact.
        Question. Historically, the Department has had some trouble in
    obligating NGREA funds in a timely manner. Please provide an update on
    current obligation rates.
        Answer. Full obligation and execution within the 3-year life of
    NGREA funds has never been an issue. In the last 12 years, the AFR has
    executed 99.7 percent of their allocated NGREA funds. The difficulty
    lies in our first year obligation rates and the reasons for those
    difficulties are many. We, in partnership with the Air National Guard,
    the Headquarters Air Force Acquisition Staff, Air Force Materiel
    Command, and the individual system program offices are currently
    working closely together to identify what the difficulties are and to
    implement new policies, procedures, and guidelines to ensure we meet
    the expectation of the Congress. As of our February 2011 NGREA
    Obligation Review, the obligation rates were: Fiscal year 2009 NGREA--
    48.5 percent, fiscal year 2009 NGREA OCO--96.8 percent, and fiscal year
    2010 NGREA--10.9 percent. We have recently re-aligned fiscal year 2009
    and fiscal year 2010 funds away from nonperforming programs to
    performing ones which will improve our obligation rates.
                       operational reserve's future role
        Question. Gentlemen, the Reserve Components continue to transition
    from a strategic to an operational Reserve. What are the biggest
    challenges still remaining in making this transition, and what role do
    you see the operational Reserve playing in the near future as the wars
    in Iraq and Afghanistan wind down?
        Answer. The Citizen Airmen of the Air Force Reserve have been
    meeting continuous and recurring operational mission commitments since
    1990. Today's security environment has led to continued demand for the
    Reserve Component to augment Active Component steady-state operational
    missions. Despite a drawdown of operations in Iraq or Afghanistan, the
    Air Force Reserve maintains its operational role while providing
    strategic depth. Our operational involvement and strategic depth are
    institutionalized and sustained by new rules within the Department, new
    planning and execution processes within the Air Force and re-calibrated
    expectations by Reservists, their families, and their employers.
        As supplemental and Overseas Contingency Operations funding wanes,
    we are challenged to ensure adequate funding exists for Reserve
    Component operational use. Budgeting for the use of the Reserve
    Component within Service base budgets helps overcome this funding
    challenge. The Nation cannot afford to put the Reserve Component ``back
    on the shelf.'' Another challenge facing the Reserve Component is the
    potential reduction of prior-service members transitioning to the
    Reserve Component. With fewer eligible Active Component members, the
    Reserve Component is faced with increased recruiting and training costs
    normally absorbed when an Active member transitions. We must rely on
    adequate funding levels to offset potential increased costs.
        Question. Do you believe the Department is adequately resourcing
    the Reserves to make this transition?
        Answer. The Department as a whole is fiscally constrained. The
    Reserve Component has become a responsive operational force that allows
    the Air Force to respond quickly and efficiently to funding reductions
    without creating warfighting capacity gaps and recruiting and training
    bills associated with the traditional force planning models. That said,
    as supplemental and Overseas Contingency Operations funding is reduced
    and as military personnel appropriations funding decreases, the
    potential for inadequate resourcing exists unless provided for in the
    Services' base budget.
        Question. The Air Force Reserve's 932nd Air Wing located at Scott
    Air Force Base in Illinois is soon scheduled to retire their three C-9C
    aircraft. Although the plan is to retain their three currently
    authorized C-40 aircraft, the 932nd is only scheduled to gain one
    additional C-40, currently in production. How will the reduction in
    total aircraft assigned to the 932nd impact their ability to perform
    their mission? Will the reduction in total aircraft assigned to the
    unit result in a decrease in personnel assigned to the unit and if so
    by how many?
        Answer. The 932nd Airlift Wing operates and maintains three C-9C
    and three C-40C aircraft. The Air Force Reserve Command (AFRC) programs
    and manages the funding for the wing's facilities, flying hours,
    support equipment, personnel training, and maintenance requirements.
        The current program of record funds C-9C operations and force
    structure through fiscal year 2011. Beginning in fiscal year 2012,
    three C-9C aircraft will be retired. AFRC has projected a 45 percent
    loss in capability from fiscal year 2011 levels of support and a
    reduction of 252 Reserve personnel. An additional C-40C is programmed
    for delivery in early fiscal year 2012 and will increase aircraft
    availability for unit operations but the unit will remain a three
    primary aircraft authorization unit. The C-9C retirement will not
    impact the unit's ability to perform its mission, however, the
    capability to meet the current level of support will be reduced.
        Please know that current mission capability and future levels of
    support are of interest and as the C-40C has no official wartime
    mission, we will strive to execute an equivalent level of service that
    three primary aircraft authorization aircraft will provide.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. This Defense Subcommittee will reconvene
    on Tuesday, May 17 at 10:30 a.m., at which time we will meet in
    closed session to receive a briefing on fiscal year 2012
    Northern Command and Southern Command programs and budgets.
        Thank you very much.
        The session is recessed.
        [Whereupon, at 11:49 a.m., Wednesday, May 11, the
    subcommittee was recessed, to reconvene subject to the call of
    the Chair.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                            WEDNESDAY, MAY 18, 2011

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:33 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senator Inouye, Leahy, Mikulski, Murray, Cochran,
    Shelby, Collins, Murkowski, and Coats.

                             DEPARTMENT OF DEFENSE

                             Department of the Army

                            Office of the Secretary

    STATEMENT OF HON. JOHN M. McHUGH, SECRETARY

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning we welcome the Honorable John
    M. McHugh, Secretary of the Army, who is providing testimony to
    our subcommittee for the second time. Beside him, we welcome
    for the first time General Martin Dempsey, the Army Chief of
    Staff. Gentlemen, I thank you on behalf of the subcommittee for
    being here with us today to review the budget request for
    fiscal year 2012.
        The Department of the Army's fiscal year 2012 base budget
    request is $144.9 billion, an increase of $7.2 billion over
    last year's enacted base budget.
        The Army is also requesting $71.1 billion for overseas
    contingency operations for fiscal year 2012, which is a
    decrease of $30.5 billion from last year's request and reflects
    the ongoing drawdown of forces from Iraq.
        As part of the fiscal year 2012 budget bill, Secretary
    Gates set a goal for the Department of Defense to achieve
    overall efficiency savings of $100 billion over the next 5
    years. The Army's share of this initiative is $29.5 billion,
    with only $2.7 billion of those savings programmed in fiscal
    year 2012, which the Army plans to achieve through aggressive
    plans to streamline headquarters, reduce overhead, terminate or
    reduce weapons systems.
        The fiscal year 2012 budget request comes at a time when
    the Army is at a turning point and is examining its post-war
    role. Your service is being challenged with sustaining an army
    at war, building readiness and strategic flexibility required
    to respond to future conflicts and accelerating the fielding of
    urgent warfighting capabilities while modernizing for future
    conflicts.
        Unfortunately, the Army does not have a good track record
    with its modernization efforts. A recent study noted that since
    2004 the service has spent between $3.3 billion and $3.8
    billion each year on programs that we eventually canceled. So I
    look forward to hearing from you today on some of the Army's
    modernization plans to develop and field a versatile and
    affordable mix of equipment to allow soldiers and units to
    succeed in both today and tomorrow's full operations.
        Along with challenges of modernizing the force, manpower
    issues are just as critical. The Army has been in continuous
    combat for 10 years, which puts a tremendous burden of stress
    on soldiers and their families. The Army has made progress in
    finding ways to mitigate the stress of multiple combat
    rotations and long family separations.
        The current size of the Army allows more time at home
    before being deployed. However, in a speech earlier this year
    at the U.S. Military Academy, Secretary Gates indicated that it
    will be increasingly difficult for Army leaders to justify the
    number, size, and costs of these heavy formations. Today I hope
    to hear your views on what the future Army force mix should be
    after operations in Iraq and Afghanistan wind down.
        Finally, I look forward to hearing from you both on your
    assessment of the Army's readiness to respond to unforeseen
    future military contingencies. We are all aware of potential
    threats from nations such as China and North Korea and Iran,
    but there are many more unknown flashpoints around the globe
    that the United States could be called upon to engage. With the
    Army continuing to support operations in Iraq and Afghanistan,
    efficiency initiatives and potentially large defense cuts to
    help reduce the national debt and difficult manpower decisions,
    I would like to get a better understanding of your concerns
    regarding the Army's readiness to respond to other
    contingencies around the world.
        And so, gentlemen, we sincerely appreciate your service to
    our Nation and the dedication and sacrifices 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. So I look forward to working with you to ensure that
    the fiscal year 2012 appropriations bill reflects the current
    and future needs of the U.S. Army.
        We have received your full statements, and I can assure you
    that they will be made part of the record.
        Now may I call upon the vice chairman, Senator Cochran?

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you. I am pleased to
    join you in welcoming our distinguished witnesses before the
    subcommittee this morning. We are here to review the budget
    request for the next fiscal year.
        The request proposes a number of significant changes and
    important budgetary issues for us to consider, but we look
    forward to working with you during the appropriations process
    as we review the budget request of the Department of the Army
    for this next fiscal year.
        We appreciate your service and we welcome you to the
    committee.
        Chairman Inouye. May I call upon Senator Shelby.
        Senator Shelby. Mr. Chairman, I look forward to hearing
    Secretary McHugh and General Dempsey. Thank you, Mr. Chairman.
        Chairman Inouye. Senator Mikulski.
        Senator Mikulski. Mr. Chairman, I just want to echo your
    remarks and that of the ranking member in thanking both
    Secretary McHugh and General Dempsey for all that they do to
    keep our country safe and to keep our troops safe. And I look
    forward to hearing their testimony in these frugal times, how
    we keep our commitment to the military in the same way that
    they keep their commitment to us.
        So thank you.
        Chairman Inouye. Senator Coats.
        Senator Coats. Mr. Chairman, I could not say it better than
    the four of you said it. I would just add a big ditto to all of
    that so we can get to the hearing.
        Chairman Inouye. Mr. Secretary.

                   SUMMARY STATEMENT OF HON. JOHN M. MC HUGH

        Mr. McHugh. Thank you very much, Mr. Chairman,
    distinguished vice chairman, Senator Cochran, members of the
    subcommittee.
        As always, it is a pleasure to be back here in the halls of
    Congress where I had the honor of serving for some 17 years,
    but especially appreciate, as you noted, Mr. Chairman, my
    second opportunity to appear before this distinguished body and
    to discuss the status today as well as the future of the
    world's greatest force for freedom, the United States Army.
        But before I begin, with your indulgence, I would like to
    recognize--not introduce because I know you all know him--but
    to recognize and express my appreciation to the Senate as a
    whole for acting very expeditiously on a nomination that I
    think President Obama made very wisely of General Marty Dempsey
    as our new Chief of Staff, 37th Chief of Staff of the Army. And
    his is a career that spans some four decades, and at every
    level at which he has served, our new chief has made incredible
    contributions. And I can say very safely, having observed him
    and now approximately a month into the job, he has already
    begun to lead and shape our force for the future challenges
    that we may face. Simply put, he is an exceptional leader. He
    is a scholar and I do believe a friend. I and, indeed, the
    entire Army family are truly excited he is on board.
        With that, I want to thank each of you on this critically
    important subcommittee for your steadfast support of our 1.1
    million soldiers, 279,000 civilian employees, and as always,
    their families who also serve. With the leadership and
    assistance of the United States Congress and particularly all
    of you, America's Army continues to be at the forefront of
    combat, counterinsurgency, counterterrorism, and security
    assistance operations in nearly 80 countries around the world.
        In Iraq, our soldiers and civilians began one of the
    largest and most complex logistical operations in our Nation's
    history. As we continue to draw down our forces to meet the
    December 31, 2011 deadline, we have already closed or
    transferred over 86 percent of the bases that we formerly
    occupied to Iraqi authorities. We have reduced the number of
    United States personnel by over 75,000 and redeployed more than
    2.3 million pieces of equipment. And having just visited in
    Iraq in January, I can tell you firsthand the enormity of that
    retrograde operation and the exceptionally high morale of our
    remaining forces as they continue to advise and assist and
    train Iraqis to support what we all recognize is still a
    burgeoning democracy.
        Simultaneously, with drawdown operations in Iraq, your army
    has surged an additional 30,000 soldiers to Afghanistan to
    defeat the al Qaeda network and the Taliban insurgency. And
    this surge has enabled our soldiers and our Afghan partners to
    seize multiple sanctuaries in the traditional insurgent
    heartland of southern Afghanistan.
        Additionally, during this past year, our forces have
    trained 109,000 Afghan National Army soldiers, as well as
    41,000 Afghan National Police. And 2 weeks ago, I visited those
    great soldiers and their leaders in Afghanistan, and although
    operating, as you know, in an extraordinarily austere and
    dangerous environment against a determined enemy, our soldiers,
    your Army, alongside our Afghan and NATO partners are defeating
    those Taliban insurgents and al Qaeda terrorists. Each day they
    are taking back enemy strongholds, while simultaneously
    protecting and providing for the Afghan people.
        Although we have seen extraordinary success in recent days,
    including a heroic raid against a key al Qaeda leader, we
    should make no mistake. The stakes in Afghanistan are high. Our
    forces remain vigilant and committed to defeating our enemies,
    supporting our allies, and protecting our Nation's security.
        And overseas contingency operations are only one part of
    our Army's diverse requirements. Our soldiers and our
    civilians, all our Army components are committed to protecting
    our homeland not only from the threat of enemies who would harm
    us, but also from the ravages of natural and manmade disasters.
    From National Guard soldiers assisting with drug enforcement
    and border security to the Army Corps of Engineers, as we have
    seen in recent days responding to the catastrophic floods along
    the Mississippi, America's Army has been there to support
    local, State, and Federal partners in saving, protecting, and
    caring for our citizens.
        As the Army continues to fight global terrorists and
    regional insurgents, we must be ever mindful of the future and
    the enemies it may bring: hybrid threats, hostile state actors,
    to name just two. It is vital, therefore, that we have a
    modernization program, one that provides our soldiers with the
    full array of equipment necessary to maintain a decisive
    advantage over the enemies we are fighting today, as well as
    deter and defeat tomorrow's threats at a price that we can
    afford.
        Our fiscal year 2012 budget request is critical to
    achieving this goal by supporting the extraordinary strides
    being made in the Army's state-of-the-art network tactical
    wheeled vehicle and combat vehicle modernization programs.
        Regarding the network, this budget requests $974 million in
    procurement and $298 million in research and development for
    the Warfighter Information Network-Tactical, WIN-T, which will
    become the cornerstone of our battlefield communications
    system.
        The budget also contains $2.1 billion in procurement for
    the joint and combat communications systems, including the
    joint tactical radio system, or JTRS.
        As we look to modernize our vehicle fleets, we are asking
    for $1.5 billion for tactical wheeled vehicle modernization and
    over $1 billion to support vital research and development for
    combat vehicle modernization, including $884 million for the
    ground combat vehicle and $156 million for the modernization of
    Stryker, Bradley, and Abrams platforms.
        Along with advances in equipment, the Army is seeking new
    methods to use and secure our scarce energy resources. Clearly,
    future operations will depend on our ability to reduce our
    dependency, increase our efficiency, and use more renewable or
    alternative sources of energy. We have made great strides in
    this area. The Army has established a senior energy council,
    appointed a senior energy executive, and adopted a
    comprehensive strategy for energy security. Based on this
    strategy, we are developing more efficient generators and power
    distribution platforms. Factoring in fuel costs is part of our
    equipment modernizations, and we have instituted a net zero
    pilot program to holistically address our installations'
    energy, water, and waste needs.
        Moreover, we are changing how we do business by undertaking
    comprehensive emphasis to reform our procurement methods. In
    2010, General Casey and I commissioned an unprecedented blue
    ribbon review of the Army acquisition systems and did it from
    cradle to grave. We are currently analyzing the panel's
    insightful report and we will use it as a guide over the next 2
    years to improve the efficiency and the effectiveness of the
    Army acquisition process.
        But we did not stop there. To ensure that we purchased the
    right equipment to meet the soldiers' needs, we instituted a
    series of capability portfolio reviews to examine all existing
    Army requirements and terminate those programs that are
    redundant, do not work, or which are just too expensive. These
    broad-based reviews have already helped us to identify key gaps
    and wasteful redundancies while promoting good stewardship of
    our Nation's resources.
        I assure you we remain committed to using every effort to
    obtain the right system, supplies, and services at the right
    time in the most cost-effective, streamlined manner possible.
    Our soldiers and the taxpayers deserve no less. We look forward
    to working closely with this committee as we continue to
    implement these sweeping changes.
        Throughout it all, at its heart, our Army is people.
    Although our soldiers and civilians are better trained, led,
    and equipped and more capable than ever before, our forces are
    clearly stretched and our personnel are strained from a decade
    of war. This is evidenced by yet another year of discouraging
    rates of suicide and high-risk behavior not only among the
    regular Army, but the reserve components as well.
        In response, under the direct supervision of our Vice Chief
    of Staff, General Pete Chiarelli, the Army completed an
    unprecedented 15-month study to better understand suicide and
    related actions amongst our soldiers. In July, we published the
    first-ever health promotion, risk reduction, and suicide
    prevention report, a very frank and candid assessment designed
    to assist our leaders in recognizing and reducing high-risk
    behavior, as well as the stigma associated with behavioral
    healthcare. The lessons from this holistic review have been
    infused into every level of command and incorporated throughout
    our efforts to strengthen the resiliency of our soldiers,
    families, and civilians.
        Moreover, our fiscal year 2012 budget request provides $1.7
    billion to fund vital soldier and family programs to provide a
    full range of essential services to include the Army Campaign
    for Health Promotion, Risk Reduction, and Suicide Prevention;
    Sexual Harassment/Assault Response and Prevention; and
    Comprehensive Soldier Fitness.
        Caring for our personnel and their families, however, goes
    beyond mental, physical, and emotional health. We are committed
    to protecting their safety both at home and abroad from the
    internal and external threats. As part of our continuing
    efforts to learn and adapt from the Fort Hood shooting, the
    Army has instituted a number of key programs to enhance
    awareness, reporting, prevention, and response to such threats.
    For example, we have implemented Eye Watch and I Salute
    programs to improve our ability to detect and mitigate high-
    risk behavior indicative of an insider threat.
        To enhance interoperability with local, regional, Federal
    agencies, Army installations will also fully implement the
    National Incident Management System by 2014. We will field the
    FBI's eGuardian system and require all installations to have
    emergency management equipment such as e-911 and mass warning
    notification systems.
        Let me close by mentioning my deep appreciation and
    admiration for all those who wear the Army uniform, as well as
    the great civilians and families who support them. Daily I am
    reminded that these heroes make enormous sacrifices for the
    defense of this Nation, sacrifices that simply cannot be
    measured.
        Moreover, I know that each of you plays a key role in the
    success of our Army. Your efforts and support ensure that our
    soldiers, civilians, and Army families receive the critical
    resources and authorities they need, and we cannot do it
    without you.

                               PREPARED STATEMENT

        So thank you. I deeply appreciate this opportunity to be
    before you, and I look forward to your questions.
        Chairman Inouye. Thank you very much, Mr. Secretary.
        [The statement follows:]
               Prepared Statement of the Honorable John M. McHugh
                                  introduction
        In the past decade, America's Army has been challenged and
    prevailed in some of the most daunting tasks in the history of our
    military. Soldiers from the Active Army, Army National Guard and Army
    Reserve demonstrate indelible spirit, sacrifice and sheer determination
    in protecting our national interests and supporting our friends and
    allies around the world.
        In the coming years, our top priorities will be to maintain our
    combat edge while we reconstitute the force for other missions and
    build resilience in our people. The Army has made significant progress
    in restoring balance through the four imperatives we identified in
    2007--sustain, prepare, reset, and transform. We are on track to
    achieve a sustainable deployment tempo for our forces and restore
    balance to the Army beginning in fiscal year 2012. We successfully
    completed combat operations in Iraq, transitioning from Operation Iraqi
    Freedom to Operation New Dawn while executing one of the largest
    wartime retrogrades in the Nation's history. Operation New Dawn marks
    the beginning of a new mission for our Army while demonstrating our
    ongoing commitment to the government and people of Iraq. Concurrently,
    we surged Soldiers to Afghanistan in support of a new strategic
    direction in this vital theater. Even with all we have done, there is
    still much work to do.
        The war is not over yet, and we remain in an era of persistent
    conflict facing an uncertain and increasingly complex strategic
    environment. Hybrid threats made up of conventional, irregular,
    criminal and terrorist capabilities will continue to test our forces.
    These threats will avoid our strengths and attack us asymmetrically.
    Therefore, we must continue to organize our formations, update our
    doctrine and prepare our forces for the full spectrum of operations.
        Additionally we remain aware of the difficult economic conditions
    at home. These conditions will drive our efforts to transform our
    generating force into an innovative and adaptive organization. We must
    adapt our institutions to effectively generate trained and ready forces
    for Full Spectrum Operations, while seeking ways to improve efficiency
    and reduce overhead expenditures that demonstrate wise stewardship of
    our taxpayers' dollars. With the continued support of the American
    people and Congress, we remain committed to the readiness and well
    being of our Soldiers, Civilians and Family members. As the Strength of
    the Nation, the American Soldier is the centerpiece of everything we
    do.
                               where we have been
        For nearly a decade, the Army has been operating at an exhausting
    pace. High operational demands have stressed our ability to supply
    trained and ready forces during most of this period. The result was an
    Army out of balance, lacking strategic flexibility to respond to other
    contingencies and lacking the ability to sustain the all-volunteer
    force. This past year the Army continued to make great strides toward
    restoring balance to the force.
        The drawdown in Iraq and change of mission from Operation Iraqi
    Freedom to Operation New Dawn on September 1, 2010 represented a
    significant accomplishment made possible by the extraordinary
    determination, hard work and sacrifice of American Soldiers, their
    Families and the Civilian workforce. During Operation New Dawn, the
    remaining 50,000 U.S. service members serving in Iraq will conduct
    stability operations focused on advising, assisting and training Iraqi
    Security Forces, all while engineering the responsible drawdown of
    combat forces in one of the largest and most complex logistical
    operations in history. The Army closed or transferred over 80 percent
    of the bases to Iraqi authorities, reduced the number of U.S. personnel
    by over 75,000 and redeployed more than 26,000 vehicles.
        Concurrently, we implemented the President's direction to surge an
    additional 30,000 Soldiers to Afghanistan to defeat the al-Qaeda
    terrorist network and the Taliban insurgency. This surge enabled our
    Soldiers and our Afghan partners to take back insurgent sanctuaries in
    the traditional insurgent Taliban heartland of southern Afghanistan.
    Additionally, during this past year our forces have trained 109,000
    Afghan National Army Soldiers, as well as 41,000 Afghan National
    Police. As a result, we are beginning to see an improvement in Afghan
    National Security Force capability.
        Last year, the Army responded to three major natural and
    environmental disasters while continuing to support homeland defense.
    The Army provided humanitarian relief in response to the devastating
    earthquake in Haiti, the summer floods in Pakistan and the catastrophic
    oil spill in the Gulf of Mexico. Additionally, our National Guard
    Soldiers were sent to the Nation's southern border to help control
    increased illegal activity. They assisted Federal law enforcement
    agencies responsible for drug enforcement and the security of our
    borders.
        During this past year the Army continued to increase its knowledge
    and understanding of Full Spectrum Operations. Last October, the Army
    conducted the first full spectrum rotation against a hybrid threat at
    the Joint Readiness Training Center, Fort Polk, Louisiana. This was the
    first time in 5 years that we have been able to conduct a training
    rotation focused on anything other than operations in Iraq and
    Afghanistan. As we continue to build dwell and increase the time
    Soldiers have at home, more units will conduct full spectrum training
    rotations at the Combat Training Centers increasing our ability to
    hedge against the unexpected and restoring strategic flexibility to the
    force.
        Though we remain heavily engaged, the Army is regaining balance. We
    are starting to be able to breathe again. We must continue efforts to
    fully restore balance while maintaining the momentum we have achieved
    over the past 4 years. The strategic environment continues to be
    complex, and the stakes are too high to become complacent or
    underprepared.
                              restoring balancing
        Through the continued support of Congress and the American people,
    we will lessen the stress on America's Army by focusing on the
    imperatives we established 4 years ago. We must continue to sustain the
    Army's Soldiers, Families and Civilians; prepare forces for success in
    the current conflicts; reset returning units; and transform the Army to
    meet the demands of the second decade of the 21st century.
                                    sustain
        Our first imperative is to sustain our all-volunteer force. We must
    reduce the stress on Soldiers, Families and Civilians who have borne
    the hardship of 9\1/2\ years of conflict. In addition to addressing
    this high level of stress, the Army invests time, energy and resources
    into quality of life programs. We must continue to inculcate resilience
    in the force, providing Soldiers, Families and Civilians the skill sets
    necessary to deal with adversity.
    Goals
        The most important component required to restore balance within our
    Army is to increase the time between deployments, known as dwell time.
    A study completed in 2009 confirmed what we already intuitively knew:
    Soldiers require at least 2 to 3 years to fully recover, both mentally
    and physically, from the rigors of a 1 year combat deployment. Training
    and schooling necessary for a professional Soldier to sustain warrior
    and leader skills are also very important. With these critical
    considerations, our interim objective is to achieve and then maintain a
    dwell time of at least 2 years at home for every year deployed for the
    active component Soldier and 4 years at home for every year mobilized
    for the reserve component Soldier. In 2011 we will examine the cost and
    benefits of increasing dwell to 1:3 and 1:5 respectively with a 9 month
    Boots on the Ground policy.
        In addition to increasing dwell time, the Army must continue to
    recruit and retain quality Soldiers and Civilians from diverse
    backgrounds. People are our most important resource, and to sustain an
    all-volunteer force it is essential to attract those with an aptitude
    for learning and then retain them as they develop the tactical,
    technical and leadership skills the Army needs. To grow and develop the
    Army's future leadership, we need appropriate incentives to encourage
    sufficient numbers of high quality personnel to continue to serve
    beyond their initial term of service.
        Another important consideration is the health of the force. We must
    provide our Soldiers and Civilians, as well as their Families, the best
    possible care, support and services by establishing a cohesive holistic
    Army-wide strategy to synchronize and integrate programs, processes and
    governance. There are myriad programs available to accomplish this,
    such as Army Family Action Plan, the Army Family Covenant and other
    community covenants. Our focus is on improving access to and
    predictability of services. We will enhance support for the wounded,
    Families of the Fallen, victims of sexual assault and those with mental
    health issues. Our effort to build an entire spectrum of wellness--
    physical, emotional, social, family and spiritual--will support
    achieving Army strategic outcomes of readiness, recruitment and
    retention. The Army is also building resilience in the force by
    addressing the cumulative effects of 9\1/2\ years of war. We have
    designed a comprehensive approach that puts mental fitness on the same
    level as physical fitness by establishing a Comprehensive Soldier
    Fitness program, developing Master Resiliency Trainers and implementing
    a campaign for Health Promotion and Risk Reduction. The Army has a
    requisite duty to provide world class healthcare for our wounded, ill
    or injured Warriors and to successfully transition these Soldiers and
    their Families back to the Army or civilian life. This is coordinated
    through the Warrior Care and Transition Program and ably led by well
    resourced Warrior Transition Units. Our final and most solemn
    responsibility is to respect and honor the sacrifice of our fallen
    comrades by continuing to support the needs of their Families.
    Progress
        Achieved 101 percent of recruiting goals for 2010, exceeding both
    numeric goals and quality benchmarks for new recruits. Over 98 percent
    of recruits had high school diplomas, the highest percentage since
    1992.
        Exceeded reenlistment goals: 114 percent for the active component
    and 106 percent for the reserve component.
        Decreased accidents and mishaps in several key categories, to
    include: Off-duty fatalities down by 20 percent; on-duty critical
    accidents down by 13 percent; Army combat vehicle accidents down by 37
    percent; and manned aircraft accidents down by 16 percent.
        Expanded Survivor Outreach Services to over 26,000 Family members,
    providing unified support and advocacy, and enhancing survivor benefits
    for the Families of our Soldiers who have made the ultimate sacrifice.
        Graduated more than 3,000 Soldiers and Civilians from the Master
    Resilience Trainer course.
        Surpassed 1 million Soldiers, Civilians and Family members who have
    completed the Army's Global Assessment Tool to begin their personal
    assessment and resilience training.
    Fiscal Year 2012 Budget Highlights for Sustain
        Provides $1.7 billion to fund vital Soldier and Family programs to
    provide a full range of essential services to include the Army Campaign
    for Heath Promotion, Risk Reduction, and Suicide Prevention; Sexual
    Harassment/Assault Response and Prevention; and Comprehensive Soldier
    Fitness. In addition, this funding supports Family services including
    welfare and recreation, youth services and child care, Survivor
    Outreach Services and education and employment opportunities for Family
    members.
        Provides Soldiers with a 1.6 percent military basic pay raise, a
    3.4 percent basic allowance for subsistence increase and a 3.1 percent
    basic allowance for housing increase.
        Continues to fund the Residential Communities Initiatives program
    which provides quality, sustainable residential communities for
    Soldiers and their Families living on-post and continues to offset out-
    of-pocket housing expenses for those residing off-post.
                                    prepare
        Properly preparing our Soldiers for combat against a ruthless and
    dedicated enemy is critical to mission success. To do so, we must
    provide the appropriate equipment and training to each Soldier and
    ensure units are appropriately manned. Our generating force must
    continuously adapt--tailoring force packages and quickly readjusting
    training, manning and equipping--to ensure units have the tools
    necessary to succeed in any conflict. At the same time, we are
    aggressively pursuing efficiency initiatives designed to reduce
    duplication, overhead and excess as well as to instill a culture of
    savings and restraint.
    Goals
        The Army identified four key goals necessary to adequately prepare
    the force for today's strategic environment. The first was to
    responsibly grow the Army. The congressionally approved growth of the
    Army was completed ahead of schedule in 2009. However, after a decade
    of persistent conflict, a number of other factors--non-deployable
    Soldiers, temporary requirements in various headquarters and transition
    teams, our wounded Warriors, elimination of stop-loss--has impacted our
    ability to adequately man units for deployment. As a result, the
    Secretary of Defense approved an additional temporary end strength of
    22,000 Soldiers, 7,000 of whom were integrated in 2010. The Army will
    return to the congressionally approved active component end strength of
    547,400 by the end of fiscal year 2013. The second key goal addressed
    training. The Army will continue its commitment to leader, individual
    and collective training in order to remain mentally, physically and
    emotionally agile against a highly decentralized and adaptive foe. The
    third key goal is to provide the Army with effective equipment in a
    timely and efficient manner. We must implement a new materiel
    management approach to ensure a timely availability of equipment that
    not only protects our Soldiers and maintains our technological edge,
    but does so prudently.
        The final and most critical goal is to fully embrace our rotational
    readiness model--a process we call Army Force Generation (ARFORGEN).
    ARFORGEN will allow a steady, predictable flow of trained and ready
    forces to meet the Nation's needs across the full spectrum of conflict.
    Drawing from both active and reserve components, the ARFORGEN process
    allows us to consistently generate one corps headquarters, five
    division headquarters, 20 brigade combat teams, and 90,000 enabler
    Soldiers (i.e., combat support and combat service support). When the
    current demand comes down, it will allow us to build and maintain the
    ability to surge one corps headquarters, three division headquarters,
    10 brigade combat teams and 40,000 enabler Soldiers as a hedge against
    contingencies. ARFORGEN also allows a predictable and sustainable dwell
    time for Soldiers. We are currently working to better align the
    generating force activities and business processes that support
    ARFORGEN.
    Progress
        Trained and deployed seven division headquarters, 16 brigade combat
    teams, four combat aviation brigades, and eight multi-functional/
    functional brigades for deployments to Operation New Dawn and Operation
    Enduring Freedom in 2010.
        Increased Army inventory of Mine Resistant Ambush Protected
    vehicles to 20,000 vehicles.
        Deployed more than 4,300 Army Civilians to Iraq and Afghanistan to
    support operations in both theaters.
        Discontinued the Stop Loss program; last Soldiers affected by the
    policy will leave active duty in early 2011.
    Fiscal Year 2012 Budget Highlights for Prepare
        Supports a permanent, all volunteer force end strength of 547,400
    for the active component, 358,200 for the National Guard and 205,000
    for the Army Reserve in the base budget. Provides for a 22,000
    temporary increase in the active component in the Overseas Contingency
    Operations request (14,600 end strength on September 30, 2012).
        Includes $2.1 billion in procurement for Joint and Combat
    Communications Systems, including the Joint Tactical Radio System
    (JTRS), and an additional $1.5 billion in Tactical Wheeled Vehicle
    modernization funding.
        Provides over $5.6 billion for the Army to implement training
    strategies in support of Full Spectrum Operations, designed to prepare
    units for any mission along the spectrum of conflict, i.e., to perform
    the fundamental aspects of offense, defense, and stability operations
    against hybrid threats in contemporary operational environments.
        Invests $1.5 billion in 71 UH-60M/HH-60M Black Hawk Helicopters--a
    critical step in modernizing the utility helicopter fleet. Provides a
    digitized cockpit, new engine for improved lift and range, and wide-
    chord rotor blades.
        Devotes $1.4 billion to procure 32 new and 15 remanufactured CH-47F
    Chinook Helicopters with a new airframe, Common Avionics Architecture
    System (CAAS), digital cockpit and a digital advanced flight control
    system, as well as an additional $1.04 billion to modernize the AH-64
    Apache.
                                     reset
        In order to ensure a quality force and a level of readiness
    necessary for the complex range of future missions, we must continue to
    reset our units' Soldiers, Families and equipment. This is especially
    critical given the tempo of deployments. It is a process that must
    continue for two to three years after the end of operations in
    Afghanistan and Iraq.
    Goals
        In order to achieve our reset goals, we continue every effort to
    revitalize Soldiers and Families by allowing them an opportunity to
    reestablish, nurture and strengthen personal relationships immediately
    following a deployment. This includes a review of our procedures for
    demobilization of reserve component Soldiers. We strive to make this
    post-deployment period as predictable and stable as possible. The Army
    also seeks to repair, replace and recapitalize equipment. As we
    continue the responsible drawdown in Iraq while simultaneously building
    up capability to complete our mission in Afghanistan, it is critical
    that we efficiently replace all equipment that has been destroyed, and
    that we repair or recapitalize equipment impacted by extreme
    environmental conditions or combat operations. We will achieve this by
    adapting the production and manufacturing processes in our arsenals and
    depots, sustaining existing efficiencies, improving collaboration and
    eliminating redundancies in materiel management and distribution. This
    will save the Army money in equipment costs and lessen the strain on
    the supply lines into and out of combat theaters. We finished the reset
    pilot program which was designed to improve the efficiency and
    effectiveness of the reset process, and we will continue to apply
    lessons learned. As we drawdown in Iraq and eventually in Afghanistan,
    we will continue to focus on retraining Soldiers, units and leaders in
    order to effectively reset the force. Too often over the last 9\1/2\
    years, the Army had to prioritize deployment over certain education and
    training opportunities for Soldiers. Given the uncertain strategic
    environment we face in the future, it is critical that the Army focus
    on education and leader development as well as provide Soldiers, units
    and leaders training for full spectrum operations.
    Progress
        Sponsored over 2,600 Strong Bonds events designed to strengthen
    Army Families with over 160,000 Soldiers and Family members
    participating.
        Completed the reset of 29 brigades' worth of equipment, and
    continued the reset of 13 more.
        Distributed 1.3 million pieces of equipment, closed or transferred
    418 bases, drew down 16 Supply Support Activities and redeployed over
    76,000 U.S. military, civilian and coalition personnel--all in support
    of the responsible drawdown of forces from Iraq.
        Deployed Army aircraft with Condition Based Maintenance plus (CBM+)
    technologies into combat theaters. CBM+ is a proactive maintenance
    capability that uses sensor-based health indications to predict failure
    in advance of the event providing the ability to take appropriate
    preventive measures. A cost-benefit analysis for CBM+ indicated that it
    has a Benefit-to-Investment Ratio of 1.2:1 given a 10 year operations
    period.
    Fiscal Year 2012 Budget Highlights for Reset
        Provides $4.4 billion to reset Army equipment through the Overseas
    Contingency Operations (OCO) request.
        Continues to support training and sustainment of Army forces
    including individual skills and leader training; combined arms training
    toward full spectrum operations; and adaptable, phased training based
    on the Army Force Generation (ARFORGEN) process.
                                   transform
        In order to provide combatant commanders with tailored,
    strategically responsive forces that can dominate across the spectrum
    of conflict in an uncertain threat environment, the Army continues to
    transform our operating force by building versatile, agile units
    capable of adapting to changing environments. We continue to convert
    brigades to more deployable, tailorable and versatile modular
    organizations while rebalancing our skills to better prepare for the
    future. This process not only positions us to win today's conflicts,
    but it also sets the conditions for future success.
        To support the operating force, our generating force must become a
    force driven by innovation, able to adapt quickly and field what our
    Soldiers and their Families will require. We must transform the
    business systems of our generating force by developing a fully
    integrated management system, improving the ARFORGEN process, adopting
    an enterprise approach and reforming the requirements and resource
    processes that synchronize materiel distribution, training and
    staffing. Transformation of the generating force is key to our ability
    to effectively manage, generate and sustain a balanced Army for the
    21st century.
    Goals
        Our plan identifies five goals necessary for effective
    transformation. The first is completing our modular reorganization. Our
    plan calls for converting all Army brigades from cold war formations to
    more deployable, tailorable and versatile modular formations. Our
    reorganized units have proven themselves extremely powerful and
    effective on today's battlefields. The second goal involves accelerated
    fielding of proven, advanced technologies as part of our modernization
    of the force. The Army will develop and field versatile, affordable,
    survivable and networked equipment to ensure our Soldiers maintain a
    decisive advantage over any enemy they confront. In the Information
    Age, the Army must be networked at all times to enable collaboration
    with Joint, combined, coalition and other mission partners to ensure
    our Soldiers have a decisive advantage. Third, we must institutionalize
    the investment in our reserve component and obtain assured and
    predictable access to them, so that the Army can achieve the strategic
    flexibility and operational depth required to respond to emerging
    contingencies across the spectrum of conflict. We are systematically
    building and sustaining readiness while increasing predictability for
    reserve component Soldiers, Families, employers and communities through
    the ARFORGEN process. We must modify Army policies and update
    congressional authorizations in order to fully realize the potential of
    an operationalized reserve component and capitalize on their
    significant combat experience. The fourth goal is the re-stationing of
    forces and Families around the world based on the Base Realignment and
    Closure statute. The Army is in the final year of this complex and
    detailed 5 year effort that has created improved work and training
    facilities for our Soldiers and Civilians as well as new or improved
    housing, medical and child care facilities for our Families. The last
    aspect of transformation is Soldier and leader development, which is an
    important factor in maintaining the profession of arms. Today's Army
    has a tremendous amount of combat experience that must be augmented
    with continued professional education and broadening opportunities in
    order to develop agile and adaptive military and civilian leaders who
    are able to operate effectively in Joint, interagency,
    intergovernmental and multi-national environments.
    Progress
        Reached 98 percent completion of the modular conversion of the
    Army. The fiscal year 2012 budget will support completion of this
    process.
        Restored nearly a brigade combat team's worth of equipment and its
    entire sustainment package in the Army Pre-Positioned Stocks program
    for the first time since 2002, greatly enhancing the Army's strategic
    flexibility.
        Provided identity management capabilities for the Department of
    Defense (DOD) and other U.S. Government and international partners
    through the DOD Automated Biometric Identification System. The nearly
    1.3 million biometric entries enabled latent identification of
    approximately 700 Improvised Explosive Device (IED) events, 1,200 IED-
    related watch list hits, and 775 high-value individual captures in
    2010.
        Issued Soldiers in the 10th Mountain Division and 101st Airborne
    Division the Soldier Plate Carrier System--a lightweight vest that
    provides ballistic protection equal to the Improved Outer Tactical Vest
    in a standalone capacity while reducing the Soldier's load, enhancing
    comfort and optimizing mobility.
        Fielded 20 million Enhanced Performance Rounds, providing our
    Soldiers with leap-ahead performance over the previous 5.56 mm round.
    The Enhanced Performance Round provides excellent performance against
    soft targets, has an exposed penetrator that is larger and sharper to
    penetrate hard targets and is more effective at extended ranges. The
    round is also lead-free.
        Educated over 300 General Officers and Senior Civilian Leaders in
    business transformation concepts and management practices through the
    Army Strategic Leadership Development Program.
        Disposed of over 24,000 acres and closed three active installations
    and five U.S. Army Reserve Centers and is on course to complete BRAC in
    fiscal year 2011.
        Supported DOD in Chemical, Biological, Radiological, Nuclear and
    High Yield Explosives (CBRN) Consequence Management support required
    for a deliberate or inadvertent CBRN incident by transforming the CBRN
    Consequence Management Response Force (CCMRF) to a new response force
    within the CBRN Consequence Management Enterprise. The CBRN Consequence
    Management Enterprise consists of a Defense CBRN Response Force, two
    Command and Control CBRN Response Elements, 10 Homeland Response
    Forces, 17 CBRN Enhanced Response Force Packages, and 57 Weapons of
    Mass Destruction Civil Support Teams.
    Fiscal Year 2012 Budget Highlights for Transform
        Provides $974 million in procurement and $298 million in continued
    Research, Development, Test and Evaluation of the Warfighter
    Information Network-Tactical (WIN-T) which will become the cornerstone
    tactical communications system by providing a single integrating
    framework for the Army's battlefield networks.
        Provides $1.04 billion in support of the Army's Combat Vehicle
    Modernization Strategy including $884 million for the Ground Combat
    Vehicle and $156 million for the modernization of the Stryker, Bradley
    and Abrams combat vehicles.
                               strategic context
        As America enters the second decade of the 21st century, the Army
    faces a broad array of challenges. First and foremost, we must succeed
    in Afghanistan and Iraq and continue to combat violent extremist
    movements such as al-Qaeda and other terrorist organizations. We must
    also prepare for future national security challenges that range across
    the spectrum of conflict. All of this must be accomplished within the
    context of challenging global economic conditions.
    Global Trends
        Global trends will continue to shape the international environment.
    Although such trends pose both dilemmas and opportunities, their
    collective impact will increase security challenges and frame the
    conflicts that will confront the United States and our allies.
        Globalization has spread prosperity around the globe and will
    continue to reduce barriers to trade, finance and economic growth.
    However, it will also continue to exacerbate tensions between the
    wealthy and the poor. Almost 85 percent of the world's wealth is held
    by 10 percent of the population while only 1 percent of the global
    wealth is shared by the bottom 50 percent of the world's population.
    This disparity can create populations that are vulnerable to
    radicalization.
        Globalization is made possible through significant technological
    advances that benefit people around the world. Unfortunately, the same
    technology that facilitates an interconnected world is also used by
    extremist groups to proliferate their ideology and foment terrorism.
    Additionally, there are an increasing number of foreign government-
    sponsored cyber programs, politically motivated individuals, non-state
    actors and criminals who are capable of initiating potentially
    debilitating attacks on the electronic infrastructure of our Nation and
    allies.
        Population growth in the developing world creates new markets, but
    the accompanying youth bulge can create a population of unemployed,
    disenfranchised individuals susceptible to extremist teachings that
    threaten stability and security. Furthermore, the bulk of the
    population growth is expected to occur in urban areas. Future military
    operations are more likely to occur in densely populated urban
    terrain--among the people rather than around them.
        The demand for resources such as water, energy and food will
    increase competition and the propensity for conflict. Even as countries
    develop more efficient uses of natural resources, some countries,
    particularly those with burgeoning middle classes, will exacerbate
    demands on already scarce resources.
        Proliferation and failing states continue to be the two trends of
    greatest concern. Proliferation of weapons of mass destruction
    increases the potential for destabilizing catastrophic attacks.
    Meanwhile, failed or failing states that lack the capacity or will to
    maintain territorial control can provide safe havens for terrorist
    groups to plan and export terror. The merging of these two trends is
    particularly worrisome: failing states that offer safe haven to
    terrorists seeking weapons of mass destruction. Al-Qaida and affiliated
    terrorist groups already seek weapons of mass destruction and will use
    them against Western interests given the opportunity.
    Persistent Conflict
        Persistent conflict has characterized the environment in which the
    Army has operated over the last 9\1/2\ years. This protracted
    confrontation among state, non-state and individual actors, using
    violence to further their ideological and political goals, will likely
    continue well into the second decade of the 21st century. As a result,
    our commitments in the future will be more frequent and continuous.
    Conflicts will arise unpredictably, vary in intensity and scope and
    will be less susceptible to traditional means of conflict resolution.
    Concurrently, the Army's Soldiers and Civilians will respond to natural
    disasters and humanitarian emergencies in support of civil authorities
    both at home and abroad. The Nation will continue to rely upon the Army
    to be ready to conduct a wide range of operations from humanitarian and
    civil support to counterinsurgency to general war.
        Violent extremism in various forms will continue to constitute the
    most likely and immediate threat around the world. A more dangerous
    threat will come from emergent hybrid adversaries who combine the
    agility and flexibility of being an irregular and decentralized enemy
    with the power and technology of a nation state. These security
    challenges, in whatever form they are manifested, constitute the threat
    that the Army and our Nation will face for the foreseeable future. Our
    Army must remain alert to changes in this volatile environment and
    build the agility to anticipate and respond to change by maintaining
    our combat edge.
                                the next decade
        The Nation continues to be faced with persistent and ruthless foes
    that maintain a clear intent to attack us on our soil. Entering the
    future under these conditions, the Army remains a resilient but
    stretched force--one that has performed superbly while simultaneously
    transforming in the midst of a war. The high demand we have seen in
    Iraq and Afghanistan will likely recede over the next few years, but
    other demands will surely arise. Our Soldiers and Civilians will have
    more time at home, and that will necessitate a different type of
    leadership at our garrisons between deployments. Given this future, the
    Army's challenge in the second decade of the century is to maintain our
    combat edge while we reconstitute the force, and build resilience for
    the long haul.
    Maintaining Our Combat Edge
        Beginning in 2012 we anticipate having about as many BCTs available
    that are not earmarked for Iraq and Afghanistan as we will have of
    those deploying. It will be imperative that we remain focused on tough,
    demanding training at home station and at our training centers to
    ensure that our Soldiers and units sustain their combat edge. This
    training must be accomplished at an appropriate tempo and while meeting
    the unique challenges associated with increased time at home. Those
    units who are not deploying to Iraq or Afghanistan will undergo full
    spectrum training and be available to combatant commanders for security
    cooperation engagements, exercises and other regional requirements as
    well as fulfilling our requirements for a Global Response Force and the
    CBRNE Consequence Management Response Force. To do this, the Army will
    need to revitalize home station and leader development programs. We
    must continue to challenge our young, combat-seasoned leaders who will
    lead our Army into the second decade of this century and beyond.
        Another aspect of maintaining our combat edge involves codifying
    our experience and lessons learned. Institutionally, we must refine our
    doctrine and warfighting concepts. While our understanding of Full
    Spectrum Operations has matured, we must continue to clarify how we
    define and how we conduct Full Spectrum Operations across the spectrum
    of conflict from stable peace to general war. As units have more time
    at home, we will train against the wider range of threats and in a
    broader range of environments. We will use these experiences to drive
    the continued adaptation of the Army.
    Reconstituting the Force
        The Army must reconstitute the force, ensuring excellence in core
    competencies while building new capabilities to support an uncertain
    and complex future operating environment. Reconstitution requires not
    only completely resetting redeploying units, but also continuous
    adaptation of our forces as we move forward in a period of continuous
    and fundamental change. While the Army has almost finished transforming
    to modular formations and balancing the force, we continue to integrate
    the lessons learned from 9\1/2\ years at war with our expectations of
    the future. The Army's Training and Doctrine Command (TRADOC) commenced
    an in-depth study of our force mix and force design to ensure that we
    have the right capabilities in the right numbers in the right
    organizations for the future. We are committed to continually
    transforming our force to retain the flexibility and versatility it
    will need for the uncertain future environment.
        Another area that will require continual adaption is our mix of
    active and reserve component forces. The Nation has been at a state of
    national emergency for 9\1/2\ years. As a result, the Army has had
    continuous access to the reserve component through partial
    mobilization. The Army National Guard and Army Reserve have performed
    magnificently, and the relationship between components is better than
    it has ever been. Our Soldiers have fought together and bled together,
    and more than ever, we are one Army--a Total Force. Our Nation cannot
    lose the enormous gains we have made.
        Transforming the reserve component into an enduring operational
    force provides a historic opportunity for the Army to achieve the most
    cost effective use of the entire force. To that end, the Army recently
    completed a study of what the future role of our reserve component
    should be in an era of persistent conflict in which continuous
    deployment is the norm. The steady, consistent and recurring demand for
    reserve capabilities during this decade has posed significant
    challenges for a force organized and resourced as a strategic reserve.
    In response, the Army recast its reserve forces from the part-time
    strategic reserve role to a fully integrated and critical part of an
    operational, expeditionary Army. We are seeking changes to achieve
    affordable, predictable and assured access to the reserve component for
    the full range of assignments in the homeland and abroad. One thing is
    certain across every echelon of this Army; we cannot relegate the Army
    National Guard and Army Reserve back to a strategic reserve. The
    security of the Nation can ill afford a reserve force that is under-
    manned, under-equipped or at insufficient levels of training and
    readiness.
        The other significant element of reconstitution--modernization--is
    designed to give our Soldiers a decisive advantage in every fight. The
    goal of our modernization strategy is to develop a versatile mix of
    tailorable and networked organizations that operate on a rotational
    cycle. This enables us to routinely provide combatant commanders
    trained and ready forces to operate across the spectrum of conflict.
    This involves developing and fielding new capabilities while
    modernizing and recapitalizing old capabilities. Our top two
    modernization initiatives will be to develop, test and field the
    network and to field a new Ground Combat Vehicle in 7 years. Throughout
    this process, our industrial base will continue to identify and adopt
    improved business practices and maximize efficiencies to repair,
    overhaul, produce and manufacture in support of modernization and
    recapitalization efforts.
    Building Resilience
        As we look toward the next decade, we must also build resilience in
    our people. The last 9\1/2\ years have taken a physical, mental and
    emotional toll on our Soldiers, Civilians and Family members. No one
    has been immune to the impacts of war. This decade of experience,
    combined with the reality that our Nation is in a protracted struggle,
    underscores how important it is that we take advantage of our time at
    home to strengthen our force for the challenges ahead, even as we
    continue to deal with the continuing impacts of war. Although off-duty,
    high risk behavior is a continuing challenge, we have made significant
    progress in the last 10 years in reducing accidental fatalities. This
    highlights the resilience of our force as our Soldiers find healthier
    ways to handle the stresses of Army life. In addition to the Army
    Safety Program, last year the Army began two efforts designed to
    strengthen our Soldiers, Families and Civilians for the challenges
    ahead: Comprehensive Soldier Fitness and the Army Campaign for Health
    Promotion, Risk Reduction and Suicide Prevention. We will
    institutionalize the best of both of these programs into the force over
    the next year.
    The Network
        The last 9\1/2\ years of war have demonstrated that the network is
    essential to a 21st century, expeditionary Army. Networked
    organizations provide an awareness and understanding required by
    leaders who must act decisively at all points along the spectrum of
    conflict, and by Soldiers on the ground who are executing the mission.
    The network is also essential for planning and operating with Joint,
    coalition and interagency partners. The network, therefore, is the
    Army's number one modernization effort.
        The Army's portion of the Department of Defense network,
    LandWarNet, must be able to provide Soldiers, Civilians and mission
    partners the information they need, when they need it and in any
    environment--from the garrison to the tactical edge. To do so, it must
    be a completely integrated and interoperable network, from the highest
    to the lowest echelon, forming a true enterprise network. The Army is
    pursuing critical initiatives to build this enterprise capability,
    including an enterprise e-mail, calendar-sharing and ID management
    service (through a partnership with the Defense Information Systems
    Agency), data center consolidation and Active Directory consolidation.
    These initiatives will increase warfighting effectiveness, improve
    network security, save hundreds of millions of dollars over the next 5
    years and reduce infrastructure. Additionally, the Army is transforming
    business systems information technology to better support our business
    operations and strategic leader decisionmaking.
        The Army is also changing the way it supplies network systems and
    capabilities to operational units by using an incremental approach to
    modernization. By aligning the delivery of new technology with the
    ARFORGEN process as it becomes available, we ensure the integration of
    network capability across our combat formations. This ``capability
    set'' approach will field enhanced performance in a more timely and
    efficient manner.
    Ground Combat Vehicle
        To operate in austere conditions against a lethal, adaptive enemy,
    our Soldiers need a fighting vehicle that is capable of full spectrum
    operations with better levels of protection than our current vehicles.
    To meet that need, the Army is focused on developing a versatile ground
    combat vehicle that will meet an array of anticipated future
    requirements and see its first delivery in 7 years. It will provide the
    needed protection against a variety of threats, including that of
    improvised explosive devices, and deliver Soldiers to the fight under
    armor. Even with the significant capabilities that a new Ground Combat
    Vehicle will provide, it comprises only one element of the Army's
    overall combat vehicle modernization strategy. Our strategy also
    addresses improvements to vehicles like the Paladin howitzer and
    Stryker combat vehicles, integration of the MRAP into our formations
    and prudent divestment of obsolete systems.
                              strategic crossroads
        Our Nation and its Army are positioned at a unique point in
    history. This is not quite like any other year. We must now consider
    the hard-won lessons of recent combat experience, current and
    anticipated resource constraints and the uncertainty of the future. The
    decisions we make will have far reaching and long lasting implications.
    This calls for deliberate and thoughtful choices and actions as we
    determine where to best invest our Nation's precious resources.
    Transforming the Generating Force
        Over the course of the past decade, the operational Army has
    evolved dramatically. The need for change was driven by a fundamental
    reality: daily contact with a decentralized, adaptive, creative and
    deadly enemy. The Army's generating force, which prepares, trains,
    educates and supports Army forces worldwide, is also working to rapidly
    address the demands placed on the organization by both the current and
    future operating environments. It has performed magnificently to
    produce trained and ready forces, even while seeking to adapt
    institutional business processes.
        Furthermore, the Army is working to provide ``readiness at best
    value'' in order to help us live within the constraints imposed by the
    national and international economic situation. In short, the need to
    reform the Army's institutional management processes and develop an
    Integrated Management System, while continuing to meet combatant
    commander requirements, has never been more urgent. Thus, to enhance
    organizational adaptive capacity, while wisely stewarding our
    resources, the Army initiated a number of efforts along three primary
    business transformation objectives: establish an enterprise mindset and
    approach; adapt institutional processes to align with ARFORGEN; and
    reform the requirements and resource process.
        To enable business transformation and foster an enterprise
    approach, we established the Office of Business Transformation and
    developed enterprise functions that are facilitated by teams of leaders
    who focus on the domains of Human Capital, Readiness, Materiel and
    Services and Infrastructure. At the most strategic level, we
    established the Army Enterprise Board to provide a forum for Army
    senior leaders to address organizational strategic choices and
    tradeoffs. Additionally, we established our Business Systems
    Information Technology Executive Steering Group to facilitate an
    enterprise approach to information technology investments.
        We are working collaboratively to reform our requirements and
    resourcing process in order to create an organizationally aligned set
    of capabilities. As part of that effort, we have initiated an Army
    Acquisition Review. This review will provide a blueprint for actions
    over the next 2 years to improve the efficiency and effectiveness of
    the Army acquisition processes. We've also commissioned a short-term
    task force to analyze costs, establish credible benchmarks and help us
    better understand not only where our investment dollars go, but also
    what we get in return. We are developing a systematic approach to the
    Army's business processes that will ensure that innovative ideas and
    efficiencies influence future budgets.
        Furthermore, we instituted a portfolio review process that is
    bringing discipline to our acquisition programs by evaluating and
    realigning requirements with the reality of today and what we will need
    in years to come. This Capability Portfolio Review process is providing
    an overarching detailed analysis and set of recommendations to
    revalidate, modify or terminate each of our requirements, including
    research and development, procurement and sustainment accounts. These
    reviews are helping us identify gaps and unnecessary redundancies,
    while ensuring good stewardship of our Nation's resources. We are
    building a foundation that will identify savings, manage strategic
    risks, maximize flexibility and posture us even more effectively for
    the future.
    Civilian Workforce Transformation
        There are approximately 279,000 Civilians in the Army. Adding the
    Army Corps of Engineers and personnel supported by non-appropriated
    funds, the number exceeds 335,000 Civilians. That is about 23 percent
    of our total Army force. Army Civilians live and work in communities
    throughout our 50 States and U.S. territories and overseas theaters of
    operation. They comprise 60 percent of our generating force.
        This generating force performs many of the essential tasks that
    support ARFORGEN so our Soldiers can concentrate on their missions.
    Army Civilians have deployed and stood in support of our Soldiers
    during the most dangerous and difficult periods of conflict. In fact,
    over 4,300 Civilians deployed to Iraq or Afghanistan in 2010. The
    Nation's ability to sustain the all-volunteer force will be difficult
    and challenged if we do not prioritize development and investment in
    our most important institutional asset, our people. Now, as never
    before, we increasingly call upon our Civilian Corps to assume greater
    levels of responsibility and accountability at organizations throughout
    the Army, and we must invest in them accordingly. The goal is to become
    a generating force driven by innovation, able to adapt quickly and to
    field what our Soldiers and their Families will require. Therefore, the
    Army has embarked upon a Civilian Workforce Transformation initiative
    to pursue five lines of effort.
        First, we will integrate requirements determination, allocation and
    resourcing processes that identify the civilian workforce capabilities.
    Second, we will improve civilian workforce lifecycle strategy, planning
    and operations to enhance mission effectiveness. Third, we will
    establish an integrated management system to support civilian human
    capital decisionmaking. Fourth, we will deliberately develop Army
    civilian leaders. Fifth, we will reform the civilian hiring process. By
    the end of 2011, the Army will implement a comprehensive competency-
    based Civilian Leadership Development Program and fully implement the
    Civilian Talent Management Program. These programs will ensure that
    employees and management understand what is required for success, with
    realistic career paths and developmental opportunities to achieve
    success.
        The pay-off for this program is four-fold. For Civilians, the
    transformation will provide an outline for success with the appropriate
    training and development opportunities to facilitate the achievement of
    their career goals within the Army. For Commanders, the Civilian
    Workforce Transformation will provide the right workforce with the
    right training and development for the current and future mission
    requirements. For the Army, it will provide a predictable and rational
    method to articulate requirements and make decisions about resourcing
    in a fluid environment. Finally, for the Nation, the transformation
    will provide the investment in human capital required to effectively
    manage the institutional Army now and in the future.
                  stewardship, innovation and accomplishments
    Fiscal Stewardship
        We take our responsibility to serve as good stewards of the
    financial resources the Nation has entrusted to our care very
    seriously, and we are taking action to improve our ability to manage
    those resources effectively.
        To help our leaders and managers make better resource-informed
    decisions, we have placed renewed emphasis on cost management
    throughout the Army. At all levels, from installation to Army
    Headquarters, we have implemented training and professional development
    programs to give our people improved cost management skills and a
    greater understanding of the cost implications of their decisions.
    Training programs include a graduate-level Cost Management Certificate
    Course for carefully selected mid-level analysts, professional
    development courses for general officers and members of the Senior
    Executive Service, training incorporated into existing courses
    throughout the Army's formal schooling system and hands-on training in
    cost-benefit analysis. These programs have reached over 2,700 Soldiers
    and Civilians, and training continues.
        In addition to providing training and professional development, we
    must give our people the essential tools that will enable them to carry
    out their cost management responsibilities. Toward this end, we have
    fielded the General Fund Enterprise Business System (GFEBS) to more
    than 11,000 users at 14 major installations. As reported by the
    Government Accountability Office, GFEBS development is on schedule and
    on budget. Much more than an accounting system, GFEBS is the Army's new
    business system. It gives managers a greatly improved capability to
    manage the cost, schedule and performance of their programs and, at the
    same time, is the centerpiece in our progress toward full auditability
    of our financial statements
    Energy Security and Sustainability
        Energy security and sustainability are operationally necessary,
    financially prudent and are key considerations for Army installations,
    weapon systems and contingency operations. Energy security means that
    the Army retains access to energy and can continue to operate when
    catastrophe strikes and energy supplies are disrupted, cut off or just
    plain difficult to secure. To remain operationally relevant and viable,
    the Army must reduce its dependency on energy, increase energy
    efficiency, and implement renewable and alternate sources of energy.
        The Army has established a Senior Energy Council, appointed a
    Senior Energy Executive, created an Energy Security Office, and adopted
    a comprehensive energy security strategy. This strategy will not only
    lead to energy cost savings but help create a more sustainable force
    with increased endurance, resilience, and force protection. We will
    enhance our stewardship of our Nation's energy resources and less
    dependent upon foreign sources of fuel. The Army's logistical tail of
    the operational energy pipeline is a handicap that must be overcome
    through technological advances. We must leverage technology to improve
    our agility and flexibility against an irregular and decentralized
    enemy.
        On Army installations, we are developing a holistic approach,
    called Net Zero, to address energy, water, and waste. Net Zero is a
    force multiplier enabling the Army to appropriately steward available
    resources, manage costs and provide our Soldiers, Families and
    Civilians with a sustainable future. In an era of persistent conflict,
    with a mission of stabilizing war-torn nations, a true stabilizing
    factor can be that of appropriate resource management. The Net Zero
    plan ensures that sustainable practices will be instilled and managed
    throughout the appropriate levels of the Army, while also maximizing
    operational capability, resource availability and well-being.
        We have taken a significant step by incorporating all fuel costs
    throughout the lifecycle of the equipment as we analyze various
    alternatives for modernization programs such as the next ground combat
    vehicle, the Joint Light Tactical Vehicle and the Armed Aerial Scout.
    This approach enables us to make informed decisions about various
    alternatives and define energy efficiency performance parameters in
    capability documents for our program managers and original equipment
    manufacturers. Of course, not all solutions will involve big pieces of
    equipment or new vehicles. We are also pursuing technologies on a much
    smaller scale, such as spray foam tent insulation and shower water
    recycle systems--investments from which direct energy savings pay off
    in a matter of months.
        We are also working on more efficient generators and power
    distribution. Development of hardware, software and controls to perform
    micro-grid implementation is underway for buildings at the Field
    Artillery Training Center at Fort Sill, Oklahoma. This technology also
    has potential for use in a deployed operational environment. The Army
    is preparing to field ``smart grid'' capabilities for tactical command
    posts and forward operating base camps that will enable generators to
    support the larger grid instead of a single end user. As they become
    scalable and deployable, renewable energy technologies can also be
    integrated into these smart grids.
                             the profession of arms
        The last 9\1/2\ years of conflict have had significant impacts on
    the Army, its Soldiers, Families and Civilians. Many of these are well
    documented and are being addressed. There remain, however, other
    consequences that we seek to understand. We will examine the impacts of
    war on our profession of arms and take a hard look at ourselves--how
    have we changed as individuals, as professionals and as a profession.
        The Army is more than a job; it is a profession. It is a vocation
    composed of experts in the ethical application of land combat power
    serving under civilian authority and entrusted to defend the
    Constitution and the rights and interests of the American people. The
    level of responsibility is like no other profession--our Soldiers are
    entrusted to apply lethal force ethically and only when necessary.
    Also, unlike other professions, the profession of arms is practiced in
    the chaotic and deadly machinations of war. Along with that awesome
    responsibility comes both individual and organizational accountability,
    which we seek to examine as parts of our Profession of Arms.
        The American Professional Soldier is an expert and a volunteer,
    certified in the Profession of Arms and bonded with comrades in a
    shared identity and culture of sacrifice and service to the Nation and
    Constitution. The Soldier adheres to the highest ethical standards and
    is a steward of the future of the profession. Contrasting this are
    state, non-state and individual actors who operate outside generally
    accepted moral and ethical boundaries. Because of this, the Army has
    received tremendous support from the American people and their elected
    representatives. We are forever grateful for that support, and we do
    not take it for granted. We understand that this generous support is
    predicated on the Army's continued professionalism, guided by our Army
    creeds, our service oaths and the Army values that anchor our conduct
    (Loyalty, Duty, Respect, Selfless Service, Honor, Integrity and
    Personal Courage).
        In order to examine the impacts of our current experience on the
    Profession of Arms, the Army will continue a discussion at all levels
    in which we will ask ourselves three fundamental questions:
      --What does it mean for the Army to be a Profession of Arms?
      --What does it mean to be a Professional Soldier?
      --After 9 years of war, how are we as individual professionals and as
            a profession meeting these aspirations?
        The dialogue will help inform our understanding on what it means to
    be a professional Soldier in an era of persistent conflict.
                                   conclusion
        The professionalism, dedicated service and sacrifice of our all-
    volunteer force are hallmarks of the Army--the Strength of our Nation.
    Soldiers, their Families and Army Civilians continue to faithfully
    serve our country as we prevail in one of the most challenging times in
    our Nation's history.
        The Army is achieving its goals to restore balance in fiscal year
    2011. We will be transitioning to a period where we must reconstitute
    the force for other missions; build resilience in our Soldiers,
    Families and Civilians and diligently maintain our combat edge. We are
    modernizing the force for the future by developing and fielding
    versatile, affordable, survivable and networked equipment to ensure
    Soldiers maintain a decisive advantage over any enemy they might face.
        We are responding to the lessons our operating force learned and
    the changes it made over the past 9\1/2\ years by adapting the
    institutional Army to effectively and efficiently generate trained and
    ready forces for full spectrum operations. The sector of the Army that
    trains and equips our Soldiers, the generating force, must be driven by
    innovation and be able to adapt quickly and field what our Soldiers and
    their Families will require. We must continue to improve efficiency and
    reduce overhead expenditures as good stewards of our Nation's valuable
    resources. We recognize that institutional change is not only about
    saving money, and efficiencies are not simply about improving the
    bottom line. Institutional change is about doing things better, doing
    them smarter and taking full advantage of the progress, technology,
    knowledge and experience that we have available to us.
        With the trust and confidence of the American public and the
    support of Congress with appropriate resources, America's Army will
    remain the Strength of the Nation.
                                     ______

         2011 Reserve Component Addendum to the Army Posture Statement
        Sections 517 and 521 of the National Defense Authorization Act
    (NDAA) 1994 require the information in this addendum. Section 517
    requires a report relating to implementation of the pilot Program for
    Active Component Support of the Reserves under Section 414 of the NDAA
    1992 and 1993. Section 521 requires a detailed presentation concerning
    the Army National Guard (ARNG), including information relating to
    implementation of the ARNG Combat Readiness Reform Act of 1992 (Title
    XI of Public Law 102-484, referred to in this addendum as ANGCRRA).
    Section 704 of the NDAA amended Section 521 reporting. Included is the
    U.S. Army Reserve information using Section 521 reporting criteria. The
    data included in the report is information that was available 30
    September 2010.
        Section 517(b)(2)(A). The promotion rate for officers considered
    for promotion from within the promotion zone who are serving as active
    component advisors to units of the Selected Reserve of the Ready
    Reserve (in accordance with that program) compared with the promotion
    rate for other officers considered for promotion from within the
    promotion zone in the same pay grade and the same competitive category,
    shown for all officers of the Army.

    ----------------------------------------------------------------------------------------------------------------
                                               Fiscal year 2009                          Fiscal year 2010
                                  ----------------------------------------------------------------------------------
                                                                    Army                                     Army
                                      AC in RC     Percent \1\    average       AC in RC    Percent \1\    average
                                                                percent \2\                              percent \2\
    ----------------------------------------------------------------------------------------------------------------
    Major........................  56 of 63......         88.9         94.1  57 of 67.....         85.1         92.1
    Lieutenant Colonel...........  16 of 20......         80.0         87.9  10 of 12.....         83.3         88.7
    ----------------------------------------------------------------------------------------------------------------
    \1\ Active component officers serving in reserve component assignments at time of consideration.
    \2\ Active component officers not serving in reserve component assignments at the time of consideration.

        Section 517(b)(2)(B). The promotion rate for officers considered
    for promotion from below the promotion zone who are serving as active
    component advisors to units of the Selected Reserve of the Ready
    Reserve (in accordance with that program) compared in the same manner
    as specified in subparagraph (A) (the paragraph above).

    ----------------------------------------------------------------------------------------------------------------
                                               Fiscal year 2009                          Fiscal year 2010
                                  ----------------------------------------------------------------------------------
                                                                    Army                                     Army
                                      AC in RC     Percent \1\    average       AC in RC    Percent \1\    average
                                                                percent \2\                              percent \2\
    ----------------------------------------------------------------------------------------------------------------
    Major........................  2 of 4........         50.0          6.0  6 of 123.....          4.9          5.7
    Lieutenant Colonel...........  0 of 1........  ...........          7.2  0 of 7.......  ...........         10.7
    ----------------------------------------------------------------------------------------------------------------
    \1\ Below the zone active component officers serving in reserve component assignments at time of consideration.
    \2\ Below-the-zone active component officers not serving in reserve component assignments at time of
      consideration.

    Section 521(b)
        1. The number and percentage of officers with at least 2 years of
    active-duty before becoming a member of the Army National Guard or the
    U.S. Army Reserve Selected Reserve units.
          ARNG officers: 21,725 or 51.5 percent of which 1,998 were fiscal
            year 2010 accessions.
          Army Reserve officers: 21,378 or 58.8 percent of which 589 were
            fiscal year 2010 accessions.
        2. The number and percentage of enlisted personnel with at least 2
    years of active-duty before becoming a member of the Army National
    Guard or the U.S. Army Reserve Selected Reserve units.
          ARNG enlisted--101,896 or 31.9 percent of which 8,281 were fiscal
            year 2010 accessions.
          Army Reserve enlisted--63,670 or 37.5 percent of which 5,592 were
            fiscal year 2010 accessions.
        3. The number of officers who are graduates of one of the service
    academies and were released from active duty before the completion of
    their active-duty service obligation and, of those officers:
        a. The number who are serving the remaining period of their active-
    duty service obligation as a member of the Selected Reserve pursuant to
    section 1112(a)(1) of ANGCRRA:
          In fiscal year 2010, there were two Service Academy graduates
            released from active duty before completing their obligation to
            serve in the Army Reserve.
        b. The number for whom waivers were granted by the Secretary of the
    Army under section 1112(a)(2) of ANGCRRA, together with the reason for
    each waiver:
          In fiscal year 2010, under section 1112(a)(2) of ANGCRRA the
            Secretary of the Army granted no waivers to the Army National
            Guard.
          In fiscal year 2010, under section 1112(a)(2) of ANGCRRA the
            Secretary of the Army granted two waivers to the Army Reserve.
            The waivers afforded Soldiers the opportunity to play a
            professional sport and complete their service obligation.
        4. The number of officers who were commissioned as distinguished
    Reserve Officers' Training Corps graduates and were released from
    active duty before the completion of their active-duty service
    obligation and, of those officers:
        a. The number who are serving the remaining period of their active-
    duty service obligation as a member of the Selected Reserve pursuant to
    section 1112(a)(1) of ANGCRRA:
          In fiscal year 2010, there are no distinguished Reserve Officers
            Training Corps (ROTC) graduates serving the remaining period of
            their active-duty service obligation as a member of the
            Selected Reserve.
        b. The number for whom waivers were granted by the Secretary of the
    Army under section 1112(a)(2) of ANGCRRA, together with the reason for
    each waiver:
          In fiscal year 2010, the Secretary of the Army granted no
            waivers.
        5. The number of officers who are graduates of the Reserve
    Officers' Training Corps program and who are performing their minimum
    period of obligated service in accordance with section 1112(b) of
    ANGCRRA by a combination of (a) 2 years of active duty, and (b) such
    additional period of service as is necessary to complete the remainder
    of such obligation served in the National Guard and, of those officers,
    the number for whom permission to perform their minimum period of
    obligated service in accordance with that section was granted during
    the preceding fiscal year:
          In fiscal year 2010, there were 20 ROTC graduates released early
            from an active-duty obligation. The following is a breakdown of
            the ROTC graduates that are completing the remainder of their
            service obligation in a Reserve Component.
          ARNG: 1
          USAR: 19
        6. The number of officers for whom recommendations were made during
    the preceding fiscal year for a unit vacancy promotion to a grade above
    first lieutenant, and of those recommendations, the number and
    percentage that were concurred in by an active duty officer under
    section 1113(a) of ANGCRRA, shown separately for each of the three
    categories of officers set forth in section 1113(b) of ANGCRRA (with
    Army Reserve data also reported).
          There are no longer active and reserve component associations due
            to operational mission requirements and deployment tempo.
            Active component officers no longer concur or non-concur with
            unit vacancy promotion recommendations for officers in
            associated units according to section 1113(a). However, unit
            vacancy promotion boards have active component representation.
          In fiscal year 2010, the ARNG recommended 1,913 ARNG officers
            (Title 10; Title 32; ADSW; AD; M-Day) for a position-vacancy
            promotion and promoted 1,913. The number consists of 265 U.S.
            Army Medical Department, 1,595 Army Promotion List and 53
            Chaplains. Of the 1,913 promoted officers, 1,053 were M-Day
            Soldiers consisting of 175 U.S. Army Medical Department, 844
            Army Promotion List and 34 Chaplains.
          In fiscal year 2010, the Army Reserve recommended 63 officers for
            a position-vacancy promotion and promoted 63.
        7. The number of waivers during the preceding fiscal year under
    section 1114(a) of ANGCRRA of any standard prescribed by the Secretary
    establishing a military education requirement for non-commissioned
    officers and the reason for each such waiver.
          In fiscal year 2010, 1,607 ARNG Noncommissioned Officers received
            a promotion to the next rank without the required military
            education (based on a waiver agreement that extends the time
            Soldiers have to complete the educational requirement). Of
            those, 648 completed their military education requirements. The
            majority of waivers were deployment related.
          In fiscal year 2010, 486 Army Reserve Noncommissioned Officers
            received a military education waiver (based on a waiver
            agreement that extends the time Soldiers have to complete the
            educational requirement). Of those, 257 waivers received
            approval based on deployment and/or operational mission
            requirements.
          Waiver consideration is case-by-case. The criteria for waiver
            consideration are: (1) eligible for promotion consideration,
            (2) recommended by their State (for ARNG), (3) disadvantaged as
            a direct result of operational deployment conflict, and (4) no
            available training quota. This includes Soldiers deployed or
            assigned to Warrior Transition Units (WTU) (Medical Hold or
            Medical Hold-Over Units) with a medical condition. Some waiver
            requests did not meet the criteria.
          The Secretary of the Army has delegated the authority for the
            waivers referred to in section 114(a) of ANGCRRA to the
            Director, ARNG and to the Commander, U.S Army Reserve Command.
            The National Guard Bureau and the U.S. Army Reserve Command
            maintain details for each waiver.
        8. The number and distribution by grade, shown for each State, of
    personnel in the initial entry training and non-deployability personnel
    accounting category established under section 1115 of ANGCRRA for
    members of the Army National Guard who have not completed the minimum
    training required for deployment or who are otherwise not available for
    deployment. (Included is a narrative summary of information pertaining
    to the Army Reserve.)
          In fiscal year 2010, the ARNG had 47,804 Soldiers considered non-
            deployable for reasons outlined in Army Regulation 220-1, Unit
            Status Reporting (e.g., initial entry training; medical issues;
            medical non-availability; pending administrative or legal
            discharge; separation; officer transition; non-participation or
            restrictions on the use or possession of weapons and ammunition
            under the Lautenberg Amendment). The National Guard Bureau
            (NGB) maintains the detailed information.
          In fiscal year 2010, the Army Reserve had 48,229 Soldiers
            considered non-deployable for reasons outlined in Army
            Regulation 220-1, Unit Status Reporting (e.g., initial entry
            training; medical issues; medical non-availability; pending
            administrative or legal discharge; separation; officer
            transition; non-participation or restrictions on the use or
            possession of weapons and ammunition under the Lautenberg
            Amendment). The U.S. Army Reserve Command (USARC) maintains the
            detailed information.
        9. The number of members of the Army National Guard, shown for each
    State, that were discharged during the previous fiscal year pursuant to
    section 1115(c)(1) of ANGCRRA for not completing the minimum training
    required for deployment within 24 months after entering the National
    Guard. (Army Reserve data also reported.)
          The number of ARNG Soldiers discharged during fiscal year 2010
            pursuant to section 1115(c)(1) of ANGCRRA for not completing
            the minimum training required for deployment after entering the
            Army National Guard is 131 officers and 265 enlisted Soldiers
            from all U.S. States and territories. NGB maintains the
            breakdown by each State. The numbers represent improvement
            driven by the Recruit Force Pool (RFP) and by miscellaneous
            administrative actions. The RFP initiative changed the way ARNG
            accounts for Soldiers. ARNG does not count Soldiers until the
            accession process is complete and they have an assigned
            position. Administrative improvements included an aggressive
            effort to eliminate Negative End Strength (defined as Soldiers
            who have been on the NOVAL Pay list for 3 months or more, have
            expired ETS dates, in a Non-MOSQ status for 21 months or more,
            or in the Training Pipeline with no class reservation). These
            improvements helped the ARNG meet the End Strength Ceiling of
            358,200 by the end of fiscal year 2010 by moving those Soldiers
            into the Inactive National Guard (ING).
          The number of Army Reserve Soldiers discharged during fiscal year
            2010 for not completing the minimum training required for
            deployment after entering the Army Reserve is 30 officers and
            62 enlisted Soldiers. Under AR 135-175, Separation of Officers,
            separation actions are necessary for Officers who have not
            completed a basic branch course within 36 months after
            commissioning. Under AR 135-178, Separation of Enlisted
            Personnel, separation actions are necessary for Soldiers who
            have not completed the required initial entry training within
            the first 24 months.
        10. The number of waivers, shown for each State, that were granted
    by the Secretary of the Army during the previous fiscal year under
    section 1115(c)(2) of ANGCRRA of the requirement in section 1115(c)(1)
    of ANGCRRA described in paragraph (9), together with the reason for
    each waiver.
          In fiscal year 2010, there were no waivers granted by the
            Secretary of the Army for the U.S. Army Reserve or the Army
            National Guard.
        11. The number of Army National Guard members, shown for each
    State, (and the number of AR members), who were screened during the
    preceding fiscal year to determine whether they meet minimum physical
    profile standards required for deployment and, of those members: (a)
    the number and percentage that did not meet minimum physical profile
    standards for deployment; and (b) the number and percentage who were
    transferred pursuant to section 1116 of ANGCRRA to the personnel
    accounting category described in paragraph (8).
        a. The number and percentage who did not meet minimum physical
    profile standards required for deployment:
          In fiscal year 2010, 163,457 ARNG Soldiers underwent a Periodic
            Health Assessment (PHA). There were 7,936 or 4.8 percent of
            personnel identified for review due to a profile-limiting
            condition or failure to meet retention standards.
          In fiscal year 2010, 162,749 Army Reserve Soldiers underwent a
            Periodic Health Assessment (PHA). There were 15,025 or 9.2
            percent of personnel identified for review due to a profile
            limiting condition or failure to meet retention standards.
        b. The number and percentage that transferred pursuant to section
    1116 of ANGCRRA to the personnel accounting category described in
    paragraph (8).
          In fiscal year 2010, the ARNG identified 7,936 or 4.8 percent of
            Soldiers for a review due to a profile limiting condition or
            failure to meet retention standards; and transferred to a
            medically non-deployable status.
          In fiscal year 2010, the Army Reserve identified 15,025 or 9.2
            percent of Soldiers for a review due to a profile limiting
            condition or failure to meet retention standards; and
            transferred to a medically non-deployable status.
          On August 23, 2010, the Department of Defense implemented a
            change to how the Army measures Individual Medical Readiness
            (IMR). The new way of measuring medical readiness by
            classifying Soldiers into Medical Readiness Categories (MRC)
            reduced the number of Soldiers considered medically non-
            deployable (MND) in the reserve component. This information is
            available through the Army's medical readiness database,
            MEDPROS.
        12. The number of members and the percentage total membership of
    the Army National Guard shown for each State who underwent a medical
    screening during the previous fiscal year as provided in section 1117
    of ANGCRRA.
          Public Law 104-106 (NDAA 1996), Division A, Title VII, Section
            704(b), February 10, 1996, repealed Section 1117 of ANGCRRA.
        13. The number of members and the percentage of the total
    membership of the Army National Guard shown for each State who
    underwent a dental screening during the previous fiscal year as
    provided in section 1117 of ANGCRRA.
          Public Law 104-106 (NDAA 1996), Division A, Title VII, Section
            704(b), February 10, 1996, repealed Section 1117 of ANGCRRA.
        14. The number of members and the percentage of the total
    membership of the Army National Guard shown for each State, over the
    age of 40 who underwent a full physical examination during the previous
    fiscal year for purposes of section 1117 of ANGCRRA.
          Public Law 104-106 (NDAA 1996), Division A, Title VII, Section
            704(b), February 10, 1996, repealed Section 1117 of ANGCRRA.
        15. The number of units of the Army National Guard that are
    scheduled for early deployment in the event of a mobilization, and of
    those units, the number that are dentally ready for deployment in
    accordance with section 1118 of ANGCRRA.
          Public Law 104-106 (NDAA 1996), Division A, Title VII, Section
            704(b), February 10, 1996, repealed Section 1118 of ANGCRRA.
        16. The estimated post-mobilization training time for each Army
    National Guard combat unit (and Army Reserve unit), and a description,
    displayed in broad categories and by State of what training would need
    to be accomplished for Army National Guard combat units (and AR units)
    in a post-mobilization period for purposes of section 1119 of ANGCRRA.
          Per January 2007 direction from the Secretary of Defense reserve
            component unit mobilizations are now limited to 400-day
            periods, including post-mobilization training time, a 30-day
            post-mobilization leave and 5 days out-processing. Timely alert
            for mobilization--at least 1 year prior to mobilization--is
            crucial. Many training tasks previously conducted during post-
            mobilization occurs in local training areas before
            mobilization. First Army, in CONUS, manages and directs post-
            mobilization training for reserve component conventional forces
            conducts the theater-specified training required and confirms
            the readiness of mobilized units to deploy. A unit's post-
            mobilization training time depends on how many of the pre-
            mobilization tasks they complete in pre-mobilization. Whatever
            pre-mobilization tasks they do not complete during pre-
            mobilization training, they will complete the remaining tasks
            at the mobilization station.
          First Army Pre-Deployment Training in support of Combatant
            Commanders' guidance identifies four categories of deploying
            units. CAT 1 includes units that rarely, if ever, travel off a
            Contingency Operating Base/Forward Operating Base (COB/FOB).
            CAT 2 includes units that will or potentially will travel off a
            COB/FOB for a short duration. CAT 3 includes units that will
            travel and conduct the majority of their missions off a COB/
            FOB. CAT 4 is maneuver units with an Area of Operations (such
            as BCTs). The pre-mobilization tasks per category increase up
            to CAT 4. A CAT 4 unit spends between 58-60 training days at
            mobilization station for post-mobilization training. The target
            is 45 training days. A CAT 4 unit is required to perform a
            Combat Training Center (NTC or JRTC) culminating training event
            (30 days) during post-mobilization in order to meet validation
            requirements and deploy.
          Army goals for post-mobilization training for reserve component
            headquarters and combat support, and combat service support
            units range from 15 to 45 days, depending on the type/category
            of the unit, and does not include administrative and travel
            days. Post-mobilization training conducted by First Army
            typically consists of counterinsurgency operations; counter-
            improvised-explosive-device training; convoy live-fire
            exercises; theater orientation; rules of engagement and
            escalation-of-force training; and completion of any theater-
            specified training not completed during the pre-mobilization
            period. Below is an outline of typical post-mobilization
            periods for various units:

    ------------------------------------------------------------------------
                                                        Post-MOB TNG days
                    Unit structure                 -------------------------
                                                       Legacy      Current
    ------------------------------------------------------------------------
    Military Police Battalion (I/R)...............           90           53
    Engineer Company (Construction)...............           90           58
    Medium Truck Company..........................           90           49
    Transportation Detachment.....................           90           37
    Infantry Battalion............................          174           71
    Expeditionary Sustainment Command.............          168           37
    ------------------------------------------------------------------------

        17. A description of the measures taken during the preceding fiscal
    year to comply with the requirement in section 1120 of ANGCRRA to
    expand the use of simulations, simulators, and advanced training
    devices and technologies for members and units of the Army National
    Guard (and the Army Reserve).
          During fiscal year 2010, the Army Reserve and Army National Guard
            continued to synchronize the use of existing and ongoing live,
            virtual, and constructive training aids, devices, simulations
            and simulators (TADSS) programs with the training requirements
            of the ARFORGEN training model. By synchronizing the use of
            TADSS with ARFORGEN, the ARNG continues to improve unit
            training proficiency prior to mobilization.
          To support the training requirements of M1A1 Abrams and M2A2
            Bradley equipped Brigade Combat Teams (BCT's) the ARNG
            continued to use the Advanced Bradley Full-Crew Interactive
            Simulation Trainer and Abrams Full Crew Interactive Simulation
            Trainer, which provide full crew-simulations training for M1A1
            and M2A2 units. The ARNG continued fielding Tabletop Full-
            fidelity Trainers for the M2A2 units and cross leveling of the
            Conduct of Fire Trainer XXI for M1A1 units. When fully fielded,
            these devices, in addition to the Conduct of Fire Trainer-
            Situational Awareness (COFT-SA) and Conduct of Fire Trainer
            Advanced Gunnery Trainer System (CAGTS) will be the primary
            simulation trainers to meet the virtual gunnery requirements of
            M1A1 and M2A2 crews.
          In order to train all ARNG units on the tactics, techniques, and
            procedures (TTPs) of convoy operations, the ARNG has fielded
            the Virtual Convoy Operations Trainer (VCOT). The VCOT with
            geo-specific databases provides commanders with unique and
            critical mission rehearsal tool. Currently, all 54 States and
            Territories have received this capability, providing a mobile
            training capability available to all Soldiers throughout the
            ARNG.
          To meet basic and advanced rifle marksmanship requirements, the
            ARNG is continuing to field the Engagement Skills Trainer (EST
            2000). This system is the Army's approved marksmanship training
            device. The ARNG is also continuing the use of its previously
            procured Fire Arms Training System (FATS) until EST 2000
            fielding is completed. The EST 2000 and FATS also provides
            static unit collective gunnery and tactical training, and
            shoot/don't shoot training. These systems also support units
            conducting vital homeland defense missions.
          The Army Reserve has a number of low-density simulators it
            employs to reduce expensive ``live'' time for unique combat
            service support equipment. For example, Army Reserve watercraft
            units train on the Maritime Integrated Training System (MITS),
            a bridge simulator that not only trains vessel captains but the
            entire crew of Army watercraft. Other simulators include
            locomotive simulators used by Army Reserve railroad units and a
            barge derrick simulator for floating watercraft maintenance
            units.
          The reserve components supplement their marksmanship-training
            strategy with the Laser Marksmanship Training System (LMTS).
            The use of LMTS helps to develop and maintain basic
            marksmanship skills, diagnose and correct problems, and
            assessing basic and advanced skills. The ARNG has over 900
            systems fielded down to the company level. The LMTS is a laser-
            based training device that replicates the firing of the
            Soldier's weapon without live ammunition. EST 2000 systems have
            been fielded to many Army Reserve Engineer and Military Police
            organizations to enable full use of its training capabilities
            by units with high densities of crew-served weapons their at
            home stations.
          The Improvised Explosive Device Effects Simulator (IEDES)
            supports the training requirements for the detection, reaction,
            classification, prevention and reporting of Improvised
            Explosive Devices. The ARNG also continues to field IEDES kits.
            The configuration of IEDES kits are set to simulate Small,
            Medium, Large, and Extra Large Explosive signatures. The IEDES
            kits provide realistic battlefield cues and the effects of
            Explosive Hazards to Soldiers in both a dismounted and mounted
            operational status.
          The ARNG continues to develop its battle command training
            capability through the Battle Command Training Capability
            Program (BCTCP). This program provides live, virtual,
            constructive and gaming (LVC&G) training support at unit home
            stations via mobile training teams. Units can also train at
            Battle Command Training Centers (BCTC). The BCTCP consists of
            three BCTCs at Camp Dodge, Iowa; Fort Indiantown Gap,
            Pennsylvania; and Fort Leavenworth, Kansas, and a regional
            Distributed Mission Support Team (DMST). The Army Campaign Plan
            2010 requires the ARNG to train 172 units (Brigade equivalents
            and above). The BCTCP synchronizes ARNG battle command training
            capabilities to help units plan, prepare and execute battle
            staff training. The objective is to develop proficient battle
            command staffs and trained operators during pre-mobilization
            training.
          In order to provide the critical Culminating Training Event for
            the U.S. Army Forces Command (FORSCOM) Army Force Generation
            (ARFORGEN) Cycle, the ARNG has implemented the Exportable
            Combat Training Capability (XCTC) Program. The ARNG XCTC
            program provides Battalion Battle Staff training to the level
            organized, coupled with a theater immersed, mission focused
            training event to certify company level proficiency prior to
            entering the ARFORGEN Available Force Pool Defined as Certified
            Company Proficiency with demonstrated Battalion Battle Staff
            proficiency, competent leaders, and trained Soldiers prepared
            for success on the battlefield.
        18. Summary tables of unit readiness, shown for each State, (and
    for the Army Reserve), and drawn from the unit readiness rating system
    as required by section 1121 of ANGCRRA, including the personnel
    readiness rating information and the equipment readiness assessment
    information required by that section, together with:
        a. Explanations of the information:
          Readiness tables are classified. The Department of the Army, G-3,
            maintains this information. The States do not capture this
            data.
        b. Based on the information shown in the tables, the Secretary's
    overall assessment of the deployability of units of the ARNG (and Army
    Reserve), including a discussion of personnel deficiencies and
    equipment shortfalls in accordance with section 1121:
          Summary tables and overall assessments are classified. The
            Department of the Army, G-3, maintains this information.
        19. Summary tables, shown for each State (and Army Reserve), of the
    results of inspections of units of the Army National Guard (and Army
    Reserve) by inspectors general or other commissioned officers of the
    Regular Army under the provisions of Section 105 of Title 32, together
    with explanations of the information shown in the tables, and including
    display of:
        a. The number of such inspections;
        b. Identification of the entity conducting each inspection;
        c. The number of units inspected; and
        d. The overall results of such inspections, including the
    inspector's determination for each inspected unit of whether the unit
    met deployability standards and, for those units not meeting
    deployability standards, the reasons for such failure and the status of
    corrective actions.
          During fiscal year 2010, Army National Guard Inspectors General
            and other commissioned officers of the Regular Army conducted
            inspections of the Army National Guard. The total number of
            ARNG units that were inspected were 1,193, plus an additional
            26 United States Property and Fiscal Offices (USPFOs), totaling
            1,219 inspections. Regular Army Officers assigned to the
            respective States and Territories as Inspectors General
            executed the inspections. The Department of the Army Inspector
            General, 1st U.S. Army, U.S. Army Forces Command (FORSCOM);
            Communications-Electronics Command (CECOM); and various
            external inspection agencies conducted the remaining 128
            inspections. Because the inspections conducted by Inspectors
            General focused on findings and recommendations, the units
            involved in these inspections did not receive a pass/fail
            rating. Requests for inspections results must go through the
            Inspector General of the Army.
          During fiscal year 2010, the Chief, Army Reserve, directed the
            Inspector General to conduct special assessments in the areas
            of Rear Detachment Operations (RDO) and Post Deployment Health
            Reassessment (PHDRA). Commissioned officers of the Army Reserve
            inspected 81 units. Because the inspections conducted by
            Inspectors General focused on findings and recommendations, the
            units involved in these assessments did not receive a pass/fail
            rating. Requests for inspections results must go through the
            Inspector General of the Army.
        20. A listing, for each ARNG combat unit (and U.S. Army Reserve FSP
    units) of the active-duty combat units (and other units) associated
    with that ARNG (and U.S. Army Reserve) unit in accordance with section
    1131(a) of ANGCRRA, shown by State, for each such ARNG unit (and for
    the U.S. Army Reserve) by: (A) the assessment of the commander of that
    associated active-duty unit of the manpower, equipment, and training
    resource requirements of that National Guard (and Army Reserve) unit in
    accordance with section 1131(b)(3) of the ANGCRRA; and (B) the results
    of the validation by the commander of that associated active-duty unit
    of the compatibility of that National Guard (or U.S. Army Reserve) unit
    with active duty forces in accordance with section 1131(b)(4) of
    ANGCRRA.
          There are no longer formal ground combat active or reserve
            component associations due to ongoing theater operational
            mission requirements and deployment tempo.
          First Army, as FORSCOM's executive agent, and the 196th Infantry
            Brigade, as U.S. Army Pacific's executive agent, executes the
            legislated active duty associate unit responsibilities through
            both their pre-mobilization and post-mobilization efforts with
            reserve component units. When reserve component units mobilize,
            they are thoroughly assessed in terms of manpower, equipment,
            and training by the appropriate chain of command, and that
            assessment is approved by First Army or USARPAC as part of the
            validation for unit deployment.
          Validation of the compatibility of the Reserve Component units
            with the active duty forces occurs primarily during training
            and readiness activities at mobilization stations, with direct
            oversight of First Army, USARPAC, and FORSCOM.
        21. A specification of the active-duty personnel assigned to units
    of the Selected Reserve pursuant to section 414(c) of the National
    Defense Authorization Act for Fiscal Years 1992 and 1993 (10 USC 261
    note), shown (a) by State for the Army National Guard (and for the U.S.
    Army Reserve), (b) by rank of officers, warrant officers, and enlisted
    members assigned, and (c) by unit or other organizational entity of
    assignment.

    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                          Title XI (fiscal year 2010) authorizations             Title XI (fiscal year 2010) assigned
                                                     -------------------------------------------------------------------------------------------------------
                                                          OFF          ENL           WO         Total         OFF          ENL           WO         Total
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    U.S. Army Reserve...............................           97          110            8          215           21          117            1          139
    TRADOC..........................................           50            3  ...........           53           36            3  ...........           39
    FORSCOM.........................................          979        2,165          101        3,245          671        2,296           83        3,050
    USARPAC.........................................           30           49            1           80           31           54            1           86
                                                     -------------------------------------------------------------------------------------------------------
          Total.....................................        1,156         2327          110        3,593          759        2,470           85        3,314
    --------------------------------------------------------------------------------------------------------------------------------------------------------

          As of September 30, 2010, the Army had 3,314 active component
            Soldiers assigned to Title XI positions. Army G-1, and U.S.
            Army Human Resources Command carefully manages the
            authorizations and fill of Title XI positions. The states do
            not capture this data.

        Chairman Inouye. Now may I call upon the new Chief of Staff
    of the United States Army, General Dempsey. General.
    STATEMENT OF GENERAL MARTIN E. DEMPSEY, CHIEF OF STAFF
        General Dempsey. Thank you very much, Chairman Inouye, Vice
    Chairman Cochran. Thank you for the opportunity to discuss our
    Army with you this morning.
        And thank you, Mr. Secretary, for the vote of confidence.
        Since I assumed the duties as the 37th Chief of Staff of
    the Army, I have worked to get a feel for where we are and help
    inform my thoughts about where we need to go in the future.
        One of the very first things I did was go to Iraq and
    Afghanistan to visit our troops to see firsthand their
    accomplishments and to thank them for their courage, their
    sacrifice, and their service. I visited soldiers and families
    back here in the continental United States as well, and this
    weekend, I will visit our Corps of Engineers who are working
    tirelessly to combat the historic flood levels along the
    Mississippi River valley. And then I will travel to Fort
    Carson, Colorado to hand out some awards at our Wounded Warrior
    Games.
        What we are able to do as an Army at home and abroad for
    soldiers, families, and for our wounded is a testament to the
    sustained support of this subcommittee. We have our challenges,
    but where it matters most on the ground around the world,
    American soldiers, Active, Guard, and Reserve, are getting it
    done and achieving the Nation's objectives in ways that should
    inspire all Americans.
        To ensure we continue to provide what the Nation needs from
    its Army, I have begun to articulate where I intend to focus my
    energy as Chief of Staff, and I would like to share just a few
    thoughts about that this morning.
        We recognize our responsibility to prevail in the wars that
    we are fighting, prepare for the challenges of an uncertain
    future, prevent and deter threats against the United States,
    its interests, our allies, and partners, and preserve the all-
    volunteer force as those tasks are laid out for us in our
    national security strategy and in the Quadrennial Defense
    Review.
        To do that, we must maintain an appropriate end strength, a
    versatile force structure, and an array of capabilities. We
    must train and equip our forces to overmatch any adversary and
    we must meet our obligations to soldiers, families, and wounded
    warriors who have sacrificed much over the last 10 years of
    sustained conflict.
        We also recognize that we must not only be good stewards of
    the resources you have provided, but look for smarter and
    better ways to provide the Nation the capabilities that we
    need. We must find the right balance between end strength and
    operational tempo. To preserve our options, we are considering,
    for example, how best to reduce the 27,000 temporary end
    strength increase we received 2 years ago and the 27,000
    permanent end strength reduction plan between now and 2015.
        All of us have come to realize the impacts of end strength
    and demand on the Army's operational tempo, and we are always
    assessing our force generation models and what you know as our
    BOG/dwell ratio, boots on the ground/time at home. We are
    currently examining whether we can transition to a 9-month
    deployment with a 27-month dwell at home as our objective for
    the active component. We assess that this would alleviate some
    of the pressures on the force while still meeting the demands
    of the combatant commanders and fulfilling our obligations to
    the Nation.
        Our obligations to the soldiers, families, and Army
    civilians, Active, Guard, and Reserve who comprise this great
    Army are simple. Give them what they need to win, provide them
    and their families with support and services that recognize
    their sacrifice.
        The Secretary discussed several of our modernization
    programs. With his support, I have also initiated an analysis
    of the squad as our fundamental fighting element. As an Army,
    no one can challenge us at corps level, division level, brigade
    level, or battalion level. I want to ensure we have done as
    much as possible to make sure that that same degree of
    overmatch exists at the squad level. Simply stated, we have
    decided to take a look at our Army from the bottom up and see
    what we learn.
        This does not mean we are going to stack even more gear on
    the individual soldier who is already strained by the load they
    have to carry in combat. What it means is that we will look at
    the squad as a collective whole, not nine individual soldiers,
    and determine how to enable it from the bottom up to ensure
    that the squad as the training, leadership, doctrine, power and
    energy, protection and lethality to win when we send them into
    harm's way.
        I assure all of you that this Nation has never had a better
    organized, a better trained, or a better equipped Army. Of
    course, that is in large measure because we have never been
    better resourced, and for that our Army owes you a great debt
    of gratitude. As our resourcing changes, we will adapt as we
    have many other times in our history, but we will be adapting
    from a position of great strength. And I could not be prouder
    of what our soldiers have done and will continue to do to
    support our Nation's interests around the world.
        I look forward to working with Secretary McHugh and the
    members of this subcommittee to make our Army smarter, better
    and more capable with the resources we are given. We remain an
    Army at war and we will be for the foreseeable future. We will
    do whatever it takes to achieve our objectives in the current
    fights and we will provide the Nation with the greatest number
    of options for an uncertain future.
        Thank you very much, and I look forward to taking your
    questions.
        Chairman Inouye. Thank you very much, General Dempsey.

                             TEMPORARY END STRENGTH

        As noted by both of you, the Secretary of Defense has
    indicated a plan to reduce our active Army forces by 27,000 by
    fiscal year 2016 or 2015. First, I would like to know whether
    you consider this a reasonable plan, and second, how do you
    propose to do it?
        Mr. McHugh. Mr. Chairman, as I know you and the other
    members of the subcommittee understand, we have spent a lot of
    time with the Secretary and the people at OSD to make sure that
    the way forward on this makes sense, that we are not buying an
    unreasonable amount of risk.
        The two phases I think need to be considered very
    separately. The temporary end strength, the 22,000, was
    something that we always assumed would be coming down in the
    near term rather than the far term. We were concerned that we
    not have to begin that process immediately. We felt, at the
    time that discussions were ongoing, that indeed the OPSTEMPO
    was such that those 22,000 continue to serve a purpose, and the
    Secretary, I think it is fair to say, understood and agreed
    with that and has allowed us to hold that 22,000 until March of
    next year when we think, particularly given the ongoing
    drawdown in Iraq, that we can take that reduction in force
    structure in stride and, in fact, do it in a way that produces
    both savings and a responsible force at the end of it.
        As the Secretary has also said with respect to the second
    tranche, due to begin in 2015 and 2016, on the 27,000, that
    that is conditions-based. And based upon what the President has
    spoken about and our NATO allies with respect to beginning
    drawdowns of some yet-to-be-determined number this summer based
    on General Petraeus' recommendations--I assume that will be
    received by the White House in the near future--you can start
    to look for a path forward. Beyond that, as our NATO partners
    have agreed, they expect to have major operations begin to
    cease in 2014 in Afghanistan and if conditions on the ground
    allow that to continue, we feel very comfortable that the
    27,000 is a very achievable target as well.

                                FUTURE DRAWDOWN

        I think the question for us, frankly, is how do we shape
    that drawdown and what is the ramp in which we assume it. So we
    are looking through our total Army analysis that we do
    routinely with respect to how the Army looks as to where the
    numbers should come from, how the ramp should be structured in
    a way that can go forward reasonably in way that does not place
    our soldiers at greater risk.
        Chairman Inouye. General Dempsey.
        General Dempsey. Yes, I would simply add, Senator, that I
    think it is a reasonable plan. Like any plan, it is based on
    some assumptions, and if those assumptions play out, then the
    plan will be prudent. If the assumptions are changed in any
    way, then we would have to come back and readdress them.
        But as I mentioned to you earlier, we also want to look not
    just at this immediate challenge, but we want to look beyond
    and determine what does the Nation need of its Army notionally
    in 2020 and make sure that these changes are building toward
    that Army so that we do not end up making these adjustments on
    an annual basis.

                              ACQUISITION PROGRAMS

        Chairman Inouye. Mr. Secretary and General, the United
    States Army has been rather unsuccessful in fielding major
    acquisition programs in recent years. Significant terminations
    include future combat system, the armed reconnaissance
    helicopter, the Comanche, and many, many more. Last summer, you
    commissioned a study to identify the causes of these failures
    which have cost the taxpayers about $100 billion.
        Would you tell the committee what you discovered and how
    you plan to improve Army acquisition?
        Mr. McHugh. If I may, Mr. Chairman, I will start and then
    certainly would defer to the Chief for anything he would like
    to add.
        As you noted, we viewed that study as long overdue. This
    really was something that General Casey had been thinking about
    for some time before actually I came to the building. And I was
    pleased that we were able to work together and bring a cadre of
    top-notch people to take an outside look. It was headed by a
    former commander of the Army, Materiel Command, and a former
    Army acquisition executive, ASAALT, and the team that they put
    together was really a blue ribbon panel of folks who had both
    been involved, most of them over a career in acquisition and
    who probably understood it better than we did.
        They came back with 76 recommendations, some of which were
    revelatory. I had a meeting, in fact, this week with our
    acquisition people, including the ASAALT, to talk about those
    recommendations to see where we are in implementing them. It
    was, indeed, that report that pointed out the failures of the
    various platforms that you mentioned and the significant costs
    to the taxpayer.
        And I think the number one thing--and it was obvious on its
    face, but how we respond to it is another matter--was our
    inclination in the past to not control requirements. And we
    have seen that in a number of programs, and FCS I think is the
    poster child for it, as is the presidential helicopter where
    requirements keep getting built on and built on. The time of
    the acquisition stretches out, and pretty soon the cost has
    skyrocketed and you have an under-performing program to state
    the least.

                             GROUND COMBAT VEHICLE

        So we tried to do a better job in stating the requirements,
    keeping them less reliant on immature or unavailable
    technologies. We have introduced competition, for example,
    through the ground combat vehicle program so that we can have
    that cost containment influence there.
        And I think the ground combat vehicle is a very good
    example of how we are doing better. When the request for
    proposal (RFP) for the ground combat vehicle went out, there
    were 990 tier 1 requirements. That was at the outset before we
    had actually seen a spiral of increased requirements. To the
    Corps' credit on the acquisition side of the equation, they
    looked at it and said to themselves, here we go again. And it
    was a tough decision, but they recalled that RFP. And as a
    result of the reexamination, they reduced the tier 1
    requirements by 75 percent and put the rest of the requirements
    up into tier 2 and tier 3 where you can trade, as the
    development goes forward, for costs. So a tough decision, but
    one, at the end of the day, I think was very soundly supported
    by the industry and will serve not just the Army, but the
    taxpayers more fairly as well.
        So we want to do a better job. We are implementing the
    study's reports, and in fact, we have either implemented or are
    taking steps right now to implement all but 13 of the 76
    recommendations. We are taking a more careful look at 13 of
    those. So we are going to do a better job, and it is not just a
    matter of the Army's responsibility to the Army. It is a matter
    of our responsibility to the taxpayer.
        Chairman Inouye. General.
        General Dempsey. Thank you, sir.
        You know, we actually have done well on ACAT II and III
    programs and on some rapid adaptation and rapid equipment
    fielding initiatives. So the real challenge for us is to figure
    out why did we do so well in some of these rapid acquisition
    procedures and not so well in the very deliberate DOD 5000
    series of acquisitions.

                              PROCUREMENT PROCESS

        And I think we will learn that we have got some work to do
    merging the requirements with the procurement objectives. I
    think we will probably find ourselves in a position of
    believing that we should pull the future toward us and not have
    aspirations to deliver programs much beyond 7, 8, 9 years. When
    they stretch beyond that, they become, by the definition of the
    word, ``incredible,'' and we are lacking credibility.
        So I think it is a combination of the Decker-Wagner
    recommendations. I think we have to look at the acquisition
    regulations particularly for the long lead time procurement
    programs and we got to merge requirements in procurement and
    senior leadership integration much sooner in the process.
        Chairman Inouye. We will have to continue on discussions on
    this.
        But now may I call upon Senator Cochran.

                             HELICOPTER REPLACEMENT

        Senator Cochran. Mr. Chairman, I think it is disturbing to
    review the difficulties faced, not of their own making, but the
    current leadership of the Army is confronted with replacing
    helicopters and doing something about aging tanks. And so it
    seems like a lot of things are piling up at once that cost an
    awful lot of money.
        I listened carefully to your responses to Senator Inouye's
    question, and I am not exactly sure what you said. In terms of
    what is the plan for replacing reconnaissance helicopters, has
    the Army agreed on what it wants or what it needs? Is there a
    contract in place now that will replace the helicopters? And
    the same thing for the tank.
        Mr. McHugh. We do have an ongoing need for an armed
    reconnaissance helicopter, and we do have a plan by which we
    are going to approach that challenge. We are not, as yet, in an
    acquisition program. We have what we call a CASUP, which is
    what the cockpit upgrade program, in the near term for the
    Kiowa Warrior that I think with high reliability we will extend
    the viability of that platform probably till 2023, and in the
    interim, we have to begin to look at the analysis of
    alternatives and develop an RFP for a follow-on to the Kiowa
    Warrior. So when the Comanche was cancelled, it did not end the
    enduring requirement. So we have a plan, but we do not have
    answers yet as to what exactly the next platform will look
    like, but we have laid a process forward.
        As to the tank, actually the Abrams platform is amongst the
    most modern of any system in our Army. The average year of the
    M1A2 Abrams is about 2 years, but the ground combat vehicle is
    our critical development program to really provide the
    survivability of an MRAP with the maneuverability of a Stryker
    and the lethality of a Bradley. So as you know, Senator, this
    budget requests $884 million for that program. So we think the
    GCB is on track.
        We do have, as you noted, a lot of platforms out there that
    are aging out, and what we are trying to do is align ourselves
    in a responsible manner so we can use the dollars that we have
    for the follow-on developments wisely. In most of those cases,
    we have a way forward that we would be glad to talk to you
    about in greater detail at your convenience.
        Senator Cochran. General.
        General Dempsey. No, I have nothing further to add. I have
    nothing to add to the Secretary's response.
        Senator Cochran. Thank you, Mr. Chairman.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Thank you, Mr. Chairman.

                                MISSILE DEFENSE

        Mr. Secretary, in the area of Army ballistic missile
    defense, I want to ask if you could comment on two programs in
    particular: Patriot and the Integrated Air and Missile Defense
    Battle Command System, or IBCS. Could you describe just for the
    subcommittee the importance of those programs to the
    warfighter, and how are those programs performing budget- and
    schedule-wise?
        Mr. McHugh. It would be hard to, from the Army perspective,
    overstate the importance of those programs.
        Senator Shelby. Would you say they are of the utmost
    importance?
        Mr. McHugh. I think that is a fair description, Senator.
    The PAC-3 is our protection system against ballistic, air-
    breathing threats. We are very, very comfortable with the
    capabilities that it provides. All of our launchers now in the
    Army have PAC-3 capability. So we think that program has been
    incredibly important, and in the near term, I do not see that
    changing.
        Senator Shelby. It has recently come to our attention that
    the Army is considering perhaps transferring its missile
    defense budget and program responsibilities to the Missile
    Defense Agency (MDA). I am concerned that Patriot and IBCS
    which, as you have said, are critical to our warfighters in
    performing well, could be used as bill payers for programs that
    MDA considers a higher priority. Could you explain to the
    subcommittee the status and the details of this proposal, where
    it is, and how can you assure that the budget for Patriot and
    IBCS will be protected if MDA controls the funding?
        Mr. McHugh. Well, if that were to go forward--and we do
    think there are some efficiencies and some logic behind that,
    in fact, occurring. But if that were to go forward, there would
    be Army representation within that organization at the highest
    level. And as I just said to you, the Army would be very, very
    ill-disposed against using Patriot PAC-3 as a bill payer, and
    we would have to fight that battle as we go forward. But at
    this moment, I do not have any indication that that would be
    the case.

                       SPACE AND MISSILE DEFENSE COMMAND

        Senator Shelby. General Dempsey, in the area of the Space
    and Missile Defense Command (SMDC) which conducts space and
    missile defense operations for the Army, as you well know, and
    in support of the U.S. Strategic Command, as we look into the
    future, how would you think SMDC's mission will evolve and
    grow? Will it continue to be a vital part of the Army and
    contributor to STRATCOM? And finally, is the SMDC budget
    request adequate to fulfill the mission that you envision for
    the command?
        General Dempsey. I will begin at the latter part of your
    question, Senator. I do think that the budget submission is
    adequate to the current task load at SMDC.
        I also would agree with the Secretary that the role of
    space in support of ground military operations is vital. As you
    know, we have done some war gaming on a day without space, and
    what that might mean in terms of global positioning, precision
    weapons, and all of that. So we clearly understand the
    importance of it.
        I am quite confident that SMDC, as an Army subcomponent
    command of Strategic Command is well placed and well
    represented, but we will keep an eye on it.
        Senator Shelby. Thank you.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Coats.
        Senator Coats. Mr. Chairman, I just want to state from the
    outset that we are all going to be facing difficult decisions
    in the days and months and years ahead relative to the budget,
    and I am hoping that we can work on sensible efficiencies
    within the military. It is clearly our number one
    constitutional responsibility, and we want to make sure we are
    adequately prepared and adequately funded to do that.
        Yet, at the same time, I think all of us have to stretch a
    little bit--and some more than others--to find those
    efficiencies and do more with less. So I look forward to
    working with the Department of the Army and the Department of
    Defense in finding that right balance.
        General, congratulations to you. It is a great complement
    to your service. I had the pleasure of knowing you before, and
    we served together--not together, but working with you on a
    number of items in Germany when I was there. So the highest
    congratulations. It is a great honor, and I think the President
    made the best selection he could possibly make.
        Congratulations to you also, Mr. Secretary.
        I want to get just a little bit parochial here and ask you
    a question just more for information purposes.

                               MILITARY VEHICLES

        It is my understanding that DARPA is now conducting
    ballistic tests on the new high mobility multipurpose vehicle,
    one with a stovepipe which provides protection for our troops.
    It comes in at less weight, considerably less weight, more
    mobility, one-third of the cost, and so forth of the MRAP. How
    do you see that playing out relative to the current budget
    situation and relative to your needs?
        My understanding is we are not getting the mobility out of
    the MRAP's that we need to get around in Afghanistan. A lot of
    them are not being used for that purpose. We now have something
    under test and evaluation that perhaps can give us that
    mobility at less cost and still provide security and safety for
    our soldiers. So could you comment on that?
        Mr. McHugh. Yes, I could. I have actually not seen the test
    in person, but I have seen the video. And watching it is pretty
    impressive. And as you noted, Senator, one of the problems we
    have with our Humvee fleet is the reluctance that commanders
    have had sending it outside, as we say, the wire because of the
    problems on survivability. And this stack defeat system holds a
    great deal of promise, and it is exciting. As you noted, it is
    in analysis and testing right now. So we are not sure exactly
    how it would fit, but it is something that we are very, very
    interested in and we intend to pursue it to its fullest.
        I am not necessarily suggesting we should limit it to a
    Humvee system. If it works in one configuration, it may work in
    others. So we want to take a broad-based look at it, and AM
    General, the company that brought the technology first to us,
    is working with us, and we appreciate that. As I said, we are
    excited about it.
        Senator Coats. General, could you comment also, but also
    relative to the question of the mobility and accessibility and
    need for something like this in Afghanistan vis-a-vis the
    MRAP's?
        General Dempsey. Well, it is, Senator. We have
    approximately 150,000 tactical wheeled vehicles in the Army.
    Some of them are intended for deployable purposes, some not.
    And as we look at our fleet, we have got to balance the
    existing inventory of MRAP vehicles and what they bring. And
    they did bring a considerable degree of protection at a very
    important time. And then the Humvee and then the other program,
    of course, that we are involved with, the Marine Corps and its
    JLTV, the joint light tactical vehicle.
        What we need to do is, again, determine what is that Army
    of 2020, what is the capability that it needs, and then have
    essentially a menu of options so that based on the threat we
    anticipate, we can employ the right capability. And I think
    that Humvee will be part of that in the future, but I cannot
    today say what part of that.
        Senator Coats. Thank you.

                                  ABRAMS TANK

        One more question. The Abrams tank, M1A2, is scheduled--my
    understanding--to end production in 2013. Could you comment
    on--concerns have been raised with me relative to maintaining
    the skills and industrial base necessary to produce this type
    of component for you. Can you give me your thoughts on that and
    where we might be going with that program?
        Mr. McHugh. And those are legitimate concerns and we share
    them. The decision on the future production of the tank was
    simply made on the business case. The business case was clear.
    We, as I mentioned earlier, have an Abrams tank inventory that
    is amongst the most modern of any of our equipment, the average
    age being just over 2 years old. And our acquisition objective
    had been met. The cost of shutting down and mothballing the
    plant, including the cost of rebuilding the employee base, was
    far more economically sensible than maintaining the minimum
    production necessary through the period until we begin to
    develop a follow-on for the Abrams platform.
        Having said that, we are looking very carefully and working
    with DOD and Dr. Ash Carter and his acquisition folks to see
    what, if anything, we can do that can help preserve that expert
    force. These are not folks that you just find on the street.
    They have a developed expertise. We recognize it. We value it.
    They have contributed, as many of our contractors have over the
    years, in incredibly important ways, and we want to do the
    right thing by them as well. But also, as you noted in your
    opening comments, Senator, we have got to make some hard
    decisions, but we are looking at it very carefully.
        Senator Coats. Thank you for that.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Mikulski.
        Senator Mikulski. Mr. Chairman, I love the names,
    ``McHugh,'' ``Dempsey.'' It sounds like an Olympic boxing team
    representing the United States. And listening to you two, you
    two really are a one-two punch for the Army. Secretary McHugh,
    you know, you come from knowledge on the battlefields of
    Congress which really takes a lot of know-how. And, of course,
    General Dempsey, your incredible service plus your most recent
    deployment in Iraq.
        Let me get to my question, and it goes to the well-being of
    the troops, the need for resiliency, the need for their well-
    being.

                                 MENTAL HEALTH

        One of the most important things to deal with their mental
    health problems is the time at home. Now, I believe--and this
    is where I want to get to my question. And also the Surgeon
    General of the Army, General Schoomaker, said the same thing,
    that if you want to reduce PTSD, stress, the terrible strain on
    the family, have them home for a longer period of time.
        Well, you know how the old wars were. You went off to war.
    Usually it was for 5 years at most, and when you came back, the
    war was over. We had surrenders and so on. That is not the
    case.
        So here goes the question. You, meaning our Government, is
    saying we are going to shrink the number of men and women in
    the Army. Is that correct?
        Mr. McHugh. That is the plan forward, yes, Senator.

                                  END STRENGTH

        Senator Mikulski. Right. And I would say a year ago that
    seemed like a good idea and made sense. Now we have the Jasmine
    Revolution. Now we have some of our colleagues who are calling
    for new deployments. I was at an international conference some
    months ago, and one of my colleagues said, let us go in Iran
    and take out the Guard, et cetera. You know, they put on camous
    for a day and they think they are it.
        Then there has been this whole thing with Libya, and the
    President has made a decision. A regime change means boots on
    the ground. But that also means what is the possibility.
        Then we have Syria. Then we have--there are so many
    unexpected consequences and dynamics in the world.
        My question is that as we look at--we thought when we were
    out of Iraq, pulling out of Afghanistan in the way that General
    Petraeus and the President are recommending, that would be kind
    of let us come home and get on with it.
        I am apprehensive that maybe we are going to need a larger
    standing Army to not only meet unintended things in the world,
    but that we have no elasticity anymore.
        So, one, what are you doing for the unexpected? Would you
    caution Congress to think twice before we shoot off our mouth
    while they are asking you to shoot off the guns?
        And then the other thing is, where do we get in here now
    with the National Guard who is really stressed and asked for
    one-third of the workforce, but are supposed to return to
    civilian jobs after 9 years of deploying them from everything
    from tornadoes to overseas?
        So the unexpected and how do we make sure we have not only
    resiliency which, General Dempsey, I really want to everything
    I can to work with you to do that. And I believe we speak for
    that.
        But what do you think about what I just said, Secretary
    McHugh?
        Mr. McHugh. I think you point out very accurately the
    challenge we all have as we make very important decisions in
    this 2012 budget and in the years that follow on.

                        BOOTS ON THE GROUND: DWELL TIME

        As to what we call BOG/dwell, as the Chief mentioned and
    you did, I do not want to simplify it because I think the
    issues of stress on the force and suicide are more complex than
    a silver bullet. The answers are not going to be like turning
    on a light in a dark room. It is going to be more like lifting
    the shades slowly.
        But we know, without any doubt, that one of the key drivers
    of these challenges is the very short time that troops have had
    over the last decade at home. And depending on what kind of job
    you had, most of these troops were coming home for 1 year, then
    going back out for 1 year. Some of them in certain high-demand,
    low-density MOS's were getting less than 1 year at home for 1
    year deployment. One of the things we have done and
    concentrated on is to stretch that out, and because, in large
    measure, of the drawdown in Iraq, we are now, on average, at
    about 1 year deployed and about 1.6 years back home. We think
    at a minimum, we need to have 2 years back home.
        Senator Mikulski. I understand that and I support that. But
    given the numbers that you are having here in the budget, do
    you think that there is enough elasticity, enough--you do not
    want to use the term ``redundancy'' in the troops, but enough
    manpower--and this is all based on the assumption that nothing
    new will happen----
        Mr. McHugh. That is true.
        Senator Mikulski [continuing]. And that the Nation will not
    ask them for nothing new to do or Congress does not go off on
    yet some urging of them to undertake a mission.
        Mr. McHugh. That is exactly true.
        Senator Mikulski. So my question is, is there that
    elasticity there to do that, or are we just making a plan that
    is going to be unrealistic and then we are going to have to
    ramp it up and place an even further intense stress on them
    while all of us in this room want to work with you on that
    mental health care, the right PTSD, the help for the families
    which are so essential to recovery and resetting and
    resiliency? Do you think you have that?
        Mr. McHugh. I think it is our responsibility to provide it,
    and I think we have charted a way forward by which that will
    happen. I cannot predict the future. As you said, it is
    uncertain at best. Secretary Gates mentioned it in his speech
    at West Point that we have a perfect record in predicting the
    future. We have been wrong 100 percent of the time.
        But what we do know is that under the current conditions
    and under the way that we now know forward, the drawdown we
    have planned, beginning with the temporary end strength
    starting in March of next year and then the 27,000 drawdown
    beginning in 2015 and 2016 is doable and is doable in a way
    that will provide the BOG/dwell that we think is necessary and
    hopefully, we believe, sufficient to return to normal stress
    levels at garrison.
        If conditions change, then we are going to have to
    reevaluate. And that is why, as I mentioned earlier, the Chief
    and I and the entire Army staff are looking through total Army
    analysis to how we ramp those drawdowns in the months ahead so
    that if conditions change, we have the flexibility to stop and
    then to build up to whatever level.
        Senator Mikulski. But conditions are changing. They are
    changing by the tweet.
        I know you. You are an outstanding public servant and you
    are a man of honor. I believe you are all putting your best
    thinking in it, but there is these other events.
        I know my time is up. I think we need to talk really more
    about this issue so that we are prepared. We could always buy
    more equipment, but you cannot always buy more troops as if you
    can pull them in off the shelf. We have already pulled them off
    of the shelf for 9 years.
        So my time is up, unless General Dempsey----
        General Dempsey. No. I just would add very briefly if you
    ask me the question today, yes, we are both elastic. We use the
    term ``expansible.'' This budget that we are here to discuss
    provides us the flexibility we need.

                                 BALANCED FORCE

        As we look forward, we know there are changes coming. The
    key for us in making those changes is to have time to balance
    what are essentially three rheostats in maintaining a balanced
    force, and those three rheostats are manning, manpower,
    modernization or equipment, and operations and maintenance and
    training. If decisions come to us precipitously, oftentimes we
    will lose one of those three rheostats, and then we lose the
    flexibility. If they come to us deliberately, we can do this.
        And by the way, it took us 10 years to build the
    magnificent Army we have today. It is not one that can be
    disassembled overnight.
        Senator Mikulski. And we do not want to.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Leahy.
        Senator Leahy. Thank you, Mr. Chairman.
        Secretary McHugh and General Dempsey, good to see you both.
    Secretary McHugh was my neighbor across the lake for years when
    he served in the House and I enjoyed very much my work with him
    during that time. I found him to be extraordinarily dedicated
    not only to his district but to making Government work right,
    and it is nice to see you here.
        Mr. McHugh. Good to see you, Senator. Thank you.

                              ARMY NATIONAL GUARD

        Senator Leahy. I want to thank both of you for all the work
    you do to improve the lives of soldiers in the Vermont Army
    National Guard, but of course across the entire Army. As you
    know, Vermont's 86th Infantry Brigade deployed to Afghanistan
    last year. As members of the brigade returned home, usually my
    wife and I would be there to greet them as they came back. I
    saw that the warrior transition system designed for active duty
    soldiers was not meeting the needs of our Guard. We worked
    together to set up a new pilot program, as you know, at Fort
    Drum, and that was a big step forward.
        A month ago, I asked General Schoomaker if he would help me
    to continue the National Guard outreach programs in Vermont and
    around the country. It is so important for mental health
    services for our Guard, and my colleague, Senator Sanders, and
    others helped to establish it. And with the help of the Army,
    the Vermont Guard has received the funding it needs to extend
    this to fiscal year 2011 and it is an impressive example of
    what the Army can do and what it has done.
        And I should also mention I hear from my staff, one of your
    liaison officers, Lieutenant Colonel Kelly Laurel, represented
    both you and the Army on these issues and has been extremely
    helpful. So it is a long way around of just saying I want to
    thank you. When we have brought up issues that affected us, you
    have been there to help. I wear two hats, one as a member of
    this subcommittee, but also along with Senator Lindsay Graham
    as co-chair of the Guard Caucus, and when we have called on you
    for help, you have always been there.

                       MEDIUM EXTENDED AIR DEFENSE SYSTEM

        Secretary McHugh, I would like to ask you about the Medium
    Extended Air Defense System, or MEADS. The Army has asked for
    another $800 million for its development 2002-2013. I
    understand it will not be purchased even after it is developed.
    Somehow we are in an international agreement that obligates the
    spending.
        We are having to pay so many cuts both in the civilian life
    and our social safety net but also in the military. Why do we
    not just cut off money for MEADS? We are not going to deploy it
    anyway. Do we just need to renegotiate whatever those
    international agreements are?
        Mr. McHugh. That would be ideal if we were successful in
    getting our international partners to renegotiate.
        This was a litany of bad choices. The reality is, based on
    the negotiated agreement of 2004 that I was not a part of, so I
    cannot speak to the motivations, any one of the three
    partners--and as you know, Senator, our two other international
    partners are Italy and Germany--who unilaterally withdraw are
    required to pay the set closeout costs, which in the case of
    MEADS is about $840 some million. So if we were to cancel the
    program today unilaterally, we would bear a bill that would be
    almost identical to the budget proposal that the administration
    has put forward.
        Now, the difference is for the $804 million that the
    President has requested and that the Army fully supports is
    that that will fund our participation through and into 2014.
    And at that time, we will be able, along with our international
    partners, to at least reap some of the technology that has been
    developed under the years that this program has been going
    forward. I cannot tell you at this point what that technology
    package will look like, but we know it will be of some
    substance. We will probably have applicability to 360 degree
    systems that right now are beyond our current capabilities. But
    it will be far more than the nothing we will get if we were to
    cancel unilaterally today.
        Senator Leahy. But these other countries must be spending
    money and they must be asking themselves whether they want to
    continue too. Is it a case that everybody wants to see who goes
    first, or is it a case where we might sit down with them and
    say, hey, look, guys, all this money we are spending--if we
    want to do something together, why do we not spend it on
    something that might work?
        Mr. McHugh. I cannot speak to the motivations of our
    partner nations. And it is important to note, the Army is the
    executive agent here. We do not negotiate it. It is a
    Department of Defense and a Department of State lead on those
    things. But my understanding is, according to what I have been
    told through OSD, that our two partner nations, for whatever
    reasons, are not interested in coming to an agreement of early
    termination prior to 2014.
        Senator Leahy. Well, I raise it and please keep it on your
    radar screen because I worry about it when we are cutting out
    so many other things. It is a big hunk of change.
        General Dempsey. Senator, could I add related to another
    question about the importance of air defense? What we do get
    out of this, besides the technology, is a better increased
    capability by our partners at a time when our particular air
    defense community is at any given time 50 percent deployed. So
    50 percent of our air defenders are either in a deployment
    cycle or forward deployed. Anything we can do to improve the
    capability of our partners is worth the investment.

                         ARMY NATIONAL GUARD THREE STAR

        Senator Leahy. My last question. Secretary McHugh, we have
    had 2 years that the Army National Guard has been without a
    full three-star director. And last year, Kit Bond and I, when
    he was in the same position as Senator Graham now, sent a
    letter to Secretary Gates asking that the position be filled. I
    understand there have been two nominees. A second nominee is
    waiting for full administration clearance before his name is
    sent to the Senate for confirmation.
        General Carpenter has been doing a great job, but can you
    kind of prod them? Please encourage them to get this moving.
        Mr. McHugh. I can, I think, do better than that. I had a
    meeting with the Vice Chief of Staff of the Army on this this
    week. He is the guy I have kind of asked to spearhead it. It
    has actually been administrative problems and certain issues
    that the current nominee had to work through. I have been
    informed this week that we are at the very end of that process,
    and I think we will hopefully have you a nominee up here in the
    very near future.
        Senator Leahy. That would be very good.
        Again, thank you both. I agree with so many others that sit
    here. We are very proud of your service. I am delighted to see
    you both here.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Collins.
        Senator Collins. Thank you, Mr. Chairman.
        First of all, General, congratulations on your new
    position.

       MENTAL HEALTH SERVICES FOR ARMY NATIONAL GUARD AND RESERVE FORCES

        Recently I welcomed home a company from the Maine National
    Guard which had returned from a 9-month tour of duty in
    Afghanistan. And it was a great day of celebration and
    happiness. But when I was looking at these men and women, I
    could not help but think about the mental health challenges
    that many of them will face, particularly in light of the
    alarming increase in suicides among our National Guard and
    Reserve members.
        I know that in your budget you have proposed a new
    prevention program, and I believe it is called the Army
    Campaign Plan for Health Promotion, Risk Reduction, and Suicide
    Prevention.
        My concern, however, is how is this program going to reach
    the Reserve and National Guard. Obviously, those who go back to
    an active duty base have support structures already built in
    easily accessible, readily available. They have people in the
    command structure watching out for them. But those who are
    going back to rural towns in Maine resuming their civilian
    lives, do not have those kind of support structures. And I
    think that is one reason you are seeing this alarming increase
    that is not present in the active duty troops.
        Could you comment on how the program you have proposed will
    reach those guardsmen and women, those reservists who are going
    back to their civilian lives?
        General Dempsey. Yes. Thank you, Senator.
        What I would like to do is offer that someone would come
    over and actually brief you on the entire program so that we
    can show you where I think we are probably going to hit the
    mark and show you where we think we may still miss the mark
    slightly.
        But I will tell you this program was designed and developed
    from the ground up from its inception to address all three
    components of our Army, Active, Guard, and Reserve. And so
    going in, we recognized the different challenges that each of
    those components have, and we would like to brief you on that.
        Senator Collins. Thank you. I do think that it is
    absolutely critical that we recognize that there are a lack of
    mental healthcare providers in rural areas of my State and I
    suspect throughout the country, and I am just really worried
    about getting those individuals, who are going back to rural
    communities to their old lives who lack that kind of support
    structure, those services.
        Mr. McHugh. May I respond briefly, Senator Collins?
        Senator Collins. Yes, Mr. Secretary.
        Mr. McHugh. And it is a huge problem. And as you noted, if
    you are in the active component, we can get our hands on you
    far more easily than when they go back.
        The interesting thing about the reserve component and Guard
    soldiers, 50 percent of these soldiers who commit suicide in
    the Guard and Reserve have never deployed. So we have other
    issues. And the comment earlier about we do not want to look
    for the one silver bullet, I think, particularly applies to the
    Guard and Reserve. And what we are trying to do--and one part,
    as you mentioned, is overcome this nationwide challenge in both
    the civilian, as well as the military sector, to get enough
    behavioral health specialists so that everybody, all three
    components have accessibility to that to extend through
    distance technologies, IT, into the home so that we can provide
    them, first of all, predeployment resiliency tools; second of
    all, those resiliency tools as follow-up, but also to continue
    to assess their mental health when they have gone back home.
        In States like Vermont and other places, the Guard units
    and the TAG's have stepped up and helped enormously. We are
    looking at everything from the Yellow Ribbon program
    reintegration program and such. But the distance challenges are
    going to provide hurdles that frankly we do not know yet how we
    are going to get over.
        Senator Collins. It is something that we are going to have
    to keep working on.

                            ALS/LOU GEHRIG'S DISEASE

        Secretary McHugh, I want to bring up an issue. I know you
    are aware of a tragic case that I have been working directly
    with you on of a 33-year-old sergeant who has ALS, Lou Gehrig's
    disease. He has three young children. He is now in the advanced
    stage of the disease. It has to be the saddest constituent
    meeting that I have had in quite some time.
        And as you are well aware, numerous studies funded by DOD,
    the VA, NIH, and the Institutes of Medicine have found a link
    between military service and ALS. And that link led the VA in
    2008 to establish a presumption of service connection
    regardless of whether there is a gap between when the ALS
    manifested itself. And yet, DOD takes a different approach.
        In this particularly tragic case, at first we received a
    letter saying that the sergeant was going to qualify for
    benefits and that his ALS was the result of military service.
    We then just 1 week ago subsequently received a letter that
    said the opposite. And I want to continue to work with you
    about that.

                           DISABILITY RATING SYSTEMS

        But on a broader issue, I am troubled that the VA and the
    Department of Defense have different standards in this area.
    The VA assumes there is a presumption of connection between
    military service and ALS, and yet as this latest letter in this
    case shows, the Army concludes otherwise. We have been trying
    to have a better integration between DOD and the VA, and the
    conflicting rulings in Sergeant Kennedy's case seemed to run
    completely counter to the intent of the new integrated
    disability evaluation system and the recommendations of the
    Dole-Shalala report.
        So my broader question for you is would it not make sense
    for there to be more consistency between the system used by the
    VA and the system used by DOD.
        Mr. McHugh. It would make the soldiers, sailors, marines,
    airmen, Coast Guard lives a lot easier.
        As I visit warrior transition units--and the case that you
    have been, to your credit, if I may, so aggressively trying to
    advance and remediate is a particularly tragic example of it.
    But every time I go to a WTU, I do not hear, usually, about bad
    medical care, bad food. I hear about this disconnect in the
    disability rating system between military and the VA. And this
    is something that Secretaries Shinseki and Gates in fact had a
    meeting at the Pentagon about 3 weeks ago in an effort to take
    it to their level to try to see what they could do to finally
    overcome the hump. Even when we had the IDES program, there are
    places where we have enacted it at Fort Carson, for example,
    where it actually expanded the disability rating system rather
    than helped it. So it has been very, very problematic.
        When I received your letter, to narrow it down now to the
    case that you spoke about, I asked that our Army folks--and
    there is a DOD equity here. So we have to kind of work at a
    higher level. But I have asked our Army folks--I told them I
    have a personal interest in this and let us see if there is any
    possible way we can work this out. I cannot make you a promise
    other than I promise you we are looking at it hard.
        Senator Collins. Thank you.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.
        General, Mr. Secretary, thank you for being here and your
    testimony.

                     ALS AND CONNECTION TO MILITARY SERVICE

        I want to thank you, Senator Collins, for bringing up not
    only the suicide issue, which I think we are all so keyed in
    on, but this issue of ALS and the connection within the
    military. It is something that I have been following for a
    period of years now as I have a relative that is struggling
    with this terrible disease. But what we are learning in these
    past few years about the connections to those who are serving
    and to this horrible disease is really quite significant.
        I think most of us associate Lou Gehrig's disease with
    those that are older. What we are seeing now with the number of
    veterans are contracting this disease at an early, early age--I
    was at the ALS conference here in Washington, DC a couple weeks
    ago, and they had brought in, I think was, about 30 different
    veterans from around the country who are relatively young who
    have ALS. And how we reconcile what Senator Collins has been
    talking about--but again, I think appreciating perhaps what is
    going on with the nature of this disease that we know so little
    about.
        So I understand your commitment to Senator Collins here to
    look into this one specific case, but I do believe that we need
    to look much more broadly. We do have the research program that
    DOD helps to fund through the disease-specific programs. I
    think we need to encourage that. But it is an issue that I find
    very, very troubling.

                          IMPROVISED EXPLOSIVE DEVICES

        General, I want to ask you this morning about where we are
    in terms of improving how we deal with IED's. I think this has
    been so frustrating over the years. We recognize that this is
    the number one killer on the battlefield, and yet our sources
    are indicating that our ability to detect and really to defeat
    these IEDs has remained relatively level versus improved.
        I was out at Walter Reed on Monday and met with an airman
    who was an explosive ordnance disposal technician. I found it
    absolutely fascinating to learn that his position, his job
    requires that he go in and render this IED safe, but he does
    that through a paintbrush and a knife on his belly.
        And we talked about the robots and whether or not the
    robots were as effective as they might be. I will tell you that
    when we look at what we are able to do on Mars with a robot,
    when we think back to a year ago under water with the Deepwater
    Horizon and what we were able to detect a mile below the
    surface, it seems incredible to me that we really have not made
    the progress that we would hope when it comes to how we handle
    the IED's.
        Can you give me an update, give me a little more optimism?
        General Dempsey. I would be loathe to give you optimism
    because as long as there is one soldier at risk for the
    technology--you know, I think we all should remain sort of
    pessimistic.
        I cannot speak to that one airman's experience, but the
    technology has actually progressed remarkably. And in some ways
    actually we have moved away from technological solutions and
    back to things like bomb-sniffing dogs. So, for example, our
    brigades in southern Afghanistan, which are the brigades taking
    the greatest number of IED strikes, are all now outfitted with
    tactical dog teams. We give them an acronym naturally called
    TEDS that have been delivering on their training.
        We have got ground penetrating radars. We have got other
    technologies that have sensors that seek to be able to identify
    the different kinds of explosives and triggering devices. Some
    of that is classified, of course. And our state of training and
    partnership with JIEDDO, the Joint IED Defeat Organization, has
    reaped a lot of benefits in not only defeating the device
    itself but defeating the network, the supply chain that
    delivers it.
        So actually in my time in Iraq and Afghanistan, which spans
    roughly 7 years between 2003 and 2010, I mean, we have made
    exponential improvements, but we should never be satisfied with
    them. Of course, then we carry that to the technology to defeat
    the device when it explodes and MRAP technology and so forth.
    So we have made a lot of progress, but I would not sit here and
    express optimism.
        Senator Murkowski. And I appreciate that. I guess I was
    just more than a little bit disconcerted to learn that still
    with a milk jug and some fertilizer and some diesel, they can
    continue to do the kind of damage and inflict the death and the
    mutilation that we continue to see.
        I was a little bit concerned, though, about what I learned
    about the robots, that in order to really be effective and be
    able to dig through the earth, you have got to have a heavier
    one, but you cannot carry the heavier ones, and the lighter
    ones are not effective. Are we doing more with that technology
    or is that going away as we get more dogs?
        General Dempsey. No, not at all. In fact, we continue to
    look for opportunities with robotics not only in encountering
    IED's but even the technology that might some day produce
    vehicles that are robotic so we do not put soldiers on roads
    that we know are susceptible to mining and IED's. So we are
    pursuing robotic technology aggressively.

                              ALASKA RANGE COMPLEX

        Senator Murkowski. One last quick question, if I may, and
    this relates to the joint Pacific Alaska Range Complex regarded
    as one of the finest joint training ranges in the Nation, I
    think perhaps the world, certainly when it comes for
    preparedness for cold-climate battlefields. When I flew over
    Afghanistan, I looked down and it looks like home. It looks
    like Alaska with the mountains and the terrain there.
        We have been doing a pretty good job with the Alaska troops
    in terms of training on the range, but I am a little bit
    disappointed that the Army does not make broader use of this
    tremendous resource for training a larger number of troops to
    fight in our cold climates. And I guess I would just ask if you
    agree that in fact we do have superior training range
    capability up there when it comes to the cold climate and if
    that is the case, what we can do to perhaps encourage the Army
    to perhaps make more extensive utilization of what we have up
    north.
        General Dempsey. Well, I could not argue against the fact
    that you have the best cold, and we cannot replicate cold the
    way you can anyplace else in our country. That is for sure.
        And we are excited about the potential that that facility
    brings and the joint capability that it brings as well.
        As you know, part of our challenge in using it especially
    to deliver cold weather training right now is we are consumed
    in a cycle of deployments and preparation for deployment that
    really is based on the exact opposite climate challenges. And
    so as these particular conflicts wane, I think we will seek
    opportunities to expand our training, and I would certainly be
    open to the use of that facility.
        Senator Murkowski. We look forward to working with you.
    Thank you. Thank you both for your service.
        Chairman Inouye. Thank you very much.
        Senator Murray.
        Senator Murray. Thank you very much, Mr. Chairman.

                            WARRIOR TRANSITION UNITS

        Thank you to both of our witnesses today. Nice to see you
    here. I apologize for being late. I was chairing a Veterans
    Affairs Committee where we had a joint hearing with the DOD and
    the VA to talk about the warrior transition units and the fact
    that we are still seeing a lot of delays and seriously
    concerned about the high percentage of suicide rates on our
    warrior transition units and people still waiting. So we are
    working.
        But I would say to the chairman and to Senator Collins, who
    brought it up, we are seeing both the DOD and VA work together
    better today than we have in the past, and I do want to thank
    you and commend you for that.
        One area that I am really focusing on at the VA is the high
    unemployment rate for our service members who are exiting, much
    higher than their peers, 27 percent. And I recently introduced
    The Hiring Heroes Act to start to address how we can better
    transition our service members with these tremendous skills
    that they learn on the ground for us, whether it is a mechanic
    or driving a truck or whether they work in healthcare. Whatever
    their service is, they have tremendous experience, but they
    come out and they cannot translate that into a skill in the
    civilian side and end up unemployed at very high rates.

                         TRANSITION ASSISTANCE PROGRAMS

        In my legislation, I mandate that the transition assistance
    program become mandatory for all service members. That effort
    will go beyond the required pre-separation counseling that we
    currently see many soldiers receive, but actually say what did
    you do in the service and what are the skills and experience
    you have and how can we translate that into a career once you
    leave.
        I wanted to ask you, General Dempsey, today what percentage
    of soldiers currently use the TAP program that is available?
        General Dempsey. Well, again, one of the realities of the
    pace of operations is that we have not been using our ACAP
    programs and other transition assistance programs to the extent
    that we should. And so we have got to find a way to jump start,
    if you will, or rekindle the interest in it because 15 years
    ago, it was mandatory and we met the gates necessary to
    transition.
        And I will just tell you. We feel an obligation to do
    better at this not only because we owe it to our transitioning
    soldiers, but it is an enormous cost to us as well to pay the
    unemployment insurance. So we agree with your concern.
        Senator Murray. Yes. I am startled by the rapidly
    increasing cost of unemployment insurance. For the Army alone,
    it has gone from $500 million in 2010 to $800 million in 2011.
    That is a cost that, obviously, we all have to pay for, but it
    is a cost in lives too for these young men and women who come
    out and do not get a job and become disillusioned, and we see
    the results in everything from drug and alcohol abuse to
    divorce rates to suicide. So it is a cost to society as well as
    a cost to the services.
        So this is something I am very focused on. I would like you
    to take a look at my legislation. I would love to see your
    support in getting that done because I think it is an
    obligation that we have to meet.
        I do know that the Army recently conducted a holistic
    review of the ACAP transition program, and I really am looking
    forward to see the results of that review and a timeline for
    implementing it and wondered if you could share with me today
    what the timeline is for completing that assessment and when
    Members of Congress will be briefed on it.
        Mr. McHugh. If I may, Senator. Thank you for your efforts
    there. We always recognize our responsibility to take care of
    soldiers when they are in the Army and service. We are
    beginning to recognize we have got to go beyond that and help
    them----
        Senator Murray. And the Nation pays a lot for the
    experience that they get there. We should benefit from it.
        Mr. McHugh. Absolutely. And we need to do a better job
    helping employers understand the incredible talent that these
    young--largely young--soldiers bring to the field.
        Under the ACAP program, it is our intent right now to put
    out an RFP this October. We would look for that RFP to
    establish three main locations and 15 satellite locations for
    the ACAP program for demobilization locations to begin to
    provide that. And we are also looking at how do we meld the
    ACAP initiative with some of our existing employment programs.
    We have partnership programs with the Fortune 500 companies and
    others, and bringing those two together seamlessly seems to us
    to be a very logical place by which employers who already
    recognize the value of these soldiers. So as we plan right now,
    you should begin to see some real changes in this fall.
        Senator Murray. In this fall. Okay. I look forward to that.
        And I did want you to know I am very supportive of the
    Joint Base Lewis-McChord ACAP model. They provide 70 hours of
    transition over 12 months. So rather than just putting somebody
    in a class a few days before they leave and they could care
    less, they actually are looking at what they are doing a year
    before they leave and saying you may need to do something
    additional if you want to get a job in the civilian world. And
    I think that is a very smart investment.
        Can you tell me when the pilot of that model begins by any
    chance?
        Mr. McHugh. As I said, we have to set out and make the
    contract let this fall. I do not expect once that is done, it
    should not be too long from enactment, but if I may, let us go
    back and get you some more detail on that.
        Senator Murray. All right. I just do not want to lose
    anybody else here.
        Mr. McHugh. Understood.
        Senator Murray. I think we have got a lot of soldiers
    transitioning and a few months means a few hundred more
    soldiers who are getting left behind.
        All right. Well, I look forward to working with both of
    you. I would like you to take a look at our legislation and
    would love to have your help and support with it.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Gentlemen, I have a lot of questions to ask, but I will
    submit them to you for your consideration.

                             WEIGHT OF COMBAT GEAR

        But I have one question. Ten years ago, the Army Science
    Board made a study, and after that study, they recommended that
    no soldier should carry more than 50 pounds of gear. Today, it
    is estimated that the weight of the gear that a soldier carries
    is 125 pounds. As a result, musculoskeletal injuries have
    increased tenfold in the last 4 years. And the cost of medical
    benefits or disability benefits exceed this annually $500
    million.
        And Johns Hopkins just made a study that indicates that
    injuries from musculoskeletal spinal injuries are double that
    of combat injuries.
        Do you have anything to say to that?
        General Dempsey. Only that this is a constant issue on our
    minds and the minds of Training and Doctrine Command, as well
    as the acquisition side of our Army. And we are looking at it
    in two parallel paths: one that you are very familiar with,
    which is the work on lightening the individual soldier's load.
    And we have made some progress with plate carriers, the weight
    of the helmet, the weight of optics on the rifle, the weight of
    the boots. But frankly, those are kind of marginal changes.
    They are important changes but they tend to be marginal
    changes.
        The other path is to do what I mentioned in my opening
    statement, Senator, which is look at the Army from the bottom
    up. What does a squad need, to take one example, in terms of
    power and energy because we have introduced so many new
    emitters that we have actually increased the burden because of
    the batteries required to run the emitters. We have connected
    the individual soldier to this network, but it requires power
    and energy to maintain it. So by looking at the squad, what we
    hope to find out is what are the squad's power and energy needs
    not just the individual soldier. And we might find our way
    forward in bringing capabilities to the squad external to the
    individual soldier, whatever that happens to be, robotic
    devices, some kind of automotive mule to take some of the load
    off the individual soldier.
        But I can only assure you that it is probably a weekly
    issue for the Chief of Staff of the Army, and I hope that lends
    the gravity to the issue that you would expect.
        Chairman Inouye. As one who served in the infantry, I feel
    for them because I believe my combat gear never exceeded 20
    pounds, including by rifle, boots, helmet, grenades, and all
    that ammo I carried. So I hope we can lighten the load and
    lighten the injuries. What shocked me was the Johns Hopkins
    report that indicated that musculoskeletal injuries exceed
    combat injuries twice.
        General Dempsey. Senator, could I add something to that,
    though? Part of the reason, we have also discovered, that young
    men and women coming in the Army today are not as fit or as
    skeletally sound as you were. And what I mean by that is the
    proliferation of bad nutritional habits and carbonated
    beverages. Even in basic training before we load the soldier
    with the gear that eventually they will have to learn to bear,
    we have these same kind of musculoskeletal injuries. It is
    really a generation of Americans that have this problem, but it
    is exacerbated by the load we ask them to bear.

                         ADDITIONAL COMMITTEE QUESTIONS

        Chairman Inouye. I thank you very much, Mr. Secretary and
    General Dempsey, and we thank you for your service to our
    Nation. And we look forward to working with you on all the
    problems that you brought up today.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
                Questions Submitted to Secretary John M. McHugh
                Questions Submitted by Chairman Daniel K. Inouye
                         fiscal year 2012 efficiencies
        Question. Secretary McHugh, with the current state of our economy,
    the Nation is challenged with becoming good stewards of our valuable
    resources. One of the major themes of the fiscal year 2012 budget
    submission is cost-savings as a result of efficiencies. The Army
    contributed $2.7 billion in fiscal year 2012 and plan to contribute $30
    billion over fiscal years 2012-2016. How confident are you that these
    savings will come to fruition?
        Answer. The Army is confident projected efficiency savings will be
    realized. We understand that savings resulting from better business
    processes may take years to materialize, so we focused our efficiencies
    during the first 3 years of the program in two limited areas: weapons
    systems with declining relevance or unnecessary redundancy, as
    identified through comprehensive capability portfolio reviews, and a
    balanced facilities strategy that reduces military construction by
    leveraging investment in Base Operations Support (BOS) and Sustainment,
    Restoration and Modernization (SRM).
        Of the approximately $9 billion of savings associated with better
    business practices, reorganizations, and contract management, $8
    billion is projected to be realized in fiscal years 2015 and 2016. This
    phased approach provides the time needed to develop and successfully
    implement future initiatives.
                            family support programs
        Question. Secretary McHugh, the American people recognize that
    soldiers and families make considerable sacrifices as they serve to
    defend the Nation. Because of these sacrifices, the Army has dedicated
    a large amount of manpower and resources toward a full range of support
    programs. Are any of these programs at risk in the Department's efforts
    to find efficiencies?
        Answer. Army family programs are not at risk in the Department's
    efforts to find efficiencies. Because of the tremendous sacrifices our
    soldiers and their families make every day, the Army has committed to
    provide them with the best possible family support services to enhance
    readiness, retention, and resiliency. We have resourced fiscal year
    2012 family programs to provide soldiers and families with a quality of
    life commensurate with their level of service and sacrifice to the
    Nation. Army family programs serve Active and Reserve Component
    soldiers and families whether they reside on or near an installation,
    or are geographically dispersed. The Army continually evaluates the
    quality, cost, and value of these programs. Our efforts ensure a
    balanced portfolio of services that are fiscally sustainable to
    strengthen soldier and family programs for the long term.
                                future force mix
        Question. Secretary McHugh, while trying to make decisions on the
    composition of the future force mix, how will you make sure the Army
    can maintain its battle-proven current capabilities and invest in
    future capabilities within a fiscally constrained environment?
        Answer. We have an Army that is poised to prevail in the current
    fight. We will smartly manage the reduction and change in size and
    composition along with changes in the demand for overseas contingency
    operations. We will sustain the warfighting capabilities to prevail,
    even as we increase our ability to prevent conflict. We will ensure
    full spectrum operational readiness and continue important
    modernization programs as we correctly apply efficiency efforts across
    our training, manning and other title 10 activities.
                             ground combat vehicle
        Question. Secretary McHugh, the fiscal year 2012 budget includes
    over $1 billion for the Ground Combat Vehicle. This is a 7-year
    development program that will cost over $40 billion. However, the
    Ground Combat Vehicle will replace less than half of your combat
    vehicle fleet, and your budget contains little funding to modernize
    those vehicles. Is this modernization strategy truly affordable?
        Answer. The Combat Vehicle Modernization Strategy, including the
    development and fielding of the Ground Combat Vehicle, is affordable.
    The Army conducted a rigorous analysis to determine an affordable cost
    for the Ground Combat Vehicle. After examining planned modernization
    efforts and new start programs across the combat vehicle fleet, the
    Army determined a Ground Combat Vehicle with a $13 million Average
    Procurement Unit Cost is affordable. The Army included a cost target
    range in the Request For Proposals, encouraging industry to submit
    proposals the Army can afford.
        We require a new ground combat vehicle to provide soldiers the
    protected mobility they need to operate across the full spectrum of
    operations. Nine years of combat experience, ranging from major
    combined-arms maneuver and close combat action, to stability operations
    and security force assistance missions, have underscored this need.
    Current and product-improved Infantry Fighting Vehicles do not provide
    the protected mobility required to operate across the spectrum of
    operations or the growth potential required to incorporate advances in
    protection or network capabilities for the full infantry squad.
        Question. Secretary McHugh, we understood that savings generated by
    the Army during the Department's efficiency initiative were going to be
    reinvested in combat vehicle modernization. Could you please detail for
    us where and when those funds will be invested?
        Answer. A sizeable portion of the funds from the efficiency
    initiative will be applied from fiscal year 2012 through fiscal year
    2017 in support of the Army's Combat Vehicle Modernization Strategy.
    The Army will take a holistic approach to the development of the Ground
    Combat Vehicle, replacement of the M113 Family of Vehicles and the
    incremental modernization of the Bradley, Abrams, Paladin, and Stryker.
    Modernization imperatives across the fleet include improved protection,
    lethality, mobility and sustainment, mitigation of existing Space,
    Weight and Power (SWaP) shortfalls and Network integration.
                              healthcare proposals
        Question. Secretary McHugh, the increases in co-pays have been
    proposed previously. Could you explain how these proposals are
    different and why they should be reconsidered by the Congress at this
    time?
        Answer. Previous proposals sought higher enrollment fees and higher
    pharmacy co-pays than the current proposal. While the cost of military
    healthcare has continued to grow because of an increase in eligible
    beneficiaries, expansion of benefits, increased healthcare utilization,
    and the growth in health inflation, TRICARE premiums have remained the
    same since the TRICARE program began in 1995. These fiscal year 2012
    proposals balance our commitment to preserve the healthcare benefit
    while slowing future growth in healthcare costs through various
    healthcare efficiencies. The Army believes these proposals to raise the
    TRICARE enrollment fees for working age retirees and adjust retail
    pharmacy co-pays for all beneficiaries except Active Duty to be modest,
    gradual, and responsible.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
                                    suicide
        Question. The Congress has established a national suicide hotline
    for returning troops, as well as increased funding for mental health
    programs for Active Duty military personnel. However, there remain a
    high number of soldier suicides. For example, it was reported that 21
    suicides involving Fort Campbell soldiers alone occurred in 2009. What
    preventative measures are the Army and the Department of Defense (DOD)
    taking to address this problem writ large and at Fort Campbell in
    particular?
        Answer. The Army has implemented several near-term projects to
    improve our understanding of suicide prevention and to improve the
    programs and services provided to soldiers and their families--such as
    the Army Campaign Plan for Health Promotion, Risk Reduction and Suicide
    Prevention and the Vice Chief of Staff's monthly suicide review
    meetings. The Army has also enlisted the help of the National Institute
    of Health (NIH) to conduct a long-term study on risk and resilience in
    the Army.
        In the past year, the Army has implemented the Comprehensive
    Behavioral Health System of Care Campaign Plan. This initiative is
    nested under the Army Campaign Plan for Health Promotion, Risk
    Reduction and Suicide Prevention. The Comprehensive Behavioral Health
    System of Care is intended to further standardize and optimize the vast
    array of Behavioral Health (BH) policies and procedures across the U.S.
    Army Medical Command. The goal is to ensure seamless continuity of care
    to better identify, prevent, treat, and track BH issues that affect
    soldiers and families.
        There has been a robust Combat and Operational Stress Control
    presence in theater since the beginning of the war, with deployed BH
    assets supporting both Operation Enduring Freedom and Operation New
    Dawn.
        The Army is enhancing BH services provided to its family members
    through Child, Adolescent and Family Assistance Centers and the School
    Behavioral Health Programs.
        We continue to invest significant resources in researching BH. The
    BH research program supports development and evaluation for prevention,
    treatment, and long term recovery needs. This includes over 150
    projects addressing post-traumatic stress disorder and 10 projects
    dedicated toward suicide prevention and intervention research.
        All of these programs and services are available to soldiers and
    their families at Fort Campbell. The soldiers of the 101st Airborne
    Division (Air Assault) were the first soldiers in the Army to implement
    the Army Campaign Plan for Warrior Traumatic Brain Injury (mTBI)
    Management. This campaign plan increased the forward screening,
    treatment and documentation for soldiers exposed to concussive events.
    The program will help the healthcare providers at Fort Campbell improve
    the medical care and treatment for soldiers who are displaying signs or
    symptoms of mTBI following their deployment. Additionally, under the
    direction of the Army's Assistant Surgeon General, a detailed plan for
    improved postdeployment behavioral health screening and treatment has
    been implemented. The plan increased both the number of providers on-
    hand at Fort Campbell, and also increased the access to behavioral
    health specialists through Virtual Behavioral Health.
                              counseling services
        Question. With the current deployment schedule, a heavy toll is
    being placed upon the spouses and children of servicemembers. How
    accessible are counseling services for deployed servicemembers' spouses
    and children?
        Answer. The Army has an extensive array of behavioral health
    services and resources for soldiers and their families. These services
    include, but are not limited to, routine behavioral healthcare, School
    Behavioral Health Programs, Child and Family Assistance Centers, Army
    Community Service, the Family Assistance for Maintaining Excellence
    program, Warrior Resiliency Program, use of chaplains, Military One
    Source, and Comprehensive Soldier Fitness for Families. The Army
    developed its Comprehensive Behavioral Health System of Care Campaign
    Plan to standardize, synchronize, and coordinate behavioral healthcare
    across the Army, to optimize care and maximize limited behavioral
    health resources to ensure the highest care to soldiers and their
    families.
        Question. Are these services available on all major military
    installations?
        Answer. Yes. Counseling services are available for deployed
    servicemembers' spouses and children at all major installations.
        Question. What programs are available for those living away from
    major military installations?
        Answer. Eligible stateside TRICARE beneficiaries can access
    behavioral healthcare services through the TRICARE Assistance Program
    and are also eligible for counseling support through secure, two-way
    audio-visual conferencing to connect with authorized providers as part
    of TRICARE's Tele-mental Health program. Military OneSource provides
    access to face-to-face, telephone, online and email supportive
    counseling services and is available 24 hours a day, 7 days a week for
    Active Duty servicemembers and their families.
                        ireland army community hospital
        Question. Ireland Army Community Hospital at Fort Knox is one of
    the oldest hospitals in the Army. With the new Brigade Combat Team
    stationed at the post, I am concerned over the state of the current
    hospital and its ability to meet the increased demands placed upon it.
    What is the status of the Army's decision on when to build a
    replacement?
        Answer. The Army intends to replace Ireland Army Community Hospital
    (IACH). The current Defense Health Program Future Year Defense Program
    includes a phased funded replacement project for IACH beginning in
    fiscal year 2013.
      post-traumatic stress disorder (ptsd)/traumatic brain injuries (tbi)
        Question. Are there any further legislative steps that the Congress
    could take to improve screening and the delivery of care to soldiers
    with PTSD and TBI?
        Answer. At this time there are no further legislative steps
    necessary to improve the screening of PTSD and TBI brain injury. The
    Army's Comprehensive Behavioral Health System of Care campaign plan was
    launched in February 2010 to standardize, synchronize, and coordinate
    behavioral healthcare across the Army and through the Army Force
    Generation cycle.
                                   fort knox
        Question. With the addition of the new Brigade Combat Team at Fort
    Knox, what is the Army doing specifically to ensure that the
    installation is capable of deploying the unit with dispatch?
        Answer. In March 2006, an assessment by the Transportation
    Engineering Agency calculated a rail deployment requirement of 360
    railcars in a 48-hour period to deploy a Brigade Combat Team. In order
    to achieve that deployment tempo, the Army has programmed a 2014
    project to upgrade the Brandenburg Station Road railhead in the fiscal
    year 2012 through 2016 Future Year Defense Program. The Army is
    currently reviewing all projects in anticipation of expected military
    construction reductions.
        Question. What additional transportation or logistics facilities
    are needed to enhance Fort Knox's capabilities in this respect?
        Answer. Two other projects will enhance the installation's
    deployment capabilities. A Container Handling Facility will support the
    increase in container processing that must occur for deployment.
    Additionally, a Vehicle/Equipment Processing Facility will assist with
    the tasks necessary to process the increased number of vehicles and
    other equipment that comes with deploying a Brigade Combat Team from
    the installation. Both projects are programmed to be funded in 2015 in
    the fiscal year 2012 through 2016 Future Year Defense Program. The Army
    is currently reviewing all projects in anticipation of expected
    military construction reductions.
                              servicemember census
        Question. It is my understanding that there are at least three ways
    that the DOD could count servicemembers for purposes of the Census. The
    DOD today apparently uses ``home of record'' as the means of
    determining where servicemembers ``live''. This appears to be the case
    even though such data are often many years old. What is the policy
    justification for the DOD using this means of counting as opposed to
    other approaches, such as legal residence or last duty station, which
    might entail a more accurate methodology?
        Answer. Using a servicemember's home of record (HOR) provides
    greater consistency and accuracy in the census in comparison to the
    other two approaches. The HOR is established at initial entry and can
    only be changed if there is an administrative error or when a
    servicemember re-enlists after having a 24-hour break in service. The
    HOR is also used to calculate a servicemember's Government travel
    expenses upon separation, therefore, returning the servicemember to the
    State of initial entry.
                           chemical weapons disposal
        Question. Please provide the Program Office Estimate (POE)
    projected date for completion of operations for chemical weapons
    disposal at Blue Grass Army Depot (BGAD), Kentucky.
        Answer. The Assembled Chemical Weapons Alternatives (ACWA) POE
    developed in 2010 estimated the completion of chemical weapons
    destruction operations at Blue Grass in May 2021. During the recently
    completed Nunn-McCurdy review of the program, risk elements were
    identified that will likely extend the schedule by approximately 24
    months. The ACWA program continues to evaluate options to improve the
    overall schedule including the consideration of the use of explosive
    destruction technology. A new Acquisition Program Baseline will be
    developed by the fourth quarter of fiscal year 2011.
                 assembled chemical weapons alternatives (acwa)
        Question. I am told that the Office of the Secretary of Defense
    Efficiency Initiatives memorandum, dated March 14, abolishes the
    Program Manager position of the Assembled Chemical Weapons Alternatives
    (ACWA). I am concerned that abolishing the ACWA Program Manager could
    leave the program without the leadership necessary to fulfill the
    mission--unless the Chemical Materials Activity Director remains as
    interim ACWA Program Manager indefinitely. I believe clarity is needed
    as to who is going to take long-term responsibility of the ACWA
    mission, consistent with existing law. If the reports are true, what
    impact would eliminating this position have on chemical weapons
    disposal efforts and the greater ACWA mission at BGAD?
        Answer. In accordance with the Office of the Secretary of Defense
    Efficiency Initiatives Decisions memorandum dated March 14, 2011, the
    Program Manager, Assembled Chemical Weapons Alternatives (PM ACWA)
    Senior Executive Service (SES) position was eliminated.
        However, as a result of the ACWA Program Nunn-McCurdy review, the
    Secretary of the Army is tasked to establish and fill the PM ACWA
    position by the first quarter of fiscal year 2012. Pursuant to section
    1421 of Public Law 111-383, the PM ACWA shall report to the Under
    Secretary of Defense for Acquisition, Technology and Logistics. The
    U.S. Army Chemical Materials Agency (CMA) Director, Mr. Conrad Whyne,
    is the Acting PM ACWA, and will manage the ACWA program until the
    position is permanently filled.
        The DOD understands the importance of the ACWA Program and will
    continue to maintain long-term responsibility and the essential
    management structure for the destruction of the chemical weapons
    stockpiles in Kentucky and Colorado.
                                     ______

                Questions Submitted by Senator Richard C. Shelby
                      research and development innovation
        Question. Secretary McHugh, in the Fiscal Year 2011 Department of
    Defense Appropriations bill passed last month the Congress provided the
    Army with $105 million for ``Research and Development Innovation''.
    This was a new program line for the Army and the bill contained no
    explicit language prescribing the uses of that money. Does the Army
    currently have a detailed plan for how the $105 million will be spent?
        Answer. The Army is developing guidance for the execution of the
    $105 million Rapid Innovation Program. We currently plan on defining a
    set of broad topic areas of importance to the Army, and issuing Request
    For Proposals (RFPs) on these topics. The RFPs should be issued in the
    next several months.
        Question. Will the Congress be briefed on a spending plan in the
    near future?
        Answer. Detailed plans will be provided to the Congress when the
    Army finalizes guidance for the Rapid Innovation Program, which should
    occur in the next several months. The Army will also provide regular
    reports on the use of this funding, as required by law.
                                industrial base
        Question. Secretary McHugh, there has been much discussion in
    recent weeks on the combat vehicle industrial base but there appears to
    be an increasing concern over the weapon system industrial base writ
    large. What analysis does the Army conduct on the impact of ending
    programs on the industrial base?
        Answer. On an annual basis, the Army conducts analysis and
    assessments on key industrial base sectors which produce weapon systems
    and critical components. The broad assessments and sector studies are
    utilized to make informed industrial base investment decisions, to
    include decisions on program termination impacts. These Army industrial
    base assessments are summarized in the Annual Industrial Base Report to
    the Congress. As an example of an Army assessment of ending combat
    vehicle production, the Army assessed and determined it prudent to
    temporarily close our primary assembly plant for heavy vehicles but
    keep critical suppliers like special armor in active production status
    to protect our ability to restart production. As a result, the Army
    programmed needed funds to maintain that capability.
        Question. Is the industrial base a manageable problem from your
    perspective?
        Answer. Yes, however the current decline in the number of
    suppliers, a lack of surge capability, a dependence on foreign sources
    of supply, and a low-productivity growth rate in some important
    industries could prove to be challenging. We need to continue pursuing
    comprehensive and integrated approaches to determine which industrial
    capabilities are unique and vital to our national defense and if our
    military will be jeopardized if a company decides to terminate a vital
    activity or move production offshore. The national defense environment
    is dynamic and, unfortunately, no single criterion applies to all
    situations. Identifying vital, at-risk capabilities requires program
    managers and other logisticians to become involved.
                            technology advancements
        Question. Secretary McHugh, recent technologies have begun to
    emerge which enhance the capabilities of our tactical assets to
    acquire, target and mitigate enemy rocket and mortar fire from the
    ground. How does the Army assess advancements in targeting sensors,
    missile guidance and control, and seeker technologies? Will the
    department pursue miniaturized, cost-effective, and deployable force
    protection systems?
        Answer. There have been significant advancements in targeting
    sensors, missile guidance and control, and seeker technologies. The
    Army has ongoing Science and Technology investments to mature and
    evaluate these technologies. We plan to demonstrate their ability to
    target and mitigate enemy rocket and mortar fire over the next few
    years.
        We have sought enhancements to all baseline components to ensure
    the capability to acquire, target and mitigate enemy rocket and mortar
    fire. At the same time, we are responding to changes in insurgent
    tactics and weapons. We have sought both mature and emerging
    technologies across the various services. We are demonstrating and
    evaluating these and programmed enhancements to existing systems over 6
    major tests/demonstrations and 20 smaller events. The Counter-Rocket,
    Artillery, and Mortar (C-RAM) Program Office has integrated existing
    Navy, Marine Corp, and Air Force systems, in many cases employing them
    to perform new functions. The C-RAM Program Directorate works with DOD
    Program Mangers of existing systems as well as the Science and
    Technology organizations and industry to identify technologies and
    systems that can improve force protection in Iraq and Afghanistan.
        The Army is developing requirements consistent with emerging war
    fighter needs that provide better force protection. Miniaturization and
    cost-effectiveness are always considerations when developing force
    protection capabilities.
                         injury prevention and control
        Question. Mr. Secretary, physical readiness is critical to mission
    success. Musculoskeletal injuries are the #1 issue inhibiting military
    readiness, resilience and deployability. At any given time we have a
    full brigade of soldiers that cannot deploy due to musculoskeletal
    injury. These injuries also strongly influence the quality of life in
    our older personnel decreasing productiveness and increasing medical
    costs. After Active Duty, these old injuries continue to affect the
    lives of our veterans. Nonetheless, the vast majority of our research
    funds are focused on battlefield injuries.
        Today only 6 percent of the United States population meets current
    enlistment standards. While TRADOC has put in motion the ``Soldier
    Athlete Initiative'' and is exploring the Musculoskeletal Action Team
    concept within the training brigades, this leaves the largest number of
    soldiers (FORSCOM) without direct support in this area. In addition, if
    the Army were to expand its efforts beyond TRADOC, I understand there
    is a severe shortage in personnel, whether military, civilian DOD, or
    contractors, trained in sports medicine and orthopedic health available
    to address this critical need.
        What is the Army currently doing to reduce the number of
    musculoskeletal injuries and the recovery time from those injuries
    across the Army? Please provide full background and statistics on
    improvement and cost savings to TRADOC, FORSCOM, and MEDCOM.
        Answer. The U.S. Army Medical Command (MEDCOM) has initiated its
    comprehensive Soldier Medical Readiness Campaign (SMRC) to address and
    improve the medical readiness of the Army. Under SMRC, the Office of
    The Surgeon General and MEDCOM are partnering with the Headquarters
    Department of the Army, FORSCOM, TRADOC, U.S. Army Special Operations
    Command, Human Resources Command, and others to promote a healthy
    population and ready force. The SMRC focuses on evidence-based health
    promotion, injury prevention, and human performance optimization. The
    U.S. Army is initiating/monitoring multiple programs that target both
    TRADOC and FORSCOM soldiers. These programs include, but are not
    limited to, the Initial Entry Training--Soldier Athlete Initiative, 4th
    Infantry Division Iron Horse Performance Optimization Program, 25th
    Infantry Division Advanced Tactical Athlete Conditioning Program, and
    the Fort Hood Physical Readiness Training Program. Additionally, the
    Army initiated the new Physical Readiness Training (PRT) in 2010.
        This is a phased program that safely focuses on training the
    fundamentals first while enhancing strength, endurance, and mobility.
    We designed the PRT to incorporate appropriate intensity and duration
    of physical conditioning while allowing for adequate rest, recovery,
    and nutrition. A study conducted by the U.S. Army Public Health Command
    (Provisional) (PHC) found that soldiers in an infantry battalion were
    1.2 to 1.4 times less likely to suffer an overuse injury when
    participating in the PRT versus traditional physical training programs.
        It is still too early to draw definitive data on cost savings that
    have been realized from these programs. MEDCOM has ongoing
    collaborative efforts with PHC and U.S. Army Research Institute of
    Environmental Medicine to identify best practices for reducing
    injuries, improving readiness, and subsequently reducing costs.
        Question. How does the Army propose to overcome the serious lack of
    sports medicine and orthopedic healthcare providers it now faces?
        Answer. Currently, the U.S. Army does not face a lack of sports
    medicine or orthopedic healthcare providers. Numerous training programs
    specifically address sports medicine and orthopedic training for
    physician providers as well as physician extender providers. Physician
    programs include fellowships in both orthopedics and sports medicine.
    Nonphysician healthcare providers also have multiple programs that
    offer training in these specific subspecialties. For example, physical
    therapists are selected each year to attend residency programs in
    orthopedics or in sports medicine and physician assistants are selected
    for attendance to an orthopedic residency program. Additionally, our
    medics and specialty technicians (physical therapy, occupational
    therapy, and dieticians) receive extensive training and education
    within their respective programs in orthopedic and sports injury
    assessment and rehabilitation.
        Question. Is the Army considering the development of training
    protocols that will increase the number of trained healthcare providers
    and as importantly the ability of officers and NCO's with oversight of
    physical training to recognize injuries or the precursor to injuries in
    an effort to prevent or control injury? If not, how will this issue be
    addressed?
        Answer. The Army has a variety of healthcare providers, from medics
    and primary care physicians to specialists, who are trained in sports
    medicine and orthopedic specialties. Numerous programs exist to sustain
    the current base and provide leading edge training opportunities for
    physician and nonphysician providers. For example, entry level training
    by the U.S. Army Baylor University doctoral program in physical therapy
    is currently recognized as a leader in orthopedic and sports physical
    therapy education, including injury prevention and human optimization
    performance training. Postgraduate education for physician and
    nonphysician providers extends opportunities as fellowships,
    residencies and short courses. These programs include, but are not
    limited to, the military sports medicine fellowship for primary care
    physicians, advanced residencies in sports medicine and orthopedics for
    physical therapists, occupational therapists, physician assistants and
    other military providers.
        Question. I understand that a number of small scale efforts are
    underway across the Army that have shown great success and cost savings
    surrounding musculoskeletal injuries. Are you aware of these efforts?
    Has the Army considered expansion of these efforts, and what would the
    impact of expansion mean for readiness?
        Answer. We are aware of numerous small scale efforts across the
    Army aimed at addressing musculoskeletal injuries. These programs
    include, but are not limited to, the Initial Entry Training--Soldier
    Athlete Initiative, 4th Infantry Division Iron Horse Performance
    Optimization Program, the 25th Infantry Division Advanced Tactical
    Athlete Conditioning Program as well as programs throughout Special
    Operations Command. These programs augment the Army's validated
    physical readiness training. Army research and public health experts
    seek to identify objective and valid measures for success and cost
    savings in these programs. The collaboration among commanders,
    researchers and medical experts will assist in identifying best
    practices in order to expand these across the Army. It will be
    difficult to determine the impact on readiness and efficacy in reducing
    the risk and incidence of musculoskeletal injury until the ongoing
    studies are complete.
                          canine explosives detection
        Question. Mr. Secretary, IEDs seem to be a growing issue in
    Afghanistan and a continuing issue in Iraq, yet statistics provided by
    the Joint IED Defeat Organization (JIEDDO) indicate little improvement
    in our ability to detect and defeat IEDs in theater. There is, however,
    one technology that has proven to have greater success--explosive
    detection canines. The current and previous Directors of JIEDDO,
    Generals Oates and Barbero, as well as General Petraeus, have all
    acknowledged that canine detection teams remain the best technology to
    detect and defeat IEDs. In fact, units with canines have an 80 percent
    detection rate compared to 50-55 percent detection rate for all units
    with differing technology.
        How many detection dogs are currently deployed or being trained for
    deployment?
        Answer. The Army has 7 Patrol Explosive Detector Dogs (PEDD)
    assigned in Iraq. There are 174 explosive detection dogs assigned in
    Afghanistan: 5 PEDD, 25 Specialized Search Dogs (SSD), 12 Mine Detector
    Dogs (MDD) and 82 Tactical Explosive Detection Dogs (TEDD).
    Additionally, there are 40 TEDD teams in training.
        Question. Where were these dogs bred, acquired and trained?
        Answer. Procurement and training of all Military Working Dogs is
    the responsibility of the DOD Executive Agent (EA) thru the 341st
    Training and Readiness Squadron at Lackland Air Force Base in Texas.
    Current inventory of canines are bred and acquired through domestic and
    nondomestic vendors. The 341st also provides dogs through their in-
    house breeding program.
        Question. What is the Army doing to acquire more quality trained
    dogs for deployment?
        Answer. The DOD EA continues to procure/train Military Working Dogs
    for the Army. Additionally, based on an Operational Needs Statement
    (ONS) for a single purpose explosive detection capability in support of
    combatant commanders, the Army developed TEDD as an emergent
    requirement for additional capacity. Headquarters, Department of the
    Army validated that each deploying Brigade Combat Team will receive 20
    TEDD dogs.
        Question. Does the Army have standards on detection dogs that must
    be met by suppliers?
        Answer. The DOD EA thru the 341st Training and Readiness Squadron
    creates and enforces the standards by which they procure dogs from a
    supplier. All dogs are screened and approved by veterinary personnel to
    ensure the dog is physically fit to meet the rigorous training
    standards. Once the dogs have completed training, all teams are
    certified by a Department of the Army certification authority before
    being accepted into the DOD program. Certification standards requires
    all teams to demonstrate the ability of finding explosives at a 95
    percent find rate with a less than 10 percent false response rate. All
    TEDD must meet the same standards.
        Question. What is the average total cost of a detector dog?
        Answer. According to the 341st Training and Readiness Squadron at
    Lackland Air Force Base, Texas, the estimated costs are $16,000 per
    dog; the average cost of a Tactical Explosive Detection Dog is $14,000
    per dog.
        Question. Is the Army currently conducting R&D on detection dogs
    and methods to increase their effectiveness? If so, please provide
    details including costs and successes.
        Answer. The Army is not conducting any Research and Development on
    detection dogs, but strives to meet operational needs by incorporating
    lessons learned and Techniques, Tactics and Procedures (TTPs) directly
    from theater into ongoing TEDD classes. One example is the introduction
    of homemade explosives into the training protocol of all explosive
    detector dogs. Army Testing and Evaluation has conducted an initial
    review of the first iteration of theTEDD. The Army is in close
    coordination with each of the services' Military Working Dog programs
    to incorporate pertinent lessons learned.
        Question. What is the total amount to date the Army has spent
    directly on or with JIEDDO on IED detection and defeat R&D and asset
    acquisition? What percentage of that does the most successful asset,
    explosive detection dogs, represent?
        Answer. The Army received $7.5 million from JIEDDO over the past 8
    years for Military Working Dog programs. Of that, $5 million was split
    over 2 years to develop the Specialized Search Dog program, an off
    leash explosive detector dog team trained by the DOD dog center at
    Lackland Air Force Base in Texas. The remaining $2.5 million was used
    to develop a combat tracking dog program in which the dog was used to
    track backwards from known IED sites.
        We do not know what that represents as JIEDDO's total budget.
                                     ______

                 Questions Submitted by Senator Lisa Murkowski
                       reserve component discharge issues
        Question. In 2007, I had the opportunity to visit with Alaska Army
    National Guard troops who were returning from Iraq and Kuwait at Camp
    Shelby in Mississippi. I was particularly interested in learning
    whether the returning guardsmen were getting medical and psychological
    screening similar in quality to the screenings that our Active Duty
    soldiers received upon their return. I was left with the sense that
    there were limited opportunities for returning Guard members to get
    help at Camp Shelby and those who sought help were referred to an Army
    medical facility in the Southeast United States rather than returned
    home to a military treatment facility in Alaska. This created an
    incentive for a soldier not to express a medical concern.
        In 2010, my colleague Senator Wyden of Oregon exposed the concern
    that Oregon National Guard members returning to Fort Lewis were being
    discharged without receiving adequate treatment or counseling. To add
    insult to injury, it appeared that some members of the Fort Lewis
    medical staff were exposed to a briefing that suggested members of the
    National Guard were gaming the system and would feign injuries in order
    to continue on Active Duty.
        All of this was deeply troubling to me . . . confirming my worst
    fears when I visited with Alaska troops at Camp Shelby.
        Has the Army completed its investigation of the complaints arising
    from Fort Lewis and what was learned?
        Answer. The investigation is complete. Based upon these
    experiences, the Army established a Demobilization Assessment Tiger
    Team (DAT2) to conduct a review of the demobilization process. The Army
    published Execution Order 178-11: Mobilization Command Support
    Relationships and Requirements Based Demobilization Process on April
    14, 2011 based on the DAT2 findings. DAT2 found the demobilization
    process lacked standardization and oversight. In other words, the
    soldier's experience was very different at each demobilization site
    which led to possible gaps in fully identifying and evaluating
    battlefield injuries prior to a Reserve Component soldier's discharge
    from Active Duty.
        The solutions currently being implemented to close the gaps
    identified include:
      --Publishing specific standards for Reverse Soldier Readiness
            Processing (i.e., demobilization) medical processes to include
            specified behavioral health tasks;
      --Coordinating with TRICARE Management Activity to update and
            standardize the TRICARE briefing provided to each RC member;
            and
      --Standardizing the Medical Briefing provided at each demobilization
            site in order to ensure each soldier has the same understanding
            of medical and dental screening tasks to be completed, medical
            evaluation and treatment options to include retention on Active
            Duty under medical retention processing authorities or care
            options if the soldier chooses to be released from Active Duty.
        U.S. Army MEDCOM and its subordinate commands will continue to
    utilize the Organization Inspection Program and Staff Assistance Visits
    to ensure compliance with these new policies and procedures throughout
    the command.
        Question. What steps are being taken to ensure that battlefield
    injuries sustained by members of the Reserve Component are being fully
    identified and evaluated before a soldier is discharged from Active
    Duty? I would like you to speak both to physical injuries and
    behavioral health issues in answering this question.
        Answer. In April 2011, the Army published a Department of the Army
    Execution Order (EXORD) to address standardization and oversight within
    the demobilization process. Specific steps to fully identify and
    evaluate battlefield injuries before a soldier is discharged from
    Active Duty includes the utilization of a down-range assessment tool.
    This assessment is used to provide early indications of who may be at
    high risk for behavioral health issues so that the receiving
    demobilization platform is ready to care for them. Additionally, along
    with the postdeployment health assessment that all soldiers receive
    upon redeployment, U.S. Army Medical Command has implemented a Periodic
    Health Assessment for Reserve Component soldiers at the demobilization
    site to ensure a comprehensive assessment of their medical and dental
    readiness is documented.
        To ensure proper coordination with Reserve Component commands, DA
    EXORD 178-11 incorporated a deployment support cell (DSC) from the
    Reserve Components' command into the demobilization process. The
    medical element of the DSC monitors and assists with line of duty
    completion for all soldiers requiring documentation of medical
    conditions sustained in the line of duty and ensuring continuity of
    care for those soldiers choosing to be released from Active Duty. DA
    EXORD 178-11 also mandates that a demobilization validation board
    reviews each soldier's record prior to departure from the
    demobilization station in order to validate whether the soldier meets
    the criteria for release from Active Duty or requires further medical
    care.
                                     ______

                 Questions Submitted by Senator Lindsey Graham
                                  competition
        Question. Mr. Secretary, what assurances can you give the Committee
    that the results of the new carbine competition will consider best
    value--a competitive procurement cost coupled with due consideration of
    the total life cycle cost of the new carbine--rather than simply
    awarding the contract to the lowest bidder?
        Answer. The IC procurement strategy is being conducted as a full
    and open competition to ensure that the soldier receives the best
    overall weapon at the best value to the Government. Full and Open
    Competition permits the Army to exploit commercially available advances
    in small arms capabilities. In addition to cost, IC candidates will be
    evaluated against a number of factors, including accuracy, reliability/
    durability, fielding, facility capability, and operational and
    supportability impacts. As part of the competition, a Limited User
    Evaluation (LUE) will be conducted in order to obtain user assessment
    of the system. At the end of the competition a Cost Benefit Analysis
    (CBA) will be conducted to consider the performance, life-cycle cost,
    and terms and conditions of the selected system as compared to the
    current carbine.
        Question. Do you agree that it would be wrong to the taxpayer and
    the soldier if the Army simply goes with the cheapest solution, only to
    have the contract winner potentially recoup its profit via engineering
    changes, delays and other modifications, as has occurred with other
    small arms contracts?
        Answer. Yes, the IC procurement strategy is designed to ensure that
    the soldier receives the best overall weapon at the best value to the
    Government. While cost is one of many considerations, best value does
    not mean lowest cost. Best value also includes an array of
    considerations, including weapon performance and reliability in test
    and evaluation, past vendor performance, soldier input, and numerous
    other factors.
                                     ______

                  Questions Submitted by Senator Daniel Coats
                                tactical radios
        Question. In 2009, the Army initiated the Rifleman Radio
    Competition Integration (RRCI) to support the test, evaluation and
    certification of alternative Rifleman Radio (RR) offerings to meet the
    warfighter's requirements at a competitive price. It is my
    understanding that to date, the RRCI has not been fully implemented. In
    January 2011, the Undersecretary of Acquisition, Technology and
    Logistics (AT&L) issued an Acquisition Decision Memorandum asking the
    Army to report back by 1 February 2011 on a new radio acquisition
    strategy with the twin goals of ``focusing on that capability which is
    within reach for near term delivery to the warfighter'' and ``providing
    potential competition for production at the earliest possible time.''
    The RRCI initiative was undertaken to increase competition, drive up
    the capability and drive down the cost of acquiring the RR. What is the
    Army doing to implement this program and are you currently expecting a
    higher than projected cost per radio?
        Answer. The RRCI efforts have been implemented as a voluntary
    program for interested vendors. The RRCI program allows the vendors to
    complete as much, as or as little testing, at their own expense, based
    on their business decisions. To date, only one vendor (ITT) has
    participated in any Joint Program Executive Office supported testing.
    ITT will complete certification testing in July 2011. ITT has not
    indicated that they are willing or interested in participating in any
    further testing. Also, no other vendors have expressed any interest in
    participating in any testing. Nevertheless, the Rifleman full-rate
    production contract will be a full and open competition allowing any
    vendor who deems their radio technically acceptable to compete. The
    Unit Cost of RR is not expected to be higher than projected. The
    current Program of Record RR has been able to reduce the number of
    components in the radio while increasing reliability, resulting in a
    lower cost radio.
                            acoustic hailing device
        Question. I commend the Army for adopting a centralized acquisition
    strategy to acquire the advanced acoustic technology Acoustic Hailing
    Device (AHD) as a supplemental component of the Program Management
    Office of the Close Combat Systems, Joint Munitions and Lethality,
    United States Army located in Picatinny Arsenal, New Jersey. Tactical
    use of AHDs has the potential to save lives and deter catastrophic
    attacks, and they should be widely fielded at the earliest opportunity.
    Can you provide me an estimate of the acquisition schedule as well as
    the status of the funding required?
        Answer. Based on an approved Capabilities Production Document, the
    Army plans to initiate the Acoustic Hailing Device (AHD) procurement
    program with a Material Development Decision in the 4th Quarter, fiscal
    year 2011, and anticipates issuing a Request For Proposal (RFP) for a
    Full and Open Competition by the end of the 1st Quarter, fiscal year
    2012. Our market research has shown that we can expect up to six
    vendors to respond to the RFP. Testing and analysis of the vendor's
    products will consume most of the remaining fiscal year. We plan to
    award a contract to a single vendor in the 4th Quarter, fiscal year
    2012. The fiscal year 2012 President's budget requested $34.923
    million, split between base budget and Overseas Contingency Operations
    funds, to procure approximately 1,209 AHDs. There is also approximately
    $50 million in fiscal years 2013 through 2016 to procure additional
    AHDs.
                                     ______

                Questions Submitted to General Martin E. Dempsey
                Questions Submitted by Chairman Daniel K. Inouye
                         fiscal year 2012 efficiencies
        Question. General Dempsey, are you confident that the efficiencies
    that the Army has identified are in areas that could be reduced with
    minimal risk to operational capabilities?
        Answer. The Army's efficiency initiatives proposed in the fiscal
    year 2012 budget request do not create undue risk to operational
    forces. We used comprehensive capability portfolio reviews to terminate
    or reduce weapons systems with declining relevance or unneeded
    redundancy; the Army ensured training programs and equipment programs
    terminated, reduced or deferred would not pose a threat to its ability
    to conduct the full range of military operations and represented the
    lowest priority requirements. Army efficiency initiatives include
    implementing an aggressive plan to streamline management headquarters
    and reduce overhead by consolidating organizations. Some service and
    support contracts were reduced within the Army's Generating Force,
    leveraging investments in existing infrastructure and consolidating
    information technology, which will provide efficiency and maintain or
    improve effectiveness in supporting the Operating Force. In accordance
    with the Office of the Secretary of Defense's direction for us to plan
    to reduce our end strength by 27,000 by fiscal year 2015, we are
    conducting deliberate analysis now to determine which capabilities
    should be reduced and how the drawdown plan will proceed to ensure that
    our operational capability is minimally affected.
                            family support programs
        Question. General Dempsey, the Army has worked hard over the last
    several years to build resilience in the force by institutionalizing
    programs such as the Comprehensive Soldier Fitness (CSF), the Army
    Campaign for Health Promotion, and Suicide Prevention. These programs
    teach soldiers, families, and civilians coping skills for dealing with
    the stress of deployments in everyday life. What role will your quality
    of life programs take in preparing the Army over the next decade?
        Answer. The Army's senior leadership is fully committed to the
    well-being of soldiers, families and civilians. They have adopted two
    major programs to address these issues: the CSF, which is designed to
    build psychological strength and resilience; and the Army Campaign Plan
    for Health Promotion and Risk Reduction, which is designed to improve
    programs and services that identify, respond and treat individuals in
    need of assistance.
        The CSF Program will play a significant role in quality of life of
    the force over the next decade. The CSF represents the Army's
    investment in the readiness of the force and the quality of life of our
    soldiers, family members, and Army civilians. It is a long-term
    strategy to provide soldiers the critical skills they need to take care
    of themselves, their families, and their teammates. The program
    develops the ``whole person,'' by giving the same emphasis to
    psychological strength that is often given to physical strength. The
    CSF training focuses on increasing physical, emotional, social,
    spiritual, and family strengths through a program of continuous self--
    development and education. Additionally, mid-level noncommissioned
    officers from both the operating and generating forces are being taught
    to train resilience concepts to soldiers in their units. This enables
    members of the Army community to more easily manage various physical
    and psychological challenges in their personal and professional lives.
    The program takes a deliberate approach to equip the force with the
    psychological tools to deal with a variety of ambiguous threats.
        The Army Campaign Plan for Health Promotion and Risk Reduction is
    the Army's method to create enduring changes to policies, programs and
    services that are designed for early identification of ``high-risk''
    behavior, such as substance abuse and behavior problems, that will
    allow leaders to intervene early. The Army is focusing its efforts on
    ensuring that policies and programs are synchronized and effective. We
    are developing a comprehensive Health Promotion and Risk Reduction
    Program Portfolio to support integration across the Army while
    leveraging the Department of Defense (DOD), Federal, VA and civilian
    community-based programs, services and initiatives. The commitment of
    Army senior leadership and the efforts of leaders at all levels will
    make significant changes to the way Army does business with respect to
    Health Promotion and Risk Reduction. This is an enduring problem that
    requires enduring solutions.
                                future force mix
        Question. Along with end strength decisions, the Army is currently
    assessing its future force composition. Recent press has reported that
    both the DOD and Army leadership have raised concerns over how the
    future Army will structure itself, including the size and the number
    and composition of its deployable units, such as combat brigades.
    General Dempsey, what is your assessment on the composition of the
    future force?
        Answer. Our plan is to reduce the Army's end strength and
    restructure the force mix consistent with reductions in overseas
    contingency operations commitments and in conjunction with the needs of
    the Department and the combatant commanders. Even with budgetary
    constraints, our intent is to have the right mix of capabilities to
    meet current demands as well as future challenges. We will achieve this
    by ensuring our forces have the greatest possible versatility while
    maintaining core capabilities. We are conducting a deliberate analysis
    for 2014-2018 to determine the correct Army capabilities and force
    structure mix and the correct path to implement. We are also working
    closely with the Joint Staff in their strategic review to ensure our
    analysis is consistent with their ongoing efforts.
                             ground combat vehicle
        Question. General Dempsey, what added fighting capability will the
    Army receive from its Ground Combat Vehicle?
        Answer. The Ground Combat Vehicle will provide soldiers the
    protected mobility they need to operate across the full spectrum of
    operations. It will also have the growth potential required to
    incorporate advances in protection or network capabilities for the full
    infantry squad. The GCV will combine the protection of the Mine
    Resistant Ambush Protected (MRAP), the mobility of the Bradley, and the
    operational flexibility of the Stryker. No single vehicle currently
    provides those attributes. Nor does a single vehicle address the
    capability gaps associated with MRAP mobility, Bradley internal
    capacity, and Stryker force protection. The GCV uses lessons learned to
    provide our soldiers a vehicle with the capabilities they need to
    accomplish the mission and provide better protection.
                              healthcare proposals
        Question. General Dempsey, I believe that the healthcare benefits
    we provide to our servicemembers and their families are one of the most
    basic benefits we can provide to the men and women serving our Nation
    and I also believe it is one of the most effective recruiting and
    retention tools you have at your disposal. The DOD is proposing several
    changes to the military health system that could go into effect as
    early as October of this year. Do you support these cost saving
    measures?
        Answer. Yes. These proposals balance our commitment to preserve the
    healthcare benefit while slowing future growth in healthcare costs.
        Question. Could you please explain what impact they might have on
    recruiting and retention?
        Answer. Healthcare benefits are an important component in
    motivating applicants to join the Army and remain for a career. Current
    accession propensity research shows the top reasons that youth would
    consider joining are extrinsic: pay/money, pay for education, and
    benefits (health, retirement, etc.). However, we believe that possible
    increases to TRICARE premiums for retirees would have little to no
    effect on recruiting and a minimal effect on retention.
                                     ______

                Questions Submitted by Senator Richard C. Shelby
                                     tanks
        Question. General Dempsey, regarding the Abrams tank program, no
    one on this subcommittee would support continued procurement of tanks
    for the sake of simply buying more tanks. However, it is our
    understanding that the Army plan includes the fielding of more than 600
    M1A1 Abrams tanks to National Guard forces for the next several
    decades. These tanks are a generation old and cannot accommodate modern
    technologies such as communications equipment. Why would we not procure
    and field the most modern tank available--the M1A2 SEP tank--to all
    Army heavy forces?
        Answer. The Army agrees with the subcommittee's position that we
    should not buy tanks for the sake of buying tanks. The M1A1 SA remains
    one of the best tanks in the world, providing overmatch against known
    threats and digital command interoperability within the Heavy Brigade
    Combat Team formation. The Army does not plan to immediately replace
    this very capable and relatively young portion of the Abrams fleet. The
    Army National Guard (ARNG) began receiving the M1A1 SA tank in August
    2008 and will complete fielding in June 2014. The ARNG will also
    receive a brigade set of M1A2SEPv2 Abrams tanks in June 2011. The Army
    plans to invest in the Combat Vehicle Modernization Strategy which
    includes modernization of the Abrams fleet to give it the power
    generation and power distribution needed to allow for the integration
    of modern technologies.
                                missile defense
        Question. General Dempsey, the DOD has spent considerable effort
    over the last decade developing a comprehensive roadmap for Integrated
    Air and Missile Defense and improving combat identification and
    friendly protection capabilities. The Army, Navy, and Air Force have
    significant joint efforts ongoing to solve these complex theater-
    dominated issues. If Army Ballistic Missile Defense (BMD) efforts
    transition to the Missile Defense Agency (MDA) control, how will the
    MDA and the Army ensure that the Army multi-purpose weapons and sensors
    remain tied to the Joint architecture and operating concepts since MDA
    is not required to participate in the Joint Capabilities Integration
    Development System (JCIDS) process?
        Answer. It is the responsibility of both organizations to ensure
    Army and the JCIDS operational requirements and Army system
    requirements are achieved and included in synchronized budget
    submittals. The Army is working closely with the MDA to ensure that
    critical issues, such as the one raised here and others along the
    Doctrine, Organization, Training, Logistics, Materiel, Personnel, and
    Facilities spectrum, are addressed in the transfer discussion. The Army
    appreciates the complexities of meeting Joint Architectures when MDA is
    not required to participate in the JCIDS process. Our initial approach
    is to designate the Program Executive Officer for Missiles and Space
    (PEO M&S) to simultaneously serve as MDA's program executive for Army
    BMD Systems to manage the development, integration, testing and
    production of Army BMD capabilities in conjunction with Army Air and
    Cruise Missile Defense (ACMD) programs. Additionally, before BMD
    materiel development responsibility transfers in October 2012, the Army
    will address how best to align JCIDS requirements with the ``Warfighter
    Involvement Process'' (WIP), which results in a ``Prioritized
    Capability List'' (PCL), a major factor in determining MDA's resource
    prioritization. Having a single PEO responsible for BMD and ACMD should
    ensure an integrated materiel solution. Including the WIP/PCL processes
    in conjunction with JCIDS should allow the Army to clearly articulate
    its needs to both communities.
        Additionally, the Missile Defense Executive Board (MDEB) will
    provide further collaborative oversight and guidance to supplement and
    integrate the work of the WIP/PCL across the Department of Defense
    (DOD). The Army expects that the current Joint Operational Concepts
    will be unaffected by transfer of BMD material development
    responsibilities.
                                     ______

                 Questions Submitted by Senator Lisa Murkowski
                                    suicide
        Question. The prevention of suicide presents very complex
    challenges. But I believe it is important that we get the issue out in
    the open and do all that we can to reduce our suicide rates to zero. I
    understand that suicide among Active Duty troops declined somewhat in
    2010 but suicide rates among members of the Reserve Component spiked.
        What, if anything, are we learning in our efforts to prevent
    suicide among our soldiers?
        Answer. While the Army has greatly increased its knowledge about
    suicidal behavior in our population, we have not found a single factor
    or issue that is the prevalent risk factor. The Army's Vice Chief of
    Staff conducts monthly ``after action reviews'' of recent suicide
    deaths via a world-wide video teleconference with senior Army leaders.
    This forum allows the Army senior leaders to learn from other
    commanders what actions are proving to be most effective at addressing
    these problems.
        The Army released the Health Promotion, Risk Reduction, and Suicide
    Prevention (HP/RR/SP) Report in July 2010. This report was the result
    of a focused 15-month effort to better understand the increasing rate
    of suicides in the force. This candid report is intended to inform and
    educate Army leaders on the importance of recognizing and reducing
    high-risk behavior related to suicide and accidental death, and
    reducing the stigma associated with behavioral health and treatment. It
    represents the next phase in the Army's ongoing campaign to promote
    resiliency in a force that has been at war for nearly a decade. Key
    findings include:
      --There are gaps in the current HP/RR/SP policies, processes and
            programs necessary to mitigate high-risk behaviors;
      --There has been an erosion of adherence to existing Army policies
            and standards;
      --The Army has seen an increase in indicators of high-risk behavior
            including illicit drug use, other crimes and suicide attempts;
      --Lapses in surveillance and detection of high-risk behavior;
      --There is an increased use of prescription antidepressants,
            amphetamines and narcotics; and
      --Degraded accountability of disciplinary, administrative and
            reporting processes exacerbate the problem of high-risk
            behavior.
        General Chiarelli sent a message to all the senior leaders in the
    Army this past month to reinforce leadership responsibilities. In it he
    told leaders: ``When it comes to suicide and other high-risk behavior,
    we cannot afford to relearn past lessons. Incumbent leaders must train
    and familiarize new leaders with the principles discussed in chapter
    three of the Task Force's July 2010 report (The Lost Art Of Leadership
    In Garrison). The report can be accessed at www.preventsuicide.army.mil
    in the commander's tool kit. The report emphasizes the need for leaders
    to respond when soldiers engage in risky behavior--first to protect
    their health and then to hold them accountable as appropriate. The
    lessons in leadership presented in this chapter are still relevant
    today and critically vital to the health of the force.''
        Finally, the Army has entered into a long term study with the
    National Institute of Mental Health (NIMH), the largest behavioral
    health epidemiological study that the Armed Forces has ever undertaken
    (The Army Study to Assess Risk and Resilience in Servicemembers or Army
    STARRS). After 1 year of finalizing the study design, obtaining
    institutional review board approval, and constructing the necessary
    capability to gather and analyze data; the Army STARRS team is
    beginning to conduct the new soldier study and all Army study. To date,
    just over 10,000 soldiers have been interviewed. No definitive results
    or conclusions have been obtained to date.
        Question. Are you identifying any innovations that offer the
    promise of further reducing the rates of suicide?
        Answer. The Army continues to evaluate and modify programs and
    services that are related to health promotion, risk reduction and
    suicide prevention. We believe that early identification of ``high-
    risk'' behavior, such as substance abuse and behavioral problems, will
    allow leaders to intervene early. The Army has engaged leaders at all
    levels to improve education and awareness of behavioral health issues
    and high-risk behaviors. The Army has increased behavioral health
    providers at the brigade level in active, National Guard, and Army
    Reserve units; required increased behavioral health screening before
    and after deployments; improved training for chaplains and suicide
    prevention coordinators; and improved training for primary care medical
    providers to identify and respond to behavioral health issues. Some of
    the actions that Army has taken include:
      --Released the Health Promotion, Risk Reduction and Suicide
            Prevention Report 2010.
      --Produced the interactive ``Home Front'' training video, which
            included scenarios for Active, National Guard and Reserve
            soldiers; Army civilians; and family members.
      --Produced the ``Shoulder to Shoulder: No Soldier Stands Alone''
            training video.
      --Initiated ``face-to-face'' postdeployment behavioral health
            screening (in person or virtual) for all Brigade Combat Teams.
      --From December 2009 to November 2010, 218,868 soldiers completed
            Post-Deployment Health Assessments (PDHA) (141,381 Active
            Component and 77,487 Reserve Component). The PDHA is used to
            help identify soldiers who may need a more detailed behavioral
            health screening by behavioral health providers or specially
            trained medical personnel.
      --Expanded behavioral health providers and services across the Army.
            During fiscal year 2010, the Army funded 40 unique
            psychological health programs providing a range of expanded
            healthcare services to our beneficiaries and obligated over
            $168 million additional dollars to behavioral health services.
      --Increased the number of Military Family Life Consultants (MFLCs)
            that work with children and families to provide them support
            during transitions and separations. Increased from 23 in fiscal
            year 2007 to over 270 in fiscal year 2010. These MFLCs are
            embedded in youth service facilities and in on- and off-post
            schools.
      --Implemented standardized screening protocols for soldiers exposed
            to concussive events to improve early diagnosis and treatment.
        Question. Is the Congress providing the Army with adequate funds to
    meet this challenge?
        Answer. Yes, adequate funding for suicide prevention has been
    provided. The Army budget adequately funds suicide prevention
    coordinators across the Active Duty force, Army National Guard, and
    Army Reserve. In fiscal year 2012 the Army intends to fund Applied
    Suicide Intervention Skills Training (ASSIST) training/kits, Shoulder
    to Shoulder and Home Front training videos, Suicide Awareness Guide for
    Leaders, and training aids/products for the Active Army, Army Reserve,
    and Army National Guard soldiers similar to previous years.
        The budget request for fiscal year 2012 includes adding 24
    behavioral health officers and enlisted technicians to National Guard
    Brigade Combat Teams and expands the Reserve Component substance abuse
    program. It also included additional funding for 54 Suicide Prevention
    Program Managers for the National Guard, 38 Suicide Prevention Program
    Managers for the Army Reserve, and ASSIST training and kits for the
    Reserve Component.
                                     ______

                 Questions Submitted by Senator Lindsey Graham
                             carbine weapon systems
        Question. In 2004, Special Operations Command (SOCOM) began a
    carbine competition. Nine vendors submitted a dozen designs for a new
    modular, multi-caliber weapons system. SOCOM chose a winner without
    protest. Over the next 6 years of research, development, testing and
    evaluation (RDT&E) and millions of taxpayer and private dollars spent,
    SOCOM ultimately approved a new carbine family of weapons for full-rate
    production in July 2010. This carbine remains a DOD program of record
    and is currently deployed in combat.
        Last July, General Chiarelli, Vice-Chief of Staff of the Army,
    stated in the National Defense Magazine that ``the Army is wasting
    money on systems that already exist within the service or in other
    branches of the military. New weapon requirements often are conceived
    `in a stovepipe.' '' He went on to say, ``that approach prevents the
    Army from taking advantage of technology that is already being
    purchased elsewhere.'' In September 2010, Army Colonel Doug Tamillo,
    the Program Executive Officer (PEO)-soldier and manager responsible for
    the Army's new carbine competition, noted the Army will spend over $30
    million of taxpayer money just in testing to make sure we get [the new
    carbine competition] right.'' He went on to describe a dual path
    strategy and how industry will be able to design a new carbine ``that
    can outperform the M4.''
        In December 2010, PEO-soldier, through Picatinny Arsenal, received
    an unsolicited proposal to obtain the new SOCOM carbine Technical Data
    Package (TDP). PEO-soldier rejected the proposal. SOCOM's carbine
    underwent 6 years of RDT&E, has fired over three million rounds, and is
    deployed in combat. Adopting SOCOM's carbine TDP would save the
    taxpayer over $30 million associated with the carbine competition,
    while minimizing acquisition timelines. The Army would therefore be
    able to have a full and open competition on continued development and
    manufacturing of an already competed and tested solution.
        Why would the Army ignore SOCOM's 2004 carbine competition that
    resulted in full-rate production only last July? Doesn't that represent
    the waste of money and the ``stovepipe'' functionality that the Vice
    Chief of Staff of the Army wants to avoid?
        Answer. The Army did give consideration to the United States Army
    Special Operations Command's (SOCOM) 2004 carbine competition. However,
    the SOCOM requirement, in which the 2004 competition was based, was for
    a multi-caliber, configurable weapon, which is not the same as the Army
    requirement. Further, since 2004, competition in the small arms
    industry has increased and there are many more competitors in the
    market today. In addition, on October 14, 2008, the Duncan Hunter
    National Defense Authorization Act for Fiscal Year 2009, Public Law
    110-417 (attached), stated that, ``If the small arms capabilities based
    assessments by the Army identifies gaps in small arms capabilities and
    the Secretary of the Army determines that a new individual weapon is
    required to address such gaps, the Secretary shall procure the new
    individual carbine using full and open competition . . .'' The
    Secretary of the Army, in a memorandum dated October 2, 2008, directed
    the Army to ``take all necessary actions to initiate a best value, Full
    and Open Competition . . . for a carbine that addresses current and
    emerging threats.''
        The Full and Open Competition for a new Individual Carbine (IC)
    will be conducted in accordance with the Competition in Contracting Act
    in order to ensure that the soldier receives the best overall weapon at
    the best value to the Government. The Government is conducting a dual
    path strategy to deliver the best carbine to the Warfighter and reduce
    the risk to the taxpayer. This approach is in-line with the Defense
    Acquisition Executive's (DAE) direction to promote real competition
    across the Department of Defense. The vendor is open to submit the
    Special Operations Forces Combat Assault Rifle (SCAR) proposal in the
    IC competition for best value evaluation.
        Question. If you believe that SOCOM and the Army have different
    weapons requirements, what steps did the Army conduct to evaluate and
    analyze SOCOM's carbine development before engaging in a similar
    carbine development effort?
        Answer. Project Manager (PM), Soldier Weapons informally
    participated in SOCOM's carbine evaluation and was kept abreast of the
    process, test results, and scoring. The PM was not authorized to use
    SOCOM's criteria and adopt the Special Operations Forces Combat Assault
    Rifle because the Army was directed to conduct a Full and Open
    Competition to consider all weapons to equip our soldiers. We are
    therefore looking beyond SOCOM-specific requirements for this
    capability.
        Question. What analysis of existing alternative capabilities did
    the Army conduct before beginning the new carbine competition?
        Answer. The Army waived the regulatory requirement for an Analysis
    of Alternatives (AoA) in December 2010. It was determined that an AoA
    would not produce additional relevant information in support of the
    program since the Key Performance Parameters and Key Systems Attributes
    were baselined on the current M4 Carbine capability as directed by the
    Army Requirements Oversight Council (AROC). Instead the Army will
    conduct a Cost Benefit Analysis (CBA) using actual data collected
    during test and evaluation of the IC candidates and proposals at the
    conclusion of the competition to determine whether the Army should
    pursue procurement of the new IC or continue to procure the current
    M4A1 carbine.
        Question. If the Army did not conduct such an analysis, please
    provide this committee with documentation demonstrating that a waiver
    was granted.
        Answer. The waiver recommendation and Acquisition Decision
    Memorandum that approve the waiver are attached.
    memorandum for deputy for acquisition and system management, assistant
        secretary of the army for acquisition, logistics and technology
        Subject.--Individual Carbine Materiel Development Decision (MDD)
    Review
      --References:
        --Memorandum, ASA (ALT) Policy, Subject: Materiel Development
                Decision (MDD) Reviews, 02 Dec 09.
        --Memorandum, DAMO-CIC, Subject: Approval of the Individual Carbine
                (IC) Capability Development Document (CDD), 09 Aug 10.
        --Memorandum, DAMO-CIA, Subject: Individual Carbine (IC) Analysis
                of Alternatives (AoA) Waiver, 31 Aug 10.
      --Request the Army Acquisition Executive (AAE) conduct an MDD Review
            to address the Individual Carbine (IC) Capabilities
            Development.
        --The IC CDD, approved on 09 August 2010, establishes the
                operational requirements to be addressed by the IC materiel
                solution.
        --Preliminary cost estimates indicate the proposal represents a
                potential ACAT II program.
        --I believe an Analysis of Alternatives (AoA) is not required to
                support the recommended IC Program. The proposed IC Program
                will execute a Commercial-off-the-Shelf/Nondevelopmental
                Items System Competition. Key Performance Parameters and
                Key System Attributes in the IC CDD were baselined on the
                current M4 Carbine capability as directed by the June 2008
                Army Requirements Oversight Counsel (AROC). An AoA would
                not provide relevant information in support of the MDD.
      --This IC CDD addresses the capability gaps identified in the January
            2008 Small Arms Capabilities Based Assessment. In June 2008 the
            AROC directed Training and Doctrine Command (TRADOC) to write a
            carbine requirement based on current capabilities with
            objective performance enhancements. In October 2008, the
            Secretary of the Army concurred with the AROC direction and
            further directed the Army Acquisition Executive to initiate a
            best value, full and open competition based on the new carbine
            requirement to provide our Warriors with an enhanced carbine
            that will maintain their weapons superiority.
      --Request that the Army MDD be scheduled in Oct 2010 so that
            decisions can be executed in conjunction with the Program
            Budget Review (PBR) 13-17. Army G-3/5/7 will coordinate with
            TRADOC, Program Executive Officer-Soldier, and the Army Staff
            to organize the information required for the MDD briefing.
      --The HQDA G-3/5/7 POC for Soldier Weapon Systems is LTC Karl
            Petkovich, DAMO-CIC.
               memorandum for program executive officer, soldier
        Subject.--Acquisition Category (ACAT) II Designation for the
    Individual Carbine Capability (IC) and Designation of Milestone
    Decision Authority (MDA)
      --I have reviewed and approve your request to designate the IC
            program as ACAT II as outlined in Chapter 3 of Army Regulation
            70-1 and I will retain the MDA as the Army Acquisition
            Executive. You are approved to initiate the IC program at pre-
            Milestone (MS) B.
      --Once I have approved the Acquisition Strategy, I authorize you to
            expend the appropriate funding to execute the strategy and
            release the final request for proposals to initiate and conduct
            the IC competition under Full and Open competition procedures.
      --In view of the recent approval of the Capability Development
            Document and the request from the Army G-3/5/7 to waive the
            regulatory requirement for an Analysis of Alternatives, I
            approve that waiver and direct that you return within 60 days
            with all the required documentation to obtain a positive MS B
            decision and enter the Engineering and Manufacturing
            Development phase.
      --The point of contact is Mr. Shelby Stevens.
        Question. If the Army did not conduct an analysis of existing
    alternatives, and received no waiver, why did you not attempt to
    thoroughly analyze current DOD programs of record before spending
    taxpayer dollars?
        Answer. As discussed previously, a waiver was granted by the Army
    Acquisition Executive.
        Question. Do you believe that the Army's new carbine competition
    indicates that the Army was not fully aware of SOCOM's competition? Do
    you think the Army's lack of proper analysis of existing programs may
    have contributed to this?
        Answer. No, the Army was fully aware of the SOCOM carbine
    competition. The Army Requirements Oversight Council directed the
    Training and Doctrine Command to develop a new carbine requirement and
    to provide our soldiers with the best carbines available in the world.
    If the Special Operations Forces Combat Assault Rifle is submitted as
    an IC candidate, it will be evaluated against the IC requirements.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The subcommittee will reconvene on
    Wednesday, May 25, at 10:30 a.m. to listen and receive
    testimony from the Missile Defense Agency.
        We will now stand in recess.
        [Whereupon, at 12:06 p.m., Wednesday, May 11, the
    subcommittee was recessed, to reconvene at 10 a.m., Wednesday,
    May 25.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                            WEDNESDAY, MAY 25, 2011

                                           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, Cochran, Shelby, Murkowski, and
    Graham.

                             DEPARTMENT OF DEFENSE

                             Missile Defense Agency

    STATEMENT OF LIEUTENANT GENERAL PATRICK J. O'REILLY,
                DIRECTOR, U.S. ARMY

                     STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning we are pleased to welcome
    Lieutenant General Patrick O'Reilly, the Director of the
    Missile Defense Agency (MDA), to discuss the administration's
    fiscal year 2012 budget request for missile defense programs.
    For fiscal year 2012, MDA is requesting $8.6 billion, an
    increase of $120 million over amounts appropriated in the last
    fiscal year, to support a viable homeland defense, finance
    European regional defenses, continue testing the current
    system, and to develop new capabilities to address emerging
    threats.
        Fiscal year 2012 will mark the 10-year anniversary of the
    Missile Defense Agency, although its predecessor organizations
    track their origins way back to 1983 when President Reagan
    launched the Strategic Defense Initiative 28 years ago. Since
    its inception MDA has developed and fielded highly complex
    integrated missile defenses against short-range, medium-range,
    and intercontinental ballistic missiles.
        For the defense of our homeland, the agency has emplaced 30
    ground-based interceptors in Alaska and California, and for
    regional defenses MDA and the Navy have delivered 23 aegis
    ballistic missile defense ships capable of engaging short to
    medium-range missiles. In addition, the President has tasked
    MDA with carrying out the European phased adaptive approach to
    provide regional missile defense for allies. Finally, MDA
    continuously develops and fields upgraded capabilities to
    counter evolving threats.
        So, General, I congratulate you and your dedicated team at
    MDA for your many, many successes. As you know, development of
    these highly sophisticated systems has not always been easy,
    and it carries a large price tag. For example, last year the
    ground-based interceptor failed two flight tests within the
    span of 11 months. From an operational perspective, this is
    obvious cause for concern. From the taxpayers' standpoint,
    these tests cost over $200 million apiece, so we can no longer
    afford to fail.
        In addition, last year the terminal high altitude area
    defense (THAAD) interceptor requested some redesign work that
    resulted in significant production delays. I strongly support
    the THAAD program and these missiles need to be fielded.
    However, it is critical that the new design works and is
    producible in quantities that have been requested.
        This subcommittee was also concerned last year over the
    procurement strategy of the standard missile program and
    redirected funding to continue buying the block 1A standard
    missile since the block 1B development was delayed.
        The fiscal year 2012 budget request again includes no funds
    for the block 1A missile. Yet the request includes over $500
    million for the procurement of 1B missiles. Although we will
    not know until the test late this summer whether the redesigned
    missile works, this seems like a risky strategy, especially
    when the Navy requires more missiles to respond to real-world
    threats than are in the inventory today.
        So I look forward to hearing from you, sir, and hearing
    your thoughts on how you plan to address the challenges
    mentioned.
        However, before we proceed I'd like to turn to the vice
    chairman of the subcommittee for any remarks he may wish to
    make.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you. I'm very pleased
    to join you in welcoming General O'Reilly to be here today to
    testify before our subcommittee as we continue our review of
    the President's budget request for fiscal year 2012 for the
    Department of Defense.
        Specifically, we are interested in the provisions relating
    to our missile defense capabilities. We recognize the
    seriousness of purpose that this office requires of General
    O'Reilly and we appreciate the experience and know-how he
    brings to this task. He's got a very challenging job. We look
    forward to hearing the testimony and working with him and
    others in the Department of Defense on making sure that we are
    allocating the funds we need and that they are justified and
    that they will lead to the development and deployment of an
    effective missile defense system.
        Thank you.
        Chairman Inouye. Thank you very much.
        Senator Shelby.
        Senator Shelby. Mr. Chairman, I too would join you and
    Senator Cochran in welcoming General O'Reilly and we look
    forward to his testimony.
        Chairman Inouye. Care to make a statement?
        Senator Graham. Thank you. I'm ready to listen.
        Chairman Inouye. Then it's your show, sir.

          SUMMARY STATEMENT OF LIEUTENANT GENERAL PATRICK J. O'REILLY

        General O'Reilly. Thank you, Chairman Inouye, Ranking
    Member Cochran, and other distinguished members of the
    subcommittee. I thank you for the opportunity to testify today
    on the Missile Defense Agency's $8.6 billion fiscal year 2012
    budget request to develop protection of our Nation, our armed
    forces, allies, and friends against the growing threat of
    proliferating--the proliferation of increasingly capable
    ballistic missiles of all ranges.
        In fiscal year 2012 we propose to complete the initial
    fielding of the Ground-based Midcourse Defense, or GMD, system
    for homeland defense against first generation intercontinental
    ballistic missiles, or ICBMs. We are also on track to develop,
    test, and deliver the phased adaptive approach to regional
    defense announced by the President in September 2009. We will
    deliver initial defense of Southern Europe by December of this
    year, enhance that defense against medium-range ballistic
    missiles in 2015, further enhance the defense of all European
    NATO countries against intermediate-range ballistic missiles by
    2018, and provide an early intercept capability against
    missiles of all range classes by the end of this decade.
        During the past year, we achieved many accomplishments,
    including the first two-stage ground-based interceptor, or GBI,
    flight test, the third missile intercept by the Japanese aegis
    program, the lowest altitude intercept by the terminal high
    altitude area defense, or THAAD, system, the destruction of two
    boosting ballistic missiles with our Airborne Laser Testbed,
    the collection of the most accurate missile tracks in history
    by our Space Tracking and Surveillance System satellites, and a
    successful intercept by Israel's Arrow 2 missile. We also
    delivered 25 SM-3 1A interceptors, began THAAD interceptor
    production, emplaced the 30th GBI, and completed the upgrade of
    the early warning radar in Thule, Greenland.
        Last year our aggressive test program also identified an
    issue with the latest version of the GBI's exo-atmospheric kill
    vehicle, or EKV. It's MDA's top priority to verify the
    resolution of the problem by conducting extensive ground
    testing this summer, conducting a non-intercept test with an
    upgraded EKV and repeating the previous failed intercept test
    in 2012. We suspended EKV--the resolution of the GMD test
    failure is dependent upon technical progress, not funding.
        We suspended the EKV production and applied funding to
    rapidly initiate activities to correct the EKV problem. Thus,
    our proposed fiscal year 2012 GMD program today differs from
    the one we proposed in the President's budget request that we
    developed prior to the latest GMD flight test failure. We are
    still requesting $1.16 billion for fiscal year 2012 to recover
    from the GBI flight test failure and continue to enhance the
    defense of our homeland by completing Missile Field 2 at Fort
    Greely, Alaska, in 2012, beginning the procurement of five new
    GBIs, upgrading the early warning radar in Clear, Alaska, and
    initiating the installation of a GBI communications system on
    the east coast of the United States.
        Today 30 operational GBIs protect the United States against
    a limited ICBM attack if current regional threats successfully
    develop an ICBM capability. We continually monitor intelligence
    assessments, and to address the possibility that our current
    GMD capability is determined to be insufficient in the future
    we are developing options to increase the number of operational
    GBIs and accelerate the delivery of new sensor and interceptor
    capabilities.
        The Department is committed to bringing to Congress soon
    our strategy to hedge against uncertainties in the threat
    estimates. But, given the two GBI flight test failures, the
    need for a new non-intercept flight test, and the repeat of the
    last flight test, we will assess the total procurement quantity
    of the additional GBIs as part of the 2013 President's budget
    request.
        We also are on schedule to execute our phased adaptive
    approach, or PAA, for regional defense. For phase 1, our first
    aegis ballistic missile ship deployment, the USS Monterey, is
    on station today. The latest command and control system
    upgrades are being installed in the European Command and the
    AN/TPY-2 forward-based radar is on track for deployment in
    southern Europe by the end of this year.
        Of note, a critical European PAA phase 1 milestone was
    achieved in March of this year when an intermediate range
    ballistic missile target was intercepted in the Pacific using
    the phase 1 aegis AN/TPY-2 radar and the European Command's
    command and control system, architecture, and configuration.
        For phase 2, we will conduct the first flight test of the
    next generation aegis interceptor, the SM-1 1B, this summer.
    Additionally, the design of the aegis Ashore system began last
    summer. The test site will be installed in Hawaii in 2013 and
    flight testing will begin in 2014. Furthermore, the Romanian
    Government recently announced the site of the aegis Ashore
    system that will be operational in 2015.
        For phase 3, the SM-3 block 2A interceptor has completed 57
    of its 60 preliminary design reviews and is on track to support
    flight testing in 2015 and deployment in 2018.
        Key to achieving cost-effective assured missile defense and
    to enable early intercepts of ballistic missiles is the
    development of the Precision Tracking Space System, or PTSS,
    and AirBorne InfraRed, or ABIR, missile sensor capabilities.
    PTSS will provide three to six times the simultaneous tracking
    capability at a small fraction of the high operations cost of
    an AN/TPY-2 or ABIR air combat patrol, and the PTSS does not
    require host nation basing or overflight approvals of other
    countries for deployment.
        Additionally, to optimize the integration of the PTSS with
    all contracted activities developing our ballistic missile
    defense system, we are using federally funded research and
    development centers to lead an industry-government team to
    develop a non-proprietary design to enable full and open
    competition for the production of PTSS satellites.
        For phase 4, we competitively awarded the design concept
    contracts for the SM-3 2B interceptor to three industry teams
    on a time line consistent with the average development of
    missile interceptors, to ensure the lowest risk delivery of an
    early intercept capability. While not necessary for the defense
    of the United States against limited attacks by early
    generation ICBMs, the SM-3 2B will augment the GMD system to
    significantly increase the cost effectiveness of homeland and
    regional missile defense.
        Beyond PAA phase 4, we are pursuing advanced technologies,
    including very efficient, lightweight, high energy laser
    systems.
        Finally, MDA continues to collaborate with over 20
    countries and NATO in international missile defense projects
    and cooperative activities.

                               PREPARED STATEMENT

        In conclusion, our requested fiscal year 2012 budget funds
    the development and deployment of missile defense capabilities
    that are adaptable, survivable, cost-effective, and tolerant of
    uncertainties in intelligence estimates of both nation-state
    and extremist ballistic missile threats.
        Thank you, Mr. Chairman. I look forward to answering the
    subcommittee's questions.
        [The statement follows:]
          Prepared Statement of Lieutenant General Patrick J. O'Reilly
        Good morning, Chairman Inouye, Ranking Member Cochran, other
    distinguished Members of the subcommittee. I thank you for the
    opportunity to testify today on the Missile Defense Agency's (MDA) $8.6
    billion fiscal year 2012 budget request to develop protection for our
    Nation, our Armed Forces, allies, and friends against a growing
    threat--the proliferation of increasingly capable ballistic missiles of
    all ranges. We continue to test and improve the reliability and
    performance of our homeland and regional missile defenses to defeat a
    growing variety of ballistic missiles over the next decade while
    posturing our Nation to respond to the uncertainties in estimates of
    future missile threats. By the end of fiscal year 2012, we will
    complete the initial fielding of the Ground-based Midcourse Defense
    (GMD) system for homeland defense against first generation
    Intercontinental Ballistic Missiles (ICBMs) potentially being developed
    by current regional threat actors. We will also continue our initial
    fielding of regional defenses against today's short-range (1,000 km or
    less), medium-range (1,000 to 3,000 km), and intermediate-range
    ballistic missiles (3,000 to 5,500 km), or SRBMs, MRBMs and IRBMs,
    respectively.
                   fiscal year 2010 accomplishment highlights
        During this past year, we have improved our homeland defense by
    emplacing the 30th Ground Based Interceptor (GBI), upgrading two
    additional GBIs, installing a training node at Fort Greely, Alaska
    (FGA), and completing a significant upgrade of the Early Warning Radar
    in Thule, Greenland. Additionally, we had a successful two-stage Ground
    Based Interceptor (GBI) booster test and conducted a three-stage GBI
    intercept test where we did not achieve our primary objective, but we
    did demonstrate integrated sensors and command, control, battle
    management, and communication (C\2\BMC) during the longest range flight
    test to date. In fiscal year 2010, we also improved our regional
    defenses by converting two Aegis BMD ships, delivering 25 SM-3 IA
    interceptors, and increasing the Aegis BMD fleet to 20 operationally
    configured BMD ships. Aegis BMD ships carrying SM-3 IA interceptors are
    currently deployed and on-station in forward operating areas, including
    the USS Monterey as part of the first phase of the European Phased
    Adaptive Approach (EPAA). We also commenced production of Terminal High
    Altitude Area Defense (THAAD) Batteries 3 and 4 and the associated
    interceptors. We accelerated the refurbishment of an AN/TPY-2 radar for
    phase 1 of the EPAA and installed a C\2\BMC system and prepared a
    second AN/TPY-2 for deployment to U.S. Central Command. Moreover, we
    successfully flew 14 target missions, including a successful intercept
    of a separating MRBM with our Japanese allies using an SM-3 IA
    interceptor (thus completing the first BMD Foreign Military Sales (FMS)
    case), and conducted a successful intercept of a unitary SRBM with
    THAAD. For future capabilities, we demonstrated the ability of the two
    Space Tracking and Surveillance System (STSS) satellites to provide
    stereo, high-fidelity tracking capabilities and transfer tracks into
    C\2\BMC. Our Airborne Laser Test Bed successfully destroyed two
    boosting ballistic missiles. We achieved our goal of demonstrating NATO
    Active Layered Theater Ballistic Missile Defense interoperability with
    the U.S. C\2\BMC in Joint Project Optic Windmill. Finally, we completed
    United States and Israeli Government project agreements on the Arrow 3
    Upper Tier Interceptor, the David's Sling Weapon System, and an Israeli
    Test Bed. Recently, we supported Israel's successful intercept mission
    of a separating threat missile off the coast of California.
                           enhancing homeland defense
        MDA's top priority is to confirm the root cause of the most recent
    GBI flight test failure, verify the resolution of the problem, and
    successfully execute the previous flight test. The Failure Review Board
    (FRB) has identified the most likely cause, but more ground testing
    this summer and an additional non-intercept flight test in fiscal year
    2012 of an upgraded GBI Exo-atmospheric Kill Vehicle (EKV) will be
    required before the next intercept in late 2012. We suspended
    production of the latest version of the EKV until the required design
    modifications are completed and verified, and we diverted fiscal year
    2011 GMD funding to expedite these modifications. Until we can resolve
    this technical issue, advancement of our GMD capability is primarily
    limited by technical progress, not funding.
        Initiation of activities to quickly recover from the GMD flight
    test failure caused us to revise our proposed fiscal year 2012 GMD
    schedule of work after we developed the current fiscal year 2012
    President's budget request. By deferring lower priority fiscal year
    2011 activities not associated with the flight test failure resolution,
    we were able to rapidly begin our resolution of the GMD flight test
    issues; however, we still need the requested $1.16 billion for fiscal
    year 2012 to complete the test failure resolution and the initial
    fielding of the defense of our homeland against limited ICBM attacks,
    including the completion of the hardened power plant and Missile Field
    2 at Fort Greely Alaska.. During the suspension of EKV production, we
    will accelerate the refurbishment of the existing GBI fleet, and also
    begin acquiring material needed to produce new GBIs to meet our minimum
    requirement of 26 operational GBIs at FGA, 4 at Vandenberg Air Force
    Base (VAFB), California, and 22 GBIs for testing, stockpile reliability
    testing, and spares. Given the two flight test failures, the need for a
    new non-intercept flight, and a repeat of the last flight test, we will
    assess the procurement quantity of additional GBIs as part of the
    fiscal year 2013 President's budget request after we have confirmation
    that we have resolved the EKV issue. As a hedge against uncertainties
    in ICBM threat estimates, we will place Missile Field 1 in a storage
    mode for possible upgrade for operational use in the future.
    Additionally, we will complete the construction of a second fire
    control node at FGA to allow testing or exercises to be conducted while
    simultaneously controlling the operational system. We will also begin
    the planning, design and environment work for a GBI In-Flight
    Interceptor Communication System (IFCS) Data Terminal (IDT) on the east
    coast of the United States by 2015. This East Coast IDT will enable
    communication with GBIs launched from FGA and VAFB on longer flights,
    thus improving the defense of the eastern United States against
    potential ICBM threats from the Middle East. Finally, we are requesting
    $177.1 millionin RDT&E funding for the Sea-Based X-band (SBX) radar in
    fiscal year 2012, which includes software upgrades to improve its
    discrimination capability.
        In addition to GMD upgrades, we are requesting $222.4 million in
    fiscal year 2012 for BMDS Sensors for homeland defense, including
    support of the Upgraded Early Warning Radars (UEWRs) and AN/TPY-2
    radars. Integration of the Thule, Greenland radar in fiscal year 2012
    will make it a fully operational UEWR in the BMDS. We will begin
    upgrade of the Clear Early Warning Radar in Alaska for full missile
    defense capability by 2016. In addition, a forward-based AN/TPY-2 X-
    band radar will be deployed to southern Europe to provide early
    tracking for both enhanced homeland and regional defense. We will
    continue to upgrade system software to address new and evolving
    threats, including enhancing Exo-atmospheric Kill Vehicle
    discrimination algorithms by 2015, improving GBI avionics, and
    increasing GBI interoperability with the Command and Control, Battle
    Management and Communications (C\2\BMC) system.
        After last year's successful initial flight of a two-stage GBI, we
    plan to conduct an intercept flight test with a two-stage GBI as a
    potential hedge to allow for a longer intercept window of time if ICBMs
    were launched against the United States from Northeast Asia or the
    Middle East. However, as a consequence of the need to repeat the failed
    three-stage GBI flight tests, we plan to delay the first intercept test
    of the two-stage GBI from fiscal year 2012 to fiscal year 2014.
    Finally, we will continue development of the Standard Missile 3 (SM-3)
    IIB to complement the GMD system's protection of our homeland in the
    future by adding an additional layer of ICBM defense, which will
    provide an early intercept capability against first generation ICBMs
    within the regions from which they were launched.
                   hedge for protection of the united states
        Today, 30 operational GBIs protect the United States against a
    medium ICBM raid size launched from current regional threats. If this
    capability is determined to be insufficient for protection of the U.S.
    homeland based on intelligence estimations of future threats, we have
    options to increase the number of operational GBIs and accelerate the
    delivery of new sensor and interceptor capabilities. The Department is
    committed to brief Congress soon on the results of our ongoing BMD
    analysis and our recommended hedge strategy.
                           enhancing regional defense
        We are also currently deploying our initial missile defense
    capability against SRBMs, MRBMs, and IRBMs. Over the next decade, we
    are enhancing this initial capability by developing increasingly
    capable missile defenses that can be adapted to the unique
    circumstances of each Combatant Command region. In regions where
    ballistic missile threats are a concern, the United States will tailor
    Missile Defense Phased Adaptive Approaches (PAAs) (like the European
    PAA, or EPAA) to plan the establishment of command and control, sensor,
    fire control, and interceptor infrastructures to provide fundamental
    defenses and facilitate the effective surge of transportable missile
    defense assets to their regions when needed.
        The EPAA focuses on addressing missile defense interoperability
    with NATO and our allies and partners as the threat from the Middle
    East is anticipated to increase over the next decade. In November 2010,
    NATO Heads of State and Government agreed to develop an Alliance
    territorial missile defense capability to ``provide full coverage and
    protection for all NATO European populations, territory and forces
    against the increasing threats posed by the proliferation of ballistic
    missiles.'' The United States has committed to provide the EPAA as a
    national contribution to this capability, built on the Active Layered
    Theater Ballistic Missile Defense (ALTBMD) command and control system,
    and we are encouraging our allies to field and provide national
    capabilities as well.
        Phase 1: Initial SRBM, MRBM, and IRBM Defense in Europe--to be
    completed by the end of 2011.--In this phase, our goal is to achieve an
    initial missile defense capability in Europe using the Aegis BMD 3.6.1
    weapon system with SM-3 IA interceptors, forward-based AN/TPY-2 and
    SPY-1 radars, and the C\2\BMC system at Ramstein Air Force Base,
    Germany, which will improve connections to NATO command and control
    structures. The USS Monterey is at sea today and, when paired with the
    AN/TPY-2 radar, will provide initial BMD protection of southern Europe
    from existing SRBM, MRBM and IRBM threats. While no decision on the
    location of the radar has been made, we expect to meet our 2011
    deployment timeline. Additionally, THAAD batteries will be available
    for deployment in this and subsequent phases. The Army activated a
    second THAAD battery in October 2009, which is scheduled to complete
    training by the end of calendar year 2011. We are requesting $290.5
    million in RDT&E funding to enhance communications and enable THAAD's
    launch-on-sensor network capability, which will allow THAAD to
    intercept threat missiles tracked by many different missile defense
    sensors. We also request $833.2 million for the production of 63 THAAD
    interceptors, six launchers, and one Tactical Station Group to be
    delivered by fiscal year 2014, and $380.2 million for the production of
    two AN/TPY-2 radars. A critical EPAA phase 1 milestone was achieved in
    March 2011 when an IRBM range target was intercepted in the Pacific by
    a SM-3 IA interceptor using the current Aegis fire control system and
    the EPAA forward based AN/TPY-2 and Command and Control architecture.
    Additionally, we will conduct two critical ground tests this year to
    demonstrate the EPAA Phase 1 capability for defending European allies
    and deployed forces from multiple and simultaneous SRBM and MRBM
    threats.
        Phase 2: Enhanced MRBM Defense in Europe by 2015.--Our goal in this
    phase is to provide a robust capability against SRBMs and MRBMs by
    launching several different interceptors to engage each threat missile
    multiple times in its flight. This architecture includes the deployment
    of the Aegis BMD 4.0.1/5.0 weapon fire control systems with SM-3 IB
    interceptors at sea and at an Aegis Ashore site at Deveselu Airbase in
    Romania. When compared to the current SM-3 IA, the IB will have an
    improved two-color seeker for greater ability to discriminate threat
    Reentry Vehicles from other objects, and it will have improvements to
    enhance reliability and producibility of the SM-3 IB's divert and
    attitude control system. These improvements also provide greater
    capability against larger sized raids. Later this summer, we will
    demonstrate Aegis BMD 4.0.1 fire control and the first flight test of
    the SM-3 IB interceptor. We are requesting $565.4 million for the
    production of 46 SM-3 Block IB interceptors to be delivered by fiscal
    year 2014 and $960 million for Aegis BMD to fund continued development
    and testing of the SM-3 IB as well as upgrades to Aegis 5.0 fire
    control software to support the operation of the SM-3 IB and IIA
    interceptors and associated flight tests. In fiscal year 2012, we are
    requesting $306.6 million to begin acquiring Aegis Ashore Missile
    Defense Systems (land-based SM-3) batteries--one for testing at the
    Pacific Missile Range Facility (PMRF), and one for deployment in
    Romania by fiscal year 2015. We request $364.1 million for the C\2\BMC
    program for continued development of software and engineering to
    incorporate enhanced C\2\BMC capability into the C\2\BMC battle
    management architecture and enable interoperability among the BMDS
    elements, incorporate boost phase tracking, and improve system-level
    correlation and tracking.
        Phase 3: Enhanced IRBM Defenses in Europe by 2018.--Key to
    achieving more cost-effective missile defense, expanding the engagement
    range of our interceptors, improving discrimination and enabling early
    intercepts of ballistic missiles is our phase 3 sensor strategy. This
    strategy is based on complementing our forward based AN/TPY-2 radars
    with the development and deployment of the Precision Tracking Space
    System (PTSS) satellites, enhanced Airborne Infrared (ABIR) capability,
    and the algorithms to rapidly fuse all our data sources to provide the
    most precise tracking for the GMD, Aegis BMD, and THAAD fire control
    systems. The PTSS is the principal capability in this sensor strategy
    as, unlike AN/TPY-2 and aircraft that require host nation and over
    flight permissions respectively, the PTSS will provide assured,
    persistent capability to detect and track large raid sizes of hostile
    ballistic missiles over their entire flight in the Northern Hemisphere
    and enable earlier engagements to improve both homeland and regional
    defense. In sum PTSS provides three to six times the simultaneous
    tracking capability of the AN/TPY-2 radars or ABIR Combat Air Patrols
    at a smaller percentage of the operations and support costs.
    Furthermore, to maximize competition and integration of the PTSS into
    all elements of the BMDS, we are executing an acquisition strategy in
    which Government federally Funded Research and Development Centers
    (FFRDCs) develop non-proprietary preliminary designs and government
    owned intellectual property, which will be used to enable full and open
    competition for the production of the satellite constellation while we
    are validating the performance of prototype satellites on orbit. Recent
    flight tests using the Space Tracking and Surveillance System (STSS)
    demonstrator satellites on orbit today have repeatedly shown the
    significant improvement in our ability to acquire and track ballistic
    missiles.
        In concert with the Phase 3 sensor architecture, the SM-3 Block IIA
    interceptor is being co-developed with the Japanese Government to
    nearly double the range of our SM-3 interceptors. The SM-3 IIA project
    is on schedule to be deployed at the Aegis Ashore site in Romania and
    at an additional Aegis Ashore site in Poland, and at sea, in 2018. The
    fiscal year 2012 request for SM-3 Block IIA co-development is $424.5
    million. Additional BMDS improvements during this phase include
    expanded coordination of missile defense fire control systems and
    improvements to radar discrimination.
        Phase 4: Early Intercept Defense in Europe by 2020.--Based on the
    enhanced early tracking capability of the PTSS and ABIR systems, the
    SM-3 IIB will provide an early intercept (pre-apogee) capability
    against MRBMs and IRBMs and provide an additional layer for a more
    enhanced homeland defense against ICBMs launched from today's regional
    threats. In fiscal year 2012, we are requesting $123.5 million to fund
    three industry teams to continue concept analysis and development of
    the SM-3 IIB design while MDA develops relevant advanced propulsion and
    lightweight material technologies. Advanced discrimination technologies
    also will be deployed during EPAA Phase 4 including GMD's use of fused
    data from the entire network of BMDS sensors (including enhancements
    from PTSS and ABIR sensor capabilities) to improve homeland defense.
             proving missile defense works through enhanced testing
        In fiscal year 2012, we are requesting nearly $1 billion of RDT&E
    funding for Testing and Targets. In collaboration with the Director,
    Operational Test and Evaluation (DOT&E) and the Operational Test
    Agencies (OTAs), MDA updated its Integrated Master Test Plan (IMTP).
    The updated test plan (version 11.1), consisting of 53 flight tests and
    74 ground tests from fiscal year 2011 through fiscal year 2016, cost-
    effectively conducts increasingly complex flight tests to achieve more
    objectives and enhance the realism of each test.
        We will hold a series of system-level operational flight and ground
    tests to demonstrate the initial capability against SRBMs and MRBMs for
    theater/regional defense as well as planning in fiscal year 2012 the
    first entirely operational test of the defense of the homeland by 2015.
    Each operational test will be conducted as realistically as possible
    and involve multiple targets of different ranges. These tests are being
    planned and will be executed in concert with the BMDS Operational Test
    Agencies and under the oversight of the Department of Defense Director
    for Operational Test & Evaluation. The BMD system under test will be
    operated by the soldiers, sailors, and airmen assigned to their
    respective missile defense equipment and placed under realistic wartime
    conditions to truly document the capabilities and limitations of the
    system. Finally, in fiscal year 2011, THAAD will execute a near-
    simultaneous engagement of an MRBM and SRBM.
                          developing new capabilities
        After completing all of their original on-orbit testing in 2010, we
    continue to operate the two STSS demonstration satellites to conduct
    cooperative tests with other BMDS elements and demonstrate the
    capability of STSS satellites against targets of opportunity. These
    tests demonstrate the ability of space sensors to provide high
    precision, real-time, tracking of missiles and midcourse objects that
    enable the fire control solutions BMDS interceptors. Two recent flight
    tests demonstrated that STSS dramatically improved the precision of
    threat missile tracks and provided more accurate fire control quality
    data to the Aegis ships several minutes earlier than less accurate data
    provided by organic radars in the Aegis or THAAD systems. We are
    requesting $96.4 million for the STSS system in fiscal year 2012 and
    are planning for an Aegis intercept in fiscal year 2013 using the STSS
    data. Lessons learned from the two STSS demonstration satellites inform
    PTSS development decisions. We are requesting $160.8 million for PTSS
    in fiscal year 2012. The PTSS, a new program, will use simple designs
    and mature technologies to provide persistent classification and
    tracking capability of enemy ballistic missiles for areas of the globe
    that have ballistic missile activity. PTSS project scope includes the
    delivery of ground segments and the launch of the first two PTSS
    spacecraft in fiscal year 2017.
        In fiscal year 2012, we are requesting $46.9 million for the
    Airborne Infrared (ABIR) program. The ABIR program will provide a
    capability to track large ballistic missile raids with an airborne
    forward-based sensor, decreasing the time between the enemy's launch of
    the first ballistic missile and the first launch of a ballistic missile
    interceptor. Initially, we will integrate an advanced sensor from the
    Multi-spectral Targeting System family of infrared sensors onto an MQ-9
    Reaper Remotely Piloted Vehicle to prove that we can enable Aegis fire
    control solutions with forward-based airborne assets. In fiscal year
    2012, using platforms and operators supplied by the Air Force, and
    working closely with the Navy, we propose to continue to demonstrate
    sensor performance and the ability to provide timely and accurate
    ballistic missile tracking. Our objective is to integrate the ABIR
    sensor into a pod that can be attached universally to the wing of a
    variety of aircraft. Additionally, in fiscal year 2012 we are enhancing
    our command and control capability to handle larger threat missile raid
    sizes and leverage airborne and space sensor missile tracking data
    networks. We will continue our development and testing of a multi-
    sensor application (ABIR and space sensors) tasking and signal
    processing capability that will provide data with sufficient quality to
    enable Aegis, THAAD, and GMD fire control solutions for launching
    interceptors.
        In fiscal year 2012, we are requesting $96.3 million for Directed
    Energy Research ($92.6 million for Airborne Laser Test Bed). Following
    the successful shoot downs of liquid-fueled and solid-fueled boosting
    ballistic missile targets with an airborne laser in fiscal year 2010,
    the Assistant Secretary for Defense Research and Engineering designated
    the Airborne Laser Test Bed (ALTB) as a science and technology test bed
    for high power laser research and development. In fiscal year 2012, we
    are teaming with the Air Force's Research Laboratory to use the ALTB
    for testing advanced directed energy technologies and conducting beam
    propagation and lethality testing. A primary objective of our directed
    energy program is to continue our partnership with Lawrence Livermore
    National Laboratory to develop Diode Pumped Alkaline-gas Laser System
    (DPALS) technology, which offers great potential for high efficiency,
    electrically driven, compact, and lightweight high energy lasers for a
    wide variety of missions of interest to MDA and the Department of
    Defense.
                           international cooperation
        As stated in the 2010 Ballistic Missile Defense Review (BMDR),
    developing international missile defense capacity is a key aspect of
    our strategy to counter ballistic missile proliferation. In Europe, we
    remain committed to working with our NATO allies to make NATO lower
    layer missile defense assets interoperable with U.S. upper-tier missile
    defense assets deployed under the EPAA through NATO's territorial
    missile defense capability. In East Asia, we are improving missile
    defenses through bilateral relationships. And in the Middle East, we
    continue to work with long-term partners and pursue strengthened
    cooperation with other countries that have expressed interest in
    missile defense. MDA is currently engaged in missile defense projects,
    studies and analyses with over 20 countries, including Australia, the
    Czech Republic, Denmark, France, Germany, Israel, Japan, Kuwait, NATO,
    Poland, Romania, Saudi Arabia, South Korea, the United Arab Emirates,
    and the United Kingdom.
        MDA continues its close partnership with Japan on the SM-3 IIA
    interceptor (Japan is leading the development efforts on the SM-3 IIA
    second and third stage rocket motors and the nosecone), studying future
    architectures, and supporting that Nation's SM-3 IA flight test
    program. We also continue collaboration with Israel on the development
    and employment of several missile defense capabilities that are
    interoperable with the U.S. BMDS. In February of this year, at a U.S.
    test range off the coast of California, the Arrow Weapon System
    successfully intercepted a target representative of potential ballistic
    missile threats facing Israel today. We are requesting $106.1 million
    for Israeli Cooperative Programs (including Arrow System Improvement
    and the David's Sling Weapon System) in fiscal year 2012. We are
    working with our partners from the United Arab Emirates on the
    development of a Foreign Military Sales (FMS) case for the THAAD system
    that would represent the first sale of this capability.
        Additionally, MDA is actively engaged with the Russian Federation
    through three missile defense working groups led by the State
    Department, Office of the Secretary of Defense, and the Joint Staff. We
    are optimistic from the outcomes of both the NATO Russia Council
    meeting at Lisbon and the U.S. bilateral working groups that we will
    make meaningful progress this year in defining how we will cooperate
    with the Russian Federation on missile defense, including considering
    leveraging the combined early warning and surveillance radars of both
    countries.
                                   conclusion
        Our fiscal year 2012 budget funds completing the initial deployment
    of SRBM, MRBM, IRBM, and ICBM defenses while meeting the warfighters'
    near-term missile defense development priorities. In parallel, we are
    developing enabling capability to create an enhanced, international
    network of integrated BMD capabilities that is flexible, survivable,
    cost-effective, and tolerant of uncertainties of estimates of both
    nation-state and extremist ballistic missile threats.
        Thank you, Mr. Chairman. I look forward to answering the
    committee's questions.

                     GROUND-BASED MIDCOURSE DEFENSE SYSTEM

        Chairman Inouye. Thank you very much, General.
        I'm happy that you have responded to our concerns rather
    fully. But are you personally satisfied that you've been able
    to identify the causes of the failures of the GMD?
        General O'Reilly. Yes, Mr. Chairman, I am. The first cause
    was a quality control problem, because we've had two failures.
    We have identified and confirmed that we had an error in the
    assembly process of our new EKV. I should stress that this is a
    new EKV. The ones we have deployed, most of them out there,
    have been successfully tested and we've seen no problems with
    them. But the newest one, the first test did have a quality
    control problem, which we have corrected.
        When we flew the second test last December, again that
    quality control problem was found to be resolved, but we ran
    into another problem very late in the flight, in the last few
    seconds of flight. We have assembled a nationally renowned team
    of experts that's been working extensively on this. We
    completed almost all of the ground testing to confirm what the
    problem was and have identified that problem. We are now in the
    process of correcting the problem, confirming it on the ground.
        But the nature of these types of problems make it very
    difficult to confirm in ground testing. So that is why I'm
    proposing to have another flight test added for the GMD system
    to verify the confirmation in space, and then we will proceed
    on with the intercept test that we've been trying to conduct in
    the last two flights.

                      TERMINAL HIGH ALTITUDE AREA DEFENSE

        Chairman Inouye. Are you also satisfied with the progress
    being made on the THAAD?
        General O'Reilly. Yes, sir, I am. The THAAD, we have a very
    extensive test program and the component that was giving us
    problems was a safety device. So it requires absolute
    confirmation over an extensive series of tests that in fact
    it's working properly, and the Army is independently confirming
    that that component is working properly. And all of our testing
    has indicated that we have resolved that issue. We have four
    THAAD missiles delivered today. There are five more in
    production, and we do believe we are beyond that problem and
    are reaching a steady production rate on the THAAD program.
        Chairman Inouye. Have you resolved the block 1B and 1A
    problem?
        General O'Reilly. Sir, with the block 1A we have had--over
    time have indicated that in our testing we do reveal shortfalls
    or concerns. We've corrected each one of them before the
    previous flight test and the last series of flight tests have
    shown that we have none of those issues today.
        We do have an issue that still allows an intercept to
    occur, but we want to confirm that it is not a greater problem
    than that, and we're working that right now. We are still on
    track for testing.
        When we test the 1B later this summer, we actually--most of
    the 1B is a 1A booster configuration. For the 1B, we did have
    an issue in--not the operation of the missile, but it was more
    to do with the shelf life in the environments that a Navy
    missile will be exposed to. The testing on the ground to date
    has indicated we have resolved that, but we have a couple more
    tests in the next 2 months to validate that we will be ready
    for a flight test in August.

                              JAPANESE GOVERNMENT

        Chairman Inouye. As you noted in your remarks, you're
    pleased with the partnership you have developed with the
    Japanese on the development of the MDA. But do you have
    concerns about the recent earthquake and tsunami? Will that
    slow down the development?
        General O'Reilly. Sir, we are working very closely with the
    Japanese Government. They have been outstanding partners to
    work with, meet every commitment, and are very meticulous in
    their planning, and it's made it very helpful for us to work
    together in the fashion which we have.
        Regarding the tsunami and earthquake, it did not interrupt
    the operations of our major activity in Nagoya with MHI,
    Mitsubishi Heavy Industry. Some of their subcontractors were
    affected. They were not stopped. It slowed down some
    deliveries. We do not anticipate, nor does the Japanese
    Government, that this will affect the ultimate delivery of the
    program.
        But in that regard, we do rely outside that program on some
    of the foundries in Japan that develop our focal plane arrays,
    and they have been affected by their proximity to their nuclear
    powerplant and we are concerned about that and we work closely
    with them. But that is an ongoing concern of our reliance on
    only one or two foundries around the world to produce these
    focal plane arrays that have wide application beyond just
    missile defense.
        Chairman Inouye. General, I have a few more questions, but
    I'd like to call upon the vice chairman.
        Senator Cochran. Mr. Chairman, thank you very much.

                     GROUND-BASED MIDCOURSE DEFENSE SYSTEM

        General O'Reilly, I was interested in your response to the
    chairman's question, questions plural. Let me ask you about the
    Ground-based Midcourse Defense System. There were two failures
    last year. Are these of particular concern to you, and if so
    what are we able to do to overcome those challenges?
        General O'Reilly. Sir, they are a concern to me. These are
    very expensive missiles and our tests are very expensive. The
    good news is we are aggressively testing these systems, and by
    ``aggressively'' I mean we are operating the GBI at the very
    longest ranges it could ever possibly have to operate and
    protect the United States.
        But from that, we have uncovered a quality control problem.
    We revised, because of this, both at Raytheon and Boeing and
    our Defense Contract Management Agency and MDA our inspection
    processes, and we have shown that we have overcome that issue
    in changing processes in the plant.
        The second problem was of a nature that made it extremely
    difficult to uncover on the ground because of the sensitivity
    of the instruments that are on board this system. We needed to
    be in space. We have uncovered the problem. I believe because
    we know that we will be able to correct that problem, and so
    when we need the system in combat we will absolutely have one
    that we can rely on.
        At that, we still have a few more tests to do and, as I
    said, a couple more flight tests, which will confirm that we
    have in fact fixed it. I am confident we will.

                                    ARROW 3

        Senator Cochran. Yesterday we had a very persuasive speech
    made in a joint session with President Netanyahu of Israel. I
    was interested in hearing what your reaction is to the fact
    that Israel is developing and fielding a missile defense system
    to protect its nation. I wonder if you can give us an update on
    the status as you understand it of the Arrow 3 and David's
    Sling programs in Israel and how that fits in with our own
    missile defense interests?
        General O'Reilly. Senator, the Missile Defense Agency is a
    co-partner to manage both of those programs with the state of
    Israel. They have demonstrated--what we have established is a
    program for Arrow 3 that's based on milestones, achieving
    technical milestones to confirm we have the capability that
    both they want and we want them to have.
        Those milestones are very aggressive, more aggressive than
    a U.S. program would normally take on. But I understand the
    risks to their country and why they're being so aggressive.
    They have successfully achieved those milestones last year, the
    ones that they were supposed to achieve. As time goes on, those
    technical milestones get more difficult to achieve. I do
    anticipate that they will achieve those milestones. The
    schedule is the question, and they are having some delays and
    repeated attempts to accomplish the technical tasks that they
    have to accomplish on Arrow 3.
        But they have shown that they do ultimately achieve the
    technical capability that they need, and we are closely
    tracking that with them. So my confidence is very high they
    will be successful in developing this missile capability. The
    question we have is the schedule associated with that might be
    a little longer than what, tracking it the way we do, than what
    they're currently projecting.
        On the David's Sling program, that is an exceptional
    capability for short and medium-range missiles, and the David's
    Sling program--also we're working with them. They've had--in
    their flight tests, they have also uncovered problems, which is
    the reason we do the flight tests, and they've shown that
    they're very quick to react to those problems and successfully
    fly afterwards.
        So the David's Sling program is experiencing the type of
    developmental issues that we all experience in developing new
    missiles. But again, they've shown their commitment and their
    technical prowess to overcome those, and we're working closely
    with them. Again, the question will be not are they going to
    develop this capability; it's the time line in which they will
    ultimately have an operational capability.
        Thank you, Mr. Chairman.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Thank you, Mr. Chairman.

                     GROUND-BASED MIDCOURSE DEFENSE SYSTEM

        You've talked about some of this, General O'Reilly, but
    I'll get back into the GMD. This administration has scaled back
    planned production and deployments of ground-based interceptors
    in favor of more research and development into futuristic SM-3
    block 2B missiles. You and I both agree that it's necessary to
    hedge against uncertainty as we seek to develop the block 2B.
        Senior defense officials, including yourself, have stated
    that we need to continue modernizing and testing GBIs in the
    event that the rogue ICBM threat develops more quickly than
    expected or that the block 2B development encounters
    unanticipated technical hurdles. Recent test failures that
    you've alluded to have called into question the status of the
    GBI hedge.
        I understand that MDA has developed a plan to fix problems
    with GBI that would cost an additional--getting into a little
    money here--$281 million in 2012. Even with full funding of the
    2012 GMD budget, this plan would require MDA to delay, I
    understand, critical development work and to slip an intercept
    test of the two-stage GBI from 2012 to 2014.
        I'm confused in a way here by a recent GAO claim that the
    GMD budget for 2012 could be cut by as much as $400 million
    with no significant impact to the program. Do you agree with
    GAO's assessment and could you explain to us what the impact of
    a significant cut in 2012 would be on the GMD program?
        General O'Reilly. Senator, I do not agree with the
    Government Accountability Office (GAO) assessment. If we
    received a $400 million cut as they proposed, it would delay
    our recovery of the program by a minimum of a year. What I
    don't believe they took into account is the additional activity
    that we're doing right now that required reapplying funding
    from production to fixing the problem.
        Senator Shelby. I assume or I believe that the problem
    resides in the EKV and not the GBI booster; is that right?
        General O'Reilly. That's correct, sir.

                            GROUND-BASED INTERCEPTOR

        Senator Shelby. Is there any reason to delay funding for
    procurement of the GBI boosters?
        General O'Reilly. Sir, the GBI has no problems with the
    booster. It has no problems with it. It is a matter of storage
    and our supply chain management. But I do want to clarify,
    there are no problems with the GBI booster. We are at a point,
    though, that we were to be applying those to the EKVs and
    producing those GBIs, and so we have to manage the rate at
    which those boosters are produced.
        Senator Shelby. You referenced earlier some quality control
    in some of the failures perhaps, whatever. In your judgment, is
    the architecture sound you're dealing with?
        General O'Reilly. Yes. Yes, Senator, it is. This work is
    very precise. When you're hitting a missile at 20,000 miles an
    hour--and we have shown over and over again we can hit it
    within inches of a point on an object--it requires extreme
    precision. But our aerospace industry has shown that they can
    have the discipline to produce those type of production
    processes.
        There is over 2,000 components in a GBI, and so, as we are
    seeing, it's very unforgiving if there is a problem.
        Senator Shelby. Very complicated.
        General O'Reilly. Yes, sir. But we have shown we can do
    this. We've adjusted our processes so that we can reliably
    produce these.
        Senator Shelby. And you--I know the chairman asked you this
    question, basically. You feel that you have, you and your team,
    have found some of the flaws in some of your testing, and
    you're in the process of correcting them; is that correct?
        General O'Reilly. That is correct, Senator. We found one
    flaw and we are aggressively working to resolve it and prove
    it.
        Senator Shelby. Okay. In your testimony today you outline a
    plan to conduct previously unplanned-for flight and intercept
    tests of GBI to ensure that you've solved the problem with the
    EKV. Do these additional tests mean that you will eventually
    need to procure more GBIs than currently planned for in the
    budget? In other words, you planned--with the test thing you're
    into production in a sense, are you not?
        General O'Reilly. Senator, it's my personal assessment--
    we're still developing the budget, but it is still my personal
    assessment that when we developed a previous number of GBIs
    that was 52 we had assessed the need for 4 spares. However, as
    you just said, in the first year since we've done that we have
    consumed two in failed flight tests. I've identified the need
    and proposed for another flight test, and then we have to
    repeat it.
        So my personal assessment is, yes, we need to procure
    additional GBIs.
        Senator Shelby. You've also stated previously that the
    threat to U.S. interests from short-range missiles is growing
    even more rapidly than the ICBM threat at the moment. One of
    the assets that we have in seeking to understand and encounter
    these threats is the Missile and Space Intelligence Center
    (MISIC) that you work with. Can you talk about here--I don't
    know if you can--about the kind of intelligence that you get
    from MISIC and how it contributes to your efforts to design
    defenses against short-range ballistic missiles? I know some of
    that is highly classified, but you do have a working
    relationship there, do you not?
        General O'Reilly. Senator Shelby, we have a very strong
    working relationship. It goes beyond that. It's a dependency on
    MISIC, with their great resources. You're correct, we can't
    talk about a lot of it, but I would like to say the accuracy of
    these short-range missiles and the ease in which they now can
    be launched is quite disturbing, and MISIC has been very good
    at identifying that in order to reduce the uncertainty that
    we're talking about of the threat. And then we can take that
    through our engineering process and develop missile systems
    more effectively to counter those threats.
        Senator Shelby. So you have a close working relationship
    there?
        General O'Reilly. Yes, Senator Shelby, yes.

            INTEGRATED AIR AND MISSILE DEFENSE BATTLE COMMAND SYSTEM

        Senator Shelby. My last question, if the chairman will
    indulge me. I understand that the Army has proposed
    transferring its missile defense budget and program
    responsibilities to the Missile Defense Agency. Programs such
    as Patriot and the Integrated Air and Missile Defense Battle
    Command System, or IBCS, I believe are critical to Army
    warfighters here. I worry, am concerned at times that the
    arrangement could dilute Army control over these critical
    systems or even put their budgets at risk.
        Could you explain for the subcommittee the status and the
    details of this proposal? Will the budget for Patriot and IBCS
    be protected if MDA controls some or all the funding? Has that
    crossed your mind?
        General O'Reilly. Yes, Senator, it has. The process in
    which MDA develops its budget is a joint process that the Army
    is a full partner in. The Army 2 years ago started asking me
    questions about why does the Missile Defense Agency manage the
    ballistic missile defense capability of every service except--
    and THAAD--except the one aspect of the Patriot program, which
    does have ballistic missile capability?
        We have provided a lot of information to the Army and from
    that the Army has been very positive on a potential transfer,
    but not this year, in the fiscal year 2013 timeframe, for a
    change. That is still being deliberated in the Department. A
    final decision hasn't been made on that.
        However, I would--to answer your question, we have very
    closely coupled budget development processes that have been
    established by the Deputy Secretary of Defense between MDA and
    the services, so the Army does review and we actually build our
    budgets together before we submit them to OSD, and then they're
    reviewed again by the Joint Chiefs and others to ensure that
    there is a prioritized budget that matches the Army's needs and
    the Joint Chiefs' needs.
        Senator Shelby. So you don't believe you would suffer in
    the management of that if it came about?
        General O'Reilly. Senator, no, I don't. And the particular
    proposal we have made for the Army's case is literally to take
    their leadership that does currently oversee Patriot; they
    would become part of the Missile Defense Agency, but still they
    are--they still have rating responsibilities to the Army, back
    to the Army and me both.
        Senator Shelby. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.

                                 MISSILE FIELD

        General, welcome. Thank you for the time that you have
    given me in talking through some of the issues that you have
    before you.
        I'd like to ask just for perhaps a more general description
    of the plans as they relate to Fort Greely and the intent to
    place Missile Field 1 into the storage mode, in basically
    mothball status, as opposed to a decommissioning; and then
    further, why the launch capabilities at these three missile
    fields at Fort Greely are necessary to hedge against ICBM
    threats? So if you can just speak to the mothballing versus
    decommissioning and then why it's so critical that we continue
    to have these in place?
        General O'Reilly. Yes, Senator. Last year's budget,
    previous budget, the plan, the proposal was to decommission the
    missile field, which effectively puts it in a--returns it as
    much as possible to its pre-construction condition, and it
    would make it very difficult in the future if we needed to use
    that missile field again to bring it back into an operational
    capability.
        It was a test missile field, so for example it is not
    hardened, it doesn't have backup power and other attributes
    that we would want in an operationally hardened system.
        So we have identified in this year's budget that, instead
    of decommissioning the field, we put it into a storage mode.
    The cost is $4 million and then every year it's about $500,000
    to maintain it in that mode. But if it's in that mode, within 2
    years we can complete the upgrade of that missile field and
    bring it back into operation as a potential hedge.
        The reason for the hedge is the uncertainty in the
    intelligence estimates on exactly what is the progress being
    made for successful development of ICBMs by regional threats
    today in northeast Asia, such as North Korea, or in the Middle
    East. And we are closely monitoring those programs, but we need
    to have capability to expand if we find that the number that we
    have is insufficient.
        That is also the reason why we completed Missile Field 2 in
    the original design, so that we have 30 operational missiles,
    but we have 8 spare silos that could be very quickly, in a
    matter of weeks, made operational with the test GBIs that we
    are producing for test purposes, that's effectively building a
    stockpile for us.
        So between the additional silos and if it was deemed
    necessary the ability to bring back Missile Field 1, we do have
    contingency plans to have a fully operational missile site, as
    we've laid out, depending on the indications and warnings from
    our intelligence community.
        Senator Murkowski. So essentially the $4 million that you
    indicate that it will take to put it into this storage mode
    allows us a level of flexibility, the option, if you will, if
    we need to, to reconfigure. We have that ability. If we
    decommission, we lose that flexibility; we do not have the
    nimbleness--I don't know if that's a word, but we don't have
    the ability to turn back as readily and in a manner that
    hopefully will be a cost savings to us?
        General O'Reilly. That is correct.
        Senator Murkowski. Let me ask you also--I think most when
    they look at the ground-based midcourse defense operations Fort
    Greely, given where Fort Greely sits up in Alaska there, they
    view this more as a defense for the west coast against any ICBM
    threats that may be coming from North Korea. But I think we
    recognize that the system is effective also against missile
    threats to the east coast by actors that may be out there in
    the Middle East. But sometimes the geography doesn't allow us
    to perhaps look that broadly.
        As you mention, it helps to look at a globe and figure it
    out from there, rather than the world of flat maps. But the
    decision to place an in-flight communications system data
    terminal on the east coast by 2015, this extends the
    communication with the ground-based interceptors that may be
    launched from Greely or from Vandenberg on in-flights, longer
    flights.
        I understand that what this will do is allow for enhanced
    communications capability to really help bolster that missile
    defense of the east coast. Can you characterize, General, in
    perhaps qualitative terms the system's effectiveness against
    the missile, any missile threats that might be directed to the
    east coast, and how Alaska's strategic location can contribute
    to all of this? Just put that out, because we haven't had a lot
    of discussion about how the east coast and this in-flight
    communication system data terminal will coordinate or integrate
    together.
        General O'Reilly. Yes, Senator. From a polar view, as you
    say, from the global view, literally the globe, you will notice
    that from the East--from the Middle East to the east coast or
    all of the United States, the most likely trajectories are over
    the poles or in the northern regions, far northern latitudes.
        Therefore, Alaska actually is in a great position in order
    to launch from there and have a side shot at a missile. Instead
    of defending the missiles head-on, which is the most difficult
    way to hit a missile, Alaska gives us the positioning, the
    geometries, so that we can intercept a missile as it's passing
    by, which is the highest probability of an intercept.
        However, there are great ranges involved in these launches.
    Due to the great distance of communication between the missile
    and the fire control center at Alaska or the one in Colorado
    Springs, we need the ability to talk to the missile late in
    flight, because so much time goes by as that missile is flying.
    We're learning about the threat missile while it is in flight,
    and the more we learn--we want to pass that on to the kill
    vehicle so that it has as much information as possible before
    it begins its final maneuvers.
        The east coast in-flight data terminal would allow us the
    opportunity to communicate late in flight, where today we only
    have those communications sites in Alaska and on the west coast
    at Vandenberg. So this is a significant improvement to the
    capability for intercepts that would occur over the Atlantic or
    heading toward the southeastern United States especially.
        Senator Murkowski. So it really does give us that full
    umbrella of protection that we talk about when we discuss the
    advantages of a missile defense system that truly does cover
    all of the United States?
        General O'Reilly. Yes. Today we do have coverage of the
    United States, but this greatly enhances the probability of
    intercepts in the first couple interceptors we launch, because
    we have this opportunity now, or will have this capability, to
    communicate late in a flight.
        Senator Murkowski. Well, I appreciate that, General.
        I know that you've spent considerable time in Alaska
    looking at the operations there at Greely. I appreciate the
    fact that you're willing to go up in January, when many others
    would prefer to find warmer climes. But I look forward to the
    opportunity to visit with you when you perhaps head north when
    the daylight hours are longer and it's a little bit warmer.
        General O'Reilly. Senator, we have a fantastic work force
    up there.
        Senator Murkowski. Yes, we do.
        General O'Reilly. And when you're working with them at 50
    below zero and you see their dedication and how professional
    they are, we don't lose a step in that operation. That's where
    that workforce shines the best, is during those parts of the
    year, and it's my honor to be up there and observe that and
    witness that in those extreme environments.
        Senator Murkowski. Well, I think your visits help to
    contribute to good strong morale and commitment to the work as
    well. So we thank you for that.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.

                                   IRON DOME

        General O'Reilly, you have assessed what you consider to be
    the value of the Arrow program and the David's Sling program.
    Can you tell us about the recent employment, deployment, of the
    Iron Dome in combat? This was the first time they used this in
    combat, and apparently they consider that to have been a great
    success. What is your assessment?
        General O'Reilly. Senator, I don't have today and did not
    have responsibility for the development of Iron Dome. But I
    have observed their testing and I have been to their plants
    where they manufacture it, and my assessment is that it has
    been very successful in intercepting the missiles that are--the
    short-range, very short-range missiles, that are extremely
    difficult to hit because of the very short time flight, time of
    flight.
        However, the issue we have or the Israelis face with the
    Iron Dome is the great number of rockets and short-range
    missiles that they face. Therefore, in our budget we have a
    proposal to assist with the procurement for four more
    batteries. So the system has shown to be effective in
    developmental testing and in actual combat, or defending their
    civilian populations. The issue is the great number, the sheer
    volume of the threat they're facing.
        In our budget, I would assist with the procurement of four
    more batteries, and that is a good capability. But obviously
    when you look at the threat numbers it shows how daunting a
    task it is and the need for additional short-range type defense
    systems.
        The Army also faces that problem, the U.S. Army. So this is
    one that's shared between our country--any of our countries
    that have deployed forces very close in a combat theater to a
    potential threat. And this is one which the United States
    benefits from understanding and studying exactly how they've
    been successful with the Iron Dome system.
        Chairman Inouye. We have spent much time today discussing
    failures, test failures and delays in production. Does that
    concern you on the basis of your industrial base?
        General O'Reilly. Sir, the challenge we have in this
    business is that--and I fully support production decisions to
    be supported by tests. But with the threat and the rate at
    which the threat continues to evolve and emerge and, even more
    importantly, the uncertainties associated with exactly what the
    threat is due to the clandestine activities in which these
    threat missiles are developed and proliferated, it makes it--we
    do need to take risks at times to move forward with the supply
    chain and the production of facilitization so that we can as
    quickly as possible, once we've completed successful testing,
    minimize the time between a decision to go to production to
    actually starting to produce these missiles.
        The need for long lead procurements is critical in this so
    that we can begin purchasing the components that take 2 or 3
    years to build before they go into final assembly. That is the
    approach we're taking with the SM-3 1B. As you stated, Senator,
    in your opening remarks, we do have technical development
    issues, which are not unusual for an interceptor at this point.
        I believe we have addressed all of them and we have no
    indication that we will not be successful this summer. However,
    instead of going to a full--or requesting a full production
    decision based on one test for the SM-3 1B, we are proposing to
    make a decision on the procurement of the long lead items in
    order to keep the industrial base set and ready to go to
    deliver components that, when we have subsequent tests over the
    next year with the 1B, we'll have enough data so that the
    operational test agencies can independently concur that this
    system is ready to be fielded or go into production.
        So we are balancing between the needs, which are urgent,
    the technical achievement, and making sure that we have a
    thoroughly tested system before we put it in the field, and we
    have to balance that with the industrial base and the need to
    keep the supply chain healthy.
        So it is a challenge, sir, and, as I described with the 1B,
    those are approaches which we're using in order to reduce the
    risk to all three.
        Chairman Inouye. Because of the nature of our
    responsibilities--we're the Appropriations Committee--we seem
    to be focusing and concentrating on failures and delays.
    However, I want the record to show that the subcommittee is
    very pleased with your leadership and with the work of your
    team, because you've had a lot of successes. But in most cases
    we cannot discuss these successes because of its
    classification. But I just wanted the record to show that we
    are pleased.
        General O'Reilly. Thank you, Senator. I have a great, great
    industry-government-FFRDC-academia team across the United
    States that does this great work. And the Missile Defense
    Agency, it's my honor to be their leader, but this truly shows
    the prowess of our country and all of the agencies that are
    involved that deliver this capability.
        Chairman Inouye. I will be submitting further questions,
    but may I call upon the vice chairman.
        Senator Cochran. Mr. Chairman, thank you. I'm pleased to
    join you in commending the distinguished witness, the Director
    of our Missile Defense Agency, on the excellent job that he has
    done leading us in this very challenging enterprise and one
    that is so essential to our national defense capability and the
    safety and security of American citizens here and around the
    world. We thank you for your service.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Mr. Chairman, I just want to associate
    myself with your remarks here. I think this has been a good
    hearing. I appreciate General O'Reilly's candor with us. I
    know, as you alluded to and I did earlier, there's a lot of
    this program that's highly classified and we have to get into
    it in another meeting. But I like the idea for the moment that
    the General feels good about the architecture, which is very
    important, the scheme that you lay out, and feels good about
    correcting some of the problems that he's recognized, and he's
    got an excellent team to deal with it.
        So thank you, Mr. Chairman, for the hearing.
        Chairman Inouye. I thank you.

                         ADDITIONAL COMMITTEE QUESTIONS

        Thank you, General, for your testimony today and for your
    service to our Nation, and we look forward to working with you
    in the coming months.
        [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
                     pacific missile range facility (pmrf)
        Question. General O'Reilly, can you provide the Committee a
    schedule of THAAD tests that will be conducted at PMRF over the next 5
    years?
        Answer. THAAD tests planned for the next 5 years at PMRF are listed
    below:

                                             THAAD FLIGHT TEST SCHEDULE (U)
    ----------------------------------------------------------------------------------------------------------------
     Flight test (fiscal year 2011-
           fiscal year 2016)                                Description                                 Date
    ----------------------------------------------------------------------------------------------------------------
    FTT-12.........................  Initial Operational Test to demonstrate soldiers' ability  4Q fiscal year 2011
                                      to plan, deploy, emplace, and operate the THAAD System
                                      using approved Tactics, Techniques, and Procedures.
                                      Demonstrate THAAD closed-loop operations and engagement
                                      functions. Demonstrate the capability to conduct a
                                      multiple, simultaneous engagement of two Short-Range
                                      Ballistic Missiles (SRBM).
    FTT-13.........................  THAAD endo-atmospheric engagement of a separating Medium-  3Q fiscal year 2012
                                      Range Ballistic Missile (MRBM) with associated objects.
    FTT-11a........................  THAAD exo-atmospheric engagement of a complex, separating  3Q fiscal year 2013
                                      SRBM with associated objects.
    FTT-15.........................  THAAD exo-atmospheric engagement of a complex, separating  3Q fiscal year 2014
                                      maximum range MRBM using Launch-on Network Track.
    FTT-17.........................  THAAD operational engagement of a MRBM with associated     3Q fiscal year 2016
                                      objects using Launch-on Network Track.
    ----------------------------------------------------------------------------------------------------------------
    Based on IMTP v11.1 as approved on February 23, 2011.

        Question. What is the current schedule for Aegis Ashore testing at
    PMRF?
        Answer. Aegis Ashore tests currently planned at PMRF are listed
    below:

                                          AEGIS ASHORE FLIGHT TEST SCHEDULE (U)
    ----------------------------------------------------------------------------------------------------------------
     Flight test (fiscal year 2011-
           fiscal year 2018)                                Description                                 Date
    ----------------------------------------------------------------------------------------------------------------
    Aegis Ashore Controlled Test     Aegis Ashore first launch events (total of 2)              4Q fiscal year 2013
     Vehicle 01 (AA CTV-01).          demonstrating system ability to launch, capture, and
                                      control the Standard Missile-3 (SM-3) Block (Blk) IB
                                      interceptor.
    AAFTM-01 (Event 1).............  Aegis Ashore will detect, track, and engage an air-        3Q fiscal year 2014
                                      launched Medium-Range Ballistic Missile (MRBM) with the
                                      SM-3 Blk IB interceptor.
    AAFTM-01 (Event 2).............  Aegis Ashore will detect, track, and engage an MRBM with   3Q fiscal year 2014
                                      an SM-3 Blk IB interceptor using Integrated Fire Control
                                      capability with AN/TPY2 (FB) (common designator for Army
                                      Navy/Transportable Radar Surveillance Forward Based).
    FTO-02.........................  Demonstrate initial BMDS operational effectiveness         4Q fiscal year 2015
                                      against full range of ballistic missile threats with SM-
                                      3 Blk IB interceptor.
    FTO-03.........................  Demonstrate initial BMDS operational effectiveness         4Q fiscal year 2018
                                      against full range of ballistic missile threats with SM-
                                      3 Blk IIA interceptor.
    ----------------------------------------------------------------------------------------------------------------
    Per IMTP v11.1 dated February 23, 2011.

        Question. I understand that within a few seconds of an SM-3 missile
    launch from the test Aegis Ashore facility on PMRF, it must be
    determined that the missile is moving in the intended direction, and,
    if not, the missile must be quickly destroyed. For safety
    considerations, PMRF is likely to require an exceptionally fast
    capability that can accurately determine missile condition and
    location, during the first few seconds of launch, something that radar
    alone may not be able to address. This is a critical requirement for
    PMRF and for safety considerations in any European country where the
    Aegis Ashore is deployed, since it will be in proximity to populated
    areas. Please provide an update on how the Navy and MDA will address
    this safety concern.
        Answer. PMRF requires extra safety considerations during Aegis
    Ashore/SM-3 testing that will not be required when proven systems are
    deployed to Host Nations. When Aegis Ashore/SM-3 is tested at PMRF, the
    range requires two independent data sources to provide SM-3 position
    and velocity to enable the Flight Safety Officer to make a decision in
    the first few seconds of flight as to whether the missile is flying a
    nominal profile. To that end, MDA is funding two independent Early
    Launch Tracking Radar's which will be installed at PMRF by fiscal year
    2013 to support the Aegis Ashore/SM-3. MDA is also funding a Telemetry
    Link Best Source Selector (BSS) upgrade which will provide fully
    automated and seamless source selection between the multiple telemetry
    antennas tracking the same link source from the missile during flight.
    In addition, MDA is funding modifications to the SM-3 Blk IB flight
    test configured missile to enable the existing destruct mechanism
    during the first few seconds after launch. These measures ensure safety
    at PMRF and allow safe developmental testing of the system to ensure it
    will perform in a safe manner when fielded in populated areas. When the
    system is fielded, the extra safety precautions required on the test
    range are no longer needed as the system has been proven to be reliable
    based on multiple successful flight tests.
                                     ______

                   Question Submitted by Senator Thad Cochran
                         naval force structure support
        Question. General O'Reilly, the Navy recently submitted a report
    outlining some challenges it will face in providing the necessary force
    structure to support ballistic missile defense. In this report, the
    Navy admitted that it presently does not have the capacity to meet
    geographic combatant commanders needs without breaking personnel
    deployment lengths or dwell time rotations.
        Do the Navy's concerns affect how you deploy future phases of the
    Phased Adaptive Approach, and how is MDA working with the Navy to
    mitigate these concerns?
        Answer. The European Phased Adaptive Approach (EPAA) concept took
    the Aegis BMD program of record and anticipated availability of Aegis
    BMD ships into consideration when developed. The Joint Staff and Navy
    deploy Aegis BMD ships as requested by the Combatant Commanders and
    adjudicated by the Global Force Management (GFM) process.
        The Navy and MDA work collaboratively to combine resources and
    maximize Aegis BMD capability development for the fleet. In a joint
    review by the Secretary of the Navy and the Director of the MDA, a
    Report to Congress was submitted entitled ``Additional Requirements for
    Investment in Aegis Ballistic Missile Defense'' dated April 2010. In
    conducting the analysis for the report, consideration was given to the
    projected number of surface combatants required to provide Aegis BMD-
    capable multi-mission ship presence as requested by the geographic
    Combatant Commanders (CCDRs) and approved by the Secretary of Defense.
    Navy and MDA have jointly worked a plan for 38 funded surface
    combatants with Aegis BMD (by fiscal year 2015) which reflects an
    achievable balance of capacity and capability while sustaining the
    requisite number of multi-mission Aegis cruisers and destroyers
    deployed worldwide to meet concurrent surface combatant requirements.
    The plan is consistent with the Quadrennial Defense Review force-sizing
    guidance and the Navy's 30 year Shipbuilding Plan.
        Navy and MDA are jointly responding to the Combatant Commanders'
    (COCOM) need for operational Aegis BMD capability in a three phase
    approach; through BMD upgrades to Aegis ships, Aegis Modernization
    Program and new construction. Today, MDA and the Navy have upgraded 22
    Aegis combatants to conduct ballistic missile defense operations.
    Sixteen of these ships are assigned to the Pacific Fleet and six ships
    assigned to the Atlantic Fleet. The Chief of Naval Operations (CNO) has
    designated Ballistic Missile Defense as a core Navy mission and looks
    to populate the BMD capability throughout the Aegis Fleet to meet the
    COCOM demand signal.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. The Defense Subcommittee will reconvene
    tomorrow, May 26, at 10:30 a.m. for a classified briefing from
    U.S. Central Command and Africa Command. The subcommittee
    stands in recess.
        [Whereupon, at 11:30 a.m., Wednesday, May 25, the
    subcommittee was recessed, to reconvene subject to the call of
    the Chair.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                            WEDNESDAY, JUNE 15, 2011

                                           U.S. Senate,
               Subcommittee of the Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 11 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Leahy, Feinstein, Mikulski, Kohl,
    Murray, Cochran, Shelby, Hutchison, Alexander, Collins,
    Murkowski, and Coats.

                             DEPARTMENT OF DEFENSE

                       Office of the Secretary of Defense

    STATEMENT OF HON. ROBERT M. GATES, SECRETARY OF DEFENSE

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. This morning I'd like to welcome Dr.
    Robert Gates, Secretary of Defense, and Admiral Mike Mullen,
    Chairman of the Joint Chiefs of Staff, to testify on the
    administration's budget request for fiscal year 2012.
        Gentlemen, it's my pleasure and privilege to welcome you
    back to your last testimony before this subcommittee, and to
    thank you for your many years of admirable and dedicated
    service to our Nation.
        You entered your current positions during a tumultuous
    period for this country, when we were losing ground in both
    Iraq and Afghanistan, and you agreed to take on what was
    arguably two of the most difficult jobs in the country. And
    your leadership not only turned the tide on the ongoing wars,
    but also maintained the capacity, capability and public
    appreciation for the United States military. You have served
    tirelessly, and you have served honorably. This subcommittee
    and this country are truly thankful to both of you.
        I understand that Secretary Gates has to leave by 2:30
    today, so, in order to have time for testimony and questions, I
    will submit my full statement for the record.
        And I will now turn to the Vice Chairman, Senator Cochran,
    for his opening remarks.
        [The statement follows:]

                Prepared Statement of Chairman Daniel K. Inouye

        Today, I would like to welcome Dr. Robert Gates, the
    Secretary of Defense and Admiral Mike Mullen, the Chairman of
    the Joint Chiefs of Staff, to testify on the administration's
    budget request for fiscal year 2012. Gentlemen, it is my
    privilege to welcome you back to your last testimony before
    this subcommittee and to thank you for your many years of
    admirable and dedicated service to our country.
        You both entered your current positions during a tumultuous
    period for this country when we were losing ground in both Iraq
    and Afghanistan. You agreed to take on what are arguably two of
    the most difficult jobs in the country, and your leadership not
    only turned the tide of the ongoing wars, but also maintained
    the capacity, capability, and public appreciation for the
    United States military. You have served tirelessly, and you
    have served honorably; this subcommittee and this country are
    truly thankful to both of you.
        But, as you know, there is no rest for the weary. Before we
    say farewell, the subcommittee has more business for you both
    and many issues to discuss regarding the budget.
        The Department's fiscal year 2012 base budget request is
    $553 billion, an increase of $40 billion over last year's
    enacted base budget. The Department is also requesting $118
    billion for overseas contingency operations for fiscal year
    2012.
        Secretary Gates, as a part of the fiscal year 2012 budget,
    you insightfully set a goal for the Department to achieve
    efficiency savings of $178 billion over the next 5 years. Since
    that time, President Obama has challenged the Department to cut
    an additional $400 billion over the next 12 years. I'd like to
    get your perspective of this reduction and your assessment of
    the impact this reduction will have on military personnel and
    warfighting capability.
        Since submitting the President's budget, many events around
    the globe have changed. The U.S. military is now engaged in
    operations over Libya, Osama bin Laden is dead, and
    longstanding dictatorships namely in the Middle East and Africa
    are being challenged or have been overthrown in favor of
    democratic governments. Yet our traditional threats remain and
    continue to grow while our attention has been focused
    elsewhere. I'd like to hear your thoughts on future force size,
    structure, and capability that will be necessary to combat
    future threats.
        Your leadership brought about a significant change in the
    way the Department buys weapons. You boldly came into the
    office and challenged the military services, the defense
    industry, and the Congress to cancel programs you deemed to be
    exquisite technologies built for a different war than the ones
    we were fighting.
        Although the enemy's tactics and tools constantly changed,
    you forced the traditionally slow-moving Pentagon bureaucracy
    to respond swiftly with better capabilities, such as systems to
    defeat improvised explosive devices and increasing much needed
    intelligence, surveillance, and reconnaissance assets. I look
    forward to hearing from you both on other lessons that you have
    learned from the last 10 years of war on how to improve the
    Department's acquisition programs.
        Gentlemen, we sincerely appreciate your service to our
    Nation, and the dedication and sacrifices made daily by the men
    and women of our armed services. We could not be more grateful
    for what those who wear our Nation's uniform do for our country
    each and every day.
        Your full statements will be included in the record. I now
    turn to the Vice Chairman, Senator Cochran, for his opening
    statement.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, it's a pleasure to join you
    in welcoming these distinguished witnesses to our subcommittee.
    They have demonstrated through their service--the Secretary of
    Defense, the Chairman of the Joint Chiefs--a skill, knowledge
    and dedication they have to keeping our country safe, and to
    helping protect the security interests of our Nation around the
    world. That's a big job. That is a huge challenge. And, in my
    view, they have provided distinguished leadership, for which
    our Nation is very grateful.
        Chairman Inouye. Mr. Secretary.
        Secretary Gates. Thank you, Mr. Chairman. And thanks for
    the kind words.
        One correction is--12:30.
        And it's in a good cause. I'm meeting with the Director of
    the Office of Management and Budget (OMB) on the Fiscal year
    2012 budget. So, wish me luck.
        Mr. Chairman, members of the sucommittee, I appreciate the
    opportunity to discuss the President's budget request for
    fiscal year 2012--as noted, my last budget testimony before
    this, or any other congressional committee ever. And, this time
    I mean it.
        The budget request for the Department of Defense being
    presented today includes a base budget request of $553 billion,
    and an overseas contingency operations request of $117.8
    billion.
        My submitted statement includes many more details of this
    request, but I would like to take this opportunity to address
    several issues that I know have been a subject of debate and
    concern in recent weeks and months: First, the planned future
    reductions in the size of the ground forces; second, the
    proposed reforms and savings to the TRICARE program for
    working-age retirees; and, third, the budget and the strategy
    choices required to meet the savings targets recently laid out
    by President Obama.
        Nearly 4\1/2\ years ago, one of my first acts as Defense
    Secretary was to increase the permanent end strength of our
    ground forces--the Army by 65,000, for a total of 547,000, and
    the Marine Corps by 27,000, to 202,000.
        At the time, the increase was needed to relieve the severe
    stress on the force from the Iraq war as the surge was getting
    underway. To support the later plus-up of troops in
    Afghanistan, I subsequently authorized a temporary further
    increase in the Army of some 22,000--an increase always planned
    to end in 2000--fiscal year 2013. The objective was to reduce
    stress on the force; limit, and eventually end, the practice of
    stop-loss; and to increase troops' home station dwell time.
    This has worked, and I can tell you that those stop-lossed in
    the Army is now over. There are no Army soldiers stop-lossed.
        As we end the U.S. troop presence in Iraq this year
    according to our agreement with the Iraqi Government, the
    overall deployment demands on our force are decreasing
    significantly. That is why we believe that, beginning in 2015,
    the United States can, with minimal risk, begin reducing Army
    active duty end strength by 27,000, and in the Marine Corps by
    somewhere between 15,000 and 20,000.
        These projections assume that the number of troops in
    Afghanistan will be significantly reduced by the end of 2014,
    in accordance with the President's and NATO's strategy. If our
    assumptions prove incorrect, there's plenty of time to adjust
    the size and schedule of this change.
        These reductions are supported by both the Army and Marine
    Corps leadership. However, I believe no further reductions
    should be considered without an honest and thorough assessment
    of the risks involved, to include the missions we may need to
    shed in the future.
        Let me turn to another issue relating to the Department's
    personnel costs--the proposed reforms to the TRICARE program.
    As you know, sharply rising healthcare costs are consuming an
    ever-larger share of this Department's budget, growing from $19
    billion in 2001 to $52.5 billion in this request. Among other
    reforms, this fiscal year 2012 budget includes modest increases
    to TRICARE enrollment fees, later indexed to the national
    health expenditures, for working-age retirees, most of whom are
    employed while receiving pensions. All six members of the Joint
    Chiefs of Staff have strongly endorsed these and other cost-
    saving TRICARE reforms in a letter to the Congress.
        Let me be clear. The current TRICARE arrangement--one in
    which fees have not increased for 15 years--is simply
    unsustainable, and if allowed to continue, the Department of
    Defense risks the fate of other corporate and government
    bureaucracies that were ultimately crippled by personnel costs
    and, in particular, their retiree benefit packages.
        The House approved most of our proposed changes in its
    version of the fiscal year 2012 authorization bill, and I
    strongly urge the Senate to endorse all of our proposals.
        Which brings me to the third and last point--the difficult
    budget choices ahead for the Department. Last spring we
    launched a comprehensive effort to reduce the Department's
    overhead expenditures. The goal was, and is, to sustain the
    U.S. military's size and strength over the long term by
    reinvesting efficiency savings in force structure and other key
    combat capabilities.
        The results of these efforts, frankly, were mixed. While
    the services leaned forward and found nearly $100 billion in
    efficiency savings, efforts to trim overhead costs of DOD
    components outside the military services were not as
    successful. I believe there are more savings to be found by
    culling more overhead, and better accounting for--and, thus,
    better managing--the funds and people we have.
        But one thing is quite clear. The efficiencies efforts the
    Department has undertaken will not come close to meeting the
    $400 billion in savings layed out by the President. To realize
    the projected savings target will require real cuts, given the
    escalating costs of so many parts of the defense budget, and,
    as a result, real choices.
        Here I would leave you with a word of caution: We must not
    repeat the mistakes of the past, where budget targets were met
    mostly by taking a percentage off the top of everything--the
    simplest and most politically expedient approach, both inside
    the Pentagon and outside of it. That kind of salami-slicing
    approach preserves overhead and maintains force structure on
    paper, but results in a hollowing out of the force from a lack
    of proper training, maintenance and equipment, and manpower.
    And that's what happened in the 1970s--a disastrous period for
    our military--and, to a lesser extent, during the late 1990s.
        That is why I launched the, a comprehensive review to be
    completed by the end of this summer to ensure that future
    spending decisions are focused on priorities, strategy and
    risks, and are not simply a math and accounting exercise. In
    the end, this process must be about identifying options for the
    President and for you, the Congress, to ensure that the nation
    consciously acknowledges and accepts additional risk in
    exchange for reduced investment in the military.
        Above all, if we are to avoid a hollowing effect, this
    process must address force structure, with the overarching goal
    to preserve a U.S. military capable of meeting crucial national
    security priorities--even if fiscal pressure requires
    reductions in that force's size. I've said repeatedly I'd
    rather have a smaller, superbly capable military than a larger,
    hollow, less capable one. However, we need to be honest with
    the President, with you, with the American people, and, indeed,
    with ourselves about what the consequences are. A smaller
    military, no matter how superb, will be able to go fewer places
    and be able to do fewer things.
        As we embark on this debate about the future size and
    composition of the American military, it would be well to
    remember that we still live in a very dangerous and often
    unstable world. Our military must remain strong and agile
    enough to face a diverse range of threats--from non-state
    actors attempting to acquire and use weapons of mass
    destruction and sophisticated missiles, to the more traditional
    threats of other states, both building up their conventional
    forces, and developing new capabilities that target our
    traditional strategies.
        Today, I ask your support for a leaner, more efficient
    Pentagon and continued sustainable, robust investments in our
    troops and future capabilities. Our troops have done more than
    their part. Now it's time for us in Washington to do ours.
        In conclusion, I want to thank this subcommittee for all
    you have done to support our troops as well as their families.
    From my earliest days as Secretary of Defense, I have made a
    point of reminding officers--from midshipmen and cadets to
    admirals and generals--that Congress is a co-equal branch of
    government that, under the Constitution, raises armies and
    provides for navies, and now air forces. Members of both
    parties serving in Congress have long been strong supporters of
    our military, and are owed candid--honesty and candor from the
    military, and from the Department.
        I've just returned from my 12th, and last, visit to
    Afghanistan as Secretary of Defense. The progress we have made
    there since President Obama announced his new strategy has been
    impressive. The sacrifices our troops are willing to endure to
    protect this country is nothing short of amazing. And all they
    ask in return is that the country support them in their efforts
    through to success.
        It has been the greatest privilege of my life to lead this
    great military for the past 4\1/2\ years. Every day, I've
    considered it my responsibility to get our troops everything
    they need to be successful in their mission and to come home
    safely. In my visits to the combat theaters, military
    hospitals, and in bases and posts at home and around the world,
    I continue to be amazed by their decency, their resilience, and
    their courage. Through the support of the Congress and our
    nation, these young men and women will prevail in the current
    conflicts, and be prepared to confront the threats that they,
    their children, and our Nation may face in the future.

                               PREPARED STATEMENT

        Thank you, Mr. Chairman.
        Chairman Inouye. Mr. Secretary, I thank you very much.
        [The statement follows:]
                     Prepared Statement of Robert M. Gates
        Mr. Chairman, members of the committee: I appreciate the
    opportunity to discuss the President's budget request for fiscal year
    2012--my last budget testimony before this, or any other, congressional
    committee.
        The budget request for the Department of Defense being presented
    today includes a base budget request of $553 billion and an Overseas
    Contingency Operations request for $117.8 billion. These budget
    decisions took place in the context of a nearly 2 year effort by this
    Department to reduce overhead, cull troubled and excess programs, and
    rein in personnel and contractor costs--all for the purpose of
    preserving the fighting strength of America's military at a time of
    fiscal stress for our country. The goal was not only to generate
    savings that could be applied to new capabilities and programs, but for
    our defense institutions to become more agile and effective
    organizations as a result.
        In all, these budget requests, if enacted by the Congress, will:
    Continue our efforts to reform the way the department does business;
    fund modernization programs needed to prepare for future conflicts;
    reaffirm and strengthen the Nation's commitment to care for the all-
    volunteer force; and ensure that our troops and commanders on the front
    lines have the resources and support they need to accomplish their
    mission.
                              reform--efficiencies
        The fiscal year 2012 budget decisions took place in the context of
    a nearly 2 year effort by the Department of Defense to reform the way
    the Pentagon does business--to change how and what we buy, to replace a
    culture of endless money with one of savings and restraint. To not only
    make every defense dollar count, but also become a more agile and
    effective organization in the process. This process culminated in my
    announcement in January that summarized the impact of these reforms on
    the fiscal year 2012 budget.
        The military services conducted a thorough scrub of their
    bureaucratic structures, business practices, modernization programs,
    civilian and military personnel levels, and associated overhead costs.
    They identified potential savings that totaled approximately $100
    billion over 5 years. More than $70 billion is being reinvested in high
    priority needs and capabilities, while about $28 billion is going to
    higher than expected operating costs--``must pay'' bills that would
    otherwise be paid from investment accounts.
        We then looked at reducing costs and deriving savings across the
    department as a whole--with special attention to the substantial
    headquarters and support bureaucracies outside the four military
    services--savings that added up to $78 billion over 5 years.
        Ten billion dollars of that total came from restructuring the Joint
    Strike Fighter program and reducing Army and Marine Corps end strength
    starting in fiscal year 2015.
        The rest of the DOD-wide savings came primarily from shedding
    excess overhead, improving business practices, and reducing personnel
    costs. Key examples include:
      --$13 billion from holding the civilian workforce at fiscal year 2010
            levels for 3 years, with limited exceptions such as growth in
            the acquisition workforce;
      --$12 billion through the governmentwide freeze on civilian salaries;
      --$8 billion by reforming military health programs to maintain high
            quality care while slowing cost growth;
      --$11 billion from resetting missions, priorities, functions for the
            defense agencies and the Office of the Secretary of Defense;
      --$6 billion by reducing staff augmentation and service support
            contracts by 10 percent annually for 3 years;
      --$2.3 billion by disestablishing Joint Forces Command and the
            Business Transformation Agency;
      --$1 billion by eliminating unnecessary studies and internal reports;
      --$4 billion in changed economic assumptions, such as a lower than
            expected inflation rate;
      --$100 million by reducing more than 100 flag officer and about 200
            civilian senior executive positions; and
      --$11 billion in a variety of smaller initiatives across the
            department.
        To better track how and where taxpayer dollars are spent, the
    department is also reforming its financial management systems and
    practices--with the goal of having auditable financial statements by
    the congressionally mandated date of 2017. We are pursuing a
    streamlined approach that focuses first on the information we most use
    to manage the department.
                                 choices ahead
        I believe there are more savings possible by culling more overhead
    and better accounting for, and thus better managing, the funds and
    people we have. But one thing is quite clear. These efficiencies
    efforts will not come close to meeting the budget targets laid out by
    the President, much less other, higher targets being bandied about.
        Nonetheless, meeting this savings target will require real cuts--
    given the escalating costs of so many parts of the defense budget--and,
    as a result, real choices. That is why I launched a comprehensive
    review last month to ensure that future spending decisions are focused
    on priorities, strategy and risks, and are not simply a math and
    accounting exercise. In the end, this process must be about identifying
    options for the President and the Congress, to ensure that the Nation
    consciously acknowledges and accepts additional risk in exchange for
    reduced investment in its military.
        As we embark on this debate about the future size and composition
    of the American military, it would be well to remember that we still
    live in a very dangerous and often unstable world. Our military must
    remain strong and agile enough to face a diverse range of threats--from
    non-state actors attempting to acquire and use weapons of mass
    destruction and sophisticated missiles, to the more traditional threats
    of other states both building up their conventional forces and
    developing new capabilities that target our traditional strengths.
                      fiscal year 2012 base budget request
        The President's request for the base defense budget is for $553
    billion, which represents about 3.5 percent real growth over the fiscal
    year 2011 defense bill enacted by Congress this year. The four major
    components are: $207.1 billion for operations, maintenance, logistics,
    and training; $142.8 billion for military pay and benefits; $188.3
    billion for modernization; and $14.8 billion for military construction
    and family housing.
                                 modernization
        In all, the fiscal year 2012 budget request includes $188.3 billion
    for modernization in the form of Procurement, Research, Development,
    Testing and Evaluation. Key modernization initiatives include:
      --$4.8 billion to enhance ISR capabilities and buy more high demand
            assets, including the MC-12 surveillance aircraft, Predator,
            Reaper, and Global Hawk UAVs--with the aim of achieving 65
            Predator-class Combat Air Patrols by the end of fiscal year
            2013;
      --More than $10 billion to modernize our heavily used rotary wing
            fleet;
      --$3.9 billion to upgrade the Army's combat vehicles and
            communications systems;
      --$4.8 billion to buy new equipment for the reserves;
      --$14.9 billion to buy new fighters and ground attack aircraft;
      --$24.6 billion to support a realistic, executable shipbuilding and
            investment portfolio that buys 11 ships in fiscal year 2012 and
            modernizes existing fleet assets;
      --$10.5 billion to advance the modernization portion of the
            administration's approach to ballistic missile defense--
            including $8.4 billion for the Missile Defense Agency; and
      --$2.3 billion to improve the military's cyber capabilities.
        Questions have been raised about whether we are too focused on
    current conflicts and are devoting too few resources to future possible
    high-end conflicts. This budget should put those questions to rest. The
    fiscal year 2012 base request provides for significant investments at
    the high end of the conflict spectrum, including:
      --$1 billion ($4.5 billion over the Future Years Defense Program
            (FYDP)) for a tactical air modernization program that would
            ensure that the F-22 will continue to be the world's preeminent
            air-to-air fighter. This effort will leverage radar and
            electronic protection technologies from the JSF program;
      --$204 million ($1.6 billion over the FYDP) to modernize the radars
            of F-15s to keep this key fighter viable well into the future;
      --$30 million ($491 million over the FYDP) for a follow-on to the
            AMRAAM, the medium range air-to-air weapon, that would provide
            greater range, lethality, and protection against electronic
            jamming;
      --$200 million ($800 million over the FYDP) to invest in technologies
            to disrupt an opponent's ability to attack our surface ships;
      --$1.1 billion ($2.2 billion over the FYDP) to buy more EA-18
            Growlers than originally planned, plus $1.6 billion over the
            FYDP to develop a new jamming system, expanding our electronic
            warfare capabilities;
      --$2.1 billion ($14 billion over the FYDP) to fund Aegis-equipped
            ships to further defend the fleet from aircraft and missile
            attack and provide theater-wide tactical ballistic missile
            defense; and
      --To improve anti-submarine capabilities, $2.4 billion for P-8
            Poseidon aircraft ($19.6 billion over the FYDP) and $4.8
            billion for procurement of Virginia-class attack submarines
            ($27.6 billion over the FYDP).
        The fiscal year 2012 budget also supports a long-range strike
    family of systems, which must be a high priority for future defense
    investment given the anti-access challenges our military faces. A key
    component of this joint portfolio will be a new long-range, nuclear-
    capable, penetrating Air Force bomber, designed and developed using
    proven technologies and with an option for remote piloting. It is
    important that we begin this project now to ensure that a new bomber
    can be ready before the current aging fleet goes out of service.
        The budget request includes $10.6 billion to maintain U.S.
    supremacy in space, in keeping with the recently released National
    Security Space Strategy. This new strategy will help bring order to the
    congested space domain, strengthen international partnerships, increase
    resiliency so our troops can fight in a degraded space environment, and
    improve our acquisition processes and reform export controls to
    energize the space industrial base.
        As the military services were digging deep for excess overhead,
    they were also taking a hard look at their modernization portfolio for
    weapons that were having major development problems, unsustainable cost
    growth, or had grown less relevant to real world needs.
        The Joint Strike Fighter program received special scrutiny given
    its substantial cost and its central place in ensuring that we have a
    large inventory of the most advanced fifth generation stealth fighters
    to sustain U.S. air superiority well into the future. The fiscal year
    2012 budget reflects the proposed restructuring of the F-35 Joint
    Strike Fighter program to stabilize its schedule and cost. The
    department has adjusted F-35 procurement quantities based on new data
    on costs, on likely orders from our foreign nation partners, and on
    realigned development and test schedules.
        The proposed restructuring adds over $4 billion for additional
    testing through 2016. It holds F-35 procurement in fiscal year 2012 at
    32 aircraft and reduces buys by 124 aircraft compared with last year's
    plans. Even after these changes, procurement ramps up sharply to 108
    aircraft by fiscal year 2016. This is the fastest that future
    procurement can prudently be increased.
        The F-35 restructuring places the Marine's STOVL variant on the
    equivalent of a 2 year probation. If we cannot fix this variant during
    this timeframe and get it back on track in terms of performance, cost
    and schedule, then I believe it should be canceled. To compensate for
    any delays in F-35 deliveries, we propose buying 41 more F/A-18s
    between fiscal year 2012 to 2014.
        I also want to reiterate the President's and my firm opposition to
    buying an extra engine for the F-35--a position echoed by the Air
    Force, Navy and Marine Corps leadership. We consider it an unnecessary
    and extravagant expense, particularly during this period of fiscal
    contraction.
        This budget proposes cancelling the Expeditionary Fighting Vehicle
    and reallocating funds to existing Marine ground combat requirements, a
    decision based on the recommendation of the Secretary of the Navy and
    the Commandant of the Marine Corps.
        Ultimately, the Navy and Marine Corps leadership based their
    recommendations on two main principles: affordability and balance. The
    EFV, a program originally conceived in the 1980s, has already consumed
    more than $3 billion to develop and will cost another $12 billion to
    build. The EFV as designed would have cost many times more than the
    system it would replace, with much higher maintenance and service
    costs. If continued over the next two decades, the EFV program would
    consume fully half of all Marine Corps procurement dollars while
    swallowing virtually the Corps' entire ground vehicle budget--
    procurement, operations, and maintenance--with all the risk to
    readiness that entails.
        To be sure, the EFV would, if pursued to completion without regard
    to time or cost, be an enormously capable vehicle. But as with several
    other high end programs completed or cancelled in recent years--the F-
    22, the Army Future Combat Systems, or the Navy's DDG-1000 destroyer--
    the mounting cost of acquiring this specialized capability must be
    judged against other priorities and needs.
        Let there be no doubt--we are committed to sustaining the Marine
    Corps amphibious mission. This fiscal year 2012 request proposes that
    the $2.8 billion previously budgeted to the EFV for the next 5 years
    instead be reinvested towards an integrated new vehicle program for the
    Marine Corps, including:
      --New armor, weaponry and engines, plus a life-extension program for
            the existing amphibious assault vehicles;
      --The development of a new, more affordable, sustainable and
            survivable amphibious vehicle;
      --Accelerated procurement of new personnel carriers; and
      --Enhancement of existing Marine vehicles such as the Abrams tank and
            Light Armored Vehicle.
        Throughout this process, we will harness the lessons learned--in
    terms of engineering, design, and testing--from the development of the
    EFV.
                                   personnel
        The fiscal year 2012 budget request includes $142.8 billion for
    military pay and benefits and continues our strong support for troops
    and their families. This includes funding for wounded, ill and injured
    care, enhancing the military healthcare system and supporting military
    families under stress. Examples in this request include: $2.3 billion
    to provide care for our Wounded Warriors and their families; and $8.3
    billion for supporting families, including child care and school
    programs.
        While the department continues to insist on and pay for the highest
    quality healthcare, we are also mindful of sharply rising health
    costs--which have risen over the last decade from $19 billion in 2001
    to $52.5 billion in this budget request. The department has taken a
    comprehensive look at all facets of the military healthcare model--
    emphasizing the need to balance the number one priority of continuing
    to provide the highest care and service, while ensuring fiscally
    responsible management.
        One area we have identified are benefits provided to working-age
    retirees under the TRICARE program. Many of these beneficiaries are
    employed full time while receiving full pensions, often forgoing their
    employer's health plan to remain with TRICARE. This should come as no
    surprise, given that the current TRICARE enrollment fee was set in 1995
    at $460 a year for the basic family plan and has not been raised since.
    By comparison, the fees for a comparable health insurance program for
    Federal workers total roughly $5,000 per year.
        Accordingly, we propose a modest increase to TRICARE Prime
    enrollment fees for working age retirees: $2.50 per month for
    individuals and $5 per month for families in fiscal year 2012, and then
    indexed to increases in national health expenditures in future years.
        We are proposing other healthcare initiatives such as efficiencies
    in pharmacy co-pays designed to provide incentives to make greater use
    of generic prescriptions and those ordered by mail. We also seek to
    phase out, over several years, special subsidies offered to a small
    group of hospitals that treat military families and retirees.
    Additionally, we are proposing providing TRICARE-for-Life to all
    Medicare-eligible retirees aged 65 and over, including future enrollees
    in the Uniformed Services Family Health Plan. It is important to note
    that none of these changes would affect healthcare benefits for active-
    duty personnel.
                           security assistance reform
        The fiscal year 2012 request includes funding and authorization for
    a key step forward in a critical policy area: helping other countries
    to protect and defend themselves. The Pentagon and the State Department
    have agreed to a 3-year pilot pooled fund--called the Global Security
    Contingency Fund--that will be used to build partner capacity, prevent
    conflicts, and prepare for emerging threats. The proposed fund would
    incentivize interagency collaboration through a new business model. It
    would provide a more agile and cost effective way to reduce the risk of
    future conflicts by allowing our Government to respond to unforeseen
    needs and take advantage of emerging opportunities to help partners
    secure their own territories and regions.
        The request is modest, an initial $50 million State Department
    appropriation, along with a request for authority to transfer an
    additional $450 million into the fund from either department if needed.
    The Department of Defense intends to make significant contributions
    from its own resources into this pooled fund. We will be requesting in
    parallel an authorization for this initiative in the fiscal year 2012
    NDAA.
                        overseas contingency operations
        Finally, this budget request includes $117.8 billion in fiscal year
    2012 to support Overseas Contingency Operations, primarily in
    Afghanistan, and to wind down our operations in Iraq--this is a
    significant reduction from the $159 billion enacted for OCO in fiscal
    year 2011. The request, which fully funds our wartime requirements,
    includes:
      --$86.4 billion for wartime operations and related costs;
      --$425 million for the Commander's Emergency Response Fund;
      --$475 million for the Afghan Infrastructure Fund;
      --$2.6 billion to support counter-IED efforts;
      --$3.2 billion for MRAP vehicles, including the MRAP All Terrain
            Vehicles developed for Afghanistan;
      --$11.9 billion to replace and restore worn, damaged or destroyed
            equipment; and
      --$12.8 billion for training and equipping of the Afghan security
            forces.
                      office of security cooperation--iraq
        I also want to mention a request in fiscal year 2012 for $524
    million for the Office of Security Cooperation--Iraq (OSC-I). The OSC-
    I, which will be jointly funded with the State Department, will execute
    our Foreign Military Sales program in Iraq. OSC-I will help ensure the
    continuation of military-to-military relationships that advise, train,
    and assist Iraq's security forces.
                                   conclusion
        In conclusion, I want to thank this committee for all you have done
    to support our troops as well as their families. From my earliest days
    as Secretary of Defense, I have made a point of reminding officers--
    from cadets to admirals and generals--that Congress is a co-equal
    branch of government that under the Constitution raises armies and
    provides for navies and air forces. Members of both parties serving in
    Congress have long been strong supporters of our military and are owed
    honesty and candor from the military and from the Department.
        It has been the greatest privilege of my life to lead this great
    military for the past 4\1/2\ years. Every day, I've considered it my
    responsibility to get our troops everything they need to be successful
    in their mission and to come home safely. In my visits to the combat
    theaters, in military hospitals, and in bases and posts at home and
    around the world, I continue to be amazed by their decency, resilience,
    and courage.
        Finally, I want to thank this committee once again for all you have
    done to support our troops as well as their families. In visits to the
    combat theaters, in military hospitals, and in bases and posts at home
    and around the world, I continue to be amazed by their decency,
    resilience, and courage. Through the support of the Congress and our
    Nation, these young men and women will prevail in the current conflicts
    and be prepared to confront the threats that they, their children, and
    our nation may face in the future.
        Thank you Mr. Chairman.
    STATEMENT OF ADMIRAL MIKE MULLEN, U.S. NAVY, CHAIRMAN,
                JOINT CHIEFS OF STAFF
        Chairman Inouye. And may I now call upon the Chairman of
    the Joint Chiefs of Staff, Admiral Mullen.

                                 DEFENSE BUDGET

        Admiral Mullen. Mr. Chairman, Senator Cochran, and
    distinguished members of this subcommittee, I'm honored to
    appear before you today to discuss the President's fiscal year
    2012 Defense budget.
        As the Secretary laid out, this budget, combined with the
    efficiencies effort that he led, provides for the well-being of
    our troops and families; fully funds current operations in
    Afghanistan and Iraq; and helps balance the global risk,
    through streamlined organizations, smarter acquisitions, and
    prudent modernization.
        The Army, for instance, will cancel procurement of the
    surface-to-air missile and the non-line-of-sight launch system;
    but it will continue production of the joint light tactical
    vehicle, and spearhead the development of a whole new family of
    armored vehicles.
        The Navy will give up its 2d Fleet headquarters, reduce its
    manpower ashore, and increase its use of multi-year procurement
    for ships and aircraft, allowing it to continue development of
    the next generation ballistic missile submarine, purchase 40
    new F/A-18s, four littoral combat ships, and another LPD-17.
        The marines will cancel the expeditionary fighting vehicle,
    and, like the Army, reduce their end strength starting in 2015.
    But they will reinvest these savings to sustain and modernize
    the amphibious assault vehicle and the light armored vehicle,
    even as they advance a new concept of operations and restore
    much of their naval expeditionary skills.
        And the Air Force will be able to continue development of
    the next-generation tanker, a new bomber, and modernize its
    aging fleet of F-15 fighters, all the while finding savings of
    more than $33 billion through reorganization, consolidation and
    reduced facilities requirements.
        None of this balancing will come on the backs of our
    deployed troops.
        We are asking for more than $84 billion for readiness and
    training, nearly $5 billion for increased Israel capabilities,
    and more than $10 billion to recapitalize our rotary aircraft
    fleet.
        These funds, plus those we are requesting to help build our
    partnership capacity in places like Afghanistan and Pakistan,
    Iraq and Yemen, all speak to the emphasis we are placing on
    giving our troops and their partners in the field everything
    they need to do the difficult jobs we've asked of them.

                          MILITARY HEALTHCARE PROGRAM

        We must also give them and their families everything they
    need to cope with the stress and the strain of almost 10 years
    at war. That's why I'm so pleased with the funds devoted in
    this proposal--almost three-quarters as much as the $200
    billion budgeted for operations and maintenance--to personnel,
    housing and healthcare issues.
        As you may know, the chiefs and I penned a rare 24-star
    letter to Congress expressing our unqualified support for the
    military healthcare program changes included in this budget. We
    sought equity across all healthcare programs, with
    beneficiaries and healthcare delivery providers having the same
    benefits and equivalent payment systems regardless of where
    they live or work. That in turn led us to propose increases in
    TRICARE enrollment fees for working-age retirees. These
    increases are modest and manageable, and leave fees well below
    the inflation-adjusted out-of-pocket costs set in 1995, when
    the current fees were established. We sincerely hope you will
    see fit to pass it. It is clearly eating us alive.
        Please know that we will continue to invest in critical
    care areas, to include research, diagnosis, and treatment of
    mental health issues and traumatic brain injury; enhanced
    access to health services; and new battlefield technologies. We
    understand that changes to healthcare benefits will cause
    concern among people we serve, and the communities from which
    we receive care. But we also understand and hold sacred our
    obligation to care completely for those who have borne the
    brunt of these wars, as well as those for whom the war never
    ends.
        I remain convinced that we haven't begun to understand
    completely the toll that war extracts from our people. Just as
    the grandchildren of World War II vets still struggle to
    comprehend the full scope of the horror those men conceal, so,
    too, will our grandchildren have to come to grips with the
    wounds unseen from these wars, unless we get it right. I
    believe the investments we are making in wounded care and
    family readiness will pay off in that regard. But it will take
    time and patience and money--three things we rarely seem to
    possess.
        That brings me back to this particular budget request. With
    limited resources and two wars in progress--three, if you count
    our support to NATO operations in Libya--we should be prudent
    in defining our priorities, in controlling our costs, and in
    slaking our thirst for more and better systems. We should also
    be clear about what the Joint Force can and cannot do, just as
    we should be clear about what we expect from our interagency
    and international partners.
        Our global commitments have not shrunk. If anything, they
    continue to grow. And the world is a lot less predictable now
    than we could have ever imagined. You need look no further than
    the events across the Middle East and North Africa to see the
    truth in that. In fact, I just returned from a trip to Egypt,
    and 1 week before that I was in Pakistan with Secretary Clinton
    as we tried to find ways to move forward our relationship with
    that nation in the wake of Osama bin Laden's killing.
        The challenges in both Egypt and Pakistan are distinct, to
    be sure, but at each stop--and, in fact, in just about every
    country I visit--I've been struck by the degree to which
    civilian and military leaders alike desire to keep our military
    partnerships strong. This desire isn't rooted in the fear of
    revolt or recrimination, but rather, a shared understanding of
    the external threats to their security and ours, which still
    plague the region. Therefore, changes to these relationships in
    either aid or assistance ought to be considered only with an
    abundance of caution and a thorough appreciation for the long
    view, rather than the flush of public passion and the urgency
    to save a dollar. The support we provide many of these
    militaries has helped them become the capable professional
    forces they are and, in that regard, has been of inestimable
    value.
        Of equal or greater value is increased appropriations for
    the State Department, and our request in this budget for
    something called the Global Security Contingency Fund--a 3-year
    pooled fund between the Pentagon and the State Department that
    will be used to build partnership capacity, prevent conflicts,
    and prepare for emerging threats. The request is modest--an
    initial $50 million appropriation--along with a request for
    authority to reprogram an additional $450 million if needed.
    But, what it will buy us is an agile and cost-effective way to
    better respond to unforeseen needs and take advantage of
    emerging opportunities for partners to secure their own
    territories and regions.
        We must get more efficient--absolutely. But, we must get
    more pragmatic about the world we live in. We can no longer
    afford bloated programs or unnecessary organizations without
    sacrificing fighting power. And we can no longer afford to put
    off investments in future capabilities or relationships that
    preserve that power across the spectrum of conflict.
        As you know, the President announced his framework for
    addressing our Nation's long-term fiscal challenges, setting a
    goal of reducing Defense spending by $400 billion. This will be
    hard work and will require difficult choices about matching
    strategy to resources. Those choices will be painful, even
    unnatural for the Services, for the Department, and for the
    Congress. But they are absolutely necessary.
        The President also directed that, before making specific
    budget decisions, the Department of Defense will assess their
    impact by conducting a fundamental review of America's military
    missions, capabilities, and roles in a changing world.
    Secretary Gates and I have begun this review, and will work
    with the service chiefs to ensure we can meet our national
    security priorities, even in the face of fiscal pressure. Our
    review will be based on strategy and risks, not simply
    budgetary math. And our goal will be to ensure that we do not
    repeat the mistakes of the past, nor, at the end of this
    endeavor, find ourselves with a hollow force--a force that
    retains an organizational structure, but lacks the people, the
    training, and equipment necessary to perform the tasks we
    expect from it.
        In my view, then, this proposed budget gives us a good
    start. It builds on the balance we started to achieve last
    year, and represents the best of both fiscal responsibility and
    sound national security.
        I would be remiss, indeed, if I did not close by praising
    the incredible efforts of our troops overseas and their
    families as they finish one war in Iraq, begin to turn corners
    in Afghanistan, and help save innocent lives in Libya. I know
    you share my pride in them and that you will keep them foremost
    in mind as you consider the elements of this proposal.

                               PREPARED STATEMENT

        I, too, would like to thank you for your longstanding
    support of our military, of our families. You have set a
    standard in many ways that those of us who are fortunate enough
    to interact with you appreciate, and I know our troops and our
    families appreciate it, as well.
        Thank you, Mr. Chairman.
        Chairman Inouye. Admiral Mullen, thank you very much.
        [The statement follows:]
                Prepared Statement of Admiral Michael G. Mullen
        Chairman Inouye, Senator Cochran, and distinguished members of the
    Committee, it is my privilege to report on the posture of the United
    States Armed Forces.
        We remain a Nation at war on multiple fronts. In the face of
    daunting challenges, our Armed Forces have successfully carried out
    their far-ranging missions over the past year. They have improved
    security in Afghanistan, continued on a path to soon end the war in
    Iraq, and promoted stability in the Pacific Rim. They have supported
    NATO in its U.N. mission to protect civilians in Libya and have
    provided humanitarian assistance, such as in Japan in the aftermath of
    the recent devastating earthquakes and tsunami. And they displayed
    their characteristic bravery and precision in the May 2 operation
    targeted against al-Qaeda leader Osama Bin Laden, the leader of al-
    Qaeda. You can be very proud of your military. However, the cumulative
    stress of 9 years of war is substantial and growing. We will need your
    sustained support, even in the midst of fiscal difficulties, to reset
    the Joint Force so it can continue to protect the American people.
        Our country is fortunate to be served by the best Armed Forces I
    have seen in over 43 years of wearing the uniform. Despite continuous
    deployments and combat operations, our men and women in uniform and
    their families have been resilient beyond all expectations. They are
    patriots who care deeply for this country and serve under very trying
    conditions. They are the most combat experienced and capable force we
    have ever had, and they continue to learn and adapt in ways that are
    truly remarkable. I am continuously humbled as I visit them around the
    country and the world. Time and again, these men and women and their
    families have proven that our All Volunteer Force is the Nation's
    greatest strategic asset.
        This Force cannot thrive without the support of the American
    people. Everything we are and everything we do comes from them. I am
    grateful for the Congress' and the American people's constant reminders
    that the service, heroism, and sacrifices of our service members and
    their families are valued. However, I am concerned that because our
    military hails from a shrinking percentage of the population, some day
    the American people may no longer know us. We cannot allow this to
    happen. With your help, we will endeavor to stay connected and to
    maintain a strong and open relationship.
        As we look to our military's posture and budget, we recognize that
    our country is still reeling from a grave and global economic downturn
    and is maintaining nearly historic fiscal deficits and national debt.
    Indeed, I believe that our debt is the greatest threat to our national
    security. If we as a country do not address our fiscal imbalances in
    the near-term, our national power will erode. Our ability to respond to
    crises and to maintain and sustain our influence around the world will
    diminish.
        Our national economic health is creating real budgetary pressures.
    For too much of the past decade we have not been forced to be fully
    disciplined with our choices. But for the foreseeable future, cost will
    be a critical element of nearly every decision we face. We must now
    carefully and deliberately balance the imperatives of a constrained
    budget environment with the requirements we place on our military in
    sustaining and enhancing our security. We must identify areas where we
    can reduce spending while minimizing risk. This will affect our
    posture, force structure, modernization efforts, and compensation and
    benefits. The Defense Department must and will become more efficient
    and disciplined, while simultaneously improving our effectiveness.
        In April, the President announced his framework for addressing our
    Nation's long-term fiscal challenges, setting a goal of reducing
    defense spending by $400 billion. This will be hard work and will
    require choices that will be painful to many, but it is necessary. The
    President also directed that before making specific budget decisions,
    the Department of Defense assess their impact by conducting a
    fundamental review of America's military missions, capabilities, and
    role in a changing world. Secretary Gates and I have launched this
    review and will work with Service Chiefs to ensure our ability to meet
    our crucial national security priorities even in the face of fiscal
    pressures. Our review will be based on strategy and risks, not simply
    budgetary math, and our goal will be to ensure that we do not repeat
    the mistakes of the past nor at the end of this endeavor find ourselves
    with a hollow force--a force that retains an organizational structure
    but lacks the people, training, and equipment necessary to perform the
    tasks we expect from it.
        In the near-term, the President's fiscal year 2012 Department of
    Defense budget of $553 billion represents a balance of military risks
    and fiscal realities we face today. The return on U.S. defense spending
    over the past two decades has been immense and historic: preventing
    world war between great powers, securing the global commons and the
    free flow of international trade and natural resources, combating
    terrorism across the globe, and protecting the American people and our
    allies. But our operations have come with stresses and strains as well
    as costs to our readiness. If we are to continue to execute the
    missions set out by our strategy, we must recognize that recovering
    from war and resetting the force is costly and will require several
    years of continued investment. Congressional support is required for
    our forces, their families, their equipment and training, and our
    military infrastructure to ensure the success of our ongoing efforts
    and for us to be ready to respond to new and emerging security
    challenges.
        The President's National Security Strategy, the National Military
    Strategy, and the President's Strategy for Afghanistan and Pakistan
    describe our military approaches and ongoing operations in great
    detail. This posture statement will focus on the strategic priorities
    for the military and the Congressional support we need. My priorities
    remain defending our vital interests in the broader Middle East and
    South Central Asia, improving the Health-of-the-Force, and balancing
    global strategic risk.
     defending our vital national interests in the broader middle east and
                               south central asia
        Over the past year, our Armed Forces have continued to shoulder a
    heavy burden, particularly in the Middle East and South Central Asia.
    The balance of this burden and our wartime focus has shifted, however,
    from Iraq to Afghanistan. This was made possible by drawing down
    military forces in Iraq and transitioning security responsibilities to
    the Iraqis. Meanwhile, we committed additional forces and resources to
    Afghanistan and Pakistan as well as participated in NATO operations in
    Libya.
        Removing Osama Bin Laden from al-Qaeda's leadership is a signature
    achievement, and it came only after years and years of painstaking and
    difficult work by intelligence and military professionals. Although the
    full import will not be known for some time, his death contributes to
    the larger struggle and steady progress we must make toward disrupting,
    dismantling, and ultimately defeating al-Qaeda. As a result of our
    operations with our Coalition, Afghan, and Pakistani partners, and
    extensive cooperation with other partners, al-Qaeda's senior leadership
    in Pakistan is weaker and under greater pressure than at any other time
    since being forced out of Afghanistan in late 2001. They have suffered
    the losses of numerous senior leaders and face significant challenges
    to coordinating operations, maintaining safe havens, and acquiring
    funding. Despite this operational progress, al-Qaeda retains the intent
    and capability to attack the United States and other Western countries.
    The movement's leaders continue to operate in the Afghanistan-Pakistan
    border region, planning operations and guiding the efforts of al-Qaeda
    networks operating out of the Arabian Peninsula, Africa, and even
    Europe. We, in turn, remain committed to our deepening and broadening
    partnerships in the region and to our goal of ultimately defeating al-
    Qaeda and creating the conditions to prevent their return to
    Afghanistan and Pakistan.
        We continue to implement our national strategy for Afghanistan and
    Pakistan with great urgency. This past November, we completed the
    deployment of the 30,000 additional U.S. forces, and we are seeing
    signs of improving security on the ground. These forces have allowed us
    to go on the offensive with our Afghan and ISAF partners, force the
    Taliban out of safe havens in its heartland of Kandahar and Helmand,
    better protect the Afghan population, and reduce civilian casualties.
    Our counterinsurgency operations, conducted in close partnership with
    Afghan forces, have reduced the Taliban's influence, reversed the
    insurgency's momentum in key areas of the country, and forced many
    Taliban leaders to flee. Our forces will consolidate recent gains in
    Helmand and Kandahar Provinces and further expand security in other
    critical parts of the country.
        This success against the Taliban and other insurgent groups is
    essential to prevent the return of al-Qaeda, gain time to build the
    Afghan National Security Forces (ANSF), and force insurgents to
    reconcile with the Afghan government on acceptable terms. We expect the
    violence in 2011 to be greater than last year. The fighting this summer
    will be tough and often costly, but it is necessary to sustain and even
    increase the pressure we have been placing on the insurgent groups. We
    cannot allow the Taliban to reorganize and reconstitute as they did in
    2004 and 2005, regain their oppressive influence over the Afghan
    people, and once again provide safe haven to al-Qaeda or its
    affiliates.
        For the success of our military operations to be enduring, it is
    critical that the ANSF be able to provide adequate security for the
    Afghan people. Our greatest success story this past year has been the
    growth and development of the ANSF. With the help of additional ISAF
    trainers, the ANSF added 49,000 soldiers and 21,000 policemen to their
    ranks--an astonishing growth of 36 percent. The ANSF also continue to
    improve on the battlefield and increasingly contribute to the war
    effort. They are fighting beside us and have grown in their ability to
    plan and conduct complex operations. In fact, their expanding
    capabilities and presence have already allowed International Security
    Assistance Forces (ISAF) units to ``thin out'' in some parts of central
    Helmand and Kabul Province. We are on track to begin the transition of
    security responsibilities and drawdown of our forces in July 2011. In
    the coming year, while continuing to grow the ANSF in size, we will
    place greater emphasis on improving its quality, professionalism, and
    self-sufficiency, to ensure that they remain on track to assume the
    overall lead for security in 2014. To this end, the Afghan Security
    Forces Fund remains critical to the building of the ANSF's capabilities
    and to the ANSF's eventual assumption of security responsibilities.
        Despite our successes, numerous other challenges remain. Achieving
    sustainable security requires developing Afghan governing capacity,
    countering corruption, cultivating the conditions needed for conflict
    resolution, and neutralizing insurgent sanctuaries in Pakistan. Absent
    these conditions, we will not succeed. Despite a dramatic increase in
    our civilian presence in Afghanistan this past year, improvements in
    sub-national governance and reconstruction have not kept pace with
    progress in improving security. This has impeded our ability to
    ``hold,'' ``build,'' and ``transfer.'' For this reason, the Commander's
    Emergency Response Program remains the most responsive means for
    addressing a local community's needs and is often the only tool our
    commanders have to address pressing requirements in areas where
    security is challenged. Along with development projects, we believe
    that new transparency and anti-corruption efforts may counter the
    deleterious effects of Afghanistan's criminal patronage networks,
    mitigate the distortive effects of international aid and development
    programs, and ultimately improve the confidence the Afghan people have
    in their government and their governing officials.
        To complement this ``bottom-up'' development, we will support the
    Afghan government's reconciliation and reintegration efforts in order
    to achieve the political solution that is an imperative to sustainable
    peace. Their efforts will only succeed if the Taliban and other
    insurgents believe they have more to gain by negotiating an end to the
    conflict than by continuing to fight. Achieving reconciliation and
    reintegration will take time, skillful diplomacy, and sustained
    military pressure, but we will not achieve a favorable and durable
    outcome unless we meet this challenge.
        Though our operational efforts are focused on Afghanistan, our
    diplomatic efforts have increasingly focused on Pakistan, a country
    critical to our strategy in the region. We must continue to pursue a
    partnership with Pakistan even as we are realistic about the difficulty
    in overcoming years of mistrust. The alternative--drifting toward a
    more contentious or fractured relationship--is far more detrimental to
    U.S. interests in strategically defeating al-Qaeda and ensuring nuclear
    weapons do not fall into terrorists' possession. We therefore should
    remain committed to close coordination, cooperation, and friendship
    with Pakistan.
        It is manifestly in our interest to enable the Pakistani military's
    counterterror and counterinsurgency operations. The series of offensive
    operations undertaken by the Pakistani military in the tribal areas
    expanded dramatically in 2009. There, the Pakistanis have fought
    bravely and sacrificed much--losing thousands of soldiers in the
    process. We have steadfastly supported them in a variety of ways,
    primarily in the development of the counterinsurgency capabilities of
    Pakistan's security forces. This development and the military's
    operations have kept pressure on al-Qaeda's senior leadership and the
    militant groups threatening Pakistan and Afghanistan.
        However, insurgent groups such as the Quetta Shura and the Haqqani
    network continue to operate unhindered from sanctuaries in Pakistan,
    posing a significant threat to NATO and Afghan forces. Our efforts to
    enable the Pakistani Military depend on several critical programs, such
    as the Pakistan Counterinsurgency Fund and Pakistan Counterinsurgency
    Capability Fund and the Multi-Year Security Assistance Commitment
    announced by Secretary Clinton last fall. It is also important that
    through exchange programs, such as the International Military Education
    and Training (IMET) program, we establish relationships with the
    generation of Pakistani officers with whom we had cut ties. In
    addition, because we so heavily depend on Pakistan as a supply route
    supporting our efforts in Afghanistan, Coalition Support Funds remain
    critical to reimbursing the Pakistanis for their assistance in securing
    those supply routes.
        In terms of our broader engagement with Pakistan and the region,
    reducing some of the long-standing enmity and mistrust between India
    and Pakistan would greatly contribute to our efforts. As neighbors, it
    is in both India and Pakistan's interests to reduce the tension between
    them and strengthen their political, security, and economic ties. While
    we acknowledge the sovereign right of India and Pakistan to pursue
    their own foreign policies, we must demonstrate our desire for
    continued and long-term partnership with each, and offer our help to
    improve confidence and understanding between them in a manner that
    builds long-term stability across the wider region of South Asia.
        Another increasingly important aspect of our engagement in South
    Central Asia is the development of the Northern Distribution Network.
    This line of communication has proven critical to maintaining
    flexibility in our logistical support to our efforts in Afghanistan. We
    will continue to work with our partners to ensure access, expand
    throughput, and sustain the viability of redundant supply routes for
    our forces.
        We have ended our combat mission in Iraq, Operation Iraqi Freedom,
    and started a new chapter in our partnership, Operation New Dawn. We
    successfully transferred lead for security responsibilities to the
    Iraqi Security Forces on August 31, 2010. Iraq's military and political
    leaders are responding to the residual, but still lethal, threat from
    al-Qaeda. As a result, and despite a drawn-out government formation
    process, the security situation there remains stable, and the Iraqi
    people are increasingly able to focus on jobs and development. Beyond
    this security transition, the State Department has taken the lead for
    U.S. efforts in Iraq, and our diplomats and other civilians are
    increasingly the face of our partnership with the Iraqi people and
    their government. Sustained funding for our civilian efforts,
    commensurate with the State Department's growing responsibilities--
    particularly our development assistance and police training programs--
    is needed to ensure we are able to successfully turn our military
    accomplishments into lasting political ones.
        However, the end of the war in Iraq will not mean the end of our
    commitment to the Iraqi people or to our strategic partnership. We must
    focus on the future to help Iraq defend itself against external threats
    and consolidate a successful, inclusive democracy in the heart of the
    Middle East. As we continue to draw down forces through December 31,
    2011, in accordance with the United States-Iraqi Security Agreement, we
    will transition to a more typical military-to-military relationship. We
    will shift the focus of our assistance from Iraq's internal domestic
    security to its external national defense, keeping in consideration the
    interests and sensitivities of all Iraqis as well as Iraq's neighbors.
    While Iraqi security forces have made great improvements, they will
    require external assistance for years to come. The cornerstone of our
    future security partnership with the Iraqis will be a robust Office of
    Security Cooperation, performing both security assistance and security
    cooperation functions, as part of the U.S. Embassy in Iraq. Key to our
    assistance and not squandering our hard won gains will be continued
    support to the Iraqi Security Forces fund through fiscal year 2011,
    IMET and other traditional security assistance programs, as well as an
    extension of Section 1234 authority to transfer equipment from
    Department of Defense stocks.
        Despite the energy we commit to defeating al-Qaeda and to
    stabilizing the situations in Afghanistan, Pakistan, and Iraq, we
    remain vigilant against other security challenges and sources of
    aggression and proliferation throughout this critical region. The
    Iranian regime continues to threaten regional stability. Despite
    growing isolation from the international community and a fourth round
    of increasingly costly U.N. sanctions, the regime has neither ceased
    providing arms and other support to Hezbollah, HAMAS, and other
    terrorist groups nor accepted a verifiable end to its pursuit of
    nuclear weapons. Many of the long-standing potential flashpoints in the
    Levant and the gulf region bear Iran's signature, and the Iranian
    regime is also attempting to seize on opportunities presented by the
    recent unrest in the region.
        That said, strong social, economic, and political tensions pull on
    the region and its people--as evidenced by the turmoil we have recently
    witnessed in Tunisia, Egypt, Libya, Yemen, Syria, and Bahrain.
    Volatility in regional affairs can often follow volatility in domestic
    affairs. Strong military-to-military relationships can help reduce and
    mitigate the risks of instability, but sometimes use of force is
    necessary. The most recent example of this is our rapid response to the
    crisis in Libya. Since mid-March, after Muammar Gaddafi turned his
    armed forces against his own, U.S. forces have participated in the
    NATO-led effort to implement and enforce U.N. Security Council
    Resolution 1973. We provided rapid planning, command and control, and
    electronic attack capabilities for the coalition force that has halted
    the regime's assault on the city and people of Benghazi, and
    subsequently transitioned the leadership responsibility of the effort
    over to NATO.
        We will continue to help counter terrorist threats, deter Iranian
    aggression, and protect our partners from coercive influence. To do
    this we will continue to build the capabilities of our partners. More
    important, we will nurture the development of a regional security
    architecture based on multi-lateral partnerships that address a wide
    range of security issues including counterproliferation, maritime
    security, counterterrorism, air and missile defense, and emergency
    response. As with our other partnerships across the globe, our security
    assistance programs are the cornerstone of our relationships. In
    particular, our Section 1206 and 1208 programs provide a unique and
    necessary flexibility and responsiveness to Combatant Commander
    requirements that we cannot currently get with our Foreign Military
    Financing (FMF) programs.
                       improving the health-of-the-force
        The ``back end'' of war--the continued care of our veterans and
    their families and the resetting of our force--cannot be an
    afterthought, and getting it right will be expensive. Moreover, because
    of the duration of these conflicts, we have begun to reset our units
    even in the midst of conflict. The stress of over 9 years of constant
    warfare has come at a great cost to the Force and its ability to
    continue to conduct operations and respond to other emergent crises. We
    must care for our people and their families and reset and reconstitute
    our weapon systems to restore our readiness, capabilities, and wartime
    effectiveness. This will require a sustained commitment of at least 3
    to 5 years, and could continue well beyond the end of our involvement
    in Iraq and Afghanistan.
    Care for our People
        Our foremost focus is on our servicemen and women, their families,
    and their supporting communities--the bedrock of our Armed Forces. They
    each play unique and growing roles in our national security fabric, but
    they have been under great, often unrecognized, stress for the past 9
    years. Over 2 million of our service members have deployed to fight
    overseas. Some have served multiple grueling tours, a great number have
    suffered significant injuries, and thousands have sacrificed their
    lives. Even those serving stateside enjoy only short respites between
    deployments. We have asked a great deal from our people, and we must
    invest in them and their families--through appropriate pay, healthcare,
    family care, education, and employment opportunities--as they are the
    single greatest guarantee of a strong military. And they become our
    best recruiters.
        The many accomplishments of our All Volunteer Force over the past 9
    years of continuous combat operations have been unprecedented. That we
    remain competitive in attracting the country's best talent during this
    period is simply extraordinary. All of our Services in the Active Duty,
    Reserve, and National Guard components continue to have exceptional
    recruiting and retention rates. Ninety-six percent of our accessions
    have earned at least a high school diploma, which helps explain why
    this is one of the finest forces we have ever fielded. Competitive
    compensation and selective bonuses are critical to our ability to
    recruit and retain talent, as are other ``people programs,'' such as
    the new GI Bill, improvements in housing, access to quality schooling
    for military children, mental health counseling, adequate child care,
    and attractive family support centers. All of these programs make the
    harsh burdens of military life easier to bear. I ask for Congress'
    continued support for them in order to sustain the Force while our
    overseas operations continue.
        I also urge Congress to continue funding the programs that will
    create a continuum of healthcare for our veterans and their families
    that seamlessly spans active duty and veteran status. With a focus on
    our enduring commitment, we must continue to improve our active and
    veteran care services, with special emphasis on Wounded Warrior
    Support. We will expand our public and private partnerships and tap
    into the ``sea of goodwill'' toward our veterans found in our Nation's
    communities and civic organizations. That will be important, but it is
    not sufficient. Long-term fiscal support for the Department of Veterans
    Affairs will serve the growing number of veterans requiring care.
        One issue that demands acute national attention is the challenge of
    Traumatic Brain Injury (TBI). The Improvised Explosive Device (IED) is
    the signature weapon of the conflicts in Iraq and Afghanistan and is
    directly responsible for many of these injuries. Many of our heroes
    suffer from severe TBI and have had their lives dramatically changed in
    ways we do not yet fully understand, and over 150,000 others have been
    exposed to events that may have caused moderate TBI. As such, we need
    to aggressively identify the victims of TBI, both within the serving
    force and among our veterans, and the treatment and rehabilitation they
    need and deserve. The effects of these efforts will pay dividends for
    some time, because we can expect to face IEDs in future conflicts as
    well.
        In addition, suicides and the many other stresses and social health
    costs that lag behind war--divorce, domestic violence, post-traumatic
    stress, depression, and even homelessness--are becoming alarmingly
    evident. Suicide rates remain unacceptably high, although programs such
    as the Department's Suicide Prevention Task Force and our improved
    leadership efforts have helped to lower the rates in 2010 in three of
    our four Services. Leaders must remain focused on this issue, as we
    work to improve our systematic understanding of the problem's scope,
    warning signs, and at-risk populations. As a society we must work to
    end the stigma that prevents our service members, veterans, and
    families from seeking early help.
        By more effectively leveraging public-private partnerships, we can
    pursue solutions and treatment for all of these health issues
    afflicting the Force with great urgency and compassion and honor the
    sacred trust our Nation has with all of our combat veterans.
    Reset and Reconstitute
        The grueling pace of deployments has not allowed for the training
    needed to keep our forces ready along the entire spectrum of military
    operations and, as a result, our readiness in some mission areas has
    atrophied over the past decade. There are some modest reasons for hope,
    though. The Army now has fewer soldiers deployed than it has had at any
    time since the invasion of Iraq. In addition, this past year we
    completed the increases in the Army and Marine Corps end strengths
    authorized in 2007. As a result, we are beginning to see some
    stabilizing deployment rates and modestly improving dwell times. We
    appreciate the Congressional support to our wartime manning needs that
    has enabled this. However, our overseas contingency operations do
    continue to demand significant numbers of ground and special operations
    forces and low-density, high-demand specialties. For our Army combat
    units, we do not expect to begin to reach our interim goal of 1:2
    deploy-to-dwell ratios until the end of 2012. After reset and
    reconstitution activities and as demand decreases, we expect to begin
    off-ramping some of our recent temporary force level increases.
        However, my concerns about the health of our force go beyond our
    people and training--we must also restore the readiness of our combat
    systems and capabilities, which have similarly been under extraordinary
    stress. In the ``back end'' of previous conflicts, we were able to
    contract our equipment inventory by shedding our oldest capital assets,
    thereby reducing the average age of our systems. We cannot do this
    today, because the high pace and durations of combat operations have
    consumed the equipment of all our Services much faster than our
    peacetime programs can recapitalize them. We must actually recapitalize
    our systems to restore our readiness and avoid becoming a hollow force.
    All of this will force us to be more efficient and disciplined in our
    choices.
        We must focus resources where they matter most, and we will reset
    and reconstitute by prioritizing people, readiness, capabilities, and
    essential modernization to maintain a technological edge. In the short-
    term, we will continue previous efforts to reconstitute and expand our
    rotary wing and tilt-rotor capacity in our Combat Aviation units and to
    convert one heavy Brigade Combat Team to a Stryker Brigade. However,
    over a period of years, we will modernize our battle fleet of ground
    combat vehicles, including replacing the Bradley Fighting Vehicle. We
    require enhancements to our manned and unmanned Intelligence,
    Surveillance, and Reconnaissance (ISR) assets, a new bomber program,
    extending the service life of a portion of our F-16 fleet, and
    continuing improvements in our missile defense and electronic warfare
    systems. We hope to modernize and extend the service life of our F/A-18
    fleet and invest in additional P-8A aircraft and tankers. Last, we ask
    for full resourcing of the Air and Missile Defense Radar, the Next-
    Generation Jammer, and communications and integrated fire control
    systems designed for operating in contested environments. These
    investments are, without question, costly, but they are critically
    demanded by our current and likely future challenges.
        Just as important as the reconstitution of these combat systems are
    the acquisition processes and production capacities underlying them.
    Our procurement systems remain complex and in need of streamlining to
    help us acquire needed capabilities faster and more affordably. Last
    year we committed to adding 20,000 experts to our acquisition corps by
    2015. In doing so we seek to improve stability in our programs, conduct
    more comprehensive design reviews, improve cost estimates, utilize more
    mature technology, and increase competition in order to make the entire
    process more responsive and effective.
        In addition, as I stated last year, I am concerned about the
    capabilities of our defense industrial base, particularly in ship
    building and space. Our ability to produce and support advanced
    technology systems for future weapon systems may be degraded by
    decreasing modernization budgets as well as mergers and acquisitions.
    Left unchecked, this trend will impact our future warfighting
    readiness. Although we are properly focusing on near-term reset
    requirements, the Department, our industry leaders, and the Congress
    need to begin considering how to equip and sustain the military we
    require after our contemporary wars come to an end.
                        balancing global strategic risk
        Balancing global risk requires maintaining a ready, forward
    presence with available forces that, overall, can meet the full scope
    of our security commitments. To meet these requirements, we must reset,
    sustain, and properly posture a force that includes both our active
    force and our National Guard and Reserve Components. But we must also
    make prudent investments and continuously evolve the force so as a
    whole it can meet the challenges of an increasingly complex global
    security environment.
        For many decades, our overmatch in our general purpose forces has
    underwritten our national security and our prosperity, as well as that
    of our many allies and partners. This credible strength has deterred
    aggression and reduced the likelihood of inter-state conflict like
    those of the 19th and early 20th centuries. With these capabilities, we
    have stood side by side with our allies in the face of belligerent
    aggression, helped secure access and responsible use of increasingly
    contested domains, and provided timely humanitarian assistance in
    response to natural disasters across the globe. However, our recent
    experience reminds us that we must continue to adapt some of our
    systems and tactics to counter anti-access and area-denial strategies,
    which may involve both the most advanced and simplest technologies.
        We already know some of the contours of what our future force will
    need to do. We know that, in addition to the current array of
    aggressive states and transnational terrorists we face, we must adjust
    to a changing global environment impacted by the rise of China and
    other emerging powers as well as the growing worldwide use and
    capabilities of cyber space. Such a world requires an agile, adaptive,
    and expeditionary force. It must ensure access, protect freedom of
    maneuver, and project power globally. It should retain decisive
    overmatch with air, land, sea, and special operations forces and be
    able to operate in degraded space and cyber environments. As such,
    transitioning to this future force will likely involve a greater
    emphasis on ISR, command and control, long range strike, area denial,
    undersea warfare, missile defense, and cyber capabilities. This
    transition will also involve further developing flexible leaders,
    operators, and technicians who are highly proficient and able to fully
    integrate our efforts with our partners from other agencies and other
    countries.
        In addition to maintaining our regular and irregular warfare
    capabilities, we will also continue to rely on secure and stable
    nuclear deterrence. It is also important that we maintain the safety
    and surety of our nuclear forces, even as we seek to reduce them in
    accordance with the Nuclear Posture Review and implement the recently
    ratified New Strategic Arms Reduction Treaty. We need to modernize our
    nuclear force and its supporting infrastructure to ensure that a
    smaller force is nonetheless safe, secure, and effective. Last, our
    missile defense systems should support the stability of our deterrence
    architectures.
        And while we work to reduce, safeguard, and provide confidence in
    our nuclear force and those of treaty signatories, we acknowledge that
    the proliferation of nuclear technology and other weapons of mass
    destruction by state and non-state actors remains one of the most
    significant and urgent worldwide threats. Effectively countering
    proliferation requires strong international partnerships, new
    surveillance technologies, and layered defenses. These are supported by
    ongoing expansion of the Cooperative Threat Reduction Program,
    establishment of a standing joint headquarters for weapons of mass
    destruction elimination, and investments in nuclear forensics
    technology and programs. These relatively small programs can have a
    disproportionately large positive impact on our security.
        Balancing global strategic risk also requires improving our
    capabilities in cyberspace. Today we face a range of threats to our
    computer systems from other states, mercenaries, and even civilian
    hackers, and their ability to wreak havoc cannot be overstated. Lower
    grade cyber threats conducted by organized criminals and talented
    individuals do not necessarily put the Nation at serious risk. But the
    effects of a well coordinated, state-sponsored cyber attack against our
    financial, transportation, communications, and energy systems would be
    catastrophic.
        Though there has been important progress across the government,
    such as the recent release of the International Strategy for Cyberspace
    and the standing up U.S. Cyber Command, more work is needed. Critical
    to Cyber Command's future success will be our ability to recruit,
    train, and most importantly, retain the right people. We must devote
    the same time and attention to cultivating this Nation's future cyber
    workforce as we do to our combat specialists. We must also empower
    Cyber Command and the combatant commands by working with the Executive
    Office of the President and other agencies to develop appropriate cyber
    authorities and by refining our cyber doctrine, tactics, and
    procedures. We will need to engage with NATO allies in the area of
    cyberdefense, as a contributing partner at the NATO Cooperative
    Cyberdefense Center of Excellence in Estonia. Last, we need to actively
    foster public discussion about international observance of cyber space
    norms.
        Balancing global strategic risk requires strong military-to-
    military engagement programs. These collaborative efforts engender
    mutual responsibility and include ongoing combined operations, multi-
    lateral training exercises, individual exchanges, and security
    assistance. They help demonstrate the United States' responsible
    military leadership in critical regions, reassure our allies, and
    strengthen the international norms that serve the interests of all
    nations. They also foster connections with other governments that
    reinforce our diplomatic channels and have proven critical during times
    of crisis.
        We currently benefit from numerous strong and well appreciated
    military partnerships, such as our North American and NATO
    relationships. For example, at the November NATO Summit in Lisbon, we
    and our allies recommitted to our alliance, ongoing operations, and a
    new Strategic Concept for the next decade. This spring, NATO released
    its Alliance Maritime Strategy and agreed to streamline its Command
    Structure, based in part on lessons learned from ongoing operations
    related to Libya. In Asia, though still underpinned by U.S. bilateral
    alliances, the region's security architecture is becoming a more
    complex mixture of multi-level multilateralism and expanded bilateral
    security ties among states. As the region's military capability and
    capacity increases, we seek new ways to catalyze greater regional
    security cooperation.
        Unfortunately, the global economic downturn is placing pressure on
    the resources of partner nations' security forces. We foresee no
    decrease in the commitment of our partners to us or to any of our
    mutual security efforts, but we must face the reality of less spending
    by our partners on our combined security and stability efforts. Any
    measures we take to strengthen our partnerships, such as the
    Administration's Export Control Reform effort, can only improve our
    collective security.
        We should not engage only with like-minded allies. Military-to-
    military engagement, in coordination with other diplomatic efforts, can
    help foster cooperation in areas of mutual interest between nations
    with varying levels of amity. We have seen the fruits of our engagement
    programs in strengthening cooperation in the Middle East, countering
    piracy in the Red Sea and the Straits of Malacca, and countering
    proliferation across the globe. We will seek out military-to-military
    relations even where they have not existed before because sound
    relations can prevent miscommunication and miscalculation that could
    lead to crisis or conflict. In particular, we are nurturing increased
    engagement with China--recently hosting the Chief of the Chinese
    General Staff for the first U.S. visit in 7 years. I intend to
    reciprocate and will visit China in July. China's peaceful,
    constructive rise would have a positive economic and security impact on
    the world, and we encourage continued improvements in transparency to
    ensure that this rise is properly understood. In addition, by
    increasing our military-to-military engagement with China we hope to
    increase understanding and cooperation on a multitude of issues,
    including encouraging North Korea to refrain from further provocation
    and ensuring access to and equitable use of the global commons.
        A significant component of our engagement program is the security
    sector assistance we provide to build the capabilities of our partner
    nations' security forces. These cost-effective programs properly place
    security responsibilities in the hands of other sovereign governments
    and reduce the tactical strain on our own forces by helping to prevent
    conflicts and instability. In many places, across the range of U.S.
    interests, investments in capacity building result in strong
    foundations for the future. These investments are often small but, if
    persistent, can yield a high return. I urge your continued support for
    Theater Security Cooperation programs, Acquisition and Cross-Servicing
    Agreements to lend military equipment for personnel protection and
    survivability (under 1202 authorities), Global Train and Equip
    initiatives (under 1206 authorities), funding for special operations to
    combat terrorism (under 1208 authorities), as well as the many security
    assistance programs managed by the Department of State, including FMF
    and IMET programs.
        However, just as these programs require full funding, they also
    need wholesale reform. Our security assistance structures are designed
    for another era--our authorities are inflexible, and our processes are
    too cumbersome to effectively address today's security challenges in a
    timely manner. I urge your assistance in modifying the laws and
    regulations surrounding security cooperation and assistance to create a
    better coordinated, pooled-resource approach--the Global Security
    Contingency Fund. This approach would create a new business model we
    believe will lead to collaborative programs to respond to emergent
    challenges and opportunities. We should not allow bureaucratic
    resistance to trump operational effectiveness when security sector
    assistance is essential to our national strategy of helping others
    secure and defend themselves.
        On this last point of interagency cooperation, I want to reiterate
    our commitment to comprehensive approaches to our security challenges
    that employ all elements of national and international power in
    coordination. Our future security concerns require a whole of
    government effort, not just a military one, and we serve best when we
    serve hand-in-hand with all of our partners and support, rather than
    lead, foreign policy. As such, we will work closely with the State
    Department and the U.S. Agency for International Development (USAID) to
    support their implementation of the Quadrennial Diplomacy and
    Development Review, particularly in the areas of conflict prevention
    and response. The capabilities and success of our interagency partners
    are inextricably linked to our own. As such, I reiterate my unequivocal
    support to Secretary Clinton and her efforts to fully resource the
    State Department's and USAID's activities and an expansion of its
    diplomacy and development capabilities, particularly in Iraq to support
    the transition from a military to a civilian-led mission. In addition,
    I support interagency cooperation programs and work to expand the
    number of exchanges between the Department of Defense and other
    Executive Agencies to institutionalize an enduring capacity to solve
    global problems using whole-of-government approaches.
                                   conclusion
        In the upcoming year, our Armed Forces will build on the past
    year's achievements and continue to provide the common defense our
    Constitution directs with distinct honor and effectiveness. We will
    advance our ongoing efforts and maintain the credibility of our forces
    while learning, adapting, and preparing for new security challenges. We
    know that the military's role in national security will remain
    substantial, and the demands on our servicemen and women will be high.
    However, we also know that we can never let our actions move us away
    from the American people, and that the quality of our work and our
    personal conduct will say far more about who we are and what we stand
    for than anything else we do. In all of our efforts, we will maintain a
    strength of character and professionalism, at the individual and
    institutional levels, that is beyond reproach and continues to be a
    source of pride for our Nation.
        Again, on behalf of all our men and women under arms, I thank this
    Committee, and the entire Congress, for your unwavering support for our
    troops in the field and their families at home during this time of war
    and for our efforts to maintain a strong, agile, well-trained, and
    well-equipped military that can prevail in our current conflicts and
    remain poised to deter or respond to new challenges.

        Chairman Inouye. I'm pleased to note the extraordinary
    attendance of members of the subcommittee. However, as a
    result, I will have to limit the questions and answers to 4
    minutes.
        Secretary Gates, you have made a couple of public
    statements on how to achieve our President's $400 billion
    reduction over the next 12 years. Instead of gutting the
    modernization programs, I know that you would prefer to see
    additional organizational reductions, in addition to changes in
    military pay, retirement, and the healthcare systems.
        Do you wish to elaborate more on these ideas, and any other
    areas that might be reduced?
        Secretary Gates. Mr. Chairman, the four areas that we're
    looking at in terms of how we would come up with $400 billion
    in reductions are, first, as I indicated in my remarks, looking
    for additional efficiencies and changes in bureaucratic
    expenditures, and the way we go about our business, and the way
    we do business on a day-to-day basis. We think there is still
    more money to be extracted out of overhead, but also in
    negotiating contracts on acquisitions, and so on. So, the first
    category is--more cuts in overhead.
        The second category is looking for marginal missions and
    marginal capabilities that can be eliminated. This would be in
    situations where, perhaps, two services have comparable
    capabilities, and we can get by having that capability in just
    one service. Or, there may be missions that we can set aside.
        The third category is the hardest, and it's the one that
    Admiral Mullen and I both talked about in our remarks, and that
    is the comprehensive review to look at what are the options
    that are available in terms of making reductions in force
    structure, and what is the impact of that on the capabilities
    of our forces and our ability to carry out our strategies? And
    how do we adjust our strategies, and how do we evaluate added
    risk by reduced investment in defense?
        One example of this, just to give you the flavor of what
    we're talking about--for many years we have had a strategy of
    being able to wage two fairly major regional conflicts
    simultaneously. If you tell yourself you're willing to accept
    the risk that won't happen, that two conflicts of that
    magnitude would not take place at the same time, but might be
    sequential, if you had to take on two others--then that has
    real impact for force structure.
        I would just note that in terms of assessing risk, between
    2007 and 2009 we, in fact, had two major regional conflicts
    going on simultaneously. So, this is not far-fetched in terms
    of risk.
        The fourth category, then, is, are the issues that,
    frankly, are politically challenging, and that have been very
    difficult for us and for the Congress to take on--working age
    retiree healthcare--and I want to make clear--none of us are
    talking about any impact on healthcare for the active force.
    This is about working-age retirees. Compensation--and
    particularly I would say in that respect, retirement, and
    whether the time has come to look at retirement.
        I think we have two challenges on the retirement side. One
    is about 70 to 80 percent of our force does not stay in the
    service long enough to retire, but they leave with nothing. So,
    if you've served 5 years, or 10 years, or a dozen years, you
    walk out the door with nothing. That doesn't make any sense.
    The private sector is well ahead of us in that respect.
        The second problem is, we get a lieutenant colonel or a
    sergeant first class with 20 years of service--they are at
    their peak, we are at their, they are at their prime--and we
    make it financially silly for them not to retire at 20 years.
    How do you incentivize them to give us another 5 years of
    service? I don't pretend to have the answers to these
    questions, but they are issues that I think we need to address
    both in terms of what's good for the force, but also in areas
    where we could save some money.
        So, those four areas, Mr. Chairman, are the areas that we
    are looking at in terms of how we can find this $400 billion.
        Chairman Inouye. I thank you very much.
        Senator Cochran.
        Admiral Mullen. Mr. Chairman, could I just make two brief
    comments?
        Chairman Inouye. Please.
        Admiral Mullen. First of all, not unlike the Government
    itself, where the Defense Department has roughly one-half of
    the discretionary spending, inside our budget, a little more
    than one-half is discretionary. And so, while we look at
    reductions in the future in where we would take the funds,
    there are obligations that we have that we just fundamentally
    have to fund as we transition to whatever this new budget
    environment is going to be for us.
        And then, second, if we don't come to grips with some of
    the most difficult issues, it is as clear as anything to me
    that the only answer is--we're going to get a lot smaller with
    a chance we could go hollow. We will give us force structure to
    sustain these benefits, to do all those things. And that, I
    think, is very dangerous in the world that we're living in, to
    meet the national, the growing national security requirements
    that I see.
        Chairman Inouye. Thank you very much.
        Senator Cochran.
        Senator Cochran. Mr. Chairman.
        Mr. Secretary, let me ask, in view of the situation in
    Libya, are we learning something about the ability of our
    allies, who volunteer to try to take up the slack in situations
    where we're not moving forward and trying to run a military
    operation? What are we learning from their capabilities or
    inadequacies that give you the most concern?

                          DEFENSE BUDGET CUTS AND NATO

        Secretary Gates. Well, I addressed this last week in
    Brussels in my usual subtle form.
        The reality is that, as they cut their defense budgets, and
    have been--have not been investing in their defense
    capabilities for a number of years, by default, the additional
    burden falls on the United States. So, I think that there is a
    genuine worry that our allies have looked to us to pick up the
    slack, as they cut their defense budgets. And the message that
    I had for them in Europe last week was that a, because of our
    financial problems--and, frankly, a growing number of Members
    of Congress who, for whom the cold war and our connection to
    Europe and to NATO are not in their genes, as they are for me,
    are going to be unwilling to pick up 75 percent of the defense
    burden of the NATO alliance.
        So I think this is a serious problem. It's been a problem
    for some years. But, I think our own financial difficulties,
    and what we're now going to face in looking at the American
    defense budget, brings this issue to center stage in a way that
    it really has not been in the past.
        Senator Cochran. Admiral Mullen, on the same subject, what
    affect does that specifically have on our ability to project
    power to other regions of the world--the Far East, for example,
    areas where we have been involved in actual combat operations,
    the Vietnam era, and what that brings in terms of expense of
    operations and training of our forces? Can you give us an
    assessment of the direct impact on the U.S. Navy?
        Admiral Mullen. Well, I share the Secretary's concerns and
    views with respect to the investment, or, the dramatically
    decreased investment in our NATO partners, or, by our NATO
    partners.
        The affect, or, one of the affects that it's had is, it's
    certainly, they don't have the depth, the resources in some
    cases, to do what their political leadership has directed them
    to do. Although, I also would say that, both in Afghanistan and
    in Libya, NATO is more together than I've seen, in terms of
    commitment, over the course of the last 10 to 15 years. And,
    while they do get criticized, they also stood this operation up
    in incredibly quick fashion. We hadn't operated an air, had an
    air operation like this in a long time. And from my
    perspective, they have executed that well. The resources to do
    it is something we're watching very carefully. And they are, in
    some ways, dependent on us.
        The other thing is, for countries who recently did their
    own strategic review, they found themselves getting rid of
    capabilities that, now that they're in a combat environment,
    they're giving second thought to that. Combat has a way of
    bringing that kind of reality to them--which just argues, for
    me, that we and others have to be very careful in our review,
    given the world that we're living in, about what capabilities
    we decide to either get rid of or trim back.
        Longstanding--where we are right now--and in particular, I
    mean, as you talk about the Western Pacific, Senator Cochran--
    we're, we've got tremendous relationships with the Japanese,
    with the Republic of Korean military, we have had with our
    Australian friends, as well as growing relationships with the
    Association of Southeast Asian Nations (ASEAN) countries. And
    so, I'm actually pretty comfortable with where we are right
    now. We've got overseas home-ported forces--as you know, both
    marines and Navy--in fairly significant numbers in that part of
    the world. And that makes a long, a lot of difference in terms
    of stability.
        The pressure over time, though--it gets back to what I
    said--is, if we get into this force structure--part of us, in
    terms of the defense review--and have to reduce our force
    structure, there will be pressure there, which in the long run,
    I think, will start to undermine stability in a place like
    that.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Cochran. Thank you, Mr. Chairman.
        Senator Shelby. Thank you, Mr. Chairman.
        Mr. Secretary and Admiral Mullen, thank you for your
    service.
        Mr. Chairman, I'd like for my opening statement to be made
    part of the record.
        Chairman Inouye. Without objection.
        [The statement follows:]

                Prepared Statement of Senator Richard C. Shelby

        I want to join the Chairmen in thanking both of you for
    your years of dedicated public service. Mr. Secretary, the
    title of a recent book describes the job you will soon be
    vacating as ``nearly impossible.'' Yet, you managed to take the
    helm of the Pentagon at one of the most difficult times in our
    Nation's history and succeed beyond all expectation. You
    successfully prosecuted a war in Iraq that many had assumed was
    lost. You have helped to oversee a surge in Afghanistan that,
    we hope, is turning the tide there, as well. Perhaps even more
    importantly, you have launched a much-needed battle to control
    defense spending in a responsible way that will help reduce our
    national debt while preserving our national security. All of
    these things you have accomplished while retaining the full
    confidence of two very different Presidents and the United
    States Congress. We all are duly impressed by your
    accomplishments, and owe you a sincere debt of gratitude for
    your service.
        Admiral Mullen, you assumed the Chairmanship in 2007, also
    under very difficult circumstances, and have acquitted yourself
    admirably in the post. I have been most impressed by your
    powerful advocacy on behalf of those who wear the uniform. You
    have spoken repeatedly about the strains on the force from a
    decade of persistent conflict, and about the need to care for
    those who have been wounded, physically or psychologically,
    defending our Nation. You have also, properly, placed our
    financial stability on the table as a fundamental issue of
    national security. All would do well to remember your words as
    we try to get our debt under control. Many thanks to you for
    everything you have done for this country.

                     NUCLEAR WEAPONS MODERNIZATION PROGRAMS

        Senator Shelby. Mr. Secretary, last year you transferred
    about $6 billion of your budget authority to the Department of
    Energy to pay for nuclear weapons modernization programs
    because, as I understood it, you're concerned about the neglect
    that had befallen the U.S. nuclear deterrent.
        How concerned are you, now that the House is considering
    appropriations legislation that we would cut the program by
    almost 10 percent from what the President requested and what
    you've already paid for out of your own very tight budget? And,
    what are the implications of failing to fund the modernization
    program here?
        Secretary Gates. Well, I'm very concerned. And, as I
    recall, the actions taken by the House cut about $1 billion
    from this modernization program.
        This modernization program was very carefully worked out
    between ourselves and the Department of Energy. And frankly,
    where we came out on that, also, I think, played a fairly
    significant role in the willingness of the Senate to ratify the
    new START agreement.
        So, the risks are to our own program, in terms of being
    able to extend the life our weapons systems; to modernize
    them--not in the sense of capability, but in terms of security
    and reliability. And this requires new construction. We have a
    lot of buildings at Los Alamos that date from the Manhattan
    Project. And so, this modernization project is, in my view,
    both from a security and a political standpoint, really
    important.
        Senator Shelby. Mr. Secretary, in my short time--missile
    defense. I understand that the Defense Science Board has
    compiled a report on the concept of what we call Early
    Intercept for Missile Defense, and the report's unclassified
    conclusion is that the Missile Defense Agency (MDA) plans to
    achieve an early intercept capability as part of the phase-
    adaptive approach are simply not credible. This is disturbing
    to some of us, since MDA's promise to develop by 2020 an early
    intercept capability for the SOME-3 Block IIB was the central
    justification, as I understood it, of, to cancel the third site
    in Europe and to kill the KEI boost-phase defense program.
        Now it looks like the Nation may be left without an
    inadequate--with an inadequate defense in Europe, and no boost-
    phase intercept capability.
        Is the Department re-examining the phase-adaptive approach
    in light of the Defense Science Board? And should the
    Department be looking at ways to use funding currently
    programmed for this SOME-3 Block IIB, to improve the GMD
    system, or, to evolve more rapidly?
        What's your thoughts on that?
        Secretary Gates. We have resources in the 2012 budget to do
    both. To fund----
        Senator Shelby. That's good.
        Secretary Gates [continuing]. The phased-adaptive approach,
    and to strengthen the ground-based interceptor (GBI) program.
    The 2012 budget buys 52 GBIs, both for deployment and for test
    purposes; it makes investments in upgrades to long-range radars
    in Greenland and the United States and Canada.
        We also have money for developmental work in terms of other
    kinds of interception of ballistic missiles. But, I believe
    that the balance between the ground-based interceptor system
    and the money we are investing in that, plus the money that we
    are investing in the phased-adaptive approach--first of all,
    the latter will give us a missile defense capability several
    years earlier than would have been the case with the third site
    in Europe. And, let's be blunt. The third site in Europe was
    not going to happen, because the Czech Government wouldn't
    approve the radar.
        Senator Shelby. Sure.
        Secretary Gates. And so, if it was going to happen at all,
    it would have taken years longer. And we still hadn't
    negotiated the required agreements with the Poles in terms of
    the interceptors. So, I think that the balanced approach
    between the GBIs, the phased-adaptive approach, and the
    developmental work we have underway, plus the additional half
    billion dollars we've added to the budget for fiscal year 2012,
    puts us in a pretty good place on missile defense.
        Senator Shelby. Admiral Mullen.

                                MISSILE DEFENSE

        Admiral Mullen. Just very quickly--and while I am not
    exceptionally close to it in this job, I've been around missile
    defense for the last 15 years--and, the whole issue of boost-
    phase intercept is an extraordinarily difficult technical
    challenge. And, at least, if someone's broken through on that,
    I haven't seen that. It doesn't mean we shouldn't seek it, but
    I've seen an awful lot of efforts go after that. And I was very
    supportive of the program adjustments that we made--
    particularly with respect to that, because I thought, my view
    was, I thought we were throwing good money after bad.
        Second--and I haven't seen this report, I'll take a look at
    it. And I certainly, I would not, without, push back on it. The
    only thing I can say is, the path through the standard missile
    is the most well-developed, robust, reliable path over time,
    with respect to developing missile defense. And it's, we're
    still almost a decade away. And I have confidence that we can
    continue to pursue that path. It's an incredibly well-tested
    system. The missile you're talking about, I know, doesn't exist
    yet. But, it's a path that----
        Senator Shelby. But it could exist, couldn't it?
        Admiral Mullen. Huh?
        Senator Shelby. It could exist.
        Admiral Mullen. No, I think--yes, sir. I think we can get
    there in that timeframe, based on my understanding.
        Senator Shelby. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Leahy.
        Senator Leahy. Thank you, Mr. Chairman.
        I want to join the others who have thanked you for the
    extraordinary service you've both shown to this country. You
    came to your roles at very challenging time.
        Admiral Mullen, I appreciate our friendship, and your trip
    to Vermont, you and Mrs. Mullen, when you joined Marcelle and
    me up there to meet with our troops when they were deploying.
        Secretary Gates, I've told you before, but I'll say it here
    publicly. I've enjoyed our friendship of, it must be about 30
    years now.
        With that said, unfortunately there's one issue we don't
    all agree on, and that's the war in Afghanistan. I think like
    most Americans--certainly most Vermonters I talk with, and an
    increasing number of Members of Congress--I think we have to
    dramatically accelerate our withdrawal of troops from that
    country.
        I supported going into Afghanistan for the purpose of
    getting Osama bin Laden after 9/11. And the subcommittee and
    all of us here on the Appropriations Committee have been
    strongly supportive of that.
        I did not support the invasion of Iraq, which distracted us
    from that goal. Iraq had nothing to do with 9/11, and we'll be
    paying for this cost for years to come. We borrowed the money
    to go into that war. It's an extraordinary thing in a war--to
    borrow the money. We're still borrowing the money. At the same
    time, we gave a tax cut for anybody who makes as much as a
    Member of Congress. So, what we said was, we'll let our
    children and our grandchildren pay for these two wars.
        I don't think we can continue to sacrifice so many lives
    and spend billions of dollars a week in a war with no end. I
    think we have to identify achievable goals in Afghanistan. I
    think we have to reduce our military footprint there.
        And then we look at Pakistan. Well, just this morning we
    see word that our putative ally arrested five people on the
    suspicion that they helped the United States to get Osama bin
    Laden. After publicly saying, of course, they wanted us to get
    Osama bin Laden, they arrested people who helped us get him.

                               AFGHAN GOVERNMENT

        Now, we could overlook the problems probably in Pakistan if
    the Afghan Government was any better, but we have President
    Karzai, who can't seem to make up his mind if he's on our side
    or the Taliban. We support them with our tax dollars when at
    the same time we say we've got to privatize Medicare,
    eviscerate education funding, shred social safety net here in
    this country, and stop all the investments that might make our
    industries more competitive.
        It's not a criticism of our military--I've visited them
    there. They are performing extraordinarily well, under very
    difficult circumstances. But, how long do we support
    governments that lie to us? When do we say enough is enough?
        Secretary Gates, I'll start with you.
        Secretary Gates. Well, first of all, I would say, based on
    27 years in the CIA and 4\1/2\ years in this job, most
    governments lie to each other. That's the way business gets
    done.
        Senator Leahy. Do they arrest----
        Secretary Gates. And we ought to----
        Senator Leahy. Do they also arrest the people that help
    us----
        Secretary Gates. Sometimes.
        Senator Leahy [continuing]. When they say they're our
    allies?
        Secretary Gates. Sometimes.
        Senator Leahy. Not often.
        Secretary Gates. And sometimes they send people to spy on
    us. And they're our close allies. So----
        Senator Leahy. And we give aid to them.
        Secretary Gates [continuing]. I mean, that's the real world
    that we deal with. But I would tell you this. First of all,
    this is not a war without end. The Lisbon Summit has made clear
    that the transfer to Afghan security responsibility and
    leadership will be complete not later than the end of 2014.
    Troops will be coming down during that period. The costs of
    these wars is coming down dramatically. The costs of these wars
    will drop between 2011--fiscal year 2011 and 2012 by $40
    billion, and between 2012 and 2013 probably by several tens of
    billions of dollars more.
        And I asked the question--first of all, I think the
    prospects of having a more stable Afghanistan, in terms of a
    country that can defend itself--I'm not talking about a Vermont
    democracy here, but a country that can defend itself----
        Senator Leahy. Neither am I, Mr. Secretary, and you know
    that.
        Secretary Gates. I know. But what I'm talking about is, we
    are not in the business of nation building. What we are trying
    to do is build the Afghan National Security Forces to the point
    where they have the ability to defend that country, and so that
    the Taliban and Al Qaeda cannot reconstitute themselves in that
    country. And I think we are making considerable headway in that
    respect.
        So I think that--I know people are frustrated. The
    country's been at war for 10 years. I know people are tired.
    But people also have to think in terms of stability and in
    terms of the potential for reconstitution. What's the cost of
    failure?

                                    PAKISTAN

        Senator Leahy. Do you want to add to that, Admiral Mullen?
        Admiral Mullen. What I would talk about, I think, in this,
    Senator Leahy, and you know I've talked about this many times,
    is Pakistan. And we are in the midst, and have been, of trying
    to, in the middle of this war, with threats that they have in
    their territory, trying to build a relationship that was badly
    broken when we left the last time, when we terminated our
    relationship with them in the late 1980s and early 1990s. And
    we are back. And it's actually my belief that if we--if we were
    to do that again, it may not be 5 years or 10 years, but we'll
    be back in a much more difficult situation. And so seeking to
    support stability in that part of the world to the degree that
    these two countries can evolve is, I think, a goal that we must
    continue to pursue--or the danger associated with a country
    that's got a nuclear arsenal, that is an--that lives next to a
    country that they view as an existential threat, it's just a
    matter of time before we're back.
        So I don't--I don't push back on the challenge associated
    with it. Some of the criticism is more than warranted. Nobody's
    worked that harder than me, very frankly, with the leadership.
    And it's a--it's a conscious decision I think that we have to
    make. And if we walk away from it, it's my view it'll be a much
    more dangerous place a decade from now, and we'll be back.
        Chairman Inouye. Thank you very much, Senator.
        Senator Coats.
        Senator Coats. Thank you, Mr. Chairman.

                            RUNAWAY DEBT AND DEFICIT

        I can't speak for other States, but I can speak for the
    people of Indiana, who are grateful for your lifetime of
    service--not only commitment to public service, but execution,
    brilliantly, in your jobs. You've been a model for us. And I
    thank you, and I know the people of Indiana thank you.
        Second, I would like to, I guess, just reaffirm that,
    Secretary Gates, your statements about one of the greatest, if
    not the greatest, threat to our future security is a runaway
    debt and a trillion dollars deficit on an annual basis, and
    that, if that is not addressed, even the difficulties and scale
    back of, ability to respond to challenges around the world that
    won't go away, are potentially reduced--that's nothing in
    comparison to the strains and stresses that will be placed on
    our ability to do that in the future if we can't get ahold of
    this runaway debt and deficit. So, that ever shrinking part of
    the pie that goes to discretionary and defense spending is
    going to keep shrinking if we don't deal with mandatory
    spending. And I appreciate you speaking out on that basis.

                                HEALTH RESEARCH

        A question that I have goes to where possibly we can get
    some savings. I note that the House Appropriations Defense
    Subcommittee passed out a bill which includes research on a
    number of health issues: $223 million cancer research, $125
    million for traumatic brain injury, $30 million for orthopedic
    research, $15 million for restoration of health research.
        I'm just wondering, are there savings that--that's $393
    million. That's a long way from $400 billion, but it's a fairly
    good chunk of money. Are there savings possible in that
    category where there is duplicative research, paid for by
    Government or conducted by the private industry, which
    addresses the very same issues?
        In the past, Defense has kind of been a go-to place for
    health research that, in many cases, is duplicated elsewhere.
    For instance, orthopedic research. I mean, our State is the
    leader of the world in orthopedic research. Some of the, all
    the leading technology and so forth comes out of the private
    sector for that. I don't know exactly what the military does in
    addition to that, but, I guess the question is, are there
    places like that we can get some--you know, I know it's the
    holy grail not to touch anything having to do with health of
    service members. I'm not suggesting that. I'm simply saying
    there may be some duplications there that we ought to be
    looking at.
        Secretary Gates. I think, you know, any of these things are
    worth looking into in detail. But, and I can't speak to the
    cancer piece of it, but I will say this--I think that we have
    funded some of the leading research being done in the country
    on traumatic brain injury, and probably also on prosthetics,
    and almost certainly on post-traumatic stress. The Congress has
    given us quite a bit of money in those areas in particular. And
    I would argue that, in terms of the practical applications of
    those things, as opposed to pure research, that those funds, I
    think there would be a strong bias to keeping those in the
    Defense budget, because we have a very direct interest in
    making sure that there is progress in, particularly, those
    three areas, because those are the areas in which our service
    members are suffering the most in these wars.

                                      NATO

        Senator Coats. I'll accept that.
        I've got 4 seconds left, so a quick yes or no. Is a
    hollowed-out NATO worse than no NATO? The reality that NATO
    just is not stepping up to its responsibilities--we're going to
    have to do it all anyway?
        Secretary Gates. Well, I would say that a NATO that has
    reduced capabilities is still better than no NATO at all. And,
    I'd just add one point to the chairman's comment--to Admiral
    Mullen's comment earlier. One of the things that has happened
    to our allies is that they really have stepped up in
    Afghanistan. But, the result of that has been that the costs of
    their participation in Afghanistan has brought further pressure
    on the modernization budgets of those European countries. And
    so, it's contributed to their overall narrowing of military
    capability, but partly it's because of the contribution that
    they've made in Afghanistan.
        Senator Coats. Thank you.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Mikulski.
        Senator Mikulski. Mr. Chairman.
        Secretary Gates, Admiral Mullen, again, like all of my
    colleagues, thank you for your service. I think the enormous
    turnout of members, and also the fact that we're actually
    staying--staying longer than you--is a tribute, really, to the
    high regard that we regard your service, and your service,
    Admiral Mullen. So, we want to thank you for it from the
    incredible job that you've done keeping America safe, your
    strong support for the military, your many trips to actually
    get out of Washington and listen to the troops and talk to our
    allies.
        And for me, one of the special things was the way--always,
    always, will be the way you responded unflinchingly with the
    Walter Reed scandal, in the way you took ownership, the way you
    ensured accountability and responsibility and corrective
    action. And I want to just thank you for that.
        And I've just watched you with the troops, not only in
    uniform and so on, but in things like the Army-Navy game, where
    you mingled with them. And the wounded warriors had such access
    to you, and the way that they felt that they could approach you
    and talk to you, and the warmth and regard you have. So, I
    think that's what a real inspirational leader is, which is the
    difference in management.
        But let me tell you, your trips, your farewell trips and
    speeches you've given, have been eyebrow-raising, jaw-dropping,
    and for me, a must-do list, from the Eisenhower Library speech
    in which you called for major fiscal reform, to the most recent
    one at NATO. You've dropped more bombs in some of these than
    the Air Force.
        But, let me get to my questions. I'd like to, really,
    follow up on, really, the questions raised about NATO. And many
    of this will have to be done with your successor. What is NATO?
    What are we going to require of NATO members? What actions
    should NATO undertake? When we ask for a coalition of the
    willing, we're going to need a coalition of the capable. Or,
    are we ever going to ask that again?
        But, let me go to something very specific, because those
    are big policy questions to be sorted out. I wonder what your
    thoughts are on an overseas base closing. And, is this the time
    where we look at the major policy and make sure we don't have a
    hollowed-out NATO? Is it time to have an overseas base closing,
    where we bring a lot of assets home, close assets, and so on?
    What would be your thought on that? Because, I think we spend
    about, the President's Commission on Deficit Reduction said we
    could save about $9 billion in that area.
        Secretary Gates. Well, first of all, any overseas base
    reductions will necessarily--first of all, just the practical
    thing--overseas base reductions would require Milcon here in
    the United States, so there would be--at least in the beginning
    it would be more expensive to bring them home than to leave
    them where they are, because they have facilities already
    built. And we do get support from the Germans, the Japanese and
    the South Koreans in supporting those facilities.
        Senator Mikulski. I'm not advocating closing all bases----
        Secretary Gates. I understand.
        Senator Mikulski [continuing]. But that kind of scrub we do
    here.
        Secretary Gates. Well, we've just been through that in the
    Department of Defense, and it's now working its way through the
    interagency in terms of an assessment of our global posture and
    our presence in a lot of these different places. Secretary
    Clinton and I will meet with the Japanese the first of next
    week in our periodic two-plus-two meetings to talk about
    Okinawa and Guam, and Japan, and the force presence there.
        I think that the biggest policy question that I think has
    to be asked is--what kind of a signal do you want to send the
    rest of the world, in terms of America's role in the world?
    And, if we, at the same time, we're cutting our Defense budget,
    and we cut our State Department budget, and State has fewer
    assets to deploy abroad, we have fewer assets to deploy abroad,
    and then we begin to close one or another foreign base, are we
    basically sending the message to the rest of the world--and, I
    would say, to China, to Iran, to North Korea, to a variety of
    other places--the United States is closing up shop and going
    home, and we're headed toward Fortress America again?
        So I think this, as I leave, I think this is a huge
    question for the country to consider, and for you to consider,
    is, what kind of a role do you want for the United States in
    the world? And frankly, I believe, for example, our presence in
    Europe, if--one of the benefits it has brought, in addition to
    the financial benefit of having troops be able to rotate from
    Germany into Iraq and Afghanistan at, actually, less cost than
    from here--but, one of the things it has brought is, if
    anything, it has slowed, I think, this deterioration of the
    NATO military capabilities.
        Senator Mikulski. Because we're there----
        Secretary Gates. Because we're there and we train----
        Senator Mikulski [continuing]. They feel we're glued
    together?
        Secretary Gates. We train with them and we work with them.
    And they have to have capabilities that match us when we're
    doing that.
        Senator Mikulski. Mr. Chairman, may Admiral Mullen respond?
        Admiral Mullen. Just very briefly--and maybe it's just
    because of my roots, and I'm a Navy guy--there's just nothing
    like being there. And you can be there a couple of ways. You
    can live there, or you can rotate there. And what I have found
    in our relationships--I just came back from Egypt, and we've
    had a long relationship with Egypt--but, the mil-to-mil
    relationship we have with Egypt is different than the one we
    have with Japan, because we live with Japan. We interact with
    their families. We know the Japanese people in ways that we
    just don't know other countries. The same is true in Germany.
    The same is true in the Republic of Korea. Extraordinarily
    strong relationships. When we are in a crisis, we can use those
    relationships, I think, to prevent a crisis, or prevent
    escalation.
        So, I don't know if--I certainly wouldn't say that it isn't
    worth a scrub. I just think the presence piece of this is so
    powerful in so many ways, and it's enduring, and it prevents
    conflicts in ways that sometimes we don't think about in the
    short term, when we're looking for savings in moves. It's not--
    our investment is significant. I understand that. And, worth a
    scrub. I just think we really need to be careful.
        Senator Mikulski. Thank you.
        Chairman Inouye. Thank you.
        Mr. Kohl.
        Senator Mikulski. Mr. Chairman, I just want to, if I could.
    If I could submit questions for the record, both in terms of
    military health care and, quite frankly, in the follow-up, in
    the undersecretary of acquisition, technology and logistics.
    That's $400 billion. The House is dragging its feet. They've
    reinvented earmarks. And I'd like to have, maybe, three to five
    items out of that area, where you think we should definitely
    stay the course in reducing our expenditures.
        And, I hope somewhere we can get a chance to ask his
    opinion on the House and earmarks.
        Chairman Inouye. We will discuss that.
        Senator Kohl.
        Senator Kohl. Thank you, Mr. Chairman.

                                  AFGHANISTAN

        Secretary Gates and Secretary Mullen, we thank you for
    being here today, and we congratulate both of you on a job well
    done. Your leadership has been critical to the progress that
    we've made in Afghanistan, Iraq, and in the global war on
    terror, most recently the death of Osama bin Laden.
        In light of this progress, many Americans are hoping that
    our forces can soon come home from Afghanistan after a decade
    of war. I share this desire to begin withdrawing our forces
    from Afghanistan, beginning with a sizable and sustained
    reduction in forces this summer.
        I'd like to ask both of you about the government of
    Afghanistan and President Karzai. President Karzai seems
    increasingly hostile to the American presence in Afghanistan,
    and his government, as we know, is plagued by corruption.
        My first question is whether you see President Karzai
    playing a positive or a negative role in Afghanistan.
        But I'd also like to hear from both of you about what comes
    after Karzai. Presumably he'll not be President forever. What
    kind of relationships are we building with Afghan leaders from
    other political parties and ethnic groups, both in power, as
    well as in the opposition?
        Mr. Secretary.
        Secretary Gates. Well, first of all, I have spent a lot of
    time with President Karzai over the last 4\1/2\ years. Frankly,
    I think that we have often not done a very good job of
    listening to President Karzai. The problems that he often
    raises in public are problems that he has often raised with us
    1 year or 2 years before in private. And, I'll give a perfect
    example--and that's private security companies. This became a
    crisis in our relationship late last year. We've worked our way
    through it, and he has participated in working his way through,
    in our working our way through this.
        But we knew from Iraq that private security companies are a
    problem in these countries, and we should have begun this
    transition to Afghan oversight of these companies a long time
    ago. So, my point is--yes, he reacts publicly to things that
    are done and said. He's very sensitive to civilian casualties.
    This has been a continuing theme. It's not a surprising theme.
    But, I think you would find, if you talked to our commanders,
    if you talked to the people that I talk to, he is somebody who
    understands the campaign plan, who understands the importance
    of our role, who wants a long-term U.S. relationship with
    Afghanistan after he's President. He told me he plans to step
    down in 2014.
        I will tell you, both our military people and our diplomats
    are in touch with a very broad range of Afghan leaders--and not
    just in Kabul, but all around the country.
        And finally, on the governance side, I would just say, at
    the NATO Defense Ministers meeting late last week, the NATO
    senior civilian representative, Ambassador Gass, reported
    that--he had just gotten back from Afghanistan--75 percent of
    deputy district governors now in Afghanistan are chosen on the
    basis of merit. And he told the defense ministers further that,
    as the provincial governors change, the quality is steadily
    improving.
        So, I think you have the Kabul environment, and you have
    the outside of Kabul environment. And, frankly, it's a lot
    better outside Kabul, in terms of what's going on around the
    country and in terms of governance, than is often reported.
        But it's a relationship from, where we're dealing with a
    President whose country has been at war, like us, for 10 years.
    And, he is very sensitive to the fact the Afghans are exhausted
    with war, too. And so, I find that, when I sit down with
    President Karzai, we have a very productive conversation. And
    it's clear that he buys into what we are trying to do, and that
    we are allies, not occupiers. And he also does see a post-2014
    relationship with the United States going forward.
        Senator Kohl. Admiral Mullen, any comments?

                              SECURITY ENVIRONMENT

        Admiral Mullen. The only thing I'd add is, as the security
    environment continues to improve--and I'd reemphasize what
    Secretary Gates said in terms of what we're seeing on the
    ground--in subdistricts and districts and provinces, it's
    getting better from a governance standpoint which, between
    security and governance, gets you to a point where you can
    start to develop the areas, which is really what the Afghan
    people care about. They're tired of war.
        There is this disparity between Kabul and what we see
    locally throughout the country. And we have to continue to
    engage. This is the elected leader of a country we're heavily
    engaged in, or, with. And, we can't do it without decent
    governance. We can get the security pieces necessary, but it's
    not sufficient, and we have to continue to push on better
    governance, the reduction of corruption, and the development
    piece of this. We're just getting to point, from my
    perspective, in the south, where security has gotten to a point
    where those other pieces can really start to kick in. We're not
    there throughout the country. But, from an overall proof of
    concept, if you will, that this approach is having the impact
    we thought it would, we're there.
        Secretary Gates. The other, one other point I would make
    is, having talked about the rest of the country being better in
    some respects than Kabul, in another respect, Kabul is a model,
    because the Afghans have had the security lead in Kabul for
    over a year now. And that's the transition we're trying to make
    throughout the rest of the country on a district-by-district,
    province-by-province basis. And at this point, about 25 percent
    of the Afghan population live in areas that are now under
    Afghan security lead.
        Senator Kohl. Thank you.
        Chairman Inouye. Thank you.
        Senator Alexander.
        Senator Alexander. Thank you, Mr. Chairman.
        Thank you, Mr. Secretary, Admiral Mullen, for extraordinary
    public service.
        Mr. Secretary, for the historical record, for young people
    who may be planning a career in public service, what's better
    preparation for Secretary of Defense--president of a big
    university, or director of the CIA?
        Secretary Gates. President of a big university.
        As you well know.
        Senator Alexander. Yeah.
        Mr. Secretary, how many, about how many military men and
    women do our European allies have?
        Secretary Gates. About 2 million in uniform.
        Senator Alexander. About how many are available to be
    deployed in an exercise like Libya or Afghanistan?
        Admiral Mullen. I would guess, Senator Alexander, it would
    be in the 10 to 15 to 20 percent in terms of----
        Senator Alexander. Twenty percent?
        Admiral Mullen [continuing]. Any single time. But that
    number can be very deceptive because, for all of us, we find
    out--we have 2.2 million men and women Active and Reserve, and
    we have about 250,000, almost 300,000 people deployed around
    the world right now. And we're going at a pretty good clip.
        Senator Alexander. I thought I'd had heard somewhere that
    they might only have 25,000 or 40,000 troops available for----
        Secretary Gates. What you heard was in my speech last week,
    where I said they'd struggled to maintain 25,000 to 40,000
    troops in Afghanistan.
        Senator Alexander. Mr. Secretary, in the gulf war, the
    first Iraq war, if I remember correctly, other countries paid
    for a large part of that. How much of that did they pay for?
        Secretary Gates. Virtually all.
        Senator Alexander. Yeah. In the Iraq, Afghanistan, and
    Libya war, how much have other countries paid for?
        Secretary Gates. Well, the other countries are essentially
    paying their own way, in the sense of they're paying for their
    own airplanes, and they're paying for their own munitions, and
    things like that.
        Senator Alexander. But, the United States is paying for
    virtually all of Iraq, Afghanistan and Libya. Is that right?
        Secretary Gates. Well, not Libya. But, we certainly have
    paid the bulk of the money in Iraq and Afghanistan.
        Senator Alexander. And was your testimony that, in NATO,
    the United States is supposed to pay what percent of the costs?
    And what percent do we actually pay?
        Secretary Gates. Well, the line that I had was that, up
    until about, well, until the end of the cold war, we paid about
    50 percent of the military costs of the alliance. Since the
    cold war, that has--since 1991, that has risen to about 75
    percent of the total military expenditures in NATO.
        Senator Alexander. Is there a lesson for this President and
    future Presidents, this Congress, as we look back at the gulf
    war and as we prepare for any future military action, that we
    might keep in mind not just getting approval of other countries
    for the, agreeing that we ought to take the action, or to join
    with us and take the action, but to do as was done in 1991 and
    1992, to actually get their commitment to help pay for it?
        Secretary Gates. Well, I think you, we can look at that two
    ways. One is, the answer is absolutely yes. One of the things
    that I pointed out last week at the NATO Defense Ministers
    meeting is that the trust fund to support the Afghan national
    security forces going forward is, in terms of the dollars or
    Euros that have been contributed, is a joke, because it's about
    350 million Euros at a time when the United States is spending
    billions of dollars to support the development of those
    military forces. So, one of the things that I have talked to
    all of our allies about is the fact that it's imperative for
    them to contribute to that trust fund.
        On the other hand, the circumstances of the gulf war were,
    I think, unique, in the sense that the countries we were
    dealing with that felt the most threatened were Kuwait, Saudi
    Arabia, the gulf states and so on. I will tell you that, sort
    of looking back, the two people who led the groups, the teams
    going around to talk to our allies about their contributions
    were led by Secretary of State Baker and Secretary of Treasury
    Nick Brady. And, somehow through the luck of the draw, Baker
    ended up with Saudi Arabia, Kuwait, the gulf states, and so on,
    and Nick Brady had to go talk to the Japanese, the Germans, and
    others. And, let's just say, Nick wasn't nearly as successful
    as Jim was.
        Senator Alexander. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Collins.
        Senator Collins. Thank you, Mr. Chairman.
        Mr. Secretary, since this is your last hearing, it seems
    ungracious to do anything except thank you and heap praise upon
    you for your service. But since you're before a group of
    senators, of course, while we'll do that, we'll also ask some
    questions. But, I do sincerely thank you for a lifetime of
    public service that has made an extraordinary difference to our
    country, and to our troops, in particular.
        I'm very concerned about the $400 billion that the
    President has assigned the Department of Defense for additional
    cuts. You have already made a tremendous effort to squeeze out
    waste and inefficiency, and to reduce unnecessary spending. I'm
    concerned that we could end up with the kind of hollow force
    that you've warned us against, and that was so devastating to
    our troops, and our security, potentially, in the 1970s, and to
    a lesser extent, two decades later.
        Were you consulted by the President or OMB on the size of
    the target--that $400 billion that has been assigned to the
    Department of Defense?
        Secretary Gates. I was informed about it the day before it
    was announced.
        Senator Collins. My concern, Mr. Chairman, is, I believe
    that military requirements have to drive the budget, and not
    the other way around. And----
        Secretary Gates. I will say this, though, Senator. When I
    was informed, I did get immediate agreement that this--before
    any specific budget decisions were made--this comprehensive
    review that the chairman and I have been talking about, would
    be carried out, that we would present options to the President
    and to the Congress that shows relative levels of risk of
    different kinds of cuts and changes in the force structure. So,
    there was agreement immediately to that review before specific
    decisions were made.
        Senator Collins. Thank you. It still seems backwards to me,
    as far as the targets given. You're going to assess the risk of
    various scenarios to meet the target, but that, to me, is the
    opposite of the way we should be proceeding.
        Admiral Mullen, let me switch just quickly to Libya, and
    ask you a question. I personally have a lot of concerns about
    our involvement in Libya and the transition from it being a
    humanitarian exercise, to the goal of having Colonel Gaddafi
    leave and relinquish power.
        Let's assume that that does happen, that Colonel Gaddafi
    does give up power. The Transitional National Council is made
    up almost exclusively of the eastern Libyans, I'm told. And I
    believe it's a real question, whether or not that council could
    effectively govern the country, given the intense regional
    rivalries and tribal nature of Libyan society. But also, I'm
    concerned that we're not really certain who we're dealing with.
        Do you feel confident that we have a plan for what we would
    do post-Gaddafi?
        Admiral Mullen. Just having come out of both Egypt and also
    Europe last week, I'm actually encouraged that there are
    countries and organizations, NATO being one, that are very
    specifically looking at--What after Gaddafi? Because I think we
    need to do that.
        I'm more encouraged, more confident that the more we learn
    about the TNC--and in fact, I also see them now linking to the
    West more than they had in the past--that there are, you know,
    civilian leaders and military leaders who recognize the
    challenge that you just described.
        What I don't, or, I just haven't seen yet, is the kind of
    comprehensive collective view of how they would run the
    country. I think they recognize that internally. Their focus on
    this is improving, but I think we're sort of at the beginning
    of that, and that there is an awful long way to go. So, I'm
    more positive than I was a few weeks ago. There's an awful lot
    that's being brought to the table in terms of international
    focus on this from our government, as well as many governments.
    But I still think we've got a long way to go.
        Secretary Gates. One of the actions taken by the NATO
    defense ministers last week was to resolve that NATO would not
    be in the lead in any kind of a transition, but also that the
    Secretary General would be in communication with the contact
    group and the United Nations, and tell them that it's our view,
    as NATO Defense Ministers, that the planning for this
    transition should get underway now--not wait until Gaddafi
    falls.
        Senator Collins. Thank you.
        And thank you both for your service.
        Chairman Inouye. Thank you very much.
        Senator Murkowski.
        Senator Murkowski. Thank you, Mr. Chairman.
        Gentleman, thank you both for your service.
        Secretary Gates, I, too, echo the high praise that we all
    have for you and for your efforts.
        Speaking about Afghanistan now, going back from Libya
    here--as we deal with the reality of a drawdown coming ahead,
    and the numbers, and all the discussion that goes on there, I'm
    going to make it a little more parochial. We had several
    thousand troops with the 1st Stryker Brigade Combat Team of the
    25th Infantry up in Fort Wainwright just deploy. They moved out
    just this past month. And the concern that I'm hearing from
    some of the folks up North is, well, okay, we want to be in
    that phase where we are withdrawing and coming out of
    Afghanistan. But we're concerned that our loved ones, who have
    just now gone in, are going to be on the back end of that
    withdrawal, so you will have these forces moving out.
        You've mentioned that between now and 2014, the amount of
    money that we will see going into Afghanistan will be, sounded
    pretty dramatically reduced. What assurances can you give to
    those who are just now going into Afghanistan, and who will be
    there through the end of this next year, that their situation
    is not increasingly riskier?
        Secretary Gates. I would make two points. First of all, the
    reduction in cost in Afghanistan, beginning in fiscal year 2013
    and beyond--so fall, let's say, of 2012--is, really correlates
    to the level of troop drawdowns. And so, the amount of money
    that is saved is associated with the number of troops that we
    have in country, not by any skimping on the support----
        Senator Murkowski. Okay.
        Secretary Gates [continuing]. Or the enablers that we have
    there to support the troops we have.
        Second, I have had conversations with the President about
    this, and I will tell you that he and I are both committed
    that, whatever decisions are made, the foremost consideration
    will be to ensure that whatever steps are taken do not put the
    troops that are leaving at greater risk, or the troops that are
    remaining at greater risk.
        Senator Murkowski. Okay. I appreciate that.
        Let me ask you a question about Guam. In light of where we
    are with the budget issues, you responded to a question about,
    to Senator Mikulski, about the overseas bases in Europe. But,
    in light of what we're seeing with the tightening budgets, can
    we expect any significant changes, perhaps in the current
    direction, with regards to the buildup in Guam? Are we going to
    meet that 2014 completion date, that target that has been set,
    given what the cost estimates are at this point in time?
        Secretary Gates. Senator, in all honesty, as I mentioned
    earlier, Secretary Clinton and I will be meeting with the
    Japanese on Monday and Tuesday, and quite honestly, I'll have a
    better answer to your question after we have that meeting.
        Senator Murkowski. Okay. We look forward to that.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you very much.
        Senator Murray.
        Senator Murray. Thank you very much, Mr. Chairman.
        Secretary Gates, Admiral Mullen, it's been a great pleasure
    to work with both of you, and I want to thank both of you for
    your tremendous service to this country. It is very much
    appreciated at a very challenging time.
        And Secretary Gates, I look forward to you coming home to
    our home State at some point, and continuing that relationship.
    But, I know you must be looking forward to that.
        Secretary Gates. Fifteen days.
        Senator Murray. Hopefully, the weather's better when you
    get there than it has been.
        Secretary Gates, last Friday, I visited the National Naval
    Medical Center up in Bethesda and had an opportunity to talk
    with a number of our wounded warriors, and their providers and
    caregivers. And as you well know, many of these service members
    have sacrificed life and limb in Afghanistan, and we, as a
    country, are going to be taking care of them, and their
    families, not just today, not just when they return home, for
    but a lifetime.
        As chairman of the Senate Veterans Affairs Committee, I
    take this issue very seriously, and I've been trying to draw
    attention to some of the all too often unseen costs of war, and
    thinking about how we should consider that as part of our
    decision in any long-term conflict.
        I think you know the major components of this long-term war
    have had real and significant impacts. Death from suicides
    among veterans and service members from the war are now on par
    with combat deaths; many of our warriors are facing difficult
    challenges with mental healthcare, as you well know, when they
    return home; and a lot of our service members have served now
    not just two, three or four, but sometimes even five times, and
    the costs of these are real.
        So, while we all talk a lot on this subcommittee about
    rebuilding projects, and Afghan aid, and military resources,
    and all the costs and components of a defense system, I wanted
    to ask you today what you and the Pentagon consider to be the
    biggest costs of this war to our wounded warriors and their
    families--particularly, those costs that we'll be paying for
    for a very long term; and whether that is ever considered in,
    those costs are factored in, when we are making decisions about
    drawing down in Afghanistan.
        Secretary Gates. I would, I mean, I think it is self-
    evident that the costs are exactly as you've described them, in
    lives that are shattered, in bodies that are shattered, in
    minds that are shattered.
        I would tell you that one of the things that we've done
    over the last 2 to 3 years is to ensure that all of the funding
    that we have gotten in the past in supplementals and overseas
    contingency operations, dealing with family programs, and with
    some of the medical research we were talking about, and care
    for our wounded warriors--that all of that money has been
    shifted into the base budget, knowing that we will deal with
    this problem for many, many years to come. So, from our part--
    in addition to Virginia--we have tried to make sure that these,
    the funds for these programs have been protected, and will be
    protected in the future.
        But it, I cannot say that decisions in terms of drawdowns
    or military strategy are made bearing in mind the cost of the
    soldiers and sailors, airmen and marines, who suffer. It is on
    the minds of everybody who makes those decisions. But, by the
    same token, it is the nature of war, and it is, frankly, one of
    the reasons why, as I told an interviewer a couple of weeks
    ago, I feel like I've become more conservative, more cautious
    about when we use force, because I've seen the consequences up
    front.
        But Admiral Mullen has devoted a huge amount of effort to
    this. He probably ought to say something.
        Senator Murray. Admiral Mullen.
        Admiral Mullen. Senator, first of all, I just appreciate
    your leadership on this because it has to, it has to have a
    voice. And, I actually believe we're just beginning to
    understand the costs.
        Your units--very specifically, I'll use Fort Lewis. I mean,
    we're now, we have more soldiers and airmen at Joint Base
    Lewis-McChord than we've ever had, and they're going to be home
    for a couple of years. Many of those units have had only 1 year
    between deployments up to now. Now, they're going to have two.
    And, I think they've been compartmentalizing challenges, and
    they're going to start unpacking that. And it's going to be
    pretty tough now, that we're back home, and addressing, the
    leadership focusing on addressing the challenges that will come
    with that.
        Medically, in the PTS-TBI world in particular, the more
    quickly we get at the problem, the less likely the damage, or,
    the damage is reduced significantly. And yet, there's still a
    great deal on the TBI side that we don't understand.
        Senator Murray. And it's changing, by the way.
        Admiral Mullen. Right.
        Senator Murray. When soldiers are home after 3 years, and
    we're finding the impacts are different 3 years later----
        Admiral Mullen. Right.
        Senator Murray [continuing]. And they're coming back into
    the system.

                               MILITARY FAMILIES

        Admiral Mullen. Right. There are time bombs set up that we
    know are out there. We just don't know when they're going to go
    off.
        The relationship that the Pentagon has with the Veterans
    Administration (VA) and with communities throughout the country
    has got to get stronger. And we've worked that in ways to try
    to focus on that. And where you and Chairman Inouye and others
    can help is, when we get into budget crunches like this, this
    incredible amount of money that we put into family programs,
    into medical research--it's some of the first money that budget
    types like to take out, historically. We like airplanes before
    we would keep our family programs intact. That's something the
    Secretary of Defense and I have talked about. And, unless we
    watch that very carefully, it will not be there when we need
    it. And so, we have to have it in a way that it is sustained
    over time. Because I think these costs are longstanding. We
    don't understand them as well as we should--not just for our
    members, but also, for our families. We see that time and time
    again.
        Our families have become as much, almost as much as part of
    our readiness, as anything else. And it wasn't that way 10 or
    15 years ago. Always critical. But, without them we would be
    nowhere in these wars.
        And so, leaders have to continue to focus on--what are
    these costs? And, I thought you said it very well--It is to
    repay this debt for the rest of their lives. And we need to
    stay with them, so that we understand what that means.
        Secretary Gates. I would just say that I've told the
    service secretaries and the chiefs to fence two areas in all of
    these budget exercises that we're going through. One is
    training, and the other is all of our family programs, that I
    don't want any money taken out of those.
        Senator Murray. Well, I appreciate that very much. And I do
    think we have to really seriously be considering this, because
    it does impact our troops today. But, it also impacts our
    ability in the future for the next big one, if we've depleted
    all of our resources, and we are not taking care of our folks.
        Admiral Mullen. The other thing--and I know that you know,
    Senator Murray--is, we are, we did it in Vietnam, and we are
    doing it again. We're generating a homeless generation; many
    more homeless female vets, because they're now, I think a
    quarter of a million have served in Iraq and Afghanistan
    incredibly well. And if we're not careful, we'll do the same
    thing we did last time--and we'll pay for them long-term, when
    an up-front investment would really make a difference right
    now. Everybody's got to be----
        Senator Murray. Because we're about to make some of the
    same mistakes we made after the Vietnam war.
        Admiral Mullen. We are.
        Senator Murray. And this country will be paying for it 20
    years from now.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Senator Hutchison.
        Senator Hutchison. Well, thank you, Mr. Chairman.
        And I will add to what has been said already. Washington
    State's gain is Texas' loss. We would take you back in a
    heartbeat if you would come, because you did a great job at
    Texas A&M, and the Bush Library and School.

                               MILCON BUDGET CUTS

        I want to go back to Senator Mikulski's line of
    questioning. We have had an overseas base closing commission.
    And after the last American BRAC, we had the overseas BRAC that
    was going in the same track, and it was decided to bring 70,000
    troops back from certain foreign locations--Germany and Korea
    especially, and then Guam, of course, in question. And now we
    are looking, Mr. Secretary, at a Fort Bliss military
    construction project that has just been completed this year,
    that would take one of the BCTs that was designated to come
    back from Germany--it is prepared and ready for taking that BCT
    from Germany. But, the Department changed the previous decision
    that was going to bring back two BCTs from Germany, to just
    basically say, we're not sure yet. So, you've got the Milcon
    that has been done in America--about $450 million worth--to
    take one BCT back, and on the five-year plan for military
    construction, there is $1 billion to be done in Germany.
    Germany contributes 7 percent of the cost of our Milcon, as
    compared with Japan, that contributes 40 percent.
        So, I would just ask you, as you are leaving in your last 2
    weeks, if you can give serious consideration to the fact that
    we don't get an effort from Germany--$1 billion of military
    construction for changing Army headquarters and bases--couldn't
    that money be saved, rather than saving it out of either
    personnel, or healthcare, or weapons systems that would
    modernize for our troops in America? Can't we take $1 billion
    out of Milcon that was supposed to be taken care of in a
    previous administration? It just seems like there's a
    disconnect from what Senator Mikulski was suggesting, and what
    seems to be an opportunity here.
        Secretary Gates. The President's decision on the posture in
    Germany was that we would come down from four brigade combat
    teams to three. Where the uncertainty is, is in the Army, in
    terms of whether that fourth BCT in 2015-2016 is simply
    disbanded, or whether, in fact, it comes back to the United
    States. The only Milcon that I'm aware of in Germany is the
    consolidation of command, control, communications, computers,
    and intelligence at Weisbaden. The original budget for that was
    $482 million. One-half of that has already been spent. There is
    no money for it, as I understand, in the fiscal year 2012
    budget, but then, there is about another $150 million between
    2013 and 2016.
        So, we'll go back and take another look at that piece of
    it. But, the decision was not made just by the Department of
    Defense, but by the President--that we would, in fact, come
    down by one BCT in Germany.
        Senator Hutchison. The original proposal was two.
        Secretary Gates. Right.
        Senator Hutchison. And in the interim time, I think we all
    believe, or, I'll speak for myself, and, along the lines of
    what you talked about in Europe last week--the Germans have
    fewer than 5,000 troops in Afghanistan. They have rules of
    engagement that are very restrictive. And I would just ask you
    to look at, and perhaps work with the incoming secretary, to
    determine if it is in our best interest to have the places
    ready at Fort Bliss for a BCT? And with the lack of German
    effort, is it in our best interest to keep three BCTs there,
    rather than two, which had been the previous decision?
        And, I certainly support having joint efforts, and working
    with our partners. But, you yourself have said our partners are
    not stepping up to the plate as they should. And I agree with
    you. So, I would just ask if, in your last 2 weeks, you could
    look at this, and could work with Secretary Panetta, to
    determine if it is in our best interests, with the lack of
    effort that the Germans make in Milcon, and the lack of effort,
    frankly, in our NATO alliance, and with the preparation that's
    already been made--$450 million in Milcon here to take the new
    troops back--I'd just ask if you would look at it one more
    time.
        Mr. Secretary, I still have time, if I could just, if
    you're not going to answer that question, then I would just ask
    if we could, if you could elaborate on your view of NATO. And,
    you said that some NATO is better than no NATO. Is there
    something that we could do proactively, besides encouraging our
    allies to be more of a player, an equal player, that would make
    the NATO alliance more effective?
        Secretary Gates. Well, I think one thing where the Congress
    could make a contribution is that, I know that the Congress has
    a variety of parliamentary exchanges with European
    legislatures. And, I think just voicing, both in those
    exchanges, but also, publicly, essentially the message that I
    delivered last week--that the American people are going to
    become increasingly skeptical about this alliance if the United
    States has to bear three quarters of the burden.
        Chairman Inouye. Thank you.

                         ADDITIONAL COMMITTEE QUESTIONS

        Mr. Secretary and Admiral Mullen, thank you very much for
    your candid testimony, but more importantly, for your service
    to our Nation. Your astute vision, and ability to quickly
    implement your vision through others, is a testament to your
    leadership ability, and this Nation is truly in your debt for
    turning the tide in Iraq and Afghanistan, and setting the stage
    for a withdrawal. So, on behalf of the subcommittee, we wish
    you the very best as you transition to the next phase.
        And we will have written questions submitted, if we may.
        Because of the time limitation, we're not able to go
    through the questions and answers.
        [The following questions were not asked at the hearing, but
    were submitted to the Department for response subsequent to the
    hearing:]
                Questions Submitted by Senator Dianne Feinstein
                                    pakistan
        Question. In the wake of the death of Osama bin Laden and
    Pakistan's claims that they had no knowledge of his whereabouts, and
    the ousting of United States military trainers from Pakistan, I
    question our financial relationship with Pakistan and their commitment
    to our partnership.
        Secretary Gates, this week you sat down with an interview with the
    Associated Press and urged patience with Pakistan. You have seen
    Pakistan's actions over the past few months. When should our patience
    with Pakistan run out?
        Answer. The United States relationship with Pakistan is far from
    ideal, but we should be working to improve the relationship. Although
    our respective views on how best to counter regional security
    challenges are not always congruent, we do have shared interests in a
    stable South Asia. A comprehensive long-term partnership with Pakistan,
    however, is not just in the interest of regional security, but in the
    United States national security interest as well. Therefore, the United
    States needs to work with Pakistan to overcome the tensions currently
    straining the relationship.
        First, let me be clear that we have seen no evidence that senior
    Pakistani leaders were aware of Osama Bin Laden's whereabouts or
    involved in harboring him. Nevertheless, the raid in Abbottabad has
    created an opportunity for Pakistan's leadership to make choices that
    advance United States and Pakistani shared interests in eradicating
    terrorist networks threatening both countries' interests.
        Since the raid on May 2, senior members of this administration,
    including Secretary Clinton and Admiral Mullen, have had very frank
    discussions with Pakistani civilian and military leadership to make
    clear that the United States will not tolerate safe-havens for
    terrorists, and to urge decisive steps to expand existing United
    States-Pakistani counterterrorism cooperation. In conversations with
    Pakistan's leaders, the administration has been unambiguous regarding
    its expectations for clear, verifiable, and sustained action against
    terrorists operating in Pakistan. Progress on this front will be
    beneficial for Pakistan's security, and will also demonstrate
    Pakistan's commitment to a positive and enduring relationship with the
    United States.
        The fact remains that Pakistan's cooperation is central to United
    States and coalition efforts to defeat al Qaeda and prevent its return
    to the region. Pakistan's participation will also be integral to
    achieving a durable political solution in Afghanistan. More broadly,
    Pakistan is the sixth most populous country in the world, with a
    majority of its population under the age of 30. It possesses nuclear
    weapons, has unresolved border issues with its neighbors, and a weak
    economy. These are just some of the factors that make continued United
    States engagement with Pakistan so important. So even when the United
    States relationship with Pakistan is strained, I believe we should
    continue to communicate clearly our commitment to a long-term
    relationship that is supportive of both countries' interests, and that
    the United States will not ``abandon'' Pakistan or disengage from the
    region.
        Question. What more can we do to improve our relationship with
    Pakistan?
        Answer. Our relationship with Pakistan is currently being tested.
    In Islamabad, and here in Washington, people are asking if both sides
    can maintain an effective partnership. I believe we can. The recent
    turbulence in the United States relationship with Pakistan, although
    troubling, is not insurmountable.
        Pakistan's Government and people harbor concerns that our
    engagement in the region will not extend beyond what is required for
    the success of the United States mission in Afghanistan. Pakistan's
    strategic importance, however, goes beyond United States objectives in
    neighboring Afghanistan. A stable, prosperous, and democratic Pakistan
    is critical to long-term regional prosperity and security. Therefore
    the United States must demonstrate its commitment to a sustained
    partnership with Pakistan that both addresses and extends beyond
    immediate security threats to both countries. Such a commitment does
    not mean we are locked into a specific menu or level of assistance
    funding, but does require that effective and needed assistance be
    available when the two countries' interests intersect.
        Question. Last week General Ashfaq Kayani said in a statement that
    U.S. assistance now being spent to support the military is more
    urgently needed for ``reducing the burden on the common man.'' Why
    should we continue to fund military operations in Pakistan?
        Answer. Pakistan's strategic importance is related to both the
    United States mission in Afghanistan and broader regional and
    international security interests. And although the United States-
    Pakistan relationship is not perfect, I do believe it is vital that the
    United States continues to advance a lasting partnership with Pakistan
    in order for it to increase its stability and prosperity over the long
    term. Cooperation--including civilian, law enforcement, and military--
    on shared security interests is a necessary component of this
    partnership.
        Since September 11, 2001, Pakistan has been a key partner in the
    fight against terrorism that threatens both countries. In partnership
    with the Government of Pakistan, we have made significant progress
    toward disrupting, dismantling, and ultimately defeating al Qaeda. U.S.
    security assistance has directly enabled Pakistan to conduct its
    counterinsurgency campaign against violent extremists in Pakistan more
    effectively. Our assistance has also allowed for greater Pakistani
    cross-border coordination with International Security Assistance Force
    (ISAF) and Afghan Forces, which has reduced the space in which al Qaeda
    and other militants intent on attacking United States, Pakistani, and
    Afghan interests can operate. Specifically, the Department of Defense
    (DOD) ``train-and-equip'' efforts, supported by the Pakistan
    Counterinsurgency Fund/Pakistan Counterinsurgency Capability Fund, are
    central to United States efforts to build the capacity of the Pakistan
    military and paramilitary forces to enable Pakistan to defeat the
    insurgents within its borders. Coalition Support Fund reimbursements
    also remain a critical enabler in combating terrorism and helping
    Pakistan to sustain its forces in their operations to reduce safe
    havens.
        In short, continued United States support to Pakistan's military
    operations against violent extremists is a clear national security
    interest. Pakistan has made progress against militants operating in its
    territory, though the gains remain tenuous, and the Pakistan military
    has struggled to ``hold'' and ``build'' in the areas it has cleared. In
    all, Pakistan has sacrificed more than 11,000 military personnel in
    this fight, and has also lost upwards of 30,000 civilian lives to
    continued insecurity. So long as Pakistan continues to advance shared
    security objectives, we should continue our support.
                                   detainees
        Question. The DOD currently has hundreds of individuals detained in
    Afghanistan that will, at some point, need to be transferred to Afghan
    control, released, charged, or held by the United States in a different
    kind of detention regime than they are at Bagram (now called Parwan).
        What is the Department's plan for handling these detainees in the
    long run?
        Answer. Drawing on our experiences in Iraq will help to ensure that
    the transition in Afghanistan is accomplished responsibly. United
    States forces will remain involved until the Government of Afghanistan
    has the trained personnel and infrastructure to be able to assume
    detention operations. Further, as necessitated by the presence of
    United States and coalition forces who are conducting operations in
    concert with Afghan forces to defeat the Taliban, al Qaeda, and
    associated forces, United States forces may need to maintain some
    detention capacity in Afghanistan, pursuant to the law of war, as long
    as military operations continue.
        Question. What is your assessment of the Afghan justice system and
    its ability to adjudicate these cases?
        Answer. The formal Afghan justice system is still developing.
    Primary issues include a shortage of adequately trained, educated, and
    compensated judges and attorneys, limitations and gaps in the Afghan
    legal code, and in some cases a lack of political will to try,
    prosecute, and incarcerate national security threats in a transparent
    and influence-free manner.
        In support of its goals, the United States--under the leadership of
    the Department of State--conducts a broad range of programs that aim to
    increase the capacity of the Afghan justice system. DOD provides
    support to these efforts through the Combined Joint Interagency Task
    Force 435 (CJIATF-435) and its subordinate command, the Rule of Law
    Field Force--Afghanistan (ROLFF-A).
        Although CJIATF-435 is primarily responsible for United States
    Government detention operations in Afghanistan, CJIATF-435 also trains
    Afghan military police detention guards, and mentors Afghan national
    security prosecutors in preparation for the conditions-based transition
    of detention operations in Afghanistan. CJIATF-435 also has made
    progress in discussions with Afghan officials about a national security
    legal framework that will be necessary for a complete transition to
    Afghan authority.
        Question. How do you compare the status of the Afghan justice
    system to the Iraqi justice system that the United States has helped
    build up?
        Answer. The Iraqi judicial system has historically been more
    advanced than the formal Afghan judicial system, reflecting a more
    centralized and urbanized state and higher literacy and education
    levels in Iraq. In contrast, rural Afghans, who comprise a significant
    majority of the population, often make use of their own community
    justice systems that are outside the purview of the Afghan Government.
        United States forces, in concert with civilian partners, have
    provided support to both the Iraqi and Afghan justice systems,
    including building physical capacity and training correctional
    officials. The United States also has provided training to Iraqi and
    Afghan investigative judges regarding the use of evidentiary files
    prepared to support criminal charges brought against detainees held by
    United States forces. In both countries, we have endeavored to develop
    rule of law systems that are adapted to, and sustainable within, the
    distinct cultural contexts of Afghanistan and Iraq.
                                  afghanistan
        Question. There has been a lot of discussion lately about the
    United States presence in Afghanistan and what the drawdown of forces
    there should look like. I am a supporter of a conditions based drawdown
    and do not want to see a hasty withdrawal jeopardize the gains that we
    have made. That being said, I think that because we are 10 years after
    9/11 we need to emphasize that this is not going to be an open-ended
    operation.
        What progress has been made in determining the specific plan for
    withdrawal and how involved has the Afghan Government been in
    determining the metrics to evaluate the withdrawal plans?
        Answer. As you know, during his December 2009 speech at West Point,
    President Obama specified that the surge would not be open-ended, and
    that he would reduce U.S. surge forces beginning in July 2011 based on
    conditions on the ground. The United States strategy in Afghanistan is
    working as designed, and the beginning of a drawdown of the surge
    forces this July is part of that strategy. The momentum has shifted to
    coalition and Afghan forces, and together these forces have degraded
    the Taliban's capability, achieved significant security gains,
    especially in the Taliban's heartland in the south, and set the
    conditions for beginning the transition of security for provinces and
    districts to Afghan lead.
        The United States is working very closely with the Government of
    Afghanistan on the transition process, which will ultimately put the
    Afghan National Security Forces in the lead of security nationwide by
    the end of 2014. The growth of the Afghan National Security Forces
    (ANSF) in quality and quantity over the past 18 months, including the
    additional 100,000 new personnel, is a key part of the progress to date
    that enables the initiation of the transition and the drawdown of U.S.
    forces. The President will take these factors into consideration when
    making his decision about the size and pace of the drawdown.
        Question. Are the Afghans in agreement on the metrics that should
    be used?
        Answer. The Afghans understand that President Obama will decide on
    the size and pace of the drawdown of our surge forces, and that it will
    be based on conditions on the ground. They recognize the substantial
    progress achieved over the past 18 months, including the progress in
    the growth and quality of their own forces and the reversal of the
    Taliban momentum that makes the initiation of the drawdown and the
    transition of several provinces and districts to Afghan security lead
    possible.
        The United States, with our allies, is in the process of building a
    350,000-man ANSF. There has been some conflicting reporting on the
    quality of that force, specifically the Afghan National Police. There
    are increasing reports of infiltrators and Afghan servicemembers
    turning their weapons on coalition forces. I am concerned that we are
    focusing on quantity and not quality.
        Question. How is Afghanistan going to build the security force it
    needs, and will they have the resources to maintain a National Army?
        Answer. The NATO Training Mission--Afghanistan, working closely
    with the Afghan Ministry of Defense and Afghan Ministry of the
    Interior, has made substantial progress over the past 18 months in
    growing the Afghan National Army (ANA) and Afghan National Police (ANP)
    while also improving their quality. U.S. forces and the Afghan
    Government have also helped establish the Afghan local police, which
    are increasingly denying the insurgents' access to rural populations.
    Although there have been instances of infiltration and Afghan
    servicemembers turning their weapons on coalition forces, as well as
    cases of insurgents mimicking the ANA or ANP, overall reporting from
    the coalition units who partner with the ANSF reflects continued
    improvement in the capability and performance of the fielded ANSF.
        Efforts are underway to ensure the long-term sustainability of the
    ANSF. The sustainment effort is in two areas, fiscal and human capital.
    NTM-A and ISAF are scrutinizing all aspects of contracting,
    infrastructure development, equipping, and sustainment to find cost
    savings. Examples include an ``Afghan First'' contracting policy that
    employs Afghan constructions standards, ensuring designs meet cultural
    and socio-economic norms, and are sustainable by Afghan maintenance
    capabilities. In order to set Afghans on the track to self-sustainment,
    DOD and its United States Government partners are working with the
    Afghans to increase revenue generation through activities such as
    collecting taxes from border stations. We project that by 2017 the
    Afghans will be spending $1.25 billion of their own funds on operations
    and maintenance, up from a projected $690 million in 2013. Regarding
    human capital we have been working to develop institutional
    professionalism and individual Afghan capacity across a broad range of
    functions within the force, including operations, leadership
    development and accountability, literacy, gender integration programs,
    transparency and development of an Afghan instructor corps. Our
    literacy training program has just reached a milestone in that the
    100,000th ANSF trooper has successfully completed a literacy course.
        Developing the ANSF remains a central element of our strategy in
    Afghanistan, and sustaining the ANSF will be an essential means of
    securing the results that so many have sacrificed to achieve. While
    Afghanistan's own resources will grow over time, it is also true that
    the international community will need to help sustain the ANSF for some
    time to come. To that end, I recently renewed my challenge to other
    ISAF members that they contribute 1 billion Euros annually to the NATO
    Afghan Nation.
        Question. What is the coalition doing to ensure we are building a
    quality security force that will serve the Afghan people?
        Answer. Coalition forces are heavily focused on improving the
    quality of the ANSF--not just its size--so that the ANSF can operate
    more independently and the Coalition can successfully transition
    security lead to the Afghans. Up until June, the primary focus was on
    building a force to provide immediate security. In June 2011, the last
    of the 97 Infantry Kandaks were fielded. This has allowed ISAF to shift
    its focus to professionalizing the force and building sustainment
    capability. Coalition initiatives to improve quality include partnering
    with ANSF units in the field, programs geared toward increasing
    literacy rates, and addressing leadership shortfalls.
        As of May 31, advisors partner with or mentor 148 of 156 Afghan
    National Army units and 223 of 239 Afghan National Police units.
    Embedded coalition military personnel live and fight with their ANSF
    partners, which enables coalition forces to provide additional on-the-
    job training, prevent and address corruption, and demonstrate how a
    professional military conducts its operations.
        Literacy training has also improved ANSF performance and morale and
    the NATO Training Mission--Afghanistan projects more than 50 percent of
    the ANSF will achieve third-grade literacy by 2012. A more literate
    force will increasingly allow the Afghans to develop the necessary
    enablers and combat support systems to develop self-sufficiency.
        Officer and noncommissioned officer (NCO) leader shortfalls have
    been a key impediment in the quality development of the ANSF, but
    leader gaps are also closing. Officer Candidate School, the National
    Military Academy, and strengthened NCO training programs, combined with
    improved Afghan Ministry of Interior and Defense personnel policies
    that are addressing problems of attrition and retention, are enabling a
    new generation of better trained and qualified ANSF officers to ascend
    in the leadership ranks.
                                      iraq
        Question. The U.S.-Iraqi Security Agreement will result in the
    departure of United States military forces from Iraq by the end of
    2011. Both of you have testified that, if asked by the Government of
    Iraq to do so, the United States should keep United States armed forces
    personnel in Iraq. In the absence of that, the Department of State will
    be assuming several of the missions now being conducted by the United
    States military.
        What is your assessment of the likelihood that the Government of
    Iraq will ask United States military forces to stay? By what date would
    that request need to be made?
        Answer. We intend to abide by our commitments in the 2008 U.S.-Iraq
    Security Agreement. The United States would be willing to consider a
    limited United States military presence should the Iraqi Government so
    request; however, to date, no such request has been made. For planning
    purposes, we would like to receive any such request from Iraq as soon
    as possible.
        It remains unclear whether the Iraqi Government will request a
    post-2011 U.S. military presence beyond the Office of Security
    Cooperation--Iraq (OSC-I). The OSC-I will operate under Chief of
    Mission authority and facilitate the transition from a military-led to
    a civilian-led mission by continuing to support development and
    modernization of the Iraqi Security Forces (ISF).
        Question. Do you both still agree that United States forces should
    stay in Iraq if asked?
        Answer. I believe it is in our mutual interest to have a limited
    U.S. military presence to help address ISFs' needs and gaps, if
    requested by the Iraqi Government.
        Question. What types of forces and what mission should they have if
    they do stay?
        Answer. We intend to abide by our commitments in the 2008 U.S.-Iraq
    Security Agreement. There are a number of areas where the ISF could
    benefit from additional assistance, such as intelligence fusion, air
    sovereignty, combined arms training, and sustainment and logistics.
    However, any post-2011 U.S. military presence would require a formal
    request from the Iraqi Government, which we would be willing to
    consider. To date, no such request has been made.
        Question. How limited can our presence be and remain effective?
        Answer. Any discussion of specific military personnel numbers and
    footprint at this point would be premature, as any post-2011 U.S.
    military mission would require a formal request from the Iraqi
    Government. To date, no such request has been made.
        Question. In your assessment, what effect will the departure of
    United States military forces have on the stability of Iraq?
        Answer. The ISF are currently functioning well as a counter-
    insurgency force and demonstrating the capability to maintain internal
    security and stability in Iraq. We believe an increase in security
    incidents is possible, but within the capacity of the ISF to handle.
        Question. Will a complete withdrawal jeopardize the progress we
    have made in the region?
        Answer. We believe an increase in security incidents is possible.
    However, ISF have the capacity to counter potential increases in
    security incidents.
        In a recent hearing by the Commission on Wartime Contracting, the
    State Department indicated that it will spend close to $3 billion on
    security forces in Iraq if the U.S.-Iraqi Security Agreement is
    enforced.
        Question. Would keeping United States military forces in Iraq be
    more cost effective than having the Department of State contract out to
    accomplish their expanded missions and their security?
        Answer. It is premature to speculate on any potential cost savings
    for the Department of State from a potential post-2011 United States
    military presence in Iraq. Any post-2011 U.S. military mission would
    require a formal request from the Iraqi Government, which we would be
    willing to consider. To date, no such request has been made.
                                     libya
        Question. This month, NATO agreed to extend the mission in Libya
    for 90 days until the end of September. Press reporting indicates that
    Gaddafi has no intention of peacefully stepping down from power and the
    United Kingdom's most senior naval officer, Admiral Stanhope, said this
    week that the campaign has been a strain on UK forces and big
    compromises will have to be made if the operations are extended any
    longer than 6 months.
        How much money are we spending every day on this campaign?
        Answer. If the current tempo of support operations continues
    through September 30, 2011, the DOD estimates it will spend $1.1
    billion in fiscal year 2011, or approximately $3 million a day from now
    to the end of the fiscal year. The amount pays to fund military
    personnel pay costs, travel and sustainment of personnel, operations
    (e.g., flying hours), expended munitions, supplies, airlift, drawdown
    of DOD supplies (up to $25 million), and a small amount for lift and
    sustainment costs for coalition partners supporting operations in
    Libya. The DOD spent more per day at the beginning of the campaign due
    to a higher level of kinetic operations.
        Question. If NATO terminates the campaign in September and Gaddafi
    is still in power, is there a plan?
        Answer. It is unlikely that NATO will terminate Operation UNIFIED
    PROTECTOR (OUP) until the Gaddafi regime complies with the criteria
    adopted at the April 14 NATO Foreign Ministers' Meeting:
      --All attacks and threats of attack against civilians and civilian-
            populated areas have ended;
      --The regime has verifiably withdrawn to bases all military forces,
            including snipers, mercenaries and other paramilitary forces,
            including from all populated areas they have forcibly entered,
            occupied or besieged throughout all of Libya; and
      --The regime must permit immediate, full, safe, and unhindered
            humanitarian access to all the people in Libya in need of
            assistance.
        This resolve was reiterated on June 8, when NATO and Partner
    Defense Ministers issued a statement extending operations for a further
    90 days from June 27, 2011. If, for some reason, NATO does not continue
    OUP into the fall, it is highly likely that a small coalition of
    capable allied and partner nations would continue the mission in Libya.
    Again, we find the scenario of NATO terminating operations to enforce
    U.N. Security Council Resolutions 1970 and 1973 highly unlikely.
                                     china
        Question. We have all been watching as the Chinese military
    continues to expand and modernize their military. We have seen
    concerning developments with the ``carrier killer'' missile and the J-
    20 stealth fighter. There are numerous open-source reports of the
    Chinese Army conducting cyber attacks on U.S. entities. Additionally,
    the Chinese continue to flaunt international norms with respect to
    their assertive attempts to expand their maritime territorial claims in
    the East and South China Sea.
        Can you please give us your assessment on the capabilities and
    intentions of the Chinese military?
        Answer. China appears to be building the capability to fight and
    win short-duration, high-intensity conflicts along its periphery. The
    country's near-term focus appears to be on preparing for potential
    contingencies involving Taiwan, including possible U.S. military
    intervention. Its modernization efforts emphasize anti-access and area
    denial capabilities. China is also devoting increased attention and
    resources to prepare to conduct operations beyond Taiwan and China's
    immediate periphery. Beijing's growing focus on military missions other
    than war includes humanitarian assistance, noncombat evacuation
    operations, and counter-piracy support. Lastly, China is strengthening
    its nuclear deterrent and enhancing its strategic strike capabilities
    through modernization of its nuclear forces and improving other
    strategic capabilities such as space and counter-space operations and
    computer network operations. Recent public revelations about its
    advanced fighter program and aircraft carrier underscore the progress
    it is making.
        Question. Can you expand on how the Chinese military expansion has
    affected regional stability?
        Answer. China's economic growth has increased the country's
    international profile and influence, and enabled its leaders to embark
    upon and sustain a comprehensive transformation of the country's
    military forces. China's continued investment in programs designed to
    improve extended-range power projection has the potential to make
    positive contributions in the delivery of international public goods--
    such as peacekeeping, disaster relief, and counter-terrorism
    operations--but also increases Beijing's options for military coercion
    to gain diplomatic advantage, advance its interests, or resolve
    disputes in its favor. The pace and scale of China's military
    modernization, coupled with the lack of transparency, raise many
    questions, both within the United States and the Asia-Pacific region as
    a whole, about China's future intentions.
        In addition, China's recent assertive behavior in the South China
    Sea has raised concerns in the region, reinforcing littoral states'
    appreciation for a robust and sustained United States presence.
    Multiple competing territorial claims have existed for decades, but
    China is increasingly confident in asserting its claims in the
    resource-rich region. Although not a claimant to any territory in the
    region, the United States has interests in the South China Sea, and we
    remain committed to the stability and prosperity of Southeast Asia as
    reflected in our extensive bilateral and multilateral engagements and
    defense activities with regional allies and partners.
        Question. Are our forces, particularly those forward based in the
    Pacific Command area of responsibility prepared to counter these
    threats?
        Answer. The U.S. forward presence in the region has played a key
    role in ensuring decades of stability in Asia. The United States will
    continue to be globally postured to secure our homeland and citizens
    from direct attack and to advance our interests around the world.
    Although there are many demands on our forces in the Asia-Pacific, the
    fiscal year 2012 defense budget ensures that we will remain prepared to
    meet challenges and fulfill our security commitments in the region.
        The fiscal year 2012 budget proposal would make a number of
    investments that would enhance the ability of U.S. forces to project
    power into the Asia-Pacific region and elsewhere. Chief among these is
    the commencement of a new long-range bomber program.
        We have worked with--and will continue to work with--our regional
    allies and partners to maintain peace and ensure stability throughout
    Asia. With the fiscal year 2012 budget, we intend to enhance our
    forward presence in the Pacific as the most critical region for long-
    term U.S. security. We will make a number of investments to ensure the
    DOD has the necessary capabilities to project power into the Asia-
    Pacific region and elsewhere if necessary. Examples include:
      --expanding future long-range strike capabilities;
      --exploiting advantages in subsurface operations;
      --increasing the resiliency of U.S. forward posture and base
            infrastructure;
      --ensuring access to space and the use of space assets;
      --enhancing the robustness of key Command, Control, Communications,
            and Computers, Intelligence, Surveillance, and Reconnaissance
            (C\4\ISR) C\4\ISR capabilities; and
      --enhancing the presence and responsiveness of U.S. forces abroad.
                               taiwan arms sales
        Question. I have expressed concerns in the past about additional
    United States arms sales to Taiwan. Admiral Willard testified at the
    PACOM hearing before this Committee that the military balance in the
    Straits of Taiwan has shifted to the mainland. In my view, we would
    best advance our national interest of peace in Asia by pursuing a goal
    to reduce military posture across the Taiwan Strait.
        What significant action could China take to ease its military
    posture in the strait in a manner that was substantive enough for the
    Pentagon to consider or reconsider the future arms sales to Taiwan?
        Answer. We welcome steps taken by both sides of the Taiwan Strait
    to improve relations. We remain committed to our one China policy based
    on the Three Joint U.S.-PRC Communiques and the Taiwan Relations Act.
    Our one China policy has been consistent for the past eight United
    States administrations. In accordance with the Taiwan Relations Act, we
    do not support independence for Taiwan, but at the same time, the
    United States makes available to Taiwan defense articles and services
    necessary to enable Taiwan to maintain a sufficient self-defense
    capability. If the environment changed, the relationship between China
    and Taiwan continues to improve, and over time, the security
    environment for Taiwan changed, then this would potentially create the
    conditions for reexamining this issue. Of course, this would be an
    evolutionary and a long-term process.
        It is difficult to identify specific steps or actions that could
    change our assessment of Taiwan's defense needs. Actions such as
    removing forces, halting the missile buildup, reducing missile
    stockpiles, or establishing a policy rejecting the reunification of
    China by force would be welcomed steps that could be taken by the
    People's Republic of China (PRC) to improve the security environment.
    However, the Department's assessment of Taiwan's defense needs is not
    predicated on a single Chinese action or even the combination of
    several actions. Our calculus is based on our understanding of the
    totality of the security environment, which not only includes actions
    taken by the PRC, but also those taken by Taiwan.
        In the interim, the DOD will continue to monitor military trends in
    the Taiwan Strait and work with the authorities on Taiwan as they
    pursue defense reform and modernization to improve the Taiwan's ability
    to defend against an attack from the mainland. Organizational reforms,
    improvement in joint operations, the hardening of infrastructure and
    weapons systems, and long-term acquisition management are all
    significant steps that will enhance Taiwan's security.
        Question. Can you identify major steps that the PRC could take,
    such as removing forces, halting the missile build up, reducing the
    missile stock, or establishing a policy rejecting reunification of
    China by force, which could change our assessment of Taiwan's defense
    needs?
        Answer. It is difficult to identify specific steps or actions that
    could change our assessment of Taiwan's defense needs. Actions such as
    removing forces, halting the missile buildup, reducing missile
    stockpiles, or establishing a policy rejecting the reunification of
    China by force would be welcomed steps that could be taken by the PRC
    to improve the security environment. However, the Department's
    assessment of Taiwan's defense needs is not predicated on a single
    Chinese action or even the combination of several actions. Our calculus
    is based on our understanding of the totality of the security
    environment, which not only includes actions taken by the PRC, but
    those taken by Taiwan.
        As documented in the Department's ``Military and Security
    Developments Involving the People's Republic of China'' annual reports
    to Congress, we remain concerned about the pace and scope of China's
    military buildup including its short- and medium-range ballistic
    missiles, cruise missiles, submarines, surface combatants, advanced
    fighter aircraft, integrated air defense systems, and space and cyber
    capabilities. We also remain concerned about the lack of transparency
    surrounding the development of these capabilities.
        In the interim, the DOD will continue to monitor military trends in
    the Taiwan Strait and work with the authorities on Taiwan as they
    pursue defense reform and modernization to improve the Taiwan's ability
    to defend against an attack from the mainland. Organizational reforms,
    improvement in joint operations, the hardening of infrastructure and
    weapons systems, and long-term acquisition management are all
    significant steps that will enhance Taiwan's security.
                                  acquisitions
        Question. Cost over-runs and delays seem to plague the Defense
    acquisitions program. The Joint Strike Fighter alone is projected to
    cost 80 percent more than the initial estimates and 30 percent more
    than when the baseline cost was redefined 4 years ago, and I am sure it
    is not the only program in this situation. In the current fiscal
    environment, it is becoming increasingly difficult to justify these
    extreme costs.
        What concrete steps are being taken to reform the acquisitions
    program and when can we expect to see results?
        Answer. On September 14, 2010, with my input and support, Dr.
    Carter, the Under Secretary of Defense for Acquisition, Technology and
    Logistics (USD(AT&L)), launched an initiative called ``Better Buying
    Power'' (BBP). In it, we issued a set of 23 points that indicated how
    we were going to ``get more without more.'' We are implementing BBP
    aggressively and are already experiencing savings on current programs.
        On November 3, 2010, Dr. Carter issued BBP guidance for the Service
    Secretaries and Directors of the Defense Agencies indicating that
    affordability will be treated as a requirement at all Milestones and
    Decision Points for our programs, and program managers will be required
    to demonstrate affordability before being granted Milestone Authority
    to proceed with a program. Independent cost estimates will be used to
    evaluate what a program will cost based on historical data, but program
    managers have been instructed to manage based on what a program should
    cost. The ``should cost'' method is already being used to drive down
    future costs in all acquisition programs.
        Another facet of the BBP initiative is incentivizing productivity
    and innovation in industry partly through use of fixed-price incentive
    (firm target) contracts, where appropriate, where the reward for saving
    as well as the burden of risk is appropriately shared with the
    contractor. The Department is also renewing its commitment to small
    business by increasing its goals and investments and placing greater
    emphasis on new technology.
        In line with President Obama's March 2009 memorandum on Government
    contracting, the BBP initiative promotes real competition as the most
    powerful tool the Department has to drive productivity. The USD(AT&L)
    requires program managers to present competitive strategies to him,
    even when there is not a traditional head-to-head competition. In those
    cases, we will harness competitive energy at the subcontract level
    where contractors can approach program managers with value engineering
    change proposals to achieve program goals in the most cost-effective
    manner.
            counternarcotics spending in mexico and central america
        Question. While the State Department is the primary U.S. agency
    providing security assistance to the Mexican and Central American
    Governments, according to a July 2010 report from the Government
    Accountability Office (GAO), ``In Mexico and Central America, the
    Department of Defense provides support to U.S. and foreign agencies
    with counternarcotics responsibilities which has increased in recent
    years and is separate from that provided under [the] Merida
    [Initiative].''
        How much Defense Department funding will support the Mexican and
    Central American Governments in their counternarcotics efforts in
    fiscal year 2012?
        Answer. The President's budget request for fiscal year 2012
    includes approximately $75.5 million in DOD counternarcotics support to
    Mexico; $4 million for Belize; $9 million for Guatemala; $2.7 million
    for Honduras; $2.1 million for El Salvador (excluding funds to operate
    and maintain the U.S. Navy's Counternarcotics Forward Operating
    Location in Comalapa, El Salvador); $2.7 million for Nicaragua; $2.6
    million for Costa Rica; and $8.2 million for Panama.
        Question. What will that funding be used for?
        Answer. U.S. Department of Defense counternarcotics (DOD CN)
    support includes training, equipment, infrastructure, and information
    sharing. DOD CN programs complement State Department-led security
    cooperation programs, principally the Merida Initiative with Mexico and
    the Central America Regional Security Initiative.
        Cooperation with Mexico concentrates on helping Mexican forces
    improve their tactical and operational proficiency, as well as air
    mobility, maritime law enforcement, communications, and reconnaissance
    capacities. Training includes air operations and maintenance,
    helicopter pilot training, rule of law, tactics for urban and night
    operations, logistics/resources management, maritime operations, ship
    maintenance and repair, search-and-rescue and lifesaving, and
    operational planning. Training includes an emphasis on intelligence-
    driven and interagency operations as well as incorporating principles
    of respect for human rights. Equipment includes rigid hull inflatable
    boats, communications equipment, nonintrusive inspection scanners,
    aircraft avionics and sensors, and navigation equipment.
        Cooperation with Central America includes building and equipping
    maritime forward operating sites, maintenance facilities, land border
    crossing control posts and related facilities; providing intercept
    boats, night vision equipment, radar equipment, ground vehicles,
    ballistic flotation vests and other equipment; providing operational
    support for partner country maritime interdiction; and training, which
    incorporates an emphasis on respect for human rights.
        In addition to providing direct support to foreign security forces,
    DOD CN operates, supports, or employs U.S. intelligence, radar,
    communications, computer, air and sea lift, counterdrug detection and
    monitoring, technology development, and related activities. Since these
    DOD activities help reduce drug trafficking and related threats to
    partner countries as well as the United States, they may in part be
    considered indirect support to those countries. This includes the work
    of Joint Task Force--North (JTF-N), which supports drug law enforcement
    agencies in the United States with an emphasis on the United States-
    Mexico border region, and Joint Interagency Task Force--South (JIATF-
    S), which conducts interagency and international counterdrug detection
    and monitoring operations. El Salvador also hosts a critical DOD CN
    Forward Operating Location to detect and monitor suspected drug
    trafficking.
        Question. How do you coordinate security funding for these
    countries with other U.S. agencies?
        Answer. Policy and strategic coordination are conducted by the DOD
    primarily through Interagency Policy Coordination (IPC) committees and
    related processes chaired by the national security staff which include
    the Office of National Drug Control Policy and the Office of Management
    and Budget (OMB). A variety of working groups support the IPC process.
    DOD requests for Drug Interdiction and Counterdrug Activities
    appropriations are coordinated with other agencies through OMB. DOD
    does not request specific levels of appropriation for CN cooperation
    with foreign countries, but allocates funding from the total
    appropriation provided.
        DOD CN support to foreign countries is requested by U.S. Military
    Groups (or equivalents) after coordination with the U.S. Embassy
    country team. DOD CN support may only be considered if requested by an
    appropriate official of a department or agency that has counter-drug
    responsibilities, as well as by an official of the recipient country.
    Proposals are forwarded to the geographic combatant command (GCC) for
    validation and prioritization and then to the Joint Staff and the
    Office of the Secretary of Defense for consideration. U.S. Northern
    Command and U.S. Southern Command are also responsible for JTF-N and
    JIATF-S respectively, while the U.S. Navy is responsible for the CN
    Forward Operating Location (FOL) in Comalapa, El Salvador. While JTF-N,
    JIATF-S, and FOL Comalapa do not provide capacity-building support to
    foreign countries, they conduct CN detection and monitoring,
    information-sharing, and related international cooperation.
        The Deputy Assistant Secretary of Defense for Counternarcotics and
    Global Threats (DASD CN>) conducts consultations with military
    commands, the Armed Services, Defense agencies, and other U.S.
    Government agencies to ensure that activities are prioritized and
    funded in line with policy and to make budgetary adjustments. Those
    processes are supplemented by a variety of working groups, program
    reviews, and similar mechanisms. The DASD CN> coordinates CN policy
    within DOD and other agencies, and provides policy, program, and
    budgetary guidance and oversight to the military commands, Armed
    Services, and Defense agencies which execute DOD CN activities.
                                     ______

               Questions Submitted by Senator Barbara A. Mikulski
        Question. Since 1997, there have been 74 Nunn-McCurdy breaches
    involving 47 major defense acquisition programs. The Government
    Accountability Office has identified proven management practices--many
    of which have been incorporated into Department of Defense (DOD)
    policy, but have yet to be fully implemented in practice--that can
    serve as tools to prevent DOD cost overruns. Greater adherence to
    practices at key phases of the acquisition process can help reduce
    weapon system costs, contain pressures for increased funding, and
    better address critical warfighter needs.
        What is being done within the DOD to incorporate better acquisition
    practices?
        Answer. With my support and input the Under Secretary of Defense
    for Acquisition, Technology and Logistics (USD(AT&L)) launched the
    Better Buying Power (BBP) initiative to reform the way we do business,
    affecting all of our acquisition programs. Treating affordability as a
    requirement and applying this standard at every milestone decision will
    have huge impacts to the Department's overall savings and will prevent
    cost overruns. Similarly, the Department's mandatory use of
    competition--even when there is not a traditional head-to-head
    situation--and requiring program managers to present a competitive
    strategy will have profound effects on the cost of weapon systems. The
    Department has set the goal of increasing the amount of contract
    obligations competitively awarded every year.
        The BBP initiative includes various other significant strategies to
    reduce nonproductive processes and bureaucracy, to incentivize
    productivity and innovation in industry, and to improve tradecraft in
    services acquisition, each with detailed focus areas and goals.
        Question. How does the DOD plan to incentivize acquisition program
    managers and contractors to drive down acquisition costs?
        Answer. Since early last year, Dr. Carter, USD(AT&L), has been
    working with the Component Acquisition Executives (CAEs) to craft and
    implement a series of initiatives geared toward gaining greater
    efficiencies and productivity. On September 14, 2010, he issued a
    memorandum for acquisition professionals, ``Better Buying Power (BBP):
    Guidance for Obtaining Greater Efficiency and Productivity in Defense
    Spending.'' He provided additional guidance with an implementation
    memorandum for the CAEs on November 3, 2010. These memoranda establish
    a framework for the enterprise to institutionalize the BBP reforms.
        To incentivize contractors, we are increasing our use of fixed-
    price-type contracts with incentives structured to reward performance
    and share risks more equitably between Government and industry. Dr.
    Carter and Mr. Hale, the Under Secretary of Defense (Comptroller), have
    jointly issued guidance addressing conditions when savings are
    realized. The intent is to seek and eliminate low-value-added
    ingredients of program cost and to reward those doing so. Program
    managers' and Program Executive Officers' performance will, in part, be
    evaluated on this basis. Realized savings may mean additional resources
    to enhance their programs, for example, by freeing up funds to buy more
    warfighting capability or quantities. For industry, it means sharing in
    savings realized in the form of increased profit and enhanced corporate
    recognition for delivering value.
        Question. How will the Department measure success in achieving
    reform of its acquisition process?
        Answer. The Department is measuring success by implementation of
    the BBP initiative across the Department's acquisition programs. This
    implementation will result in quantifiable savings for the Department.
        The BBP initiative mandates treating affordability as a
    requirement. Program managers must establish an affordability target as
    a Key Performance Parameter equivalent for all ACAT I Milestone
    programs. The 100 percent application of this standard at all Milestone
    decisions will result in savings. For example, by conducting
    engineering tradeoff analysis with the commencement of the Ohio-class
    replacement--for example, examining the submarine design and evaluating
    what could be changed in the interests of lowering costs--the Navy has
    already reduced the estimated average procurement cost by 16 percent,
    with a goal of reaching a 27 percent reduction. This savings would not
    have been achieved without making affordability a requirement.
        As a part of the BBP initiative, the Department is increasing the
    use of competition to control costs of goods and services. Again,
    success in this initiative will be measured by implementation; for
    instance, every ACAT program milestone acquisition strategy must
    contain a competitive strategy for evaluation at each milestone review.
    Another measurable competition goal of the Department is to increase
    the amount of contract obligations competitively awarded by 1 percent
    every year.
        We expect each program to have aggressive goals. These goals will
    be tracked and monitored to ensure implementation and to harvest and
    share good ideas with broader applicability.
        Continued aggressive application of the BBP initiative will
    continue to bring measurable success in terms of real cost savings to
    the Department.
        Many aspects of wounded warrior care in the military healthcare
    system is in need of reform. The Dole-Shalala Report on military
    healthcare reform has still not been fully implemented. Many wounded
    warriors still find that the Medical and Physical Evaluation Board
    process takes too long, is too adversarial, and is duplicative with the
    VA process. Less than 40 percent of active, reserve, or guard members
    were even ``somewhat'' satisfied with the disability evaluation system
    and less than 50 percent said they ``completely'' or ``mostly''
    understood the system.
        Question. What is the status of implementing the Dole-Shalala
    Report recommendations pertinent to the reform of the military health
    system?
        Answer. The Dole-Shalala recommendation to reform the disability
    evaluation system requires considerable legislative action to fully
    implement. In the meantime, the DOD and VA have implemented new
    processes to improve and coordinate what was previously two separate
    disability evaluation systems, while preserving DOD's requirement for
    determining fitness for military duty and the VA's requirement to
    compensate for disabling conditions as a result of military service.
    Both Departments are committed to use existing authorities to reform
    and continuously improve existing processes.
        Question. What is DOD's goal for implementing a single disability
    evaluation system with the VA that will ensure when wounded warriors
    are discharged, they do not have to wait months with mo income or
    support to access the VA medical system?
        Answer. In order to address the challenges in the prior systems
    created to address disability evaluation for our wounded warriors, the
    Integrated Disability Evaluation System (IDES) (a joint DOD/VA program)
    was created beginning in November 2007. The DOD goal is that IDES will
    be available at all Military Treatment Facilities (MTFs) by September
    2011. The IDES combines two previously separate and sequential systems
    (the military Disability Evaluation System and the VA Compensation &
    Benefit process) into one concurrent process. This simplifies
    Disability evaluation processes, eliminates duplicate disability
    examinations and ratings and places VA counselors (Military Service
    Coordinators (MSCs)) in MTFs to ensure a smooth transition to Veteran
    status. This eliminates the benefits gap, provides a VA disability
    rating, (amount of benefits they will receive from VA) before leaving
    the service and provides a more simple, seamless, fast and fair
    Disability Evaluation System for servicemembers.
        The US Family Health Plan (USFHP) designed by the Congress in 1996
    provides the full TRICARE Prime benefit for military beneficiaries in
    16 States and the District of Columbia for more than 115,000
    beneficiaries. Beneficiaries are highly satisfied with this healthcare
    option. In 2010, more than 91 percent of USFHP beneficiaries were
    highly satisfied with the care they received, making it the highest-
    rated healthcare plan in the military health system. The fiscal year
    2012 President's budget request includes a proposed legislative
    provision that future enrollees in US Family Health Plan would not
    remain in the plan upon reaching age 65.
        Question. Shouldn't DOD be using USFHP as a model to improve access
    to care and achieve better health outcomes? How are you planning to
    utilize the experience of USFHP in expanding these principles across
    the military health system for all beneficiaries?
        Answer. Yes, DOD is currently using USFHP as a model. US Family
    Health Plans, like all TRICARE contractors, have embraced the following
    goals: improved health, a positive patient experience, and responsible
    management of the costs; all in support of the central aim of assured
    military readiness. Their emphasis on preventive care, disease
    management, and enrollment of 30,000 of their 115,000 TRICARE
    beneficiaries in Patient Centered Medical Homes is significant. All
    TRICARE programs now offer preventive care with no copays; disease
    management programs are widely available for those diagnosed with
    chronic illness; and hundreds of thousands of TRICARE patients across
    the Nation are enrolled in Medical Home practices.
        The President's budget initiative would limit enrollment of any new
    patients older than age 65 under the current financial structure. In
    planning to utilize the experience of USFHP in expanding these
    principles across the military health system for all beneficiaries, we
    have encouraged USFHP leaders to continue to care for these patients
    under Medicare and TRICARE for Life. We expect the early investment in
    prevention will result in greater wellness later in life, independent
    of the payment model; that loyal patients will choose to remain with
    their doctors; and the Federal Government will still accrue important
    savings.
        The most recent data for those older than age 65, our dual-eligible
    DOD/Medicare population, shows that satisfaction with the TRICARE For
    Life benefit is equal to the satisfaction of USFHP enrollees. We
    anticipate that this satisfaction will remain equivalent for the long
    term.
        Question. DOD has proposed that, after a certain date, Medicare
    eligible beneficiaries will no longer be able to enroll in USFHP. What
    is DOD's plan to reach out to, and work with CMS and the USFHPs to
    explore options that ensure continuity of care for those beneficiaries?
        Answer. The Department's primary concern is the effect of this
    proposal on the beneficiaries, and we believe that there will be no
    impact on continuity of care. The following plan details how DOD will
    work with CMS and the USFHP's to explore options to ensure continuity
    of care.
        Current enrollees will be grandfathered into the program and will
    see no change in their coverage. For those who enroll in the USFHP in
    the future, they would be transitioned to TRICARE For Life (TFL) upon
    reaching age 65, consistent with other TRICARE Prime enrollees. Under
    TFL, beneficiaries will receive comprehensive healthcare coverage with
    minimal out-of-pocket expenses.
        Although Medicare becomes the primary payer when beneficiaries age
    out of Prime, with TFL paying the difference, USFHP providers accepting
    Medicare can continue to see and treat TFL beneficiaries.
        Providers can also continue to manage care and referrals for their
    primary care patients as well as offer disease management and
    prevention program which are hallmarks of quality patient care.
        The Department remains deeply committed to the continued success of
    the USFHPs. These six plans, covering approximately 115,000 of our 9.6
    million beneficiaries, are a valued part of our military healthcare
    system. We will continue to work with the USFHPs on behalf of all of
    our patients to meet the goals of improved health, a positive patient
    experience, and responsible management of the costs.
                                     ______

                  Questions Submitted by Senator Patty Murray
                     minimum essential security conditions
        Question. The President has made it clear that he intends to
    withdraw troops from Afghanistan in the coming months, and while I am a
    supporter of this drawdown, I am concerned with the security situation
    on the ground for our remaining forces.
        What are the minimum essential conditions in Afghanistan that can
    sustain stability with a minimum level of support from the United
    States and other countries?
        Answer. The ability to transition provinces and districts to Afghan
    security lead while reducing the support required of the United States
    will depend first and foremost on the readiness and capability of
    Afghan forces to provide security to the population relative to the
    threat in each area. Governance and development are also crucial as
    they are ultimately the keys to providing secure communities the basic
    levels of services and economic opportunity that will keep them
    resistant to insurgency. Continuing progress and efforts to dismantle
    and defeat al Qaeda and to degrade the insurgency are also essential to
    achieving these conditions. Finally, we are negotiating a strategic
    partnership with Afghanistan that will help ease uncertainty in the
    region by underscoring the continued United States interest in and
    commitment to Afghanistan's stability and security.
                         joint electronic health record
        Question. However, the agreement to develop a joint electronic
    health record is only one step in a very difficult multi-step process.
        What steps have you taken to ensure that the progress you have made
    on the joint electronic health record continues, and is ultimately
    successful, once you leave the Department?
        Answer. I have taken critical steps with Secretary Shinseki to
    ensure forward progress on the integrated electronic health record
    (iEHR).
      --At the highest departmental levels, we have reaffirmed our
            commitment, to jointly chair recurring oversight meetings and
            are establishing a robust governance structure which is
            essential to the continued success of the iEHR.
      --A critical component of this governance structure is the iEHR
            Advisory Board, which will include clinical proponents
            appointed by the Assistant Secretary of Defense Health Affairs,
            Service Surgeons General, and their clinical counterparts from
            the VA.
      --Additionally, a Program Executive and the Deputy Director will be
            selected jointly by the SECDEF and the Secretary of Veterans
            Affairs (VA). The Program Executive will make decisions related
            to requirements, design methodologies, application priorities,
            implementation schedule, and deployment sequence.
                    integrated disability evaluation system
        Question. Just last week, I met with an amputee at Bethesda who has
    been in the process of getting his Medical Evaluation Board (MEB)
    completed since January. This is a young man who was severely injured
    several years ago and is ready to leave the service and begin the next
    phase of his life. Six months is much too long for a servicemember to
    languish in this process.
        Will the Department of Defense commit to looking at the overall
    issue of MEB timeliness and come back with a plan to improve the
    process?
        Answer. Yes, DOD agrees that such delays for our transitioning
    servicemembers are unacceptable. The Department is committed to not
    only looking at the MEB timeliness but to improving it.
                                wounded warriors
        Question. I am concerned about the human cost of this war. We have
    invested more than $421 billion in combat operations, but this war is
    fought by people. Last Friday I met with Corporal Todd Nicely, 1 of 3
    quadruple amputees from the wars in Iraq and Afghanistan.
        What efforts are underway to better address the injuries faced by
    dismounted troops?
        Answer. The Department's efforts are underway to continuously study
    the injuries from the current conflict and more effective ways to treat
    them. For example:
      --The Armed Forces Medical Examiner reviews all fatalities to
            document cause of death and assesses the performance of
            personal protective equipment (PPE) to document its
            effectiveness and opportunities for improvement. The Services
            are continually looking for ways to improve PPE to prevent
            injury.
      --Combat trauma surgical teams are continually improving their
            techniques for care. Stateside surgical teams are enhancing
            limb salvage techniques and improving amputation care.
      --The U.S. Army Surgeon General (SG) recently appointed the
            ``Dismounted Complex Blast Injury Task Force'' which has
            studied the causation, prevention, protection, treatment, and
            long-term care options of these more serious and complex battle
            injury patterns. The Task Force was comprised of clinical and
            operational medical experts from the Departments of Defense
            (DOD) and Veterans Affairs (VA) and solicited input from
            subject matter experts in both Federal and civilian sectors.
            Efforts to act upon these recommendations of the Task Force are
            ongoing.
        Question. Will the DOD commit to working with Secretary Shinseki to
    collaboratively improve the ability of the VA to address some of the
    new prosthetics provided to servicemembers? I am concerned the VA is
    receiving these amputees into their system and they do not have the
    capacity to properly service their new limbs.
        Answer. Yes, the DOD is committed to working with Secretary
    Shinseki. There is already close coordination between the two agencies
    to ensure we meet the needs of our wounded warriors. Our Center of
    Excellence for Extremity Injuries and Amputations will offer
    opportunities to share best practices and technical innovation in
    rehabilitation. Two of the current activities between VA and DOD to
    improve prosthetic care are:
      --evaluation of the new highly technical prostheses and the
            ``legacy'' less complicated devices; and
      --creating a joint network of prosthetic care to improve service
            delivery for servicemembers and veterans.
        Oversight of this collaborative work is conducted by the VA/DOD
    Joint Executive Council, composed of leaders from both agencies and the
    Services.
        In addition to our collaborative work on prosthetics, VA and DOD
    participate in many additional joint activities, including processes to
    share healthcare resources, development of clinical practice
    guidelines, joint facility planning, information sharing and electronic
    health record development, integrating the disability evaluation
    systems, improving transitions and coordination of care, and suicide
    prevention efforts. Both agencies are committed to ongoing and
    developing collaborative strategies and coordinated efforts to assist
    servicemembers and veterans.
                                     ______

                 Questions Submitted by Senator Mitch McConnell
        Question. What is the Department of Defense doing to recover
    missing U.S. military personnel in the Global War on Terror?
        Answer. Searching for and rescuing captured servicemembers in the
    Global War on Terror are top priorities for the U.S. military. U.S. and
    coalition forces, along with the Intelligence Community and other
    agencies, continue to make every effort to facility this recovery. Upon
    their return, these servicemembers will undergo a methodical process
    designed to assist those who have experienced the ordeals of capture
    and captivity. In addition, we continue to assist family members during
    this difficult period.
        Question. Please explain the purpose behind the recently directed
    project #1892/AT&L 10-402 Rand Study entitled ``A review of the
    Department of Defense's Plans to Disposal of its Existing Stockpile of
    Chemical Weapons.'' It was reported that $500,000 was spent on this
    project. Please provide the project's justification and cost.
        Answer. The purpose of the RAND Study was to conduct an independent
    review of DOD plans for completing destruction of the remaining
    stockpiles of chemical weapons. Specific areas of review included
    identifying potential schedule and cost efficiencies, determining
    whether the planned acquisition strategy is most advantageous for
    meeting the Government's treaty obligations and other national
    priorities, and examining the current organizational construct of the
    chemical demilitarization program. The study was a key element in
    identifying performance and schedule risks leading to congressional
    notification of a Nunn-McCurdy breach.
        Increased program cost projections justified the review, which will
    ensure appropriate steps are taken to maximize efficiencies in
    completing destruction of the remaining U.S. chemical weapons
    stockpile.
        The RAND Study cost $502,000.
        Question. Please explain why the study ``A review of the Department
    of Defense's Plans to Disposal of its Existing Stockpile of Chemical
    Weapons'' does not mention communication with the Citizens Advisory
    Commissions at either ACWA site when these Commissions were
    specifically established under Public Law 102-484, subtitle G, section
    172 to receive citizen concerns regarding the chemical weapons disposal
    program.
        Answer. The RAND National Defense Research Institute, a federally
    funded research and development center, was commissioned to conduct an
    objective independent review of DOD plans for completing destruction of
    the remaining stockpiles of chemical weapons. The specific tasks
    originally assigned to RAND were:
      --Task 1: Review the pending (January 2010) contract between the
            Government and the Bechtel-Parsons contractor team for the next
            construction phase of the Blue Grass Army Depot;
      --Task 2: Conduct a detailed examination of the acquisition strategy/
            business plan for the ACWA program and provide recommendations
            for improvement;
      --Task 3: Analyze the Government's management structure for running
            the ACWA and U.S. Army Chemical Materials Agency (CMA)
            programs; and
      --Task 4: Describe an appropriate close-out plan for CMA sites.
        During the study effort, Task 4, which would have more directly
    involved the Citizens Advisory Commissions, was de-scoped to allow RAND
    to allocate more resources to Task 2.

                              SUBCOMMITTEE RECESS

        Chairman Inouye. So, the subcommittee will reconvene on
    Wednesday, June 22, at 10:30 a.m. for our last hearing, and
    we'll close our books then.
        The subcommittee stands in recess.

        [Whereupon, at 12:35 p.m., Wednesday, June 15, the
    subcommittee was recessed, to reconvene at 10:30 a.m.,
    Wednesday, June 22.]

           DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2012

                                  ----------

                            WEDNESDAY, JUNE 22, 2011

                                           U.S. Senate,
                                   Committee on Appropriations,
                                                        Washington, DC.
        The subcommittee met at 10:39 a.m., in room SD-192, Dirksen
    Senate Office Building, Hon. Daniel K. Inouye (chairman)
    presiding.
        Present: Senators Inouye, Cochran, and Shelby.

                           NONDEPARTMENTAL WITNESSES

                 OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE

        Chairman Inouye. First, I'd like to apologize to all of you
    for this lateness. Last night we were deluged with
    thunderstorms, and I live in Rockville, Maryland. It took me 2
    hours to get in. No traffic lights, and American drivers
    without traffic lights.
        So I'd like to welcome all of you to this hearing to
    receive testimony pertaining to the various issues related to
    defense appropriations requests. Because we have so many
    witnesses, I will have to remind the witnesses that they will
    be limited to 4 minutes apiece. I'm sorry about that.
        At this point I'd like to recognize my vice chairman,
    Senator Cochran.

                       STATEMENT OF SENATOR THAD COCHRAN

        Senator Cochran. Mr. Chairman, thank you. It's a pleasure
    to join you in welcoming the witnesses to the hearing. We
    appreciate your interest in our work and it will make a
    contribution to helping improve our national security and the
    work we do here in supporting our military forces and related
    interests around the world.
        Chairman Inouye. Our first witness is Dr. Matthew King of
    the American Thoracic Society. Dr. King.
    STATEMENT OF MATTHEW KING, M.D., ON BEHALF OF THE
                AMERICAN THORACIC SOCIETY
        Dr. King. Mr. Chairman, members of the subcommittee: Thank
    you for hearing me today. My name is Matt King. I'm a pulmonary
    physician in Nashville, Tennessee, and I've worked at both
    Vanderbilt University and the Nashville Veterans Administration
    (VA) Hospital with military personnel and veterans.
        I'm testifying today on behalf of the American Thoracic
    Society, which is a medical professional organization dedicated
    to the prevention, treatment, and cure of lung disease. Many of
    the members of the American Thoracic Society work in the
    military and with the VA, and as such we've become deeply
    concerned with the respiratory issues that some of our military
    personnel are suffering.
        There is a real cause for concern here. As you may have
    read in the New York Times over the weekend, there have been
    several studies reporting a startling number of respiratory
    disorders in our military personnel returning from Iraq and
    Afghanistan. In fact, military personnel that have served in
    Iraq and Afghanistan are reporting severe respiratory diseases
    at a rate seven times higher than people who are serving
    elsewhere.
        Studies have documented increases in asthma, fixed
    obstructive lung disease, allergic rhinitis, and several other
    rare pulmonary disorders. I personally have been involved in a
    study that's going to be published next month of 50 veterans
    returning from Iraq and Afghanistan that have a rare incurable
    pulmonary disease caused constrictive bronchiolitis. These
    patients often have normal pulmonary function tests, but,
    despite their normal tests, are having severe respiratory
    symptoms.
        We don't know exactly why, but Iraq and Afghanistan
    veterans are exposed to a number of inhalational insults,
    ranging from dust storms to inhaled smoke from burn pits to
    aerosolized metal and chemicals from exploding improvised
    explosive devices (IEDs), blast overpressure or shock waves to
    the lung, outdoor allergens such as date pollen, and indoor
    allergens such as the mold aspergillus. We think many of these
    are contributing. We've identified many respiratory illnesses,
    but we really don't know the scope of the problem.
        So there are several questions: What are the key causative
    agents? How many veterans are experiencing this disease? What
    is the best way to identify and treat the servicemen and women?
    Attention is needed to address these and other important
    questions.
        The American Thoracic Society recommends the following
    steps: All service men and women should have pre- and post-
    deployment pulmonary function testing. The Department of
    Defense (DOD) and VA should support projects to establish a
    more comprehensive normative pulmonary function test database
    used to evaluate military men and women. The DOD and VA should
    jointly create and fund a program to study the respiratory
    exposures that may be contributing to these respiratory
    illnesses. Potential goals of this kind of research program
    could include identifying the exact agents to which people are
    exposed and that may be causing the illnesses, considering
    potential population-based and individual interventions that
    could prevent or at least reduce exposure to these causative
    agents, and supporting research and to improve prevention,
    detection, and treatments for deployment-related respiratory
    diseases.
        Also, the DOD and VA should consider establishing centers
    of excellence to enhance research and clinical treatment of
    these service men and women that are returning with deployment-
    related respiratory illnesses.
        Finally, we believe that the DOD and VA should create a
    standard administrative approach to determining respiratory
    disability for the Operation Iraqi Freedom and Enduring Freedom
    service personnel.
        Thank you. The American Thoracic Society appreciates the
    opportunity to testify here. I'd be happy to answer any
    questions.
        [The statement follows:]
                     Prepared Statement of Dr. Matthew King
        The American Thoracic Society appreciates the opportunity to
    testify before the Senate Department of Defense Appropriations
    Subcommittee regarding the fiscal year 2012 budget.
        The American Thoracic Society is a medical professional society of
    over 15.000 members who are dedicated to the prevention, detection,
    treatment and cure of respiratory, sleep and critical care related
    illnesses. Our physicians, nurses, respiratory therapists and basic
    scientists are engaged in research, education and advocacy to reduce
    the worldwide burden of respiratory diseases.
        Many members of the American Thoracic Society service as
    researchers and clinicians in the U.S. military and at VA medical
    centers. As such, we are deeply concerned about the respiratory health
    of U.S. military personal.
        And there is cause for concern.
        A surprising number of returning service men and women from Iraq
    and Afghanistan are experiencing moderate to server respiratory
    diseases. There are several anecdotes of military personal who were
    elite athletes--marathon runners, road cyclists--before deployment are
    no longer able to complete the 2 mile physical readiness run. Even more
    puzzling, is in many cases, these service men and women have normal
    pulmonary function text values. Despite having normal pulmonary
    function test values, these service members severely de-saturate during
    exercise.
        Physicians have described a new disease called Iraq-Afghanistan War
    lung injury (IAW-LI), among soldiers deployed to these countries as
    part of Operation Iraqi Freedom, Operation Enduring Freedom, and
    Operation New Dawn. Not only do soldiers deployed to Iraq and
    Afghanistan suffer serious respiratory problems at a rate seven times
    that of soldiers deployed elsewhere, but the respiratory issues they
    present with show a unique pattern of fixed obstruction in half of
    cases, while most of the rest are clinically reversible new-onset
    asthma, in addition to the rare interstitial lung disease called
    nonspecific interstitial pneumonitis associated with inhalation of
    titanium and iron.
        Iraq and Afghanistan veterans are faced with a barrage of
    respiratory insults, including: (1) dust from the sand, (2) smoke from
    the burn pits, (3) aerosolized metals and chemicals from exploded IEDs,
    associated with (4) blast overpressure or shock waves to the lung, (5)
    outdoor aeroallergens such as date pollen, and (6) indoor aeroallergens
    such as mold aspergillus. Researchers have experimentally exposed mouse
    models to samples of the dust taken from Iraq and Afghanistan and found
    that it produces extreme histological responses, underscoring the
    severe exposures that these soldiers undergo.
        A case series study was recently presented at the American Thoracic
    Society international conference by Robert Miller, MD, of Vanderbilt
    University. Dr. Miller discussed a cohort of patients with constrictive
    bronchiolitis who were deployed in Iraq.
        While clinicians and researchers have defined the condition, there
    is much we don't know. There are uncertainties regarding the number of
    service men and women who are experiencing deployment related
    respiratory illnesses. Complicating both clinical and research efforts
    is that fact that deployed troops do not receive pre and post
    deployment pulmonary function tests--in this case a simple spirometry
    test--that would help doctors know the extent of lung damage.
        Further challenges include the spectrum of possible lung diseases
    that may be occurring from Southwest Asia exposures, such as asthma,
    constrictive bronchiolitis, acute eosinophilic pneumonia and
    rhinosinusitis, and the variability in exposures that may confer risk,
    including particulate matter from desert dusts, burn pits, vehicle
    exhaust and tobacco smoke.
        Clinicians face a different set of challenges with this patient
    population, including the role of targeted medical surveillance in
    determining need for further respiratory diagnostic evaluation, and,
    importantly, the role of surgical lung biopsy in clinical diagnosis of
    post-deployment lung disease.
        Attention is needed to address the respiratory illnesses suffered
    by returning service men and women. The ATS recommends the Department
    of Defense and the Department of Veterans Affairs take the following
    steps:
      --The American Thoracic Society recommends all military personal
            deployed in combat receive a pre- and post-deployment pulmonary
            function test.
      --Support projects to establish more comprehensive normative
            pulmonary function test values for military men and women.
      --The Department of Defense and the Department of Veterans Affairs
            jointly create and fund a program to study respiratory
            exposures of servicemen and women deployed in Iraq and
            Afghanistan. Potential goals of this joint research program
            could include:
        --Identify likely agents responsible for respiratory illnesses of
                returning OEF and OIF personal;
        --Consider potential population based and individual interventions
                to prevent or reduce exposure to causative agents; and
        --Support research into improved prevention, detection and
                treatments for deployment-related respiratory disease.
      --Establish Centers of Excellence to facilitate improved research and
            clinical treatment of service men and women experiencing severe
            deployment-related respiratory illnesses.
      --The Department of Defense and the Department of Veterans Affair
            consider administrative standardized approaches to determining
            respiratory disability for deployment related respiratory
            illnesses.
        The American Thoracic Society appreciates the opportunity to
    testify before the House Department of Defense Appropriations
    Subcommittee. We would be happy to answer any questions or provide
    follow up information.

        Chairman Inouye. Dr. King, I thank you very much. Will you
    share with this subcommittee the results of your testing, your
    findings?
        Dr. King. Of my personal study?
        Chairman Inouye. Yes.
        Dr. King. We have had 80 to 100 people from Fort Campbell
    in Kentucky referred to Vanderbilt University, where we've done
    extensive testing in patients, in whom we were unable to
    identify any other cause of potential respiratory symptoms. We
    did open-lung biopsies and found this constrictive
    bronchiolitis, which is an untreatable and irreversible
    condition, to which we speculate it is a reaction to some
    inhalational toxin experienced in Southwest Asia.
        Chairman Inouye. Thank you.
        Senator Cochran.
        Senator Cochran. I think we owe you a debt of gratitude and
    thanks for bringing this to our attention. I think you can be
    assured we'll look into it and try to make a decision that
    responds to the challenge.
        Dr. King. Thank you very much.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. No comments. I just want to hear the
    witnesses. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Our next witness is Ms. Dee Linde of the Dystonia Medical
    Research Foundation. Ms. Linde.
    STATEMENT OF DEE LINDE, PATIENT ADVOCATE, DYSTONIA
                MEDICAL RESEARCH FOUNDATION
        Ms. Linde. Thank you, Mr. Chairman, and aloha nui loa to
    you.
        Mr. Chairman and members of the Senate Defense
    Appropriations Subcommittee: Thank you for the opportunity to
    testify today. My name is Dee Linde and I am a dystonia patient
    and volunteer with the Dystonia Medical Research Foundation, or
    DMRS. As a veteran and former Navy petty officer, I am honored
    to testify before this subcommittee.
        The DMRS is a patient-centered nonprofit organization
    dedicated to serving dystonia patients and their families.
    Dystonia is a neurological movement disorder that causes
    muscles to contract and spasm involuntarily. Dystonia is a
    chronic disorder whose symptoms vary in degrees of frequency,
    intensity, disability, and pain. Dystonia can be generalized or
    focal. Generalized dystonias affect all major muscle groups,
    resulting in twisting repetitive movements and abnormal
    postures. Focal dystonias affect a specific part of the body,
    such as the legs, arms, eyelids, or vocal cords.
        Dystonia can be hereditary or caused by trauma, and it
    affects approximately 300,000 persons in the United States. At
    this time there is no cure for dystonia and treatment is highly
    individualized. Patients frequently rely on invasive therapies.
        In 1995, after my Navy career, I started feeling symptoms
    for what would later be diagnosed as tardive dystonia, which is
    medication-induced dystonia. The symptoms started as
    uncontrollable shivering sensations. Over the next 2 years, the
    symptoms continued to worsen and I started feeling like I was
    being squeezed in a vise. My diaphragm was constricted and I
    couldn't breathe. I also had blepharospasm, a form of dystonia
    that forcibly shut my eyes, leaving me functionally blind even
    though there was nothing wrong with my vision.
        My dystonia affected my entire upper body and for years my
    spasms wouldn't allow me to sit in a chair or sleep safely in
    bed with my husband. I spent those years having to sleep and
    even eat on the floor.
        After I developed dystonia, I was forced to give up my
    private practice as a psychotherapist. Since I am a veteran, I
    receive all my medical care through the VA system. In 2000, I
    underwent surgery to receive deep brain stimulation (DBS). The
    neurosurgeon implanted leads into my brain that emit constant
    electrical pulses which interrupt the bad signals and help
    control my symptoms. Thanks to DBS, I have gone from being
    completely nonfunctional to having the ability to walk and move
    like a healthy individual. I'm happy to say that I am now
    almost completely symptom free.
        The DMRS has received reports that the incidence of
    dystonia in the United States has noticeably increased since
    our military forces were deployed to Iraq and Afghanistan. A
    June 2006 article in Military Medicine titled ``Post-Traumatic
    Shoulder Dystonia in an Active Duty Soldier'' stated that:
    ``Dystonia after minor trauma can be as crippling as a
    penetrating wound, with disability that renders the soldier
    unable to perform his duties.''
        Awareness of this disorder, dystonia, is essential to avoid
    mislabeling and possibly mistreating a true neurological
    disease. The Department of Defense peer-reviewed medical
    research program is the most essential program studying
    dystonia in military and veteran populations, and I myself was
    the consumer reviewer on this panel. This program is critical
    to developing a better understanding of the mechanisms
    connecting trauma and dystonia.
        The dystonia community would like to thank the subcommittee
    for adding dystonia to the list of conditions eligible for
    study under the program in the fiscal year 2010 and 2011
    defense appropriation bills. We urge the subcommittee to
    maintain dystonia as an eligible condition in the defense peer-
    reviewed medical research program in fiscal year 2012.
        Thank you for allowing me the opportunity to address the
    subcommittee today.
        Chairman Inouye. Ms. Linde, I thank you very much for your
    testimony and we will do our best.
        Ms. Linde. Thank you.
        Chairman Inouye. Senator Cochran.
        Senator Cochran. Mr. Chairman, I have nothing further to
    add. We appreciate your presence and your advice and
    observations for the benefit of the subcommittee.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Nothing to add either, but I appreciate all
    of you being here.
        Ms. Linde. Thank you.
        Chairman Inouye. Thank you very much.
        [The statement follows:]
                        Prepared Statement of Dee Linde
        Mr. Chairman and members of the Senate Appropriations Defense
    Subcommittee, thank you for the opportunity to testify today. My name
    is Dee Linde, and I am a dystonia patient and volunteer with the
    Dystonia Medical Research Foundation or ``DMRF.'' I am also a former
    Navy service member and I am honored to testify before this
    subcommittee. The DMRF is a patient-centered, nonprofit organization
    dedicated to serving dystonia patients and their families. The DMRF
    works to advance dystonia research, increase dystonia awareness, and
    provide support for those living with the disorder.
        Dystonia is a neurological movement disorder that causes muscles to
    contract and spasm involuntarily. Dystonia is not usually fatal, but it
    is a chronic disorder whose symptoms vary in degrees of frequency,
    intensity, disability, and pain. Dystonia can be generalized or focal.
    Generalized dystonia affects all major muscle groups, resulting in
    twisting repetitive movements and abnormal postures. Focal dystonia
    affects a specific part of the body such as the legs, arms, hands,
    neck, face, mouth, eyelids, or vocal chords. Dystonia can be hereditary
    or caused by trauma, and it affects approximately 300,000 persons in
    the United States. At this time, there is no cure for dystonia and
    treatment is highly individualized. Patients frequently rely on
    invasive therapies like botulinum toxin injections or deep brain
    stimulation (DBS) to help manage their symptoms.
        In 1995, after my Navy career, I started feeling symptoms for what
    would later be diagnosed as tardive dystonia, which is medication-
    induced dystonia. The symptoms started as an uncontrollable shivering
    sensation that often prompted people to ask me if I was cold. Over the
    next 2 years, the symptoms continued to worsen and I started feeling
    like I was being squeezed: my diaphragm was constricted and I couldn't
    breathe. I also had belpharospasm which meant that my eyes would shut
    forcibly and uncontrollably, leaving me functionally blind even though
    there was nothing wrong with my vision.
        The tardive dystonia affected my entire upper body and for years my
    spasms didn't allow me to sit in a chair, or sleep safely in the bed
    with my husband. As a family joke, my mother made my husband a nose
    guard to wear because I kept hitting him during the night. I spent
    those years having to sleep and even eat on the floor. Before I
    developed dystonia, I had my own private practice as a licensed
    psychotherapist which I had to give up as a result of my spasms.
        Because I have other service-connected disabilities and am
    considered 100 percent unemployable, I receive care at the Veterans
    hospital in Portland, Oregon. In 2000, I underwent surgery to receive
    deep brain stimulation (DBS). The surgeons implanted leads into my
    basil ganglia which is the part of the brain that controls movement.
    The leads emit electric pulses that interrupt the bad signals that my
    brain is sending to my body and allow me to control my movement. Thanks
    to DBS, I have gone from being completely non-functional, to having the
    ability to walk and to move like a healthy individual. I am happy to
    say that I am now almost completely symptom free. The battery packs for
    the DBS are implanted under my clavical, and I used to return to the
    hospital every 2 years to surgically replace them. In 2010, I had the
    new rechargeable battery implanted. This battery lasts for 9 years, and
    now I literally ``recharge my batteries'' for 2.5 hours at the end of
    every week.
        The DMRF has received reports that the incidence of dystonia in the
    United States has noticeably increased since our military forces were
    deployed to Iraq and Afghanistan. This recent increase is widely
    considered to be the result of a well-documented link between traumatic
    injuries and the onset of dystonia. A June 2006 article in Military
    Medicine, titled ``Post-Traumatic Shoulder Dystonia in an Active Duty
    Soldier'' reported on dystonia experienced by military personnel and
    stated that ``Dystonia after minor trauma can be as crippling as a
    penetrating wound, with disability that renders the soldier unable to
    perform his duties . . . awareness of this disorder [dystonia] is
    essential to avoid mislabeling, and possibly mistreating, a true
    neurological disease.'' As military personnel remain deployed for
    longer periods, we can expect dystonia prevalence in military and
    veterans populations to continue to rise.
        Although Federal dystonia research is conducted through a number of
    medical and scientific agencies, the Department of Defense (DOD) Peer-
    Reviewed Medical Research Program remains the most essential program
    studying dystonia in military and veteran populations. This program is
    critical to developing a better understanding of the mechanisms
    connecting trauma and dystonia. The DMRF would like to thank the
    Subcommittee for adding dystonia to the list of conditions eligible for
    study under the DOD Peer-Reviewed Medical Research Program in the
    fiscal year 2010 and 2011 Defense Appropriation bills. The DMRF is
    excited to report that dystonia researchers were granted two awards in
    fiscal year 2010. We urge the Committee to maintain dystonia as a
    condition eligible for study through the Peer-Reviewed Medical Research
    Program in fiscal year 2012.
        Thank you again for allowing me the opportunity to address the
    Subcommittee today. I hope you will continue to include dystonia as a
    condition eligible for study under the DOD Peer-Reviewed Medical
    Research Program. Below is a poem that I composed during one of my most
    difficult moments, and I hope this poem provides greater insight to the
    hardships and loneliness faced in enduring this disorder.
                                  dysharmonia
    The twitch \1\ doctor says it's dystonia
    Which is far from the likes of harmonia
    The muscles don't work in dystonia
    But how graceful they are in harmonia
    I can walk down the street
    Without two left feet
    I can hold my head high
    Not low like a geek
    I can keep both my eyes wide open
    And swallow my food without chokin'
    But that's with harmonia
    And I've got dystonia
    Which leaves me just feelin'
    Alonia

        \1\ twitch doctor = Movement Disorder Specialist.

        Chairman Inouye. Our next witness is Ms. Barbara Zarnikow,
    Interstitial Cystitis Association.
    STATEMENT OF BARBARA ZARNIKOW, CO-CHAIR, INTERSTITIAL
                CYSTITIS ASSOCIATION
        Ms. Zarnikow. Chairman Inouye, Ranking Member Cochran, and
    distinguished members of the Defense Subcommittee: Thank you
    for the opportunity to testify today, to present testimony
    today on interstitial cystitis, commonly known as ``IC.'' I am
    Barbara Zarnikow from Buffalo Grove, Illinois. I am an IC
    patient and co-chair of the Interstitial Cystitis Association,
    a nonprofit organization which provides advocacy, research
    funding, and education for patients living with IC.
        IC is a chronic debilitating condition characterized by
    recurring pain, pressure, and discomfort in the bladder and
    pelvic region. It is often associated with frequent and urgent
    urination. There is no known cause and it can take years to
    diagnose because it is often misdiagnosed. There is not a test
    to diagnose IC, so it is diagnosed through the process of
    elimination of other diseases with similar symptoms.
        IC affects an estimated 3 to 8 million women in the United
    States and is often believed to be primarily a women's disease.
    However, recent research shows that 1 to 4 million men suffer
    from IC as well. IC is a debilitating disease that has an
    impact on the quality of life similar to what's been reported
    by individuals suffering from end stage renal disease and
    rheumatoid arthritis. IC can cause patients to suffer from
    severe pain, sleep deprivation, high rates of depression,
    anxiety, and overall decline in quality of life. IC affects all
    aspects of a patient's life.
        A study conducted between 1992 and 2002 found that
    approximately 1.4 percent of veterans served by the Veterans
    Health Administration were being treated for IC. The study also
    showed a 14 percent increase in patients being treated for IC
    in VHA during this same period.
        IC is currently part of the Department of Defense peer-
    reviewed medical research program. This is so important because
    studies have shown that the incidence of IC in our population
    is much higher than previously thought.
        A prime example of how IC can impact members of the
    military is former Navy Captain Gary Mowrey, retired, who was
    forced to cut his career short as a result of IC. Captain
    Mowrey was in the Navy for 25 years and has served as commander
    of the VAQ133 Squadron, operations officer on the USS Dwight D.
    Eisenhower, chief of the Enlisted Performance Division in the
    Bureau of Naval Personnel, and earned a Southwest Asia Service
    Medal with two stars for his service in Operation Desert Storm.
        In 1994 he began to experience significant pelvic pain and
    could not always make it to the bathroom. He was not even able
    to sit through normal meetings. After months of unsuccessful
    antibiotic treatments for urinary tract infections, Captain
    Mowrey was diagnosed with IC, and shortly after retired due to
    the pain and limitations imposed by IC.
        He then attempted to teach high school math, but had to
    retire from this position as well due to the pain, frequent
    urination, and fatigue associated with having to urinate 20 to
    30 times each night. If you've ever had a bladder infection or
    know someone who has, imagine if that infection never went away
    and you had to live with these symptoms your entire life. That
    is IC.
        On behalf of IC patients, including many veterans, we
    request IC continue to be eligible for the peer-reviewed
    medical research program for fiscal year 2012. Thank you for
    your time and consideration.
        Chairman Inouye. Ms. Zarnikow, I thank you very much on
    behalf of the subcommittee. We appreciate it very much.
        [The statement follows:]
         Prepared Statement of Barbara Gordon, RD, Executive Director,
                       Interstitial Cystitis Association
        Chairman Inouye, Ranking Member Cochran, and distinguished members
    of the Subcommittee, thank you for the opportunity to present
    information on Interstitial Cystitis (IC). The Interstitial Cystitis
    Association (ICA) provides advocacy, research funding, and education to
    ensure early diagnosis and optimal care with dignity for people
    affected by IC. Until the biomedical research community discovers a
    cure for IC, our primary goal remains the discovery of more efficient
    and effective treatments to help patients live with the disease.
        IC is a chronic condition characterized by recurring pain,
    pressure, and discomfort in the bladder and pelvic region. The
    condition is often associated with urinary frequency and urgency,
    although this is not a universal symptom. The cause of IC is unknown.
    Diagnosis is made only after excluding other urinary and bladder
    conditions, possibly causing 1 or more years of delay between the onset
    of symptoms and treatment. Men suffering from IC are often misdiagnosed
    with bladder infections and chronic prostatitis. Women are frequently
    misdiagnosed with endometriosis, inflammatory bowel disease (IBD),
    irritable bowel syndrome (IBS), vulvodynia, and fibromyalgia, which
    commonly co-occur with IC. When healthcare providers are not properly
    educated about IC, patients may suffer for years before receiving an
    accurate diagnosis and appropriate treatment.
        Although IC is considered a ``women's disease,'' scientific
    evidence shows that all demographic groups are affected by IC. Women,
    men, and children of all ages, ethnicities, and socioeconomic
    backgrounds develop IC, although it is most commonly found in women.
    Recent prevalence data reports that 3 to 8 million American women and 1
    to 4 million American men suffer from IC. Using the most conservative
    estimates, at least 1 out of every 77 Americans suffer from IC, and
    further study may indicate prevalence rates as high as 1 out of every
    28 people. Based on this information, IC affects more people than
    breast cancer, Alzheimer's diseases, and autism combined.
        The effects of IC are pervasive and insidious, damaging work life
    and productivity, psychological well-being, personal relationships, and
    general health. Quality of life studies have found that the impact of
    IC can equal the severity of rheumatoid arthritis and end-stage renal
    disease. Health-related quality of life in women with IC is worse than
    in women with endometriosis, vulvodynia, or overactive bladder alone.
    IC patients have significantly more sleep dysfunction, higher rates of
    depression, increased catastrophizing, anxiety and sexual dysfunction.
        Although IC research is currently conducted through a number of
    Federal entities, including the National Institutes of Health (NIH) and
    the Centers for Disease Control and Prevention (CDC), the DOD's Peer-
    Reviewed Medical Research Program (PRMRP) remains essential. The PRMRP
    is an indispensable resource for studying emerging areas in IC
    research, such as prevalence in men, the role of environmental
    conditions such as diet in development and diagnosis, barriers to
    treatment, and IC awareness within the medical military community.
    Specifically, IC education and awareness among military medical
    professionals takes on heightened importance, as neither the
    President's fiscal year 2012 budget request nor the Centers for Disease
    Control and Preventions fiscal year 2011 Operating Plan include renewed
    funding for the CDC's IC Education and Awareness Program.
        On behalf of ICA, and as an IC patient, I would like to thank the
    Subcommittee for including IC as a condition eligible for study under
    the DOD's PRMRP in the fiscal years 2010 and 2011 DOD Appropriations
    bills. The scientific community showed great interest in the program,
    responding to the initial grant announcement with an immense outpouring
    of proposals. We urge Congress to maintain IC's eligibility in the
    PRMRP in the fiscal year 2012 DOD Appropriations bill, as the number of
    current military members, family members, and veterans affected by IC
    is increasing.

        Ms. Zarnikow. Thank you.
        Senator Cochran. Thank you for your attendance. We
    appreciate your giving us this information and the observations
    you have about this problem.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. I thank the whole panel and I thank this
    woman who just gave this presentation. This is very
    interesting. It affects a lot of people. I know that.
        Thank you, Mr. Chairman.
        Ms. Zarnikow. It does affect a lot of people.
        Chairman Inouye. Thank you very much.
        Ms. Zarnikow. Thank you.
        Chairman Inouye. Our next witness is Mr. Dane Christiansen,
    International Foundation for Functional Gastrointestinal
    Disorders.
    STATEMENT OF DANE R. CHRISTIANSEN, DEVELOPMENT
                COORDINATOR, INTERNATIONAL FOUNDATION FOR
                FUNCTIONAL GASTROINTESTINAL DISORDERS
        Mr. Christiansen. Chairman Inouye, Ranking Member Cochran,
    Senator Shelby, and the distinguished members of the Defense
    Appropriations Subcommittee: Thank you for the opportunity to
    present testimony. My name is Dane Christiansen and I am
    testifying on behalf of the International Foundation for
    Functional Gastrointestinal Disorders, or IFFGD. We request
    that the subcommittee include functional gastrointestinal
    disorders on the list of conditions deemed eligible for study
    through the Department of Defense peer-reviewed medical
    research program within fiscal year 2012 defense appropriations
    legislation.
        Founded in 1991, IFFGD is a nonprofit patient-driven
    organization dedicated to helping individuals affected by
    functional gastrointestinal and motility disorders. The phrase
    ``functional gastrointestinal disorder'' or ``functional GI
    disorder'' refers to a family of conditions where the nerves,
    muscles, and related mechanisms of the digestive tract do not
    function properly. The result is multiple, persistent, and
    often painful symptoms, ranging from nausea and vomiting to
    altered bowel habit.
        Over two dozen functional gastrointestinal disorders have
    been identified. Severity ranges from bothersome to disabling
    and life-altering. The conditions may strike anywhere along the
    GI tract. One thing they have in common is that little is
    understood about their underlying mechanisms and as a result
    little is understood about treatment.
        The few treatments available reduce symptoms in some but
    not all patients. These conditions are chronic, costly from a
    healthcare standpoint, impair productivity, and exact a
    tremendous toll in terms of quality of life. The onset of a
    functional gastrointestinal disorders can be triggered by
    infection of the GI tract and/or severe stress. Deployed
    military personnel face an elevated chance of experiencing
    these risk factors.
        The 2010 Institute of Medicine (IOM) report that looked at
    health effects of serving in the gulf war concluded that there
    is sufficient evidence for an association between deployment
    and symptoms consistent with functional gastrointestinal
    disorders. Functional gastrointestinal disorders are one of the
    hallmarks of what was previously described as gulf war
    syndrome.
        The Veterans Administration recognizes a presumption of
    service connection for the purposes of soldiers with functional
    gastrointestinal disorders applying for disability benefits.
        In order to better articulate the suffering associated with
    functional gastrointestinal disorders, I would like to be the
    voice of Dr. Brennan Spiegel, a physician who regularly sees
    military personnel affected by these conditions. I'm quoting
    now:
        ``Those of us in the VA are now witnessing a near-epidemic
    emerging and that is chronic GI symptoms, like abdominal pain,
    nausea, vomiting, and diarrhea. The stories are heartbreaking
    and compelling and they are constant and unrelenting. Imagine
    having the stomach flu. Now think about having that every day
    and being told that we can't treat it very well.
        ``Every Monday morning at the West Los Angeles VA Medical
    Center, our clinic cares for at least 5 to 10 patients with
    service-related GI symptoms. Recently, a soldier entered my VA
    exam room square-jawed and battle-tested. Within minutes, he
    was crying, averting eye contact, and trying to explain that
    his life came to a near halt after kicking in a door one day in
    Tikrit. His abdomen was burning while in the moment and he
    stifled nausea to get through the event. Then, when it was
    over, he broke from his troop and threw up. It's never stopped
    and that was 2 years ago.
        ``There are so many other stories like this. We're making
    progress, but we don't have good answers or good treatments.''
        Please consider including functional gastrointestinal
    disorders on the eligible conditions list for the DOD peer-
    reviewed medical research program within fiscal year 2012
    defense appropriations legislation. This would allow
    researchers to begin working to better understand, diagnose,
    and treat these conditions, particularly as they impact
    veterans and active duty military personnel.
        Thank you for your time and your consideration of this
    request.
        [The statement follows:]
       Prepared Statement of Nancy J. Norton, President and Co-Founder,
       International Foundation for Functional Gastrointestinal Disorders
        Thank you for the opportunity to present the views of the
    International Foundation for Functional Gastrointestinal Disorders
    (IFFGD) regarding functional gastrointestinal disorders (FGIDs) among
    service personnel and veterans. I am here today to request that that
    the Subcommittee include FGIDs as a condition eligible for study in the
    Department of Defense (DOD) Peer-Reviewed Medical Research Program in
    fiscal year 2012.
        Established in 1991, IFFGD is a patient-driven nonprofit
    organization dedicated to assisting individuals affected by functional
    GI disorders, and providing education and support for patients,
    healthcare providers, and the public at large. Our mission is to inform
    and support people affected by painful and debilitating digestive
    conditions, about which little is understood and few (if any) treatment
    options exist. The IFFGD also works to advance critical research on
    functional GI and motility disorders, in order to provide patients with
    better treatment options, and to eventually find a cure.
        FGIDs are disorders in which the movement of the intestines, the
    sensitivity of the nerves of the intestines, or the way in which the
    brain controls intestinal function is impaired. People who suffer from
    FGIDs have no structural abnormality which makes it difficult to
    identify their condition using X-rays, blood tests or endoscopies.
    Instead, FGIDs are typically identified and defined by the collection
    of symptoms experienced by the patient. For this reason, it is not
    uncommon for FGID suffers to have unnecessary surgery, medication, and
    medical devices before receiving a proper diagnosis. Examples of FGIDs
    include irritable bowel syndrome (IBS) and functional dyspepsia. IBS is
    characterized by abdominal pain and discomfort associated with a change
    in bowel pattern, such as diarrhea and/or constipation. Symptoms of
    functional dyspepsia usually include an upset stomach, pain in the
    belly, and bloating.
        FGIDs can be emotionally and physically debilitating. Due to
    persistent pain and bowel unpredictability, individuals who suffer from
    this disorder may distance themselves from social events, work, and
    even may fear leaving their home. Stigma surrounding bowel habits may
    act as barrier to treatment, as patients are not comfortable discussing
    their symptoms with doctors. Because FGID symptoms are relatively
    common and not life-threatening, many people dismiss their symptoms or
    attempt to self-medicate using over-the-counter medications.
        In April 2010, the National Academy of Sciences (NAS) published a
    report titled ``Gulf War and Health, Volume 8: Update on the Health
    Effects of Serving in the Gulf War'' which determined that there is
    sufficient evidence to associate deployment to the gulf war and FGIDs,
    including IBS and functional dyspepsia. According to the report, there
    have been a large number of FGID cases among gulf war veterans, and
    their symptoms have continued to be persistent in the years since that
    war. The NAS report focused on the incidence of GI disorders among
    veterans and did not attempt to determine causality. However, the
    report provides compelling evidence linking exposure to enteric
    pathogens during deployment and the development of FGIDs. The NAS
    recommended that further research be conducted on this association.
        The Department of Defense (DOD) Peer-Reviewed Medical Research
    Program conducts important research on medical conditions that impact
    veterans and active duty military personnel. Given the conclusions of
    the NAS report, and the report's recommendations for further research
    on the link between FGIDs and exposures experienced by veterans in the
    gulf war, FGIDs would make an appropriate addition to the eligible
    conditions list for the Defense Medical Research Program. Therefore, we
    ask that you include ``functional gastrointestinal disorders'' as a
    condition eligible for study in the fiscal year 2012 DOD Peer-Reviewed
    Medical Research Program.
        Thank you again for the opportunity to address the Subcommittee
    today. I hope you agree that the evidence linking FGIDs to service in
    the gulf war is compelling, and that you will include ``functional
    gastrointestinal disorders'' as a condition eligible for study in the
    Department of Defense Peer-Reviewed Medical Research Program in fiscal
    year 2012.
                                ibs information
        IBS, one of the most common functional GI disorders, strikes all
    demographic groups. It affects 30 to 45 million Americans,
    conservatively at least 1 out of every 10 people. Between 9 to 23
    percent of the worldwide population suffers from IBS, resulting in
    significant human suffering and disability. IBS as a chronic disease is
    characterized by a group of symptoms that may vary from person to
    person, but typically include abdominal pain and discomfort associated
    with a change in bowel pattern, such as diarrhea and/or constipation.
    As a ``functional disorder'', IBS affects the way the muscles and
    nerves work, but the bowel does not appear to be damaged on medical
    tests. Without a definitive diagnostic test, many cases of IBS go
    undiagnosed or misdiagnosed for years. It is not uncommon for IBS
    suffers to have unnecessary surgery, medication, and medical devices
    before receiving a proper diagnosis. Even after IBS is identified,
    treatment options are sorely lacking and vary widely from patient to
    patient. What is known is that IBS requires a multidisciplinary
    approach to research and treatment.

        Chairman Inouye. I thank you very much, Mr. Christiansen.
    Your request will be very seriously considered. Thank you.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you for bringing the
    witnesses to the subcommittee today to let us hear about these
    situations. I think we have an obligation to look carefully
    into the suggestions of service connection between the events
    in their military deployment and the symptoms that are later
    discovered. I hope we have enough people who are willing to
    devote attention to this so we can figure out a way to find a
    cure or medicinal palliatives that make it better or in any
    other way possible to help restore them to good health.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. What are the, say, two most promising areas
    of research in this area to date, dealing with all of these
    issues?
        Mr. Christiansen. I am not a physician like Dr. King. I
    would hate to comment. But we do work extensively to support
    and encourage research whenever possible. There is a number of
    areas where we're learning more and more about gut flora and
    the type of bacteria that is normally within the gut and how
    something like a GI infection or eating food or drinking water
    from a country or an area where health conditions aren't up to
    par may throw that balance off, allow things, pathogens, to
    leak deeper into the gut than they would normally be, and that
    would explain why the conditions are chronic as opposed to it
    just goes through your system and then you're okay a couple
    weeks later. So looking at the gut flora is becoming more and
    more of a promising area.
        I would also say--and this is a little bit off of
    functional gastrointestinal disorders directly, but it applies
    to this whole larger family of functional GI motility
    disorders, particularly as it applies to veterans and members
    of the military--that tremendous steps are being made in
    regenerative medicine, trying to actually regrow parts of the
    digestive system that may not be working. The anal sphincter is
    a perfect example. There is tremendous efforts underway to
    actually in a lab setting repair and regrow anal sphincters,
    and if this--for example, if there's a soldier who suffered an
    IED attack and significant pelvic floor damage, regenerative
    medicine could one day be at a point where he could get a new
    anal sphincter and return to a normal quality of life. So those
    are two areas I'd acknowledge off the top.
        Senator Shelby. Have there been studies to show that this
    is a higher rate of problems with military service personnel as
    opposed to the general population?
        Mr. Christiansen. Yes. The IOM report I previously cited,
    there was actually two IOM studies that looked at this. I'd be
    happy to share the results of those studies with the
    subcommittee. But it is--they had a very high threshold for
    acknowledging service connection and they found that the
    incidence was higher than it would be in the general population
    as a result of military service.
        Senator Shelby. Thank you.
        Chairman Inouye. I thank you very much. I'd like to thank
    the panel.
        Our next panel consists of: Ms. Kathleen Moakler, National
    Military Family Association; Chief Master Sergeant John R.
    ``Doc'' McCauslin, Air Force Sergeants Association; Captain
    Charles D. Connor, U.S. Navy retired, American Lung
    Association; Mr. Rick Jones, National Association for Uniformed
    Services.
        Our first witness, Ms. Kathleen Moakler. Welcome.
    STATEMENT OF KATHLEEN B. MOAKLER, GOVERNMENT RELATIONS
                DIRECTOR, NATIONAL MILITARY FAMILY
                ASSOCIATION
        Ms. Moakler. Thank you, Chairman Inouye, Senator Cochran,
    Senator Shelby, for allowing us to speak with you this morning
    about military families, our Nation's families. We continue to
    share the concerns of military families with policymakers, as
    we have for over 40 years.
        In the past several years, the National Military Family
    Association has done informal surveys with military families on
    our web site. In our most recent survey, when 1,200 family
    members responded on their top priorities, over 84 percent felt
    it was important that Congress and DOD focus on ensuring
    support programs meet the needs of families experiencing
    multiple deployments. Almost 80 percent felt that helping
    wounded service members and their families should be a top
    priority, and 78 percent felt that helping surviving families
    was an important priority.
        We applaud the words of Defense Secretary Gates and
    Chairman Mullen before this subcommittee last week when they
    stressed the need for continued funding for military family
    programs and support of the wounded. Our association agrees
    that we will be dealing with the costs of these wars for years
    to come and we cannot afford to shortchange our wounded
    warriors and our military families, who have sacrificed so much
    and will continue to sacrifice.
        We also agree with Admiral Mullen that communities must
    join with DOD and the services to support service members,
    veterans, and military families in their midst. To help with
    that effort, our association has developed ``Finding Common
    Ground,'' a toolkit for communities supporting military
    families that includes easily achievable action items and
    useful resources to guide anyone who wants to support military
    families, but doesn't know where to start. It can be downloaded
    for free at our website, militaryfamily.org.
        Child care remains a concern for military families, as
    evidenced by a recent Pew Center on the States survey. We are
    pleased that, in addition to building new child development
    centers, DOD and the services are taking innovative steps to
    address these concerns by working to improve capacity in
    private child care agencies within States. But the need
    remains, especially for the families of the deployed National
    Guard and Reserve.
        At our Operation Purple Healing Adventures Camp for
    families of the wounded, ill, and injured, families continue to
    tell us there is a tremendous need for child care services at
    or near military treatment facilities. Families need child care
    to attend medical appointments, especially mental healthcare
    appointments. Our association urges Congress to sustain funding
    and resources to meet the child care needs of military
    families, to include hourly, drop-in, and increased respite
    care across all services, for families of deployed service
    members and the wounded, ill, and injured, as well as those
    with special needs family members.
        Our association also feels that funding to provide more
    dedicated resources, such as youth or teen centers, and
    enhanced partnerships with national youth-serving
    organizations, would be important ways to better meet the needs
    of our older youth and teens during deployment.
        In 2009 the policy concerning the attendance of the media
    at the dignified transfer of remains at Dover Air Force Base
    was changed. Family members are now given the option of flying
    to Dover. In previous years only about 3 percent of family
    members attended this ceremony. Since the policy change, over
    90 percent of families are sending members to Dover to attend.
    This is provided by the--the money for this is provided by the
    services and none of the costs have been funded. We would ask
    that funds be appropriated to cover the costs of this
    extraordinary expense.
        Thank you for your long-term interest in support of--and
    support for military families. I look forward to any questions
    you may have.
        [The statement follows:]
                   Prepared Statement of Kathleen B. Moakler
        The National Military Family Association is the leading nonprofit
    organization committed to improving the lives of military families. Our
    over 40 years of accomplishments have made us a trusted resource for
    families and the Nation's leaders. We have been at the vanguard of
    promoting an appropriate quality of life for active duty, National
    Guard, Reserve, retired service members, their families and survivors
    from the seven uniformed services: Army, Navy, Air Force, Marine Corps,
    Coast Guard, Public Health Service and the National Oceanic and
    Atmospheric Administration.
        Association Volunteers and Representatives in military communities
    worldwide provide a direct link between military families and the
    Association staff in the Nation's capital. These volunteers are our
    ``eyes and ears,'' bringing shared local concerns to national
    attention.
        The Association does not have or receive Federal grants or
    contracts.
        Chairman Inouye and Distinguished Members of the Subcommittee, the
    National Military Family Association would like to thank you for the
    opportunity to present testimony for the record concerning the quality
    of life of military families--the Nation's families. In the 10th year
    of war, we continue to see the impact of repeated deployments and
    separations on our service members and their families. We appreciate
    your recognition of the service and sacrifice of these families. Your
    response through legislation to the increased need for support as
    situations have arisen has resulted in programs and policies that have
    helped sustain our families through these difficult times.
        We recognize, too, the emphasis that the Administration is placing
    on supporting military families. The work of Mrs. Obama and Dr. Biden
    through the Joining Forces initiative in raising awareness of the
    sacrifices military families are making has been well received by the
    Nation and appreciated by our families. The American people are
    beginning to understand how 1 percent of our population in the United
    States is being called upon to bear 100 percent of the burden of
    defending our Nation, giving up years of family life together, and how
    they need the support of the other 99 percent of Americans to continue
    carrying that burden.
        The recent Presidential Study Directive-9, which called on Federal
    agencies to outline how they are presently or could in the future
    support military families, reinforced Administration support as well.
    The vision of the study, as contained in the report Strengthening Our
    Military Families, Meeting America's Commitment, is, ``to ensure that:
      --The U.S. military recruits and retains the highest-caliber
            volunteers to contribute to the Nation's defense and security;
      --Service members can have strong family lives while maintaining the
            highest state of readiness;
      --Civilian family members can live fulfilling lives while supporting
            their service member(s); and
      --The United States better understands and appreciates the
            experience, strength, and commitment to service of our military
            families.
        This vision resonates with all that our Association has tried to
    work for during our 42 year history. We believe policies and programs
    should provide a firm foundation for families challenged by the
    uncertainties of deployment and transformation. Our Association cares
    about the health and resilience of military families. Innovative and
    evidence based approaches are essential to address the needs of
    military children. Families promote a service member's well-being. We
    realize support for service members and their families is not solely
    provided by the government. Communities also uphold the families.
        Our Nation did not expect to be involved in such a protracted
    conflict. Our military families continue to require effective tools and
    resources to remain strong. We ask Congress, policymakers, non-
    government organizations, and communities to remain vigilant and
    respond in a proactive manner. Our Nation can express recognition for
    their sacrifices by promoting the well-being of military families.
        In this statement, the National Military Family Association will
    expand on several issues of importance to military families: Family
    readiness, family health, and family transitions.
    Family Readiness
        Policies, programs and services must adapt to the changing needs of
    service members and families. Standardization in delivery,
    accessibility, and funding are essential. Educated and resourced
    families are able to take greater responsibility for their own
    readiness. Recognition should be given to the unique challenges facing
    families with special needs. Support should provide for families of all
    components, in every phase of military life, no matter where they live.
        We appreciate provisions in the National Defense Authorization Acts
    and Appropriations legislation in the past several years that
    recognized many of these important issues. Excellent programs exist
    across the Department of Defense (DOD) and the Services to support our
    military families. There are redundancies in some areas and times when
    a new program was initiated before anyone looked to see if an existing
    program could be adapted to answer an evolving need. We realize all
    Americans will be asked to tighten their belts in this time of tighter
    budgets and some military family programs may need to be downsized or
    eliminated. We ask your support for programs that do work when looking
    for efficiencies, rewarding best practices and programs that are truly
    meeting the needs of families. While we understand that communities and
    non-government organizations may fill gaps in areas where government
    programs are lacking, we maintain DOD and the Department of Veterans
    Affairs (VA) still have a responsibility to provide an appropriate
    level of support for our service members, veterans, their families, and
    survivors. In this section we will highlight some of these best
    practices and identify needs.
                Child Care
        Child care remains a concern for military families, as evidenced by
    a recent Pew Center on the States survey (http://www.preknow.org/
    documents/2011_MilitaryFamiliesSurvey.pdf). We are pleased that in
    addition to building new Child Development Centers, DOD and the
    Services are taking innovative steps to address these concerns.
        In December, DOD announced a new pilot initiative in 13 States
    aimed at improving the quality of child care within communities, which
    should translate into increased child care capacity for military
    families living in geographically dispersed areas. Last year, DOD
    contracted with SitterCity.com to help military families find
    caregivers and military subsidized child care providers. The military
    Services and the National Association of Child Care Resource and
    Referral Agencies (NACCRRA) continue to partner to provide subsidized
    child care to families who cannot access installation based child
    development centers.
        At our Operation Purple Healing Adventures camp for families of
    the wounded, ill and injured, families continue to tell us there is a
    tremendous need for child care services at or near military treatment
    facilities. Families need child care to attend medical appointments,
    especially mental health appointments. Our Association encourages the
    expansion of drop-in child care for medical appointments on the DOD or
    VA premises or partnerships with other organizations to provide this
    valuable service.
        We appreciate the requirement in the fiscal year 2010 National
    Defense Authorization Act calling for a report on financial assistance
    provided for child care costs across the Services and Components to
    support the families of service members deployed in support of a
    contingency operation and we look forward to the results.
        Our Association urges Congress to sustain funding and resources to
    meet the child care needs of military families to include hourly, drop-
    in, and increased respite care across all Services for families of
    deployed service members and the wounded, ill, and injured, as well as
    those with special needs family members.
                Working with Youth
        Older children and teens must not be overlooked. School personnel
    need to be educated on issues affecting military students and must be
    sensitive to their needs. To achieve this goal, schools need tools.
    Parents need tools, too. Military parents constantly seek more
    resources to assist their children in coping with military life,
    especially the challenges and stress of frequent deployments. Parents
    tell us repeatedly they want resources to ``help them help their
    children.'' Support for parents in their efforts to help children of
    all ages is increasing, but continues to be fragmented. New Federal,
    public-private initiatives, increased awareness, and support by DOD and
    civilian schools educating military children have been developed.
    However, many military parents are either not aware such programs exist
    or find the programs do not always meet their needs.
        Through our Operation Purple camps, our Association has begun to
    identify the cumulative effects multiple deployments are having on the
    emotional growth and well-being of military children and the challenges
    posed to the relationship between deployed parent, caregiver, and
    children in this stressful environment. Understanding a need for
    qualitative analysis of this information, we commissioned the RAND
    Corporation to conduct a longitudinal study on the experience of 1,500
    families. RAND followed these families for 1 year, and interviewed the
    non-deployed caregiver/parent and one child per family between 11 and
    17 years of age at three time points over the year. Recruitment of
    participants was extremely successful because families were eager to
    share their experiences. The research addressed three key questions:
      --How are school-age military children faring?
      --What types of issues do military children face related to
            deployment?
      --How are non-deployed caregivers handling deployment and what
            challenges do they face?
        In January 2011, RAND released the report, ``Views from the
    Homefront: The Experience of Youth and Spouses from Military Families''
    (http://www.rand.org/pubs/technical_reports/TR913.html), detailing the
    longitudinal findings. The research showed:
      --Older teens reported more difficulties during deployment and
            reintegration.
      --Girls reported more difficulties during reintegration.
      --There were few differences on military characteristics, but reserve
            component youth reported more difficulties during deployment.
      --Reserve component caregivers reported more challenges with
            deployment and reintegration.
      --The total number of months away mattered more than the number of
            deployments.
      --There is a direct correlation between the mental health of the
            caregiver and the well-being of the child.
      --Quality of family communication mattered to both children and
            caregiver well-being.
        What are the implications of these findings? Families facing longer
    deployments need targeted support--especially for older teens, girls
    and the reserve component. Support needs to be in place across the
    entire deployment cycle, including reintegration, and some non-deployed
    parents may need targeted mental health support. One way to address
    these needs would be to create a safe, supportive environment for older
    youth and teens. Dedicated installation Youth Centers with activities
    for our older youth would go a long way to help with this. Since many
    military families, especially those with older children, live off the
    installation, enhanced partnerships between DOD and national youth-
    serving organizations are also essential. DOD's current work with the
    4-H program is an example of this outreach and support of military
    children in the community. DOD can encourage other organizations to
    share outreach strategies and work together to strengthen a network of
    support for military youth in their civilian communities. We must
    ensure, however, that, once we have encouraged these community
    organizations and services to engage with families, we also encourage
    installations and installation services to be collaborative and not set
    up roadblocks to interaction and support.
        To address the issues highlighted by our research, our Association
    hosted a summit in May 2010, where we engaged with experts to develop
    research-based action items. Our Blue Ribbon Panel outlined innovative
    and pragmatic ideas to improve the well-being of military families,
    recognizing it is imperative solutions involve a broad network of
    government agencies, community groups, businesses, and concerned
    citizens.
        We've published the recommendations from the summit in Finding
    Common Ground: A Toolkit for Communities Supporting Military Families.
    The toolkit is organized in a format similar to our Association's well-
    received Military Kids and Teens Toolkits. It contains cards for each
    of the intended communities--including Educators, Friends and Family,
    Senior leaders, Employers, and Health Care Providers--whose help is so
    important to military families. It also contains the summary document
    with the recommendations formulated by our Blue Ribbon Panel and summit
    participants.
        Our goal was to create a user-friendly resource, with easily
    achievable action items and pertinent resources to guide everyone who
    wants to support military families, but may not know how. The toolkit
    lists concrete actions individuals, organizations, and communities can
    take to assist and support our military families. We hope that when
    someone receives a copy, they will go first to the card that most fits
    their relationship to military families and look for ideas and
    resources. We would like them to then take the time to explore other
    cards and the summit summary. While many of the suggested actions are
    simple, we've also presented some of the tougher things that require
    the building of partnerships and a longer-term focus. These actions are
    not exhaustive. It is our hope this toolkit will start conversations
    and stimulate action. Everyone can contribute--it doesn't need to be
    complicated or expensive. Just remembering to include military families
    in outreach is the beginning.
        Our Association feels that funding to provide more dedicated
    resources, such as youth or teen centers and enhanced partnerships with
    national youth-serving organizations, would be important ways to better
    meet the needs of our older youth and teens during deployment.
                Military Housing
        In our recent study conducted by RAND, researchers found that
    living in military housing was related to fewer caregiver-reported
    deployment-related challenges. Fewer caregivers who lived in military
    housing reported their children had difficulties adjusting to parent
    absence (e.g., missing school activities, feeling sad, or not having
    peers who understand what their life is like) as compared to caregivers
    who rented homes. The study team explored the factors that determine a
    military family's housing situation in more detail. Among the list of
    potential reasons provided for the question, ``Why did you choose to
    rent?'' researchers found that the top three reasons parents/caregivers
    cited for renting included: military housing was not available (31
    percent), renting was most affordable (28 percent), and preference to
    not to invest in the purchase of a home (26 percent).
        Privatized housing expands the opportunity for families to live on
    the installation and is a welcome change for military families. We are
    pleased with the annual report that addresses the best practices for
    executing privatized housing contracts. As privatized housing evolves,
    the Services are responsible for executing contracts and overseeing the
    contractors on their installations. With more joint basing, more than
    one Service often occupies an installation. The Services must work
    together to create consistent policies not only within their Service,
    but across the Services as well. Pet policies, deposit requirements,
    and utility policies are some examples of differences across
    installations and across Services. How will Commanders address these
    variances under joint basing? Military families face many transitions
    when they move, and navigating the various policies and requirements of
    each contractor is frustrating and confusing. It's time for the
    Services to increase their oversight and work on creating seamless
    transitions by creating consistent policies across the Services.
        In the GAO Report ``Military Housing: Enhancements Needed to
    Housing Allowance Process and Information Sharing among Services'' GAO
    published in May 2011, GAO highlighted the military Services have
    consistently underestimated the amount needed to pay the basic
    allowance of housing by $820 million to $1.3 billion each year since
    2006. Since the Services have underestimated the amount needed to pay
    the allowance, DOD has had to shift funds budgeted from other
    programs--which disrupts the funding to these program.
        The key factor to underestimation is the timing of developing the
    budget process--it takes nearly 1 year to determine the rates. While
    this process is needed, it causes the Services to underestimate the
    true cost of the housing allowance. Rates are set in December--10
    months after the President's budget is submitted to Congress and 2
    months after the new fiscal year begins. In addition, changes in
    planned force structure (i.e. grow the force initiatives), and the
    increased use of mobilized reserve personnel (more personnel eligible
    to receive a housing allowance) present other challenges.
        The same GAO report highlighted housing deficits ranging from 1
    percent to 20 percent of the total demand at growth installations.
    While Military construction does not fall under the purview of this
    Committee, this Committee can help address the housing deficient by
    extending the use of the Temporary Lodging Expense Allowance. This
    allowance is designed to partially offset expenses when the service
    member occupies temporary quarters while relocating from one
    installation to another. Generally payable for up to 10 days--the Army
    has extended it up to 60 days at growth installations, such as Fort
    Drum and Fort Bliss.
        We ask Congress to consider the importance of family well-being by
    addressing Basic Allowance for Housing (BAH) inequities.
        We also ask for additional money to cover the housing allowance
    shortage.
        We recommend that DOD provide the Services with the flexibility to
    extend the Temporary Lodging Expense Allowance at growth installations
    where there is a shortage of available housing.
                Commissaries and Exchanges
        The Military Personnel Subcommittee of the House Armed Services
    Committee (HASC) held two hearings this year to discuss the importance
    of sustaining Morale, Welfare, and Recreation (MWR) programs and the
    commissary and exchange systems. We maintain that these programs must
    not become easy targets for the budget cutters. The military resale
    hearing reinforced the importance of the commissary and exchange and
    stressed the need for them to remain fiscally sound without reducing
    the benefit to military families. Our Association feels strongly that
    these quality programs for military families should be preserved,
    especially during this era of increased budget austerity.
        Our Association is concerned about one issue raised at the recent
    HASC resale hearing: the potential negative repercussions of the Tax
    Increase Prevention and Reconciliation Act of 2005 (TIPRA) on the
    military community. This legislation included a provision, Section 511,
    mandating Federal, State, and local governments to withhold 3 percent
    from payments for goods and services to contractors after December 31,
    2010. While the implementation has been delayed until December 31,
    2011, we believe this withholding requirement will have a direct impact
    on military families. We believe vendors who provide products sold in
    exchanges and commissaries will end up passing on the implementation
    costs to patrons and will be less willing to offer deals, allowances,
    promotions, and prompt payment discounts, which will thus diminish the
    value of the benefit for military families. The implementation costs
    for the exchange systems may also result in reduced dividends for MWR
    programs, which already operate on tight budgets. Although our
    Association realizes this tax issue does not fall under the Senate
    Appropriations Committee's jurisdiction, we ask Congress to repeal
    Section 511 of TIPRA in order to protect this important benefit for
    military families. If full repeal is not possible, we urge Congress to
    exempt the Defense Commissary Agency, Exchanges and MWR programs from
    the withholding requirement. Military families, who have borne the
    burden of this war for nearly 10 years, should not have to incur
    additional costs at commissaries and exchanges due to the effects of
    this law, which will compromise their quality of life programs when
    they need them most.
        The commissary benefit is a vital part of the compensation package
    for service members and retirees, and is valued by them, their
    families, and survivors. Our surveys and those conducted by DOD
    indicate that military families consider the commissary one of their
    most important benefits. In addition to providing average savings of
    more than 30 percent over local supermarkets, commissaries provide a
    sense of community. Commissary shoppers gain an opportunity to connect
    with other military families and are provided with information on
    installation programs and activities through bulletin boards and
    publications. Commissary shoppers also receive nutritional information
    through commissary promotions and campaigns, as well as the opportunity
    for educational scholarships for their children.
        Active duty and reserve component families have benefitted greatly
    from the addition of case lot sales. Our Association thanks Congress
    for allowing the use of proceeds from surcharges collected at these
    sales to help defray their costs. Case lot sales continue to be
    extremely well received and attended by family members not located near
    an installation. According to Army Staff Sgt. Jenny Mae Pridemore,
    quoted in the Charleston Daily Mail, ``We don't have easy access to a
    commissary in West Virginia and with the economy the way it is everyone
    is having a tough time. The soldiers and the airmen really need this
    support.'' On average, case lot sales save families between 40 and 50
    percent compared to commercial prices. This provides tremendous
    financial support for our remote families, and is a tangible way to
    thank them for their service to our Nation.
        In addition to commissary benefits, the military exchange system
    provides valuable cost savings to members of the military community,
    while reinvesting their profits in essential MWR programs. Our
    Association strongly believes that every effort must be made to ensure
    that this important benefit and the MWR revenue is preserved,
    especially as facilities are down-sized or closed overseas.
        Our Association urges Congress to continue to protect the
    commissary and exchange benefits, and preserve the MWR revenue all of
    which are vital to maintaining a health military community.
        We also ask Congress to repeal Section 511 of TIPRA. If full repeal
    is not achievable, we urge Congress to exempt the Defense Commissary
    Agency, Exchanges and MWR programs from this withholding requirement.
                National Guard and Reserve
        Our Association has long recognized the unique challenges our
    National Guard and Reserve families face and their need for additional
    support. Reserve component families are often geographically dispersed,
    live in rural areas, have service members deployed as individual
    augmentees, and do not consistently have the same family support
    programs as their active duty counterparts. According to the research
    conducted for us by the RAND Corporation, spouses of service members in
    the National Guard and Reserves reported poorer emotional well-being
    and greater household challenges than their full-time active duty
    peers. Our Association believes that greater access to resources
    supporting National Guard and Reserve caregivers is needed to further
    strengthen our reserve component families.
        We appreciate the great strides that have been made in recent years
    by both Congress and the Services to help support our reserve component
    families. Our Association would like to thank Congress for the fiscal
    year 2011 NDAA provision authorizing travel and transportation for
    members of the Uniformed Services and up to three designees to attend
    Yellow Ribbon Reintegration Program events, and for the provision
    enhancing the Yellow Ribbon Reintegration Program by authorizing
    service and State-based programs to provide access to all service
    members and their families. We appreciate your ongoing support of the
    Yellow Ribbon Reintegration Program and ask that you continue funding
    this quality of life program for reserve component families.
        Our Association is gratified that family readiness is now seen as a
    critical component to mission readiness. We have long believed that
    robust family programs are integral to maintaining family readiness,
    for both our active duty and reserve component families. We are pleased
    the Department of Defense Reserve Family Readiness Award recognizes the
    top unit in each of the Reserve Components that demonstrate superior
    family readiness and outstanding mission readiness.
        Our Association asks Congress to continue funding the Yellow Ribbon
    Reintegration Program and stresses the need for greater access to
    resources supporting our Reserve Component caregivers.
                Flexible Spending Accounts
        Congress has provided the Armed Forces with the authority to
    establish Flexible Spending Accounts (FSA), yet the Service Secretaries
    have not established these important tax savings accounts for service
    members. We are pleased H.R. 791 and S. 387 have been introduced to
    press each of the seven Service Secretaries to create a plan to
    implement FSAs for uniformed service members. FSAs were highlighted as
    a key issue presented to the Army Family Action Plan at their 2011
    Department of the Army level conference. FSAs would be especially
    helpful for families with out-of-pocket dependent care and healthcare
    expenses. It is imperative that FSAs for uniformed service members take
    into account the unique aspects of the military lifestyle, such as
    Permanent Change of Station (PCS) moves and deployments, which are not
    compatible with traditional FSAs. We ask that the flexibility of a
    rollover or transfer of funds to the next year be considered.
        Our Association supports Flexible Spending Accounts for uniformed
    service members that account for the unique aspects of military life
    including deployments and Permanent Change of Station moves.
                Financial Readiness
        Ongoing financial literacy and education is critically important
    for today's military families. Military families are not a static
    population; new service members join the military daily. For many, this
    may be their first job with a consistent paycheck. The youthfulness and
    inexperience of junior service members makes them easy targets for
    financial predators. Financial readiness is a crucial component of
    family readiness. The Department of Defense Financial Readiness
    Campaign brings financial literacy to the forefront and it is important
    that financial education endeavors include military families.
        Our Association looks forward to the establishment of the Office of
    Service Member Affairs this July. We encourage Congress to monitor the
    implementation of this office to ensure it provides adequate support to
    service members and their families. Military families should have a
    mechanism to submit a concern and receive a response. The new office
    must work in partnership with DOD.
        Military families are not immune from the housing crisis. We
    applaud Congress for expanding the Homeowners' Assistance Program to
    wounded, ill, and injured service members, survivors, and service
    members with Permanent Change of Station orders meeting certain
    parameters. We have heard countless stories from families across the
    Nation who have orders to move and cannot sell their home. Due to the
    mobility of military life, military homeowners must be prepared to be a
    landlord. We encourage DOD to continue to track the impact of the
    housing crisis on military families.
        We appreciate the increase to the Family Separation Allowance (FSA)
    that was made at the beginning of the war. In more than 10 years,
    however, there has not been another increase. We ask that the Family
    Separation Allowance be indexed to the Cost of Living Allowance (COLA)
    to better reflect rising costs for services.
        Our Association asks Congress to increase the Family Separation
    Allowance by indexing it to COLA.
    Family Health
        When considering changes to the healthcare benefit, our Association
    urges policymakers to recognize the unique conditions of service and
    the extraordinary sacrifices demanded of military members and families.
    Repeated deployments, caring for the wounded, and the stress of
    uncertainty create a need for greater access to professional behavioral
    healthcare for all military family members.
        Family readiness calls for access to quality healthcare and mental
    health services. Families need to be assured the various elements of
    their military health system are coordinated and working as a
    synergistic system. The direct care system of Military Treatment
    Facilities (MTFs) and the purchased care segment of civilian providers
    under the TRICARE contracts must work in tandem to meet military
    readiness requirements and ensure they meet access standards for all
    military beneficiaries.
        Congress must provide timely and accurate funding for healthcare.
    DOD healthcare facilities must be funded to be ``world class,''
    offering state-of-the-art healthcare services supported by evidence-
    based research and design. Funding must also support the renovation of
    existing facilities or complete replacement of out-of-date DOD
    healthcare facilities. As we close Walter Reed Army Medical Center and
    open the new Fort Belvoir Community Hospital and the new Walter Reed
    National Military Medical Center, as part of the National Capitol
    Region BRAC process, we must be assured these projects are properly and
    fully funded. We encourage Congress to provide any additional funding
    recommended by DOD and the Defense Health Board's BRAC Subcommittee's
    report.
        Our Association recommends that DOD be funded to ``world class'',
    offering state-of-the-art healthcare services. Funding must also
    support renovation of existing facilities or replacement of out-of-date
    DOD healthcare facilities.
                TRICARE Reimbursement
        Our Association is concerned that continuing pressure to lower
    Medicare reimbursement rates will create a hollow benefit for TRICARE
    beneficiaries. We are appreciative Congress passed the Medicare and
    Medicaid Extenders Act of 2010 (Public Law 111-309), which provided a
    1-year extension of current Medicare physician payment rates until
    December 31, 2011. As the 112th Congress takes up Medicare legislation
    this year, we ask you to consider how this legislation will impact
    military healthcare, especially our most vulnerable populations, our
    families living in rural communities, and those needing access to
    mental health services.
        While we have been impressed with the strides TMA and the TRICARE
    contractors are making in adding providers, especially mental health
    providers to the networks, we believe more must be done to persuade
    healthcare and mental healthcare providers to participate and remain in
    the TRICARE system, even if that means DOD must raise reimbursement
    rates. We frequently hear from providers who will not participate in
    TRICARE because of what they believe are time-consuming requirements
    and low reimbursement rates. National provider shortages in the mental
    health field, especially in child and adolescent psychology, are
    exacerbated in many cases by low TRICARE reimbursement rates, TRICARE
    rules, or military-unique geographic challenges, such as large military
    beneficiary populations in rural or traditionally underserved areas.
    Many mental health providers are willing to see military beneficiaries
    on a voluntary status. We need to do more to attract mental health
    providers to join the TRICARE network. Increasing reimbursement rates
    is just one way of enticing them.
        Since TRICARE payments are linked to Medicare payments, we need
    Medicare reimbursement rates to be increased to improve access to
    providers.
        DOD will need additional funding to offset proposed TRICARE savings
    through increasing TRICARE Prime Retiree enrollment fees and changes to
    the Pharmacy copays enacted by Congress.
                Cost Saving Strategies in the 2012 Budget
        We appreciate DOD's continued focus on cost savings strategies in
    the 2012 budget. DOD's proposed TRICARE changes include a change in
    enrollment fees for TRICARE Prime for under age 65 retirees and a
    change in pharmacy co-pays. DOD should also incur savings through
    better management of healthcare costs. Our Association has always
    supported a mechanism to provide for modest increases to TRICARE Prime
    enrollment fee for retirees under age 65. TRICARE Prime, the managed
    care option for military beneficiaries, provides guaranteed access, low
    out of pocket costs, additional coverage, and more continuity of care
    than the basic military health benefit of TRICARE Standard. The annual
    enrollment fee of $230 per year for an individual retiree or $460 for a
    family has not been increased since the start of TRICARE Prime in 1995.
        We agree that DOD's proposed fiscal year 2012 increase of $5 per
    month per family and $2.50 per month per individual plan is indeed
    modest. We applaud DOD for deciding not to make any changes to the
    TRICARE benefit for active duty, active duty family members, medically
    retired service members, and survivors of service members and for not
    making any changes to the TRICARE Standard and TRICARE for Life (TFL)
    benefit.
        We have some concerns regarding DOD's selection of a civilian-based
    index in determining TRICARE Prime retiree enrollment fee increases
    after 2012. Our Association has always supported the use of Cost of
    Living Allowance (COLA) as a yearly index tied to TRICARE Prime retiree
    enrollment fee increases. We believe if DOD thought the rate of $230
    for individual and $460 for family was appropriate in 1995, then yearly
    increases tied to COLA would maintain that same principle. Our
    objection to the utilization of a civilian index is based on our
    concern that civilian healthcare experts cannot agree on an accurate
    index on which to base civilian healthcare yearly cost increases. The
    Task Force on the Future of Military Health Care ``strongly recommended
    that DOD and Congress accept a method for indexing that is annual and
    automatic.'' However, the Task Force recommended ``using a civilian-
    only rather than total cost (including civilian and MTF costs for Prime
    beneficiaries) because the Task Force and DOD have greater confidence
    in the accuracy of the civilian care data and its auditability.'' We
    ask Congress to adopt the Task Force's DOD accountability
    recommendation and require DOD to become more accurate and establish a
    common cost accounting system across the MHS. Until it can do so,
    however, we believe increases tied to COLA are the most fair to
    beneficiaries and predictable for DOD.
        We do not support DOD's budget proposal to change the U.S. Family
    Health Plan (USFHP) eligibility, asking newly enrolled beneficiaries to
    transition from USFHP once they become Medicare/TRICARE for Life
    eligible. Our Association believes USFHP is already providing TMA's
    medical home model of care, maintaining efficiencies, capturing
    savings, and improving patient outcomes. Every dollar spent in
    preventative medicine is captured later when the onset of beneficiary
    co-morbid and chronic diseases are delayed. It is difficult to quantify
    the long-term savings not only in actual cost to the healthcare plan--
    and thus to the government--but to the improvement in the quality of
    life for the beneficiary. Removing beneficiaries from USFHP at a time
    when they and the system will benefit the most from their preventative
    and disease management programs would greatly impact the continuity and
    quality of care to our beneficiaries and only cost shift the cost of
    their care from one government agency to another. Almost all USFHP
    enrollees already purchase Medicare Part B in case they decide to leave
    the plan or spend long periods of time in warmer parts of the country.
    There must be another mechanism in which beneficiaries would be allowed
    to continue in this patient-centered program. USFHP also meets the
    Patient Protection and Accountability Care Act's definition of an
    Accountable Care Organization. They certainly have the model of care
    desired by civilian healthcare experts and should be used by DOD as a
    method to test best-practices that can be implemented within the direct
    care system.
        Our Association understands the need for TRICARE to align itself
    with Medicare reimbursement payments. DOD's proposal to implement
    reimbursement payment for Sole Community Hospitals is another example
    of its search for efficiencies. According to TMA, 20 hospitals that
    serve military beneficiaries could be affected by this change. We
    appreciate the 4-year phased-in approach. However, our Association
    recommends Congress encourage TMA to reach out to these hospitals and
    provide waivers if warranted and provide oversight to ensure
    beneficiaries aren't unfairly impacted by this proposal.
        Our Association approves of DOD's modest increase to TRICARE Prime
    enrollment fees for working age retirees.
        We recommend that future increases to TRICARE Prime enrollment fees
    for working age retirees be indexed to retired pay cost of living
    adjustments and support legislative language in the House NDAA fiscal
    year 2012.
        We recommend that Medicare-eligible beneficiaries using the USFHP
    be allowed to remain in the program and Congress should continue to
    fund this TRICARE option for beneficiaries.
        We recommend Congress encourage TMA to reach out to Sole Community
    hospitals serving large numbers of military beneficiaries and provide
    waivers if warranted. Congress may need to provide additional funding
    to help offset this proposed reimbursement change by TMA.
                Other Cost Saving Proposals
        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 healthcare in a cost-effective manner.
      --Creating a committee, similar in nature to the Medicare Payment
            Advisory Commission, to provide oversight of the DOD Military
            Health System (MHS) and make 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 within 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. This
            was recommended by the Defense Health Board in 2006 and 2009
            and included in the U.S. House Armed Service Committee's fiscal
            year 2011 NDAA proposal and passed by the House of
            Representatives.
        We are supportive of TMA's movement toward a medical home model of
    patient and family centered care within the direct and purchase care
    systems. An integrated healthcare model, where beneficiaries will be
    seen by the same healthcare team focused on well-being and prevention,
    is a well-known cost saver for healthcare expenditures. Our concern is
    with the individual Services' interpretation of the medical home model
    and its ability to truly function as designed. Our MTFs are still
    undergoing frequent provider deployments; therefore, the model must be
    staffed well enough to absorb unexpected deployments to theater, normal
    staff rotation, and still maintain continuity of providers within the
    medical home.
        Our Association believes right-sizing to optimize MTF capabilities
    through innovating staffing methods; adopting coordination of care
    models, such as medical home; timely replacement of medical facilities
    utilizing ``world class'' and ``unified construction standards;'' and
    increased funding allocations, would allow more beneficiaries to be
    cared for in the MTFs. This would be a win-win situation because it
    increases MTF capabilities, which DOD asserts is the most cost
    effective. It also allows more families, who state they want to receive
    care within the MTF, the opportunity to do so. 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 healthcare
    practices. We encourage Congress to include the recommendations of the
    Task Force on the Future of Military Health Care in this year's fiscal
    year 2012 NDAA. These include:
      --Restructuring TMA to place greater emphasis on its acquisition
            role.
      --Examining and implementing strategies to ensure compliance with the
            principles of value-driven healthcare.
      --Incorporating health information technology systems and
            implementing transparency of quality measures and pricing
            information throughout the MHS. (This is also a civilian
            healthcare requirement in the recently passed Patient
            Protection and Affordable Care Act.)
      --Reassessing requirements for purchased care contracts to determine
            whether more cost effective strategies can be implemented.
      --Removing systemic obstacles to the use of more efficient and cost-
            effective contracting strategies.
                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. 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. For the past 3 years, we have piloted our Operation Purple
    Healing Adventures camp to help wounded, ill, and injured service
    members and their families learn to play again as a family. We hear
    from the families who participate in this camp, as well as others
    dealing with the recovery of their wounded service members, that, even
    with Congressional intervention and implementation of the Services'
    programs, many issues still create difficulties for them well into the
    recovery period. Families find themselves having to redefine their
    roles following the injury of the 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 all
    must focus on treating the whole family, with DOD and VA programs
    offering skill based training for coping, intervention, resiliency, and
    overcoming adversities. Injury interrupts the normal cycle of
    deployment and the reintegration process. DOD, the VA, and non-
    governmental organizations must provide opportunities for the entire
    family and for the couple to reconnect and bond, especially during the
    rehabilitation and recovery phases.
        DOD and the VA must do more to work together both during the
    treatment phase and the wounded service member's transition to ease the
    family's burden. They must break down regulatory barriers to care and
    expand support through the Vet Centers the VA medical centers, and the
    community-based outpatient clinics (CBOCs). We recommend DOD partner
    with the VA to allow military families access to mental health services
    throughout the VA's entire network of care using the TRICARE benefit.
    Before expanding support services to families, however, VA facilities
    must establish a holistic, family centered approach to care when
    providing mental health counseling and programs to the wounded, ill,
    and injured service member or veteran.
        We remain concerned about the transition of wounded, injured, and
    ill service members and their families from active duty status to that
    of the medically retired. While we are grateful, DOD has proposed to
    exempt medically retired service members, survivors, and their families
    from the TRICARE Prime enrollment fee increases, we believe wounded
    service members need even more assistance in their transition. We
    continue to recommend that a legislative change be made to create a 3-
    year transition period in which medically retired service members and
    their families would be treated as active duty family members in terms
    of TRICARE fees, benefits, and MTF access. This transition period would
    mirror that currently offered to surviving spouses and would allow the
    medically retired time to adjust to their new status without having to
    adjust to a different level of TRICARE support.
        Case Management.--Our Association still finds families trying to
    navigate a variety of complex healthcare systems alone, trying to find
    the right combination of care. Our most seriously wounded, ill, and
    injured service members, veterans, and their families are often
    assigned multiple case managers. Families often wonder which one is the
    ``right'' case manager. We believe DOD and the VA must look at whether
    the multiple, layered case managers have streamlined the process or
    have only aggravated it. We know the goal is for a seamless transition
    of care between DOD and the VA. However, we continue to hear from
    families, whose service member is still on active duty and meets the
    Federal Recovery Coordinator (FRC) requirement, who have not been told
    FRCs exist or that the family qualifies for one. We are awaiting the
    Government Accountability Office's (GAO) FRC report to determine how
    that program is working in caring for our most seriously wounded, ill,
    and injured service members and veterans and what can be done to
    improve the case management process.
                Caregivers of the Wounded
        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 healthcare 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 healthcare dollars in the long run. Their long-term
    psychological care needs must be addressed. Caregivers of the severely
    wounded, ill, and injured service 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 VA has made a strong effort in supporting veterans' caregivers.
    DOD should follow suit and expand its definition, which still does not
    align with Public Law 111-163. We appreciate the inclusion in fiscal
    year 2010 NDAA of compensation for service members with assistance in
    everyday living and the refinement in fiscal year 2011 NDAA. The VA
    recently released their VA Caregiver Implementation Plan. Our
    Association had the opportunity to testify at a recent House Veterans'
    Affairs Committee hearing Implementation of Caregiver Assistance: Are
    we getting it right? about our concerns related to the VA's caregiver
    implementation plan. We believe the VA is waiting too long to provide
    valuable resources to caregivers of our wounded and injured service
    members and veterans who had served in Operation Iraqi Freedom/
    Operation Enduring Freedom/Operation New Dawn (OIF/OEF/OND). The intent
    of the law was to allow caregivers to receive value-added benefits in a
    timely manner in order to improve the caregiver's overall quality of
    life and train them to provide quality of care to their service member
    and veteran. The VA's interpretation also has the potential to impact
    the DOD's Special Compensation for Service Members law passed as part
    of fiscal year 2010 NDAA and modified in fiscal year 2011. The one area
    of immediate concern is the potential gap in financial compensation
    when the service member transitions to veteran status. The VA's
    application process and caregiver validation process appear to be very
    time intensive. The DOD compensation benefit expires at 90-days
    following separation from active duty. Other concerns include:
      --Narrower eligibility requirements than what the law intended;
      --Lack of illness being covered, such as cancer from a chemical
            exposure;
      --Delay in the caregiver's receipt of healthcare benefits if
            currently uninsured, respite care, and training; and
      --Exclusion of non-medical care from the VA's caregiver stipend.
        The VA's decision to delay access to valuable training may force
    each Service to begin its own training program. Thus, each Service's
    training program will vary in its scope and practice and may not meet
    VA's training objectives. This disconnect could force the caregiver to
    undergo two different training programs in order to provide and care
    and receive benefits.
        Our Association also believes the current laws do not go far
    enough. Compensation of caregivers should be a priority for DOD and the
    Secretary of Homeland Security. Non-medical care should be factored
    into DOD's compensation to service members. The goal is to create a
    seamless transition of caregiver benefit between DOD and the VA. We ask
    Congress to assist in meeting that responsibility. Congress will need
    to be ready to fully fund both DOD and VA caregiver benefit programs.
        The VA currently has eight caregiver assistance pilot programs to
    expand and improve healthcare education and provide needed training and
    resources for caregivers who assist disabled and aging veterans in
    their homes. DOD should evaluate these pilot programs to determine
    whether to adopt them for caregivers of service members still on active
    duty. Caregivers' responsibilities start while the service member is
    still on active duty. Congress will need to fund these pilot programs.
        Relocation Allowance and Housing for Medically-Retired Single
    Service Members.--Active Duty service members and their spouses qualify
    through the DOD for military orders to move their household goods 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.
        Our Association suggests that legislation be passed to allow
    medically retired single service members 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
    healthcare 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 FRC (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 healthcare,
    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.
        We ask Congress to allow medically retired service members and
    their families to maintain the active duty family TRICARE benefit for a
    transition period of 3 years following the date of medical retirement,
    comparable to the benefit for surviving spouses.
        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.
        Congress will need to fully fund training, compensation and other
    support programs for caregivers of the wounded, ill and injured because
    of the important role they play in the successful rehabilitation and
    care of the service member and veteran.
        We request legislation funding medically retired single service
    members to have their caregiver's household goods moved as a part of
    their final PCS move.
        Congress will need to fully fund DOD's Caregiver Compensation
    benefit for military service members and the VA's caregiver benefit for
    caregivers.
                Senior Oversight Committee
        Our Association is appreciative of the provision in the fiscal year
    2009 NDAA continuing the DOD and VA Senior Oversight Committee (SOC)
    until December 2010. The DOD established the Office of Wounded Warrior
    Care and Transition Policy to take over the SOC responsibilities. The
    Office has seen frequent leadership and staff changes and a narrowing
    of its mission. We urge Congress to put a mechanism in place to
    continue to monitor this Office for its responsibilities in maintaining
    DOD and VA's partnership and making sure joint initiatives create a
    seamless transition of services and benefits for our wounded, ill, and
    injured service members, veterans, their families, and caregivers.
                Defense Centers of Excellence
        A recent GAO report found the Defense Centers of Excellence (DCoE)
    for Psychological Health and Traumatic Brain Injury has been challenged
    by a mission that lacked clarity and by time-consuming hiring
    practices. DCoE has experienced a lack of adequate funding hampering
    their ability to hire adequate staff and begin to provide care for the
    patient population as they were created to address. These include the
    Vision Center of Excellence, Hearing Center of Excellence, and the
    Traumatic Extremity Injury and Amputation Center of Excellence. We
    recommend Congress immediately fund these Centers and require DOD to
    provide resources to effectively establish these Centers and meet DOD's
    definition of ``world class'' facilities.
        The Defense Centers of Excellence is providing a transition benefit
    for mental health services for active duty service members, called
    inTransition. Our Association recommends this program be expanded to
    provide the same benefit to active duty spouses and their children.
    Families often complain about the lack of seamless transition of care
    when they PCS. This program will not only provide a warm hand-off
    between mental health providers when moving between and within Regions,
    but more importantly, enable mental health services to begin during the
    move, when families are between duty stations and most venerable.
        We must educate those who care for our service members and veterans
    about the effects of Traumatic Brain Injury (TBI), Post-Traumatic
    Stress (PTS), Post-Traumatic Stress Disorder (PTSD), and suicide 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 healthcare providers.
    Families need tools to help them deal with the daily issues that arise
    when living with and caring for a service member or veteran with TBI
    and/or PTS/PTSD. Programs are being developed by each Service. However,
    they are narrow in focus targeting line leaders and healthcare
    providers, but not broad enough to capture our military family members
    and the communities they live in. As Services roll out suicide
    prevention programs, we need to fund programs that include our
    families, communities, and support personnel. The Deployment Health
    Clinical Center (DHCC), an umbrella organization to DCoE, offers a 3
    week PTSD course for service members and a separate 1-week course for
    their family members. These programs are making a difference in the
    quality of the service members and their families lives. Currently, the
    family member PTSD program is funded by a nonprofit organization. These
    programs need to continue; therefore, they need to be fully funded by
    Congress.
        Our Association encourages all Congressional Committees with
    jurisdiction over military personnel and veterans matters to talk on
    these important issues. Congress, DOD, and VA can no longer continue to
    create policies in a vacuum and focus on each agency separately because
    our wounded, ill, and injured service members and their families need
    seamless, coordinated support from each.
        We recommend Congress immediately fund the Vision Center of
    Excellence, Hearing Center of Excellence, and the Traumatic Extremity
    Injury and Amputation Center of Excellence and require DOD to provide
    resources to effectively establish these Centers and meet DOD's
    definition of ``world class'' facilities.
        We recommend Congress fully fund DHCC's PTSD programs for service
    members and their family members s they may continue uninterrupted.
        We recommend the ``inTransition'' program be expanded to provide
    the same benefit to active duty family members. This program would need
    to be funded to be expanded to include them.
    Family Transitions
        Policies and programs must provide training and support for
    families during the many transitions military families experience.
    Quality education for spouses and children, financial literacy, and
    spouse career progression need attention. When families experience a
    life-changing event, they require a responsive system to support them.
    Our Nation must continue to ensure our surviving family members receive
    the support they deserve.
                Survivors
        The Services continue to improve their outreach to surviving
    families. In particular, the Army's SOS (Survivor Outreach Services)
    program makes an effort to remind these families they are not
    forgotten. We most appreciate the special consideration, sensitivity,
    and outreach to the families whose service members have committed
    suicide. We would like to acknowledge the work of the Tragedy
    Assistance Program for Survivors (TAPS) in this area as well. They have
    developed unique outreach to these families and held support
    conferences to help surviving family members navigate what is a very
    difficult time with many unanswered questions. 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. We
    believe Congress must grant authority to allow coverage of bereavement
    or grief counseling under the TRICARE behavioral health benefit. The
    goal is the right care at the right time for optimum treatment effect.
        In 2009, the policy concerning the attendance of the media at the
    dignified transfer of remains at Dover AFB was changed. Primary next-
    of-kin (PNOK) of the service member who dies in theater is asked to
    make a decision shortly after they are notified of the loss as to
    whether or not the media may film the dignified transfer of remains of
    their loved one during this ceremony. Family members are also given the
    option of flying to Dover themselves to witness this ceremony. In
    previous years, only about 3 percent of family members attended this
    ceremony. Since the policy change, over 90 percent of families send
    some family members to Dover to attend. The travel of up to 3 family
    members and the casualty assistance officer on a commercial carrier are
    provided for. In the NDAA fiscal year 2010, eligible family member
    travel to memorial services for a service member who dies in theater
    was authorized. This is in addition to travel to the funeral of the
    service member. None of the costs associated with this travel has been
    funded for the Services. We would ask that funds be appropriated to
    cover the costs of this extraordinary expense.
        Our Association recommends that grief counseling be more readily
    available to survivors as a TRICARE benefit.
        We ask that funding be appropriated for the travel costs for
    surviving family members to attend the dignified transfer of remains in
    Dover and for eligible surviving family members to attend memorial
    services for service members who die in theater.
        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 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 believe there needs to be DIC equity with other Federal survivor
    benefits. Currently, DIC is set at $1,154 monthly (43 percent of the
    Disabled Retirees Compensation). Survivors of Federal workers have
    their annuity set at 55 percent of their Disabled Retirees
    Compensation. Military survivors should receive 55 percent of VA
    Disability Compensation. We are awaiting the overdue report. We support
    raising DIC payments to 55 percent of VA Disability Compensation. When
    changes are made, we ask Congress to ensure that DIC eligibles under
    the old system receive an equivalent increase.
        Imagine that you have just experienced the death of your spouse, a
    retired service member. In your grief, you navigate all the gates you
    must, fill out paperwork, notify all the offices required. Then, the
    overdrawn notices start showing up in your mailbox. Bills that you
    thought had been paid at the beginning of the month suddenly appear
    with ``overdue'' on them. Retirees are paid proactively, that is, they
    receive retired pay for the upcoming month i.e. on May 31, a retiree
    receives retired pay for the month of June. Presently, the government
    has the authority to take back the full month's pay from the retiree's
    checking account when that retiree dies. Payment for the number of days
    the retiree was alive in the month is subsequently returned to the
    surviving spouse. The VA, on the other hand, allows the surviving
    spouse to keep the last month of disability pay. We support H.R. 493,
    which would allow the surviving spouse or family to keep the last month
    of retired pay to avoid financial penalties caused by the decrease of
    funds in a checking account.
        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
    support H.R. 178 and S. 260, which both provide for that elimination.
        We also request that SBP benefits be allowed to be paid to a
    Special Needs Trust in cases of disabled family members.
        We ask that DIC be increased to 55 percent of VA Disability
    Compensation.
        We support H.R. 493, ``The Military Retiree Survivor Comfort Act'',
    to provide for forgiveness of overpayments of retired pay paid to
    deceased retired members of the Armed Forces following their death.
                Education of Military Children
        Military families place a high value on the quality of their
    children's education. It is a leading factor in determining many
    important family decisions, such as volunteering for duty assignments,
    choosing to accompany the service member or staying behind, selecting
    where a family lives within their new community, deciding whether to
    spend their financial resources on private school, or considering
    homeschooling options. It can even impact a families' decision to
    remain in the Service.
        Military families want quality education for their children just as
    their civilian counterparts do. It is important to remember that
    military families define ``quality of education'' differently. For
    military families, it is not enough for children to be doing well in
    their current schools they must also be prepared for the next location.
    Most military children will move at least twice during their high
    school years and most will attend six to nine different schools between
    kindergarten and 12th grade. Although the Interstate Compact on
    Educational Opportunity for Military Children is helping to alleviate
    many of the transition issues our families face when moving, it does
    not address the quality of education in our schools. Though many of our
    civilian schools are already doing an excellent job of educating and
    supporting our military children, we believe military children deserve
    a quality education wherever they may live. That is why our Association
    has spent over 40 years working to improve education for our military
    children and empowering parents to become their children's best
    advocate.
        With more than 90 percent of military-connected students now
    attending civilian schools, our Association is pleased that the
    Department of Defense has completed a 90-day preliminary assessment of
    how to provide a world-class education for all of the 1.2 million
    school-aged children, not just those under the Department of Defense
    Education Activity's (DODEA) purview. Our Association was invited by
    Dr. Clifford L. Stanley, Under Secretary of Defense for Personnel and
    Readiness, to participate in the Education Review Debriefing and to
    offer our insights on the way ahead. We look forward to the final
    report and to working with DOD to support its implementation. We thank
    the Department of Defense for the educational support programs already
    available to military children, such as the tutoring program for
    deployed service member families, and DODEA's virtual high schools. Our
    Association believes these programs are making a difference and would
    be beneficial to all military families.
        We were also pleased the President's landmark directive,
    ``Strengthening Our Military Families,'' listed as one of its top
    priorities the need to ensure excellence in military children's
    education and their development. We greatly appreciate the Department
    of Education committing to making military families one of its
    priorities for its discretionary grant programs and for including our
    Association as a military stakeholder in finding ways to strengthen
    military families within the Reauthorization of the Elementary and
    Secondary Education Act.
        Our Association thanks Congress for providing additional funding to
    civilian school districts educating military children through DODEA's
    Educational Partnership Grant Program. We are aware that DODEA's
    expanded authority to shares its expertise, experience and resources to
    assist military children during transitions, to sharpen the expertise
    of teachers and administrators in meeting the needs of military
    children, and to provide assistance to local education agencies on
    deployment support for military children is set to expire in 2013. We
    ask Congress to extend the authority for the Educational Partnership
    Grant Program past 2013.
        We strongly urge Congress to ensure it is providing appropriate and
    timely funding of Impact Aid through the Department of Education. We
    also ask that you allow school districts experiencing high levels of
    growth, due to military base realignment, to apply for Impact Aid funds
    using current student enrollment numbers rather than the previous year.
    In addition, we call on Congress to increase DOD Supplemental Impact
    Aid funding for schools educating large numbers of military connected
    students. Our Association has long believed that both Impact Aid
    programs are critical to ensuring that school districts can provide
    quality education for our military children.
        We strongly urge Congress to ensure it is providing appropriate
    funding of Impact Aid through the Department of Education at authorized
    levels and to allow school districts experiencing high growth due to
    base realignments to apply for Impact Aid funds using current student
    enrollment numbers.
        We ask Congress to increase the DOD supplement to Impact Aid to $60
    million.
        We also ask Congress to extend the authority for the DODEA
    Educational Partnership Grant Program.
                Spouse Education and Employment
        We are pleased the NDAA fiscal year 2011 calls for a report on
    military spouse education programs. Our recent surveys and feedback we
    have received from military families indicates they appreciate in-state
    tuition and the Post 9/11 G.I. Bill transferability. Our Association
    would like to thank Congress for the enhancements made to the Post 9/11
    G.I. Bill last session. We are especially pleased that spouses of
    active duty service members are now eligible for the book stipend and
    the authority to grant transferability has been extended to families of
    the Commissioned Corps of NOAA and the U.S. Public Health Service.
        DOD's most-cited program success for military spouses is the
    Military Spouse Career Advance Account (MyCAA)--in its original form.
    In October 2010, MyCAA was significant revised and seasoned spouses who
    are no longer eligible feel their education pursuits are not supported
    by the Department of Defense. Many military spouses delay their
    education to support the service member's career. 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. Of particular interest, 33.5 percent of
    applicants from our 2011 scholarship applicant pool stated their
    education was interrupted because of the military lifestyle (frequent
    moves, TDYs, moving expenses, etc.) and 12.2 percent of those directly
    attributed the interruption to deployment of the service member.
    Military spouses remain committed to their education and need
    assistance from Congress to fulfill their educational pursuits. We ask
    Congress to push DOD to fully reinstate the MyCAA program to include
    all military spouses, regardless of their service member's rank and to
    ensure the funding is available for this reinstatement. We also ask
    Congress to work with the appropriate Service Secretaries to extend the
    MyCAA program to spouses of the Coast Guard, the Commissioned Corps of
    NOAA, and the U.S. Public Health Service.
        The fiscal year 2011 NDAA report on military spouse education
    programs only addresses one aspect--education. In order to determine if
    the education programs are working, we recommend a report on spouse
    employment programs. The NDAA fiscal year 2010 created a pilot program
    to secure internships for military spouses with Federal agencies.
    Funding for the program continues through fiscal year 2011. A report on
    military spouse employment programs should include an assessment of the
    military spouse Federal internship program. Military spouses want more
    Federal employment opportunities. Should the pilot become a permanent
    program? We urge Congress to monitor the pilot to ensure spouses are
    able to access the program and eligible spouses are able to find
    Federal employment after successful completion of the internship. Our
    Association recommends Congress requests a report on military spouse
    employment programs.
        To further spouse employment opportunities, we recommend an
    expansion to the Work Opportunity Tax Credit for employers who hire
    spouses of active duty and reserve component service members as
    proposed through the Military Spouse Employment Act, H.R. 687. This
    employer tax credit is one way to encourage corporate America to hire
    military spouses.
        We also recommend providing a tax credit to military spouses to
    offset the expense of obtaining a career license or credential when the
    service member is relocated to a new duty station. Military spouses are
    financially disadvantaged by government ordered moves when they are
    required to obtain a career license in a new State to practice in their
    profession. Many military spouses must maintain a career license in
    multiple States, costing hundreds of dollars. For example, a pharmacist
    can only reciprocate to another State from their original license,
    which requires a military spouse pharmacist to maintain a license in
    more than one State. When our Association asked military spouses to
    share their employment challenges with us, a military spouse of 26
    years stated, ``The very most frustrating part about the process, is
    that obtaining a license does not guarantee that I will find
    employment. I have been licensed in [Kentucky] for a full year and in
    that time have gotten one 6-hour shift of work. That one shift does not
    even begin to recover the expense of obtaining my license here.'' We
    recommend that Congress pass the Military Spouse Job Continuity Act or
    similar legislation to reduce the financial barrier licensed military
    spouses must overcome with each move in order to find employment.
        Our Association urges Congress to recognize the value of military
    spouses by fully funding the MyCAA program for all military spouses,
    expand the Work Opportunity Tax Credit to include military spouses, and
    provide a tax credit to offset state license and credential fees.
                Support for Special Needs Families
        The NDAA fiscal year 2010 established the Office of Community
    Support for Military Families with Special Needs to enhance and improve
    DOD support around the world for military families with special needs,
    whether medical or educational. Our Association remains concerned that
    the Office has not received the proper resources to address the
    medical, educational, relocation, and family support resources our
    special needs families often require. This Office must address these
    various needs in a holistic manner in order to effectively implement
    change. The original intent of the legislation was to have the office
    reside in the Office of the Under Secretary of Defense for Personnel
    and Readiness in order to bring together all entities having
    responsibility for the medical, educational, relocation, and family
    support needs of special needs military family member. At present,
    however, the office comes under the jurisdiction of the Deputy
    Assistant Secretary of Defense for Military Community and Family
    Policy.
        Case management for military beneficiaries with special needs is
    not consistent across the Services or the TRICARE Regions because the
    coordination care for the military family is being done by a non-
    synergistic healthcare system. Beneficiaries try to obtain an
    appointment and then find themselves getting partial healthcare within
    the MTF, while other healthcare is referred out into the purchased care
    network. Thus, military families end up managing their own care.
    Incongruence in the case management process becomes more apparent when
    military family members transfer from one TRICARE Region to another and
    when transferring within the same TRICARE Region. This incongruence is
    further exacerbated when a special needs family member is involved and
    they require not only medical intervention, but non-medical care as
    well. Families need a seamless transition and a warm hand-off between
    and within TRICARE Regions and a universal case management process
    across the MHS. Each TRICARE Managed Care Support Contractor (MCSC) has
    created different case management processes. TRICARE leaders must work
    closely with their family support counterparts through the Office of
    Community Support for Military Families with Special Needs to develop a
    coordinated case management system that takes into account other
    military and community resources.
        We applaud the attention Congress and DOD have given to our special
    needs family members in the past 2 years and their desire to create
    robust healthcare, educational, and family support services for special
    needs family members. 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, preferably in the same State in which they plan to
    live after the service member retires, to enable them to begin the
    process of becoming eligible for State and local services while still
    on active duty. We also suggest the Extended Care Health Option (ECHO)
    be extended for 1 year after retirement for those family members
    already enrolled in ECHO prior to retirement. More importantly, our
    Association recommends if the ECHO program is extended, it must be for
    all who are eligible for the program because we should not create a
    different benefit simply based on medical diagnosis.
        The Office of Community Support is beginning a study on Medicaid
    availability for special needs military family members. Our Association
    is anxiously awaiting this report's findings. We will be especially
    interested in the types of value-added services individual State
    Medicaid waivers offer their enrollees and whether State budget
    difficulties are making it more difficult for military families to
    qualify for and participate in waiver programs. This information will
    provide yet another avenue to identify additional services ECHO may
    include in order to help address our families' frequent moves and their
    inability to often qualify for these additional value-added benefits in
    a timely manner.
        There has been discussion over the past several years by Congress
    and military families regarding the ECHO program. 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 request a GAO report to determine if the ECHO program
    is working as it was originally designed and if it has been effective
    in addressing the needs of this population. We also hear from our ECHO
    eligible families that they could benefit from additional programs and
    healthcare services to address their special needs. We request a DOD
    pilot study to identify what additional service(s), if any, our special
    needs families need to improve their quality of life, such as cooling
    vests, diapers, and some nutritional supplements. We recommend families
    have access to $3,000 of additional funds to purchase self-selected
    items, programs, and/or services not already covered by ECHO. DOD would
    be required to authorize each purchase to verify the requested item,
    program, or service is appropriate. The pilot study will identify gaps
    in coverage and provide DOD and Congress with a list of possible extra
    ECHO benefits for special needs families. We need to make the right
    fixes so we can be assured we apply the correct solutions. Our
    Association believes the Medicaid waiver report, the GAO report, along
    with the pilot study will provide DOD and Congress with the valuable
    information needed to determine if the ECHO program needs to be
    modified in order to provide the right level of extra coverage for our
    special needs families. We also recommend a report examining the impact
    of the war on special needs military families.
        We ask Congress to request a GAO report to determine if the ECHO
    program is working as it was originally designed and if it has been
    effective in addressing the needs of this population.
        We request Congress fund a DOD pilot study to identify what
    additional service(s), if any, our special needs families need to
    improve their quality of life.
        We recommend that the Extended Care Health Option (ECHO) program be
    extended for 1 year after retirement for those already enrolled in ECHO
    prior to retirement.
        We also recommend a report examining the impact of the war on our
    special needs families.
                Families on the Move
        A Permanent Change of Station (PCS) move to an overseas location
    can be especially stressful for our families. 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 extracurricular 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.
        Travel allowances and reimbursement rates have not kept pace with
    the out-of-pocket costs associated with today's moves. In a recent PCS
    survey conducted by our Association, more than 50 percent of survey
    respondents identified uncovered expenses related to the move as their
    top moving challenge. Military families are authorized 10 days for a
    housing hunting trip, but the cost for trip is the responsibility of
    the service member. Families with two vehicles may ship one vehicle and
    travel together in the second vehicle. The vehicle will be shipped at
    the service member's expense and then the service member will be
    reimbursed funds not used to drive the second vehicle to help offset
    the cost of shipping it. Or, families may drive both vehicles and
    receive reimbursement provided by the Monetary Allowance in Lieu of
    Transportation (MALT) rate. MALT is not intended to reimburse for all
    costs of operating a car but is payment in lieu of transportation on a
    commercial carrier. Yet, a TDY mileage rate considers the fixed and
    variable costs to operate a vehicle. Travel allowances and
    reimbursement rates should be brought in line with the actually out-of-
    pocket costs borne by military families.
        Our Association supports the Service Members Permanent Change of
    Station Relief Act, S. 472 and believes it will reduce some of the
    additional moving expenses incurred by many military families.
        Our Association requests that Congress authorize the shipment of a
    second vehicle to an overseas location (at least Alaska and Hawaii) on
    accompanied tours, and that Congress address the out-of-pocket expenses
    military families bear for government ordered moves.
                Military Families--Our Nation's Families
        Military families have been supporting their warriors in time of
    war for 10 years. DOD and the military Services, with the help and
    guidance of Congress have developed programs and policies to respond to
    their changing and developing needs over this time. Families have come
    to rely on this support. They appreciate the spotlight of recognition
    that has been shone on their experience by the First Lady and Dr.
    Biden. They are heartened by the new sense of cooperation between
    government agencies in coordinating support. They know that it is up to
    them to make use of the tools and programs provided to become more
    resilient with each deployment. Congress provides the authorization and
    funding for these tools and programs. Even in a time of austere
    budgets, our Nation needs to sustain this support in order to maintain
    readiness. Our military families deserve no less.

        Chairman Inouye. I thank you very much, Ms. Moakler.
        Senator Cochran.
        Senator Cochran. I'm curious, what's the estimated cost of
    the reimbursement if the Congress desired to or decided to
    respond to that request?
        Ms. Moakler. I don't know, because it depends on how long,
    how far the family is coming from. But right now the units
    themselves are taking that money out of hide, out of their
    family support funds.
        Senator Cochran. Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, just an observation. I know
    Ms. Moakler is her as an advocate and she's got a great record
    of family support. I believe this subcommittee has a good
    record of support for our military through the appropriation,
    and their families, which we think are very important to the
    wellbeing and the readiness of our soldiers.
        Ms. Moakler. We agree.
        Senator Shelby. Thank you.
        Chairman Inouye. Thank you very much.
        Our next witness, Chief Master Sergeant John McCauslin, Air
    Force Sergeants Association.
    STATEMENT OF CHIEF MASTER SERGEANT JOHN R. ``DOC''
                McCAUSLIN, CHIEF EXECUTIVE OFFICER, AIR
                FORCE SERGEANTS ASSOCIATION
        Sergeant McCauslin. Good morning, Chairman Inouye, Ranking
    Member Cochran, Senator Shelby, and other members of this
    subcommittee. On behalf of the 110,000 members of the Air Force
    Sergeants Association, thanks for this opportunity to offer our
    views of our members on the fiscal year 2012 priorities. This
    morning I will briefly cover some specific areas we urge your
    subcommittee to provide funding for.
        Let me begin with healthcare. In coordination with the
    Military Coalition and governmental agencies, we want to ensure
    that our military members and their families continue to
    receive a cost-effective sustainable healthcare benefit, and we
    greatly appreciate the past efforts of you and this
    subcommittee to make that happen.
        Last week the Senate Armed Services Committee marked the
    National Defense Authorization Act and we were greatly
    disappointed that the bill permits TRICARE fee increases.
    Before seeking increases in military healthcare, we would urge
    that you consider all funding options relative to adequate and
    sustainable healthcare for our military and their families and
    get full detailed justification for the raise of such from DOD.
        The care of those who have borne the horrors and hazards of
    battle needs your constant attention. More than 42,000 service
    members have been wounded in action since the conflicts began.
    Thousands more suffer from the unseen wounds of war. We support
    full funding for the care of wounded warriors, including moneys
    for research and treatment of traumatic brain injuries, post-
    traumatic stress disorder, and all those other war-related
    issues.
        On a related matter, this Nation owes those heroes an
    everlasting gratitude and compensation that extends well beyond
    their time in the military. It calls attention to the
    importance of proper documentation of care received on the
    battlefield and their recovery afterward. DOD and VA have made
    great strides in recent years developing a joint electronic
    health record. But it's imperative that this work continue
    until that job is done. This is one that actually saves the
    taxpayers money.
        We also urge continued funding of military base pay, so
    that annual military pay raises exceed the ECI index by at
    least one-half of 1 percent, and we support targeted pay raises
    for midgrade enlisted personnel who have recently assumed
    increased responsibility. The bottom line here is regular
    military pay raises must be maintained by DOD so that we can
    continue to recruit and retain the very best and brightest.
        Another hot button issue is the homelessness and
    unemployment of our veterans. The VA has estimated that 25
    percent of all homeless individuals in the United States are
    veterans. According to the Bureau of Labor Statistics, the
    estimated jobless rate among male veterans ages 18 to 24 was
    more than 30 percent just last month, compared to 18 percent
    among civilians of the same age and gender group. This is an
    absolute shame. DOD and VA recently agreed to tackle this issue
    jointly, so we encourage you to provide enough resources to
    make that happen.
        Caring for survivors of military members is always a matter
    of concern. Those with military survivor plan annuities should
    be able to also receive VA's dependency and indemnity
    compensation payments without offset. The special survivors
    indemnity allowance created by Congress in 2008 to minimize
    those losses is appreciated, but it only restores a fraction of
    the nearly $1,200 surviving spouses lose each month. We as a
    Nation must be able to do better than that.
        We would like to thank Senator Bill Nelson for introducing
    S. 260 and the 38 Senators, 8 of which are on your
    subcommittee, sir, who have co-sponsored this important
    legislation. You may recall that in the 111th Congress there
    were 62 co-sponsors in the Senate to fix this. It's high time
    we act.
        Another precious asset is, the National Guard and Air Force
    Reserve currently have to wait until they reach age 60 before
    they draw their retirement pay. They are currently over 50
    percent of our mission completion, yet subject to this holding
    situation. A provision in last year's NDAA allows the reserve
    components to shave off some time of their minimum retired age
    in exchange for equal periods of active duty service in combat
    zones. We are nowhere near resolving this issue and appreciate
    your continued attention.
        Mr. Chairman, that's all I have today. On behalf of our
    association, I thank you and the members of your subcommittee
    for their dedication to those of us who serve.
        [The statement follows:]
                Prepared Statement of John R. ``Doc'' McCauslin
        Chairman Inouye, Ranking Member Cochran, and distinguished members
    of the Defense subcommittee, on behalf of the 111,000 members of the
    Air Force Sergeants Association, thank you for this opportunity to
    offer the views of our members on the military personnel programs that
    affect those serving (and who have served) our Nation. This hearing
    will address issues critical to those serving and who have served our
    Nation.
        AFSA represents active duty, guard, reserve, retired, and veteran
    enlisted Air Force members and their families, and this year marks our
    50th Anniversary in doing so. Your continuing efforts toward improving
    the quality of their lives make a real difference, and our members are
    grateful. In this statement, I will list several specific goals that we
    hope this committee will consider funding in fiscal year 2012 on behalf
    of current and past enlisted members and their families. The content of
    this statement reflects the views of our members as they have
    communicated them to us. As always, we are prepared to present more
    details and to discuss these issues with your staffs.
                               basic military pay
        Tremendous progress has been made in recent years to close the gap
    between civilian sector and military compensation. AFSA appreciates
    these steady efforts and we hope they will continue. We believe linking
    pay raises to the employment cost index (ECI) is essential to
    recruiting and retaining the very best and brightest volunteers.
        The President's fiscal year 2012 budget proposal calls for a 1.6
    percent pay increase for active duty service members--the minimum
    amount by law. AFSA believes that 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, we
    must continue on the path to close the aforementioned pay gap!
                                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 them and their families, with decent and safe
    work centers, family housing and dormitories, healthcare, 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 3 years and I can assure you that the demand for
    adequate child care is a top priority among our Airmen and their
    families. The availability of on base Child Development Centers (CDC)
    plays a critical role in each military family's decision whether or not
    to remain in the service. So I urge Congress to dedicate the funding
    necessary to build more CDCs and eliminate the space deficit that
    exists today.
                                   healthcare
        Like many Military and Veterans Service Organizations (MSO/VSO's),
    AFSA wants to ensure that past, present and future service members and
    families receive the inexpensive, high quality healthcare benefit that
    they so richly deserve. And we are concerned with repeated attempts by
    DOD to shift healthcare costs onto the back of retirees--particularly
    how they are perceived by active duty service members, many of whom
    have fought in Iraq and Afghanistan over the past 10 years.
        As Abraham Lincoln correctly observed, ``The willingness with which
    our young people are likely to serve in any war, no matter how
    justified, shall be directly proportional to how they perceive the
    Veterans of earlier wars were treated and appreciated by their
    nation.''
        To date, Congress has rejected the Pentagons proposed raids on
    earned medical benefits, and we greatly appreciate your work which
    allowed that to happen.
        This year the Pentagon is once again asking for higher fees and
    their current plan would raise enrollment fees for ``working age''
    retirees and their families who use TRICARE Prime would increase by 13
    percent in fiscal year 2012. The National Health Expenditure index,
    produced by the Centers for Medicare and Medicaid Services, would be
    used beginning in fiscal year 2013, to determine annual enrollment fee
    increases thereafter.
        Co-pays for prescription drugs obtained at retail pharmacies would
    also rise under DOD's plan--from $3 to $5 for generics, $9 to $12 for
    brand name, and $22 to $25 for non-formulary medications at retail
    pharmacies. Non-formulary medications obtained through TRICARES Home
    Delivery would also increase to $25 from $22.
        At first glance, the increases DOD is proposing appear modest but
    we view them as the ``foot in the door'' which will provide the impetus
    for a long line of future TRICARE program changes. Regrettably, the
    House recently chose to include, or rather exclude, language in its
    version of the fiscal year 2012 National Defense Authorization Act
    (H.R. 1540) which would allow DOD's plan to move forward. It does
    however, limit increases in fiscal year 2013 and beyond to the rate of
    the annual COLA.
        AFSA does not discount the country's current fiscal dilemma, or the
    need to get the Federal budget under control. Nor is it is an issue of
    sacrificing a little more so everyone shares a greater portion of the
    load. The question is should they pay more before lesser priority
    programs are cut first? No one has sacrificed more then the men and
    women who have worn or are wearing the Nation's uniform. We simply
    believe it is unwise to raise TRICARE fees at a time when we have
    thousands of men and women in harms way overseas. What kind of message
    are we sending to them? Many of the individuals that would be affected
    by the proposed increases were promised free lifetime healthcare by
    DOD's recruiters to entice them to enlist, and career counselors to
    induce them to reenlist. Right, wrong, or indifferent, a decision to
    increase fees at this time would likely be viewed as another breech of
    promises made by the government. This in turn could adversely affect
    the services quality recruiting and retention efforts.
        I urge this Subcommittee to ensure continued, full funding for
    Defense Health Program. Before seeking increases in enrollment fees,
    deductibles or co-payments, DOD should pursue any and all options to
    contain the growth of healthcare spending in ways that do not
    disadvantage beneficiaries and provide incentives to promote healthy
    lifestyles.
        Again, we appreciate your consistent support in recent years to
    protect beneficiaries from disproportional healthcare fee increases.
    Support Judicious VA-DOD Sharing Arrangements
        We encourage this Subcommittee to fund programs that eliminate
    waste and increase efficiency between DOD and VA.
        AFSA supports the judicious use of VA-DOD sharing arrangements
    involving network inclusion in the DOD healthcare program, especially
    when it includes consolidating physical examinations at the time of
    separation. It makes no sense to order a full physical exam on your
    retirement from the military and then within 30 days the VA has ordered
    their own complete physical exam with most of the same exotic and
    expensive exams.
        The decision to begin this process represents a good, common-sense
    approach that should eliminate problems of inconsistency, save time,
    and take care of veterans in a timely manner. These initiatives will
    save funding dollars. AFSA recommends that Congress closely monitor the
    collaboration process to ensure these sharing projects actually improve
    access and quality of care for eligible beneficiaries. DOD beneficiary
    participation in VA facilities must never endanger the scope or
    availability of care for traditional VA patients, nor should any VA-DOD
    sharing arrangement jeopardize access and/or treatment of DOD health
    services beneficiaries. One example of a successful joint sharing
    arrangement is the clinic with ambulatory care services being in
    Colorado Springs, Colorado. This will aid the large number of veterans
    remaining in the area and support the increases in Colorado Springs as
    a result of BRAC initiatives. The VA and DOD each have a lengthy and
    comprehensive history of agreeing to work on such projects, but follow-
    through is lacking. ``We urge these committees to encourage joint VA-
    DOD efforts, but ask you to exercise close oversight to ensure such
    arrangements are implemented properly.''
                              caring for survivors
        Support of Survivors.--AFSA commends this committee for previous
    legislation, which allowed retention of Dependency and Indemnity
    Compensation (DIC), burial entitlements, and VA home loan eligibility
    for surviving spouses who remarry after age 57. However, we strongly
    recommend the age 57 DIC remarriage provision be reduced to age 55 to
    make it consistent with all other Federal survivor benefit programs.
        We also endorse the view that surviving spouses with military
    Survivor Benefit Plan (SBP) annuities should be able to concurrently
    receive earned SBP benefits and DIC payments related to their sponsor's
    service-connected death.
        We strongly recommend the Subcommittee fund Senator Bill Nelson's
    (D-FL) bill, S. 260 which would eliminate this unfair offset.
        Survivors of retirees who draw the final full month's retired pay
    for the month in which retirees die should not have to pay this
    compensation back. This is however, what current law requires.
        At a time when the surviving spouse and family members are trying
    to put their lives back together, DOD comes and takes the money back.
    Not some of it; all of it. The entire month. Weeks later, the
    proportionate amount of retired pay may be returned to the spouse but
    the damage has already been done.
        AFSA believes it is wrong to subject survivors to this kind of
    ``financial nit-picking'' at a tragic time lives. If there's ever a
    time for the Government to give a military beneficiary a tiny break,
    surely this is it. And we encourage this subcommittee to provide
    sufficient funding to remove this requirement from the books.
        Other Survivor issues included in our Top Priorities are:
      --Permit the member to designate multiple SBP beneficiaries with a
            presumption that such designations and related allocations of
            SBP benefits must be proportionate to the allocation of retired
            pay.
      --Provide for eligibility for housing loans guaranteed by the
            Department of Veterans Affairs for the surviving spouses of
            certain totally disabled veterans.
                           debt commission proposals
        Oppose the following Debt commission recommendations:
      --Freeze Federal salaries, bonuses and other comp for 3 years
            including military non-combat pay;
      --Reduce spending on base support and facility maintenance;
      --Integrate military kids into local schools in the United States;
      --Use highest 5 years for civil svc and military retiree pay;
      --Reform military retiree system to vest after 10 years and defer
            collection to age 60; and
      --Full 20+ years of military retired pay starts age 57.
        Work Toward a Consistent Funding Formula and Program Permanence.--
    This association believes that the parameters of who will be served,
    what care will be provided, the facilities needed, and the full funding
    to accomplish those missions should be stabilized as mandatory
    obligations. If that were so, and Congress did not have to go through
    redefinition drills as economic philosophies change, the strength of
    the economy fluctuates, and the numbers of veterans increases or
    decreases--these committees and this Nation would not have to re-debate
    obligations and funding each year. We believe that these important
    programs should be beyond debate and should fall under mandatory rather
    than discretionary spending.
        The following are a few of the Debt Commission issues recognized in
    our Top Priorities:
      --Make adjustments to the Household Goods (HHG) weight allowances
            that take into consideration the number of family members;
      --If advantageous to the Government, reimburse transportation
            expenses for PCSing members to take their POVs to a location
            other than a commercial storage facility;
      --Resist DOD/DECA efforts to reduce the benefit that negatively alter
            current pricing policies, or provide the benefit to non-
            military beneficiaries;
      --Resist the Base Exchange merger process to prevent degradation of
            the benefit; and
      --Monitor/scrutinize housing privatization efforts to preclude
            adverse impact on all military members.
                   air national guard and reserve retirement
        Reduce the earliest Guard and Reserve retirement compensation age
    from 60 to 55.--Legislation was introduced in previous years to provide
    a more equitable retirement for the men and women serving in the Guard
    and Reserves. This proposed legislation would have reduced the age for
    receipt of retirement pay for Guard and Reserve retirees from 60 to 55.
    Active duty members draw retirement pay the day after they retire. Yet,
    Guard and Reserve retirees currently have to wait until they reach age
    60 before they can draw retirement pay.
        Provide Concurrent Retirement and Disability Pay (CRDP) For Service
    Incurred Disabilities.--National Guard and Reserve with 20 or more good
    years are currently able to receive CRDP, however, they must wait until
    they are 60 years of age and begin to receive their retirement check.
    This policy must be changed, and along with the reduction in retirement
    age eligibility, is a benefit our Guard and Reserve deserve. They have
    incurred a service connected disability and we must provide concurrent
    retirement and disability pay to them.
        Many Guard/Reserve retirees have spent more time in a combat zone
    than their active duty counterparts. The DOD has not supported
    legislation to provide Guard/Reserve men and women more equitable
    retirement pay in the past. Additional requirements and reliance has
    been placed on the Guard/Reserve in recent years. It is time to
    recognize our men and women in uniform serving in the Guard and Reserve
    and provide them a more equitable retirement system.
        Provide employer and self-employed tax credits and enhance job
    security.--AFSA supports legislation to allow the work opportunity
    credit to small businesses, which hire members of the Reserve
    Components. We encourage this Subcommittee to provide the funding
    necessary to make this happen.
        Award Full Veterans Benefit Status to Guard and Reserve Members.--
    It is long overdue that we recognize those servicemembers in the Guard
    and Reserve who have sustained a commitment to readiness as veterans
    after 20 years of honorable service to our country. Certain Guard and
    Reserve members that complete 20 years of qualifying service for a
    reserve (non-regular) retirement have never been called to active duty
    service during their careers. At age 60, they are entitled to start
    receiving their reserve military retired pay, Government healthcare,
    and other benefits of service including some veterans' benefits. But,
    current statutes deny them full standing as a ``veteran'' of the armed
    forces and as a result they are not entitled to all veteran benefits.
    Our goal, along with our TMC partners, is to support pending
    legislation that will include in the definition(s) of ``veteran''
    retirees of the Guard/Reserve components who have completed 20 years or
    more of qualifying service, but are not considered to be veterans under
    the current statutory definitions.
                               education programs
        There's no escaping the fact that college costs are rising. As the
    gap between the cost of an education and value of the Montgomery GI
    Bill (MGIB) widened, the significance of the benefit became less
    apparent. For that reason, the Post-9/11 GI Bill is a giant step
    forward. However, we must make sure that the new Post-9/11 GI Bill
    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 remaining technical corrections to the Post-9/11 GI Bill. Examples
    that standout are active duty not receiving the $1,000 annual book
    stipend, Title 32 credit for Guard and Reserve service, and BAH for
    those veterans or retirees taking on-line college courses full-time.
        Providing in-State tuition rates at federally supported State
    universities and colleges.--Regardless of residency requirements, is an
    important goal for AFSA due to the rise in servicemembers and their
    families returning to institutions to further their education and other
    numerous PCS moves involved with the CONUS.
        Ensure full funding for the mission of the Impact Aid Program.--
    Impact Aid Program is to disburse payments to local educational
    agencies that are financially burdened by Federal activities and to
    provide technical assistance and support services.
        Preserve Tuition Assistance.--The discretionary Air Force Tuition
    Assistance (TA) Program is an important quality of life program that
    provides tuition and fees for courses taken by active duty personnel.
    The program is one of the most frequent reasons given for enlisting and
    re-enlisting in the Air Force.
        Implement the Interstate Compact!.--The Interstate Compact on
    Educational Opportunity for Military Children works to correct the
    inequalities that military children face as they transfer from one
    school (system) to another due to deployments or permanent change of
    station moves by their servicemember parent.
        By implementing this Compact, States can work together to achieve
    cohesive education goals and assure military students are well prepared
    for success after high school graduation. We encourage your strong
    support for those who serve this Nation and ask that you take necessary
    measures to pass this Act in your State and implement this important
    program. The States that thus far are absent from supporting the
    ``sense of the Senate'' are Nebraska, Massachusetts, Vermont, West
    Virginia, Minnesota, New Hampshire, and Wyoming.
        Repeal or Greatly Modify the Uniformed Services Former Spouses
    Protection Act (USFSPA--Public Law 97-252).--AFSA urges this
    Subcommittee to support some fairness provisions for the USFSPA. While
    this law was passed with good intentions in the mid 1980s, the
    demographics of military service and their families have changed. As a
    result, military members are now the only U.S. citizens who are put at
    a significant disadvantage in divorce proceedings.
        Because of the USFSPA, the following situations now exist:
      --A military member is subject to giving part of his/her military
            retirement pay (for the rest of his/her life) to anyone who was
            married to him/her during the military career regardless of the
            duration of the marriage.
      --The divorce retirement pay separation is based on the military
            member's retirement pay--not what the member's pay was at the
            time of divorce (often many years later).
      --A military retiree can be paying this ``award'' to multiple former
            spouses.
      --It takes a military member 20 years to earn a retirement; it takes
            a former spouse only having been married to the member (for any
            duration, no matter how brief) to get a portion of the member's
            retirement pay.
      --Under this law, in practice judges award part of the member's
            retirement pay regardless of fault or circumstances.
      --There is no statute of limitations on this law; i.e., unless the
            original divorce decree explicitly waived separation of future
            retirement earnings, a former spouse who the military member
            has not seen for many years can have the original divorce
            decree amended and ``highjack'' part of the military member's
            retirement pay.
      --The former spouse's ``award'' does not terminate upon remarriage of
            the former spouse.
      --The ``award'' to a former spouse under this law is above and beyond
            child support and alimony.
      --The law is considered unfair, illogical, and inconsistent. The
            member's military retired pay which the Government refers to as
            ``deferred compensation'' is, under this law, treated as
            property rather than compensation. Additionally, the law is
            applied inconsistently from State to State.
      --In most cases, the military retiree has no claim to part of the
            former spouse's retirement pay.
      --Of all U.S. citizens, it is unconscionable that military members
            who put their lives on the line are uniquely subjected to such
            an unfair and discriminatory law.
      --While there may be unique cases (which can be dealt with by the
            court on a case-by-case basis) where a long-term, very
            supported former spouse is the victim, in the vast majority of
            the cases we are talking about divorces that arise which are
            the fault of either or both parties--at least half of the time
            not the military member. In fact, with the current levels of
            military deployments, more and more military members are
            receiving ``Dear John'' and ``Dear Jane'' letters while they
            serve.
      --This is not a male-vs.-female issue. More and more female military
            members are falling victim to this law. These are just a few of
            the inequities of this law. We believe this law needs to be
            repealed or, at the least, greatly modified to be fairer to
            military members. We urge the Subcommittee to support any
            funding requirement that may be necessary to take action on
            this unfair law--for the benefit of those men and women who are
            currently defending the interests of this nation and its
            freedom.
                                   conclusion
        Chairman Inouye, Ranking Member Cochran, in conclusion, I want to
    thank you again for this opportunity to express the views of our
    members on these important issues as you consider the fiscal year 2012
    budget. We realize that those charged as caretakers of the taxpayers'
    money must budget wisely and make decisions based on many factors. As
    tax dollars dwindle, the degree of difficulty deciding what can be
    addressed, and what cannot, grows significantly.
        AFSA contends that it is of paramount importance for a nation to
    provide quality healthcare and top-notch benefits in exchange for the
    devotion, sacrifice, and service of military members. So, too, must
    those making the decisions take into consideration the decisions of the
    past, the trust of those who are impacted, and the negative
    consequences upon those who have based their trust in our Government?
    We sincerely believe that the work done by your committees is among the
    most important on the Hill. On behalf of all AFSA members, we
    appreciate your efforts and, as always, are ready to support you in
    matters of mutual concern.
        The Air Force Sergeants Association looks forward to working with
    you in this 112th Congress.

        Chairman Inouye. I can assure you that the matter of the
    unemployed and homeless will be a very high priority. Thank you
    very much.
        Sergeant McCauslin. Thank you, Senator.
        Chairman Inouye. Senator Cochran.
        Senator Cochran. Thank you for bringing these facts and
    figures to our attention. It occurs to me that we need to give
    this our best consideration. I think you can be assured that
    that will happen.
        Sergeant McCauslin. Thank you, sir.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, just an observation.
    Sergeant, Mr. McCauslin----
        Sergeant McCauslin. Yes, sir.
        Senator Shelby [continuing]. You speak well for the
    Sergeants Association. There are a lot of you, but you had a
    distinguished military record yourself. I was just reading
    that. You're to be commended. You're a good spokesman for them.
    Thank you. We respect that.
        Sergeant McCauslin. Thank you, sir.
        Chairman Inouye. Thank you very much, Sergeant.
        Our next witness is Captain Connor, American Lung
    Association. Captain.
    STATEMENT OF CAPTAIN CHARLES D. CONNOR, UNITED STATES
                NAVY (RETIRED), PRESIDENT AND CHIEF
                EXECUTIVE OFFICER, AMERICAN LUNG
                ASSOCIATION
        Captain Connor. Thank you very much, Senator. It's a
    pleasure to be here. Mr. Chairman, with your permission, I
    would like to pass on the greetings of two of your admirers in
    Honolulu I met with last week, Dr. Michael Chun and Aaron Mahi.
    I'm passing on their greetings to you this morning.
        I'm, as you said, a retired Navy captain. I'm President and
    CEO of the American Lung Association. The American Lung
    Association has been around for more than 100 years and our
    mission is to save lives by improving lung health and fighting
    lung disease. We do this through three big things: research,
    advocacy, and educational programs.
        I'd like to take a few seconds of the subcommittee's time
    to talk about three big things today: the terrible burden on
    the military caused by tobacco use and the need for DOD to
    start combatting it; to ask your consideration for restoring
    funding for the peer-reviewed lung cancer research program to
    $20 million; and third, to discuss briefly what you've heard
    about this morning already, which is the threat posed by our
    soldiers in Iraq and Afghanistan to toxic pollutants in the
    air.
        Firstly, let me address tobacco use if I may. Tobacco use,
    as you well know, is the leading cause of preventable death in
    the United States today. Not surprisingly, it is also a very
    significant problem in our military as well. DOD has made some
    small progress, but much, much more needs to be done. Currently
    the smoking rate for civilians in America is about 20 percent.
    It's about 30 percent in the military, 30.5 exactly, and we
    think the combat arms people in deployed status, it's probably
    much higher than that. The highest smoking rates in the
    military are for those people between 18 and 25, especially
    soldiers and marines.
        More than one in seven active duty personnel begin smoking
    after they join the military. So it's a very, very severe
    problem.
        The use of tobacco is a severe compromiser of readiness and
    performance. Studies have shown that smoking is the best
    predictor of training failure and it's also been shown to
    increase soldiers' chances of physical injury and
    hospitalization. Now, you may have been surprised, as I was, to
    see the Secretary of Defense in the last year for the first
    time in my recollection complain about the cost of military
    healthcare. The biggest driver of healthcare is tobacco use. So
    the Pentagon spends over $1.6 billion of appropriated funds in
    treating tobacco-related medical care, increased
    hospitalization, and lost days of work.
        Just 2 years ago, the Institute of Medicine issued a big
    thick report I could have brought today entitled ``Tobacco Use
    in the Military and Veterans Population.'' The panel found that
    tobacco control does not have a very high priority in the
    military--that's what we think as well--and that it will take a
    long time to get the military off tobacco. They suggested as
    long as 20 years.
        So the American Lung Association believes now is the time
    to attack this problem if it's going to take that long, and DOD
    is overdue in announcing how it intends to implement those
    recommendations.
        Two other things briefly in the minute I have left. We
    strongly support the lung cancer research program in the
    congressionally directed medical research program. We urge you
    to restore it to its original intent and the $20 million. The
    original intent was for competitive research grants and
    priority given to deployment of integrated components to
    identify, treat, and manage early curable lung cancer.
        Last, I will not repeat what you've heard already today,
    but we are extremely concerned about the respiratory disease of
    soldiers and marines coming back from theater. We recommend DOD
    immediately begin to find alternatives to burning trash for
    waste disposal and to make burn pits more efficient. We also
    urge DOD to take steps to minimize troop exposure to pollutants
    and to further monitor pollution efforts. We think military
    people should be measured for respiratory illness before they
    go to theater and then coming back, so that we can compare
    apples to apples, so to speak, without comparing military
    respiratory disease with the civilian population. So I think
    there's some attention that needs to be paid to that.
        Thank you very much.
        [The statement follows:]
                    Prepared Statement of Charles D. Connor
        Mr. Chairman and members of the Committee, the American Lung
    Association is honored to present this testimony to the Senate
    Appropriations Subcommittee on Defense. The American Lung Association
    was founded in 1904 to fight tuberculosis and today, our mission is to
    save lives by improving lung health and preventing lung disease. We
    accomplish this through research, advocacy and education.
        The American Lung Association wishes to call your attention to
    three issues for the Department of Defense's (DOD) fiscal year 2012
    budget: the terrible burden on the military caused by tobacco use and
    the need for the Department to aggressively combat it; the importance
    of restoring funding for the Peer-Reviewed Lung Cancer Research Program
    to $20 million; and the health threat posed by soldiers' exposure to
    toxic pollutants in Iraq and Afghanistan.
        First, the American Lung Association is concerned about the use of
    tobacco products by the troops. The effects of both the health and
    performance of our troops are significantly hindered by the prevalence
    of smoking and use of smokeless tobacco products. As a result, we urge
    the Department of Defense to immediately implement the recommendations
    in the Institute of Medicine's 2009 Report, Combating Tobacco Use in
    Military and Veteran Populations.
        Next, the American Lung Association recommends and supports
    restoring funding to $20 million for the Peer-Reviewed Lung Cancer
    Research Program (LCRP) within the Department of Defense
    Congressionally Directed Medical Research Program (CDMRP). Finally, the
    American Lung Association is deeply concerned about the respiratory
    health of our soldiers in Iraq and Afghanistan. We urge the DOD to
    immediately find alternatives to using burn pits, to track the
    incidence of respiratory disease related to service, and to take other
    steps that will improve the lung health of soldiers.
    Combating Tobacco Use
        Tobacco use remains the leading cause of preventable death in the
    United States and not surprisingly, is a significant problem within the
    military as well. The DOD has made some small progress, including its
    recent smokefree policy on submarines, but significantly more will need
    to be done to reduce the billion dollar price tag that comes with
    military personnel using tobacco products.
        The 2008 Department of Defense Survey of Health Behaviors among
    Active Duty Personnel found that smoking rates among active duty
    personnel have essentially remained steady since 2002. However, smoking
    rates among deployed personnel are significantly higher and,
    alarmingly, more than one in seven (15 percent) of active duty
    personnel begin smoking after joining the service.
        Currently, the smoking rate for active duty military is 30.5
    percent, with smoking rates highest among personnel ages 18 to 25--
    especially among soldiers and Marines. The Department of Veterans
    Affairs estimates that more than 50 percent of all active duty
    personnel stationed in Iraq smoke.\1\ The use of tobacco compromises
    military readiness and the performance of our men and women in the
    armed forces. Studies have found that smoking is one of the best
    predictors of training failure, and it has also been shown to increase
    soldiers' chances of physical injury and hospitalization.\2\ Tobacco
    use not only costs the DOD in troop readiness and health--it also costs
    the DOD money. The Pentagon spends over $1.6 billion on tobacco-related
    medical care, increased hospitalization and lost days of work.\3\
    ---------------------------------------------------------------------------
        \1\ Hamlett-Berry, KW, as cited in Beckham, JC et al. Preliminary
    findings from a clinical demonstration project for veterans returning
    from Iraq or Afghanistan. Military Medicine. May 2008; 173(5):448-51.
        \2\ Institute of Medicine. Combating Tobacco Use in Military and
    Veteran Populations. 2009; 3-4.
        \3\ Institute of Medicine. Combating Tobacco Use in Military and
    Veteran Populations. 2009; 56.
    ---------------------------------------------------------------------------
        In 2009, the prestigious Institute of Medicine (IOM) issued a
    report entitled, Combating Tobacco Use in Military and Veteran
    Populations. The panel found ``tobacco control does not have a high
    priority in DOD or VA.'' This report, which was requested by both
    departments, issued a series of recommendations, which the American
    Lung Association fully supports and asks this Committee to ensure are
    implemented.
        The IOM recommendations include commonsense approaches to
    eliminating the use of tobacco in the U.S. military. Some of the IOM's
    recommendations include:
      --Phase in tobacco-free policies by starting with military academies,
            officer-candidate training programs, and university-based
            reserve officer training corps programs. Then the IOM
            recommends new enlisted accessions be required to be tobacco-
            free, followed by all active-duty personnel;
      --Eliminate tobacco use on military installations using a phased-in
            approach;
      --End the sales of tobacco products on all military installations.
            Personnel often have access to cheap tobacco products on base,
            which can serve to start and perpetuate addictions;
      --Ensure that all DOD healthcare and health promotion staff are
            trained in the standard cessation treatment protocols;
      --Ensure that all DOD personnel and their families have barrier-free
            access to tobacco cessation services.
        A recent investigation conducted by American Public Media \4\
    highlights that the discount price for tobacco products on base is
    significantly more--in some cases 20 percent--than the 5 percent
    permitted under law. The easiest way to end this problem is to end
    tobacco sales on all military installations.
    ---------------------------------------------------------------------------
        \4\ Herships, Sally. ``Military underprices tobacco more than law
    allows.'' American Public Media. http://marketplace.publicradio.org/
    display/web/2011/06/01/pm-military-underprices-tobacco-more-than-law-
    allows/. Accessed June 3, 2011.
    ---------------------------------------------------------------------------
        The American Lung Association recommends that the Department of
    Defense implement all recommendations called for in the 2009 IOM
    report. The IOM has laid out a very careful, scientifically based road
    map for the DOD to follow and the American Lung Association strongly
    urges the Committee to ensure that the report's recommendations be
    implemented without further delay.
    Peer Reviewed Lung Cancer Research Program
        The American Lung Association strongly supports the Lung Cancer
    Research Program (LCRP) in the Congressionally Directed Medical
    Research Program (CDMRP) and its original intent to research the scope
    of lung cancer in our military.
        In fiscal year 2011, LCRP received $12.8 million. We urge this
    Committee to restore the funding level to the fiscal year 2009 level of
    $20 million. In addition to the reduced funding, the American Lung
    Association is troubled by the change in governance language of the
    LCRP authorized by the Congress in fiscal year 2010. We request that
    the 2012 governing language for the LCRP be returned to its original
    intent, as directed by the 2009 program: ``These funds shall be for
    competitive research . . . . Priority shall be given to the development
    of the integrated components to identify, treat and manage early
    curable lung cancer''.
    Troubling Lung Health Concerns in Iraq and Afghanistan
        The American Lung Association is extremely troubled by reports of
    soldiers and civilians who are returning home from Iraq and Afghanistan
    with lung illnesses including asthma, chronic bronchitis and sleep
    apnea. Several new studies discussed below show that the airborne
    particle pollution our troops breathe in these areas may cause or
    contribute to these problems.
        A recent DOD study found that air in several Middle East locations
    contained high concentrations of desert sand, as well as particles that
    likely came from human-generated sources--especially trash burned in
    open pits and diesel exhaust. Breathing particulate matter causes heart
    attacks, asthma attacks, and even early death. People most at risk from
    particulate matter include those with underlying diseases such as
    asthma, but the health impact of particle pollution is not limited to
    individuals with pre-existing chronic conditions. Healthy, young adults
    who work outside--such as our young men and women in uniform--are also
    at higher risk. Data from a 2009 study of soldiers deployed in Iraq and
    Afghanistan found that 14 percent of them suffered new-onset
    respiratory symptoms, a much higher rate than their non-deployed
    colleagues. In a review of the DOD studies, the National Academy of
    Sciences National Research Council (NRC) concluded that troops deployed
    in the Middle East are ``exposed to high concentrations'' of
    particulate matter associated with harm ``affecting troop readiness
    during service'' and even ``occurring years after exposure.'' \5\
    ---------------------------------------------------------------------------
        \5\ National Academy of Sciences, National Research Council. Review
    of the Department of Defense Enhanced Particulate Matter Surveillance
    Program Report. 2010. http://www.nap.edu/catalog/12911.html. Accessed
    June 7, 2011.
    ---------------------------------------------------------------------------
        Several studies, released in May at the American Thoracic Society
    2011 International Conference, show mounting evidence for the
    importance of solving these problems. One large study showed that
    asthma rates in soldiers deployed to Iraq are higher than in soldiers
    deployed elsewhere. The study also showed that soldiers who served in
    Iraq had more serious asthma--i.e., lower lung function--than non Iraq
    personnel. In fact, records show that 14 percent of medic visits in
    Iraq are for respiratory issues, which is a higher percentage than from
    the previous Iraq war.\6\
    ---------------------------------------------------------------------------
        \6\ Szema, Anthony M. Overview of Exposures And New Onset Asthma In
    Soldiers Serving In Iraq And Afghanistan. As presented at American
    Thoracic Society 2011 International Conference, May 18, 2011.
    ---------------------------------------------------------------------------
        There are several probable causes for this alarming prevalence of
    respiratory disease in our current war arenas. The most obvious cause
    is exposure to dust. There are multiple kinds of dust from multiple
    sources in the Middle East. Measurements show that the amount of
    harmful particles in the air is over 600 percent higher than the levels
    considered acceptable for public health in the United States. More
    significant sources of toxic air pollution are burn pits, which are lit
    with jet fuel and sometimes burn continuously for years. This method of
    disposing of trash can be incredibly harmful to soldiers who work in
    the pits' vicinity. Major explosions, IEDs, and fungus can also cause
    harmful respiratory effects.\7\
    ---------------------------------------------------------------------------
        \7\ Szema, Anthony M. Overview Of Exposures And New Onset Asthma In
    Soldiers Serving In Iraq And Afghanistan. As presented at American
    Thoracic Society 2011 International Conference, May 18, 2011.
    ---------------------------------------------------------------------------
        While we know these problems exist, it is also clear that the DOD
    needs to do a better job at identifying and tracking them. Respiratory
    disease is difficult to detect, especially in personnel who are
    younger, healthier and more athletic than the general population.
    Military personnel need to be tested for respiratory and lung function
    pre-deployment so that doctors can make useful comparison with post-
    deployment results, instead of comparing soldiers to the population
    average. Another possible solution is to use non-traditional measures
    to detect problems--such as ability to complete a 2-mile run, as
    suggested by one researcher.\8\
    ---------------------------------------------------------------------------
        \8\ Miller, Robert. Constrictive Bronchiolitis Among Soldiers
    Exposed To Burn Pits, Desert Dust And Fires In Southwest Asia. As
    presented at American Thoracic Society 2011 International Conference,
    May 18, 2011.
    ---------------------------------------------------------------------------
        To protect the troops from the hazards discussed and resulting lung
    disease, the American Lung Association recommends that DOD begin
    immediately to find alternatives to burning trash for waste disposal
    and/or make burn pits more efficient. We also strongly urge DOD to take
    steps to minimize troop exposure to pollutants and to further monitor
    pollution levels. Military doctors also must develop better ways to
    measure and track lung disease in military personnel, including taking
    baseline measures prior to deployment and creating a national registry
    to track all veterans who were exposed to these pollutants while in
    Iraq and Afghanistan. These problems are pervasive throughout the
    military, and DOD officials need to take leadership roles in creating
    positive change.
    Conclusion
        Mr. Chairman, in summary, our Nation's military is the best in the
    world and we should do whatever necessary to ensure that the lung
    health needs of our armed services are fully met. Our troops must be
    protected from tobacco and unsafe air pollution and the severe health
    consequences. Thank you for this opportunity.

        Chairman Inouye. I thank you very much, Captain. I'm one of
    the one out of seven. I began smoking after I got in, but I
    quit. But all of us received in our K rations a pack of four
    cigarettes free. That's how we learned.
        Senator Cochran.
        Senator Cochran. We appreciate very much your being here
    today and bringing this reminder to our attention. It's
    something that we need to work hard on and I hope we can be
    successful. It seems to me that this is probably the most
    preventable kind of medical problem that we can work on and the
    chairman has certainly indicated a willingness to cooperate, so
    I think you can look forward to cooperation from this
    subcommittee.
        Captain Connor. Thank you.
        Mr. Vice Chairman, if I may, I'd like to leave behind a
    very recent article from the American Journal of Public Health,
    which fully reveals the extent to which the tobacco industry
    has got its hands in the Senate and the House. We actually have
    enshrined into law, if you can believe it, obstacles to DOD
    attacking the smoking problem. So with your permission, I'd
    like to leave that behind.
        Chairman Inouye. Without objection, it will be made part of
    the record.
        [The information follows:]

            [From the American Journal of Public Health, March 2011]

    Forcing the Navy to Sell Cigarettes on Ships: How the Tobacco Industry
                 and Politicians Torpedoed Navy Tobacco Control

       (Naphtali Offen, Sarah R Arvey, Elizabeth A Smith, Ruth E Malone)

        In 1986, the U.S. Navy announced the goal of becoming smoke-free by
    2000. However, efforts to restrict tobacco sales and use aboard the USS
    Roosevelt prompted tobacco industry lobbyists to persuade their allies
    in Congress to legislate that all naval ships must sell tobacco.
    Congress also removed control of ships' stores from the Navy. By 1993,
    the Navy abandoned its smoke-free goal entirely and promised smokers a
    place to smoke on all ships. Congressional complicity in promoting the
    agenda of the tobacco industry thwarted the Navy's efforts to achieve a
    healthy military workforce. Because of military lobbying constraints,
    civilian pressure on Congress may be necessary to establish effective
    tobacco control policies in the armed forces. (Am J Public Health.
    2011;101:404-411. doi: 10.2105/AJPH.2010.196329)
        At more than 30 percent,\1\ \2\ the prevalence of smoking in the
    military is 50 percent higher than is the civilian rate, with a 40
    percent prevalence among those aged 18 to 25 years \3\ and nearly 50
    percent among those who have been in a war
    zone.\2\ \4\ From 1998 to 2005, tobacco use in the military increased
    7.7 percent, from 29.9 percent to 32.2 percent, reversing the decline
    of prior decades.\4\ A tobacco-friendly military culture persists,
    including the availability of cheap tobacco products,\5\ liberal
    smoking breaks,\6\ and easily accessible smoking areas.\6\ \7\ Smoking
    damages health and readiness \8\ \9\ \10\ \11\ and increases medical
    and training
    costs.\12\ \13\ \14\ \15\ In addition to short-term effects, such as
    impairment to vision and hearing, long-term consequences include lung
    and other cancers, cardiovascular disease, chronic obstructive
    pulmonary disease, and problematic wound healing.\4\ The U.S.
    Department of Defense spends more than $1.6 billion annually on
    tobacco-related health care and absenteeism.\4\
    ---------------------------------------------------------------------------
        \1\ Bray RM, Hourani LL. Substance use trends among active duty
    military personnel: findings from the United States Department of
    Defense Health Related Behavior Surveys, 1980-2005. Addiction.
    2007;102(7):1092-1101.
        \2\ Volkow ND. Director's perspective: substance abuse among
    troops, veterans, and their families. NIDA Notes. 2009; 22(5):1092-
    1101.
        \3\ Bray RM, Hourani LL, Olmsted DLR, et al. 2005 Department of
    Defense survey of health related behaviors among active duty military
    personnel: a component of the Defense Lifestyle Assessment Program
    (DLAP). December 2006. Prepared by RTI International. Report No. DAMD
    17-00-2-0057. Available at: http://www.ha.osd.mil/special_reports/
    2005_Health_Behaviors_Survey_1-07.pdf. Accessed May 10, 2010.
        \4\ Institute of Medicine. Combating Tobacco Use in Military and
    Veteran Populations. Washington, DC: National Academic Press; 2009.
        \5\ Smith EA, Blackman VS, Malone RE. Death at a discount: how the
    tobacco industry thwarted tobacco control policies in U.S. military
    commissaries. Tob Control 2007;16(1):38-46.
        \6\ Haddock CK, Hoffman KM, Peterson A, et al. Factors which
    influence tobacco use among junior enlisted in the United States Army
    and Air Force: a formative research study. Am J Health Promot.
    2009;23(4):241-246.
        \7\ Jahnke SA, Haddock CK, Poston WS, Hoffman KM, Hughey J, Lando
    HA. A qualitative analysis of the tobacco control climate in the U.S.
    military. Nicotine Tob Res. 2010;12(2):88-95.
        \8\ Dept of the Navy, Office of the Secretary. SECNAV instruction
    5100.13E, Navy and Marine Corps tobacco policy. Available at: http://
    www. mccsmiramar.com/pdfs/5100_13E.pdf. Accessed March 3, 2010.
        \9\ Conway T, Cronan T. Smoking, exercise, and physical fitness.
    Prev Med. 1992;21(6):723-734.
        \10\ Zadoo V, Fengler S, Catterson M. The effects of alcohol and
    tobacco use on troop readiness. Mil Med. 1993;158(7): 480-484.
        \11\ Conway TL. Tobacco use and the United States military: a
    longstanding problem. Tob Control. 1998;7(3):219-221.
        \12\ Helyer AJ, Brehm WT, Perino L. Economic consequences of
    tobacco use for the Department of Defense, 1995. Mil Med.
    1998;163(4):217-221.
        \13\ Klesges RC, Haddock CK, Chang CF, Talcott GW, Lando HA. The
    association of smoking and the cost of military training. Tob Control.
    2001;10(1):43-47.
        \14\ Dall TM, Zhang Y, Chen YJ, et al. Cost associated with being
    overweight and with obesity, high alcohol consumption, and tobacco use
    within the military health system's TRICARE prime-enrolled population.
    Am J Health Promot. 2007; 22(2):120-139.
        \15\ Woodruff SI, Conway TL, Shillington AM, Clapp JD, Lemus H,
    Reed MB. Cigarette smoking and subsequent hospitalization in a cohort
    of young U.S. Navy female recruits. Nicotine Tob Res. 2010; 12(4):365-
    373.
    ---------------------------------------------------------------------------
        In addition to compromised military readiness and Department of
    Defense expenses, a tobacco-friendly military culture takes a societal
    toll--economic and human--long after military personnel return to
    civilian life. The Department of Veterans Affairs spent $5 billion in
    2008 treating veterans with chronic obstructive pulmonary disease, a
    diagnosis most often associated with smoking.\4\ Lifelong smokers have
    a 50 percent chance of dying prematurely.\4\ Most costs must be borne
    by the veteran: in 1998, Congress denied disability pensions to
    tobacco-sickened veterans who began to smoke during their service,
    initially labeling smoking in the military as ``willful misconduct.''
    \16\
    ---------------------------------------------------------------------------
        \16\ Offen N, Smith EA, Malone RE. ``Willful misconduct'': how the
    U.S. government prevented tobacco-disabled veterans from obtaining
    disability pensions. Am J Public Health. 2010;100(7):1166-1173.
    ---------------------------------------------------------------------------
        Department of Defense Directive 1010.10, issued in 1986,
    established a baseline ``policy on smoking in the DOD [Department of
    Defense] occupied buildings and facilities.'' \17\ The policy
    emphasized a healthy military that discouraged smoking and designated
    authority to the services and to individual commanders to set specific
    policies.\18\ However, subsequent attempts to set such policies
    achieved limited results,\19\ \20\ in part because of the tobacco
    industry's influence on Congress.\5\ \18\
    ---------------------------------------------------------------------------
        \17\ Taft WH. Department of Defense Directive 1010.10 Health
    Promotion. March 11, 1986. Philip Morris collection. Bates no.
    2047563159/3166. Available at: http://legacy.library.ucsf.edu/tid/
    des52e00. Accessed October 23, 2006.
        \18\ Arvey S, Malone RE. Advance and retreat: tobacco control
    policy in the U.S. military. Mil Med. 2008;173(10):985-991.
        \19\ Smith EA, Malone RE. Tobacco targeting of military personnel:
    ``The plums are here to be plucked.'' Mil Med. 2009;174(8):797-806.
        \20\ Smith EA, Malone RE. ``Everywhere the soldier will be'':
    wartime tobacco promotion in the U.S. military. Am J Public Health.
    2009;99(9):1595-1602.
    ---------------------------------------------------------------------------
        The industry successfully lobbied Congress to prevent the military
    from raising the prices of tobacco products sold in military stores,\5\
    and to ensure that in-store tobacco promotions would not be
    prohibited.\18\ Congress also prevented the army from implementing a
    stronger tobacco control policy than that set by Directive 1010.10,
    although the directive was intended to be a policy floor upon which the
    services could expand.\18\ To achieve its goals, Congress privately
    pressured military tobacco control advocates,\18\ publicly scolded
    them,\5\ interfered with funding for military programs,\5\ and passed
    laws preventing the establishment of recommended tobacco control
    policies.\5\ \16\
        We examined an attempt by a former captain of the USS Theodore
    Roosevelt to ban smoking on the aircraft carrier and showed how tobacco
    industry lobbyists, working through their allies in the U.S. Congress,
    were successful in stymieing his efforts and forcing the Navy to sell
    cigarettes on all ships.
                                    methods
        As part of a larger project examining tobacco industry influence on
    the U.S. military, we searched internal tobacco industry documents
    released following the Master Settlement Agreement.\21\ Data were
    collected from the University of California, San Francisco Legacy
    Tobacco Documents Library (available at: http://legacy.
    library.ucsf.edu) and Tobacco Documents Online (available at: http://
    tobaccodocuments.org). Initial search terms included ``Navy/smokefree''
    and ``Navy/cigarettes''; we used a snowball approach to locate
    additional material.\22\ We also searched the LexisNexis database for
    media coverage,\23\ the Library of Congress Thomas database of
    legislative history,\24\ and the U.S. Code collection at Cornell
    University Law School,\25\ and conducted Internet searches for
    supplemental documents. We attempted to interview all principals in
    this case study and spoke with the former captain of the USS Roosevelt,
    Admiral Stanley Bryant (November 9, 2009) and former Navy Master Chief
    Petty Officer James Herdt (January 14, 2010), both of whom advocated
    for the USS Roosevelt policy change. We also interviewed former
    Secretary of the Navy John Dalton (October 22, 2009), who opposed the
    policy. Otherwise unattributed quotations from these individuals are
    taken from the interviews. Our inability to secure other interviews is
    a limitation of this study. We analyzed approximately 340 industry
    documents and 80 documents from other sources using an interpretive
    approach, chronologically organizing our findings as a descriptive case
    study.\26\ \27\
    ---------------------------------------------------------------------------
        \21\ National Association of Attorneys General. Master Settlement
    Agreement. Available at: http://www.naag.org/upload/
    1109185724_1032468605_cigmsa.pdf. Accessed July 7, 2009.
        \22\ Malone RE, Balbach ED. Tobacco industry documents: treasure
    trove or quagmire? Tob Control. 2000;9(3):334-338.
        \23\ LexisNexis Academic Web site. Available at: http://
    www.lexisnexis.com/us/lnacademic. Accessed September 20, 2008.
        \24\ Library of Congress Thomas Web page. Available at: http://
    thomas.loc.gov/home/multicongress/multicongress.html. Accessed
    September 20, 2008.
        \25\ Cornell University Law School US Code collection. Available
    at: http://www.law.cornell.edu/uscode. Accessed September 13, 2008.
        \26\ Hill MR. Archival Strategies and Techniques. Newbury Park, CA:
    Sage Publications; 1993.
        \27\ Yin RK. Case Study Research Design and Methods. Thousand Oaks,
    CA: Sage Publications; 1994.
    ---------------------------------------------------------------------------
                                    results
        Following Directive 1010.10, some Navy leaders began to propose
    policies to reduce smoking among their personnel. As early as 1986,
    Chief of Naval Operations James Watkins (1982-1986) proposed a tobacco-
    free Navy,\28\ a goal reiterated in 1990 by the Navy surgeon general,
    Vice-Admiral James Zimble (1987-1990).\29\ In February 1992, the Navy
    issued Instruction 6100.2, emphasizing tobacco-use prevention,
    cessation, and the protection of nonsmokers from secondhand smoke.\30\
    As a result, a number of ships restricted tobacco sales by limiting the
    number of brands carried, raising prices, or not selling tax-free
    cigarettes.\31\ Some ships restricted smoking to limited venues,\31\
    tobacco-related promotional activities were curtailed at one Navy
    exchange,\32\ and naval hospitals ashore went smoke-free.\33\ In early
    1993, Navy Surgeon General Donald Hagen (1991-1995) asked the Office of
    the Secretary of Defense to end tobacco product price subsidies in
    commissaries and exchanges in all service branches, arguing that low
    cigarette prices contributed to high rates of smoking in the
    military.\34\ By late 1993, the Office of the Secretary of Defense had
    not responded.\35\ \36\ (Cigarette prices in commissaries remained low,
    and only in 1996 were they marginally increased, at the instigation of
    an Assistant Secretary of Defense.) \5\
    ---------------------------------------------------------------------------
        \28\ Taylor M, Stump D. Sailors are under the ``smoking gun.''
    September 6, 1995. Philip Morris collection. Bates no. 2048895176/5180.
    Available at: http://legacy.library.ucsf.edu/tid/yre35c00. Accessed
    January 16, 2008.
        \29\ Zimble JA. I am writing to strongly object to Camel cigarette
    advertising that includes naval vessels and aircraft in the background.
    June 11, 1990. RJ Reynolds collection. Bates no. 507471512. Available
    at: http://legacy.library.ucsf.edu/action/document/view?tid=eso24d00.
    Accessed January 24, 2007.
        \30\ Dept of the Navy, Office of the Chief of Naval Operations.
    OPNAV Instruction 6100.2, Health Promotion Program. Available at:
    http://www-nehc.med.navy.mil/bumed/tcat/tobacco/opnav%206100.2.pdf.
    Accessed March 3, 2010.
        \31\ Glennie L. Navy ship smoking restrictions. May 18, 1992.
    Philip Morris collection. Bates no. 2023176786. Available at: http://
    legacy.library.ucsf.edu/tid/trs95e00. Accessed April 15, 2008.
        \32\ O'Rourke R. Dept of the Navy, Sale and use of tobacco
    products. June 19, 1992. Philip Morris collection. Bates no.
    2076220349/0350. Available at: http://legacy.library.ucsf.edu/tid/
    bqc62c00. Accessed April 28, 2009.
        \33\ Navy News & Undersea Technology. First steps to a smoke-free
    Navy are under way. May 14, 1990. Philip Morris collection. Bates no.
    2023175502. Available at: http://legacy.library.ucsf.edu/tid/oqx83e00.
    Accessed April 8, 2008.
        \34\ Hagen DF. Tobacco use reduction. March 24, 1993. Philip Morris
    collection. Bates no. 2023172986. Available at: http://
    legacy.library.ucsf.edu/tid/iuc85e00. Accessed December 6, 2006.
        \35\ Juliana J. Key issues: DOD smoking policies. May 6, 1993.
    Available at: http://tobaccodocuments.org/nysa_ti_s1/TI03081755.html.
    Accessed April 8, 2008.
        \36\ Linehan K. Washington outlook for 1994. December 29, 1993.
    Philip Morris collection. Bates no. 2025774681/4698. Available at:
    http://legacy.library.ucsf.edu/tid/vho14e00. Accessed January 5, 2008.
    ---------------------------------------------------------------------------
    USS Roosevelt Bans Smoking
        Shortly after assuming command of the aircraft carrier Theodore
    Roosevelt, Captain Stanley W. Bryant announced that the ship would
    become entirely smoke-free by July 1993, including an end to cigarette
    sales in the ship's store. Motivated by a recently released report that
    secondhand smoke caused cancer in nonsmokers, Bryant felt obliged to
    act. He said, ``I'm the commanding officer of these kids and I can't
    have them inhaling secondhand smoke. I wouldn't put them in the line of
    fire. I'm not going to put them in the line of smoke.'' Navy Surgeon
    General Hagen and Chief of Naval Operations Admiral Frank B. Kelso
    (1990-1994) supported Bryant's efforts.\37\ \38\
    ---------------------------------------------------------------------------
        \37\ Law Offices of Shook. Hardy & Bacon. Report on recent ETS and
    IAQ developments. August 6, 1993. Lorillard collection. Bates no.
    87806034/6062. Available at: http://legacy.library.ucsf.edu/tid/
    tzb40e00. Accessed April 15, 2008.
        \38\ Tobacco Institute. Executive summary. August 6, 1993. Tobacco
    Institute collection. Bates no. TICT0004527/4528. Available at: http://
    legacy.library.ucsf.edu/tid/lgc42f00. Accessed April 28, 2009.
    ---------------------------------------------------------------------------
        The Roosevelt left port in March 1993 for 6 months at sea, having
    informed the crew in advance of the impending policy change. Cigarettes
    were removed from the ship's store, but chew tobacco was available
    because, according to Bryant, ``although it's bad for the person, it
    doesn't adversely affect the other crew members.'' Crewmen were allowed
    to bring cigarettes aboard and would be able to smoke them in the few
    lavatories set aside for that purpose until the ban went into effect
    July 4. Thereafter, they would be able to smoke only in ports of call.
    Those lavatories were among the only spaces on board where the air was
    vented directly to the outside and not recirculated; however,
    maintaining smoking in the lavatories was untenable because
    measurements of the air quality in the lavatories showed high levels of
    toxicity and the smoke strayed to nearby berths.
        According to Bryant, crew reaction was mixed: many nonsmokers
    expressed support, and some smokers complained. Command Master Chief
    James Herdt, who served as the highest-ranking enlisted person under
    Bryant, said the new policy was opposed by an ``incredibly small group
    of people.'' When a crew member asked Bryant how he could take away his
    right to smoke, Bryant told him the military regulates the length of
    hair and fingernails, how one dresses, and other such matters that many
    things, such as conjugal privileges and alcohol consumption, are
    prohibited on ship; and that smoking cigarettes, like drinking alcohol
    and smoking marijuana, affected the health and welfare of the rest of
    the crew. Bryant reported that few infractions occurred and that he
    received many letters from his crew's family members thanking him for
    protecting their loved ones from smoke and making it easier for smokers
    to quit.
    Tobacco Industry Reaction
        Philip Morris and the Tobacco Institute, the industry's lobbying
    arm, observed that Navy Instruction 6100.2 represented a policy shift
    from accommodating both smokers and nonsmokers to privileging
    nonsmokers. One Philip Morris military sales executive said, ``We are
    very concerned that the Navy appears to be getting to the point where
    they are mandating non-smoking.'' \31\ His colleague, Rita O'Rourke,
    noted that Instruction 6100.2 established that ``where conflicts arise
    between the rights of smokers and rights of the nonsmokers, those of
    the nonsmokers shall prevail.'' \39\ She called attention to permission
    given to commanders to punish violations, and argued that the provision
    forced smokers to quit.\39\ With the emergence of stricter policies
    than Department of Defense Directive 1010.10, O'Rourke wondered whether
    to suggest that the Department of Defense revisit the issue, although
    that would risk a decision that ``all Services . . . become smoke-
    free.'' \40\
    ---------------------------------------------------------------------------
        \39\ O'Rourke R. Department of the Navy violations of Department of
    Defense Directive 1010.10. March 6, 1993. Philip Morris collection.
    Bates no. 2023172961/2965. Available at: http://
    legacy.library.ucsf.edu/tid/ouc85e00. Accessed November 17, 2006.
        \40\ O'Rourke R. DOD-sale and use of tobacco products. March 16,
    1993. Philip Morris collection. Bates no. 2023172957/2959. Available
    at: http://legacy.library.ucsf.edu/tid/muc85e00. Accessed October 17,
    2006.
    ---------------------------------------------------------------------------
        Bryant's tobacco control measures on the Roosevelt elicited
    particular industry concern. In a list of suggested talking points,
    Tobacco Institute counsel Jim Juliana told colleagues that the policy
    constituted ``discrimination,'' a denial of freedom of choice, and a
    breach of contract. He argued,

        People are recruited and granted certain privileges and rights
    which now seem to be denied in the middle of their service to their
    country.\35\

        (Bryant noted that when recruits ledge an oath to the Constitution,
    ``it doesn't say a damn thing about smoking.'') Juliana argued that the
    Roosevelt was home as well as workplace and suggested that tobacco
    products would be smuggled aboard and ``used illegally and unwarranted
    and unnecessary punitive actions'' would result.\35\
    Congressional Hearing
        Only a month after the Roosevelt went smoke-free, the Morale,
    Welfare, and Recreation (MWR) Panel of the House Armed Services
    Committee (HASC) took up the issue of tobacco control in the Navy, and
    the USS Roosevelt in particular.\41\ The panel had oversight of MWR
    activities offered to sailors, such as entertainment and sports
    programs. MWR was funded by profits from the ships' stores. Tobacco-
    friendly politicians challenged Rear Admiral Commander John Kavanaugh
    of Navy Exchange Command on the Navy's tobacco control policies, using
    many of the arguments suggested in a memo prepared by Juliana. For
    example, Representative Herbert Bateman (R-VA) characterized not being
    able to smoke aboard ship as a ``trauma'' for crew.\41\ He likened Navy
    smoking restrictions to the failed national policy of Prohibition
    (although alcohol use is prohibited on Navy ships).\42\ Representative
    John Tanner (D-TN), thought it was ``entirely appropriate to perhaps
    restrict smoking for the convenience of those who object violently.''
    \41\ ``But,'' he added, ``somebody is banning a legal commodity.'' \41\
    He wondered if lottery tickets or hair spray might be next.\41\
    Representative Solomon Ortiz (D-TX), chair of the panel, assured
    Kavanaugh that forcing sailors to remain smoke-free for months-long
    deployments would ``cause problems.'' \41\
    ---------------------------------------------------------------------------
        \41\ Exchange operations and activities: hearing before the Morale,
    Welfare, and Recreation Panel of the Committee on Armed Services, House
    of Representatives, 103rd Congress (1993).
        \42\ Moore RS, Ames GM, Cunradi CB. Physical and social
    availability of alcohol for young enlisted naval personnel in and
    around home port. Subst Abuse Treat Prev Policy. 2007;2:17.
    ---------------------------------------------------------------------------
        The panel was most concerned about eliminating cigarette sales in
    the ship's store. Will Cofer, MWR Panel staff member and long-time
    tobacco industry ally,\43\ contended that the Roosevelt policy
    prohibiting sales had ``created a black market within the Navy of
    selling cigarettes from one ship to another ship.'' He said, ``[S]ome
    GIs are selling cigarettes at inflated prices to guys on the ship that
    can't buy cigarettes.'' \41\ (Bryant and Herdt acknowledged there was
    some profiteering on the Roosevelt when cigarettes were removed from
    the ship's store, but said that it was minimal.)
    ---------------------------------------------------------------------------
        \43\ Gaillard RC. Project Breakthrough. March 24, 1994. RJ Reynolds
    collection. Bates no. 509721550/1552. Available at: http://
    legacy.library.ucsf.edu/tid/ofz63d00. Accessed February 17, 2010.
    ---------------------------------------------------------------------------
        The real question about sales, however, involved the profits from
    the ship's stores. These profits supported MWR activities, and
    eliminating tobacco sales would reduce funding for them. Representative
    Bateman found it ``incredible'' that implementing a smoke-free base
    policy wouldn't ``impact revenues generated from the sale of tobacco
    products on that base.'' Kavanaugh acknowledged that ``profits and
    sales will be reduced,'' assuring the panel that there had been ``no
    move to take cigarettes out of Navy exchanges,'' and that only 2 out of
    the Navy's ``500 some ships'' had banned sales.\41\ Representative
    Martin Lancaster (D-NC) questioned Kavanaugh about allowing local-level
    leaders to implement site-specific policy, expressing concern about how
    MWR funds would be equitably distributed among units that profited from
    tobacco sales and those that did not.\41\
        Under congressional pressure, Kavanaugh said that he would report
    the panel's concerns to the Office of the Secretary of the Navy and the
    Chief Naval Officer.\41\ After Kavanaugh delivered the message that the
    MWR Panel was very disturbed by Captain Bryant's decision, the Navy
    sent the panel an official response, stating, ``The Navy's smoking
    policy, for both afloat and ashore commands, is under review by Navy
    leadership.'' \41\
        During the first 3 Congresses of the 1990s, the percentage of
    members of the MWR Panel who accepted contributions from the tobacco
    industry was higher than the congressional average. Although MWR Panel
    members received about 15 percent more industry money than other
    members during the first 2 Congresses of the 1990s, they accepted 93
    percent more than all House members during the 103rd Congress (1993-
    1994), when this issue was considered (Table 1). In total, the tobacco
    industry contributed at least $4.4 million to members of the House
    during these 3 Congresses.\44\
    ---------------------------------------------------------------------------
        \44\ Center for Responsive Politics. Tobacco: Money to Congress.
    Available at: http://www.opensecrets.org/industries/
    summary.php?cycle=1990&ind=A02. Accessed May 12, 2010.

      TABLE 1.--CAMPAIGN CONTRIBUTIONS FROM THE TOBACCO INDUSTRY TO MEMBERS OF THE MORALE, WELFARE AND RECREATIONAL
                        (MWR) PANEL OF THE HOUSE OF REPRESENTATIVES' COMMITTEE ON ARMED SERVICES
                                                  [Amounts in dollars]
    ----------------------------------------------------------------------------------------------------------------
                                                                                     Contributions
                                                                 ---------------------------------------------------
                                                                    1990 \1\     1992 \2\     1994 \3\      Career
    ----------------------------------------------------------------------------------------------------------------
    MWR Panel recipient:
        Neil Abercrombia (D-HI).................................  ...........          500        1,500        9,500
        Herbert H. Bateman (R-VA)...............................        8,100        8,450        5,260       41,548
        Earl Hutto (D-FL).......................................  ...........  ...........  ...........  ...........
        John R. Kasich (R-OH)...................................          500          500        1,500        9,500
        H. Martin Lancaster (D-NC)..............................       18,200       22,198       44,720       85,118
        Donald H. Machtley (R-RI)...............................        1,750  ...........  ...........        1,750
        Solomon P. Ortiz (D-TX).................................        1,000          500        6,000       33,000
        Owen B. Pickett (D-VA...................................        2,850        2,000        6,500       25,750
        Bob Stump (R-AZ)........................................        2,000        3,500        2,500       15,250
        John S. Tanner (D-TN)...................................        5,700        4,700        5,500      157,700
        Robert A. Underwood (D-GU)..............................  ...........  ...........  ...........  ...........
                                                                 ---------------------------------------------------
          Total contributions received..........................       40,100       42,348       73,480      379,116
                                                                 ===================================================
    Average donation received by all MWR Panel members..........        3,645        3,850        6,680  ...........
    Average donation received by all House members..............        3,118        3,393        3,458  ...........
    ----------------------------------------------------------------------------------------------------------------
    \1\ MWR Panel members received on average 16.9 percent more than all House members.
    \2\ MWR Panel members received on average 13.5 percent more than all House members.
    \3\ MWR Panel members received on average 93.2 percent more than all House members.

    Congress Retaliates
        Tobacco industry observers interpreted the outcome of the HASC MWR
    Panel hearing as favorable to the industry. Internal industry
    communique's described various members of the panel as supportive of
    the industry's position and noted that ``the military commanders who
    appeared before the panel stated that they would not support
    eliminating sales of tobacco products and would make their opposition
    known to officials.'' \45\
    ---------------------------------------------------------------------------
        \45\ [Philip Morris.] House panel voices opposition to DOD efforts
    to establish ``smoke-free'' military. August 9, 1993. Philip Morris
    collection. Bates no. 2047992778/2785. Available at: http://
    legacy.library.ucsf.edu/tid/rgi57d00. Accessed January 25, 2008.
    ---------------------------------------------------------------------------
        However, industry reports were overly optimistic. Just 3 days after
    the hearing, the Tobacco Institute learned that Admiral Kelso had
    endorsed Bryant's decision to ban smoking and cigarette sales aboard
    the USS Roosevelt. The Institute reported to tobacco companies that

        Several Members of Congress believe they were betrayed by this
    decision and intend to take legislative action including the removal of
    all Naval ship stores from the commissary system, thus eliminating the
    subsidy and forcing price increases on all other products.\38\

        Command Master Chief Herdt of the USS Roosevelt received a
    shipboard call from the highestranking enlisted person in the Navy,
    Master Chief Petty Officer John Hagan, urging a reversal of the ban.
    Hagan had been summoned to the office of a HASC MWR congressman, who
    chastised him severely about the nosmoking policy. Hagan reportedly
    said he had never been treated so abusively in his role as Master Chief
    Petty Officer. Nonetheless, Herdt and Bryant decided to continue the
    no-smoking policy.
        A month after the hearing, in September 1993, Representative Owen
    Pickett (D-VA) and Representative Ortiz sponsored an amendment to the
    Defense Authorization Act for Fiscal Year 1994, stripping Federal
    subsidies from Navy ships' stores and requiring that they all sell
    tobacco products.\46\ The amendment did not contain obviously pro-
    tobacco language, but merely revised the applicable section to replace
    the word ``may'' with ``shall,'' thus reading: ``(c) Items Sold.--
    Merchandise sold by ship stores afloat shall include items in the
    following categories . . .'' and listed ``tobacco products'' as one
    among many items that must be made available.\47\ The law does not
    mention specific tobacco products.
    ---------------------------------------------------------------------------
        \46\ Tobacco Institute. Executive summary. September 17, 1993.
    Lorillard collection. Bates no. 87686227/6228. Available at: http://
    legacy.library.ucsf.edu/tid/txt21e00. Accessed April 15, 2008.
        \47\ Cornell University Law School U.S. Code collection. Title 10,
    Subtitle C, Part IV, Chapter 651, Sec. 7604 ships' stores: sale of
    goods and services. Available at: http://www.law.cornell.edu/uscode/
    html/uscode10/usc_sec_10_00007604--000-.html. Accessed August 14, 2009.
    ---------------------------------------------------------------------------
        The amendment also transferred ``the authority over all ships [sic]
    stores from ship captains to the Navy Exchange Command (NEXCOM).'' \48\
    This transfer meant that oversight would now reside in ``the Morale
    Welfare, and Recreation (MWR) Panel of the House Armed Services
    Committee.'' \49\
    ---------------------------------------------------------------------------
        \48\ Scott GR. Sale of tobacco products on ships stores. April 7,
    1994. Philip Morris collection. Bates no. 2073010489. Available at:
    http://legacy.library.ucsf.edu/tid/xps57c00. Accessed January 16, 2008.
        \49\ [Philip Morris.] Washington Report: Defense Authorization Bill
    conferees adopt provision requiring ship stores to sell tobacco
    products. November 29, 1993. Philip Morris collection. Bates no.
    2046215439/5445. Available at: http://legacy.library.ucsf.edu/tid/
    vuh92e00. Accessed January 16, 2008.
    ---------------------------------------------------------------------------
        The tobacco industry reported that the legislation was prompted by
    the Navy's tobacco control efforts. Philip Morris observed that
    ``Congressional intervention reversed the imposition of a `smokefree'
    policy aboard Navy ships.'' \36\ The Tobacco Institute noted that the
    Chief of Naval Operations angered Congressman Pickett and others by
    ``reneging on his promise to reverse the order by the Commanding
    Officer of the USS Roosevelt banning smoking and tobacco sales aboard
    ship.'' \46\
    Navy Response
        Before the Defense Authorization Act had been approved and signed
    by the President, the Navy implemented a new service-wide policy that
    prevented local-level personnel from banning smoking entirely.\50\ On
    October 21, 1993, Secretary of the Navy John Dalton issued the
    ``Smoking policy for Department of Navy controlled spaces,'' effective
    January 1, 1994, which described exactly where designated smoking
    spaces would be established on ships or submarines.\50\
    ---------------------------------------------------------------------------
        \50\ Dept of the Navy. Smoking policy for Department of the Navy
    (DoN) controlled spaces. October 22, 1993. Philip Morris collection.
    Bates no. 2023172656/2658. Available at: http://
    legacy.library.ucsf.edu/tid/jtt14e00. Accessed December 1, 2006.
    ---------------------------------------------------------------------------
        Dalton sent Ortiz a copy of the policy.\51\ He wrote,
    ``Appreciating your interest in the issue of smoking aboard Navy ships,
    I am pleased to advise you that . . . I have approved a policy that
    will be applicable to all Navy ships.'' \51\ He continued, ``Tobacco
    products will be sold in ship's stores and will be priced similarly to
    those sold in Navy Exchanges ashore.'' The new policy addressed only
    smoking regulations and not sales, suggesting that Dalton may have
    raised the sales issue in his cover letter and implemented the policy
    in an effort to forestall the adoption of the Pickett-Ortiz amendment.
    Ortiz immediately shared the victory with his tobacco industry allies,
    faxing the documents to Philip Morris just ``minutes after'' receiving
    Dalton's letter and policy memo.\52\
    ---------------------------------------------------------------------------
        \51\ Dalton JH. Letter from John Dalton to Solomon Ortiz. October
    21, 1993. Philip Morris collection. Bates no. 2023172654. Available at:
    http://legacy.library.ucsf.edu/tid/suc85e00. Accessed December 7, 2006.
        \52\ Scott G. Navy smoking policy. October 22, 1993. Philip Morris
    collection. Bates no. 2023172653. Available at: http://
    legacy.library.ucsf.edu/tid/ruc85e00. Accessed January 25, 2008.
    ---------------------------------------------------------------------------
        A naval press release characterized the policy as protecting people
    from ``involuntary exposure to environmental tobacco smoke'' \53\
    rather than reinstating smoking areas on ships that had eliminated
    them. The media thus reported Dalton's policy as a crackdown on
    smoking, as opposed to a capitulation to members of the HASC MWR
    Panel.\54\ When interviewed, Dalton was unable to recall additional
    details of the incident.
    ---------------------------------------------------------------------------
        \53\ Navy announces new smoking policy [press release]. Washington,
    DC: U.S. Navy; October 21, 1993. Available at: http://www.navy.mil/
    navydata/news/mednews/med93/med93041.txt. Accessed November 9, 2009.
        \54\ Morris P. Navy cracks down on smoking with uniform new
    regulations. November 17, 1993. Philip Morris collection. Bates no.
    2048159074/9146. Available at: http://legacy.library.ucsf.edu/tid/
    xrs65e00. Accessed April 24, 2008.
    ---------------------------------------------------------------------------
        Despite Dalton's policy, the Pickett-Ortiz amendment passed. The
    Navy tried to argue for amending it, contending that it would
    ``increase the cost of merchandise to sailors, reduce funding for their
    ship's morale, welfare, and recreation (MWR) programs and result in a
    less efficient program.'' \55\ In response, Pickett inserted language
    into the act delaying the date of implementation for 1 year, which
    successfully thwarted the Navy's attempt to repeal the law.\56\
    ---------------------------------------------------------------------------
        \55\ Roark D. Impact on afloat sailors by converting ships stores
    from appropriated to non-appropriated funding. April 6, 1994. Philip
    Morris collection. Bates no. 2073010490. Available at: http://
    legacy.library.ucsf.edu/tid/wps57c00. Accessed April 10, 2008.
        \56\ U.S. Congress. Sec. 382. Ships' stores. May 4, 1994. Philip
    Morris collection. Bates no. 2073010557. Available at: http://
    legacy.library.ucsf.edu/tid/fps57c00. Accessed April 15, 2008.
    ---------------------------------------------------------------------------
        In September 1995, the Navy newspaper Soundings reported that the
    Navy had ``thrown in the towel'' and abandoned plans to become smoke-
    free by 2000.\28\ The Navy was reported to have ``conceded'' that the
    goal was ``unrealistic.'' \28\ Instead, it established a goal to reduce
    smoking rates to 35 percent, the equivalent civilian rate at the
    time.\28\ As of 2005, the smoking prevalence in the Navy was 32
    percent,\4\ still more than 50 percent above the corresponding civilian
    rate of 21 percent.
    Tobacco Industry Confidence
        Internal industry communique's with wording such as ``the provision
    we put through last year'' \57\ reveal the extent to which the industry
    was confident of the power it wielded. At the end of 1993, one Philip
    Morris executive wrote, ``We are continuing to stimulate congressional
    opposition to efforts to restrict the sale of tobacco products in the
    military.'' \36\ Another Philip Morris employee wrote in 1994, ``We
    will be working with the MWR Panel to attempt to ensure that the
    Pickett-Ortiz provision is not repealed.'' \48\ Industry lobbyists
    enjoyed access to key committee members.\40\
    ---------------------------------------------------------------------------
        \57\ Scott GR. DOD--cigarettes. May 5, 1994. Philip Morris
    collection. Bates no. 2073010555. Available at: http://
    legacy.library.ucsf.edu/tid/hps57c00. Accessed April 10, 2008.
    ---------------------------------------------------------------------------
        Kelso visited the Roosevelt when it was deployed in the
    Mediterranean in August 1993 and told Bryant he was doing the right
    thing in banning smoking. However, when the Roosevelt returned to port
    in September 1993, Kelso told Bryant he was taking ``immense heat''
    from every corner, including Congress and the Secretary of the Navy,
    for Bryant's actions and that all ships, including the Roosevelt, would
    have to accommodate smokers by providing a dedicated smoking area. In
    retrospect, Bryant was grateful that Kelso had put off overriding the
    Roosevelt's smokefree policy until after its deployment. Bryant said,
    ``I'm taking care of my crew. Who's going to take me to task for that?
    And in fact, the military did not.'' He added, ``You've got to do what
    you think is right. For the most part, the media and Congress respect
    that, but then you've got big money and the tobacco industry that work
    against it.''
                                   discussion
        In this case, the tobacco industry's influence over Congress
    clearly has harmed sailors in 2 ways. Foremost, sailors have been left
    exposed to secondhand smoke while deployed, compromising their safety
    and health. Congressional action mandating cigarette sales also ensured
    that this exposure would continue; the Navy could not in the future
    adopt strong tobacco control policies without congressional approval,
    since doing so would likely be difficult--and obviously hypocritical--
    to enforce a smokefree ship while still selling cigarettes. For
    instance, smoking on submarines continued to be allowed until it was
    prohibited at the end of 2010.\58\ \59\ Second, an opportunity to
    denormalize smoking was lost, and a tobacco-friendly atmosphere was
    maintained.
    ---------------------------------------------------------------------------
        \58\ U.S. Navy. Smoking to be extinguished on submarines. Available
    at: http://www.navy.mil/search/display.asp?story_id=52488. Accessed May
    12, 2010.
        \59\ Shanker T. To protect health of nonsmokers, Navy bans tobacco
    use on its submarine fleet. The New York Times. June 21, 2010:A16.
    Available at: http://www.nytimes.com/2010/06/21/us/21smoking.html.
    Accessed June 24, 2010.
    ---------------------------------------------------------------------------
        The tobacco industry appears to have had significant influence on
    Navy tobacco control efforts. Between 1988 and 1994, nearly 70 percent
    of Members of Congress received tobacco industry money,\44\ which has
    been found to be associated with legislative support for tobacco
    industry positions.\60\ \61\ \62\ House MWR Panel members, many of whom
    represented tobacco States, accepted on average more and larger
    campaign contributions than other Housemembers. Certainly the industry
    and its consultants believed their actions resulted in reversing the
    smoke-free policies aboard the USS Roosevelt.
    ---------------------------------------------------------------------------
        \60\ Luke DA, Krauss M. Where there's smoke there's money: tobacco
    industry campaign contributions and U.S. Congressional voting. Am J
    Prev Med. 2004; 27(5):363-72.
        \61\ Glantz SA, Begay ME. Tobacco industry campaign contributions
    are affecting tobacco control policymaking in California. Journal of
    the American Medical Association. 1994;272(15):1176-82.
        \62\ Monardi F, Glantz SA. Are tobacco industry campaign
    contributions influencing State legislative behavior? Am J Public
    Health. 1998;88(6):918-23.
    ---------------------------------------------------------------------------
        The U.S. military is one of the most powerful institutions in the
    world. Its mission, the protection of the country, requires personnel
    at peak readiness and performance; hence, military training stresses
    physical and mental fitness. The ultimate responsibility for
    maintaining this force lies with Congress, which retains essential
    civilian oversight of the military. Such oversight, however, leaves
    military policy vulnerable to other interests.
        A consistent pattern of congressional interference with military
    tobacco control efforts suggests several lessons for advocates. First,
    the industry-scripted response to military tobacco control policy that
    positions tobacco use as a ``right'' to be defended by Congress must be
    countered. Military readiness requires restrictions on activities or
    characteristics that interfere with fitness. All branches of the
    military, for example, set healthy weight parameters for recruits \63\;
    restricting tobacco use is no more a violation of rights than is
    requiringmaintenance of appropriate weight.
    ---------------------------------------------------------------------------
        \63\ 10 Steps to joining the military: height and weight charts.
    Available at: http://www.military.com/Recruiting/Content/
    0,13898,rec_step07_hw,00.html. Accessed May 3, 2010.
    ---------------------------------------------------------------------------
        Second, congressional intervention has largely taken place out of
    public view; the MWR Panel's actions ultimately took the form of small,
    seemingly technical changes to a comprehensive and necessary piece of
    legislation. It is likely that most Members of Congress were unaware of
    these amendments and their long-term impact on the health of Navy
    personnel. Such action is in keeping with other pro-tobacco legislative
    efforts, such as the passage of an amendment to the 1986 defense
    authorization bill requiring military commissaries to sell tobacco and
    forbidding them to raise prices.\5\ Directing public attention to such
    legislation, and making its proponents justify it in public, will
    likely be a necessary part of changing military tobacco control policy.
        Finally, civilian public health organizations must play a stronger
    role in these efforts. The public may believe that the military is
    resistant to tobacco control; however, multiple studies have
    demonstrated that advocates at all levels of tobacco control in the
    military find themselves or their services to be the target of
    political attacks.\5\ \18\ Because all active-duty military personnel
    are constrained by the structural controls on their lobbying activity,
    their ability to respond to these attacks is limited. A coalition of
    public health, tobacco control, and veterans' service groups and
    health-focused congressional allies needs to organize to achieve
    effective military tobacco control policies. Such a coalition could
    shine a light on congressional actions that thwart military tobacco
    control efforts and facilitate those that help the military achieve the
    goal recently called for by the Institute of Medicine: a tobacco-free
    military.\4\
        This coalition could reframe military tobacco control issues.
    Veterans might be particularly effective at debunking the idea that
    military personnel deserve the freedom to smoke by talking about years
    of postservice addiction that began in a tobaccofriendly military.\16\
    Similar reframing should be used in advocating for clean indoor air for
    all military personnel. Tobacco-sickened veterans could help drive home
    the point that military policy lags behind civilian policy in the
    percentages of people fully protected by proven, effective tobacco
    control policies recommended for use globally,\64\ including smoke-free
    spaces and high tobacco taxes. Members of the services assume
    unavoidable risks as part of the military mission, but exposure to
    cigarette smoke should not be one of them.
    ---------------------------------------------------------------------------
        \64\ World Health Organization. WHO Framework Convention on Tobacco
    Control. Available at: http://www.who.int/tobacco/framework/en.
    Accessed February 26, 2010.

        Senator Cochran. Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Have there been studies comparing, say, the
    returning veterans' respiratory and lung problems, say, with
    the ones that came out of the Gulf in 1991?
        Captain Connor. Senator Shelby, I would like to research
    that and get right back to you with a full answer to that.
        Senator Shelby. Would you do that for the record?
        Captain Connor. We certainly will get right back to you on
    that.
        [The information follows:]

        I wanted to thank you and the Senate Appropriations
    Subcommittee on Defense for allowing me the opportunity to
    testify on June 22 about lung health and the military. I also
    wanted to follow up with some information regarding questions
    you asked me about lung health problems in veterans and steps
    the Department of Defense (DOD) has taken regarding tobacco.
        First, you asked me if there were any data comparing the
    lung health of veterans of the 1991 gulf war to veterans of the
    current conflict. Researchers and doctors are beginning to
    address this question. The evidence thus far shows that
    veterans of the first gulf war had a variety of respiratory
    problems, which we are likely to find in veterans of the
    current war. However, there are also differences in the toxins
    personnel were exposed to, and in length of time they were
    exposed. As you know, the first gulf war was much shorter than
    the current one. We are still learning how these differences
    affect the lung health of today's troops.
        There is certainly enough evidence to warrant concern for
    our current troops and action from DOD. One study conducted by
    Vanderbilt University suggests that certain exposures during
    the current conflict have caused serious cases of constrictive
    bronchiolitis, a condition associated with damage or
    destruction of over 50 percent of small airways.\1\ In a review
    of DOD studies, the National Academy of Sciences' National
    Research Council (NRC) concluded that troops deployed in the
    Middle East are ``exposed to high concentrations'' of
    particulate matter associated with harm ``affecting troop
    readiness during service'' and even ``occurring years after
    exposure.'' \2\ Much more surveillance and research is needed,
    which is why I urged in my testimony that DOD be required to
    develop better ways to measure and track lung disease in
    military personnel, including taking baseline measures prior to
    deployment and creating a national registry to track all
    veterans who were exposed to pollutants while in Iraq and
    Afghanistan.
    ---------------------------------------------------------------------------
        \1\ Robert F. Miller, MD. Vanderbilt University Medical Center.
    Testimony before the United States Senate Committee on Veterans'
    Affairs. ``Airway injury in U.S. soldiers following service in Iraq and
    Afghanistan'' October 8, 2009.
        \2\ National Academy of Sciences, National Research Council. Review
    of the Department of Defense Enhanced Particulate Matter Surveillance
    Program Report. 2010. http://www.nap.edu/catalog/12911.html. Accessed
    June 7, 2011.
    ---------------------------------------------------------------------------
        I also wanted to follow-up with you regarding your question
    about what the DOD has done so far to help tobacco users in the
    military quit. As I shared in my testimony, the Institute of
    Medicine (IOM) found that the Pentagon spends $1.6 billion
    annually on tobacco-related medical care, increased
    hospitalization and lost days of work. While there have been
    some efforts--notably the ``Quit Tobacco, Make Everyone Proud''
    website \3\--they have not been enough, especially in light of
    the severity of the problem. Access to tobacco cessation
    programs and medication varies among bases and military
    branches. And despite urgings from the Institute of Medicine
    report on the subject,\4\ and a requirement in the Duncan
    Hunter National Defense Authorization for Fiscal Year 2009,\5\
    TRICARE still does not cover treatments to help tobacco users
    quit.
    ---------------------------------------------------------------------------
        \3\ www.ucanquit2.org.
        \4\ Institute of Medicine. Combating Tobacco Use in Military and
    Veteran Populations. 2009. http://www.nap.edu/
    catalog.php?record_id=12632.
        \5\ http://www.dod.gov/dodgc/olc/docs/2009NDAA_PL110-417.pdf.
    ---------------------------------------------------------------------------
        The American Lung Association recommends that the
    Department of Defense implement all recommendations called for
    in the 2009 IOM report Combating Tobacco Use in Military and
    Veterans Populations that I discussed in my testimony. The IOM
    has laid out a very careful, scientifically based road map for
    the DOD to follow and the American Lung Association strongly
    urges the Committee to ensure that the report's recommendations
    be implemented without further delay.

        Senator Shelby. Second, what is the Department of Defense
    doing to discourage smoking? As the chairman noted, they used
    to promote smoking, I guess, or help, aid, and abet it. What
    are they doing to discourage it, because a lot of the young
    people, not just soldiers but in our college campuses, a lot of
    them smoke. A lot of them quit. A lot of them quit too late.
        Captain Connor. Right. It's a two-part question, what are
    they doing to prevent it and stop it; and then what are they
    doing to help people get off cigarettes.
        Senator Shelby. Right.
        Captain Connor. There are some smoking cessation efforts
    which we believe could be better resourced. We don't feel
    they're doing nearly enough to prevent it. The study that I
    referred to has very excellent concrete recommendations, like
    let's suggest all officers not smoke. When kids come into boot
    camp, they can't smoke. So we could start by grandfathering
    that starting today, saying, okay, when you get through boot
    camp, guess what, you can't go back smoking.
        So there's a number of things that could be done to attack
    this problem over time. Nobody's suggesting that the knife come
    down tomorrow and say no smoking. But I think steps could be
    taken to arrest this problem and stop it from growing.
        Senator Shelby. I think all of us know that the more you
    smoke the less you're going to run, probably the fewer miles
    you're going to march, the fewer minutes you can do exercise,
    too. That's just common sense.
        Captain Connor. That's right. The other thing, you've got
    the military exchanges are making money from the cigarettes.
    That's a big issue, too. Then there's a reluctance of combat
    commanders that we hear about from the health people in DOD, a
    reluctance to deprive troops of something that they say affects
    their morale and things like that.
        Senator Shelby. Thank you.
        Chairman Inouye. Thank you very much, Captain.
        The next witness is Mr. Rick Jones, National Association
    for Uniformed Services.
    STATEMENT OF RICK JONES, LEGISLATIVE DIRECTOR, NATIONAL
                ASSOCIATION FOR UNIFORMED SERVICES
        Mr. Jones. Chairman Inouye, Vice Chairman Cochran, Senator
    Shelby: Thank you very much.
        The National Association for Uniformed Services is
    concerned about the investment we're making in our defense. As
    hard as you work, too often we still depend on aging fleets of
    aircraft, ships, and vehicles across the services. We must
    continue to drive toward modernization and that means
    investment.
        The message our members ask me to bring is simple and
    direct: Anyone who goes into harm's way under the flag of the
    United States needs to be deployed with the best our Nation can
    provide. Our troops in the field depend on America's support.
    Critical funding provides them the margins they need for
    success.
        TRICARE, the provision of quality, timely healthcare, is
    considered one of the most important non-cash earned benefits
    afforded those who serve a career in the military. Our service
    members and their families make great sacrifices for all of us.
    The TRICARE benefit reflects the commitment of a Nation to
    those who serve, and it deserves your wholehearted support.
        Our fiscal situation, of course, requires shared sacrifice.
    But our military and our military retirees should bear no more
    than their share. For those who give their career to a
    uniformed service, our organization asks you to provide full
    funding for the securing of their earned benefit.
        It's our understanding that certain leaders in Congress
    have agreed with the Department of Defense regarding a 13
    percent increase in TRICARE fees paid by military retirees.
    NAUS does not agree and, after hearing for more than a year the
    Secretary of Defense and the Chairman of the Joint Chiefs say
    that rising costs of retiree healthcare was crippling our
    Nation's national security, we read that the House
    Appropriations Committee intends to use $330 million of
    unexecuted money in the TRICARE health program for funding
    additional congressionally directed medical research programs,
    many of which are outside traditional battlefield medicine and/
    or duplicate subjects covered by the National Institutes of
    Health. It's not appropriate. Our folks might be outraged when
    they hear this, that their healthcare they'll have to pay more
    for, but the money's going for additional research in areas
    unrelated to the military.
        My association urges you to provide adequate funding for
    military construction and family housing accounts. The funds
    for base allowance and housing should ensure that those serving
    our country are able to afford to live in quality housing.
        Walter Reed. Another matter of great interest to our
    members is the plan to realign the National Capital area's
    military health programs. While we herald this development,
    we're hearing that things may not be quite in order or ready by
    the September BRAC deadline. The deadline may have to be
    extended and we hope that you'll take a look at that to make
    sure that our wounded warriors don't fall through the cracks in
    this transfer from the old Walter Reed to the new Bethesda
    facility.
        DOD prosthetic research. My organization and association
    encourages the subcommittee to ensure that funding for DOD
    prosthetic research is adequate to support the full range of
    programs needed to meet current and future challenges facing
    wounded warriors.
        Post-traumatic stress and traumatic brain injury are indeed
    signature injuries and they deserve your support.
        We would also ask that the Armed Forces Retirement Home
    receive your attention. We encourage both the home in
    Washington, DC, and the home in Gulfport, Mississippi, give
    your attention to both of those for adequate funding. The
    Gulfport home has been open now for about 9 months, the new
    one, and we're encouraged to read what's going on down there
    with regard to care. But we're also concerned about some of the
    investigations regarding employees.
        The Uniformed Services Health System deserves your support
    and we thank you very much for the opportunity to testify.
        [The statement follows:]
                        Prepared Statement of Rick Jones
        Chairman Inouye, Vice Chairman 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 2012 Defense Appropriations bill.
        My name is 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 fiscal 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 personnel of the active, retired, Reserve and
    National Guard, disabled veterans, veterans community and their
    families. We love our country and our flag, 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.
        We simply must have a strong investment in the size and capability
    of our air, land and naval forces. And we must invest in fielding new
    weapons systems today to meet the challenges of tomorrow.
        We cannot depend on aging fleets of aircraft, ships and vehicles
    across the services. We must continue to drive toward modernization and
    make available the resources we will need to meet and defeat the next
    threats to our security.
        Our Nation is protected by the finest military the world has ever
    seen. The message our members want you to hear is simple and direct:
    Any one who goes into harm's way under the flag of the United States
    needs to be deployed with the best our Nation can provide. We need to
    give our brave men and women everything they need to succeed. And we
    must never cut off or unnecessarily delay critical funding for our
    troops in the field.
        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 also carries concerns about a number of related
    matters. Among these is the provision of a proper healthcare 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 healthcare 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 increases in TRICARE fees.
    Mullen said, ``It's a given as far as I'm concerned.''
        Our Association does not believe those who have given so much to
    their country in service and sacrifice should again be placed at the
    head of the line for budget reductions. We have testified before the
    authorizing committee to ``hold the line'' on fee increases. However,
    with comments like these from those in military leadership positions,
    there is little wonder that retirees and active duty personnel are
    concerned.
        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, even in a down economy.
    Fraud and Criminal Activity Costs Medicare and TRICARE Billions of
            Dollars
        Reports continue from the Government Accountability Office (GAO),
    the investigative arm of the United States Congress, and related
    government agencies that show us that multi-billions of Medicare money
    is being ripped off every year. While those in government responsible
    for the management of Medicare and TRICARE tell us that their
    investigations into these matters are working, the clear sign suggests
    otherwise. Our Medicare and TRICARE programs are desperately in need of
    improved management to stop the loss of 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 $1 million. 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.
        We need action to corral fraud and bring it to an end. What we've
    seen, however, is delay and second-hand attention with insufficient
    resources dedicated to TRICARE fraud conviction and recovery of money
    paid wrongly to medical care thieves.
        Last year, we cited the lack of information on TRICARE fraud
    activities. We suggested that one need only view the TRICARE Program
    Integrity Office web site to see a reflection of this inactivity. At
    that time the most recent Fraud Report was dated 2008 there were only
    two items listed under ``News'' for 2010 and no items for 2009.
        This year, it's good, though hardly adequate, to see the TRICARE
    Program Integrity Office update its information on its activities. The
    report for 2010 indicates that a TRICARE Anti-Fraud Conference took
    place last April. While these is no related ``News'' on this conference
    as there was in 2007, the report notes, ``the education, information
    sharing and networking that takes place during and after each
    conference creates a surge in fraud case identification and referrals
    from attendees.'' Yet there is nothing in the ``News'' that supports
    such a surge of beneficial activity took place. It seems more gloss
    than fact.
        Our members tire of hearing they should pay more for the healthcare
    earned in honorable service to country when they hear stories about or
    see little evidence of our government doing anything but sitting on its
    hands, often taking little to no action for years on this type of
    criminal activity, with the exception of an annual conference.
        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, we all know who will be left
    holding the bag and paying higher fees to cover fraud losses--the law-
    abiding retiree and family.
        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. Use your spending power to move TRICARE to root out
    the corruption, fraud and waste. And help 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 2012, the Administration recommends a 1.6 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 commends Congress
    and the Administration for its attention to troops pay. A good job has
    been done over the recently past years 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 below 3
    percent with the January 2011 pay increase.
        The National Association for Uniformed Services applauds you, Mr.
    Chairman, for the strides you have made, and we encourage you to
    continue your efforts to ensure DOD manpower policy maintains a
    compensation package that is attractive and competitive to our fighting
    men and women.
        We also encourage your review of providing bonus incentives to
    entice individuals with certain needed skills into special jobs that
    help supply our manpower for critical assets. These packages can also
    attract ``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: 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
    September 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 that Reserve Component
    Forces 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, tornado, 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, Maryland, and the closing of the
    existing Walter Reed by September 15, 2011.
        Our members are concerned about recent reports that the newly
    expanded medical center in Bethesda, Maryland, and the new community
    hospital at Fort Belvoir in Fairfax County, Virginia, are unready for
    the move. According to these reports, a number of operating rooms and
    patient services are not in conditions to allow transferring patients
    and staff from Walter Reed.
        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 required for
    uninterrupted care of our catastrophically wounded soldiers and Marines
    as they move through needed treatment in 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 both Bethesda and Fort Belvoir are in place, fully
    functional and ready to give appropriate care and treatment to the men
    and women wounded in armed service. A 9-month delay would make a world
    of difference for our retirees and for the wounded warriors and their
    families.
        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.
        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
    systems in use 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 healthcare and other benefits earned in military service.
        To improve the DOD/VA exchange, the transfer 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 effective 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 September 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
    heathcare 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 these
    funds, 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 is pleased to note
    the Subcommittee's continued interest in providing funds for the Armed
    Forces Retirement Home (AFRH). We urge the Subcommittee to meet the
    challenge in providing adequate funding for the facilities in
    Washington, DC, and Gulfport, Mississippi.
        And we thank the Subcommittee for the provision of funding that has
    led to the successful reopening of the Armed Forces Retirement Home in
    Gulfport, destroyed in 2005 as a result of Hurricane Katrina. The
    Gulfport facility has the capacity to provide independent living,
    assisted living and long-term care to more than 500 residents.
        Regarding Gulfport, members of our association are seriously
    concerned about a recent investigation into healthcare and related
    operations at the Mississippi Retirement Home. According to published
    reports five employees have resigned as a result of the investigation
    initiated by the AFRH acting chief operating officer. We ask that you
    ensure that residents' care and health is not put at risk by the
    reported troubles at Gulfport.
        The National Association for Uniformed Services applauds the
    Subcommittee's clear recognition of the Washington AFRH as a historic
    national treasure. And we look forward to working with the Subcommittee
    to continue providing a residence for and quality-of-life enhancements
    to these deserving veterans. We ask that continued care and attention
    be given to the mixed-use development to the property's southern end,
    as approved.
        The AFRH homes are historic national treasures, and we thank
    Congress for its oversight of this gentle program and its work to
    provide for a world-class care for military retirees.
    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 these patients out of military
    facilities and 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.
        Our members would also like to recognize the high quality of the
    medical education and training provided at the Uniformed Services
    University of the Health Sciences. The care given Congresswomen
    Gabrielle Giffords offers a clear example.
        USUHS trained three of the key physicians who performed life-saving
    procedures in the hours following the tragedy in Tucson. Retired Navy
    Captain Peter Rhee relied on more than 20 years of military medical
    experience to provide experienced trauma care to the Congresswoman.
    Interim Chief of Neurology Army Colonel Geoffrey Ling assisted and Dr.
    Jim Ecklund, another highly regarded neurosurgeon, was also part of the
    brain injury team. All are graduates of the military university, and by
    the way, Dr. Ecklund was a classmate of Dr. Rhee's at USUHS.
    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 owed to the families of those still missing as
    well as to those who served and who currently serve.
        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 2012.
    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 are
    confident you will give them 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 service and
    their earned benefits is a continuing cost of war, and it will never
    cost more nor is it ever likely to equal the value of their service.
        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. Mr. Jones, your concerns will be seriously
    considered, I guarantee you, sir.
        Senator Cochran. Mr. Chairman, I can't help but compliment
    the witness for mentioning the retirement home in Gulfport. I'm
    happy to report the last time I drove by the facility it looked
    like it was on the road to full recovery. Residents who had
    lived there before Hurricane Katrina are returning and happy to
    be back home. So thank you for the support that you've given to
    that initiative.
        Mr. Jones. Great to hear that report. Thank you, Senator.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I just want to thank the
    whole panel, and add Mr. Jones's testimony to that. Thank you
    very much.
        Chairman Inouye. Thank you very much.
        May I thank the panel on behalf of the subcommittee.
        Our next panel: Ms. Fran Visco, National Breast Cancer
    Coalition; Ms. Mary Hesdorffer, Mesothelioma Applied Research
    Foundation; Major General David Bockel, Reserve Officers
    Association; Captain Mike Smith, National Military and Veterans
    Alliance.
    STATEMENT OF FRAN VISCO, PRESIDENT, NATIONAL BREAST
                CANCER FOUNDATION
        Ms. Visco. Thank you very much. Thank you, Chairman Inouye,
    Ranking Member Cochran, and Senator Shelby, for inviting me to
    testify today. I'm Fran Visco, a 23-year breast cancer survivor
    and President of the National Breast Cancer Coalition, which is
    a coalition of hundreds of organizations from across the
    country.
        I also want to thank you so very much for launching and
    supporting the DOD peer-reviewed breast cancer research
    program. It's meant so much to women and men across the
    country, both within the military and without. You know that
    you created something innovative, something very special, that
    has saved lives, and it's given hope to very many.
        But there are still too many women and men who die of
    breast cancer. Like you may remember Lieutenant Colonel Karen
    Moss of the U.S. Air Force, who spoke to the subcommittee many
    times about the importance of this program. Lieutenant Colonel
    Yvonne Andejeski of the U.S. Army, who died of breast cancer in
    her 30s while she was a director of the peer-reviewed program.
    And just yesterday, at a meeting of the DOD program we took a
    moment to remember Lieutenant Commander Yowanna Maria Collins
    Wilson of the U.S. Navy, who died of breast cancer in her 30s
    while on active duty.
        The partnership that has developed over the years between
    the military, the public, and the scientists who are involved
    in this program is extremely important and helpful to all of
    us. I cannot say enough about the dedication and passion the
    military has brought to this program. The breast cancer
    research program is the only government program focused solely,
    funding program focused solely, on ending breast cancer. It is
    a program that leverages years of this Nation's investment in
    biomedical research and in breast cancer and applies the
    results of that investment to women and men everywhere. It is
    known and respected worldwide and it expands this Nation's
    preeminence in scientific research.
        Ninety percent of the funds appropriated go to research.
    The administrative costs of this program are minimal and that
    is because of the military and how well they operate this
    program. It is a transparent program. It's accountable to the
    taxpayers, and it is complementary and not duplicative of other
    programs.
        Because of the way it is structured and because of the fact
    that it is in the Army, it is able to rapidly respond to
    scientific discoveries and quickly fill gaps in scientific and
    patient needs. I recall General Martinez Lopez, who led these
    efforts a number of years ago, telling us how important this
    program was to the military, not just because of the morale
    that it brought, but also because of the relationships that had
    been created between DOD and a part of the scientific community
    that is important to their work, but not typically engaged with
    the military, and also because of the models that the program
    created that have been replicated elsewhere within the military
    and actually even in other countries.
        This program has been a resounding success, and I'm here to
    express our appreciation for your leadership in getting this
    program started and in making certain that it continues.
        Thank you very much.
        [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 22-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. Since its founding in 1991, NBCC has been guided
    by three primary goals: 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 healthcare and
    breast cancer clinical trials for all women; and expand the influence
    of breast cancer advocates wherever breast cancer decisions are made.
    Last September, in order to change the conversation about breast cancer
    and restore the sense of urgency in the fight to end the disease, NBCC
    launched Breast Cancer Deadline 2020--a deadline to end breast cancer
    by January 1, 2020.
        Chairman Inouye and Ranking Member Cochran, we appreciate your
    longstanding support for the Department of Defense peer reviewed Breast
    Cancer Research Program. As you know, this program was born from a
    powerful grassroots effort led by NBCC, and has become a unique
    partnership among consumers, scientists, Members of Congress and the
    military. 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 ending this disease. 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 healthcare
    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. To support this unprecedented progress moving forward, we
    ask that you support a separate $150 million appropriation, level
    funding, for fiscal year 2012. In order to continue the success of the
    Program, you must ensure that it maintain its integrity and separate
    identity, in addition to level funding. This is important not just for
    breast cancer, but for all biomedical research that has benefited from
    this incredible government program.
    Vision and Mission
        The vision of the Department of Defense peer reviewed Breast Cancer
    Research Program is to ``eradicate breast cancer by funding innovative,
    high-impact research through a partnership of scientists and
    consumers.'' The meaningful and unprecedented partnership of scientists
    and consumers has been the foundation of this model program from the
    very beginning. It is important to understand this collaboration:
    consumers and scientists working side by side, asking the difficult
    questions, bringing the vision of the program to life, challenging
    researchers and the public to do what is needed and then overseeing the
    process every step of the way to make certain it works. This unique
    collaboration is successful: every year researchers submit proposals
    that reach the highest level asked of them by the program and every
    year we make progress for women and men everywhere.
        And it owes its success to the dedication of the U.S. Army and
    their belief and support of this mission. And of course, to you. It is
    these integrated efforts that make this program unique.
        The Department of the Army must be applauded for overseeing the DOD
    BCRP which has established itself as a model medical research program,
    respected throughout the cancer and broader medical community for its
    innovative, transparent and accountable approach. This program is
    incredibly streamlined. The flexibility of the program has allowed the
    Army to administer it with unparalleled efficiency and effectiveness.
    Because there is little bureaucracy, the program is able to respond
    quickly to what is currently happening in the research community. Its
    specific focus on breast cancer allows it 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 pioneering research performed through the program and the
    unique vision it maintains has the potential to benefit not just breast
    cancer, but all cancers as well as other diseases. Biomedical research
    is literally being transformed by the DOD BCRP's success.
    Consumer Participation
        Advocates bring a necessary perspective to the table, ensuring that
    the science funded by this program is not only meritorious, but that it
    is also meaningful and will make a difference in people's lives. The
    consumer advocates bring accountability and transparency to the
    process. They are trained in science and advocacy and work with
    scientists willing to challenge the status quo to ensure that the
    science funded by the program fills important gaps not already being
    addressed by other funding agencies. Since 1992, more than 600 breast
    cancer survivors have served on the BCRP review panels.
        Two years ago, Carolina Hinestrosa, a breast cancer survivor and
    trained consumer advocate, chaired the Integration Panel and led the
    charge in challenging BCRP investigators to think outside the box for
    revelations about how to eradicate breast cancer. Despite the fact that
    her own disease was progressing, she remained steadfast in working
    alongside scientists and consumers to move breast cancer research in
    new directions. Unwilling to give up, she fought tirelessly until the
    end of her life for a future free of breast cancer.
        Carolina died in June 2009 from soft tissue sarcoma, a late side
    effect of the radiation that was used to treat her breast cancer. She
    once eloquently described the unique structure of the DOD BCRP:

        ``The Breast Cancer Research Program channels powerful synergy from
    the collaboration of the best and brightest in the scientific world
    with the primary stakeholder, the consumer, toward bold research
    efforts aimed at ending breast cancer.''

        No one was bolder than Carolina, who was fierce and determined in
    her work on the DOD BCRP and in all aspects of life she led as a
    dedicated breast cancer advocate, mother to a beautiful daughter, and
    dear friend to so many. Carolina's legacy reminds us that breast cancer
    is not just a struggle for scientists; it is a disease of the people.
    The consumers who sit alongside the scientists at the vision setting,
    peer review and programmatic review stages of the BCRP are there to
    ensure that no one forgets the women who have died from this disease,
    and the daughters they leave behind, and to keep the program focused on
    its vision.
        For many consumers, participation in the program is ``life
    changing'' because of their ability to be involved in the process of
    finding answers to this disease. In the words of one advocate:

        ``Participating in the peer review and programmatic review has been
    an incredible experience. Working side by side with the scientists,
    challenging the status quo and sharing excitement about new research
    ideas . . . it is a breast cancer survivor's opportunity to make a
    meaningful difference. I will be forever grateful to the advocates who
    imagined this novel paradigm for research and continue to develop new
    approaches to eradicate breast cancer in my granddaughters'
    lifetime.''------Marlene McCarthy, two-time breast cancer ``thriver'',
    Rhode Island Breast Cancer Coalition

        Scientists who participate in the Program agree that working with
    the advocates has changed the way they do science. Let me quote Greg
    Hannon, the fiscal year 2010 DOD BCRP Integration Panel Chair:

        ``The most important aspect of being a part of the BCRP, for me,
    has been the interaction with consumer advocates. They have currently
    affected the way that I think about breast cancer, but they have also
    impacted the way that I do science more generally. They are a constant
    reminder that our goal should be to impact people's lives.''------Greg
    Hannon, PhD, Cold Spring Harbor Laboratory
    Unique Structure
        The DOD BCRP uses a two-tiered review process for proposal
    evaluation, with both steps including scientists as well as consumers.
    The first tier is scientific peer review in which proposals are weighed
    against established criteria for determining scientific merit. The
    second tier is programmatic review conducted by the Integration Panel
    (composed of scientists and consumers) that compares submissions across
    areas and recommends proposals for funding based on scientific merit,
    portfolio balance and relevance to program goals.
        Scientific reviewers and other professionals participating in both
    the peer review and the programmatic review process are selected for
    their subject matter expertise. Consumer participants are recommended
    by an organization and chosen on the basis of their experience,
    training and recommendations.
        The BCRP has the strictest conflict of interest policy of any
    research funding program or institute. This policy has served it well
    through the years. Its method for choosing peer and programmatic review
    panels has produced a model that has been replicated by funding
    entities around the world.
        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 and consumers 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 to that mission of 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.
    Distinctive Funding Opportunities
        The DOD BCRP research portfolio includes many different types of
    projects, including support for innovative individuals and ideas,
    impact on translating research from the bench to the bedside, and
    training of breast cancer researchers.
                Innovation
        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. They
    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 as well.
        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. For example, in fiscal
    year 2008, Dr. Mauro Ferrari of the University of Texas Health Science
    Center at Houston was granted an Innovator Award to develop novel
    vectors for the optimal delivery of individualized breast cancer
    treatments. This is promising based on the astounding variability in
    breast cancer tumors and the challenges presented in determining which
    treatments will be most effective and how to deliver those treatments
    to each individual patient. In fiscal year 2006, Dr. Gertraud
    Maskarinec of the University of Hawaii received a synergistic IDEA
    grant to study effectiveness of the Dual Energy X-Ray Absorptiometry
    (DXA) as a method to evaluate breast cancer risks in women and young
    girls.
        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. Dr. Shiladitya Sengupta from Brigham and Women's
    Hospital, Harvard Medical School, received a fiscal year 2006 Era of
    Hope Scholar Award to explore new strategies in the treatment of breast
    cancer that target both the tumor and the supporting network
    surrounding it. In fiscal year 2007, Dr. Gene Bidwell of the University
    of Mississippi Medical Center received an Era of Hope Postdoctoral
    Award to study thermally targeted delivery of inhibitor peptides, which
    is an underdeveloped strategy for cancer therapy.
        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. 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 targets that are involved in the initiation and
    progression of cancer.
        These are just a few examples of innovative funding opportunities
    at the DOD BCRP that are filling gaps in breast cancer research.
                Translational Research
        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 process by which the application of well-founded
    laboratory or other pre-clinical insight result in 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 Multi Team 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 toward the eradication of breast cancer. Many
    of these Teams are working on questions that will translate into direct
    clinical applications. These Teams include the expertise of basic,
    epidemiology and clinical researchers, as well as consumer advocates.
                Training
        The DOD BCRP is also cognizant of the need to invest in tomorrow's
    breast cancer researchers. Dr. J. Chuck Harrell, Ph.D. at the
    University of Colorado, Denver and the University of North Carolina at
    Chapel Hill, for example, received a Predoctoral Traineeship Award to
    investigate hormonal regulation of lymph node metastasis, the majority
    of which retain estrogen receptors (ER) and/or progesterone receptors.
    Through his research, Dr. Harrell determined that lymph node
    microenvironment alters ER expression and function in the lymph nodes,
    effecting tumor growth. These findings led Dr. Harrell to conduct
    further research in the field of breast metastasis during his
    postdoctoral work. Jim Hongjun of the Battelle Memorial Institute
    received a postdoctoral award for the early detection of breast cancer
    using post-translationally modified biomarkers.
        Dr. John Niederhuber, former 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 2012.
    Outcomes and Reviews of the DOD BCRP
        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.
        The success of the DOD peer reviewed Breast Cancer Research Program
    has been illustrated by several unique assessments of the Program. The
    Institute of Medicine (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.
        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 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 . . .''
    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,
    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 website http://
    influence.breastcancerdeadline2020.org/ to learn more about the
    exciting research reported at the 2008 Era of Hope. The next Era of
    Hope meeting will occur this August.
        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 reaching Breast Cancer Deadline 2020's goal of ending the
    disease by the end of the decade. 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.
        Consumer advocates have worked hard over the years to keep this
    program free of political influence. Often, specific institutions or
    disgruntled scientists try to change the program though legislation,
    pushing for funding for their specific research or institution, or try
    to change the program in other ways, because they did not receive
    funding through the process, one that is fair, transparent and
    successful. The DOD BCRP has been successful for so many years because
    of the experience and expertise of consumer involvement, and because of
    the unique peer review and programmatic structure of the program. We
    urge this Committee to protect the integrity of the important model
    this program has become.
        There are nearly 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 260,000 will be diagnosed. We still do not know how to
    prevent breast cancer, how to diagnose it in a way to make a real
    difference 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 approach 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
    nearly 3 million women in the United States living with breast cancer
    and all those who share in the mission to end breast cancer.

        Chairman Inouye. I thank you very much, Ms. Visco. My wife
    of 57 years died of cancer, so I'm constantly reminded.
        Ms. Visco. Yes.
        Chairman Inouye. Senator Cochran.
        Senator Cochran. Thank you very much for your presence. We
    appreciate the information that you've provided to the
    subcommittee.
        Ms. Visco. You're welcome.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I appreciate the testimony
    and her commitment to finding a cure. We all are supporting
    this on the subcommittee.
        Mr. Chairman, I would be interested--and the subcommittee
    may have done some work in this, because we all support this
    because this is the right thing to do, connected to our service
    people, we all benefit. What connection and how does this
    correlate with, what we're doing in DOD, to what they're doing
    in NIH? Because I serve on that subcommittee, as all of you do,
    and that would be interesting, to make sure that we're spending
    all we can and getting the bang that we can with the taxpayers'
    money and make sure that there's not a lot of overlap there.
        I don't know this, but as an appropriator with all of us--
    and you're the chair--we're going to have to look at this,
    because we're all committed to helping you.
        Ms. Visco. Yes. Actually, Senator, the program is
    structured in a way to make certain that there is no overlap. I
    know that members of the military have been and are perfectly
    willing and capable of briefing you on exactly how that works.
        Senator Shelby. Thank you.
        Ms. Visco. Thank you.
        Chairman Inouye. Thank you very much.
        Ms. Hesdorffer.
    STATEMENT OF MARY HESDORFFER, MS, CRNP, MEDICAL
                LIAISON, MESOTHELIOMA APPLIED RESEARCH
                FOUNDATION
        Ms. Hesdorffer. Thank you, Chairman Inouye and Ranking
    Member Cochran and members of the subcommittee. Thank you for
    the opportunity to discuss mesothelioma and its connection to
    the military service. Your support is critical to our mission
    and I look forward to continuing our relationship with the
    committee.
        My name is Mary Hesdorffer. I'm a nurse practitioner with
    over a decade's experience in mesothelioma treatment and
    research, and I serve as the medical liaison to the
    Mesothelioma Applied Research Foundation, as well as being on
    staff at Johns Hopkins Medical Institution.
        The Mesothelioma Applied Research Foundation is a national
    nonprofit dedicated to eradicating mesothelioma as a life-
    ending disease by funding research, providing education and
    support for patients, and leading advocacy for the national
    commitment to end this tragedy.
        Mesothelioma, as many of you know, is an aggressive cancer.
    It's directly caused by asbestos. It's one of the most painful
    and fatal of cancers. It invades the chest, destroys vital
    organs, and crushes the lungs. Long-term survivors of
    mesothelioma are described as 3-year survivors, so you know the
    seriousness of what we are facing.
        It disproportionately affects our service men and women and
    their families. As you may know, until its fatal toxicity
    became fully recognized it was considered a magic mineral. It
    was used extensively in the Navy right up until the 1970s. It
    was used in engines, nuclear reactors, conditioners, packing,
    brakes, clutches, winches. In fact, it was used all over Navy
    ships, even in living spaces, where pipes were overhead, and in
    kitchens, where asbestos was used in the ovens. It was used in
    wiring of appliances. Aside from the Navy ships, it was used on
    military planes extensively, on military vehicles, insulating
    materials on quonset huts, and in living quarters.
        As a result, millions of Navy--millions of defense
    personnel, servicemen and shipyard workers, have been exposed
    to asbestos. A study at a Groton, Connecticut, shipyard found
    that over 100,000 workers have been exposed to asbestos over
    the years at just this one shipyard.
        Following the time of exposure, the disease can manifest
    itself any time from 10 to 50 years. So we still have many,
    many, many patients who were diagnosed or who were exposed to
    asbestos in the 70s who will still be developing this disease
    in future years.
        As the daughter of a merchant marine and the mother of a
    veteran of the war in Iraq, it's an issue that's very close to
    my heart. These are the people who have defended our country
    and built its fleet. They're heroes like former Chief Naval
    Officer Admiral Elmo Zumwalt, who led the Navy during Vietnam.
    He was diagnosed in the year 2000 and just 3 months after his
    diagnosis he was dead from this disease.
        Lewis Deets was another one of our Navy veterans. He was
    serving on a ship where a fire broke out. He was exposed to
    asbestos during the burning and then he was also exposed as he
    replaced the burned asbestos blocks. In 1999 he was diagnosed
    with mesothelioma and died 4 months later at the age of 55.
        Bob Tregget, another retired sailor, was diagnosed in 2008.
    He was exposed as a sailor.
        I can go on and talk to you about all of these military
    personnel, but I think we all understand the connection between
    asbestos and this disease.
        Since 1992 the Department of Defense has been charged with
    promoting research on diseases related to military service.
    Since then it has funded over $5.4 billion for a range of
    diseases, some only tangentially related to military service,
    but overlooked mesothelioma research for 16 years, even though
    asbestos was used all over military installations and vehicles,
    especially Navy ships. This is an injustice to the estimated
    one-third of mesothelioma patients who were exposed to asbestos
    on U.S. Navy ships and shipyards.
        Currently there are about 3,500 patients a year diagnosed
    with mesothelioma and 3,000 patients a year die from the
    disease. If we look at one-third of the patients having been
    Navy vets, we're looking at about 1,000 patients a year of
    former people who were exposed on the Navy ships.
        In fiscal year 2009 the DOD took responsibility more
    seriously and made awards totaling $2.7 million for two
    mesothelioma projects. In January of this year, we had two
    people awarded technology development awards. We have many
    people applying for the awards, but we're giving less than 2.6
    percent of these awards out.
        We feel that all of these research areas warrant attention,
    but since mesothelioma is a rapidly fatal, excruciating and
    painful cancer, we ask the subcommittee to appropriate to DOD
    for fiscal year 2012 $5 million for a dedicated mesothelioma
    research program. I'm asking for your help. We can't do this
    alone.
        Thank you.
        [The statement follows:]
                     Prepared Statement of Mary Hesdorffer
        Chairman Inouye, Ranking Member Cochran, and Members of the
    Committee, thank you for the opportunity to discuss the Mesothelioma
    connection to military service. Your support is critical to our
    mission, and I look forward to continuing our relationship with this
    committee.
        My name is Mary Hesdorffer, I am a nurse practitioner with over a
    decade's experience in mesothelioma treatment and research, and serve
    as the Medical Liaison to the Mesothelioma Applied Research Foundation.
    The Mesothelioma Applied Research Foundation is the national nonprofit
    dedicated to eradicating mesothelioma as a life-ending disease by
    funding research, providing education and support for patients, and
    leading advocacy efforts for a national commitment to end the
    mesothelioma tragedy.
        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. Mesothelioma
    disproportionally affects our service men and women and their families.
        As you may know, until its fatal toxicity became fully recognized,
    asbestos was regarded as the magic mineral. It has excellent
    fireproofing, insulating, filling and bonding properties. By the late
    1930's and through at least the late 70's the Navy was using it
    extensively. It was used in engines, nuclear reactors, decking
    materials, pipe covering, hull insulation, valves, pumps, gaskets,
    boilers, distillers, evaporators, conditioners, rope packing, and
    brakes and clutches on winches. In fact it was used all over Navy
    ships, even in living spaces where pipes were overhead and in kitchens
    where asbestos was used in ovens and in the wiring of appliances. Aside
    from Navy ships, asbestos was also used on military planes extensively,
    on military vehicles, and as insulating material on Quonset huts and
    living quarters.
        As a result, millions of military defense personnel, servicemen and
    shipyard workers, were heavily exposed. A study at the Groton,
    Connecticut shipyard found that over 100,000 workers had been exposed
    to asbestos over the years at just one shipyard. The disease takes 10
    to 50 years to develop, so many of these veterans and workers are now
    being diagnosed. As the daughter of a merchant marine and the mother of
    a veteran of the war in Iraq, this is an issue close to my heart.
        These are the people who defended our country and built its fleet.
    They are heroes like former Chief Naval Officer Admiral Elmo Zumwalt,
    Jr., who led the Navy during Vietnam and was renowned for his concern
    for enlisted men. Despite his rank, prestige, power, and leadership in
    protecting the health of Navy servicemen and veterans, Admiral Zumwalt
    died at Duke University in 2000, just 3 months after being diagnosed
    with mesothelioma.
        Lewis Deets was another of these heroes. Four days after turning
    the legal age of 18, Lewis joined the Navy. He was not drafted. He
    volunteered, willingly putting his life on the line to serve his
    country in Vietnam. He served in the war for over 4 years, from 1962 to
    1967, as a ship boilerman. For his valiance in combat operations
    against the guerilla forces in Vietnam he received a Letter of
    Commendation and The Navy Unit Commendation Ribbon for Exceptional
    Service. In December 1965, while Lewis was serving aboard the USS Kitty
    Hawk in the Gulf of Tonkin, a fierce fire broke out. The boilers,
    filled with asbestos, were burning. Two sailors were killed and 29 were
    injured. Lewis was one of the 29 injured; he suffered smoke inhalation
    while fighting the fire. After the fire, he helped rebuild the boilers,
    replacing the burned asbestos blocks. In 1999 he was diagnosed with
    mesothelioma, and died 4 months later at age 55.
        Bob Tregget was a 57 year old retired sailor who was diagnosed with
    mesothelioma in 2008. Bob was exposed to asbestos as a sailor in the
    U.S. Navy from 1965 to 1972, proud to serve his country aboard a
    nuclear submarine whose mission was to deter a nuclear attack upon the
    United States. To treat his disease, Bob had the state of the art
    treatment. He had 3 months of systemic chemotherapy with a new, and
    quite toxic, drug combination. Then he had a grueling surgery, to open
    up his chest, remove his sixth rib, amputate his right lung, remove the
    diaphragm and parts of the linings around his lungs and his heart.
    After 2 weeks of postoperative hospitalization to recover and still
    with substantial postoperative pain, he had radiation, which left him
    with second degree burns on his back, in his mouth, and in his airways.
    Less than 1 year later, in 2009, he lost his battle with Mesothelioma.
        Admiral Zumwalt's, Boilerman Deets' and Sailor Tregget's stories
    are not atypical. Many more meso patients were exposed in the Navy, or
    working in a shipyard. Almost 3,000 Americans die each year of meso,
    and one study found that one-third of patients were exposed on U.S.
    Navy ships or shipyards. That's 1,000 U.S. veterans and shipyard
    workers per year, lost through service to country, just as if they had
    been on a battlefield.
        I am currently working with Mike Clements, who was diagnosed with
    Mesothelioma in 2005 at the age of 59. Mike served in active duty for 6
    years, at which time he worked in 3 different shipyards and spent time
    on a submarine. While he cannot pinpoint this exposure to asbestos, he
    is certain there is a correlation between his service and diagnosis.
    Further, he lost his father to Mesothelioma, who was also a Navy
    veteran.
        Asbestos exposure among naval personnel was widespread from the
    1930s through the 1980s, and exposure to asbestos still occurred after
    the 1980s during ship repair, overhaul, and decommissioning. We have
    not yet seen the end of exposures to asbestos. Asbestos exposures have
    been reported among the troops in Iraq and Afghanistan. On July 14,
    2004, members of the 877th Engineer Battalion of Alabama's Army
    National Guard were exposed to asbestos in their camp in Mosul, Iraq.
    Soldiers in wars that extend into third world countries, where asbestos
    use is increasing without stringent regulations, may also be at risk
    for exposure during tours of duty. Even low-dose, incidental exposures
    cause mesothelioma. 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.
        Since 1992, the Department of Defense (DOD) has been charged with
    promoting research on diseases related to military service. Since then
    it has funded over $5.4 billion for a range of diseases--some only
    tangentially related to military service, but overlooked mesothelioma
    research for 16 years even though asbestos was used all over military
    installations and vehicles, especially Navy ships. This is an injustice
    to the estimated one-third of mesothelioma patients were exposed to
    asbestos on U.S. Navy ships and shipyards.
        There are brilliant researchers are dedicated to mesothelioma. The
    Food and Drug Administration (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 biomarker discovery for early
    detection and treatment--look particularly promising in mesothelioma.
    The Meso Foundation has funded $7.1 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.
        Your subcommittee has recognized the need and taken the lead. For
    the past 3 years a budget has been passed (fiscal years 2008, 2009 and
    2010), 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.
        As a result, in early 2008 the DOD awarded its first mesothelioma
    research grant ever, a $1.4 million award to Courtney Broaddus, M.D.
    for exciting work to understand the role of macrophage induced
    inflammation in mesothelioma.
        The mesothelioma community greatly appreciated this important first
    step. Thirty-eight mesothelioma researchers applied for support in
    2008. The single award represents only a 2.6 percent success rate for
    mesothelioma applications. This does not comply with the Senate's
    directive that DOD begin to seriously address this critical disease.
    Thirty-seven other researchers put in the time, effort and expense to
    gather preliminary data and apply, and then were rejected. Such a low
    success rate of 2.6 percent will discourage top researchers from
    interest in mesothelioma; they will direct their effort and expertise
    into other, better funded cancers. 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.
        In fiscal year 2009, the DOD took its responsibility more
    seriously, and made awards totaling $2,750,549 for two important
    mesothelioma projects: Harvey Pass, M.D. and Margaret E. Huflejt, Ph.D.
    to investigate new markers for early detection of mesothelioma and
    identify new therapeutic targets. Lee Krug, M.D. received an award to
    lead a multi-site clinical trial of a promising new therapy based on
    the WT-1 vaccine, which will directly impact patients and offers them
    new hope. For the 2009 grants, two mesothelioma projects were awarded,
    out of 56 applications submitted. This is slightly better, but still an
    awards-to-applications ratio of only 4 percent.
        In January of this year, Michel Sadelain, M.D., Ph.D., and Prasad
    Adusumilli, M.D. were awarded a $2.6 million Technology/Therapeutic
    Development Award to translate mesothelin-targeted immunotherapy for
    fiscal year 2010. This is a reduction of $150,000 from fiscal year 2009
    funding levels for mesothelioma.
        Such low success rates will not encourage top young researchers to
    move into mesothelioma, or experienced researchers to stay in meso.
    Rather than mere eligibility, mesothelioma needs to be one of the
    diseases that is assigned a specific appropriation.
        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; and
      --Peer Reviewed Cancer Research Program--$16 million.
        The Peer Reviewed Cancer Research Program funds are 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.
        In 2010, Congress added dedicated funding for the following as new
    programs:
      --Chiropractic Clinical Trial--$8.2 millionl; and
      --Defense Medical Research and Development $275 million.
        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 2012 $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. We thank you for considering our fiscal year 2012 request
    for $5 million for Mesothelioma research.

        Chairman Inouye. Thank you very much, Ms. Hesdorffer.
        Senator Cochran.
        Senator Cochran. Thank you very much. I think your
    testimony has added to our understanding of how devastating
    some of these physical problems and life and death issues are,
    particularly for those of us who served in the Navy. As you
    were reciting that list of names, I couldn't help but remember
    my service in the Navy aboard a ship out of Boston,
    Massachusetts--a wonderful opportunity for me, growing up in
    the Deep South, to get to know about things around the world
    that I would have never been exposed to. But to find out I was
    also exposed to some of these life-threatening situations
    brings to me the realization of how lucky so many of us are who
    have led healthy lives in spite of the fact that we've been
    exposed to these dangerous situations.
        But I think we have a definite obligation to do everything
    we can to try to save lives now and improve the quality of life
    of those who have been more unfortunate than I was.
        Ms. Hesdorffer. Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Thank you, Mr. Chairman.
        I appreciate your testimony here. We know this is a
    horrible situation. I've known people--I had a former
    congressional colleague of mine from Alabama who worked one
    summer, who's dead now, as an asbestos worker, because it was a
    great insulator, as you point out. They didn't know then or, if
    they knew, the workers didn't know what danger they were
    playing with.
        I guess my question--we know that a lot of this lies
    dormant for years and years and years. I guess we've all been
    exposed, but some to more degree than others, to a lot of this
    and didn't even know it. We used to--oh, gosh, all over America
    we used to have asbestos siding on homes, asbestos everywhere,
    because it was, as you pointed out, the so-called perfect
    mineral for insulation. It had great qualities, but a big
    danger.
        What is the real danger today of our troops as they are in
    harm's way, posted everywhere in the world? Is it third world
    countries using asbestos because it's there and it's available
    and maybe they don't appreciate the danger to it?
        Ms. Hesdorffer. Well, I think part of the problem is life
    is cheap, it's expendable. Canada is still mining asbestos and
    still exporting it. So we have India, we have so many patients
    are dying of mesothelioma, probably before they're diagnosed
    because it's mistaken often for tuberculosis.
        Our troops have been exposed in Afghanistan, Iraq, in many
    of the third world countries. An epidemic now is occurring in
    Japan, because Japan probably has used asbestos now for a
    number of years, where they're just beginning to see diagnosed
    cases.
        Senator Shelby. Are they still using--a lot of countries in
    the world, like you mentioned Japan, are they still using
    asbestos because of the properties of a great insulator?
        Ms. Hesdorffer. Yes.
        Senator Shelby. Irrespective of the danger?
        Senator Shelby. Slumdog Millionaire, if you look at that
    movie and you saw those huts that those children were running
    over, those were asbestos huts. Those roofs were all made of
    asbestos. We're using it as a fire retardant in many countries.
        Senator Shelby. My last question: Briefly, tell us what
    drug, pharmaceutical breakthroughs, other things, methods of
    treatment, either help alleviate some of the problems, or is
    that just too far away?
        Ms. Hesdorffer. Well, I'd like to just briefly--we had
    Olympta was approved in 2004. Prior to that, there was no
    approved agent. Patients who get Olympta now--without
    treatment, the life expectancy is 9.2 months. With Olympta, the
    life expectancy is 12.3 months. Surgery where----
        Senator Shelby. It's a killer, period.
        Ms. Hesdorffer. It's a uniformly fatal disease. That's how
    every research article starts out.
        Senator Shelby. Thank you.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Ms. Hesdorffer. Thank you.
        Chairman Inouye. Major General Bockel.
    STATEMENT OF MAJOR GENERAL DAVID BOCKEL, UNITED STATES
                ARMY (RETIRED), EXECUTIVE DIRECTOR, RESERVE
                OFFICERS ASSOCIATION
        General Bockel. Mr. Chairman, Mr. Vice Chairman, Senator
    Shelby: The Reserve Officers Association thanks you for the
    invitation to appear and give testimony. I'm Major General
    David Bockel, Executive Director of the Reserve Officers
    Association. I'm also authorized to speak in behalf of the
    Reserve Enlisted Association.
        As both the Congress and the Pentagon are looking at
    reducing defense expenses, ROA finds itself again confronted
    with protecting one of America's greatest assets, the reserve
    components. The National Guard and the other Reserve components
    are proud members of the total force who fully understand their
    duty and are proudly serving operationally. Not only have they
    contributed to the war effort, but they have made a difference
    in maintaining an all-volunteer military force and providing
    the active force more time at home.
        Yet, as discussions occur in both Congress and the Pentagon
    on how to reduce the budget and the deficit, the peril of lower
    defense spending is that the Reserve components will become the
    billpayer. As seen in the past, the risk exists where defense
    planners may be tempted to put the National Guard and title 10
    reserve on the shelf by providing them hand-me-down outmoded
    equipment and underfunded training.
        With over 800,000 Guard and Reserve members having been
    mobilized, this Nation has a generation of warfighters who have
    the knowledge and experience that hasn't existed in the Reserve
    component since the end of the Vietnam war. Almost every
    officer and enlisted leader is a combat-tested veteran. To
    waste this capability is a poor return on the investment of
    money already spent. Only by establishing parity in training,
    equipment, pay, and compensation will permit us to keep them
    available for use as an enduring operational force.
        ROA and REA's written testimony includes a list of unfunded
    requirements that we hope this subcommittee will fund, but we
    also urge the subcommittee to specifically identify funding for
    both the National Guard and other Reserve components
    exclusively to train and equip the Reserve components by
    providing funds for the National Guard and Reserve equipment
    appropriation. Dedicating funds to Guard and Reserve equipment
    provides Reserve chiefs and National Guard directors with the
    flexibility of prioritizing their funding.
        But some in the active component would cut National Guard
    and Reserve pay for the active duty, undermining the concept of
    the total force. Some would have you believe that the National
    Guard and Reserve are more expensive to maintain than the
    active duty forces. However, when citizen warriors are recalled
    for an extended period the cost is about the same as for an
    active duty member. It's the lower overhead in the years when
    the National Guard and Reserve member is not on active duty
    that provides the economy. The citizen warrior cost over a life
    cycle is far less than the cost of an active component
    warfighter.
        Additional cost savings are found when civilian knowledge
    and proficiencies can be called upon at no cost to the military
    for training. DOD officials have admitted that many Reserve
    component members are working in state-of-the-art industries as
    civilian employees, an asset that the Pentagon can't match.
        Another concern ROA and REA share is legal support for
    veterans and Guard and Reserve members returning from
    deployment to face ever-increasing challenges of reemployment.
    On June 1, 2009, ROA established the Servicemembers Law Center.
    This is a service to provide active, Guard, and Reserve, as
    well as separated veterans. The center is averaging over 5,000
    inquiries a year, with the majority of them about employment
    and reemployment rights.
        This is a no-fee service and it does not provide legal
    representation. But such a service does cost money. Currently,
    through ROA's financial support it allows this center to be a
    one-man shop. Our vision is to grow this, to increase the staff
    and services provided to our veteran and Reserve component
    community, which will take additional funding.
        ROA would love to meet with your staff to discuss how this
    subcommittee can provide monetary support, and it appears that
    the language may be included in the Senate NDAA that would
    provide an authorizing source for such funding.
        Another concern that I personally have been working for is
    on the treatment for the victims of traumatic brain injury.
    Anecdotal evidence of hyperbaric oxygen therapy as well as
    other alternative treatments have shown significant success and
    needs to be better funded.
        Thank you again for your consideration of our testimony.
    I'm available to answer any questions.
        [The statement follows:]
                Prepared Statement of Major General David Bockel
        The Reserve Officers Association of the United States (ROA) is a
    professional association of commissioned and warrant officers of our
    Nation's seven uniformed services, and their spouses. ROA was founded
    in 1922 during the drawdown years following the end of World War I. It
    was formed as a permanent institution dedicated to National Defense,
    with a goal to teach America about the dangers of unpreparedness. When
    chartered by Congress in 1950, the act established the objective of ROA
    to: ``. . . support and promote the development and execution of a
    military policy for the United States that will provide adequate
    National Security.''
        The Association's 65,000 members include Reserve and Guard
    Soldiers, Sailors, Marines, Airmen, and Coast Guardsmen who frequently
    serve on Active Duty to meet critical needs of the uniformed services
    and their families. ROA's membership also includes officers from the
    U.S. Public Health Service and the National Oceanic and Atmospheric
    Administration who often are first responders during national disasters
    and help prepare for homeland security.
        The Reserve Enlisted Association is an advocate for the enlisted
    men and women of the United States Military Reserve Components in
    support of National Security and Homeland Defense, with emphasis on the
    readiness, training, and quality of life issues affecting their welfare
    and that of their families and survivors. REA is the only Joint Reserve
    association representing enlisted reservists--all ranks from all five
    branches of the military.
                                   priorities
        CY 2011 Legislative Priorities are:
      --Recapitalize the Total force to include fully funding equipment and
            training for the National Guard and Reserves.
      --Ensure that the Reserve and National Guard continue in a key
            national defense role, both at home and abroad.
      --Provide adequate resources and authorities to support the current
            recruiting and retention requirements of the Reserves and
            National Guard.
      --Support citizen warriors, families and survivors.
    Issues to help fund, equip, and train
        Advocate for adequate funding to maintain National Defense during
    times of war and peace.
        Regenerate the Reserve Components (RC) with field compatible
    equipment.
        Improve and implement adequate tracking processes on Guard and
    Reserve appropriations and borrowed Reserve Component equipment needing
    to be returned or replaced.
        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 and Maintenance
    funding separate.
    Issues to assist recruiting and retention
        Support continued incentives for affiliation, reenlistment,
    retention and continuation in the Reserve Component.
                Pay and Compensation
        Simplify the Reserve duty order system without compromising drill
    compensation.
        Offer Professional pay for Reserve Component medical professionals,
    consistent with the Active Component's pay.
        Eliminate the one-thirtieth rule for Aviation Career Incentive Pay,
    Career Enlisted Flyers Incentive Pay, Diving Special Duty Pay, and
    Hazardous Duty Incentive Pay.
                Education
        Continue funding the GI Bill for the 21st Century.
                Health Care
        Provide Medical and Dental Readiness through subsidized preventive
    healthcare.
        Extend military coverage for restorative dental care for up to 90
    days following deployment.
                Spouse Support
        Repeal the Survivor Benefits Plan--Dependency Indemnity Clause
    (DIC) offset.
                 national guard and reserve equipment accounts
        It is important to maintain separate equipment and personnel
    accounts to allow Reserve Component Chiefs the ability to direct
    dollars to vital 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.
      --Modernize by 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 add-ons.
      --National Guard and Reserve Appropriations (NGREA).
      --Supplemental appropriation, such as OCO funding.
               national guard and reserve equipment appropriation
        Once a strategic force, the Reserve Components are now also being
    employed as an operational asset; stressing an ever greater need for
    procurement flexibility as provided by the National Guard and Reserve
    Equipment Appropriations (NGREA). Much-needed items not funded by the
    respective service budget are frequently purchased through NGREA. In
    some cases, it is used to procure unit equipment to match a state of
    modernizations that aligns with the battlefield.
        The Reserve and Guard are faced with the ongoing challenges of how
    to replace worn out equipment, equipment lost due to combat operations,
    legacy equipment that is becoming irrelevant or obsolete, and, in
    general, replacing what is lost in combat, or aged through the abnormal
    wear and tear of deployment. The Reserve Components benefit greatly
    from a National Military Resource Strategy that includes a National
    Guard and Reserve Equipment Appropriation.
        Congress has provided funding for the NGREA for over 30 years. At
    times, this funding has made the difference in a unit's abilities to
    carry out vital missions.
        ROA thanks Congress for approving $850 million for NGREA for fiscal
    year 2011, but more dollars continue to be needed. ROA urges Congress
    to appropriate into NGREA an amount that is proportional to the
    missions being performed, which will enable the Reserve Component to
    meet its readiness requirements.
    End Strength
        The ROA would like to place a moratorium on any potential
    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 the support of:
      --Army National Guard of the United States, 358,200.
      --Army Reserve, 206,000.
      --Navy Reserve, 66,200.
      --Marine Corps Reserve, 39,600.
      --Air National Guard of the United States, 106,700.
      --Air Force Reserve, 71,400.
      --Coast Guard Reserve, 10,000.
        In a time of war and force rebalancing, 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.
                   nonfunded army reserve component equipment
        While General Martin E. Dempsey, U.S. Army Chief of Staff, has said
    that the Army is not going forward with any unfunded requirements in
    his letter to Congress, this is not the case for the Army Reserve or
    the Army National Guard.
    Army Reserve (USAR) Unfunded Requirements
        While the Army Reserve has 80 percent of its equipment on-hand,
    only 65 percent of it modernized. Further, the USAR remains short in
    several areas of critical equipment. Around 35 percent of its required
    equipment lines are at less than 65 percent on hand. A percentage of
    the USAR equipment is deployed.
        An enduring operational force cannot be fully effective if it is
    underfunded and has to borrow personnel and equipment from one unit to
    shore up another to meet mission requirements. Currently in the basic
    budget, the USAR is funded at strategic levels rather than for its
    operational contributions.
        Top USAR Equipping Challenges of an Operational Reserve:
      --Equip USAR formations to optimal operational levels for full
            spectrum operations.
      --Maintain USAR equipment at the Army standard of 90 percent fully
            mission capable.
      --Increase equipment modernization in an era of decreasing resources.
      --Increase facility and manpower capabilities to sustain modernized
            and emerging equipment.
      --Modernize the Army Reserve Tactical Wheeled Vehicle (TWV) fleet.
      --Increase Resourcing for logistics automation technology required
            refresh.
      --Increase Funding for state-of-the-art maintenance facilities.
      --Gain full transparency for equipment procurement through unit level
            receipt.

                              [Dollars in millions]
    ------------------------------------------------------------------------
                                                                   Amount
    ------------------------------------------------------------------------
    Ground Vehicles:
        Heavy Expanded Mobility Tactical Truck (HEMTT-LET),           $161
         1086 req'd...........................................
        Rough Terrain Container Handler, 215 req'd............         192
        Truck, Forklift, ATLAS, 71 req'd......................          11.8
        Tractor Line Haul M915, 169 req'd.....................          29
        HEMTT Common Bridge Transporter, M1977, 69 req'd......          15.4
    Command Post of the Future (CPOF), 49 req'd...............          16
    Soldier Weapons...........................................          15.7
        Machine Gun, 7.62 mm, M240B, req'd 1,000..............
        Carbine, 5.56 mm, M4, req'd 3,233 $1,329 20,058 23,291
        Machine Gun, Grenade, 40 mm, MK19 MOD III,............
    Helicopter, Utility, UH-60L, 8 req'd......................          38.4
    Power Plants and Generators:
        100KW Distribution System, 1,062 req'd................          15.5
        Power Plant, 5kW, TM, AN/MJQ-35, 250 req'd............          11.6
        Generator Set, 10kW, MEP-803A TQG, 445 req'd..........           6.4
        Generator Set, 10kW, PU-798 TQG, 242..................           6.2
    ------------------------------------------------------------------------

        Simulators.--The use of simulations and simulators minimizes
    turbulence for USAR Soldiers and their families caused by training
    demands during the first 2 years of the ARFORGEN process by enabling
    individuals and units to train at their home station and during
    exercises in a safe environment without the increased wear and tear on
    equipment.
    Army National Guard (ARNG) Unfunded Equipment Requirements
        Even though Congress has provided $37 billion in equipment to the
    Army National Guard (ARNG) in the past 6 years, the on-hand percentage
    for all equipment is currently at 92 percent, there is a need for
    modernization and restoration. The Army National Guard provides more
    than 40 percent of the Army's rotary wing assets. With the increased
    optemp there is an increase in need for aircraft modernization.
    Required land force maintenance results in shortages as the ARN does
    not have a quantity of selected end-items authorized for use by units
    as immediate replacements when critical equipment is sent to depots for
    repair.
        Top ARNG Equipping Challenges:
      --Improve interoperability with AC forces.
      --Equip units for pre-mobilization training and deployment.
      --Equip units for their Homeland Missions.
      --Modernize ARNG helicopter fleet.
      --Modernize ARNG Tactical Wheeled Vehicle (TWV) fleet.

                              [Dollars in millions]
    ------------------------------------------------------------------------
                                                                   Amount
    ------------------------------------------------------------------------
    Ground Transportation:
        Light, Med, and Heavy Tactical Trailers, 6,675 req'd..        $200
        Armored Security Vehicle (ASV), M1117.................          91
        Bradley Fighting Vehicle, Infantry, M2A2, 95 req'd....         123
        HMMWV Shelter Carrier, Heavy, M1097, 707 req'd........          43.6
    Aviation:
        Helicopter, Utility, UH-60L, 30 req'd.................         145.7
        Light Utility Helicopter, UH-72A, 44 req'd............         171.6
        Helicopter, Cargo CH-47F, 3 req'd.....................          90
    Medical Field Systems, 2,249 req'd........................          11
    ------------------------------------------------------------------------

        The Assistant Secretary of the Army (Acquisitions, Logistics &
    Technology) recently directed the Program Executive Office--Aviation to
    divest the C-23 Sherpa aircraft not later than December 31, 2014 as the
    Army had decided that it shouldn't be in the fixed wing business. Yet
    these aircraft are needed in the ARNG because the assets would be
    utilized in state missions, if not Federal.
               air force reserve components equipment priorities
    Air Force Reserve Unfunded Requirements
        The Air Force Reserve (AFR) is focused on rebalancing its force,
    recapitalizing its equipment and infrastructure, and supporting its
    Reservists. Sustaining operations on five continents, the resulting
    wear and tear weighs heavily on aging equipment. When Legacy aircraft
    are called upon to support operational missions, the equipment is
    stressed at a greater rate. Since the start of combat, the majority of
    AFR equipment requirements have been aircraft upgrades.
        Top AFR Equipping Challenges:
      --Defensive Systems.--LAIRCM, ADS, and MWS: equip aircraft lacking
            adequate infrared missile protection for combat operations.
      --Data Link and Secure Communications.--Data link network supporting
            image/video, threat updates, and SLOS/BLOS communications for
            combat missions.

                              [Dollars in millions]
    ------------------------------------------------------------------------
                                                                   Amount
    ------------------------------------------------------------------------
    F-16 Systems, CDU, Combined AIFF w/Mode 5/S, Sim Trainer           $10
     Upgrade..................................................
    C-130 Systems, New Armor, RWR, TAWS, VECTS, LED posit               92.8
     Lights...................................................
    LAIR Countermeasures KC-135 (15)..........................         118.4
    Infra-Red Counter Measures C-17s..........................          60
    Security Forces Weapons & Tactical Equipment..............           3.2
    Guardian Angel Weapon System (GAWS):
        Tactical Communication Headset........................           5
        HC-130 Wireless Intercom..............................           6
        CSAR Common Data Link.................................           6
    ------------------------------------------------------------------------

    Air National Guard Unfunded Equipment Requirements
        Given adequate equipment and training, the Air National Guard (ANG)
    will continue to fulfill its Total Force obligations. As the Nation's
    first military responder, the Air Force has increased reliance on its
    Reserve Components, requiring equipment and training comparable to the
    active component Air Force. The Air National Guard's support to civil
    authorities is based upon the concept of ``dual use,'' equipment
    purchased by the Air Force for the Air National Guard's Federal combat
    mission, which can be adapted and used domestically when not needed
    overseas.
        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.
        ANG Equipping Challenges:
      --Modernize aging aircraft and other weapons systems for both dual-
            mission and combat deployments.
      --Equipment to satisfy requirements for domestic operations in each
            Emergency.
      --Support Function (ESF).
      --Maintain C-5: Failing major fuselage structures and funding for
            depot maintenance.
      --Define an Air Force validation process for both Federal and state
            domestic response needs.
      --Program aging ANG F-16 aircraft for the Service Life Extension
            Program (SLEP).
        An ANG wing contains not only aircraft but fire trucks, forklifts,
    portable light carts, emergency medical equipment including ambulances,
    air traffic control equipment, explosives ordinance equipment, etc., as
    well as well trained experts--valuable in response to civil
    emergencies.

                              [Dollars in millions]
    ------------------------------------------------------------------------
                                                                   Amount
    ------------------------------------------------------------------------
    C-27J Airlift, 4 req'd....................................        $124
    C-40C Airlift, 1 req'd....................................          98
    C-38 Replacement Aircraft, 4 req'd........................         254
    C-5 Structural Repair.....................................         310
    C-17 Next Generation Threat Detection System..............          59
    MC-130 Integrated BLOS/LOS/Data Link/VDL, 167, req'd......          66.8
    F-16 Advanced Targeting Pod Upgrades......................         260
    ------------------------------------------------------------------------

                        navy reserve unfunded priorities
        Active Reserve Integration (ARI) aligns Active and Reserve
    component units to achieve unity of command. Operationally, the Navy
    Reserve is fully engaged across the spectrum of Navy, Marine Corps, and
    joint operations, from peace to war. It has been the primary provider
    of Individual Augmentees for the overseas contingency operations
    filling Army, and Air Force assignments.
        Top U.S. Navy Reserve Equipping Challenges:
      --Aircraft procurement (C-40A, P-8, KC-130J, C-37B and F/A-18E).
      --Expeditionary equipment procurement (MESF, EOD, NCF, NAVELSG,
            MCAST, EXPCOMBATCAM, and NEIC).

                              [Dollars in millions]
    ------------------------------------------------------------------------
                                                                   Amount
    ------------------------------------------------------------------------
    C-40 A Combo cargo/passenger Airlift, 5 req'd.............        $425
        Aircraft recapitalization is necessary due to the C-
         9B's increasing operating and depot costs, decreasing
         availability and inability to meet future avionics/
         engine mandates required to operate worldwide. The C-
         40A has twice the range, payload, days of
         availability of the C-9B, and also has the unique
         capability of carrying hazardous cargo and passengers
         simultaneously with no restrictions. C-40 replaces an
         aging fleet of C-9, C-12 and C-20.
    Maritime Expeditionary Security Force.....................          20
        Navy Expeditionary Combat Command has 17,000 Navy
         Reservists and requires $3.1 billion in Reserve
         Component Table of Allowance equipment. Force Utility
         Boat MPF-UB, 3 req'd $3 million.
    KC-130J Super Hercules Aircraft tankers, 2 req'd..........         168
        Aircraft needed to fill the shortfall in Navy Unique
         Fleet Essential Airlift. Procurement price close to
         upgrading existing C-130Ts with the benefit of a
         longer life span. 24 req'd.
    Helicopter, Combat SAR, HH-60H (Seahawk), 1 req'd.........          15.5
    C-37 B (Gulf Stream) Aircraft (1).........................          64
        The Navy Reserve helps maintain executive transport
         airlift to support the Depart. of the Navy.
    Civil Engineering Support Equipment--Tactical Vehicles....           4.4
    ------------------------------------------------------------------------

                    marine corps reserve unfunded priorities
        Marine Forces Reserve (MFR) has two primary equipping priorities--
    outfitting individuals who are preparing to deploy and sufficiently
    equipping units to conduct home station training. Individuals receive
    100 percent of the necessary warfighting equipment. MFR units are
    equipped to a level identified by the Training Allowance (TA). MFR
    units are equipped with the same equipment that is utilized by the
    Active Component, but in quantities tailored to fit Reserve training
    center needs. It is imperative that MFR units train with the same
    equipment they will utilize while deployed.
        Top MCR Equipping Challenges:
      --Providing units the ``right amount'' of equipment to effectively
            train in a pre-activation environment.
      --Achieving USMCR goal that the Reserve TA contains the same
            equipment as the active component.
      --Resetting and modernizing the MRF to prepare for future challenges.

    ------------------------------------------------------------------------
                                                                  Amount
    ------------------------------------------------------------------------
    KC-130J Super Hercules Aircraft tankers, 21 remaining...    $1.5 billion
        The ``T'' and ``J'' aircraft are very different
         airframes, requiring different logistical,
         maintenance, and aircrew requirements. The longer
         both airframes are maintained, the longer twice the
         cost for logistics, maintenance training, and
         aircrew training will be spent.
    Light Armored Vehicles--LAV-25, procure 27 remaining,...     $68 million
        Completing modernization of Light Armored Vehicle
         (LAV) family filling a shortfall in a USMCR light
         armor reconnaissance company. It provides strategic
         mobility to reach and engage the threat, tactical
         mobility for effective use of fire power.
    Logistics Vehicle System Replacement (LVSR) 108 required   $650,000 each
        Supports accelerated modernization and rapid
         fielding.
    Simulators: KC-130J Weapons System Trainer..............     $25 million
        Training transformation remains the cutting-edge
         arena of simulation and simulators.
    Training Allowance (T/A) Shortfalls.....................    $145 million
        Shortfalls consist of over 300 items needed for
         individual combat clothing and equipment, including
         protective vests, ponchos, liners, gloves, cold
         weather clothing, environmental test sets, tool
         kits, tents, camouflage netting, communications
         systems, engineering equipment, combat and
         logistics vehicles and weapon systems.
    ------------------------------------------------------------------------

                           service members law center
        The Reserve Officers Association developed a Service Members Law
    Center, advising Active and Reserve service members who are subject to
    legal problems that occur during deployment.
        In the last year, the Service Members Law Center has received over
    6,000 calls and e-mails with legal questions. Eighty percent of them
    deal with the issue of employment and reemployment of veterans. Of
    those who have contacted us, the ROA Service Members Law Center has
    referred about 5 percent to attorneys.
        The American Bar Association supports legislation S. 1106, Justice
    for the Troops, to support programs on pro bono legal assistance for
    members of the Armed Forces. The Service Members Law Center has already
    been educating the law community on just that, and provides over 700
    case studies for online use by law offices.
        The Law Center refers names of attorneys who work on related legal
    issues, encouraging law firms to represent service members. The Center
    also educates and trains lawyers, especially active and reserve judge
    advocates, on service member protection cases. It is also a resource to
    Congress. Last year, the Supreme Court gave judgment on its first
    USERRA case. The Service Members Law Center filed an amicus curiae
    (friend of the court) brief on this case.
        ROA sets aside office spaces and staffs a lawyer to answer
    questions of serving members and veterans. Legal services, as suggested
    by S. 1106, could be sought by the Service Members Law Center if it
    expanded its staff. This would require additional financial support.
        Anticipated overall cost for expansion in fiscal year 2012:
    $150,000.
    Military Voting
        The Service Members Law Center also answers questions about
    Military Voting. Its director works with the Federal Voting Assistance
    Program staff to help communicate information to improve military voter
    participation in Federal elections. FVAP announced a $16 million grant
    program to expand those online voting support tools at the State and
    local level, all of which will be linked to the voter through the FVAP
    website portal.
        ROA and REA fully support additional funding of DOD's Federal
    Voting Assistance Program for $35.107 million.
                           cior/ciomr funding request
        The Interallied Confederation of Reserve Officers (CIOR) was
    founded in 1948, and the Interallied Confederation of Medical Reserve
    Officers (CIOMR) was founded in 1947. These organizations are
    nonpolitical, independent confederations of national reserve
    associations of the signatory countries of the North Atlantic Treaty
    Organization (NATO). Presently, there are 16 member nation delegations
    representing over 800,000 reserve officers. CIOR supports several
    programs to improve professional development and international
    understanding. The Reserve Officers Association of the United States
    represents the United States as its official member to CIOR.
        Military Competition.--The CIOR Military Competition is a strenuous
    3 day contest on warfighting skills among Reserve Officers teams from
    member countries. The contest emphasizes 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.
        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. Presently no service has Executive Agency for CIOR, so
    these programs aren't being funded.
        Military Competition funding needs at $150,000 per fiscal year.
                                   conclusion
        The impact of operations in Iraq and Afghanistan is affecting the
    very nature of the Guard and Reserve, not just the execution of Roles
    and Missions. 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
    subcommittee 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. Thank you very much, General Bockel.
        Senator Cochran.
        Senator Cochran. Thank you, General Bockel. We appreciate
    your coming here today and giving us your observations and your
    service, too, to veterans who have served in our military. When
    you mentioned the hyperbaric chamber, I just recalled the use
    of that in rehabilitating horses, thoroughbreds for racing. The
    fellow who really put the biggest bit of attention and his own
    personal funds into that had a horse that finally won the
    Kentucky Derby a couple of years ago.
        General Bockel. There it is.
        Senator Cochran. It didn't make him run any faster, but it
    showed the capabilities of treatment for damaged tissues, and
    it led to the use by men and women who had been in the service.
    Out at our Bethesda Naval Hospital, I think they have planned
    for a unit to be installed for trial, and we now will have an
    opportunity for a higher rate of recovery from a lot of things
    because of that initiative.
        General Bockel. In the case of traumatic brain injury,
    there is no uniform understanding of the condition and the
    treatment. It is also a continuity of care issue. From DOD
    healthcare through Veterans Affairs into the private healthcare
    arena, there is no continuity, no common understanding. The
    treatment does work. It's been proven anecdotally. There's a
    doctor at LSU by the name of Paul Harch who's the leader in the
    treatment, and I personally know of a retired Army Reserve
    brigadier general who's a judge in Fort Walton Beach, Florida,
    who spent 2 years in Walter Reed, most of that time suffering
    from traumatic brain injury, who received the hyperbaric
    therapy at George Washington University Hospital, and he's back
    on the bench practicing today.
        Senator Shelby. That's remarkable.
        Well, thank you very much for being here. Your testimony
    will be given very careful consideration.
        General Bockel. Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I appreciate the General's
    testimony and his advocacy here through the paper. He had a
    distinguished military career before he came to that. We share
    one thing in common: We both are graduates of the University of
    Alabama. When he was there he was a distinguished student, but
    he was also a distinguished graduate of their ROTC program,
    which served him well in his career.
        General Bockel. They never thought I would get this far,
    Senator.
        Senator Shelby. But you have.
        Chairman Inouye. Thank you very much.
        Captain Smith.
    STATEMENT OF CAPTAIN MIKE SMITH, UNITED STATES NAVY
                (RETIRED), NATIONAL MILITARY AND VETERANS
                ALLIANCE
        Captain Smith. Chairman Inouye, Senator Cochran, and
    Senator Shelby: The National Military and Veterans Alliance, or
    NMVA, is honored to again testify. The alliance represents
    military retiree veterans and survivor associations with over
    3.5 million members. The NMVA supports a strong national
    security.
        The challenges of the deficit and an adequately funded
    defense are at the forefront of discussions in Congress and,
    while the alliance is well aware that the subcommittee faces
    certain budget constraints, the NMVA continues to urge the
    President and Congress to increase defense spending to 5
    percent of gross domestic product during times of high
    utilization of the military to cover procurement, prevent
    unnecessary personnel cuts, and afford needed benefits for
    serving members and retirees. With the U.S. military taking
    action in four different countries, no one can deny that it is
    being decidedly used.
        It is crucial that military healthcare is funded. NMVA is
    concerned that as new programs are initiated they won't receive
    the funding that they need. Treating PTS and TBI shouldn't be
    on the cheap and alternative treatments should be explored so
    that our serving members can return to a normal life.
        The alliance is concerned that the President's DOD
    healthcare budget continues to undercut the military's
    beneficiaries' needs. We ask that you continue to fully fund
    military healthcare in fiscal year 2012.
        It is also important that we have parity in equipment and
    training for the new operational Guard and Reserve. Cuts in the
    strength of the Reserve component seem counterintuitive to
    prevent any unforeseen strategic event. The willingness of our
    young people today to serve in future conflicts will relate to
    their perception of how the veterans of this war are being
    treated.
        The NMVA thanks this subcommittee for funding the phased-in
    survivor benefit plan dependency and indemnity compensation
    offset. But widows of members who were killed in the line of
    service are continuing to be penalized. Even under the present
    offset, the vast majority of our enlisted families receive
    little benefit from this new program because SBP is almost
    completely offset by DIC. The NMVA respectfully requests that
    this subcommittee find excess funding to expand this provision.
        The alliance also hopes that this subcommittee will fully
    fund the $67.7 million authorized by the Senate Armed Services
    Committee for the two armed forces retirees homes.
        As the overseas contingency operations wind down, the
    challenges faced by our active and Reserve serving members will
    not go away. The alliance is confident of your ongoing support
    of national security and that you will keep the budgeting
    burden off the shoulders of the warriors, the retirees, their
    families, and survivors.
        The NMVA would like to thank the subcommittee for its
    efforts and, of course, this morning's opportunity to testify.
    Thank you.
        [The statement follows:]
                    Prepared Statement of Captain Mike Smith
                                   membership
    American Logistics Association
    American Military Retirees Association
    American Military Society
    American Retirees Association
    American Veterans (AMVETS)
    American WWII Orphans Network
    Armed Forces Marketing Council
    Armed Forces Top Enlisted Association
    Army Navy Union
    Association of the U.S. Navy
    Catholic War Veterans
    Gold Star Wives of America
    Hispanic War Veterans Association
    Japanese American Veterans Association
    Korean War Veterans Foundation
    Legion of Valor
    Military Order of Foreign Wars
    Military Order of the Purple Heart
    Military Order of the World Wars
    National Association for Uniformed Services
    National Gulf War Resource Center
    Naval Enlisted Reserve Association
    Paralyzed Veterans of America
    Reserve Enlisted Association
    Reserve Officers Associations
    Society of Military Widows
    TREA Senior Citizen League
    The Flag and General Officers' Network
    The Retired Enlisted Association
    Tragedy Assistance Program for Survivors
    Uniformed Services Disabled Retirees
    Veterans of Foreign Wars of the U.S.
    Veterans of Modern Warfare
    Vietnam Veterans of America
    Women in Search of Equity
                                  introduction
        Mister Chairman and distinguished members of the Committee, the
    National Military and Veterans Alliance (NMVA) is very grateful to
    submit testimony to 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.
        The ``Alliance'' is made up of 35 organizations, which provide it
    with a scope of expertise in military, veteran, family, and survivor
    issues.
        While the NMVA highlights the funding of benefits, we do this
    because it supports National Defense. A often quoted phrase, ``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 and shouldn't be discounted.
        The NMVA is very concerned over comments made by the leadership at
    the Pentagon that pay and compensation of serving members should be
    cut. This is very short sighted, based on a false premise that
    recruiting and retention successes will continue. To make such cuts
    will just hasten a hollowing of the force.
        The young men and women who serve do so under enormous pressures.
    Telltale signs of this strain include growing post traumatic stress,
    upsetting suicide rates, and increasing divorce rates. The impact goes
    beyond just the serving member and affects extended families and
    communities with further unintended consequences and sometimes tragic
    results.
        The National Military and Veterans Alliance, through this
    testimony, hopes to address funding issues that apply to the current
    and future veterans who have defended this country.
                            funding national defense
        NMVA is pleased to observe that the Congress continues to discuss
    how much should be spent on National Defense, but the baseline defense
    budget is now 3.5 percent of America's Gross Domestic Product (GDP).
    The Alliance urges the President and Congress to maintain defense
    spending at 5 percent of GDP 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 1
    percent.
        If unable to provide a pay raise higher than the President's
    request, this committee should target pay raises for the mid-grade
    members, who have increased responsibility in relation to the overall
    service mission, are also at the highest risk of leaving the service.
        NMVA supports applying 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. Guard and Reserve members are
    performing more specialized hours, but are currently being paid less.
        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) into the
    calculations of Retirement Pay for military healthcare 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. This point cannot be understated. The operation
    tempo, financial stress and competition with Active Duty recruiting
    necessitate continuing incentives. The NMVA supports expanding and
    funding bonuses to the Reserve Components.
        Reserve/Guard Funding.--NMVA is concerned about a possible
    recommendation from the 11th Quadrennial Review of Military
    Compensation to end ``2 days pay for 1 days work,'' and replace it with
    a plan to provide one-thirtieth of a month's pay model, which would
    include both pay and allowances.
        Even with allowances, pay would be less than the current system,
    and the accounting would be far more complex. Allowances differ between
    individuals and can be affected by commute distances and even zip
    codes. Certain allowances that are unlikely to be uniformly paid
    include geographic differences, housing variables, tuition assistance,
    travel, and adjustments to compensate for missing healthcare.
        Additionally there have been DOD suggestions that pay should differ
    for those in the Guard and Reserve who are in strategic units and
    operational units. This concept would undermine the Force Generation
    Plan, which would have the readiness of a Reserve Component unit
    increase over a 5 year cycle, favored by both the Army and the Marine
    Reserve. In the early years a unit would be in a strategic status, and
    for the final 2 years be in an operational mode. Pay should not differ
    during different stages of FORCGEN.
        The NMVA strongly recommends that the reserve pay system continue
    on a ``2 days pay for two drills in a day,'' be funded and be retained,
    as is.
                               educational issues
        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.
    Post 9/11 GI Bill
        According to a survey conducted by military.com, 36 percent of
    individuals on active duty want to transfer the benefit to their spouse
    and 48 percent would transfer it to their children. The Post 9/11 GI
    Bill provides the much desired transferability option to spouses and
    children in exchange for an agreement from the serving member that they
    will continue to serve another 4 years in military service.
        The National Military and Veterans Alliance supports future funding
    to continue the transferability of the Post 9/11 GI Bill, as it is an
    important retention and recruiting resource.
    MGIB-SR Enhancements
        The Montgomery G.I. Bill for Selective Reserves (MGIB-SR) will
    continue to be an important recruiting and retention tool for the
    Reserve Components. With massive troop rotations, the Reserve forces
    can expect to have retention shortfalls, unless the government provides
    enhanced education 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
    million/first year, $1.4 billion over 10.
                           force policy and structure
    End Strength
        The NMVA is concerned about cuts in the end strength boosts of the
    Active Duty Component of the Army and Marine Corps as have been
    recommended by Defense Authorizers. The goal for active duty dwell time
    is 1:3. This has yet to be achieved under current operations tempo, and
    end strength cuts will only further impact dwell time. Trying to pay
    the defense bills by premature manpower reductions will 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 rebalancing of the force is understood.
    The Alliance is pleased to see a recommended increase in the Navy and
    Air Force Reserves. NMVA urges this subcommittee to at least fund to
    last year's levels for other Reserve Components.
             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, including
    funding the Special Survivor Indemnity Allowance.
        However, there is still an issue remaining to deal with:
        Providing funds to end the SBP/DIC offset.
        SBP is a purchased annuity, available as an elected earned employee
    benefit. This 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 benefits created to fulfill different purposes and needs. At
    this time the SBP annuity the service member has paid for is offset
    dollar for dollar for the DIC survivor benefits paid through the
    Department of Veteran Affairs.
        SBP/DIC Offset affects several groups. The first is the family of a
    medically retired member of the uniformed services. If the service
    member is leaving the service disabled it is only wise to enroll in the
    Survivor Benefit Plan (perhaps being uninsurable in the private
    sector). If a later death is service connected then the survivor loses
    their SBP annuity to DIC.
        A second group affected by this offset is 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.
        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 that this Subcommittee fund the SBP/
    DIC offset.
              current and future issues facing uniformed services
    Healthcare
        The National Military and Veterans Alliance once again thanks this
    Committee for the great strides that have been made over the last few
    years to improve the healthcare 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 improved the life and health
    of Medicare Eligible Military Retirees, their families, and survivors.
    Yet many serious problems need to be addressed:
    Wounded Warrior Programs
        The Alliance supports continued funding for the wounded warriors,
    including monies for research and treatment on Traumatic Brain Injuries
    (TBI), Post Traumatic Stress Disorder (PTSD), 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 Military 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 healthcare 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 military healthcare. 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 dollar 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 healthcare providers to accept TRICARE Standard
    patients. Healthcare 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 healthcare 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
    healthcare 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. 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 healthcare
    Mobilized Healthcare--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.
    However, 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 have no 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, have 180 days of transition healthcare
    following their period of active service, but 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 a subsidy for 180 days after demobilization 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-
    payments 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 January 28, 2008 are eligible, which is
    nearly 6 years and four months after Guard and Reserve members first
    were mobilized to support the active duty force in this conflict. Over
    725,000 Reservists, who have served during this period, 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.
                                military voting
        NMVA also feels that significant progress has been made in military
    voting rights in the past 2 years through passage of the MOVE Act of
    2009, and the new programs implemented by the Federal Voting Assistance
    Program. These new programs include such innovations as online tools to
    assist voters in filling out registration forms and back-up ballots, as
    well as the online ballot delivery tools developed by 17 States, with
    FVAP support, and fielded for the 2010 election. Recently, FVAP
    announced a $16 million grant program to expand those online voting
    support tools at the State and local level, all of which will be linked
    to the voter through the FVAP website portal.
        NMVA fully supports additional funding of DOD's Federal Voting
    Assistance Program for $35.107 million, and the budget PE Numbers are
    0901220SE and 0605803SE, Project 4.
                             reintegration programs
        As overseas contingency operations wind down, a temptation will be
    to reduce funds to yellow ribbon and other reintegration programs, but
    young men and women will continue to leave active duty, and members
    serving and the Guard and Reserve will likely continue to be called up
    to active duty. NMVA supports continued funding to Yellow Ribbon and
    TAP programs.
        These programs must be further examined to enhance the resilience
    training. Resilience survival training prepares one to better adapt to
    life's misfortunes and setbacks. While programs are in place to focus
    on suicide, there are other challenges to be faced such as unemployment
    and military divorce that need to be addressed, including seminars to
    better understand the current laws.
                         armed forces retirement homes
        Dormitories and buildings at the AFRH--Washington, DC campus
    continue to need refurbishing. While the AFRJ--Gulfport facility has
    reopened, the Navy/Marine Corps residents continue to need funding for
    the finishing touches of the site.
        NMVA urges this subcommittee to continue funding upgrades at the
    Washington, DC facility and improvements at 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.

        Chairman Inouye. Thank you very much, Captain Smith.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you.
        Let me again reiterate our appreciation for the
    participation of those of you who have served in the military
    and through your experience have direct knowledge of a lot of
    these issues that we are now confronting. The information that
    you're providing and the suggestions are deeply appreciated.
    Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. I thank Captain Smith and the whole panel.
    I was looking at your membership. You represent the umbrella of
    all these groups, so you do it well.
        So thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        I'd like to thank the panel. Now the next panel: Captain
    Ike Puzon, U.S. Navy retired, Associations for America's
    Defense; Dr. Donald Jenkins, National Trauma Institute; Rear
    Admiral Casey Coane, U.S. Navy retired, Association for the
    U.S. Navy; Ms. Karen Goraleski, American Society of Tropical
    Medicine and Hygiene.
        May I call on Captain Puzon.
    STATEMENT OF CAPTAIN IKE PUZON, UNITED STATES NAVY
                (RETIRED), ON BEHALF OF THE ASSOCIATIONS
                FOR AMERICA'S DEFENSE
        Captain Puzon. Mr. Chairman, Senator Cochran, Senator
    Shelby: The Associations for America's Defense is very grateful
    to testify today. We would like to thank the subcommittee for
    your stewardship on the defense issues and setting an example
    through your nonpartisan leadership.
        The Associations for America's Defense is concerned that
    U.S. defense policy is sacrificing security due to budget
    pressures and readiness. Most concerning is the vigorous
    pursuit to cut existing programs. Chairman of the Joint Chiefs
    of Staff Admiral Mike Mullen in his testimony before the Senate
    Armed Services Committee in February recognized that: ``In the
    back end of previous conflicts, we were able to contract our
    equipment inventory by shedding our oldest capital assets,
    reducing the average age of our systems. We cannot do this
    today because of the high pace and duration of combat
    operations. We must actually recapitalize our systems to
    restore our readiness and avoid becoming a hollow force.''
        A4AD is in agreement, and in addition we are alarmed that
    the fiscal year 2012 unfunded program list submitted by the
    military services was not made publicly available and that the
    Army do not even have such a list this year. Moreover, the past
    2 years we saw significant reductions in the unfunded lists
    submitted, leading to a speculation that military services are
    no longer permitted to produce their full unfunded needs.
        Additionally, the results of such budgetary policy could
    again lead to a hollow force whose readiness and effectiveness
    has been subtly degraded and lessened efficiency will not be
    immediately evident.
        We support increasing defense spending to 5 percent of the
    gross domestic production during times of war to cover
    procurement and prevent unnecessary personnel end strength
    cuts. As always, our military will do everything possible to
    accomplish its missions, but response time is measured by
    equipment readiness and availability.
        Defense Secretary Robert Gates has warned against hollowing
    out the force from a lack of proper training, lack of proper
    maintenance and equipment and manpower. Also, U.S. Joint Forces
    Command General Ray Odierno said recently: ``We must avoid the
    trap of doing more with less, which is a recipe for creating a
    hollow force.'' He further qualified this by asking: ``What are
    we going to stop doing?''
        Ominously, both the 30-year shipbuilding and aviation plans
    are at risk of achieving their goals. The Navy's plan to build
    a 313-ship fleet doesn't match reality, in which funding is
    highly unlikely to meet this goal. In addition, there are plans
    to extend the service life of already 40-year-old ships another
    28 years. For the aviation plan, the original assumption
    forecasted a 3 percent average annual growth for aviation
    programs over the next decade. But now there are predicted a
    zero-growth aviation budget for 2017.
        As these plans are not bearing the fruit that was
    originally projected, it is imperative that until the new
    systems are acquired in sufficient quantities to replace legacy
    fleets, legacy systems must be sustained and kept operational.
        As the military continues to become more expeditionary,
    more airlifts are needed, such as C-17s, C-130Js, and C-40s.
    They will be required. Yet DOD has decided to shut down
    production of C-17. Procurement needs to be accelerated,
    modernized, and mobility requirements need to be acknowledged.
    We ask this subcommittee to continue to provide appropriations
    for unfunded National Guard and Reserve equipment requirements.
        Of great concern is the potential to revert the Reserve
    component back to a strategic reserve. Our national security
    demands both an operational and strategic reserve. We urge the
    subcommittee to study the comprehensive review of the future
    role of Reserve components, which calls for reserve equipment.
        We genuinely appreciate the support of the subcommittee,
    particularly at the time when there is growing pressure on the
    congressional members promoting further cuts. Thank you again.
    I look forward to your questions.
        [The statement follows:]
                    Prepared Statement of Captain Ike Puzon
                       associations for america's defense
        Founded in January 2002, the Association for America's Defense
    (A4AD) is an adhoc group of Military and Veteran Associations that have
    concerns about National Security issues that are not normally addressed
    by The Military Coalition (TMC) and the National Military Veterans
    Alliance (NMVA), but participants are members from each. Members have
    developed expertise in the various branches of the Armed Forces and
    provide input on force policy and structure. Among the issues that are
    addressed are equipment, end strength, force structure, and defense
    policy. A4AD, also, cooperatively works with other associations, who
    provide input while not including their association name to the
    membership roster.
                           participating associations
    American Military Society
    Army and Navy Union
    Association of the U.S. Navy
    Enlisted Assoc. of the National Guard of the U.S.
    Hispanic War Veterans of America
    Marine Corps Reserve Association
    Military Order of World Wars
    National Assoc. for Uniformed Services
    Naval Enlisted Reserve Association
    Reserve Enlisted Association
    Reserve Officers Association
    The Flag and General Officers' Network
    The Retired Enlisted Association
                                  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 13
    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 ongoing stewardship that it has demonstrated on
    issues of defense. While in a time of war, this subcommittee's pro-
    defense and non-partisan leadership continues to set an example.
    Force Structure: Erosion in Capability
        The 2010 Quadrennial Defense Review's (QDR) objectives include:
    further rebalance the Armed Force's capabilities to prevail in today's
    wars while building needed capabilities to deal with future threats;
    and reform Department of Defense's (DOD) institutions and processes to
    better support warfighters' urgent needs; purchase weapons that are
    usable, affordable, and needed; and ensure that taxpayer dollars are
    spent wisely and responsibly. The new QDR calls for DOD to continually
    evolve and adapt in response to the changing security environment.
        Retiring Secretary of Defense Robert Gates said that, ``It is
    vitally important to protect the military modernization accounts,'' and
    to, ``push ahead with new capabilities, from an air refueling tanker
    fleet to ballistic missile submarines.'' Additionally when referring to
    paying America's budget by defense Gates also stated that, ``If you cut
    the defense budget by 10 percent, which would be catastrophic in terms
    of force structure, that's $55 billion out of a $1.4 trillion
    deficit,'' further saying, ``We are not the problem.''
        The Chairman of the Joint Chiefs of Staff Admiral Mike Mullen well-
    known for his saying that the ``national debt is the greatest threat to
    national security,'' in his testimony before the Senate Armed Services
    Committee in February 2011 also recognized the following regarding
    equipment:
        In the ``back end'' of previous conflicts, we were able to contract
    our equipment inventory by shedding our oldest capital assets, reducing
    the average age of our systems. We cannot do this today, because the
    high pace and durations of combat operations have consumed the
    equipment of all our Services much faster than our peacetime programs
    can recapitalize them. We must actually recapitalize our systems to
    restore our readiness and avoid becoming a hollow force.
    Hollow Force
        A4AD strongly disagrees with placing budgetary constraints on
    defense especially in light of the fact that many have recommended
    cutting defense in order to pay off debt despite it only being 20
    percent of the overall budget. Member associations also question the
    current administration's spending priorities which place more
    importance on the immediate future rather than a short and long term
    approach. The result of such a budgetary policy again lead to a hollow
    force whose readiness and effectiveness has been subtly degraded and
    lessened efficiency will not be evident immediately. This process,
    echoing the past, raises no red flags and sounds no alarms, and the
    damage can go unnoticed and unremedied until a crisis arises
    highlighting readiness decay.
        Even Secretary Gates has ominously warned against ``. . . hollowing
    out of the force from a lack of proper training, maintenance and
    equipment--and manpower.'' But he's not the only one, the commander of
    U.S. Joint Forces Command General Raymond Odierno also has said
    recently, ``We must avoid the trap of doing more with less, which is a
    recipe for creating a hollow force,'' and further qualified this by
    asking, ``what are we going to stop doing?''
    Emergent Risks
        Members of this group are concerned that U.S. defense policy is
    sacrificing future security for near term readiness. Our efforts are so
    focused to provide security and stabilization and then withdrawal in
    Afghanistan and Iraq. While risk is being accepted as an element of
    future force planning, current planning is driven by current overseas
    contingency operations, and progressively more on budget limitations.
        What seems to be overlooked is that the United States is involved
    in a Cold War in S.E. Asia as well as a Hot War with two theaters in
    S.W. Asia. Security issues in North Africa, the Middle East, North
    Korea, China, Iran, and Russia add to the growing areas of risk.
    Arab Awakening
        The Middle East is in the midst of great turmoil in which multiple
    countries have and continue to see uprisings, there's a widening gap
    between Christians and Muslims in Egypt, Syria has seen numerous
    civilian deaths, Israel is increasingly defensive, Yemen edges closely
    to civil war, more attacks are surfacing in Iraq, Libya remains in a
    stalemate, in addition to other problems.
        It is concerning that while in the thick of continuing protests and
    instability numerous western nations are pledging significant funding
    for alleged ``Arab countries in transition to democracy''. The United
    States' best interest is to ensure that there is reliable leadership in
    Arab states, civil relations toward Israel, and reduced violence
    against civilians. Also any assistance given must be targeted to
    support the U.S. National Security Strategy and have detailed goals
    attached.
    Korean Peninsula
        North Korea has 1.2 million active and 7.7 million reserve forces
    while South Korea had 653,000 active and 3.2 million reserve soldiers
    in 2010, and there are 28,500 U.S. troops stationed to the South. While
    not an immediate danger to the United States, North Korea is viewed as
    an increased threat to its neighbors, and is potentially a
    destabilizing factor in Asia. North Korea may be posturing, but it is
    still a failed state, where misinterpretation clouded by hubris could
    start a war.
        Recently South Korea has admitted that it has held secret
    discussions with North Korea in May, yet North Korea utilized the
    opportunity to embarrass the South. Some analysts actually believe that
    the two nations may be entering into a new dangerous phase. This is
    further emphasized by the cool relations of the past year in which
    North Korea committed attacks against South Korea on Yeonpyeong Island
    and the sinking of the navy vessel ROKS Cheonan, which resulted in 50
    deaths. In fact South Korea intends to increase its defense budget by
    nearly 5.8 percent in 2011, which is partially in response to these
    attacks.
    China
        China has worked very hard to create a facade to the world to
    conceal its true strengths and weaknesses. According to Chief of Naval
    Operations Admiral Gary Roughead, at a SAC-D hearing, ``The Chinese
    Navy is the fastest-growing in the world today.''
        Of great concern is China's defense budget which `officially' will
    increase 12.7 percent, 600 billion Yuan or roughly $91 billion, for
    2011. Some of the increase will go toward the strategic nuclear force,
    the strategic missile unit, and the Navy. But this is not the whole
    budget and in fact it doesn't include the cost for procuring or
    building new weapons which could almost double the defense budget.
    What's more experts across the board estimate that China's actually
    spends far more than is reported, ranging from over $150 billion as DOD
    reported in 2010 (up to 250 percent higher than figures reported by the
    Chinese government ) to as much as $400 billion as estimated by
    GlobalSecurity.org based on ``a more appropriate purchasing power
    parity (PPP) basis''.
        In addition their cost of materials and labor is much lower.
    China's GDP climbed to 9.6 percent while the United States is at 2.6
    percent as of the third quarter for 2010. According to the CIA World
    Fact Book ``because China's exchange rate is determine by fiat, rather
    than by market forces, the official exchange rate measure of GDP is not
    an accurate measure of China's output; GDP at the official exchange
    rate substantially understates the actual level of China's output vis-
    a-vis the rest of the world; in China's situation, GDP at purchasing
    power parity provides the best measure for comparing output across
    countries.''
        China's build-up of sea and air military power appears aimed at the
    United States, according to Admiral Michael Mullen. Furthermore China
    is reluctant to support international efforts in reproaching North
    Korea. China has stated that it will field its advanced new J-20
    stealth fighter in 2017-19.
        Furthermore there is also the aggressive behavior. Recently the
    Philippines deployed two warplanes when a ship searching for oil
    complained of being harassed by two Chinese patrol boats in the South
    China Sea, Japan deployed F-15 fighter jets when Chinese surveillance
    and anti-submarine aircraft flew near the East China Sea disputed
    islands, and at all times China pursues overtaking Taiwan. China also
    associates with adversarial nations, specifically Iran and Venezuela
    who both openly antagonize the United States.
    Iran
        While Iran lobs petulant rhetoric toward the United States, the
    real international tension is between Israel and Iran, and Iran's
    handiwork in various Middle Eastern uprisings such as Bahrain which is
    already considered to be an Iranian quasi-satellite state.
        Israel views Tehran's atomic work as a threat, and would consider
    military action against Iran as 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.
        Two Iranian warships passed through the Suez Canal upon receiving
    approval from Egypt, which Israel called a provocation. Iran has also
    sent a submarine into the Red Sea.
    Russia
        While the Obama Administration has been working on a ``reset''
    policy toward Russia, including a new START treaty, there are areas of
    concern. A distressing issue is their ongoing relationship with Iran.
    Additionally Russia sells arms to countries like Syria and Venezuela.
        Prime Minister Vladimir Putin stated recently, ``Despite the
    difficult environment in which we are today, we still found a way to
    not only maintain but also increase the total amount of state defense
    order.'' Russia's defense budget rose by 34 percent in 2009, as
    reported by the International Institute of Strategic Study, and has
    plans for incremental defense spending increases starting 2011 with a
    $19.2 billion, $24.3 billion in 2012, and then $38.8 billion in 2013.
    Funding for the Future
        Since Secretary Gates initiated the practice of reviewing all the
    services' unfunded requirements lists prior to testifying before
    Congress the unfunded lists have shown a dramatic reduction from $33.3
    billion for fiscal year 2008 and $31 billion for fiscal year 2009 to
    $3.8 billion for fiscal year 2010 and $2.6 billion for fiscal year
    2011.
        Secretary Gates instituted a plan to save $100 billion over 5
    years. Two-thirds of the savings are supposed to come from decreasing
    overhead and one-third from cuts in weapons systems and force
    structure. For the 2012 budget, the military services and defense
    agencies have been asked to find $7 billion in savings. In addition
    President Obama has ordered $400 billion in national security spending
    cuts over 10 years as the administration identifies ways to reduce the
    Federal deficit. These impending cuts are in addition to weapon systems
    cuts from the past couple years amounting to more than $330 billion.
        Secretary Gates stated, ``. . . sustaining the current force
    structure and making needed investments in modernization will require
    annual real growth of 2 (percent) to 3 percent, which is 1 (percent) to
    2 percent above current top line budget projections,'' in a briefing at
    DOD in Aug. 2010.
    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 defense spending at 5 percent of Gross
    Domestic Product during times of war to cover procurement and prevent
    unnecessary end strength cuts.
    A Changing Manpower Structure
        The 2010 QDR reduces the number of active Army brigade combat teams
    to 45 and Air Force tactical fighter wings to 17, while maintaining the
    202,100 Marine Corps active manpower level. The Navy's fiscal year 2011
    budget keeps the goal of a 313 ship battle fleet, but its 30 year
    shipbuilding plan includes 276 ship, thus not reaching the goal. As a
    result of these planned cuts, the Heritage Foundation projects there
    will be a 5 percent decrease in manpower over the next 5 years.
        A4AD supports a moratorium on further cuts including the National
    Guard and Title 10 Reserve. We further suggest that a Zero Based Review
    (ZBR) be performed to evaluate the current manning requirements.
    Additionally, as the active force is cut, these manpower and equipment
    assets should be transferred into the Reserve Components.
    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 communications 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.
    Dependence on Foreign Partnership
        Part of the U.S. military strategy is to rely on long-term
    alliances to augment U.S. forces. 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.'' The fiscal year 2012 budget request included $500
    million for fiscal year 2012, which helps build capabilities of key
    partners. Yet many allies are cutting their forces.
        The risk of basing a national security policy on foreign interests
    and good world citizenship is increasingly uncertain because their
    national objectives can differ from our own. Alliances should be viewed
    as a tool and a force multiplier, but not the foundation of National
    Security.
    Seapower Dominance
        The United States, as a maritime Nation, is on the cusp of losing
    it dominance at sea. The U.S. Navy has been incrementally depreciating
    through reductions and ever-more aging assets. Now, there are plans to
    extend the service life of already 40-year old ships another 28 years
    through 2039. While service life extension programs may cost effective
    in the short term, continual repairs and downgraded readiness will
    prove to be more expensive than replacing an asset in the long term.
        The cost will not just be defense based, but will impact the
    national and world economy. The United States has maintained its
    presence and strength throughout the world, attributing greatly to
    reducing aggressive behavior such as dealing with piracy, regional
    disorder, drug trade, human trafficking and much more. According to
    MacKenzie Eaglen of Heritage Foundation, ``The U.S. Navy's global
    presence has added immeasurably to U.S. economic vitality and to the
    economies of America's friends and allies, not to mention those of its
    enemies.''
        A4AD is particularly concerned that the Navy is no longer as of
    2011 required to submit a full plan each year to Congress, but rather
    ties it to the QDR which is only updated once every 4 years, causing
    the Navy to be slow to respond to changing threats. Once the U.S.
    seapower capability is lost, it will be extremely difficult to regain a
    dominant position in the world seas.
                             unfunded requirements
        The Unfunded Program Lists submitted by the military services to
    Congress have been reduced significantly since fiscal year 2009 and
    A4AD has concerns that these requests continue to be driven more by
    budgetary factors than risk assessment. Of particular concern is the
    Army who officially has no unfunded requirements, in spite of the fact
    that its equipment has been the most highly utilized in overseas
    contingency operations in Iraq and Afghanistan, leading to high wear
    and tear. A4AD is distressed that by limiting the unfunded lists,
    Congress is unable to make informed decisions on appropriating for
    defense.
    Aviation Plans
        Although the first long-term aviation plan was submitted to
    Congress in fiscal year 2011 forecasting a 3 percent average annual
    real growth for aviation programs over the next decade, in the fiscal
    year 2012 report investment assumptions changed and now predict a zero
    real growth aviation budget after 2017. Regrettably the aviation plan
    did not consider rotary wing, tilt-rotor, or trainer aircraft.
    Tactical Aircraft
        The Air Force has accelerated a plan to retire 250 fighter jets
    including 112 F-15s and 134 F-16s. Also the Air Force plans to ground
    18 F-16s in the USANG due to the fiscal year 2012 presidential budget
    request that didn't include funding for three F-16s for six States
    each.
        The Air Force-Navy-Marine Corps fighter inventory will decline
    steadily from 3,264 airframes in fiscal year 2011 to 2,883 in fiscal
    year 2018, at which point the air fleet is supposed to have a slow
    increase.
        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. Air Force and Naval
    airframes and air crews are being stressed by these lift missions. As
    the military continues to be more expeditionary it will require more
    airlift. Procurement needs to be accelerated and modernized, and
    mobility requirements need to be reported upon.
        While DOD has decided to shut down production of C-17s, existing C-
    17s are being worn out at a higher rate than anticipated. Congress
    should independently examine actual airlift needs, and plan for C-17
    modernization, a possible follow-on procurement. Furthermore shutting
    down production of C-17s or any equipment causes great difficulty for
    reopening such lines and will cause unnecessary delays in the future.
        The Navy and Marine Corps need C-40A replacements for the C-9B
    aircraft; only nine C-40s have been ordered since 1997 to replace 29 C-
    9Bs. 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.
    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 and lists are not in priority order. Amounts are total
      cost, not individual. If item is preceded by a number in parentheses
                          that is the quantity needed.]
    ------------------------------------------------------------------------
                                                                 Amount
    ------------------------------------------------------------------------
    Air Force Active:
        F-35 Joint Strike Fighter.........................           Unknown
        Aircraft Training Simulators......................           Unknown
        F-16 SLEP.........................................           Unknown
    Air Force Reserve (USAFR):
        C-130--requirement of LAIRCOM and SLOS/BLOS            $73.3 million
         capability.......................................
        A-10/F-16--requirement of Day/Night Helmet Mounted      $9.8 million
         Integrated Targeting (HMIT) (PA, SP).............
        ACS--requirement of Grissom R-12 Refuelers........      $0.9 million
        HC-130--requirement of Integrated EW suite (ALQ-          $6 million
         213) with VECTS..................................
        C-130--requirement of SAFIRE Look Out Capability       $19.3 million
         and MASS Spray System............................
    Air Force Reserve (USAFR) Submitted MILCON
     Requirements:
        Airfield Control Tower/Base Ops, March, CA........    $16.39 million
        RED HORSE Readiness and Training Facility,            $9.593 million
         Charleston, SC...................................
        Unspecified Minor Construction--Reserve, Various      $5.434 million
         Locations........................................
        Planning and Design--Reserve, Various Locations...      $2.2 million
    Air Force Reserve (USAFR) Significant Major Item
     Shortages Submitted:
        (21) C-130 Large Aircraft Infrared Countermeasures       $63 million
         (LAIRCOM)........................................
        (55) C-130 SLOS/BLOS Capability...................     $20.7 million
        (148) A-10/F-16 Mounted Cueing System (HMCS)......      $4.3 million
        (4) Grissom R-12 Refuelers........................      $0.9 million
        (5) HC-130 Integrated EW suite (ALQ-213) with             $3 million
         VECTS............................................
    Air National Guard (USANG):
        F-15 AESA--Continues to be a high priority for               Unknown
         adds because it is too expensive to spend NGREA
         on. Some could be a purchased if NGREA is
         significantly increased..........................
        A-10 and F-16 HMIT................................           Unknown
        KC-135 IRCM.......................................           Unknown
        C-130 IRCM........................................           Unknown
        Guardian Angel (GA) Recovery Vehicles. This is               Unknown
         also called ``PJ recovery vehicles'', but GA is
         the weapon system encompassing PJs, Special
         Tactics Squadrons, and Combat Controllers and
         they all need recovery vehicles..................
    Air National Guard (USANG) Significant Major Item
     Shortages Submitted:
        (322) A-10/F-16 Helmet Mounted Integrated             $38.64 million
         Targeting System.................................
        (77) Large Aircraft Infrared Countermeasures          $431.2 million
         (LAIRCOM) (C-140, C-17, C-5).....................
        (68,272) Security Force Mobility Bag Upgrades,        $86.15 million
         Personal Protective Equipment (PPE), and Wea-
         pons.............................................
        C-130 Loadmaster Lookout Windows and Crashworthy        $164 million
         Loadmaster Seats.................................
        (30) F-15 Active Electronically Scanned Array         $261.6 million
         (AESA) Radar.....................................
    Army Active:
        Ground Combat Vehicle.............................           Unknown
        Mobile, Secure Wireless Network--Brigade Combat              Unknown
         Team Modernization (BCTM)........................
        HMWWV Modernization...............................           Unknown
        CH-47 Chinook Helicopter..........................           Unknown
        AH-64 Apache Longbow Block III upgrade............           Unknown
    Army National Guard (USARNG) Significant Major Item
     Shortages Submitted:
        (30,442) Command Posts--Tactical Operations Center    $1.166 million
         (TOC) & Standardized Integrated Command Post
         System (SICPS)...................................
        (5,428) Family of Medium Tactical Wheeled Vehicles    $1.519 million
        (11) Shadow Tactical Unmanned Aircraft Systems....      $297 million
        (3,614) General Engineering Equipment--for            $366.7 million
         homeland response missions.......................
        (290) Chemical/Biological protective Shelter......    $208.8 million
    Army National Guard (USARNG) Top Equipment MOD and
     Capability Shortfall List:
        Army Battle Command System (ABCS).................           Unknown
        Air & Missile Defense Systems (Avenger                       Unknown
         Modernization)...................................
        ATLAS (All Terrain Lifter-Army System I and II)...           Unknown
        Aviation Ground Support Equipment.................           Unknown
        Aviation Systems (CH-47F, UH60 A-A-L Mod, UH-60M,            Unknown
         AH64 MOD, LUH-72 MEP)............................
    Army Reserve (USAR) Significant Major Item Shortages
     Submitted:
        (34) Command Post System and Integration (SICPS)..      $6.8 million
        (4,860) Medium Tactical Vehicles..................    $1.701 billion
        (63) HMMWV Ambulance..............................    $25.01 million
        (4,541) Light Medium Tactical Truck Cargo.........    $1.589 billion
        (98) Heavy Scraper--for Horizontal Construction       $30.58 million
         mission..........................................
    Marine Corps Reserve (USMCR) Significant Major Item
     Shortages Submitted:
        (5) Light Armored Vehicle (LAV), 25 mm (LAV-25A2).       $16 million
        (5) LAV, Maint/Recovery (LAV-R)...................       $11 million
        (15) LAV, Logistics (LAV-L).......................       $30 million
        (3) LAV, Mortar (LAV-M)...........................      $7.5 million
        (14) LAV, Anti-tank (LAV-AT)......................     $44.8 million
    Navy and Marine Corps Active \1\:
        F-35 Joint Strike Fighter.........................           Unknown
        Attack Submarines.................................           Unknown
        LPD-17............................................           Unknown
    Navy Reserve (USNR) Significant Major Item Shortages
     Submitted:
        (5) C-40A.........................................    $408.5 million
        Naval Construction Force (NCF) Tactical Vehicles         $38 million
         and Support Equipment Table of Allowances (TOA)..
        Navy Expeditionary Logistics Support Group               $75 million
         (NAVELSG) TOA Equipment..........................
        Explosive Ordnance Disposal (EOD) TOA Equipment...    $58.89 million
        Maritime Expeditionary Security Force (MESF) TOA        $119 million
         Equipment........................................
    ------------------------------------------------------------------------
    \1\ The Navy's fleet is the smallest it has been in almost 100 years.
      While the service has made plans to expand in the coming years; to 324
      ships by 2021; funding doesn't support this growth. Shipbuilding costs
      continue on an exponential path and at the same time domestic
      shipbuilding yards are beginning to close, putting a larger fleet at
      risk; the ship building budget needs to be increased.

    Reserve Components (RCs)
        According to the National Guard and Reserve Equipment Report
    (NGRER) for fiscal year 2012 the aggregate equipment shortage for all
    of the RCs is about $54.2 billion as compared to $45 billion from last
    year. Common challenges for the RCs are ensuring that equipment is
    available for pre-mobilization training, transparency of equipment
    procurement and distribution, and maintenance.
                                   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. Thank you very much, Captain Puzon.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I want to join you in
    welcoming and thanking this panel of witnesses for being here
    today. We have a copy of the testimony and background
    information that our staff has provided us. It's a shame that
    we have such a pressurized situation that we're facing here
    with many commitments all during the same day and at the same
    time we're supposed to be here. I was just looking at my
    schedule to see where I was supposed to be right about now and
    it was somewhere else.
        But that's something that you shouldn't have to suffer
    from, and that's why I wanted to simply say, because we are not
    spending 2 or 3 hours, which we probably ought to do, with this
    one panel because of the pressure of so many other activities
    and issues, we are forced to make decisions that are
    troublesome to us.
        So, having said that, I'm going to yield to my good friend
    from Alabama for specific questions that he may have of this
    witness. But thank you very much for taking time to provide us
    with your testimony.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Thank you, Mr. Chairman.
        Thank you for your testimony and also your complete written
    testimony. I think one of your strong statements is in the
    record. You say members of this group--that's your group--``are
    concerned that the U.S. defense policy is sacrificing future
    security for near-term readiness.'' That is a concern of all of
    us. We've got to balance that, because if we have near-term
    readiness where are we going to be in 10 years, 5 years,
    because we've been on the cutting edge a long time, and it's
    served us well and we cannot give this up.
        The other point that you make in your written testimony,
    the Chinese navy is the fastest growing navy in the world
    today. I think we realize this on this Defense Appropriation
    Committee, and we've got to consider today, but we've also got
    to consider tomorrow, because if we're not prepared for
    tomorrow, as you pointed out, we've not served our country
    well, have we?
        Captain Puzon. That's correct, sir. Thank you.
        Senator Shelby. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Dr. Jenkins.
    STATEMENT OF DONALD H. JENKINS, M.D., VICE CHAIRMAN,
                NATIONAL TRAUMA INSTITUTE
        Dr. Jenkins. Mr. Chairman, Vice Chairman Cochran, Senator
    Shelby: Thank you for the opportunity to testify today on
    behalf of the National Trauma Institute, or NTI, to urge the
    subcommittee to invest a greater amount of Department of
    Defense medical research funds in the primary conditions which
    kill our soldiers.
        According to military medical officials, non-compressible
    hemorrhage is the leading cause of death among combatants whose
    deaths are considered potentially survivable. NTI believes an
    accelerated program of research into non-compressible
    hemorrhage will result in the first truly novel advances in
    treating this difficult problem, will save the lives of
    soldiers wounded in combat, and will have a tremendous impact
    on civilian casualties and costs as well.
        I'm currently the Chief of Trauma for the Mayo Clinic and
    serve on the Defense Health Board. Prior to retiring from the
    United States Air Force, I was Chairman of General Surgery and
    Chief of Trauma at Wilford Hall Air Force Medical Center, the
    Air Force flagship medical facility. I'm here today in my
    capacity as Vice Chairman of the nonprofit National Trauma
    Institute, which was formed in 2006 by leaders of America's
    trauma organizations in response to frustration over lack of
    trauma research funding.
        NTI advocates for trauma research and is a national
    coordinating center for trauma research and funding. Military
    officials estimate that 19 percent of combat deaths are
    potentially survivable. To put that in context of our current
    war operations, 1,100 warriors wounded in the current wars
    might have survived, but didn't because treatment strategies
    were lacking.
        Over 84 percent of those deaths were due to hemorrhage and
    about 600 potentially survivable deaths resulted from
    hemorrhage in regions of the body, such as the neck, chest,
    abdomen, groin, and back, that couldn't be treated by
    tourniquets or compression. New tourniquets and hemostatic
    bandages have had major impact on the decline in trauma combat
    deaths due to extremity hemorrhage, but compression is rarely
    effective for penetrating wounds to the torso, where major
    vessels can be damaged, resulting in massive hemorrhage. At
    present such wounds are normally only treatable through surgery
    and typically such patients do not survive to reach the
    operating table.
        Current combat casualty care guidelines for medics do not
    include strategies to stop bleeding from non-compressible
    hemorrhage, because there are none. There is not even a method
    to detect whether a soldier is bleeding internally or how much
    blood has been lost. It should be a priority to develop simple,
    rapid, and field-expedient techniques which can be used by
    medics on the battlefield or first responders in the civilian
    setting to detect and treat non-compressible hemorrhage.
        Turning to that civilian context, trauma is responsible for
    over 60 percent of deaths of Americans under the age of 44.
    That's more than all other causes of death combined in that age
    group. It's responsible for the deaths of nearly 180,000
    Americans and nearly 30 million injuries every year. And it's
    the second most expensive public health problem facing the
    United States. Hemorrhage is responsible for nearly 40 percent
    of deaths following traumatic injury in the civilian setting.
        Advances in research can be applied to both military and
    civilian casualties. It has been proven repeatedly that medical
    research saves lives. In 1950 a diagnosis of leukemia was a
    death sentence. Research led to chemotherapy and treatments
    such as bone marrow transplant, such that today 90 percent of
    those patients survive. Imagine even a 5 percent decrease in
    trauma-related death, injury, and economic burden. That would
    save the United States $35 billion a year, prevent 1.5 million
    injuries, and save nearly 9,000 American lives every year.
        NTI recommends the subcommittee fund research into the
    major cause of preventable death of our military and set aside
    at least $15 million for peer-reviewed research into non-
    compressible hemorrhage for the fiscal year 2012 DOD
    appropriations bill.
        Mr. Chairman, Senator Cochran, Senator Shelby, thank you
    for the opportunity to present the views of the National Trauma
    Institute.
        [The statement follows:]
                  Prepared Statement of Dr. Donald H. Jenkins
        Mr. Chairman, Vice Chairman Cochran and Members of the
    Subcommittee: Thank you for the opportunity to testify today to urge
    the subcommittee to invest a greater amount of DOD medical research
    funds in the primary conditions which kill our soldiers. According to
    military medical officials, non-compressible hemorrhage is the leading
    cause of death among combatants whose deaths are considered
    ``potentially survivable.'' The National Trauma Institute (NTI)
    believes an accelerated program of research into non-compressible
    hemorrhage will result in the first truly novel advances in treating
    this difficult problem, will save the lives of soldiers wounded in
    combat, and will have tremendous impact on civilian casualties and
    costs.
        I am currently the Chief of Trauma for the Mayo Clinic and serve on
    the Defense Health Board. Prior to retiring from the Air Force in 2008,
    I was Director of the Joint Theater Trauma System, Chair of General
    Surgery and Chief of Trauma Services at Wilford Hall Medical Center,
    the Air Force's flagship medical facility. During my Air Force career,
    I also served as principal advisor to the Air Force Surgeon General on
    all surgery and trauma-related issues for first-strike deployable
    teams.
        I am here today in my capacity as vice chairman of the nonprofit
    National Trauma Institute which was formed in 2006 by leaders of
    America's trauma organizations in response to frustration over lack of
    funding of trauma research. With the support and participation of the
    national trauma community, NTI advocates and manages funding for trauma
    research and is a national coordinating center for trauma research
    funding. Since September 2009, NTI has issued two national calls for
    proposals and has received a total of 177 pre-proposals from 32 States
    and the District of Columbia. After rigorous peer-review, the
    organization awarded $3.9 million to 16 proposals--seven single-center
    studies and nine multi-center studies involving an additional 32
    centers. Studies are ongoing, and NTI expects the first research
    outcomes within 6 months. However, $3.9 million is a drop in the
    bucket, and these studies will barely begin to build the body of
    knowledge necessary for improved treatments and outcomes in the field
    of trauma in the United States.
                          non compressible hemorrhage
        According to military documents and officials, the major cause of
    death from combat wounds is hemorrhage. Nineteen percent of combat
    deaths are judged to be potentially survivable \1\. In other words,
    1,100 warriors wounded in Iraq or Afghanistan might have survived to
    come home to their loved ones, but didn't because treatment strategies
    were lacking. Over 900 (84 percent) deaths were due to hemorrhage, and
    66 percent of these, about 600 potentially survivable deaths, resulted
    from hemorrhage in regions of the body such as the neck, chest,
    abdomen, groin, and back that couldn't be treated by a tourniquet or
    compression \1\.
    ---------------------------------------------------------------------------
        \1\ Kelly, J.F., Ritenour, A.E., McLaughlin, D.F., Bagg, K.A.,
    Apodaca, A.N., Mallak, C.T., Pearse, L., Lawnick, M.M., Champion, H.R.,
    Wade, C.E., and Holcomb, J.B. (2008) Injury severity and causes of
    death from Operation Iraqi Freedom and Operation Enduring Freedom:
    2003-2004 versus 2006. J Trauma 64, S21-26.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Extremity wounds are amenable to compression to stop bleeding, and
    new tourniquets and hemostatic bandages have had a major impact on the
    decline in combat deaths due to extremity hemorrhage. But compression
    is rarely effective for penetrating wounds to the torso and major
    vessels can be damaged resulting in massive hemorrhage. At present,
    such wounds are normally only treatable through surgical intervention
    and typically such patients do not survive to reach the operating room.
        Currently, there is no active intervention for noncompressible
    hemorrhage available to military medics, who along with civilian
    responders have only the tools their predecessors had in the early 20th
    century. There is not even a method to detect whether the wounded
    warrior is bleeding internally, and if so, how much blood has been
    lost. The current Tactical Combat Casualty Care guidelines for medics
    and corpsmen do not include strategies to stem bleeding from non-
    compressible hemorrhage because no solutions are available \2\. NTI
    hopes to decrease the mortality of severely injured patients suffering
    from torso hemorrhage. This can only be accomplished through research
    into the development of simple, rapid and field-expedient techniques
    which can be used by medics on the battlefield or first responders in a
    civilian context to detect and treat non-compressible hemorrhage.
    Examples of current NTI research in non-compressible hemorrhage
    include:
    ---------------------------------------------------------------------------
        \2\ (2009) Tactical Combat Casualty Care Guidelines. http://
    www.usaisr.amedd.army.mil/tccc/TCCC%20Guidelines%20091104.pdf. Accessed
    June 2, 2011.
    ---------------------------------------------------------------------------
      --The use of ultrasonography to measure the diameter of the vena cava
            to determine whether this will give an accurate indication of
            low blood volume.
      --An observational study to determine the incidence and prevalence of
            clotting abnormalities in severely injured patients and to
            study the complex biology of proteins to better understand,
            predict, diagnose and treat bleeding after trauma.
      --Supplementation of hemorrhagic shock patients with vasopressin, a
            hormone needed to support high blood pressure. Vasopressin at
            high doses has been shown to improve blood pressure, decrease
            blood loss and improve survival in animal models with lethal
            blood loss. This study will investigate the use of vasopressin
            in trauma patients.
        Another challenge in hemorrhage is resuscitation--the restoration
    of blood volume and pressure. Traditional resuscitation includes large
    volumes of intravenous fluids followed by blood and finally plasma.
    However, now this large intravenous fluid load is thought to worsen the
    trauma patient's coagulopathy (blood clotting problems), increasing
    bleeding. There is strong retrospective evidence that for patients
    requiring massive transfusion, a higher proportion of plasma and
    platelets, when compared to red cells, results in improved survival.
    Based on a 2004 research study \3\, the current Joint Theater Trauma
    Clinical Practice Guideline for Forward Surgical Teams and Combat
    Support Hospitals advocates a plasma, platelet, and red cell
    resuscitation regime in lieu of the standard intravenous fluids.
    Currently, there is no blood substitute available for in-theater use.
    The Army Medical Department/USA Institute of Surgical Research is
    working on a freeze dried plasma solution; however this product has not
    yet received FDA approval. Remarkably, current treatments used by
    military medics for restoration of blood volume are very similar to
    those originally used in 1831 when saline was first given as an
    intravenous fluid to cholera patients \4\.
    ---------------------------------------------------------------------------
        \3\ Holcomb, J.B., Jenkins, D., Rhee, P., Johannigman, J., Mahoney,
    P., Mehta, S., Cox, E.D., Gehrke, M.J., Beilman, G.J., Schreiber, M.,
    Flaherty, S.F., Grathwohl, K.W., Spinella, P.C., Perkins, J.G.,
    Beekley, A.C., McMullin, N.R., Park, M.S., Gonzalez, E.A., Wade, C.E.,
    Dubick, M.A., Schwab, C.W., Moore, F.A., Champion, H.R., Hoyt, D.B.,
    and Hess, J.R. (2007) Damage Control Resuscitation: Directly Addressing
    the Early Coagulopathy of Trauma. The Journal of Trauma 62, 307-310.
        \4\ Blackborne, L.H.C. (2011) 1831. The Army Department Medical
    Journal April-June 2011, 6-10.
    ---------------------------------------------------------------------------
                  impact of trauma on united states civilians
        Traumatic injury is the cause of death of nearly every soldier in
    combat. On the civilian front, trauma/injury is responsible for over 61
    percent of the deaths of Americans between the ages of 1 and 44 each
    year \5\. That's more than all forms of cancer, heart disease, HIV,
    liver disease, stroke and diabetes combined. An American dies every 3
    minutes due to trauma. That's 179,000 deaths in addition to 29.6
    million injuries every year \5\.
    ---------------------------------------------------------------------------
        \5\ CDC (2006) Centers for Disease Control/WISQARS. http://
    webappa.cdc.gov/sasweb/ncipc/mortrate10_sy.html. Accessed March 16,
    2011.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Trauma is the second most expensive public health problem facing
    the United States. Data from the Agency for Healthcare Research and
    Quality (AHRQ) on the 10 most expensive health conditions puts the
    annual medical costs from trauma at $72 billion, second only to heart
    conditions at $76 billion, and ahead of cancer and all other diseases
    \6\. The National Safety Council estimates the true economic burden to
    be more than $690 billion per year, since trauma has an ongoing cost to
    society due to disability, and is the leading cause of years of
    productive life lost \7\.
    ---------------------------------------------------------------------------
        \6\ AHRQ (2008) Big Money: Cost of 10 Most Expensive Health
    Conditions Near $500 Billion. Agency for Healthcare Research and
    Quality http://www.ahrq.gov/news/nn/nn012308.htm. Accessed June 2,
    2011.
        \7\ NSC (2011) Summary from Injury Facts, 2011 Edition. National
    Safety Council http://www.nsc.org/news_resources/
    injury_and_death_statistics/Documents/Summary%202011.pdf. Accessed
    March 16, 2011.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Advances in research can be applied to both military and civilian
    casualties. Many of the problems associated with hemorrhage of all
    kinds are potentially solvable and are transferable between military
    and civilian trauma care. The funding recommended by NTI could have a
    dramatic impact on civilian mortality in the U.S. Hemorrhage is
    responsible for 30 percent to 40 percent of deaths following a
    traumatic injury to civilians \8\.
    ---------------------------------------------------------------------------
        \8\ Holcomb, J.B. (2010) Optimal Use of Blood Products in Severely
    Injured Trauma Patients. Hematology, 465-469.
    ---------------------------------------------------------------------------
                     why trauma research is so challenging
        Trauma research is challenging for many reasons. Injury can be
    severe, and diagnosis of extent and location of injury can be
    difficult. Sometimes the patient is unconscious or unable to
    communicate, unable to give consent. Patients are often unaccompanied
    by next-of-kin to assist in decisionmaking. Enrolling patients in
    trauma studies sometimes requires community consent and involvement
    because treatments may need to be started en route to the hospital or
    military treatment facility. Placebos are not usually an option,
    because real treatment must be given to injured patients.
        In trauma, there is no time to try different treatments, consider
    alternatives or have multiple appointments to discuss care. We must arm
    medical personnel with the tools they need to make the right decisions
    quickly. Lives can be saved. Focused clinical research will provide
    knowledge, tools and answers.
        Often a single Level 1 Trauma Center can't recruit enough patients
    with specific enrollment criteria to conduct a statistically
    significant study that provides enough evidence to reach a conclusion
    that would alter clinical practice. Therefore large, multi-center
    studies are required, and these necessitate substantial funding. Due to
    limited funding, studies have often been narrow in size, sporadic, and/
    or conducted on the basis of a physician's personal interest, rather
    than a cohesive approach borne from a national trauma research agenda.
        The majority of the funding added by Congress in fiscal year 2011
    did not go to trauma-related research \9\. The Congressionally Directed
    Medical Research Program did fund some research into areas that cause a
    high degree of disability in wounded warriors returning home, such as
    orthopaedic, eye, ear, craniofacial, and traumatic brain injury. NTI
    urges the subcommittee to equally fund the major cause of preventable
    death of our soldiers, sailors, airmen and marines.
    ---------------------------------------------------------------------------
        \9\ (2011) H.R.1473.
    ---------------------------------------------------------------------------
        For fiscal year 2011, Congress added over $700 million to the
    President's budget request for DOD medical research funding.
    Recognizing the need to reduce overall Federal spending, this sum is
    significantly less than Congress provided in fiscal year 2009 and
    fiscal year 2010 when over $1 billion was added each year.
        The National Trauma Institute believes that whatever additional sum
    Congress determines can be allocated to DOD medical research for fiscal
    year 2012 should be directed more specifically to research of the
    traumatic medical conditions which most severely affect our soldiers.
                                 research works
        It has been proven repeatedly that medical research saves lives.
    For instance, in 1950 a diagnosis of leukemia was tantamount to a death
    sentence. Research led to chemotherapy treatments in the 1950s and bone
    marrow transplantations in the 1970s. A substantial investment in
    research has led to safer and more effective treatments, and today
    there is a 90 percent survival rate for leukemia \10\. Another example
    is breast cancer. Thirty years ago only 74 percent of women who were
    diagnosed lived for another 5 years. Due to research into early
    detection, chemotherapy and pharmaceuticals, the 10-year survival rate
    for breast cancer is now 98 percent \11\.
    ---------------------------------------------------------------------------
        \10\ (2011) Research Successes. Leukemia and Lymphoma Society
    http://www.lls.org/#/aboutlls/researchsuccesses/. Accessed June 2,
    2011.
        \11\ (2011) Our Work. Susan G. Komen For the Cure http://
    ww5.komen.org/AboutUs/OurWork.html. Accessed June 2, 2011.
    ---------------------------------------------------------------------------
        Fifty years of dedicated research into proper diagnosis and
    treatment of leukemia has led to an 80 percent reduction in the death
    rate. Imagine even a 5 percent reduction in trauma deaths, injuries and
    economic burden--this would save the United States $35 billion, prevent
    1.5 million injuries, and save almost 9,000 lives every year.
        Recommendation.--Hence NTI recommends that Congress set aside a
    major portion of DOD medical research funding--at least $15 million--in
    the Defense Health Program account for a peer-reviewed research program
    to spur better technology to treat non-compressible hemorrhage.

        Chairman Inouye. I thank you very much, Dr. Jenkins.
        Senator Cochran. I may have missed it, but what
    specifically would you recommend that we do in terms of
    procedure or education requirements that would help address the
    problem that you've described in your testimony?
        Dr. Jenkins. Yes, sir. Hemorrhage from the extremities has
    been treated with a number of devices that have been developed,
    invented specifically for use in combat, that have now been
    translated over into the civilian setting, so that EMS agencies
    carry tourniquets and hemostatic bandages. There is no such
    device if your liver or spleen is damaged in a traumatic event.
    The soldiers on the battlefield when injured, cared for by
    medics, the medic has no tools to treat that non-compressible
    hemorrhage except to get him to surgery as soon as possible.
    These soldiers have died awaiting the opportunity to get to
    surgery.
        We need treatments that we can render to those soldiers on
    the battlefield, to those citizens in the field, by EMS
    agencies, so that we can stop that hemorrhage and stop that
    death.
        Senator Cochran. Thank you very much.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Mr. Chairman, just a quick observation and
    question. We've learned a lot and we've also, with helicopters
    and medical treatment, which have changed a lot. We've learned
    a lot since Vietnam, certainly since Korea, since the Second
    World War, and so forth. What is the basic survival rate in
    combat, heavy combat, now compared to, say, Vietnam, Korea? Do
    you have some statistics on that, because I know from what I
    have observed at Walter Reed and Bethesda and talking to a lot
    of veterans they probably wouldn't have survived, a lot of
    them, even in Vietnam, in the Second World War, Korea, and so
    forth.
        You're doing a lot better that way, but also they're facing
    great challenges. The sooner you get to them and the sooner
    they get medical help and sometimes get to the hospital, the
    better.
        Have you got any comments on that? Am I right, on the right
    track here?
        Dr. Jenkins. You are on the right track, sir. The Joint
    Trauma Registry keeps very specific data on this and keeps a
    rolling number that they look at. We look specifically at what
    one would call the case fatality rate, if injured the risk of
    dying.
        Senator Shelby. Can you furnish this to the subcommittee?
    You may have, but as I said earlier, I serve on another
    committee, subcommittee, dealing with the NIH and everything,
    and we're all interested in all of it. Right now we're focused
    on the military. But trauma is everywhere and what goes on in
    the military translates to others too, does it not?
        Dr. Jenkins. Yes, sir. Survival is better because of
    advances in combat medicine, because of better body armor.
    We're at the point now where we have--we're looking
    specifically at casualties who should have survived had we only
    better tools and techniques to be able to get them to live
    through it.
        Senator Shelby. Thank you, Mr. Chairman.
        Chairman Inouye. Thank you, Dr. Jenkins.
        Rear Admiral Coane.
    STATEMENT OF REAR ADMIRAL CASEY COANE, UNITED STATES
                NAVY (RETIRED), EXECUTIVE DIRECTOR,
                ASSOCIATION FOR THE UNITED STATES NAVY
        Admiral Coane. Mr. Chairman, Senator Cochran, Senator
    Shelby: The Association for the United States Navy is once
    again very pleased to have this opportunity to testify. Our
    association focuses its legislative activity on both personnel
    issues and the equipment necessary for the Navy and Navy
    Reserve to accomplish its missions. It is only through the
    attention of Congress and SUBcommittees such as yours that we
    can be sure that their needs are met.
        We are grateful for this annual opportunity and, in a
    departure from many of my colleagues earlier this morning, I'm
    going to speak about equipping the Navy. The ships and aircraft
    of which I am speaking are vital to this war effort and
    directly support the thousands of Navy and other services' men
    and women serving on the ground in Iraq, Afghanistan, or other
    places ashore in operations worldwide, 53,000 sailors deployed
    today, including 5,300 mobilized reservists.
        I have a few general statements and then I will address
    specific programs. We are pleased with the increased emphasis
    that the House and Senate have shown toward Navy shipbuilding
    in order to fulfil the Nation's maritime strategy. To meet
    those requirements, the Navy needs your support for the current
    shipbuilding plans. The Navy is behind on the 313-ship plan due
    to funding shortages and the only means to achieve a realistic
    plan is through this subcommittee's efforts.
        As the current efforts in Iraq and Afghanistan wind down,
    the need for our Navy to protect our sea lines of
    communication, through which 90 percent of our commerce flows,
    will, as always, remain an issue of national security.
        Regarding the Navy Reserve, the irreversible transition
    from a strategic reserve to an operational reserve with
    predictable and periodic mobilization increases the need for
    these Reserve components to be properly resourced for
    equipment. The recent comprehensive review on Reserve component
    report stresses the need to ensure that these components have
    both the equipment necessary to do the job and also the
    equipment necessary to train for the mission.
        The Navy's 30-year aircraft program, the Naval Aviation
    Plan 2030, is well laid out and moving forward, but it still
    has significant challenges ahead in the areas of tactical
    fighters and logistics for out-CONUS operations. Aircraft
    programs of great concern are the C-40 replacement for the C-9s
    and the KC-130J tactical airlifters to replace the C-130s. Both
    of these aircraft are extensively used for intra-theater
    operations for Iraq, Afghanistan, and support Navy fleet
    movements worldwide, including disaster relief operations.
        The issue is not just newer aircraft. The C-40As are Navy-
    unique fleet essential airlift, not VIP transport. The issue is
    that the current C-9 aircraft and C-20Gs have turned the
    maintenance expense curve to the extent that prudent business
    practices dictate replacement now. These aircraft in Hawaii,
    Fort Worth, and Maryland are scheduled to be decommissioned in
    fiscal year 2012 to 2014.
        The Navy needs five to six more C-40s to finish the program
    and it needs some of them this year. Anything that this
    subcommittee could do to fund and accelerate that program,
    perhaps by utilization of the National Guard and Reserve
    equipment accounts, would be most beneficial to the Navy and
    the Navy Reserve.
        The 30-year plan has the requirement for the replacement of
    the C-130Ts with the KC-130J aircraft. Currently this essential
    tactical intra-theater airlift is operating five aircraft short
    of requirement. Each year that the new aircraft is delayed will
    force the Navy to spend more money to upgrade worn-out aircraft
    to meet the new worldwide aviation equipment standards. We urge
    the committee to bring the KC-130J forward in the FYDP or by
    adding to the NGRE account.
        The P-8 aircraft is an on-time, on-budget program to
    replace the P-3 aircraft, the backbone of the Navy's
    reconnaissance effort in theater, as well as the Navy's current
    anti-submarine and anti-shipping combat aircraft, as
    demonstrated recently in Libyan operations. Unfortunately, P-8
    procurement was planned so far to the right that many, many P-
    3s are already grounded with broken wings. Anything that this
    subcommittee could do to accelerate that program, perhaps again
    by use of the NGRE accounts, would be most beneficial.
        Again, the Association of the United States Navy thanks the
    subcommittee for their tireless efforts on behalf of the Navy
    and for providing this opportunity to be heard today.
        [The statement follows:]
                 Prepared Statement of Rear Admiral Casey Coane
                   the association of the united states navy
        The Association of the United States Navy (AUSN) recently changed
    its name as of May 19, 2009. The association, formerly known as the
    Naval Reserve Association, traces its roots back to 1919 and is devoted
    solely to service to the Nation, Navy, the Navy Reserve and Navy
    Reserve officers and enlisted. It is the premier national education and
    professional organization for Active Duty Navy, Navy Reserve personnel,
    Veterans of the Navy, families of the Navy, and the Association Voice
    of the Navy and Navy Reserve.
        Full membership is offered to all members of the U.S. Navy and
    Naval Reserve. Association members come from all ranks and components.
        The Association has active duty, reserve, and veterans from all 50
    States, U.S. Territories, Europe, and Asia. Forty-five percent of AUSN
    membership is active reservists, active duty, while the remaining 55
    percent are made up of retirees, veterans, and involved DOD civilians.
    The National Headquarters is located at 1619 King Street Alexandria,
    Virginia. 703-548-5800.
        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 transitioned VSO-MSO association works diligently to educate
    Congress, our members, and the public on Navy equipment, force
    structure, policy issues, personnel and family issues and Navy
    veterans.
        I thank this Committee for the ongoing stewardship on the important
    issues of national defense and, especially, the reconstitution and
    support of the Navy during wartime. At a time of war, non-partisan
    leadership sets the example.
        Your unwavering support for our deployed Service Members in Iraq
    and Afghanistan (of which over 14,000 Sailors are deployed at Sea in
    the AOR and over 10,000 are on the ground--Active and Reserve) and for
    the world-wide fight against terrorism is of crucial importance.
    Today's Sailors watch Congressional actions closely. AUSN would like to
    highlight some areas of emphasis.
        As a Nation, we need to supply our service members with the
    critical equipment and support needed for individual training, unit
    training and combat as well as humanitarian and peacekeeping
    operations. Additionally, we must never forget the Navy families,
    reserve members and the employers of these unselfish volunteers--Active
    and Reserve.
        In recent years, the Maritime Strategy has been highlighted,
    debated and disputed. We feel this is a time where the Total Navy force
    needs to be stabilized, strengthened, and be reconstituted--because of
    the consistent, constant, and increasing National Security crisis in a
    dangerous world--
      --Piracy is on the rise in many areas of the world, and especially in
            the 5th Fleet AOR;
      --The flow of commerce still remains a top priority for our economy;
      --Naval engagement and support on the ground, in the air, and on the
            seas for OIF and OEF has not decreased;
      --Ever increasing Middle East instability;
      --Ballistic missile threats (N Korea-Iran) and the Navy requirement
            to be the front line of defense for missile defense threat;
      --U.S. Navy response to natural disasters; tsunami, Haiti, Chile, and
            possible man made disasters (oil spill support);
      --Humanitarian assistance in the Philippines, Indonesia, and American
            Samoa; and
      --Ever increasing and changing Arctic issues.
        In addition to equipment to accomplish assigned missions, the AUSN
    believes that the administration and Congress must make it a high
    priority to maintain, if not increase, but at least stabilize the end
    strengths of already overworked, and perhaps overstretched, military
    forces. This includes the Active Navy and the Navy Reserve.
      --Reductions in manpower are generally resource driven within the
            Service, not because people are not needed, and the reductions
            of their benefits are resource driven.
        Our current maritime history and strategy--requires that our Nation
    must achieve the 313+ Navy Ships, not decrease them, and there should
    be a balance between personnel end-strengths and equipment.
        As proven in recent events (Libya, Piracy, Osama Bin Laden, OCO
    operations) Naval Special Operations, U.S. Carriers, submarines, and
    Naval Aviation are more relevant than ever--as proven by constant
    actions in Iraq and Afghanistan and ongoing operations in OIF-OEF and
    throughout Southwest Asia. Additionally--Navy weapon systems and
    personnel play a critical role in Natural disasters around the world!
    Therefore, it is not a time--to cut back. Our adversaries are only
    waiting for the time for us to cut back or to stall. China is
    developing a peer Chinese Navy.
        We must fund the Navy for proper shipbuilding and aviation programs
    which the House this year authorized funds to accomplish.
        As you know, neither the Navy nor the Navy Reserve has ever been a
    garrisoned force--but, a deployed force. Nothing has changed in recent
    contingency operations or wars, except that the Navy's forces needs
    equipment as much as anyone. We have worn out current equipment and we
    need the manpower and infrastructure to ensure that current and future
    equipment stays ready.
        We recognize that there are many issues and priorities that need to
    be addressed by this Committee and this Congress. The Association of
    the United States Navy supports the Navy's fiscal year 2012 budget
    submission and the past years Unfunded Programs List provided by the
    Chief of Naval Operations that addressed an increased shipbuilding and
    increase aircraft procurement to relieve the documented shortages and
    maintenance requirements.
        Overwhelmingly, we have heard Service Chiefs, Reserve Chiefs and
    Senior Enlisted Advisors discuss the need and requirement for more
    equipment and unit equipment for training in order to be ready as well
    as combat equipment in the field. Navy needs to have equipment and unit
    cohesion to keep personnel trained. This means--Navy equipment and Navy
    Reserve equipment with units.
    Equipment Ownership
        Issue: Sharing of equipment has been done in the past. However,
    nothing could be more of a personnel readiness issue and is ill
    advised. This issue needs to be addressed if the current National
    Security Strategy is to succeed.
        Position: The overwhelming majority of Navy and Navy Reserve
    members join to have hands-on experience on equipment. The training and
    personnel readiness of members depends on constant hands-on equipment
    exposure. History shows, this can only be accomplished through
    appropriate equipment, since the training cycles are rarely if ever--
    synchronized with the training or exercise times or deployment times.
    Additionally, historical records show that units with unit hardware
    maintain equipment at higher than average material and often have
    better training readiness. This is especially true with Navy Reserve
    units. Current and future warfighting requirements will need these
    highly qualified units when the Combatant Commanders require fully
    ready units.
        Navy has proven its readiness. The personnel readiness, retention,
    and training of all members will depend on them having equipment that
    they can utilize, maintain, train on, and deploy with when called upon.
    AUSN recommends the Committee strengthen the Navy equipment
    appropriation as the House has done in the fiscal year 2012 NDAA in
    order to maintain optimally qualified and trained Navy and Navy Reserve
    forces.
    Equipment Needs and Request
        AUSN respects the tremendous pressure on the U.S. budget. However,
    the Navy and the Navy Reserve where a deployed force prior to September
    11, 2001 and the Navy and the Navy Reserve will remain a deployed force
    for foreseeable future. Therefore we request that you give strong
    consideration to: Funding one C-40A in the fiscal year 2012
    appropriations bill for replacement of aged aircraft in Maryland and
    Hawaii; fund two C-130J aircraft for Navy and Navy Reserve in the
    fiscal year 2012 appropriations bill; and ensure the proper lead
    funding is available to maintain TACAIR aircraft for 11 Carrier Air
    Wings.
    Manpower issues--Pay, and End-strength
        Pay needs to be competitive. If pay is too low, or expenses too
    high, a service member knows that time may be better invested
    elsewhere.
        The current discussions about changes in retirement and increases
    in healthcare is woefully inappropriate when the Nation considers what
    service members, Navy members, are doing in defense of this Nation, and
    in support of natural disasters. The risks and sacrifices of every
    service member, to defend this great Nation, make it illogical to
    formulate a policy change in retirement pay for military when they
    sacrifice so much. It just does not make common sense.
        End-strength is the core of any service accomplishing the mission.
    Navy and Navy Reserve has taken a fair share of budget driven end-
    strength cuts in the previous 10 years. It is time to stop the cuts and
    ensure that we have the right number of people to conduct operations.
        Care must be taken that the current tremendous reservoir of
    operational capability be maintained and not lost due to resource
    shortages. Officers, Chief Petty Officers, and Petty Officers need to
    exercise leadership and professional competence to maintain their
    capabilities. In the current environment of Navy Individual Augmentee
    in support of ground forces, there is a risk that Navy mid-grade
    leadership will not be able to flourish due to the extended ground war
    of OIF and OEF. Having the right equipment is critical to our Maritime
    Strategy.
        In summary, we believe the Committee needs to address the following
    issues for Navy and Navy Reserve in the best interest of our National
    Security:
      --Fund one C-40A for the Navy, per the past years documented request;
        --Navy must replace the C-9s and replace the C-20Gs in Hawaii and
                Maryland.
      --Fund the FA-18 E/F and FA-18 E/F Growlers per the House fiscal year
            2011 NDAA and include unit assets for Navy Reserve units
            currently in EA-6B aircraft.
      --Fund the Navy Ships provided for in the House fiscal year 2012
            NDAA.
      --Just as other services are having difficulties with intra theater
            C-130 assets, the Navy needs to replace their C-130 aircraft
            with C-130J for the Navy and Navy Reserve.
        --Request you fund 2 C-130J Aircraft for Navy Reserve for combat
                support for Navy and Navy Reserve assets in theater
                operations for OCO.
      --Increase funding for Naval Reserve equipment in NGREA
        --Increase Navy Reserve NGREA by $100 million
        --Naval Expeditionary Combat Equipment
      --Ensure proper lead funding for TACAIR Navy Aircraft.
        For the foreseeable future, we must be realistic about what the
    unintended consequences are from a high rate of usage. History shows
    that an Active force and Reserve force are needed for any country to
    adequately meet its defense requirements, and to enable success in
    offensive operations. Our Active Duty Navy and the current operational
    Reserve members are pleased to be making a significant contribution to
    the Nation's defense as operational forces; however, the reality is
    that the added stress on Active Navy and the Reserve could pose long
    term consequences for our country in recruiting, retention, family and
    employer support. In a time of budget cut discussions, this is not the
    time to cut end-strengths on an already stressed force. We have already
    been down this road previously. This issue deserves your attention in
    pay, maintaining end-strengths, proper equipment, Family Support
    Programs, Transition Assistance Programs and for the Employer Support
    for the Guard and Reserve programs.
        Thank you for your ongoing support of the Nation, the Armed
    Services, the United States Navy, the United States Navy Reserve, their
    families, and Navy veterans, and the fine men and women who defend our
    country.

        Chairman Inouye. Thank you very much, Rear Admiral Coane.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I was wondering about our
    other witness at the table here. We're to ask you questions
    now?
        Let me ask you. If the funding is added as you request, is
    this going to be additional funding that we'll have to come up
    with over and above the allocation of the subcommittee, or do
    you recommend any offsets in funding that would have to be
    undertaken?
        Admiral Coane. No, sir. I'm concerned--we have--in this
    year's budget there's one C-40, but in the 2012, 2013, and 2014
    budgets those have been zeroed out. The Navy's program is to
    buy 17 of them. There are still five more they've got to have.
    As I mentioned, the C-20Gs are falling off the table,
    literally.
        So this is additional National Guard and Reserve equipment
    funding that we're suggesting. The unfunded list, as has been
    mentioned before, for the Navy is virtually nonexistent. That's
    not because they don't need things. That's because of DOD
    policy. So we need to look further into supporting these
    aircraft.
        The C-20Gs in Hawaii and the ones here at Andrews have
    flown thousands of hours beyond what Gulfstream ever intended
    those airplanes to fly, because they were built as corporate
    jets. The Navy operates them with cargo doors, but they're used
    up and they're going to just simply go away. We've got to
    replace that asset.
        Senator Shelby. Do we run the risk of having accidents and
    failures if we don't replace those with other assets?
        Admiral Coane. Senator, I'm careful. I had a 34-year career
    in the airline world as well as an aviator, so I'm very careful
    to talk about--are we running the risk? Well, flying aircraft
    is always a risk-reward or risk-benefit business. Any time we
    get airborne, as you know, there's risk involved. Does the risk
    go up on the aircraft? I would say that our military people
    manage the aging of the aircraft. What goes up is the expense
    of operating the aircraft. In the case of broken-wing P-3s,
    they're simply worn out and you can't do anything about it.
        So I wouldn't suggest to you that--I wouldn't ring the
    safety bell and say that our military won't continue to be
    safe, because they're good at that. But the financial
    obligation--when an aircraft turns the maintenance curve, the
    dollars go significantly higher very, very quickly. Our C-9s
    and our C-20s and the C-130Ts are at that point.
        Senator Cochran. Thank you very much for your perspective.
    I think that's very helpful to our subcommittee.
        Admiral Coane. Yes, sir.
        Senator Cochran. Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I'll try to be brief here.
    The Admiral here has gotten my attention on some things, and
    I'm sure the subcommittee.
        The survivability rate--well, the death rate of
    hemorrhage--hemorrhage is a big cause of death, right,
    battlefield, hemorrhaging?
        Admiral Coane. Senator, are you referring to my colleague
    here to my right?
        Senator Shelby. Yes, hemorrhaging; is that right, on the
    battlefield?
        Dr. Jenkins. Yes, sir.
        Senator Shelby. So what they're trying to do, you're trying
    to get into research whether you can deal with wounds to the
    torso, the neck, the blood vessels, all of this, because if you
    can do that you'll save lives, right?
        Dr. Jenkins. Yes, sir, precisely correct.
        Senator Shelby. But a lot of that is--you're using, a lot
    of it's the same treatment we've used for years. We haven't had
    a super-breakthrough there, have we?
        Dr. Jenkins. And that's directly related to the lack of
    research funding and why NTI exists, sir, yes, sir.
        Senator Shelby. Thank you.
        Chairman Inouye. Thank you very much.
        Ms. Goraleski.
    STATEMENT OF KAREN A. GORALESKI, EXECUTIVE DIRECTOR,
                AMERICAN SOCIETY OF TROPICAL MEDICINE AND
                HYGIENE
        Ms. Goraleski. Chairman Inouye, Ranking Member Cochran,
    Senator Shelby, and subcommittee staff: My name is Karen
    Goraleski and I am the Executive Director of the American
    Society of Tropical Medicine and Hygiene. Thank you for the
    privilege of testifying before you today. We are the principal
    professional membership organization of scientists, physicians,
    clinicians, epidemiologists, and program professionals
    dedicated to the prevention and control of tropical diseases.
        We are here today to request that the subcommittee expand
    funding for the DOD's efforts to develop new preventions,
    treatments, vaccines, and diagnostics that will prevent--that
    will protect our service members and other Americans from
    tropical diseases and at the same time will reduce premature
    deaths and disability in the developing world.
        The central public policy priority of the Society is to
    reduce the burden of infectious disease in the developing
    world, areas of the world where many of our military serve.
    Many of our top health concerns align with the superbly
    executed and longstanding DOD research on tropical diseases and
    on what are also called the neglected tropical diseases.
    Mission success and readiness will be hampered without
    sustained efforts to reduce these no longer so-called
    ``exotic'' health threats.
        Infectious disease is the ever-present enemy. The drugs and
    preventive measures used in earlier conflicts in tropical
    regions no longer are as reliable as they once were. Therefore,
    our task list for new and effective tools must not only focus
    on today, but on tomorrow.
        There are three particular DOD facilities working to
    strengthen mission readiness and success: The Army Medical
    Research Institute for Infectious Diseases, the Walter Reed
    Army Institute for Research, and the U.S. Naval Medical
    Research Center.
        First, USAMRID. Its mission is to protect our military from
    biological threats. Through its biosafety levels 3 and 4 labs
    and its world-class highly trained personnel, they are in the
    business of generating countermeasures to biological threats to
    our country. Like each of these facilities, their work delivers
    a return on investment that extends beyond our military to
    citizens.
        Next is WRAIR. A large part of the DOD investment in
    infectious disease research and development is facilitated
    through WRAIR. In addition to DOD funding, WRAIR has advanced
    infectious disease research and provided cost-effective
    solutions, in part by working smart through domestic and
    international public-private partnerships. Their portfolio
    includes work on a malaria vaccine and efforts to control its
    transmission, as well as that of other vector-borne diseases,
    drug developments for leishmaniasis, enteric disease research,
    and HIV/AIDS research.
        Through its collaborative efforts, WRAIR has developed
    several exciting vaccine candidates, including one that
    recently began the ever-large phase 3 trial for a malaria
    vaccine, RTSS. Is this encouraging? Yes. Do we need to find out
    more? Yes.
        Last, NMRC. The premier research facility includes a focus
    on malaria, enteric diseases, causes of traveler's diarrhea,
    dengue fever, now seen in southern Florida, and scrub typhus.
    In addition to its work accomplished in the United States, the
    Navy's three overseas medical research laboratories located in
    Peru, Egypt, and Indonesia offer outstanding scientific
    collaborations and equally productive relationships with their
    governments that in turn help the United States.
        In closing, all three facilities offer state-of-the-art
    technologies to protect our troops and can save millions of
    lives of people around the world. Closer to home, they also
    provide good-paying, quality jobs to American scientists, lab
    personnel, and ancillary businesses. ASTMH is confident that
    increased support for efforts to reduce these global and in
    some instances U.S. health threats is the smart thing to do for
    America and the right thing to do for the world.
        Thank you for this opportunity. The Society stands ready to
    serve as an expert resource to you. We are all in this
    together.
        [The statement follows:]
                    Prepared Statement of Karen A. Goraleski
                               executive summary
        The American Society of Tropical Medicine and Hygiene (ASTMH)--the
    principal professional membership organization representing, educating,
    and supporting scientists, physicians, clinicians, researchers,
    epidemiologists, and other health professionals dedicated to the
    prevention and control of tropical diseases--appreciates the
    opportunity to submit written testimony to Senate Defense
    Appropriations Subcommittee.
        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
    research, prevention, and control of infectious diseases that are
    leading causes of death and disability in the developing world, and
    which pose threats to U.S. citizens. Many of our current priorities
    overlap with the excellent and long-standing tropical medicine and
    neglected disease research work being done within the Department of
    Defense, including malaria and other vector-borne diseases; tropical
    diseases such as dengue fever and leishmaniasis; and enteric diseases.
        Because U.S. servicemen and women are often deployed to tropical
    regions endemic to tropical diseases, reducing the risk that these
    diseases present to servicemen and women is often critical to mission
    success. Our military has long taken a primary role in the development
    of treatments for tropical diseases, such as anti-malarial drugs. As a
    result of this investment and the innovation employed by these military
    scientists, they have developed many of the most effective and widely
    used treatments for these diseases.
        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 service members from malaria and tropical diseases.
    Specifically, ASTMH requests that increased funding be allocated to the
    Army Medical Research Institute for Infectious Diseases (USAMRIID), the
    Walter Reed Army Institute of Research (WRAIR), and the U.S. Naval
    Medical Research Center (UNMC), who work closely together to maximize
    and ensure the most efficient research portfolios.
     united states army medical research institute for infectious diseases
        USAMRIID's mission includes advancing research to develop medical
    solutions--vaccines, drugs, diagnostics, and information--to protect
    our military service members from biological threats. USAMRIID has
    Biosafety Level 3 and Level 4 laboratories and world-class expertise in
    the generation of countermeasures for biological threats playing a
    critical role in the status of our country's preparedness for
    biological terrorism and biological warfare. While their primary
    mission is to protect the service members, like each of the research
    facilities, their important work benefits civilians as well.
                     walter reed army institute of research
        A large part of DOD investments in infectious disease research and
    development are facilitated through WRAIR, which since fiscal year 2007
    has performed more that $250 million in DOD research. Through critical
    public private partnerships with companies such as GSK and Sanofi, as
    well as nonprofits such as the Gates Foundation and Medicines for
    Malaria Venture, WRAIR invests in malaria vaccine and drug development,
    drug development for leishmaniasis, enteric disease research, vector
    control for malaria and other vector-born infections, and HIV/AIDS
    research and treatment. While each of these investments is crucial to
    the protection of U.S. troops abroad, WRAIR is also a partner to the
    global health community in saving the lives of some of the world's
    poorest people suffering from some of the most neglected diseases.
        WRAIR has research laboratories around the globe, including a
    public health reference laboratory in The Republic of Georgia; dengue
    fever clinical trials in the Philippines; malaria clinical studies and
    Global Emerging Infectious Surveillance in Kenya; military entomology
    network field sites in Thailand, the Philippines, Nepal, Cambodia,
    Korea, Kenya, Ethiopia, Egypt, Libya, Ghana, Liberia and Peru; as well
    as several other coordination efforts with national health ministries
    and defense units. This diversity in research capacity puts WRAIR in
    the unique position to be a leader in research and development for
    tropical diseases--research that will aid our military men and women as
    well as people living in these disease-endemic countries.
                  united states naval medical research center
        NMRC is a premier medical and health research organization whose
    focus includes tropical medicine and infectious disease. The Infectious
    Disease Directorate (IDD) of NMRC focuses on malaria, enteric diseases,
    and viral rickettsial diseases. IDD has an annual budget exceeding $10
    million and conducts research on infectious diseases that are
    considered to be a significant threat to our deployed sailors, marines,
    soldiers and airmen. Their current research efforts are focused on
    malaria, bacterial causes of traveler's diarrhea, dengue fever, and
    scrub typhus with particular emphasis on vaccine discovery and testing.
    The research is enhanced by IDD's close working relationship with the
    Navy's three overseas medical research laboratories located in Peru,
    Egypt, and Indonesia. These laboratories also afford diplomatic
    advancement through the close working relationships they have developed
    with governments and citizens of those countries.
                    tropical medicine and tropical diseases
        The term ``tropical medicine'' refers to the wide-ranging clinical,
    research, and educational efforts of physicians, scientists, and public
    health officials with a focus on the diagnosis, mitigation, prevention,
    and treatment of vector borne diseases prevalent in the areas of the
    world with a tropical climate. Most tropical diseases are located in
    either sub-Saharan Africa, parts of Asia (including the Indian
    subcontinent), or Central and South America. Many of the world's
    developing nations are located in these areas; thus tropical medicine
    tends to focus on diseases that impact the world's most impoverished
    individuals.
        U.S. troops are currently deployed or likely to be deployed in many
    of these same tropical areas. U.S. citizens, working, traveling and
    vacationing overseas are similarly impacted by these same tropical
    diseases, many of which have been ignored and neglected for decades.
    Furthermore, some of the agents responsible for these diseases could be
    introduced and become established in the United States (as was the case
    with West Nile virus), or might even be weaponized.
        The United States has a long history of leading the fight against
    tropical diseases which cause human suffering and pose a great
    financial burden that can negatively impact a country's economic and
    political stability. The benefits of U.S. investment in tropical
    diseases extend beyond economics and humanitarianism and into diplomacy
    as well.
             malaria--a formidable foe for u.s. military operations
        Service members deployed by the U.S. military comprise a majority
    of the healthy adults traveling each year to malarial regions on behalf
    of the U.S. Government. Malaria has long been a threat to U.S. military
    deployment success. In fact, more person-days were lost among U.S.
    military personnel due to malaria than to bullets during every military
    campaign fought in malaria-endemic regions during the 20th century. 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.
        In recent years the broader international community has increased
    its efforts to reduce the impact of malaria in the developing world,
    particularly by reducing childhood malaria mortality, and the U.S.
    military plays an important role in this broad partnership. However,
    military malaria researchers at NMRC and WRAIR 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. NMRC and WRAIR are working on the development of a malaria
    vaccine and on malaria diagnostics and other drugs to treat malaria--an
    especially essential investment as current malaria drugs face their
    first signs of drug resistance.
        The malaria parasite demonstrates a notorious and consistent
    ability to quickly develop resistance to new drugs. The latest
    generation of medicines is increasingly facing drug-resistance. Malaria
    parasites in Southeast Asia have already shown resistance to
    mefloquine; resistant strains of the parasite have also been identified
    in West Africa and South America. There are early indications that
    parasite populations in Southeast Asia may already be developing
    limited resistance to artemisinin, currently the most powerful anti-
    malarial available. Further, the most deadly variant of malaria--
    Plasmodium falciparum--is believed by the World Health Organization to
    have become resistant to ``nearly all anti-malarials in current use.''
        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. However, the sheer
    speed with which the parasite is developing resistance to mefloquine
    and artemisinin--drugs developed in the 1970s--bodes of a crisis of
    such significance that military malaria researchers cannot afford to
    rest on their laurels.
        WRAIR, in concert with multiple organizations including the CDC and
    vaccine manufacturers, has developed several exciting vaccine
    candidates, including one that recently began the first ever large-
    scale Phase 3 trial for a malaria vaccine, (RTS,S). In earlier trials,
    the vaccine has been shown to decrease clinical episodes of malaria by
    over 50 percent in children in Africa. Despite these advances, the
    vaccine might be unsuitable for deploying personnel and travelers,
    because of its efficacy level. As a result, there is still a
    significant need for continued funding for ongoing research.
        Developing new antimalarials as quickly as the parasite becomes
    resistant to existing ones is an extraordinary challenge, and one that
    requires significant resources, especially as U.S. military operations
    in malaria-endemic countries increase. Without new anti-malarials to
    replace existing drugs as they become obsolete, military operations
    could be halted in their tracks by malaria. The recent malaria outbreak
    affecting 80 of 220 Marines in Liberia in 2003 serves as an ominous
    reminder of the impact of malaria on military operations. Humanitarian
    missions also place Americans at risk of malaria as evidenced by
    several Americans contracting malaria while supporting Haitian
    earthquake relief efforts.
                 tropical disease impact on military operations
        Few other U.S. Government agencies devote as much time, funding,
    manpower, and direct research to tackling these devastating diseases as
    the DOD. The work ultimately goes beyond protecting soldiers and
    benefits the people living in the countries where these diseases cause
    the most harm. The recent success of the RTS, S malaria vaccine and its
    advancement to Phase 3 trials is just one success story from this
    program. DOD also does great research for other tropical diseases
    including leishmaniasis and dengue fever, two potentially deadly
    diseases of great risk to our troops and even greater risk to the
    citizens of these disease endemic regions.
        Leishmaniasis is a vector borne disease that is caused by the
    parasite leishmania. It is transmitted through the bite of the female
    phlebotomine sandfly. Leishmaniasis comes in several forms, the most
    serious of which is visceral leishmaniasis, which affects internal
    organs and can be deadly if left untreated.
        According to the WHO, over 350 million people are at risk of
    leishmaniasis in 88 countries around the world. It is estimated that 12
    million people are currently infected with leishmaniasis and 2 million
    new infections occur annually. Coinfection of leishmaniasis and HIV is
    becoming increasingly common, and WHO notes that because of a weakened
    immune system leishmaniasis can lead to an accelerated onset of AIDS in
    HIV-positive patients.
        Because of leishmaniasis' prevalence in Iraq, the DOD has spent
    significant time and resources on the development of drugs and new
    tools for the treatment of leishmaniasis. As more troops return from
    Iraq and Afghanistan, it is likely DOD will see an increase in
    leishmaniasis cases in our soldiers. WRAIR discovered and developed
    Sitamaquine, a drug that once completed, will be an oral treatment for
    leishmaniasis. While essential for the safety of our servicemen and
    women abroad, these types of innovations will also be extremely
    beneficial to the at risk populations world wide that are living in
    leishmaniasis endemic countries.
        Dengue fever, according to the WHO is the most common of all
    mosquito-borne viral infections. About 2.5 billion people live in
    places where dengue infection is possible and last year we saw a few
    cases pop up in the United States. There are four different viruses
    that can cause dengue infections. While infection from one of the four
    viruses will leave a person immune to that strain of the virus, it does
    not prevent them from contracting the other three, and subsequent
    infections can often be more serious.
        The DOD has seen about 28 cases of dengue in soldiers per year.
    While none of these cases resulted in the death of a soldier,
    hospitalization time is lengthy. Currently, there are several research
    and development efforts underway within the department of defense both
    for treatments and vaccines for dengue.
             u.s. government action is needed for mission readiness
        The role of infectious disease in the success or failure of
    military operations is often overlooked. Even a cursory review of U.S.
    and world military history, however, underscores that the need to keep
    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 and tropical diseases 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 tools. Additional funds and a greater commitment from the
    Federal Government are necessary to make progress in malaria and
    tropical disease prevention, treatment, and control.
        ASTMH feels strongly 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. We appreciate the opportunity to share
    our views in our testimony, and please be assured that ASTMH stands
    ready to serve as a resource on this and any other tropical disease
    policy matters.
        Thank you for your attention to this matter.

        Chairman Inouye. I thank you very much, Ms. Goraleski.
        Senator Cochran.
        Senator Cochran. Ms. Goraleski, how close do you think we
    are to developing a new vaccine or a more effective vaccine
    against malaria? It seems to be a big threat.
        Ms. Goraleski. We are at a very positive place in terms of
    a malaria vaccine. We're just starting that phase 3 clinical
    trial. We're very hopeful.
        Chairman Inouye. Thank you very much.
        Senator Shelby.
        Senator Shelby. Besides malaria, what are, say, one or two
    of the most challenging tropical diseases? I know there are
    many out there.
        Ms. Goraleski. The parasitic diseases are very, very
    challenging. Sandflies transmit leishmaniasis. We also have
    other parasites that are equally debilitating and often hard to
    diagnose at first and then can last for decades.
        Senator Shelby. Thank you.
        Chairman Inouye. I thank the panel very much.
        Now may I call upon: Major General Gus Hargett, National
    Guard Association of the United States; Mr. Dale Lumme, Navy
    League of the United States; Mr. John R. Davis, Fleet Reserve
    Association; Ms. Susan Leighton, Ovarian Cancer National
    Alliance.
        May I call upon Major General Hargett.
    STATEMENT OF MAJOR GENERAL GUS HARGETT, UNITED STATES
                ARMY (RETIRED), PRESIDENT, NATIONAL GUARD
                ASSOCIATION OF THE UNITED STATES
        General Hargett. Mr. Chairman, thank you for the
    opportunity to testify on behalf of the 470,000 national
    guardsmen across the country, our citizen soldiers and airmen.
        As our Nation struggles with how to get its financial house
    in order, I propose we give a hard look at how we could
    leverage the cost efficiencies inherent in the National Guard
    to reduce defense costs without reducing capabilities. Every
    day soldiers and airmen of the National Guard are serving
    across the Nation and around the world in more places than any
    component of the armed forces, and they do it for a fraction of
    the cost. To best meet its Federal and State missions, the
    National Guard must be resourced adequately and
    proportionately, increasing National Guard personnel end
    strength and ensuring the force has the equipment and resources
    needed to provide more capabilities at a lower cost to the
    taxpayer.
        Our National Guard has been an integral part of the war
    fight. Hundreds of thousands of Army national guardsmen have
    deployed overseas since September the 11th, many serving
    multiple deployments. We have a battle-proven operational force
    and it would be a disservice for our National Guard to revert
    back to pre-9-11 levels of equipment, readiness, and training.
        It has been estimated that the annual requirement for the
    Army Guard to maintain its current operational level is $400
    million. While DOD has asked more and more of our National
    Guard, the funding requests for the Guard have not kept pace.
    Thankfully, Congress has helped bridge the gap. Since 1982
    Congress has provided valuable funding through the National
    Guard and Reserve equipment account, enabling both the Army and
    Air Guard to procure more needed equipment and provide
    essential modernization upgrades. With this funding, the Army
    Guard has been able to significantly close the gap on many of
    its unfunded requirements. It has enabled units across the
    Nation to go from 40 percent of its required dual use equipment
    on hand just a few years ago to nearly 75 percent today. While
    the Army Guard has made significant progress in recent years,
    the need for equipment, additional equipment, remains.
        The Air Guard also continues to use NGREA funding for vital
    modernization efforts and domestic operation requirements.
    Along with NGREA, Congress has been instrumental in other
    modernization efforts for the Air Guard. This subcommittee has
    led the way in funding the active electronic scanned array
    radar, or AESAR, for the Air Guard F-15s. However, even with
    the progress made to date, there remains a shortfall in funding
    of $52.8 million to complete this program.
        Without adequate funding from NGREA and other sources, the
    Air Guard will be unable to modernize fighter and mobility
    legacy platforms. The Air Guard must remain an equal and
    effective partner in all fielding modernization, to include the
    C-130Js, C-27s, F-35s, the KC-45.
        While equipment funding is vital, the true strength of the
    National Guard is its people. An unrivaled blend of civilian
    and military skills ensures that our National Guard members are
    effective when conducting missions abroad and at home. The
    National Guard State Partnership Program, the Agricultural
    Development Teams, and the Southwest Border Missions are
    shining examples of the unique skill set of our National Guard
    men and women. However, the current budget request creates a
    shortfall of $12 million for the State Partnership Program and
    $75 million for the counterdrug program.
        In conclusion, as America's first military organization,
    the National Guard has proven for 375 years that it is right
    for America. Drawing on the experience of the last 10 years of
    the war fight, we are convinced that the National Guard will
    emerge as a more cost effective and more mission-capable force
    into the future.
        Thank you for the opportunity to testify today on behalf of
    our Guard men and women.
        [The statement follows:]
                Prepared Statement of Major General Gus Hargett
        The National Guard Association of the United States is a
    nonpartisan organization representing nearly 45,000 current and former
    Army and Air National Guard officers. Formed in 1878, NGAUS is focused
    on procuring better equipment, standardized training and a more combat-
    ready force by petitioning Congress for resources. Well over a century
    later, NGAUS has the same mission.
        Our goal is to maintain the freedom and security of this Nation by
    guaranteeing a strong national defense through the provision of a
    vital, dynamic National Guard as a part of the Total Force.
                   the national guard--``right for america''
        ``A National Guard in balance is one that adds value to America. It
    is structured and resourced with adaptive and innovative citizen
    Soldiers and Airmen, ready to provide global security and assistance. A
    National Guard in balance works as a critical interagency partner at
    the local, State and Federal levels . . . anytime, anywhere.''------
    General Craig R. McKinley, Chief, National Guard Bureau

        Following the Vietnam war, General Creighton Abrams was determined
    to establish a clear linkage between the employment of the Army and the
    engagement of public support for military operations. General Abrams
    reasoned that by creating a force structure that integrated Reserve and
    Active Components so closely as to make them inextricable would ensure
    Presidents would never again send the Army to war without the Reserves
    and the commitment of the American people.
        Today, with locations in more than 3,300 communities across the
    Nation, the National Guard provides an indispensable link between the
    military and the citizens of our great Nation.
        The key to National Guard efficiency is the predominantly part-time
    (traditional) force that can mobilize quickly for combat operations, or
    respond when needed for disaster response or homeland defense.
        Unless activated for combat service, fully trained traditional
    National Guard members cost approximately 25 percent of their Active
    counterparts. National Guard efficiencies compared to regular military
    components include: fewer ``pay days'' per year, lower medical costs,
    significantly lower training costs beyond initial qualification
    training, virtually no costs for relocating families and household
    goods to new duty assignments every 3 or 4 years, fewer entitlements
    such as basic allowance for housing, lower base support costs in terms
    of services and facilities including commissaries, base housing, base
    exchanges, and child care facilities.
        On average, 17 United States Governors call out their National
    Guard each day to protect life or property, and the Guard responds
    immediately, effectively, appropriately, and in-force.
        The Air National Guard (ANG) has 106,700 personnel and provides 33
    percent of the Total Air Force capabilities for less than 7 percent of
    the Total Force Defense Budget including: 100 percent of the Air
    Force's air defense interceptor force, 33 percent of the general
    purpose fighter force, 45 percent of the tactical airlift and 6 percent
    of the special operations capability, 43 percent of the air refueling
    KC-135 tankers, 28 percent of the rescue and recovery capability, 23
    percent of tactical air support forces, 10 percent of the bomber force
    and 8 percent of the strategic airlift forces. Additionally, Air Guard
    members provide a wide variety of support missions to include:
    security, medical support, civil engineering, air refueling, strike,
    airlift, and Intelligence, Surveillance, and Reconnaissance (ISR).
        The Army National Guard has 358,200 personnel and provides 32
    percent of the Total Army end-strength for only 11 percent of the Total
    Army Defense Budget. By the end of fiscal year 2010, the Army National
    Guard force structure will include 8 Division Headquarters, seven
    Brigade Combat Teams (BCT), and 44 multi-functional Support Brigades.
    Additionally, the Army National Guard will have continued the
    conversion of 21 BCTs, completing transformation of the second set of
    seven BCTs in fiscal year 2010. Since 9/11/2001, more than 340,000 Army
    National Guard men and women have been activated in support of ongoing
    combat operations. On any given day, more than 50,000 Guard soldiers
    are ``on point'' for the Nation.
        As the Department of Defense implements policies to reform the way
    the Pentagon does business by directing the Service chiefs to find more
    than $100 billion in savings over the next 5 years, the National Guard
    is ready and able to play an important role in achieving these
    necessary goals.
        The National Guard provides vast capabilities to our country in its
    dual-use, domestic support missions and overseas defense, missions
    while continuing to maintain cost-effectiveness. Increasing National
    Guard end strength and resourcing and recapitalizing its force will
    offer more capability and value at a lower cost to America.
    Maintaining a Ready, Relevant, and Accessible National Guard
        For the National Guard to best meet it's Federal and State missions
    it must be resourced adequately and proportionately. Since fiscal year
    1982 Congress has funded the National Guard and Reserve Equipment
    Account (NGREA) enabling both the Army and Air National Guard to
    procure much needed equipment and provide essential modernization
    upgrades. Since its start in fiscal year 1982, the Army National Guard
    has received more $9.29 billion and the Air National Guard has received
    $6 billion in NGREA funding.
        Since fiscal year 2006 Congress has provided the ARNG with 50
    percent of its total NGREA funding. With this funding, the ARNG has
    been able to significantly close the gap on many of its emerging
    requirements and new equipment program procurements. This has enabled
    our units across the country to go from 40 percent of required
    equipment on-hand a few years ago, to nearly 75 percent today. This
    dramatic turnaround is the direct result of congressional support and
    action.
        For example, using NGREA funds, the ARNG has been able to purchase
    an additional 1,500 Family of Medium Tactical Vehicles (FMTVs), with
    plans to purchase another 1,100. The ARNG has been able to invest
    millions in critical updates to systems such as Tactical Operation
    Combat System (TOCS), Standard Integration Command Post System (SICPS),
    and War fighter Information Network-Tactical (WIN-T).
        While the ARNG has made significant progress, the need for
    additional equipment funding remains. The National Guard and Reserve
    Equipment Report for Fiscal Year 2012 (Fiscal Year 2012 NGRER),
    completed in accordance with Section 10541, Title 10, United States
    Code, identifies several challenges for the ARNG. The fiscal year 2012
    NGRER identifies a $40 billion total shortfall for the ARNG (Page 1-4).
    Additionally, the ARNG estimates it needs ``$3.5 to $4.5 billion in
    annual programmed funding (versus a $2.3 billion per year average in
    the current Future Years Defense Program) to continue to modernize and
    maintain current EOH levels and interoperability'' (Fiscal Year 2012
    NGRER, Page 2-9).
        The Fiscal Year 2012 NGRER also identifies the following challenges
    regarding equipment:
      --Achieving full component-level transparency for equipment
            procurement and distribution;
      --Equipping ARNG units for pre-mobilization training and deployment;
            and
      --Equipping ARNG units for their homeland missions (pages 1-8, 1-9).
        NGAUS has worked with Congress over the years to increase the
    transparency of equipment procurement and better equip the force for
    training requirements and homeland missions.
        The ARNG helicopter fleet remains an area of concern. The Army
    National Guard Black Hawk fleet will soon grow to 849 helicopters. Five
    hundred of these are older UH-60A models, with an average age exceeding
    25 years. Many UH-60As are in need of immediate replacement/conversion.
    The ``A'' model is more expensive to operate, cannot operate at higher
    altitudes, and has a 1,000 lbs lower payload capability than the newer
    ``L'' and ``M'' models.
        The ARNG currently has a documented requirement for 210 UH-72A
    Lakota helicopters to support domestic missions in ``permissive''
    environments. With over 150 aircraft now delivered to the Army on-cost
    and within schedule, the UH-72A has proven to be a robust and efficient
    multirole platform. Leveraging the success of this program for
    additional missions could lead to even greater efficiencies in meeting
    operational needs.
        The Army National Guard Chinook helicopter fleet total requirement
    is 161 aircraft. Currently, the shortage is 17 aircraft, and all
    aircraft in this fleet are CH-47D models except 3 new CH-47Fs that were
    delivered in May. The average age of the CH-47D aircraft are 25 years,
    with many that are older. The need for replacement is immediate because
    the helicopters are not only being utilized at home to support many
    missions, but also in deployments abroad especially in Afghanistan.
    This is compounded with the CH-47D's deterioration from age, recent
    operational tempo, and losses in theater. The new CH-47F provides
    better survivability, upgraded avionics (CAAS cockpit), a new airframe,
    and improved operational capability. The new features save lives and
    allow missions to be completed that wouldn't have been attempted with
    the CH-47D models.
        Finally, modernizing the ARNG Tactical Wheeled Vehicle fleet is an
    issue. While the ARNG has reached 100 percent of the requirement for
    High-Mobility Multipurpose Wheeled Vehicles (HMMWV), 72 percent of the
    fleet has already reached its Economic Useful Life of 20 years and over
    60 percent of the ARNG's HMMWV inventory are legacy vehicles, and are
    between 20 to 25 years old. Additionally, the ARNG remains short of its
    requirement for Family of Medium Tactical Vehicles.
        The ANG continues to use NGREA funding for vital modernization
    efforts and specialized domestic operations requirements. They have
    procured essential equipment such as satellite communications kits for
    our Tactical Air Control Party (TACP), medical equipment for
    pararescue, body armor for security forces, helmet mounted cuing
    systems for fighter aircraft, defensive systems for mobility aircraft,
    firefighting vehicles, and more. With the need to fully fund ongoing
    operations and continued pressure on defense budgets, obtaining
    adequate funding for procuring equipment and modernization efforts will
    continue to be a challenge. Without adequate funding from NGREA or
    other sources, the ANG will be unable to modernize legacy platforms and
    equipment and will no longer remain an equal and effective partner in
    the Total Force.
        In the last year the National Guard Bureau has implemented process
    changes in order to better obligate these funds and field the procured
    equipment and upgrades to our Soldiers and Airmen at a more rapid rate.
        Along with NGREA, Congress has been instrumental in other
    modernization efforts for the Air National Guard. It was Congress that
    funded the LITENING Targeting pods for the Air National Guard F-16
    which killed the insurgent leader Abu Musab al-Zarqawi in Iraq. And it
    is Congress that has continued to fund the Active Electronic Scanned
    Array (AESA) radar for Air National Guard F-15Cs. Since fiscal year
    2006, Congress has provided $313 million for the AESA radar program for
    ANG F-15s. The AESA radar is being fielded to our fighter wings which
    currently perform the air sovereignty alert mission in the skies over
    our Nation. This new radar provides our pilots with the combat
    capability necessary to perform the homeland defense mission by
    providing the ability to detect asymmetric threats like cruise missiles
    or low observable aircraft threatening our Nation's security. However,
    there remains a shortfall in funding to complete this program. The
    fiscal year 2012 President's budget request again did not provide the
    necessary funding to continue this essential program. For fiscal year
    2012, the ANG has recognized an unfunded requirement of $52.8 million
    for F-15C AESA radars in its Weapons System Modernization Book.
        The Fiscal Year 2012 NGRER identifies a $7 billion shortfall for
    modernization programs and shortfalls (page 5-11) in the ANG documented
    in the Weapons System Modernization Book. NGAUS has identified unfunded
    modernization priorities to include (in addition to the already
    identified AESA radar):
      --$13.85 million for the Helmet Mounted Integrated Targeting (HMIT)
            for A-10's (Aircraft Procurement);
      --$8.3 million for the HMIT for F-16's (Aircraft Procurement);
      --$12.12 million for the Center Display Unit for F-16's (Aircraft
            Procurement);
      --$32.8 million for the Center Display Unit for F-16's (RDTE);
      --$9 million for the Center Display Unit for F-15's (RDTE);
      --$20.5 million for LC-130 Eight Bladed Propeller Upgrade (Aircraft
            Procurement);
      --$10.74 million for Advanced Infrared Countermeasures (IRCM) Self
            Protection Suite for C-130's (Aircraft Procurement);
      --$70.3 million for Infrared Counter Measures (IRCM) Defensive
            Systems for KC-135's (Aircraft Procurement);
      --$6 million for Infrared Counter Measures (IRCM) Defensive Systems
            for KC-135's (RDTE);
      --$2.4 million for Improved Watercraft and Ground Recovery Vehicles
            (Other Than Aircraft Procurement); and
      --$46 million for two D-RAPCON Systems (Other than Aircraft
            Procurement).
        In the near future the ANG will be fully submerged into the
    recapitalization crisis that the entire Air Force has become victim
    too. When the F-22 buy was cut off at 187 aircraft (from the 750
    originally planned to be purchased) the ANG lost most hope of being
    assigned those aircraft, with the exception of the classic associate
    relationship at Langley (Richmond, Virginia ANG) and Hawaii.
        Although the USAF is planning to acquire 1763 F-35's, the only ANG
    facility identified to receive the F-35 to date has been Burlington,
    Vermont. Beyond that, the USAF has been very slow to make any other
    final decisions as to which, if any other, ANG locations will receive
    these aircraft beyond the first six Active units, leaving ANG leaders
    wondering if the Guard will make the cut if the F-35 buy is cut short.
        The USAF has announced that it will perform a Service Life
    Extension Program (SLEP) to approximately 300 F-16s, most of which will
    be Active Component (AC) Block 50 and 40's. The question remains, how
    will the USAF ensure the longevity of older ANG F-16s, or will they
    eventually ``cascade'' the modernized Block 40/50's F-16's to the ANG
    as the AC receives new F-35's? And, what happens if the AC does not
    receive F-35's as anticipated? The Air Force has lacked transparency
    with the Air National Guard leadership. We believe it is time to end
    this and use the ANG as a model of how to field and execute the fighter
    mission in the future.
        When discussing the crisis as related to the airlift and transport
    fleet one should remember how the ANG received the aircraft they now
    have. During the 1980's and early 1990's, the Air National Guard
    acquired a significant number of C-130 Hercules via congressional ad's,
    even though the effort was opposed by the Pentagon. Today, however, the
    Pentagon is either looking to transfer some of the newer models to AC
    locations, or claiming there is an excess of up to 40 of these
    aircraft, which, they indicate are offsetting an equal amount of C-
    27Js.
        The USAF is modernizing its C-5B/C fleet with both the Avionics
    Modernization Program (AMP) and Reliability Enhancement and Re-engining
    Program (RERP), to the C-5M configuration. However, even though the Air
    Force has programmed the C-5A's (only operated in the Reserve
    Component) for AMP, these aircraft are not programmed to receive the
    RERP upgrade. Today, the USAF has begun to retire some of these
    aircraft. Despite not having the same upgraded range and fuel
    efficiency, unmodified C-5A's would not be inter-flyable by Active/
    Reserve Component crews. This lack of commitment to the ANG C-5 fleet
    has left units that operate these aircraft wondering what lies ahead in
    their future, thereby negatively impacting their ability to recruit the
    future generation of militia airmen.
        After several years of the Army and Air Force coordinating to
    determine how many C-27J's would be required to provide direct ``last
    tactical mile'' airlift support for the Army, and homeland response
    capabilities for the ANG, the Joint Requirements Oversight Council
    (JROC) validated that 78 aircraft were necessary to fill this
    requirement. However, subsequently, the Secretary of Defense (SECDEF)
    seemed to ``arbitrarily'' change that number to 38, assigned the
    mission to the ANG, and justified the cut in C-27's to the Mobility
    Capabilities Requirements Study 16 (MCRS) that had identified an excess
    of 40 older C-130's. Unfortunately, the MCRS had not included the C-27
    direct support mission in this study. When the total number of C-27's
    were reduced from 78 to 38, this caused the Air Force to also reduce
    the number of aircraft based in any one location from the standard 8
    Primary Assigned Aircraft (PAA) per unit to 4, which hampers effective
    training and operations. Additionally, since the Army has declared that
    ``fixed wing aviation is not a core competency,'' the Pentagon is also
    divesting the ARNG of its aging C-23 fleet before the ANG will be in a
    position to provide comparable airlift support stateside, since it will
    be focused on fulfilling its combat mission in the Middle East.
        Although the USAF has finally selected a new tanker aircraft, to
    date, it is unclear where these aircraft will be stationed.
        Finally, even though the Army does not consider fixed-wing aviation
    to be a core competency, logic tells us that some level of fixed-wing
    capability makes economic and functional sense as a niche mission,
    which has always been acknowledged and authorized under Joint Doctrine.
    And, even though the ANG may fully commit to providing direct support
    (primarily during combat operations), there will always be ``pop up''
    missions, both stateside and deployed, that would justify a small fleet
    of fixed-wing support aircraft for the ARNG. Thus, a program to replace
    the aging C-12 and C-26 aircraft with a fleet of new light aircraft to
    take on this requirement should be pursued.
    The Added Value of Citizen Soldiers and Airmen
        The true strength of the National Guard is in its people. It's our
    citizen soldiers and airmen who juggle two jobs and a family life are
    invaluable to our Nation's defense. An unrivaled blend of civilian and
    military skills ensures that our members are effective when conducting
    missions abroad and at home.
        The National Guard supports programs unmatched to other Active and
    Reserve Components. Members of the National Guard actively work on
    global engagement programs, domestic support programs and youth
    programs to improve our communities.
        The State Partnership Program (SPP) was created in 1993 with only a
    handful of partner nations. Today, these mutually beneficial
    relationships are established with more than 60 foreign nations. They
    work together to improve regional security, stability and prosperity.
    The fiscal year 2012 President's budget request creates a shortfall of
    $12 million for the SPP.
        The Agribusiness Development Teams (ADT) is another great example
    of the National Guard's fusion of military capability and civilian
    skills. The ADTs are working with the Afghan Ministry of Agriculture,
    Irrigation and Livestock to educate and train Afghan farmers in modern
    agriculture methods and techniques. These efforts will undoubtedly
    increase the quality of life and economic stability for the region
    while leading to improved opportunities for the Afghanistan agriculture
    community.
        The domestic support realm ranges depending on the immediate needs
    of the regions and the longer term outcomes that they will produce. The
    National Guard has successfully supported the Southwest border security
    mission during Operation Jump Start from 2006-2008 and has continued to
    assist the U.S. Customs and Border Protection, Department of Homeland
    Security and the Immigrations and Customs Enforcement. Along with
    border security, National Guard members are assisting these entities by
    engaging in counter-narcotic missions on the Southwest border.
        The National Guard's Counter Drug Programs help local law
    enforcement agencies with analysis and ground support resulting in tens
    of billions of dollars worth of drugs, property, weapons and cash each
    year. The National Guard's Training Centers in Mississippi, Florida,
    Iowa, Pennsylvania, and Washington train over 100,000 military
    personnel, law enforcement officers, and interagency members each year.
    The fiscal year 2012 funding shortfall for the Counterdrug Program is
    $75 million.
        When a crisis occurs, whether man-made or natural, the National
    Guard is ready to respond. National Guard members have responded to an
    unprecedented number of devastating tornadoes across the Nation in from
    Alabama to Massachusetts, including the town of Joplin, Missouri; they
    are currently performing flood relief missions in Arkansas, Louisiana,
    Mississippi, Montana, North and South Dakota, Nebraska, Vermont and
    Wyoming; and just a few months ago they were fighting wildfires over
    West Texas with their C-130Js from the California ANG.
        The National Guard has designed structured response packages which
    are scalable to provide tiered response to local, State, regional or
    national level chemical, biological, radiological, nuclear, or
    explosives (CBRNE) incidents. In addition, the National Guard is
    working with the Department of Defense to stand up 10 Homeland Response
    Forces (HRFs). These HRFs will consist of 566 personnel and provide
    life saving capabilities during emergencies, bridging the gap between
    the initial National Guard response and Title 10 capabilities.
        Our citizen soldiers and airmen are dedicated to improving their
    communities and our Nation's future. This is why the National Guard
    Youth ChalleNGe Program exists. The NGYCP is an award winning,
    community based program which mentors high school dropouts and leads
    them to become successful and productive citizens and lead successful
    and fulfilling lives. Since 1993, the NGYCP has graduated over 95,500
    students and saved over $175 million annually in juvenile correction
    costs.
    Conclusion
        In today's fiscally challenged environment, it is imperative that
    our Nation looks to our cost effective and mission proven National
    Guard as a solution to maintain our high level of national security at
    an affordable cost. As America's first military organization, the
    National Guard has proven for 375 years that it is ``Right for
    America.'' With the continued support of Congress, the National Guard
    will emerge as an even more cost-effective and mission capable force in
    the future.

        Chairman Inouye. Thank you very much, General Hargett.
        Senator Cochran.
        Senator Cochran. You may have mentioned this in your
    statement and I didn't notice the specifics, but is the
    National Guard being called on for deployments at this time in
    any conflict going on anywhere outside the United States?
        General Hargett. Yes, sir. There are still guardsmen in
    Iraq, Afghanistan, and Kuwait, and probably Kosovo and other
    places around the world.
        Senator Cochran. Do you have any estimation or any
    indication--you can't predict when the war's going to be over
    and we can come home and declare victory, but what do you hear
    from people you trust about the future for the Guard's
    deployment? At some point you're going to have to say, hey,
    wait a minute, we don't have anybody to send.
        General Hargett. I predict that we will be deploying
    guardsmen long into the future. I think we're an integral part
    of the force and I think to continue to even do the
    peacekeeping operations we will continue to deploy some
    guardsmen.
        Senator Cochran. It seems to me that, with the continued
    pressures and strains on family relationships and
    unpredictability of deployment schedules, how you can maintain
    a job at home, in the traditional sense of the Guard and
    Reserve being mobilized for emergencies only, things that
    aren't anticipated or couldn't be handled by regular forces--do
    you see any breakdown in the system?
        General Hargett. You know, as the former Adjutant General
    of the Tennessee Guard, I can speak for Tennessee. But I will
    tell you that the one thing that's unrecognized in what we have
    done for the last 10 years are the families and employers who
    have--I will tell you that I think the guardsmen are willing to
    do this forever. I think the strain will be families and
    employers as we go forward, and I think we've got to have
    programs that take care of families, programs that take care of
    employers, and look toward the future.
        But I think continued use of the Guard and Reserve can
    easily be accomplished with the proper programs with employers
    and families involved in those programs.
        Senator Cochran. Well, I know just from my personal
    experience, my son was a National Guard officer in the
    Mississippi Army National Guard and he loved it and was ready
    to go any minute, anywhere. I think that's an indication of the
    way most people felt in our State. I just wonder how long they
    can sustain that, though, and manage family, homes, careers,
    which is what they do.
        But thank you very much. It's a real compliment, I think,
    to those who are involved in the Guard and continue to make it
    an important force for our national security.
        General Hargett. Thank you.
        Senator Cochran. Thank you for your service.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. I just appreciate his appearance here and
    his testimony. All of you, I think this has been a good
    hearing. I know you've had limited time, but we're going to
    absorb a lot of this.
        Thank you, Mr. Chairman.
        Chairman Inouye. Thank you.
        Mr. Lumme.
    STATEMENT OF DALE LUMME, NATIONAL EXECUTIVE DIRECTOR,
                NAVY LEAGUE OF THE UNITED STATES
        Mr. Lumme. Chairman Inouye, Ranking Member Cochran,
    distinguished members of the subcommittee: Thank you for the
    opportunity to appear before you today to discuss the most
    urgent needs of our sea services and maritime industry. As a
    retired Navy captain and naval aviator, and on behalf of the
    thousands of worldwide members of the Navy League, I would like
    to thank this subcommittee for its diligent stewardship and
    oversight of the sea services. I think, as witnessed by
    Chairman Inouye receiving the highest Navy League award 3 years
    ago for his maritime stewardship and then the reigning Navy
    League Award winner Senator Cochran, thank you for your service
    to the Navy, Marine, Coast Guard, and flag merchant marine.
        The Navy League is a nonprofit civilian organization whose
    mission it is to educate the American people about the enduring
    importance of sea power to a maritime Nation and to support the
    men and women of the United States sea services. Since the Navy
    League's founding in 1902 with the support of President Teddy
    Roosevelt, the organization has vigorously promoted America's
    maritime interests through our strong advocacy of our sea
    services, the U.S. flag merchant marine, Coast Guard, Marine
    Corps, and Navy.
        President Roosevelt asserted that a Navy could justify its
    existence only by the protection of maritime shipping. He
    stated that ``True national greatness has in all ages and in
    all countries throughout the world been based upon waterborne
    commerce.''
        Just this past weekend, in response to the President's
    weekend address, North Dakota Senator John Hoeven stated:
    ``Over 100 years ago, President Roosevelt launched a Navy
    mission known as the Great White Fleet on a voyage around the
    world. President Roosevelt's leadership put the world on notice
    that the United States was a global maritime Nation open for
    business.''
        The Navy League strongly believes that a vibrant U.S.
    maritime industry is a critical part of our national security
    and now a vital part of our economic recovery. Navy veteran
    President John F. Kennedy in June 1963 aboard the USS Kitty
    Hawk stated: ``Recent events have indicated that control of the
    sea means security, control of the seas can mean peace, and the
    United States must control the seas to protect its own national
    security.''
        Over the last 20 years, a disturbing trend has emerged. We
    continue to ask our sea services to do more and more for our
    country, yet the size of our naval fleet continues to shrink.
    The Congress has heard recent testimony that our Navy is at its
    lowest level since 1916.
        It is not the job of the Navy League to advise the U.S.
    Congress how to tackle our national debt crisis, but it is the
    job to pass appropriations bills and not continuing
    resolutions. The Navy and Marine Corps and Coast Guard is still
    recovering from the continuing resolution from fiscal year 2011
    and we implore upon you for fiscal year 2012 not to pass
    another continuing resolution to harm our combat readiness.
        It may appear an easy way to cut spending is to cut defense
    and big procurement items like ships and aircraft, and that may
    be considered some of the easiest targets. The national
    security of the United States depends on a Navy with sufficient
    number of ships to maintain a forward global presence critical
    to the U.S. economy and the protection of our democratic
    freedoms that we take for granted.
        The number one problem facing the United States Navy today
    is the lack of a fully funded, achievable shipbuilding program
    that produces the right ships with the right capabilities for
    the right cost, in the most cost-efficient, economic
    quantities. The Navy League of the United States fully supports
    rebuilding the fleet to a goal, as recently stated by the
    Secretary of the Navy, of 325 ships to properly execute the
    maritime strategy.
        The Navy League also supports pursuit of multi-year
    procurement strategies for the MH-60 helicopter, continued
    acquisition of the F-35 to replace the AV-8, the acquisition of
    an affordable combat vehicle to replace the aging and costly
    amphibious assault vehicle, and, importantly, supports the
    sustainment of a significant deterrent capability of our
    ballistic missile submarine forces, including the replacement
    of the Ohio class submarines, and strongly believes this should
    be funded on a national imperative outside of the Navy's FCN.
    The Navy is buying what they can afford, not what our Nation's
    security needs.
        The CNO recently commented at a current strategy forum:
    ``It is our persistent forward presence that allows for speed
    and flexibility of response for our Nation that has been called
    upon repeatedly over the last 2 decades, and most recently in
    ongoing ops in Libya and Japan.''
        The Secretary of the Navy recently commented that:
    ``Sometimes the U.S. Navy-Marine Corps team follows the storm
    to the shore and sometimes it must bring the storm.'' The
    United States is a maritime Nation with global
    responsibilities. With a forward-engaged naval tradition as a
    foundation of our existence, the Navy-Marine Corps team is
    inseparable.
        The future success of shipbuilding and many of our Navy
    programs is contingent upon our Nation's support of science,
    technology, engineering, and math education programs. The Navy
    League strongly supports additional funding levels for STEM and
    is working to support efforts to expand this program through
    our Navy Sea Cadets and Worldwide Councils.
        In conclusion, America is a maritime Nation and must
    maintain its status of maritime superiority if there is to be
    peace and prosperity and economic prosperity throughout the
    world.
        Thank you for your continued support of America's sea
    services.
        [The statement follows:]
                        Prepared Statement of Dale Lumme
        Chairman Inouye, Ranking Member Cochran, distinguished members of
    the Subcommittee, thank you for the opportunity to appear before you
    today to discuss the most urgent needs of our sea services and maritime
    industry.
        On behalf of the 50,000 members of the Navy League worldwide, I
    would like to thank this committee for its diligent work to ensure our
    sea services are provided with the very best our country can give them.
        The Navy League is a nonprofit civilian organization whose mission
    is to educate the American people and their leaders about the enduring
    importance of sea power to a maritime nation, and to support the men
    and women of the U.S. sea services.
        Since the Navy League's founding, in 1902, with the support of
    President Theodore Roosevelt, the organization has vigorously promoted
    America's maritime interests through our strong advocacy of all the sea
    services--to include the U.S.-Flag Merchant Marine, the U.S. Coast
    Guard, the U.S. Marine Corps and the U.S. Navy--and the industries that
    support them.
        The founding direction of the Navy League--adopted 109 years ago--
    is still appropriate today. The Navy League mission strongly supports
    the long-standing U.S. policy that a viable U.S. maritime industry is a
    critical part of our national security and now a vital part of our
    economic recovery.
        President Roosevelt asserted that a navy could justify its
    existence only by the protection of maritime shipping. He described the
    sea as a network of trade routes, and stated that true national
    greatness has, in all ages and in all countries throughout the world,
    been based upon waterborne commerce.
        It is the Navy League's firm belief that providing for maritime
    security is--and must always be--the first and most important
    cornerstone of national security.
        However, over the last 20 years, a disturbing trend has emerged. We
    continue to ask our sea services to do more and more for our country,
    yet the size of our naval fleet continues to shrink and plans to fund
    and rebuild naval platforms continue to be plagued by unchecked cost
    growth and significant construction delays. The security and prosperity
    of our Nation lies in our ability to protect and defend our people, our
    shores and our economic interests at home and abroad. Until we change
    the tone of the conversation on the industrial base and future
    readiness from ``like to have'' to ``urgent priority,'' we may be
    putting the security and prosperity of the American people in jeopardy.
    With respect to the Navy League's support of the United States Navy
        The number one problem facing the Navy today is the lack of a fully
    funded, achievable shipbuilding program that produces the right ships,
    with the right capabilities, for the right costs, in the most cost
    effective economic quantities.
        The goal of a 325-ship Navy is a long way from reality, but as we
    have seen in recent operations this Nation's fleet is in high demand on
    a daily basis.
        Our fleet already is stretched to the breaking point and it will
    become more difficult to react rapidly to humanitarian and disaster
    situations and stand ready to defeat aggression. The United States will
    not be able to meet all of our global commitments as the number of
    ships continues to decline.
        In order to provide our Nation with the maritime security
    capability needed to meet our global commitments, our Shipbuilding and
    Conversion, Navy (SCN) account should be funded at $25 billion per year
    (or more) to achieve a force level of 325 ships.
        A 325-ship Navy is not just a number. It means hulls with the
    capability to maintain presence, project power and influence events.
    They must be capable of prevailing in conflict, whether alone or as
    part of a task force.
        The fleet must have sufficient aircraft of the right mix, and key
    to that requirement is getting the next-generation fighter/attack
    aircraft--the carrier variant and the short take-off and vertical-
    landing (STOVL) variant of the F-35 Lightning II, also known as the
    Joint Strike Fighter (JSF)--operational in numbers. The timely delivery
    of the JSF, along with the recently extended multiyear buy of F/A-18E/F
    Super Hornet multirole fighters and EA-18G Growler airborne electronic
    attack aircraft, will help close the projected strike fighter gap in
    the latter part of this decade.
        Finally, it is vitally important that the Navy maintain a credible
    cyber force and develop leap-ahead, interoperable and resilient
    capabilities in cyberspace to successfully counter and defeat a
    determined, asymmetric threat.
        Chief of Naval Operations Admiral Gary Roughead recently commented
    at the Current Strategy Forum in June 2011 that:
        The Navy's forward presence and flexible range of capabilities
    gives our Nation options to remain globally engaged with partners, and
    ensure our access wherever our Nation's interests might dwell.
        While our ships are able to surge on short notice, it is our
    persistent forward presence that allows for the speed and flexibility
    of response the Nation has called upon repeatedly over the last two
    decades, and most recently in ongoing operations in Libya and Japan.
        Specifically, the CNO stated:

        ``Off Libya, deployed ships and submarines broke off their patrol
    and maritime ballistic missile defense missions to deliver tomahawk
    missiles against radar and command and control sites, creating in short
    order the conditions under which a no-fly zone could be imposed.
        ``Off Japan, the deployed Ronald Reagan Strike Group responded
    immediately to the natural disaster there, with helicopter flights to
    deliver humanitarian aid and medical capabilities, with nuclear
    expertise and heavy lift to participate in the relief effort.''

        The Navy League of the United States:
      --Fully supports rebuilding the fleet to a level of 325 ships to
            properly execute the Maritime Strategy and, inclusive in this
            ship count, should be not less than: 11 aircraft carriers; 38
            amphibious ships, four more if the Global Fleet Station concept
            is adopted; 48 attack submarines; and 55 Littoral Combat Ships
            (LCSs).
      --Supports the sustainment of a minimum of 10 carrier air wings,
            including the continued multi-year procurement of the F/A-18E/F
            Super Hornet, the pursuit of multi-year procurement strategies
            for the MH-60 helicopter and the E-2C/D Hawkeye airborne early
            warning (AEW) aircraft, and full development and follow-on
            procurement of the F-35 Lightning II.
      --Supports the continuing development, procurement and deployment of
            the Navy portion of the Ballistic Missile Defense System,
            including long-range surveillance and tracking capability to
            queue ground-based intercept systems and, ultimately, the
            ability to detect, track and engage medium and long-range
            ballistic missiles well distant from the United States.
      --Supports the sustainment of the significant deterrent capability
            that our ballistic-missile submarine, or SSBN, force offers,
            including the replacement of the Ohio-class SSBNs at the rate
            of one per year, which should be funded as a national
            imperative outside of the Navy's SCN plan.
      --Strongly supports the acquisition of two new Virginia-class
            submarines per year.
      --Supports maintaining two U.S.-owned sources for building Navy
            submarines, and maintaining a teaming agreement for
            constructing Virginia-class submarines wherein one shipyard
            serves as the prime contractor and the other serves as its
            major subcontractor.
      --Supports the Navy's LCS acquisition strategy to select 10 units of
            each hull form, based on sea trials and operating experience of
            the initial hulls, to attain the unique attributes of each for
            the LCS class.
      --Supports the P-8A Multi-mission Maritime Aircraft and Broad Area
            Maritime Surveillance System, which will contribute
            surveillance data to Maritime Operations Centers and Regional
            Operations Centers. These centers will fuse information for
            dissemination to Navy, Coast Guard and Joint Force Maritime
            Component Commanders and our allies for military and
            counterdrug operations.
      --Supports the continuing integration of unmanned aircraft systems
            (UASs) into the fleet, including the expansion of the
            deployment of the MQ-8B Fire Scout vertical takeoff unmanned
            aerial vehicle, and deploying an unmanned aircraft squadron on
            an aircraft carrier at the earliest opportunity.
      --Believes that increased emphasis and funding is required to allow
            Navy and Coast Guard operations in the polar regions to protect
            our access to natural resources as well as preclude these
            regions from becoming sanctuaries for potential adversaries.
            Communications, logistics, ship and aircraft modifications are
            essential for such operations.
      --Supports continued funding for Combat Logistics Force assets,
            including oiler/ammunition carriers and dry cargo/ammunition
            carriers; large, medium-speed roll-on/roll-off ships; and new
            classes of special mission vessels, all of which will be
            employed in the Maritime Preposition Force (Future) squadrons.
      --Urges that naval C\4\ISR systems have increased levels of
            information flow, resource assignments and adaptability, and
            that procurement processes be modified to ensure the rapid
            insertion of new technology.
      --Supports Navy emphasis on cyber warfare to ensure the viability of
            our C\2\ systems even in the face of increased cyber attacks.
      --Supports rapid passage of the United Nations Convention on the Law
            of the Sea, or Law of the Sea Treaty, which seeks to establish
            a comprehensive set of rules governing the oceans.
    With respect to the Navy League's support of the United States Marine
            Corps
        The United States is a maritime nation with global
    responsibilities. With a forward engaged naval tradition as the
    foundation of our existence, the Navy-Marine Corps Team is inseparable.
    The forward presence allows for the Navy-Marine Corps Team to build
    relationships around the globe. But, we must remember, countries, like
    mothers-in-law, are happy to see you come, but you are just as happy to
    see you go.
        The Navy-Marine Corps Team's persistent forward presence and
    multimission capability present an unparalleled ability to rapidly
    project U.S. power across the global commons--land, sea, air, space and
    cyber.
        Amphibious forces with robust and organic logistical sustainment
    bring significant advantages, including the ability to overcome the
    tyranny of distance and to project power where there is no basing or
    infrastructure--a strong deterrent capability for our Nation. To
    Marines, ``expeditionary'' is a state of mind that drives the way they
    organize, train, develop and procure equipment.
        By definition, the role of the Navy-Marine Corps Team as America's
    crisis response force necessitates a high state of unit readiness and
    an ability to sustain ourselves logistically.
        The Corps must regain its expertise in amphibious operations and
    maintain that capability in force structure. The service also must be
    provided the resources to reset the force; restore or acquire anew the
    equipment capabilities consumed in the ongoing wars; and field the F-
    35B STOVL variant, develop a new, affordable Amphibious Combat Vehicle
    and field sufficient amphibious lift, starting with an additional LPD
    17.
        The new Marine Armor System, the up-armored High Mobility
    Multipurpose Wheeled Vehicle (or Humvee), the Marine Personnel Carrier
    and the Joint Light Tactical Vehicle will be instrumental in achieving
    these goals. To enhance the forcible-entry ability, the Corps must
    develop the expeditionary fighting vehicle replacement vehicle, the
    Amphibious Combat Vehicle.
        Significant support is needed for weapon improvements for the
    MAGTF, particularly in the 155 mm Howitzer, the High Mobility Artillery
    Rocket System (HIMARS) and Naval Surface Fire Support.
        Within Marine Aviation, the F-35B STOVL variant of the Lightning
    II, the MV-22 Osprey tiltrotor, the CH-53K heavy-lift helicopter, the
    UH-1 and AH-1 helicopters will provide the MAGTF commander with
    unsurpassed warfighting capability.
        The combatant commanders (COCOMs) multiple missions require more
    than the planned number of amphibious ships to meet their demand for
    forward presence and crisis response. At a minimum, 38 amphibious ships
    are needed to provide an adequate number of Expeditionary Strike Groups
    (ESGs) and Marine Expeditionary Units, deploy naval forces in single
    ships as Global Fleet Stations and provide adequate time for training
    and maintenance.
        The COCOMs know that in a natural disaster or humanitarian crisis,
    a large-deck amphibious ship is the most utilitarian platform in the
    naval fleet. The Amphibious Force brings helicopter lift, mobile
    communications, medical and engineering, all the capabilities most
    needed in a humanitarian assistance or disaster relief scenario.
        The Nation requires a fleet of amphibious ships to support the
    forcible entry amphibious force of two brigades. In light of fiscal
    constraints, the Department of the Navy stated that it will sustain a
    minimum of 33 amphibious ships in the assault echelon. Amphibious
    capability demands sea basing and the Maritime Prepositioning Force.
    Protecting U.S. interests around the globe and forcible entry are
    directly tied to these amphibious capabilities.
        The Navy League of the United States supports:
      --The full funding of costs associated with resetting the force to
            meet current and future requirements.
      --The acquisition of an affordable amphibious combat vehicle to
            ensure we have the ability to maneuver against adversaries that
            are becoming increasingly capable, and to replace the aging and
            costly Amphibious Assault Vehicle force.
      --The continued acquisition of the F-35B to replace the AV-8 Harrier
            and F/A-18 Hornet aircraft, and the acquisition of unmanned air
            and ground systems to further enhance the flexibility, mobility
            and versatility of Marine Corps forces.
      --Adequate Navy shipping and sealift platforms to provide the
            expeditionary lift to support present and future COCOM
            requirements.
      --Continued full-rate production of the MV-22 Osprey. Recent
            successful deployments to Afghanistan of the MV-22 reinforce
            the immediate need for this capability for both the Marine
            Corps and U.S. Special Operations Command.
      --The recapitalization of the workhorses of Marine Corps aviation--
            the KC-130J aircraft, equipped with an improved aerial
            refueling system, and the CH-53K, and the acquisition of UH-1Y
            Huey and AH-1Z Super Cobra helicopters.
      --The acquisition of modern air, ground and logistics C\2\ systems
            such as Combat Operations Centers, the Joint Tactical Radio
            System, the Common Air C\2\ System, Joint Tactical Common
            Operational Picture Workstation and the Global Combat Support
            System to support joint and coalition operations.
      --The successful and continuous armor upgrades of vehicles as well as
            anti-sniper technology and anti-improvised explosive device
            technologies.
      --The continued acquisition of MAGTF fires improvements, particularly
            in the 155 mm Howitzer and HIMARS, and sufficient naval surface
            fire for joint forcible-entry operations.
      --The ongoing reconstitution and modernization efforts in the wake of
            the extremely demanding rotation cycle of personnel and
            equipment in Afghanistan.
      --The transition to network-centric expeditionary forces able to
            execute the war on terrorism with ready, relevant and capable
            forces, supported by ISR assets that strengthen joint and
            combined capabilities, ensure presence and provide surge.
    With respect to the Navy League's support of the United States Coast
            Guard
        The U.S. Coast Guard, the 5th Armed Force, is the lead agency for
    maritime homeland security. The USCG is in the process of determining
    operational requirements for the Offshore Patrol Cutter, and then will
    build the ships as soon as feasible to replace outdated and unreliable
    Medium Endurance Cutters. The total requirement is for 25 vessels
    delivered at two per/year.
        Global climate change is opening up polar sea lanes, highlighting
    competing territorial claims. Therefore, it is essential that
    responsibility for ensuring our national sovereignty and interests in
    the Polar Regions is assigned appropriately to the U.S. Coast Guard.
        The NLUS Supports the transfer of icebreaker maintenance funds from
    the National Science Foundation to the Coast Guard. The need for a
    robust presence in the polar regions is supported by the Joint Chiefs
    of Staff to accommodate security and sovereignty concerns. The first
    step is to put the management of the Nation's icebreaking capability
    where it belongs--with the Coast Guard.
    With respect to the Navy League's support of the United States Flag
            Merchant Marine
        A strong commercial U.S. Flag Merchant Marine is more critical than
    ever.
        95 percent of the equipment and supplies required to deploy U.S.
    forces is delivered by U.S. flagged and government owned vessels,
    manned by U.S. citizen mariners.
        The Navy League of the United States supports the Jones Act and the
    Passenger Vessels Services Act which requires U.S. built ships and U.S.
    citizen crews--because they protect critical national infrastructure
    and provide added sealift capacity, are important to economic and
    national security.
        The recapitalization of the ready reserve force (RRF) is vitally
    important to our maritime industry. The RRF should not be cut back
    until sufficient replacement capacity and capability are available.
        A strong strategic sealift merchant reserve component is needed in
    the U.S. Navy to ensure that critical mariner skills and experience are
    retained to support Navy and strategic sealift transportation.
        The Navy League of the United States supports combined government
    and industry efforts to counter piracy by introducing new technologies,
    and if requested by the shipping companies, placing armed guards aboard
    ships to prevent boardings.
                                  shipbuilding
        The Navy continues to struggle to meet its operational demand for
    deployable warships. The Navy deploys as many ships today as it did in
    the early 1990s, but with only two-thirds the number of ships in the
    fleet. The Navy is hard pressed to match and outpace threats from
    ballistic missiles, cruise missiles, aircraft and submarines.
        All three of the U.S. Navy's fleets--the fleet in planning, the
    fleet in construction and the fleet in being--are stressed with budget
    limitations.
        Good news lies with the success of aircraft carrier construction
    and the midlife refueling overhauls of the existing Nimitz class. The
    Virginia-class submarine construction continues with two boats a year
    authorized and funded beginning in 2011.
        The Ohio SSBN replacement is under design, with efforts to restrain
    costs and still meet the expected operational demands. This development
    and construction program, if allowed to remain in the Navy's SCN
    funding accounts, will create havoc with other vital construction
    programs. These costs should be funded independently as a national
    strategic investment.
        Major shipyards along the gulf coast have suffered from modest
    amounts of facility modernization and significant storm damage repair
    over the past decade. These shipyards must be able to plan on a
    sustainable and predictable workload, which will provide the revenue to
    support a trained work force, and facilities needed to construct our
    fleet.
        Along with constructing and supporting the Navy fleet, these yards,
    with the Naval Sea Systems Command, must support and cooperate closely
    with the U.S. Coast Guard, Military Sealift Command and MARAD. The
    plans, best practices, procedures, and research and development all
    must be shared with the industrial base. There also must be development
    in the domestic oil and gas industry's emergency response capability,
    sufficient to handle large and small oil spill response, such as the
    Deepwater Horizon oil spill.
        The shipbuilding industry needs increased investment in maritime
    research and development that includes dual-use vessels for America's
    Marine Highway System, with military-useful capabilities that can be
    called upon for DOD strategic sealift capability.
        The Navy must continue to strengthen and improve research and
    reassess its design, procurement and integration processes to produce
    affordable, combat-credible and survivable surface ships and
    submarines. Research is vital to the future fleet and its capabilities.
        The Navy League of the United States supports:
      --An increase of shipbuilding funds to the level of at least $25
            billion per year, with the associated research and development
            dollars to fund the requirements and design work that precedes
            contracting for ship and submarine construction.
      --Ensuring that the funds for the SSBN(X), the Ohio-class submarine
            replacement, are provided as needed outside of the Navy's SCN
            budgets to preclude the disruption and delay of other vital
            shipbuilding programs.
      --Adequate funding to recover and continue to build and sustain a
            vital organic Navy Shipbuilding Technical Authority, including
            a robust design and research capability and capacity, which has
            dwindled and remains at a reduced and inadequate size.
                                industrial base
        The industrial base that services this Nation's Sea Services is, at
    best, stagnant and most likely declining. This is cause for great
    concern because it inhibits efficient ship construction, ship repair
    (battle damage) and ship modernization in a time of increased tension
    or crisis. It also inhibits price and technical competition, which
    results in paying more for goods and services and acquiring less
    advanced equipment and systems for warships and aircraft.
        The Navy and Coast Guard are only purchasing what they can afford--
    not what they require to meet fleet needs. Our stocks of spare parts
    are reduced in number and our critical battle spares (shafts,
    propellers, reduction gears) are nearly nonexistent. The same limited
    availability of combat system components, such as weapon launchers,
    guns and sensors, would preclude our performing meaningful battle
    damage repairs and restoration, which with a small fleet is an
    important capability.
        The only practical source of this equipment today is found in the
    new-construction shipyards. The manufacturing lead time is extensive,
    therefore we need spares. The defense supply system stocks little if
    any of the critical steel, aluminum, piping and electric cable needed
    for major repairs.
        The labor pool possessing the critical skills necessary to produce
    our equipment and systems and construct our warships is aging, with key
    personnel leaving and not being replaced in kind. Ship construction and
    related industries are not viewed by today's younger generation as a
    viable career path.
        The key element to achieving on-time and on-price production for
    our technically advanced systems and ships is a trained and dedicated
    workforce. These shortages result in the all-too-common poor
    performance experienced in shipyards and manufacturing plants. The only
    solution is additional training and education at all levels. We are
    especially stressed with the low number of experienced ship design
    personnel and senior managers within the Navy and in industry.
        The future success of shipbuilding and many other Navy programs is
    contingent on our Nation's support of Science, Technology, Engineering,
    and Mathematics (STEM) education programs. According to the Office of
    Naval Research, more than 30 percent of current DOD Science and
    Technology professionals are expected to retire within the next 9
    years.
        STEM education equips our next-generation Sailors, Marines,
    scientists, architects, and engineers with the tools they need to
    develop new technologies and platforms that will defend America in the
    future.
        The National Science Foundation notes that roughly half of all U.S.
    economic growth over the last 50 years was the product of scientific
    innovation. It is vital to our economic and national security that we
    encourage and support math and science education programs at all
    levels. A host of programs have been designed and funded in STEM
    disciplines in order to reach kids in middle school and high school and
    inspire them to explore the opportunities and rewards that exist with a
    technical major.
        From its beginnings, the U.S. Navy has been a leader in leveraging
    technology and developing science-based solutions to defend U.S.
    interests. Today's investments in science and technology research will
    help the Navy maintain its edge as the high-tech service of the future.
    The Navy League supports additional funding levels for STEM and is
    working to support efforts to expand this program.
        Global trade is still robust, yet our own foreign commerce is
    carried in mostly foreign-built and foreign-crewed ships. A modest
    increase, beyond Jones Act construction, in commercial shipbuilding
    would give a substantial boost to our shipyards and marine vendors.
        Facilities at the larger shipyards in the United States are capable
    of constructing merchant ships as well as warships, but cannot match
    the costs, schedules and efficiencies of shipyards in Europe and Asia.
    On the other hand, U.S. yards construct and equip the best warships,
    aircraft carriers and submarines in the world. They are unmatched in
    capability, but are struggling to maintain that lead.
        No nation can support and sustain a capable and sizeable Navy
    without a strong and sustaining industrial base manned with adequate
    numbers of skilled personnel. It is essential that this Nation have a
    policy at the highest levels of government to support and sustain an
    adequate industrial base capable of providing and supporting a strong
    Navy and maritime commerce.
        The Navy League of the United States urges:
      --The U.S. Government to develop and institute an effective
            industrial base policy that addresses critical issues such as
            the development of improved ships, ship systems and weapons
            with the capacity to annually produce multiple ships of a class
            and the capability to increase capacity rapidly in time of
            national need or emergency.
      --An increased and stable level of predictable funding for the ships,
            submarines, aircraft and combat systems that are the essential
            elements of our fleet. The cost of these programs continues to
            rise beyond normal inflation rates, which is linked to low
            production rates and unstable funding. Improved staffing,
            additional research and stable programs with a reasonable
            annual production rate will help contain rising costs. Costs
            are related to schedule and, at present, our production times
            are excessive and should be reduced. A strong industrial base
            will assist in achieving affordable pricing for the Navy's
            programs.
      --Capital investments in our existing infrastructure to allow us to
            stay abreast of the latest technological advances, attract the
            best young engineers and skilled workers, and ensure that we
            have the capability and capacity to surge repair, produce and
            construct the nation's fleet in time of crisis.
      --Expanded use of advanced acquisition strategies, including block
            buys, multiyear-priced options with innovative funding
            approaches, such as time-phased and advanced appropriations
            that stabilize accounts and avoid disruptive funding spikes and
            voids.
      --Support of the provision included in the fiscal year 2012 National
            Defense Authorization Act that allows the Secretary of the Navy
            the authority of advance purchase of major components during
            construction of the next two Ford-class aircraft carriers and
            to achieve cost savings by entering into multiyear advance
            procurement agreements.
      --Adopting incentives to cut costs and schedules and reward firms
            that achieve significant savings in both money and time, while
            maintaining quality. This will create an environment in which
            high-performing companies can achieve returns on capital
            comparable to those commercial enterprises of similar risk and
            capitalization. Contracts should be structured so that earning
            higher fees for higher performance is achievable.
                              resetting our forces
        The national imperative to reset our Maritime Forces requires, not
    only the replacement of equipment, but also demands the continued
    effort to attract, train and retain intelligent and capable men and
    women.
        The resetting of our Maritime Forces requires the will of the
    American people, the President and Congress to commit the necessary
    resources to be prepared for our Nation's next battle. We can no longer
    demand more from an already stressed manpower pool to respond to
    worldwide disasters while redeploying to war zones and maintaining a
    high operational tempo.
        Combat operations have been continuous and equipment has been
    subjected to intense use in harsh environments. Aside from the
    requirement to buy new equipment for the increased end strength, the
    entire force needs extensive rehabilitation, repair and replacement as
    weapons and equipment are rotated out of combat.
        Likewise, prepositioned stocks and training base stocks must be
    replenished. The current reset cost estimate exceeds $15.6 billion, of
    which only about $10.9 billion has been funded. As the fight continues,
    the reset costs for equipment and training will increase apace, and
    Congress needs to understand and support this requirement.
        As the Marine Corps modernizes its combat forces, funding must be
    continued for individual survivability programs, to include personal
    protective equipment, lighter-weight gear and modern force-protection
    systems. Ground mobility must be improved to provide the Marine Corps
    the capability to effectively operate across the mission spectrum yet
    remain tailored in size to be deployable and employable.
    Navy League Community Service
        Every year, the Navy League participates in countless activities
    that support service members and their families. Highlights of some of
    the accomplishments of the Navy League this past year include:
      --$1,395,712 was given by Navy League of the United States to support
            the members of the sea services and their families.
      --Navy League supported 1,545 Welcome Home Receptions, Holiday
            Parties, Child Care, R&R Programs, Ship Dinners and Luncheons
            and BBQ's totaling $603,046.
      --Navy League adopted or supported 401 Navy, Coast Guard and Merchant
            Marine ships and Marine Corps units in 2010.
      --Navy League organized or provided substantial support for 16 Navy
            and Coast Guard ship commissioning ceremonies.
      --1,925 Sea Service Awards were given in 2010 totaling $185,720.
      --$41,970 was given in support of 546 transitioning sea service
            members and their families.
      --$230,227 was provided to 146 Sea Cadets.
      --$103,158 was provided to 415 JROTC units.
      --$112,981 in scholarships were given to 71 sea service youths.
      --Over $20,000 worth of care packages were sent to the USO and troops
            overseas.
      --Over 1 million paperback books have been sent to Operation
            Paperback for overseas military personnel.
        Additionally, the Navy League of the United States is the sponsor
    of the Naval Sea Cadet Corps (NSCC). The Sea Cadets were founded by the
    Navy League in 1958 at the request of then-CNO Admiral Arleigh Burke.
    The goal was to establish a youth organization that would ``create a
    favorable image of the Navy on the part of American youth.'' The Naval
    Sea Cadet Corps was subsequently chartered by Congress in 1962 as a
    nonprofit, civilian development and training organization for youth
    ages 13 through 17, sponsored by the Navy League and supported by both
    the U.S. Navy and U.S. Coast Guard.
        The Sea Cadets recently signed a Memorandum of Understanding with
    the Coast Guard Auxiliary for training and support, and have also
    discussed Sea Cadet participation in the activities of NOAA. Included
    under the NSCC umbrella is the Navy League Cadet Corps, a junior
    program for children ages 11 through 13. The NSCC program has grown
    nationally to 10,487 participants in 387 units in all 50 States, Guam
    and Puerto Rico. The program is run by volunteers with the objective of
    developing within youth an interest and skill in seamanship and
    seagoing subjects; developing an appreciation for our navy's history,
    customs, traditions and its significant role in national defense;
    developing positive qualities of patriotism, courage, self-reliance,
    confidence, and pride in our Nation and other attributes which
    contribute to development of strong moral character, good citizenship
    traits and a drug-free, gang-free lifestyle; and to present the
    advantages and prestige of a military career.
        Many cadets enlist in the services, estimated at about 2,000 per
    year from an eligibility pool of about 20,000. Admiral Roughead
    recently indicated that every ex-Sea Cadet that enlists in the Navy
    represents a $14,000 saving in recruiting costs to the Navy. We are
    very proud that over 12 percent of the current brigade of Naval Academy
    Midshipmen are former Naval Sea Cadets.
                                   conclusion
        Forward deployed forces provide a forward presence creating global
    engagements that are critical to the U.S. economy, world trade and the
    protection of democratic freedoms that so many take for granted. The
    guarantors of these vital elements are hulls in the water, boots on the
    ground and aircraft overhead.
        Since ``presence with the capability to engage'' is the primary
    strength of the Sea Services, it is imperative that we fund an
    aggressive shipbuilding and modernization program. Sustained maritime
    superiority is paramount to supporting the American economy.
        America is a maritime nation and must maintain its status of
    maritime superiority if there is to be peace and economic prosperity
    around the world. Secretary of the Navy Mabus recently commented that:
    ``Sometimes the U.S. Navy-Marine Corps Team follows the storm to the
    shore--sometimes we must bring the storm''.
        In 2020, 40 percent of the U.S. Gross Domestic Product will be
    dependent on ocean shipping and maritime trade. Maritime superiority is
    essential to our economy.
        The Navy League is committed to educating and informing, the senior
    leadership in the Executive and Legislative branches of the U.S.
    Government, as well as the media and the American people, of the
    continuing need for U.S. sea power, both naval and commercial, to
    protect U.S. interests throughout the world and ensure the Nation's
    economic well-being.
        The most important ``reform'' that can be made in the field of
    national defense is to provide adequate funding for America's Sea
    Services, which are the greatest force for peace in the world.

        Chairman Inouye. Thank you very much, Mr. Lumme.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, thank you.
        Thank you very much, Mr. Lumme, for your comments and
    observations. I know the Navy League is a voluntary
    organization of mostly former officers or enlisted active duty
    persons who have served in the U.S. Navy; is that right?
        Mr. Lumme. Actually, it's not, sir. We only have 28 percent
    that are former military, so we have over 70 percent that are
    volunteers that had no military service at all.
        Senator Cochran. How do you sell people on the fact that
    they ought to pay dues to the Navy League? What is the purpose
    of the organization?
        Mr. Lumme. Our advocacy of the sea service is not only for
    the combat readiness and support of maritime--because we do
    flag merchant marine and Coast Guard also. We also support the
    families. We have individual augmentee programs, we have adopt
    a sailor programs, adopt a ship programs. Most of the ship
    commissionings that go on around the United States, Coast Guard
    and Navy, are done by the Navy League as a sponsor.
        So we sell that because of patriotic support by the members
    who didn't join the military, but maybe want to help in other
    ways.
        Senator Cochran. Well, I think that's admirable and I
    commend you for the work you do. I enjoyed serving in the Navy.
    We were lucky we weren't at war at the time. I might not have
    enjoyed it so much if somebody had been shooting at us or
    trying to sink our ship.
        But the Navy has really done a great job in projecting
    power and a presence and influence throughout the world, I
    guess for the last--how many years? When did the Navy League
    start?
        Mr. Lumme. The Navy League started in 1902.
        Senator Shelby. 1902. Quite a record of service and
    accomplishment.
        Thank you.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Mr. Chairman, I just want to tell Mr. Davis
    I appreciate his testimony and appearing here today.
        Chairman Inouye. Our next witness is Mr. John Davis of the
    Fleet Reserve Association.
    STATEMENT OF JOHN R. DAVIS, DIRECTOR, LEGISLATIVE
                PROGRAMS, FLEET RESERVE ASSOCIATION
        Mr. Davis. Chairman Inouye, Vice Chairman Cochran, and
    Senator Shelby: My name is John Davis and I want to thank you
    for the opportunity to express the views of the Fleet Reserve
    Association.
        Ensuring adequate funding for the military health system is
    a top legislative priority for the association and very
    important to every segment of our membership. This is reflected
    in responses to the association's 2011 online survey, which
    revealed that over 90 percent of all active duty, reserve,
    retired, and veteran respondents cited healthcare access as a
    critically important quality of life benefit associated with
    their military service.
        FRA opposes drastic TRICARE enrollment fee increases and
    opposed the 2006 proposed increase, which was up to $2,000
    increase every year for TRICARE Prime and an estimated index
    which would cause an increase every year of about 7.5 percent.
        The association opposes the current administration's
    proposal. Although it provides a modest increase in 2012, it
    does mandate further increases past 2012 based on an index that
    measures healthcare inflation and assumes a 6.2 percent
    increase every year.
        The FRA prefers the TRICARE provisions in the House and
    Senate defense authorization bills. That, like the
    administration's proposals, provides a modest adjustment, $2.50
    per month for individuals and $5 per month for families that
    are getting TRICARE Prime, and--and I can't overestimate this
    enough--in the out-years it provides a cap for any future
    increases that is no more greater than the percentage increase
    for the cost of living adjustment for retirees. This ensures
    that the military retirees' compensation will not be eroded by
    their healthcare costs in future years.
        We are also thankful that there are no increases for
    TRICARE Standard, for their survivors, for TRICARE for Life,
    and of course for active duty military.
        The House version also eliminates copays for mail order
    generic drug prescriptions. That is something that FRA has long
    supported.
        FRA welcomes the administration's focus on creating an
    electronic health record for service members that can follow
    them to the Department of Veterans Affairs and for the rest of
    their life.
        Notwithstanding the oversight limitations, adequate funding
    for an effective delivery system between DOD and VA to
    guarantee a seamless transition and quality of service for
    wounded personnel is very important to our membership.
        The association notes that the administration has not
    proposed authorizing chapter 61 retirees to receive full
    military retired pay and veterans disability compensation, as
    it has done the last 2 years. FRA continues to seek
    authorization and funding of full concurrent receipt from all
    disabled retirees.
        Family support is also important and should include funding
    for compensation, training, and certification for respite care
    for family members functioning as full-time caregivers for
    wounded warriors. These provisions were enacted in the fiscal
    year 2011 defense authorization and are similar to the
    Caregivers and Veterans Omnibus Health Care Service Act, S.
    1963, that was enacted for the VA. Both acts improve
    compensation, training, and assistance for caregivers of
    severely disabled active duty service members.
        FRA also supports the funding for a 1.6 percent active duty
    pay increase, which at least keeps pace with salaries in the
    private sector. If authorized, FRA supports funding retroactive
    eligibility for early retirement benefit, to include reservists
    who have supported contingency operations since September 11,
    2001.
        Again, I want to thank you for allowing me to submit my
    views, the FRA's views, to this subcommittee.
        [The statement follows:]
                      Prepared Statement of John R. Davis
                                    the fra
        The Fleet Reserve Association (FRA) is the oldest and largest
    enlisted organization serving active duty, Reserves, retired and
    veterans of the Navy, Marine Corps, and Coast Guard. It is
    Congressionally Chartered, recognized by the Department of Veterans
    Affairs (VA) as an accrediting Veteran Service Organization (VSO) for
    claim representation and entrusted to serve all veterans who seek its
    help. In 2007, FRA was selected for full membership on the National
    Veterans' Day Committee.
        FRA was established in 1924 and its name is derived from the Navy's
    program for personnel transferring to the Fleet Reserve or Fleet Marine
    Corps Reserve after 20 or more years of active duty, but less than 30
    years for retirement purposes. During the required period of service in
    the Fleet Reserve, assigned personnel earn retainer pay and are subject
    to recall by the Secretary of the Navy.
        FRA's mission is to act as the premier ``watch dog'' organization
    in maintaining and improving the quality of life for Sea Service
    personnel and their families. FRA is a leading advocate on Capitol Hill
    for enlisted active duty, Reserve, retired and veterans of the Sea
    Services. The Association also sponsors a National Americanism Essay
    Program and other recognition and relief programs. In addition, the
    newly established FRA Education Foundation oversees the Association's
    scholarship program that presents awards totaling nearly $120,000 to
    deserving students each year.
        The Association is also a founding member of The Military Coalition
    (TMC), a consortium of more than 30 military and veteran's
    organizations. FRA hosts most TMC meetings and members of its staff
    serve in a number of TMC leadership roles.
        FRA celebrated 86 years of service in November 2010. For nearly
    nine decades, dedication to its members has resulted in legislation
    enhancing quality of life programs for Sea Services personnel, other
    members of the uniformed services plus their families and survivors,
    while protecting their rights and privileges. CHAMPUS, now TRICARE, was
    an initiative of FRA, as was the Uniformed Services Survivor Benefit
    Plan (USSBP). More recently, FRA led the way in reforming the REDUX
    Retirement Plan, obtaining targeted pay increases for mid-level
    enlisted personnel, and sea pay for junior enlisted sailors. FRA also
    played a leading role in advocating recently enacted predatory lending
    protections and absentee voting reform for service members and their
    dependents.
        FRA's motto is: ``Loyalty, Protection, and Service.''
                                    overview
        Mr. Chairman, the Fleet Reserve Association salutes you, members of
    the Subcommittee, and your staff for the strong and unwavering support
    for essential programs important to active duty, Reserve Component, and
    retired members of the uniformed services, their families, and
    survivors. The Subcommittee's work in funding these programs has
    greatly enhanced care and support for our wounded warriors, improved
    military pay, eliminated out-of-pocket housing expenses, improved
    healthcare, and enhanced other personnel, retirement and survivor
    programs. This funding is critical in maintaining readiness and is
    invaluable to our Armed Forces engaged in a long and protracted two
    front war, sustaining other operational commitments and fulfilling
    commitments to those who've served in the past. But more still needs to
    be done.
        A continuing high priority for FRA is full funding of the Military
    Health System (MHS) to ensure quality care for active duty, retirees,
    Reservists, and their families. FRA's other 2011 priorities include
    annual active duty pay increases that are at least equal to the
    Employment Cost Index (ECI), to help keep pace with private sector pay,
    retirement credit for reservists that have been mobilized since
    September 1, 2001, enhanced family readiness via improved
    communications and awareness initiatives related to benefits and
    quality of life programs, retention of full final month's retired pay
    for surviving spouse, and introduction and enactment of legislation to
    eliminate inequities in the Uniformed Service Former Spouses Protection
    Act (USFSPA).
        The Association also supports additional concurrent receipt
    improvements to expand the number of disabled military retirees
    receiving both their full military retired pay and VA disability
    compensation as proposed in the administration's budget request from
    last year.
        The fiscal year 2012 budget calls for a 1.6-percent active duty pay
    increase that equals the Employment Cost Index (ECI) and FRA supports
    that increase. The Association also supports efforts to reduce the so-
    called ``Military Widows tax'' imposed on beneficiaries whose Survivor
    Benefit Plan (SBP) annuity is offset by the amount they receive in
    Dependency and Indemnity Compensation (DIC), and if authorized, funding
    to support this change.
                                   healthcare
        Healthcare is especially significant to all FRA Shipmates
    regardless of their status and protecting and/or enhancing this benefit
    as noted above is the Association's top legislative priority. Responses
    to a recent FRA survey indicate that nearly 90 percent of active duty,
    Reserve, retired, and veteran respondents cited healthcare access as a
    critically important quality-of-life benefit.
        The administration is proposing an increase to the TRICARE Prime
    annual enrollment fee from $230 to $260 for individuals and from $460
    to $520 per retired family. Starting in 2013 the annual enrollment fee
    would be increased to keep pace with a medical inflation index. The
    proposal also eliminates pharmacy co-pays for mail-order generic drugs
    and increases the current retail formulary pharmacy $9 co-pay by $2 to
    $3. There are no proposed increases for TRICARE Standard, survivors,
    TRICARE-for-Life beneficiaries, and those who are medically retired.
    There are also no out-of-pocket costs for active duty service members.
    This proposed fee increase would represent a 13 percent increase in the
    TRICARE Prime annual enrollment fee in the first year and would
    apparently be indexed to Medicare Part B coverage cost increases in the
    out-years. FRA is opposed to using Medicare costs for disabled and 65
    and older beneficiaries as a basis for adjusting premiums for military
    retirees age 38-64 that undoubtedly have lower healthcare costs than
    individuals under Medicare.
        If approved, FRA believes future premium adjustments for TRICARE
    Prime beneficiaries under age 65 should be based on the Consumer Price
    Index (CPI) since military retired pay cost-of-living-adjustments
    (COLAs) are based on that measure. Any index in excess of the CPI would
    grind down the value of their retired pay and would counter the purpose
    of the COLA which to maintain the purchasing power of the beneficiary.
    The House Defense Authorization bill (H.R. 1540) authorizes the 2012
    fees increase per the administration's budget, but limits further
    increases to no more than the annual COLA, and provides the requested
    changes to pharmacy co-pays.
        The House Defense Appropriations Subcommittee bill provides $32.3
    billion for the Military Health System (MHS) in 2012 which is $935
    million more than the last fiscal year and $119 million more than
    requested by the administration. In conjunction with this, FRA strongly
    supports funding to fully implement bidirectional electronic health
    records that will follow service members as they transition from DOD to
    the VA.
        FRA also notes recommendations in recent Government Accountability
    Office (GAO) testimony before the House Committee on Oversight and
    Government Reform which identified Federal programs, agencies, offices
    and initiatives that have duplicative goals or activities. Number two
    on a list of 81 areas for consideration is realigning DOD's military
    medical command structures and consolidating common functions to
    increase efficiency which would result in projected savings of from
    ``$281 million to $460 million'' annually. In addition, GAO cites
    opportunities for DOD and the Department of Veterans' Affairs (VA) to
    jointly modernize their respective electronic health record systems,
    and also control drug costs by increasing joint contracting.
        DOD must continue to investigate and implement other TRICARE cost-
    saving options. The Association notes the elimination of 780 contract
    positions in conjunction with streamlining TRICARE Management Activity
    functions along with increasing inter-service cooperation and co-
    locating medical headquarters operations.
        FRA also notes progress in expanding use of the mail order pharmacy
    program, Federal pricing for prescription drugs, 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 healthcare spending in the coming years.
                              wounded warrior care
        Last year Congress authorized a monthly stipend under the DOD
    family caregiver program for catastrophically injured or ill wounded
    warriors that is equal to the caregiver stipend provided by the
    Department of Veterans' Affairs (VA). The new program will help many
    caregivers, however, the enactment and implementation of the
    legislation is only the first step and effective oversight and
    sustained funding are also critical to ensuring future support for
    these caregivers. A recent Navy Times survey on wounded warrior care
    (November 29, 2010) indicates that 77 percent of caregivers have no
    life of their own; 72 percent feel isolated; and 63 percent suffer from
    depression.
                                      des
        In response to the Dole/Shalala Commission Report a pilot program
    was created (NDAA--fiscal year 2008--Public Law 110-181) known as the
    Disability Evaluation System (DES). The pilot provides a single
    disability exam conducted to VA standards that will be used by both VA
    and DOD and a single disability rating by VA that is binding upon both
    Departments. This pilot program has expanded and become the Integrated
    Disability Evaluation System (IDES) and is viewed as a common-sense
    approach that FRA believes will reduce bureaucratic redtape and help
    streamline the process and warrants expansion to the entire disability
    rating system. Despite jurisdictional concerns, the Association urges
    the Subcommittee to provide oversight and adequate funding as the IDES
    is implemented.
                               concurrent receipt
        The Association notes that the administration has not proposed
    authorizing Chapter 61 retirees to receive their full military retired
    pay and veteran's disability compensation as it has the last two fiscal
    years. FRA continues to seek timely and comprehensive implementation of
    legislation that authorizes and funds the full concurrent receipt for
    all disabled retirees and supports ``The Retired Pay Restoration Act''
    (S. 344) sponsored by Majority Leader Senator Harry Reid (Nevada) which
    is comprehensive legislation that authorizes concurrent receipt for all
    disabled retirees, including those with less than 20 years of service
    who have been medically retired (Chapter 61s).
                             full final month's pay
        Current regulations require survivors of deceased armed forces
    retirees to return any retirement payment received in the month the
    retiree passes away or any subsequent moth thereafter. Upon the demise
    of a retired service member in receipt of military retired pay the
    surviving spouse is to notify the Department of Defense of the death.
    The Defense Department's finance arm, Defense Finance and Accounting
    Service (DFAS) then stops payment on the retirement account,
    recalculates the final payment to cover only the days in the month the
    retiree was alive, forwards a check for those days to the surviving
    spouse (beneficiary) and, if not reported in a timely manner, recoups
    any payment(s) made covering periods subsequent to the retiree's death.
    The recouping is made without consideration of the survivor's financial
    status.
        At a most painful time, the surviving spouse is faced with the task
    of arranging and paying for the deceased retiree's interment and that
    difficulty is only amplified by the loss of retirement income when it
    is needed most.
        That is why FRA is supporting ``The Military Retiree Survivor
    Comfort Act,'' (H.R. 493) sponsored by Rep. Walter Jones (North
    Carolina).
        The measure is related to a similar pay policy enacted by the
    Department of Veterans Affairs (VA). Congress passed a law in 1996 that
    allows a surviving spouse to retain the veteran's disability and VA
    pension payments issued for the month of the veteran's death. FRA
    believes military retired pay should be no different.
        To offset some of the costs, if the spouse is entitled to survivor
    benefit annuities (SBP) on the retiree's death, there will be no
    payment of the annuity for the month the retirement payment is provided
    the surviving spouse. If authorized, FRA urges this subcommittee to
    provide adequate funding to correct inequities associated with this
    policy.
                                 defense budget
        FRA supports a defense budget of at least 5 percent of GDP to fund
    both people and weapons programs. The current level of defense spending
    (4.7 percent including supplemental spending in fiscal year 2010) is
    significantly lower than past wartime periods as a percentage of GDP
    and the Association is concerned that the administration's 5-year
    spending plan of 1 percent above inflation may not be enough for both
    people programs and weapon systems.
                                active duty pay
        The military has been appropriately excluded from the pay freeze
    for Federal employees announced by President Obama on November 29, 2010
    and FRA strongly supports the proposed 1.6 percent pay increase that
    equals the 2010 Employment Cost Index (ECI). The United States however,
    is in the 10th year of war and there is no more vital morale issue for
    our current warriors than adequate pay.
        A total of 92 percent of active duty personnel who responded to
    FRA's recent quality of life issues survey consider pay as ``very
    important,'' which was the highest rating. The Association appreciates
    the strong support from this distinguished Subcommittee in reducing the
    13.5 percent pay gap to 2.4 percent since 1999 and reiterates the fact
    that the ECI lags 15 months behind the effect date of pay adjustments
    due to budget preparation and associated Congressional action on annual
    authorizing and appropriations legislation. It should also be noted
    that the enacted fiscal year 2011 1.4 percent pay increase and the
    proposed fiscal year 2012 adjustment are the smallest pay increases in
    recent memory and do not further reduce the pay gap .
        The Association recommends that this distinguished Subcommittee
    provide funding for an active duty pay increase at least equal to the
    ECI so as not to increase the pay gap between civilian and military
    pay.
                                 end strengths
        Sufficient funding to support adequate end strengths for the
    military is vital for success in Afghanistan and to sustaining other
    operations vital to our national security. FRA is concerned about calls
    for reducing end strength in the out-years to save money on the defense
    budget while still engaged for almost 10 years of war in Iraq and
    Afghanistan, a third war in Libya, renewed violence in Korea late last
    year, and support for the natural disaster in Japan. The strain of
    repeated deployments continues and is reflected in troubling stress-
    related statistics that include alarming suicide rates, prescription
    drug abuse, alcohol use and military divorce rates. These are also
    related to the adequacy of end strengths and the need for adequate
    dwell time between deployments--issues that have been repeatedly
    addressed in Congressional oversight hearings.
                                 reserve issues
        FRA stands foursquare in support of the Nation's Reservists. Due to
    the demands of the War on Terror, Reserve units are increasingly
    mobilized to augment active duty components. As a result, the Reserve
    component is no longer a strategic Reserve, but is an essential
    operational Reserve that is an integral part of the total force that
    has been at war for almost a decade. And because of these increasing
    demands, including missions abroad over longer periods of time, it is
    essential to ensure adequate funding for military 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 (H.R. 181). 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 after the effective date (January 28, 2008)
    leaving out more than 600,000 Reservists mobilized since 9/11 for duty
    in Afghanistan and Iraq.
        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 these
    recommendations to this distinguished Subcommittee. The Association
    reiterates its gratitude for the extraordinary progress this
    Subcommittee has made in funding a wide range of military personnel and
    retiree benefits and quality-of-life programs for all uniformed
    services personnel and their families and survivors.

        Chairman Inouye. Thank you very much, Mr. Davis.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I think we should express
    our appreciation to Mr. Davis for being here and helping us
    understand the recommendations of his organization. We know
    it's one of the oldest organizations supporting active duty
    military personnel and has a record of achievement. We thank
    you for your continued interest.
        Mr. Davis. Thank you.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I already thanked him. I got
    ahead of the panel a minute ago. But I will reiterate that.
        Mr. Davis. You can thank me again.
        Senator Shelby. We appreciate you being here.
        Mr. Davis. Thank you.
        Senator Shelby. Thank you.
        Chairman Inouye. Thank you.
        Now may I call upon Ms. Leighton. Ms. Leighton.
    STATEMENT OF SUSAN LEIGHTON ON BEHALF OF THE OVARIAN
                CANCER NATIONAL ALLIANCE
        Ms. Leighton. Good morning, Mr. Chairman, Mr. Vice
    Chairman, and Senator Shelby. I'm honored to appear before you
    in support of the Ovarian Cancer National Alliance's request of
    $20 million for the Department of Defense ovarian cancer
    research program, which I will henceforth refer to as the
    ``OCRP.''
        My name is Susan Leighton. I'm from Huntsville, Alabama,
    where my husband and I settled after his retirement from the
    United States Army as a chief warrant officer 3. I am also a
    veteran.
        In the summer of 1997, at the age of 48, I was diagnosed
    with stage 3C ovarian cancer. Women diagnosed in later stages
    like myself have only a 20 percent chance of surviving 5 years.
    In an instant, I went from preparing to take my daughter to
    college to wondering whether I would see her graduate.
        I was treated at the University of Alabama in Birmingham.
    My healthcare was paid for by my husband's military health
    plan. I was fortunate to enter treatment the year after two
    chemotherapeutic agents had been approved for use as first-time
    treatment of ovarian cancer. The combination of surgery and
    those two agents put me into remission. With the exception of
    one recurrence, I have remained with no evidence of disease.
        The research that led to the discovery of those two agents
    saved my life. I saw my daughter graduate from Auburn
    University, begin a career, and walk down the aisle to marry.
    Unfortunately, the majority of women diagnosed do not have this
    fairy tale ending.
        Ovarian cancer is a heterogeneous disease. Many women do
    not respond to the type of chemotherapy that helped me. The
    survival rate for this disease has remained fairly stable.
    Fewer than 50 percent of the approximately 21,000 women
    diagnosed each year will be alive in 5 years.
        The solution to improving the survival rates is simple:
    Research. Being one of the handful of long-term survivors, I
    feel a responsibility to speak for other ovarian cancer
    patients. I have participated as a consumer reviewer on the
    OCRP panels for 2 years, bringing the patient's perspective to
    the table. As a reviewer, I help decide which research will
    benefit women diagnosed with ovarian cancer and those at risk
    of developing it in the future.
        I have seen the focus move toward studying cellular
    pathways of cancer. We are on the precipice of understanding
    how ovarian cancer develops, grows, and spreads, and ultimately
    eliminating it.
        I recently returned from the annual meeting of the American
    Society of Clinical Oncology, where I heard about studies of
    PARP inhibitors and anti-angiogenesis agents, which are showing
    promising results for ovarian cancer survivors. Many of those
    studies were funded by grants from the OCRP.
        We are very aware of the current economic climate and
    understand the constraints you face when determining where best
    to allocate funds. For that reason, we are asking for flat
    funding of the OCRP in fiscal year 2012.
        My cancer support group in Alabama has a memorial statue in
    our garden of life and remembrance. I have watched over the
    years as we have added name after name to that statue. The
    young man who engraves those names for us each year refuses to
    take payment, telling us that the only payment he wants is a
    call telling him that we have no new names to add. The only way
    this will happen is by eliminating ovarian cancer.
        The situation in Alabama is no different than in Hawaii,
    Tennessee, Texas, or any other State. By flat funding the OCRP
    we will be able to maintain our current level of research and
    move closer to that goal.
        Thank you for the opportunity to speak on behalf of women
    battling ovarian cancer today, and I'm happy to answer any
    questions.
        [The statement follows:]
                      Prepared Statement of Susan Leighton
        Good morning, Mr. Chairman, Mr. Vice Chair and Members of the
    Subcommittee. I am honored to appear before you in support of the
    Ovarian Cancer National Alliance's request of $20 million for the
    Department of Defense Ovarian Cancer Research Program (DOD OCRP), which
    I will henceforth refer to as the OCRP. My name is Susan Leighton. I am
    from Huntsville, Alabama, where my husband and I settled after his
    retirement from the United States Army as a Chief Warrant Officer,
    Three.
        The Ovarian Cancer National Alliance (the Alliance) thanks the
    Subcommittee for the opportunity to submit comments for the record
    regarding the Alliance's fiscal year 2012 funding recommendations. We
    believe these recommendations are critical to ensure that advances can
    be made to help reduce and prevent suffering from ovarian cancer. For
    the last 14 years, the ovarian cancer community has worked to increase
    awareness of ovarian cancer and advocated for additional Federal
    resources to support research that would lead to more effective
    diagnostics and treatments.
        As an umbrella organization representing more than 50 State and
    local groups, the Alliance unites the efforts of grassroots activists,
    women's health advocates and healthcare professionals to bring national
    attention to ovarian cancer.
        As part of these efforts, Alliance advocates for continued Federal
    investment in the Department of Defense Congressionally Directed
    Medical Research Programs (CDMRP). The Alliance respectfully requests
    that the Senate Appropriations Subcommittee on Defense maintain the
    fiscal year 2011 funding level of $20 million for the DOD OCRP in
    fiscal year 2012.
        In the summer of 1997, at the age of 48, I was diagnosed with stage
    IIIC ovarian cancer. Women diagnosed in later stages, like me, have
    only a 20 percent chance of surviving 5 years. In an instant, I went
    from preparing to take my daughter to college to wondering whether I
    would see her graduate.
        I was treated at the University of Alabama. I was fortunate to
    enter treatment the year after two chemotherapeutic agents had been
    approved for use as first line treatment of ovarian cancer. The
    combination of surgery and those two agents put me into remission. With
    the exception of one recurrence, I have remained with no evidence of
    disease. The research that led to the discovery of those two agents
    saved my life. I saw my daughter graduate from Auburn University, begin
    a great career and walk down the aisle to marry. Unfortunately, the
    majority of women diagnosed do not have this fairy tale ending.
        Ovarian cancer is a heterogeneous disease. Many women do not
    respond to the type of chemotherapy that helped me. The survival rate
    for this disease has remained relatively stable; fewer than 50 percent
    of the approximately 21,000 women diagnosed each year will be alive in
    5 years. The solution to improving these survival rates is simple:
    research.
        Being one of a handful of long-term survivors, I feel a
    responsibility to speak for other ovarian cancer patients. I have
    participated as a consumer reviewer on the OCRP panels for 2 years,
    bringing the patient's perspective to the table. As a reviewer, I help
    decide which research will benefit women diagnosed with ovarian cancer
    and those at risk of developing it in the future. I have seen the focus
    move toward studying cellular pathways of cancer. We are on the
    precipice of understanding how ovarian cancer develops, grows and
    spreads--and ultimately eliminating it. I recently returned from the
    annual meeting of the American Society of Clinical Oncology, where I
    heard about studies of PARP inhibitors and anti-angiogenesis agents,
    which are showing promising results for ovarian cancer survivors. Many
    of those studies were funded by grants from the OCRP.
        The DOD OCRP, which belongs to U.S. Army Medical Research and
    Materiel Command (USAMRMC), complements but does not duplicate the
    important ovarian cancer research carried out by the National Cancer
    Institute (NCI). There are three critical differences between these
    research programs.
        First, the OCRP funds innovative, high risk, high reward research
    which many large, non-DOD Federal research agencies do not have the
    flexibility to engage in.
        Second, the OCRP is designed to prevent funding research that
    overlaps with other ovarian cancer research that has been funded by the
    NCI or other agencies. Before funding an award, OCRP grant managers are
    required to thoroughly check all sources of information to determine if
    a proposal is redundant of a previous OCRP grant or a grant awarded by
    another Federal agency such as the NCI.
        Third, the OCRP pushes investigators to make rapid progress in
    their research by requiring them to reapply every funding cycle.
    Because proposal reviews conducted by the OCRP are double-blinded by
    investigator and research institution, an investigator's progress is
    evaluated on its own merit and must have sufficient new findings, data
    or ideas to warrant new funding. The OCRP's unique method of funding
    ovarian cancer research has yielded tremendous breakthroughs in the
    fight against ovarian cancer, including:
      --a new treatment using nanoparticles to deliver diphtheria toxin-
            encoding DNA to ovarian cancer cells, leaving healthy cells
            unaffected;
      --the discovery of a compound that potentially inhibits a form of
            ovarian cancer that makes up 40 percent of ovarian cancer
            tumors;
      --the finding that ovarian cancer cells are sensitive to glucose
            deprivation and resveratrol treatment; and
      --identification of the earliest molecular changes associated with
            BRCA1- and BRCA2-related ovarian cancers, leading to biomarker
            identification for early detection.
        Cancer research performed by the DOD has been responsible for
    fundamentally changing the way cancer research is conducted. Many
    innovative practices and methods created by the CDRMPs have been
    adopted by the NCI, such as the use of cancer patients as consumer
    reviewers in the proposal review process. Furthermore, the CDRMP has
    created funding mechanisms to incentivize research that would fill
    voids in our understanding of cancer, which NCI has closely duplicated.
    One such example is the Idea Award Other awards originated by CDRMPs
    that have been duplicated by NCI are the Era of Hope Scholar and
    Concept Award mechanisms.
    A Modest Research Program that Creates Jobs
        The OCRP remains a modest program compared to the other cancer
    programs in the CDMRP:

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        However, even with limited funding, the OCRP has been able to make
    vast strides in the fight against ovarian cancer. With flat funding for
    fiscal year 2012, the program can maintain current levels of research
    regarding screening, early diagnosis and treatment of ovarian cancer.
        In a time that necessitates fiscal constraint, the OCRP has been
    designed to fund ovarian cancer research with extremely low overhead:
    only 4 to 8 percent of the Federal funding is used for administrative
    costs.
        Additionally, biomedical research like that conducted through the
    DOD OCRP, is a major provider of jobs in the United States economy. A
    2008 Families USA study found that for every NIH dollar invested in
    States, $2 of economic output were created. Additionally, the report
    estimated that approximately 350,000 jobs were supported by medical
    research in 2007.
    Ovarian Cancer's Deadly Statistics
        In the 40 years since the War on Cancer was declared, ovarian
    cancer mortality rates have not significantly improved. We are very
    concerned that without continued funding in fiscal year 2012 for the
    DOD OCRP to continue ovarian cancer research efforts, the Nation will
    see growing numbers of women losing their battle with ovarian cancer.
        The American Cancer Society estimates that in 2011, more than
    21,000 American women will be diagnosed with ovarian cancer, and
    approximately 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 one-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.
        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
    mothers, daughters, sisters and friends have lost their lives to
    ovarian cancer.
        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 promptly.
    Unfortunately, we know that this does not always happen. Too many women
    are diagnosed at late stage 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.
        Our organization exists to ensure that women are diagnosed early,
    receive appropriate treatments, are active participants in their care
    and not just survive, but thrive. All women should have access to
    treatment by a gynecologic oncology specialist. All women should have
    access to a valid and reliable detection test. We must deliver new and
    better treatments to patients and the physicians and nurses who treat
    them. Until we have a test, we must continue to increase awareness and
    educate women and health professionals about the signs and symptoms
    associated with this disease.
    Even with Limited Funding, OCRP Expands
        Large ovarian cancer research teams do not exist in many academic
    medical or research centers. In order to provide much-needed mentoring,
    networking and a peer group for young ovarian cancer researchers, the
    OCRP created an Ovarian Cancer Academy award in fiscal year 2009. The
    OCRP Ovarian Cancer Academy is intended to develop a unique,
    interactive virtual academy that will provide intensive mentoring,
    national networking and a peer group for junior faculty. The
    overarching goal of this award is to develop young scientists into the
    next generation of successful and highly productive ovarian cancer
    researchers within a collaborative and interactive research training
    environment.
        Additionally, in fiscal year 2010 the OCRP allowed ovarian cancer
    researchers to compete for the Consortium Award. The Consortium
    Development Award is an infrastructure development mechanism that
    provides support to create a Coordinating Center and establish the
    necessary collaborations at potential research sites for the
    development of a multi-institutional ovarian cancer research team.
    Participants in these consortiums will be scientists and/or clinicians
    who have made significant contributions to the field of ovarian cancer
    or who have a specific expertise related to the early changes
    associated with ovarian cancer progression.
    Senate Support for Fiscal Year 2012 Appropriation Request
        This year, the ovarian cancer community has been proactive in
    securing support for our fiscal year 2012 appropriation request. A
    letter addressed to you in support of the $20 million appropriation for
    the OCRP was signed by Senators Robert Menendez and Olympia Snowe, who
    were joined by Richard Blumenthal, Susan Collins, Dick Durbin, Kirsten
    Gillibrand, Kay Hagan, John F. Kerry, Herb Kohl, Jeffrey Merkley,
    Debbie Stabenow and Ron Wyden.
        A letter from Senator Robert Casey addressed to you in support of
    all medical research conducted by the Department of Defense through the
    Congressionally Directed Medical Research Program (CDMRP) was signed by
    Senators Barbara Boxer, Al Franken, Kirsten Gillibrand, Tim Johnson,
    John Kerry, Patrick Lautenberg, Jack Reed, Olympia Snowe, Jon Tester
    and Ron Wyden.
    Summary
        The Alliance maintains a long-standing commitment to work with
    Congress, the Administration, and other policymakers and stakeholders
    to improve the survival rate from ovarian cancer through education,
    public policy, research and communication. Please know that we
    appreciate and understand that our Nation faces many challenges and
    that Congress has limited resources to allocate; however, we are
    concerned that without the funding to maintain ovarian cancer research
    efforts, the Nation will continue to see many women lose their lives to
    this terrible disease.
        We are very aware of the current economic climate, and understand
    the constraints you face when determining where best to allocate funds.
    For that reason, we are asking for flat funding of the OCRP in fiscal
    year 2012 at $20 million.
        My cancer support group in Alabama has a memorial statue in our
    Garden of Life and Remembrance. I have watched over the years as we
    added name after name to the statue. The young man who engraves those
    names each year refuses to take payment, telling us that the only
    payment he wants is a call telling him that we have no new names to
    add. The only way this will happen is by eliminating ovarian cancer.
    The situation in Alabama is no different than that in Hawaii,
    Tennessee, Texas or any other State. By flat-funding the Ovarian Cancer
    Research Program, we will be able to maintain our current level of
    research and move closer to that goal.
        Thank you for this opportunity to speak on behalf of women battling
    ovarian cancer today. I am happy to answer any questions.

        Chairman Inouye. I thank you very much, Ms. Leighton.
        Ms. Leighton. Thank you.
        Chairman Inouye. Senator Cochran.
        Senator Cochran. Mr. Chairman, I am reminded of the
    leadership that you and former Chairman Senator Ted Stevens
    have given to research in many different areas of troubling
    concern, not only to traditional threats to the life and good
    health of men and women in active duty situations, but to
    families and how they can be affected by misfortune and
    illness.
        So I think of Ted Stevens and you working together over the
    years to make sure that funds are found where there is a need
    that exists. I think this is an indication of one of those
    instances and we should respond in a favorable way.
        Ms. Leighton. Thank you.
        Chairman Inouye. Thank you.
        Senator Shelby.
        Senator Shelby. Mr. Chairman, I appreciate my constituent
    testifying here today. I also appreciate her sharing her story,
    because she is a survivor where a lot of women with ovarian
    cancer have not. As she said in her testimony, her written
    testimony, she was fortunate to enter a treatment the year
    after two breakthrough agents had come through, through
    research, for the treatment.
        She also mentions in her--answers one of my questions that
    I posed to the subcommittee earlier, whether or not we were
    duplicating any of these things. She points out in her
    testimony--I think it's very important--that a lot of this
    research complements, but does not duplicate, the important
    ovarian research, cancer research, carried out by the National
    Cancer Institute, and the differences there. I think that's
    very, very important.
        I'm proud to have her testify here. I like her story and
    what she's doing is trying to save other people's lives.
        Thank you.
        Ms. Leighton. Thank you.
        Chairman Inouye. I thank the panel very much. Thank you
    very much.
        Our last panel: Dr. John Elkas, Society of Gynecologic
    Oncologists; and Mr. Jonathan Schwartz, representing ZERO--The
    Project to End Prostate Cancer.
        May I call upon Dr. Elkas.
    STATEMENT OF JOHN C. ELKAS, M.D., COMMANDER, U.S. NAVAL
                RESERVE, ON BEHALF OF THE SOCIETY OF
                GYNECOLOGIC ONCOLOGISTS
        Dr. Elkas. Chairman Inouye, Senator Cochran, Senator
    Shelby: Thank you for inviting me to testify in today's
    hearing. My name is Dr. John Elkas and I am here today on
    behalf of the Society of Gynecologic Oncologists and the
    millions of Americans touched each year by ovarian cancer,
    including our military families.
        I practice medicine in the D.C. metropolitan area, where I
    am an associate clinical professor in the department of
    obstetrics and gynecology at the George Washington University
    Medical Center, and I am also a commander in the United States
    Naval Reserve and an adjunct associate professor of obstetrics
    and gynecology at the Uniformed Services University of the
    Health Sciences.
        I am honored to be here and pleased that this subcommittee
    is focusing attention on the Department of Defense
    congressionally directed medical research program in ovarian
    cancer. Since its inception 14 years ago, the OCRP has targeted
    the highest needs in ovarian cancer research, funding high-
    risk, high-reward research on a range of issues from early
    cancer detection to personalized treatment and quality of life.
        One in 69 women will develop ovarian cancer and less than
    one-half will survive for 5 years. One woman dies of ovarian
    cancer every hour in our country. It is expected that more than
    22,000 women will be diagnosed with the disease this year and
    14,000 women will die from the disease in 2011.
        During the last 5 years, over 2600 members of our military
    or their families have been hospitalized for ovarian cancer or
    suspected ovarian cancer. These individuals have spent over
    14,000 bed-days in military treatment facilities.
        The Department of Defense ovarian cancer research program,
    which belongs to the U.S. Army Medical Research and Material
    Command, supports the forward momentum of critical research to
    understand, prevent, and treat this disease that affects the
    warfighter, military beneficiaries, and the general public.
        The DOD OCRP is able to facilitate collaboration between
    civilian and military research programs and because of this it
    is able to share successes, such as raising the standard of
    care of both military and civilian populations, lowering the
    incidence, mortality, and burden of ovarian cancer, while in
    turn reducing the economic drain on society.
        The OCRP's unique method of funding ovarian cancer research
    has yielded tremendous breakthroughs in the fight of ovarian
    cancer, such as a new treatment using nanoparticles to attack
    ovarian cancer cells while leaving healthy cells unaffected,
    the finding that ovarian cancer cells are sensitive to glucose
    deprivation, leading to more targeted treatments, and
    identifying the earliest molecular changes associated with
    BRCA1- and BRCA2-related ovarian cancers, leading to biomarker
    identification, again for early detection.
        Today ovarian cancer researchers are still struggling to
    develop the first ovarian cancer screening test. With
    traditional research models largely unsuccessful, the innovator
    grants awarded by the DOD OCRP are integral in moving this
    field of research forward.
        The Society of Gynecologic Oncology joins with the Ovarian
    Cancer National Alliance and the American Congress of
    Obstetricians and Gynecologists to urge this subcommittee to
    maintain Federal funding for the OCRP at $20 million for fiscal
    year 2012. Military beneficiaries will benefit in the same way
    the American general public stands to gain from research on
    this deadly disease. For every dollar that is saved from
    reducing the cost of cancer care for our military, another
    dollar can be used to support the warfighter. The DOD ovarian
    cancer research program is making a difference in the lives of
    our military beneficiaries and the general public.
        Thank you again for your attention to this request and for
    allowing me to testify before you today.
        [The statement follows:]
                      Prepared Statement of John C. Elkas
        Mr. Chairman, Ranking Member and members of the subcommittee, thank
    you for inviting me to testify at today's hearing. My name is Dr. John
    C. Elkas and I am here today on behalf of the Society of Gynecologic
    Oncology. I practice medicine in the D.C. metropolitan area, where I am
    an associate clinical professor in the department of obstetrics and
    gynecology at the George Washington University Medical Center and in
    private practice in Annandale, Virginia. I am also a Commander in the
    U.S. Naval Reserve and an adjunct associate professor of obstetrics and
    gynecology for the Uniformed Services University of the Health Sciences
    in Bethesda, Maryland.
        I am honored to be here and pleased that this subcommittee is
    focusing attention on the Department of Defense (DOD) Congressionally
    Directed Medical Research Program in Ovarian Cancer (OCRP). Since its
    inception now 14 years ago, the OCRP has targeted the highest needs in
    ovarian cancer research, funding high-risk, high-reward research on a
    range of issues from early cancer detection to personalized treatment
    and quality of life.
        This morning, I will try to outline some of the important
    contributions this DOD program has made to ovarian cancer research, the
    well-being of our patients, and its relevance to our military and to
    their families. In fact, it is quite easy to demonstrate that this
    investment by the Federal Government has resulted in substantial
    benefits and value to medicine, to science and most importantly
    improved patient care.
        As this subcommittee may know, ovarian cancer usually arises from
    the cells on the surface of the ovary and can be extremely difficult to
    detect. According to the American Cancer Society, in 2010, more than
    22,000 women were diagnosed with ovarian cancer and approximately
    14,000 lost their lives to this terrible disease. Ovarian cancer causes
    more deaths than all the other cancers of the female reproductive tract
    combined, and is the fourth highest cause of cancer deaths among
    American women. One of our biggest challenges lies in the fact that
    only 19 percent of all ovarian cancers are detected at a localized
    stage, when the 5-year relative survival rate approaches 93 percent.
    Unfortunately, most ovarian cancer is diagnosed at late or advanced
    stage, when the 5-year survival rate is only 31 percent.
        Nationally, biomedical research funding has grown over the last
    decade through increased funding to the National Institutes of Health,
    in no small part to the amazing efforts of members of this
    Subcommittee. Yet funding for gynecologic cancer research, especially
    for the deadliest cancer that we treat, ovarian cancer, has been
    relatively flat. Since fiscal year 2003, the funding levels for
    gynecologic cancer research and training programs at the NIH, NCI, and
    CDC have not kept pace with inflation, with the funding for ovarian
    cancer programs and research training for gynecologic oncologists
    actually suffering specific cuts in funding due to the loss of an
    ovarian cancer Specialized Project of Research Excellence (SPORE) in
    2007 that had been awarded to a partnership of DUKE and the University
    of Alabama-Birmingham. Were it not for the DOD OCRP, many researchers
    might have abandoned their hopes of a career in basic and translation
    research in ovarian cancer and our patients and the women of America
    would be waiting even longer for reliable screening tests and more
    effective therapeutic approaches.
        As a leader in the Society of Gynecologic Oncology (SGO) and as a
    gynecologic oncologist who has provided care to women affiliated with
    the United States Navy, I believe that I bring a comprehensive
    perspective to our request for increased support. The SGO is a national
    medical specialty organization of physicians who are trained in the
    comprehensive management of women with malignancies of the reproductive
    tract. Our purpose is to improve the care of women with gynecologic
    cancer by encouraging research, disseminating knowledge which will
    raise the standards of practice in the prevention and treatment of
    gynecologic malignancies and cooperating with other organizations
    interested in women's healthcare, oncology and related fields. More
    information on the SGO can be found at www.sgo.org.
        We, the members of the SGO, along with our patients who are
    battling ovarian cancer every day, depend on the DOD OCRP research
    funding. It is through this type of research funding that a screening
    and early detection method for ovarian cancer can be identified which
    will allow us to save many of the 14,000 lives that are lost to this
    disease each year.
        During the last 5 years, over 2,600 members of our military or
    their families have been hospitalized for ovarian cancer or suspected
    ovarian cancer. These individuals have spent over 14,000 bed days of
    care in military treatment facilities.
        The Department of Defense Ovarian Cancer Research Program (DOD
    OCRP) which belongs to U.S. Army Medical Research and Materiel Command
    (USAMRMC) supports the forward momentum of critical research to
    understand, prevent, and treat this disease that affects the
    warfighter, military beneficiaries, and the general public. DOD OCRP is
    able to facilitate collaboration between civilian and military research
    programs. Because the military is involved in research performed at
    civilian health facilities nationwide, the DOD OCRP is able to share
    successes and assist in raising the standard of care for both military
    and civilian populations, lowering the incidence, mortality and burden
    of this cancer, while in turn reducing the economic drain on society.
        Therefore, on behalf of the SGO, I respectfully request that the
    Senate Appropriations Subcommittee on Defense maintain the fiscal year
    2011 funding level of $20 million for the OCRD for fiscal year 2012.
    Department of Defense Ovarian Cancer Research Program: Building an Army
            of Ovarian Cancer Researchers
                New Investigators Join the Fight
        Since its inception in fiscal year 1997, the DOD OCRP has funded
    236 grants totaling more than $160 million in funding. The common goal
    of these research grants has been to promote innovative, integrated,
    and multidisciplinary research that will lead to prevention, early
    detection, and ultimately control of ovarian cancer. Much has been
    accomplished in the last decade to move us forward in achieving this
    goal.
        In Senator Mikulski's home State of Maryland, where many of my
    patients also live, the DOD OCRP has funded research on important
    questions such as:
      --Defining biomarkers of serous carcinoma, using molecular biologic
            and immunologic approaches, which are critical as probes for
            the etiology/pathogenesis of ovarian cancer. Identifying
            biomarkers is fundamental to the development of a blood test
            for diagnosis of early stage disease and also ovarian cancer-
            specific vaccines;
      --Developing and evaluating a targeted alpha-particle based approach
            for treating disseminated ovarian cancer. Alpha-particles are
            short-range, very potent emissions that kill cells by incurring
            damage that cannot be repaired; one to three alpha-particles
            tracking through a cell nucleus can be enough to kill a cell.
            The tumor killing potential of alpha-particles is not subject
            to the kind of resistance that is seen in chemotherapy; and
      --Understanding of the molecular genetic pathways involved in ovarian
            cancer development leading to the identification of the cancer-
            causing genes (``oncogenes'') for ovarian cancer.
        In Senator Murray's home State of Washington, the DOD OCRP has
    funded five grants in the last 5 years to either the University of
    Washington or to the Fred Hutchinson Cancer Center to study research
    questions regarding:
      --The usefulness of two candidate blood-based microRNA markers for
            ovarian cancer detection, and the identification of microRNAs
            produced by ovarian cancer at the earliest stages, which may
            also be the basis for future blood tests for ovarian cancer
            detection;
      --The first application of complete human genome sequencing to the
            identification of genes for inherited ovarian cancer. The
            identification of new ovarian cancer genes will allow
            prevention strategies to be extended to hundreds of families
            for which causal ovarian cancer genes are currently unknown;
            and
      --Proposed novel technology, stored serum samples, and ongoing
            clinical studies, with the intend of developing a pipeline that
            can identify biomarkers that have the greatest utility for
            women; biomarkers that identify cancer early and work well for
            the women in most need of early detection, that can immediately
            be evaluated clinically.
        One of the first, and very successful, grant recipients from the
    DOD OCRP hails from the Fred Hutchinson Cancer Research Center in
    Seattle, Washington, Dr. Nicole Urban. Dr. Urban has worked extensively
    in the field of ovarian cancer early detection biomarker discovery and
    validation. Her current program in translational ovarian cancer
    research was built on work funded in fiscal year 1997 by the OCRP,
    ``Use of Novel Technologies to Identify and Investigate Molecular
    Markers for Ovarian Cancer Screening and Prevention.'' Working with
    Beth Karlan, M.D. at Cedars-Sinai and Leroy Hood, Ph.D., M.D. at the
    University of Washington, she identified novel ovarian cancer
    biomarkers including HE4, Mesothelin (MSLN), and SLPI using comparative
    hybridization methods. These discoveries lead to funding in 1999 from
    the National Cancer Institute (NCI) for the Pacific Ovarian Cancer
    Research Consortium (POCRC) Specialized Program of Research Excellence
    (SPORE) in ovarian cancer.
        The DOD and NCI funding allowed her to develop resources for
    translational ovarian cancer research including collection, management,
    and allocation of tissue and blood samples from women with ovarian
    cancer, women with benign ovarian conditions, and women with healthy
    ovaries. The DOD grant provided the foundation for what is now a mature
    specimen repository that has accelerated the progress of scientists at
    many academic institutions and industry.
        In Senator Feinstein's home State of California, 25 grants have
    been funded by the DOD OCRP since the program was created in 1997 to
    study research questions such as:
      --Strategies for targeting and inhibiting a protein called focal
            adhesion kinase (FAK) that promotes tumor growth-metastasis.
            With very few viable treatment options for metastatic ovarian
            cancer, this research could lead to drug development targeting
            these types of proteins;
      --Developing a tumor-targeting drug delivery system using Nexil
            nanoparticles that selectively adhere to and are ingested by
            ovarian carcinoma cells following injection into the peritoneal
            cavity. The hypothesis for this research is that the
            selectivity of Nexil can be substantially further improved by
            attaching peptides that cause the particle to bind to the
            cancer cells and that this will further increase the
            effectiveness of intraperitoneal therapy; and
      --Using several avenues of investigation, based on our understanding
            of the biology of stem cells, to identify and isolate cancer
            stem cells from epithelial ovarian cancer. This has significant
            implications for our basic scientific understanding of ovarian
            cancer and may drastically alter treatment strategies in the
            near future. Therapies targeted at the cancer stem cells offer
            the potential for long-term cures that have eluded most
            patients with ovarian cancer.
        In Senator Hutchinson's home State of Texas, 20 grants have been
    funded since the inception of the DOD OCRP in 1997, to study research
    questions regarding:
      --Understanding the pre-treatment genomic profile of ovarian cancer
            to then isolate the predictive response of the cancer to anti-
            vasculature treatment, possibly leading to the identification
            of targets for novel anti-vasculature therapies;
      --Ovarian cancer development directly in the specific patient and her
            own tumor. While this process has lagged behind in ovarian
            cancer and improving patient outcomes, it has shown great
            promise in other solid, tumor cancers; and
      --Identifying the earliest molecular changes associated with BRCA1-
            and BRCA2-related and sporadic ovarian cancers, leading to
            biomarker identification for early detection.
        As you can see from these few examples, the 236 grants have served
    as a catalyst for attracting outstanding scientists to the field of
    ovarian cancer research. In the 4 year period of fiscal year 1998-
    fiscal year 2001 the OCRP enabled the recruitment of 29 new
    investigators into the area of ovarian cancer research.
                Federally Funding is Leveraged Through Partnerships and
                        Collaborations
        In addition to an increase in the number of investigators, the
    dollars appropriated over the last 13 years have been leveraged through
    partnerships and collaborations to yield even greater returns, both
    here and abroad. Past-President of the SGO, Dr. Andrew Berchuck of Duke
    University Medical Center leveraged his OCRP DOD grants to form an
    international Ovarian Cancer Association Consortium (OCAC) that is now
    comprised of over 20 groups from all across the globe. The consortium
    meets biannually and is working together to identify and validate
    single nucleotide polymorphisms (SNPs) that affect disease risk through
    both candidate gene approaches and genome-wide association studies
    (GWAS). OCAC reported last year in Nature Genetics the results of the
    first ovarian cancer GWAS, which identified a SNP in the region of the
    BNC2 gene on chromosome 9 (Nature Genetics 2009, 41:996-1000.)
        Dr. Berchuck and his colleagues in the association envision a
    future in which reduction of ovarian cancer incidence and mortality
    will be accomplished by implementation of screening and prevention
    interventions in women at moderately increased risk. Such a focused
    approach may be more feasible than population-based approaches, given
    the relative rarity of ovarian cancer.
        The DOD OCRP program also serves the purpose of strengthening U.S.
    relationships with our allies, such as Australia, the United Kingdom,
    and Canada. Dr. Peter Bowtell, from the Peter MacCallum Cancer Centre
    in Melbourne, Australia, was awarded a fiscal year 2000 Ovarian Cancer
    Research Program (OCRP) Program Project Award to study the molecular
    epidemiology of ovarian cancer. With funds from this award, he and his
    colleagues formed the Australian Ovarian Cancer Study (AOCS), a
    population-based cohort of over 2,000 women with ovarian cancer,
    including over 1,800 with invasive or borderline cancer. With a bank of
    over 1,100 fresh-frozen tumors, hundreds of formalin-fixed, paraffin-
    embedded (FFPE) blocks, and very detailed clinical follow-up, AOCS has
    enabled over 60 projects since its inception, including international
    collaborative studies in the United States, United Kingdom, and Canada.
    AOCS has facilitated approximately 40 publications, most of which have
    been released in the past 2 years.
        One last important example of the value of the DOD OCRP's
    contribution to science is the program's focus on inviting proposals
    from the Historically Black Colleges and Universities and Minority-
    Serving Institutions. This important effort to reach beyond established
    clinical research partnerships expands the core research infrastructure
    for these institutions which helps them to attract new investigators,
    leveraging complementary initiatives, and supporting collaborative
    ventures.
        Over the decade that the OCRP has been in existence, the 236
    grantees have used their DOD funding to establish an ovarian cancer
    research enterprise that is much greater in value than the annually
    appropriated Federal funding.
                Opportunities are Lost Because of Current Level of Federal
                        Funding
        These examples of achievement are obscured to a great degree by
    opportunities that have been missed. At this current level of funding,
    this is only a very small portion of what the DOD OCRP program could do
    as we envision a day where through prevention, early detection, and
    better treatments, ovarian cancer is a manageable and frequently
    curable disease. Consistently, the OCRP receives over 500 letters of
    intent for the annual funding cycle. Of this group, about 50 percent
    are invited to submit full proposals. Prior to fiscal year 2009, the
    OCRP was only able to fund approximately 16 grants per year, a pay line
    of less than 7 percent. With an increase in funding to $20 million in
    fiscal year 2009, $18.75 million in fiscal year 2010 and $20 million in
    fiscal year 2011, the program had been able to consistently fund more
    grants with the DOD being able to account for every dollar and how it
    is used.
    Department of Defense Ovarian Cancer Research Program: Exemplary
            Execution with Real World Results
                Integration Panel Leads to Continuous Evaluation and
                        Greater Focus
        By using the mechanism of an Integration Panel to provide the two-
    tier review process, the OCRP is able to reset the areas of research
    focus on an annual basis, thereby actively managing and evaluating the
    OCRP current grant portfolio. Gaps in ongoing research can be filled to
    complement initiatives sponsored by other agencies, and most
    importantly to fund high risk/high reward studies that take advantage
    of the newest scientific breakthroughs that can then be attributed to
    prevention, early detection and better treatments for ovarian cancer.
    An example of this happened in Senator Mikulski's and my home State of
    Maryland regarding the development of the OVA1 test, a blood test that
    can help physicians determine if a woman's pelvic mass is at risk for
    being malignant. The investigator, Zhen Zhang, Ph.D. at Johns Hopkins
    School of Medicine, received funding from an Idea Development Award in
    fiscal year 2003. Dr. Zhang discovered and validated five serum
    biomarkers for the early detection of ovarian cancer. This bench
    research was then translated and moved through clinical trials. The OVA
    test was approved by the FDA and is now available to clinicians for use
    in patient care.
                More Than a Decade of Scientific Success
        The program's successes have been documented in numerous ways,
    including 469 publications in professional medical journals and books;
    576 abstracts and presentations given at professional meetings; and 24
    patents, applications and licenses granted to awardees of the program.
    Investigators funded by the OCRP have succeeded with several crucial
    breakthroughs in bringing us closer to an algorithm for use in
    prevention and early detection of ovarian cancer.
        The Society of Gynecologic Oncology joins with the Ovarian Cancer
    National Alliance and the American Congress of Obstetricians and
    Gynecologists to urge this Subcommittee to maintain Federal funding for
    the OCRP at $20 million for fiscal year 2012. Military beneficiaries
    will benefit in the same way the general American public stands to gain
    from research in these deadly diseases. For every dollar that is saved
    from reducing the cost of cancer care for our military, another dollar
    can be used to support the warfighter. The DOD Ovarian Cancer Research
    Program is making a difference in the lives of military beneficiaries
    and the general public. I thank you for your leadership and the
    leadership of the Subcommittee on this issue.

        Chairman Inouye. I thank you very much, Dr. Elkas.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, we appreciate very much Dr.
    Elkas being here and bringing us up to date on the ovarian
    cancer research program. This subcommittee has supported this.
    Interesting how many women members of our Committee on
    Appropriations are mentioned in the testimony. It just reminds
    us that throughout not only the military, but our civilian
    population, more and more of our leaders are women, and it's
    certainly appropriate that this insidious illness is being
    targeted by your organization. We wish you well.
        Dr. Elkas. Thank you, sir.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I just want to pick up on
    some of his testimony.
        One of our biggest challenges, you say, lies in the fact
    that only 19 percent of all ovarian cancers are detected at a
    localized and early stage, when the 5-year relative survival
    rate then would approach 93 percent. You point out most ovarian
    cancer is diagnosed at a later, advanced stage when the 5-year
    survival rate drops down to 31 percent.
        Tell me what research is being done and what promise is
    there to help do the early detection when the survival rate
    could be so high?
        Dr. Elkas. Thank you for your question, Senator. I'm
    excited because I think what makes the DOD OCRP program so
    unique and so wonderful is its ability to fund programs that
    would be otherwise very difficult to get funded through the NIH
    funding mechanism. Very recently, the FDA approved a screening
    test, a serum, a blood test that was developed through these
    dollars, that now better allows us to screen and detect ovarian
    cancer. It's not a perfect test, but it's certainly a step
    forward.
        In the coming weeks, in my practice at Fairfax I'll operate
    on 20 women in the coming weeks and find one ovarian cancer.
    That's 19 unnecessary surgeries. From my 14 years on active
    duty service, bringing women back from overseas for surgeries,
    many of which unnecessary, but certainly had to be done because
    of our lack of a screening modality--we hope that advances like
    we've already made will continue to be made, and it's certainly
    your help that allows us to do that.
        Senator Shelby. What is your approach to the early
    treatment? If you could diagnose something or indications real
    early, would it, one, save a lot of lives? Obviously. It would
    save a lot of money, too, would it not?
        Dr. Elkas. Oh, absolutely, absolutely, Senator. Our
    survival for early stage ovarian cancer, stage 1 and stage 2,
    approaches 88, 85 percent.
        Senator Shelby. Something else that got my attention in
    here because, as I said earlier, I'm the ranking Republican on
    another subcommittee dealing with NIH and so forth, and I'm new
    as far as ranking. But you're pointing out that funding for
    this cancer research in this area has remained flat, if not
    declined, through that; and that there was one ovarian cancer
    specialized project of research excellence that had been
    awarded to Duke and the University of Alabama-Birmingham and it
    was cancelled. What happened there? Was it not promising or
    what happened, because I'd be very interested in that.
        Dr. Elkas. The specific details of that I will certainly
    forward you.
        Senator Shelby. Will you send it to me?
        Dr. Elkas. Absolutely.
        Senator Shelby. And I'll share it with the subcommittee.
        Dr. Elkas. Please.
        Senator Shelby. Thank you so much.
        Dr. Elkas. Thank you. Thank you for your time.
        Chairman Inouye. Thank you very much.
        Now may I call on Mr. Schwartz.
    STATEMENT OF JONATHAN D. SCHWARTZ, CHAIRMAN, BOARD OF
                DIRECTORS, ZERO--THE PROJECT TO END
                PROSTATE CANCER
        Mr. Schwartz. Thank you. Mr. Chairman and distinguished
    members of the subcommittee: Thank you for the opportunity to
    share my thoughts. I know this has been a long session and I
    admire your dedication. Hopefully the last is not least here.
        My name is Jonathan Schwartz and I am the Chairman of the
    Board of Directors of ZERO--The Project to End Prostate Cancer.
    I'm here to stress the importance of research and the
    congressionally directed medical research program, and
    particularly the prostate cancer research program.
        ZERO is a patient advocacy organization that raises
    awareness and educates men and their families about prostate
    cancer. Of particular importance to us is the issue of early
    detection. Not only do we operate a mobile screening program,
    we also work with policymakers in Congress and throughout
    Government and other organizations to ensure that men have
    access to information and services to make decisions that are
    in the best interest of their health.
        My dad was William Schwartz. He was diagnosed with prostate
    cancer at the age of 55. We thought he'd be okay because the
    cancer was detected early. Unfortunately, his cancer was very
    aggressive and had already spread to his lymph nodes. The
    doctors gave him just 2 years to live because back then there
    were very few treatment options for prostate cancer.
        Thankfully, new treatments became available that extended
    his life. He fought the disease for 8 years, and during that
    gift of time he saw all his children get married, became a
    grandfather, and between chemo sessions was able to travel and
    enjoy the company of family and friends. He also volunteered as
    the first CEO of the National Prostate Cancer Coalition, which
    is now ZERO. He worked tirelessly to increase Federal research
    funding because he knew that research would help him and
    countless other men.
        As a family, we enjoyed much of my dad's last years. But he
    also experienced great suffering. We saw firsthand the impact
    of this cruel disease.
        My dad died at age 63, younger than when most people
    retire. We all miss him dearly and wonder what it would be like
    to have him in our lives today. I still find it hard to accept
    that he will never get to meet my two daughters and they'll
    never get to know their ``Papa Bill.''
        Our family's experience has led me, my brother and sister,
    and of course our mom to care deeply about dad's cause. We
    don't want other families to go through this. We want the
    number of men suffering from prostate cancer to be as small as
    possible. Eventually we want that number to be zero.
        I'm here today because of my dad. I'm here today because
    prostate cancer affects the family, not just the man. And as I
    mentioned, I'm here today because I want to stress the
    importance of research at the prostate cancer research program.
        Prostate cancer is a disease that's diagnosed in over
    200,000 American men each year and will kill nearly 34,000 men
    in 2011. It's the second leading cause of cancer-related deaths
    among men. One in six men, one in four African American men,
    will get prostate cancer, and some of them will be in their
    30s. It is not just an old man's disease.
        There is much controversy about prostate cancer and
    particularly the controversy over testing, when men should
    start getting tested, how often they should be tested, what
    type of treatment a man should undergo when diagnosed. I
    recently met with my Georgia Senators on this topic. Senator
    Chambliss, a prostate cancer survivor whose live was saved by
    early detection, said it well when he said: ``You have to know
    you have it to have a choice about treatment.''
        Despite what some people call overdiagnosis, the number of
    men dying from prostate cancer is rising. So, Mr. Chairman, the
    problem isn't the number of men we are or should be testing.
    The problem is knowing whether they have aggressive or indolent
    disease and whether or not they should be treated. The only way
    doctors will ever really know the answer to these questions is
    through advances that may be closer than we think.
        Last year, research partially funded by the prostate cancer
    research program identified 24 different types of prostate
    cancer. Eight of these are aggressive forms of the disease. If
    we could identify what type of prostate cancer a man has, we
    could more effectively determine if he needs treatment and how
    aggressive that treatment should be. This would render moot the
    argument some make about the disease being overtreated and
    ultimately save men's lives.
        Another innovative funding mechanism of the prostate cancer
    research program is the Clinical Trials Consortium. To address
    the significant logistical challenges of multi-center clinical
    research, the Clinical Trials Consortium was started to promote
    rapid phase 1 and phase 2 trials of promising new treatments
    for prostate cancer. Since 2005, nearly 90 trials with more
    than 2,600 patients have taken place, leading to potential
    treatments that will soon be available to patients. Two
    recently approved drugs, Xgeva and Zytiga, benefited from the
    consortium, accelerating their approval time by over 2 years.
        Today, without adequate funding, the program could not
    support this award mechanism.
        The prostate cancer research program is funding some of the
    most critical work in cancer today. The program uses innovative
    approaches to funnel research dollars directly into the best
    research to accelerate discovery, translate discoveries into
    clinical practice, and improve the quality of care and quality
    of life of men with prostate cancer. It is the only federally
    funded program that focuses exclusively on prostate cancer,
    which enables them to identify and support research on the most
    critical issues facing prostate cancer patients today. The
    program funds innovative, high-impact studies, the type of
    research most likely to make a difference.
        I understand that the subcommittee is working under
    extremely tight budgetary constraints this year and the many
    tough decisions are ahead. This program is important to the
    millions of men who are living with the disease, those who have
    survived the disease, and those who are at risk for the
    disease, including our veterans and active duty military
    personnel.
        Active duty males are twice as likely to develop prostate
    cancer as their civilian counterparts. While serving their
    country, the United States armed forces are exposed to
    deleterious contaminants such as Agent Orange and depleted
    uranium. These contaminants are proven to cause prostate cancer
    in American veterans. Unfortunately, the genomes of prostate
    cancer caused by Agent Orange are the most aggressive strands
    of the disease and they also appear earlier in a man's life. In
    addition, a recent study showed that Air Force personnel were
    diagnosed with prostate cancer at an average age of just 48.
        In closing, I ask that you support our fight against all
    cancers and in particular prostate cancer. Prostate cancer can
    and should be a 100 percent detectable and treatable cancer,
    and hopefully some day a preventable one. Please support the
    research conducted through the congressionally directed medical
    research program and the prostate cancer research program by
    maintaining their funding levels.
        Thank you very much for your time. I'll be happy to answer
    any questions.
        [The statement follows:]
                   Prepared Statement of Jonathan D. Schwartz
        Mr. Chairman and distinguished members of the subcommittee, thank
    you for the opportunity to share my thoughts. My name is Jonathan
    Schwartz, and I am Chairman of the Board of Directors of ZERO--The
    Project to End Prostate Cancer (ZERO). I am the son of William
    Schwartz, who fought prostate cancer for 8 years and volunteered as the
    first CEO of the National Prostate Cancer Coalition, which is now ZERO.
        My dad was diagnosed at the age of 55. We thought that he would be
    okay since the cancer was detected early. The strain of prostate cancer
    that he was diagnosed with was very aggressive and had spread to his
    lymph nodes. Thankfully there were new treatments that extended his
    life. During that 8 year gift, he was there to see his children get
    married, become a grandfather, travel, and enjoy family and friends. He
    worked tirelessly because he knew that research would help him and
    countless other men.
        My dad enjoyed much of his last years, but we also experienced
    great suffering. We saw firsthand the impact of this cruel disease. We
    all miss him dearly, and we are so saddened by all he has missed,
    including five more grandchildren. We often wonder what it would be
    like to have him in our lives today. Our family's experience has led me
    and my brother and sister to care deeply about dad's cause. We don't
    want other men and their families to go through this. We want the
    number of men suffering from prostate cancer to be as small as
    possible. Eventually, we want that number to be ZERO.
        I am here today because of my dad. I am here today because prostate
    cancer affects the family, not just the man. I am here today because I
    want to stress the importance of research and particularly the Prostate
    Cancer Research Program and the other programs of the Congressionally
    Directed Medical Research Program.
        Prostate cancer is a disease that is diagnosed in over 200,000 men
    each year and will kill nearly 34,000 men in 2011. It is the second
    leading cause of cancer related deaths among men and will inflict 1 in
    6 men in their lifetime.
        There are too many questions that continue to surround prostate
    cancer and too many uncertainties for us to just ignore this disease.
    It has been well publicized that cancer is killing less people every
    year, but the same cannot be said for prostate cancer. Prostate cancer
    deaths have continued to increase.
        The answers to these questions are found in research. The
    Congressionally Directed Medical Research Program and the Prostate
    Cancer Research Program are funding some of the most critical work in
    cancer today. The program uses innovative approaches to funnel research
    dollars directly into the best research to accelerate discovery,
    translate discoveries into clinical practice, and improve the quality
    of care and life of men with prostate cancer.
        An example of the innovative nature of the PCRP is the Clinical
    Trials Consortium. To address the significant logistical challenges of
    multicenter clinical research, the PCRP began support of a clinical
    trials consortium for rapid Phase I and Phase II clinical trials of
    promising new treatments for prostate cancer.
        Since their first PCRP award in 2005, each site has fulfilled key
    responsibilities in clinical trials design and recruitment. Nearly 70
    trials with more than 1,800 patients have taken place, leading to
    potential treatments that will soon be at patients' bedsides. Two
    recently approved drugs (XGEVA and ZYTIGA) benefited from PCRP funding
    and the consortium accelerating their approval time by over 2 years.
        The PCRP has played a unique role by identifying two key research
    gaps inhibiting forward movement of clinical trials, multicenter
    intellectual property and regulatory issues. The program developed and
    funded mechanisms to reduce those barriers resulting in unprecedented
    accomplishments for recruiting participants over an 18-month period.
        Today, without adequate funding, the PCRP cannot support this award
    mechanism.
        I understand that the committee is working under extremely tight
    budgetary constraints this year and that many tough decisions are
    ahead. This program is important to the millions of men who are living
    with the disease, those who have survived the disease and those who are
    at risk for the disease including our veterans and active duty military
    personnel.
        Active duty males are twice as likely to develop prostate cancer as
    their civilian counterparts. While serving our country, the United
    States' Armed Forces are exposed to deleterious contaminants such as
    Agent Orange and Depleted Uranium. These contaminants, particularly
    Agent Orange, are proven to cause prostate cancer in American Veterans.
    Unfortunately, the genomes of prostate cancer caused by Agent Orange
    are the more aggressive strands of the disease and appear earlier in a
    man's life. Studies have shown that military personnel at risk for the
    disease are also more likely to be diagnosed earlier in life.
        In closing, I ask that you support our fight against all cancers
    and in my case in particular, prostate cancer. Support the research
    conducted through the Congressionally Directed Medical Research Program
    and the Prostate Cancer Research Program by maintaining their funding
    levels.

        Chairman Inouye. Thank you, Mr. Schwartz.
        Senator Cochran.
        Senator Cochran. Mr. Chairman, I think it's important to
    note that the testimony here reminds us that, while we are
    learning more about cancer, we are wondering why cancer is
    killing more people every year in the general population,
    including more prostate cancer. Prostate cancer seems to be on
    the rise. Some other life-threatening cancers seem to be on the
    decline.
        Another thing I think in the witness's testimony that's
    appropriate for this subcommittee to consider when we decide
    how much funding is available, if any, for this program is that
    Agent Orange has been identified as a causal connector with
    prostate cancer for those who have been exposed to that
    substance. This is something I think is peculiarly of interest
    to the military and appropriate for this subcommittee's
    attention. So I'm hopeful that we can find a way to support, as
    this witness suggests, an increase in funding for prostate
    cancer research.
        We appreciate your bringing these facts to the attention of
    the subcommittee.
        Chairman Inouye. Senator Shelby.
        Senator Shelby. Mr. Chairman, I'll be brief, but I would be
    remiss if I didn't--I'm a 17-year-old--``17-year-old''--I'm a
    17-year survivor of prostate cancer. I've been through that, as
    you went through it with your father and your family. A lot of
    people don't survive. It's my understanding that--I've been
    told that prostate cancer is the number two killer of men in
    this country. Research in new surgery procedures, everything,
    early diagnosis, has helped save a lot of lives.
        I agree with Senator Cochran. We don't need to cut back on
    this because if we do break through the research, we're going
    to not only save lives, but on a policy level we will save
    money down the road. You can do both if we do it right.
        Thank you, Mr. Chairman, for calling this hearing. This has
    been a very good hearing for me. As I've pointed out, I am the
    ranking Republican over on the other subcommittee dealing with
    NIH and all the other, and I'm curious as to how this works and
    I've found out a lot today.
        Thank you, Mr. Chairman.
        Chairman Inouye. I thank you very much.
        Three organizations have submitted testimony. Without
    objection, the testimony of Cummins, Incorporated, Washington
    State Neurofibromatosis Families, and the American Foundation
    for Suicide Prevention will be made part of the record along
    with any other statements that the subcommittee may receive.
        On behalf of the subcommittee, I thank all the witnesses
    for their testimony, and the subcommittee will take these
    issues in consideration and I can assure you will look at it
    very seriously.
        [The statements follow:]
     Prepared Statement of Dr. Wayne A. Eckerle, Vice President, Research
                          and Technology, Cummins Inc.
        Cummins Inc., headquartered in Columbus, Indiana, is a corporation
    of complementary business units that design, manufacture, distribute
    and service engines and related technologies, including fuel systems,
    controls, air handling, filtration, emission solutions and electrical
    power generation systems. The funding requests outlined below are
    critically important to Cummins' research and development efforts, and
    would also represent a sound Federal investment toward a cleaner
    environment and improved energy efficiency for our Nation. We request
    that the Committee fund the programs as identified below.
                             department of the army
    Other Procurement
        Budget Activity 03, Other Support Equipment, Line No. 177,
    Generators and Associated Equipment (MA9800), Medium generator Sets (5-
    60 kW) (M53500), Advanced Medium Mobile Power System (AMMPS).--Increase
    the Administration's request of $11.6 million by $28.4 million to bring
    the program total to $40 million in fiscal year 2012. $40 million was
    appropriated in fiscal year 2011 and fiscal year 2010. This program is
    critical to providing our troops with the latest technology in power
    generation. AMMPS generators are the latest generation of Prime Power
    Generators for the DOD and will replace the obsolete Tactical Quiet
    Generators (TQG's) developed in the 1980s. The AMMPS gensets are 21
    percent more fuel-efficient, 15 percent lighter, 35 percent quieter,
    and 40 percent more reliable than the TQG. Generators are the Army's
    biggest consumer of diesel fuel in current war theatres. When AMMPS
    gensets are fully implemented, the Army and Marines will realize annual
    fuel savings of approximately 52 million gallons of JP-8 fuel and over
    $745 million in savings based on fuel costs and current use pattern.
    This will mean fewer fuel convoys to bases in active war zones
    resulting in saved lives of military and civilian drivers. AMMPS
    generators are fully EPA compliant and will result in annual carbon
    emissions reductions of 509,698 metric tons CO2 or 7.7
    million metric tons over the expected life of the generators.
    Research and Development Test and Evaluation Programs
        Volume V-B, Budget Activity 05, System Development & Demonstration,
    Line No. 120, Program Element No. 0604854A: Artillery Systems, Paladin
    Integrated Management (PIM).--Support the Administration's request of
    $120.1 million in fiscal year 2012. The M109A6 Paladin is the primary
    indirect fire weapons platform in the U.S. Army's Heavy Brigade Combat
    Team (HBCT) and is expected to be in the Army inventory through 2050.
    This request is to further develop Paladin Integrated Management (PIM)
    vehicles and conclude testing. The PIM effort is a program to ensure
    the long-term viability and sustainability of the M109A6 Paladin and
    its companion ammunition resupply vehicle, the M992 Field Artillery
    Ammunition Support Vehicle (FAASV). PIM is vital to ensuring the long-
    term viability and sustainability of the M109 family of vehicles
    (Paladin and FAASV). The program will significantly reduce the
    logistics burden placed on our soldiers, and proactively mitigate
    obsolescence. The system will feature improved mobility (by virtue of
    Bradley-based automotive systems), allowing the fleet to keep pace with
    the maneuver force.
        Volume VII, Budget Activity 07, Operational Systems Development,
    Line No. 163, Program Element No. 0203735A: Combat Vehicle Improvement
    Program, Armored Multi-Purpose Vehicle (AMPV).--Support
    Administration's request of $53.3 million in fiscal year 2012. The
    Armored Multi-Purpose Vehicle (AMPV) is a new Army initiated program to
    replace the M113 platforms, which cannot be optimized for future U.S.
    Army combat operations. The Army has identified a significant
    capability gap within the Heavy Brigade Combat Team (HBCT) formation.
    The Bradley Family of Vehicles are the most capable and cost effective
    platform for replacement of the M113. Along with established
    production, the recapitalized Bradley vehicles bring combat-proven
    mobility, survivability, and adaptability to a variety of missions. The
    Army currently has approximately 1,900 Bradley hulls that could be
    inducted into the production process. This low cost, low risk,
    Military-off-the-Shelf (MOTS) to replace the M113 addresses the
    significant capability shortfalls within the HBCT formation and is an
    efficient use of existing Government owned assets and existing Public-
    Private Partnership arrangements to bridge the modernization gap.
    Recapitalizing existing Bradley chassis provides the most survivable,
    mobile and protected solution for our soldiers at a significant lower
    cost.
    Procurement of Weapons and Tracked Combat Vehicles (W&TCV)
        Activity No. 01 Tracked Combat Vehicles, Line No. 07, Howitzer, Med
    Sp Ft 155MM M109A6 (MOD) (GA0400), Paladin Integrated Management
    (PIM).--Support Administration's request of $46.88 million in fiscal
    year 2012. This is to begin low rate initial production vehicles for
    Paladin Integrated Management (PIM) procurement. The M109A6 Paladin is
    the primary indirect fire weapons platform in the U.S. Army's Heavy
    Brigade Combat Team (HBCT) and is expected to be in the Army inventory
    through 2050. The PIM program will incorporate Bradley-based drive-
    train and suspension components which reduce logistics footprint and
    decrease operations and sustainment costs. PIM is vital to ensuring the
    long-term viability and sustainability of the M109 family of vehicles
    (Paladin and FAASV). The program will significantly reduce the
    logistics burden placed on our soldiers, and proactively mitigate
    obsolescence. The system will feature improved mobility (by virtue of
    Bradley-based automotive systems), allowing the fleet to keep pace with
    the maneuver force. The system will improve overall soldier
    survivability through modifications to the hull to meet increased
    threats.
                          department of the air force
    Other Procurement
        Budget Activity 04, Other Base Maintenance and Support Equip, Item
    No. 61, Mobility Equip, Basic Expeditionary Airfield Resources.--
    Maintain the Administration's request of $27 million in fiscal year
    2012. Appropriations in fiscal year 2010 and fiscal year 2011 totaled
    $29.7 million. Basic Expeditionary Airfield Resource (BEAR) is funded
    by the U.S. Air Force and is administered by the PM-MEP office. The
    BEAR product is an 800kW prime power mobile generator used by Combat
    Air Forces to power mobile airfields in-theatre and around the world.
    The finished product will replace the existing MEP unit that is 25
    years old and will offer greater fuel economy, increased fuel options
    (JP8), improved noise reduction, and the latest innovative control
    technology and functionality. With the ever increasing global reach of
    the U.S. military, the need for reliable mobile power is paramount.
    This program is currently funded for the design, development and
    preproduction of 8 individual BEAR units. These units will undergo a
    battery of validation tests. Design and development of the BEAR product
    is on schedule. There is interest from other branches of the military
    for the BEAR product as well given the increased need for mobile
    electric power.
                                     ______

     Prepared Statement of Karen Gunsul, Vice President, Washington State
                           Neurofibromatosis Families
        Thank you for the opportunity to submit testimony to the
    Subcommittee on the importance of continued funding for research on
    Neurofibromatosis (NF), a terrible genetic disorder closely linked too
    many common diseases widespread among the American population.
        On behalf of Washington State Neurofibromatosis Families (WSNF) a
    participant in a national coalition of NF advocacy groups, I speak on
    behalf of the 100,000 Americans who suffer from NF as well as
    approximately 175 million Americans who suffer from diseases and
    conditions linked to NF such as cancer, brain tumors, heart disease,
    memory loss and learning disabilities. I also speak from the heart as
    the mother of a son who deals with NF every day. To find treatments
    and, ultimately, a cure, for this disorder would benefit him and
    countless others.
        In fiscal year 2012, I am requesting $16 million to continue the
    Army's highly successful Neurofibromatosis Research Program (NFRP), the
    same amount that was included for the NFRP in fiscal year 2011. The
    Peer-Reviewed Neurofibromatosis Research Program, one of the Department
    of Defense's Congressionally Directed Medical Research Programs
    (CDMRP), is now conducting clinical trials at nationwide clinical
    trials centers created by NFRP funding. These clinical trials involve
    drugs that have already succeeded in eliminating tumors in humans and
    rescuing learning deficits in mice. Administrators of the Army program
    have stated that the number of high-quality scientific applications
    justify a much larger program.
    What is Neurofibromatosis (NF)?
        NF is a genetic disorder involving the uncontrolled growth of
    tumors along the nervous system which can result in terrible
    disfigurement, deformity, deafness, blindness, brain tumors, cancer,
    and even death. NF can also cause other abnormalities such as unsightly
    benign tumors across the entire body and bone deformities. In addition,
    approximately one-half of children with NF suffer from learning
    disabilities. While not all NF patients suffer from the most severe
    symptoms, all NF patients and their families live with the uncertainty
    of not knowing whether they will be seriously affected because NF is a
    highly variable and progressive disease.
        NF is not rare. It is the most common neurological disorder caused
    by a single gene and three times more common than Muscular Dystrophy
    and Cystic Fibrosis combined, but is not widely known because it has
    been poorly diagnosed for many years. Approximately 100,000 Americans
    have NF, and it appears in approximately 1 in every 2,500 births. It
    strikes worldwide, without regard to gender, race or ethnicity.
    Approximately 50 percent of new NF cases result from a spontaneous
    mutation in an individual's genes and 50 percent are inherited. There
    are three types of NF: NF1, which is more common, NF2, which primarily
    involves tumors causing deafness and balance problems, and
    schwannomatosis, the hallmark of which is severe pain. In addition,
    advances in NF research stand to benefit over 175 million Americans in
    this generation alone because NF is directly linked to many of the most
    common diseases affecting the general population.
    NF's Connection to the Military
        Neurofibromatosis Research addresses areas of great clinical need
    directly affecting the health of the warfighter. NF is a complicated
    condition closely connected to many common diseases and disorders that
    can lead to unmanageable pain, learning disabilities, cancer,
    orthopedic abnormalities, deafness, blindness, memory loss, and
    amputation. NF also involves inflammation similar to that involved in
    wound healing.
        Pain Management.--Severe and unmanageable pain is seen in all forms
    of NF, particularly in one form of NF called schwannomatosis. Over the
    past 3 years, schwannomatosis research has made significant advances
    and new research suggests that the molecular or root cause of
    schwannomatosis pain may be the same as phantom limb pain. Research is
    currently moving forward to identify drugs that might be able to treat
    this pain, and these exciting findings could have broad applications
    for the military.
        Wound Healing, Inflammation and Blood Vessel Growth.--Wound healing
    requires new blood vessel growth and tissue inflammation. Mast cells
    are critical mediators of inflammation in wound healing, and they must
    be quelled and regulated in order to facilitate this healing. Mast
    cells are also important players in NF1 tumor growth. In the past few
    years, researchers have gained deep knowledge on how mast cells promote
    tumor growth, and this research has led to ongoing clinical trials to
    block this signaling. The result is that tumors grow slower. As
    researchers learn more about blocking mast cell signals in NF, this
    research could be translated to the management of mast cells in wounds
    and wound healing.
        Orthopedic Abnormalities and Amputation.--One-third of children
    with NF1 are at risk of developing orthopedic abnormalities that as a
    result break easily. In the leg particularly, repeated injuries lead to
    amputation below the knee, often in very young children. Recent
    research has identified the molecular basis of this, and drug trials in
    humans will begin in the next year. This research will lead to a deeper
    understanding of how to heal challenging bone breaks and directly
    benefit warfighters with major bone breakages or recurring bone breaks
    that heal poorly.
        Three-Dimensional Clinical Imaging Technologies.--Because NF tumors
    are often large and abnormally shaped, they lend themselves well to the
    emerging technology of volumetric MRI. This is used to monitor tumor
    volume and growth as well as to monitor the effectiveness of a drug
    treatment to induce tumor shrinkage or cessation of tumor growth. It is
    anticipated that MRI volumetric imaging could have broad applications
    in military use.
    Link to Other Illnesses
        Researchers have determined that NF is closely linked to cancer,
    heart disease, learning disabilities, memory loss, brain tumors, and
    other disorders including deafness, blindness and orthopedic disorders,
    primarily because NF regulates important pathways common to these
    disorders such as the RAS, cAMP and PAK pathways. Research on NF
    therefore stands to benefit millions of Americans.
        Cancer.--NF is closely linked to many of the most common forms of
    human cancer, affecting approximately 65 million Americans. In fact, NF
    shares these pathways with 70 percent of human cancers. Research has
    demonstrated that NF's tumor suppressor protein, neurofibromin,
    inhibits RAS, one of the major malignancy causing growth proteins
    involved in 30 percent of all cancer. Accordingly, advances in NF
    research may well lead to treatments and cures not only for NF
    patients, but for all those who suffer from cancer and tumor-related
    disorders. Similar studies have also linked epidermal growth factor
    receptor (EGF-R) to malignant peripheral nerve sheath tumors (MPNSTs),
    a form of cancer which disproportionately strikes NF patients.
        Heart disease.--Researchers have demonstrated that mice completely
    lacking in NF1 have congenital heart disease that involves the
    endocardial cushions which form in the valves of the heart. This is
    because the same ras involved in cancer also causes heart valves to
    close. Neurofibromin, the protein produced by a normal NF1 gene,
    suppresses ras, thus opening up the heart valve. Promising new research
    has also connected NF1 to cells lining the blood vessels of the heart,
    with implications for other vascular disorders including hypertension,
    which affects approximately 50 million Americans. Researchers believe
    that further understanding of how an NF1 deficiency leads to heart
    disease may help to unravel molecular pathways involved in genetic and
    environmental causes of heart disease.
        Learning disabilities.--Learning disabilities are the most common
    neurological complication in children with NF1. Research aimed at
    rescuing learning deficits in children with NF could open the door to
    treatments affecting 35 million Americans and 5 percent of the world's
    population who also suffer from learning disabilities. In NF1 the
    neurocognitive disabilities range includes behavior, memory and
    planning. Recent research has shown there are clear molecular links
    between autism spectrum disorder and NF1; as well as with many other
    cognitive disabilities. Tremendous research advances have recently led
    to the first clinical trials of drugs in children with NF1 learning
    disabilities. These trials are showing promise. In addition because of
    the connection with other types of cognitive disorders such as autism,
    researchers and clinicians are actively collaborating on research and
    clinical studies, pooling knowledge and resources. It is anticipated
    that what we learn from these studies could have an enormous impact on
    the significant American population living with learning difficulties
    and could potentially save Federal, State, and local governments, as
    well as school districts, billions of dollars annually in special
    education costs resulting from a treatment for learning disabilities.
        Memory loss.--Researchers have also determined that NF is closely
    linked to memory loss and are now investigating conducting clinical
    trials with drugs that may not only cure NF's cognitive disorders but
    also result in treating memory loss as well with enormous implications
    for patients who suffer from Alzheimer's disease and other dementias.
    Indeed, one leading Army funded researcher is pursuing parallel
    research into both NF and Alzheimer's simultaneously.
        Deafness.--NF2 accounts for approximately 5 percent of genetic
    forms of deafness. It is also related to other types of tumors,
    including schwannomas and meningiomas, as well as being a major cause
    of balance problems.
    The Army's Contribution to NF Research
        While other Federal agencies support medical research, the
    Department of Defense (DOD) fills a special role by providing peer-
    reviewed funding for innovative, high-risk/high-reward medical research
    through the CDMRP. CDMRP research grants are awarded to researchers in
    every State in the country through a competitive two-tier review
    process. These well-executed and efficient programs, including the
    NFRP, demonstrate the government's responsible stewardship of taxpayer
    dollars.
        Recognizing NF's importance to both the military and to the general
    population, Congress has given the Army's NF Research Program strong
    bipartisan support. From fiscal year 1996 through fiscal year 2011
    funding for the NFRP has amounted to $230.05 million, in addition to
    the original $8 million appropriation in fiscal year 1992. In addition,
    between fiscal year 1996 and fiscal year 2009, 245 awards have been
    granted to researchers across the country.
        The Army program funds innovative, groundbreaking research which
    would not otherwise have been pursued, and has produced major advances
    in NF research, including conducting clinical trials in a nationwide
    clinical trials infrastructure created by NFRP funding, development of
    advanced animal models, and preclinical therapeutic experimentation.
    Because of the enormous advances that have been made as a result of the
    Army's NF Research Program, research in NF has truly become one of the
    great success stories in the current revolution in molecular genetics.
    In addition, the program has brought new researchers into the field of
    NF. However, despite this progress, Army officials administering the
    program have indicated that they could easily fund more applications if
    funding were available because of the high quality of the research
    applications received.
        In order to ensure maximum efficiency, the Army collaborates
    closely with other Federal agencies that are involved in NF research,
    such as the National Institutes of Health (NIH). Senior program staff
    from the National Institute of Neurological Disorders and Stroke
    (NINDS), for example, sits on the Army's NF Research Program
    Integration Panel which sets the long-term vision and funding
    strategies for the program. This assures the highest scientific
    standard for research funding, efficiency and coordination while
    avoiding duplication or overlapping of research efforts.
        Thanks in large measure to this Subcommittee's support; scientists
    have made enormous progress since the discovery of the NF1 gene. Major
    advances in just the past few years have ushered in an exciting era of
    clinical and translational research in NF with broad implications for
    the general population. These recent advances have included:
      --Phase II and Phase III clinical trials involving new drug therapies
            for both cancer and cognitive disorders;
      --Creation of a National Clinical and Pre-Clinical Trials
            Infrastructure and NF Centers;
      --Successfully eliminating tumors in NF1 and NF2 mice with the same
            drug;
      --Developing advanced mouse models showing human symptoms;
      --Rescuing learning deficits and eliminating tumors in mice with the
            same drug;
      --Determining the biochemical, molecular function of the NF genes and
            gene products;
      --Connecting NF to more and more diseases because of NF's impact on
            many body functions.
    Fiscal Year 2012 Request
        The Army's highly successful NF Research Program has shown tangible
    results and direct military application with broad implications for the
    general population. The program has now advanced to the translational
    and clinical research stages, which are the most promising, yet the
    most expensive direction that NF research has taken. The program has
    succeeded in its mission to bring new researchers and new approaches to
    research into the field. Therefore, continued funding is needed to take
    advantage of promising avenues of investigation, to continue to build
    on the successes of this program, and to fund this promising research
    thereby continuing the enormous return on the taxpayers' investment.
        I respectfully request an appropriation of $16 million in the
    fiscal year 2012 Department of Defense Appropriations bill for the
    Army's Neurofibromatosis Research Program.
        In addition to providing a clear military benefit, the DOD's
    Neurofibromatosis Research Program also provides hope for the 100,000
    Americans who suffer from NF, as well as over 175 million Americans who
    suffer from NF's related diseases and disorders. Leading researchers
    now believe that we are on the threshold of a treatment and a cure for
    this terrible disease. With this Subcommittee's continued support, we
    will prevail. Thank you for your support.
                                     ______

      Prepared Statement of the American Foundation for Suicide Prevention
        Chairman Inouye, Ranking Member Cochran and members of the
    Subcommittee. My name is John Madigan, Senior Director of Public Policy
    with The American Foundation for Suicide Prevention (AFSP). AFSP thanks
    you for the opportunity to provide testimony on the funding needs of
    programs within the Department of Defense that play a critical role in
    suicide prevention efforts.
        AFSP is the leading national not-for-profit organization
    exclusively dedicated to understanding and preventing suicide through
    research, education and advocacy, and to reaching out to people with
    mental disorders and those impacted by suicide. You can find more
    information at www.asfp.org and www.spanusa.org.
        More than 1.9 million warriors have deployed for Operation Iraqi
    Freedom (OIF) and Operation Enduring Freedom (OEF), two of our Nation's
    longest conflicts (IOM, 2010). The physical and psychological demands
    on both the deployed and non-deployed warriors are enormous. From 2005
    to 2009, more than 1,100 members of the Armed Forces took their own
    lives, an average of 1 suicide every 36 hours. In that same period, the
    suicide rates among Marines and Soldiers sharply increased; the rate in
    the Army more than doubled. Numerous commissions, task forces, and
    research reports have documented the ``hidden wounds of war''--the
    psychological and emotional injuries that have so affected our military
    members and their families. The years since 2002 have placed
    unprecedented demands on our Armed Forces and military families.
    Military operational requirements have risen significantly, and manning
    levels across the Services remain too low to meet the ever-increasing
    demand. This current imbalance places strain not only on those
    deploying, but equally on those who remain in garrison. The cumulative
    effects of all these factors are contributing significantly to the
    increase in the incidence of suicide and without effective action will
    persist well beyond the duration of the current operations and
    deployments. Heightened concern regarding this increase in suicides has
    led to development of scores of initiatives across the DOD to reduce
    risk (Final Report of DOD Task Force on the Prevention of Suicide by
    Members of the Armed Forces, August, 2010).
        In testimony before this Subcommittee on May 18, Secretary of the
    Army John McHugh and General Martin Dempsey, Chief of Staff of the
    United States Army, called for the sustainment of $1.7 billion to fund
    vital Soldier and Family programs. These programs provide a full range
    of essential services and include the Army Campaign for Health
    Promotion, Risk Reduction, and Suicide Prevention. Additionally, The
    fiscal year 2012 budget request includes adding 24 behavioral health
    officers and enlisted technicians to the National Guard Brigade Combat
    Teams and expands the Reserve component substance abuse program. It
    also included additional funding for 54 Suicide Prevention Program
    managers for the National Guard, 38 Suicide Prevention Program Managers
    for Army Reserve, and Applied Suicide Intervention Skills Training
    (ASIST) and kits for the Reserve component. AFSP commends the
    Department of the Army for their efforts to reduce suicides within
    their ranks, and urges this Subcommittee to provide the $1.7 billion
    requested to sustain their important efforts.
        While there is sufficient funding for suicide prevention research
    within DOD right now, these efforts need to be sustained to ensure
    sufficient resources are devoted to research in the long term. We
    believe that funding needs to be sustained for confidential treatment
    programs like the Army Confidential Alcohol Treatment and Education
    Pilot (CATEP) and TRICARE Assistance Program (TRIAP) which are helping
    to change the culture and decrease stigma toward behavioral health
    treatment. AFSP also urges this Subcommittee to fully fund the OSD
    Office for Suicide Prevention that was created this month.
        In addition to Secretary McHugh and General Dempsey's request, AFSP
    urges this Subcommittee to fund the following programs or initiatives
    at the highest levels possible to address the unacceptably high rates
    of suicide among our military personnel.
    Comprehensive Behavioral Health System of Care (CBHSOC)
        General Eric Shoomaker outlined this program in his testimony
    before this Subcommittee on April 6. CBHSOC is based on outcome studies
    that demonstrate the profound value of using the system of multiple
    touch points in assessing and coordinating health and behavioral health
    for a soldier and Family. The CBHSOC creates an integrated,
    coordinated, and synchronized behavioral health service delivery system
    that will support the total force through all ARFORGEN (Army Force
    Generation) phases by providing full spectrum behavioral healthcare.
        The CBHSOC is a system of systems built around the need to support
    an Army engaged in repeated deployments and its intent is to optimize
    care and maximize limited behavioral health resources to ensure the
    highest quality of care to Soldiers and Families through a multi-year
    campaign with a long-term goal of preventing suicide.
    Yellow Ribbon Reintegration Campaign (YRRP)
        The Yellow Ribbon Reintegration Program provides information,
    services, referrals, and proactive outreach to Soldiers, spouses,
    employers, and youth through the different stages of mobilization: pre-
    alert, alert, pre-deployment, deployment, post-deployment and
    reintegration.
        Public Law 111-84, Section 595 gave the YRRP Office the
    responsibility for establishing a program to provide Reserve and
    National Guard Service members, and their families, training in suicide
    prevention, community healing, and response to suicide. The YRRP Office
    has engaged several national associations to provide ongoing assistance
    in coordinating with community based behavioral health providers and
    conducted a needs and gap analysis of all the Reserve Components
    existing suicide prevention programs. Continuation of these efforts
    will be vital in lowering the rate of suicides among our National Guard
    and Reserve personnel.
    Air Force Suicide Prevention Efforts
        In testimony before this Subcommittee on April 6, Lt. General (Dr.)
    Charles Green discussed numerous efforts on behalf of the United States
    Air Force that AFSP believes will reduce the rate of suicide in the Air
    Force. This includes the additional support the Air Force provides its
    most at-risk airmen with frontline supervisor's suicide prevention
    training given to all supervisors in career fields with elevated
    suicide rates, expanded counseling services beyond those available
    through chaplains and mental health clinics, Military Family Life
    Consultants and Military OneSource which provides counseling to active
    duty members off-base for up to 12 sessions.
        Chairman Inouye, Ranking Member Cochran and Members of the
    Committee, AFSP once again thanks you for the opportunity to provide
    testimony on the funding needs of programs within the Department of
    Defense that play a critical role in suicide prevention efforts. With
    your help, we can assure those tasked with leading the Department of
    Defense's response to the unacceptably high rate of suicide among our
    military personnel will have the resources necessary to effectively
    prevent suicide.

                             CONCLUSION OF HEARINGS

        Chairman Inouye. The subcommittee will stand in recess, but
    we will reconvene on Tuesday, June 28, at which time we'll meet
    in closed session to receive testimony on the fiscal year 2012
    budget for intelligence activities. The subcommittee is
    recessed.
        [Whereupon, at 1:06 p.m., Wednesday, June 22, 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
    American Foundation for Suicide Prevention, Prepared Statement of
      the............................................................   716
    Amos, General James F., Commandant, United States Marine Corps,
      Office of the Secretary, Department of the Navy, Department of
      Defense........................................................    70
        Prepared Statement of........................................    72
        Questions Submitted to.......................................   126

    Bockel, Major General David, United States Army (Retired),
      Executive Director, Reserve Officers Association...............   632
        Prepared Statement of........................................   634

    Carpenter, Major General Raymond W., Director, Army National
      Guard, Department of Defense...................................   311
        Prepared Statement of........................................   312
        Questions Submitted to.......................................   397
    Christiansen, Dane R., Development Coordinator, International
      Foundation for Functional Gastrointestinal Disorders...........   568
    Coane, Rear Admiral Casey, United States Navy (Retired),
      Executive Director, Association for the United States Navy.....   663
        Prepared Statement of........................................   665
    Coats, Senator Daniel, U.S. Senator From Indiana, Questions
      Submitted by...................................................   470
    Cochran, Senator Thad, U.S. Senator From Mississippi:
        Prepared Statement of........................................   303
        Questions Submitted by...30, 113, 123, 128, 180, 184, 394, 400, 500
        Statements of..............2, 36, 132, 188, 303, 414, 480, 502, 559
    Collins, Senator Susan, U.S.Senator From Maine:
        Questions Submitted by................................114, 124, 180
        Statement of.................................................     3
    Connor, Captain Charles D., United States Navy (Retired),
      President and Chief Executive Officer, American Lung
      Association....................................................   597
        Prepared Statement of........................................   599

    Davis, John R., Director, Legislative Programs, Fleet Reserve
      Association....................................................   690
        Prepared Statement of........................................   692
    Debbink, Vice Admiral Dirk, Chief, Navy Reserve, Department of
      Defense........................................................   357
        Prepared Statement of........................................   358
        Questions Submitted to.......................................   403
    Dempsey, General Martin E., Chief of Staff, Department of the
      Army, Office of the Secretary, Department of Defense...........   440
        Questions Submitted to.......................................   471
    Donley, Michael B., Secretary, Office of the Secretary,
      Department of the Air Force, Department of Defense.............   131
        Prepared Statement of........................................   135
        Questions Submitted to.......................................   173

    Eckerle, Dr. Wayne A., Vice President, Research and Technology,
      Cummins Inc., Prepared Statement of............................   712
    Elkas, John C., M.D., Commander, U.S. Naval Reserve, on Behalf of
      the Society of Gynecologic Oncologists.........................   701
        Prepared Statement of........................................   702

    Feinstein, Senator Dianne, U.S. Senator From California,
      Questions Submitted by..........26, 107, 121, 127, 175, 391, 395, 543

    Gates, Hon. Robert M., Secretary of Defense, Office of the
      Secretary of Defense, Department of Defense....................   501
        Prepared Statement of........................................   505
    Goraleski, Karen A., Executive Director, American Society of
      Tropical Medicine and Hygiene..................................   668
        Prepared Statement of........................................   670
    Gordon, Barbara, RD, Executive Director, Interstitial Cystitis
      Association, Prepared Statement of.............................   566
    Graham, Senator Lindsey, U.S. Senator From South Carolina,
      Questions Submitted by.......................................470, 475
    Green, Lieutenant General Charles B., Surgeon General, Department
      of the Air Force, Department of Defense........................   213
        Prepared Statement of........................................   214
        Questions Submitted to.......................................   290
    Gunsul, Karen, Vice President, Washington State Neurofibromatosis
      Families, Prepared Statement of................................   713

    Hale, Robert F., Under Secretary of Defense, Comptroller,
      Department of Defense..........................................     1
    Hargett, Major General Gus, United States Army (Retired),
      President, National Guard Association of the United States.....   673
        Prepared Statement of........................................   675
    Harkin, Senator Tom, U.S. Senator From Iowa, Questions Submitted
      by.............................................................    25
    Hesdorffer, Mary, MS, CRNP, Medical Liaison, Mesothelioma Applied
      Research Foundation............................................   627
        Prepared Statement of........................................   628
    Horoho, Major General Patricia, Chief, Army Nurse Corps,
      Department of the Army, Department of Defense..................   237
        Prepared Statement of........................................   239
        Questions Submitted to.......................................   278
    Hutchinson, Senator Kay Bailey, U.S. Senator From Texas,
      Questions Submitted by.........................................    32

    Inouye, Chairman Daniel K., U.S. Senator From Hawaii:
        Opening Statements of...........1, 35, 131, 187, 301, 413, 501, 559
        Prepared Statement of........................................   502
        Questions Submitted by.......................................  103,
                                    115, 126, 173, 181, 278, 283, 290, 295,
                                    296, 388, 397, 400, 403, 409, 461, 471,
                                    498, 405
        Statement of.................................................   479

    Jenkins, Donald H., M.D., Vice Chairman, National Trauma
      Institute......................................................   656
        Prepared Statement of........................................   658
    Johnson, Senator Tim, U.S. Senator From South Dakota, Questions
      Submitted by.............................179, 184, 283, 289, 294, 400
    Jones, Rick, Legislative Director, National Association for
      Uniformed Services.............................................   612
        Prepared Statement of........................................   613

    King, Matthew, M.D., on Behalf of the American Thoracic Society..   559
        Prepared Statement of........................................   561
    Kohl, Senator Herb, U.S. Senator From Wisconsin, Questions
      Submitted by............................................111, 182, 396

    Leighton Susan, on Behalf of the Ovarian Cancer National Alliance   696
        Prepared Statement of........................................   697
    Linde, Dee, Patient Advocate, Dystonia Medical Research
      Foundation.....................................................   562
        Prepared Statement of........................................   564
    Lumme, Dale, National Executive Director, Navy League of the
      United States..................................................   680
        Prepared Statement of........................................   682
    Lynn, William J., III, Deputy Secretary of Defense, Department of
      Defense........................................................     1
        Prepared Statement of........................................     7
        Questions Submitted to.......................................    25
    Mabus, Hon. Ray, Secretary of the Navy, Office of the Secretary,
      Department of the Navy, Department of Defense..................    35
        Prepared Statement of........................................    39
        Questions Submitted to.......................................   103
        Summary Statement of.........................................    37
    McCauslin, Chief Master Sergeant John R. ``Doc'', Chief Executive
      Officer, Air Force Sergeants Association.......................   590
        Prepared Statement of........................................   592
    McConnell, Senator Mitch, U.S. Senator From Kentucky, Questions
      Submitted by.......................................124, 394, 462, 556
    McHugh, Hon. John M., Secretary, Department of the Army, Office
      of the Secretary, Department of Defense........................   413
        Prepared Statement of........................................   419
        Questions Submitted to.......................................   461
        Summary Statement of.........................................   415
    McKinley, General Craig R., Chief, National Guard Bureau,
      Department of Defense..........................................   301
        Prepared Statement of........................................   305
        Questions Submitted to.......................................   388
    Mikulski, Senator Barbara, U.S. Senator From Maryland:
        Questions Submitted by......................................29, 552
        Statement of.................................................     3
    Moakler, Kathleen B. Government Relations Director, National
      Military Family Association....................................   571
        Prepared Statement of........................................   572
    Moore, Major General Darrell L., Acting Commander, Marine Forces
      Reserve, United States Marine Corps, Department of Defense.....   364
        Prepared Statement of........................................   364
        Questions Submitted to.......................................   405
    Mullen, Admiral Mike, U.S. Navy, Chairman, Joint Chiefs of Staff,
      Department of Defense..........................................   510
        Prepared Statement of........................................   513
    Murkowski, Senator Lisa, U.S. Senator From Alaska, Questions
      Submitted by........................115, 126, 128, 184, 397, 469, 473
    Murray, Senator Patty, U.S. Senator From Washington, Questions
      Submitted by....113, 123, 177, 183, 280, 286, 292, 392, 399, 402, 555

    Niemyer, Rear Admiral Elizabeth S., Director, Navy Nurse Corps,
      Department of the Navy, Department of Defense..................   244
        Prepared Statement of........................................   246
        Questions Submitted to.......................................   295
    Norton, Nancy J., President and Co-Founder, International
      Foundation for Functional Gastrointestinal Disorders, Prepared
      Statement of...................................................   569

    O'Reilly, Lieutenant General Patrick J., Director, U.S. Army,
      Missile Defense Agency, Department of Defense..................   479
        Prepared Statement of........................................   483
        Summary Statement of.........................................   481

    Puzon, Captain Ike, United States Navy (Retired), on Behalf of
      the Associations for America's Defense.........................   648
        Prepared Statement of........................................   649

    Robinson, Vice Admiral Adam M., Jr., Surgeon General, Department
      of the Navy, Department of Defense.............................   201
        Prepared Statement of........................................   203
        Questions Submitted to.......................................   283
    Roughead, Admiral Gary, Chief of Naval Operations, United States
      Navy, Office of the Secretary, Department of the Navy,
      Department of Defense..........................................    51
        Prepared Statement of........................................    53
        Questions Submitted to.......................................   115

    Schoomaker, Lieutenant General Eric B., Surgeon General,
      Department of the Army, Department of Defense..................   187
        Prepared Statement of........................................   192
        Questions Submitted to.......................................   278
    Schwartz, General Norton A., Chief of Staff, Office of the
      Secretary, Department of the Air Force, Department of Defense..   154
        Questions Submitted to.......................................   181
    Schwartz, Jonathan D., Chairman, Board of Directors, Zero--The
      Project to End Prostate Cancer.................................   707
        Prepared Statement of........................................   710
    Shelby, Senator Richard C., U.S. Senator From Alabama:
        Prepared Statement of........................................   525
        Questions Submitted by.....................................465, 473
    Siniscalchi, Kimberly, Assistant Surgeon General for Nursing
      Services, Department of the Air Force, Department of Defense...   254
        Prepared Statement of........................................   256
        Questions Submitted to.......................................   296
    Smith, Captain Mike, United States Navy (Retired), National
      Military and Veterans Alliance.................................   641
        Prepared Statement of........................................   642
    Stenner, Lieutenant General Charles E., Jr., Chief, Air Force
      Reserve, Department of Defense.................................   375
        Prepared Statement of........................................   376
        Questions Submitted to.......................................   409
    Stultz, Lieutenant General Jack, Chief, Army Reserve, Department
      of Defense.....................................................   335
        Prepared Statement of........................................   336
        Questions Submitted to.......................................   400

    Visco, Fran, President, National Breast Cancer Foundation........   620
        Prepared Statement of........................................   621

    Wyatt, Lieutenant General Harry M., III, Director, Air National
      Guard, Department of Defense...................................   307
        Prepared Statement of........................................   309
        Questions Submitted to.......................................   395

    Zarnikow, Barbara, Co-Chair, Interstitial Cystitis Association...   565

                                 SUBJECT INDEX

                                  ----------

                             DEPARTMENT OF DEFENSE

                                                                       Page

    Additional Committee Questions...................................    25
    Alternative Fuels................................................    19
    Arctic Policy....................................................    20
    Budget Proposal for Fiscal Year 2012.............................     7
    Contract Oversight and Audit.....................................    22
    Cost-Share.......................................................    21
    DOD Financial Statements.........................................    31
    Decreased NASA Funding--Impact on DOD............................    32
    Defense Department Budget Cuts...................................    28
    Defense Procurement..............................................    27
    Efficiency Initiatives...........................................30, 31
    Energy Issues....................................................    18
    Fiscal Year 2012 Legislative Proposal on U.S. Family Health Plan.    29
    Handheld Global Positioning Systems (GPS) for Platoon Leaders....    32
    Impact on Private Sector Employment..............................    16
    Iraq Drawdown....................................................    31
    MilCon/Deferred Maintenance......................................    15
    Military:
        Equipment....................................................    28
        Medicine.....................................................    13
    Must-Pay Bills...................................................    14
    Operating Under a Continuing Resolution..........................    12
    Operations in Iraq...............................................    26
    Overseas Contingency Operations..................................    27
        Budget.......................................................    20
    Paying More......................................................    16
    Reprogramming....................................................    14
        Issue........................................................    15
    Research and Development.........................................    23
    Serious Problems Associated With a Year-Long Continuing
      Resolution.....................................................     9
    Shortfall in Military Personnel Accounts.........................    11
    TRICARE..........................................................    14
    Uniformed Services Family Health Plan............................    17

                          Department of the Air Force

                            Office of the Secretary

    Additional Committee Questions...................................   172
    Affordability of Air Force Recapitalization Strategy.............   173
    Agile Combat Support.............................................   149
    Air Force:
        Financial Services Center....................................   163
        Global Operations............................................   133
        Role in Libya..............................................175, 181
    Air Superiority..................................................   143
    Analysis of Alternatives on JSTARS GMTI..........................   183
    Building Partnerships............................................   149
        With Emerging Air Force......................................   159
    B-1 Fleet:
        Modernization..............................................161, 167
        Reductions and Consolidation.................................   179
    B-1s in Libya....................................................   184
    Caring for:
        Airmen and Their Families....................................   157
        Total Force Airmen...........................................   135
    Coal to Liquids Technology.......................................   168
    Command and Control..............................................   148
    Controlling DOD Healthcare Costs.................................   157
    Countering Violent Extremism.....................................   156
    Cyberspace Superiority...........................................   147
    Difficult Resource Allocation Decisions..........................   160
    Effects of Operating Under Fiscal Year 2011 Continuing
      Resolutions....................................................   133
    Efficiencies Across the FYDP.....................................   134
    Full Spectrum of Air Operations..................................   155
    F-22 and Activities in North Africa..............................   165
    F-35 Production..................................................   166
    Global Integrated Intelligence, Surveillance and Reconnaissance..   144
    Global Precision Attack..........................................   141
    Healthcare Proposals...........................................173, 181
    Helicopter Acquisition...........................................   176
    Increased Intelligence Surveillance and Reconnaissance
      Capabilities...................................................   176
    Joint Strike Fighter Alternate Engine............................   164
    KC-46A:
        Base Selection and Number of Aircraft........................   178
        Basing:
            And Active Duty Associate Units..........................   180
            Criteria.................................................   178
            Process..................................................   177
        Clear Winner.................................................   177
        Milestone in Basing Process..................................   178
        Timeline.....................................................   177
    Large Military Aircraft Defense Industrial Base..................   175
    Military Sexual Assault..........................................   184
    New Penetrating Bomber...........................................   158
        Aircraft Program...........................................180, 184
    Nuclear Deterrence Operations....................................   140
    Operating Under Fiscal Year 2011 Continuing Resolutions..........   156
    Operation Odyssey Dawn Costs.....................................   161
    Pacific Range Complex............................................   170
    Personnel Recovery...............................................   148
    Powder River Training Complex EIS................................   162
    Preparing/Delivering Space Shuttle ``Atlantis'' to Ohio..........   167
    Primary Aircraft Authorized by Truax Field, Wisconsin............   182
    Rapid Global Mobility............................................   144
    Realization of Efficiencies......................................   158
    Remotely Piloted Aircraft Personnel Requirements...............174, 181
    Reshaping the Air Force for Present and Future Threats...........   134
    Role for F-22 in Libya...........................................   182
    Satellite Acquisition Strategy...................................   174
    Space Superiority................................................   145
    Special Operations...............................................   148
    Strategic Basing Process for KC-46A Tanker.......................   171
    Strengthening International and Regional Security................   157

                             Department of the Army

                            Office of the Secretary

    ALS and Connection to Military Service...........................   455
    ALS/Lou Gehrig's Disease.........................................   454
    Abrams Tank......................................................   447
    Acoustic Hailing Device..........................................   470
    Acquisition Programs.............................................   442
    Additional Committee Questions...................................   461
    Alaska Range Complex.............................................   457
    Army National Guard..............................................   451
        Three Star...................................................   452
    Assembled Chemical Weapons Alternatives (ACWA)...................   465
    Balanced Force...................................................   450
    Boots on the Ground: Dwell Time..................................   449
    Canine Explosives Detection......................................   468
    Carbine Weapon Systems...........................................   475
    Chemical Weapons Disposal........................................   464
    Competition......................................................   470
    Counseling Services..............................................   463
    Disability Rating Systems........................................   455
    End Strength.....................................................   448
    Family Support Programs........................................461, 471
    Fiscal Year 2012 Efficiencies..................................461, 471
    Fort Knox........................................................   464
    Future:
        Drawdown.....................................................   442
        Force Mix..................................................461, 472
    Ground Combat Vehicle.....................................443, 462, 472
    Healthcare Proposals...........................................462, 472
    Helicopter Replacement...........................................   444
    Improvised Explosive Devices.....................................   456
    Industrial Base..................................................   465
    Injury Prevention and Control....................................   466
    Ireland Army Community Hospital..................................   464
    Medium Extended Air Defense System...............................   451
    Mental Health....................................................   448
        Services for Army National Guard and Reserve Forces..........   453
    Military Vehicles................................................   446
    Missile Defense................................................445, 473
    Post-Traumatic Stress Disorder (PTSD)/Traumatic Brain Injuries
      (TBI)..........................................................   464
    Prepare..........................................................   421
    Procurement Process..............................................   444
    Research and Development Innovation..............................   465
    Reserve Component Discharge Issues...............................   469
    Reset............................................................   422
    Restoring Balancing..............................................   420
    Servicemember Census.............................................   464
    Space and Missile Defense Command................................   446
    Stewardship, Innovation and Accomplishments......................   429
    Strategic:
        Context......................................................   424
        Crossroads...................................................   427
    Suicide........................................................462, 473
    Sustain..........................................................   420
    Tactical Radios..................................................   470
    Tanks............................................................   473
    Technology Advancements..........................................   466
    Temporary End Strength...........................................   441
    The Next Decade..................................................   425
    The Profession of Arms...........................................   430
    Transform........................................................   423
    Transition Assistance Programs...................................   458
    2011 Reserve Component Addendum to the Army Posture Statement....   431
    Warrior Transition Units.........................................   458
    Weight of Combat Gear............................................   460
    Where We Have Been...............................................   419

                             Department of the Navy

                            Office of the Secretary

    Additional Committee Questions...................................   103
    Aegis:
        Ballistic Missile Defense....................................   113
            Operations...............................................   117
        Missile Defense..............................................   116
    America's Expeditionary Force in Readiness.......................    72
    Amphibious Warfare Ships.........................................    61
    Arctic Considerations--Convention on Law of the Sea..............    98
    Aviation Programs................................................    56
    Bow Wave in Ship Procurement.....................................   118
    Brunswick Naval Air Station Closure..............................   114
    Build Tomorrow's Navy............................................    55
    Chinese:
        Military Advances............................................   121
        Missile Development..........................................   100
        Navy:
            Assessment...............................................    92
            Strategic Intentions.....................................    99
    Continuing Resolution Impacts on 313 Ship Goal...................    91
    Creating Acquisition Excellence..................................    48
    Current Operations...............................................    42
    DDG 51 Multiyear Procurement...................................124, 125
    Departmental Priorities..........................................    41
    Develop and Support Our Sailors, Navy Civilians and Their
      Families.......................................................    66
    Development and Deployment of Unmanned Systems...................    50
    Earthquake.....................................................126, 128
    Effects of Continuing Resolution on Military Personnel.........119, 126
    Energy Security and Leadership...................................    46
    Evolving Arctic Considerations...................................    96
        Task Force Climate Change....................................    97
    Fiscal Year 2012:
        Budget Submission............................................    43
        Budgetary Submission.........................................    75
    Future Security Environment......................................    73
    F-35B (STOVL) Development........................................   101
    Great Green Fleet................................................   123
    Health Care Proposals............................................   103
    High Performance Computing.......................................   123
    Humanitarian Relief..............................................   110
    Information Dominance Programs...................................    61
    Littoral Combat Ship Split Buy Plan..............................    90
    Military Health..................................................   107
    Naval Tactical Aircraft Shortfall................................   121
    Navy:
        Cybersecurity and the Tenth Fleet............................   119
        Energy.......................................................   104
        Shift in Sea Billets.........................................   115
        Shipbuilding Plan............................................   125
    Next-Generation Ballistic Missile Submarine......................   120
    Nuclear Funding..................................................   109
    Operational Impact of Amphibious Ship Decommissionings...........   128
    Phalanx Close-In Weapon System...................................   124
    P-8A Basing......................................................   113
    Remain Ready to Fight Today......................................    63
    Role of the Marine Corps.........................................    73
    Russian Navy Assessment..........................................    91
    Seapower: A Critical Strategic Enabler...........................    41
    Ship to Shore Connector..........................................   111
    Shipbuilding.....................................................   122
    Submarine Programs...............................................    60
    Surface Ship Programs............................................    58
    Taking Care of Sailors, Marines, Civilians, and Their Families...    45
    U.S. Navy:
        And Marine Corps Readiness Posture...........................   103
        Chinese Navy Relationships...................................    99
        Disaster Relief Assistance to Japan:
            CMC......................................................    95
            CNO......................................................    95
            SECNAV...................................................    94
        Environmental Remediation on Adak............................   115
    United States Marine Corps:
        Force Structure Change Impacts...............................    93
        F-35 Joint Strike Fighter....................................   127
        Priorities...................................................    74

                            Medical Health Programs

    Acquisition Community Interaction................................   282
    Additional Committee Questions...................................   278
    Advanced in Medical Training.....................................   255
    Aeromedical Crews Save Lives.....................................   254
    Alternative Treatment............................................   281
    Assessing Physical Disability....................................   225
    Capability Building..............................................   241
    Caring for Our Heroes, Their Families and Caregivers.............   206
    Collaboration Engagement.........................................   212
    Concept of Care..................................................   206
    Continuously Improving Readiness Assets..........................   217
    Disability Services..............................................   226
    Electronic Health Record..................................236, 283, 289
    Elmendorf Hospital--A Joint Venture Facility.....................   231
    Excellence in Research and Development and Health Education......   210
    Force:
        Development..................................................   259
        Health Protection............................................   204
        Management...................................................   262
    Funding to Support an Incentive Special Pay Program..............   271
    Future Direction.................................................   254
    Global Operations................................................   257
    Humanitarian Assistance and Disaster Relief......................   205
    Incidence of Sexual Assault in the Military......................   277
    Information Management...........................................   253
    Joint Veterans Eye Injury And Vision Registry....................   290
    Medical:
        Acquisition Programs.........................................   288
        Community....................................................   280
        Force Structure..............................................   286
        Pay Scales...................................................   220
        Services to Deployed Marines.................................   221
        Training.....................................................   282
            Programs.................................................   288
    Mental Health....................................................   280
        Force Structure..............................................   286
        Issues.......................................................   268
        System Achievements..........................................   213
    Military:
        Medicine...................................................284, 291
        Nursing Leadership...........................................   267
    Naval Bethesda--Walter Reed Nurse Staffing.......................   272
    Nurse Transition Programs........................................   255
    Nursing:
        Issues.....................................................280, 298
        Knowledge....................................................   249
        Research.........................................252, 279, 296, 297
    Operational Support..............................................   246
    Optimizing Patient Care Delivery.................................   239
    Our Workforce....................................................   248
    Patient:
        CareTouch System.............................................   239
        Centered:
            Care.....................................................   263
            Medical Homes................................214, 279, 286, 292
    Pediatric Injuries on the Battlefield............................   295
    Portfolio of Expertise...........................................   242
    Psychological Health...........................................278, 285
    Recapturing Care and Maintaining Currency........................   216
    Recruiting:
        And Retention................................................   284
        Medical Professionals........................................   220
    Recruitment and Retention.................................279, 295, 296
    Sexual Assault...................................................   274
    Sources of Help for Servicemembers and Their Families.....278, 283, 290
    Strategic:
        Alignment, Integration and Efficiencies......................   203
        Partnerships.................................................   252
    Task Force Treatment.............................................   281
    The Navy Medicine Team...........................................   210
    The Way Ahead....................................................   219
    The Way Forward..................................................   212
    Tiered-based Model of Resiliency.................................   269
    Vision Center Of Excellence......................................   289
    Warrior Care.....................................................   240
    Way Ahead........................................................   265

                             Missile Defense Agency

    Additional Committee Questions...................................   498
    Arrow 3..........................................................   490
    Developing New Capabilities......................................   487
    Enhancing:
        Homeland Defense.............................................   484
        Regional Defense.............................................   485
    Fiscal Year 2010 Accomplishment Highlights.......................   483
    Ground-based:
        Interceptor..................................................   492
        Midcourse Defense System..............................488, 490, 491
    Hedge for Protection of the United States........................   485
    Integrated Air and Missile Defense Battle Command System.........   493
    International Cooperation........................................   487
    Iron Dome........................................................   496
    Japanese Government..............................................   489
    Missile Field....................................................   494
    Naval Force Structure Support....................................   500
    Pacific Missile Range Facility (PMRF)............................   498
    Proving Missile Defense Works through Enhanced Testing...........   486
    Terminal High Altitude Area Defense..............................   489

                                 National Guard

    A Great Value For America........................................   307
    ARNG Resilience..................................................   315
    Air National Guard in National Defense...........................   309
    Aviation Support.................................................   314
    Citizen Soldiers as Part of the Operational Force................   312
    Domestic:
        Operations...................................................   310
        Response Mission.............................................   307
    Equipment and Critical Dual Use..................................   313
    Medical Readiness................................................   317
    Military Construction (Milcon)...................................   315
    National Guard:
        And Reserve Equipment Appropriation..........................   314
        Overview.....................................................   305
    Overseas Defense Mission.........................................   306
    Quality Facilities...............................................   313
    Soldiers, Airmen, and Family Support Programs....................   307
    Support to Global Engagements....................................   306

                       Office of the Secretary of Defense

    Acquisitions.....................................................   551
    Additional Committee Questions...................................   543
    Afghan Government................................................   528
    Afghanistan....................................................533, 546
    Balancing Global Strategic Risk..................................   519
    China............................................................   549
    Choices Ahead....................................................   506
    Counternarcotics Spending in Mexico and Central America..........   551
    Defending our Vital National Interests in the Broader Middle East
      and South Central Asia.........................................   514
    Defense Budget...................................................   510
        Cuts and NATO................................................   523
    Detainees........................................................   545
    Fiscal Year 2012 Base Budget Request.............................   507
    Health Research..................................................   530
    Improving the Health-of-the-Force................................   517
    Integrated Disability Evaluation System..........................   555
    Iraq.............................................................   547
    Joint Electronic Health Record...................................   555
    Libya............................................................   548
    Milcon Budget Cuts...............................................   542
    Military:
        Families.....................................................   540
        Healthcare Program...........................................   511
    Minimum Essential Security Conditions............................   555
    Missile Defense..................................................   527
    Modernization....................................................   507
    NATO.............................................................   530
    Nuclear Weapons Modernization Programs...........................   525
    Office of Security Cooperation--Iraq.............................   510
    Overseas Contingency Operations..................................   509
    Pakistan.......................................................529, 543
    Personnel........................................................   509
    Reform--Efficiencies.............................................   506
    Runaway Debt and Deficit.........................................   529
    Security:
        Assistance Reform............................................   509
        Environment..................................................   534
    Taiwan Arms Sales................................................   550
    Wounded Warriors.................................................   556

                                    Reserves

    Access to Army Reserve for Non-emergency Missions................   387
    Additional Committee Questions...................................   388
    Air Force:
        Reserve:
            Force Generation Center..................................   409
            Operations Tempo.........................................   385
            Priorities...............................................   375
            Response to Natural Disasters............................   386
        Wingman Day..................................................   383
    An Operational:
        Force Benefits the Nation....................................   337
        Reserve......................................................   365
    Army:
        And Air Guard--Equipment.....................................   388
        Guard:
            Equipment Shortfalls.....................................   398
            Permanent Director.......................................   400
        National Guard Director......................................   394
        Reserve Suicide Rates........................................   401
    Casualty Assistance and Military Funeral Honors..................   374
    Defining our Future..............................................   362
    Equipment........................................................   368
        Shortfalls and Modernization.................................   382
    Facilities.......................................................   371
    Family Support and Yellow Ribbon Programs........................   389
    Firefighting support.............................................   395
    Force:
        Readiness....................................................   377
        Rebalance....................................................   379
        Support......................................................   380
    Hawaii Army National Guard.......................................   391
    Health Services and Behavioral Health............................   372
    Initial Steps Taken to Date......................................   337
    Marijuana on Public Lands........................................   391
    Marine Corps Reserve--Strain on the Force........................   405
    National Guard:
        Military Construction........................................   393
        Southwest Border Mission.....................................   397
        Stryker Brigade Combat Team..................................   399
        And Reserve Equipment Account (NGREA).......390, 402, 404, 407, 409
            And Supplemental Funding.................................   376
    Navy Reserve--Officer Recruiting.................................   403
    168th Air Refueling Wing Communications Facility.................   397
    Operational Reserve's Future Role....................400, 405, 408, 410
    Organized to Respond to Emergency Callups........................   386
    Personnel........................................................   367
        Policies.....................................................   360
    Priorities for the Next Year.....................................   337
    Quality of Life..................................................   373
    Reserve:
        Callup Response..............................................   386
        Equipment Shortfalls.............................401, 404, 406, 409
    Reserves as First Responders.....................................   388
    Road Map for the Next Decade.....................................   336
    S. 325, Embedded Mental Health Providers for Reserves Act of 2011   392
    Suicide..........................................................   402
        Prevention Efforts...........................................   383
        Rates........................................................   397
    Supporting our Wounded, Ill, and Injured Marines and their
      Families.......................................................   374
    Title X Authority for Emergency Callups..........................   387
    Training.........................................................   370
        On Modernized Equipment......................................   382
    2010: Fully Engaged--From Peace to War...........................   359
    United States Army Reserve 2011 Posture Statement................   337
        An Enduring Operational Force................................   337
        Army Reserve:
            Priorities...............................................   340
            Snapshot.................................................   355
        Conclusion: The Force is in Good Hands.......................   354
        Equipping....................................................   352
        Personnel....................................................   342
        Program Provides Advantage to Local Communities and the
          Military...................................................   346
        Readiness....................................................   348
        The Employer Partnership Promotes Skills and Opportunity
          Sharing With the Home Front................................   346
        The Fiscal Year 2012 Budget Request: Where We Are Going......   342
        The Posture of the Army Reserve: Where We Stand Today........   340
        The President's Budget.......................................   340
        Your Army Reserve............................................   355

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